Rapid clinical management of leishmaniasis in emergency department: A case report with clinical review of recent literature

Systemic or localized lympho-adenomegaly is a common cause of access to the emergency department (ED), and differential diagnosis is often complicated. The combination of anamnesis, physical examination, laboratory tests, and instrumental diagnosis are extremely important to orientate toward a rapid and correct therapy, even if a prompt discrimination of the etiology of this lymphadenomegaly is not often possible. Our aim with this review is to improve the management of a differential diagnosis between hematological and infective diseases as leishmaniasis in ED and suggest quick diagnostic techniques that might be useful for early identification. Together in the review, we describe a case report of a young man affected from visceral leishmaniasis who presented to our ED and was incorrectly addressed to the wrong ward for the study of his condition. Subsequently, we focus on the clinical presentation of visceral leishmaniasis and compare it to the most common differential diagnoses that are usually taken into account in the management of such patients

Tradition and modernity in the mediterranean cities. The tunisian cities: Tunis, Kairouan, Tozeur, Nefta.

L’articolo fa un confronto tra le differenti forme urbane delle città del Nord Africa, in particolare quelle della Tunisia (Tunisi, Kairouan, Tozeur, Nefta). Tali città, distribuite tra il Nord ed il Sud del paese, esprimono, nelle loro medine, l’identità della forma urbana e ne dichiarano la modernità lungo i loro bordi. Tunisi, posta tra due laghi, costruisce la sua modernità con la città coloniale che, anche se con linguaggi diversi, evidenzia i temi del Mediterraneo. La città di Kairouan mantiene la sua identità nella grande moschea, luogo centrale di organizzazione urbana. Le città d’oasi, come Tozeur e Nefta, esprimono il loro rapporto col paesaggio ed evidenziano con le loro architetture i materiali usati

Assessment of neurological manifestations in hospitalized patients with COVID-19

Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases