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Leptospirosis, a re-emerging zoonosis caused by pathogenic Leptospira, has a low incidence in Bulgaria. This paper reports a case of leptospirosis in Pleven, Bulgaria, in which the subject was infected after wading through irrigative canal in northern Greece. Two days later, he had a fever, myalgia and vomiting followed by jaundice, darkness of urine and oliguria. The patient was admitted to Clinic of Infectious Diseases at University Hospital-Pleven after returning to Bulgaria. The history and laboratory findings suggested icterohaemorrhagic leptospirosis. Penicillin G was prescribed and intensive supportive treatment was initiated. Dialysis was performed two hours after admission and was followed by poliuric stage of acute renal failure (peak urine output 16 600 mL/day). Microaglutination test (MAT) for sero-diagnosis was positive (L. hardjo 1:1600, L. icterohaemorrhagiae 1:800). The patient was discharged after sixteen days with improved renal and liver functions. In conclusion, The probability of leptospirosis should not be ignored in patients with fever after returning from abroad. The prompt dialysis and adequate treatment improve prognosis. [ABSTRACT FROM AUTHOR]

Background: In Bulgaria, more than 20 autochthonous human parasitic infections have been described and some of them are widespread. Over 50 imported protozoan and helminthic infections represent diagnostic and therapeutic challenges and pose epidemiological risks due to the possibility of local transmission. Aims: To establish the distribution of autochthonous and imported parasitic diseases among the population of the country over a 2-year period (2013-2014) and to evaluate their significance in the public health system. Study Design: Cross sectional study. Methods: We used the annual reports by regional health inspectorates and data from the National Reference Laboratory at the National Centre of Infectious and Parasitic Diseases on all individuals infected with parasitic diseases in the country. Prevalence was calculated for parasitic diseases with few or absent clinical manifestations (oligosymptomatic or asymptomatic infections). Incidence per 100.000 was calculated for diseases with an overt clinical picture or those that required hospitalisation and specialised medical interventions (e.g. surgery). Results: During the research period, parasitological studies were conducted on 1441.244 persons, and parasitic infections were diagnosed in 22.039 individuals. Distribution of various parasitic pathogens among the population displayed statistically significant differences in prevalence for some intestinal parasites (enterobiasis 0.81%, giardiasis 0.34% and blastocystosis 0.22%). For certain zoonotic diseases such as cystic echinococcosis (average incidence of 3.99 per 100.000) and trichinellosis (average incidence of 0.8 per 100.000), the incidence exceeds several times the annual incidence recorded in the European Union. Conclusion: Parasitic diseases still pose a substantial problem with social and medical impacts on the residents of our country. Improved efficiency regarding autochthonous and imported parasitic diseases is essential in providing the public health system the tools it needs to combat these diseases. Attention should be focused on the various imported vector-borne parasitic diseases (e.g. malaria and cutaneous leishmaniasis) for which the country is potentially endemic. [ABSTRACT FROM AUTHOR]