Background. Brain abscesses (BA) are a medical emergency in all age groups and require early diagnosis and treatment. Childhood BA constitute 25% of all abscesses and may have a different clinical course than adults. This article aims to investigate patients followed up for adult and child BA over a 10-year period. Materials and Methods. A retrospective analysis was performed on adult and pediatric patients diagnosed with BA. Demographic, clinical, predisposing factors, imaging, treatment modalities, and prognosis of the patients, and clinical differences were examined. Results. Of a total of 46 patients; 54.3% of the patients were children and the mean age was 10.9±6.3 years for the pediatric group and 46.2±16.7 years for the adult group. Fever, vomiting, and seizures were significantly higher in children (p<0.05). When the differences between the groups were examined, headache was the most common finding in the adult group, while the most common finding in children was fever and vomiting. The classic triad of fever, headache, and focal neurological deficits was present in 12 (48%) of the children, compared to only 4 (19.1%) of the adults. Trauma history (21.7%), immunosuppression (19.5%), and local spread (mastoiditis, sinusitis, and otitis) (32.6%) were among the most common predisposing factors. Previous otorhinolaryngogenic infections were the most common cause in children (36%), while immunosuppression was the most common cause in adults (28.5%). The frontal lobe was most frequently involved among the patients (47.8%). BA was more commonly localized in the left hemisphere in both groups. Culture growth was detected in 23.9% of all operated patients, with a positivity rate of 20% in children and 28% in adults. The most common microorganism was Staphylococcus aureus (8.6%). The average hospitalization time was significantly longer in children than in adults (46 ± 18 days vs 34 ± 13 days; p=0.024). 26.1% of the patients recovered with sequelae, and the mortality rate was 8.6%. Conclusion. Our findings suggest that a high index of suspicion should be maintained for BA in children, especially in the presence of fever, vomiting, and seizures. This study highlights significant clinical and etiological differences between pediatric and adult BA, underscoring the importance of age-specific diagnostic and management strategies. The differences observed in clinical presentation and underlying causes between the two groups warrant further investigation to improve outcomes.

Brucellosis is a common zoonosis worldwide, yet large-scale pediatric data are scarce. This nationwide multicenter study from Türkiye, a highly endemic country, aimed to characterize pediatric brucellosis and identify independent risk factors for complications, relapse, and hospitalization. A retrospective cohort was conducted across 32 hospitals between January 2019 and June 2024. Children aged 0–18 years with confirmed brucellosis were included. Data were analyzed by multiple backward logistic regressions, with Firth penalization for the complication and relapse models. A total of 1052 children were included (median age 12 years; 69.9

Düşük maliyetli, yüksek hassasiyetli ve kompakt yapıya sahip bir salınım tipi dijital yoğunluk ölçer geliştirilmiştir. Sistem; ‘U’ şeklinde bükülmüş cam tüp, piezoelektrik tahrik mekanizması, tüp sapmasını algılayan optik slot sensör ve rezonans frekansını ölçen Arduino tabanlı elektronik devreden oluşmaktadır. Cihazın çalışma prensibi, sıvının tüp içerisindeki kütlesine bağlı olarak rezonans frekansının değişmesine dayanmaktadır. Bu değişim, yoğunluk ile rezonans frekansı arasında doğrusal bir ilişki oluşturmakta; sistem, yoğunluğu bilinen referans çözeltiler (saf su ve farklı tuz konsantrasyonları) ile kalibre edilmiştir. Ölçümler sonucunda rezonans frekansı ile sıvı yoğunluğu arasındaki ilişkinin yüksek derecede lineer olduğu belirlenmiştir (R² = 0.9996). Yoğunluk değerleri virgülden sonra üç basamak hassasiyetle ve kararlı şekilde ölçülmüştür. Düşük maliyetli bileşenlerle üretilen bu prototip, laboratuvar ve endüstriyel kalite kontrol uygulamaları için ekonomik ve güvenilir bir alternatif sunmaktadır. Ayrıca sistemin taşınabilir yapısı, saha koşullarında hızlı ölçüm yapılmasına imkan tanımakta ve gelecekte sıcaklık kompanzasyonu gibi ek iyileştirmelerle daha geniş bir kullanım alanına uyarlanabileceğini göstermektedir.

