[Leishmaniasis: case report]. / Lejsmanioza: prikaz slucaja.

INTRODUCTION: Leishmaniasis is a chronic parasitic disease of the reticuloendothelial system which is manifested by gradual onset, unspecific disorders and can take a form of visceral, cutaneous or mucocutaneous leishmaniasis. The aim of the study is to present the patient who was treated for visceral leishmaniasis at the Clinic for Infectious Diseases in Novi Sad. CASE REPORT: A patient, 22 years old, had been admitted at the Clinic one month after the beginning of the disease with gradual onset malaise, fatigue, loss of appetite, intermittent temperature and night sweating. A few days before the admittance to the hospital, dark colour of urine and the pain under the left rib occurred. On admission, the patient had been afebrile, dehydrated, intoxicated, he had subicteric sclerae with enlarged liver and extremely enlarged spleen. Laboratory findings revealed anemia, leucopenia, and increased level of gamma globulins. Hypercellularity of the bone marrow with cells of all degrees of maturity had been determined by sternal puncture. We have epidemiologically obtained information about the bites of a mosquito from the Phlebotomus genus at the Adriatic coastal region, two years and two months ago. The diagnosis had been confirmed by the formol-gel test and by the indirect hemaglutination test. Leishmaniae donovani had been found in the bone marrow punctate. TREATMENT: The patient had been treated by appropriate doses of N-methyl-glucamine-antimonate (Glucantime), during three weeks, after which he was cured. During the one-year follow-up period normalization of laboratory findings as well as liver and spleen ultrasonographic findings occurred. CONCLUSION: Because of gradual onset and polymorphic troubles during the beginning of leishmaniasis, many diseases can be taken into account for diagnostic differentiation. From this study it is obvious that even the possibility of such a disease must be considered, despite the fact that it is rare in our region, because fatal outcome is avoidable only by the timely diagnosis and therapy.

[Therapy of salmonella gastroenterocolitis]. / Terapija salmoneloznog gastroenterokolitisa.

At the Clinic for infectious and dermatovenerologic diseases in Novi Sad a prospective randomized, simple, blind investigation of differently organized treatments of salmonellal gastroenterocolitis (symptomatic therapies, ampicillin, co-trimoxazole and ciprofloxacine) was carried out. It was established that there is no statistically significant difference in the length of febrile states in any of the compared therapeutic groups. However, ciprofloxacine significantly shortens diarrhea and excretion of germs comparing with other therapeutic treatments.

[Sensorineural impairment in the inner ear in epidemic parotitis]. / Senzorineuralno ostecenje unutrasnjeg uva u toku epidemicnog parotitisa.

During morbilli and mumps, classical forms of acquired deafness develop in childhood. The aim of the study was to investigate effects of mumps virus on cochlear function. Of 237 examined patients 71 had parotitis and 166 meningitis-meningoencephalitis. Audiometric analyses were carried out at the beginning of the treatment and after 6 months. Hearing loss above 30 dB was found in 109 patients (45.99%). Mild hearing impairment of sensorineural type was registered in the majority of patients, while total one-sided hearing loss was found in 2.53% of subjects. No correlation between clinical manifestations of parotitis or meningoencephalitis and hearing loss was found. Cytochemical liquor levels did not influence the development of hearing loss. 6 months later a recovery followed mainly in patients with mild impairments.

[Meningococcal sepsis and difficulties in differential diagnosis--case report]. / Meningokokna sepsa i diferencijalno-dijagnosticke teskoce--prikaz slucaja.

We report a case of meningococcal sepsis in a healthy immunocompetent sixteen year old boy who had developed upper respiratory tract acute infection 10 days before the admittance. Clinical manifestations were similar to those found in allergic hemorrhagic purpura (Schonlein's form of the disease). The clinical course of these two diseases is usually different but sometimes they cannot be easily differentiated. The acute onset of polyarthritis, temperature and skin manifestations in the form of erythematous maculopapular exanthema which within several hours evolved into hemorrhagic purpura is typical for the sepsis caused by Neisseria meningitides but these characteristics might be found in allergic Henoch-Schonlein' purpura as well. In our case the accurate diagnosis was set by the identification of the group C Neisseriae meningitides from the patient's blood. The first choice was penicillin therapy.

[Abdominal typhus today]. / Trbusni tifus danas.

Abdominal typhus is all the rearer disease among acute infectious diseases in Vojvodina. In the last ten years (1981-1990) 16 patients with abdominal typhus were treated at the Department of Infectious Diseases in Novi Sad, mostly young individuals from 6 to 30 years of age (13 patients). Positive epidemiologic features were found in 13 patients. In 80% of the cases the source of infection was outside Vojvodina. They usually were admitted at the Department on the first and second week of the disease (11 patients), and 3 patients were admitted on the third week. None of the patients was suspected of having abdominal typhus at the time of admittance. Delayed hospitalization and unrecognized abdominal typhus were most likely due to the atypical onset and course of the disease. Atypical features in the clinical picture occurred in all the patients with a sudden onset of the disease. The abrupt temperature elevation in 50% of the patients was followed by shivering, fever and shaking. Hepatosplenomegaly was found in 12 patients, abdominal meteorism in 10, typical typhus tongue in none. Typhus state was not found in any of the patients. Normal leucocyte count was found in 7 patients, positive Widal's agglutination reaction in 13, coproculture in 8 and hemoculture in 15 patients. The atypical clinical picture was the result of early administration of broad-spectrum antibiotics before the established etiology of the febrile state.

[Typhoid fever--case report]. / Tifusna groznica--prikaz slucaja.

The paper describes a case treated at the Department of Infective Diseases in Novi Sad admitted during the remittance of typhoid fever. The course of the disease was atypical. Epidemiological and clinical features resembled those found in malaria but laboratory findings gave the true diagnosis. We found the case interesting because the diseased patient moved around a lot, making contacts with many people. Fortunately, contact diseases never happened to occur.