Dugotrajno praćenje kompleksnog pacijenta s običnom varijabilnom imunodeficijencijom – prikaz bolesnika

Common variable immunodeficiency (CVID) is a primary immune disorder that results from insufficient immunoglobulin (IG ) secretion. Hypogammaglobulinemia is currently treated with substitute IG s, however, the substantial variation of post-application IG levels, as well as the development of complex clinical manifestations in patients set up a significant challenge for their physicians. A 33-year-old male patient has been followed-up with the diagnosis of CVID. From early childhood, he presented with recurrent respiratory infections. In 2010, he was diagnosed with CVID. Treatment was started with substitute intravenous (IV) IG . During a 9-year follow-up in day care and stationary University Hospital Centre (UHC) departments, the patient experienced a total of 14 respiratory and 2 digestive system complications of the disease. Eventually, he developed a non-infectious pulmonary complication – granulomatous- lymphocytic interstitial lung disease (GLILD). In 2015, treatment was altered to accomplish satisfactory IG levels from IV to conventional subcutaneous (SC) IG therapy. Due to easier application and greater volume of subcutaneously inserted IG , the patient was switched to a new generation of SCIG therapy in 2019. Additionally, corticosteroids and mesalazine were also administered, and with current treatment the patient is stable. In the 9-year period, he never reached the preferable reference levels of IG s presumed for healthy individuals. Respiratory infections are common CVID complications, but it is necessary to consider the autoimmune and neoplastic manifestations of the disease. A multidisciplinary approach, regular follow-up, and regular application of IG therapy are the key factors in decreasing morbidity and mortality in these patients.Obična varijabilna imunodeficijencija (CVID) oblik je primarne imunodeficijencije koja nastaje kao posljedicasmanjene proizvodnje imunoglobulina (IG ). Posljedična hipogamaglobulinemija trenutačno se liječi nadomještanjem IG -a, a značajne varijacije u postaplikacijskim vrijednostima IG -a kao i razvoj komplikacija osnovne bolesti predstavljaju značajan izazov u liječenju ovih pacijenata. Prikazujemo 33-godišnjeg muškarca koji se više godina prati s dijagnozom CVID-a. Od ranog djetinjstva pokazivao je podložnost opetovanim respiratornim infekcijama. Pacijentu je 2010. godine dijagnosticiran CVID te započinje liječenje intravenskim (IV) nadomjestkom IG -a. Tijekom devetogodišnjeg praćenja putem dnevne bolnice i stacionara Kliničkoga bolničkog centra pacijent je razvio ukupno 14 respiratornih i dvije probavne komplikacije osnovne bolesti. Razvio je i neinfektivnu plućnu komplikaciju: granulomatoznu limfocitnu intersticijsku plućnu bolest (GLILD). Bolesnik je 2015. godine sa svrhom postizanja poboljšanih vrijednosti IG -a prešao s IV na konvencionalnu supkutanu terapiju (SC) IG -a. Uslijed lakše primjene i povećanog volumena supkutanog unosa IG -a, 2019. godine dotadašnja terapija zamijenjena je novom generacijom SCIG pripravaka. Kao dodatak, propisani su mu kortikosteroidi i mesalazin te je pacijent s trenutačnom terapijom stabilno. U posljednjih devet godina nikada nije postigao referentne vrijednosti za zdrave osobe. Respiratorne infekcije česta su komplikacija CVIDa, ali je potrebno razmatrati i autoimune te neoplastične manifestacije ove bolesti. Multidisciplinarni pristup, redovito praćenje i redovita primjena imunoglobulina ključni su čimbenici u smanjenju morbiditeta i mortaliteta u pacijenata s CVID-om

Humani koronavirusi u kontekstu ‘Jednog zdravlja’

