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, HAEMOPHILUS INFLUENZAE MENINGITIS IN A ADULT: A RARE ETIOLOGY OF MENINGITIS – CASE REPORT(Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10); ; ; Rangelov, GoranHaemophilus influenzae is a gram-negative bacterium that commonly causes meningitis in children, rarely in adults, particularly in immunocompetent individuals. Most adult cases occur in those with predisposing conditions such as chronic diseases and immunosuppression. We describe a case of meningitis caused by Haemophilus influenzae in an immunocompetent 66- year-old male. The patient received treatment with ceftriaxone and he was discharged in good clinical condition, with no neurological deficits. Haemophilus influenzae meningitis in adults underscores the importance of considering this rare pathogen in the differential diagnosis of bacterial meningitis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, VARICELLA ZOSTER VIRUS AND MENINGITIS IN IMMUNOCOMPETENT PATIENT - CASE REPORT(Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10); ; ; Varicella zoster virus reactivation, also known as herpes zoster is common in older adults and immunocompromised individuals and often causes a painful, vesicular rash limited to a dermatomal distribution. On occasion, it can lead to various neurological complications as well. Meningitis caused by varicella zoster virus infection is uncommon in immunocompetent patients. We report the case of a 49-year-old male patient that presented with a one-week history of persistent headache that did not resolve with analgesics. He was previously healthy and immunocompetent, with a history of chickenpox in childhood. The CSF PCR analysis revealed a VZV infection causing acute aseptic meningitis with no shingles rash eruption on physical examination. Intravenous treatment with Acyclovir was started and following a three-week treatment course, the patient was discharged in good general condition with normal CSF results. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COMPARISON OF THREE SEVERITY SCORING MODELS FOR MORTALITY PREDICTION OF COMMUNITY-ACQUIRED PNEUMONIA(Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10); ; ; Cana, FadilIntroduction: Community-acquired pneumonia (CAP) is among the leading cause of morbidity and mortality worldwide. Several scoring models have been developed to accurately asses a disease severity and early to predict the outcome, however an optimal prognostic tool still is not clearly defined. The aim of this study was to compare three commonly used scores in patients with CAP, in order to determine the best tool that will early identify those with increased risk for mortality. Methods: The study included 129 patients aged ≥18 years with CAP hospitalized at the intensive care unit (ICU) at the University Clinic for Infectious Diseases in Skopje, during a 3-year period. Demographic, clinical and biochemical parameters were recorded and three scores were calculated at admission: SOFA (Sequential Organ Failure Assessment Score), SAPS II (Simplified Acute Physiology Score) and APACHE II (Acute Physiology and Chronic Health Evaluation II). Primary outcome was 30-day in-hospital mortality. Receiver Operating Curve (ROC) analysis was performed and areas under the curve (AUC) were compared to evaluate mortality prediction capacities of the scores. Results: The mean age of the patients was 61 year, predominantly were males (66,7%), most (79,1%) had co-morbid condition and Charlson Comorbidity index was significantly increased in non-survivors. An overall mortality was 43.4%. All severity scores had higher values in patients who died, that was statistically significant with the outcome. The AUC values of the scores were 0,749 for SOFA, 0.749 for SAPS II and 0.714 for APACHE II, showing similar prediction ability. Conclusion. Commonly used severity scoring models accurately identified patients with CAP that had an increased risk for poor outcome, but none of them showed to be superior over the others in ability to predict the mortality. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUS BACTEREMIA AND MENINGITIS ASSOCIATED WITH SPINAL AND PSOAS MUSCLE ABSCESS – CASE REPORT(Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10); ; ; Rangelov, GoranMethicillin-sensitive Staphylococcus aureus (MSSA) can cause a range of severe infections, including bacteremia and meningitis. While MSSA-related bacteremia and meningitis are serious on their own, they can also be associated with complex complications such as intraspinal and psoas abscesses. We report a case of a 72-year-old male with symptoms including lower back pain, leg weakness, malaise, fever and headache. Initial laboratory results showed leucocythosis, hyponatriemia and elevated CRP, while cerebrospinal fluid analysis indicated significant pleocytosis and neutrophilia. After admission, three blood cultures were obtained, all of which isolated MSSA. During hospitalization, a CT scan of the thorax and MR of the spine were performed, revealing bilateral pleural effusion, L5-S1 intraspinal abscess, and an abscess in the ileopsoas muscle. After 6 weeks of antibiotic therapy, a follow-up MRI was performed, which showed regression of the abscesses. This case underscores the severe complications of Staphylococcus aureus infection, including meningitis, sepsis and abscesses. Effective management relies on prompt diagnosis, comprehensive evaluation, and targeted antibiotic therapy. The patient’s positive outcome highlights the importance of early recognition and tailored treatment in complex infections. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, TESTICULAR INVOLVEMENT IN BRUCELLOSIS - A STUDY OF 34 CASES(Asocijacija infektologa u Bosni i Hercegovini, 2018-09); ; - Some of the metrics are blocked by yourconsent settings
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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>