Faculty of Medicine
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Item type:Publication, Acute bacterial meningitis – challenges and conclusions(IMAB Peytchinski Publishing Ltd., 2024-10); ; ; Acute bacterial meningitis is an urgent condition characterized by significant morbidity and mortality. In the last decades, epidemiology of the most common etiologic agents as well as the age limit has changed significantly, with dominant involvement of the adult population and population at risk. Streptococcus pneumoniae remains the most common bacteria causing bacterial meningitis. The aim of this study is to observe the changes in the prevalence of etiologic agents and their dominance, the most commonly affected age groups, as well as comorbidities and complications in patients with acute bacterial meningitis treated at the University Clinic for Infectious Diseases in Skopje, R.N. Macedonia. In the last seven-year period, 194 patients with acute bacterial meningitis were treated. The etiologic agent in cerebrospinal fluid was confirmed in 94 (48.45%) patients, with the predominance of S. pneumoniae in 74 (78.72%). L. monocytogenes with 10 (10.63%) and N. meningitides with 6 (6.38%) were less represented. Male sex is dominant with 111 (57.21%) and older age groups as well. More than half of the patients, from the study, belonged to the at risk population with the highest percentage of them presenting with more than two comorbidities, as well as complications. In our study group, 41 (21.13%) of the patients died. Because of the substantial mortality and morbidity, it remains an urgent need to optimally deploy existing vaccines worldwide and develop new prevention strategies and treatment options. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Visceral Leishmaniasis in the Republic of North Macedonia: A Retrospective Cohort Study(Galenos Yayinevi, 2025-11-11); ; Visceral leishmaniasis (VL) is a systemic protozoan vector-borne disease and represents the most severe clinical form of leishmaniasis, with fatal outcomes if left untreated. This study aimed to evaluate the key epidemiological, clinical, and laboratory findings, treatment options, and outcomes in patients with VL. Materials and Methods A retrospective analysis was conducted on the epidemiological and clinical characteristics of 84 patients diagnosed and treated for VL at the University Hospital for Infectious Diseases in Skopje, Republic of North Macedonia (RNM), between 2001 and 2023. Results The median age of patients was 47 years (range 1-74), with 77.4% being male. Contact with dogs was reported in 41.7% of cases. Seven percent of patients were immunosuppressed, and all were Human Immunodeficiency Virus-negative. The median time from symptom onset to diagnosis was 30 days (range 4-330 days). The predominant clinical manifestations were splenomegaly (97.6%), fever (96.4%), hepatomegaly (90.5%), and weight loss (54.8%). On admission, anemia, leukopenia, thrombocytopenia, and hypergammaglobulinemia were detected in 75%, 73.8%, 70.2%, and 63.1% of patients, respectively. A favorable outcome was achieved in 91.7% of cases; therapeutic failure occurred in 1.2%, and 7.1% of patients died. Conclusion VL should be considered a crucial differential diagnosis in patients from the RNM presenting with prolonged unexplained fever, splenomegaly, cytopenia, and hypergammaglobulinemia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Rhabdomyolysis Associated with Recent SARS-COV-2 Infection in a Patient with Carnitine Palmitoyltransferase II Deficiency(Macedonian Academy of Sciences and Arts / Walter de Gruyter GmbH, 2022-11-01); ; ; ; Cana, FadilCarnitine palmitoyltransferase II deficiency (CPT II) is an autosomal recessive inherited disorder of long-chain fatty acid oxidation in the mitochondrial matrix, resulting in an inability to utilize fat for energy in cells. The most frequent myopathic form occurs in young adults and is associated with recurrent episodes of exercise-induced rhabdomyolysis. The myopathic form is caused by the Ser113Leu mutation of the CPT II gene. Rarely, massive rhabdomyolysis could be complicated by acute kidney injury (AKI), car-diomyopathy, and respiratory insufficiency.We present a case of an 18-year old male with myalgia, muscular weakness, and dark-colored urine after prolonged exercise and a recent mildSARS-CoV-2infection. Massive rhabdomyolysis was diagnosed with markedly increased serum concentrations of myoglobin and creatine kinase, with normal kidney function. The patient experienced two similar episodes in the years 2017 and 2018, with rhabdomyolysis and AKI treated with hemodialysis. After excluding autoimmune and infectious diseases as causes of recurrent rhab-domyolysis, the patient was genetically tested and Ser113Leu mutation of the CPT II gene was confirmed. When a patient presents with myalgia and dark-colored urine triggered by minor physical activities, genetic testing for possible CPT II deficiency should be initiated. TheSARS-CoV-2infection could be a factor that triggers the occurrence of rhabdomyolysis and aggravates the severity of the attack in patients with CPT II deficiency - Some of the metrics are blocked by yourconsent settings
Item type:Publication, First Experience in Management of Coronavirus Disease 2019 (COVID-19) in Kidney Transplant Patient – Case Report(Scientific Foundation SPIROSKI, 2020-08-18); ; ; ; Cana, Fadil<jats:p>BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently emerged in the world. There are limited data describing the clinical progression of COVID-19 in transplanted patients. In the general population, clinical presentation ranges from asymptomatic infection to severe pneumonia and may also develop renal failure. In kidney transplant (KT) patients, management of these patients was mainly based on anecdotal experience. CASE REPORT: We report our first experience of KT patients with COVID-19. A 49-year-old male with KT in 2017 presented on March 20, 2020, with fever, weakness, smell loss, chest pain, and caught. On chest X-ray, he presented ground-glass opacities and bilateral pneumonia. There was a slight progression to acute hypoxic respiratory failure. We reduced immunosuppression therapy and since we suspected seasonal flu, we applied available antiviral oseltamivir till confirmation of RNA sequence of the SARS-CoV-2 virus. Moreover, we applied azithromycin and broad spectrum of antibiotics as well as an anticoagulant therapy. Graft function remained stable during 14 days of hospitalization. The patient clinically improved with decreasing oxygen requirements and manifested clinical recovery. After two negative PCR test, he was discharged and immunosuppression therapy was returned to previous. CONCLUSION: This case highlights the importance of earlier outpatient hospitalization and testing which may improve COVID-19 outcomes among transplanted patients.</jats:p>