Ergin Ciftçi

Akdeniz University, Satalia, Antalya, Turkey

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Publications (101)188.89 Total impact

  • T.T. Kara · H. Ozdemir · E. Ciftci · E. Ince
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    ABSTRACT: Parvovirus B19 can cause different skin rashes like maculopapular, erythematous, petechial, or purpuric lesions. In addition, parvovirus B19 can cause some important hematologic disorders like aplastic anemia, leukopenia, neutropenia, and thrombocytopenia. We report a child who was admitted to the hospital with petechial-purpuric rashes. On laboratory analysis, leukopenia and thrombocytopenia were found and serologic testing of parvovirus B19 IgM was determined to be positive. After the third day of hospitalization, the petechial-purpuric rashes began to decline and laboratory results were in the normal range. We think that the disease was parvovirus B19 infection. The patient was treated with only antipyretic drugs. On follow up, the clinical and laboratory findings had completely returned to normal. In conclusion, parvovirus B19 can cause clinical signs such as petechiae and purpura. Also, hematologic disorders may be a complication. Because of this, it should be considered in the differential diagnosis in patients with rash, thrombocytopenia, and leukopenia. © 2016, Journal of Clinical and Analytical Medicine. All rights reserved.
    No preview · Article · May 2016
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    Full-text · Poster · Dec 2015
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    ABSTRACT: Objective: Acute gastroenteritis is an important cause of morbidity and mortality in developing countries. Children under 5 years of age are more commonly affected, while 80% of deaths occur in children under 2 years of age. Escherichia coli, Salmonella spp., and Shigella spp. are the most common causative bacterial pathogens. Since the summer of 2014, a large number of Salmonella and Shigella gastroenteritis cases have occurred in our region, which is considered as a small local outbreak. We aim to report the features and antibiotic susceptibility of microorganism isolates obtained during this epidemic. Material and Methods: Between July and September 2014, patients who were admitted to pediatric clinics and emergency services on account of acute gastroenteritis lasted less than 15 days were included in this retrospective study. Stool microscopy, stool cultures, and blood cultures were performed. Salmonella and Shigella strains were subjected to antimicrobial susceptibility testing. Results: A total of 2425 patients were admitted because of acute gastroenteritis during the study period. Salmonella spp. and Shigella spp. were isolated in 113 children. The mean age of the children was 91.5±60.3 months (4-213 months). Of the 113 patients, 56% were male and 44% were female. Shigella spp. were found in 77 patients (3.2%), and Salmonella spp. were found in 36 patients (1.5%). Salmonella enteritidis was detected in 29 patients (80.5%), whereas Salmonella typhimurium was detected in 3 patients (8.3%). In addition, Shigella sonnei was identified in 63 patients (81.8%) and Shigella flexneri in 8 patients (10.3%). In contrast to ceftriaxone susceptibility in Salmonella strains, 9.1% of Shigella strains were found to be resistant to ceftriaxone. Ciprofloxacin resistancewas found in 5.6% and 1.3% strains of Salmonella and Shigella spp. respectively. Although the ampicillin resistance values of 2 strains were close, trimethoprim-sulfamethoxazole (TMP) resistance was found in 89.6% Shigella strains. Conclusion: Salmonella and Shigella are common bacterial pathogens. Resistance patterns must be known to select the most effective treatment. According to our study, ceftriaxone and ciprofloxacin appear to be the first choice of empirical treatment for acute bacterial gastroenteritis. Additionally, if the resistance states of ampicillin and TMP are known, these drugs can also be used as empirical treatment.
    Preview · Article · Oct 2015
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    ABSTRACT: Rotavirus may cause life-threatening complications in untreated patients during the course of gastroenteritis. Electrolyte imbalance, bacteremia and sepsis are the most common complications of rotavirus gastroenteritis (RG). It is believed that translocation of intestinal microorganisms as a result of intestinal epithelium dysfunction is the underlying mechanism of bacteremia in RG. Although Gram-negative bacteremia has been noted as a complication in RG, Staphylococcus aureus bacteremia and endocarditis have not been reported previously. A 22-month-old boy was admitted with complaints of fever, diarrhea and dehydration. He was diagnosed with RG complicated with S. aureus bacteremia, pyomyositis and endocarditis. We call attention to these complications in patients with prolonged or late-onset fever during RG as rare complications of the disease. © 2015 Japan Pediatric Society.
    No preview · Article · Aug 2015 · Pediatrics International
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    ABSTRACT: Aims: To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. Design: An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Results: We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6–93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79–0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73–0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54–0.60, p 0.0001). Conclusions: Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance.
    Full-text · Article · Jul 2015 · Journal of Infection Prevention
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    ABSTRACT: Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition. This report, as a part of the prospective national pediatric varicella hospitalizations study (including 29 centers, represent 50% of pediatric population) in Turkey, is aimed to evaluate breakthrough varicella infection requiring hospitalization before the routine use of single-dose live varicella vaccine in national program from 2008 to 2013 (<10% of the pediatric age group received a single-dose vaccine). In the time period, 1939 children were hospitalized due to varicella infection in Turkey; 36 children (20 boys, 16 girls, mean age 68.0+37.6 months, all received single dose live varicella vaccine) with breakthrough varicella infection. Breakthrough varicella infection might be severe in previously healthy children (61.1%) and children with immune-compromising conditions (38.9%). The time elapsed between vaccination and hospitalization was approximately 5 years, and neurological complications, mainly encephalitis and meningitis, were the most common reason for hospitalization in previously healthy children. Pediatric breakthrough varicella requiring hospitalization have been seen in Turkey, is mainly observed in previously healthy children at 5 years after a single-dose varicella vaccine. The varicella vaccine has been implemented as part of the National Immunization Program in Turkey in 2013 (a single dose at age 12 months). Further surveillance in the same settings could evaluate the effectiveness of national immunization with single-dose varicella vaccine at 12 months of age and potential need for second dose of vaccine. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jun 2015 · Vaccine
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    Full-text · Dataset · Jun 2015
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    ABSTRACT: Background Combined immunodeficiencies are marked by inborn errors of T-cell immunity in which the T cells that are present are quantitatively or functionally deficient. Impaired humoral immunity is also common. Patients have severe infections, autoimmunity, or both. The specific molecular, cellular, and clinical features of many types of combined immunodeficiencies remain unknown. Methods We performed genetic and cellular immunologic studies involving five unrelated children with early-onset invasive bacterial and viral infections, lymphopenia, and defective T-cell, B-cell, and natural killer (NK)-cell responses. Two patients died early in childhood; after allogeneic hematopoietic stem-cell transplantation, the other three had normalization of T-cell function and clinical improvement. Results We identified biallelic mutations in the dedicator of cytokinesis 2 gene (DOCK2) in these five patients. RAC1 activation was impaired in the T cells. Chemokine-induced migration and actin polymerization were defective in the T cells, B cells, and NK cells. NK-cell degranulation was also affected. Interferon-α and interferon-λ production by peripheral-blood mononuclear cells was diminished after viral infection. Moreover, in DOCK2-deficient fibroblasts, viral replication was increased and virus-induced cell death was enhanced; these conditions were normalized by treatment with interferon alfa-2b or after expression of wild-type DOCK2. Conclusions Autosomal recessive DOCK2 deficiency is a new mendelian disorder with pleiotropic defects of hematopoietic and nonhematopoietic immunity. Children with clinical features of combined immunodeficiencies, especially with early-onset, invasive infections, may have this condition. (Supported by the National Institutes of Health and others.).
    Full-text · Article · Jun 2015 · New England Journal of Medicine

