Introduction: Pancreatitis is a rare complication of hemorrhagic fever with renal syndrome (HFRS). The causative agents of HFRS are hantaviruses, which belong to the genus Hantavirus, family Bunyaviridae. The purpose of this study was to evaluate cases of acute pancreatitis (AP) in patients with HFRS at the Service of Infectious Diseases, Tirana, Albania. Methodology: In this retrospective study, clinical and laboratory data was obtained from 36 patients with confirmed HFRS, between January 2011 and December 2016. The diagnosis had been confirmed by a positive enzyme-linked immunosorbent assay (ELISA) for IgM or IgG antibodies to hantavirus. Results: The average patient age was 39.7 ± 14.1 years with a range of 15-59 years. From 36 HFRS patients, four (11.1%) were found to have AP, all were male. Abdominal pain was the most common symptom and an increase in amylase and lipase was observed in all four patients. Abdominal computed tomography (CT) indicated pancreatitis with surrounding edema, necrosis and hemorrhage. In this study, the total mortality was 11.1% (4/36), while mortality in patients with AP was 25% (1/4). Conclusions: The results indicate that AP is a serious complication of HFRS, with a poor prognosis. Increased awareness of AP in clinicians and assessment of amylasemia or lipasemia in patients with HFRS should be considered, especially in endemic areas where a rapid diagnosis is crucial for a positive outcome.
Encephalitis is an acute inflammation of the brain matter, very often associated with viral infections, but it can also be caused by non-viral pathogens such as leptospirosis. Leptospirosis is a systemic disease caused by bacteria of the Leptospira genus. Leptospiral infection has a broad spectrum of clinical manifestations ranging from subclinical or mild illness to a fulminant life-threatening illness. In this case report we describe a young patient from Southern Albania with isolated encephalitis caused by Leptospira, where acute encephalitis was the initial presentation of the disease.
Hantaviruses are enveloped tri-segmented negative-stranded RNA viruses. Infection from these viruses is growing in last decades. They are causative agent for two types of diseases: a) Hemorrhagic fever with renal syndrome (HFRS), mostly observed in Eurasia and b) Hantavirus cardiopulmonary syndrome (HPS), mostly observed in American continent. There are several Hantaviruses known to infect humans, and their main hosts are rodents. HFRS is caused from Hantaan, Dobrava, Saaremaa, Seoul and Puumala virus. The main factor, which determines the severity of Hantavirus infection, is the degree of increased permeability of infected endothelium, and the most common clinical findings in those patients are fever, headache, abdominal pains, backache, myalgia and nausea or/and vomiting. There are already numerous publications with regards to the involvement of two major systems such as renal and pulmonary in patients with HFRS. In this paper we would try to make a short review about the involvement of other organs and systems of our body in those patients. Extrarenal manifestations of Hantavirus infection include: acute ocular impairment with visual function, acute myopia, central nervous system (CNS) complications, cardiovascular impairment with myocarditis, gastrointestinal hemorrhages, but liver and pancreas may be also affected.
Hemorrhagic fever with renal syndrome is presented with so many different clinical symptoms. It can present mild form of the disease or the severe symptoms. We reported two cases with HFRS, at pregnant women, ended with pregnancy interruption. Both of them had nearly the same age, both 16 weeks pregnant. They presented with fever, malaise, muscle pain and headache. They were febrile when presented at the hospital, hypotensive, hyperemia on the face. They complained about oligo-anuria too. One of them continued to be hypotension, despite the supportive therapy she had an abortion after 8 hours. The other patient had the abortion on the 4 th day of hospitalization. The diagnose was set based on the clinical, epidemiological findings and the serological positive confirmation for IgM Hantavirus by enzyme-linked immunosorbent assay and immunofluorescence assay IFA.The abortion is a rare complication of HFRS in pregnancy. The symptoms are not specific. Early diagnosis and appropriate management are necessary to improve the maternal and fetal outcome. J Microbiol Infect Dis 2017; 7(4):198-201
Introduction; An increasing number of intravenous drug users are seen in now days. Intravenous drug users (IDUs) are a group of subjects who inject different drugs, generally in the extremities. This way of taking drugs, apart from leading to an addiction, on the other hand also serves as the possibility of taking or spreading infections. The aim of this paper is to provide a brief overview of IDUs patients, who were presented to the emergency department of the infectious diseases service, and required further hospitalization, during the period January 2012 - December 2015. Material and methods: The study is retrospective and was carried out in the emergency department of the infectious disease service and the infectious disease service as well. During the period January 2012 – December 2015, 26 patients were hospitalized in our hospital as IDUs. There were 20 male patients. The average age of the patients was 32 years. The main clinical symptoms were fever, dyspnea, chest pain, pain in the extremities, edema of the extremities, necrotic ulcers at the injection site, jaundice in the sclera, confusional state. The resulting diagnoses were viral infections (HIV/AIDS infection, viral hepatitis), septic conditions (endocarditis, fasciitis), skin infections (cellulitis, S. aureus infections), pulmonary infections. Conclusions: Viral, bacterial and fungal infectious diseases are quite frequent among the people of this community. This is related to the way of life (poor social economic conditions, poor hygiene), risky sexual behaviors and the use of syringes from one person to another. The screening of this community is important to prevent any infectious disease.
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