Introduction: The genito-urinary system is one of the most common areas of involvement in brucellosis. To present the epidemiological, clinical, and laboratory characteristics of patients with testicular involvement associated with brucellosis, together with the diagnostic and therapeutic approaches. Methodology: Patients followed up for brucellosis-related testicular involvement between January 2012 and November 2022 were included in the study. Brucellosis is defined as the production of Brucella spp. in cultures, or clinical symptoms together with the serum standard tube agglutination test titer of ≥ 1/160. Inflammation in scrotal Doppler ultrasonography was based on testicular involvement. Results: A retrospective evaluation was made of the data of 194 patients with brucellosis-related testicular involvement. The rate of determination of testicular involvement in brucellosis was 2.57%. The most affected patients were determined in the 16-30 years age range. On presentation, brucellosis was in the acute stage in 83.7% of patients. The most common symptoms on presentation were swelling and/or pain in the testes (86.6%). In the patients where a spermiogram could be performed, oligospermia was determined in 41.7%, and aspermia in 8.3%. When the testicular involvement of brucellosis was evaluated, epididymo-orchitis was present at the rate of 55.7%, epididymitis at 27.3%, and testis abscess at 5.1%. Conclusions: Although epididymo-orchitis was the most frequently determined form of involvement in this study, there was also seen to be a significant number of patients presenting with epididymitis. Male patients presented with the clinical status of brucellosis should be questioned about swelling and pain in the testes to avoid overlooking testicular involvement.

Background/Objectives: Studies attempting to predict the development of severe respiratory failure in patients with a COVID-19 infection using machine learning algorithms have yielded different results due to differences in variable selection. We aimed to predict the development of severe respiratory failure, defined as the need for high-flow oxygen support, continuous positive airway pressure, or mechanical ventilation, in patients with COVID-19, using machine learning algorithms to identify the most important variables in achieving this prediction. Methods: This retrospective, cross-sectional study included COVID-19 patients with mild respiratory failure (mostly receiving oxygen through a mask or nasal cannula). We used XGBoost, support vector machines, multi-layer perceptron, k-nearest neighbor, random forests, decision trees, logistic regression, and naïve Bayes methods to accurately predict severe respiratory failure in these patients. Results: A total of 320 patients (62.1% male; average age, 54.67 ± 15.82 years) were included in this study. During the follow-ups of these cases, 114 patients (35.6%) required high-level oxygen support, 67 (20.9%) required intensive care unit admission, and 43 (13.4%) died. The machine learning algorithms with the highest accuracy values were XGBoost, support vector machines, k-nearest neighbor, logistic regression, and multi-layer perceptron (0.7395, 0.7395, 0.7291, 0.7187, and 0.75, respectively). The method that obtained the highest ROC-AUC value was logistic regression (ROC-AUC = 0.7274). The best predictors of severe respiratory failure were a low lymphocyte count, a high computed tomography score in the right and left upper lung zones, an elevated neutrophil count, a small decrease in CRP levels on the third day of admission, a high Charlson comorbidity index score, and a high serum procalcitonin level. Conclusions: The development of severe respiratory failure in patients with COVID-19 could be successfully predicted using machine learning methods, especially logistic regression, and the best predictors of severe respiratory failure were the lymphocyte count and the degree of upper lung zone involvement.

Purpose: Mucormycosis is a rapidly progressive angioinvasive fungal infection with limited large-scale outcome data. We aimed to describe the epidemiology, clinical spectrum, treatment strategies, and predictors of outcomes in adult patients with proven mucormycosis in Türkiye. Methods: We conducted a nationwide, retrospective study of 280 adults diagnosed with proven mucormycosis between 2004 and 2024 across 27 tertiary centers. Case definitions were applied according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clinical characteristics, antifungal management, surgical interventions, and outcomes were systematically analyzed. Results: The median age of the cohort was 60 years, and diabetes mellitus, frequently complicated by ketoacidosis, was the most common underlying condition. Rhino-orbital-cerebral disease represented the predominant clinical form, whereas pulmonary, gastrointestinal, and disseminated presentations were less frequent but carried less favorable prognoses. Liposomal amphotericin B was the main first-line therapy, often combined with surgery, although antifungal treatment was initiated at a median of five days after symptom onset. Ninety-day mortality was 42.1% by Kaplan–Meier estimation (crude 49.3%) and reached 49.3% (crude 55.0%) at 365 days. Crude mortality was lowest in patients who did not undergo surgery; however, this association was not significant in the time-dependent Cox regression analysis, suggesting confounding by baseline severity. Poor outcomes were associated with corticosteroid exposure, prolonged neutropenia, and neurological manifestations, while a history of sinusitis appeared to be associated with improved survival. Conclusion: In this multicenter study, survival was mainly determined by host-related factors rather than the choice of antifungal agent. Corticosteroid exposure, prolonged neutropenia, and neurological involvement independently predicted poor outcomes, whereas a prior history of sinusitis was linked to improved survival, likely reflecting earlier diagnosis and intervention. These findings reinforce the need for heightened clinical awareness, rapid recognition, and prompt multidisciplinary management to improve outcomes in patients with mucormycosis.

