Severe invasive methicillin-resistant S. aureus (USA300 clone) infection in an Italian adolescent

This report describes an uncommon presentation of invasive community-acquired methicillin-resistant S. aureus (CA-MRSA) infection in an immunocompetent adolescent without any other risk factor, characterized by septicaemia, meningitis, necrotising pneumonia and deep venous thrombosis (DVT). Successful treatment was performed with linezolid, rifampicin and low-molecular-weight heparin (LMWH). MRSA molecular typing revealed the presence of Panton-Valentine leukocidin (PVL) gene, and a genetic background identical to USA300 clone, an emerging aggressive CA-MRSA strain in USA and Europe

The Northern Adriatic Forecasting System for Circulation and Biogeochemistry: Implementation and Preliminary Results

This paper described the implementation of a forecasting system of the coupled physical and biogeochemical state of the northern Adriatic Sea and discussed the preliminary results. The forecasting system is composed of two components: the NEMO general circulation model and the BFM biogeochemical model. The BFM component includes an explicit benthic pelagic coupling providing fluxes at the sediment-water interface and the dynamic of the major benthic state variables. The system is forced by atmospheric forcing from a limited-area model and by available land-based (river runoff and nutrient load) data. The preliminary results were validated against available remote and in situ observations. The validation effort indicated a good performance of the system in defining the basin scale characteristics, while locally the forecasting model performance seemed mostly impaired by the uncertainties in the definition of the land-based forcing

Congenital syphilis in a two-month-old infant

This report describes a rare case of congenital syphilis in a two-month-old Romanian infant. Diagnosis was possible when the baby showed decrease in the left upper limb movements and a papular rash. Her father had been infected and transmitted the infection to the mother, who had two non-treponemal serological tests during pregnancy, both with negative results. Congenital syphilis was confirmed by serological tests and the newborn was successfully treated. A global overview on diagnosis and treatment of children with suspected congenital syphilis is presented

Chest wall TB and low 25-hidroxy-vitamin D levels in a 15-month-old girl

Parietal chest wall tuberculosis is an extremely rare manifestation of tuberculosis (TB) in children. We present the case of a 15 month-old girl presenting with a chest wall lesion initially thought to be of neoplastic origin and eventually diagnosed as chest wall TB, which was treated with surgical debridement and specific antitubercular therapy. The girl had not-measurable 25-hidroxy-vitamin D levels, an increasingly recognized risk factor for the development of active TB. To our knowledge, in the English literature there are no similar described cases in such young infants. This case highlight the possibility of dealing with TB and its different manifestations also in low TB burden countries, due to continuously increasing migration flows. A detailed history is a key point to reach the diagnosis. Moreover, our case confirm the possible non casual relationship between TB and low 25-hidroxy-vitamin D levels, pointing out the importance of measuring its levels in all TB patients and considering its supplementation in addition to specific antitubercular therapy

Potential Application of Lung Ultrasound in Children with Severe Uncontrolled Asthma: Preliminary Hypothesis Based on a Case Series

: In recent years, lung ultrasound (LUS) has been increasingly used for the diagnosis of respiratory diseases in both adult and pediatric patients. However, asthma is a field in which the use of LUS is not yet well defined, or is in development. In the following case series, we describe clinical, laboratory, and radiological results, as well as detailed lung ultrasound findings of six children with asthma: some of them with acute asthma attack and with inadequately controlled allergic asthma or childhood asthma; others with acute asthma and allergic or infantile asthma adequately controlled by preventive therapy. Finally, we describe the clinical, laboratory, and imaging parameters of a child with severe allergic asthma in the absence of exacerbation. In these cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up. It also showed different ultrasound features depending on the severity of the individual asthma based on the type of asthmatic phenotype and control of it

Increased levels of neurotrophins in the cerebrospinal fluid of children with Epstein–Barr virus meningoencephalitis

SummaryObjectiveThe aim of this study was to evaluate the expression of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in the cerebrospinal fluid (CSF) of children with Epstein–Barr virus (EBV)-induced meningoencephalitis (ME) in order to establish a possible correlation with laboratory findings and neurological manifestations.MethodsA prospective observational clinical study was performed on 10 children with viral ME, five of them with EBV-induced ME. As controls, we used CSF samples collected from children admitted with febrile seizures. Neurotrophin levels were measured using an enzyme immunoassay.ResultsSignificantly higher levels of BDNF and NGF were detected in all patients with viral ME compared to controls. Moreover, in patients with EBV-induced ME, the neurotrophin levels were higher than in those with other viral ME. Of note, in children with EBV-induced ME, we found a significant correlation between neurotrophic factor levels and the number of lymphocytes in the CSF (p<0.001). In these patients we also found a significant correlation between BDNF expression and the blood platelet count (p<0.001). Interestingly, two patients with EBV-induced ME showed a correlation between neurotrophin increase and persistent brain abnormalities, such as prolonged alteration of mental status, psychomotor agitation, and athetosis.ConclusionsViral ME induces an early and strong increased biosynthesis of neurotrophic factors. This neurotrophin over-expression is likely to play a key role in the mechanisms of neuronal inflammation and in the severity of brain damage, particularly in EBV-induced ME

What Happens When I Watch a Ballet and I Am Dyskinetic? A fMRI Case Report in Parkinson Disease.

The identical sets of neurons – the mirror neuron system (MNS) – can be activated by simply observing specific, specific movements, decoded behaviors and even facial expressions performed by other people. The same neurons activated during observation are those recruited during the same movements and actions. Hence the mirror system plays a central role in observing and executing movements. Little is known about MNS in a neurodegenerative motor disorder, such as Parkinson’s Disease (PD) is