Seven human coronaviruses have been identified so far: four seasonal coronaviruses (HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1) and three novel coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2). While seasonal coronaviruses cause only mild symptoms, novel coronaviruses cause severe and potentially fatal infections. All known coronaviruses originated in animals. Bats are considered as an origin for the majority of coronaviruses capable of infecting humans; however, rodents are proposed as natural hosts for HCoV-OC43 and HCoV-HKU1. Different animal species could serve as intermediate hosts including alpacas (HCoV-229E), livestock (HCoV-OC43), civet cats (SARS-CoV), camels (MERS-CoV), and pangolins (SARS-CoV-2). In Croatia, SARS-CoV-2 was detected in humans, pet animals, wildlife, and the environment. The COVID-19 pandemic has highlighted the role of the ‘One Health’ approach in the surveillance of zoonotic diseases.Do sada je otkriveno sedam humanih koronavirusa: četiri sezonska koronavirusa (HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1) i tri nova koronavirusa (SARS-CoV, MERS-CoV, SARS-CoV-2). Dok sezonski koronavirusi uzrokuju tek blage infekcije, novi koronavirusi su uzročnici teških i potencijalno smrtonosnih infekcija. Svi poznati koronavirusi su podrijetlom od životinja. Šišmiši se smatraju izvorom većine koronavirusa koji uzrokuju infekcije u ljudi, međutim prirodnim rezervoarima HCoV-OC43 i HCoV-HKU1 se smatraju glodavci. Različite životinjske vrste predstavljaju prijelazne domaćine uključujući alpake (HCoV-229E), stoku (HCoV-OC43), cibetke (SARS-CoV), deve (MERS-CoV) te ljuskaše (SARS-CoV-2). Na području Hrvatske SARS-CoV-2 je dokazan u ljudi, kućnih ljubimaca, divljih životinja te okolišu. Pandemija COVID-19 naglašava ulogu pristupa ‘Jedno zdravlje’ u nadzoru zoonoza

Vogt-Koyanagi-Harada syndrome – a case report and differential diagnosis of uveitis and meningitis

Vogt-Koyanagi-Harada sindrom je autoimuna, multisistemska bolest i važan uzrok uveitisa. Ovim prikazom bolesnika naglašavamo važnost pouzdane dijagnostike te uključivanje autoimunih bolesti u diferencijalnu dijagnozu sindroma uveitisa i meningitisa.Vogt-Koyanagi -Harada syndrome is an autoimmune, multisystem disease and important cause of uveitis. In this case report we address the significance of reliable diagnostics and including autoimmune diseases in differential diagnosis of uveitis and meningitis syndrome

Epidemiological characteristics of patients with acute pelvic inflammatory disease during the period 2009-2019 at the University Hospital "Sveti Duh"

