Canak G

Infections and the elderly

Epidemiology Aging is a natural process and a part of our lives, but nowadays there is an increase in the number of persons aged 65 and over. Today infectious diseases are still responsible for one-third of all deaths in the world. The elderly population is most vulnerable to serious infections and at greatest risk for death and complications. Among geriatric population pneumonia and influenza are the fourth most common cause of death Vaccination One of the goals of preventive medicine is to reduce the rate of complications and mortality from infectious diseases by increasing immunization rates. Influenza and pneumococcal vaccines are indicated for persons aged 65 and over. Despite well-recognized benefit of such vaccination, less than 50% of eligible patients receive the vaccine each year. Infections Older persons generally have increased susceptibility to infections because of multiple risk factors and they are the most vulnerable population to nosocomial and health-care associated infections. Older persons may manifest infectious diseases atypically, with acute confusion or delirium which can lead into delay in diagnosis and therapy. It is important to know that the older present with delayed or poor response to antimicrobial therapy and high rates of adverse reactions to drugs, including antibiotics Conclusion As elderly population is rapidly growing, majority of patients with serious or life-threatening infections are old. Geriatric issues have not typically been a focus of training in infectious diseases, but we must become aware of and knowledgeable about special and unique aspects of infections in this population.

Leptospirosis distribution related to freshwater habitats in the Vojvodina region (Republic of Serbia)

The retrospective study (2002–2007) for human leptospirosis in Vojvodina was undertaken in order to describe the distribution of the disease in relation with some environmental factors. Regarding the presented results, the major detected number of leptospirosis cases concurs with stagnant waters, wetlands, fish pond areas and protected regions, which comprised the basis for mapping of the region in three risk zones: very high risk (incidence rate higher than 5.0), high risk (2.5–5.0) and medium risk of leptospirosis infection (1.0–2.5). During the investigated period, 97 cases were registered with an average of 13.85 cases per year: 2002, 32 cases; 2003, 7; 2004, 22; 2005, 16; 2006, 4 and 2007, 16. Out of these 97 cases only 5 were women. Serovars from 11 presumptive serogroups caused infection, with a predominance of Icterohaemorrhagiae and Bratislava, accounting for 72.72% of cases together. Icterohaemorrhagiae was the commonest infecting serogroup mostly connected with fish ponds. Case fatality ratio was 9.4%.

Rhabdomyolysis and influenza a (H3N2) infection: A case report

Influenza causes respiratory tract diseases with acute respiratory distress syndrome (ARDS) as the leading and most severe life threatening complication. In terms of early diagnosis, extrapulmonary complications are less common, but clinically a significant problem [1]. In the territory of Vojvodina, influenza occurs in epidemic forms, usually in the winter months. The most common cause is the virus Influenza A. In the season 2014/2015, the dominant type was A/H3N2. Pulmonary complications were the most common complications, and also the most common cause of death [2, 3]. However, we are witnessing the appearance of other rare and often unrecognized, life threatening complications. Rhabdomyolysis (RM) is the destruction of skeletal muscle followed by the release of intracellular myofibrils into the bloodstream and extracellular fluid. Clinical manifestations vary, from asymptomatic to life threatening conditions, such as acute renal failure and disseminated intravascular coagulation [4]. Although myositis is the most common symptom of the flu syndrome, the development of RM is rare, and it is more likely to occur in individuals with a genetic predisposition. The aim of this paper is to highlight RM as a potentially life threatening complication of influenza. Summary Introduction. Extrapulmonary complications of influenza infections are often unrecognized. The aim of this paper is to point to rhabdomyolysis as a potentially life threatening complication of influenza. Case Report. A month after the onset of influenza complicated by bronchopneumonia, the general condition of a nineteen year old female deteriorated with development of progressive muscle weakness and dark-colored urine. Despite intensive hydration and antibiotic therapy, her condition got worse, laboratory findings showed pancytopenia, hypoalbuminemia and creatine phosphokinase about 1000 times higher than normal. Influenza A H3N2 was confirmed by polymerase chain reaction analysis of the throat swab sample. Electromyoneurography showed severe acute polyneuropathy of muscles innervated by perineal nerve and signs of polymyositis; pathohistological examination of gastrocnemius muscle biopsy sample confirmed chronic myositis with necrotic neurogenic atrophy. In spite of intense hydration, the patient’s status continued deteriorating, so methylprednisolone was administered. Six weeks later, the patient was discharged in a good general condition, with blood test results within reference ranges, with weakness of foot dorsiflexors and tilting of the pelvis to the left during verticalization. Conclusion. Rhabdomyolysis caused by influenza-A is on the increase, and given the degree of morbidity and mortality, thorough assessment of patients is necessary.