Efficacia e tollerabilità dell'associazione caspofungin/amphotericina B liposomiale in pazienti con candidosi

Considerazioni su un caso di schizosomiasi urinaria

Leprosy-like cutaneous presentation of Histoplasma capsulatum infection in an African HIV+ patient

Histoplasma capsulatum is an opportunistic dimorphic fungus responsible for most often self-limiting or flu-like infections but potentially lethal in immunocompromised hosts. Histoplasmosis is rare in Europe. We reported a case of disseminated histoplasmosis in an African HIV patient with a leprosy-like primary cutaneous presentation and involvement of lungs, brain, limphnodes and eye. The therapy with liposomial B amphotericin and itraconazole led to a prompt resolution of the symptoms.

Acalculous cholecystitis in a patient with plasmodium falciparum malaria and cytomegalovirus infection

Acalculous cholecystitis is a syndrome of gallbladder inflammation without gallstones, recognized within the setting of critically ill patients. Acalculous cholecystitis associated with infectious agents is reported in the literature to be rare. Herein we describe a case of acalculous cholecystitis in a patient with malaria caused by Plasmodium falciparum and apparent cytomegalovirus infection, and discuss the possible role of CMV in the pathogenesis of acalculous cholecystitis in patients with malaria.

Considerazioni su tre casi di endocardite brucellare

Viral gastroenteritis in children hospitalised in Sicily, Italy

The aim of the present study was to describe the epidemiologic and clinical characteristics of acute viral gastroenteritis in hospitalised Italian children. A total of 215 stool specimens were collected from January to December 2003 from patients hospitalised in Palermo for acute diarrhoea. Samples were tested for group A rotavirus, astrovirus, adenovirus, norovirus, enteropathogenic bacteria, and parasites. Rotaviruses, mostly belonging to types G1-G4, were detected in 25.1% of samples, astrovirus in 7%, adenovirus in 6%, norovirus in 18.6%, and bacterial agents in 17.2%. No parasitic infections were diagnosed. Mixed infections represented 9.8% of all cases. The mean and median ages of chi…

Considerazioni su un caso di schistosomiasi vescicale

Cuteneous leishmaniasis (CL) in western Sicily

Infezione da HHV8 e leucemia linfoblastica acuta in età pediatrica

HHV8 è un virus erpetico correlato, sulla base di dati ormai concordi, al sarcoma di Kaposi (KS), al linfoma effusivo primario ed alla Ma- lattia di Castleman multicentrica. Tale virus è stato inoltre associato con altre patologie tumorali ma gli studi in proposito non sono stati confermati. Poco, d’altra parte, si conosce sulle modalità prevalenti di trasmissione del virus, probabilmente diverse nelle nazioni industrializzate ed in quelle in via di sviluppo. In Sicilia una elevata prevalenza del KS clas- sico era già presente in epoca pre-AIDS. Abbiamo condotto uno studio sierologico in immunofluorescenza per rilevare gli anticorpi anti-HHV8 in 40 bambini con leucemia linfoblastica acuta (…

The return of anthrax. From bioterrorism to the zoonotic cluster of Sciacca district [Il ritorno del carbonchio. Dal bioterrorismo al focolaio zoonotico del distretto di Sciacca]

Anthrax is a disease caused by Bacillus anthracis which affects herbivorous animals. Humans acquire the disease incidentally by exposure to infected animals, animal products or spores on soil. The infection is still endemic in many regions in developing countries. In Italy animal clusters are very rare and human cases are exceptional. Bacillus anthrax is also a potential source for acts of bioterrorism. In the natural human infection, cutaneous anthrax is the most widespread, while the other two, pulmonary and gastrointestinal anthrax, are very rare forms. We describe the first case of human anthrax occurring in western Sicily in the last twenty years. The cutaneous lesion healed without si…

Indagine clinico epidemiologica sulle enteriti infettive a Palermo II- Campylobacter: primi isolamenti in Sicilia occidentale

Visceral leishmaniasis, hypertriglyceridemia and secondary hemophagocytic lymphohistiocytosis

cytokines, an upregulation of adhesion molecules and MHC I and II molecules on mono/macrophages, and an expansion of inflammatory monocytes. This exaggerated inflammatory response is responsible for necrosis and organ failure and results in uncontrolled proliferation and phagocytic activity of histiocytes [2]. Hypertriglyceridemia (fasting, greater than or equal to 265 mg/100 ml) is one of the current diagnostic criteria for HLH [2]. Several studies link hypertriglyceridemia to inhibition of lipoprotein lipase (LPL) by tumor necrosis factor-α (TNF-α), and TNF-α is a powerful autocrine and paracrine regulator of adipose tissue [3]. Indeed, many different sources of intense and prolonged T-ly…

Diagnostica delle zoonosi

Children, parents and Respiratory Syncytial Virus in Palermo, Italy: prevention is primary.

