RESUMO
AIM: To characterize the clinical and laboratory manifestations in patients with HG viral infection frequently concurrent with chronic HCV infection and the potentialities of their treatment. MATERIALS AND METHODS: 109 patients with suspected chronic hepatic disease were examined. The markers of HGV, HCV, HBV, and TTV infections were determined. The possible factors of infection, biochemical parameters, and the efficiency of antiviral therapy were assessed. RESULTS: Hepatitis G virus RNK was detected in 32 cases, a combined variant of hepatitis G + C viruses RNA was found in 77 patients with chronic viral hepatitis (CVH). Among the presumed routes of contamination in the mixed variant of CVH, there were most common intravenous injection of narcotic drugs; in monoinfection (HGV), there were parenteral interventions in medical facilities and blood transfusion. Antiviral treatment of 13 patients with chronic HGV + HCV infection yielded a positive result in 5 patients after 3-month therapy. CONCLUSION: In patients with CVH, HG virus infection was more frequently observed in combination with CVHC, less frequently as monoinfection. In HG virus monoinfection, biochemical studies revealed the enhanced activity of transaminases and hyperbilirubinemia that was absent in the mixed variant of HGV + HCV. The financial capacities of patients should be taken into account while choosing therapy.
Assuntos
Antivirais/uso terapêutico , Infecções por Flaviviridae , Vírus GB C/isolamento & purificação , Hepatite Viral Humana , Adulto , Feminino , Infecções por Flaviviridae/tratamento farmacológico , Infecções por Flaviviridae/etiologia , Infecções por Flaviviridae/virologia , Vírus GB C/efeitos dos fármacos , Hepatite C/tratamento farmacológico , Hepatite C/etiologia , Hepatite C/virologia , Hepatite Viral Humana/tratamento farmacológico , Hepatite Viral Humana/etiologia , Hepatite Viral Humana/virologia , Humanos , Masculino , Resultado do TratamentoRESUMO
Clinical patterns of tuberculous meningitis have been analyzed for 32 admissions to the bacterial meningitis department of the 2nd Moscow Infection Hospital in 1983-1991. Early diagnosis of tuberculous meningitis caused great difficulties because of rare cases of tuberculous history, atypical symptoms (an acute onset, in particular), an obscure meningeal syndrome, rare neurological symptoms, atypical liquor characteristics (frequent neutrophil pleocytosis, a small protein rise, normal glucose). Secondary bacterial meningitides presented most serious difficulties for differential diagnosis. So did cerebral abscesses and viral meningitis. Antituberculous therapy should be started at first sings of tuberculous nature of meningitis as the disease outcomes are determined to a large extent by early administration of proper treatment.
Assuntos
Tuberculose Meníngea/diagnóstico , Adolescente , Adulto , Diagnóstico Diferencial , Erros de Diagnóstico , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tuberculose Meníngea/líquido cefalorraquidianoAssuntos
Meningite/etiologia , Meningocele/complicações , Fístula Retal/complicações , Adulto , Feminino , Humanos , Recidiva , Região SacrococcígeaAssuntos
Barreira Hematoencefálica/fisiologia , Meningite Meningocócica/metabolismo , Meningite Pneumocócica/metabolismo , Proteínas do Tecido Nervoso/análise , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , alfa-Globulinas/análise , Antígenos/análise , Encéfalo/imunologia , Epitopos/análise , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Altogether 20 patients with purulent meningitis caused by agents of rare species were observed. Difficulties in etiological diagnosis and the severity of a clinical course were noted. In most cases this disease developed in persons with associated diseases. In a lingering course of the disease repeated bacteriological investigations of blood and liquor, and serological investigations are recommended.
