A Case of Rickettsia felis Infection Imported from Nepal

Rickettsia felis is an emerging spotted fever group pathogen that may be responsible for potentially life-threatening infections. A cosmopolitan distribution has been postulated though most human cases were observed in Africa and the Americas. We report an imported case from Nepal that occurred in an Italian tourist who presented with a 1-week history of fever, headache, nausea, vomiting, and a mild maculopapular rash 14 days after return

Impact of the SARS Coronavirus 2 epidemic on tuberculosis treatment outcome, Northern Italy

It is important to recognise the impact of COVID-19 on TB care to mitigate its consequences. TB services have an urgent need to identify novel strategies to ensure the continuum of TB care at the time of the coronavirus pandemic

Imported malaria in northern italy: Epidemiology and clinical features observed over 18 years in the teaching hospital of Brescia

Background: Even though malaria incidence is decreasing worldwide, travel-related cases reported in Europe have remained stable in recent years. In Italy, incidence had increased in the 1990s, reaching a peak in 1999; a slow decline was then reported over the subsequent decade. To our knowledge, few published data are available on imported malaria in Italy since 2010. In this article we aimed to analyse trends in imported malaria in the teaching hospital of Brescia, northern Italy, over the last 18 years. Methods: All malaria cases diagnosed from 1999 to 2016 in Spedali Civili Hospital, Brescia, were retrospectively identified. Demographic, clinical and travel-related data were described. Results: A total of 1200 cases of imported malaria were diagnosed in Brescia during the study period. Among them, 225 were children. A trend of increasing paediatric cases was identified over the study period, while cases in adults were stable. Most cases were diagnosed between August and October. Patients were most likely exposed in sub-Saharan Africa (87.2%). The main reported travel reason was travelling to visit friends and relatives (66.0%). A significantly higher risk of severe malaria was observed in non-immune patients and children visiting friend and relatives (P < 0.001 and P = 0.006, respectively). Conclusions: Our study reveals a relatively stable incidence in imported malaria cases with a peak during the summertime. A large and increasing paediatric burden of disease was identified. Imported malaria requires attention since in Italy a potential reappearance of autochthonous Plasmodium vivax malaria transmission cannot be excluded. Preventive action and physician awareness should be especially directed to children visiting friends and relatives in endemic countries and to non-immune patients since they both represent high-risk groups for severe malaria

Louse-borne relapsing fever in a refugee from Mali

INTRODUCTION: Due to the increasing number of refugees from East Africa, louse-borne relapsing fever (LBRF) has become an emergent disease in Europe. No single case of LBRF has been reported in Europe in refugees from other parts of Africa. CASE REPORT: We report a case of LBRF in a refugee from Mali, likely acquired in Libya, where several migration routes into Europe meet. The disease must be considered in any febrile refugee regardless the country of origin

A Strange Manifestation of Malaria in a Native Nigerian Boy

The protective role of Sickle Cell Trait (SCT) in malaria endemic areas has been proved, and prevalence of HbS gene in malaria endemic areas is high. Splenic infarction is a well-known complication of SCT, while the association with malaria is considered rare. A Nigerian boy was admitted to our ward after returning from his country of origin, for P. falciparum malaria. He underwent abdominal ultrasound for upper right abdominal pain, showing cholecystitis and multiple splenic lesions suggestive of abscesses. Empiric antibiotic therapy was undertaken. Bartonella, Echinococcus, Entamoeba serologies, blood cultures, Quantiferon test, copro-parasitologic exam were negative; endocarditis was excluded. He underwent further blood exams and abdomen MRI, confirming the presence of signal alterations areas, with radiographic appearance of recent post-infarction outcomes. Hemoglobin electrophoresis showed a percentage of HbS of 40.6% and a diagnosis of SCT was then made. Splenic infarction should be taken into account in patients with malaria and localized abdominal pain. Moreover, diagnosis of SCT should be considered

Delay in schistosomiasis diagnosis and treatment: a multicenter cohortstudy in Italy

14noBACKGROUND: Barriers to access to care, different diagnostic strategies, and low awareness remain challenging issues in the fight against schistosomiasis.Our study aims to examine management of schistosomiasis in migrants attending large tertiary hospitals in Italy, in order to call for a comprehensive approach. METHODS: A retrospective review of schistosomiasis cases was carried out between January 1, 2016 and December 31, 2017 in five large Infectious Disease Centers in Italy. We included all patients diagnosed with schistosomiasis. We differentiated among i) asymptomatic patients diagnosed by serology either as healthy 'migrant evaluation' or as 'late evaluation' in patients followed because of a different infection and ii) patients tested because of a suggestive clinical presentation. Patients characteristics and clinical data were recorded. RESULTS: 149 patients were included, 137 (91.9%) were male, the median age was 26 years and 70% of them came from Sub-Saharan Africa.Thirty-eight asymptomatic patients (25.5%) were diagnosed by serology [15, (10.1%) among 'migrant evaluation' and 23 (15.4%) among 'late evaluation' group] and 111 (74.5%) presented with signs/symptoms.The median diagnostic delay from arrival in Italy was 31 months: 110 for asymptomatic group and 16 months for symptomatic patients. Among the 111 symptomatic patients, 41 individuals were already followed in our Clinics and they never underwent screening before appearance of evident disease. Among patients with positive serology who were tested by microscopy, 32/86 (37.2%) had confirmed diagnosis. Forty-five (37.8%) patients presented radiologic abnormalities. Praziquantel was the treatment of choice (70.1% for 3 days and 29.9% in a single-day dose) and 77 (51.7%) were lost to follow-up. CONCLUSION: In our centers, a high proportion of patients were tested late after arrival and most of them presented with clinical apparent disease. Well-defined strategies and implementation of recent guidelines are needed to improve early diagnosis and to overcome heterogeneity of practice.nonenoneComelli, Agnese; Riccardi, Niccolò; Canetti, Diana; Spinicci, Michele; Cenderello, Giovanni; Magro, Paola; Nicolini, Laura Ambra; Marchese, Valentina; Zammarchi, Lorenzo; Castelli, Francesco; Bartoloni, Alessandro; Di Biagio, Antonio; Caligaris, Silvio; Gaiera, GiovanniComelli, Agnese; Riccardi, Niccolò; Canetti, Diana; Spinicci, Michele; Cenderello, Giovanni; Magro, Paola; Nicolini, Laura Ambra; Marchese, Valentina; Zammarchi, Lorenzo; Castelli, Francesco; Bartoloni, Alessandro; Di Biagio, Antonio; Caligaris, Silvio; Gaiera, Giovann