M.D. Dilara Akman

A 28-year-old professional freediver from Antalya presented with recurrent episodes of severe vertigo and hearing loss after deep dives in the Mediterranean. Dr. Akman identified a rare case of otogenic barotrauma-induced labyrinthitis with a secondary, atypical Pseudomonas aeruginosa infection in the inner ear, likely introduced through microscopic sinus tears. Treatment involved a novel combination of intratympanic gentamicin injections and hyperbaric oxygen therapy, coordinated with ENT specialists. The patient's recovery was slow but complete over six months, requiring him to abandon extreme-depth diving.

A 72-year-old retired beekeeper from rural Thrace was admitted with progressive neurological decline, muscle weakness, and unexplained fevers. His family noted he'd been increasingly forgetful. Dr. Akman, suspecting a zoonotic link, ordered specialized serology and CSF analysis, revealing neurobrucellosis from chronic, untreated Brucella melitensis infection. The treatment involved an extended, multi-drug regimen of doxycycline, rifampin, and ceftriaxone. His neurological recovery was partial, with residual cognitive deficits, but the infection was cleared after a nine-month outpatient follow-up.

A 19-year-old international university student from Nigeria presented with a persistent, ulcerating skin lesion on her ankle that failed to respond to standard antibiotics. Dr. Akman diagnosed cutaneous leishmaniasis, likely acquired during a visit home, but with an unusual co-infection of Mycobacterium marinum, traced to a separate incident involving a minor aquarium gravel cut. Treatment required a carefully sequenced approach: topical paromomycin for the leishmaniasis first, followed by a course of clarithromycin and ethambutol for the mycobacterium. The lesion healed with significant scarring over four months.

A 45-year-old Syrian refugee and seamstress, living in a crowded Istanbul shelter, was found to have disseminated tuberculosis with rare bone marrow involvement, presenting with pancytopenia and profound fatigue. Dr. Akman managed a complex treatment protocol for multidrug-resistant TB, while also navigating significant social barriers, including unstable housing and food insecurity. She coordinated with social workers to ensure treatment adherence. After a rocky 18-month course with multiple drug adjustments, the patient achieved cure but with lasting mild renal impairment.