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A ‘new’ group of pathogenic agents, enterohemorrhagic Escherichia coli (EHEC) (particularly the strains of O157 serogroup), emerged in the last 20 years causing an increased number of sporadic and epidemic diarrhoeal diseases with hemorrhagic enterocolitis as a most common clinical manifestation of the infection. As a consequence of the absorption and cytotoxic effect of the main virulence factor of these bacteria - verotoxin (shiga-toxin), in about 10% of the affected persons extraintestinal complications, most frequently hemolytic-uremic syndrome (HUS), occurred 7-14 days after an episode of diarrhoeal disease. The first case of hemorrhagic enterocolitis with the documented EHEC O157 infection in Yugoslavia is presented in this paper. Considering the existing expansion trend of these carriers, practitioners should be aware of them in case of the occurrence of diarrhoeal disease (particularly hemorrhagic enterocolitis), and keep these patients under control during the reconvalescence period because of potential development of extraintestinal complications, such as HUS.

Kikuchi-Fujimoto disease (KFD), also know as histiocytic necrotizing lymphadenitis, is a benign disorder characterized histologically by necrotic foci surrounded by histiocytic aggregates, and with the absence of neutrophils. KFD was recognized in Japan, where it was first described in 1972. The disease is most commonly affecting young women. The cause of the disease is unknown, and its exact pathogenesis has not yet been clarified. Many investigators have postulated viral etiology of KFD, connecting it with Epstein Barr virus, human herpes simplex virus 6 parvo B 19, but also with toxoplasmic infection. Kikuchi-Fujimoto disease is usually manifested with lymphadenopathy and high fever, and is associated with lymphopenia splenomegaly, and hepatomegaly with abnormal liver function tests arthralgia, and weight loss. The disease has the tendency of spontaneous remission, with mean duration of three months. Single recurrent episodes of KFD have been reported with many years’ pauses between the episodes. Kikuchi-Fujimoto disease may reflect systemic lupus erythematosus (SLE), and self-limited SLE-like conditions. Final diagnosis could only be established on the basis of typical morphological changes in the lymph node, and lymph node biopsy is needed for establishing the diagnosis. Lymphadenopathy in a patient with fever of the unknown origin could provide a clue to the diagnosis of lymphoma, tuberculosis, metastatic carcinoma, toxoplasmosis and infectious mononucleosis. As KFD does not have any classical clinical features and laboratory characteristics, it may lead to diagnostic confusion and erroneous treatment. We described a case of KFD, and suggested that this disease should be considered as a possible cause of fever of the unknown origin with lymphadenopathy.

Tuberculosis is an unusual infectious disease because of the latent period between the infection and the appearance of the disease may be prolonged for many weeks, months, or years as it is in case of the secondary tuberculosis. Tuberculosis in organs other than the lung has been observed for many years but has not always been recognized as tuberculosis, and it has been given many names. Extrapulmonary tuberculosis gained new importance, because it represented a progressively greater proportion of new cases. Multiple extrapulmonary sites were reported rarely except for one anatomical site, which was reported frequently. Extrapulmonary rates increase with age, so there are marked differences in age in specific rate patterns among the sites. Extrapulmonary tuberculosis occurred in respiratory organs other than lung, such as lymphatic, urogenital, and central nervous system, abdominal, osteoarticular, as well as tuberculosis of other organs such as skin, pericardium and endocrine glands. This case was reported to analyse clinical, morphologic and laboratory characteristics, method of diagnosis and the outcome in patients with multiorgan tuberculosis in order to explore the factors which might contribute to the decision making, concerning these forms of tuberculosis. Recent knowledge of pathogenesis was summarized as well as clinical presentation and the effects of cytokines produced by T lymphocytes and cellular population on antimycobacterial immune defences, and also susceptibility to tuberculosis. Mortality remains high and the treatment should start as soon as tuberculosis is suspected.

The first case of the confirmed necrotizing fasciitis caused by Group A Streptococcus in Yugoslavia was presented. Male patient, aged 28, in good health, suddenly developed symptoms and signs of severe infective syndrome and intensive pain in the axillary region. Parenteral antibiotic, substitution and supportive therapy was conducted along with the radical surgical excision of the necrotizing tissue. The patient did not develop streptococcal toxic shock syndrome thanks to the early established diagnosis and timely applied aggressive treatment. He was released from the hospital as completely cured two months after the admission.

The relation between HCV genotypes and the progression of chronic hepatitis is still unknown. Some studies implied more pathogenic effect of genotype 1b for the severity of liver inflammation. However, other studies did not show the association between HCV genotype 1b and the severe outcome of HCV infection. The aim of this study was to determine the most frequent genotypes in this environment and their influence on hepatitis C severity. The investigation included 34 patients with histologically confirmed chronic hepatitis C, aged 20-65 (mean 35.0 years). On the basis of patohistological findings, applying the modern classification, the disease activity was graded as: minimal (A1), moderate (A2) and severe (A3). The extent of fibrosis was marked as: absent (F0), mild (F1), moderate (F2) and severe (F3). Genotyping was performed by nested PCR with type-specific primers and LIPA test and verified by sequencing. The most prevailing genotype in our group of patients was 1b (44.1%), followed by genotype 3a (26.4%), genotype 1a (11.7%) and 2a (2.8%). Five patients had mixed genotypes (four 3a/1b, and one 1a/1b). The severity of liver cell necrosis, measured by alanintransferaze (ALT) levels in serum was not related to any of HCV genotypes. There was no statistically significant difference between histological disease activity in relation to HCV genotypes. Stage of the disease was not significantly related to the HCV genotypes. There was a strong association between the degree of fibrosis and the age of patients (p

Background/Aim. Ultrasonographic kidney changes might be a part of the clinical picture, or consequence of the various infections diseases. The aim of this study was to establish ultrasonographic findings obtained by portable devices, the frequency of abnormal findings of the kidneys in the non-selected group of the patients with infections diseases. Methods. Over a five-year period (January 1, 2000-December 31, 2004), the kidneys were examined by ultrasonography in 2718 patients, 1452 males and 1266 females, mean age 47.52±17 years, (16-92 years). The examination included the measurement of the size of the kidneys, evaluation of the condition of parenchyma and pyelo-calix, detection of simple cysts, calculi and tumor. The conventional portable ultrasonographic devices ALOKA SSD-500 and SSD-1000 (B-mode) with a convex 3.5 and 5 MHz sonde were used. Results. The size of kidneys was normal in 95% of the patients, while they were enlarged in 1.3% and reduced in 1.5% of the patients. A normal ultrasonographic recording was noted in 68.9% of the patients, double pelvis in 0.1%, while hydronephrosis was revealed in 0.9% of the patients. A reduced renal parenchyma was observed in 16.1% of the patients. Nephrolithiasis was found in 10.9% of the patients, and simple cysts of kidneys in 8.9% of the patients. The finding of polycystic kidneys was seen in 0.5% of the patients. An ultrasonographic recording of angiomyolipoma was noted in 0.4% of the patients, and the finding of other tumors in 0.1% of the patients. Adrenal tumors were found in 0.1% of the patients. Conclusion. Portable ultrasonographic units may be highly useful for the standard morphological diagnostics of renal changes during infections, as well as in clinical-epidemiological studies and screening of hereditary and the acquired diseases of this organ.