1
|
Kocoğlu Barlas Ü, Akçay N, İrem Sofuoğlu A, Şevketoğlu E, Sevketoglu E. Charcoal Hemoperfusion in Calcium Channel Antagonist Poisoning. Turk Arch Pediatr 2023; 58:112-114. [PMID: 36476406 PMCID: PMC9885812 DOI: 10.5152/turkarchpediatr.2022.22103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ülkem Kocoğlu Barlas
- Pediatric Intensive Care, University of Health Sciences Turkey, Bağcılar Training and Research Hospital, İstanbul, Turkey,Corresponding author:Ülkem Kocoğlu Barlas✉
| | - Nihal Akçay
- Pediatric Intensive Care, University of Health Sciences Turkey, Bakırköy Dr Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Ayşe İrem Sofuoğlu
- Pediatric Intensive Care, University of Health Sciences Turkey, Bakırköy Dr Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Pediatric Intensive Care, University of Health Sciences Turkey, Bakırköy Dr Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | | | | | | | | |
Collapse
|
2
|
Akçay N, Bakırtaş Palabıyık F, Şevketoğlu E. Bilateral lentiform and caudate nucleus lesions in a child with COVID-19: A case report. Biomed J 2022; 45:957-960. [PMID: 35680117 PMCID: PMC9169421 DOI: 10.1016/j.bj.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 12/31/2022] Open
Abstract
Neurological complications are frequently mentioned in the published reports regarding the coronavirus disease 2019 (COVID-19). Especially encephalopathy draws attention as the leading symptom or complication of COVID-19 in some reports. This article discussed a 3-year-old patient with bilateral lentiform and caudate nuclei involvement on brain imaging, who presented with mental status changes and acute muscular weakness, possibly due to COVID-19. To the best of our knowledge, this case is the first one showing pathological signal enhancement and edema in bilateral lentiform and caudate nuclei associated with COVID-19.
Collapse
Affiliation(s)
- Nihal Akçay
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey,Corresponding author. Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, 34093, Turkey
| | - Figen Bakırtaş Palabıyık
- Department of Pediatric Radiology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Esra Şevketoğlu
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
3
|
Akçay N, Menentoğlu ME, Oğur M, Tosun D, Palabıyık FB, Şevketoğlu E. COVID-19-associated transverse myelitis treated by therapeutic plasma exchange: A case report. J Clin Apher 2022; 38:65-68. [PMID: 36226604 PMCID: PMC9874494 DOI: 10.1002/jca.22024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Transverse myelitis (TM) is a very uncommon condition in children which can be associated with viral infections. Acute TM cases have been reported after Coronavirus disease 2019 (COVID-19) infection during the pandemic. CASE REPORT We report a child with TM related to severe acute respiratory syndrome coronavirus 2, who was successfully treated with therapeutic plasma exchange (TPE). Inability to walk and urinary retention were the central nervous system symptom. Spinal magnetic resonance imaging revealed signal changes in the spinal cord. Her neurological symptoms worsened despite receiving IVIG and high-dose steroids for the first 3 d. We performed 10 TPE sessions with 5% albumin replacement and the neurological symptoms rapidly improved. CONCLUSION We demonstrated that a child diagnosed with acute TM related to COVID-19 infection, was successfully treated with TPE.
Collapse
Affiliation(s)
- Nihal Akçay
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training HospitalUniversity of Health SciencesIstanbulTurkey
| | - Mehmet Emin Menentoğlu
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training HospitalUniversity of Health SciencesIstanbulTurkey
| | - Mustafa Oğur
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training HospitalUniversity of Health SciencesIstanbulTurkey
| | - Demet Tosun
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training HospitalUniversity of Health SciencesIstanbulTurkey
| | - Figen Bakırtaş Palabıyık
- Department of Pediatric Radyology, Bakırköy Dr. Sadi Konuk Research and Training HospitalUniversity of Health SciencesIstanbulTurkey
| | - Esra Şevketoğlu
- Department of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Research and Training HospitalUniversity of Health SciencesIstanbulTurkey
| |
Collapse
|
4
|
Akçay N, Bektaş G, Menentoğlu ME, Şevketoğlu E. Response to Finsterer on the letter to the editor ''Diagnose SARS-CoV-2 associated Guillain-Barre syndrome upon appropriate criteria and after exclusion of differentials''. J Med Virol 2022; 94:4595-4596. [PMID: 35761161 PMCID: PMC9349811 DOI: 10.1002/jmv.27960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/08/2022] [Accepted: 06/24/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Nihal Akçay
- University of the Health Sciences, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Pediatric Intensive Care Unit, Istanbul
| | - Gonca Bektaş
- University of the Health Sciences, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Pediatric Neurology, Istanbul
| | - Mehmet Emin Menentoğlu
- University of the Health Sciences, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Pediatric Intensive Care Unit, Istanbul
| | - Esra Şevketoğlu
- University of the Health Sciences, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Pediatric Intensive Care Unit, Istanbul
| |
Collapse
|
5
|
Akçay N, Topkarcı Z, Menentoğlu ME, Oğur M, Sofuoğlu Aİ, Boydağ Güvenç K, Baydemir C, Şevketoğlu E. New dermatological findings of MIS-C: Can mucocutaneous involvement be associated with Severe Disease Course? Australas J Dermatol 2022; 63:228-234. [PMID: 35290661 DOI: 10.1111/ajd.13819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about mucocutaneous involvement in critically ill patients with the multisystem inflammatory syndrome in children (MIS-C). The aim of our study was to describe the localisation and variety of rash and to investigate whether presenting with rash at admission alters the clinical course of MIS-C. METHODS This prospective, observational cohort study was conducted amongst children under 18 years of age who were admitted to our paediatric intensive care unit (PICU) between May 2020 and May 2021 with a possible diagnosis of MIS-C. RESULTS A total of 33 children with MIS-C, 21 boys (64%), with a median age of 9.4 years (3.4-11.5) were enrolled. Twenty-four children presented with mucocutaneous symptoms (72%). Age, male gender, PICU length of stay, presenting symptoms, inotrope requirement, the existence of myocarditis or respiratory failure were higher but not significantly different in patients with rash compared to those without rash (P > 0.05). The median duration of symptoms before admission and presence of cervical lymphadenopathy were significantly higher in patients than those without rash (P < 0.05). Children with a rash had a significantly higher neutrophil count, CRP, procalcitonin, troponin levels and lower lymphocyte counts and albumin levels than those without rash (P < 0.05). Twelve children with rash (50%) had symmetrical intertriginous distribution. Two children had erythematous lesions on the areola and the surroundings. In conclusion, intertriginous involvement, periareolar erythema and other mucocutaneous manifestations might be the first alarming symptoms of moderate to severe MIS-C. Therefore, close monitoring with a multidisciplinary approach should be considered for these patients to assess potential disease progression.
