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Introduction. Coxiella burnetii is the etiological agent of Q fever, a zoonosis that is still subject of „Query”. Formerly classified as a Rickettsia, C. burnetii is a highly infectious obligate intracellular bacteria, whose main animal reservoirs are cattle, sheep and goats. Commonly following transmission through inhalation of aerosols containing the pathogen spread during animal parturition, Q fever may present as a self-limited febrile illness, pneumonia or acute hepatitis. Nevertheless, the possibility of evolving towards a chronic form exists under certain circumstances, mainly involving previously affected heart valves or blood vessels. Diagnosis is usually serologically based and Doxycycline represents the most frequent choice of antibiotherapy. Objectives. The aim of this study is to analyse the clinical and laboratory settings that led to diagnosis of acute or chronic Q fever, the treatment regimens applied and consecutive outcome within the group of patients defined below. Materials and methods. The present paper represents an observational descriptive study performed on a group composed of 24 patients admitted in our hospital along 2018 and diagnosed with confirmed or probable acute or chronic Q fever. Both male and female subjects regardless of their age were included, under the condition of meeting the CDC case definition, by integrating the serological results into the clinical context. Results and conclusions. A suggestive epidemiological frame was rarely proven. Out of the 24 subjects with ages between 34 and 80 years old, of which only 2 were women, 22 had acute Q fever, manifested mostly as a combination of atypical pneumonia and hepatitis (9 cases, representing 41. Only 2 of the acute Q fever cases had a confirmed diagnosis. Frequent complaints were fever (all cases), chills, headaches and vomiting. Only 28% of the radiologically confirmed pneumonias were accompanied by dry cough, whilst only 21% of the hepatitis cases associated jaundice. Biologically, although leukocytosis was more weakly correlated with acute disease activity, all patients exhibited a moderate to high inflammatory response (through C reactive protein). Considering the latency of specific antibodies' dosage results, the decision of initiating treatment was based on a clinical support. Antibiotherapy consisted of Doxycyclin, alone or in combinations meant to cover a larger spectrum, given the usually nonspecific symptoms and the initially low clinical suspicion for Q fever. Clinical evolution was favorable in all cases. Regarding the two patients with chronic Q fever, manifested as blood culture-negative endocarditis, of which only one was confirmed according to the CDC definition, both had presented valvular lesions before developing IE and had no history of acute infection with C. burnetii. In the first case, under empirical infective endocarditis agents (Ceftriaxone and Vancomycin), acute heart failure and necessity of surgical replacement of the affected valve occurred, only afterwards being followed by the elevated phase I IgG level that brought diagnostic confirmation. Meanwhile, the second patient did receive a combination with Doxycycline, followed by favorable clinical evolution during admission. [ABSTRACT FROM AUTHOR]

Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatology, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has challenged the medical world in many ways regarding diagnosis troubles and therapeutic options. In this paper, we will present three cases of patients from different age groups, in which we identified specific ways of evolution, from both clinically and laboratory data point of view. We used a critical evolution risk estimation calculator at admission and compared the results with the subsequent evolution of patients. From the analysis of the presented cases, we found persistent organic damage that will require their long-term follow-up. [ABSTRACT FROM AUTHOR]

Knowledge about the manifestations of SARS-CoV-2 infection is constantly enriching as more reports of the disease appear. Anosmia, which had not been linked to SARS-CoV-2 infection at the beginning of the pandemic outbreak, later became, through evidence, an important symptom of the disease. In the presented paper we studied the correlation between this symptom and the complex pathological context of patients. Using statistical analysis we demonstrated that anosmia can be considered an independent predictor for the extended period of hospitalization in patients in the study group. [ABSTRACT FROM AUTHOR]

Introduction. In the history of his usage, by the 1850`s, Lithium was first used for the treatment of the gout. As mania and melancholia were included in the same diagnostic group, Lithium started to be used for the treatment of mental disorders. Nowadays, Lithium is still used in the bipolar disorder and as adjuvant in depression, schizophrenia, schizoaffective disorder and for the control of child aggressiveness. Methods and objective. Reporting a case of Lithium Intoxication in a patient with infection and chronic treatment with Lithium Carbonate. Objectives. Reporting a case of Lithium Intoxication in a patient with streptococcal angina infection and chronic treatment with Lithium Carbonate. Conclusion. Lithium intoxication may be rare in medical practice because of rare usage of Lithium therapy and strict monitorization of serum concentration. In this case, the tonsillar infectious accompanied by fever, impossibility of proper oral hydration and impairment of renal functions were the initial trigger of the pathological mechanism of intoxication syndrome. Secondary, the excretion of Lithium decreased and the low serum volume led to high blood concentration of Lithium. Later on, the gastrointenstinal impairment which appeared slowly added to the vicious circle which involved hydration, excretion and serum concentration of Lithium producing and intoxication syndrome. [ABSTRACT FROM AUTHOR]