[Brucellosis spondilitis in a ten year boy]. / Brucelozni spondilitis u desetogodisnjeg djecaka.

INTRODUCTION: Brucellosis is acute infectious disease classified as zoonosis, which can leave humans with chronic damages and disability. It can appear as sporadic cases or a smaller epidemic anywhere in the world but it is more common in some areas and there it presents significant public health issue. Clinical picture is very variegated. A long period of latency is possible, unnoticed asymptomatic start or forms with mild clinical picture up to the forms with per acute septic-toxic shock and possible lethal outcome. Symptoms of general infectious syndrome, wave like (undulating) temperature, profuse night sweat, muscle, bone and joint pain can be considered to be characteristic. Diagnosis is made based on epidemiological data, clinical findings, microbiological and serological tests. Differentially diagnostic all long-lasting febrile diseases may be considered and disease with neuralgic and arthralgic syndromes. Therapy includes antibiotics and prevention implies sanitary veterinary control, food control and measures of professional protection. METHODS: This paper descriptively describes clinical course of the disease in ten year old boy with brucellosis spondylitis. CASE REPORT: Ten year old boy was hospitalized for febrile condition and acute pain in back and abdomen of unknown etiology. We did diagnostic and therapeutic treatment with multidisciplinary approach and due to information on previous cases of brucellosis in family we also added tests to brucellosis. Diagnosis of brucellosis spondylitis is made based on MRI of lumbosacral spine and is confirmed with positive serological tests and positive blood cultures to Brucella melitensis. The boy had no other localized foci of the disease in other organs or systems. Etiological treatment was done in accordance to recommended antimicrobic scheme. A complete recovery was achieved with further need for observation of condition and Elisa titer to this agent. CONCLUSION: Osteoarticular form of brucellosis is relatively common focal form of the disease in adult patients but not so common in children. Syndrome of acute lumbosacral pain in children is of unknown etiology and diagnostic procedures must include infectious diseases with possible osteo-articular symptoms including brucellosis.

[Retrospective analyzes of patients with meningococcal sepsis and meningitis during the period of ten years (1995-2004)]. / Retrospektivna analiza bolesnika s meningokoknom sepsom i meningitisom u desetogodisnjem razdoblju (1995.-2004.).

Meningococcal disease is the most significant cause of morbidity and mortality even in the most developed socio-economic surroundings. Meningococcal sepsis and meningitis are caused by Neisseria meningitidis (NM), which is surrounded by polysaharide capsule, which is the main factor of virulence. THE GOAL OF THE WORK: was to confirm the frequency and characteristics of meningococcal disease as well as the justification of introducing vaccination. Through retrospective analysis of the history of the disease, a total of 87 patients with meningococcal sepsis hospitalized at the hospital for infectious in Tuzla in the period 1995 to 2004. diseases were included. Out of 87 hospitalized patients, 34 patients (39%) had meningococcal sepsis, meningococcal sepsis and meningitis had 50 patients (57.6%), and only 3 patients (3.4%) had only meningitis. The diseases most frequently appears in males, 54 patients (62.0%), and in females, 33 patients (38.0%). The largest number of diseased is in the period 0-12 months, 39 patients (44.8%), and then in the period from 13-24 months, 19 diseased (21.8%), from 3-6 years of age 12 patients (13.8%), after sixth year of age meningococcal disease appears in a smaller percent. The youngest patient was 3 and a half months old, and the oldest was 23 years old. Diagnosis was established based on the history of the disease, clinical examination, lab researches, biochemical and bacteriological search of liquid. Etiological cause was proved through liquor culture in 24 cases (27.5%), hemoculture in two cases (2.29%). Death was the result in eight cases (9.1%), one patient (1.1%) resulted in the amputation of a finger, and the rest of 78 patient (89.6%) are cured without sequel. Patients are treated with the Penicillin G, Ampicillin, and in a case of the resistance, were treated with cephalospores of third generation. CONCLUSION: the meningococcal disease, and especially its form of Waterhause-Friderichsen syndrome represents a hard disease which in 50% of cases has a death as the result.