Clinical significance of asymptomatic [i]Clostridium difficile[/i] colonisation in patients undergoing antibiotic treatment.

BACKGROUND: [i]Clostridium difficile[/i] infections become a serious problem in terms of nosocomial infections, as well as a consequence of common use of antibiotics. AIM: The aim of the study was to evaluate [i]Clostridium difficile[/i] carriage in patients admitted to the Clinical Department of Infectious Diseases and Hepatology without acute or chronic diarrhea and to assess the impact of antibiotic treatment on the development of enteritis in hospital. Other factors that may affect the risk of infection were also analyzed. RESULTS: Fourteen patients (14%) were carriers of [i]Clostridium difficile[/i] at admission. Second assessment taken after fourteen days of antibiotic treatment showed decrease in GDH antigen prevalence to eight subjects (12.1%). Three patients (3%) had diarrhea during hospitalization, and the toxins A and/or B were found in them. CONCLUSIONS: The frequency of [i]Clostridium difficile[/i] carriage among adults in Poland may be underestimated. Screening for Clostridium difficile GDH antigen may be useful although do not provide definite prognosis of symptomatic disease during ceftriaxone treatment. The risk of Clostridium difficile infection may be reduced mainly by rationalizing antibiotic therapy and following appropriate procedures.

Estimation of cognitive and affective disorders occurrence in patients with Lyme borreliosis.

INTRODUCTION AND OBJECTIVE: Lyme borreliosis (LB) is a disease caused by the bacteria Borrelia burgdorferi. The most common symptoms are related to the skin, musculo-scelatal system, central and peripheral nervous system, rarely to the heart muscle and the eye, and may occur in the multistage course of the disease. LB may additionally be accompanied by psychopathological symptoms. The aim of the study is estimation of the cognitive and affective disorders occurence in patients with LB. MATERIAL AND METHODS: The study was carried out in the group of 121 patients (61 females, 60 males) aged 18-65; mean age 46 years. All patients were diagnosed with late-stage of LB: 46 patients (38%) with Lyme arthritis and 75 patients (62%) with neuroborreliosis. Evaluation of the cognitive and affective functioning of patients was performed on the basis of a standardized interview and test methods: the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT) and the Beck Depression Inventory (BDI). RESULTS: Cognitive disorders occurred statistically significantly more often in patients with neuroborreliosis (14.7%) than in patients with Lyme arthritis (4.3%). A group of females with neuroborreliosis and a group of males with the same diagnosis demonstrated cognitive deficits significantly more often (23.3% and 8.9%, respectively), compared to groups of patients with Lyme arthritis (6.5% in females and no cognitive deficits in males). A significantly higher percentage of depressive disorders was also noted in the group of males and females with neuroborreliosis (50.7%), compared to the group of patients with Lyme arthritis (39.1%). The symptoms of depression were particularly frequent in the females with neuroborreliosis (60%). The severity of depression measured by BDI was mild or moderate in most cases. In the examined groups, more patients with neuroborreliosis (44%), both in females (36.7%) and males (48.9%), demonstrated anxiety disorders. The obtained results showed a higher frequency of affective disorders compared to cognitive deficits, both in patients with Lyme arthritis and neuroborreliosis. CONCLUSIONS: An increased frequency of depressive and neurotic disorders was observed in patients with LB, particularly in patients with neuroborreliosis. Neurotic disorders, mainly adaptive, were most common in males with LB, while depressive disorders were more frequent in females. An increased frequency of cognitive deficits was observed in patients with neuroborreliosis, particularly in females.

