Acute intestinal infections (AII) remain one of the pressing health problems. The incidence of AII in children is significantly higher than in adults. Despite the significant diversity of AII pathogens, the composition of the intestinal microbiocenosis plays a significant role in the pathogenesis of the disease. An analysis of publications in the PubMed, EM BASE and Web of Science systems from December 2000 to June 2024 was carried out, covering studies on the clinical use of probiotics for AII in children.

The analysis of the literature data shows that the treatment and prevention of AII are the most reliable indication for the use of probiotics, including in relation to children. At present, there is reliable evidence of the effectiveness of probiotic strains both in the treatment and prevention of intestinal infections. Thus, the results of numerous studies have confirmed that probiotics are a safe means used both for the prevention and treatment of AII. They are one of the key components of the pathogenetic therapy of AII in children. Based on systematic reviews and randomized controlled trials, it has been established that the use of probiotics helps to reduce the duration and severity of AII symptoms. The most significant effects have been demonstrated in relation to the treatment of AII of viral etiology. Evaluation of the effectiveness of probiotics in the prevention of diarrhea episodes varies depending on the etiology of the pathogen, age, concomitant pathology and immune status of patients, which indicates the need for further research in this area. The problems with the dosage and duration of probiotic therapy for various nosological forms of AII in children remain not fully resolved. Multi-strain probiotics require further study.

The review presents current information on the epidemiological situation with whooping cough during the COVID-19 pandemic and in the post-pandemic period: the dynamics and age structure of the incidence in different countries of the world are shown with an analysis of the causes of changes. According to the literature, the effect of isolation measures on the incidence of whooping cough in 2023–2024 is described using the example of Japan, as well as vaccination of pregnant women against whooping cough using the example of South Korea. Some aspects of the pathogenesis of whooping cough and COVID-19 are presented, which can affect the course of combined diseases in children. The article presents an analysis of two described clinical cases in unvaccinated children aged 1 and 4 months, showing the dominance of typical clinical manifestations of whooping cough, the absence of fever and intoxication characteristic of COVID-19, the development of bronchiolitis with respiratory failure, which aggravated the severity of the disease. This justifies the advisability of examining patients with whooping cough with atypical respiratory manifestations for a new coronavirus infection, and for whooping cough – COVID-19 convalescents with a long cough.

The aim was to conduct a systematic review and meta-analysis of published studies assessing the impact of HIV infection on treatment outcomes and the development of adverse reactions in MDR-TB patients.

Material and Methods. We searched for publications using the specified keywords in MEDLINE (PubMed), Google Scholar, and eLibrary databases. Twenty-seven publications with a total number of 13944 patients were selected for meta-analysis. Meta-analysis was performed using Review Manager software (RevMan version 5.4; Cochrane Collaboration, Oxford, UK). Statistical heterogeneity of studies was checked using a Q-test based on χ2. An effect was considered statistically significant at p<0.05.

Results. The meta-analysis revealed that the incidence of adverse outcomes in patients 6with MDR-TB/HIV coinfection was higher than in the HIV-free group and was 37%, OR=1.49 [CI: 1.15-1.93]; the incidence of fatal outcomes was 20.3%, OR=2.02 [95% CI: 1.64-2.49]. Among HIV-infected patients, there was a higher incidence of adverse adverse reactions: OSH=1.51 [95% CI: 1.01-2.26], adverse adverse reactions of severe severity: OSH=1.53 [95% DI: 1.1-2.13].

Conclusion. The results of the meta-analysis show that patients with MDR-TB/HIV coinfection are characterized by an increased incidence of adverse outcomes and risk of any adverse adverse adverse reactions, further analysis of the problem is needed to optimize treatment outcomes in this population.

Objective: to study polymorphic variants of IL-2 (T330G), IL-10 (A592C), IL-6 (rs180795), INF a/b receptor (rs9984273), INFL4 (rs368234815), INFL3 (rs12979860), INF-γ (rs2430561) genes in COVID-19 patients to determine the risk of development and severity of the disease.