Collapse
Affiliation(s)
- Nihal Akçay
- Department of Pediatric Intensive Care Unit, Bakırkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Topkarcı
- Department of Dermatology, Bakirkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Emin Menentoğlu
- Department of Pediatric Intensive Care Unit, Bakırkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Oğur
- Department of Pediatric Intensive Care Unit, Bakırkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ayşe İrem Sofuoğlu
- Department of Pediatric Intensive Care Unit, Bakırkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kübra Boydağ Güvenç
- Department of Pediatric Intensive Care Unit, Bakırkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Canan Baydemir
- Department of Biostatistics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Esra Şevketoğlu
- Department of Pediatric Intensive Care Unit, Bakırkoy Dr Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
6
|
Serdar Kıhtır H, Akçay N, Şevketoğlu E. Pressure-Regulated Volume Control and Pressure-Control Ventilation Modes in Pediatric Acute Respiratory Failure. Turk J Anaesthesiol Reanim 2022; 50:18-23. [PMID: 35256341 PMCID: PMC9153944 DOI: 10.5152/tjar.2021.1412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective The objective of this study is to present our experience using the pressure-regulated volume control and the pressure-control ventilation modes in children. Methods Patients with acute respiratory failure ventilated with pressure-regulated volume control or pressure-control modes were retrospectively evaluated. The patient’s ventilation parameters (of the first 7 days of ventilation or of the whole ventilation period, if the patient had been ventilated less than 7 days), SpO2, blood gases, and demographic data were collected from the pediatric intensive care unit database. Results Sixty-one patients (median age 12 [4.8-36.4] months) were enrolled in the study. The pressure-control ventilation mode was used on 40 patients (65.6%) and the pressure-regulated volume-control mode was used on 21 (34.4%) patients. Twenty-eight patients (45.9%) had hypoxemic respiratory failure and 44 (72.1%) had hypercapnic respiratory failure. The median positive end-expiratory pressure was higher in pressure-control ventilation mode (5.4 [4.2-6.3] cmH2O) than the pressure-regulated volume-control mode (4.05 [3.68-4.41] H2O, P < .001). Pressure-control mode was used more frequently in hypoxemic cases but both modes were used equally in hypercapnic cases. Hypoxic respiratory failure (yes/no), odds ratio: 3.9 (95% CI 1.2-12.3, P = .02), Ph (nadir), odds ratio: 0.004 (95% CI 0.000-0.275, P = .01), and base excess, odds ratio: 0.88 (95% CI 0.79-0.98, P = .02) were associated with intensive care mortality. Conclusions Although the pressure-control ventilation mode was preferred more frequently in hypoxemic respiratory failure, there was no significant difference between the 2 respiratory modes in terms of length of pediatric intensive care unit stay, MV duration, and mortality. The pressure-regulated volume-control mode seems to be a safer option for physicians who do not have enough experience in using pressure-control ventilation mode.
Collapse
Affiliation(s)
- Hasan Serdar Kıhtır
- Department of Pediatric Critical Care, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
- Corresponding author: Hasan Serdar Kıhtır, e-mail:
| | - Nihal Akçay
- Department of Pediatric Critical Care, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Department of Pediatric Critical Care, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
7
|
Botan E, Uyar E, Öztürk Z, Şevketoğlu E, Sarı Y, Dursun O, Sincar Ş, Duyu M, Oto A, Celegen M, Özçiftçi G, Havan M, Nilüfer Öztürk M, Ağın H, Yener N, Yaman A, Gün E, Yılmaz M, Şimşek N, Özdemir H, Yıldızdaş D, Kendirli T. COVID-19 Transmission and Clinical Features in Pediatric Intensive Care Health Care Workers. Turk Arch Pediatr 2022; 57. [PMID: 35110085 PMCID: PMC8867499 DOI: 10.5152/turkarchpediatr.2021.21205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE This study aims to investigate modes of transmission and clinical features of coronavirus disease 2019 in healthcare workers in pediatric intensive care units. MATERIALS AND METHODS This multicenter descriptive study was conducted between March and November 2020. Patient demographics, clinical characteristics, origin of coronavirus disease 2019, treatment modalities, and loss of workdays were recorded. RESULTS Seven hundred and sixty-eight healthcare workers from 16 pediatric intensive care units were enrolled and 114 (14.8%) healthcare workers with a mean age of 29.7 ± 6.7 years became coronavirus disease 2019 patients. Seventy-six (66.7%) patients were female. Approximately half (54.3%) of the patients were physicians, 34.2% were nurses, and 11.4% were ancillary staff. Transmission was deemed to occur through patient contact in 54.3% of the patients. Comorbid illness was present 10.5% of the patients. Transmission occurred during endotracheal intubation in 21%, cardiopulmonary resuscitation in 9.6%, and non-invasive ventilation in 12.2% of patients, while transmission was a result of multiple possible procedures in 43.8%. Intensive care admission was needed for 13.1% of the patients. Five patients needed oxygen by cannula, 7 needed oxygen with a non-rebreathing mask, 5 needed high-flow nasal cannula support, 5 needed non-invasive ventilation, and 3 needed invasive mechanical ventilation. Fortunately, no infected healthcare workers died. CONCLUSION Coronavirus disease 2019 in healthcare workers is a significant problem in pediatric intensive care units. Transmission seems to occur particularly frequently during patient care procedures such as intubation, ventilation and aerosol therapy, which highlights the importance of proper use of full sets of personal protective equipment during all procedures during care of coronavirus disease 2019 patients.