Introduction: Coinfection of COVID-19 with influenza pathogens, may complicate the diagnosis, treatment, and prognosis, which is a new concern. This study aims to evaluate COVID-19 and influenza coinfected cases during the flu season, while the SARS-CoV-2 pandemic continues. Methodology: The study was conducted between November 2021 and January 2022. A total of 1987 (1752 outpatients, 235 inpatients) patients were included, and 44 simultaneous COVID-19 and influenza laboratory-confirmed diagnoses. Results: During the study period, 1553 patients were diagnosed with COVID-19, 390 influenza, and 44 were diagnosed with coinfection. The incidence of coinfected cases was 2.2% (n = 44) in all patients, When coinfected cases were examined, there was a statistically significant difference between the disease duration in the inpatients (19.86 ± 10.78 days) and the disease duration in the outpatients (7.63 ± 2.25 days) (p < 0.05). 31.8% (n = 14) of coinfected cases were hospitalized, and the mortality rate was 50.0% (n = 7) in hospitalized patients. Conclusions: Coinfection with SARS-CoV-2 and İnfluenza was not uncommon. Data on coinfected cases are limited in the literature. The coinfection with SARS-CoV-2 and influenza A should be considered in patients with complaints such as fever, myalgia, weakness, shortness of breath, and cough during the flu season. Using the diagnostic test showing two diseases in a single sample may contribute to protecting patient and community health in follow-up and treatment.

Introduction: This study aims to evaluate the demographic characteristics, clinical manifestations, laboratory findings, radiological features, and the relationship between brucella capture titers and blood culture positivity in patients followed up due to brucellosis. Methods: The medical records of 214 patients diagnosed with brucellosis, who were followed up at the infectious diseases clinic and/or outpatient clinic between January 2017 and December 2018, were retrospectively reviewed. Demographic and clinical characteristics of 118 included patients were recorded. Brucella capture tests and blood cultures were processed at bacteriology department of Dicle University Hospital Laboratory. Results: The mean age of the patients was 39.54±17.123 years. Fifty percent of the patients were male and 58.5% of the patients resided in rural areas. The most common complaints at presentation were fever (89%) and bone-joint pain (73.7%). The most frequent physical examination findings were fever (89%) and tenderness in bones and joints (73.7%). Elevated erythrocyte sedimentation rate was observed in 29.6% of patients, while elevated c-reactive protein levels were seen in 55.9% of the patients. The two most common hematological findings at the time of diagnosis were anemia with 45.8% and lymphomonocytosis with 26.3%. A statistically significant disparity was observed in the incidence of complications among patients displaying hematological manifestations, including anemia, leukopenia, and thrombocytopenia, associated with brucellosis (p<0.05). The most commonly encountered organ involvements were sacroiliitis, with a prevalence of 31.4%, and splenomegaly, noted in 25.4% of cases. Among the patient cohort, disease reporting was documented in 59.3% of instances. The reporting rate was notably higher at the infectious diseases clinic, accounting for 64.7% of cases, whereas non-infectious clinics exhibited a lower reporting rate of 25%. Blood cultures were taken from 56 of 118 patients followed up due to brucellosis and growth was detected in 30 of them. All of the microorganisms grown were determined to be B. Melitensis. Notably, 62.5% of patients with a brucella capture titer ≥1/ 1280 and 31.25% of those with titers <1/ 1280 exhibited growth in blood cultures. There was a statistically significant correlation between the elevation of brucella capture titers among patients, ranging from 1/320 to 1/5120, and an increased likelihood of detecting brucella bacteria through blood culture (p<0.05). Conclusion: This study revealed a correlation between higher brucella capture titers and blood culture positivity. In addition, markers such as anemia, leukopenia, and thrombocytopenia were associated with an increased risk of complications, emphasizing their importance as prognostic indicators.

Background and Objectives: Long-acting cabotegravir and rilpivirine (LA-CAB/RPV) offers an alternative to daily oral antiretroviral therapy (ART) for people living with HIV (PLWH). Although LA-CAB/RPV has been approved in Turkey, the country remains in the pre-rollout period, and national data on patient perspectives are lacking. This is the first nationwide study from Turkey, a setting of increasing HIV incidence, assessing PLWH perspectives on switching to LA-CAB/RPV and the influence of motivational factors on treatment preferences. Materials and Methods: A prospective, multicenter, cross-sectional study was conducted across 11 HIV treatment centers representing all regions of Turkey. Virologically suppressed PLWH meeting current eligibility criteria for LA-CAB/RPV were included. Treatment preferences (switch to LA-CAB/RPV or remain on oral ART) and five anticipated motivational domains, namely perceived efficacy, safety, convenience, privacy, and cost, were systematically assessed through structured, face-to-face interviews. Results: Among 200 eligible participants, 86% (n = 172) preferred switching to LA-CAB/RPV. In all subgroups, LA-CAB/RPV was preferred over oral ART, except for those with no formal literacy. Prior awareness of LA-CAB/RPV was significantly associated with the switching preference (p < 0.001), with healthcare providers being the most common source of information, at 45.5% (n = 172) (p < 0.001). Residential proximity to the healthcare center (p = 0.018) and all motivational factors significantly influenced the preference (p < 0.05). Notably, when participants who initially chose to remain on oral ART were asked whether they would reconsider switching if injections were administered every six months, overall preference for long-acting therapy increased from 86% to 98%. Conclusions: High clinical eligibility and strong acceptability for LA-CAB/RPV were observed among Turkish PLWH. Our findings demonstrate that structured motivational factors significantly influence the treatment preference. Addressing these patient-centered factors and logistical barriers may support the successful integration of long-acting therapies into routine HIV care. Future longer-interval agents may improve patient-centered acceptability.