Tuberculous meningitis is a highly morbid, often fatal disease. We describe a case of an Italian child. we diagnosed early a Tuberculous meningitis complicated by the occurrence of hydrocephalus, stroke, and paradoxical reaction with brain pseudo-abscesses. The child started readily a specific therapy associated with steroids and thalidomide was introduced few month later. the patient had a favorable outcome without neurologic sequelae. Despite the prompt specific anti-tubercular and adjuvant corticosteroid therapies, only the addition of thalidomide to the treatment allow to a favorable clinical outcome.

Pediatric tuberculous meningitis is a highly morbid, often fatal disease. Its prompt diagnosis and treatment saves lives, in fact delays in the initiation of therapy have been associated with high mortality rates. This is a case of an Italian child who was diagnosed with tuberculous meningitis after a history of a month of headache, fatigue and weight loss. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis with predominance and decreased glucose concentration. Microscopy and conventional diagnostic tests to identify Mycobacterium tuberculosis were negative, while a non classical method based on intracellular cytokine flow cytometry response of CD4 cells in cerebral spinal fluid helped us to address the diagnosis, that was subsequently confirmed by a nested polymerase chain reaction amplifying a 123 base pair fragment of the M. tuberculosis DNA. We diagnosed tuberculous meningitis at an early stage through an innovative immunological approach, supported by a nested polymerase chain reaction for detection of M. tuberculosis DNA. An early diagnosis is required in order to promptly initiate a therapy and to increase the patient’s survival.

Gender medicine is now an approach that can no longer be neglected and must be considered in scientific research. We investigated the systemic and mucosal immune response in a population of women living with HIV (WLWH) who were receiving successful ART and the sexual and psychological repercussions of HIV infection on the women’s health. As control group, healthy women (HW) matched for age and sex distribution, without any therapy, were included. In summary, our study highlighted the persistence of immune-inflammatory activation in our population, despite virological suppression and a normal CD4 cell count. We found a hyperactivation of the systemic monocyte and an increase in inflammatory cytokine concentrations at the systemic level. The analysis carried out showed a significantly higher risk of HPV coinfection in WLWH compared to HW. Furthermore, our data revealed that WLWH have a profile compatible with sexual dysfunction and generalized anxiety disorders. Our study underlines that patients living with HIV should be evaluated by multidisciplinary teams. These findings also support the idea that more and different immunological markers, in addition to those already used in clinical practice, are needed. Further studies should be carried out to clarify which of these could represent future therapy targets.

Introduction: Skeletal tuberculosis (TB) accounts for about 10 to 35% of extrapulmonary cases and the knee is the most frequent site after the spine and hip. The diagnosis is difficult and largely clinical. Case presentation: This is a case of a young Pakistani man with a history of joint pain for about 4 years, who was diagnosed with chronic arthritis of the right knee. Microscopy of synovial fluid and conventional diagnostic tests to identify Mycobacterium tuberculosis were negative, while a non-classical method based on intracellular cytokine flow cytometry response of CD4 T-cells in synovial fluid helped us to address the diagnosis, which was subsequently confirmed by Polymerase Chain Reaction (PCR). Conclusions: Thanks to an innovative immunological approach, supported by PCR for detection of M. tuberculosis DNA, we were able to diagnose tuberculous arthritis of the knee, which allowed prompt initiation of treatment to reduce morbidity and mortality.

Antimicrobial resistance represents a major global health challenge, and hospital-based antimicrobial stewardship programs (ASPs) are essential for promoting appropriate antibiotic use. This study aimed to introduce and implement an ASP in a university hospital and to assess its impact on antibiotic prescribing patterns and patient outcomes. We conducted a single-center study including infectious disease (ID) consultations performed before ASP introduction (2023), during implementation (2024), and after full implementation (December 2024–February 2025). Primary outcomes were carbapenem prescriptions and antimicrobial stewardship interventions, while secondary outcomes included in-hospital mortality, 30-day in-hospital mortality, and length of hospital stay (LOS). A total of 1673 ID consultations involving 975 patients in pre- and post-interventional phases were analyzed. Carbapenem prescriptions progressively and significantly declined over the study phases (from 32.1% to 18.6%; adjusted OR 0.57 [95% CI 0.35–0.92] in Phase II and 0.39 [95% CI 0.22–0.70] in Phase III compared to Phase I). Antimicrobial stewardship interventions increased significantly over time (reaching 54.0% in Phase III; adjusted OR 1.94, 95% CI 1.40–2.69). No significant differences in 30-day in-hospital mortality or LOS were detected across the study phases. In conclusion, a structured ASP was associated with improved antibiotic prescribing practices, supporting its role as a key strategy for optimizing antimicrobial use in hospital settings.