Materials and methods: genetic analysis of the studied gene polymorphisms was performed in 172 patients with COVID-19 (group 1 – with mild, group 2 – with moderate and group 3 – with severe and extremely severe degrees of severity). The control group consisted of 40 healthy donors. Statistical processing of the obtained results was carried out with the help of STATISTICA 12.0 programs.

Results: It was found that genotypes were significantly more frequent in COVID-19 patients compared to controls: TT of IL-2 gene (T330G), T/TT polymorphism of INFL4 gene (rs368234815), T/T polymorphismof INFL3 gene(rs12979860), A/A polymorphism of INF-γ gene (rs2430561). In the group of patients with mild severity, genotype G/G polymorphism of IL-2 (T330G) and genotype C/T polymorphism of INF a/b receptor (rs9984273) were significantly more frequent compared to patients with moderate severity. When comparing the group with a mild course of the disease in comparison with the group with a severe and extremely severe course of the disease, an increase in the occurrence of genotypes T/G polymorphism of IL-2 (T330G) and A/A polymorphism of INF-γ (rs2430561) was revealed.

Conclusions: significantly high occurrence of genotype TT polymorphism of IL-2 gene (T330G), T/TT polymorphism of INFL4 gene (rs368234815), genotype T/T polymorphism of INFL3 gene (rs12979860) and genotype A/A polymorphism of INF-γ gene (rs2430561) in patients with COVID-19 may indicate their role in the risk of disease development. Differences in T/G and G/G genotypes of IL-2 gene (T330G), C/T of INF a/b -receptor gene (rs9984273), T/T of IFNL3 gene (rs12979860) and A/A of INF-1γ gene (rs2430561) may play a role in the development of severe COVID-19.

Objective: to study neuroimmunoendocrine dysfunctions in children with bacterial purulent meningitis and to determine their value in the character of the disease course and outcomes.

Materials and methods. 56 children hospitalized to Pediatric Research and Clinical Center for Infectious Diseases with the diagnosis of bacterial purulent meningitis were examined. Besides standard clinical, biochemical and hemostasis tests there were studied concentration of cytokines by xMAP technology; A, M, and G immunoglobulins – by quantitative immunoturbodimetric method; cortisol, neurospecific proteins – by immune-enzyme test; blood subpopulations of lymphocytes – by flow cytofluorimetry method.

Results. Different changes of laboratory indicators characterizing neuroimmunoendocrine dysfunctions dependent on severity of the course and outcome of bacterial purulent meningitis were identified. Children with more severe course of the disease during its acute period had a reliable increase of S-100 protein in blood serum, concentration of granulocytic colony-stimulating, and concentration of BВ subunit produced by growth factor platelets was decreased. In case of the formation of expressed neurologic consequences within the disease outcome, higher concentration of neurospecific enolase, relative content of natural killers, and lower concentration of monocytic chemoattractant protein 1 were identified during the period of reconvalescence in comparison with a favorable neurologic outcome.

Conclusion. The results of the study give evidence of the possibility of more accurate early prognosis of the disease course and outcome on the basis of evaluation of neuroimmunoendocrine dysfunctions and this is extremely important to determine therapy management during both acute and reconvalescence periods of bacterial purulent meningitis.

Objective: in the context of a new epidemiological situation, assess the severity of the course of pertussis and the formation of complicated forms in patients of all ages hospitalized in GBUZ IKB No. 1 DZM (Moscow).

Materials and methods. Clinical analysis was carried out based on the study of medical records and clinical observation of pertussis patients hospitalized in GBUZ ICB No. 1 DZM in 2023. In total, 508 children from 0 to 17 years old and 81 adults were under observation.

