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    Adult Tetanus With Fatal Course: A Case Report
    (Aves, 2019) Arslan-Gulen, Tugba; Destegul, Dilek; Ortakoylu-Kilickaya, Refika; Imre, Ayfer; Atan-Ucar, Zuhal; Kayabas, Uner
    Despite improvements in medicine, tetanus is still a fatal infectious disease which can be prevented by immunoprophylaxis and it should always be kept in mind after injuries. In this case report, we present a patient who had no previous immunization history and did not have tetanus prophylaxis completed at the first visit of the emergency department after injury. The patient was followed with a clinical picture of generalized tetanus in intensive care unit, but autonomic dysfunction could not be taken under control despite treatment and resulted in mortality. Tetanus prophylaxis should be questioned in patients applying with injury or trauma. Strategies should be developed in order to achieve regular vaccination, with respect to adult immunization in particular.
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    Examination of Tuberculin Skin Test Results of Health Care Workers in a Hospital and Healthy Individuals Who Are Not in Risk of Tuberculosis
    (Aves, 2020) Imre, Ayfer; Arslan-Gulen, Tugba; Kocak, Muradiye; Bas-Sarahman, Emine; Kayabas, Uner
    Objective: This study was carried out to determine the Bacillus Calmette-Guerin (BCG) vaccination status and tuberculin skin test (TST) responses in health care workers and to compare the results with the results of healthy individuals who had TST screening in Tuberculosis Dispensary. Methods: Demographic characteristics of the two groups were analysed by survey form. The TST results and BCG scar counts on the left shoulder of the participants were obtained from Infection Control Committee and Tuberculosis Dispensary records and evaluated retrospectively. After data were recorded in IBM SPSS Statistics for Windows. Version 22.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA) statistical program, descriptive statistics were used for demographic variables, Shapiro -Wilk test was used for normality test, Mann -Whitney U test was used for continuous variables and Pearson chi(2) test were used for the other categorical variables. Results: A total of 294 cases were included in the study. Number of scars ranged from one to four in each group, and the BCG vaccination rate was 98.6% in health care workers and 87.1% in control group (p<0.05). The TST induration diameters of the healthcare workers ranged from 0 to 22 mm, and the results of 32 (21.8%) employees were found to be positive. In the control group, the induration diameters were between 0-18 mm, and 12 (8.2%) were found to be positive. Differences between groups in terms of both mean diameters of induration and the TST positivity were statistically significant (p<0.05). The TSTpositive health care workers were evaluated for tuberculosis (TB) and TB was not detected in any of them. Conclusions: Health care workers are in the risk group for TB. For this reason, employee health units of each hospital should implement TST and tuberculosis screening programs in a planned way. We determined that health care workers had high TST induration diameters, but none of them had active TB. This may be explained by repeated BCG vaccinations and exposure to mycobacteria other than Mycobacterium tuberculosis.