Background and Objectives: Infective endocarditis (IE) remains a severe infection with high morbidity and mortality, particularly among people who inject drugs (PWID). Data from Eastern Europe are limited, despite the increasing burden of intravenous drug use in the region. Materials and Methods: We conducted a retrospective, observational cohort study of 153 patients diagnosed with IE and admitted to the “Dr. Victor Babeș” Clinical Hospital for Infectious and Tropical Diseases in Bucharest, Romania, between August 2019 and July 2024. Patients were classified into PWID (n = 51) and non-PWID (n = 102). Clinical characteristics, microbiological profiles, echocardiographic findings, complications, and outcomes (in-hospital, 10-week, and 12-month mortality) were compared between groups. Results: PWID were significantly younger (mean 34.0 ± 6.6 years vs. 64.3 ± 13.1 years; p < 0.001), predominantly male (86.3% vs. 62.7%; p = 0.003) and had higher rates of HIV (64.7%) and HCV (98.1%). Right-sided IE and larger vegetations were more common in PWID, whereas non-PWID had more left-sided disease, pre-existing valvular pathology, and prosthetic valve involvement. Staphylococcus aureus predominated in PWID (68.6% vs. 27.5%; p < 0.001), while non-PWID had more Streptococcus spp. and Coxiella burnetii cases. Embolic complications, particularly pulmonary emboli, and valvular rupture were significantly more frequent in PWID, while non-PWID had higher rates of heart failure and surgical interventions. In-hospital mortality was similar (17.6% vs. 11.8%; p = 0.318), but 12-month mortality was higher in PWID (27.5% vs. 13.7%; p = 0.038). Conclusions: IE in PWID shows a distinct clinical and microbiological profile, with more aggressive complications and worse long-term survival. Tailored management, early diagnosis, harm reduction programs, and dedicated follow-up are urgently needed in this high-risk population.

Grass pollen allergy has a high prevalence worldwide, making an accurate diagnosis critical in the framework of multifaceted environmental exposures. Our narrative review provides a comprehensive synopsis of component-resolved diagnosis biomarkers for pollen of Pooideae and Chloridoideae grasses, along with practical approaches in European clinical settings. We present a structured overview of allergen components utilized in singleplex, multiparameter, and multiplex IgE immunoassays. Molecular biomarkers have key roles in distinguishing genuine grass pollen sensitization from cross-reactivity and in assessing the risks associated with various IgE sensitization patterns, thereby enabling precise allergy diagnosis and facilitating targeted allergen immunotherapy. Diagnostic algorithms are provided to assist clinicians in making molecular biomarker-based personalized decisions. This tailored approach supports better management of patients with grass pollen sensitizations and allergies.

Background/Objectives: Acute subdural hematomas (aSDH) represent a frequent and potentially life-threatening form of traumatic intracranial hemorrhage. This study aims to assess prognostic factors associated with mortality and clinical outcome, with particular emphasis on coagulation-related parameters, especially international normalized ratio (INR). Methods: A single-center retrospective cohort study was performed. We included 151 patients with traumatic aSDH, admitted between January 2020 and June 2025 to the Department of Neurosurgery of the Clinical Emergency Hospital “Saint Pantelimon”. Demographic, clinical, laboratory, and imaging parameters obtained at admission were analyzed. Univariate and multivariable regression analyses were performed to identify predictors of in-hospital mortality. Internal validation included bootstrap resampling, calibration analysis, penalized regression and spline modeling. Results: The cohort had a mean age of 67.4 years and was predominantly male (72.8%). Overall, in-hospital mortality was 36.4%, while 58.3% of patients underwent surgical intervention. Admission Glasgow Coma Scale (GCS) score represented the strongest predictor of mortality. Hematoma thickness was significantly associated with midline shift, mortality, and surgical intervention. Elevated INR was significantly associated with increased hematoma thickness, greater midline shift, lower GCS, and increased mortality. In multivariable analysis, INR ≥ 1.4 remained independently associated with mortality (OR 4.08, 95% CI 1.56–11.29, p = 0.005), together with lower GCS. The final model demonstrated very good discrimination (AUC 0.887) and good calibration. Conclusions: Outcome in traumatic aSDH appears to be influenced by neurological severity, hematoma burden, and coagulation status. Admission GCS remained the strongest predictor of mortality, while elevated INR independently predicted poor outcome.

