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Pipitò L, Zinna G, Trizzino M, Gioè C, Tolomeo M, Di Carlo P, Colomba C, Gibaldi L, Iaria C, Almasio P, Cascio A. Causes of hospitalization and predictors of in-hospital mortality among people living with HIV in Sicily-Italy between 2010 and 2021. J Infect Public Health 2023; 16:1703-1708. [PMID: 37729685 DOI: 10.1016/j.jiph.2023.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Despite the rising number of people living with human immunodeficiency virus (HIV), there is a lack of knowledge about the factors that lead to PLWHs being hospitalized in worldwide literature. Our study aimed to investigate PLWH admissions in Sicily (Italy) between January 2010 and September 2021 and to analyze the characteristics and risk factors for in-hospital mortality and differences between Italians and foreigners. METHODS Data from the hospital discharge forms of all people living with HIV (PLWH) hospitalized in Sicilian hospitals were retrospectively collected. Age, sex, nationality, length of stay, acquired immunodeficiency syndrome (AIDS), and non-AIDS-related diseases were evaluated using univariate analysis according to in-hospital mortality rates. The factors associated with mortality were included in the logistic regression model. RESULTS In total, 5281 admissions from 2726 PLWHs occurred, most of which were related to non-AIDS diseases. Approximately 20 % regarded foreign patients, mainly from Africa. Logistic regression analysis revealed an association between in-hospital mortality and some AIDS- and non-AIDS-related diseases (wasting syndrome, lymphomas, Kaposi sarcomas, progressive multifocal leukoencephalopathy, cryptococcosis, abscesses, sepsis, cardiovascular disease, nephropathy, and respiratory diseases). African patient admissions were significantly associated with tuberculosis, toxoplasmosis, Burkitt lymphoma, and hepatitis B diagnoses. CONCLUSIONS Our study showed that most hospitalizations were related to non-AIDS-defining diseases, with differences between Italian and foreign patients, mainly from Africa.
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Affiliation(s)
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Giuseppe Zinna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Manlio Tolomeo
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Paola Di Carlo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy; Pediatric Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Lidia Gibaldi
- Dipartimento per la pianificazione strategica, Assessorato della Salute Regione Siciliana, Palermo, Italy
| | - Chiara Iaria
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy; Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127 Palermo, Italy
| | - Piero Almasio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the fight against AIDS, AOU Policlinico "P. Giaccone", 90127 Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy.
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Pipitò L, Piccione M, Trizzino M, Calà C, Cascio A. An Uncommon Case of Syphilis With Simultaneous, Different Lesions: Moth-Eaten Alopecia, Syphilitic Keratoderma, and Psoriasiform Syphilis. Cureus 2023; 15:e49181. [PMID: 38130559 PMCID: PMC10734655 DOI: 10.7759/cureus.49181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Syphilis is a re-emerging disease, and an increasing number of cases are being reported in Italy and worldwide. In this report, we present a case of a male patient with secondary syphilis characterized by the heterogenicity of the lesions: hyperkeratosis, psoriasiform-like lesions, papules, macules, and patchy alopecia on the scalp. The patient had applied several topical antimicrobials and steroid medicaments and taken oral acyclovir, which yielded no relief, for a previous wrong diagnosis. At the time of his presentation to our clinic, syphilis was suspected and confirmed by serology. The administration of a single intramuscular dose of penicillin led to a full recovery in three weeks. Screening for HIV and other sexually transmitted infections returned negative. Clinicians should maintain a high index of suspicion for syphilis when encountering sexually active patients with atypical skin manifestations.
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Affiliation(s)
- Luca Pipitò
- Infectious and Tropical Diseases Unit; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo, ITA
| | - Manfredi Piccione
- Infectious and Tropical Diseases Unit; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo, ITA
| | - Marcello Trizzino
- Infectious and Tropical Diseases Unit; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo, ITA
| | - Cinzia Calà
- Microbiology and Virology Unit; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo, ITA
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo, ITA
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Mauceri R, Coppini M, Cascio A, Trizzino M, Crivello V, Florena AM, Campisi G. Oral Secondary Syphilis in an HIV-Positive Transgender Patient: A Case Report and Review of the Literature. Dent J (Basel) 2023; 11:231. [PMID: 37886916 PMCID: PMC10605375 DOI: 10.3390/dj11100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Syphilis is a worldwide sexually transmitted infection caused by Treponema pallidum. In most cases, the oral manifestations of syphilis infection are associated with cutaneous involvement. However, the present case report is noteworthy since the oral lesions are the sole clinical sign in an HIV-positive transgender patient. CASE PRESENTATIONS We reported an uncommon case of secondary syphilis in a 37-year-old seropositive transgender male, whose diagnostic suspect was based only on oral mucosal lesions. The patient was referred to the Oral Medicine Unit for the presence of multiple undiagnosed painful oral lesions. The intraoral examination revealed the presence of white and red plaques on the right and the left buccal mucosa and several painful lesions localized on the upper and lower labial mucosa. No cutaneous lesions were observed. Considering the sexual history of the patient and clinical findings, secondary syphilis infection was suspected. The serologic analysis was conducted, and the diagnosis of syphilis was confirmed. Moreover, to exclude the presence of oral epithelial dysplasia or malignant disease, an incisional biopsy was performed. DISCUSSION Compared to the literature data, oral lesions as lone signs of secondary syphilis infection are uncommon, especially in HIV-positive patients. Syphilis and HIV coinfection create a concerning situation as they interact synergistically, leading to an increased risk of transmission and faster disease progression. CONCLUSIONS This case report emphasizes the importance of considering syphilis as a diagnostic possibility, even when oral lesions are the only clinical manifestations, especially in HIV-positive patients. Comprehensive evaluation, including a detailed sexual history and careful oral examination, is essential for accurate diagnosis and appropriate management in such cases.
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Affiliation(s)
- Rodolfo Mauceri
- Department of Surgical, Oncological and Oral Sciences (DiChirOnS), University of Palermo, 90127 Palermo, Italy; (R.M.); (G.C.)
