Silvia Iuliano

Helicobacter Pylori Infection: We Should Always Verify the Intrafamilial Transmission

Background and Aims: Helicobacter pylori infection is one of the most common gastrointestinal infections in humans; it affects about 30% of people in developed countries and about 80% in developing ones. The majority of patients acquire the infection during childhood and the intrafamilial transmission is considered one of the most important routes of infection. The aim of this study was to assess the intrafamilial transmission rate among family members of index subjects. Methods: We have suggested all patients H. pylori-positive (99 patients, symptomatic index subjects) diagnosed during 18 months (Sep 2011-Dec 2012) to screen their family members by stool antigen test (SAT) and, when positive, to perform upper gastrointestinal endoscopy. Results: Through SAT we identified 126 patients belonging to 41 households of 99 initial index subjects, therefore 41 index subjects (41.4%) had at least one family member affected. The entire population studied included 225 H. pylori-positive patients: 99 index subjects (symptomatic) and 126 family members diagnosed by SAT screening and histological examination by gastroscopy. Of these, 103 patients (81.7%) were considered slightly symptomatic (mild clinical history until then not important enough to perform further diagnostic study) and 23 patients (18.3%) were totally asymptomatic. Conclusions: In the spread of H. pylori infection, the intrafamilial transmission is an important route of contamination; besides the known mother-to-child dyad, also the transmission among family members plays a considerable role and it should be always verified.

Cutaneous Leishmaniasis with Long Duration and Bleeding Ulcer

Leishmaniasis may cause visceral, cutaneous and/or mucocutaneous diseases. Cutaneous and mucocutaneous forms are caused by a single celled parasite transmitted by sand fly bites. Although the cutaneous form of the disease is often self-limiting, it results in significant scarring and can spread to more invasive, mucocutaneous disease. Therefore, treatment may be considered to prevent these complications. We describe a case report of cutaneous leishmaniasis contracted in a healthy man in Italy (Emilian Apennines). This cutaneous ulcer healed only with intralesional injection of meglumine antimoniate. After about 18 and 30 months a scar area is still present and no satellite lesion appeared. We have had no side effects or complications due to therapy.

A Giant Congenital Lobular Capillary Haemangioma

Lobular capillary haemangioma is a relatively common benign mucocutaneous lesion in paediatric age. The etiopathogenesis is not very clear, but it seems that lesions originate de novo from a process of lobular vascular proliferation that appears to be neoplastic. Congenital onset is usually very rare; it happens only in 1.1% in literature. We report a case of a newborn with a giant congenital lobular capillary haemangioma of the head (left occipital region) which increased rapidly with superficial ulcers in the early days of life. The baby was operated on by full-thickness excision using the linear closure technique; this treatment allows histological examination, ensures the most efficacy aesthetic results and gives the lowest recurrence rate.