[Early neonatal manifestations of group B Streptococcus infection: case series and preventive strategy]. / Manifestazioni neonatali precoci da GBS: casistica e strategie preventive.

Group B Streptococcus (GBS) is, so far, one of the most important causes of neonatal morbidity and mortality. In order to elucidate the extent of this problem a screening for GBS has been performed on a group of pregnant women and their neonates. Maternal vaginal and rectal swabs were obtained on admission to the labor area. In these infants throat swabs at birth and throat and rectal swabs on day 4th and 6th were obtained. In the 14,248 pairs mother/infant examined, the rate of colonization was, respectively, 9 (7%) and 4 (1%). 6 among 569 colonized newborn show evidence of the early onset type infection (respiratory form: 2 cases; meningitic form: 4 cases). Fatal outcome and severe neurologic impairment were observed respectively in 3 and 1 patient. Risk factors (prematurity) were present only in two patients. In all cases clinic evidence was observed before that laboratory findings were disposable. The Authors remark the importance of the bacteriological screening in pregnancy, and of antibiotic therapy intrapartum in women with risk factors and in colonized newborn in the first hour of life when acute phase reactants are positive.

[Rhodococcus equi infections in AIDS: personal cases]. / Sepsi da Rhodococcus equi in corso di AIDS: osservazioni personali.

We report on the occurrence of an uncommon pathogen, Rhodococcus equi (R.e.) in HIV infection. In the period february 1990-July 1991 we performed the diagnosis of R.e. infection (lung, lung-central nervous system) in two infected patients, aged 27 and 31 years, both males, drug addicts, classified as CDC IV. In the first of them an cavitating right bronchopneumonia (bpm) was diagnosed as of tuberculous origin, on the ground of the microscopic demonstration of an acid-fast, gram-positive strain in b.a.l.. A standard antituberculous regimen was uneffective and R.e. was eventually isolated in three blood culture taken shortly before the exitus and at post-mortem examination of the lungs. In the second patient a subclavian right bpm developed without microbiological evidence of any common pathogen. A third-generation cephalosporin course was only partially successful (clinical amelioration, incomplete clearing of radiological findings). After 3 months the patient relapsed and an aseptic meningitis developed. Cultures of blood and csf yielded a R.e. strain; post-mortem examination revealed a diffuse, cavitating bpm. Our personal experience underlines the difficulty in recognizing R.e. infections in compromised host, because of similarity to other entities (i.e. tuberculosis) and the absence of pathognomonic hints.

Seborrheic dermatitis in otherwise healthy patients and in patients with lymphadenopathy syndrome/AIDS-related complex: treatment with 1% bifonazole cream.

Recent studies reported in the literature have repeatedly pointed out the utility of imidazole derivatives, one of which is bifonazole, in the therapy of seborrheic dermatitis (SD). The cause of this pathological situation is still under discussion but the therapeutic success obtained with antimycotics speaks in favor of the pathogenetic importance of Malassezia ovale in this context. There is a high frequency of SD type complaints in patients with HIV infections in whom immune defenses against various pathogens, including yeasts, are deficient. We therefore verified the clinical efficacy of 1% bifonazole cream on 15 subjects with SD of the face, 9 of whom were affected with lymphadenopathy syndrome/AIDS-related complex (LAS/ARC). The treatment was administered over a four-week period and gave good results in 12 patients. The best results, however, were observed in those suffering from LAS/ARC.

[Yersinia enterocolitica sepsis in splenectomized thalassemic subjects. Description of 2 cases]. / La sepsi da Yersinia enterocolitica nei soggetti talassemici splenectomizzati. Descrizione di due casi.

Two cases of Yersinia enterocolitica septicemia in two splenectomized children with thalassemia major are reported. Human Yersinia enterocolitica septicemia is an uncommon condition, but its frequency may increase in patients having debilitating diseases or blood disorders, as well as a consequence of the splenectomy. Some brief considerations on the pathogenetic factors yielding, to severe infections in splenectomized thalassemic children are discussed. The high number of thalassemic people in Italy makes necessary an early diagnosis in case of septicemia. Particularly important is the blood culture, because of the slowness of the microbic development in stools.