Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Author: search.filters.author.Dimitrova, EmilijaHas files: Yes

Search Results

Now showing 1 - 5 of 5
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    RECURRENT CLOSTRIDIOIDES DIFFICILE COLITIS – CASE REPORT
    (Peytchinski Publishing Ltd., 2024-10-06)
    Georgievska, Dajana
    ;
    ;
    Vidinic, Ivan
    ;
    Shopova, Zhaklina
    ;
    Rangelov, Goran
    Recurrent Clostridium difficile infection (rCDI) is usually defined as the reappearance of enteral symptoms 2-8 weeks after resolution of the initial episode with an appropriate therapy. Recurrence occurs in approximately 25% of patients within the first 30 days of the treatment. A 62-year-old female was initially hospitalized at our hospital within the intensive care unit (ICU) due to acute encephalitis and bilateral bronchopneumonia. Her comorbidities were diabetes mellitus and hypertension. She was treated with a combination of parenteral beta-lactam antibiotics for 35 days, acyclovir, probiotics, gastric suppression, and other supportive therapies. On the 18th hospital day, she developed diarrhea with liquid mucous green stools, prompting stool cultures and a C.difficile toxins test, which were negative and her condition stabilized spontaneously. A week later, she experienced a recurrence of enteral symptoms when stool cultures showed C.difficile positivity, but negative toxin tests. A colonoscopy was performed, revealing pseudomembranous pancolitis. Treatment continued with intravenous metronidazole and oral vancomycin for two weeks, alongside probiotics. This led to gradual improvement and normalization of stool consistency. Control cultures were C.difficile negative, and she was discharged after 49 days. Three weeks later, she complained of persistent watery stools and malaise, thus she was readmitted. New stool cultures confirmed C.difficile positivity with negative toxin tests. A repeat colonoscopy showed significant regression of pseudomembranous colitis and biopsy results indicated chronic nonspecific colitis. She was treated with probiotics, intravenous metronidazole for a week, and oral vancomycin. On first follow-up visit after three weeks, she returned asymptomatic with normal stools, and was advised to continue oral vancomycin, rifaximin, and probiotics. A second follow-up visit two weeks later confirmed normal stool characteristics. Prolonged use of antibiotics, extended hospital stays, advanced age, severe preexisting illness are significant risk factors for recurrent CDI. Prolonged oral vancomycin therapy has shown high efficacy in treatment of this serious condition.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    HAEMOPHILUS INFLUENZAE MENINGITIS IN A ADULT: A RARE ETIOLOGY OF MENINGITIS – CASE REPORT
    (Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10)
    Milosavljevikj, Ane
    ;
    ;
    ;
    ;
    Rangelov, Goran
    Haemophilus 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.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    VARICELLA ZOSTER VIRUS AND MENINGITIS IN IMMUNOCOMPETENT PATIENT - CASE REPORT
    (Peytchinski Publishing Ltd., Pleven, Bulgaria, 2024-10)
    Stojanoska, Tatjana
    ;
    ;
    ;
    ;
    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.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent 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)
    Dimitrova, Emilija
    ;
    ;
    ;
    ;
    Rangelov, Goran
    Methicillin-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.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    RHABDOMYOLYSIS IN PATIENT WITH INFLUENZA A - CASE REPORT
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2023-12)
    ;
    ;
    Stojanoska, Tatjana
    ;
    Dimitrova, Emilija
    ;
    Geogrgievska, Dajana
    Introduction. Rhabdomyolysis is a serious condition characterized by muscle breakdown. Common causes include exertion, crush, and drugs. Infection, many more viral infections such as influenza A and B, coxsackie viruses, Epstein-Barr virus, herpes simplex, adenovirus, echovirus, HIV, and cytomegalovirus are also recogni-zed as the reason for rhabdomyolysis. Case report. We present a case of a 47-year-old male patient with fever, muscle pain, and dark urine whose nasopharyngeal swab detected Influenza A infection. Initial laboratory analysis revealed extremely elevated levels of creatine kinase (CK) necessitating hospital treatment. Following a ten-day course of treatment, the patient was discharged without complications such as acute renal failure or myositis. Conclusion. Influenza A is a common infection that causes outbreaks and epidemics in cold months that do not always cause respiratory complications. Rhabdo-myolysis is a rare but serious complication that should be recognized and treated because of the high risk of morbidity and mortality.