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At present despite methods of fast recognition of the disease and efficient antituberculosis drugs not only we cannot contain the epidemic but we can see an increase in new cases of tuberculosis including its drug resistant variety. Causes of aggravation of the situation are varied and ought to be examined separately in case of any particular region. One of the major ones are bad programmes of fighting against the disease or their inadequate realization, ignoring a problem of tuberculosis in developed countries, lack of money for treatment in developing countries and coincidence with HIV virus. Among the mentioned factors the phenomenon of drug resistance is considered one of most important reasons of expansion of tuberculosis in the modern world. In epidemiological investigations it is important to determine, apart from drug resistance patterns, what molecular families strains belong to. This allows us to track their transmission routes. Genotyping has given us knowledge of the threats connected with transmission of the infection and made it possible to identify a risk factor which is the cause of MDR (multidrug-resistant), XDR (extensively drug-resistant tuberculosis) strains dissemination as well as strains representing new molecular families. Results of some analyses proved to be surprising. For instance high proportion of genetically similar strains has been shown in countries of low incidence. It proves higher than expected transmission in societies of high economic standard. Analyses of DNA of mycobacteria led to distinguishing several genetic families among which M. tuberculosis Beijing is one of most important.

Malakoplakia is a rare, chronic, granulomatous disease seen in immunocompromised patients, caused by multiple infectious agents, most often bacteria. Microscopically, accumulations of macrophages with granular cytoplasm and intra- or extracellular structures, called Michaelis-Gutmann bodies are characteristic. Main cause of pulmonary malakoplakia is Rhodococcus equi infection. We report two cases of pulmonary malakoplakia, in one case R. equi infection was confirmed. We also present a summary of recent knowledge about the pathogenesis, morphology and clinical course of the disease.

For better control of tuberculosis World Heath Organization has prepared directly observed treatment short-course strategy (DOTS). The number of countries implementing the DOTS has increased bringing the total to 180. TB mortality decreased in western countries but it is very important problem in Africa and Asia. Multidrug-resistant tuberculosis, defined as resistance of M. tuberculosis to at least INH and RMP is especially worrisome because of its potential impact on the control of TB. MDRTB has been reported in most parts of the world but especially in Eastern Europe and in the countries where TB and HIV coinfection is endemic. TB is one of the most frequent opportunistic infections among HIV-infected individuals, and often the first manifestation of HIV disease.

HIV infection leads to progressive deterioration of immunity. Upper gastrointestinal symptoms are often reported in patients with this infection. The aim of the study was to evaluate morphological changes in upper gastrointestinal tract mucosa and prevalence of opportunistic infections and Helicobacter pylori in HIV-infected people in relationship to the degree of immunosupression. We studied 94 HIV-infected patients with dyspeptic symptoms, 47 suffered from severe immunodeficiency expressed by low CD4+ lymphocyte count below 200/ mm3. Control group consisted of 52 non HIV-infected patients. During endoscopy, gastrointestinal tract mucosa was evaluated and biopsy samples were taken from gastric body and antrum for histopathological analysis and rapid urease test. In patients with CD4+ lymphocyte count below 200/mm3, endoscopic examination revealed significantly more frequent esophageal candidiasis (36%); whereas reflux esophagitis (13%) was significantly less often diagnosed in comparison to the rest of the patients. Duodenitis and duodenal erosions were also less frequent in them. Prevalence of Helicobacter pylori infection in gastric antrum was significantly lower in HIV-infected patients with severe immunodeficiency (40%) in comparison to the rest of the patients (72%) and control group (69%). Chronic active gastritis of the antral mucosa was less frequent in HIV-infected patients with CD4+ lymphocyte count below 200/mm3.

The objective of the study was a mycological and clinical evaluation of the course of oral cavity fungal infection in HIV patients in relation to the immune response impairment. The patients were examined physically (symptoms and signs) and mycologically (isolation and identification of fungi, semiquantitative evaluation their growth abundance in the cultures); the immunity status was expressed in terms of the number of CD4 lymphocytes. The most frequently isolated fungal species was Candida albicans. The decreasing immunity was conductive to more abundant fungal growth in the oral cavity as well as to more frequent occurrence of clinical manifestations of candidiasis.

Central nervous system (CNS) becomes infected in early days of primary HIV infection. It is concerned to be one of the most important reservoirs of HIV in the human organism. It is also often affected by a number of conditions of different etiology, associated with HIV infection: opportunistic infections, neoplasms, disorders caused by HIV itself, adverse events of drugs, etc. These conditions appear in certain stages of HIV infection, connected with the state of the host's immunological system and degree of immunodeficiency. Unique physiological features of CNS cause that viral replication in CNS is to certain degree independent and different from systemic mechanisms of HIV infection. We overview the natural history of CNS HIV infection and common disorders of CNS associated with HIV regarding the stages of infection and possible mechanisms of viral entry to CNS and its progressive damage.

Objective: The aim of the search was investigation of tuberculosis in AIDS patients. Each year 8-9 mln people fall ill of tuberculosis and one third of them die. To the infection of tuberculosis and fast development into active state are especially exposed people with AIDS., Material and Methods: 696 people were examined on tuberculosis most of which were AIDS patients hospitalized and cured in Hospital of Infection Diseases and Prison Hospital. 159 patients were women and 537 were men. The average age was between 25 and 45 (70%). The investigated population was characterized according to age, social and living conditions, using drugs and former contact with tuberculosis. All patients suspected of tuberculosis had chest X-rayed, sputum, BAL and pleural liquor were taken to bacteriological examination when extrapulmonary tuberculosis was suspected. The material was taken adequately to the disease process: CSF, urine, lymph nodes, peritoneal fluids, blood, stool, swabs and other. Bacteriological investigations have been carried out by fast cultivating method since 1998 and rapid genetic method since 1999. Apart from modern, fast diagnostic methods, routine bacteriological procedures were applied in tuberculosis diagnosis., Results: More than 30% of the examined population were from bad social-living conditions, 78% had risk factors, 65% were drug users. The analysis of the tuberculosis illness from 1997 to July 2001 shows growing tendency. Nowadays it is 20% cases proved by bacteriological diagnosis. The structure of falling ill with tuberculosis has changed. Considerable increase of extrapulmonary tuberculosis was observed, 20 patients died due to tuberculosis and 8 patients due to mycobacteriosis. Resistance of M.tub.complex occurred within the range of 10% cases.

In the period of 1988-2001 (June) 24 HIV-positive patients with symptoms of sepsis were observed. Most of them (17 persons) were intravenous drug addicts, six patients were infected HIV trough sexual contact and one person-via blood transfusion. There were 26 cases analyzed (one of the patients went trough three episodes of sepsis). Bacterial sepsis dominated (22 cases). In three patients fungoid etiology was diagnosed, and one case was of mixed character. The highest risk factors of sepsis were: intravenous drug addiction and advanced stage of HIV infection.

A new data from investigations on Pneumocystis carinii were presented as well as an application of molecular techniques to the diagnosis of P. carinii pneumonia.

Fungal gastric ulcer is a relatively frequent from of gastric mycosis coexisting in 20-30% of cases with peptic ulcer. In such cases fungi were present in patients without other disease and in those with concomitant diseases such as neoplasms, polyps of the stomach, haematological diseases, and in patients treated with cytostatics and H2-blockers. Fungal ulcer differ from common ulcers in greater size and tendency for bleeding. In certain situations "fungal ulcer" requires routine antimycotic treatment especially if operation is planned.