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, 90127 Palermo, Italy
| | - Martina Coppini
- Department of Surgical, Oncological and Oral Sciences (DiChirOnS), University of Palermo, 90127 Palermo, Italy; (R.M.); (G.C.)
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, 90127 Palermo, Italy; (A.C.); (M.T.); (V.C.); (A.M.F.)
| | - Marcello Trizzino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, 90127 Palermo, Italy; (A.C.); (M.T.); (V.C.); (A.M.F.)
| | - Valentina Crivello
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, 90127 Palermo, Italy; (A.C.); (M.T.); (V.C.); (A.M.F.)
| | - Ada Maria Florena
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, 90127 Palermo, Italy; (A.C.); (M.T.); (V.C.); (A.M.F.)
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences (DiChirOnS), University of Palermo, 90127 Palermo, Italy; (R.M.); (G.C.)
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, 90127 Palermo, Italy
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Pipitò L, Medaglia AA, Trizzino M, Mancuso A, Catania B, Mancuso S, Calà C, Florena AM, Cascio A. Hemophagocytic lymphohistiocytosis secondary to histoplasmosis: A case report in a patient with AIDS and recent SARS-CoV-2 infection and minireview. Heliyon 2023; 9:e18537. [PMID: 37533984 PMCID: PMC10392081 DOI: 10.1016/j.heliyon.2023.e18537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023] Open
Abstract
Here, we describe the case of a naïve HIV late presenter female African patient with progressive disseminated histoplasmosis and a severe life-threatening clinical picture in a non-endemic area. She had not visited Africa in the past decade. She developed a reactive hemophagocytic lymphohistiocytosis and an acute psychiatric disorder. Histoplasmosis was diagnosed after two bone marrow biopsies. Therapy with liposomal amphotericin B resulted in rapid and progressive improvements in blood examinations and clinical conditions, including the disappearance of psychiatric disorders. The characteristics of our case were compared with those of all other cases of hemophagocytic syndrome secondary to histoplasmosis in HIV-positive patients reported in PubMed. In conclusion, clinicians outside endemic areas should evaluate histoplasmosis as a cause of severe clinical picture, especially in a patient with a travel history to an endemic area, even after many years, considering the possible reactivation of latent infection.
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Affiliation(s)
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Alice Annalisa Medaglia
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Alessandro Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Bianca Catania
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
| | - Salvatrice Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
| | - Cinzia Calà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
- Microbiology and Virology Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
| | - Ada Maria Florena
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
- Unit of Pathology, Universital Hospital Paolo Giaccone, Palermo (PA), viale del vespro 147, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D'Alessandro,” University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
- Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143 Palermo, Italy
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Gaudiano R, Trizzino M, Torre S, Virruso R, Fiorino F, Argano V, Cascio A. Enterococcus hirae Mitral Valve Infectious Endocarditis: A Case Report and Review of the Literature. Antibiotics (Basel) 2023; 12:1232. [PMID: 37627650 PMCID: PMC10451254 DOI: 10.3390/antibiotics12081232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Enterococcus hirae is a rare pathogen in human infections, although its incidence may be underestimated due to its difficult isolation. We describe the first known case of E. hirae infective endocarditis (IE), which involves the mitral valve alone, and the seventh E. hirae IE worldwide. Case presentation: a 62-year-old male was admitted to our department with a five-month history of intermittent fever without responding to antibiotic treatment. His medical history included mitral valve prolapse, recent pleurisy, and lumbar epidural steroid injections due to lumbar degenerative disc disease. Pre-admission transesophageal echocardiography (TEE) showed mitral valve vegetation, and Enterococcus faecium was isolated on blood cultures by MALDI-TOF VITEK MS. During hospitalization, intravenous (IV) therapy with ampicillin and ceftriaxone was initiated, and E. hirae was identified by MALDI-TOF Bruker Biotyper on three blood culture sets. A second TEE revealed mitral valve regurgitation, which worsened due to infection progression. The patient underwent mitral valve replacement with a bioprosthetic valve and had an uncomplicated postoperative course; he was discharged after six weeks of IV ampicillin and ceftriaxone treatment.
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Affiliation(s)
- Roberta Gaudiano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (R.G.); (F.F.)
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
- Antimicrobial Stewardship Team, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
| | - Salvatore Torre
- Department of Cardiac Surgery, University Hospital “Policlinico”, 90127 Palermo, Italy; (S.T.); (V.A.)
| | - Roberta Virruso
- UOC of Microbiology, Virology and Parassitology, AOU Policlinico, 90127 Palermo, Italy;
| | - Fabio Fiorino
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (R.G.); (F.F.)
| | - Vincenzo Argano
- Department of Cardiac Surgery, University Hospital “Policlinico”, 90127 Palermo, Italy; (S.T.); (V.A.)
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (R.G.); (F.F.)
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight against AIDS, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
- Antimicrobial Stewardship Team, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy
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Pipitò L, Medaglia AA, Trizzino M, Bonura S, Gioè C, Di Carlo P, Colomba C, Cascio A. A case of syphilis associated with immune reconstitution inflammatory syndrome and review of the literature. AIDS Res Ther 2023; 20:28. [PMID: 37170352 PMCID: PMC10176857 DOI: 10.1186/s12981-023-00522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Immune reconstitution inflammatory syndrome (IRIS) associated with syphilis has rarely been described in HIV-infected patients. Diagnosis can be challenging because it is not always possible to discern it from a recent infection or a worsening of an undiagnosed one. CASE PRESENTATION An HIV-positive 42-year-old man with a poor compliance history of antiretroviral therapy presented at our unit and complained of ocular symptoms. Ocular syphilis diagnosis was posed after initial misdiagnosing with cytomegalovirus infection, and antiretroviral therapy compliance improved after switching to a bictegravir-based regimen. Despite intravenous (IV) penicillin, we observed an initial worsening with the appearance of new skin lesions, and IRIS syphilis was suspected. In the literature, 14 cases of IRIS syphilis are described, all regarding male patients. Seven were HIV naïve to therapy, and 7 HIV-experienced with poor therapy compliance. Basal syphilis serology was negative in ten, with subsequent seroconversion after the development of IRIS. IRIS-syphilis development was observed after a median time of 28 days from ART initiation; 10 cases were considered "unmasking-IRIS" and 4 "paradoxical-IRIS". Skin and ocular involvement were the most often reported. In most cases, it was not necessary to use a systemic steroid. A good outcome was reported in 12. CONCLUSIONS Syphilis should be considered in differential diagnosis with other diseases associated with IRIS. A negative syphilis serology before beginning antiretroviral therapy could convey the impression that syphilis has been ruled out. Whereas a high index of suspicion should be maintained when symptoms suggestive of syphilis, such as ocular and skin manifestations, are noticed after therapy has begun.
