Intracranial tuberculous mass lesions treated with thalidomide in an immunocompetent child from a low tuberculosis endemic country: A case report

Rationale: Tuberculous meningitis is a highly morbid, often fatal disease. Patient concern: We describe a case of an Italian child. Diagnoses: we diagnosed early a Tuberculous meningitis complicated by the occurrence of hydrocephalus, stroke, and paradoxical reaction with brain pseudo-abscesses. Interventions: The child started readily a specific therapy associated with steroids and thalidomide was introduced few month later. Outcomes: the patient had a favorable outcome without neurologic sequelae. Lessons: Despite the prompt specific anti-tubercular and adjuvant corticosteroid therapies, only the addition of thalidomide to the treatment allow to a favorable clinical outcome

Primary retroperitoneal abscesses due to Rhodococcus equi in a patient with severe nephrotic syndrome: successful antibiotic treatment with linezolid and tigecycline.

Abstract We present a case of Rhodococcus equi primary retroperitoneal abscesses without pulmonary involvement in an immunocompromised patient with severe nephrotic syndrome. No risk factors for exposure to R. equi were present. The infection was successfully treated with long-term combination antibiotic treatment including linezolid and tigecycline

Anosmia and ageusia as predictive signs of COVID-19 in healthcare workers in Italy. A prospective case-control study

The aim of this study was to investigate the diagnostic accuracy of symptoms and signs in healthcare workers (HCW) with Sars-CoV-2

In Vivo and In Vitro Effects of Antituberculosis Treatment on Mycobacterial Interferon-γ T Cell Response

Background: In recent years, the impact of antituberculous treatment on interferon (IFN)-c response to Mycobacterium tuberculosis antigens has been widely investigated, but the results have been controversial. The objective of the present study was: i) to evaluate longitudinal changes of IFN-c response to M. tuberculosis-specific antigens in TB patients during antituberculous treatment by using the QuantiFERON-TB Gold (QFT-G) assay; ii) to compare the differences in T-cell response after a short or prolonged period of stimulation with mycobacterial antigens; iii) to assess the CD4+ and CD8+ T cells with effector/memory and central/memory phenotype; iv) to investigate the direct in vitro effects of antituberculous drugs on the secretion of IFN-c. Principal Findings: 38 TB patients was evaluated at baseline and at month 2 and 4 of treatment and at month 6 (treatment completion). 27 (71%) patients had a QFT-G reversion (positive to negative) at the end of therapy, while 11 (29%) TB patients remained QFT-G positive at the end of therapy. Among the 11 patients with persistent positive QFT-G results, six had a complete response to the treatment, while the remaining 5 patients did not have a resolution of the disease. All 27 patients who became QFT-G negative had a complete clinical and microbiological recovery of the TB disease. In these patients the release of IFN-c is absent even after a prolonged 6-day incubation with both ESAT-6 and CFP-10 antigens and the percentage of effector/memory T-cells phenotype was markedly lower than subjects with persistent positive QFT-G results. The in vitro study showed that antituberculous drugs did not exert any inhibitory effect on IFN-c production within the range of therapeutically achievable concentrations. Conclusions: The present study suggests that the decrease in the M. tuberculosis-specific T cells responses following successful anti-TB therapy may have a clinical value as a supplemental tool for the monitoring of the efficacy of pharmacologic intervention for active TB. In addition, the antituberculous drugs do not have any direct down-regulatory effect on the specific IFN-c response

Invasive aspergillosis in patients with liver disease

Invasive aspergillosis (IA) has been traditionally considered an infection occurring in patients with well established risk factors, such as neutropenia, hematologic malignancies, organ transplantation, or HIV. However there is increasing evidence that apparently immunocompetent patients, such as those with severe liver disease, are also at high risk for Aspergillus infections. Here we report two cases of proven invasive aspergillosis and review 72 others of aspergillosis reported since 1973 in patients with liver disease. Most patients had end-stage cirrhosis or acute hepatic failure. Overall mortality rate was 72.2% and the majority of patients who died had CNS involvement, disseminated infections, and received antifungal agents on a less common basis. A trend toward higher survival for cases reported during the period 2000-2009 was observed. Literature data suggest that invasive aspergillosis is a potential fatal complication of severe liver disease. The high mortality rate observed in these patients appears to be related not only to the severity of their underlying conditions, but also to a lack in clinical diagnosis. New diagnostic tools, e. g., galactomannan (GM) antigen test, in association with increased clinical suspicion may allow an early diagnosis and improve the outcome of IA in this particular category of patients.Invasive aspergillosis (IA) has been traditionally considered an infection occurring in patients with well established risk factors, such as neutropenia, hematologic malignancies, organ transplantation, or HIV. However there is increasing evidence that apparently immunocompetent patients, such as those with severe liver disease, are also at high risk for Aspergillus infections. Here we report two cases of proven invasive aspergillosis and review 72 others of aspergillosis reported since 1973 in patients with liver disease. Most patients had end-stage cirrhosis or acute hepatic failure. Overall mortality rate was 72.2% and the majority of patients who died had CNS involvement, disseminated infections, and received antifungal agents on a less common basis. A trend toward higher survival for cases reported during the period 2000-2009 was observed. Literature data suggest that invasive aspergillosis is a potential fatal complication of severe liver disease. The high mortality rate observed in these patients appears to be related not only to the severity of their underlying conditions, but also to a lack in clinical diagnosis. New diagnostic tools, e. g., galactomannan (GM) antigen test, in association with increased clinical suspicion may allow an early diagnosis and improve the outcome of IA in this particular category of patients

Elevated levels of tumor necrosis factor (TNF) in the cerebrospinal fluid from patients with HIV-associated neurological disorders.

[No abstract available

Human immunodeficiency virus-1 specific and natural cellular immunity in HIV seronegative subjects with multiple sexual exposures to virus

The probability of HIV infection by sexual contact, although it varies greatly, appears to be lower than that of infection by other routes of exposure. The aim of this study was to evaluate immunological determinants involved in protection against HIV infection in subjects with multiple and repeated sexual exposures to the virus. Twenty-two subjects were studied for CD8+ cell anti-HIV suppression activity and serum neutralizing activity against the HIV strain of their own partners, beta -chemokine production, and natural killer cell activity. CD8+ cell anti-HIV activity and neutralizing activity of sera were found in 13 (76%) and 12 (70.5%) out of 17 HIV-1 negative subjects, respectively. Six individuals had a relevant immune response against HIV: three subjects with a high CD8+ cell antiviral suppression activity and three individuals with sera neutralizing activity titer >1:10. These last three subjects had the highest beta -chemokine levels, a very prolonged period of multiple sexual intercourse (>6 years) and a seropositive partner with a high viral load. A partial reduction of neutralizing activity titer was observed when preincubating the sera with anti-beta -chemokine neutralizing antibodies. A spontaneous natural killer cell activity was suppressed in the majority of HIV-1 negative subjects with sexual exposure in comparison with normal individuals. The protection from sexual HIV transmission appears to be the result of a network of different humoral and cellular factors. J. Mad. Virol. 64:232-237. 2001. (C) 2001 Wiley-Liss, Inc