  • No preview · Article · May 2015 · Clinical Pediatrics

  • No preview · Article · Apr 2015
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    ABSTRACT: Chronic granulomatous disease (CGD) is an autosomal recessive or X-linked disorder caused by NADPH oxidase deficiency leading to an impaired ability of reactive superoxide anion and metabolite formation and recurring severe bacterial and fungal infections, with a high mortality rate. Diarrhea, colitis, ileus, perirectal abscess formation and anal fissures are reported gastrointestinal findings in these patients. We report a case of intractable colitis associated with CGD in a young girl.
    No preview · Article · Mar 2015 · The Turkish journal of pediatrics
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    ABSTRACT: Objective: Orbital infections require prompt diagnosis and treatment because of the risk of severe complications. Although preseptal cellulitis and orbital cellulitis are different clinical conditions, they can often be confused or can be seen concomitantly. In this study, we aimed to evaluate all patients diagnosed with these diseases treated in our clinic in order to analyze clinical findings, preferred imaging modalities, treatment choices, and clinical outcomes. Material and Methods: This retrospective study was performed between January 1999 and January 2013. We evaluated patients who were admitted to the Ankara University Pediatric Infectious Disease Clinic with a diagnosis of preseptal or orbital cellulitis. Clinical and laboratory characteristics of the patients were compared. Significance level was determined as α=0.05. Results: A total of 71 patients (34 girls, 37 boys) with a diagnosis of preseptal (50 patients) or orbital cellulitis (21 patients) were included into the study. The mean age at diagnosis was 49±37.4 (2-168) months. Waters graphy and/or orbital computed tomography was performed in 27 (54%) patients with preseptal cellulitis and in 18 (85%) patients with orbital cellulitis. Almost all of the patients responded to medical therapy without sequelae, and only 3 of them required surgical treatment additionally. The patients with preseptal and orbital cellulitis were treated successfully with sulbactam-ampicillin (150 mg/kg/day and 200 mg/kg/day, respectively). Conclusion: We conclude that these infections can be treated without any morbidity and mortality if it is diagnosed early and suitable antibiotic treatment is promptly instituted. Imaging tools can give us detailed information regarding disease involvement, differential diagnosis, and the need for surgical intervention. However, we think that these imaging modalities, such as computed tomography, should be restricted as much as possible because of high-dose radiation exposure risk.
    Full-text · Article · Feb 2015
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    Halil Ozdemir · Ergin Ciftci
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    ABSTRACT: Invasive meningococcal disease is a serious and global life-threatening disease. It affects more than 500.000 people worldwide annually, with 50.000 deaths and 50.000-100.000 severe sequelae, despite treatment. Six serogroups (A, B, C, W135, X, and Y) account for the majority of cases of meningococcal disease worldwide. Meningococcal polysaccharide vaccines were introduced several decades ago and have led to the decline in the burden of disease. However, these vaccines have several limitations, including poor immunogenicity in infants and toddlers, short-lived protection, lack of immunologic memory and herd immunity, and negligible impact on nasopharyngeal carriage. The conjugation of polysaccharide vaccines has the potential to overcome these drawbacks. Herein, we reviewed the new information about the quadrivalent conjugated meningococcal vaccines and meningococcal serogroup B vaccines.
    Full-text · Article · Feb 2015
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    ABSTRACT: Kawasaki disease (KD) is a multisystemic vasculitic disease. Recurrent KD is rare and generally presents in a similar clinical picture as the first episode, and early diagnosis with prompt treatment is the key point in preventing associated cardiovascular morbidities. A 9-year-old boy, who was diagnosed with KD when he was 1.5 years’ old, was referred to our hospital for surgical drainage of retropharyngeal abscess. He had a 7-day history of high fever, sore throat, left-sided neck swelling, and restricted neck movements. Subsequently, he was diagnosed with recurrent KD and retropharyngeal involvement. He was successfully treated with a single dose of intravenous immunoglobulin (IVIG) and acetyl salicylic acid. Recurrence is rare and occurs most commonly in children. Atypical presentation, incomplete disease, short duration of fever, and reduced response to IVIG treatment were found to be the risk factors for recurrence. KD can occasionally present with clinical and radiographic findings of deep neck bacterial infection. Unusual presentations in KD may cause delay in diagnosis and increase the risk of life-threatening complications. We describe a case of recurrent KD presenting with a clinical picture resembling retropharyngeal infection who fully recovered after 1 dose of IVIG instead of surgical drainage and antibiotic use.
    Full-text · Article · Dec 2014 · Medicine

