RESUMEN
A case of the first ocular thelaziosis in a human male patient in Croatia is presented. Thelaziosis is a zoonosis caused by the nematodes of the genus Thelazia. In all, two types of the genus have been described as causes of infection in humans, Thelazia callipaeda and Thelazia californiensis. This zoonosis, called "oriental eye worm" is very rare in humans in European countries, with high incidence in Asian countries, especially in China, Thailand, and Japan.
Asunto(s)
Infecciones Parasitarias del Ojo/diagnóstico , Infecciones Parasitarias del Ojo/parasitología , Enfermedades Raras/diagnóstico , Infecciones por Spirurida/diagnóstico , Infecciones por Spirurida/parasitología , Thelazioidea/aislamiento & purificación , Anciano de 80 o más Años , Animales , Croacia , Diagnóstico Diferencial , Infecciones Parasitarias del Ojo/terapia , Humanos , Masculino , Enfermedades Raras/parasitología , Enfermedades Raras/terapia , Infecciones por Spirurida/terapia , Resultado del TratamientoRESUMEN
Noninvasive ventilation (NIV) is a proved and effective therapeutic option for some patients with respiratory failure. During an epidemic, NIV can free up respirators and other intensive care unit equipment for patients with respiratory insufficiency whose survival depends exclusively on invasive ventilation. Some guidelines have indicated that NIV is potentially hazardous and should not be recommended for use during epidemics, given the perceived potential risk of transmission from aerosolized pathogen dispersion to other patients or medical staff. Conversely, some reports of previous epidemics describe NIV as a very efficient and safe modality of respiratory support, if strict infection control measures are implemented. We discuss NIV use during epidemics and indicate the need for prospective randomized clinical studies on the efficacy of NIV in epidemic conditions to provide important information to the current body of literature. Meanwhile, the use of NIV under strict infection control guidelines should be incorporated into epidemic preparedness planning.
Asunto(s)
Infección Hospitalaria/prevención & control , Brotes de Enfermedades , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Ventilación no Invasiva/estadística & datos numéricos , Insuficiencia Respiratoria/terapia , Humanos , Ventilación no Invasiva/normas , Ventilación no Invasiva/tendenciasRESUMEN
Colorectal carcinoma (CRC) is a major public health problem as the third leading malignant tumor in men and fourth in women in Croatia. Prognosis and treatment greatly depend on tumor stage at the time of detection. Therefore, the National Program of Colorectal Carcinoma Early Detection has been performed since 2007. The aim is to present the response rate, colonoscopy findings and number of newly detected CRC cases in Brod-Posavina County. During five years of the National Program performance, 28 CRC cases were detected in Brod-Posavina County, with the 3.3% rate of carcinoma detection. The majority of CRC cases were found in the 50-64 age group. The response rate in the County was low (20.4%), corresponding to the national rate but far from the recommended one. Such a result could be attributed to the low level of awareness in the population at large, complex testing technique for general population, fear from disease detection and from colonoscopy as a diagnostic procedure. Note should be made of the underestimated role of family physicians; their involvement in the National Program should certainly result in better response rate in our County as well as at the national level.
Asunto(s)
Neoplasias Colorrectales/diagnóstico , Tamizaje Masivo/organización & administración , Programas Nacionales de Salud/organización & administración , Anciano , Neoplasias Colorrectales/epidemiología , Croacia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Trichosporon asahii (formerly T. beigelii) is a rare cause of human infections with very varied clinical manifestations ranging from superficial infections to severe and systemic diseases. T. asahii is a life-threatening opportunistic pathogen especially for granulocytopenic, immunocompromised and immunodeficient patients. It is the possible cause of summer-type hypersensitivity pneumonitis in Japan and systemic infections in transplant patients, patients on corticosteroid therapy, patients with solid tumors and burn patients. Cases of infection in non-immunocompromised surgical patients and patients with long-term stay in ICU are described in the literature. We report on T. asahii fungemia in a polytraumatized neurosurgical patient with long-term stay in the hospital. Urinary tract was the source of fungemia, with the same pathogen isolated from urine and blood at the same time. In the Referral Center for Systemic Mycoses, Croatian Institute of Public Health, Zagreb, the strain from the urine and blood culture was identified as T. asahii, with good susceptibility to fluconazole, voriconazole and 5 fluorocytosine, reduced susceptibility to itraconazole and resistance to amphotericin B. The patient responded to fluconazole therapy very well. Since systemic trichosporonoses are generally associated with immunocompromised patients (hematologic, granulocytopenic and AIDS patients), this case confirms the possibility of infection with this pathogen in patients with long-term hospital stay and reduced local immunity, but without classic immunodeficiency.