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Affiliation(s)
- Luca Pipitò
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Alice Annalisa Medaglia
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Silvia Bonura
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Claudia Gioè
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Paola Di Carlo
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Claudia Colomba
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy
- Pediatric Infectious Diseases Unit, ARNAS Civico-Di Cristina-Benfratelli Hospital, 90127, Palermo, Italy
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy.
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Via del Vespro 129, 90127, Palermo, Italy.
- Palermo Fast-Track City, Casa Dei Diritti, Via Libertà 45, 90143, Palermo, Italy.
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Pipitò L, Catania B, Trizzino M, Rodolico V, Cascio A. Fever with perinasal and tongue lesions: A diagnostic challenge. Travel Med Infect Dis 2023; 53:102566. [PMID: 36913993 DOI: 10.1016/j.tmaid.2023.102566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/15/2023]
Abstract
The diagnosis may be challenging, and high suspicion index should be maintained in immunosuppressed patients with unusual mucocutaneous lesions, even in non-endemic areas for mucocutaneous leishmaniasis.
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Affiliation(s)
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Bianca Catania
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Vito Rodolico
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Unit of Pathology, Universital Hospital Paolo Giaccone, Palermo (PA), viale del vespro 147, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy.
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Pipitò L, Trizzino M, Orlando E, Calà C, Cascio A. Lepromatous nodular syphilis: A case from Italy. Travel Med Infect Dis 2023; 53:102564. [PMID: 36898489 DOI: 10.1016/j.tmaid.2023.102564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Luca Pipitò
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit, Sicilian Regional Reference Center for the Fight against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit, Sicilian Regional Reference Center for the Fight against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy
| | | | - Cinzia Calà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Microbiology and Virology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro,", University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro", University of Palermo, Palermo, Italy; Infectious and Tropical Disease Unit, Sicilian Regional Reference Center for the Fight against AIDS, AOU Policlinico "P. Giaccone", 90127, Palermo, Italy; Palermo Fast-Track City, Casa dei Diritti, Via Libertà 45, 90143, Palermo, Italy.
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Pipitò L, Trizzino M, Ferraro D, Cascio A. Monkeypox proctitis treated with doxycycline in an HIV MSM returning to Italy from France. Travel Med Infect Dis 2022; 50:102469. [PMID: 36180023 PMCID: PMC9534081 DOI: 10.1016/j.tmaid.2022.102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Luca Pipitò
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy
| | - Marcello Trizzino
- Infectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy
| | - Donatella Ferraro
- Microbiology and Virology Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro," University of Palermo, Palermo, Italy.
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Taramasso L, De Vito A, Ricci ED, Orofino G, Squillace N, Menzaghi B, Molteni C, Gulminetti R, De Socio GV, Pellicanò GF, Sarchi E, Celesia BM, Calza L, Rusconi S, Valsecchi L, Martinelli CV, Cascio A, Maggi P, Vichi F, Angioni G, Guadagnino G, Cenderello G, Dentone C, Bandera A, Falasca K, Bonfanti P, Di Biagio A, Madeddu G, Bonfanti P, Di Biagio A, Ricci E, Sarchi E, Chichino G, Bolla C, Bellacosa C, Angarano G, Saracino A, Calza L, Menzaghi B, Farinazzo M, Angioni G, Bruno G, Celesia BM, Falasca K, Mastroianni A, Guadagnino G, Vichi F, Salomoni E, Martinelli C, Di Biagio A, Dentone C, Taramasso L, Bassetti M, Cenderello G, Molteni C, Piconi S, Pellicanò GF, Nunnari G, Valsecchi L, Cordier L, Parisini S, Rizzardini G, Rusconi S, Conti F, Bandera A, Gori A, Motta D, Puoti M, Bonfanti P, Squillace N, Migliorino GM, Maggi P, Martini S, Cascio A, Trizzino M, Gulminetti R, Pagnucco L, De Socio GV, Nofri M, Francisci D, Cibelli D, Parruti G, Madeddu G, Mameli MS, Orofino G, Guastavigna M. Durability of Dolutegravir-Based Regimens: A 5-Year Prospective Observational Study. AIDS Patient Care STDS 2021; 35:342-353. [PMID: 34524918 DOI: 10.1089/apc.2021.0089] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This study evaluates the frequency and causes of dolutegravir (DTG) discontinuation along 5 years of follow-up, in both antiretroviral treatment (ART)-naive and experienced people living with HIV (PLWH). This is a prospective multi-center cohort study enrolling PLWH on DTG from July 2014 until November 2020. DTG-durability was investigated using the Kaplan-Meier survival curve. The Cox proportional-hazards model was used for estimating the hazard ratio (HR) of DTG discontinuation for any cause, and for adverse events (AEs). Nine hundred sixty-three PLWH were included, 25.3% were women and 28.0% were ART-naive. Discontinuations for any causes were 10.1 [95% confidence interval (95% CI) 8.9-11.5] per 100 person-years, similar in most regimens, with the apparent exception of tenofovir alafenamide/emtricitabine+DTG (p < 0.0001). In the multivariable Cox regression model, non-Caucasian ethnicity, age ≥50 years, and lower estimated glomerular filtration rate (eGFR) were associated with a higher probability of DTG interruption. The incidence rate of virological failure was 0.4 (95% CI 0.2-0.7) per 100 person-years, while the estimated discontinuation rate for AEs was 4.0 (3.2-4.9) per 100 person-years. Thirty-four DTG interruptions were due to grade ≥3 events (10 central nervous system, 6 hypersensitivity, 3 renal, 3 myalgia/asthenia, 3 abdominal pain, 2 gastrointestinal, and 7 other events). People with lower body mass index, age ≥50 years, and lower eGFR were at higher risk of AEs, while dual combinations were protective (HR 0.41 compared with abacavir/lamivudine/DTG, 95% CI 0.22-0.77). In this prospective observational study, we found high DTG durability and a low rate of virological failures. Dual therapies seemed protective toward AEs and might be considered, when feasible, a suitable option to minimize drug interactions and improve tolerability.
