Spondylodiscitis is an infection of the intervertebral disc, the adjacent vertebral body, and/or contiguous structures due to the introduction of infectious agent, usually by the hematogenous route. Imaging is crucial in assessing bacterial and tubercular spondylodiscitis, as well as their associated complications. Magnetic resonance imaging in particular can clearly depict osteo-structural changes in the vertebral body and the associated disc, as well as any soft-tissue complications, such as paravertebral abscess and/or epidural abscess, improving disease characterization and helping to recognize the agent involved. Nevertheless, other non-infectious diseases may mimic imaging appearances of spondylodiscitis and one should be aware of these conditions when interpreting MR images, which include Modic type I degenerative changes, ankylosing spondylitis, acute Schmorl’s node, porotic fractures, and spinal neuropathy arthropathy. This pictorial review aims at describing imaging findings of bacterial and non-bacterial spondylodiscitis, complications, and those pathologies that mimic these infections.

The impact of the coronavirus disease (COVID-19), caused by the novel coronavirus SARS-CoV-2, continues to be widespread, with more than 100 million cases diagnosed in more than 220 countries since the virus was first identified in January 2020. Although patients with mild to moderate forms of COVID-19 could be efficiently managed at home, thus reducing the pressure on the healthcare system and minimizing socio-psychological impact on patients, no trial has been proposed, conducted, or even published on COVID-19 home therapy to date. These expert opinions provide indications on the therapeutical at home management of COVID-19 patients, based on the evidence from the literature and on current guidelines.

De Quervain’s thyroiditis, sometimes referred to as subacute thyroiditis (SAT), is the most common granulomatous disease of the thyroid, typically found after a viral infection in middle-aged women. The mRNA encoding for the angiotensin-converting enzyme-2 (ACE-2) receptor is expressed in follicular thyroid cells, making them a potential target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Besides infection, SARS-CoV-2 vaccines have also been implicated in SAT pathogenesis. We present a case of a woman developing SAT following vaccination with Comirnaty by Pfizer Inc. (New-York, USA). We performed a systematic review of similar cases available in the literature to provide a better understanding of the topic. We searched the databases PubMed and Embase and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Patient records were then sorted according to the type of administered vaccine and a statistical analysis of the extracted data was performed. No statistically significant difference between mRNA vaccines and other vaccines in inducing SAT was found, nor was any found in terms of patient demographics, symptoms at presentation, initial, or follow-up blood tests. In our case report, we described the possible association between SARS-CoV-2 mRNA-based vaccine Comirnaty and SAT.

Background. Hafnia alvei is considered an uncommon pathogen in immunocompetent individuals. It has been isolated in several cases of nosocomial pneumonia, but it has rarely been associated with community-acquired pneumonia (CAP) in immunocompetent adults. In 2010 a genotypically distinct species of Hafnia was identified, for which the name Hafnia paralvei was proposed. Since then, very few cases of human infection by H. paralvei have been reported. We describe here a case of CAP sustained by H. paralvei in a man without major systemic comorbidities and the genomic characterization of antibiotic resistance, together with a review of the literature on this topic. Case presentation. A 54-year-old man was admitted to the Emergency Room (ER) with a 3-day history of fever, fatigue, nausea. In the ER a thoracic CT scan revealed an extensive area of consolidation in the left lower lobe. He was empirically treated with piperacillin/tazobactam + azithromycin. After an initial improvement, clinical conditions worsened and empirical therapy was changed to meropenem + linezolid. An aerosol-induced sputum for bacterial culture yielded Hafnia alvei 10⁷ colony-forming-units/mL; the germ was resistant to piperacillin/tazobactam and was sensitive to ceftriaxone, cefepime, and meropenem. Therefore, linezolid was withdrawn and meropenem continued obtaining resolution of the pneumonia. During the revision process, in silico analysis of sequences using three independent genome-based methods was performed: all three approaches, each relying on a different taxonomic metric, consistently assigned the isolate to H. paralvei. Moreover, the study of resistance-associated genes showed that the isolate harbored bla_ACC-1a and bla_mcr-9.1. Conclusions. We have described a case of CAP due to H. paralvei in an immunocompetent man. Limitations in antibiotic choices and duration of treatment have been discussed, and genomic characterization of antibiotic resistance has been studied.

The Gram-positive, anaerobic bacterium Clostridioides difficile (CD) represents the most common cause of nosocomial diarrhea worldwide and is responsible for increased morbidity and mortality, and prolonged hospital stays