[Changes in the immunocompetent cell system of the peripheral blood in HIV carriage]. / Izmeneniia v sisteme immunokompetentnykh kletok perifericheskoi krovi pri nositel'stve VICh.

HIV-carriage is characterized by hematological signs such as normocytosis of the general leucocyte count and deviations within normal range of values for myeloid series cells (neutrophiles, eosinophiles, basophiles). A peculiar hematological sign seen in HIV-infection is a finding of a raised content of cellular elements of mononuclear type on a hemogramme of peripheral blood and consistent decrease in the level of small T-lymphocytes against the background of substantial growth of suppressor-killer populations (large lymphocytes and lymphocyte-like mononuclears) as evidenced by a mononucleorogramme of peripheral blood, which fact provide a mechanism of antiviral protection at early stages of HIV-infection. Such changes in hemogrammes of peripheral blood, consistently found in all virus carriers, may be used in clinical settings as an early diagnostic sign of HIV-infection.

[The pseudotumorous course of viral hepatitis B]. / Psevdotumoroznoe techenie virusnogo gepatita B.

A rare case is described of viral B hepatitis in a woman of 60 years with prevailing clinical, ultrasonic and scintigraphic signs of mechanical jaundice due to a tumour in the hepatopancreatoduodenal zone. The diagnosis of viral hepatitis B was confirmed by 5-fold detection of HBsAg in the blood, positive clinical dynamics revealed after corticosteroid treatment with subsequent complete recovery of the patient.

[Systemic vasculitis combined with connective tissue involvement in a patient with yersiniosis]. / Sistemnyi vaskulit v sochetanii s porazheniem soedinitel'noi tkani u bol'nogo iersiniozom.

A clinico-morphological description is presented of a severe systemic disease in 36-year-old male, the trigger factor of which was Yersinia enterocolitica. The patient developed a peculiar nosological variant of systemic necrotic vasculitis of infectious-allergic genesis with signs of nodular periarteritis in the intestine and kidneys in association with diffuse involvement of the connective tissue which resulted 6 months later in a dominating abdominal syndrome with profuse diarrhea, progressive cachexia with a fatal outcome. The diagnosis was established after death.

[The characteristics of the course of Yersinia hepatitis in cholelithiasis patients]. / Osobennosti techeniia iersinioznogo gepatita u bol'nykh kholelitiazom.

The paper is concerned with a clinical description of yersiniosis in 12 women who suffered from manifest or uneventful cholelithiasis. The disease started by an attack of biliary colic. The clinical symptomatology was noticed to run in stages during which the signs of calculous cholecystitis vanished while the symptoms of hepatitis persisted. In the acute period, the conservative treatment of the patients was carried out by the infectionist jointly with the surgeon, followed by dispensary observation lasting 1 to 3 months until complete and stable normalization of aminotranferase activity. The outcomes were favourable.

[Acute appendicitis in patients with Yersinia infection]. / Ostryi appenditsit u bol'nykh iersinozom.

The article is the result of the joint work of a surgeon and a specialist in infectious diseases and is based on the results of treatment of 307 patients with the abdominal form of Yersinia infection Acute appendicitis was diagnosed in 73 (23.8%) of them. The abdominal form of Yersinia infection is encountered frequently among children. The authors analyse the clinical picture of acute appendicitis in patients with Yersinia infection, the time between the onset of the disease and the patient's call for the doctor, the dependence of the histologic findings in the examined removed vermiform processes on the duration of the disease, and the results of surgery. The difficulties in making the diagnosis of acute appendicitis in patients with yersinosis and concomitant mesadenitis and terminal ileitis are discussed. It is concluded that laparoscopy is advisable in doubtful clinical signs of acute appendicitis in patients with Yersinia infection due to the high frequency of destructive forms (77.9%). The average duration of in-patient treatment of persons with acute appendicitis and Yersinia infection was 4.8 days. The positive results of treatment are attributed to timely prescription of specific antibacterial therapy--the prescription of chloramphenicol from the moment that the diagnosis of yersinosis was established.

