RESUMEN
Early diagnosis of the central nervous system (CNS) infections is a precondition of their successful treatment. However, the essential standard examination of the cerebrospinal fluid (CSF) is sometimes neither specific enough to define their basic nature, nor sufficient to differentiate them from processes of non-infectious origin. Supposing that the released surface molecules of activated immunocompetent cells could better define the character of inflammatory reaction, the levels of soluble CD4 antigens (sCD4) were determined with enzyme-immunosorbent test in the CSF of the patients with various CNS diseases. In contrast to cerebrovascular insults, toxic-metabolic, and other conditions in control group, detectable sCD4 concentrations in acute encephalitis (24 +/- 11 U/ml) were verified at the beginning of the disease, being also present in cytologically diagnosed normal CSF findings. They were significantly higher (p<0.05) compared to acute serous meningitis (13.5 +/- 8 U/ml), while in purulent meningitis they were measurable only after the disease progression--in correlation with the disturbed brain system function. The obtained results suggested the significance of CD4 antigen levels in CSF as a sensitive and specific marker of lymphocytic infiltration of the brain parenchyma, the measurement of which could contribute to early identification of the CNS infections, better understanding of their pathogenesis, and the assessment of the actual level of the destruction of neurons.
Asunto(s)
Antígenos CD4/líquido cefalorraquídeo , Infecciones del Sistema Nervioso Central/diagnóstico , Enfermedad Aguda , Biomarcadores/líquido cefalorraquídeo , Infecciones del Sistema Nervioso Central/líquido cefalorraquídeo , Infecciones del Sistema Nervioso Central/patología , Líquido Cefalorraquídeo/citología , Humanos , Linfocitos/patología , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
Tularaemia, as a rare disease, surprised medical workers in 1999 and 2000 when it was detected and diagnosed in 31 patients. In 1999 patients were registered in villages of the Sokobanja community, and in 2000 also in other communities in the district of Nish. Patients were peasants, mostly housewives. Glandular form of the disease was dominant. The main clinical symptoms were: tonsillitis, pain in the region of enlarged lymphatic glands and temperature, Biohumoral syndrome presented accelerated sedimentation of erythrocytes and elevated fibrinogen values. Antibody titer of Francisella tularensis was extremely high in the majority of patients. The disease was cured in all patients: in 27 patients after the first therapy, in 4 subjects after recidivation and 5 patients were surgically treated.