[Show abstract][Hide abstract] ABSTRACT: The study examines the pathological circumstances related to Byron's death, the primary issue being malaria. Lord Byron died during the Greek War of Independence against the Ottoman Empire, in Messolonghi on 19 April 1824. Byron's medical profile consists of recurrent onsets of fever, which gave rise to the issue of malaria relapses. According to Byron's letters he reported crises of fever in Greece (1810), Malta (1811), Italy (1817-1819) and England. Evidence from Byron's autopsy, specifically the absence of hepatosplenomegaly, does not support a hypothetical diagnosis of malaria. Nonetheless, the relapsing fevers cannot be ignored and the same applies to the possibility of malaria relapse or re-infection in line with the endemic nature of the Messolonghi area. Our research on the chronologies of Byron's reported fevers found that new attacks occurred at intervals of 540 days on average. Moreover, the most outstanding feature of Plasmodium vivax and Plasmodium ovale is their ability to form dormant forms of hypnozoites in the liver which, when reactivated (110-777 days), cause true relapses of clinical disease. Of course, an ex post facto diagnosis is under debate, because the diagnosis is not clinical but microscopic. Byron's example raises alarm over a current medical problem, i.e. the diagnosis of unexplained fevers, and the need for a detailed travel or immigration history, which will include malaria in the differential diagnosis.
Le infezioni in medicina: rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive 09/2015; 23(3):288-195.
[Show abstract][Hide abstract] ABSTRACT: Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of unclear etiology. The role of bacteria in the pathogenesis of disease remains controversial. Materials and Methods: Specimens were obtained from 22 HS patients by direct percutaneous needle aspiration. The collected material was cultured in aerobic and anaerobic conditions, and sensitivity tests were performed. Results: Of the 22 patients, 32% were culture negative and 68% were culture positive. A total of 16 isolates was obtained, 14 aerobic and 2 anaerobic. Aerobic bacteria were present in 86% of the specimens, whereas only anaerobic bacteria were isolated in 7%. The predominant aerobic species were Proteus mirabilis, Staphylococcus haemolyticus and Staphylococcus lugdunensis. The isolated anaerobic bacteria were Dermacoccus nishinomiyaensis and Propionibacteriumgranulosum. Conclusion: A variety of aerobic and anaerobic bacteria was isolated from the HS lesions of our patients. In contrast to previous studies, fewer patients were found to be culture positive, and Staphylococcus aureus was isolated in only 1 of them. More studies are necessary to elucidate the controversial role of bacteria in the pathogenesis of HS.
[Show abstract][Hide abstract] ABSTRACT: As MRSA are considered Staphylococcus aureus isolates with oxacillin minimum inhibitory concentration (MIC) of ≥4 mg/L or harboring the mecA gene. However, the presence of mecA does not necessarily lead to oxacillin resistance and mecA gene-carrying isolates may have oxacillin MIC within the susceptible range (≤2 mg/L). During the last few years it has become apparent that oxacillin-susceptible (OS) mecA-positive S. aureus isolates (commonly called OS-MRSA) are rather commonly detected worldwide and may remain undiagnosed using phenotypic susceptibility testing methods. This review will summarize the current reports on OS-MRSA isolations and the underlying mechanisms regulating the expression of oxacillin resistance and also oxacillin susceptibility in mecA-positive S. aureus isolates. As MRSA commonly cause severe infections against which effective therapies are limited, understanding of these mechanisms could enable the identification of new targets for the treatment or reversion of the MRSA phenotype.
Current pharmaceutical design 03/2015; 21(16). DOI:10.2174/1381612821666150310103754 · 3.45 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Rhodococcus equi infection in humans was first reported in 1967. Since the advent of the AIDS epidemic, the reported cases of human infection increased dramatically and Rhodococcus equi has become an important opportunistic pathogen in immunocompromised patients. The presented case is a necrotizing pneumonia in a 45-year-old HIV-positive man who responded well to clarythromycin and rifampicin / isoniazid. The aim of this report is to increase physician awareness so as to suspect a Rhodococcus equi infection and to render the microbiologists more vigilant.
[Show abstract][Hide abstract] ABSTRACT: Influenza virus infection can cause serious complications in children who are immunosuppressed concerning their medical treatment against cancer. The increased risk of infection in this group of patients may be due to either the disease itself or to their immunosuppression as a result of chemotherapy. Influenza virus infections present in the form of annual infections and may cause interruption of the cancer treatment for up to several weeks. In patients with cancer, immunization via vaccine has been shown to provide protection against several virus infections at similar levels to those of healthy individuals. This evidence can be translated into reduced duration and severity of the infection and potential improvement in patients' morbidity and mortality. Immune responses depend on the time of the immunization via vaccine, concerning the time that has passed since the last chemotherapy treatment. It has been shown that patients receiving chemotherapy develop weaker immune responses compared with those who have completed chemotherapy, as well as with healthy people. However, few data are available for cancer patients who are in childhood, as the groups of patients are heterogeneous with regard to underlying malignancy, the type of chemotherapy, the dose, the time and the route of administration of influenza vaccine. As for the vaccine's composition, the circulating human influenza viruses are subject to antigenic changes requiring annual adjustment of the composition of the vaccine. We can underline that the vaccine containing inactivated virus strains contains no risk to cause outbreak or secondary complications and is considered safe for administration to immunocompromised individuals, even though these are children.