Acute liver failure during treatment of interferon alpha 2a chronic hepatitis B and coinfection of parvovirus B19

Parvovirus B19 infection is associated with a broad spectrum of clinical manifestations among which some are well known but others remain controversial. The role of this infection as a cause of acute hepatitis or exacerbation of chronic liver disease requires discussion regarding its significance in a strategy of prevention and treatment of patients with chronic hepatitis. Clinical importance of this infection in patients with chronic hepatitis B treated with pegylated interferon alpha 2a is still unclear but exactly in this population significant complications during treatment may arise. Parvovirus B19 infection is not rare among persons with chronic hepatitis B, therefore searching for co-infection should be placed in standard diagnostic procedures especially in case of exacerbation of chronic hepatitis, pancytopaenia or anaemia of unknown origin. Pegylated interferon alpha 2a still remains a gold standard of therapy of patients with chronic hepatitis B according to European (EASL) and Polish guidelines. We present a case of 35 years old woman treated with pegylated interferon alpha 2a who developed acute liver failure in 23rd week of chronic hepatitis B therapy. An exacerbation of hepatitis with encephalopathy and pancytopaenia have been observed. Parvovirus B19 and HBV co-infection does not increase the frequency of liver function abnormalities in patients with chronic hepatitis B. Further investigations should be done to describe the natural course of co-infection with parvovirus B19 and HBV and to establish possible association between parvovirus B19 infection and chronic hepatitis B and also the influence of interferon alpha 2a on the infections course.

Cerebrospinal fluid ferritin concentration in patients with purulent, bacterial meningitis ­ own observations / Stezenie ferrytyny w plynie mózgowo-rdzeniowym chorych z ropnymi, bakteryjnymi zapaleniami opon i mózgu - obserwacje wlasne

THE AIM: The aim of the study was to evaluate the usefulness of cerebrospinal fluid (CSF) ferritin concentration assessment in adults with purulent, bacterial meningoencephalitis. MATERIAL AND METHODS: The investigation was performed in 18 subjects hospitalized at the Clinical Ward of Infectious Diseases, Medical University of Silesia in Bytom from 2008 through 2012, for purulent, bacterial meningoencephalitis. The patients were divided into two groups, according to severity of their clinical condition: Group I ­ very severe course of the disease, group II ­ moderate and mild course of the disease. In all the individuals, CSF interleukin-6 concentration was evaluated during the first 24 hours of hospitalization. RESULTS: Mean CSF ferritin concentration in patients in very severe clinical condition (group I) was 314.71 ng/mL as compared to 162.13 ng/mL in subjects of group II with moderate and mild course of the disease. The difference between CSF mean concentration of this cytokine was statistically significant (p<0.01). Correlations between CSF ferritin and CSF protein and lactate were determined. The control assays performed in 6 patients from group I revealed only slightly decrease of CSF ferritin level in the fatal course of the disease. In survivals with recovery CSF concentration of this protein was decreased markedly as compared to the initial level. CONCLUSIONS: The obtained results indicate the usefulness of CSF ferritin concentration assessment in estimation of intensity of inflammation in the subarachnoid space, and indirectly, of severity of the patient's clinical condition. The level of this protein concentration also seems to be helpful as a prognostic marker in purulent, bacterial meningoencephalitis.

Omentin serum concentration and hepatic expression in chronic hepatitis C patients - together or apart?

Chronic hepatitis C (CHC) is accompanied by numerous metabolic disorders, partially associated with altered adipokine system regulation. Omentin (intelectin-1) is a novel adipokine known to play a pivotal role in metabolic regulation in CHC. In a group of 63 CHC patients (29 men/34 women) infected with genotype 1b, aged 6.6 ± 14.6 years, serum omentin levels and its gene expression in liver tissue were examined and their association with metabolic and histopathological features was assessed. Serum omentin levels were significantly higher in CHC patients compared to controls (p < 0.001), regardless of sex, body mass index (BMI), insulin sensitivity and lipid concentrations. There was no correlation between serum omentin and omentin hepatic expression. Neither parameter was associated with any histological features. Serum omentin in non-obese CHC patients seems not to be related to metabolic disorders or liver pathology. Omentin hepatic expression shows no relationship with either serum omentin levels or histopathological features. This suggests different mechanisms regulating circulating omentin concentration and omentin hepatic expression in CHC.

Chemokine CXCL13 concentration in cerebrospinal fluid in patients with neuroborreliosis--own observations.