Upalna zdjelična bolest klinički je sindrom koji podrazumijeva upalu jednog ili više reproduktivnih organa na području zdjelice. Upala je uzrokovana infekcijom koja se obično ascendentnim putem proširi iz donjeg u gornji dio spolnog sustava žene. Većina je dijagnosticiranih pacijentica u fertilnoj dobi, a infektivnim uzročnicima bivaju izložene tijekom spolnog odnosa. U literaturi je najbolje dokumentiran akutni oblik bolesti koji se ovisno o težini kliničke slike zbrinjava ambulantno ili bolničkim liječenjem. Temeljni terapijski pristup je antibiotska terapija, no u težim slučajevima nužna je kirurška intervencija. Cilj ovog retrospektivnog istraživanja bio je prikazati epidemiološke karakteristike pacijentica s akutnim PID-om koje su u periodu od 1. rujna 2009. do 1. rujna 2019. bile kirurški liječene na Klinici za ginekologiju i porodništvo KB „Sveti Duh“. Pregledom Protokola ginekoloških operacija i SPP-a izdvojene su 92 pacijentice koje su zadovoljavale kriterije uključivanja (prijem u bolnicu pod kliničkom slikom akutnog PID-a nakon čega je provedeno kirurško liječenje) i isključivanja (kronični oblik PID-a, prijem u bolnicu zbog unaprijed planiranog operativnog zahvata). Obrađeni epidemiološki podaci prikazani u ovom radu proizlaze iz SPP-a. Dobiveni podaci prikazuju kako je akutni PID koji je zahtijevao kirurško liječenje najčešći u dobnoj skupini od 35 do 44 godina s 39,13% slučajeva. Pacijentice su najčešće bile krvne grupe A+ (39,13%), a najviše zabilježenih slučajeva bolesti bilo je tijekom srpnja (19,58%). U vrijeme postavljanja dijagnoze, 42,39% žena bile su nulipare bez zabilježenih prekida trudnoće (spontanih ili namjernih). Promatrajući pojavnost simptoma u određenoj fazi ciklusa primijećeno je da su pacijentice najčešće navodile prve simptome u sekrecijskoj fazi (39,08%), a u toj fazi MC bili su i najčešći prijemi u bolnicu (48,27%). Njih 67,82% liječničku pomoć zatražilo je u istoj fazi MC u kojoj su se i javili prvi simptomi bolesti. Analizom povezanosti trajanja bolničkog liječenja i dobi pacijentica nije pronađena statistički značajna razlika. S obzirom da ova bolest može ostaviti trajne posljedice na reproduktivnom sustavu i utjecati na fertilitet žena, ovim su se radom pokušale istaknuti pojedine epidemiološke karakteristike oboljelih koje bi mogle utjecati na dijagnostiku i liječenje.Pelvic inflammatory disease (PID) is a clinical syndrome that includes inflammation of one or more pelvic reproductive organs. Infection is the main cause of the inflammation and it usually spreads ascendingly from lower to upper portions of female genital system. Diagnosis is commonly established in fertile women who were exposed to infective agents during sexual intercourse. Disease mostly presents in acute form and, depending on severity of symptoms, management of the disease can occur in outpatient or inpatient settings. The basic clinical management of PID is antibiotic therapy. However, in some cases surgical intervention is required. The aim of this retrospective study was to demonstrate epidemiological characteristics of surgically treated patients with acute PID from Clinical department of obstetrics and gynaecology, University Hospital „Sveti Duh“ (September 1st, 2009 – September 1st, 2019). Following assessment of surgical data records and hospital informatic system (HIS) data, 92 patients matched the inclusion (hospital admission under clinical presentation of acute PID and subsequent surgical treatment) and exclusion criteria (chronic PID, hospital admission due to elective surgical procedure). Epidemiological information displayed in this research was also withdrawn from HIS. The results showed that acute PID which required surgical intervention presented in 39.13% of cases between the age of 35 and 44. The majority of patients were A+ blood group (39.13%) whereas most of the cases occurred during July (19.58%). At the moment of diagnosis, 42.39% of women were nulliparous without any noted abortions (spontaneous or induced). Evaluation of PID symptoms, regarding the certain phase of menstrual cycle (MC), pointed out that first manifestations most frequently occurred during the secretion phase (39.08%) and moreover, during the same phase hospital admission was the most required (48.27%). Furthermore, 67.82% of patients needed medical assistance during the same phase of MC in which symptoms occurred. The analysis of correlation between the age of women and duration of hospital treatment showed no statistical significance. In conclusion, taking into account that PID can cause permanent damage on reproductive system and female fertility, this study attempts to emphasize certain epidemiological characteristic of affected patients which could be impactful in diagnosis and treatment

Epidemiological characteristics of patients with acute pelvic inflammatory disease during the period 2009-2019 at the University Hospital "Sveti Duh"

