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Two cases of imported visceral leishmaniasis are described. The first patient was a 32-year-old Czech man who developed leishmaniasis 5 months after a holiday in Italy (Bibione). The second patient was a 62-year-old Czech man who developed leishmaniasis 18 months after visiting Croatia (Makarska); the disease began after a course of chemotherapy due to metastasizing testicular tumor. Both patients were successfully treated with amphotericin B lipid complex (Abelcet). Difficulties in establishing the correct diagnosis of visceral leishmaniasis are discussed.

Expanding travel industry may increase the incidence of some rare infections diseases. One of them is cryptococcosis developing especially in immunosuppressed individuals. However, massive cryptococcal infection may lead to a severe clinical course even in people without impaired immunity. The case report describes the disease in a non-immunosuppressed 26-year-old man who returned to the Czech Republic after a 2.5-month stay in Egypt. He was hospitalized for increasing fever, weight loss and changes in behaviour. Thorough examination including thoracoscopy and histological analysis of the mediastinal lymph nodes revealed cryptococcal disease. Various organs, mainly the small bile ducts, were affected by the dissemination mimicking primary sclerosing cholangitis. The discussion is concerned with the properties of the Cryptococcus, variety of clinical manifestations, differential diagnosis and treatment.

The case history of a man referred to our department with the diagnosis of purulent meningitis; actually, he presented spondylodiscitis of the lumbar spine with the infection spreading into the spinal canal and the left psoas muscle. The disease was caused by a strain of Staphylococcus aureus, which in vitro was sensitive to penicillin. However, treatment with crystalline penicillin in combination with ciprofloxacin failed. The paper suggests a differential diagnosis permitting to distinguish a typical purulent meningitis and an abscess in the spinal canal. The authors also discuss the suitability of administering penicillin in staphylococcal sepsis caused by a sensitive strain. The authors do not recommend crystalline penicillin in the management of severe staphylococcal infections even in cases, where the isolated S. aureus strain is really sensitive to penicillin.

Background: A combination of ticarcillin with clavulanate has been used for more than 12 years in many countries in the treatment of infections caused by Gram-negative microorganisms and a mixed microbe flora, in particular where the presence of beta-lactamase producers can be anticipated. In the Czech Republic it is not very well known, probably more for commercial than medical reasons, and the objective of the present paper to draw attention to this old but still useful antibiotic., Methods and Results: In a simple open trial the therapeutic results in a group of 15 patients treated by the above preparation in 1992-1995 at the unit for septic infections of the Clinic for Infectious Diseases in Prague were summarized and compared with the results of a previous trial conducted in the same department in 1987-91 and with results published in the literature. The mean success of treatment was about 90%., Conclusions: A combination of ticarcillin, a semisynthetic broad spectrum penicillin with clavulanic acid is an antibiotic which is still very valuable in the treatment of sepsis and other severe forms of bacterial infection, incl. patients with a significantly reduced immunity. The tolerance is very good and an important factor is also the relatively favourable price. The author's results are consistent with experience published by departments abroad.

Three methods of blood cultivation were compared: collection of blood into transport bottles containing only dextran-sulphate, collection into cultivation media containing bottles (aerobic, anaerobic and paediatric Dulab) and the semi-automatic continuous blood culture system (Bactec 9000, using aerobic, anaerobic and paediatric bottles). A total amount of 1.250 blood samples collected from 626 patients was divided equally into the compared bottles and processed parallelly. The yield of the Bactec aerobic bottles was significantly higher than the yield of the transport bottles and aerobic Dulab bottles (p < 0.001). However, this result was influenced by the higher rate of contaminating bacteria isolated from the aerobic Bactec bottles. The yield of the aerobic Dulab bottles was higher than the yield of the transport bottles (p < 0.01). The average time needed for the detection of microorganisms in the Bactec bottles was by 24 hours shorter than in the transport bottles and by 19 hours shorter than in the aerobic Dulab bottles (p < 0.001). The difference between the yields of the anaerobic and the paediatric bottles in our study was not significant. The time needed for the detection of microorganisms was by 17 hours shorter in the anaerobic Bactec bottles than in the transport bottles (p < 0.05).