Fatal hyalohyphomycosis with cutaneous involvement caused by Purpureocillium lilacinum in an immunocompromised patient with bullous pemphigoid.

Emergent pathogen as Purpureocillium lilacinum are becoming cause of morbidity and mortality in our population, especially in immunocompromised patients. We describe a case of hyalohyphomycosis in a diabetic man under systemic steroid treatment for a bullous pemphigoid. Treatment with different antimycotic drugs were ineffective and infection spread diffusely, leading to deterioration of general conditions and ultimately death. The aim of this article is to increase awareness of clinicians about this uncommon, but frequently fatal refractory mycotic infection.

C-reactive protein levels in the first days of life: a systematic statistical approach.

OBJECTIVE: Microbial neonatal infections are responsible for considerable morbidity and mortality and for this reason there is a growing interest for new approaches in the clinical government of this human affection. Using an integrated statistical model, this work investigated the role of the C-reactive protein (CRP) in the diagnosis of sepsis and therapy assessment in newborns admitted in neonatal intensive care unit. METHODS: 386 newborns admitted in neonatal intensive care unit were enrolled in this work. Different clinical-laboratory parameters, such as: CRP level, blood culture, complete blood cell count, urine and other blood tests were assessed for the first 7 days after birth. Several statistical methods have been used to estimate the correlation CRP-septicaemia, using Chi-squared, Pearson, analysis of the variance and Poisson distribution. RESULTS: a statistical positive correlation (CRP value vs. septicaemia status) was observed to integrate the analysis of the variance and Poisson distribution methods, especially in the first days after birth. CONCLUSION: A correct statistical evaluation of CRP values could be significant for risk prediction and subsequent prompt therapy in neonatal sepsis.

The role of the laboratory in choosing antibiotics.

OBJECTIVE: Antimicrobial resistance is one of the biggest problem in medicine at the beginning of the third millennium. Antibiotic resistance is frequently associated with significant morbidity, longer hospitalization, excess costs and mortality. METHODS: In this work we discussed the role of clinical microbiology laboratory as an essential part for an effective infection control program, especially in management and treatment of "difficult infections". RESULTS: At present time, laboratory personnel have a broad range of new technologies that they can use to support and enhance the efforts of the infection control staff. In addition a network of established experts in the determination of antimicrobial breakpoints and in antimicrobial susceptibility testing has been constituted in Europe under the auspices of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC). CONCLUSION: Qualified personnel and new strategies to overcome drug resistance can contribute to solve the microbial infections problems.