Upalna zdjelična bolest klinički je sindrom koji podrazumijeva upalu jednog ili više reproduktivnih organa na području zdjelice. Upala je uzrokovana infekcijom koja se obično ascendentnim putem proširi iz donjeg u gornji dio spolnog sustava žene. Većina je dijagnosticiranih pacijentica u fertilnoj dobi, a infektivnim uzročnicima bivaju izložene tijekom spolnog odnosa. U literaturi je najbolje dokumentiran akutni oblik bolesti koji se ovisno o težini kliničke slike zbrinjava ambulantno ili bolničkim liječenjem. Temeljni terapijski pristup je antibiotska terapija, no u težim slučajevima nužna je kirurška intervencija. Cilj ovog retrospektivnog istraživanja bio je prikazati epidemiološke karakteristike pacijentica s akutnim PID-om koje su u periodu od 1. rujna 2009. do 1. rujna 2019. bile kirurški liječene na Klinici za ginekologiju i porodništvo KB „Sveti Duh“. Pregledom Protokola ginekoloških operacija i SPP-a izdvojene su 92 pacijentice koje su zadovoljavale kriterije uključivanja (prijem u bolnicu pod kliničkom slikom akutnog PID-a nakon čega je provedeno kirurško liječenje) i isključivanja (kronični oblik PID-a, prijem u bolnicu zbog unaprijed planiranog operativnog zahvata). Obrađeni epidemiološki podaci prikazani u ovom radu proizlaze iz SPP-a. Dobiveni podaci prikazuju kako je akutni PID koji je zahtijevao kirurško liječenje najčešći u dobnoj skupini od 35 do 44 godina s 39,13% slučajeva. Pacijentice su najčešće bile krvne grupe A+ (39,13%), a najviše zabilježenih slučajeva bolesti bilo je tijekom srpnja (19,58%). U vrijeme postavljanja dijagnoze, 42,39% žena bile su nulipare bez zabilježenih prekida trudnoće (spontanih ili namjernih). Promatrajući pojavnost simptoma u određenoj fazi ciklusa primijećeno je da su pacijentice najčešće navodile prve simptome u sekrecijskoj fazi (39,08%), a u toj fazi MC bili su i najčešći prijemi u bolnicu (48,27%). Njih 67,82% liječničku pomoć zatražilo je u istoj fazi MC u kojoj su se i javili prvi simptomi bolesti. Analizom povezanosti trajanja bolničkog liječenja i dobi pacijentica nije pronađena statistički značajna razlika. S obzirom da ova bolest može ostaviti trajne posljedice na reproduktivnom sustavu i utjecati na fertilitet žena, ovim su se radom pokušale istaknuti pojedine epidemiološke karakteristike oboljelih koje bi mogle utjecati na dijagnostiku i liječenje.Pelvic inflammatory disease (PID) is a clinical syndrome that includes inflammation of one or more pelvic reproductive organs. Infection is the main cause of the inflammation and it usually spreads ascendingly from lower to upper portions of female genital system. Diagnosis is commonly established in fertile women who were exposed to infective agents during sexual intercourse. Disease mostly presents in acute form and, depending on severity of symptoms, management of the disease can occur in outpatient or inpatient settings. The basic clinical management of PID is antibiotic therapy. However, in some cases surgical intervention is required. The aim of this retrospective study was to demonstrate epidemiological characteristics of surgically treated patients with acute PID from Clinical department of obstetrics and gynaecology, University Hospital „Sveti Duh“ (September 1st, 2009 – September 1st, 2019). Following assessment of surgical data records and hospital informatic system (HIS) data, 92 patients matched the inclusion (hospital admission under clinical presentation of acute PID and subsequent surgical treatment) and exclusion criteria (chronic PID, hospital admission due to elective surgical procedure). Epidemiological information displayed in this research was also withdrawn from HIS. The results showed that acute PID which required surgical intervention presented in 39.13% of cases between the age of 35 and 44. The majority of patients were A+ blood group (39.13%) whereas most of the cases occurred during July (19.58%). At the moment of diagnosis, 42.39% of women were nulliparous without any noted abortions (spontaneous or induced). Evaluation of PID symptoms, regarding the certain phase of menstrual cycle (MC), pointed out that first manifestations most frequently occurred during the secretion phase (39.08%) and moreover, during the same phase hospital admission was the most required (48.27%). Furthermore, 67.82% of patients needed medical assistance during the same phase of MC in which symptoms occurred. The analysis of correlation between the age of women and duration of hospital treatment showed no statistical significance. In conclusion, taking into account that PID can cause permanent damage on reproductive system and female fertility, this study attempts to emphasize certain epidemiological characteristic of affected patients which could be impactful in diagnosis and treatment

ZADOVOLJSTVO KORISNIKA USLUGA ŽELJEZNIČKOG ČVORIŠTA KOLODVORA VINKOVCI

Tema ovog rada je željeznički kolodvor Vinkovci i uvjeti koje kolodvor mora ispuniti kako bi zadovoljio potrebe svojih korisnika. Osnovna svrha ovoga rada bila je ocijeniti zadovoljstvo korisnika usluga željezničkog čvorišta kolodvora Vinkovci. Zadovoljstvo korisnika može se ispitati na više načina, a u radu je prikazano anketno istraživanje zadovoljstva korisnika željezničkog čvorišta kolodvora Vinkovci. Rad se sastoji od bitnih značajki vezanih za sam kolodvor Vinkovci i od istraživačkog dijela u kojemu je prikazana analiza anketa o zadovoljstvu korisnika željezničkog čvorišta Vinkovci. Anketno istraživanje se provelo kako bi se dobio uvid o zadovoljstvu korisnika spomenutim kolodvorom Vinkovci

Epidemiological characteristics of patients with acute pelvic inflammatory disease during the period 2009-2019 at the University Hospital "Sveti Duh"

