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Helien Bebek Ivanković

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Introduction: Inflammatory fibroblast tumor is rare tumor that most often occurs in younger people, usually 30 years old or younger, but most commonly in children age 6-10 years. It usually affects gastrointestinal tract and the lungs but it can also occur in several places at the same time. Clinical manifestations vary depending of the affected system of the body so it is very difficult to determine diagnosis without surgical extirpation and patohistological analysis. Complete surgical resection is curative in most patients and recidivism is rare. Liver abscesses more common occur in females with risk factors and medical history of diabetes, previous liver disease and less likely in patients with granulomatous diseases. Liver abscesses mortality in developing countries is 2-12%, increasing due to open surgical drainage.Case report: We present a 35 years-old patient who was treated at the Clinic for Infectious Diseases University Hospital Mostar and University Hospital Sarajevo, Clinic for Infectious Diseases in August and September 2018 and Clinical Hospital Merkur, Zagreb Surgery Clinic in December 2018. Data was used from medical documentation. Young, immunocompetent patient who was addmited to a hospital following high fever, chills and poor general condition was diagnosed with multiple focal necrotic lesions, differential-diagnostically most likely liver and spleen abscesses with high suspicion of liver malignancy. Liver biopsy was performed and patohistological analysis confirmed the diagnosis of multiple liver abscesses in the IV and VI liver segment, and inflamatory fibroblast tumor in the IV liver segment. Eight weeks of conservative treatment resulted in a complete regression of liver abscesses and inflamatory fibroblast tumor was surgically extirpated at the Clinic Hospital Merkur, Surgery Clinic in the Zagreb in December 2018.Conclusion: An approach to a patient with a multiple liver abscesses and liver tumor requires sub-specialists experience and urgent multidisciplinary diagnostic and treatment approach to prevent further complications and deadly outcome. 

Jurica Arapović, S. Skočibušić, B. Jelavic, H. B. Ivanković, M. Jurić, D. Mamić, S. Grgić, J. Lesko, M. Leventić et al.

Two cases of human cutaneous anthrax were reported in September 2014 in south-western Bosnia and Herzegovina. The two men were involved in slaughtering a cow and handled its Bacillus anthracis-infected meat. Anthrax has been sporadically observed in livestock in Bosnia and Herzegovina, but no confirmed human cases had been reported in the country in the last two decades. Clinicians in the country should be aware that anthrax may occur in humans, arising from exposure to infected animals.

J. Nikolić, I. Kuzman, A. Markotić, O. Rode, I. Curić, H. B. Ivanković, S. Grgić

Bosnia and Herzegovina (B&H) has been known as an endemic region for hemorrhagic fever with renal syndrome (HFRS) for over 50 years. Multiple epidemics of this disease have been registered so far, especially in endemic parts of Central and Northeastern Bosnia, as well as the Sarajevo region. Seroepidemiological investigations demonstrate naturalization of Hantaviruses and their wide spread in B&H. However, there are no studies from the southern areas of B&H, and endemic foci of this disease are unknown. The aim of this study was to determine the distribution and serologic prevalence of Hantavirus infections by testing for specific IgG antibodies against hantaviruses in the population of Herzegovina. This study included two groups of participants. The target group consisted of 300 participants from exposed professional and population groups, and control group included 100 educators with lower exposure to HFRS. Identification of specific IgG antibodies against hantaviruses in 16 participants confirmed an initial assumption about the presence of Hantavirus infections in the region of interest. Seroprevalence of 5% was registered in the "exposed" and 1% in the "unexposed" group. Simultaneous circulation of Puumala (PUU) and Dobrava (DOB) viruses was discovered. The frequency of positive antibody results was higher in the population above 50 years of age, and three times more prevalent in men then at women. The highest proportion of exposed participants (80%) was registered in the municipalities which geographically belong to high or mountainous Herzegovina.

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