Collapse
Affiliation(s)
- Edin Botan
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey,Corresponding author:Edin Botan✉
| | - Emel Uyar
- Department of Pediatric Critical Care Medicine, Ankara City Hospital, Ankara, Turkey
| | - Zeynelabidin Öztürk
- Department of Pediatric Critical Care Medicine, Health Sciences University, Ankara Dr. Sami Ulus Women, Children’s Health and Diseases Education And Research Hospital, Ankara, Turkey
| | - Esra Şevketoğlu
- Department of Pediatric Critical Care Medicine, Health Sciences University Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Yusuf Sarı
- Department of Pediatric Critical Care Medicine, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Oğuz Dursun
- Department of Pediatric Critical Care Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Şahin Sincar
- Department of Pediatric Critical Care Medicine, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Muhterem Duyu
- Department of Pediatric Critical Care Medicine, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Arzu Oto
- Department of Pediatric Critical Care Medicine, University of Health Sciences Bursa Highly Specialized Training and Research Hospital, Bursa, Turkey
| | - Mehmet Celegen
- Department of Pediatric Critical Care Medicine, Afyonkarahisar University of Health Sciences, Afyon, Turkey
| | - Gökçen Özçiftçi
- Department of Pediatric Critical Care Medicine, Health Sciences University Van Training and Research Hospital, Van, Turkey
| | - Merve Havan
- Department of Pediatric Critical Care Medicine, Mersin City Education and Research Hospital, Mersin, Turkey
| | - Makbule Nilüfer Öztürk
- Department of Pediatric Critical Care Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Hasan Ağın
- Department of Pediatric Intensive Care, University of Health Sciences Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Nazik Yener
- Department of Pediatric Intensive Care, Samsun Ondokuz Mayıs University Faculty of Medicine, Turkey
| | - Ayhan Yaman
- Department of Pediatric Intensive Care, Istinye University Liv Hospital, İstanbul, Turkey
| | - Emrah Gün
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Merve Yılmaz
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Naile Şimşek
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Dinçer Yıldızdaş
- Department of Pediatric Intensive Care, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Tanıl Kendirli
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
8
|
Akçay N, Oğur M, Menentoğlu ME, Boydağ Güvenç K, Sofuoğlu AI, Şevketoğlu E. MIS-C and Identical Twins: A Case Series. Pediatr Infect Dis J 2022; 41:e32-e34. [PMID: 34862348 PMCID: PMC8658060 DOI: 10.1097/inf.0000000000003392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Nihal Akçay
- From the Department of Pediatric Intensive Care Unit, Bakirköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Oğur
- From the Department of Pediatric Intensive Care Unit, Bakirköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Emin Menentoğlu
- From the Department of Pediatric Intensive Care Unit, Bakirköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kübra Boydağ Güvenç
- From the Department of Pediatric Intensive Care Unit, Bakirköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ayse Irem Sofuoğlu
- From the Department of Pediatric Intensive Care Unit, Bakirköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Esra Şevketoğlu
- From the Department of Pediatric Intensive Care Unit, Bakirköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
9
|
Tosun D, Akçay N, Menentoğlu E, Şevketoğlu E, Salihoğlu O. Newborn treated with continuous renal replacement therapy for citrulinemia-type 1. Sanamed 2022. [DOI: 10.5937/sanamed0-40473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: Hyperammonemia occurs as a result of the inability to convert ammonia, a metabolic toxin, into urea due to a block in the urea cycle, and there resulting neurotoxicity is responsible for the pathogenesis. Case Presentation: Our patient was 7 days old when followed up in an external center for 3 days with a preliminary diagnosis of neonatal sepsis. Lethargy, vomiting, tachypnea, and convulsions, which are frequently seen in the first neonatal forms of urea cycle disorders, were also present in our patient. He was referred to us as a result of high ammonia levels when he was examined in terms of congenital metabolic diseases. He was intubated due to the rapid development of respiratory failure. When he was admitted to our intensive care unit with hyperammonemia, light reflex could not be obtained, and widespread cutis marmaratus was developed. Continuous renal replacement therapy was started in our patient and administered intermittently for 120 hours. The glucose infusion rate was followed by high fluid. When it orally tolerated, it is supported with sodium benzoate and sodium stearyl fumarate to reduce ammonia. Nutrition was limited to protein with Basic P. Conclusion: After staying in the intensive care unit for 30 days, our patient was discharged with the recommendation of outpatient follow-up by the pediatric metabolism physician. When our patient came for his check up after two months, there was no nystagmus and no seizures.