Results. The article is devoted to the analysis of the pertussis clinic in 2023 in sick children and adults based on the materials of GBUZ “IKB No. 1” DZM. In 2023, an increase in the hospitalization rate of pertussis patients of all age groups, especially children under the age of 1 year, was recorded. A detailed study of various forms of severity showed the prevalence of moderate forms and did not reveal an increase in severe forms. As before, the age group of children threatened by the development of severe forms and mortality is the age group of children 0-3 months. In 30.8% of cases, the pertussis clinic was accompanied by the development of complications and, in most cases, the appearance of bronchopneumonia. As well as in the whole of the Russian Federation, most of the diagnoses were made using PCR diagnostics. In addition, in 2023, an increase in mixed infections was recorded, among which the combination of whooping cough and rhinovirus infection and respiratory mycoplasma infection dominated.

Conclusion. The increase in the incidence of pertussis in 2023 was not accompanied by an increase in the severity of the disease. The most severe course is still recorded in children 0-3 months of life. Mortality is recorded among children of this age group, and therefore it became necessary to focus the attention of pediatricians on adequate therapy of severe forms of pertussis with the use of antitoxic specific drugs in the early stages of the disease.

Infectious diseases occupy a leading place in the pathology of children and adolescents, accounting for 70–80% of the structure of morbidity and causes of mortality. Underestimation of clinical manifestations of infectious diseases by pediatricians is the reason that this pathology is not diagnosed in time, which leads to inadequate therapy, worsening of the course and chronicity of the process.

Purpose of the study. Assess the nature of the pathology and the reasons for referring children by district pediatricians for consultation with an infectious disease specialist at the consultative and diagnostic center (CDC).

Materials and methods. A retrospective analysis of the medical records of 532 children aged 0-17 years who sought specialized medical care from an infectious disease specialist at the Clinical Diagnostic Center of the St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation in 2021-2023 was conducted.

Results and discussions. The most frequent diagnoses for referral to an infectious disease specialist were: «frequently ill child» (31.0%), «prolonged cough» (20.7%), «streptococcal infection» (15.6%), «infectious mononucleosis» (13.7%), «salmonellosis, prolonged excretion of salmonella» (10.2%), «congenital herpesvirus infection» (8.8%). The immediate reasons for seeking specialized medical care were identified: insufficient clinical effect from the therapy performed in outpatient settings (36.3%); lack of eradication of the infectious pathogen from the child’s body (25.8%): the need for in-depth laboratory and instrumental examination (24.2%), the desire of parents to receive specialized medical care in an expert-level institution (13.7%).

Conclusion. In outpatient settings, pediatricians have difficulties in diagnosing patients with infectious pathology, which is due to insufficient alertness to various childhood infections and the lack of opportunity for in-depth laboratory and instrumental examination.

In addition, to establish a final diagnosis, a multidisciplinary approach is often required with the participation of doctors of various specialties (otolaryngologist, allergist, neurologist, audiologist, etc.).

In the world practice, there is an increase in the number of cases of new coronaviruses among children against the background of mass vaccination of adults/ Numerous reports in domestic and foreign literature allow to talk about various variants of COVID-1919 in children from mild to severe forms. The aim of the study. To study clinical and laboratory characteristic of COVID-19 in children. Patients and methods. The study carried out retrospective analysis of 285 cases of children who received Children’s Infectious Hospital. G.E. Sibirtsev» from May to December 2020 with the established diagnosis of «coronavirus infections». Among them, 154 boys (54.0%), 131 girls (46.0%). Results. The average age of children with COVID-19 – 11.7 [3,42:15,67] years. Hospitalization was carried out on 4 days [2:8] day. Patients reported: weakness (61.8%), cough (50.5%), cold (46.9%), decreased appetite (25.1%), aenosis (20.4%), headache (15.3%), sore throat (14.9%), diarrhea (10.2%). Intoxication syndrome was reported in 91.9% of patients. Fever (38.3 [37.7:39.0]) °C continued for 3 [2:6] days. Asymptomatic course of the disease was observed in 22 (8.1%) children. Pneumonia was reported on the 6th [3:9] day in 46 (16.1%) patients, objectively local change syndrome was determined only in 6 (2.6%) cases. The severity of pneumonia was considered to be average in most patients (93.5%). 3 children had acute respiratory failure (4.3%). Virus exposure lasted an average of 9 [9:11] days, with 104 (36.5%) patients having the virus for 10 or more days.

