Introduction: Chickenpox is very contagious childhood disease, which occurs due to varicella-zoster virus (VZV) primary infection. Disease in healthy children resolves usually without complications, but risk of complication is much higher in adults and immunocompromised hosts. The goal of this study was to determine different clinical and epidemiological characteristics, laboratory features, clinical course, and outcome of chickenpox in children and adults. Material and methods: The descriptive study was conducted at the Department of Infectious Diseases, Clinical Center in Sarajevo, Bosnia-Herzegovina. The study included 120 patients chosen randomly. We compared their clinical and epidemiological characteristics, laboratory investigations, complications and the outcome of the disease. Results: Age of patients was in range from one to 48 years. Male patients prevailed in both groups (65% in adults, 52% in children). Hospitalization rate was 10.7/100,000 inhabitants. Positive contact with chickenpox was confirmed in 80% adults and 82% children. Dominating symptoms were fever, rash and muscle aches. Levels of C-reactive protein, erythrocyte sedimentation rates (ESR) and fibrinogen levels were elevated in both groups, while thrombocytopenia was presented in 33% of adults and 3% of children. Adults had complications in 83.3% and their hospitalization rate was longer compared to children (11.5 days vs. 9.5 days, p<0.001). Conclusions: Chickenpox is a potentially severe illness in adult patients. Introduction of active immunization in BosniaHerzegovina should be considered to prevent severe forms of chickenpox. J Microbiol Infect Dis 2012; 2(2): 64-67

Introduction: Pulmonary thromboembolism (PTE) is the most serious manifestation of thromboembolic disease. Objective: To determine the most common risk and etiologic factors of pulmonary tromboembolism in patients treated in Intensive care unit of Clinic for Pulmonary Diseases and TB “Podhrastovi” in three-year- period from 2008. to 2010. Material and methods: We retrospectively analysed patients with PTE treated in Intensive care unit of Clinic for Pulmonary Diseases and TB “Podhrastovi” in three-year period from 2008. to 2010. PTE was diagnosed by high resolute computed tomography, in most of them ventilatory /perfusion scintigraphy (V/P SPECT) was made, with proper laboratory analyses (D-dimmer, platelets , fibrinogen, and if it was needed protein C, S and AT III factor were examined). In all of them echosonography of abdomen and pelvis was done, also the examination by angiologist, and in patients with indications echosonography of the heart and Color Doppler of leg veins was made. We analysed risk and etiologic factors for PTE in each patient. Results: In 222 treated patients with PTE risk factors were found in 124 or 55.86% patients, etiologic factors were found in 31 or 13.96%, and both risk and etiologic factors in one patient were found in 18 or 8.11% patients. Conclusion: PTE is very serious disease that very often has fatal prognosis, and can develop with previously entirely healthy people, and as soon as we become suspicious of its presence we have to made appropriate diagnostic procedures and include appropriate therapy. We can after look for risk and etiologic factors and try to influence them.

SUMMARY CONFLICT OF INTEREST: none declared. Introduction Staphylococcal bacteremia/sepsis is one of the most serious bacterial infections around the world. In individuals with pre-existing diseases, there is always an increased risk of infections occurring due to impaired immune system, a variety of drug therapy, exposure to a diagnostic and therapeutic procedure and frequent hospitalizations. Objectives To analyze the prevalence of comorbidity in a patient with the staphylococcal bacteremia/sepsis according to the diagnosis, the site of infection and according to the isolated agent. Patients and methods We analyzed the patients affected by the staphylococcal bacteremia/sepsis and treated in the Clinic for Infectious Diseases during a ten-year period. Results 87 patients were included, out of whom 20 (23%) with clinical signs of the bacteremia and 67 (77%) of sepsis. In the analyzed sample, in 36 (41.4%) were not registered comorbidity. Hospital infections are represented by the previous antibiotic, corticosteroid and chemo therapy, pressure ulcers, and different implants. In all comorbidity, the most common isolated bacteria was S. aureus primarily strain MSSA followed by MRSA strain which is more frequent in patients who were surgically treated (comorbidity–various implants). Conclusion The results suggest the importance of being mindful of the staphylococcal etiology of the bacteremia/sepsis in patients with comorbidities due to the selection of an adequate initial empirical therapy and reducing the risks of the septic shock.

