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    A case of pulmonary tularemia mimicking lung cancer
    (Elsevier Science Inc, 2024) Kiymaz, Yasemin cakir; Ozbey, Mahmut
    Tularemia is a zoonotic infectious disease caused by Francisella tularensis. The main reservoir for F. tularensis is lagomorphs, rodents, arthropods, and the hydrotelluric environment. It also can be transmitted by infected animals or by drinking contaminated water. Pulmonary tularemia is a rare form of tularemia mostly transmitted by inhalation. In this report, we present a 51-year-old male patient who was admitted to the hospital with fever, cough, sputum, and chest pain. Biopsy of the lesion compatible with mass on chest radiography revealed granulomatous inflammation. The diagnosis of pulmonary tularemia was made based on a history of rodent contact and tularemia microagglutination test (MAT): 1/1280.
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    Evaluation of the clinical characteristics, laboratory parameters, and antibiotic treatment in patients diagnosed with tularemia
    (Elsevier, 2025) Kiymaz, Yasemin cakir; Bolat, Serkan; Katirci, Bilge; Aldemir, Ozlem; Altinkaya, Isik; Ozcan, Merdan Mustafa; Hopoglu, Serhat Murat
    Introduction: This retrospective, cross-sectional, multi-center study aimed to evaluate the impact of laboratory results and treatments on the treatment response in patients diagnosed with tularemia. Methods: The study included 190 adult patients diagnosed with tularemia between November 2023 and June 2024. Results: 67.9 % were female, mean age was 45.8 +/- 14.9 years. The most frequently detected symptoms were sore throat (74.2 %), fatigue (71.6 %), and neck swelling (56.3 %). The most common form of tularemia was oropharyngeal (82.6 %) and glandular (14.2 %). The most used monotherapy was ciprofloxacin (80.5 %, n = 136), and combination therapy was streptomycin-ciprofloxacin (81.0 %, n = 17). Treatment failure was observed in 29 patients (15.2 %). No difference was found between patients who responded and didn't respond to treatment regarding laboratory parameters. Lymph node drainage or excision was performed in 47 patients (23 %). Suppurative lymphadenitis, abscess, necrosis, and conglomerate lymphadenopathy were more common in the lymph node drainage group. Reactive lymph nodes were more common in the group without lymph node drainage. There was no difference between the two groups regarding laboratory parameters of patients with and without lymph node drainage. The duration of antibiotic treatment was longer in patients who underwent lymph node drainage than in those who didn't. Conclusion: Radiological evaluation of lymph nodes upon hospital admission, in addition to antibiotic therapy during treatment, may help predict which patients are more likely to require surgical drainage. Laboratory parameters may not provide significant benefits in predicting the need for lymph node drainage and long-term treatment did not affect the treatment response.
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    Hidden threats: Brucellosis diagnosis and co-infection patterns in Crimean-Congo Hemorrhagic Fever suspects
    (Elsevier Science Inc, 2025) Oz, Murtaza; Cubuk, Fatih; Kiymaz, Yasemin cakir; Oksuz, Caner; Hasbek, Mursit; Buyuktuna, Seyit Ali; Elaldi, Nazif
    Purpose: This study aims to investigate the frequency of brucellosis in patients with Crimean-Congo Hemorrhagic Fever (CCHF). Method: In this study, 1231 patients were evaluated retrospectively, including 14 patients with CCHF and brucellosis coinfection and 25 patients with brucellosis alone. Statistical methods such as the Mann-Whitney U test and Fisher's exact test were used. Result: Of the patients with a preliminary diagnosis of Crimean-Congo Hemorrhagic Fever (CCHF), 3.2% were found to have brucellosis. In the group co-infected with brucellosis and CCHF, the time to hospital admission was shorter. Additionally, tick exposure and headache were observed more frequently in this group. Creatine kinase levels were found to be higher in the co-infected group, while lymphocyte counts and fibrinogen levels were lower compared to the group with brucellosis alone. Conclusion: Our study revealed a 3.2% rate of brucellosis in patients with a preliminary diagnosis of CCHF. Due to the similarity of symptoms and common risk factors, the differential diagnosis of brucellosis should be considered in patients diagnosed with CCHF. Additionally, the possibility of brucellosis coexisting with CCHF should always be considered. Even in patients diagnosed with CCHF, an evaluation for brucellosis must be conducted.
