Acute pancreatitis in children and rotavirus infection. Description of a case and minireview

In this article, we describe a case of acute pancreatitis occurred on a 2-year-old boy following rotavirus gastroenteritis. Its characteristics are analyzed and contextualized among those of other 4 cases of pancreatitis associated with rotavirus infection found through a systematic review of the international literature. None of the five children underwent surgery or was referred to an intensive care unit and all the 5 children cured with normalization of pancreatic enzyme within 5-10 days. The pathogenesis of this rare complication remains to be cleared, and its actual incidence may be higher than that reported. Although acute pancreatitis associated with rotavirus gastroenteritis seems t…

The role of endosomal toll-like receptors in bacterial recognition

BACKGROUND: Infections caused by extracellular Gram positive bacteria are still a major health problems. Better understanding of the mechanisms underlying immune responses to these organisms is key to develop pharmacological agents, including vaccines, to control these infections. OBJECTIVE AND PERSPECTIVES: The objective of this review is to highlight the importance of nucleic acid-sensing, intracellular Toll-like receptors in innate immune recognition and in host defenses against extracellular bacteria. CONCLUSIONS: Toll-like receptors 7 and 9 have a major role in inducing host-protective type I interferon responses in conventional dendritic cells in response to streptococci and other ext…

Canine pancytopoenia and hemophagocytic lymphohistiocytosis.

Leishmaniasis and rickettsial diseases are endemic and common in Mediterranean countries and so, as in humans, these diseases could be an important cause of HLH in dogs and may respond to similar medications. In conclusion, we think that the diagnosis of HLH should be considered in dogs with pancytopenia and, in selected cases, immunosuppressive treatment might be warranted.

Multidrug-resistant Gram-negative post-neurosurgical meningitis and the role of intraventricular colistin: a case series

: The aim of this study was to report the clinical experience of intraventricular colistin for the treatment of multi-resistant Gram-negative post-surgical meningitis in a tertiary hospital. Post-neurosurgical meningitis (PNM) is one of the life-threatening complications of neurosurgical procedures, and is frequently sustained by Acinetobacter baumannii and Klebsiella pneumoniae. Here we describe our experience of five cases of PNM caused by gram-negative multi-drug resistant (MDR) bacteria, treated with intraventricular (IVT) colistin, admitted to the Neurosurgery Unit of A.R.N.A.S. Civico of Palermo, Italy, from January 2016 to June 2020. In four patients the cerebrospinal fluid (CSF) cul…

CLINICAL FEATURES AND TREATMENT OF MEDITERRANEAN SPOTTED FEVER IN CHILDREN: A PRACTICAL UPDATE FOR THE CLINICIAN

Mediterranean spotted fever (MSF) is a tick-borne disease caused by Rickettsia conorii. It is characterized by the symptomatologic triad of fever, exanthema and «tache noire» – the typical eschar at the site of the tick bite. Oral or parenteral administration of tetracyclines or chloramphenicol represent the standard treatment; however, both these drugs may cause significant adverse effects in children. Recent studies indicate that oral clarithromycin and azithromycin may represent an acceptable alternative for the treatment of children with MSF. There are no data to indicate that antimicrobial prophylaxis is beneficial for tick-bitten patients to prevent MSF. However, in the presence of a …

Coronary involvement in Mediterranean spotted fever

Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii and characterized by fever, a maculo-papular rash and a black eschar at the site of the tick bite. We describe the case of a 3-year-old boy with MSF who developed a transient right coronary artery ectasia. The patient was brought to the hospital after four days of fever and mild myalgia of the legs. The suspicion of MSF arose due to the presence of a maculo-papular skin rash and treatment with oral clarithromycin was started. After four days fever persisted and the differential diagnosis of Kawasaki syndrome was considered. Echocardiography showed a dilated right coronary artery with hyperre…

Haemophagocytic syndrome in rheumatic patients. A systematic review

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH), is a potentially fatal hyperinflammatory syndrome characterized fever, hepatosplenomegaly, and cytopenias. HLH can be either primary, with a genetic aetiology, or secondary, associated with malignancies, autoimmune diseases, or infections. Among rheumatic disorders, HLH occurs most frequently in systemic juvenile idiopathic arthritis. AIM: To draw attention on this severe syndrome that may often go undiagnosed in patient with rheumatic diseases. MATERIALS AND METHODS: PubMed search was performed by combining the terms (haemophagocytic, haemophagocytosis, hemophagocytosis, hemophagocytic, erythrophagocytosis, macrophage activation syndrom…

Epidemiology and Microbiology of Skin and Soft Tissue Infections: Preliminary Results of a National Registry

Skin and soft tissue infections (SSTIs) represent a wide range of clinical conditions characterized by a considerable variety of clinical presentations and severity. Their aetiology can also vary, with numerous possible causative pathogens. While other authors previously published analyses on several types of SSTI and on restricted types of patients, we conducted a large nationwide surveillance programme on behalf of the Italian Society of Infectious and Tropical Diseases to assess the clinical and microbiological characteristics of the whole SSTI spectrum, from mild to severe life-threatening infections, in both inpatients and outpatients. Twenty-five Infectious Diseases (ID) Centres throu…

Secondary hemophagocytic lymphohistiocytosis in zoonoses. A systematic review

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome that is often fatal despite treatment. It is caused by a dysregulation in natural killer T-cell function, resulting in activation and proliferation of histiocytes with uncontrolled hemophagocytosis and cytokines overproduction. The syndrome is characterized by fever, hepatosplenomegaly, cytopenias, liver dysfunction, and hyperferritinemia. HLH can be either primary, with a genetic aetiology, or secondary, associated with malignancies, autoimmune diseases, or infections. AIM: To focus on secondary HLH complicating zoonotic diseases. MATERIALS AND METHODS: PubMed search of human cases of HLH occurring during zoonotic dise…

MODULATION OF GRO-ALPHA AND TNF-ALPHA PRODUCTION BY PERIPHERAL BLOOD MONONUCLEAR CELLS TREATED WITH KILLED HELICOBACTER PYLORI.

GRO-alpha seems to play an important role in recruiting and activating neutrophils during Helicobacter pylori infection. In the present study, we examined how treatment with killed H. pylori or/and live H. pylori may differentially influence the in vitro GRO-alpha and TNF-alpha release by peripheral blood mononuclear cells (PBMC). The amounts of TNF-alpha and GRO-alpha produced by PBMC after stimulation with live H. pylori were higher than those produced after stimulation with a combination of killed and live H. pylori and the latter were higher than those produced after stimulation with killed H. pylori. In conclusion, the treatment of peripheral blood mononuclear cells with killed H. pyl…

Therapy monitoring by real time PCR in patients with Brucellosis

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

Forty-one children 0.2).