A rare case of an HIV-seronegative patient with Toxoplasma gondii meningoencephalitis

Cerebral toxoplasmosis is a common opportunistic infection that causes expansive brain lesions in people living with HIV/AIDS. But it is extremely rarely associated with HIV negative patients. This study presents a case of a 23-year-old male with non HIV-relative cerebral toxoplasmosis. There was an acute onset of the disease. The first symptoms included fever and signs of meningoradicular irritation. Neurological abnormalities progressed in cranial nerves disorders and pyramidal syndrome. The cerebrospinal fluid (CSF) changes were consistent with those of viral meningoencephalitis. CT and MRI showed multiple ring-enhancing lesions with high-intensity signals in cerebrum brain stem and cerebellum. The tests for HIV (ELISA and Western blot) were negative. Serological detection of Toxoplasma gondii (T. gondii) IgM and IgG antibodies in the CSF confirmed the diagnosis. Parasitic, bacterial, viral encephalitis and meningoencephalitis, as well as neoplastic metastatic process and other neurological diseases were discussed in the differential diagnosis. The intensity of the disease activity fluctuated during the hospital stay regardless of the adequate therapy.

[Rare case of Crimean haemorrhagic fever in a pregnant woman]

A rare case of Crimean haemorrhagic fever in a pregnant woman during the sixth month of gestation is described. The typical clinical course of the disease is present with positive anamnesis and visible locus from tick bite. After several days, fever and local lymphadenitis appear, followed by severe toxicoinfectious and haemorrhagic syndromes. The disease is proved virologically and serologically. The outcome is favourable for the pregnant woman. She is discharged home after 16-day hospital treatment. During the illness no complications of the fetus are documented. The pregnancy terminates with a normal-term delivery of a healthy newborn baby with birthweight of 3350g. The clinical and laboratory follow up of the baby showed no abnormalities. The case is of interest because of the rarely and often severe course of the disease during pregnancy. In this case the outcome is favourable for both the mother and the newborn child.

[The assisted reproduction and the newborn child]

A review of the literature was made concerning the perinatal complications of children conceived through assisted reproduction technology. The main complications were due to the high frequency of multiple gestation and prematurity. There is convicting data for a twofold increase of the frequency of congenital malformations: neural tube defects, intestinal atresia and hypospadias. Chromosomal disorders are more frequent when Intracytoplasmic spermal injection is used. There is no evidence of increased risk of tumors. The psychomotor and intellectual development of the children conceived by assisted reproduction is normal. Nowadays, in order to decrease the incidence of multiple pregnancy, elective single embryo transfer if the preferable technology of assisted reproduction.

Clostridium difficile-associated disease with lethal outcome in a 77-year-old woman. A case report

Clostridium difficile-associated disease (CDAD) ranges in severity from mild diarrhoea to fulminant colitis and death. Antimicrobial use is the primary risk factor for development of CDAD. C. difficile typically affects older or severely ill patients, hospitalized or residents in long-term-care facilities. We report a case of CDAD in a 77-year-old woman operated on for cholecystitis calculosa and treated with cephalosporins and aminoglycosides. Symptoms and signs of CDAD were watery diarrhoea, mucus stool, high fever and, weakness. Sigmoidoscopy was provided on the second day after hospitalization. It revealed diffuse pseudomembranes throughout the distal colon, confirming C. difficile infection. Antimicrobial agents administered at the admission were stopped and treatment with oral vancomycin, metronidazole and famotidine was initiated. Despite this the patient's status worsened and she died because of cardiogenic shock.