[Ehrlichiosis: a tick-born infection]. / Erlichioza--choroba przenoszona przez kleszcze.

Ehrlichiosis is the potentially life-threating infection. It is caused by obligate intracellular bacteria. The clinical presentations are fever, headache, myalgia, malaise, nausea, vomiting and other nonspecyfic symptoms. Some patients develop neurologic symptoms and signs. The are two distinct forms of human ehrlichiosis: human monocytic ehrlichiosis /HME/--cased by Ehrlichia chaffeensis that infects mononuclear phagocytes and human granulocytic ehrlichiosis /HGE/--caused by E. species closely related to E. phagocytophyla and E. equi and infects granulocytes. Successful treatment of these infections may depend on proper diagnosis. Appropiate diagnostic tests are still not available. This diagnisis should be considered in febrile patients with tick bites.

[Detection of antibodies to Borrelia burgdorferi among forestry workers in North-Eastern Poland]. / Wykrywalnosc przeciwcial przeciwko Borrelia Burgdorferi wsród pracowników lesnictwa w pólnocno-wschodnim regionie Polski.

The purpose of the study was to assess the incidence of Borrelia burgdorferi antibodies and clinical forms of Lyme borreliosis among forestry workers in north-eastern Poland. The group studied consisted of 1,466 persons (297 women and 1,169 men), aged 20-70 years. In 439 (23.81%) persons the presence of B. burgdorferi antibodies was detected in serum, in 271 (18.49%) persons active Lyme borreliosis was diagnosed and 78 (5.32%) persons were carriers of B. burgdorferi antibodies. Arthritis (43.84%) and neuroborreliosis (32.95%) were found to be the most common forms of borreliosis.

[Lasting hearing loss in the course of neuro-borreliosis]. / Trwale uszkodzenie sluchu w przebiegu neuroboreliozy.

Lyme borreliosis is spirochetal disease that frequently affects the nervous system months or years after infection giving rise to a varied clinical picture named neuro-borreliosis. We report a case of 47 year old female with progressing hearing loss, tinnitus, paraparesis and ataxia. The disease was beginning six month earlier by weakness of the lower limbs associated with hearing loss. The patient did not remember to be exposed to ticks and did not recall the presence of erythema migrans, arthritis or other systemic signs. CSF was with mononuclear pleocytosis and protein concentration over 600 mg%. Firstly patient was unsuccessfully treated like encephalomeningitis with tbc etiology. Next cerebrospinal fluid analysis showed presence of antibodies against Borrelia burgdorferi in IgG and IgM class. IgG antibodies in serum were founded. Audiometry electric responses from brain stem showed sensorineural hearing loss. Therapy with ceftriaxone was successful. Because negative tick bile history and many signs from different parts of CNS, relationship of this spirochetal infection and severe otolaryngological and neurological disease was firstly difficult to recognition.

[Otoneurologic state estimation 2 years after tick-borne encephalitis]. / Ocena stanu otoneurologicznego po 2 latach od przebycia kleszczowego zapalenia mózgu.

In this paper an attempt is described to estimate the incidence and frequency of neurologic and otologic symptoms among patients two years after TBE. We examined 43 persons of both sexes aged 17-58. The most frequent complaints were: headache--34.9%, equilibrium problems--37.2%, buzzing in the ears--27.9%, hearing problems--23.3%, memory problems--25.6%. Decrease of throat reflexes was stated in 3 (7%) and pseudobulbaris symptoms in 2 (4.6%), weakness of muscles in 4 (9.3%). In audiometric examination decrease of hearing was stated in 8 persons (18.5%). We registered nystagmus: spontaneous--4.6-7%, gaze--13.9-18.6%, positional-T, mainly Nylen I and III type-18.6-25.6%. Pathologic recording in the eye-tracking pattern test was shown in 7 (16.3%) persons. Asymmetry of optokinetic nystagmus was stated in 6 (13.9%) examined persons. Asymmetry in caloric test was proved in 25.5% of examined persons.

[Lymphocytic meningitis with the involvement of the skull in the course of spinal cord neoplasm simulating neuroborreliosis. Case report]. / Limfocytarne zapalenie opon mózgowo-rdzeniowych z zajeciem nn. czaszkowych w przebiegu procesu nowotworowego kanalu kregowego imitujace neuroborelioze. Opis przypadku.

