Aspergillosis covers a wide range of diseases caused by the genus Aspergillus fungi. Aspergillus saprophytic mold is widespread in the environment; its spores are easily inhaled. However, despite the fact that most people inhale aspergillus spores daily, aspergillosis develops mainly in immunocompromised individuals (due to illness or during immunosuppressive therapy).the lungs are affected most often, being the portal for the fungus penetration, but the naso-orbital sinus is also involved in the process. There are few reports on extrapulmonary aspergillosis. Even rarer in the literature are publications about the co-infection of a saprophytic fungus and a hydatid cyst. Only single clinical observations of the coexistence of aspergillosis and echinococcosis in the lungs have been described. No literature data are available on the coexistence of these two pathogens in the liver. The authors present a clinical case of a 54-year-old woman with two echinococcal cysts in the liver and Aspergillus revealed in their structure. The co-infection of liver echinococcosis and aspergillosis is extremely rare. Preoperative verification of the presence of local aspergillosis in this case is practically impossible. However, early diagnosis and treatment are vital, preventing possible complications from becoming infected with these two pathogens. Treatment is based on an early morphological diagnosis and the detection of both pathogens.
Congenital clubfoot requires complete correction before the period of verticalization. Conservative methods are priority in treatment. The most effective method is Ponseti method that allows correcting all the deformations even in severe clubfoot. However, if clubfoot is accompanied with abnormal anatomy of foot or significant changes in functional ability of muscles, operative treatment is inevitable. The extent of surgical intervention depends on the severity of detected abnormalities and is determined individually. The use of ultasound, radiographic, and CT investigations, according to indications, contributes to the diagnostics. The indication for surgery is the lack of effect of conservative treatment after 10-12 cast correction in children over the age of 4 months. Diagnostic criteria for deciding in favor of surgery are: availability of fibrous coalition, the deformation of the talar or the sphenoid bone, the anomaly in the point of attachment of the tendon of the tibialis anterior muscle, lack of the repositioning of navicular bone on the talar head. Orthosis supply and rehabilitation treatment depend on the extent of surgical intervention.
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