Collapse
|
10
|
Botan E, Uyar E, Öztürk Z, Şevketoğlu E, Sarı Y, Dursun O, Sincar Ş, Duyu M, Oto A, Celegen M, Özçiftçi G, Havan M, Öztürk MN, Ağın H, Yener N, Yaman A, Gün E, Yılmaz M, Şimşek N, Özdemir H, Yıldızdaş D, Kendirli T. COVID-19 Transmission and Clinical Features in Pediatric Intensive Care Health Care Workers. Turk Arch Pediatr 2021; 57:93-98. [DOI: 10.5152/turkarchpediatr.2022.21205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
11
|
Aksu Uzunhan T, Maraş Genç H, Kutlubay B, Kalın S, Bektaş G, Yapıcı Ö, Çıracı S, Sözen HG, Şevketoğlu E, Palabıyık F, Gör Z, Çakar NE, Kara B. Cytotoxic lesions of the corpus callosum in children: Etiology, clinical and radiological features, and prognosis. Brain Dev 2021; 43:919-930. [PMID: 34120800 DOI: 10.1016/j.braindev.2021.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/15/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Cytotoxic lesions of the corpus callosum (CLOCCs) are secondary lesions associated with entities like infection manifested by restricted diffusion on diffusion-weighted cranial magnetic resonance imaging. Our objectives are to evaluate the clinic-radiological spectrum of pediatric patients with cytotoxic lesions of the corpus callosum (CC). METHODS Children (0-18 years) admitted between February 2017 and May 2020 with splenial lesions showing diffusion restriction on MRI, either isolated or within involvement of other parts of the brain, were included retrospectively. The primary lesions of the CC (e.g. acute disseminated encephalomyelitis, acute ischemic infarction, and glioblastoma multiforme) were excluded. CLOCCs were divided into infection-associated, metabolic disorder-associated, and trauma-associated lesions, as well as CLOCCs involving other entities. Data were collected from the medical databases. RESULTS Forty-one patients were determined to have CLOCCs. Twenty-five (61%) were infection-associated, nine (22%) were trauma-associated, and three (7%) were metabolic disorder-associated cases, including 2 inherited disorders of metabolism. There were four (10%) patients with other entities, three with epilepsy, and one had an apparent life-threatening event. Six patients had a known etiology among the infection-associated group; one had multisystem inflammatory syndrome caused by COVID-19 and one had been infected by COVID-19 without any complications. All the infection-associated patients with isolated splenial lesions recovered totally, although six patients required intensive care hospitalization. Four trauma-associated patients had sequela lesions. CONCLUSIONS CLOCCs are associated with a spectrum of diseases, including the new coronavirus, COVID-19 infection. Infection-associated CLOCCs has the best prognosis, although severe cases may occur. Sequelae are possible based on the etiology.
Collapse
Affiliation(s)
- Tuğçe Aksu Uzunhan
- Department of Pediatric Neurology, Prof Dr Cemil Taşcıoğlu City Hospital, University of Health Sciences, İstanbul, Turkey.
| | - Hülya Maraş Genç
- Department of Pediatric Neurology, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Büşra Kutlubay
- Department of Pediatric Neurology, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Sevinç Kalın
- Department of Pediatric Radiology, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Gonca Bektaş
- Department of Pediatric Neurology, Bakırköy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Özge Yapıcı
- Department of Pediatric Radiology, Prof Dr Cemil Taşcıoğlu City Hospital, University of Health Sciences, İstanbul, Turkey
| | - Saliha Çıracı
- Department of Pediatric Radiology, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Hatice Gülhan Sözen
- Department of Pediatric Neurology, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Esra Şevketoğlu
- Department of Pediatric Intensive Care, Bakırköy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Figen Palabıyık
- Department of Pediatric Radiology, Bakırköy Dr Sadi Konuk Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Zeynep Gör
- Department of Pediatrics, Bitlis Tatvan Government Hospital, Bitlis, Turkey
| | - Nafiye Emel Çakar
- Department of Pediatric Metabolism, Prof Dr Cemil Taşcıoğlu City Hospital, University of Health Sciences, İstanbul, Turkey
| | - Bülent Kara
- Department of Pediatric Neurology, Kocaeli University Hospital, University of Health Sciences, İstanbul, Turkey
| |
Collapse
|
12
|
Abstract
BACKGROUND Coronavirus disease 2019 may have neurological manifestations including meningitis, encephalitis, post-infectious brainstem encephalitis and Guillain-Barre syndrome. Neuroinflammation has been claimed as a possible cause. Here, we present a child with multisystem inflammatory syndrome in children (MIS-C) who developed pseudotumor cerebri syndrome (PTCS) during the disease course. CASE A 11-year-old girl presented with 5 days of fever, headache and developed disturbance of consciousness, respiratory distress, conjunctivitis and diffuse rash on her trunk. Immunoglobulin M and G antibodies against severe acute respiratory syndrome coronavirus 2 were positive in her serum. She was diagnosed with MIS-C. On day 10, she developed headache and diplopia. Left abducens paralysis and bilateral grade 3 papilledema were observed. Brain magnetic resonance imaging revealed optic nerve head protrusion, globe flattening. She was diagnosed with secondary PTCS. Papilledema and abducens paralysis improved under acetazolamide and topiramate. Neurological examination became normal after 2 months. CONCLUSION PTCS may emerge related to MIS-C.
Collapse
Affiliation(s)
- Ayşe İrem Sofuoğlu
- Division of Pediatric Intensive Care, Department of Pediatrics, Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey,Correspondence: Ayşe İrem Sofuoğlu, Division of Pediatric Intensive Care, Department of Pediatrics, Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey. Tel: +90 533 320 5799. E-mail: <>
| | - Nihal Akçay
- Division of Pediatric Intensive Care, Department of Pediatrics, Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Esra Şevketoğlu
- Division of Pediatric Intensive Care, Department of Pediatrics, Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Gonca Bektaş
- Division of Pediatric Neurology, Department of Pediatrics, Bakıkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| |
Collapse
|
13
|
Akçay N, Menentoğlu ME, Bektaş G, Şevketoğlu E. Axonal Guillain-Barre syndrome associated with SARS-CoV-2 infection in a child. J Med Virol 2021; 93:5599-5602. [PMID: 33851741 PMCID: PMC8250647 DOI: 10.1002/jmv.27018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/31/2021] [Accepted: 04/12/2021] [Indexed: 12/20/2022]
Abstract
The relation between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and demyelinating Guillain-Barre syndrome (GBS) has been defined. We aim to report the clinical features of a child with axonal GBS associated with SARS-CoV-2. A 6-year-old male presented with symmetric ascending paralysis progressed over a 4-day course and 2 days of fever. He had bilateral lower and upper limb flaccid weakness of 1/5 with absent deep tendon reflexes. He had severe respiratory muscle weakness requiring invasive mechanical ventilation. On admission, SARS-CoV-2 returned as positive by real-time polymerase chain reaction on a nasopharyngeal swab. Cerebrospinal fluid analysis showed elevated protein without pleocytosis. He was diagnosed with GBS associated with SARS-CoV-2 infection. The nerve conduction study was suggestive of acute motor axonal neuropathy. Ten consecutive therapeutic plasma exchange sessions with 5% albumin replacement followed by four sessions on alternate days were performed. On Day 12, methylprednisolone (30 mg/kg/day for 5 days) was given. On Day 18, intravenous immunoglobulin (2 g/kg/day) was given and repeated 14 days after due to severe motor weakness. On Day 60, he was discharged from the hospital with weakness of neck flexor and extensor muscles of 3/5 and the upper limbs and the lower limbs of 2/5 on home-ventilation. Our patient is considered to be the youngest patient presenting with a possible para-infectious association between axonal GBS and SARS-CoV-2 infection. The disease course was severe with a rapid progression, an earlier peak, and prolonged duration in weakness as expected in axonal GBS.
