[Cholera epidemic in Brescia in 1836].

Cholera first made its appearance in Italy in 1836. According to reports of the time the consequences were catastrophic: both the number of the people falling ill and the incidence of mortality were high. On the basis of extensive documentation from various archives, the disease appears to have been known in its clinical aspect but its aetiology remained obscure.

[The Plague of 1478 in Brescia from Giacomo Melga's diary].

A severe epidemic of bubonic plague devastated Brescia in 1478. We became aware of the tragic events via a manuscript preserved in the town's Queriniana Library after it had been rediscovered and brought to light by the well-known local historian, Paolo Guerrini, who also edited the complete transcription. An important symptom of the disease, as reported from the beginning of a notary's dramatic description, was a splitting headache, described by people as mal del zuchot or del mazzucco.

Retinopathy in chronic hepatitis C patients during interferon treatment: a case report.

Ocular involvement, mainly as optic neuropathy or retinopathy, in the course of interferon therapy is clinically rare, while the subclinical retinal toxicity is quite frequent. We present a case of retinal toxicity during treatment with PEG-INF alpha 2b and ribavirin for HCV hepatitis. We suggest that all patients receive an ophthalmological examination at base-line and repeated ophthalmological examination only if clinically advisable.

Which antibiotic prophylaxis to use for urologic procedures in patients at risk for infective endocarditis: a report on two cases.

In urologic surgery, antibiotic prophylaxis is generally recommended for transrectal prostate biopsies and transurethral prostate resection. While a fluoroquinolone (such as ciprofloxacin or levofloxacin) may be appropriate in most instances, patients at risk for infectious endocarditis (IE) may require a different regimen, effective also against Enterococcus species. We describe and comment on the cases of two patients who, following urologic procedures and antibiotic prophylaxis, developed Enterococcus faecalis endocarditis.

Conservative management of deep neck abscesses in adults: the importance of CECT findings.

Objectives: To review cases of DNAs with special emphasis on contrast-enhanced computed tomography (CECT) findings and their implications for treatment planning.

Study Design And Settings: Retrospective evaluation of adult patient records with diagnosis of DNAs on CECT at Treviso Regional Hospital.

Results: Eighty patients were identified.

Deep neck infections: a constant challenge.

Background: Although the advent of antibiotics and improved dental care decreased the incidence and mortality, deep neck infections (DNIs) are not uncommon and present a challenging problem due to the complex anatomy and potentially lethal complications that may arise.

Objectives: This study reviews our experience with DNIs and tries to identify the predisposing factors of life-threatening complications.

Methods: A retrospective review was conducted of patients who were diagnosed as having DNIs in the Department of Otolaryngology and in the Department of Infectious Diseases at Treviso Regional Hospital from 1995 to 2003.

Brain abscess: clinical aspects of 100 patients.

Objective: To verify if, in the last two decades, there have been any changes in epidemiological, clinical, diagnostic, therapeutic and prognostic aspects of patients with brain abscess.

Method: We studied retrospectively 100 patients discharged over a 17-year period from Ca' Foncello Regional Hospital, Treviso, Italy with a diagnosis of brain abscess.

Results: Post-surgical abscesses were more frequent than those related to contiguous infections and the spectrum of etiologic agents was very heterogeneous.

[Brain abscesses after extracranial infections of the head and neck area].

The authors report on 20 immunocompetent patients with brain abscess after 12 cases of middle ear, seven tooth and a single frontal sinus infection. The clinical aspects, hematochemical and microbiological data, the role of imaging diagnostics (CT, MR) and the type of treatment are analysed. Neurosurgery was performed on 17 patients (85%), eight of whom subsequently underwent evacuation of the primary source of infection (four mastoidectomies, two timpanoplasties, two tooth extractions).

Levofloxacin disposition in cerebrospinal fluid in patients with external ventriculostomy.

In vitro levofloxacin exhibits both potent or intermediate activity against most of the pathogens frequently responsible for acute bacterial meningitis and synergistic activity with some beta-lactams. Since levofloxacin was shown to penetrate the cerebrospinal fluid (CSF) during meningeal inflammation both in animals and in humans, the disposition of levofloxacin in CSF was studied in 10 inpatients with external ventriculostomy because of communicating hydrocephalus related to subarachnoid occlusion due to cerebral accidents who were treated with 500 mg of levofloxacin intravenously twice a day because of extracerebral infections. Plasma and CSF concentration-time profiles and pharmacokinetics were assessed at steady state.

Hepatitis-like syndrome induced by nimesulide?

The authors describe a case report of a 17 years old woman, complaining of weakness and malaise, associated with a significant increase of serum transaminases, that occurred twice in a month soon after the administration of Nimesulide per o.s.

Laryngeal tuberculosis: an often forgotten diagnosis.

Objective: Clinical description of laryngeal tuberculosis.

Methods: Clinical case review.

Results: The authors report three cases of laryngeal tuberculosis with lung involvement in HIV-negative patients; symptoms were mostly laryngeal.

[Disulfiram-induced hepatitis].

Overt disulfiram-induced hepatitis is rare; it has a high mortality rate, especially when the etiology is non suspected and when the treatment is not promptly discontinued. The Authors describe a case of disulfiram-induced acute hepatitis and emphasize close clinical and biochemical monitoring.

Primary dorsal localization of invertebrate hydatidosis.

We describe patient with Echinococcus granulosus disease primary localized on the back. This case is uncommon because of the lack of risk exposure history and the sole muscular localization. The patient received several surgical operations on the back, without eradication of the infestation.

[Abdominal actinomycosis].

The authors present a case of abdominal actinomycosis in a 65-year old woman undergoing explorative laparatomy for suspected colic neoplasm. Only histological examination allowed a correct diagnosis to be made, showing once again the considerable difficulty of differential diagnosis.

Combination of quinupristin/dalfopristin and glycopeptide in severe methicillin-resistant staphylococcal infections failing previous glycopeptide regimens.

Background: We report our experience with quinupristin/ dalfopristin in combination with a glycopeptide in the treatment of severe staphylococcal infections failing previous glycopeptide regimens.

Patients And Methods: Five patients, affected by persistent bacteremia (n = 2), post-cardiothoracic surgery infection (n = 2) and post-traumatic bone infection (n = 1) due to methicillin-resistant Staphylococcus aureus (MRSA, n = 4) methicillin-resistant coagulase-negative Staphylococcus (MRCNS, n = 1) and unsuccessfully treated with antibiotics including a glycopeptide, were treated with a quinupristin/ dalfopristin and glycopeptide combination.

Results: Three patients were clinically cured; one patient with MRSA thoracic aorta prosthetic infection relapsed after 3 months; one patient was lost to follow-up.

Cerebrospinal fluid penetration of levofloxacin in patients with spontaneous acute bacterial meningitis.

We have assessed levofloxacin penetration in cerebrospinal fluid (CSF) and the liquor-to-plasma ratio (C(L)/C(P)) at 2 hours after dosing in 5 patients with spontaneous acute bacterial meningitis. CSF levofloxacin concentration at 2 hours after dosing was 1.99+/-0.

Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient.

Cytomegalovirus (CMV)-associated transverse myelitis is rare in immunocompetent patients. The case of a 54-year-old man is reported here who developed acute transverse myelitis with cerebrospinal fluid (CSF) alterations, suggesting a central nervous system infection. CMV-IgM positivity in serum and CMV isolated from blood, positive CMV PCR and positivity for pp65 antigen in blood, without viral antigens in the CSF and a positive response to therapy with ganciclovir (followed by progressive improvement) supported the diagnosis.