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Abstract Objectives Respiratory Syncytial Virus (RSV) is the leading cause of hospitalization for lower respiratory tract infections (LRTI) in young children worldwide. We evaluate the epidemiological and clinical patterns of RSV infection in infants hospitalized for LRTI in in Palermo, South Italy, Sicily. Methods We collected the demographic details of infants hospitalized to G. Di Cristina Children's Hospital in Palermo for LRTI between November 2005 and May 2006. We also included all cases occurred in newborns hospitalized in the Neonatal Intensive Care Unit (NICU) Of Palermo. Results During the studied period, 335/705 hospitalized infants for LRTI were enrolled in the study. The trend of hospitalization started in late winter and lasting until May 2006 with an epidemic peak in spring. 178/335 infants tested for viral infection showed RSV disease. Three cases occurred in preterm newborns hospitalized from birth in NICU. The likelihood to be RSV+, rather than RSV negative (RSV-) was higher for infants < 6 months and lower for infants with history of breast feeding (P < 0.05). RSV infection was associated with a higher likelihood to be admitted to intensive care unit and to a longer hospitalization and oxygen therapy. Conclusion The study shows that, in Sicily, RSV is an important cause of LRTI in infants. The seasonal distribution shows that both LRTI and RSV infections peak in late spring, in contrast to Northern Italy. Our data could help to define the regional appropriate start of prophylactic interventions.

Objective: Dynamic changes of cytotoxic T cell responses against Human Immunodeficiency Virus 1 (HIV-1) infection have been the subject of an innovative investigation using antiretroviral therapy (ART). Currently, human CD8 naïve central memory (T CM ), effector memory (T EM ), and effector memory cells re-expressing CD45RA (T EMRA ) T-cells have been thoroughly studied with ART. CD45RA is a marker usually found on naïve T-cells., Materials and Methods: We performed a longitudinal study of mono-/polyfunctional T-cells in the peripheral blood while targeting three functionally distinct cell populations of CD4 + and CD8 + T-cells (single IL2 and IFN-γ, dual IL2/IFN-γ) in 50 HIV-1 patients. These patients consisted of 5 controllers, 15 non-controllers, 20 ART responders, and 10 highly active antiretroviral therapy (HAART) non-responders., Results: We found that (1) non-controllers had the highest rate of IFN-γ-expressing CD4 or CD8, but the lowest rate of IL2-producing CD4 or CD8. (2) The control of HIV-1 infection was associated with polyfunctional Gag-specific T cell responses in controllers and responders. (3) Non-responders had high serum levels of IL2 and IFN-γ. There was a high percentage of CD4 + T cell response cells within the less differentiated phenotype in controllers. CD8 + T cell showed a high rate of T EM and T EMRA in responders., Conclusion: High levels of pro-inflammatory cytokines are typical in non-responders, exhausted T-cells may be associated with HIV-1 progression., (© 2019 by the Association of Clinical Scientists, Inc.)

Acute osteomyelitis is a relatively rare disorder in the neonatal period, with considerable morbidity and mortality. Early diagnosis and prompt treatment are essential for a successful outcome. In this report we present a case of acute osteomyelitis of the talus due to methicillin-resistant Staphylococcus epidermidis, observed in a 30-day-old infant.

Intestinal intussusception is the invagination of an intestinal segment into another. Childhood intussusception is usually idiopathic, whereas adult intussusception is usually due to a definable intraluminal lesion or to a systemic disease. Although the aetiology of idiopathic forms often remains unclear, there is appreciable evidence to support an indirect role played by certain infectious agents. In this report we present a case of childhood intussusception probably due to adenovirus infection.

In a retrospective study of cases of infective endocarditis (IE) observed in adult patients, the data of patients hospitalized for definite IE in the Cardiosurgery Unit of ARNAS-Civico in Palermo (Italy) from March 2003 to September 2006 were analysed. All cases were classified according to the modified Duke criteria. In all, 36 immunocompetent patients with "definite" IE were included (20 males and 16 females with a median age of 54 years). The aortic valve (23/36, 64%) was the most commonly involved, followed by the mitral (19/36, 52.7%) and tricuspid valve (4/36, 11%). In 10 patients (27.7%), a double localization was observed. Blood culture yielded a positive result in 15 cases. Staphylococci and enterococci were the pathogens most commonly identified. Valvular diseases and previous cardiosurgical procedures were the risk factors most commonly noted. Four patients developed complications during the course of the disease, one of whom died. In patients with positive blood culture, antibiotics were prescribed on the basis of susceptibility test results. In patients with negative blood culture, empiric therapy was directed against Gram+ bacteria (glycopeptides, aminoglycosides and betalactams). Surgical therapy was necessary in 25 patients (69.4%). The patients were subsequently enrolled in a cardiological and infectivological follow-up. Our results showed that rapid diagnosis, correct antibiotic therapy and early surgical treatment improve the outcome in patients with infective endocarditis.

Over the last few years evidence has emerged to indicate the involvement of herpes viruses in several infectious complications observed in patients undergoing antiblastic chemotherapy. We present a case of bilateral parotiditis due to EBV reactivation in a patient who had received chemotherapy because of an invasive thymoma. In October 2006, a 53-year-old man with pulmonary and pleural metastases owing to an invasive thymoma, was started on chemotherapy with cisplatin, adriamycin and cyclophosphamide. In January 2007, after consultation with an infectious disease specialist, the patient was admitted to the oncology department because of bilateral swelling of the parotid glands which was most likely of infectious or mycotic origin and attributed to immunosuppression by chemotherapy (the last cycle was completed on 28th December 2006). During his hospital stay, the patient underwent routine blood tests, serological tests (EBV-VCA IgM/IgG: positive/positive, EBV-EBNA IgG: positive), cultural and instrumental tests. Due to the serological results, we decided to search for EBV in blood by using PCR (23,000 copies/100,000 cells). We hypothesize that EBV infection could have caused both thymoma and bilateral parotiditis. Accordingly, a multidisciplinary approach, including consultation with an oncologist, infectious disease and microbiology specialists, is the best way to manage infectious complications in patients with a deficit of cells-mediated immunity.