  • No preview · Article · Nov 2014 · Pediatric Annals
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    Full-text · Article · Jul 2014
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    ABSTRACT: We aimed both to define the characteristics of patients with Kawasaki Disease (KD), and to highlight infrequent and unusual findings of the disease by presenting selected cases. We retrospectively evaluated 35 patients diagnosed with KD in our clinic between January 1994 and January 2013. The male to female ratio was 1.33 and the median age at admission was 22 months (1.5-132 months). Fourteen patients (40%) had coronary artery lesions (CAL). Twenty-five cases (72%) had complete and 10 cases (28%) had incomplete KD; the incidence of CAL in these groups was 36% and 50%, respectively. Two patients had giant coronary aneurysms. Six cases received a second dose of intravenous immunoglobulin, and one patient received pulse methylprednisolone. Seven cases had unusual and/or infrequent presentation patterns and/or follow-up. Physicians should be aware of all symptoms and laboratory findings of KD in order to avoid any delays in diagnosis and decrease the risk of life-threatening complications.
    No preview · Article · Jul 2014 · The Turkish journal of pediatrics

  • No preview · Article · Jun 2014 · Cocuk Enfeksiyon Dergisi
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    Preview · Article · Apr 2014
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    ABSTRACT: A 2.5-month-old boy admitted to our hospital with irritability, poor feeding and fever of 12 hours duration. On physical examination, he was febrile and extremely irritable. Initial whole blood count revealed a hemoglobin level of 10.1 g/dl, white blood count of 17,800/mm3 and platelet count of 454,000/mm3. Erythrocyte sedimentation rate was 80 mm/h and C-reactive protein was 3.96 mg/dl. Biochemical examinations of serum, urinalysis, chest X-ray, and analysis of cerebrospinal fluid (CSF) were normal. He was started on intravenous ampicillin and ceftriaxone empirically for provisional occult bacteremia. His blood, urine and CSF cultures were negative. On the 7th day of the treatment, there were no additional symptoms or findings other than fever. Echocardiography revealed aneurysms in both the left and right coronary arteries. Intravenous immunoglobulin (IVIG) and per oral aspirin were administered, and the fever resolved after IVIG infusion. Two years later, the echocardiography showed disappearing of the saccular aneurysm on the right coronary artery, but the dilatation of the left coronary artery was persisting. In conclusion, incomplete Kawasaki disease should always be included in the differential diagnosis of an infant with persistent fever, especially one younger than three months of age, when the conventional work-up fails to reveal the underlying cause.
    No preview · Article · Jan 2014 · The Turkish journal of pediatrics

Publication Stats

655 Citations
188.89 Total Impact Points

Institutions

  • 2015
    • Akdeniz University
      Satalia, Antalya, Turkey
  • 1999-2015
    • Ankara University
      • • Department of Pediatrics
      • • Department of Pediatric Infectious Diseases
      Engüri, Ankara, Turkey
  • 2011
    • Hacettepe University
      Engüri, Ankara, Turkey
  • 2006
    • University of Leipzig
      Leipzig, Saxony, Germany