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.

Background: Lyme disease (Lyme disease-LD) is a disease of humans and animals that is transmitted by hematophagous insects, especially ticks. The causative agent is the spirochete Borrelia burgdorferi, a bacterium with a complex structure and a slow biorhythm, which has the ability to coat the host's organism with mucus - create a biofilm - or turn into a cyst, and the host does not recognize it and does not create antibodies. This is the reason why, in 10-60% of cases, Borrelia tests are negative, even though it is present. The diagnosis of LD is made clinically, and it is confirmed serologically and microbiologically by isolation and/or detection of the causative agent by the PCR method from tissue samples and body fluids. Lyme disease stage II and III is called „the great imitator“ because its symptoms resemble those of other diseases, so diagnostic errors are often made. Objective: In this article we presented a case of stubborn urticaria in a 28-year-old saleswoman. Case presentation: Mother of two children, who was ruled out by clinical examination for autoimmune diseases and allergies to available allergens. We subsequently confirmed the diagnosis of chronic borreliosis, caused by five types of borrelia, serologically, after advanced intermittent antibiotic therapy, and after acquired food intolerance was discovered. In the available literature, we did not find information that chronic generalized urticaria was caused by Borrelia in combination with food intolerance. Conclusion: The presented case of a patient with chronic urticaria indicates that similar cases with urticaria, as well as all skin changes with intermittent walking symptomatology, should: Undergo clinical treatment, rule out immunological diseases and drug allergies, then test for Borrelia (ELISA+ immunoblot with Borrelia protein sequences!). Take into account the duration of the disease, the possibility of the disappearance of antibodies created in early childhood or a false-negative finding of antibodies, and in case of a negative finding, do not give up ex-yuvantibus therapy.

INTRODUCTION While determining a diagnosis and during a disease follow-up, laboratory, or non-specific inflammatory parameters in particular, platelets reference values, nitrogen matters, and liver enzymes play a significant role because their values may indicate multiple organ failures. GOALS To analyse laboratory parameters in patients diagnosed with the staphylococcal bacteraemia/sepsis. PATIENTS AND METHODS Analysed patients have been treated at the Clinic for Infectious Diseases through the period often years. RESULTS Differences in average CRP values, leucocytes, neutrophils and platelets among the patients diagnosed with the sepsis and bacteraemia are not statistically relevant p > 0,05. Difference in the average sedimentation values of the erythrocytes between the patients diagnosed with the sepsis and the patients diagnosed with the bacteraemia are statistically relevant p = 0,035. Differences between the average INR values between the patients diagnosed with sepsis and the patients with bacteraemia are not statistically significant, but indicative p = 0,051. Differences in the average blood sugar values, urea, creatinine, bilirubin and ALT between the patients diagnosed with bacteraemia and sepsis are not statistically significant p > 0.05. CONCLUSION The results have showed that even in the course ofa bacteraemia, there is a significant increase in the non-specific inflammatory parameters indicating the gravity ofbacteraemia as well, with a constant risk of developing sepsis and septic shock. The importance of running and following-up the laboratory parameters herewith is emphasised for the purpose of detecting sepsis in a timely manner and administering an adequate therapy.

INTRODUCTION Incidence mumps infection has declined since the introduction of the inevitable MRP vaccination during the stage of childhood. In Bosnia and Herzegovina (BIH), from a period of February 2011 until today, there is an evident inclination of the recorded cases of the mumps infection. Orchitis usually occurs in between 3 to 10 days after the parotitis and is found with the post-puberty population. AIM The aim of the study is to confirm the changes that occur during an early stage of the spermiogram and hormonal status, and after treated mumps orchitis, the patients treated in the Clinic for the Infectious Diseases. PATIENTS AND METHODS Retrospectively, the analysis of 54 historical diseases was undertaken. During the research stage, the patients after being discharged have made an inquiry to our clinical consultancy units with final results of the spermiogram and hormone-FSH, LH and testosteron. The data analysis was processed with the SPSS program for Windows. RESULTS the average length of the hospitalization period was in between 8 (medium) days, and average age M (mean) = 21,9 +/- 5,4 years. The speriogram of the treated patients was undertaken one month after the acute phase of the disease and has shown the following results: azoospermia with 14 patients (25,9%), oligospermia with 30 patients (55,6%) and normospermia with 10 patients (18,5%). During the hormonal status with 11 patients (20,4%), the results have shown the inclination of the value in FSH hormons, with 11 patients (20,4%), have shown the lesser value of the testosterons. CONCLUSION The current study suggests that post-orhitis atrofia is expected within a period of 2-3 months after the infection, and thus, the monitoring on the patients' treatment would continue. The male infertility as a result of mumps ocrhitis is controversial and continues to be the thematic issue as well as the effect of orchitis on testicular endocrine function. Key words: epidemic, mumps

UNLABELLED Lyme borreliosis is multisistemic zoonosis that is transmitted from animals to humans by ticks of the Ixodes ricinus complex, which presents vectors for causative organism. Lyme borreliosis is caused by Borelia burgdorferi sensu lato, which has four different species. Objective of this research was to investigate frequency of borreliosis on our material, to determine seasonal yearly distribution of disease and to investigate variability of clinical forms of disease. MATERIALS AND METHODS Retrospective analysis of medical records and discharge notes of treated patients with borreliosis in period 01 January 1996-31 December 2006 was conducted at the Clinic for Infectious Diseases in Sarajevo. Diagnosis of disease was confirmed serologically using Indirect Immunofluorescency method (IF), ELISA and Western-blot methods. RESULTS During the investigated period at Clinic for Infectious Diseases, 51 patient with borreliosis was treated. Most affected was work-capable population. Since year 2000 number of treated patients is increasing. Disease is registered from May to September with peak in June. Most frequent symptoms were fever, fatigue, myalgias, and arthralgias. Disease was mainly diagnosed as Erythema migrans (39), than neuroborreliosis (7), borelial arthritis (4) and rarely eye infections-endophtalmitis and episcleritis. CONCLUSION based on conducted 11-year period research of borreliosis we can conclude following: disease is mainly diagnosed as Erythema migrans, followed by neuroborreliosis. Women were more affected than men. Work-capable population is exposed to higher risk of getting disease. Highest peak of disease was in June. Due to various clinical forms and severity of late complications (II and III stage) it would be useful to conduct borreliosis testing with every etiologically unexplained neurological, cardiac and bone-joint manifestation.

Q-fever is antropozoonosis caused by Coxiella burnetii. The microorganism usually transmitted to humans through the inhalation of infected dust from sub clinical infected mammals. The most common reservoirs for Coxiella burnetii are large numbers domestic and wild animals. The illness can occur by farmers or slaughterhouses, or veterinarian and laboratories workers. In this report we presented case of endocarditic caused by Coxiella burnetii. The patient is driver 43 years old, who lived in the countryside Nahorevo. He hospitalized in May, 2002. He had symptoms of hepatitis, with elevation of transaminases in sera. Endocarditic was diagnosed by echosonografy. The patient is controlled by infectologist, cardiologist by cardio-surgeon, but since disease is in progress and operation treatment will be probably necessary.