Predviđanje težine krpeljnog meningoencefalitisa na temelju izabranih pokazatelja

Autor: Ljiljana Mišić Majerus, Oktavija Đaković-Rode, Eva Ružić-Sabljić, Nevenka Bujić, Vesna Mađarić, Gordana Kolarić
Jazyk: chorvatština
Rok vydání: 2010
Předmět:
Zdroj: Infektološki glasnik
Volume 30
Issue 1
ISSN: 1848-7769
1331-2820
Popis: Svrha našeg rada bila je istražiti može li se u bolesnika s KME na temelju izabranih pokazatelja određenih kod primitka na bolničko liječenje predvidjeti težina tijeka akutne bolesti. Retrospektivnim istraživanjem uključili smo odrasle bolesnike s KME koji su od 1995. do 2005. godine obrađeni u Djelatnosti za infektivne bolesti Opće bolnice u Koprivnici. Sve podatke o pojedinom bolesniku prikupili smo iz povijesti bolesti. Akutna meningoencefalitička (ME) faza klasificirana je kao lagana ili teška, ovisno o prisutnosti meningealnih simptoma, težini znakova encefalitisa i prisutnosti žarišnih znakova središnjeg živčanog sustava (SŽS). Svi su bolesnici uglavnom pregledani i kategorizirani od istog liječnika. Izabrani i analizirani pokazatelji s mogućim učinkom na težinu bolesti uključuju: spol i dob bolesnika, podatak o višekratnim ubodima krpelja, sezonsku raspodjelu, vremensko razdoblje (u danima) od prvih simptoma do prvog pregleda, trajanje asimptomatskog razdoblja (u danima), stanje svijesti, tijek bolesti (bifazni, monofazni), nalaz lumbalnoga likvora i periferne krvi, pridruženu infekciju s Borrelia burgdorferi sensu lato (BBSL). Sa ciljem što bolje i ujednačenije obrade te lakše mogućnosti uspoređivanja, sve podatke o pojedinom bolesniku upisivali smo u posebno pripremljene anketne listiće (upitnike). Akutnu infekciju virusom KME dokazali smo u 133 bolesnika, u dobi od 16 do 76 godina. Prevladava muški spol (83/133, 62,4%). Višekratni ubodi krpelja zabilježeni su u 33 (38,4%) bolesnika, od kojih u 24 (48,0%) s laganim i devetero (25,0%) s teškim ME stadijem bolesti. Klinički se bolest najčešće očituje kao ME (66/49,6%), bifaznog tijeka u 94 (70,7%) bolesnika. Lagani ME prisutan je u 77 (57,8%), a teški u 56 (42,1%) bolesnika. Na početku bolesti samo kratko asimptomatsko razdoblje (P
The main purpose of our study was to investigate whether the severity and course of acute illness in patients with tick-borne encephalitis can be predicted based on selected parameters determined on admission to hospital. This retrospective study included adult patients with TBE, who were treated at the Department of Infectious Diseases, General Hospital, Koprivnica, Croatia, between 1995 and 2005. Case records of all patients were reviewed. On admission to hospital the acute meningoencephalitic (ME) stage was classified as mild or severe, depending on the presence of meningeal symptoms, the severity of clinical signs of encephalitis and presence of focal central nerves systems (CNS) signs. The patients were generally examined and categorized by the same physician. We analyzed and compared selected parameters determined on admission to hospital including: sex and age, multiple tick bite, seasonal distribution, period of time (days) between the onset of first symptoms of disease and the first examination, duration of asymptomatic interval (days), state of mind, course of illness (biphasic, monophasic), cerebrospinal fluid and peripheral blood findings, concomitant infection with Borrelia burgdorferi sensu lato (BBSL). All data collected from patients were entered into specially prepared questionnaire. Recent infection with TBE was confirmed in 133 patients, 83 (62,4%) males and 50 (37,6%) females, aged 16 to 76. A history of tick-bite was noted in 86 (64,6%) of whom multiple in 33 (38,3%) patients. TBE presented as isolated meningitis in 50 (37,6%), as ME in 66 (49,6%) and as meningoencephalomyelitis (MEM) in 17 (12,8%) patients. A biphasic course of disease occurred in 94 (70,7%) patients. Mild ME stage was noticed in 77 (57,8%) and severe in 56 (42,1%) patients. On admission to hospital only a short period of time between finishing initial stage and beginning of second ME stage (p
Databáze: OpenAIRE
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