Background: Campylobacter jejuni is a common cause of acute gastroenteritis, but central nervous system infections are rare manifestations of Campylobacter infection. Therefore, C. jejuni trauma-related subdural hygroma infection in children is poorly described in the literature. Case presentation: We described a 2-year old boy with lobar holoprosencephaly presenting with subdural hygroma following head trauma. C. jejuni infection was confirmed from a subdural hygroma sample by culture as well as by DNA sequencing of a broad range 16S rDNA PCR product. Cerebrospinal fluid from the ventriculoperitoneal shunt remained sterile. Combined neurosurgical and antimicrobial treatment led to complete recovery. Review of the literature showed that the most common manifestation of Campylobacter central nervous system infection is meningitis, mostly in neonates, and subdural hygroma infection was described for only one case. Conclusions: Subdural hygroma infection caused by C. jejuni is a rare clinical condition in children. Molecular methods represent an important tool for the detection of rare or unexpected pathogens. No standard recommendations for antimicrobial treatment of C. jejuni subdural space infection in children are available, but meropenem treatment combined with surgery seems to be an effective approach.

Congenital cytomegalovirus infection is the most common congenital infection worldwide and an important cause of neurodevelopmental delay and sensorineural hearing loss. Neuroimaging represents the best prognostic marker in cCMV infection. The aim of this study was to establish the role of cranial ultrasound and brain magnetic resonance imaging in the development of long-term sequelae in symptomatic and asymptomatic children with cCMV infection. Of the 47 children enrolled in the study, 25 (53.1%) were classified as symptomatic at birth. In 27/47 patients, SNHL was diagnosed with a similar proportion among the symptomatic and asymptomatic at birth (51.8% and 48.1%, respectively; p = 1.0). Thirty case patients had available data on follow-up. Neurological sequelae were more frequently seen in patients with symptomatic cCMV, but only cerebral abnormalities seen on initial MRI results had a consequential link with the later development of motor (OR 17.5; 95% Cl: 2667, 114,846; p = 0.002) and speech disorders (OR 15; 95% Cl: 2477, 90,843; p = 0.02). Although not statistically significant, hearing deterioration was more frequent in children with abnormal MRI results (OR 5; 95% Cl: 0.846, 29,567; p = 0.121). Neuroimaging abnormalities, as identified through both cranial ultrasound (CrUS) and MRI, are critical prognostic indicators for long-term sequelae, applicable to both symptomatic and asymptomatic children.

Background: The COVID-19 pandemic has caused significant changes in healthcare. Infectious disease (ID) physicians were among the most affected, yet comparisons are scarce on training implementation and the levels of residents’ satisfaction between the pre-pandemic and the pandemic era. Methods: We conducted a nationwide cross-sectional survey among Croatian ID residents between May and July 2021. The survey included 34 Likert-scale and multiple-choice questions pertaining to training rotation interruptions, educational opportunities, work hours, symptoms of burnout and overall satisfaction. Results: The survey was completed by 52 (67.5%) ID trainees in Croatia. The curriculum-defined rotations were not met in real life before the pandemic (56.8%), and 63.5% of participants reported working exclusively with COVID-19 patients more than a year into the pandemic. The pre-pandemic educational opportunities included regular lectures for 61.4%, extra-curricular training for 59.1%, congress and symposia attendances for 52.3% and peer lectures for 27.3%. As many as 11.4% had never had a meeting with their mentor, while 59.1% only met in passing. Overtime work affected 90.9% of residents before and 96.1% during the pandemic. All burnout symptoms have increased from the pre-pandemic to the pandemic era. Overall satisfaction with specialty training has dropped from an average of 3.1 (SD 0.9) before the pandemic to 1.9 (SD 0.9) during the pandemic. Conclusions: Our survey among Croatian ID residents indicated problems with educational opportunities and disruption of the planned training rotations before the pandemic. These problems were aggravated during the pandemic, thus causing a plunge in resident satisfaction levels. A closer monitoring of adherence to the training curriculum is mandated, as well as improvements in mentorship programs and burnout detection and reduction activities.