Background. Influenza remains a major cause of morbidity and mortality in children worldwide, yet vaccination coverage is still suboptimal in many countries. We aimed to understand parental awareness, attitudes, and determinants of vaccine uptake to guide effective strategies for increasing coverage and protecting vulnerable pediatric populations. Method. A cross-sectional study was conducted between October 2023 and May 2024 in 38 hospitals across 23 provinces in Türkiye. Data were collected from 5002 families through face-to-face interviews, with 4404 valid responses analyzed. Results. The overall influenza vaccination rate among children was 4.4% (n=195/4404). Vaccination coverage was slightly higher in high-risk groups compared to non-high-risk groups (5.2% vs. 3.5%, p=0.003). Factors positively associated with vaccination uptake included the presence of chronic illness in the child (15.1% in vaccinated vs. 4.7% in unvaccinated, p

BACKGROUND:Candidemia is a life-threatening infection, and uncommon Candida species (UCS) are increasingly reported in pediatric patients. We aimed to evaluate the demographic and clinical characteristics of UCS candidemia in children. MATERIALS AND METHODS:This multicenter retrospective study included pediatric patients with UCS candidemia (species other than Candida albicans , Candida parapsilosis , Candida glabrata , Candida tropicalis and Candida krusei ) from 14 tertiary hospitals in Turkey between January 2013 and December 2023. RESULTS:A total of 221 episodes in 204 patients were analyzed. The median age was 29 months (interquartile range [IQR]: 7.8-78.5), and 58.8% were male. The most common UCS were Candida lusitaniae (n = 44, 19.9%), Candida kefyr (n = 40, 18.1%) and Candida guilliermondii (n = 31, 14%). Hematologic malignancy was the most frequent underlying condition (n = 50, 22.6%). Central venous catheters (CVC) were present in 76% (n = 168) of patients and were removed in 67.9% (n = 114) of episodes. Immunosuppressive therapy and recent surgery were documented in 53.8% (n = 119) and 53.4% (n = 118) of episodes, respectively, while total parenteral nutrition was used in 44.3% (n = 98). Recent antibiotic exposure was observed in 95.5% (n = 211) of episodes, and concomitant bacteremia occurred in 27.1% (n = 60). Neutropenia and thrombocytopenia were present in 59.7% (n = 132) and 48% (n = 106) of episodes, respectively. Antifungal prophylaxis was recorded in 23.5% (n = 52) of episodes, predominantly with fluconazole (76.9%). Susceptibility rates were 89.2% (116/130) for fluconazole, 90.4% (113/125) for caspofungin and 85.7% (102/119) for amphotericin B. Pediatric intensive care unit admission was required in 25.8% (n = 57) of episodes. The 7-day and 30-day mortality rates were 7.2% (n = 16) and 14.5% (n = 32), respectively. Female sex and longer hospital stay before infection were associated with increased mortality (7-day: P = 0.04 and P = 0.047; 30-day: P = 0.02 and P = 0.023). Mechanical ventilation, urinary catheterization and total parenteral nutrition were more frequent among nonsurvivors in both mortality periods (7-day: P < 0.001, P = 0.03, P < 0.001; 30-day: P < 0.001, P < 0.001, P = 0.03). The CVC removal rate was lower in mortality groups than in survivors (7-day: P = 0.005 and 30-day: P = 0.006).Thrombocytopenia was associated with both 7-day and 30-day mortality ( P < 0.001 and P = 0.001), while elevated C-reactive protein levels were associated with 7-day mortality ( P = 0.046). CONCLUSIONS:UCS candidemia in children most commonly occurred in patients with solid-hematologic malignancy, central venous catheters and recent antibiotic exposure within 1 week. Female sex, prolonged pre-infection hospitalization, intensive care-related interventions, thrombocytopenia, lower CVC removal rate and elevated C-reactive protein were associated with increased short-term mortality.

Background: Although tetanus is a vaccine-preventable disease, it remains a clinical concern among unvaccinated and under-immunized children, particularly in vulnerable populations. Methods: We conducted a retrospective multicenter case series of 5 pediatric patients diagnosed with tetanus between 2018 and 2024 at 4 tertiary care centers in Turkey. Demographic characteristics, clinical presentation, management strategies and outcomes were analyzed. Results: All patients were unvaccinated migrant boys with generalized tetanus. The most common risk factor was penetrating foot injury. Prominent clinical features included muscle rigidity, spasms, airway compromise and autonomic instability. All patients required pediatric intensive care, and 3 required mechanical ventilation. Tetanus immune globulin, antibiotics and multimodal sedation were administered to all cases. No mortality was observed, and all patients recovered with supportive care and subsequent immunization. Conclusions: This case series highlights that tetanus remains a preventable, yet persistent threat among unvaccinated migrant children. Strengthening targeted vaccination strategies and maintaining a high index of clinical suspicion are essential to prevent morbidity in at-risk pediatric populations.

