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Our case report describes a case of an otherwise predominantly childhood disease in a young adult woman with a good socioeconomic background who developed pruritic exanthema on the 2nd day after spontaneous delivery. The aim of the paper is to characterize the disease and to describe the possible risks for mother and child according to the available literature, as well as complications not only in puerperium but also during pregnancy.

Při letu letadlem dochazi ke kolisani tlaku a objemu vzduchu ve středousnich a paranazalnich dutinach. Pokud z nějake přiciny neni možna výměna vzduchu v dutinach, může dojit k barotraumatu, ktere může způsobit i važne mechanicke poskozeni nebo zanětlive onemocněni. Bakterialni hnisava meningitida, ktera se projevi během několika dni po cestě letadlem, je pravděpodobně přimým nasledkem barotraumatu. Bolesti hlavy a dalsi neurologicke přiznaky vznikle v souvislosti s letem by měly být posuzovany i s ohledem na možne nasledky popsaneho tlakoveho poskozeni.

Chemokin CXCL13 působi v mozkomisnim moku jako silný atraktant pro leukocyty. Bylo prokazano, že u pacientů v ranem stadiu lymeske neuroboreliozy je koncentrace chemokinu CXCL13 v mozkomisnim moku výrazně zvýsena, dokonce jestě před tim, než jsou v tomto kompartmentu syntetizovany specificke protilatky. Průkaz CXCL13 ma u neuroboreliozy vysokou negativni i pozitivni diagnostickou prediktivni hodnotu a nebyl do rutinniho diagnostickeho algoritmu dosud zařazen. Proto byly na klinickem souboru pacientů s lymeskou neuroboreliozou a dalsimi seroznimi neuroinfekcemi porovnany dvě metody na stanoveni koncentrace CXCL13 chemokinu v mozkomisnim moku 1) semikvantitativni imunochromatický ReaScan CXCL13 rapid test a 2) kvantitativni test CXCL13/BLC/BCA-1 Quantikine ELISA. Pomoci Cohenova koeficientu kappa bylo ověřeno, že shoda mezi oběma testy je vysoka (p

Lymeska borrelioza je bakterialni infekce přenasena klisťaty, ktera postihuje řadu organů a tkani. Diagnosticke obtiže působi hlavně rozmanitost klinických projevů a mala dostupnost a využitelnost přimých laboratornich metod. Zakladem laboratorni diagnostiky je v soucasne době průkaz specifických IgM a IgG protilatek, potvrzujici kontakt s infekcnim agens, nikoliv aktivitu infekce. Předpokladem spravne diagnozy je peclive zhodnoceni klinickeho obrazu v korelaci s výsledky laboratornich testů. Zakladnimi skupinami antibiotik ucinných na lecbu borreliove infekce jsou tetracykliny, penicilinova antibiotika, cefalosporiny a makrolidy. Nedostatecna nebo žadna klinicka odpověď by měla vest k přehodnoceni diagnozy a rozsiřeni diagnostickeho postupu o jine, i neinfekcni přiciny obtiži. Opakovani ani prodlužovani lecby antibiotiky neni doporucovano.

We recently compared diagnostic parameters of different commercial serological kits based on three different antigen types and correlated test results with the status of the patient’s Borrelia infection ([1][1]). We thank Lacout et al. for comments on our article expressed in their comment letter

The national guideline aims to highlight the latest knowledge about clinical manifestations of the infection, to summarize the diagnostic algorithm and to recommend the appropriate antibiotic therapy with respect to evidence-based medicine. The recommendations are consistent with most European guidelines as well as those published by the IDSA. The guideline provides the most recent information on the epidemiology, etiology and pathogenesis of Lyme borreliosis, dermatological, neurological and musculoskeletal involvement, the appropriate diagnostic procedure and prevention. Some information is also provided about post-treatment Lyme disease syndrome. Recommended oral and intravenous antimicrobials are listed in a table showing the doses and duration of therapy. The guideline also mentions diagnostic methods to be avoided or whose results should be interpreted with caution. Although the guideline cannot account for all individual variations among patients, it may provide instructions to physicians in typical and frequent clinical situations.

