[Dilated cardiomyopathy in HIV infection]. / Kardiomiopatia rozstrzeniowa w przebiegu zakazenia HIV.

The HIV-positive patient with dilated cardiomyopathy was described. Possible causes of heart failure in HIV infection was discussed. To achieve subclinical heart failure diagnosis authors suggest to perform echocardiography as a routine procedure in HIV-positive patients with low CD4 lymphocytes count and who have been infected for long time or when their disease becomes more advanced.

[Cryptosporidiosis in HIV-positive patients]. / Kryptosporydioza u osób zakazonych HIV.

Cryptosporidium parvum is a coccidian parasite that affects millions of people worldwide. Clinical outcome of human cryptosporidiosis differs between immunocompetent and immnunodeficient individuals. C. parvum is responsible for causing protracted and life-threatening diarrhea, biliary, and pulmonary infections in immunocompromised persons, especially in patients with AIDS. Though no effective treatment has been found so far, early diagnosis may be useful in controlling the infection. Thirty-eight stool specimens obtained from 35 HIV-positive patients admitted to the Clinic of Infectious Diseases in Poznan, Poland, were examined for the detection of oocysts, coproantigen and DNA of Cryptosporidium using standard microscopic, immunologic and molecular diagnostic methods. The presence of Cryptosporidium was detected in 10 HIV-positive patients. Oocysts, coproantigen and DNA of this parasite were identified solely in one specimen while Cryptosporidium DNA was detected in 8 specimens. Cryptosporidium coproantigen was found only in one sample. Although, the PCR was the most useful technique in the detection of Cryptosporidium in HIV-positive patients it should be noted that PCR has many pitfalls and needs to be carefully controlled to avoid both false positive and false negative results.

[Spontaneous splenic rupture as a complication of infectious mononucleosis]. / Samoistne pekniecie sledziony w przebiegu mononukleozy zakaznej.

Spontaneous splenic rupture as a complication of infectious mononucleosis in 17-years old man was described. Clinical manifestations of infectious mononucleosis were typical without any sign of the splenic rupture. At the end of third week of the disease sonographic investigation revealed subcapsular hematoma of the spleen without overt rupture. The patient was observed. Five days later in the next sonographic investigation the second hematoma of the spleen appeared. Patient was treated underwent splenectomy and he remain alive and well. Authors suggest that in cases with subcapsular hematoma of the spleen splenectomy remains the treatment of choice. Mononucleosis patients with significant enlarged spleen should be observed very carefully. Authors propose control sonographic investigation in 3rd or 4th week of the disease in those cases.

[Long term results of vaccination against viral hepatitis B using recombinant vaccine Engerix B]. / Odlegle wyniki szczepienia przeciwko wirusowemu zapaleniu watroby typu B przy uzyciu rekombinowanej szczepionki Engerix B.

Among nineteen persons vaccinated against hepatitis B (recombinant Engerix B vaccine) fifteen (80 per cent) have developed anti-HBs (investigated 30 days after the third doses) on the protective level (10 U/l). After three and a half year three of them lost antibodies, and four had anti-HBs at level below 100 U/l. All of them received a booster doses, which resulted in a very high anti-HBs level one month later. Four persons without anti-HBs after the basic vaccination received in turn two booster doses: at the 3rd and 46th month. Only one person of them have remained a non-responder. We suggest to control a level of anti-HBs one month after basic vaccination for individual determination of the term of booster dose.

[Use of the "Multitest-CMI" in the evaluation of cutaneous delayed hypersensitivity reaction to antigens in patients with chronic diseases of the liver]. / Zastosowanie "Multitestu-CMI" w ocenie skórnej odpowiedzi typu póznego na antygeny przypominajace u chorych z przewlekøymi chorobami watroby.

Delayed cutaneous hypersensitivity was assessed in 120 patients (among them 109 HBsAg positive), with chronic persistent hepatitis, chronic active hepatitis, and compensated as well as decompensated liver cirrhosis by simultaneous application of seven standardized antigens and negative control ("Multitest CMI"). In 21 patients, after 12-24 months the tests were repeated. The sum of indurations of all positive responses ("score") were calculated. Responsiveness measured as results below a normal values was related to the advancing of liver disease (from 13% in chronic persistent hepatitis up to 77% in compensated and 61% in decompensated liver cirrhosis). A comparative analysis (t-Student test) of the arithmetical means of the "scores" revealed statistically significant differences between results obtained in diagnostic groups. It was also dependent from the severity of liver disease. Patients with chronic persistent hepatitis (without specific treatment) and patients with chronic active hepatitis (treated using thymus extract, TFX - "Polfa") has showed an increased "score" values. In contrast to this group, all persons with liver cirrhosis without skin-responsiveness in the first and second tests (anergy) died at the period of 18 months. "Multitest CMI" can be of value in assessing of results of immunotherapy, as well as prognosis of the course of advanced liver disease.