The Many Faces of Cat Scratch Disease – A Report of Four Cases

Bolest mačjeg ogreba (BMO) infekcija je uzrokovana Gram negativnom, fakultativno intracelularnom bakterijom Bartonella henselae. Glavni rezervoar infekcije je mačka i oko 75% bolesnika ima podatak o ogrebu ili ugrizu mačke u anamnezi. Rjeđe se infekcija javlja u kontaktu s psom, posredovano mačjom buhom ili neizravnim kontaktom oštećene kože ili sluznice s površinom kontaminiranom mačjom slinom. Infekcija može proći asimptomatski, ali se i prezentirati spektrom kliničkih manifestacija. U 85-90 % bolesnika radi se o klasičnoj BMO s kožnom lezijom i samoograničavajućim, regionalnim limfadenitisom dok ostale, rjeđe kliničke manifestacije, mogu zahvatiti gotovo svaki organ i organski sustav. Prikazujemo četiri bolesnika s BMO liječenih u Klinici za infektivne bolesti Kliničkog bolničkog centra Rijeka te raspravljamo o dijagnostičkim i terapijskim izazovima ove bolesti.Cat scratch disease (CSD) is an infection caused by the Gram negative, facultative intracellular bacteria Bartonella henselae. The main reservoir of the infection is cat and about 75% of the patients have a cat scratch or a bite in anamnesis. Rarely, infection results from exposure to dogs, cat fleas or from contact with cat saliva through broken skin or mucosal surfaces. Infection can be asymptomatic or present with a number of clinical manifestations. In wast majority (85-90%) of the patients CSD presents as a cutaneous lesion and self-limiting, regional lymphadenitis near the site of organism inoculation, other seldom manifestations, however, can include virtually every organ and organ system. We present four patients with CSD treated at the Clinical Hospital Center Rijeka and discuss diagnostic and therapeutic challenges of the CSD

Temporal Bone Actinomycosis Accompanied by Actinomycotic Meningitis and Cervical Lymphadenitis – a Case Report

Aktinomikoza predstavlja rijetku kroničnu infekciju uzrokovanu anaerobnom, Gram pozitivnom bakterijom koja pripada rodu Actinomyces. U ovom smo radu prikazali slučaj aktinomikoze temporalne kosti i meningitisa uzrokovanog Aktinomicetama te limfadenitisa vrata kod imunokompetentne bolesnice s anamnezom kroničnog supurativnog otitisa nakon traumatske perforacije bubnjića starijeg datuma. Liječenje je uspješno provedeno kombiniranom kirurškom i dugotrajnom antimikrobnom terapijom. Ovim prikazom želimo skrenuti pozornost na meningitis kojeg uzrokuje Actinomyces spp. te kojeg je, iako je rijedak, potrebno uključiti u diferencijalnu dijagnozu kroničnog meningitisa, osobito kod pacijenata s kroničnom upalom srednjeg uha i paranazalnih sinusa. Jednako tako, želimo skrenuti pozornost i na ostale manifestacije ove rijetke bolesti.Actinomycosis represents rare chronic infection caused by anaerobic, Gram positive bacteria belonging to Actinomyces genus. Here we present a case of temporal bone actinomycosis accompanied by meningitis and cervical lymphadenitis in imunocompetent patient with case history of chronic suppurative otitis media as a tympanic membrane perforation sequelae. The patient was successfully treated with both surgical and prolonged antimicrobial therapy. This case, although rare, implies cosideration of Actinomyces spp. in diferential diagnosis of chronic meningitis, especially in patients with case history of chronic otitis media or chronic sinusitis

Epidemiology and Clinical Course of Haemorrhagic Fever with Renal Syndrome in New Endemic Area for Hantavirus Infection in Croatia

Background: Hantaviruses remain an important case of emerging and re-emerging infections in human medicine. This study aimed to analyse the epidemiology, clinical presentation, and outcome of hantavirus infections in the western part of Republic of Croatia, a new geographical area for hantavirus infections. Methods: Retrospective analysis of medical records of patients treated for hemorrhagic fever with renal syndrome (HFRS) at the infectious diseases Clinic of the Clinical Hospital Center in Rijeka, Croatia, from 1 January 2014, to 31 December 2021. Results: During the eight-year period, 251 patients were hospitalized and treated for HFRS, with epidemic outbreaks in years 2014 and 2021. Most patients had a typical clinical course of HFRS and received supportive care. Serological analysis revealed the Puumala Virus (PUUV) as the predominant etiology of the disease. Epidemiological analysis revealed clustering of infections in the region of Gorski Kotar and spread to the area on the Mediterranean coast (Adriatic Sea), which was previously considered an area free from hantavirus infections. Conclusions: The presented results indicate the spread of hantavirus infections in Croatia from the central low-lying parts of the country to the tourist-attractive western area adjacent to the Mediterranean coast, which was previously considered free of hantavirus infections