The study evaluates the clinical significance of CXCL13 (leukocyte chemoattractant synthesized in CSF ) in Lyme neuroborreliosis (LNB) and other aseptic CNS infections. 244 patients with symptoms of neuroinfection and/or LNB were divided into groups: A - patients with LNB-positive antibodies in serum and CSF (96) or CSF only (14); B - patients with aseptic non-borrelial neuroinfections (82); C - negative controls (52). Group A was divided into A1-A4 according to pleocytosis in CSF and AIIgG positivity. The highest CSF CXCL13 concentrations (max. 81,287.60pg/ml; median 1766.90pg/ml) were in A1 (positive AI, pleocytosis) and A3 (negative AIIgG, pleocytosis; max. 7201,60pg/ml, median 56.22pg/ml). A2 (positive AI without pleocytosis) and A4 (negative AI without pleocytosis) had low CXCL13 levels - A2 max. 650.50pg/ml (median

The study compares diagnostic parameters of different commercial serological kits based on three different antigen types and correlates test results with the status of the patient's Borrelia infection. In total, 8 IgM and 8 IgG kits were tested, as follows: enzyme-linked immunosorbent assay (ELISA) (Euroimmun) based on whole-cell antigen, 3 species-specific enzyme immunoassays (EIAs) (TestLine), Liaison chemiluminescence (DiaSorin), ELISA-Viditest (Vidia), EIA, and Blot-Line (TestLine) using recombinant antigens., The study compares diagnostic parameters of different commercial serological kits based on three different antigen types and correlates test results with the status of the patient's Borrelia infection. In total, 8 IgM and 8 IgG kits were tested, as follows: enzyme-linked immunosorbent assay (ELISA) (Euroimmun) based on whole-cell antigen, 3 species-specific enzyme immunoassays (EIAs) (TestLine), Liaison chemiluminescence (DiaSorin), ELISA-Viditest (Vidia), EIA, and Blot-Line (TestLine) using recombinant antigens. All tests were performed on a panel of 90 samples from patients with clinically characterized borreliosis (53 with neuroborreliosis, 32 with erythema migrans, and 5 with arthritis) plus 70 controls from blood donors and syphilis patients. ELISA based on whole-cell antigens has superior sensitivity and superior negative predictive value and serves as an excellent screening test, although its specificity and positive predictive values are low. Species-specific tests have volatile parameters. Their low sensitivity and low negative predictive value handicap them in routine diagnostics. Tests with recombinant antigens are characterized by high specificity and high positive predictive value and have a wide range of use in diagnostic practice. Diagnostic parameters of individual tests depend on the composition of the sample panel. Only a small proportion of contradictory samples giving both negative and positive results is responsible for discrepancies between test results. Correlation of test results with the patient's clinical state is limited, especially in the erythema migrans group with high proportions of negative and contradictory results. In contrast, IgG test results in the neuroborreliosis group, which are more concordant, show acceptable agreement with Borrelia status.

Pasteurella multocida is a common commensal of the gastrointestinal and respiratory tracts of animals, especially cats and dogs. It is transmitted to humans through contact with animals. Bite wound infection is the most common clinical manifestation. Systemic infections are unusual and mainly affect immunocompromised individuals. The article presents two cases of Pasteurella infection. Wound infection in a 75-year-old female following a bite from her pet cat was associated with bacteremia. The disease course was favorable with the initial clindamycin treatment despite in vitro resistance. The other patient was a 62-year-old female diagnosed with acute bacterial meningitis with multiple brain abscesses and transient expressive aphasia. She reported frequent contacts with pets and domestic animals without a recent bite. Hematogenous dissemination of the infection was suspected. Because of poor therapeutic response, cefotaxime was switched to chloramphenicol which was later switched to a combination of cefotaxime with ciprofloxacin due to anemia. Following 6 weeks of intravenous antibiotic therapy and another 10 weeks of oral ciprofloxacin therapy, magnetic resonance imaging showed normal results and the neurological defect resolved. Epidemiological, clinical and therapeutic aspects of Pasteurella infection are discussed and literature is reviewed.

