Systemic lupus erythematosus (SLE) is per se a disease characterized by suppressed immune response and thus susceptibility to various opportunistic infections. We describe the case of a 21-year old woman who developed a rare zoonosis - hemotrophic mycoplasma infection in the initial stage of SLE, complicated with Nocardia asteroides pneumonia afterwards. Nocardia infection coincided with initiation of glucocorticoids and cyclophosphamide therapy for SLE. After the treatment she recovered completely. To our knowledge the only case of human hemoplasmosis (then referred to as eperythrozoonosis) in medical literature was the one described by a group of Croatian authors 22 years ago. No cases of a hemotrophic mycoplasma infection in a SLE patient have been published up to now.
Inclusion body myositis is a clinical entity which should be considered on differential diagnosis of patients presenting with weakness and wasting of proximal muscle groups, lack of laboratory and histologic evidence of muscle necrosis and systemic inflammatory response. We describe a 43-year-old woman with muscle weakness and wasting of proximal muscle groups. Glucocorticoid treatment yielded no effect and the muscle symptoms worsened. The diagnosis of inclusion body myositis was established after repeat biopsy of the affected muscle and even higher doses of glucocorticoids were admitted, again with no effect. The patient died from stroke before any other treatment for inclusion body myositis could be considered.
Background: The article describes the clinical picture of hepatitis B and the most recent findings concerning its etiopathogenesis, diagnostics, therapy and prevention. Survey and conclusions: The illness is caused by the DNA virus from the group of Hepadna viruses. Its antigen HBsAg is composed of three types of protein, each of which causes the formation of specific antibodies. Hepatitis B occurs as a result of damage caused by immune mechanisms. Sensitized/sensibilized cytotoxic T cells recognize the antigen on the surface of infected hepatocytes and destroy them. Morphological changes in the liver depend on the course (acute, chronic) and intensity of the illness. The course of the hepatitis B infection is divided into five phases: incubation, prodromal stadium, icteric phase, reconvalescence and chronic illness. The diagnosis is made on the basis of the clinical examination and laboratory and serological tests. In differential diagnosis all the virus forms of hepatitis, leptospirosis, malaria, the effect of chemicals, toxines, drugs, alcohol and ischemia are taken into account. The therapy is symptomatic. Spreading of the illness is prevented by taking strict hygienic measures while with the patient and with passive and active immunization.
Background. Acquired cystic disease of the kidney is common in patients on maintenance haemodialysis and is in association with renal neoplasm. Methods. With real time sonography 39 patients with endstage renal failure on haemodialysis were examined. Patients with polycystic kidney disease were excluded. We analysed three groups of patients: patients who were on haemodialysis up to one year, from one to nine years and over nine years. We established the presence of acquired cystic disease of the kidney and the appearances were divided into three grades: grade 0, no cysts; grade 1, less than 10 cysts in both kidneys; grade 2, more than 10 cysts. We also established the volume of the kidneys and the presence of solid lesions (renal neoplasm). Results. Twentythree (59%) patients had acquired cystic disease of the kidney: 2 (33%) patients who were on haemodialysis up to one year, 16 (57%) patients who were on haemodialysis from one to nine years and 5 (100%) patients who were on haemodialysis over nine years. No solid lesions were found. We observed an enlargement of kidney volume in patients with acquired cystic disease of the kidney. Conclusions. Acquired cystic disease of the kidney was common in patients on haemodialysis but we did not find renal neoplasm.
Background: The authors wished to assess the number of injured people in whom sudden breathing failure had to be overcome at the time of the transport from the place of the injury to the final care, since this is not inconsiderable as the cause of death in injured persons. Methods: An appropriate questionnaire for the period from 1987 to 1990 was sent to 18 surgical and otorhinolaryngological departments. Results: Only seven departmentsresponded to the questionnaire; it was not possible to extract relevant data from the answers. Some answers were diametrically opposed to those expected, while the autheniticity of others was doubtful. Conclusions: The authors established an impermissible deficiency in medical documentation of injuried in traffic accidents and doubt the seriousness of questionnaire naswers, especially in comparison with foreign literature. The number of persons injured in traffic accidents with sudden obstructive breathing failure is probably higher. Suitable measures are proposed for the organization of a more effective emergency health service.