UNLABELLED: We describe a case of 48 year old male patient treated in the Department of Parasitic Diseases and Neuroinfections AMB with suspected neuroborreliosis. CLINICAL SYMPTOMS: lymphocytic meningitis with cranial neuropathies n. VII palsy and radiculitis after numerous tick bites in endemic area--indicated neuroborreliosis. Because there was no effect of antibiotic therapy and lack antibodies against B-burgdorferi in serum and CSF we excluded neuroborreliosis. Developing neuropathies III-XII, increasing cytosis and protein concentration, radiculalgia and difficulties in walking, cachexia made us think of tbc etiology. Patient failed to improve after anti-tbc treatment. CT and MR showed presence of neoplasmatic masses in spinal canal. In cytologic examination "neoplasma malignum male differentiatum probabiliter metastaticum" was found. Primary focus of neoplasmatic process was not found.

[Tuberculous lymphadenitis--diagnostic difficulties]. / Gruzlicze zapalenie Wezlów chlonnych--trudnosci diagnostyczne.

Three cases of tuberculous lymphadenitis hospitalized in Department of Parasitology and Neuroinfection are presented. In all patients tuberculin test was positive. In 2 patients minimal lesions in lungs were present. In non patient BK in sputum was found. In microscopic picture of enlarged lymph nodes non specific inflammation granulomatosis was found but microbiological examinations were not done. In all patients the results of smears of lymph nodes pus were negative. In 2 patients culture was positive. Persistent enlarged peripheral lymphatic nodes, especially with fistula should be suspected of tuberculous etiology. Material obtained from node's biopsy should be taken to microbiological and histological examination.

[Diagnostic difficulties in tuberculous meningoencephalitis]. / Trudnosci w rozpoznaniu gruzliczego zapalenia opon mózgowo-rdzeniowych i mózgu.

Five cases of tuberculous meningoencephalitis with severe course treated in the period 1991-1994 at the Department of Parasitic Diseases and Neuroinfections, Medical Academy in Bialystok are reported. Diagnostic difficulties encountered in these cases, the clinical courses and the results of the treatment are discussed. The always lethal outcome of untreated tuberculous meningoencephalitis requires antituberculosis treatment to be tried in all cases of meningitis with severe and protracted course, with equivocal results of cerebrospinal fluid analysis, and lacking effect of non-specific therapy.

[A case of tuberculous lymphadenitis--diagnostic difficulties]. / Przypadek gruzliczego zapalenia wezlów chlonnych szyjnych--trudnosci diagnostyczne.

There is presented the case of tuberculous cervical lymphadenitis of 60 years old patient who was hospitalized in Clinic of. Parasitic Diseases and Neuroinfection in 1992 and diagnostic difficulties connected with it.

[Tuberculous meningoencephalitis from personal material]. / Gruzlicze zapalenie opon mózgowo-rdzeniowych i mózgu w materiale wiasnym.

Clinical characteristics of 6 patients with tuberculous meningoencephalitis is presented. The increased morbidity of tuberculosis in recent years makes it necessary to consider this etiology in the diagnosis of CNS infections especially with severe atypic and long lasting course. In the case when tuberculous etiology is suspected the anti tuberculous treatment should be applied. Using new and modern diagnostic methods of CSF will allow to diagnose tuberculous meningoencephalitis earlier and will improve prognosis in this disease.

[Encephalitis with cerebellar syndrome as rare complication of varicella]. / Rzadkie powiklanie pod postacia zapalenia mózgu z zespolem mózdzkowym w przebiegu ospy wietrznej.

A 17-years old patient with severe encephalitis during chicken-pox is presented. The authors discuss the efficacy of used corticosteroid therapy.

[Otoneurological aspects of tick-borne encephalitis]. / Aspekty otoneurologiczne kleszczowego zapalenia opon mózgowo-rdzeniowych i mózgu.

In analysed material of 31 patients with TBE (tick borne encephalitis) we noticed symptoms evidence the impact of TBE virus vestibular system. We showed that 21 patients had disorders like dizziness and lack of balance. And 11 patients had inaudility of conductive and receiving type what was the evidence of injury of vestibular nerve. In these 11 patients we observed not normal recording of optokinetical reaction.