RESUMO
This multicenter study in Italian hospitals highlights the epidemiologic disruptions in the circulation of the 5 main respiratory viruses from 2019 to 2023. Our data reveal a resurgence of respiratory syncytial virus and influenza during the 2022-2023 winter season, with an earlier peak in cases for both viruses, emphasizing the importance of timely monitoring.
Assuntos
Hospitalização , Infecções por Vírus Respiratório Sincicial , Infecções Respiratórias , Estações do Ano , Humanos , Itália/epidemiologia , Estudos Retrospectivos , Hospitalização/estatística & dados numéricos , Lactente , Pré-Escolar , Criança , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Influenza Humana/epidemiologia , Masculino , Feminino , Adolescente , Recém-NascidoRESUMO
OBJECTIVE: To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period. STUDY DESIGN: A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded. RESULTS: Of 98 patients (62 boys, mean age 8.81 ± 3.04 years), 59 (60.2%) reported a positive history of pharyngotonsillitis; 48 (49%) had received antibiotic (mean duration of treatment of 5.9 ± 3.1 days), and, among these, 28 (58.3%) had carditis. Carditis was the second most frequent finding, subclinical in 27% of patients. Mitral regurgitation was present in 49 of 56 patients (87.5%) and aortic regurgitation in 36/56 (64.3%) no stenosis was documented. CONCLUSIONS: ARF is still present in high-income countries and can develop despite primary prophylaxis, especially when given for a short course. Our findings highlight the need for 10 days of antistreptococcal treatment to prevent ARF. Echocardiography is important because 27% of cases with carditis were subclinical.
Assuntos
Miocardite/diagnóstico , Miocardite/epidemiologia , Febre Reumática/diagnóstico , Adolescente , Antibacterianos/uso terapêutico , Insuficiência da Valva Aórtica/diagnóstico por imagem , Artrite/microbiologia , Bloqueio Atrioventricular/diagnóstico , Sedimentação Sanguínea , Criança , Pré-Escolar , Coreia/microbiologia , Países Desenvolvidos , Ecocardiografia Doppler em Cores , Eletrocardiografia , Eritema/microbiologia , Feminino , Hemoglobinas/análise , Humanos , Itália/epidemiologia , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Faringite/epidemiologia , Estudos Retrospectivos , Febre Reumática/tratamento farmacológico , Febre Reumática/epidemiologia , Estações do Ano , Tonsilite/epidemiologiaRESUMO
OBJECTIVE: To assess the risk of post-natal cytomegalovirus (CMV) transmission to very low birth weight (VLBW) infants fed with their mother's fresh milk. STUDY DESIGN: Prospective, observational study of 80 VLBW infants and their 68 mothers. Infants' urine and their own mother's fresh breast milk were tested for CMV by means of culture tests once a week until discharge. CMV in infected milk and urine were genotyped. The clinical course, laboratory findings, and outcome of infants infected with CMV at 2 years of age are reported. RESULTS: Fifty-three mothers (78%) were CMV-seropositive at delivery. CMV was detected in the milk of 21 of 53 seropositive mothers (40%), and CMV was in the urine in 9 of 26 infants (35%) fed with CMV-positive milk. The same gN-genotype was found in milk and urine. Three infected infants <28 weeks gestational age (GA) had a mild sepsis-like illness. Five more infants had neutropenia, conjugated hyperbilirubinaemia, or both. Post-natal CMV infection occurred in 1 of 19 infants with a GA<28 weeks who were treated at birth with intravenous immunoglobulin versus 3 of 5 non-treated infants (P < .02). Symptomatic CMV infection was associated with bronchopulmonary dysplasia. No neurosensorial sequelae were found at 2 years of corrected age. CONCLUSIONS: CMV infection via fresh human milk is mild, self-limiting, and without sequelae. Very-low GA and pre-existing chronic diseases are associated with symptomatic infection.
Assuntos
Infecções por Citomegalovirus/transmissão , Citomegalovirus/isolamento & purificação , Recém-Nascido de muito Baixo Peso , Transmissão Vertical de Doenças Infecciosas , Leite Humano/virologia , Anticorpos Antivirais/sangue , Citomegalovirus/imunologia , Infecções por Citomegalovirus/diagnóstico , DNA Viral/análise , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Complicações Infecciosas na Gravidez/virologia , Urina/virologiaRESUMO
OBJECTIVE: To report the accuracy of ultrasound scanning (US) in predicting neurodevelopmental and sensorineural outcome in patients with congenital cytomegalovirus (CMV) infection. STUDY DESIGN: Fifty-seven neonates with congenital CMV infection underwent brain US and were observed prospectively for motor skills, developmental quotient, and hearing function. RESULTS: Abnormal results on US were found in 12 of 57 neonates. US lesions were more frequent in newborns with clinical and laboratory signs of congenital CMV infection at birth (10/18) than in newborns who had no symptoms at birth (2/39; P < .001). At least 1 sequela developed in all neonates with symptoms who had abnormal US results, whereas none of the neonates with symptoms who had normal US results had long-term sequelae (P < .001). In the population without symptoms, sensorineural hearing loss developed in 3 of 37 (8.1%) neonates with normal US results, whereas severe sequelae developed in 1 of 2 neonates with abnormal US results. CONCLUSIONS: A good correlation was found between cerebral US abnormalities and the prediction of outcome in newborns who were congenitally infected with CMV and had symptoms at birth. US could be performed as the first neuroimaging study in these newborns. Data are insufficient to permit any suggestions for the population without symptoms.