Conclusion. Thus, COVID-19 in children are mostly mild and manifest as intoxication and cataract syndrome from the upper respiratory tract. The lack of specific manifestations in children with pneumonia emphasizes the need for radiation therapy when there is no effect from the treatment. The long-term persistence of SARS-CoV-2, diagnosed in one third of patients, indicates an important epidemiological role of children in the spread of COVID-19.

Objective: to present the clinical and laboratory characteristics of measles in hospitalized children during the period of rising incidence in 2023-2024 in St. Petersburg.

Materials and methods. А retrospective study was conducted at the clinic of the Federal State Budgetary Institution DNACIB FMBA of Russia, which included 68 patients aged from 3 months to 17 years 10 months hospitalized from January 2023 to April 2024. The patients underwent clinical and biochemical analyzes blood with assessment of indicators in comparison with age norms. Statistical processing of the results was carried out using Microsoft Excel and Statistica 7 for Windows. Differences were considered statistically significant at p<0.05.

Results. In the first four months of 2024, the number of hospitalized patients exceeded the figure for all of 2023 by 2.4 times. Boys were hospitalized more often than girls (1.2:1). The median (Me) age of the patients was 6 years 9 months (interquartile range (IQR) 2 years 11 months – 10 years 11 months). 85% of children had no history of vaccination against measles. In 54% of cases, the epidemiological history could not be clarified. 27% of children had contact with measles in the family, less often – in treatment and prophylactic (10%), educational (3%) institutions and on the front door (6%). The median duration of illness at the time of hospitalization was 5.5 days (IQR 5–6 days). One of the leading complaints was fever (Me 39.0°C (IQR 38.5° – 39.5°C). In 24% of cases, the disease proceeded without symptoms of conjunctivitis. In 97% of children, a typical course of measles was noted with staged rashes. Spots Belsky-Filatov-Koplik were not detected in 6 children (9%). Clinical blood tests revealed leukopenia (63% of cases), lymphopenia (47%) and thrombocytopenia (44%). The described changes in laboratory parameters over time persisted only in 16%, 2% and 2% of children. The differences in the levels of leukocytes, lymphocytes, platelets on admission and discharge were statistically significant (p<0.001). In blood serum, the median level of C-reactive protein (CRP) was 6 mg/l (IQR 2–14 mg/l). An increase in the values of alanine (ALT) and aspartate aminotransferases (AST) was noted in 34% and 50% of the examined patients. Co-infection with other viruses (parvovirus B-19 and respiratory viruses) was detected in 14 patients (21%).

Conclusion. In 2024, there was a significant increase in measles incidence. Children over 6 years of age, unvaccinated, with family contact with measles prevailed. Most patients suffered a typical form of measles with the formation of Belsky-Filatov-Koplik spots and the staged nature of maculopapular rashes. Laboratory examination revealed leukopenia, lymphopenia and thrombocytopenia, increased levels of transaminases. In 21% of cases, a combined viral-viral infection was observed.

Purpose of the study. To evaluate the psycho-emotional state in patients with chronic viral hepatitis C before and after treatment with bicyclol.

Materials and methods. The study included 124 male patients with chronic hepatitis C aged 20 to 52 years (average 34.7 ± 6.5). The patients were randomized into 2 groups: group I, including 83 patients with mild to moderate liver fibrosis (F1-2 according to METAVIR); and group II – 41 patients with severe liver fibrosis (F3 according to METAVIR). After antiviral therapy with direct antiviral agents, patients in each group were divided into 2 subgroups: an experimental group, which was prescribed the bicyclol to potentiate the anti-inflammatory effect, and a control group – without pathogenetic therapy. The psycho-emotional state was evaluated using the “Well-being, activity, mood” methodology.