Background Injection drug use is causing a wave of infective endocarditis (IE) worldwide, a severe and potentially deadly infection of the heart’s endothelium. While this important public health problem has been well described in Western countries, available data from Eastern Europe are quite limited. Our study set out to describe this particular patient profile and its background, the clinical course of IE in this population, and evolution during and after hospitalization in a major infectious disease hospital in Bucharest, Romania. Methodology We reviewed the patient records of 57 people who inject drugs (PWID) admitted with IE between August 2019 and July 2025. Clinical, microbiological, and outcome data were collected and analyzed using standard descriptive statistics. Results The patients were mostly young men with a median age of 34 years. Most of these patients used heroin and other psychoactive substances and faced severe chronic co-infections: 63% were human immunodeficiency virus-positive, and 98% had hepatitis C. Most patients presented to the hospital with fever, malaise, and respiratory symptoms. Echocardiography confirmed valvular vegetations in over 90% of cases, most frequently on the tricuspid valve. Blood cultures were positive in 70%, most often revealing Staphylococcus aureus bacteriemia. More than half had embolic complications, 30% needed intensive care, and a quarter were candidates for cardiovascular surgery. The median hospital stay was 28 days, while mortality remained high at 17.5% during hospitalization and 35% at one year. Conclusions IE among PWID represents a life-threatening illness, particularly affecting young adults with multiple infections and comorbidities who are additionally burdened with social challenges. Despite prolonged hospitalizations and intensive care, their short- and long-term outcomes remain unfavorable.

Background: Community-acquired pneumonia (CAP) is one of the most significant childhood diseases worldwide and a leading infectious cause of death in children. This study aimed to evaluate the prognostic value of the inflammatory markers—C-reactive protein (CRP) and procalcitonin (PCT)—and the polymorphic glycoprotein mannose-binding lectin (MBL), deficiency of which is associated with severe infections, in the determination of the optimal type and timing of therapeutic intervention for CAP in childhood. Methods: Retrospective evaluation was conducted on a cohort of 204 children aged 4 months–17 years hospitalized with CAP. Their levels of CRP, PCT, and MBL were assessed for their association with a variety of outcomes, including the incidence of local and systemic complications, admission to the ICU, duration of antibiotic treatment and hospital stay, and death. Results: CRP and PCT proved to be better predictors of complications of CAP than MBL. The area under the curve (AUC) value was highest for PCT as a predictor of systemic complications (AUC = 0.931, 95%CI 0.895–0.967), while CRP (AUC = 0.674, 95%CI 0.586–0.761) performed best as a predictor of local complications (AUC = 0.674, 95%CI 0.586–0.761). Regarding admission to the ICU, CRP was the weakest predictor (AUC = 0.741), while PCT performed the best (AUC = 0.833), followed by MBL (AUC = 0.797). Sensitivity and specificity were calculated for the optimal threshold generated by receiver operating characteristic (ROC) curves, rendering sensitivity of 90% and specificity of 87% for PCT in assessing the risk of systemic complications, compared to sensitivity of 83% and specificity of 90% for CRP. MBL showed relatively high sensitivity (96%) but low specificity (25%) for predicting the need for ICU admission. Conclusions: Early measurement of CRP, PCT, and MBL provides clinicians with important information regarding the course and prognosis of children diagnosed with CAP, thus ensuring prompt, optimal therapeutic management.

"Although infrequent, lung cancer can be disguised by the synchronous presence of a fungal infection, most notably by the Aspergillus species. Some cases of incidental adenocarcinoma diagnosed during surgical treatment of pulmonary aspergillosis have been reported, showing just how these fungi can hide more serious, underlying pathology. This review aims to raise awareness about this occurrence to accelerate the correct etiological diagnosis, establish a timely oncological treatment, and improve the overall morbidity and mortality in lung cancer patients. In addition, we present a rather alluring case of concurrent adenocarcinoma and Aspergillus infection to display how these two entities can appear together."