[Show abstract][Hide abstract] ABSTRACT: West Nile virus (WNV) is a mosquito-borne arbovirus of the Flaviviridae family. Transmission to humans occurs predominantly following a bite from an infected mosquito, principally of the genus Culex, which acquires virus after feeding on avian amplifying hosts. Most people infected with WNV remain asymptomatic, and only 20% of infected individuals develop West Nile fever (WNF), a mild and self-limited flu-like illness of fever. Less than 1% of WNV infections progress to clinical disease associated with severe neurological manifestations, including aseptic meningitis, encephalitis, and acute flaccid paralysis. Since its first isolation in the West Nile district of Uganda in 1937, a geographic expansion and westward spread of the virus has occurred during the last 20 years. Until recently, its medical and veterinary health concern was relatively low; however, the number, frequency and severity of outbreaks with neurological consequences in humans and horses have lately increased in Europe and the Mediterranean basin. Even though great advances have been obtained lately regarding WNV infection, and although efficient equine vaccines are available, no specific treatments or vaccines for human use are on the market. Peak WNV transmission occurs during mosquitoes' active period, usually between midsummer and early autumn. Climatic conditions (temperature and precipitation), landscape features and land-use seem to react on WNV transmission. This review updates the most recent investigations in different aspects of WNV life cycle: molecular virology, host range, transmission dynamics, pathogenesis, clinical manifestations, diagnosis, vaccine development, control, and prevention, and highlights some aspects that require further research.
[Show abstract][Hide abstract] ABSTRACT: Influenza human infections are considered as a persistent global public health issue. Whereas vaccination is important for prevention, given its limitations, antiviral therapy is at the forefront of treatment, while it also plays a significant role in prevention. Currently, two classes of drugs, adamantanes (M2 blockers) and neuraminidase inhibitors (NAIs), are available for treatment and chemoprophylaxis of influenza infections. Given the resistance patterns of circulating influenza strains, adamantanes are not currently recommended. The current review mainly focuses on the development of resistance to NAIs among A and B subtypes of influenza virus strains over the last 5 years. 'Permissive' drift mutations and reassortment of viral gene segments have resulted in NAI oseltamivir-resistant A/(H1N1) variants that rapidly became predominant worldwide in the period 2007-2009. However, the prevalence of antiviral resistance to NAI zanamivir remains relatively low. In addition, the recently developed NAIs, peramivir and laninamivir, while licensed in certain countries, are still under evaluation and only a few reports have described resistance to peramivir. Although in 2014, the majority of circulating human influenza viruses remains susceptible to all NAIs, the emergence of oseltamivir-resistant influenza variants that could retain viral transmissibility, highlights the necessity for enhanced epidemiological and microbiological surveillance and clinical assessment of antiviral resistance.
[Show abstract][Hide abstract] ABSTRACT: ABSTRACT Aim: The bacterial and atypical etiology of acute exacerbations of chronic obstructive pulmonary disease was investigated and the diagnostic techniques used were compared among 92 hospitalized patients.
Sputum specimens were investigated using culture and PCR, serological status evaluation was performed and the inflammatory profile was associated with the microbiological results.
The majority of the patients (65.2%) had very severe airway obstruction. The most common bacteria were Haemophilus influenzae and Pseudomonas aeruginosa (23.9 and 14.1%, respectively). Acinetobacter baumannii- and P. aeruginosa-positive cultures were associated with prolonged hospitalization and severe airway obstruction (p = 0.03 and 0.031, respectively). Chlamydia pneumoniae or Mycoplasma pneumoniae infection was diagnosed in four and two patients, respectively. Discrepant results were detected between PCR and serology, especially regarding C. pneumoniae.
[Show abstract][Hide abstract] ABSTRACT: The effects of doxycycline-streptomycin-rifampin versus a standard doxycycline-streptomycin regimen on residual Brucella DNA were compared in 36 acute brucellosis patients. At admission, all patients given triple (n = 22) and double (n = 14) regimens had detectable Brucella DNA with similar mean loads (P = 0.982). At follow-up, 14 to 20 months postpresentation, significantly more patients receiving triple than double regimens
had undetectable Brucella DNA (P = 0.026). The doxycycline-streptomycin-rifampin regimen eliminates Brucella DNA more efficiently than doxycycline-streptomycin, which may result in superior long-term clearance of Brucella.
[Show abstract][Hide abstract] ABSTRACT: Serological, molecular and phylogenetic analyses of a recently imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Greece are reported. Although MERS-CoV remained detectable in the respiratory tract secretions of the patient until the fourth week of illness, viraemia was last detected 2 days after initiation of triple combination therapy with pegylated interferon, ribavirin and lopinavir/ritonavir, administered from Day 13 of illness. Phylogenetic analysis of the virus showed close similarity with other human MERS-CoVs from the recent Jeddah outbreak in Saudi Arabia. Immunoglobulin G (IgG) titres peaked 3 weeks after the onset of illness, whilst IgM levels remained constantly elevated during the follow-up period (second to fifth week of illness). Serological testing confirmed by virus neutralisation assay detected an additional case that was a close contact of the patient.
International Journal of Antimicrobial Agents 09/2014; 44(6). DOI:10.1016/j.ijantimicag.2014.07.026 · 4.30 Impact Factor