ABSTRACT
A coronavirus disease 2019 (COVID-19) surveillance study was performed in March-April 2020 among asymptomatic healthcare workers (HCWs) at a specialist infectious diseases hospital in Naples, Italy. All HCWs underwent two rounds of molecular and serological testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). One hundred and fifteen HCWs were tested; of these, two cases of infection were identified by reverse transcriptase polymerase chain reaction and two HCWs were SARS-CoV-2 immunoglobulin G seropositive. The overall prevalence of current or probable previous infection was 3.4%. The infection rate among HCWs was reasonably low. Most of the infected HCWs had been asymptomatic for the preceding 30 days, which supports the need for periodic screening of HCWs for COVID-19.
Subject(s)
Coronavirus Infections/epidemiology , Emergency Medical Services/statistics & numerical data , Health Personnel/statistics & numerical data , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Pneumonia, Viral/epidemiology , Adult , Betacoronavirus , COVID-19 , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Population Surveillance , Prevalence , SARS-CoV-2ABSTRACT
UNLABELLED: Tuberculosis (TB) is an important cause of morbidity and mortality worldwide. Here, we describe our experience of childhood tuberculous meningitis (TBM), focusing on factors influencing presentation and outcome. PATIENTS AND METHODS: Children aged 0-14 years, with diagnosis of TBM and 24 months of post-therapy follow-up, were evaluated in this retrospective study. RESULTS: Thirty-two patients with TBM were identified. Fever, nuchal rigidity and vomiting were the main presenting symptoms. Fourteen cases (44%) presented with cranial nerve palsy. Seventeen (53%) patients were in advanced stage of the disease on admission. Cerebrospinal fluid (CSF) examinations showed low glucose, high proteins and pleocytosis. A central nervous system device was placed in 4 cases (13%) because of worsening hydrocephalus. Four (13%) patients died, while 6 (19%) had sequelae. Faster normalization of CSF parameters was associated with better outcome. CONCLUSION: Early antimycobacterial therapy and close monitoring of TBM in childhood improve the outcome.
Subject(s)
Tuberculosis, Meningeal/diagnosis , Adolescent , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Child , Child, Preschool , Drug Therapy, Combination , Humans , Infant , Infant, Newborn , Retrospective Studies , Treatment Outcome , Tuberculosis, Meningeal/drug therapy , Tuberculosis, Meningeal/physiopathologyABSTRACT
UNLABELLED: In this study we reviewed M. tuberculosis meningitis (TBM) cases in childhood at our unit in a five-year period. METHODS: Included in this retrospective study were children admitted to Cotugno Hospital from 1995 to 1999 who fulfilled criteria for a TBM diagnosis. Medical records were analyzed for epidemiological data, clinical manifestations, laboratory test results, radiological investigations and clinical outcome. RESULTS: We identified 10 children with TBM. Family history of tuberculosis (TB) was observed in 6 patients. Fever preceded hospital admission of 4-60 days (median 8 days); neurological signs were present 1-6 days before admission in 8 patients. All patients showed a predominance of lymphocytes, elevated proteins and reduced glucose concentration in cerebrospinal fluid (CSF). Mycobacterium tuberculosis was either cultured or identified by acid fast stain in 5 patients. Cranial CT-scans and MRI showed hydrocephalus in 8 patients and ring-enhancing lesions in 6. Antituberculous therapy was administered according to current recommendations for at least 12 months, with a 4-6 week steroid therapy course. Two patients had permanent neurological sequelae. CONCLUSIONS: Careful evaluation of symptoms and CSF findings is the only way to establish an early diagnosis and reduce sequelae.
Subject(s)
Tuberculosis, Meningeal , Child , Child, Preschool , Female , Humans , Infant , Male , Tuberculosis, Meningeal/diagnosis , Tuberculosis, Meningeal/drug therapy , Tuberculosis, Meningeal/epidemiologyABSTRACT
The aim of the present study was to assess the significance of IgE and interleukin-6 (IL-6) in paired CSF and serum of patients with viral and bacterial infections of the central nervous system. The results suggest that the detection of IL-6 and IgE in CSF is an useful marker for monitoring course and prognosis of these patients.
Subject(s)
Immunoglobulin E/cerebrospinal fluid , Interleukin-6/cerebrospinal fluid , Meningitis, Bacterial/immunology , Meningitis, Viral/immunology , Humans , Immunoglobulin E/blood , Interleukin-6/bloodABSTRACT
Eleven hospitalized patients with bacterial meningitis were treated with cefoperazone at daily dosage ranging between 3 and 8 g intravenously. Seven patients had proven Gram-negative bacterial infections, but in four patients the aetiological agent remained unknown. Eight patients completely recovered from infection and the pathogens were eradicated, in one patient the treatment failed and in two patients only some improvement was registered. Furthermore in five patients cefoperazone serum and cerebrospinal fluid levels were determined four times in the first week of treatment (1st, 3rd, 5th and 7th day). No side-effects were recorded. Cefoperazone can be considered as effective antimicrobial agent in the therapy of bacterial meningitis.