Collapse
Affiliation(s)
- Nihal Akçay
- Pediatric Intensive Care Unit, Bakirkoy Dr Sadi Konuk Education and Research Hospital, University of the Health Sciences, Istanbul, Turkey
| | - Mehmet Emin Menentoğlu
- Pediatric Intensive Care Unit, Bakirkoy Dr Sadi Konuk Education and Research Hospital, University of the Health Sciences, Istanbul, Turkey
| | - Gonca Bektaş
- Pediatric Neurology, Bakirkoy Dr Sadi Konuk Education and Research Hospital, University of the Health Sciences, Istanbul, Turkey
| | - Esra Şevketoğlu
- Pediatric Intensive Care Unit, Bakirkoy Dr Sadi Konuk Education and Research Hospital, University of the Health Sciences, Istanbul, Turkey
| |
Collapse
|
14
|
Barlas ÜK, Kıhtır HS, Yeşilbaş O, Petmezci MT, Akçay N, Petmezci E, Hatipoğlu N, Şevketoğlu E. Tetanus; a forgotten infection disease: a report of two cases. Turk J Pediatr 2020; 62:274-279. [PMID: 32419420 DOI: 10.24953/turkjped.2020.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Tetanus is an infectious disease that can be seen in all age groups in underdeveloped and developing countries, where vaccination programs are inadequate. In developed countries, it is reported more frequently in the adult age group, where the protection of vaccination is diminished and the doses are delayed. CASE In this report, we present generalized tetanus, which was observed in two male patients aged 12 and 6 years, admitted at different times, together with clinical course and treatment approaches. Both patients belong to different nationalities, who immigrated a couple of months before their application to our hospital. They applied with similar histories and complaints and were not vaccinated during infancy. CONCLUSION With the development of vaccination programs, this disease with high morbidity and mortality can be prevented.
Collapse
Affiliation(s)
- Ülkem Koçoğlu Barlas
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Hasan Serdar Kıhtır
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Osman Yeşilbaş
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Mey Talip Petmezci
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Nihal Akçay
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Ercüment Petmezci
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Nevin Hatipoğlu
- Department of Pediatrics, University of Health Science, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| | - Esra Şevketoğlu
- Division of Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Health Training and Research Center, İstanbul, Turkey
| |
Collapse
|
15
|
Aydin Köker S, Yeşilbaş O, Köker A, Şevketoğlu E. Propionic acidemia: an extremely rare cause of hemophagocytic lymphohistiocytosis in an infant. ARCH ARGENT PEDIATR 2020; 118:e174-e177. [PMID: 32199059 DOI: 10.5546/aap.2020.eng.e174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 09/09/2019] [Indexed: 11/12/2022]
Abstract
Hemophagocytic lymphohystiocytosis (HLH) may be primary (inherited/familial) or secondary to infections, malignancies, rheumatologic disorders, immune deficiency syndromes and metabolic diseases. Cases including lysinuric protein intolerance, multiple sulfatase deficiency, galactosemia, Gaucher disease, Pearson syndrome, and galactosialidosis have previously been reported. It is unclear how the metabolites trigger HLH in metabolic diseases. A 2-month-old infant with lethargy, pallor, poor feeding, hepatosplenomegaly, fever and pancytopenia, was diagnosed with HLH and the HLH-2004 treatment protocol was initiated. Analysis for primary HLH gene mutations and metabolic screening tests were performed together; primary HLH gene mutations were negative, but hyperammonemia and elevated methyl citrate were detected. Propionic acidemia was diagnosed with tandem mass spectrometry in neonatal dried blood spot. We report this case of HLH secondary to propionic acidemia. Both metabolic disorder screening tests and gene mutation analysis may be performed simultaneously especially for early diagnosis in infants presenting with HLH.
Collapse
Affiliation(s)
| | - Osman Yeşilbaş
- Pediatric Intensive Care Unit University of Health Sciences, Van Training and Research Hospital
| | - Alper Köker
- Hatay State Hospital, Pediatric Intensive Care Unit, Hatay
| | - Esra Şevketoğlu
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey
| |
Collapse
|
16
|
Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Ersoy M, Petmezci MT, Akkuş CH, Şahin Ö, Ceylaner S. A rare structural myopathy: Nemaline myopathy. Turk Arch Pediatr 2019; 54:49-52. [PMID: 31217710 PMCID: PMC6559969 DOI: 10.5152/turkpediatriars.2018.4402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 12/27/2016] [Indexed: 12/24/2022]
Abstract
Nemaline myopathy, which is characterized by the accumulation of ‘’rod’’ bodies in muscle fibers is a very rare inherited muscle disease. According to the underlying mutation, the disease has varying severity of clinical outcomes. Patients with severe forms of the disease die because of hypotonia, feeding difficulties, aspiration pneumonia, and respiratory failure in the neonatal or infancy period. Mild forms of the disease present with walking-swallowing difficulties and respiratory distress in late childhood or adulthood. A two-and-a-half-month-old boy was monitored in our Pediatric Intensive Care Unit with hypotonia, pneumonia, and respiratory distress. Nemaline myopathy was diagnosed as the result of a muscle biopsy. An advanced molecular examination revealed heterozygous mutations in the skeletal muscle α-actin (ACTA1) gene, which is the second most common cause of this disease. Nemaline myopathy should be kept in mind in patients of all age groups with respiratory failure and walking difficulty secondary to muscle weakness.