Results. As a result of complex etiopathogenetic therapy, a decrease in liver stiffness was observed in both patients with moderate and severe liver fibrosis. In patients of the experimental subgroup with moderate liver fibrosis, a decrease in liver density was observed from 7.10 kPa [6.70; 8.70] to 5.80 kPa [5.60; 7.00] (p = 0.008), and in the control subgroup – up to 6.40 kPa [5.80; 7.40] (p = 0.03), while in the experimental subgroup the decrease in liver density was significantly more pronounced (p = 0.04). When taking the questionnaire “Well-being, activity, mood” by patients with mild and moderate liver fibrosis before starting antiviral therapy, the final scores were in the normal range: total score 5.77 [5.53; 6.03], “well-being” indicator 5.80 [5.60; 6.20], “activity” indicator 5.30 [5.00; 5.60], “mood” indicator 6.10 [6.00; 6.20]. At the same time, patients with severe fibrosis had statistically significantly lower results for the studied indicators (p<0.001): total score 5.13 [4.90; 5.30], “well-being” 4.60 [4.50; 5.30], “activity” 5.20 [5.10; 5.50], “mood” 5.40 [5.20; 5.50], while the “well-being” indicator was below normal. After etiopathogenetic therapy, there was an improvement in the results of the “Well-being, activity, mood” method (p<0.05) both in the group with mild and moderate, and in the group with severe liver fibrosis, while in the control subgroups the severity of the observed changes was significantly lower (p<0.05).

Conclusion. The use of bicyclol after antiviral therapy in patients with pre-cirrhotic liver fibrosis due to chronic hepatitis C led to a statistically significant decrease in liver stiffness, contributed to an improvement in the psycho-emotional state and was accompanied by a decrease in the activity of alanine aminotransferase, aspartate aminotransferase, an increase in the number of platelets and fibrinogen in the blood serum.

Introduction. An analytical review of regulatory legal acts and scientific literature on the problem of public adherence to vaccination prevention and the development of positive vaccination propaganda in Russia has been conducted.

The article examines the implementation of vaccination propaganda in Russia as the most important tool for psychological influence on public commitment to active immunoprophylaxis of infectious diseases, as well as the powers of Russian authorities to carry out such propaganda. The reasons that prevent citizens from realizing the need for vaccination and ways to overcome “vaccination nihilism” are identified.

Materials: scientific publications and national regulatory legal acts on this issue.

Methods: general analytical methods of cognition (analysis, synthesis, generalization) made it possible to comprehensively consider the socio-legal validity of vaccination propaganda in Russia; a formal legal method consisting in the analysis of current legal norms, legal concepts and definitions, which became the basis for the study of legal norms governing the specifics of vaccination propaganda by government officials, health workers and the leaders of public opinion, and also allowed to propose measures to improve legislation on this issue.

Results. The fragmentation of vaccination propaganda by authorities and public organizations, the imperfection of its legal regulation, the absence of responsible government authorities for its implementation, as well as the positive relationship between vaccination propaganda and the coverage of the population by active immunoprophylaxis of diseases has been established.

Conclusion. Solving the identified problems in the mechanism of vaccination promotion in Russia by the authorities, as well as providing the Russian population with up-to-date information based on the results of evidence-based medicine about the benefits and minor risks of vaccination, will contribute to a more effective implementation of the authorities’ powers to create a culture of responsible attitude of citizens to their health.

The official statistic data on Q fever cases in Russia do not reflect the real spread of this infection. One of the reasons for Q fever significant underdiagnosis is the difficulty of its clinical diagnosis due to the pronounced polymorphism of the disease manifestations and the absence of pathognomonic symptoms.

The study objective was to determine the level of seroprevalence of the population to the Coxiella burnetii in the Republic of Tatarstan.

Materials and methods. ELISA was used to detect IgG antibodies to Q fever pathogen in blood sera sampled from volunteers (480 samples). The volunteers whose serum samples proved to be IgG–positive were offered a questionnaire intended to reveal the risk factors for contamination with the Q fever causative agent, and their blood was re-sampled after 5-6 months in order to determine the duration of IgG antibodies persistence.

