A review of the literature is devoted to one of the most common and clinically significant zoonoses - leptospirosis. The article summarizes modern information on prevalence, epidemiology, etiopathogenesis and clinical features, diagnosis of leptospirosis infection over the last 10 years. The particular attention is paid to the characterization of severe forms of the disease, complex approaches to the treatment of the disease, correction of organ dysfunction and hemostasis disorders; review.

Objective: Improvement of the diagnosis and prognosis of liver disease of viral etiology based on the analysis of clinical and epidemiological characteristics of the course and outcome of viral mixt-hepatitis. Materials and methods There are presented results of the retrospective study of 106 patients with chronic viral mixt-hepatitis (study group), which were under the medical observation for a period from two to five years between 2010 and 2014. The comparison group was consisted of 1,913 patients with chronic hepatitis C. Results and discussion The morbidity of chronic viral mixt-hepatitis in the majority of cases is registered among socially active groups of young and middle age persons, more common among males. Frequent risk factors are the artificial factor (55%), the intravenous drug usage (25%), tattooing (19%). Typical concomitant illnesses are diseases of the gastrointestinal tract and the endocrine system. Chronic viral mixt-hepatitis is mainly caused by a combination of HCV and HBV, and HCV + HBV + HDV also. HCV replication is noted in 64% of cases, the replication of HBV - in 58%, HDV replication - in 20%. Transformation into cirrhosis in patients with mixt-hepatitis C+B+D was recorded in 25% of cases, in mixt-hepatitis C+B cases - in 7.1%. In the group of C+B+D hepatitis patients, viral replication of HBV and HDV without HCV replication transformation into cirrhosis was seen in 36%. In the case of HDV replication alone, the rate of cirrhosis was 25%, while in cases with isolated HBV replication - 14%. In patients with mixt-infection C+B, the development of cirrhosis was registered within subgroup with simultaneous replication of HBV and HCV viruses in 9% cases. An isolated HCV replication, in general was less often, and led to the transformation into cirrhosis in 6% cases. Conclusions. Simultaneous replication of more than one type of hepatitis virus promotes transformation into cirrhosis, in greater extent, simultaneous replication of HBV + HDV, and monoreplication of HDV virus also. In order to prevent further progression of the pathological process it is recommended the well-timed causal treatment order with account for the predominant virus replication.

The purpose of the study the improvement of early diagnostics of Lyme disease on the based of clinical and epidemiological analysis of the main clinical forms of the acute course of the disease in new natural foci in the Krasnodar Krai. Patients and methods. There was analyzed the clinical course of disease and epidemiological data for 207 patients in the early period of acute course of Lyme disease within the period from 2004 to 2013. Results. In the territory of the Krasnodar Krai and the Republic of Adygea there has formed a set of foci of tick-borne borreliosis (TB), i.e. Lyme disease (LD). The infection of cases is observed not only in the natural foci of disease, but also within the city limits. The disease is registered mainly in the erythematous form (74% of patients), non-erythematous form accounts for 26%. The average age of patients was 41,1±1,83, years, males 38%, females 62%. In the non-erythematous form initial clinical symptoms are recorded in average in 11,6 ± 2,20 days after tick suction; in the erythematous form in 6,4 ± 0,70 days ( p

Objective: to define clinical, epidemiological and entomological characteristics of malaria in the Krasnodar Territory in 2001-2014. Materials and methods. The clinical and epidemiological aspects of malaria in 25 patients hospitalized in the regional clinical hospital for the period 2005-2014 were studied. A comparative analysis of the incidence of malaria was done, entomological indicators of malaria season in the region for pathogens vivax in the last 3 years were considered. Results and discussion. In the Krasnodar Territory malaria is imported mainly from Africa (68%), more than half of cases (54.2%) - local residents, Russian citizens. Foreign citizens (Africans, migrants from Tajikistan) amounted to 45.8%. Basically middle-aged (21-59 years) men (88%) are subjected, traveling abroad for professional purposes, the tourists among the cases amounted to 15.4%. The residence time in an endemic area ranged from 16 days to 24 months, with regular chemoprophylaxis absence in 80% of cases. Cases of imported malaria in were recorded mainly from May to September, which corresponds to the epidemiological season with a high risk of disease transmission. In the etiological structure of imported malaria Pl.falciparum (64%) prevailed, cases of Pl.vivax were 32%, in one case (4%) Pl.ovale was found. Reference clinical and epidemiological features of imported malaria were acute onset of high fever, chills, headache, general weakness with the presence of the majority of patients with hepato-splenic syndrome, thrombocytopenia, in half the cases at a tropical malaria dyspeptic symptoms with increasing theirfrequencies in parallel of the disease severity were observed. For timely diagnosis, in addition to knowledge of the main clinical symptoms and disease complications, of paramount importance was the identification and registration of epidemiological history (stay in endemic area), knowledge of the disease phases, the duration of the incubation period for different kinds of invasions and timely screening for malaria patients with fever of unknown origin. Conclusion. Epidemiological and entomological studies confirm the presence in Krasnodar Territory of high malariogenic potential with the duration of the epidemic season, the possible transfer of the three-day malaria from May to October. Retention of the threat of imported malaria requires necessary level of knowledge among doctors in the diagnosis and prevention of malaria and ensuring effective health care facilities with antimalarial drugs.

Over the past decade, there has been an increasing number of patients infected with HIV. The disease gradually leads to a pronounced immunodeficiency and death. In the vast majority of patients, polymorbidity phenomena are noted, which leads to the need for a differentiated interdisciplinary approach to their management. The knowledge of dermatologists of other dermatological aspects of HIV-infection by dermatologists and doctors will allow timely early detection of HIV-infected patients and avoid diagnostic errors. A clinical follow - up was carried out which showed issues of diagnostics while examining patients with HIV infection in outpatient practice.