Central nervous system (CNS) infections caused by Candida species are serious clinical conditions associated with high morbidity and mortality, especially in children with neurosurgical devices. The aim of this study is to evaluate the clinical characteristics, changing microbiological profile, and treatment outcomes of pediatric Candida meningitis/ventriculitis cases followed in our center. Twenty-five pediatric patients followed at a tertiary referral center, with Candida growth in CSF or shunt culture between August 2018 and September 2025 were analyzed retrospectively. Demographic data, associated clinical characteristics, CSF findings, isolated species, and treatment approaches were analyzed. The median age of the patients was 16.7 months (range 3.7–144), and 84

This study aims to evaluate the diagnostic and follow-up utility of complete blood count-derived biomarkers -neutrophil-to-lymphocyte ratio, mean platelet volume, and red cell distribution width - in pediatric tuberculosis. A total of 52 children diagnosed with tuberculosis and 55 healthy controls, followed between 2020 and 2023 at a tertiary pediatric infectious disease clinic, were retrospectively analyzed.Laboratory values were recorded at diagnosis, the second month of treatment, and at least 6 months post-treatment. Receiver operating characteristic analysis was performed to assess diagnostic performance. At diagnosis, the neutrophil-to-lymphocyte ratio and red cell distribution width levels were significantly higher in the tuberculosis group than in control group (p<0.001), while mean platelet volume showed no significant difference (p=0.096). During treatment, the neutrophil-to-lymphocyte ratio and red cell distribution width values progressively decreased. Receiver operating characteristic analysis demonstrated good diagnostic performance with optimal cut-off values of 1.7 for the neutrophil-to-lymphocyte ratio and 15.4 for the red cell distribution width. The neutrophil-to-lymphocyte ratio and red cell distribution width are accessible, cost-effective biomarkers that may support the diagnosis of tuberculosis and monitor treatment responses in children.While promising as supportive tools, the diagnostic specificity of these markers is subject to study limitations, including an age-unmatched control group. Therefore, they should be considered complementary to existing diagnostic methods, especially when microbiological confirmation is challenging in pediatric cases.

Objective: Coronavirus disease-2019-related multisystem inflammatory syndrome in children (MIS-C) is a rare inflammatory disease that can be serious in children. In this study, we aimed to show the differences in MIS-C cases, depending on the years that emerged during the course of the pandemic. Material and Methods: Demographic characteristics and clinical data of the patients between September 2020 and April 2022 were collected retrospectively. MIS-C cases, between late 2020 and the end of 2021, were classified as Group 1, cases admitted after the end of 2021 were classified as Group 2. Results: In this study, 124 patients from a single center were evaluated. Of these patients, 61.3% were males, 38.7% were females, with a median age of 9 years. Of the patients, 66.9% were assigned to Group 1 and 33.1% were Group 2. Compared to Group 1, the prevalence of vomiting, conjunctivitis and hypotension was significantly higher in Group 2 (p= 0.034, 0.003 and 0.01, respectively). Pulse steroid use was higher in Group 2 (p= 0.003). Intensive care unit (ICU) need and mean ICU stay were higher in Group 2 (p= 0.049 and 0.044, respectively). Conclusion: While the rate of spread of the disease increased with new variants formed during the course of pandemic, severity of the disease decreased. It was discovered that the need and duration of stay in ICU, pulse steroid use of MIS-C patients increased in course of the pandemic, compared to the initial stages of the pandemic.