THE AIM: of the study was to evaluate the usefulness of cerebrospinal fluid chemokine CXCL13 concentration assay in diagnostics of neuroborreliosis in adults. MATERIAL AND METHODS: Investigations were carried out in 22 patients treated for neuroborreliosis , manifested as lymphocytic meningitis, at the Department of Infectious Diseases, Medical University of Silesia, in Bytom between 2011-2013. Based on the presence or absence of anti-borrelial antibodies in the cerebrospinal fluid, the examined individuals were divided into two groups on the day of admission: group I--patients with antiborrelial antibodies in the cerebrospinal fluid (confirmed diagnosis of neuroborreliosis), group II--patients without antiborrelial antibodies in the cerebrospinal fluid (possible diagnosis of neuroborreliosis). In all patients the cerebrospinal fluid CXCL13 level was assessed on the first day of hospitalization. Control tests were performed in both groups after 14 days of therapy with antibiotics. RESULTS: Mean cerebrospinal fluid CXCL13 concentration in group I on the 1st day was 4123 pg/mL, and in group II--3422 pg/mL. Differences in mean concentrations of this chemokine were statistically insignificant. No correlations between examined mean CXCL13 concentrations and other cerebrospinal fluid inflammatory parameters were revealed. The control tests showed the evident decrease of CXCL13 level in cerebrospinal fluid in both groups. Besides, in individuals of group II anti-Borrelia burgdorferi antibodies appeared in cerebrospinal fluid, whereas in group I, the control results of this parameter were similar to preliminary values. CONCLUSION: The obtained results indicate a kind of usefulness of estimation of cerebrospinal fluid chemokine CXCL13 concentration in diagnostics of early, acute neuroborreliosis, manifested as lymphocytic meningitis, especially in case of anti-borrelia antibodies absence in cerebrospinal fluid. Changes in this chemokine concentrations, opposite to cerebrospinal fluid levels of anti-borrelia antibodies, may be prognostic in acute, early neuroborreliosis.

The epidemiological and clinical analysis of Clostridium difficile infections in patients hospitalized due to the infection at the Department of Infectious Diseases in Bytom.

UNLABELLED: Clostridium difficile infections are becoming a more serious problem as hospital-acquired infections and the consequence of common antibiotic therapy, also on an out-patient basis. AIM OF THE STUDY: The aim of the study was the epidemiological and clinical analysis of patients with Clostridium difficile-associated disease (CDAD) at the Clinical Department of Infectious Diseases and Hepatology, Bytom in 2014. MATERIAL AND METHODS: A retrospective analysis of the medical documentation of patients with the diagnosis of CDAD was performed. The study group was comprised of 24 patients. The following factors were analysed: gender, age, recent hospitalization, use of proton-pump inhibitors, H2-receptor inhibitors, use of antibiotics, co-morbidities, and the clinical course with consideration given to additional laboratory tests (CRP, creatinine, WBC count). RESULTS: All patients with diagnosed CDAD had been previously hospitalized and 75% of subjects were treated with antibiotics in the period preceding the onset of the disease. Recurrence of the disease was observed in 29% of cases, on average, 12.5 days after hospital discharge. In 16.7% of patients, CDAD resulted in death. Higher CRP concentrations on admission were observed in patients who died compared to the survivors (91.1 mg/l vs. 33.6 mg/l, p=0.015). Additionally, higher concentrations of CRP and leukocytosis were observed in patients with an unfavourable outcome of the disease. Respiratory insufficiency and hypotension were connected with a higher risk of death. CONCLUSION: Hospitalization, antibiotic therapy, advanced age and co-morbidities may contribute to the occurrence of CDAD. In our study, initially high concentrations of CRP, respiratory insufficiency and hypotension were the predictive factors of a fatal outcome of the disease. The dynamics of changes in the leukocyte value and CRP concentration were of lesser importance.

Hepatic chemerin and chemokine-like receptor 1 expression in patients with chronic hepatitis C.

