No abstract

Aim: The aim of this study was to describe the etiological distribution, clinical and laboratory characteristics of patients with Fever of unknown origin (FUO), admitted to one Bulgarian hospital. Material and Method: A retrospective study was done for a period of four years. The modified criteria of Petersdorf and Beeson were applied. Complete history, physical examination and basic laboratory investigations were done. According to the potentially diagnostic clues, specific tests, immunological and imaging methods were performed. The invasive procedures were the last step. Results: Fifty-four patients met the inclusion criteria. The estimated causes were: infection 59.3%, neoplasm 3.7%, non-infectious inflammatory disease 14.8%, miscellaneous 5.5% and undiagnosed cases 16.7%, respectively. The mean age was 44.3 years. The leading clinical features were fever, chills, sweats and fatigue. The association of clinical signs, physical exam and laboratory results were discussed. Discussion: The infectious diseases were the leading cause of FUO. The etiological distribution of causes was near to results reported from South-East Europe. Some geographic, climatic, zoonotic and social factors influenced the results.

The origin of 'natural' anti-sperm antibodies found in fertile humans, virgin girls, and boys before puberty, is quite obscure. One hypothetical mechanism relates their existence to inflammatory gastrointestinal entities: as a result of the disease, cross-reactive antibodies produced against gastrointestinal flora bind spermatozoa. To test this assumption, we evaluated the level of serum sperm antibodies after diarrhoeal infections. Serum samples from 17 patients with shigellosis and 12 patients with salmonellosis were screened for anti-sperm antibodies directed against sperm surface antigens (gelatin agglutination test - GAT, tray agglutination test - TAT, sperm immobilization test - SIT), profound sperm antigens [enzyme-linked immunosorbent assay (ELISA)], and anti-bacterial antibodies (slide agglutination test - SAT) upon diagnosis (group A) and 4-35 days later (group B). The patients from group B demonstrated an increased sperm antibody incidence by GAT (20.7%), TAT (13.8%) and ELISA (31%) when compared to group A and to healthy controls, although statistically significant data were acquired only for the latter group. The absorption of positive sera with bacteria and/or spermatozoa revealed significant reactivity changes in the antibody values by GAT and TAT for shigellosis, and by TAT and ELISA for salmonellosis patients. These data demonstrate increased serum sperm antibody levels in salmonellosis and shigellosis patients.

Accepted methods of the ESR methodology (the Westergren mode and ZSR mode) and its alternative the plasma viscosity were tested for diagnostic utility in pregnancy induced hypertension and pre-eclampsia. The receiver-operating characteristic curve (ROC) analysis approved moderate diagnostic accuracy for the ESR methodology and supplied support for its preliminary estimated cutoff values but failed to indicate cogent discernment of pathology by values of plasma viscosity. Likely pathological whole blood alterations boost the erythrocyte aggregation while the concomitant depletion of macromolecules degrades plasma viscosity values.