Background: Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with congenital CMV infection. Methods: In order to evaluate the efficacy of Valganciclovir in preventing clinical sequelae and its possible side effects, we performed a review of the published literature. This search was completed via PubMed for manuscripts published from January 2007 to December 2021, combining the MeSH words “Valganciclovir”, “Congenital”, and “Cytomegalovirus”. Results: A total of 27 articles were included (12 retrospective studies, 4 prospective studies, 1 randomized controlled trial, and 10 case reports). The clinical features were similar to those already described in the literature. The therapeutic protocols used were very different between the various studies included and neonatal antiviral treatments were only moderately effective. The therapy proved to be well-tolerated. Conclusions: The quality of the included studies and the sample size were limited due to the rarity of the disease. The use of different therapeutic protocols in terms of starting dates, doses, and durations made it impossible to compare and correctly evaluate the efficacy of the treatments. Randomized controlled trials are needed to establish the correct effective dose with the fewest side effects and the most efficient duration of therapy.

Introduction: Community-acquired pneumonia remains a noteworthy concern in pediatrics due to the difficulty in identifying the underlying etiology and the risk of complications associated with high morbidity and mortality. Methods: This is a multicenter, prospective study that enrolled 315 children admitted to three different hospitals in Italy between March 2023 and June 2024. The ultrasound scans were performed according to the approach proposed by Soldati et al. in 2020 at admission (T0) and during hospitalization (T1). Results: Lung ultrasound proved to be a valuable tool for differentiating etiologies, with significantly higher scores observed in bacterial and viral pneumonias compared to atypical cases (respectively p < 0.001 and p = 0.018). Furthermore, elevated ultrasound scores were predictive of adverse outcomes, such as the need for respiratory support or admission to the intensive care unit ( p < 0.05). Finally, our findings highlight the importance of timing in follow-up assessments: a 72-hour interval was sufficient to detect improvements in lung ultrasound findings in severe cases ( p < 0.01), while it appeared unnecessary in mild ones ( p = 0.139). Discussion: This study confirms the usefulness of lung ultrasound in monitoring children with community-acquired pneumonia and in the early identification of those at risk of clinical deterioration. Moreover, our findings offer useful guidance for optimizing follow-up timing, supporting personalized ultrasound approaches tailored to disease severity while reducing unnecessary examinations.

Aims: To describe lung ultrasound (LUS) features of Mycoplasma pneumoniae pneumonia and their distribution in pediatric age, and to correlate imaging findings with clinical and laboratory data. Methods: This is a multicenter, prospective, pilot study that involved three hospitals. In total, 35 patients aged 1 month to 17 years, admitted with a diagnosis of Mycoplasma pneumoniae infection, were enrolled. History, clinical, microbiological, and ultrasound data were collected. The LUS examination was performed at admission, recording the following features: presence of subpleural consolidation, bronchograms, B lines, or pleural effusion, and their characteristics. The scans were performed using a standardized approach, in which a composite score was obtained by summing the scores of the different parameters. Results: Consolidations were seen in 97% of children (mostly located in basal, posterior, and lateral fields), and 65% of patients had multiple ones. Non-perilesional B lines were found in 43% of cases, principally in the posterior and basal fields. Pleural effusion was found in 37% of children. The univariate logistic regression showed a correlation between the age of the patient and large-sized consolidations. Moreover, increased lymphocyte count was associated with a lower risk of large-sized consolidations. Conclusions: LUS is a low-cost, non-invasive tool that can reveal findings suggestive of Mycoplasma pneumoniae infection and help physicians better manage children with lower respiratory tract infections, supporting a more personalized diagnostic and therapeutic approach, including antibiotic selection. These preliminary findings also indicate that a larger, comparative study involving other bacterial and viral etiologic agents is warranted to confirm whether LUS patterns are pathogen-specific and whether they can predict clinical outcomes.

Background: Neurocysticercosis is a parasitic infection of the central nervous system caused by the larval stage of Taenia solium. This disease is endemic in some countries in Central and South America, South and South-East Asia, and sub-Saharan Africa. In North America, Europe, Japan, and Australia, only sporadic cases are documented. Moreover, reports of bacterial superinfection arising within neurocysticercotic lesions remain exceptionally scarce. Methods: We report a clinically severe and diagnostically challenging case of suspected neurocysticercosis with cerebral streptococcal superinfection in a 17-year-old Italian patient with Down syndrome and no history of travel to endemic regions. Results: The patient, with pre-existing epileptic encephalopathy, presented with progressive drowsiness and altered mental status, rapidly deteriorating to cardiorespiratory arrest. Neuroimaging demonstrated multiple ring-enhancing lesions, in conjunction with positive Taenia solium serology. Streptococcus spp. was identified in one neurosurgically drained lesion, consistent with secondary bacterial involvement in association with concurrent pneumonia. Combined antiparasitic therapy and targeted antimicrobial treatment resulted in sustained clinical and radiological improvement. Conclusions: In non-endemic settings, neurocysticercosis should remain within the differential diagnosis of unexplained epilepsy and multifocal CNS lesions. Although rare, bacterial superinfection warrants consideration in atypical presentations, particularly in individuals with concomitant infectious foci and underlying immune dysfunction such as that associated with Down syndrome.

A 14-year-old girl presented to the Emergency Department with right gluteal pain, functional limitation of the left hip, sciatica, and low-grade fever. Tests revealed elevated inflammatory markers, and ultrasound showed joint effusion and muscle thickening. After infectious and rheumatologic evaluations, reactive arthritis with enthesitis caused by Salmonella was diagnosed, confirmed by a detailed medical history. Antibiotic therapy was discontinued, and sulfasalazine treatment was started, leading to clinical improvement. Reactive arthritis usually occurs after gastrointestinal infections and typically resolves within 3-5 months with supportive therapy.