Collapse
Affiliation(s)
- Osman Yeşilbaş
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Hasan Serdar Kıhtır
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Melike Ersoy
- Pediatric Metabolic Diseases, Pediatrics Clinic, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Mey Talip Petmezci
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Canan Hasbal Akkuş
- Pediatrics Clinic, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Önder Şahin
- Department of Pathology, İstanbul Univesity İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Serdar Ceylaner
- Division of Clinical Genetics, Intergen Genetics Center, Ankara, Turkey
| |
Collapse
|
17
|
Yeşilbaş O, Şevketoğlu E, Petmezci MT, Kıhtır HS, Benzer M, Berdeli A. Hemolytic uremic syndrome with multiple organ involvement secondary to complement factor H p.Arg1215X mutation. Turk J Pediatr 2019; 59:576-580. [PMID: 29745120 DOI: 10.24953/turkjped.2017.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Complement mediated hemolytic uremic syndrome which is caused by excessive activation of the alternative complement system is a thrombotic microangiopathy. The disease frequently occurs as a result of mutations in the genes that regulates complement proteins. Complement factor H gene has the most common mutations. A nine-month-old male patient was transferred to pediatric intensive care unit with the diagnosis of hemolytic uremic syndrome. Nonsense heterozygous p.Arg1215X mutation in the complement factor H gene was detected. The patient who had pulmonary, intestinal and hepatic involvement accompanying acute renal failure was successfully treated with therapeutic plasma exchange and eculizumab. Nonsense heterozygous p.Arg1215X mutation is extremely rare and can cause severe hemolytic uremic syndrome. As far as we know, our patient is the third case with this mutation in the literature.
Collapse
Affiliation(s)
- Osman Yeşilbaş
- Departments of Pediatric Critical Care, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Departments of Pediatric Critical Care, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Mey Talip Petmezci
- Departments of Pediatric Critical Care, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Hasan Serdar Kıhtır
- Departments of Pediatric Critical Care, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Meryem Benzer
- Departments of Nephrology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Afig Berdeli
- Department of Pediatrics, Molecular Medicine Laboratory and Stem Cell Department of Health Science Institute, Ege University Faculty of Medicine İzmir, Turkey
| |
Collapse
|
18
|
Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Petmezci MT, Koçoğlu Barlas Ü, Akçay N, Hatipoğlu N, Meşe S. Fatal Adenovirus Pneumonia Despite Extracorporeal Life Support Treatments. J Pediatr Inf 2018. [DOI: 10.5578/ced.201817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
19
|
Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Petmezci MT, Koçoğlu Barlas Ü, Akçay N, Hatipoğlu N, Meşe S. Vücut Dışı Yaşam Destek Tedavilerine Rağmen Ölümcül Seyreden Adenovirüs Pnömonisi. J Pediatr Inf 2018. [DOI: 10.5578/ced.66623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
20
|
Yeşilbaş O, Şevketoğlu E, Bursal Duramaz B, Kıhtır HS, Gedikbaşı A, Talip Petmezci M, Baydemir C. Role of hepcidin in the diagnosis of sepsis and septic shock in children. Turk J Med Sci 2018; 48:517-524. [PMID: 29914246 DOI: 10.3906/sag-1707-120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: The purpose of this study is to compare the diagnostic value of hepcidin level with the white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) levels in pediatric sepsis and septic shock. Materials and methods: A cohort of 89 individuals were divided into four groups: a healthy control group (HCG, n = 28), pediatric intensive care unit control group (PICUCG, n = 17), sepsis group (SG, n = 23), and septic shock group (SSG, n = 21). WBC, CRP, PCT, IL-6, and hepcidin levels were studied in the PICUCG, SG, and SSG, while hepcidin and IL-6 levels were studied in the HCG. Results: In distinguishing the SG and SSG from the HCG, hepcidin sensitivity and specificity were found to be 100%. Distinguishing between the PICUCG and the SG, hepcidin sensitivity was calculated as 95.6% and specificity was calculated as 100%. The sensitivity of WBC, CRP, and PCT was lower than that of hepcidin, but the sensitivity of IL-6 was higher than that of hepcidin. While the specificity of PCT and IL-6 was the same as hepcidin, the specificity of WBC and CRP was lower than that of hepcidin. Conclusion: Hepcidin is a more reliable indicator than WBC and CRP levels in distinguishing children with sepsis and septic shock from healthy children and nonseptic pediatric ICU patients.
Collapse
|
21
|
Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Talip Petmezci M, Bato E, Balkaya S, Hatipoğlu N, Kuşkucu MA, Palabıyık F, Çakır E. [A case of bronchiolitis obliterans secondary to human metapneumovirus bronchiolitis]. MIKROBIYOL BUL 2017; 50:606-612. [PMID: 28124966 DOI: 10.5578/mb.32195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human metapneumovirus (hMPV), formerly classified in Paramyxoviridae family is now moved into Pneumoviridae, which was described as a novel family. It causes upper and lower respiratory tract infections (LRTIs) usually in children younger than five years old. The recent epidemiological studies indicated that hMPV is the second most frequently detected virus in LRTIs of young children, following the respiratory syncytial virus (RSV). Bronchiolitis obliterans (BO) is a chronic obstructive lung disease characterized by fibrosis of the distal respiratory airways. It is usually a result of an inflammatory process triggered by a LRTI related to adenovirus, RSV, Mycoplasma pneumoniae, measles virus, Legionella pneumophila, influenza virus or Bordetella pertussis as a causative agent. In this report, a case of hMPV bronchiolitis complicated with BO has been reported to point out the complications and severity of the clinical progress belongs to this virus. A three-month-old female patient has admitted to our pediatric intensive care unit with the diagnosis of acute bronchiolitis and respiratory failure. She was born at term, weighing 2950 gram and had been hospitalized in newborn intensive care unit for 11 days with the diagnosis of transient tachypnea of the newborn and neonatal sepsis. On auscultation, there were bilateral crepitant rales, wheezing and prolonged expirium. Her oxygen saturation was 97-98% while respiratory support was given with a non-rebreathing reservoir mask. Complete blood count, procalcitonin and C-reactive protein levels were in normal ranges. The chest radiography yielded right middle lobe atalectasia, left paracardiac infiltration and bilateral air trapping. A nasopharyngeal swab sample was analyzed by a commercial multiplex real-time reverse transcriptase-polymerase chain reaction (Thermo Fisher Scientific®, USA) developed for the detection of 15 respiratory viruses. Her sample yielded positive result for only hMPV. On the 4th day of hospitalization, the patient was intubated because of respiratory failure and carbon dioxide retention. She was extubated on the 19th day but could not tolerate. In the thorax computed tomography (CT), bilateral hyperinflation, patchy infiltration, mosaic perfusion and atelectasis especially bilateral posterior areas were detected. Bronchoscopy was normal except mild bronchomalacia in right middle lobe bronchus. The patient was diagnosed as BO secondary to hMPV bronchiolitis, according to the clinical, virological, bronchoscopic and thorax CT results. On the 76th day of admission, she was discharged with respiratory support with home ventilation via a tracheostomy cannula and medical treatments of oral metilprednisolone, nebulized salbutamol and budesonide. In conclusion, hMPV should not be undervalued especially in infants with severe LRTI that can be complicated with BO.