Temporal Bone Actinomycosis Accompanied by Actinomycotic Meningitis and Cervical Lymphadenitis – a Case Report

Aktinomikoza predstavlja rijetku kroničnu infekciju uzrokovanu anaerobnom, Gram pozitivnom bakterijom koja pripada rodu Actinomyces. U ovom smo radu prikazali slučaj aktinomikoze temporalne kosti i meningitisa uzrokovanog Aktinomicetama te limfadenitisa vrata kod imunokompetentne bolesnice s anamnezom kroničnog supurativnog otitisa nakon traumatske perforacije bubnjića starijeg datuma. Liječenje je uspješno provedeno kombiniranom kirurškom i dugotrajnom antimikrobnom terapijom. Ovim prikazom želimo skrenuti pozornost na meningitis kojeg uzrokuje Actinomyces spp. te kojeg je, iako je rijedak, potrebno uključiti u diferencijalnu dijagnozu kroničnog meningitisa, osobito kod pacijenata s kroničnom upalom srednjeg uha i paranazalnih sinusa. Jednako tako, želimo skrenuti pozornost i na ostale manifestacije ove rijetke bolesti

Temporal Bone Actinomycosis Accompanied by Actinomycotic Meningitis and Cervical Lymphadenitis – a Case Report

Aktinomikoza predstavlja rijetku kroničnu infekciju uzrokovanu anaerobnom, Gram pozitivnom bakterijom koja pripada rodu Actinomyces. U ovom smo radu prikazali slučaj aktinomikoze temporalne kosti i meningitisa uzrokovanog Aktinomicetama te limfadenitisa vrata kod imunokompetentne bolesnice s anamnezom kroničnog supurativnog otitisa nakon traumatske perforacije bubnjića starijeg datuma. Liječenje je uspješno provedeno kombiniranom kirurškom i dugotrajnom antimikrobnom terapijom. Ovim prikazom želimo skrenuti pozornost na meningitis kojeg uzrokuje Actinomyces spp. te kojeg je, iako je rijedak, potrebno uključiti u diferencijalnu dijagnozu kroničnog meningitisa, osobito kod pacijenata s kroničnom upalom srednjeg uha i paranazalnih sinusa. Jednako tako, želimo skrenuti pozornost i na ostale manifestacije ove rijetke bolesti.Actinomycosis represents rare chronic infection caused by anaerobic, Gram positive bacteria belonging to Actinomyces genus. Here we present a case of temporal bone actinomycosis accompanied by meningitis and cervical lymphadenitis in imunocompetent patient with case history of chronic suppurative otitis media as a tympanic membrane perforation sequelae. The patient was successfully treated with both surgical and prolonged antimicrobial therapy. This case, although rare, implies cosideration of Actinomyces spp. in diferential diagnosis of chronic meningitis, especially in patients with case history of chronic otitis media or chronic sinusitis

Cerebralna toksokaroza – prikaz slučaja

Aim: To present a case of a patient with an atypical clinical course of toxocariasis, which was manifested by isolated affection of the central nervous system. Case report: A 55-year-old patient was hospitalized at the Clinic for Infectious Diseases of the University Hospital Center Rijeka due to cerebral toxocariasis, which was initially presented as aneosinophilic aseptic meningitis. Since the clinical course of the disease did not initially indicate a parasitic infection, the diagnosis was established after repeated cytological-biochemical and serological analyzes of the cerebrospinal fluid and serum. Conclusions: Cerebral toxocariasis is a rare disease and can also present as severe meningitis, encephalitis, or myelitis. This case report of a patient with proven cerebral toxocariasis initially presented as aneosinophilic aseptic meningitis indicates the importance of including neurotoxocariasis in the differential diagnosis of aseptic meningitis syndrome with no other proven causative agent.Cilj: Prikazati slučaj bolesnika s atipičnom kliničkom slikom toksokaroze, koja se manifestirala izoliranom afekcijom središnjeg živčanog sustava. Prikaz slučaja: Bolesnik u dobi od 55 godina liječen je u Klinici za infektivne bolesti KBC-a Rijeka zbog cerebralne toksokaroze koja se prezentirala inicijalno aneozinofilnim aseptičnim meningitisom. Klinički tijek bolesti u početku nije ukazivao na parazitarnu infekciju, već je dijagnoza postavljena nakon ponavljajućih citološko-biokemijskih i seroloških analiza cerebrospinalnog likvora i seruma. Zaključci: Cerebralna toksokaroza je rijetka bolest, a može se prezentirati i kao teški meningitis, encefalitis ili mijelitis. Prikaz slučaja bolesnika s dokazanom cerebralnom toksokarozom koja se inicijalno prezentirala kao aneozinofilni aseptični meningitis ukazuje na važnost uključivanja neurotoksokaroze u diferencijalnu dijagnozu sindroma aseptičnog meningitisa bez drugog dokazanog uzročnika

