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Clinical practice -- difficulties in the diagnostics 2007

SUMMARIES 2007
REVIEWS more...
ORIGINAL ARTICLES more...
DIFFICULTIES IN THE DIAGNOSTICS more...

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VARIABLE IMMUNODEFICIENCY („SWISSE TYPE”) IN A 17-YEAR-OLD GIRL
M. Zheleva

University Clinic for Lung Diseases in Children, Medical University -- Sofia

Summary: Presented is a case of a 17-year-old girl with history of recurrent upper and lower respiratory tract infections , recurrent neck l ymph node infections, osteoarthritis of the hip, chronic mesenterial lymphadenitis. Laboratory studies found that all circulating Ig levels were low. Late-onset disease is usually referred to as common variable immunodeficiency (CVID). Treatment includes intravenous infusion of Ig (IVIG), aggressive antibiotic therapy, surgical interventions, physiotherapy. Overall prognosis is good when patients comply with their IVIG therapy and attend to the possible complications by chronic infections in the upper and lower respiratory tract.

Key words: agammaglobulinemia, hypogammaglobulinemia, immunodeficiency, Ig levels, late-onset agammaglobulinemia

Address for correspondence:
Maya Zheleva, MD, University Clinic for Lung Diseases in Children,
17 Acad. I. Geshov blvd., Bg – 1431, Sofia, tel. 80-54-299, e-mail: maya_jeleva@yahoo.com

PERIPHERAL LYMPHADENITIS IN CHILDHOOD – PROBLEMS OF DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
A. Spassova

Pediatric Clinic, University Hospital of Pulmonary Diseases „Sv. Sofia” – Sofia

Summary: A case of 17 years old boy report is given to illustrate a child with a clinical manifestation of specific peripheral lymphadenitis. The peripheral lymphadenitis is one of the hardest diagnoses in the pediatric pratice. This case is a description of quick and accurate diagnosis without use of invasive methods. The opportunity treatment is a guarantee for successful clinical outcome in these patients.

Key words: adenitis, tuberculous adenitis

Address for correspondence:
Albena Spasova, MD, Pediatric Clinic, University Hospital of Pulmonary Diseases “Sv. Sofia”, 17 Acad. Iv. Geshov, Bg – 1606 Sofia

TUBERCULOUS INFECTION OF THE CENTRAL NERVOUS SYSTEM
Ts. Doychinova(1), P. Yordanova-Laleva(2) and P. Ilieva(1)

(1)Clinic of Infectious Diseases, University Multiprofile Hospital for Active Treatment -- Pleven
(2)MDKL at the University Multiprofile Hospital for Active Treatment -- Pleven

Summary: The most modern method for diagnosing tuberculous meningitis (TBM) is the Interferon-gamma. The reaction of IFN-gamma causes strong secondary regulation of some cytokine and chemokine genes, and its use increases the probability of confirming or rejecting the diagnose of TBM. Purpose of the present work is to support the statement that the INF-gamma test can be a reliable diagnostic test for a TBC infection.We have presented 3 cases of children with TBM, treated in the Clinic for Infectious Diseases at UMPHAT -- Pleven in 2006-2007. For an early diagnosis, we used a QuantiFERON test. The children with TBC meningitis were positively affected by the combined tuberculostatic therapy. The IFN-g test supports the diagnosing of the TBC infection.

Key words: tuberculosis, CNS, QuantiFERON test

Address for correspondence:
Tsetsa Doychinova, MD, Clinic for Infectious Diseases at University Multiprofile Hospital for Active Treatment, 8a bvld., G.Kochev, Bg -- 5800 Pleven, tel. +359 888 729 532, e-mail: doichinova_ceca@abv.bg


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