A study was conducted to describe the characteristics of the Respiratory Syncytial Virus (RSV) infection cases occurring in the season 2006—7 in Palermo, Italy, and to evaluate the parents’ knowledge and behaviours concerning prevention and control of acute respiratory infections (ARIs). All children aged between 0 and 2 years, admitted for a lower respiratory tract infection (LRTI) between October 2006 and May 2007, were enrolled in the study. Data were collected about demographic and household characteristics. Furthermore, their parents were asked to compile a structured questionnaire on transmission, prevention and management of ARIs in children. A total of 198 children with a diagnosis…

Screening sierologico per Leishmania infantum su donatori di sangue e HIV+ asintomatici residenti in area endemica [Serological screening for Leishmania infantum in asymptomatic blood donors and HIV+ patients living in an endemic area]

Visceral leishmaniasis (VL) is endemic in Sicily (48 new cases in 2004, of which nine were in Agrigento). In southern Europe between 25-70 per cent of adult VL cases are related to HIV infection. The HIV cases have a high risk (1.5-9%) of developing VL either as a new infection or as the revival of a latent infection. We therefore carried out serologic screening to detect antibodies against L. infantum by IFAT in 1449 blood donors in Agrigento and the surrounding area (May-December 2005) and in 120 HIV+ in western Sicily, all of whom were asymptomatic and had no history of VL. L. DNA was assessed by nested PCR in blood samples of some seropositive donors. Of the 1449 blood donors, 11 (0.75%…

Indagine clinico epidemiologica sulle enteriti infettive a Palermo II- Camphylobacter: primi isolamenti in Sicilia occidentale

Procalcitonin levels in plasma in oncohaematologic patients with an without bacterial infections

BACKGROUND: The flogosis markers currently in use show both low sensitivity and specificity, particularly in neoplastic and degenerative diseases. Procalcitonin (PCT) is a pro-peptide of calcitonin produced mainly but not only in the C-cells of the thyroid glands and, as several studies show, PCT levels in plasma increase during infections. Bacterial infections are also the main cause of death in oncological patients. Furthermore, in patients with leukaemia in chemotherapy recovery, infections often induce relapses. The aim of the present study is to detect PCT levels in plasma in oncohaematologic patients with and without infections. METHODS: The study was carried out on 54 patients by a q…

Parassitosi emergente: la sindrome da LMV

Pulmonary hydatid disease in childhood: a case report [Idatidosi polmonare in età infantile: Descrizione di un caso clinico]

Echinococcosis/hydatidosis is a parasitic zoonosis caused in humans by the larval stage of the Echinococcus granulosus cestode. Although notification of infestation is required, there are no reliable data on the prevalence of this parasitosis among humans in Italy. This zoonosis was first reported in ancient times (Hippocrates, fourth century BC) and since then many cases of echinococcosis/hydatidosis have been described. Currently, it is considered one of the main parasitoses affecting animals bred for income and one of the most important parasitic zoonoses. We present the clinical case of a three-year-old child, living in Palermo with a dog in his house, who came to our observation for dy…

Idatidosi umana: recenti acquisizioni e descrizione di quattro casi pediatrici a sede inusuale

Human hydatid disease due to Echinococcus granulosus is frequently observed in Italy, especially in the central and southern areas and on the islands. In the last twenty years some major advances in the field thefield of epidemiology as well as diagnostic and therapeutical approaches have changed our knowledge of this disease. In Italy, localization in the liver, kidney or peritoneum accounts for about 95% of cases. The authors describe four describe four paediatric cases with unusual localization (kidney and muscle), highlighting difficulties in the diagnosis

Monocyte and lymphocyte apoptosis resistance in acute and chronic brucellosis and its possible implications in clinical management.

This study evaluated the level of susceptibility of monocytes and lymphocytes to spontaneously induced and CH11-induced apoptosis in 16 patients with Brucella infection. The expression of some immunological and apoptotic markers was evaluated. Before therapy, monocytes showed a high level of resistance to spontaneously induced or CH11-induced apoptosis in all patients. In patients with acute infection, this resistance persisted for 10-20 days after treatment was initiated, then decreased; in chronically infected patients, it persisted after 45 days of treatment. Lymphocytes were also more resistant to CH 11-induced apoptosis. The level of activated CD8++ T lymphocytes was high in patients w…

Murine Typhus and Hemophagocytic Syndrome

No Abstract

Procalcitonin levels in plasma in oncohaematologic patients with and without bacterial infections.