[Infectious erythema of yersiniosis etiology]. / Infektsionnaia éritema iersinioznoi étiologii.

A study is presented of 14 patients (9 adults, 5 children) with infectious erythema interpreted as one of the clinical variants of generalized skin form of yersiniosis. Along with typical signs of erythema, signs were found characteristic of yersiniosis, namely, mesadenitis, acute hepatitis, desquamative glossitis, changes in the ileocecal region, dyspeptic phenomena, tendency to a wave-like course. The clinical signs and symptoms of infectious erythema of yersiniosis etiology are illustrated by cases from the practice. The diagnosis was confirmed in 13 patients serologically in the reaction of agglutination with living cultures of yersiniae, in 1 patients bacteriologically and serologically.

[The anginal form of yersiniosis]. / Anginoznaia forma iersinioza.

The anginal form of yersiniosis is described in 16 patients (1.3% of all patients with this kind of infection). Clinico-laboratory investigations revealed signs of a generalized process with bacteremia and toxemia. The syndrome complex of infectious mononucleosis is often observed in this form of yersiniosis. Two patients showed a diphtheria-like form of severe angina. In 31% of patients recurrence developed but usually without angina. The outcomes are favourable.

[Yersinia-induced reactive arthritis]. / Iersinnoznye reaktivnye artrity.

Twenty-four patients were under observation. It is shown that reactive arthritides requiring surgical treatment are often of Yersinia etiology. A preceding episode of acute diarrhea can be revealed in the immediate anamnesis. Besides affection of the joints, the clinical picture is characterized by protracted high fever, general toxicosis syndrome, enlarged mesenteric lymph nodes, and, occasionally, enlargement of the liver and spleen. The diagnosis is confirmed by identification of specific antibodies in blood serum. Yersinia arthritides are unresponsive to the routine therapy. Administration of chloramphenicol and/or gentamicin with indomethacin produces a rapid positive effect.

[Outbreaks of pseudotuberculosis and intestinal yersiniosis among Soviet specialists and members of their families in the Mongolian People's Republic]. / Vspyshki psevdotuberkuleza i kishechnogo iersinioza sredi sovetskikh spetsialistov i chlenov ikh semei v Mongol'skoi Narodnoi Respublike.

In summer and winter of 1986 two outbreaks of alimentary enteric diseases occurred among Soviet specialists and members of their families in Ulan Bator. These diseases were identified as Yersinia infections registered in Mongolia for the first time. In July 114 children in a kindergarten fell ill after being fed with salad prepared from vegetables and spring onions supplied from a nearby state farm. 20 Y. pseudotuberculosis cultures, serovar 1, were isolated, and in 25 persons antibodies to the isolated microorganisms were detected; altogether 32% of cases were confirmed by laboratory methods. During the December outbreak 187 persons were affected, among them 90% of children, through the consumption of imported oranges and tangerines, simultaneous infection with Y. enterocolitica, serovars 05.27 and 09, and hepatitis A virus being observed. The fact of associated infection was registered after the simultaneous detection of the markers of viral hepatitis A and Yersinia infection in 61 patients. In the kindergarten the disease produced a typical clinical picture of Far Eastern scarlatiniform fever, and in winter the abdominal forms of the disease prevailed. In cases of combined Yersinia and viral infection a specific variant of acute hepatitis developed; as regards this variant, the authors present heretofore unknown information on its epidemiology, clinical features and outcome.

[Reiter's syndrome in patients with yersiniosis]. / Sindrom Reitera u bol'nykh iersiniozom.

Reiter's syndrome is a rare pathology in patients with yersiniosis and occurs in 0.9% of all clinical forms of the disease. Yersiniosis etiology was established in 7 patients with Reiter's syndrome. The diagnosis was confirmed serologically. Treatment consisted of levomycetin, gentamycin, in one patient--tetracycline as well as non-steroidal anti-inflammatory drugs indomethacin, metindol. All patients recovered completely within 1-2 months. No recurrences were noted within a 6-18 month follow-up.