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Affiliation(s)
- Lucia Taramasso
- Infectious Disease Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Andrea De Vito
- Unit of Infectious and Tropical Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Giancarlo Orofino
- Unit of Infectious Diseases, “Divisione A”, Amedeo di Savoia Hospital, Torino, Italy
| | - Nicola Squillace
- Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Barbara Menzaghi
- Unit of Infectious Diseases, ASST della Valle Olona, Busto Arsizio Hospital, Busto Arsizio, Italy
| | - Chiara Molteni
- Infectious Disease Unit, Ospedale A. Manzoni, Lecco, Italy
| | - Roberto Gulminetti
- Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giuseppe Vittorio De Socio
- Clinic of Infectious Diseases, Department of Medicine 2, Azienda Ospedaliera di Perugia, Santa Maria Hospital, Perugia, Italy
| | - Giovanni Francesco Pellicanò
- Unit of Infectious Diseases, Department of Human Pathology of the Adult and the Developmental Age ‘G. Barresi’, University of Messina, Messina, Italy
| | - Eleonora Sarchi
- Infectious Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | | | - Leonardo Calza
- Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, S. Orsola-Malpighi Hospital, “Alma Mater Studiorum” University of Bologna, Bologna, Italy
| | - Stefano Rusconi
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences ‘Luigi Sacco’, Università degli Studi di Milano, Milan, Italy
| | - Laura Valsecchi
- Infectious Disease Unit (I Divisione), ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Paolo Maggi
- Department of Infectious Disease, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Vichi
- Infectious Diseases Department, SOC 1, USLCENTROFIRENZE, Santa Maria Annunziata Hospital, Florence, Italy
| | | | - Giuliana Guadagnino
- Department of Infectious and Tropical Diseases, St. Annunziata Hospital, Cosenza, Italy
| | | | - Chiara Dentone
- Infectious Disease Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Alessandra Bandera
- Infectious Disease Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda, University of Milan, Ospedale Maggiore Policlinico, Milan, Italy
| | - Katia Falasca
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University ‘G. d'Annunzio’ Chieti-Pescara, Chieti, Italy
| | - Paolo Bonfanti
- Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Antonio Di Biagio
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, San Martino Hospital-IRCCS, Genoa, Italy
| | - Giordano Madeddu
- Unit of Infectious and Tropical Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Mulè G, Mulè G, Tranchida V, Colletti P, Mazzola G, Trizzino M, Colomba C, Cascio A. Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies. Artery Res 2020. [DOI: 10.2991/artres.k.200314.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Colomba C, Saporito L, Di Carlo P, Tolomeo M, Cervo A, Firenze A, Trizzino M, Cascio A. Direct-acting antivirals and visceral leishmaniasis: a case report. BMC Infect Dis 2019; 19:328. [PMID: 30999874 PMCID: PMC6471807 DOI: 10.1186/s12879-019-3947-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 04/03/2019] [Indexed: 11/15/2022] Open
Abstract
Background Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite. Case presentation We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II and III IFNs, their receptors, which accompany HCV clearance achieved during treatment with sofosbuvir and ribavirin might have a negative impact on a risk for reactivation of a previous Leishmania infection. We know indeed that IFN-γ is important to enhance killing mechanisms in macrophages, which are the primary target cells of Leishmania. Conclusion Since VL is endemic in Sicily as well as in other countries of the Mediterranean basin, physicians should be aware of the possible unmasking of cryptic Leishmania infection by DAAs.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy.
| | - Laura Saporito
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
| | - Paola Di Carlo
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
| | - Manlio Tolomeo
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
| | - Adriana Cervo
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
| | - Alberto Firenze
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
| | - Marcello Trizzino
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
| | - Antonio Cascio
- Dipartimento di Scienze per la promozione della Salute e Materno-infantile, Università di Palermo, Palermo, Italy
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Mazzola G, Adamoli L, Calvaruso V, Macaluso FS, Colletti P, Mazzola S, Cervo A, Trizzino M, Di Lorenzo F, Iaria C, Prestileo T, Orlando A, Di Marco V, Cascio A. Suboptimal performance of APRI and FIB-4 in ruling out significant fibrosis and confirming cirrhosis in HIV/HCV co-infected and HCV mono-infected patients. Infection 2018; 47:409-415. [PMID: 30519966 DOI: 10.1007/s15010-018-1258-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 11/27/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE We aimed to assess the diagnostic reliability of two indirect biomarkers, APRI and FIB-4, for the staging of liver fibrosis using transient elastography (TE) as reference standard, among HIV/HCV co-infected and HCV mono-infected patients. METHODS This is an observational, retrospective study on subjects who had access to the RESIST HCV from October 2013 to December 2016, a regional network encompassing 22 hospitals and academic centers throughout Sicily. Sensitivity, specificity and diagnostic accuracy of indirect biomarkers for liver stiffness measurement (LSM) < 9.5 kPa (significant fibrosis) and LSM ≥ 12.5 kPa (cirrhosis) were determined by receiver operator characteristics (ROC) curves. RESULTS 238 HIV/HCV co-infected and 1937 HCV mono-infected patients were included. Performances of FIB-4 and APRI for the detection of significant fibrosis and cirrhosis proved to be unsatisfactory, with very high false negative and false positive rates among both cohorts. No significant differences were found after stratification of HIV/HCV co-infected patients for BMI < or ≥ 25, ALT < or ≥ 40 IU/L, ALT < or ≥ 80 IU/L, and presence/absence of a bright liver echo pattern on ultrasonography. CONCLUSIONS Differently from other studies, we detected the unreliability of APRI and FIB-4 for the assessment of liver fibrosis in both HCV mono-infected and HIV/HCV co-infected patients.