Results. IgG antibodies to C. burnetii were revealed in 7.7% of the surveyed volunteers. The re-examination of seropositive persons revealed the corresponding antibodies in 82% of them. Based on the results of the questionnaire survey it was concluded that the majority of the respondents were involved in pet care or farm animals keeping, and 80% of the respondents had suffered febrile illness during past two years. The highest seroprevalence was detected in humans over 40, while more often in women than in men.

Conclusion. The results obtained indicate the existence of active foci of Q fever on the territory of the Tatarstan Republic, where residents come into contact with C. burnetii. It is likely that ELISA is a useful assay for detecting IgG antibodies over rather long period of time after contamination with the causative agent of Q fever. The revealed irregularity of the territorial distribution of infected residents argues for the advisability of further research in order to identify the infection sources, first of all, in areas with high seroprevalence. The detected rather high C. burnetii seroprevalence in the population of the Republic of Tatarstan in the absence of reported Q fever incidence bear witness to significant underdiagnosis of the infection, and hence justifies the needs of effective preventive measures development taking into account the local conditions.

Primary pertussis vaccination in the Russian Federation is carried out with 3 doses of the vaccine against diphtheria, whooping cough and tetanus at 3; 4.5 and 6 months. At 18 months, children are revaccinated against diphtheria, whooping cough and tetanus. At the age of 6-7 and 14 years, children are revaccinated against diphtheria and tetanus without the whooping cough component. Observational studies have shown that the clinical effectiveness of vaccination against whooping cough significantly decreases over time.

The aim of the work is to assess the cost-effectiveness of revaccination of 6-year-old children against whooping cough infection.

Material and methods. A modeling study of the cost-effectiveness of revaccination of 6-year-old children against whooping cough using an acellular vaccine was carried out from the societal perspective (direct medical and indirect costs were estimated) taking into account the herd effect of vaccination. The incidence of whooping cough and mortality associated with it corresponded to the official indicators of the Ministry of Health of the Russian Federation. In the base case the time horizon of the study is 12 years. The analysis of the costs of whooping cough therapy was carried out on the basis of the of the State Guarantees Program for the Free Provision of Medical Care to Citizens for 2024 and for the planning period of 2025 and 2026. Vaccination costs were calculated taking into account the weighted average price of the vaccine during government procurement in July-August 2024. Indirect costs were estimated based on gross domestic product (GDP) loss due to temporary disability of patients’ parents and death of patients. Costs and quality-adjusted life expectancy were discounted by 3% per year.

Results. The incremental cost-effectiveness ratio (ICER) of revaccination of children aged 6 years against whooping cough is 205.110 thousand rubles / QALY. The volume of averted costs is 2.642 thousand rubles per vaccinated child, including 0.416 thousand rubles – averted direct medical costs and 2.226 thousand rubles – averted indirect costs.

Conclusion. Taking into account the accepted assumptions, а booster dose of pertussis vaccine to 6-year-old children can be considered as a highly cost-effective intervention.

Goodpasture’s syndrome, an autoimmune disease resulting from the appearance of antibodies to the glomerular basement membrane, is a rare and potentially dangerous complication of infectious diseases such as influenza, new coronavirus infection, adenovirus infection. The course may be atypical and manifest as a severe form of viral disease complicated by acute respiratory distress syndrome and sepsis against the background of an accompanying bacterial infection. The necessary diagnostic methods may be unavailable or performed with a significant delay if biological material is sent to third-party organizations. Timely diagnosis and initiation of specific treatment can reduce mortality by almost half. The article presents a clinical case of a patient with Goodpasture syndrome who was at the clinic of infectious diseases S.M. Kirov Military Medical Academy with acute respiratory viral infection complicated by polysegmental pneumonia.