INTRODUCTION: Chemerin seems to be involved in pathogenesis of chronic hepatitis C (CHC). Hepatic expressions of chemerin and its receptor, chemokine receptor-like 1 (CMKLR1), in CHC have not been studied so far. AIM: To evaluate chemerin and CMKLR1 hepatic expression together with serum chemerin concentration in CHC patients and to assess their relationship with metabolic and histopathological abnormalities. METHODS: The study included 63 nonobese CHC patients. Transcription of chemerin and CMKLR1 was assessed by quantitative real-time PCR, while serum chemerin was assessed by enzyme-linked immunosorbent assay. RESULTS: Expression of chemerin and CMKLR1 was present in the liver of all CHC patients regardless of sex or age. This expression was not associated with necroinflammatory activity and steatosis grade, fibrosis stage, and metabolic abnormalities. There was a negative association between serum chemerin and chemerin hepatic expression (r = (-0.41), P = 0.006). CONCLUSION: The study for the first time confirmed a marked expression of chemerin and CMKLR1 in the liver of CHC patients. The study was performed using the homogenates of human liver tissue, so it is not possible to define whether hepatocytes or other cell types which are abundantly represented in the liver constitute the main source of chemerin and CMKLR1 mRNA.

Cerebrospinal fluid interleukin-6 concentration in patients with purulent, bacterial meningitis - own observations.

AIM: This study aimed at evaluating the usefulness of determining cerebrospinal fluid (CSF) interleukin-6 (IL-6) concentration in adults with purulent, bacterial meningoencephalitis. MATERIALAND METHODS: A study group consisted of 16 patients hospitalized in the Department of Infectious Diseases of the Medical University of Silesia in Bytom in 2008 - 2012 due to purulent, bacterial meningoencephalitis. All of them were classified into two groups based on clinical severity, assessed on admission: group I - severe condition, group II - moderately severe or mild condition. CSF IL-6 concentration was measured in all patients on the first day of hospitalization. RESULTS: Mean concentrations of IL-6 in CSF were assessed at 391.54 pg/mL and 110.51 pg/mL in patients in severe (group I) and moderately severe or mild condition (group II), respectively. Differences between CSF mean concentrations of this cytokine in both groups were statistically significant (p<0.01). No correlations between CSF IL-6 concentrations and other CSF inflammatory parameters were determined. Control testing performed in 5 patients of group I revealed only slight decrease of CSF IL-6 concentration in fatal cases. In case of patients who recovered from disease, IL-6 concentration in CSF was evidently decreased compared to its initial value. CONCLUSIONS: Results suggest the usefulness of determining CSF interleukin-6 concentration to estimate inflammation intensity in the subarachnoid space, and indirectly, patient's clinical severity. IL-6 concentration may be also of prognostic importance in purulent, bacterial meningoencephalitis.

Evaluation of cerebrospinal fluid S100B protein concentration in patients with purulent, bacterial meningitis - own observations.

UNLABELLED: The aim of the study was evaluation of usefulness of cerebrospinal fluid (CSF) S100 B protein concentration assessment in adults with purulent, bacterial meningoencephalitis. MATERIAL AND METHODS: The investigation was performed in 16 subjects hospitalized at the Department of Infectious Diseases of Medical University of Silesia in Bytom in 2008 - 2012 due to purulent, bacterial meningoencephalitis. All patients were divided into two groups according to the severity of their clinical condition: I group - very severe course of the disease, II group - moderate and mild course of the disease. In all individuals CSF S100 B protein concentration was evaluated during the first 24 hours ofhospitalization. RESULTS: Mean CSF S100 B protein concentration in patients in very severe clinical condition (group I) was 1215.63 pg/mL compared to 419.56 pg/mL in subjects of group II with moderate and mild course of disease. The difference between CSF mean concentration of this protein was statistically significant (p<0.01). No correlations were assessed between CSF S100 B protein concentrations and other CSF inflammatory parameters. Control assays performed in 7 patients from group I revealed only slightly decrease of CSF S100 B protein level in fatal course of the disease. In survivals with recovery CSF concentration of this protein was evident decreased compared to initial level. CONCLUSIONS: The obtained results indicate the usefulness of CSF S100 B protein concentration assessment in estimation of severity of the patient's clinical condition. The level of this protein concentration also seems to be helpful as prognostic marker in purulent, bacterial meningoencephalitis.

[Evaluation of the concentration of cerebrospinal fluid ciliary neurotrophic factor (CNTF) in patients with purulent, bacterial meningitis--own observations]. / Ocena stezenia rzeskowego czynnika neurotropowego (CNTF) w plynie mózgowo-rdzeniowym chorych z ropnymi, bakteryjnymi zapaleniami opon i mózgu--obserwacje wlasne.

