In children, the incidence of Legionnaires’ disease (LD) is unknown, hospital-acquired LD is associated with clinical risk factors and environmental risk, and children with cell-mediated immune deficiency are at high risk of infection. Both newborns were born in the same delivery room; stayed in the same hospital room where they were cared for, bathed, and breastfed; were male; were born on time, with normal birth weight, and with high Apgar score at birth; and survived this severe infection (L. pneumophila, serogroup 2-15) but with different clinical courses. In neonate 1, bleeding in the brain, thrombosis of deep pelvic veins, and necrosis of the lungs, which left behind cystic and cavernous changes in the lungs, were found, while neonate 2 suffered from pneumonia alone. The only difference in risk factors for LD between these two newborns is the number of days of illness until the start of azithromycin treatment (sixth versus the third day of illness). We suggest that a change in the guidelines for diagnosing and treating community-acquired pneumonia and hospital-acquired pneumonia in newborns is needed in terms of mandatory routine testing for Legionella pneumophila. Early initiation of macrolide therapy is crucial for the outcome of LD in the newborn.

When hypostatic pneumonia is present at the same time as COVID-19 pneumonia, the clinical course is almost always prolonged (prolonged-COVID-19) due to persistent inflammation, long-term anti-inflammatory syndrome, followed by immune exhaustion, i.e., by immunosuppression and catabolic syndrome. In the immunosuppression phase, viral reactivation can be accompanied by a secondary infection, which, in this case, is pulmonary tuberculosis. Pulmonary tuberculosis in post-COVID-19 patients and in patients with spastic quadriplegic cerebral palsy does not have a typical clinical course nor laboratory, radiological, immunological, microbiological, or fiberbronchoscopic pathohistological confirmation. Due to this, the treatment of pulmonary tuberculosis was not carried out on time, postponed after the unsuccessful treatment of sepsis, post-COVID-19, and other accompanying viral (adenovirus, RSV) and bacterial (streptococcus viridans) infections. The treatment of pulmonary tuberculosis was possible only “ex juvantibus” (trial) post-COVID-19. It becomes imperative to search for a new, more precise and reliable diagnostic test for the detection of tuberculosis bacillus.

Background and Objectives: Although vitamin D insufficiency or deficiency is prevalent in children with allergic diseases, recommendations for supplementation dosing regimens are imprecise and variable in the literature, because clinical trials aiming to determine optimal doses were scarce in the past. This study aimed to investigate supplementation of vitamin D3 that may achieve therapeutically effective but not toxic serum levels in a subpopulation of children with allergic diseases and concomitant hypovitaminosis D. Materials and Methods: The retrospective, observational study with a cross-sectional design included 94 children suffering from allergic diseases and having vitamin D deficiency/insufficiency who were prescribed high-dose vitamin D3 supplementation by a pediatrician for at least 6 weeks and not more than 9 weeks. Serum levels of the major metabolite of vitamin D (25-(OH)D) were determined in all children twice: before and two weeks after the end of vitamin D3 supplementation. Results: An increase in serum level of the 25-(OH)D after supplementation was significant. However, if the subjects had higher serum levels of the 25-(OH)D before the supplementation, and if the supplementation lasted 8 instead of 6 weeks, the absolute increase in serum level of the 25-(OH)D was lower. Patients taking corticosteroids as inhalation or intranasally had a more intense effect of vitamin D3 supplementation, i.e., the absolute increase in levels of 25-(OH)D was higher than in patients not using such medication. Conclusions: Vitamin D deficiency and insufficiency in children with allergic diseases can be treated with maximal recommended doses of vitamin D3 for a short period of time, especially if they were prescribed with inhalation or intranasal corticosteroids.

Background and Study Aim. Given the global spread of COVID-19 and its profound effects on public health, understanding its impact on the physical health and performance of young athletes is crucial for developing guidelines to support their recovery and well-being. The goal of this research was to assess the impact of the COVID-19 infection and possible consequences on the functional abilities of schoolchild athletes, and determine whether there are differences compared to their peers who did not suffer the infection. Material and Methods. This study involved 100 teenagers (median age 15.7±1.167), who engage in two different sports (basketball and soccer), divided into two groups. The first group comprised young athletes (n=53, age 15.79±1.854) who had contracted COVID-19 and underwent 14 days of home isolation. The second group consisted of healthy child athletes (n=47, age 15.60±1.313). Participants underwent a comprehensive pre-participation sports medical examination, which included a cardiopulmonary exercise test (CPET) on a treadmill. CPET assessed various physiological parameters: maximum oxygen consumption (VO2max); heart rates at the first and second ventilatory thresholds (HR at VT1 and HR at VT2); respiratory exchange ratio (RER); maximal pulmonary ventilation (VEmax); ventilatory efficiency (VE/VCO2); oxygen pulse (O2/HR); maximum heart rate (HRmax); three-minute heart rate recovery; and potential electrocardiographic changes. Results. The results indicate that COVID-19 infection has led to statistically significant impairments in the cardiorespiratory functions of child athletes. Notably, there were significant reductions in maximum oxygen consumption (VO2max), maximal pulmonary ventilation (VEmax), oxygen pulse (O2/HR), as well as heart rates at the first ventilatory threshold (HR at VT1), maximum heart rate (HRmax), and heart rate recovery following maximal effort, all demonstrating p-values less than 0.05. Conclusions. The assessed parameters demonstrated that the functions were statistically significantly impaired in child athletes who had recovered from COVID-19 compared to their healthy peers of the same age. However, the infection appeared to have a minimal impact on heart rate variability at ventilatory thresholds. These findings offer valuable insights for coaches and sports medicine physicians in adjusting training programs and supporting the rehabilitation process for young adolescent athletes resuming their training after recovering from COVID-19.