SUMMARYIntroduction: Brucella endocarditis (BE) is a rare but severe and potentially lethal manifestation of brucellosis. Pre-existing valves lesions and prosthetic valves (PV) are favorable for BE. Case report: We represent the case of a 46-year-old man who was treated at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, as blood culture positive (Brucella melitensis) mitral and aortic PV endocarditis. He was treated with combined anti-brucella and cardiac therapy. Surgical intervention was postponed due to cardiac instability. Four months later he passed away. Surgery was not performed.

ntroduction: Cellulitis is acute skin infection and/or infection of subcutaneous tissue, mostly caused by Streptococcus pyogenes and Staphylococcus aureus. Clinical preview is usually obvious and enough for diagnosis. Tretment is antimicrobial therapy. In recurrent cases a prophylaxis is very often needed. Objectives: Analysis some of the epidemiological and clinical characteristics of cellulitis. Patients and methods: Retrospective analysis of medical documentation of patients with clinical preview of cellulitis who were hospitalized in Clinic for infective diseases of Clinical Center of University of Sarajevo in last three years. Results: In period of three years 123 patients were hospitalized with clinical preview of cellulitis in the broadest sense of the word. In 123 of cellulitises, 35/123 (28.45 %) were erisipelases-superficial type and 88/123 (71,55 %) were deep cellulitises. Men were more affected 56,09 %, average of age was 50.22 years. Before hospitalization patients had ambulance treatment in average of 5.12 days, and hospitalization was long in average of 13.33 days. Risk factors wich contributes to the disease were found in 71.54 % of cases. Due to localisation, skin disorders on lower limb were the most frequent 71.56 %, cellulitis of upper limb were found in 12.19 % , head and/or neck in 13.08 %, trunk in 3.25 %. Repetition of disease were found in 4.8 % in patients wtih risk factors. Bacteremic isolats were confirmed in 27.64 % of cases. In all patients empirical antibiotic treatment were started, in the 62.60 % the first choice of medicine was antibiotic from the group of lincosamides. Conclusion: Cellulitis is very serious disease that can be prevented.

SUMMARY Introduction:Staphylococcal bacteremia/sepsis is one of the most serious bacterial infections around the world. In individuals with pre-existing diseases, there is always an increased risk of infections occurring due to impaired immune system, a variety of drug therapy, exposure to a diagnostic and therapeutic procedure and frequent hospitalizations. Objectives: To analyze the prevalence of comorbidity in a patient with the staphylococcal bacteremia/sepsis according to the diagnosis, the site of infection and according to the isolated agent. Patients and methods: We analyzed the patients affected by the staphylococcal bacteremia/sepsis and treated in the Clinic for Infectious Diseases during a ten-year period.Results: 87 patients were included, out of whom 20 (23%) with clinical signs of the bacteremia and 67 (77%) of sepsis. In the analyzed sample, in 36 (41.4%) were not registered comorbidity. Hospital infections are represented by the previous antibiotic, corticosteroid and chemo therapy, pressure ulcers, and different implants. In all comorbidity, the most common isolated bacteria was S. aureus primarily strain MSSA followed by MRSA strain which is more frequent in patients who were surgically treated (comorbidity-various implants). Conclusion: The results suggest the importance of being mindful of the staphylococcal etiology of the bacteremia/sepsis in patients with comorbidities due to the selection of an adequate initial empirical therapy and reducing the risks of the septic shock.

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