[A case of meningitis emerged as a complication of hidradenitis suppurativa]. / Süpüratif hidradenitin komplikasyonu olarak ortaya çikan bir menenjit olgusu.

Hidradenitis suppurativa (HS), which is characterized by the obstruction of the apocrine gland channels and development of secondary bacterial infections, is a rare clinical entity mostly seen in women. In this case report, a bacterial meningitis case, which emerged after HS in the gluteal region, was presented. To the authors' knowledge this is the first case in the literature. Sixty-years-old male patient was admitted to the infectious disease department with high fever, lack of consciousness and orientation and cooperation problems. Upon detection of neck stiffness during physical examination, cerebrospinal fluid (CSF) specimen was taken. CSF analysis revealed increased pressure, turbidity, (++++) Pandy reaction and 33.600/ml leucocytes (95% PMNL). CSF glucose was 2 mg/dl (simultaneous blood glucose was 156 mg/dl) and protein was 360 mg/dl. Gram stained smear of the CSF specimen yielded high numbers of gram-positive cocci. Empirical treatment with intravenous ceftriaxone (2 x 2 g/day) and linezolid (2 x 600 mg/day) was initiated upon the diagnosis of acute bacterial meningitis. Physical examination of the patient revealed HS characterized by common fistulas in gluteal area and drainage from the fistula with drainage in left gluteal area. White blood cell blood count was 26.700/mg, platelet count was 501.000/ml and hemoglobin was 14.8 mg/dl. Erythrocyte sedimentation rate was 120 mm/hour. In the magnetic resonance imaging of the vertebra, fistula tract was determined between inflammed tissue and sacral subarachnoid region. Since the culture of CSF and blood did not yield any growth, the probable causative agent was thought to be an anaerobic gram-positive coccus. The treatment continued for 21 days for ceftriaxone and 28 days for linezolid. The patient was successfully treated and was transferred to neurosurgery department without any sequela for the management of fistulas.

An outbreak of respiratory infection due to respiratory syncytial virus subgroup B in Ankara, Turkey.

During the outbreak, from 16 January 2002 to 3 March 2002, nasopharyngeal secretions obtained from 35 pediatric patients under 2 years of age and suffering from acute respiratory disease were tested by VIDAS respiratory syncytial virus (RSV) assay (an automated enzyme-linked fluorescent immunoassay) and reverse transcription- polymerase chain reaction (RT-PCR). RSV antigen was detected in 16 specimens by VIDAS RSV assay, and 15 of these were confirmed by the RT-PCR. A total of 18 samples were found to be positive by RT-PCR. RSV subgroup B was identified by further restriction fragment length polymorphism analysis using AvaII and BglII endonucleases in 17 of 18 (94%) RT-PCR positive samples. These findings indicated that RSV subgroup B was highly dominant during an outbreak of RSV infection among children in Ankara. To our knowledge, this is the first outbreak due to dominant RSV subgroup B documented in Turkey.