HIV mother-to-child transmission (MTCT) continues to pose a significant public health challenge, especially in regions with limited resources, although the worldwide distribution of antiretroviral therapy (ART) has drastically lowered the risk of vertical transmission to even below 1% in some regions. There are still uncertainties regarding the safety of some ART regimens during pregnancy and their longer-term effects on infants who are perinatally exposed to HIV but remain uninfected. This review explores current evidence regarding the interplay between maternal HIV infection, ART during pregnancy, and both maternal and pediatric outcomes. Particular attention is given to the risk/benefit ratio surrounding different drug classes, with integrase inhibitors seeming promising choices in MTCT due to their rapid viral suppression and favorable safety profiles. Meanwhile, regimens containing protease inhibitors or nucleoside reverse transcriptase inhibitors have been linked to some adverse outcomes such as low birth weight, growth restriction, and potential mitochondrial or metabolic disturbances. Although ART remains central in preventing MTCT, a deeper understanding of its effects on fetal development and postnatal health is needed, and it should be thoroughly monitored through future research and longitudinal surveillance.

Constipation affects around 30% of children and in 95% of cases is functional (FC), a consequence of alterations in digestive tract peristalsis, modulated by the immune and nervous systems, bile acid metabolism, and the gut microbiota. The aim of this review was to assess the role of gut microbiota and the use of probiotics in children with constipation. The current treatment involves education, toilet training, and oral laxatives, effective in only 50% of patients. In chronic FC, the composition of the microbiota is altered, with increased abundance of Bacteroidetes, Enterobacteriaceae, and Firmicutes and decreases in Prevotella, Bifidobacteria, Faecalibacterium prausnitzii, and Clostridium leptum. Probiotics replenish lacking beneficial resident bacteria, downregulate mucosal inflammation, or produce short-chain fatty acids (SCFAs). Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain. Bifidobacterium animalis subsp. lactis XLTG11 improves the gut microbiota by upregulating SCFA genes and downregulating those related to methane metabolism. Lactobacilli produce organic acids that stimulate bowel peristalsis and augment fecal bolus moisture. The heterogeneity of the current studies involving pediatric subjects thus far hinders the use of probiotics as a standard in the management of children with constipation.

Background: Recurrent malaria refers to repeated episodes of the disease in the same individual. Plasmodium vivax is known for its ability to relapse due to dormant liver-stage hypnozoites and poses a particular risk to travelers returning from endemic areas. Prompt diagnosis and treatment are crucial to prevent recurrences. Case Presentation: We present the case of a 41-year-old man from Romania who developed Plasmodium vivax malaria after traveling through Southeast Asia without chemoprophylaxis. He presented with fever, chills, myalgia, headache, vomiting, and abdominal pain. Clinical findings included mild jaundice and slight neurological signs. Laboratory tests showed severe thrombocytopenia, elevated bilirubin, inflammatory markers, and borderline creatinine levels. Malaria was confirmed by a rapid diagnostic test and blood smear microscopy. The patient was treated with doxycycline and atovaquone–proguanil. He improved and was discharged, but experienced two relapses, both confirmed as Plasmodium vivax by RT-PCR. Despite receiving primaquine as radical cure after the first Plasmodium vivax malaria relapse, a second relapse occurred. Each episode was managed with blood-stage antimalarial therapy, leading to full clinical and biological recovery. Conclusions: Malaria rarely occurs in non-endemic areas; it should be considered in patients with compatible travel history and symptoms. Given the high relapse potential of Plasmodium vivax, accurate species identification is critical to guide appropriate long-term management.

