Acute hepatitis caused by methyldopa

Prikazan je slučaj 35-godišnje bolesnice sa slikom akutnog hepatisa, koja je zbog hipertenzije za vrijeme trudnoće i u puerperiju, liječena metildopom. Nakon prekida terapije došlo je do potpunog oporavka. Hepatotoksičnost lijekova je unatoč brojnim kliničkim i toksikološkim istraživanjima često prisutna i predstavlja diferencijalno dijagnostički problem u infektološkoj praksi.The case of a 35-year-old patient has been shown as a manifestation of acute hepatitis, which is due to hypertension during pregnancy and puerperium treated with methyldopa. After therapy interruption, there was a full recovery. Drug hepatotoxicity is still present and represents a differential diagnostic problem in infectology practice, despite of numerous clinical and toxical researches

ACCIDENTAL POISONING WITH A PLANT COLCHICUM AUTUMNALE: REPORT OF TWO CASES

Otrovanja kolhicinom teška su i veoma opasna stanja koja nastaju kao posljedica otrovanja hranom s biljkama koje sadržavaju ovaj alkaloid ili predoziranja lijekom koji sadržava kolhicin. Lišće jestivoga medvjeđeg luka (srijemuša) zbog svoje se sličnosti često zamijeni s vrlo otrovnim listovima mrazovca (lat. Colchicum autumnale) koji uzrokuju otrovanja. Opisana su dva slučaja otrovanja hranom s mrazovcem, koji su imali slične simptome u početnoj fazi, ali različit klinički tijek i ishod. Znakovi otrovanja zahtijevaju rano prepoznavanje i intenzivnu potpornu terapiju, što povećava izglede za preživljavanje.Colchicine poisonings are serious and highly fatal conditions that occur as a result of food poisoning from plants that contain this alkaloid or overdose with drug containing colchicine. The leaves of edible wild garlic because of their similarity are often replaced with highly poisonous leaves of autumn crocus, causing poisoning. Described are two cases of food poisoning with Colchicum autumnale, who had similar symptoms in the initial stage, but different clinical course and outcome. Signs of poisoning require early identification and intensive supportive therapy, which increases the chances of survival

Rare routes of transmission of hepatitis C

Prospektivno su u oboljelih od hepatitisa C (HC) s nepoznatim putevima prijenosa (n = 119) i njihovih obiteljskih kontakata (n = 297) istražene mogućnosti i načini obiteljske transmisije. Područje istraživanja je Zeničko-dobojski kanton, 2008. – 2009. godine. U 31,07% (119/383; P 0,05). Najznačajniji rizični faktori za nastanak bolesti (P 0,05). The major risk factors for the occurrence of disease (P < 0,00) were: a combination of two or more risk factors (OR 13,67; 95% CI 6,10–30,64); a family member with HC (OR 7,28 and 95% CI 0,89–59,22); members of the household who use drugs (OR 5,88; 95% CI 1,68–20,60); the presence of a chronic illness in the household (OR 5,80; 95% CI 2,74–12,77); sharing a razor (OR 4,45; 95% CI 2,36–8,37); exposure to blood in the household (OR 3,57; 95% CI 1,91–6,26). The frequency of HCV genotypes was significant (P < 0,00) for 1a (χ2 = 12,33) in the group with unknown routes, and for 1b (χ2 = 11,50) in the group of patients with known routes of disease transmission. Cumulative incidence of newly discovered HC within examined familial contacts is 1,35% (4/297). The total probability of the exposure in newly discovered familial contacts (OR 1,38; 95% CI 0,15–12,48) is greater than in unexposed individuals. Anti-HCV point prevalence in examined familial contacts is 4,13%, and among the general population 2,42%. The results of this research suggest that the presence of a family member with HC is a significant risk factor. Therefore, for the purpose of disease prevention there is a need for a routine serological testing and continuous monitoring of all intrafamilial contacts of anti-HCV positive individuals