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    Investigation of Long Noncoding RNA-NRAV and Long Noncoding RNA-Lethe Expression in Crimean-Congo Hemorrhagic Fever
    (Wiley, 2024) Baysal, Aysenur Comez; Kiymaz, Yasemin cakir; Sahin, Nil Ozbilum; Bakir, Mehmet
    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic infectious disease caused by the CCHF virus, a member of the Bunyavirales order and the Orthonairoviridae family. The exact pathogenesis is not fully understood. Long noncoding RNAs (lncRNAs) are RNAs that are shown to play a role in various pathological processes of viral diseases. NRAV and Lethe are two well-known lncRNAs. Although previous studies have shown that NRAV and Lethe play important roles in the pathogenesis of viral infections, their role in CCHF is unknown. This study aimed to evaluate the expression levels of NRAV and Lethe in patients with CCHFV. Eighty patients diagnosed with CCHF were included, and RNA was extracted from their blood samples. The expression of NRAV and Lethe was measured using quantitative real-time polymerase chain reaction (qPCR). Patients were divided into three groups based on severity score, which was mild, moderate, and severe, and into two groups (survivors and non-survivors). The expression levels of NRAV and Lethe were compared between these groups. Of the patients, 49 (61.25%) were male, 31 (38.75%) were female, and the mean age was 38.62 +/- 19.28 years. No differences in age or gender were found between the groups. It was shown that NRAV expression was 21.86 times higher in the severe patient group compared to the moderate group and 22.74 times higher than in the mild group, statistically significant. When comparing fatal cases with survivors, NRAV expression levels were found to be 9.2 times higher in fatal cases. Lethe levels were 3 times lower in moderately severe cases compared to mild cases, but this difference was not statistically significant. In conclusion, our study suggests that NRAV may be a lncRNA involved in the pathogenesis of CCHFV.
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    Mortality rates and risk factors associated with mortality in patients with stenotrophomonas maltophilia primary Bacteraemia and Pneumonia
    (Elsevier Science Inc, 2025) Hasbek, Mursit; Aldemir, Ozlem; Kiymaz, Yasemin cakir; Baysal, Cihad; Yildirim, Dilara; Buyuktuna, Seyit Ali
    This study aims to evaluate the risk factors associated with the mortality of S. maltophilia infections. Patients aged 18 years and older with S. maltophilia infection. Patients were divided into two groups primary bacteraemia and pneumonia. Of 176 S. maltophilia infections, 85 (48.2 %) were classified as bacteremia and 91 (51.8 %) as pneumonia. The mortality rate was 56 %, with no significant difference observed between the groups. Invasive mechanical ventilation, history of carbapenem use, and high Charlson Comorbidity Index (CCI) were significantly higher in the pneumonia group. In univariate analysis, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher Sequential Organ Failure Assessment (SOFA) score, and use of total parenteral nutrition (TPN) were identified as independent risk factors for 28-day mortality. This study demonstrates a mortality rate of 56 % in S. maltophilia infections and provides concrete data on risk factors for mortality.
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    Triple threat: Sequential meningitis infections in an immunosuppressed patient with Morganella morganii, Acinetobacter baumannii, and vancomycin-resistant Enterococcus faecium
    (Elsevier Science Inc, 2025) Kiymaz, Yasemin cakir; Kiymaz, Eren; Bulut, Zekeriya; Buyuktuna, Seyit Ali; Elaldi, Nazif
    Gram-negative bacilli and vancomycin-resistant enterococci (VRE) are rare causative agents in the etiology of bacterial meningitis and can lead to significant mortality due to the difficulty of treatment. This article reports three successive cases of different meningitis clinical presentations in an immunosuppressed patient diagnosed with diffuse large B-cell lymphoma. A 65-year-old male patient was initially followed with Morganella morganii meningitis. Later, the patient was diagnosed with Acinetobacter meningitis and VRE meningitis. Clinical and microbiological success was achieved following a prolonged hospital stay and antibiotic therapy.