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Affiliation(s)
- Giovanni Mazzola
- Department of Sciences for Health Promotion "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Lucia Adamoli
- Department of Sciences for Health Promotion "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Vincenza Calvaruso
- Di.Bi.M.I.S, Section of Gastroenterology, University of Palermo, Palermo, Italy
| | | | - Pietro Colletti
- Department of Sciences for Health Promotion "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Sergio Mazzola
- Clinical Epidemiology and Cancer Registry Unit, A.O.U.P. "Paolo Giaccone", Palermo, Italy
| | - Adriana Cervo
- Department of Sciences for Health Promotion "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Marcello Trizzino
- Department of Sciences for Health Promotion "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Chiara Iaria
- ARNAS "Civico-Benefratelli" Hospital, Palermo, Italy
| | | | - Ambrogio Orlando
- IBD Unit, "Villa Sofia-Cervello" Hospital, Via Trabucco 180, 90146, Palermo, Italy
| | - Vito Di Marco
- Di.Bi.M.I.S, Section of Gastroenterology, University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Department of Sciences for Health Promotion "G. D'Alessandro", University of Palermo, Palermo, Italy
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14
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Colomba C, Cascio A, Caruso C, Trizzino M, Gioè C, Guadagnino G, Tuttolomondo A, Pinto A, Saracino A, Angarano G, Di Bona D. [Role of combination NK/KIRs in the natural history of viral infections.]. Recenti Prog Med 2018; 108:333-337. [PMID: 28845855 DOI: 10.1701/2731.27839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Immunological mechanisms involved in the genesis of the immune response against viral infections take into account the activation of both innate adaptative response. Innate immune defenses trigger a rapid local response, which is often sufficient to control viral infection, and promotes the subsequent activation of specific immune defenses. Natural killer (NK) cells that constitute a subpopulation of lymphocyte-related cells are a key factor of innate immune response and play a role in defense against viral infections by killing infected cells or by producing cytokines and interacting with adaptative immune system's cells. Killer immunoglobulin-like receptors (KIRs) regulate the activation of NK cells through their interaction with human leukocyte antigens (HLA). KIRs and HLA loci are highly polymorphic and certain HLA-KIRs combinations have been found to protect against viral infections. In this study we review how the KIRs/HLA repertoire may influence the course of hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and Herpes Simplex Virus 1 (HSV-1) infection. Results of our study suggest that a combination of KIRs/HLA gene/alleles is able to predict the outcome of viral infection and allows to plan successful customized therapeutic strategies.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Antonio Cascio
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Calogero Caruso
- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo
| | - Marcello Trizzino
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Claudia Gioè
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | - Giuliana Guadagnino
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo
| | | | - Antonio Pinto
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo
| | | | | | - Danilo Di Bona
- Dipartimento dell'Emergenza e dei Trapianti d'Organo, Università di Bari Aldo Moro
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Fasciana TM, Colomba C, Di Carlo P, Caputo V, Romanin B, Mililli D, Trizzino M, Scarlata F, Serra N, Rea T, Giovanni US. HPV genotypes in precancerous cervical lesions: histological and biomolecular investigations in the Sicilian area, Italy. Gazz Med Ital - Arch Sci Med 2018. [DOI: 10.23736/s0393-3660.18.03816-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Colomba C, Trizzino M, Giammanco A, Bonura C, Di Bona D, Tolomeo M, Cascio A. Israeli Spotted Fever in Sicily. Description of two cases and minireview. Int J Infect Dis 2017; 61:7-12. [PMID: 28408252 DOI: 10.1016/j.ijid.2017.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/28/2017] [Accepted: 04/03/2017] [Indexed: 11/15/2022] Open
Abstract
Mediterranean spotted fever (MSF) is endemic in Italy, where Rickettsia conorii subsp. conorii was thought to be the only pathogenic rickettsia and Rhipicephalus sanguineus the vector and main reservoir. R. conorii subsp. israelensis, which belongs to the R. conorii complex, is the agent of Israeli spotted fever (ISF); apart from Israel, it has also been found in Italy (Sicily and Sardinia) and in different regions of Portugal. We describe here two severe cases of ISF which occurred in otherwise healthy Italian adults. Their characteristics are analyzed and discussed in the light of other 91 cases found through a systematic review of international literature.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la Promozione Della Salute e Materno-Infantile, Università di Palermo, Italy.
| | - Marcello Trizzino
- Dipartimento di Scienze per la Promozione Della Salute e Materno-Infantile, Università di Palermo, Italy.
| | - Anna Giammanco
- Dipartimento di Scienze per la Promozione Della Salute e Materno-Infantile, Università di Palermo, Italy.
| | - Celestino Bonura
- Dipartimento di Scienze per la Promozione Della Salute e Materno-Infantile, Università di Palermo, Italy.
| | - Danilo Di Bona
- Dipartimento dell'Emergenza e dei Trapianto d'Organo, Università di Bari, Italy.
| | - Manlio Tolomeo
- Dipartimento di Scienze per la Promozione Della Salute e Materno-Infantile, Università di Palermo, Italy.
| | - Antonio Cascio
- Dipartimento di Scienze per la Promozione Della Salute e Materno-Infantile, Università di Palermo, Italy.