Abstract Background: The flogosis markers currently in use show both low sensitivity and specificity, particularly in neoplastic and degenerative diseases. Procalcitonin (PCT) is a pro-peptide of calcitonin produced mainly but not only in the C-cells of the thyroid glands and, as several studies show, PCT levels in plasma increase during infections. Bacterial infections are also the main cause of death in oncological patients. Furthermore, in patients with leukaemia in chemotherapy recovery, infections often induce relapses. The aim of the present study is to detect PCT levels in plasma in oncohaematologic patients with and without infections. Methods: The study was carried out on 54 patien…

Fourth case of louse-borne relapsing fever in Young Migrant, Sicily, Italy, December 2015. Mini Review Article

Abstract Objectives Currently louse-borne relapsing fever (LBRF) is primarily found in limited endemic foci in Ethiopia, Somalia and Sudan; no case of imported LBRF has been reported in Europe in the 9 years prior to 2015. The aim of our paper is to describe a new case of imported LBRF detected in Sicily, Italy, and to review all cases reported in migrants arrived in Europe in the last 10 years. Study design Mini review of all published cases of louse-borne relapsing fever in Europe in the last 10 years. Methods A computerized search without language restriction was conducted using PubMed combining the terms ‘(louse-borne relapsing fever or LBRF or recurrentis) and (refugee or Europe or mig…

Screening sierologico per l'infantum in soggetti HIV+ in area endemica Sicilia occidentale

No findings of dental defects in children treated with minocycline

Thanks to their broad antimicrobial spectrum, tetracyclines were found to be valuable for the treatment of many infections (10). Unfortunately, they irreversibly bind to calcifying tissues and are deposited along the incremental lines of dentine and enamel, causing defects and staining, from bright yellow to dark brown (3, 5, 8). According to the American Academy of Pediatrics, tetracyclines are not indicated for the treatment of common infections in children younger than 8 years of age. However, doxycycline (a tetracycline analogue) is recommended for treatment of Rocky Mountain spotted fever in children of any age (1). Minocycline has several advantages over other tetracyclines: it is bet…

La spondilodiscite oggi: osservazioni su nove casi

Considerazioni su un caso di actinomicosi cervicale

Actinomycosis is a bacterial infection due to Gram positive bacteria of Actinomyces genus. Actinomyces israelii is the most common in human infection.The authors described a case occurred in a 43 aged woman with a clinical presentation of a right submandibular indurative mass.After surgery, histological examination showed a granulomatous tissue with many actinomycetes. Patient was submitted to treatment with i.v penicillin. On the 11th day antibiotic therapy was replaced with ceftriaxone and teicoplanina. Patient did not present intercurrence during this period and presented improvement of the lesion.Actinomycosis is an uncommon disease. Establishment of the definite diagnosis requires a hi…

Un caso di sinusite da Aspergillus

Un caso di FBM neonatale in corso di un outbrek familiare

Infezione actinomicotica: considerazioni su due casi clinici

Acute Parvovirus B19 Infection and Anemia duringPlasmodium falciparumMalaria

Considerazioni su un caso di schistosomiasi urinaria.

Urinary tract schistosomiasis is a parasitic disease caused by S. haematobium with a wide range of clinical manifestations related to the mucosal and submucosal granulomatous lesions of the bladder. It affects about 80 million people in Africa, Middle-East and India, while in Italy it is rarely seen among immigrants from endemic areas and returning travellers. The authors describe a case occurred in a 26 year old man, recently emigrated from a rural area of Ghana. He had the symptoms of a haemorrhagic cystitis. Cystoscopy and biopsy showed granulomatous lesions of bladder with calcified eggs. Microscopic examination of urine was positive for Schistosoma haematobium eggs. The therapy with Pr…

Human toxocariasis: a report of nine cases

Aim: Human toxocariasis is caused by infection with the larval stage of nematode parasites of dogs and cats, Toxocara canis or Toxocara cati. These helminths are not able to complete their life cycle in undefinitive hosts and so undergo aberrant migrations in the tissues causing a wide spectrum of signs and symptoms. Eosinophilia is often severe and sometimes represents the only sign of infection, except in ocular and neurological forms. Methods: We describe the clinical features of nine children affected by toxocariasis admitted to our Infectious Diseases department from 2004 to 2006. Results: Fever and hepatomegaly were the most common clinical findings. In two cases eosinophilia was not …

Il ruolo di Campylobacter spp quale agente di enterite in Sicilia Occidentale. Considerazioni su 35 casi

Introduction: Campylobacter spp is the main cause of bacterial gastroenteritis in the developed countries, resulting mainly from the contamination of poultry and animal products. Pathogenesis remains unclear. Various clinical features ranging from watery diarrhoea in apyrexia to dysentery in hyperpyrexia may be the result of differences between strains in the expression of different pathogenetic factors. There are many difficulties in isolating the bacteria in question. Methods: We processed 540 faecal specimens of children with gastroenteritis. We detected enteropathogen bacteria including Campylobacter spp as well as Rotavirus, Adenovirus and protozoans. For the isolation of Campylobacter…

Clinical and microbiological features of Salmonella gastroenteritis in children

Asymptomatic Leishmania infantum/chagasi infection in blood donors of western Sicily.

