| Sažetak | Cilj: Prikazati karakteristike kliničke slike, dijagnostike i liječenja pacijenata liječenih od kala-azara na Klinici za infektologiju KBC-a Split i MEFST-a u razdoblju od 1.siječnja 2000. do 31.prosinca 2019. godine. Materijali i metode: U ovo retrospektivno opažajno istraživanje uključeno je 37 pacijenata liječenih od kala-azara na Klinici za infektologiju KBC-a Split i MEFST-a u razdoblju od 1.siječnja 2000. do 31.prosinca 2019. godine. Podatci su prikupljeni pretraživanjem pisanog protokola te arhive povijesti bolesti Klinike za infektologiju KBC-a Split i MEFST-a, te zatim uneseni u program Microsoft Excel te obrađeni u programu MedCalc. Rezultati: Od 37 pacijenata, bilo je 51,36% pedijatrijskih pacijenata. 59% pacijenata bili su muškog spola. Najčešći simptomi i klinički znakovi pri prijemu bili su vrućica (91,89%) uz zimicu (75,68%) i tresavicu (48,65%), splenomegalija (89,19%) te hepatomegalija (81,08% pacijenata). Komorbiditete je imalo 51,35% pacijenata, a češće su bili prisutni u odraslih pacijenata. Prosječno trajanje hospitalizacije bilo je 25,37 dana. Laboratorijski parametri s najznačajnijim odstupanjima, tj. najvažniji za dijagnozu bili su anemija (94,29%), trombocitopenija (78,38%), leukopenija (43,24% pacijenata) te nalaz elektoroforeze proteina (nizak omjer albumina i globulina). Kala-azar se dijagnosticirao IFA-om ili pregledom punktata koštane srži ili limfnog čvora. Pacijenti su liječeni amfotericinom B (35,14%), natrijevim stiboglukonatom (75,68%) ili alopurinolom (16,22% pacijenata). Udio relapsa u svih pacijenata iznosio je 16,22%. Prosječno vrijeme za dijagnozu bolesti bilo je 2,5 puta kraće u pedijatrijskoj nego u odrasloj populaciji. Zaključci: Vrijeme potrebno za dijagnozu kala-azara bilo je 2,5 puta kraće u pedijatrijskoj nego u odrasloj populaciji. U naših ispitanika udio relapsa nakon liječenja liposomalnim amfotericinom B bio je veći nego nakon liječenja natrijevim stiboglukonatom, a također je bio 1,4 puta veći i u usporedbi s literaturnim podacima o liječenju kala-azara amfotericinom B |
| Sažetak (engleski) | Objectives: The aim of the research is to present the characteristics of the clinical features, diagnosis and treatment of patients treated with kala-azar at the Clinic of Infectious Diseases of the University Hospital of Split and University of Split School of Medicine in the period from 1 January 2000 to 31 December 2019. Materials and methods: This retrospective observational study included 37 patients treated with kala-azar at the Clinic for Infectious Diseases of University Hospital of Split and University of Split School of Medicine in the period from January 1, 2000 to December 31, 2019. The data were collected by searching the written protocol and the archive of the medical history of the Clinic for Infectious Diseases of the University Hospital of Split and University of Split School of Medicine, entered into Microsoft Excel and then statistically processed in MedCalc. Results: Of the 37 patients, 51.36% were pediatric patients, and 59% of all patients were male. The most common symptoms and clinical signs at admission were fever (91.89%) with chills (75.68%) and shivering (48.65%), splenomegaly (89.19%) and hepatomegaly (81.08% of patients). 51.35% of patients had comorbidities, and they were more often present in adult patients. The average duration of hospitalization was 25.37 days. Laboratory parameters with the most significant deviations, ie the most important for diagnosis were anemia (94.29%), thrombocytopenia (78.38%), leukopenia (43.24% of patients) and the findings in protein electrophoresis (low ratio of albumin and globulin). Kala azar was diagnosed by IFA or examination of a bone marrow or lymph node puncture. Patients were treated with amphotericin B (35.14%), sodium stibogluconate (75.68%) or allopurinol (16.22% of patients). The relapse rate in all patients was 16.22%. The average time to diagnose the disease was 2.5 times shorter in the pediatric than in the adult population. Conclusions: The time required to diagnose kala-azar was 2.5 times shorter in the pediatric than in the adult population. In our examinees, the relapse rate after treatment with liposomal amphotericin B was higher than after treatment with sodium stibogluconate, and it was also 1,4 times higher compared with the literature data on the treatment of kala-azar with amphotericin B. |