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Colomba C, Trizzino M, Gioè C, Coelho F, Lopo I, Pinheiro P, Sousa J, Cascio A. Malaria and the heart: Two rare case reports of Plasmodium falciparumassociated pericarditis. J Vector Borne Dis 2017; 54:372-374. [DOI: 10.4103/0972-9062.225845] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Colomba C, Giuffrè M, La Placa S, Cascio A, Trizzino M, De Grazia S, Corsello G. Congenital cytomegalovirus related intestinal malrotation: a case report. Ital J Pediatr 2016; 42:105. [PMID: 27923378 PMCID: PMC5141648 DOI: 10.1186/s13052-016-0318-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/30/2016] [Indexed: 11/10/2022] Open
Abstract
Background Cytomegalovirus is the most common cause of congenital infection in the developed countries. Gastrointestinal involvement has been extensively described in both adult and paediatric immunocompromised patients but it is infrequent in congenital or perinatal CMV infection. Case presentation We report on a case of coexistent congenital Cytomegalovirus infection with intestinal malrotation and positive intestinal Cytomegalovirus biopsy. At birth the neonate showed clinical and radiological evidence of intestinal obstruction. Meconium passed only after evacuative nursing procedures; stooling pattern was irregular; gastric residuals were bile-stained. Laparatomy revealed a complete intestinal malrotation and contextually gastrointestinal biopsy samples of the appendix confirmed the diagnosis of CMV gastrointestinal disease. Intravenous ganciclovir was initiated for 2 weeks, followed by oral valgancyclovir for 6 month. Conclusion CMV-induced proinflammatory process may be responsible of the interruption of the normal development of the gut or could in turn lead to a disruption in the normal development of the gut potentiating the mechanism causing malrotation. We suggest the hypothesis that an inflammatory process induced by CMV congenital infection may be responsible, in the early gestation, of the intestinal end-organ disease, as the intestinal malrotation. CMV infection should always be excluded in full-term infants presenting with colonic stricture or malrotation.
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Affiliation(s)
- Claudia Colomba
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy.
| | - Mario Giuffrè
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy
| | - Simona La Placa
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy
| | - Antonio Cascio
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy
| | - Marcello Trizzino
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy
| | - Simona De Grazia
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Via del Vespro 129, 90127, Palermo, Italy
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Colomba C, Siracusa L, Trizzino M, Gioè C, Giammanco A, Cascio A. Myocarditis in Mediterranean spotted fever: a case report and a review of the literature. JMM Case Rep 2016; 3:e005039. [PMID: 28348768 PMCID: PMC5330236 DOI: 10.1099/jmmcr.0.005039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/19/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii. Most cases follow a benign course, with a case fatality rate of 3-7 % among hospitalized patients. Complications are described mainly in adult patients and include hepatic, renal, neurological and cardiac impairment. Among cardiac complications, pericarditis, myocarditis and heart rhythm disorders are uncommon complications in MSF and only a few cases have been reported in the literature. CASE PRESENTATION We describe a new case of acute myocarditis complicating MSF in an immunocompetent adult patient without risk factors for severe MSF. CONCLUSION Myocarditis is an uncommon but severe complication of MSF. Clinicians should be aware of a possible cardiac involvement in patients with MSF. Close monitoring and an aggressive approach are essential to reduce mortality rates of MSF.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Lucia Siracusa
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Marcello Trizzino
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Claudia Gioè
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Anna Giammanco
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
| | - Antonio Cascio
- Dipartimento di Scienze per la promozione della salute e materno-infantile, Università di Palermo, Italy
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Colomba C, Scarlata F, Di Carlo P, Giammanco A, Fasciana T, Trizzino M, Cascio A. Fourth case of louse-borne relapsing fever in Young Migrant, Sicily, Italy, December 2015. Mini Review Article. Public Health 2016; 139:22-26. [PMID: 27340042 DOI: 10.1016/j.puhe.2016.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/12/2016] [Accepted: 05/23/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Currently louse-borne relapsing fever (LBRF) is primarily found in limited endemic foci in Ethiopia, Somalia and Sudan; no case of imported LBRF has been reported in Europe in the 9 years prior to 2015. The aim of our paper is to describe a new case of imported LBRF detected in Sicily, Italy, and to review all cases reported in migrants arrived in Europe in the last 10 years. STUDY DESIGN Mini review of all published cases of louse-borne relapsing fever in Europe in the last 10 years. METHODS A computerized search without language restriction was conducted using PubMed combining the terms '(louse-borne relapsing fever or LBRF or recurrentis) and (refugee or Europe or migrant)' without limits. Furthermore, the 'Ahead-of-Print Articles' of the top 10 journals (ranked by Impact factor - Web of Science) of Infectious diseases and of Epidemiology were checked. RESULTS Our search identified 26 cases of LBRF between July and October 2015 in migrants recently arrived in Europe: 8 had been described in Italy; 1 in Switzerland; 2 in the Netherlands; 15 in Germany. We describe data regarding the clinical characteristics, diagnostic methods, therapy and outcome of these patients and of the new case. CONCLUSIONS LBRF by Borrelia recurrentis should be considered among the clinical hypotheses in migrants presenting with fever, headache, chills, sweating, arthralgia, myalgia, dizziness, nausea and vomiting.
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Affiliation(s)
- C Colomba
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy.
| | - F Scarlata
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - P Di Carlo
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - A Giammanco
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - T Fasciana
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - M Trizzino
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
| | - A Cascio
- Department of Sciences for Health Promotion and Mother-Child Care "G.D'Alessandro", Palermo, Italy
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Colomba C, Di Carlo P, Guadagnino G, Siracusa L, Trizzino M, Gioè C, Cascio A. A Case of Epididymo-orchitis after intravesical bacille Calmette-Guérin therapy for superficial bladder carcinoma in a patient with latent tuberculosis infection. Infect Agent Cancer 2016; 11:25. [PMID: 27257433 PMCID: PMC4890504 DOI: 10.1186/s13027-016-0072-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/22/2016] [Indexed: 11/10/2022] Open
Abstract
Background Intravesical instillation of bacille Calmette-Guérin (BCG) has been established as efficient therapy for superficial bladder carcinoma. Overall, intravesical BCG is well tolerated and results in complications of less than 5 %. However, adverse effects such as granulomatous prostatitis, pneumonitis, hepatitis, sepsis, and hypersensitivity reactions may occur. The reported rate for tuberculous orchitis after BCG intravesical therapy is 0.4 %. Findings We report a case of monolateral tuberculous orchitis occurring one month after the second course of intravescical instillation of bacille Calmette-Guérin in a patient with proven superficial bladder carcinoma and latent tuberculosis infection. Conclusions In our opinion intravesical instillation of BCG should be considered on an individual patient basis, with full patient disclosure of the potentially significant risks. A screening with an intradermal Mantoux before starting the first cycle of BCG instillation should be recommended and isoniazid would be indicated as the treatment for latent tuberculosis infection.
