Emergencies are the primary cause of lethality in infectious diseases.
OBJECTIVES: Our aim was to study some emergency situations in infectology in relation to the outpatient healthcare.
METHODS: We used data from the official acute infectious diseases registration, the outpatient journals, the admission journals and the hospital documentation of the Department of Infectious diseases of "Saint Marina" Hospital in Varna for the period 2006-2007.
RESULTS: We examined 6604 patients, 2378 of which were admitted in the hospital. Emergency cases were 538 (22,62%). In that period were treated 373 infants with diarrhea, 55 patients with nervous system infections, 108 with Mediterranean spotted fever (MSF) and 2 with Congo-Crimean haemorrhagic fever. Only 21,71% of the infants with diarrhea considered to be at risk had the necessary minimum of labs on admission. Similarly, 13,89%of the patients with MSF had some labs. For 24% of the patients in this study the specialist of infectious diseases on admission was the first physician who performed a clinical examination. We found a delay in the hospital admission in 15,61% of the cases.
CONCLUSIONS: The data processed showed many problems in the relationship between the outpatient and the inpatient management. The major ones are: delayed diagnosis or unrecognized infectious disease (mostly the tick-borne spotted fevers), a poor assessment of the diarrhea severity in infants, difficulties to provide consultants and laboratory analysis for fast and accurate diagnosis and inappropriate antibacterial treatment before the diagnostic activities, impeding the etiologic identification.
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