Ivana Raković, Biljana Popovska Jovicic, Andriana Bukonjic, Sara Petrovic, Petar Canovic and Nedim Hamzagic
Pseudomembranous colitis is a frequent nosocomial infection associated with significant morbidity and mortality. Clostridium difficile infection incidence most frequently increases due to unreasonable antibiotic use and the appearance of new hypervirulent bacterial strains, which leads to prolonged hospitalization and an increase in the total cost of hospital treatment.
This is a retrospective design study conducted at Clinical Centre Kragujevac from January to December 2014. The patient data were obtained from the protocol of the Virological Laboratory and from medical documentation. All statistical analyses were performed using the computer program SPSS. The descriptive statistical data are expressed as percentage values. Continuous variables are expressed as the arithmetic mean with the standard deviation.
Clostridium difficile infection occurred more frequently with elderly patients (123 patients were over 65 years old). Out of 154 patients on antibiotic treatment, 110 patients were treated with a combination of two or more antibiotics from different pharmacological groups. The most represented antibiotics were from the cephalosporin (71.4%) and quinolone (46.3%) groups. A total of 85.8% of the patients used proton pump inhibitors and H2 blockers.
Our results describe the clinical and demographic characteristics of patients with diagnosed Clostridium difficile infection. The most prevalent characteristics (age, antibiotic therapy, PPI and H2 blocker use), which other researchers have also mentioned as risk factors, were present in our study as well.
Ljiljana Nesic, Biljana Popovska-Jovicic, Ivana Rakovic, Sara Petrovic, Dusan Todorovic and Zeljko Mijailovic
Influenza virus type A is known for its capacity to transform its antigenic structure and create new viral subtypes. The clinical picture varies from non-febrile, mild upper respiratory tract infection to severe or fatal pneumonia. Neurological complications include encephalitis, encephalopathy, Reye’s syndrome and other neurological diseases. Patients with encephalopathy exhibit a disturbed state of consciousness lasting more than 24 hours, and patients with encephalitis exhibit high temperature, focal neurological signs and pathological CSF results in addition to disturbed state of consciousness.
A 54-year old, previously healthy male farmer was hospitalized at the Clinic for Infectious Diseases of the Clinical Centre Kragujevac on the fifth day of disease. In addition to general symptoms of the disease, the clinical picture was dominated by a disturbed state of consciousness (Glasgow Coma Scale score <8). The aetiological agent was an H1N1 influenza A virus, which was isolated from nasopharyngeal secretions. No other causes of infection were demonstrated from both serum and cerebrospinal fluid specimens. Interstitial pneumonia was detected by radiographic examination of the chest. There were also some changes present in the EEG. The patient was cured without consequences.
Because our country is in a whirlwind of pandemic H1N1 virus activity, we should think of all the possible complications that this virus can produce regardless of the epidemiological data and the clinical picture.
Biljana Popovska-Jovicic, Ivana Rakovic, Sara Petrovic, Petar Canovic, Dejan Petrovic, Sofija Sekulic, Ivan Jovanovic and Nemanja Jovicic
Febrile conditions of unidentified origin are still unknown in modern medicine despite the development of diagnostic procedures. There are various agents of long-term temperature encompassing numerous infectious or non-infectious diseases.
The aim of this study was to determine if there was a statistically significant difference in the values of proinflammatory cytokines (IL-1, TNFα, IL-6) in patients who meet the criteria for febrile conditions of unidentified origin, between the group of infectious, malignant, rheumatic, “other” diseases and undiagnosed patients.
The study was conducted in the Immunology laboratory of the Center for Molecular Medicine and Stem Cells Research of the Faculty of Medical Sciences in Kragujevac. Blood samples were taken from patients tested at the Clinic for Infectious Diseases, of the Clinical Center of Kragujevac, in the period from 2014 to 2016. The study included 70 patients.
The measured values of the level of TNFα showed significantly higher values in a group of malignant diseases than in the group of infectious diseases, while the values of IL-1 and IL-6 did not show statistical significance.
TNFα can improve diagnosing in case of patients with an unknown febrile condition, which can shorten the length of the hospital stay and reduce the volume of performance of diagnostic procedures.
Petar Canović, Aleksandra Vranic, Sara Petrovic, Ivana Rakovic, Biljana Popovska Jovicic and Nedim Hamzagic
Primary infection with Epstein-Barr virus (EBV) usually occurs in early childhood and often does not present clinical symptoms. More than 90% of adults are infected with this virus. A primary infection that occurs in adolescence or adulthood is usually clinically presented as infectious mononucleosis with a triad of symptoms: fever, lymphadenopathy and pharyngitis. Our retrospective study included 51 patients with a median age of 17 (9-23) years and serologically confirmed infectious mononucleosis. All patients with infectious mononucleosis were treated at the Clinic for Infectious Diseases at the Clinical Center in Kragujevac during 2013. We analysed the clinical, haematological and laboratory parameters of patients. The aspartate-aminotransferase levels were increased in 40 patients, with a mean value of 116.24 (±93.22); the alanine-aminotransferase levels were increased in 44 patients, with a mean value of 189.24 (±196.69). Lymphadenopathy was the most common clinical feature upon admission in 49 patients (96%); 38 patients (74.5%) had splenomegaly, and 20 (39%) had hepatomegaly. Twenty-six patients (51%) had leukocytosis with lymphocytosis, while 15 (75%) of the 20 who had a normal leukocyte count also had lymphocytosis. In the present study, we updated the clinical, haematological and laboratory parameters, which may lead to the establishment of an accurate diagnosis and promote further treatment of the patients.