Background and Objectives: Recent literature suggests that lung ultrasound might have a role in the diagnosis and management of bronchiolitis. The aim of the study is to evaluate the relationship between an ultrasound score and the clinical progression of bronchiolitis: need for supplemental oxygen, duration of oxygen therapy and hospital stay. Materials and Methods: This was a prospective observational single-center study, conducted in a pediatric unit during the 2017–2018 epidemic periods. All consecutive patients admitted with clinical signs of acute bronchiolitis, but without the need for supplemental oxygen, underwent a lung ultrasound in the first 24 h of hospital care. The lung involvement was graded based on the ultrasound score. During clinical progression, need for supplemental oxygen, duration of oxygen therapy and duration of hospital stay were recorded. Results: The final analysis included 83 patients, with a mean age of 4.5 ± 4.1 months. The lung ultrasound score in patients that required supplemental oxygen during hospitalization was 4.5 ± 1.7 (range: 2.0–8.0), different from the one of the not supplemented infants (2.5 ± 1.8; range: 0.0–6.0; p < 0.001). Ultrasound score was associated with the need for supplemental oxygen (OR = 2.2; 95% CI = 1.5–3.3; p < 0.0001). Duration of oxygen therapy was not associated with LUS score (p > 0.05). Length of hospital stay (coef. = 0.5; 95% CI = 0.2–0.7; p < 0.0001) correlates with LUS score. Conclusion: Lung ultrasound score correlates with the need of supplemental oxygen and length of hospital stay in infants with acute bronchiolitis.

Background: Child abuse represents an important issue in the medico-legal and social context. In the last few decades, various aspects and mechanisms have been identified in child abuse case studies; however, constant research is needed in the field. With this paper, the authors will present a case of a new entity of Abusive Head Trauma that has come to the attention of medico-legal experts. Discussion: The trauma analysis performed on the cranio-encephalic district of the baby revealed quite peculiar lesions that led the authors to exclude that the injuries had been solely caused by violent shaking of the baby’s head, as suggested by Shaken Baby Syndrome. Instead, the authors hypothesised that another lesion mechanism had been added to this one, namely latero-lateral cranial compression. The comprehensive and exhaustive analysis of the case led the authors to present a new possible entity in child abuse trauma, namely ‘Compressed Baby Head’. Conclusions: To the best of our knowledge, in the current literature, no similar clinical cases have ever been described. Thus, the case’s uniqueness deserves to be brought to the attention of experts and the entire scientific community, as well as medical personnel, paediatricians, and reanimators. These professional figures are the first individuals who may encounter complex clinical cases such as the one presented in this paper; thus, they need to know how to properly manage the case and ensure protection for the abused infants and children.

Nirsevimab is a long-acting monoclonal antibody designed to prevent infections due to respiratory syncytial virus (RSV). Here we report on a retrospective, multicenter study encompassing a total of 19 Italian neonatal and pediatric centers evaluating the epidemiology of lower respiratory tract infection (LRTI)-related hospitalizations in infants younger than 2 years during the first RSV season following the introduction of nirsevimab prophylaxis. A total of 401 hospitalizations were reported, with 40.4% being in children with previous prophylaxis with nirsevimab. Respiratory syncytial virus was the most frequently identified pathogen (47.5%), followed by rhinovirus/enterovirus (20.2%) and human metapneumovirus (hMPV; 6.9%). In multivariable analyses adjusted for age, sex, and month of diagnosis, prior nirsevimab immunization was associated with a significantly reduced likelihood of RSV-related hospitalization (adjusted odds ratio [aOR], 0.259; 95% CI, 0.157–0.427), corresponding to an estimated effectiveness of 74.1% (95% CI, 57.3–84.3). Conversely, nirsevimab-immunized infants showed increased odds of hospitalization due to hMPV (aOR, 2.490; 95% CI, 1.019–6.085) and rhinovirus/enterovirus (aOR, 2.573; 95% CI, 1.424–4.650). Lower respiratory tract infections associated with hMPV predominantly occurred outside the typical RSV season, being associated with moderate-to-severe clinical presentations. These findings confirm the real-world effectiveness of nirsevimab against RSV hospitalizations, also highlighting the need for the continued surveillance of non-RSV respiratory pathogens in the context of universal RSV immunoprophylaxis.