UNLABELLED: THE AIM of the study was evaluation of usefulness of cerebrospinal fluid (CSF) ciliary neurotrophic factor (CNTF) concentration assessment in adults with purulent, bacterial meningoencephalitis. MATERIAL AND METHODS: The investigation was performed in 14 subjects hospitalized at the Department of Infectious Diseases of Medical University of Silesia in Bytom from 2007 - 2009 due to purulent, bacterial meningoencephalitis. All patients were divided into to groups according to the severity of their clinical condition: I group - very severe course of the disease, II group - moderate and mild course of the disease. In all individuals CSF CNTF concentration was evaluated during the first 24 hours of hospitalization. RESULTS: Mean CSF CNTF concentration in patients in very severe clinical condition (group I) was 14,73 pg/ mL compared to 6,79 pg/mL in subjects of group II with moderate and mild course of disease. The difference between CSF mean concentration of this cytokine was statistically significant (p < 0,01). No correlations were assessed between CSF CNTF concentrations and other CSF inflammatory parameters. Control assays performed in 4 patients from group I revealed evident decrease of CSF CNTF level in fatal course of the disease. In survivals with recovery CSF concentration of this cytokine was only slightly decreased compared to initial level. CONCLUSIONS. The obtained results indicate the usefulness of CSF CNTF concentration assessment in estimation of severity of the patient's clinical condition. The level of this cytokine concentration also seems to be helpful as prognostic marker in purulent, bacterial meningoencephalitis.

Serum FGF21 and RBP4 levels in patients with chronic hepatitis C.

INTRODUCTION: Fibroblast growth factor-21 (FGF21) regulates glucose, lipid, and energy homeostasis. Retinol-binding protein-4 (RBP4) controls metabolic and proliferative cell functions. AIMS AND METHODS: Aims of the study were to assess (1) serum FGF21 and RBP4 levels in 75 non-obese chronic hepatitis C (CHC) patients and 41 healthy controls similar in age and BMI; (2) the relationship between their serum concentration and insulin resistance, liver histology, and biochemical parameters; (3) their effectiveness as diagnostic markers. RESULTS: FGF21 levels increased significantly in CHC patients compared with controls (p = 0.04). CHC patients with steatosis had significantly higher FGF21 levels compared with those without steatosis (p = 0.01). FGF21 concentration was positively related to steatosis grade (r = 0.39, p = 0.007). RBP4 levels did not differ between CHC patients and controls, but were negatively associated with necro-inflammatory activity grade (r = (-0.34), p = 0.04), with significantly higher levels in patients with minimal inflammatory activity (G1 vs. G2/3, p < 0.001; G1 vs. G2, p = 0 < 001; G1 vs. G3, p = 0.01). After stepwise linear regression analysis adjusting for potential confounders, RBP4 levels retained their independent significance as a predictor of necro-inflammatory activity (ß = -0.31; t = -2.15, p = 0.035) and FGF21 levels as a predictor of steatosis (ß = 0.34; t = 2.31, p = 0.024). Serum FGF21 correlated with serum RBP4 levels (r = 0.32, p = 0.02). CONCLUSIONS: Serum FGF21 levels increased in CHC patients, especially in those with steatosis and were associated with steatosis grade. FGF21 seems to be a useful diagnostic marker in determining hepatic steatosis in CHC. A negative association between serum RBP4 and necro-inflammatory activity indicates that disease severity may determine RBP4 levels.

[Evaluation of cerebrospinal fluid and plasma neuron-specific enolase (NSE) concentration in patients with purulent, bacterial meningoencephalitis]. / Ocena stezenia enolazy neuronowo-swoistej (NSE) w plynie mózgowo-rdzeniowym i w surowicy chorych z ropnymi, bakteryjnymi zapaleniami opon i mózgu.

The aim of the study was evaluation of usefulness of cerebrospinal fluid (CSF) neuron--specific enolase (NSE) concentration assessment in diagnostics of purulent, bacterial meningoencephalitis in adults. The investigations were performed in 16 subjects. In all individuals CSF and plasma NSE concentration was estimated during the first 24 hours of hospitalization. Mean CSF NSE concentration in patients in very severe clinical state (group I) was 19.8 microg/L compared to 10.46 microg/L in subjects of group II with moderate and mild course of disease. The difference between mean CSF concentrations of this enzyme was statistically significant (p<0.01). The obtained results indicate the usefulness of CSF NSE concentration assessment in estimation of severity of the patient's clinical state. The magnitude of this concentration seems to be also helpful as prognostic marker in purulent, bacterial meningoencephalitis.

[Evaluation of the usefulness cerebrospinal fluid myelin basic protein (MBP) concentration examination in patients with Lyme neuroborreliosis--preliminary study]. / Ocena przydatnosci oznaczania stezenia bialka zasadowego mieliny (MBP) w plynie mózgowo-rdzeniowym u chorych z neuroborelioza z Lyme--doniesienie wstepne.

The aim of the study was evaluation of usefulness of cerebrospinal fluid (CSF) myelin basic protein (MBP) level examination in diagnostics of Lyme neuroborreliosis. The study was performed in 24 subjects. In all individuals CSF MBP concentration was estimated on the 1st day of hospitalization. In patients with depressive and cognitive impairments, proved in neuropsychological tests (group I), mean CSF MBP concentration was 3.1 ng/mL, whereas in subjects without abnormalities in tests (group II), respectively, 1.2 ng/mL. The difference of mean CSF MBP levels was statistically significant (p<0.01). The obtained results indicate usefulness of this CSF parameter, besides neuropsychological tests, in objective evaluation of clinical state in patients with chronic Lyme neuroborreliosis.

[Community-acquired Escherichia coli meningoencephalitis in an adult--case report]. / Zapalenie opon mózgowo-rdzeniowych i mózgu wywolane pozaszpitalnym zakazeniem Escherichia coli u doroslego--opis przypadku.

The case of community-acquired meningoencephalitis induced by Escherichia coli in a 89-year-old man was presented. The authors paid attention to possibility of occurring central nervous system infections caused by this bacterium also in adults, in community environment and without concomitant factors favourable to the infection.

[Evaluation of cerebrospinal fluid serotonin (5-HT) concentration in patients with post-Lyme disease syndrome--preliminary study]. / Ocena stezenia serotoniny (5-HT) w plynie mózgowo-rdzeniowym chorych z tzw. zespolem po chorobie z Lyme--doniesienie wstepne.

The aim of the study was evaluation of usefulness of cerebrospinal fluid (CSF) serotonin level examination in diagnostics of post-Lyme disease syndrome. The study was performed in 16 subjects. In all individuals CSF serotonin concentration was estimated on the 1st day of hospitalization. In patients with depressive and cognitive impairments, proved in neuropsychological tests, - group I--mean CSF serotonin concentration was 1,26 ng/ml, whereas in subjects without abnormalities in tests--group II--respectively--3,87 ng/ml. The difference of mean CSF serotonin levels was statistically significant (p<0,01). The obtained results indicate usefulness of this CSF parameter, besides neuropsychological tests, in objective evaluation of clinical state in patients with post-Lyme disease syndrome.

[Evaluation of cerebrospinal fluid and plasma creatine kinase (CK) activity in patients with purulent, bacterial meningoencephalitis]. / Ocena aktywnósci kinazy kreatynowej (CK) w plynie mózgowo-rdzeniowym i w surowicy chorych z ropnymi, bakteryjnymi zapaleniami opon i mózgu.

The aim of the study was evaluation of usefulness of cerebrospinal fluid (CSF) creatine kinase (CK) activity assessment in diagnostics of purulent, bacterial meningoencephalitis in adults. The investigations were performed in 18 subjects. In all individuals CSF and plasma CK activity was estimated during the first 24 hours of hospitalization. Mean CSF CK activity in patients in very severe clinical state (group I) was 27,41 IU/L compared to 16,73 IU/L in subjects of group II with moderate and mild course of disease. The difference between mean CSF activities of this enzyme was statistically significant (p < 0,01). The obtained results indicate the usefulness of CSF CK activity assessment in estimation of severity of the patient's clinical state. The magnitude of this activity seems to be also helpful as prognostic marker in purulent, bacterial meningoencephalitis.

