Faculty of Medicine

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Author: search.filters.author.Shopova, ZhaklinaHas files: Yes

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    FEVER OF UNKNOWN ORIGIN: CLINICAL CHARACTERISTICS AND ETIOLOGICAL SPECTRUM
    (Здружение на инфектолози на Република Македонија = Macedonian Society of Infectious Diseases, 2024-10-06)
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    Shopova, Zhaklina
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    Vidinic, Ivan
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    Objective: This study aimed to provide an overview of the etiological distribution, clinical features, and laboratory findings among patients with classic fever of unknown origin (FUO) admitted to the University Clinic for Infectious Diseases and Febrile Conditions in Skopje. Materials and Methods: All participants underwent a comprehensive medical history review, physical examination, and predetermined laboratory investigations. The final diagnosis was established using specific diagnostic procedures guided by potential diagnostic clues (PDCs). After diagnosis, patients were categorized into infectious and non-infectious FUO groups. Results: The analysis included 47 participants, with a mean age of 57 years, the majority of whom were male. Fever lasted an average of 30 days, with a median temperature of 39 °C. Infections accounted for 53.2% of cases, followed by inflammatory non-infectious diseases (25.5%), malignancies, and other miscellaneous conditions (10.6%). The most frequent symptoms were myalgia, arthralgia, fever, sweating, and malaise. On physical examination, hepatosplenomegaly, heart murmurs, joint swelling, and skin rashes were the predominant findings. Significant laboratory abnormalities included elevated ferritin and procalcitonin levels across groups. Conclusion: Specific variations in clinical presentation and laboratory findings may help facilitate a more rapid differential diagnosis of classic FUO.
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    RECURRENT CLOSTRIDIOIDES DIFFICILE COLITIS – CASE REPORT
    (Peytchinski Publishing Ltd., 2024-10-06)
    Georgievska, Dajana
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    Vidinic, Ivan
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    Shopova, Zhaklina
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    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.
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    ARTERIAL THROMBOSIS IN A COVID-19 PATIENT
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2022)
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    Shopova, Zhaklina
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    Vidinic, Ivan
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    Arterial thrombosis is one of the complications descry bed in severe COVID-19. Our presented case had throm bosis of abdominal aorta and left renal artery despite prophylactic treatment with low molecular heparin - enoxaparine. Thrombotic lesions were defined with CT angiography. Treatment consisted of therapeutic doses of low molecular heparin and Bergman solution. After 42 day of hospital treatment, the patient was dischar ged and vascular surgeon consultations were performed. By presenting this case, we want to draw attention to the need for early diagnosis of this complication and to highlight the need for treatment with therapeutic doses of low molecular heparin in patients with severe Covid pneumonia or oxygen dependent patients and in risk for thrombosis.
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    Clinical outcome in hospitalized patients with COVID-19 and Diabetes
    (Macedonian Infectious Diseases Society, 2022-11-11)
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    Shopova, Zhaklina
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    Vidinic, Ivan
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    Imported viremic dengue case in a southeastern European country: Established Aedes mosquitoes warrant urgent surveillance
    (Wolters Kluwer – Medknow, 2024-07)
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    Shopova, Zhaklina
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    Loga, Arlinda Osmani
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    In 2023, international tourism nearly reached the levels seen before the COVID-19 pandemic. Tropical and sub-tropical countries are a popular travel destination, where mosquito-bome diseases pose a significant public health challenge[1]. Dengue, the most prominent human arboviral disease is transmitted by several species of Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus[2]. These vectors are also present in Europe, especially Aedes albopictus, which has been recorded in most countries in Mediterranean Europe. Prompt international travel allows travelers to return while they are in their viremic phase, notably 4 to 5 days after the onset of symptoms. The mosquitoes get infected after feed on a viremic person, and consequently can transmit the virus into susceptible local population[2]. Autochthonous dengue transmissions in Europe, where Aedes albopictus is the dominant vector, was reported in Veneto region in Italy, Catalonia Spain, southern France, and Adriatic coast in Croatia[3]. The presence of such competent vectors is progressively making dengue fever an emerging public health issue in Europe. For the first time, we report a viremic dengue fever imported into the Republic of North Macedonia.