Upalna zdjelična bolest klinički je sindrom koji podrazumijeva upalu jednog ili više reproduktivnih organa na području zdjelice. Upala je uzrokovana infekcijom koja se obično ascendentnim putem proširi iz donjeg u gornji dio spolnog sustava žene. Većina je dijagnosticiranih pacijentica u fertilnoj dobi, a infektivnim uzročnicima bivaju izložene tijekom spolnog odnosa. U literaturi je najbolje dokumentiran akutni oblik bolesti koji se ovisno o težini kliničke slike zbrinjava ambulantno ili bolničkim liječenjem. Temeljni terapijski pristup je antibiotska terapija, no u težim slučajevima nužna je kirurška intervencija. Cilj ovog retrospektivnog istraživanja bio je prikazati epidemiološke karakteristike pacijentica s akutnim PID-om koje su u periodu od 1. rujna 2009. do 1. rujna 2019. bile kirurški liječene na Klinici za ginekologiju i porodništvo KB „Sveti Duh“. Pregledom Protokola ginekoloških operacija i SPP-a izdvojene su 92 pacijentice koje su zadovoljavale kriterije uključivanja (prijem u bolnicu pod kliničkom slikom akutnog PID-a nakon čega je provedeno kirurško liječenje) i isključivanja (kronični oblik PID-a, prijem u bolnicu zbog unaprijed planiranog operativnog zahvata). Obrađeni epidemiološki podaci prikazani u ovom radu proizlaze iz SPP-a. Dobiveni podaci prikazuju kako je akutni PID koji je zahtijevao kirurško liječenje najčešći u dobnoj skupini od 35 do 44 godina s 39,13% slučajeva. Pacijentice su najčešće bile krvne grupe A+ (39,13%), a najviše zabilježenih slučajeva bolesti bilo je tijekom srpnja (19,58%). U vrijeme postavljanja dijagnoze, 42,39% žena bile su nulipare bez zabilježenih prekida trudnoće (spontanih ili namjernih). Promatrajući pojavnost simptoma u određenoj fazi ciklusa primijećeno je da su pacijentice najčešće navodile prve simptome u sekrecijskoj fazi (39,08%), a u toj fazi MC bili su i najčešći prijemi u bolnicu (48,27%). Njih 67,82% liječničku pomoć zatražilo je u istoj fazi MC u kojoj su se i javili prvi simptomi bolesti. Analizom povezanosti trajanja bolničkog liječenja i dobi pacijentica nije pronađena statistički značajna razlika. S obzirom da ova bolest može ostaviti trajne posljedice na reproduktivnom sustavu i utjecati na fertilitet žena, ovim su se radom pokušale istaknuti pojedine epidemiološke karakteristike oboljelih koje bi mogle utjecati na dijagnostiku i liječenje.Pelvic inflammatory disease (PID) is a clinical syndrome that includes inflammation of one or more pelvic reproductive organs. Infection is the main cause of the inflammation and it usually spreads ascendingly from lower to upper portions of female genital system. Diagnosis is commonly established in fertile women who were exposed to infective agents during sexual intercourse. Disease mostly presents in acute form and, depending on severity of symptoms, management of the disease can occur in outpatient or inpatient settings. The basic clinical management of PID is antibiotic therapy. However, in some cases surgical intervention is required. The aim of this retrospective study was to demonstrate epidemiological characteristics of surgically treated patients with acute PID from Clinical department of obstetrics and gynaecology, University Hospital „Sveti Duh“ (September 1st, 2009 – September 1st, 2019). Following assessment of surgical data records and hospital informatic system (HIS) data, 92 patients matched the inclusion (hospital admission under clinical presentation of acute PID and subsequent surgical treatment) and exclusion criteria (chronic PID, hospital admission due to elective surgical procedure). Epidemiological information displayed in this research was also withdrawn from HIS. The results showed that acute PID which required surgical intervention presented in 39.13% of cases between the age of 35 and 44. The majority of patients were A+ blood group (39.13%) whereas most of the cases occurred during July (19.58%). At the moment of diagnosis, 42.39% of women were nulliparous without any noted abortions (spontaneous or induced). Evaluation of PID symptoms, regarding the certain phase of menstrual cycle (MC), pointed out that first manifestations most frequently occurred during the secretion phase (39.08%) and moreover, during the same phase hospital admission was the most required (48.27%). Furthermore, 67.82% of patients needed medical assistance during the same phase of MC in which symptoms occurred. The analysis of correlation between the age of women and duration of hospital treatment showed no statistical significance. In conclusion, taking into account that PID can cause permanent damage on reproductive system and female fertility, this study attempts to emphasize certain epidemiological characteristic of affected patients which could be impactful in diagnosis and treatment

Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen

Background: Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection. ----- Aim: To summarize the epidemiological, clinical, and diagnostic features of reported patients with congenital LCMV infection. ------ Methods: A literature search was conducted in PubMed, Medline, Google Scholar, and ResearchGate. The keywords used were 'congenital lymphocytic choriomeningitis virus,' and 48 studies were included. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com). ----- Results: The results have shown 27 reports of congenital LCMV infection in 86 patients, with 52.73% of them being males. Patients presented with chorioretinitis (83.53%), hydrocephalus (54.12%), and psychomotor retardation or developmental delay (54.12%). Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly (74.07%), periventricular calcifications (66.67%), and microcephaly (40%). Most mothers of congenitally infected infants were exposed to rodents during pregnancy, predominantly mice, with flu-like symptoms mainly occurring during the first two trimesters of gestation. Mortality in congenitally infected children was 16.47%. The diagnosis of congenital LCMV infection was confirmed serologically in most patients (86.67%). ----- Conclusion: LCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae. Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH (T: Toxoplasma gondii, O: Other pathogens, R: Rubella virus, C: Cytomegalovirus, H: Herpes simplex virus) pathogens

Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen

Background: Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection. ----- Aim: To summarize the epidemiological, clinical, and diagnostic features of reported patients with congenital LCMV infection. ------ Methods: A literature search was conducted in PubMed, Medline, Google Scholar, and ResearchGate. The keywords used were 'congenital lymphocytic choriomeningitis virus,' and 48 studies were included. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com). ----- Results: The results have shown 27 reports of congenital LCMV infection in 86 patients, with 52.73% of them being males. Patients presented with chorioretinitis (83.53%), hydrocephalus (54.12%), and psychomotor retardation or developmental delay (54.12%). Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly (74.07%), periventricular calcifications (66.67%), and microcephaly (40%). Most mothers of congenitally infected infants were exposed to rodents during pregnancy, predominantly mice, with flu-like symptoms mainly occurring during the first two trimesters of gestation. Mortality in congenitally infected children was 16.47%. The diagnosis of congenital LCMV infection was confirmed serologically in most patients (86.67%). ----- Conclusion: LCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae. Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH (T: Toxoplasma gondii, O: Other pathogens, R: Rubella virus, C: Cytomegalovirus, H: Herpes simplex virus) pathogens

Current Status of Vector-Borne Diseases in Croatia: Challenges and Future Prospects

Different vector-borne pathogens are present or have (re-)emerged in Croatia. Flaviviruses tick-borne encephalitis (TBEV), West Nile (WNV), and Usutu (USUV) are widely distributed in continental regions, while Toscana virus (TOSV) and sandfly fever viruses are detected at the Croatian littoral. Recently, sporadic clinical cases of Tahyna orthobunyavirus (TAHV) and Bhanja bandavirus infection and seropositive individuals have been reported in continental Croatia. Acute infections and serologic evidence of WNV, TBEV, USUV, and TAHV were also confirmed in sentinel animals and vectors. Autochthonous dengue was reported in 2010 at the Croatian littoral. Lyme borreliosis is the most widely distributed vector-borne bacterial infection. The incidence is very high in northwestern and eastern regions, which correlates with numerous records of Ixodes ricinus ticks. Acute human Anaplasma phagocytophilum infections are reported sporadically, but there are many records of serologic evidence of anaplasmosis in animals. Mediterranean spotted fever (Rickettsia conorii) and murine typhus (Rickettsia typhi) are the main rickettsial infections in Croatia. Human leishmaniasis is notified sporadically, while serologic evidence of leishmaniasis was found in 11.4% of the Croatian population. After the official eradication of malaria in 1964, only imported cases were reported in Croatia. Since vector-borne diseases show a growing trend, continuous monitoring of vectors is required to protect the population from these infections