Imported and autochthonous histoplasmosis in Bergamo province, Northern Italy.

This paper reviews the Italian literature and illustrates the results of a survey on Histoplasma capsulatum var. capsulatum infection carried out in the Bergamo area of Italy over the last 10 y. During the period January 1989-July 1999, 7 patients were diagnosed as being affected by the H. capsulatum var. capsulatum infection. Until 1999 41 cases have been described in the Italian literature (9 before the 1980s, 6 in the 1980s and 26 in the 1990s). The epidemiological profile of histoplasmosis is well-defined: risk factors are activities such as visiting caves or building sites, travelling and immigration, and it affects both immunocompetent and patients with AIDS. However, in the past, the Italian soil was considered as a low-endemic pabulum for H. capsulatum var. capsulatum and only a few autochthonous cases of histoplasmosis have been reported in Italy, specifically in the Po valley. In the present series, the identification of new cases in the Po valley in Lombardy suggests the possible autochthonous presence of histoplasmosis in Italy.

Vibrio cholerae O2 as a cause of a skin lesion in a tourist returning from Tunisia.

Isolates of Vibrio cholerae other than O1 and O139 (non O1 Vibrio cholerae) are associated with sporadic diarrheal disorders, and limited outbreaks of diarrhea, and have often been reported in association with extraintestinal infections. The majority of cases of non O1 Vibrio cholerae infection involve immunocompromised patients with hematologic malignancies or cirrhosis. In Italy, very few cases of gastrointestinal and extraintestinal infections due to non O1 Vibrio cholerae have been described in the past years. We describe a case of non O1 Vibrio cholerae infection with cutaneous bullous lesions in a tourist returning from Tunisia.

Nosocomial outbreak of severe Pseudomonas aeruginosa infections in haematological patients.

From June to September 1988, an outbreak of Pseudomonas aeruginosa infections in neutropenic patients admitted to the Haematological Wards of "Ospedali Riuniti" in Bergamo, Italy, was detected. Out of 11 cases of P. aeruginosa infections, 8 were bacteremic. Of these, 7 died within few days of onset (mortality rate: 87.5%). Consequently, possible sources of infection were investigated, and moist areas of the hospital environment were shown to be highly contaminated by P. aeruginosa. A clinical and microbiological follow-up of patients admitted to the Haematological Wards was performed for a 10 month period following the outbreak. Adequate measures for cleaning and disinfection were shown to reduce the frequency of P. aeruginosa hospital infections.