Development of a Model for Preliminary Diagnosis of Human Granulocytic Anaplasmosis.

Background: Human granulocytic anaplasmosis (HGA) is a vector-borne natural focal disease that is not officially registered in Ukraine. The first 13 cases of HGA in adults in Ukraine were identified in 2007. The purpose of our study was to develop a predictive model of HGA based on clinical and laboratory characteristics to develop a three-level standard case definition of HGA. Materials and Methods: Researchers examined 498 patients with suspected tick-borne infections and carried out a retrospective clinical and epidemiological analysis of 60 cases recruited from Lviv regional infectious disease hospitals. Logistic regression was used to create a model of the probability of the diagnosis of HGA depending on the presence of certain clinical and laboratory factors that, when examined, together may help to confirm a case of HGA. For logistic regression, eight clinical and laboratory factors were selected: history of tick bite, hyperthermia, signs of pharyngitis, changes in chest X-ray picture (enhancement of the pulmonary pattern and enlargement of the lung root boundaries), increased bilirubin (˃21 µmol/L), increased alanine aminotransferase (ALT ˃36 U/L), erythema migrans, and detected Lyme disease. Results: In the presence of all eight factors, the probability of HGA is 95.7%. When the five main signs are absent-signs of pharyngitis, changes in chest X-ray picture, increased bilirubin and ALT, and a history of tick bite-the probability of HGA in the patient dramatically decreases to 6.8%, meaning that HGA might be excluded. Conclusions: Based on the analysis of epidemiological, clinical, and laboratory signs, criteria for establishing a suspected, probable, and confirmed diagnosis of HGA have been developed to improve diagnosis.

A Single Clinical Case of Leptospirosis in a 70-Year-Old Man During the Military Conflict in Ukraine.

Leptospirosis is a bacterial disease that affects both humans and animals worldwide. Clinical symptoms of leptospirosis in humans range widely, from mild to severe illness, with symptoms that can include severe jaundice, acute renal failure, hemorrhagic pneumonia, and meningitis. We present a detailed clinical description of a 70-year-old man with leptospirosis. This case presented without the typical prodromal period for leptospirosis, thus making diagnosis more difficult. This isolated case occurred in the Lviv region during the ongoing military conflict between Russia and Ukraine where Ukrainian citizens have been forced to hide in premises that are not properly adapted for their long-term stay, which result in conditions that can potentially lead to the emergence of many infectious diseases. This case highlights the need for heightened awareness into the symptoms of a variety of infectious diseases, including but not limited to leptospirosis.

A case report of septic gardnerellosis.

Gardnerella vaginalis is a bacterium that is found as the most common cause of bacterial vaginitis in women. In this paper, we describe a case report of a 22-years old woman infected with G. vaginalis, who was initially suspected to have Dengue fever. The similarity of clinical symptoms developed by this disease with the symptoms of some other tropical infectious diseases, as well as a travel history, complicated identification of the disease cause for this particular patient. Here, we present a detailed epidemiological and clinical description of this case, leading to a final diagnosis of a septic form of gardnerellosis.

Application of PCR for Specific Diagnosis of Leptospirosis in Humans in Ukraine.

Leptospirosis remains one of the most widespread zoonotic diseases in the world and Ukraine, in particular. Ukrainian clinicians have been faced with early detection of the disease due to the availability of only a serological method for routine diagnostics in Ukraine, namely the microscopic agglutination test (MAT). This paper demonstrates the first results of the complex application of MAT and polymerase chain reaction (PCR) for routine verification of leptospirosis, which were first applied simultaneously in Lviv Oblast of Ukraine in 2016. We examined the sera of 150 patients clinically suspected of leptospirosis, 31 of whom were treated at the Lviv Oblast Clinical Hospital for Infectious Diseases (LOCHID). The application of PCR during the first seven days of the disease allowed increasing the share of confirmed leptospirosis cases by 16,1% in patients that were treated in LOCHID during 2016-2017.

Leptospira interrogans in mammals in Lviv Oblast, Ukraine, 2001-2015.

This study describes changes in the prevalence of Leptospira interrogans infections among small mammals, including rats and larger domestic and wild mammals in Lviv Oblast, a region in western Ukraine from 2001-2015, using the microscopic agglutination test (MAT). A total of 439,948 domestic or wild animals were tested. We found the prevalence of Leptospira interrogans exposure varied among tested species and changed over the time. Infection was significantly less common in domestic animals, than in wild rodents. In swine the overall seroprevalence was 0.51%, while in cattle it was 0.19%. In dogs it was higher-2.75%. After 2006, evidence of infection was only observed in swine among domestic animals. The prevalence among large wild animals (0.25%) was similar to that among domestic animals. Among small mammals and rats, seroprevalence was most commonly observed among Rattus norvegicus (18.44%) and it was less common among other wild small mammals (8.74%). There were two dominant serogroups among large wild and domestic animals-L. icterohaemorrhagiae and L. hebdomadis while among wild small mammals the two most common were L. icterohaemorrhagiae and L. grippotyphosa. Wild animals with antibodies were found throughout the entire oblast.

Leptospirosis in Ukraine (Lviv Oblast): Clinical and Epidemiological Features.

The article describes the results of a retrospective analysis of medical records of 395 patients with a clinical diagnosis of leptospirosis treated at the Lviv Oblast Infectious Disease Clinical Hospital (Ukraine) between 2002 and 2016. The main risk factors for leptospirosis were contact with rodents or their excrements (26.84%) and bathing in ponds, small lakes, and reservoirs (10.63%). Among 276 patients in whom the anti-leptospira antibodies were detected by the microscopic agglutination test (MAT), the most common serotypes were Leptospira icterohaemorrhagiae (33.33%) and Leptospira grippotyphosa (25.0%). The mortality rate was significantly higher in patients where leptospirosis diagnosis was established based on clinical symptoms without confirmation by MAT (15.13% vs. 5.43%, p < 0.01).

Characteristics of Meningitis Due to Methylobacterium mesophilicum: A Rare Case.

Methylobacterium mesophilicum is a gram-negative bacillus most often isolated in medical establishments. In humans, M. mesophilicum is considered a conditionally pathogenic flora. Infections in humans generally occur in immunodeficient individuals. This article describes a rare case of M. mesophilicum infection that developed into acute meningitis in a 26-year-old patient. Decreased neutrophil bactericidal activity was also detected. To our knowledge, there have been no previous reports of meningitis due to M. mesophilicum.