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Object: To analyze the clinical, epidemiological and laboratory characteristics of the cases with measles in the Plovdiv region, Bulgaria, in the period March-July 2017. Materials and Methods: The study included 139 hospitalized patients with measles, treated in the Clinic of Infectious Diseases, University Hospital "St. George"-Plovdiv, during the observed period. Diagnosis was verified by ELISA in 133 of the patients. The following methods were used: clinical and epidemiological analysis, laboratory, microbiological and imaging tests. Results: The age distribution of the patients was: infants below 1 year were 23.8%; 1-3 years-24.5%; 4-17 years-30.9%; and over 18 years-20.8%. Ethnicity: from Roma origin were 83.5% and Bulgarians-16.5%. Most of the patients (62%) reported contact with a measles patient. Ninety eight of the patients were over 13 months of age and they should have been immunized, as the vaccine in Bulgaria is applied on the 13 month. Of these 98 patients, 49% were immunized, 28% were not, and for 23% there were not data. The most common clinical symptoms were: fever-97.1%, cough-98.6% and runny nose-82.7%. Conjunctivitis was observed in 82%, asthenia in 46%, and diarrhea in 51.1%. The rash appeared average on the 4 th day of the onset of complaints. Koplik's spots were observed in 71.9%, cervical lymphadenopathy in 56.1%, hepatomegaly-in 25.2%, and splenomegaly-in 7.9%; auscultation data for bronchitis/pneumonia-in 33.1%. Laboratory tests: leucopenia in 32.4%, leukocytosis-2.2%, normal results-in the rest 65.4%. ESR was increased in 39.1% and CRP in 76.5% of the patients. X-ray of the lung was performed under indication and was positive in 28/46. The serological test-anti-measles IgM (ELISA) was positive in 95.7% (133/139

Introduction. Bacterial meningitis is a severe disease with high mortality and frequent residual neurological sequelae. It is associated with multiple risk factors. The aim of the study was to establish the main risk factors associated with bacterial meningitis and to outline the incidence of chronic diseases in patients with bacterial meningitis and their relationship to the patients’ age and etiology of meningitis, if any. Materials and methods. The study included 90 patients with bacterial meningitis admitted to the Clinic of Infectious Diseases, University Hospital “Sv. Georgi” – Plovdiv during the period January 1, 2016 – September 30, 2019. Epidemiological analyses, clinical examinations, laboratory and microbiological tests, and statistical methods were used. Results. A total of 76.8% of patients had concomitant conditions: cardiovascular diseases (38.9%), diabetes mellitus (16.7%), immunosuppression (16.7%), liver diseases (11.1%), pulmonary diseases (10%), neoplasms (7.8%), chronic kidney diseases (7.8%). The incidence of immunosuppression (p = 0.009), cardiovascular disease (p = 0.0001), and diabetes (p = 0.009) were significantly higher in adults compared to children. Risk factors were present in 37.8% of patients (44% in children and 35.4% in adults, p > 0.05), especially in patients with pneumococcal meningitis (47.1%). The main risk factor was otitis or sinusitis in the last 3 months before meningitis (17.8%), followed by head trauma (6.7%), alcoholism (6.2%), recurrent episode of meningitis (4.4%), nasal leakage of cerebrospinal fluid (3.3%), general surgery (3.3%), and splenectomy (2.2%). Conclusion. Elderly patients with meningitis had more frequent comorbidities than children, mostly cardiovascular diseases, diabetes, and immunosuppression. The highest incidence of chronic diseases was found in patients with listerial meningitis. Risk factors were found in both age groups.

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