Rare routes of transmission of hepatitis C

Prospektivno su u oboljelih od hepatitisa C (HC) s nepoznatim putevima prijenosa (n = 119) i njihovih obiteljskih kontakata (n = 297) istražene mogućnosti i načini obiteljske transmisije. Područje istraživanja je Zeničko-dobojski kanton, 2008. – 2009. godine. U 31,07% (119/383; P 0,05). Najznačajniji rizični faktori za nastanak bolesti (P 0,05). The major risk factors for the occurrence of disease (P < 0,00) were: a combination of two or more risk factors (OR 13,67; 95% CI 6,10–30,64); a family member with HC (OR 7,28 and 95% CI 0,89–59,22); members of the household who use drugs (OR 5,88; 95% CI 1,68–20,60); the presence of a chronic illness in the household (OR 5,80; 95% CI 2,74–12,77); sharing a razor (OR 4,45; 95% CI 2,36–8,37); exposure to blood in the household (OR 3,57; 95% CI 1,91–6,26). The frequency of HCV genotypes was significant (P < 0,00) for 1a (χ2 = 12,33) in the group with unknown routes, and for 1b (χ2 = 11,50) in the group of patients with known routes of disease transmission. Cumulative incidence of newly discovered HC within examined familial contacts is 1,35% (4/297). The total probability of the exposure in newly discovered familial contacts (OR 1,38; 95% CI 0,15–12,48) is greater than in unexposed individuals. Anti-HCV point prevalence in examined familial contacts is 4,13%, and among the general population 2,42%. The results of this research suggest that the presence of a family member with HC is a significant risk factor. Therefore, for the purpose of disease prevention there is a need for a routine serological testing and continuous monitoring of all intrafamilial contacts of anti-HCV positive individuals

Akutna bruceloza udružena sa Coombs-pozitivnom autoimunosnom hemolitičkom anemijom i diseminiranom intravaskularnom koagulacijom

Hematološke manifestacije bruceloze su različite.Akutna hemoliza i diseminirana intravaskularnakoagulopatija (DIK) jako se rijetko viđaju kodbruceloze. Terapijski pristup ovakvim formamabolesti je jako kompleksan. U ovom radu prikazanje slučaj bolesnika s akutnom brucelozomudruženom s Coombs-pozitivnom autoimunomhemolitičkom anemijom i diseminiranom intravaskularnomkoagulacijom. Pacijent je dobroreagirao na terapiju antibioticima i kortikosteroidima

Brucellosis in children in Bosnia and Herzegovina in the period 2000 - 2013

Aim To analyse clinical, laboratory and epidemiological characteristics of brucellosis in children in Bosnia and Herzegovina. Methods The study included 246 children aged 0-18 years, who were hospitalized in Clinics and Departments for Infectious Diseases in Tuzla, Sarajevo, Banja Luka, Zenica and Bihać in the period 2000-2013, in whom the diagnosis of brucellosis was established based on anamnestic data, clinical features and positive results from blood culture and/or positive results from one of the serological tests. Results In this period, a total of 2630 patients, 246 (9.35%) of whom were children, were treated from brucellosis at the Clinics and Departments in Bosnia and Herzegovina. In the majority of cases, the children were from rural parts of the country, 226 (91.87%);214 (87.04%) cases had direct contact with sick animals, sick family member or consumption of unpasteurized dairy products from farms where brucellosis had been already established. Male children predominated, 157 (63.82%). The most frequent clinical features in affected children were fever, 194 (78.86%) and joint pain, 158 (64.22%). The average duration of antimicrobial treatment was 42.85 ± 10.67 days. A total of 228 (92.68%) children were completely cured, while relapses occurred in 18 (7.32%) children. Conclusion Since brucellosis is an endemic disease in Bosnia and Herzegovina, it is important that physicians in their daily practice consider brucellosis and establish proper diagnosis and therapy in children with prolonged fever, arthralgia, leukopenia and positive epidemiological data, especially in rural parts of the country