Faculty of Medicine

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Author: search.filters.author.Ivanovska, JulijaHas files: Yes

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    COVID-19 IN CHILDREN WITH DOWN SYNDROME-CASE SERIES
    (Macedonian Association of Anatomists and Morphologists, 2023-11-05)
    Ivanovska, Julija
    ;
    Nestorov, Hristijan
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    Popova, Gorica
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    Chakalaroska, Irena
    ;
    Petlichkovska, Sandra
    Down syndrome (DS) is the most common genetic disease and presents withcognitive impairment, cardiac and gastrointestinal abnormalities, increasedrisk of hematological malignancy and several autoimmune conditions in additionto other miscellaneous clinical conditionsThe aim is to show if the comorbidities that children with Down Sy have, were risk factors for more severe form of COVID-19.We present three cases of children with Down Sy and COVID-19, with different clinical features. All of them had good clinical outcome, only the firstchild had more severe form of Covid 19 with needfor oxygen support, longer hospitalization but with good clinical improvement and withdrawal of the X-ray changes. Children with Down Sy are always a high-risk group for more severeand prolonged course of disease, which are partiallyattributed to defects of the immune system.
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    COMPLICATED TUBERCULOSIS IN A 13-YEAR-OLD CHILD WITH DOWN SYNDROME: A CASE REPORT
    (Macedonian Association of Anatomists and Morphologists, 2023-11-05)
    Nestorov, Hristijan
    ;
    ;
    Doksimovski, Filip
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    Chakalaroska, Irena
    ;
    Ivanovska, Julija
    Tuberculosis (TB) is the most common cause of infectious disease-related mortality worldwide. Most persons infected won’t develop active disease, but in certain instances such as extremes of age or defects in cell-mediated immune response, TB may develop. Down syndrome (DS) is the most common neurodevelopmental disorder of know genetic causeand described simply as arising from an extra copy of chromosome 21, presenting with characteristic features. Due to immune defects, DS suffer more frequently from respiratory tract infections than normal children.We present a case of a 13yearsold child with Down Syndrome who was diagnosed with lung tuberculosis, after a right sided lobectomy due to a lung abscess.The child was hospitalized, following a period of one and a half month with fever and vomiting that did not improve with therapy. Investigations were made, including CT scan on the lungs. Due to right sided empyema and abscess on the right upper lobe, right sided lobectomy was preformed. The postsurgical pathohistological findings were in addition to pulmonary tuberculosis. Four drug antituberculosis regimenwas started. The four-drugcourse was given for two months, and then a two-drugregime was continued. To this day the child is on the sixth month of the two-drugantituberculosis regime. CT scans, regular Chest X-rays and ultrasoundof the lungs were made, with gradual improvement.In Down syndrome patients who have a complicated pneumonia that doesn’t respond to standard treatment, a tuberculosis disease should be considered.
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    UNEXPECTED FOREIGN BODY AS A REASON OF LOBAR PNEUMONIA IN A 6,5 YEARS OLD BOY – CASE REPORT
    (Macedonian Association of Anatomists, 2022)
    Mitrovska Josifova, Veselinka
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    ;
    Chakalaroska, Irena
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    ;
    Spasova, Olga
    We present a case of a foreign body as a reason for right lobar pneumonia in 6,5 years old boy. He was admitted in our hospital because of 6 day high fever (up to 40 Cͦ), malaise, cough, stomach ache. Clinically he had impaired breathing in the basis of the right lung, and laboratory findings were with elevated inflammatory markers. The radiogram of the chest showed round consolidation in the right low lung lobus. Microbiologicaly, we isolated Mycoplasma pneumonia (IgM) from pneumoslide, and also Staphylococcus aureus – MRSA from the sputum. Additional immunology tests like immunoelectrophoresis ( IgA, IgG, IgM) were done, all of them with results in normal ranges. After one week of therapy with parenteral rehydration, wide spectral antibiotics (according to antibiogram), inhalatory bronchodilatator and systemic corticosteroid, the child presented with scarce haemoptysis, with consecutive clear haemoptysis on the 10-th day. This set for bronchoscopy and Mx-test with PPD5, which was negative. Flexibile bronchoscopy was made at 11th day of the stay, with visualized foreign body- grass like structure in the openings of the arm of middle and lower right bronchus. We continued with rigid bronchoscopy, with successfully removed grass- Hordeum murinum. After the intervention we observed completely clinical recovery of the lung findings, as well as radiological improvement