SARS-CoV-2 and Burkholderia cenocepacia infection in a patient with Cystic Fibrosis: An unfavourable conjunction?

The effects of the concomitant infection by COVID-19 and Burkholderia cepacia (Bc) in CF are not known. We describe the case of a 34 years woman with CF, colonized by Bc and found SARS-CoV2 positive. In the first hospital week she suffered acute respiratory failure and chest imaging showed interstitial involvement and multiple thickenings. She was treated with antibiotics, dexamethasone, remdesivir and heparin, with gradual improvement and discharge at day 20th. The reciprocal role of SARS-CoV-2 and Bc, their potential interactions and the contribution of the individual therapies to the favourable outcome are unclear. It is debatable whether it was SARS-CoV2 that triggered a Bc pulmonary exacerbation or if the chronic Bc infection facilitated the development of a COVID-19 more aggressive than usually seen in CF. If the latter hypothesis were confirmed by similar cases, Bc colonization should be regarded as a risk factor for severe COVID-19 expression in CF.

[Respiratory emergencies in adolescents]. / Le emergenze respiratorie nell'adolescente.

BACKGROUND: The aim of this paper was to examine the present situation of adolescents admission for respiratory emergency, management of these patients, identify strategies for the best therapeutic options and better collaboration. METHODS: We have gathered data of adolescent patients who were referred to the Emergency Unit of "G. Gaslini" Children's Hospital, and "San Martino" Hospital in Genoa and to the Intensive Care Unit of both Hospitals and to the Emergency Service 118 in Liguria district. Respiratory emergency in adolescence is a rare condition and it is usually due to a poor control of respiratory chronic diseases, i.e. respiratory distress in patients with asthma. RESULTS: We found that there is an increased number of respiratory emergencies because of psychological problems, drugs addiction, multiple trauma; in other words, we had an increased number of admissions due to behavioural problems. Temporary in-patients care has been showed to be the best therapeutic option after the admission in the Emergency Unit. CONCLUSIONS: In conclusion, adolescent patients need to be hospitalized, but appropriate spaces and structures need to be found either in pediatric or adult Hospitals and qualified personnel must be trained.