No abstract

In the last two decades, a number of studies analyzing environmental, epidemiological, immunological, pathogenetic, and clinical aspects of hantavirus infection were published. Scientists are searching for effective treatments and are developing new methods of specific disease prevention. The classification of pathogens has been optimized and species names of hantaviruses have been changed. Hantavirus infection has been registered on almost all continents with different incidence. Considering the wide spread of hantavirus infection, it is rather not a feral herd infection, but a natural ubiquitous infection. Hantavirus infection has two clinical variants, including hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). In our opinion, the similarity of pathogenetic mechanisms underlying the development of both variants of hantavirus infection suggests the need to unite HFRS and HCPS (coded in the ICD as А98 and В33, respectively) into a single category ‘Hantavirus infection’ with clinical variants of its course. We believe that damage to the respiratory tract (regardless of the type of pathogen) should be considered as primary and pathogenetically determined condition; it can be considered as a complication only if the diagnosis was laboratory confirmed. Key words: Hantavirus, haemorrhagic fever with renal syndrome, HFRS, hantavirus (cardio) pulmonary syndrome, HPS, capillary leak syndrome

The article describes four clinical observations of patients with babesiosis detected in the European part of the Russian Federation, two of whom were under the direct supervision of the authors. The analysis of epidemiological data, clinical picture, results of laboratory studies in the dynamics of the disease. Differential diagnosis and treatment are discussed.

Adult-onset Still’s disease (AOSD) is a rare multisystem disease of unknown etiology. According to the literature, AOSD incidence in the world is 0.1–0.4 per 100 thousand population and it has two age-related peaks: the first peak — young age (15–25 years), the second — in persons aged 35–46 years. The causes and pathogenetic mechanism of AOSD are not established. The infectious pathology nature has not received proper scientific confirmation. According to modern concepts, this disease belongs to the group of auto-inflammatory, occurring without autoimmune disorders. It was found that patients with AOSD have a T-cell regulation disorder, increased production of the proinflammatory cytokine, the long-term persistence of which leads to the occurrence of fever and aseptic inflammation in various organs and tissues. The main criteria for this nosology are young age, persistent fever, arthritis, maculopapular rash, elevated ferritin level, neutrophilic leukocytosis, seronegative rheumatoid arthritis. Concomitant diseases include polyserositis, lymphadenopathy, hepatosplenomegaly, and nasopharyngeal infection. The article presents a clinical case of AOSD verified in a young woman at the Infectious Diseases Clinical Hospital. The difficulties of diagnostics are described, taking into account the variety of symptoms and the absence of pathognomonic disease signs. KEYWORDS: Adult-onset Still’s disease, fever, auto-inflammatory disease, arthritis, maculopapular rash, ferritin. FOR CITATION: Kharlamova T.V., Smirnova T.Yu., Golub V.P. et al. Adult-onset Still’s disease in the clinical practice of infectious disease physician. Russian Medical Inquiry. 2020;4(11):705–709. DOI: 10.32364/2587-6821-2020-4-11-705-709.

The symptomatic form of Blastocystis spp. infection not only with mild diarrhea or dysentery-like syndrome, but also with the development of severe ulcerative necrotic lesions of the intestine. Meanwhile, the pathogenicity of these microorganisms should not be exaggerated, due to majority asymptomatic cases or infection transmission with minor impaired bowel function.