Introduction: Infectious mononucleosis is one of the most common syndromes in our clinical practice. It is characterized by elevated temperature, pharyngitis and generalized lymphadenopathy. Objectives: To describe a clinical charachteristics of infectious mononucleosis (IM) caused by the Epstein Barr virus (EBV) in splenectomized patients since in the literature we found insufficient data. Subjects and Methods: Retrospective analysis of medical documentation of the patient treated in the Clinic for Infectious Diseases of the University Clinical Center of Republic of Srpska. Results: We have described the case of infectious mononucleosis, caused by Epstein Barr virus in a splenectomized patient. In support of acute EBV viral infection were the presence of lymphadenopathy, pharyngitis, hepatomegaly, as well as the occurrence of a typical generalized maculopapulous rash, and positive ELISA EBV VCA IgM and anti EBV VCA / EA IgG, were reported. According to the aforementioned patient, it fulfilled most criteria for setting the diagnosis of acute EBV infectious mononucleosis. Our patient showed some atypical signs such as absence of fever during hospitalization, marked leukocytosis with lymphocytosis (with a maximum increase in leukocyte count at 37.3 x 10 9 , in the differential blood sample dominated lymphocytes with 29.96 x 10 9 (reference values 1.1-3.35), i.e. 80.3% (Ref. 20.0-46.0). Due to the maintenance of leukocytosis with lymphocytosis, the range of clinical has been extended trials (US abdomen, US neck, CT neck, chest, abdomen and pelvis, sternal puncture, hematologists' consultation). Based on the aforementioned hematologists' consultation, and post-release and recovery monitoring it is concluded that there has been no sign of acute hematologic disease but it has been just EBV-IM. Conclusion: Because of insufficient data on clinical presentation of Epstein Barr viral infections in splenectomized this we believe that this is one of the clinical variants although the possibility of individual variation cannot be excluded. Briefly, we can conclude that the immune system in the splenectomized patient can greatly modify the clinical presentation of Epstein barr viral infection, with the pathogenic mechanism that are still unclear.. However, due to the variety of clinical syndromes and the oncogenic potency of the Epstein-Barr virus, we should be extremely cautious and sometimes expand the diagnostic range beyond conventional examinations.
Background: The purpose of this study was to assess the antiviral efficacy and safety of the direct-acting antivirals (DAAs) in therapy of chronic hepatitis C virus (HCV) infection. Methods: This real-life multi-centric study was performed at the Clinic for Infectious Diseases, University Clinical Centre of the Republic of Srpska, Banja Luka and it included a total of 89 patients. All patients received the adequate doses of ombitasvir (OBV)/ paritaprevir (PTV)/ritonavir (RTV) + dasabuvir (DSV) plus ribavirin (RBV). RBV was given to all patients except to those with HCV sub-genotype 1b. DSV was not administered to patients infected with HCV genotype 4. For the majority of patients the treatment duration was 12 weeks. For ten patients with liver cirrhosis the duration of treatment was 24 weeks. Viraemia was assessed at three points in time: at baseline, 12 or 24 weeks after the beginning of treatment (end of treatment response-ETR), and 12 weeks after the end of treatment (sustained viral response-SVR). Results: Complete ETR after 12 weeks of treatment was achieved in 79 patients, while in 10 high-risk patients it was achieved after 24 weeks of treatment. Full SVR was recorded in 88 patients 12 weeks after the end of treatment. This therapy was well tolerated and mild adverse effects were recorded in only 10 patients. Conclusion: Treatment of patients with chronic HCV infection with OBV/PTV/ RTV+ DSV + RBV resulted in excellent antiviral activity and mild adverse events.
Introduction: Mumps is a systemic viral infection characterized by swelling of salivary glands, especially the parotid ones. Gonads, meninges, pancreas and other organs may also be affected. Aims of the study: The aim of this study was to analyze the epidemiological characteristics of mumps meningitis in the last epidemic of mumps in the Republic of Srpska, and to analyze the frequency of mumps meningitis and vaccination status in patients who were supposed to be vaccinated against mumps in the war and early postwar period, and also in those patients who were supposed to be vaccinated before or after this period. Patients and Methods: The study included 175 patients divided in the experimental group (140 patients with mumps meningitis) and the control group (35 patients with serous meningitis of other etiology, probably enteroviral). We compared epidemiological characteristics of these patients and additionally we analyzed the differences in these characteristics in patients with different vaccination status. Results: The mean age of patients in the experimental group was 20.0 years (18.0-24.5; IQ), and in the control group 7.0 years (5.0-14.0; IQ) (p <0.001). Patients born between 1985 and 1996 more frequently suffered from meningitis (p <0.001) caused with mumps virus than other patients in the experimental group. There was no statistically significant difference in sex distribution between patients in the experimental and control group (p = 0.746), nor between patients in the experimental group with previously different vaccination status (p = 0.371). Most patients in the experimental group didn't have data of their immunization status. The subsequent are those patients who received only one dose of vaccine, followed by unvaccinated patients and those who were vaccinated correctly. Conclusion: The epidemic of mumps during 2011 and 2012 is a consequence of maintaining the virus in non-vaccinated population (mainly because of the omissions made during the war and early postwar period) and insufficient duration of protection after vaccination, especially in vaccination with one dose of vaccine.
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