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Affiliation(s)
- C Colomba
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - P Di Carlo
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - G Guadagnino
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - L Siracusa
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - M Trizzino
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - C Gioè
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
| | - A Cascio
- Dipartimento di scienze per la promozione della salute e materno-infantile, Università di Palermo, via del vespro 129, Palermo, 90127 Italy
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Colomba C, Trizzino M, Gioè C, Di Bona D, Mularoni A, Cascio A. HIV infection with viro-immunological dissociation in a patient with polycystic kidney disease: Candidate for transplantation? IDCases 2016; 6:74-76. [PMID: 27752472 PMCID: PMC5066192 DOI: 10.1016/j.idcr.2016.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022] Open
Abstract
Autosomal dominant polycystic kidney disease is the most common among inherited cystic kidney diseases. Patients with HIV infection are at risk of developing acute kidney injury and chronic kidney disease. We provide the first report of HIV infection in a patient with polycystic kidney disease. Lymphopenia should not contraindicate kidney transplantation in patients with HIV infection.
Here we describe the case of a HIV-infected patient with polycystic kidney disease and end stage renal diseases not transplantable due to the persistence of a CD4 count <200 notwithstanding a good virological response to highly active antiretroviral therapy and suggest that such limitation to kidney transplantation in such as cases might be bypassed.
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Colomba C, Trizzino M, Imburgia C, Madonia S, Siracusa L, Giammanco GM. Candida glabrata meningitis and endocarditis: a late severe complication of candidemia. Int J Infect Dis 2014; 29:174-5. [PMID: 25449253 DOI: 10.1016/j.ijid.2014.04.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/12/2014] [Accepted: 04/29/2014] [Indexed: 11/26/2022] Open
Abstract
We report an unusual case of Candida glabrata meningitis and endocarditis in a young Caucasian woman with a prosthetic aortic valve and suffering from a dissecting thoraco-abdominal aortic aneurysm. C. glabrata was isolated from culture of the cerebrospinal fluid. Candida infection of the central nervous system is an uncommon manifestation of disseminated infection due to Candida species. Our case report also highlights the intrinsic resistance of C. glabrata to azoles.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo, Palermo, Italy.
| | - Marcello Trizzino
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo, Palermo, Italy
| | - Claudia Imburgia
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo, Palermo, Italy
| | - Simona Madonia
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo, Palermo, Italy
| | - Lucia Siracusa
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo, Palermo, Italy
| | - Giovanni Maurizio Giammanco
- Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università di Palermo, Palermo, Italy
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Colomba C, Imburgia C, Trizzino M, Titone L. First case of Mediterranean spotted fever-associated rhabdomyolysis leading to fatal acute renal failure and encephalitis. Int J Infect Dis 2014; 26:12-3. [DOI: 10.1016/j.ijid.2014.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 12/26/2013] [Accepted: 01/24/2014] [Indexed: 11/17/2022] Open
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Colomba C, Rubino R, Siracusa L, Lalicata F, Trizzino M, Titone L, Tolomeo M. Disseminated tuberculosis in a patient treated with a JAK2 selective inhibitor: a case report. BMC Res Notes 2012; 5:552. [PMID: 23039051 PMCID: PMC3515333 DOI: 10.1186/1756-0500-5-552] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 09/22/2012] [Indexed: 11/25/2022] Open
Abstract
Background Primary myelofibrosis is a myeloproliferative disorder characterized by bone marrow fibrosis, abnormal cytokine expression, splenomegaly and anemia. The activation of JAK2 and the increased levels of circulating proinflammatory cytokines seem to play an important role in the pathogenesis of myelofibrosis. Novel therapeutic agents targeting JAKs have been developed for the treatment of myeloproliferative disorders. Ruxolitinib (INCB018424) is the most recent among them. Case presentation To our knowledge, there is no evidence from clinical trials of an increased risk of tuberculosis during treatment with JAK inhibitors. Here we describe the first case of tuberculosis in a patient treated with Ruxolitinib, a male with a 12-year history of chronic idiopathic myelofibrosis admitted to our Institute because of fever, night sweats, weight loss and an enlarging mass in the left inguinal area for two months. Conclusion Treatment with Ruxolitinib may have triggered the reactivation of latent tuberculosis because of an inhibition of Th1 response. Our case highlights the importance of an accurate screening for latent tuberculosis before starting an anti-JAK 2 treatment.
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Affiliation(s)
- Claudia Colomba
- Dipartimento di Scienze per la promozione della salute - Sezione di Malattie infettive, Università di Palermo, Via del Vespro, 129-90127 Palermo, Italy.
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Cillino S, Di Pace F, Trizzino M, Li Vecchi V, Di Carlo P. Chancre of the eyelid as manifestation of primary syphilis, and precocious chorioretinitis and uveitis in an HIV-infected patient: a case report. BMC Infect Dis 2012; 12:226. [PMID: 23006858 PMCID: PMC3517902 DOI: 10.1186/1471-2334-12-226] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 09/21/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ocular syphilis is often difficult to diagnose because of the wide variation in clinical features.HIV co-infection may further complicate the picture. CASE PRESENTATION Herein the authors report an unusual primary syphilitic ocular lesion in a 45-year-old Italian HIV-infected bisexual man who presented with a unilateral eyelid lesion. Associated precocious signs and symptoms in the posterior segment of both eyes, bilateral chorioretinitis and uveitis, are described. Intravenous penicillin and steroid treatment produced a rapid improvement in clinical status and complete resolution. CONCLUSIONS Careful questioning about sexual behavior is crucial for unmasking unusual features of ocular syphilis in HIV-infected subjects.
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Affiliation(s)
- Salvatore Cillino
- Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Via Liborio Giuffrè 13, 90127, Palermo, Italy.
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Scarlata F, Imburgia C, Trizzino M, Titone L. [Leprosy-like cutaneous presentation of Histoplasma capsulatum infection in an African HIV+ patient]. Infez Med 2012; 20:211-213. [PMID: 22992563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Histoplasma capsulatum is an opportunistic dimorphic fungus responsible for most often self-limiting or flu-like infections but potentially lethal in immunocompromised hosts. Histoplasmosis is rare in Europe. We reported a case of disseminated histoplasmosis in an African HIV patient with a leprosy-like primary cutaneous presentation and involvement of lungs, brain, limphnodes and eye. The therapy with liposomial B amphotericin and itraconazole led to a prompt resolution of the symptoms.