The purpose of this study was to evaluate whether the risk of transfusion-transmitted visceral leishmaniasis was present in an area of western Sicily where the incidence of the disease is higher than the regional average. From May to December 2005, 1449 blood donors from Agrigento district (Sicily, Italy) were screened for the presence of anti-Leishmania antibodies by an indirect immunofluorescent antibody test (IFAT). Blood samples from IFAT-positive donors were examined by PCR to detect Leishmania DNA. Anti-Leishmania antibodies were found in 11 (0.75%) cases, among which Leishmania DNA was detected from four (36.4%). Particular techniques to inactivate different pathogens would be consid…

EMPIEMA PLEURICO MICOTICO: UNA ENTITà CLINICA EMERGENTE

Canine pancytopoenia and hemophagocytic lymphohistiocytosis

Rickettsia typhi and Haemophagocytic Syndrome

Appropriate therapy (dexamethasone, cyclosporin, and etoposide) could save the patient in those cases in which the pathogen-direct therapy has not been sufficient by itself to control the disease.

Il significato della proteina C reattiva in cardiochirurgia nella diagnosi delle infezioni post-operatorie

Indagine clinico-epidemiologica sulle enteriti infettive a Palermo:II- Le infezioni da Salmonella

TBC, LUE e AIDS in immigrati extracomunitari. Considerazioni su tre casi

Mediterranean visceral leishmaniasis in immunocompetent children. Report of two cases relapsed after specific therapy

Visceral leishmaniasis (VL) is endemic in areas bordering the Mediterranean Sea (Spain, Italy, France, Greece, Morocco, Tunisia) where it is caused by Leishmania infantum and is transmitted by the bite of a hematophagous sandfly belonging to Phlebotomus spp.; the dog constitutes the main reservoir of infection. Two cases of VL in immunocompetent children are described. Both patients lived in endemic areas for leishmaniasis (Sicily) and at admission were febrile, pale and had splenomegaly. In both patients anti-leishmania antibodies were present and a definitive diagnosis was confirmed by demonstration of leishmania parasites by microscopy or polymerase chain reaction (PCR) in the bone marro…

Endocardite non brucellare

Therapy monitoring by real time PCR in patients with Brucellosis

Sindrome nefrosica e sepsi da Gram negativi in corso di strongiloidiasi: considerazioni su un caso in immigrato imunocompetente

Strongyloidiasis is caused by a small intestinal nematode with a complex life cycle. In Italy the infection is endemic in rural areas of the Po Valley. The clinical syndrome of S. stercoralis encompasses a broad spectrum of symptoms and signs and, in the immunocompromised host, larvae can migrate to different organs and tissues. Also immune response seems to play a role in the pathogenesis of the disease. We report a case of strongyloidiasis complicated by Gram-negative sepsis and nephrotic syndrome in an immigrant from South America with a normal immune response. Whereas sepsis cleared up quickly, parasitic clearance was obtained only after treatment with ivermectin and nephrotic syndrome …

Echinococcosi polmonare: un caso clinico

A case of Brucella endocarditis in association with subclavian artery thrombosis.

Brucellosis is a common zoonosis, endemic in Mediterranean countries, and caused by bacteria ofBrucellagenus. Brucellosis is a systemic infection and the clinical presentation varies widely from asymptomatic and mild to severe disease. Cardiovascular complications are extremely rare. We present a case of arterial thrombosis in a previously healthy young patient withBrucellaendocarditis. Careful attention must be paid to any sign or symptom of thrombosis in patients affected by brucellosis, regardless of the presence of endocarditis and cardiovascular risk factors.

Madura foot: An imported case of a non-common diagnosis

Mycetoma (or "madura foot") is characterized by deformation, cutaneous lesions, infection of tissues extending from the cutaneous layer to the underlying fascia, and an indolent course. A number of fungal or bacterial agents that are introduced through traumatic inoculation can be responsible for the disease, but Actinomadura madurae is among the most common agents of mycetoma occurring worldwide. We report a case of madura foot caused by A. madurae in an immunocompetent young Somali man who was admitted with a diagnosis of skin and soft tissue infection of the left foot with osteomyelitis. The present report emphasizes the importance of the knowledge of this infection, which is sporadic bu…

M. hominis ed U. urealyticum: prevalenza e sensibilità agli antibiotici

No findings of dental defects in children treated with minocycline: a matched case-control study

Forty-one children 0.2).

Rickettsia conorii Indian Tick Typhus Strain and R. slovaca in Humans, Sicily

Letter to the Editor.-- et al.