Background: Lyme disease represent an emergent zoonosis caused by the spirochete Borrelia burgdorferi. The disease is transmitted from animals to humans by hematophagous insects, primarily ticks. The question of the existence of chronic borreliosis in children and adults is today a stumbling block in diagnostics and therapy at the global level. Objective: The aim of this article is to answer the questions: is the diagnosis of Lyme disease complicated and is Borrelia burgdorferi the cause of chronic Lyme disease in children and adults. Methods: A retrospective-prospective clinical study of outpatients treated and monitored in a private infectious disease clinic over 13 years from January 1, 2013 – November 30, 2025 was conducted. The study was clinical, descriptive and analytical, and was conducted in three phases; the first retrospective and two prospective phases. The diagnosis of the disease was made on the basis of anamnestic-epidemiological data, clinical picture, clinical findings of new clinical markers and the course of the disease, and verified by serological detection of specific antibodies using ELISA, WB methods, detection of antibodies to protein sequences by Immunoblot0m, and detection of Borrelia burgdorferi bacteria in serum using a light microscope in a dark field. Results: In the investigated period, a total of 1,095 patients with Lyme disease symptoms were treated. Of that number, 120 children and 975 adults were treated. M : F = 436 : 659. The average age of children was 10.7 years, and of adults 50.1 years. 11.62% of patients had an acute and subacute phase of the disease, the rest were chronic patients with Lyme disease, children and adults. Out of 105 patients who were examined for Borrelia by light microscopy in the dark field, Borrelia was confirmed in 31 patients before therapy and in 19 relapses. In 21 patients before the therapy, as expected, Borrelia was not found in the blood, nor in 46 controls after the therapy, which was carried out intermittently for more than 50 days. In 3 patients, who had a slow recovery, Borrelia was found in the blood after 30 and 80 days of intermittent therapy. Conclusion: Lyme borreliosis is a persistent infection and in susceptible individuals it has a chronic remitting course. Diagnosis of the disease is simple if an individual approach is adopted, an adequate history is taken, new clinical markers are found on the skin and confirmed by the detection of antibodies to the Borrelia protein sequences in Immunoblot. The confirmatory test is the detection of Borrelia by light microscopy in the dark field. Chronic borreliosis in children and adults and vertical transmission from mother to child are unquestionable.

Background: Lyme borreliosis is a multisystemic infection caused by the spirochete Borrelia burgdorferi. Erythema migras is the main clinical marker of the disease. Objective: This study aimed was to investigate the frequency and clinical manifestations of European borreliosis on the skin, and to determine the significance of these findings for diagnosis and therapy. Methods: A retrospective-prospective clinical study of outpatients treated and monitored in a private clinic of an infectologist was conducted over nine years from to 2013-2021. The study was clinical, descriptive and analytical in nature. Results: In the investigated period, 509 (30.8%) patients with borreliosis symptoms were treated. EM in our patients occurred under the following conditions: a) ringed redness, b) redness of target cels and d) continuous round or oval redness of different sizes of individual redness, or multiple occurrences with primary dissemination. Skin changes with multiorgan chronic symptoms of borreliosis occurred in 67.7% of cases the including: walking redness of different shapes and sizes, pink borreliosis stretch marks, white borreliosis stretch marks, borreliosis palms and soles, psoriatic changes, Acrodermatitis chronica atrophicans, Scleroderma circumscripta-morphae, Erythema nodosum, Granuloma anulare and Lichen striatus et atrophicans. Of the 509 patients treated for borreliosis, 32.3% with multi-organ symptomatology had no skin changes. Conclusion: The skin manifestations of European borreliosis are multi-layered and Erythema migrans are basic, but not the only markers of the disease. ‘Pink borreliose stretch marks, “white borreliosis striae”, “borreliosis palms or soles”, and intermittent redness accompanied by itching are unique markers for the diagnosis of chronic borreliosis, if they are manifested.

Brucellosis is primarily an animal disease, and in them it passes as an asymptomatic chronic infection. In humans, brucellosis can be acute, sub-acute and/or chronic disease, but its geographical distribution follows the pattern found in animals. After the last war, the first Brucella cases in Bosnia and Herzegovina were reported in 2000, in returnees, owners of donated livestock. The objective of this paper was to address an increased public health problem regarding brucellosis in Bosnia and Herzegovina and to initiate better cooperation among epidemiologists, veterinarians, microbiologists and infectologists and responsible authorities toward elimination and eradication of this severe disease. Retrospective analysis of Brucella case histories and treatment protocols of all the cases hospitalized in Clinic for Infectious Diseases, University of Sarajevo Clinics Center (CCUS) was conducted. All the patients hospitalized between 1 January 2000 and 1 July 2005 were included. The diagnoses were confirmed by laboratory tests, chemo culture or serologically. The Rose Bengal agglutination and ELISA tests were used as laboratory confirmation methods. The number of hospitalized cases over the last 5 years was compared with total number of reported cases in the first 6 months of 2005. The results of this study showed that Brucella infections in humans, compared to other zoonoses, was represented with 11.8%. Brucellosis was the second zoonose in a ranking of zoonotic diseases cases with steady increase in the number of reported cases each year. The number of cases treated in the first 6 months of 2005 already exceeded half of the total number of cases treated in the last 5 years. Human brucellosis is an increasing public health problem in Bosnia and Herzegovina, and it reflects spreading of the same disease in animals. The applied prevention measures have been insufficient, so it is necessary to mobilize all the available resources of human and veterinary medicine, as well as the authorities, microbiological laboratory diagnostics in order to identify foci of epidemics and to try to eliminate and eradicate this complicated disease.