Vol 23, No 1 (2018)

Pregnant women are at the high risk for the development of severe both pandemic and seasonal influenza. There were analyzed medical histories of 277 influenza pregnant women observed in 2009-2016. Patients were divided into two groups: I (113 cases, 40.8%) - influenza A women (H1N1) pdm09, II (164 patients, 59.2%) - seasonal influenza pregnant women: A (H3N2) (109 females, 66.5%) or B (55 cases, 33.5%). Most women developed influenza in the second and third trimester of the gestation (114 cases, 41.2%, and 94 cases, 33.9%, respectively). The duration of inpatient treatment of pregnant women in the first group was significantly longer than in cases from the second group (p <0.01). In pandemic influenza pregnant women symptoms, as follows: a rise in body temperature to 38° C and higher (χ2 = 8.360, p <0,01), headache (χ2 = 10.468, p <0.01), dry cough (χ2 = 6.612, p <0.05), dyspnea (χ2 = 21.270, p <0.01), weakness (χ2 = 3.960, р <0.05), nausea and vomiting (χ2 = 8.197, p<0,01) were significantly more frequent than in patients with seasonal form. The severe course of influenza in women from the first group was significantly more frequent than in patients from the second group (χ2 = 17.717, p <0.01). In high pathogenic influenza pneumonia (φ*emp = 4.09, p <0.01) and catarrhal sinusitis (φ*emp = 1.914, р<0.05) were recorded significantly more often in comparison with seasonal form. 238 influenza pregnant women (85.9%) received the antiviral therapy. In influenza women from the first group the course of pregnancy was complicated by the development of edemas (φ*emp = 2.536, p<0.01), chronic fetal hypoxia (φ*emp = 2.247, p <0.05), premature and early discharge of amniotic fluid (χ2 = 4.723, p <0.05) significantly more often than in cases from the second group. Pandemic influenza was characterized by the more severe course due to the prevalence of severe manifestations of the febrile-intoxication syndrome in the clinical picture, high incidence of complications, among which pneumonia was leading and lethality in contrast with seasonal influenza.

In connection both with the continuing prevalence of the listeriosis disease, and polymorphism of clinical manifestations, as well as the high lethality rate, it is necessary to better understand this problem. Listeriosis infection often affects patients with the weakened immunity, the elderly persons, pregnant women, and newborns. In particular, in pregnant women, the risk of infection with listeriosis is 18 times higher than in the general population. This feature is due to cell-mediated immune suppression in pregnant women and placental tropism of the causative agent of listeriosis L. monocytogenes. The problem of listeriosis during pregnancy includes the maternal, fetal and neonatal disease. Listeriosis in a pregnant woman is usually characterized by a sharp onset, rapid development, and a high incidence, and often it does not take much trouble. Along with this, there are cases of asymptomatic, complicated and atypical variants of the disease, which requires a high degree of clinical awareness of various specialists and the implementation of adequate screening. Fetal listeriosis is characterized by the high mortality rate amounting to up 25-35%, depending on the gestational age at the time of the onset of infection. Clinical manifestations of listeriosis in newborn infants depend on the time and pathway of infection (antenatal or intranatal infection). Neonatal listeriosis can manifest as sepsis or meningitis with severe consequences and high mortality rate (up to 20%). The appropriate treatment of maternal listeriosis is aimed at preventing the fetal disease, it also has important therapeutic value for newborn babies. The empirical use of antibiotics may appear to be ineffective for listeria. Amoxicillin or ampicillin are at the first line of the treatment in pregnant women, alone or in the combination with gentamycin, followed by trimethoprim /sulfamethoxazole. The aim of the work is to summarize the available knowledge about the problem of listeriosis, including the features of the course of the disease during pregnancy, with presenting the example of a clinical case. The article reports a clinical case demonstrating the clinical problem of listeriogenic meningitis in a pregnant woman aged 35 years. Data showing different treatment strategies are also presented.

Fascioliasis is one of the common types of helminths. Most disease affects cattle and, less frequently, the infestation occurs in humans. Caucasus Pathological changes associated with migration of worms through the liver parenchyma within 4 to 6 weeks. Characteristic features of the early stage are fever and leukocytosis with eosinophilia. Deworming is assigned after the extinction of the symptoms of the acute stage. The clinical case presented in details.