Background: Influenza is a viral infection affecting all age groups, with high transmissibility and the potential to cause epidemics and pandemics. Accurate and early prognosis prediction is essential for effective disease management and outbreak control. The objective of the present research was to assess the significance of mean platelet volume (MPV) and its relationship with inflammatory markers, particularly C-reactive protein (CRP), in predicting the prognosis of Influenza A (H1N1) infection. Methods: A retrospective analysis was conducted on 133 hospitalized patients who presented with respira tory symptoms and tested positive for H1N1 via nasopharyngeal swab. Data on MPV and CRP levels were collected at admission. The presence of comorbidities and clinical outcomes, including mortality, were also recorded. The relationship between MPV, CRP, and patient outcomes was statistically evaluated. Results: Comorbid conditions were found in 66.2% of the patients. Among the 31 patients who died (23.3%), 77.4% had comorbidities. Mortality was significantly higher in those with comorbidities (27.3%) than those without (15.5%). Compared with the healthy control group, patients exhibited a markedly lower MPV and higher CRP levels (both P < .005). Intensive care unit (ICU) patients had higher CRP levels than non-ICU patients (P < .005), but MPV did not differ significantly (P = .638). Higher CRP was associated with mortality (P < .005), whereas MPV showed no significant association (P = .086). Conclusion: H1N1 infection has the potential to cause severe and fatal outcomes, particularly in elderly patients with comorbidities. Elevated CRP at admission may serve as a valuable prognostic marker. Although MPV may contribute diagnostically, its prognostic utility appears limited compared to CRP. Cite this article as: Tüzün Z, Saler T, Tüzün K, Çelik U, Avci BŞ. Association between mean platelet volume and other inflammatory markers in patients with influenza A (H1N1). Eurasian J Med. 2025, 57(4), 0972, doi:10.5152/eurasianjmed.2025.25972.

AIM:We aimed to investigate the frequency and clinical characteristics of tuberculosis in pediatric patients receiving both anti-TNF-alpha and other biological agents. MATERIALS AND METHODS:The data of 270 patients who used biological agents due to rheumatologic diseases and inflammatory bowel disease (IBD) and were followed between January 2021 and October 2023 were retrospectively collected from their files. RESULTS:Of the patients, 138(51.1%) were female, 132(48.9%) were male. The mean age at diagnosis was 107 months (min 8-max 215 months). Patients were most commonly followed for juvenile idiopathic arthritis (JIA) (191 patients, 70.7%), followed by other autoinflammatory diseases (49 patients) and IBD (26 patients, 9.6%). Treatments included adalimumab (97 patients, 35.9%), etanercept (85 patients, 31.5%), canakinumab (33 patients, 12.2%), tocilizumab (31 patients, 11.5%), infliximab (16 patients, 5.9%), anakinra (5 patients, 1.9%), tofacitinib (2 patients, 0.7%), and rituximab (1 patient, 0.4%). During follow-up, latent tuberculosis infection (LTBI) developed in 5 (1.9%) patients. Three of these patients had JIA (using adalimumab, etanercept and tocilizumab), one had Familial Mediterranean Fever (using canakinumab), and one had IBD (using adalimumab). The mean duration of biological agent treatment until LTBI development was 14.6 months (min 6-max 29 months). Tuberculosis disease was diagnosed in two patients. Both were patients followed up due to IBD. One of the patients was diagnosed with miliary tuberculosis after infliximab treatment, while the other was followed for tuberculosis lymphadenitis after adalimumab treatment. Quadruple anti-tuberculosis therapy was initiated for the patients. CONCLUSION:The use of biological agents has revolutionized the course of chronic inflammatory diseases in childhood. However, in these patients, monitoring for tuberculosis risk is crucial.

OBJECTIVE:Influenza is a contagious viral respiratory tract infection that causes severe illness, particularly in high-risk populations such as young children and individuals with pre-existing health conditions. The study aims to identify clinical characteristics and key risk factors associated with respiratory support and mortality in children with influenza infection. MATERIALS AND METHODS:This retrospective, multicenter study was conducted across 33 hospitals from 19 cities in Türkiye. Data from pediatric inpatients aged <18 years diagnosed with influenza between October 2023 and May 2024 were analyzed. RESULTS:Among 1032 hospitalized children infected with influenza, 394 (38.2%) required respiratory support. The respiratory support group was significantly younger, with a mean age of 3.40 ± 4.37 years, compared to 4.96 ± 4.36 years in the non-respiratory support group (P < .001). The frequency of any underlying disease was significantly higher in the respiratory support group (P < .001). Notably, conditions such as neurometabolic disorders (20.3% vs. 9.6%) and pulmonary diseases (7.1% vs. 2.8%) were more common in this group. Influenza A infection and viral coinfections, particularly with respiratory syncytial virus, increased the likelihood of mechanical ventilation and mortality. The mortality proportion of all patients with influenza infection was 1.3% and the influenza vaccine coverage was only 1.1%. CONCLUSION:These findings highlight the urgent need to incorporate influenza vaccination into the national immunization program, especially for high-risk pediatric populations.