Collapse
Affiliation(s)
- Osman Yeşilbaş
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Hatipoğlu N, Yıldırım HM, Akyol MB, Aktay-Ayaz N, Gökçe İ. Leptospirosis in a child with acute respiratory distress syndrome. Turk J Pediatr 2017; 59:688-692. [PMID: 30035402 DOI: 10.24953/turkjped.2017.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Hatipoğlu N, Yıldırım HM, Akyol MB, Aktay-Ayaz N, Gökçe İ. Leptospirosis in a child with acute respiratory distress syndrome. Turk J Pediatr 2017; 59: 688-692. Leptospirosis is an infectious vasculitis, which can occur with different clinical features. While it is generally a subclinical and self-limited infection; kidney and liver dysfunction, pulmonary hemorrhage, thrombocytopenia, and cardiovascular collapse may occurr. A six-year-old boy presented with acute respiratory distress syndrome, shock, thrombocytopenia-associated multiple organ failure, and persistent high fever secondary to leptospirosis. Persistent high fever was resistant to intravenous immunoglobulin and pulse steroid therapy. He was successfully treated with plasmapheresis and hemofiltration with endotoxin-cytokine cleaning filter. In conclusion; leptospirosis may cause thrombocytopenia-associated multiple organ failure, persistent high fever, and acute respiratory distress syndrome. Plasmapheresis and hemofiltration should be considered in cases of severe leptospirosis with multiorgan failure.
Collapse
Affiliation(s)
- Osman Yeşilbaş
- Departments of Pediatric Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Esra Şevketoğlu
- Departments of Pediatric Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Hasan Serdar Kıhtır
- Departments of Pediatric Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Nevin Hatipoğlu
- Department of Pediatric Infectious Disease, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Hamdi Murat Yıldırım
- Departments of Pediatric Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Mehmet Bedir Akyol
- Department of Pediatric Cardiology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Nuray Aktay-Ayaz
- Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - İbrahim Gökçe
- Department of Pediatric Nephrology, Marmara University Medical Faculty Hospital, Istanbul, Turkey
| |
Collapse
|
23
|
Kıhtır HS, Yıldırım HM, Yeşilbaş O, Duramaz BB, Şevketoğlu E. Single-pass albumin dialysis in a child aged six months with phenobarbital poisoning. Turk Arch Pediatr 2016; 51:228-230. [PMID: 28123338 DOI: 10.5152/turkpediatriars.2016.2335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 04/07/2015] [Indexed: 11/22/2022]
Abstract
A girl aged six months was hospitalized because of resistant seizures and was discharged with phenobarbital and carbamazepine therapy. She was admitted to a state hospital with symptoms of inability to waken and difficulty in breathing. It was learned that phenobarbital had been used incorrectly and the patient was sent to our pediatric intensive care unit because of severe phenobarbital overdose. The decision was taken for hemodialysis. Single-pass albumin dialysis was planned because phenobarbital can bind to high levels of plasma protein. The process was undertaken with 1% albumin-containing dialysate, which was prepared manually. After 6 hours of dialysis, the phenobarbital blood level measured 62 mcg/mL (>140 mcg/mL on admission) and the patient's clinical findings were markedly regressed. There are no case reports about phenobarbital overdose treated with single-pass albumin dialysis in the literature. We conclude that single-pass albumin dialysis may be a useful treatment, especially with intoxications of drugs that bind protein at high levels.
Collapse
Affiliation(s)
- Hasan Serdar Kıhtır
- Clinic of Pediatrics, Division of Pediatric Intensive Care, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Hamdi Murat Yıldırım
- Clinic of Pediatrics, Division of Pediatric Intensive Care, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Osman Yeşilbaş
- Clinic of Pediatrics, Division of Pediatric Intensive Care, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Burcu Bursal Duramaz
- Clinic of Pediatrics, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Clinic of Pediatrics, Division of Pediatric Intensive Care, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
24
|
Yeşilbaş O, Kıhtır HS, Yıldırım HM, Hatipoğlu N, Şevketoğlu E. Pediatric Fulminant Leptospirosis Complicated by Pericardial Tamponade, Macrophage Activation Syndrome and Sclerosing Cholangitis. Balkan Med J 2016; 33:578-580. [PMID: 27761292 DOI: 10.5152/balkanmedj.2016.151240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 02/03/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU). To the best of our knowledge, sclerosing cholangitis due to leptospirosis has not been reported in the literature. CONCLUSION Leptospirosis should be kept in mind in the differential diagnosis of sepsis and septic shock with fever, thrombocytopenia, jaundice and renal failure. TPE and CVVHF should start early after the diagnosis of leptospirosis with multiorgan failure.