Aim: The aim of the study was to map the incidence of mumps in the Czech Republic in terms of clinical symptoms, epidemiological links, and characteristics of circulating genotypes. Methods: Patients with suspected mumps examined in the Infectious Diseases Clinic of the Na Bulovce Hospital in 2013 were enrolled in the study. Buccal swab specimens were tested by means of nucleic acid detection (RT-qPCR) and when positive, they were cultured in tissue culture. Sequencing was carried out using the BigDye Terminator v3.1 Cycle Sequencing Kit and Genetic Analyzer 3500. The SeqScape software was used for the analysis of sequencing data and filtering out low quality reads. The phylogenetic analysis and genotyping were performed using the Mega 6 software. To generate the phylogenetic tree, all sequences were aligned by the MAFFT tool and the alignment obtained was edited using the BioEdit software. In all patients, selected biochemical markers (C-reactive protein, white blood cell count and serum amylase) were measured. The EPIDAT system used for reporting infectious diseases, record keeping, and data analysis in the Czech Republic was the source of statistical data. Results: Eighty-nine patients with suspected mumps were examined in the Na Bulovce Hospital and 65 of them were laboratory confirmed with mumps: 40 males (61.5%) and 25 females (38.5%). The mean age of the study cohort was 25.9 years (median age of 23 years, age range from 10 to 73 years) and 14 patients were under 18 years of age. Thirty-four (52.3%) patients were vaccinated in childhood, 28 (43.1%) were unvaccinated, and for three persons, vaccination data were not available. A severe course of the disease was reported in 15 (23.1%) patients. Fourteen of them needed hospitalization because of orchitis (9 males) and meningitis (5 patients). One patient with orchitis was treated on an outpatient basis. The need for hospitalization tended to be lower in the unvaccinated patients (14.7% vs. 35.7%, p=0.076). In 2013, 1,553 cases of mumps were reported to the EPIDAT system. Of these, 640 were laboratory confirmed. The most often reported complications were orchitis (90 cases, i.e. 10.3%) and meningitis (21 cases, i.e. 1.4%). Orchitis was diagnosed in 30.3% of the unvaccinated and in 6.4% of the vaccinated males. Meningitis occurred in 3.1% of the unvaccinated and in 1.0% of the vaccinated patients. Conclusion: Despite the emergence of mumps among the vaccinated population, the present study has confirmed a positive effect of the vaccine, particularly on the incidence of complications and inflammatory markers. All 30 sequenced mumps virus strains were assigned to group G. A secondary vaccine failure due to waning immunity seems to be a plausible explanation for the rise in mumps cases.

Botulism, a life-threatening condition, is very rare in the Czech Republic. Since 1960, a total of 155 cases have been reported; between 2010 and 2012, not a single case was identified. This is a case report of familiar occurrence of botulism following consumption of home-made pork and liver pâté in three family members admitted to the Department of Infectious, Tropical and Parasitic Diseases, Na Bulovce Hospital in Prague in May 2013. The neurological symptoms were dominated by diplopia and dysarthria. After administration of an antitoxin, all patients recovered. Given the poor availability of the antitoxin, a decision was made following this small family epidemic to have an emergency reserve of life-saving anti-infective drugs for the Czech Republic in the Toxicological Information Center in Prague.

Immune thrombocytopenia (immune thrombocytopenic purpura, ITP) is an acquired autoimmune disease, mediated by antibodies against platelet glycoproteins. ITP can develop in the context of other disorders (secondary ITP), including acute and chronic infections (HIV, H. pylori, HCV, HBV, CMV, EBV, VZV, parvovirus B19, rubella, etc.). The case reports present two children and one adult with ITP complicating VZV, EBV and HAV infections. Corticosteroids are usually initial drugs, but they are controversial in case of ITP during acute infections. Intravenous immunoglobulins are preferred, especially in children, because of their smaller suppression of inflammatory response. Two of the patients were successfully treated with intravenous immunoglobulins. In the remaining patient, corticosteroid therapy had good but delayed effects as compared to immunoglobulins.

Leptospirosis is a worldwide zoonosis with the highest incidence in tropical regions. The reservoir animals, mainly mice and rats, excrete leptospira organisms in their urine asymptomatically. It is transmitted to human hosts either by contact with the infected urine or via contaminated water or soil during the work and recreational activities. The aim of the case reports is to point out to another potential source of leptospiral infection - domestic rats which have become favorite home pets in the last twenty years. Three patients with various severities of the disease and treated in 2005-2010 are reported. The patients most likely acquired the leptospiral infection from their pet rats.

Listeria monocytogenes is ubiquitous in nature, being commonly present in faecal flora of otherwise healthy human population or animals. Clinical manifestation of listeria infection may vary widely from mild to invasive, life-threatening disease. In an immunocompromised host, a rather serious course should be expected. Due to cell-mediated immune insufficiency associated with pregnancy even a short bacteraemia in pregnant women can result in transplacental infection. Most listeria infections are sporadic but outbreaks may occur. An outbreak of listeriosis in the Czech Republic in the autumn of 2006 and winter of 2007 was associated with an increased incidence of perinatal listeriosis. More information on listeriosis prevention in pregnancy should be given and each febrile episode during pregnancy should be carefully examined. Early treatment of listeriosis reduces the risk of vertical transmission.