Temporal Bone Actinomycosis Accompanied by Actinomycotic Meningitis and Cervical Lymphadenitis – a Case Report

Aktinomikoza predstavlja rijetku kroničnu infekciju uzrokovanu anaerobnom, Gram pozitivnom bakterijom koja pripada rodu Actinomyces. U ovom smo radu prikazali slučaj aktinomikoze temporalne kosti i meningitisa uzrokovanog Aktinomicetama te limfadenitisa vrata kod imunokompetentne bolesnice s anamnezom kroničnog supurativnog otitisa nakon traumatske perforacije bubnjića starijeg datuma. Liječenje je uspješno provedeno kombiniranom kirurškom i dugotrajnom antimikrobnom terapijom. Ovim prikazom želimo skrenuti pozornost na meningitis kojeg uzrokuje Actinomyces spp. te kojeg je, iako je rijedak, potrebno uključiti u diferencijalnu dijagnozu kroničnog meningitisa, osobito kod pacijenata s kroničnom upalom srednjeg uha i paranazalnih sinusa. Jednako tako, želimo skrenuti pozornost i na ostale manifestacije ove rijetke bolesti

Vaccination provides superior in vivo recall capacity of SARS-CoV-2 specific memory CD8 T cells on April 02, 2023.

Memory CD8 T cells play an important role in the protection against breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether the route of antigen exposure impacts these cells at a functional level is incompletely characterized. Here, we compare the memory CD8 T cell response against a common SARS-CoV-2 epitope after vaccination, infection, or both. CD8 T cells demonstrate comparable functional capacity when restimulated directly ex vivo, independent of the antigenic history. However, analysis of T cell receptor usage shows that vaccination results in a narrower scope than infection alone or in combination with vaccination. Importantly, in an in vivo recall model, memory CD8 T cells from infected individuals show equal proliferation but secrete less tumor necrosis factor (TNF) compared with those from vaccinated people. This difference is negated when infected individuals have also been vaccinated. Our findings shed more light on the differences in susceptibility to re-infection after different routes of SARS-CoV-2 antigen exposur

Vaccination provides superior in vivo recall capacity of SARS-CoV-2 specific memory CD8 T cells on April 02, 2023.

Memory CD8 T cells play an important role in the protection against breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether the route of antigen exposure impacts these cells at a functional level is incompletely characterized. Here, we compare the memory CD8 T cell response against a common SARS-CoV-2 epitope after vaccination, infection, or both. CD8 T cells demonstrate comparable functional capacity when restimulated directly ex vivo, independent of the antigenic history. However, analysis of T cell receptor usage shows that vaccination results in a narrower scope than infection alone or in combination with vaccination. Importantly, in an in vivo recall model, memory CD8 T cells from infected individuals show equal proliferation but secrete less tumor necrosis factor (TNF) compared with those from vaccinated people. This difference is negated when infected individuals have also been vaccinated. Our findings shed more light on the differences in susceptibility to re-infection after different routes of SARS-CoV-2 antigen exposur

Vaccination provides superior in vivo recall capacity of SARS-CoV-2-specific memory CD8 T cells

Summary: Memory CD8 T cells play an important role in the protection against breakthrough infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whether the route of antigen exposure impacts these cells at a functional level is incompletely characterized. Here, we compare the memory CD8 T cell response against a common SARS-CoV-2 epitope after vaccination, infection, or both. CD8 T cells demonstrate comparable functional capacity when restimulated directly ex vivo, independent of the antigenic history. However, analysis of T cell receptor usage shows that vaccination results in a narrower scope than infection alone or in combination with vaccination. Importantly, in an in vivo recall model, memory CD8 T cells from infected individuals show equal proliferation but secrete less tumor necrosis factor (TNF) compared with those from vaccinated people. This difference is negated when infected individuals have also been vaccinated. Our findings shed more light on the differences in susceptibility to re-infection after different routes of SARS-CoV-2 antigen exposure