Asunto(s)
Traumatismos Craneocerebrales/complicaciones , Huésped Inmunocomprometido , Traumatismo Múltiple/complicaciones , Infecciones Oportunistas/complicaciones , Tricosporonosis/complicaciones , Antifúngicos/uso terapéutico , Traumatismos Craneocerebrales/inmunología , Traumatismos Craneocerebrales/microbiología , Traumatismos Craneocerebrales/cirugía , Humanos , Masculino , Tricosporonosis/diagnóstico , Adulto JovenRESUMEN
Urinary tract infections (UTI) following catheterization are the most common hospital-acquired infections, with their frequency amounting to 30-40% of all hospital infections. Major percentage of this kind of infectious episodes can be prevented via active and continual education of health care workers (HCW), implementation of transparent protocols concerning installation and attendance of urinary catheters and regular control of catheterized patients through surveillance lists. This research shows the importance of a fore-mentioned activities, demonstrating a significant decrease of UTI following catheterization at the Department of Urology in Slavonski Brod General Hospital during two periods. After the aforementioned procedures were conducted, a statistically significant discrepancy in the decrease of the UTI incidence following catheterization was identified, from 20.4% to 11.7%, i.e. chi2 = 17.5; p < 0.01, and accordingly, significant decrease of the number of hospital bed-days, i.e. chi2 = 16.62; p < 0.0, while total consumption of antibiotics at the Department was not reduced, despite the decrease in the number of UTI. The most common uropathogens, with no significant difference in both periods, were E. coli (29.7%), Enterococcus spp (20%), and Pseudomonas aeruginosa (15.8%). Strict implementation and close surveillance of the recommended preventive measures are an important factor in reducing the number of hospital infections.
Asunto(s)
Personal de Hospital/educación , Cateterismo Urinario/efectos adversos , Infecciones Urinarias/prevención & control , Humanos , Incidencia , Cateterismo Urinario/normas , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiologíaRESUMEN
A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva. Upon surgical extirpation of the parasite, the diagnosis of dirofilariasis was verified by microbiologic identification.
Asunto(s)
Dirofilariasis/diagnóstico , Infecciones Parasitarias del Ojo/diagnóstico , Anciano , Dirofilariasis/cirugía , Infecciones Parasitarias del Ojo/cirugía , Femenino , HumanosRESUMEN
Streptococcus suis is primarily pig's pathogen, but can cause disease in a man exposed to contact with pigs (butchers, abatoir workers, farmers). Infection in man is most frequently manifested as purulent meningitis, with deafness and ataxia, but there are rare reports on septic shock with multiple organ failure and death. We report two patients with Streptococcus suis type 1 infection, treated in "Dr Josip Bencevic" General Hospital, Slavonski Brod. The first patient suffered a very abrupt and severe illness, with septic shock, multiple organ failure and lethal outcome. The second patient had purulent meningitis with deafness. Both of them had a defect in immunologic function before infection. They were probably infected during manipulation with pork meat at home. Our patients had infection with Streptococcus suis type 1, contrary to reports on prevalent human infection with type 2. It is necessary to make epidemiologic survey on human infection with that pathogen, especially in those professionally exposed to pigs and pork meat.