Background and clinical significance:Pasteurella spp. are Gram-negative coccobacilli, aerobic facultatively anaerobic, belonging to the Pasteurellaceae family. In humans, they are known to cause zoonotic diseases, which usually develop after dog or cat bites, licks or scratches. Case presentation: We present the case of a 61-year-old patient, with cardiovascular comorbidities, who presented to the Orthopedics Department, 38 days after knee replacement surgery, with recurrence of pain on walking, an antalgic gait with auxiliary support, and local signs of inflammation at the level of the left knee joint. The patient admitted to owning a dog who accidentally licked the post-surgical wound. The symptoms were suggestive of a post-surgical wound infection with extension to the periprosthetic area. A purulent discharge was collected from the wound during surgical debridement and sent to the microbiological laboratory for diagnosis, where Pasteurella canis was identified using MALDI-TOF MS. Antibiotic susceptibility testing (AST) was performed according to the EUCAST guidelines and empiric antibiotic treatment was started with Cefuroxime. During his future admissions to the Orthopedics and Infectious Diseases departments, two more samples were collected, in which Pasteurella canis was isolated, along with Klebsiella oxytoca (second sample), and Klebsiella oxytoca and Pseudomonas aeruginosa (third sample). Patient evolution was favorable due to the debridement of the wound and combined antibiotic treatment, with Ceftazidime and Gentamicin. Conclusions: Infections with Pasteurella canis are rare but slowly increasing due to more and more humans owning pets. The present case underlines the importance of interdisciplinary collaborations when rare pathogens are identified.

Introduction : Co-occurrence of multiple systemic diseases, particularly in late presenters, can obscure diagnosis and delay appropriate treatment. This work aims to highlight the complex clinical presentation, diagnostic and treatment challenges of a late presenter with new human immunodeficiency virus infection, complicated by Salmonella sepsis, oropharyngeal candidiasis, and Cytomegalovirus meningo-encephalitis, as well as the importance of a comprehensive diagnostic approach in immunocompromised patients with polymorphic symptoms. Material and Methods : We report the case of a 43-year-old male who presented with systemic symptoms, including fever, wasting syndrome, urinary and neurological complaints. Clinical, microbiological, imaging, and molecular diagnostic tools were used to evaluate the patient. Diagnostic investigations included blood and urine cultures, human immunodeficiency virus and syphilis serology, cerebrospinal fluid analysis via molecular detection tools, and imaging studies. Results : The patient was diagnosed with Human Immunodeficiency Virus-1 infection, Salmonella enterica group B sepsis emerging from a urinary infection, oropharyngeal and esophageal Candidiasis, and cytomegalovirus meningoencephalitis confirmed via polymerase chain reaction testing of cerebrospinal fluid. He was treated with a combination of antibacterial (Ceftriaxone), antifungal (Fluconazole), and antiviral therapy (Ganciclovir/Valganciclovir), alongside supportive care and initiation of antiretroviral therapy. After 29 days of hospitalization, he exhibited notable clinical improvement, including weight gain, neurological recovery, and resolution of oropharyngeal lesions. Conclusions : This case illustrates the diagnostic and therapeutic complexity of managing patients with advanced Human Immunodeficiency Virus infection and multiple opportunistic complications. The prompt use of diagnostic tools, a multidisciplinary approach, and the staged initiation of antiretroviral therapy were fundamental for achieving favorable outcomes. Early recognition of late presenters remains essential to prevent life-threatening complications.

Introduction. Varicella-zoster virus (VZV), a herpesvirus, is the cause of two pathologies with greatly different epidemiology and clinical expressions. The primary infection is varicella, commonly known as “chickenpox”, manifesting in most cases during childhood, and herpes zoster or “shingles” which occurs due to the reactivation of the latent virus in elderly or immunosuppressed. The virus primarily spreads aerogenically but may also cross the placenta, having various complications depending on the pregnancy’s stage. Case presentation. We report a case of herpes zoster in an otherwise healthy 10-month-old infant, whose mother contracted varicella during the third trimester. The infant presented with a unilateral vesicular rash, located on the left leg and foot, associating irritability. The diagnosis was made clinically and confirmed using PCR (polymerase chain reaction) which identified VZV DNA inside the vesicle liquid. The clinical progression was favorable, with the patient making a full recovery, without complications. Conclusions. Due to the fact that herpes zoster is very rare during infancy, this case emphasizes the importance of comprehensive maternal history inquiry and early recognition of herpes zoster in this risk population.