This study aims to evaluate the diagnostic and follow-up utility of complete blood count-derived biomarkers –neutrophil-to-lymphocyte ratio, mean platelet volume, and red cell distribution width – in pediatric tuberculosis. A total of 52 children diagnosed with tuberculosis and 55 healthy controls, followed between 2020 and 2023 at a tertiary pediatric infectious disease clinic, were retrospectively analyzed. Laboratory values were recorded at diagnosis, the second month of treatment, and at least 6 months post-treatment. Receiver operating characteristic analysis was performed to assess diagnostic performance. At diagnosis, the neutrophil-to-lymphocyte ratio and red cell distribution width levels were significantly higher in the tuberculosis group than in control group (p<0.001), while mean platelet volume showed no significant difference (p=0.096). During treatment, the neutrophil-to-lymphocyte ratio and red cell distribution width values progressively decreased. Receiver operating characteristic analysis demonstrated good diagnostic performance with optimal cut-off values of 1.7 for the neutrophil-to-lymphocyte ratio and 15.4 for the red cell distribution width. The neutrophil-to-lymphocyte ratio and red cell distribution width are accessible, cost-effective biomarkers that may support the diagnosis of tuberculosis and monitor treatment responses in children. While promising as supportive tools, the diagnostic specificity of these markers is subject to study limitations, including an age-unmatched control group. Therefore, they should be considered complementary to existing diagnostic methods, especially when microbiological confirmation is challenging in pediatric cases.

Dysnatremia is a common electrolyte abnormality in children, but its prevalence and impact in pediatric earthquake victims are not well established. This study aimed to define the frequency of dysnatremia in pediatric earthquake victims and evaluate its relationship with complications, mortality, and morbidity. We retrospectively analyzed data from 312 pediatric patients admitted to our hospital after the 2023 Türkiye–Syria earthquakes. Patients were categorized based on admission sodium levels: hyponatremic (< 135 mmol/L), hypernatremic (> 145 mmol/L), and normal (135–145 mmol/L). Demographic, clinical, and laboratory data were analyzed. Of the 312 patients, 36.2

Crimean Congo haemorrhagic fever (CCHF) is an emerging, life-threatening tick-borne infection that can be fatal. As yet, there is no definitive treatment. In this case report we present a severe paediatric CCHF case that was successfully treated with anakinra. A previously healthy 13-year-old female presented with high fever, fatigue, rash and loss of appetite. Bone marrow aspiration showed rare haemophagocytocis and the patient's clinical condition continued to deteriorate. Anakinra was given on the day 5 of admission, as she was in the midst of cytokine storm syndrome. By the third day of anakinra, the patient's symptoms and laboratory tests improved. After 14 d of anakinra, she was discharged in full recovery. Anakinra may be a new therapeutic agent in CCHF, in which inflammation plays important role.

Septic pulmonary embolism (SPE) is a rare, life-threatening disease in children. We assessed the clinical, microbiological, radiological, and treatment results of patients who developed SPE due to Staphylococcus aureus (S. aureus). We retrospectively reviewed the medical records of patients with SPE associated with S. aureus between 2012 and 2023. Six patients were included in the study; the median age was 13 years (range: 9-16 years), and four (66.7%) of them were boys. At admission, the most common complaints were chest pain (83.3%), respiratory distress (83.3%), limb swelling (83.3%), limitation of movement in the extremities (83.3%), fever (50%), fatigue (50%), and cough (16.7%). Extrapulmonary septic foci were identified as follows: septic arthritis in four patients (66.7%), soft tissue infection in one patient (16.7%), and deep vein thrombosis in one patient (16.7%). Methicillin-resistant S. aureus was the most common causative pathogen (66.7%) and methicillin-susceptible S. aureus was found in 33% of patients. The median length of hospital stay was 43.5 days (range: 25-45 days). Three (50%) patients required intensive care, and one required mechanical ventilation support. No mortality was observed. In our study, the clinical and radiological features of staphylococcal SPE in children were nonspecific, similar to the literature. Although no mortality was observed in our study, previous studies have reported mortality rates of up to 11.8% in children with SPE. Early diagnosis, appropriate antibiotic treatment, and respiratory support are important in patients with SPE, especially in low-income settings where timely access to healthcare and diagnostic resources may be limited.