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Affiliation(s)
- Francesco Scarlata
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Universita di Palermo, Palermo, Italy
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Colomba C, Rubino R, Siracusa L, Lalicata F, Trizzino M, Titone L, Tolomeo M. Disseminated tuberculosis in a patient treated with a JAK2 selective inhibitor: a case report. BMC Res Notes 2012. [DOI: 10.1186/1756-0500-5-2101791285670497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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di Carlo P, Romano A, Casuccio A, Cillino S, Schimmenti MG, Mancuso G, la Chiusa S, Novara V, Ingrassia D, li Vecchi V, Trizzino M, Titone L. Investigation and management of Toxoplasma gondii infection in pregnancy and infancy: a prospective study. Acta Pharmacol Sin 2011; 32:1063-70. [PMID: 21743484 DOI: 10.1038/aps.2011.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIM Toxoplasma gondii infection during pregnancy poses a serious risk to the fetus, therefore timely and accurate diagnosis is essential. The aim of this study was to estimate the frequency of congenital infection via evaluating mother's immunological status and the possibility to improving the diagnostic and therapeutic approaches. METHODS Eighty five mothers with Toxoplasma seroconversion and their offspring were enrolled (among them, 2 spontaneous abortions were documented in the first trimester). Prenatal PCR diagnosis was carried out on 50 patients (60%), with 7 positive cases (14%). Morphological ultrasound scanning revealed anomalies in one fetus. Long-term follow-up included general physical examinations, serological status tested using Western blot, neuro-radiological, ophthalmologic and neurologic examinations, psychological and developmental tests, visual evoked potential tests and audiology tests, as well as anti-Toxoplasma treatment regimes. RESULTS Fourteen (17%) of the infants were infected at one-year serological follow-up. Chi-square for linear trend of vertical transmission from the first to the third trimester was significant (P=0.009). Western blot analysis showed IgM and IgA in half of the infected infants. In 69 uninfected infants, anti-Toxoplasma IgG immunoblot analysis excluded infection within the 3 months in 18 infants (26%) and in the others within 6 months of life. The most relevant instrumental findings are described. CONCLUSION Western blot analysis may help to evaluate infection within the 6 months of life. The accuracy of ultrasound imaging to determine the brain damage in the fetus and newborns is doubtful, and should be combined with MR imaging. Multistep approaches can improve the timing of postnatal follow-up.
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Di Carlo P, Trizzino M, Titone L, Capra G, Colletti P, Mazzola G, Pistoia D, Sarno C. Unusual MRI findings in an immunocompetent patient with EBV encephalitis: a case report. BMC Med Imaging 2011; 11:6. [PMID: 21435249 PMCID: PMC3073885 DOI: 10.1186/1471-2342-11-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 03/24/2011] [Indexed: 11/27/2022] Open
Abstract
Blackground It is well-known that Epstein-Barr virus (EBV) can affect the central nervous system (CNS). Case presentation Herein the authors report unusual timely Magnetic Resonance Imaging (MRI) brain scan findings in an immunocompetent patient with EBV encephalitis. Diffusion weighted MRI sequence performed during the acute phase of the disease was normal, whereas the Fast Relaxation Fast Spin Echo T2 image showed diffuse signal intensity changes in white matter. The enhancement pattern suggested an inflammatory response restricted to the brain microcirculation. Acyclovir and corticosteroid therapy was administered. After three weeks, all signal intensities returned to normal and the patient showed clinical recovery. Conclusion This report demonstrates that EBV in an immunocompetent adult can present with diffuse, reversible brain white matter involvement in the acute phase of mononucleosis. Moreover, our case suggests that a negative DWI sequence is associated with a favorable improvement in severe EBV CNS infection. More extensive studies are needed to assess what other instrumental data can help to distinguish viral lesions from other causes in the acute phase of disease.
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Affiliation(s)
- Paola Di Carlo
- Dipartimento di Scienze per la Promozione della Salute, Università di Palermo, Italy.
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Scarlata F, Colletti P, Bonura S, Trizzino M, Giordano S, Titone L. [The return of anthrax. From bioterrorism to the zoonotic cluster of Sciacca district]. Infez Med 2010; 18:86-90. [PMID: 20610930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Anthrax is a disease caused by Bacillus anthracis which affects herbivorous animals. Humans acquire the disease incidentally by exposure to infected animals, animal products or spores on soil. The infection is still endemic in many regions in developing countries. In Italy animal clusters are very rare and human cases are exceptional. Bacillus anthrax is also a potential source for acts of bioterrorism. In the natural human infection, cutaneous anthrax is the most widespread, while the other two, pulmonary and gastrointestinal anthrax, are very rare forms. We describe the first case of human anthrax occurring in western Sicily in the last twenty years. The cutaneous lesion healed without significant scarring after antibiotic treatment with tigecycline, rifampin and ciprofloxacin. Following our diagnosis, a cluster of bovine anthrax was detected in the district of Sciacca, causing the death of 13 animals. A larger outbreak was avoided by the vaccination of over 5000 herbivores.
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Affiliation(s)
- Francesco Scarlata
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Palermo, Italy
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Audisio P, Trizzino M, De Biase A, Rossetti G, Mancini E, Antonini G. Molecular and morphological evidence of a new sibling species ofCalobius(Coleoptera: Hydraenidae) of theC. quadricolliscomplex from peninsular Italy. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/11250000902845738] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Audisio P, Brustel H, Carpaneto GM, Coletti G, Mancini E, Trizzino M, Antonini G, De Biase A. Data on molecular taxonomy and genetic diversification of the European Hermit beetles, a species complex of endangered insects (Coleoptera: Scarabaeidae, Cetoniinae,Osmoderma). J ZOOL SYST EVOL RES 2009. [DOI: 10.1111/j.1439-0469.2008.00475.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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