Collapse
Affiliation(s)
- Osman Yeşilbaş
- Pediatric Intensive Care Unit, Pediatric Critical Care Medicine, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Hasan Serdar Kıhtır
- Pediatric Intensive Care Unit, Pediatric Critical Care Medicine, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Hamdi Murat Yıldırım
- Pediatric Intensive Care Unit, Pediatric Critical Care Medicine, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Nevin Hatipoğlu
- Division of Pediatric Infectious Disease, Department of Pediatrics, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Pediatric Intensive Care Unit, Pediatric Critical Care Medicine, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| |
Collapse
|
25
|
Yeşilbaş O, Kıhtır HS, Talip Petmezci M, Balkaya S, Hatipoğlu N, Meşe S, Şevketoğlu E. [Very rare and life-threatening complications of bocavirus bronchiolitis: pneumomediastinum and bilateral pneumothorax]. MIKROBIYOL BUL 2016; 50:159-64. [PMID: 27058341 DOI: 10.5578/mb.10312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human bocavirus (HBoV), that was first identified in 2005 and classified in Parvoviridae family, is a small, non-enveloped, single-stranded DNA virus, responsible for upper and lower respiratory tract infections, especially in young children. Although HBoV generally causes self-limited influenza-like illness, it may also lead to pneumonia, bronchiolitis, croup and asthma attacks. In this report, a case of acute bronchiolitis complicated with pneumomediastinum and bilateral pneumothorax caused by HBoV has been presented. A three-year-old boy was referred to our pediatric intensive care unit with a two day history of fever, tachypnea, hypoxia and respiratory failure. On auscultation, there were widespread expiratory wheezing and inspiratory crackles. The chest radiography yielded paracardiac infiltration and air trapping on the right lung and infiltration on the left lung. The patient had leukocytosis and elevated C-reactive protein level. On the second day of admission, respiratory distress worsened and chest radiography revealed right pneumothorax and subcutaneous emphysema in bilateral cervical region and left chest wall. He was intubated because of respiratory failure. In the thorax computed tomography, pneumomediastinum and bilateral pneumothorax were detected and right chest tube was inserted. Repetitive blood and tracheal aspirate cultures were negative. A nasopharyngeal swab sample was analyzed by multiplex real-time polymerase chain reaction method with the use of viral respiratory panel (FTD(®) Respiratory Pathogens 21 Kit, Fast-Track Diagnostics), and positive result was detected for only HBoV. On the ninth day of admission, pneumomediastinum and bilateral pneumothorax improved completely and he was discharged with cure. In conclusion, HBoV bronchiolitis may progress rare but severe complications, it should be kept in mind as an etiological agent of the respiratory tract infections especially children younger than five years old.
Collapse
Affiliation(s)
- Osman Yeşilbaş
- Bakırköy Dr. Sadi Konuk Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
26
|
Yeşilbaş O, Kıhtır HS, Ersoy M, Yıldırım HM, Sungur MÜ, Şevketoğlu E. Peroxisomal disorder characterized with severe cerebral dysgenesis and hypotonia. Dicle Med J 2015. [DOI: 10.5798/diclemedj.0921.2015.04.0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Duramaz BB, Yıldırım HM, Kıhtır HS, Yeşilbaş O, Şevketoğlu E. Evaluation of forensic cases admitted to pediatric intensive care unit. Turk Arch Pediatr 2015; 50:145-50. [PMID: 26568689 DOI: 10.5152/turkpediatriars.2015.2399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/04/2015] [Indexed: 11/22/2022]
Abstract
AIM This study aimed to determine the epidemiological and clinical characteristics of pediatric forensic cases to contribute to the literature and to preventive health care services. MATERIAL AND METHODS Pediatric forensic cases hospitalized in our pediatric intensive care unit below the age of 17 years were reviewed retrospectively (January 2009-June 2014) . The patients were evaluated in two groups as physical traumas (Group A) and poisonings (Group B). The patients' age, gender, complaints at presentation, time of presentation and referral (season, time) and, mortality rates were determined. Cases of physical trauma (Group A) were classified as traffic accidents, falling down from height, falling of device, drowning, electric shock, burns and child abuse. Poisonings (Group B) were classified as pharmaceuticals, pesticides, other chemicals and unknown drug poisonings. RESULTS Two hundred twenthy cases were included. The mean age was 5.1+3.1 years. One hundred fifteen (%52.5) of the cases were male and 105 (%47.5) were female. Group A consisted of 62 patients and Group B consisted of 158 patients. The patients presented most frequently in summer months. The most common reason for presentation was falling down from height (12.7%) in Group A and accidental drug poisoning (most frequently antidepressants) in Group B. The mortality rate was 5%. CONCLUSION Forensic cases in the pediatric population (physical trauma and poisoning) are preventable health problems. Especially, preventive approach to improve the environment for falling down from height must be a priority. Increasing the awareness of families and the community on this issue, in summer months during which forensic cases are observed most frequently can contribute to a reduction in the number of cases.
Collapse
Affiliation(s)
- Burcu Bursal Duramaz
- Clinic of Pediatrics, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Hamdi Murat Yıldırım
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Hasan Serdar Kıhtır
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Osman Yeşilbaş
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Esra Şevketoğlu
- Pediatric Intensive Care Unit, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
28
|
Onan İS, Haydin S, Ündar A, Yalındağ-Öztürk MN, Demirkol D, Kalkan G, Ceyran H, Atay Y, Şaşmazel A, Karacı AR, Şevketoğlu E, Köroğlu T, Altın HF, Yazıcı P, Yıldızdaş D, Çicek AE, Ödemiş E, Akçevin A, Bakır İ. A multidisciplinary approach to expand the use of pediatric ECLS systems in Turkey. Artif Organs 2015; 39:7-13. [PMID: 25626574 DOI: 10.1111/aor.12374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- İsmihan Selen Onan
- Department of Cardiovascular Surgery, Pediatric Cardiac Surgery Division, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Ayaz NA, Şevketoğlu E, Oral SS, Kontbay T, Aybar D, Hatipoğlu S, Aydoğan G. A novel therapeutic approach for macrophage actıvatıon syndrome due to SoJIA. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194452 DOI: 10.1186/1546-0096-9-s1-p104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|