[Evaluation of cerebrospinal fluid and plasma lactate dehydrogenase activity in patients with purulent, bacterial meningoencephalitis]. / Ocenaaktywnosci dehydrogenazy mleczanowej (LDH) w plynie mózgowo-rdzeniowym i w surowicy chorych z ropnymi, bakteryjnymi zapaleniami opon i mózgu.

The aim of the study was evaluation of usefulness of cerebrospinal fluid (CSF) lactate dehydrogenase (LDH) activity assessment in diagnostics of purulent, bacterial meningoencephalitis in adults. The investigations were performed in 17 subjects. In all individuals CSF and plasma LDH activity was estimated during the first 24 hours of hospitalization. Mean CSF LDH activity in patients in very severe clinical state (group I) was 299,11 U/L compared to 163,67 U/L in subjects of group II with moderate and mild course of disease. The difference between mean CSF activities of this enzyme was statistically significant (p<0,001). The obtained results indicate the usefulness of CSF LDH activity assessment in estimation of severity of the patient's clinical state. The magnitude of this activity seems to be also helpful as prognostic marker in purulent, bacterial meningoencephalitis.

[EEG examination in patients with purulent, bacterial meningoencephalitis--literature review and own observations]. / Badania EEG u chorych z ropnymi, bakteryjnymi zapaleniami opon i mózgu- przeglad publikacji i obserwacje wlasne.

The study presents the literature review on EEG examination in purulent, bacterial meningoencephalitis as well as own observations carried out in 42 patients with this neuroinfection treated in I Department of Infectious Diseases of Medical University of Silesia in Bytom between 1989-2001. In 19 patients the result of the first examination was abnormal and the degree of EEG patterns pathology correlated with the severity of their clinical condition. Abnormal electroencephalogram was also noted in 7 cases in the control examination. Two of this group of patients died and in two cases pathological EEG patterns preceded epileptic seizures during further hospitalization. Besides, the conversion of normal at the beginning into abnormal EEG patterns was found in cases of purulent, bacterial meningoencephalitis various complications, e.g. brain abscess. The obtained results indicate that EEG examination carried out in the acute phase of purulent, bacterial meningoencephalitis may be helpful in the estimation of severity of patient's clinical state. Performing of EEG examination in series during and after hospitalization may be useful for monitoring the course of the disease and prognosis of its outcome.

[Procalcitonin (PCT) concentration in cerebrospinal fluid and plasma of patients with purulent and lymphocytic meningoencephalitis--own observations]. / Prokalcytonina (PCT) w plynie mózgowo-rdzeniowym i w surowicy chorych z bakteryjnymi ropnymi i limfocytarnymi zapaleniami opon i mózgu u doroslych--obserwacje wlasne.

The aim of the study was assessment of usefulness of cerebrospinal fluid (CSF) and plasma procalcitonin concentration estimation in differential diagnosis of neuroinfections in adults. Examinations were carried out in 17 subjects with purulent, bacterial meningoencephalitis and in 16 patients with lymphocytic meningitis. In all individuals CSF and plasma PCT concentrations were assessed on the 1st day of hospitalization. In patients with purulent, bacterial meningoencephalitis mean CSF concentration was 0,63 ng/mL, mean plasma PCT concentration--9,97 ng/mL. Mean CSF PCT concentration in patients with lymphocytic meningitis was 0,23 ng/mL and mean plasma PCT concentration--0,27 ng/mL. Differences of mean PCT concentrations between both groups of patients were statistically significant: CSF--p<0,05 and plasma--p<0,01. Obtained results indicate usefulness of plasma PCT concentration estimation in differential diagnosis of neuroinfections in adults. Cerebrospinal fluid PCT concentration seems to be of lesser importance in differential diagnosis of neuroinfections, but value of this parameter often correlates with the severity of the clinical state of the patients and may be taken into consideration in prognosis of the course and outcome of the bacterial meningoencephalitis.