Chickenpox, despite of introduction of vaccination, remains a common disease, mainly among children. In most cases, chickenpox is a self-limiting disease without the development of life-threatening conditions. The case of atraumatic splenic rupture associated with chickenpox is a too rare and we described seventh case over the past 55 years. The man was hospitalized in the infectious diseases hospital with a vesicular rash, abdominal pain and repeated vomiting with a referral diagnosis of “acute pancreatitis, chickenpox”. The diagnosis of chickenpox was confirmed (family contact, typical rash and IgM-VZV). Splenic rupture was described with computed tomography with a contrasting agent. Splenectomy performed in first day of hospitalization. Symptoms resolved against the background of antiviral therapy. There were no surgical complications.

Meningococcal infection is one of the potentially fatal infectious diseases. In particular, in the case of a generalized form of meningococcal infection, the probability of death ranges from 6.9% to 12.8%. To date, there has been an increase in the incidence of generalized meningococcal infection on the territory of the Russian Federation with an increase in the incidence rate by 2 times (0.44 per 100 thousand population in 2022). At the same time, rare forms of meningococcal infection, such as pericarditis, myocarditis, focal glomerulonephritis, arthritis, etc., in the onset of the disease are characterized by the absence of pathognomonic clinical symptoms, which makes it difficult to timely verify the diagnosis and, as a result, increases the risk of developing a generalized form of meningococcal infection and an unfavorable outcome of the disease. The article presents a clinical case of isolated (primary) pericarditis caused by N. meningitidis.

The Q705K variant of the NLRP3 gene is considered a variant of uncertain significance and a risk factor contributing to the autoinflammatory disease phenotype. To present a clinical picture of the disease in a pediatric patient carrying the Q705K variant of the NLRP3 gene with a diagnosed cryopyrin-associated periodic syndrome. A 10-year-old child with frequent episodes of fever, refractory to antipyretic therapy, with urticaria, enlarged cervical lymph nodes, manifestations of pharyngitis and frequent respiratory diseases was examined. 338 genes associated with primary immunodeficiency have been analyzed by targeted multigene sequencing. Variant c.2113C>A (p. Gln705Lys) of the NLRP3 gene in a heterozygous state has been identified. The results of laboratory and instrumental research methods during several hospitalizations are analyzed. During hospitalizations with febrile episodes the child was diagnosed, as a rule, with infectious exanthems (yersiniosis, parvovirus, enterovirus, infectious mononucleosis). Chronic persistent herpes type 6 and Epstein-Barr viral infection and a deficiency of cellular immunity have been confirmed. Despite the positive results of the etiological methods, on the example of the last hospitalization - contradictory and not consistent with the clinical picture, given the long history of regular febrile episodes of the same type, accompanied by rashes, a cold reaction, and the identification of an uncertain clinical significance of the NLRP3 gene Q705K in accordance with the accepted diagnostic criteria a child at the age of 18 was diagnosed with cryopyrin-associated periodic syndrome.

In a situation of repeated episodes of the same type of febrile disease, the identification of infection markers, especially markers of opportunistic infections, does not exclude autoinflammatory syndrome.

Protothecosis is a rare infectious disease caused by non-photosynthetic algae belonging to the genus Prototheca. Its clinical manifestations may be acute or chronic, localized or generalized. In humans, protothecosis is a rare and, in severe cases, highly lethal disease. Protothecosis manifests as three syndromes: skin or soft tissue infection, ulnar bursitis, or disseminated infection, including lesions of the brain membranes and substance (meningoencephalitis).

The diagnosis is made on the basis of histologic examination of biopsy material and microbiologic examination of cerebrospinal fluid and affected tissues. In this paper we consider a clinical case of meningoencephalitis caused by the pathogen Prototheca spp. Current literature sources, case history, and data of laboratory examinations of the patient were analyzed.

The accumulation of information about this disease, its epidemiologic and clinical features, and identification possibilities will contribute to the verification of the diagnosis, reduction of lethal outcomes, including in patients with chronic diseases and immunodeficiency states.