SUMMARY CONFLICT OF INTEREST: none declared. Introduction Varicella or chickenpox is highly contagious, childhood infectious disease caused by primary infection with varicella – zoster virus from the herpes family of viruses. Usually it has a mild clinical course, rarely with described complication, mostly affecting respiratory tract and rarely the central nervous system. Case report The case present 8 year old boy hospitalized eighth day of disease with clinical pictures of varicella complication. Upon receipt tachydyspnea, high fever, tachycardia, hypotensive with positive findings on lung auscultation in the sense of pneumonia. Extremely high values of non-specific inflammatory parameters are implied on bacterial infection which is treated using triple antimicrobial therapy and antiviral. A detailed clinical, laboratory and radiological evaluation is determined of clinical disease complication under a picture of MODS that required prolonged multidisciplinary treatment in ICU. Conclusion The disease had a favorable clinical outcome in terms of training completely without consequences but, with the detected congenital absence lower lobe of right lung and transposition of the brachiocephalic trunk.

SUMMARY CONFLICT OF INTEREST: none declared. Introduction Chickenpox is disease caused by varicella-zoster virus (VZV), with possibly devastated consequences during pregnancy, for mother and neonate. Pneumonia is most common complication in pregnancy with very high mortality. Case report A 39-year-old female in third trimester twin pregnancy, referred to Clinic for infectious diseases in Sarajevo, with five days history of illness. Before the admission her condition get worse, with fatigue, exhaustion, and shortness of breath. In a first three days patient was febrile, tachydispnoic and ortopnoic. We started therapy with acyclovir and antibiotic. After four days we had detoriation in patient’s condition. Chest X-ray revealed infiltrative shadows in basal parts of lung. Antimicrobial therapy was changed and corticosteroids were associated. Significant improvement was noticed after five days of therapy. Conclusion Varicella pneumonia during third trimester may have serious consequences for mother and child, with possible fatal outcome.

SUMMARY CONFLICT OF INTEREST: none declared. Introduction Brucella endocarditis (BE) is a rare but severe and potentially lethal manifestation of brucellosis. Pre-existing valves lesions and prosthetic valves (PV) are favorable for BE. Case report We represent the case of a 46-year-old man who was treated at the Clinic for Infectious Diseases, Clinical Center of Sarajevo University, as blood culture positive (Brucella melitensis) mitral and aortic PV endocarditis. He was treated with combined anti-brucella and cardiac therapy. Surgical intervention was postponed due to cardiac instability. Four months later he passed away. Surgery was not performed.

SUMMARY The 4th Congress of Infectiologists of Bosnia-Herzegovina with international participation was held in Konjic, on 30. May to 02. June 2012. In addition to the prominent infectious disease experts from almost all university centers in B&H, the teachers at medical schools in Bosnia-Herzegovina, infectious disease specialists who work in health institutions in B&H, this Congress was attended by infectious disease experts from Serbia (12 participants), Turkey (3 participants), Croatia (3 participants), Macedonia (3 participants), Germany (2 participants) and Montenegro (2 participants). Topics included: Infections of the skin, soft tissue and bones, Sepsis and endocarditis, Infectious diseases emergencies and pediatric infectology, Emerging and reemerging infectious diseases, Hospital infections, Sexualy transmitted diseases, Infectious diagnostic and therapeutic protocols. Participating invited speakers were following professors: Salih Hosoglu (Turkey), Hakan Leblebicioglu (Turkey), Resat Ozaras (Turkey), Karsten Plötz (Germany), Ilija Kuzman (Croatia), Bruno Baršić (Croatia), Goran Tešović (Croatia). In addition to experts in infectious diseases at this Congress, their works were presented by experts from other medical disciplines, but with infectious character issues (Professors: Sead Ahmetagić, Ismet Gavrankapetanović, Zora Vukobrat-Bijedić, Senija Rašić, Halima Resić, Adnan Kapidžić, Ivo Curić, Jelena Ravlija, Amela Begić, Izet Mašić, Sadeta Hamzić, and others). Some of the papers that were presented at this Congress have been published in extenso, in the Medical Archives and Materia Socio Medica. One part as abstracts (both journals are indexed in over 10 databases), and will be electronically available to the general scientific community in Bosnia-Herzegovina, Europe and worldwide. In this way, the Bosnian infectious disease experts, as a science and profession, will be worthily represented to the colleagues from other countries in the region and beyond.