[Listeriosis of the Central nervous system].

OBJECT: To study the main causes of severe course and high mortality in patients with nervous form of listeriosis. MATERIALS AND METHODS: The analysis of the course of Listeria meningoencephalitis (LM) in 36 patients aged from 9 to 85 years, who were treated in the Infectious clinical hospital No. 2 DZM (IKB No. 2 DZM). Along with standard examination methods, blood and cerebrospinal fluid (CSF) polymerase chain reaction tests were performed to identify Listeria monocytogenes. The sensitivity of the pathogen to antibiotics was determined by serial dilutions on the WalkAway 96 Plus device of Siemens, USA. RESULTS: LM in 84% of cases developed in patients with disorders in the immune system, in particular, with infection with the human immunodeficiency virus - in 25% of cases. The clinical picture of the disease, changes in CSF were not typical for bacterial purulent meningitis of another etiology. It is noted that LM is characterized by early involvement of the substance and ventricles of the brain in the process. CONCLUSION: Severe course and high mortality are due to atypical picture of the disease, late diagnosis, low bioavailability of the pathogen for antibiotics (intracellular persistence of the pathogen) and frequent resistance to them. The mortality from the nervous form of listeriosis was 33.3%.

[Methodological features of DNA isolation for nested PCR for the differential diagnosis of malaria].

Current PCR assays for the differential diagnosis of malaria need to be further developed and certified in the Russian Federation. PCR may serve as a control diagnostic method. These investigations have demonstrated that an erythrocytic clot may be used as an adjunct to microscopy and the described procedure can be employed to isolate DNA for PRC in an inpatient setting.

[Human babesiasis].

The paper describes a case of imported babesiasis caused by Babesia microti. This is an account of the second case of babesiasis in the Russian-language medical literature. Its clinical picture and laboratory data in the course of the disease are depicted and analyzed. Its clinical differential diagnosis with malaria and an update on the diagnosis and treatment of babesiasis are discussed.

[The specific features of imported Plasmodium vivax malaria, Chesson strain type].

The details of imported case of Chesson strain of P. vivax malaria to Russian Federation (Moscow) from border areas between Myanmar and Thailand is given. It might further confirm the expansion of this strain from its original place in the Western Pacific towards other territories in the World, described in various publications.

[Monitoring delagil (chloroquine) efficacy against imported Plasmodium vivax strains].

The efficiency of P. vivax malaria treatment with delagil (chloroquine) was evaluated in 122 patients, including 82 cases in Moscow and the Moscow region. The origin of the cases was malaria endemic areas in Asia, Africa, the Pacific Region, South America, and Transcaucasia. Forty other cases were imported malaria cases (secondary to imported ones), detected in Moscow and the Moscow region. Standard treatment with delagil (2.5 g) resulted in clinical improvement during 3 days in the majority of cases. Initial signs of degradation of asexual stages of P. vivax--kernels of nucleus, refinement of cytoplasm and its vacuolization, aggregation of pigment in isolated instances, its pushing out from cytoplasm--were observed after 1-2 hours after administration of delagil. Thereafter, parasite degradation was increasing, and it disappeared within 48 hours. Disappearance of fever slowed down in a few cases. However, degradation of parasites occurred during the same period among the rest of cases. It can not be excluded that fever was determined by the pyrogenic effect of remnants of degraded parasites and by the products of destroyed infected erythrocytes. It is probable that the findings of gametocytes, not completely degraded after disappearance of asexual forms in conjunction with prolonged fever, could result in a wrong conclusion of drug resistance. Negative results of microscopy and nested PCR on the last day of treatment, as well as in the following 10 days and absence of complains during 45 days, suggest the absence of resistance to delagil in P. vivax strains imported from different regions of the world. It is also probable that the literature on P. vivax resistance to chloroquine is limited to sporadic cases.