Development of a Model for Preliminary Diagnosis of Human Granulocytic Anaplasmosis.

Background: Human granulocytic anaplasmosis (HGA) is a vector-borne natural focal disease that is not officially registered in Ukraine. The first 13 cases of HGA in adults in Ukraine were identified in 2007. The purpose of our study was to develop a predictive model of HGA based on clinical and laboratory characteristics to develop a three-level standard case definition of HGA. Materials and Methods: Researchers examined 498 patients with suspected tick-borne infections and carried out a retrospective clinical and epidemiological analysis of 60 cases recruited from Lviv regional infectious disease hospitals. Logistic regression was used to create a model of the probability of the diagnosis of HGA depending on the presence of certain clinical and laboratory factors that, when examined, together may help to confirm a case of HGA. For logistic regression, eight clinical and laboratory factors were selected: history of tick bite, hyperthermia, signs of pharyngitis, changes in chest X-ray picture (enhancement of the pulmonary pattern and enlargement of the lung root boundaries), increased bilirubin (˃21 µmol/L), increased alanine aminotransferase (ALT ˃36 U/L), erythema migrans, and detected Lyme disease. Results: In the presence of all eight factors, the probability of HGA is 95.7%. When the five main signs are absent-signs of pharyngitis, changes in chest X-ray picture, increased bilirubin and ALT, and a history of tick bite-the probability of HGA in the patient dramatically decreases to 6.8%, meaning that HGA might be excluded. Conclusions: Based on the analysis of epidemiological, clinical, and laboratory signs, criteria for establishing a suspected, probable, and confirmed diagnosis of HGA have been developed to improve diagnosis.

A Single Clinical Case of Leptospirosis in a 70-Year-Old Man During the Military Conflict in Ukraine.

Leptospirosis is a bacterial disease that affects both humans and animals worldwide. Clinical symptoms of leptospirosis in humans range widely, from mild to severe illness, with symptoms that can include severe jaundice, acute renal failure, hemorrhagic pneumonia, and meningitis. We present a detailed clinical description of a 70-year-old man with leptospirosis. This case presented without the typical prodromal period for leptospirosis, thus making diagnosis more difficult. This isolated case occurred in the Lviv region during the ongoing military conflict between Russia and Ukraine where Ukrainian citizens have been forced to hide in premises that are not properly adapted for their long-term stay, which result in conditions that can potentially lead to the emergence of many infectious diseases. This case highlights the need for heightened awareness into the symptoms of a variety of infectious diseases, including but not limited to leptospirosis.

A case report of septic gardnerellosis.

Gardnerella vaginalis is a bacterium that is found as the most common cause of bacterial vaginitis in women. In this paper, we describe a case report of a 22-years old woman infected with G. vaginalis, who was initially suspected to have Dengue fever. The similarity of clinical symptoms developed by this disease with the symptoms of some other tropical infectious diseases, as well as a travel history, complicated identification of the disease cause for this particular patient. Here, we present a detailed epidemiological and clinical description of this case, leading to a final diagnosis of a septic form of gardnerellosis.

Application of PCR for Specific Diagnosis of Leptospirosis in Humans in Ukraine.

Leptospirosis remains one of the most widespread zoonotic diseases in the world and Ukraine, in particular. Ukrainian clinicians have been faced with early detection of the disease due to the availability of only a serological method for routine diagnostics in Ukraine, namely the microscopic agglutination test (MAT). This paper demonstrates the first results of the complex application of MAT and polymerase chain reaction (PCR) for routine verification of leptospirosis, which were first applied simultaneously in Lviv Oblast of Ukraine in 2016. We examined the sera of 150 patients clinically suspected of leptospirosis, 31 of whom were treated at the Lviv Oblast Clinical Hospital for Infectious Diseases (LOCHID). The application of PCR during the first seven days of the disease allowed increasing the share of confirmed leptospirosis cases by 16,1% in patients that were treated in LOCHID during 2016-2017.

Is Localized Scleroderma Caused by Borrelia burgdorferi?

Despite considerable achievements in the study of localized scleroderma, the etiology of the disease has not been investigated completely. Borrelia burgdorferi-the agent of Lyme disease-is suggested to be one of the possible etiological factors of localized scleroderma. However, among scientists, this hypothesis is quite controversial. We have conducted investigations of the level of IgM and IgG class antibodies to B. burgdorferi in the serum of patients with localized scleroderma. To rationally substantiate the role of B. burgdorferi in the occurrence of localized scleroderma, thirty-two patients with localized scleroderma treated at an in-patient department were examined. The level of anti-Borrelia antibodies was determined in ELISA. Diagnostic levels of IgM and/or IgG were detected in 18.8% of patients with localized scleroderma, which is more than in the population (p < 0.01). Positive levels of anti-Borrelia antibodies in patients with localized scleroderma confirm the borreliosis nature of the disease, requiring conduction of complex antimicrobial treatment.

Original inhibition method of excessive synthesis of pro-inflammatory cytokine of tumour necrosis factor α.

Influence on pro- and anti-inflammatory cytokines of an ill person is an urgent aspect of treatment of many diseases. For inhibition of synthesis of a high level of pro-inflammatory cytokines, medications which are recombinant monoclonal antibodies, especially to tumour necrosis factor α (TNF-α), are used. However, these methods of treatment require further improvement by elaborating new approaches with a wider spectrum of influence on the immune system. A completely new method of reduction in high activity of TN F-α with the method of intradermal autoleukocyte immunization is presented in the article. Investigation was performed in a group of patients with psoriasis (24) with a high level of TNF-α in the blood (over 30 pg/ml). Simultaneously such investigation was performed on patients with psoriasis (9) without TNF-α detected (0 pg/ml). As a result of immunization, a significant reduction in TNF-α occurred in all patients with its high level, in 16 (66.7%) from 24 patients - to 0-5 pg/ml. The level of reduction and duration of the achieved effect was of an individual character and requires further investigation. However, the achieved results prove the expediency of administration of this immunization method for patients requiring reduction of TNF-α synthesis. However, the content of TNF-α in blood serum could not be detected in most patients with a low level of cytokine (in 6 from 9) after immunization (as well as before immunization), but an increase in its level from 0 to 5-8 pg/ml was observed in 3 patients. On the basis of the conducted research, the authors suggest that the influence of immunization on cytokine synthesis depends on the condition of immune cells and correlation of pro- and anti-inflammatory cytokines in a patient's skin.

Characteristics of Meningitis Due to Methylobacterium mesophilicum: A Rare Case.

Methylobacterium mesophilicum is a gram-negative bacillus most often isolated in medical establishments. In humans, M. mesophilicum is considered a conditionally pathogenic flora. Infections in humans generally occur in immunodeficient individuals. This article describes a rare case of M. mesophilicum infection that developed into acute meningitis in a 26-year-old patient. Decreased neutrophil bactericidal activity was also detected. To our knowledge, there have been no previous reports of meningitis due to M. mesophilicum.