Revista de Științe ale Sănătății din Moldova : Moldovan Journal of Health Sciences 2026 Vol. 13, Issue 2

Non-immune fetal hydrops and intestinal obstruction: rare manifestations of congenital syphilis

Thu, 01 Jan 2026 00:00:00 GMT

Non-immune fetal hydrops and intestinal obstruction: rare manifestations of congenital syphilis Neagu, Anastasia; Crivceanscaia, Larisa Introduction. Fetal hydrops is defined as the pathological accumulation of extracellular fluid in at least two fetal anatomical compartments, including skin edema (> 5 mm thickness), pericardial effusion, pleural effusion, and ascites. Non-immune fetal hydrops (NIHF) accounts for over 90% of all fetal hydrops cases and has a heterogeneous etiology. Congenital infections contribute to approximately 6–7% of NIHF cases and are associated with a severe neonatal prognosis. Case presentation. A preterm newborn was delivered from a pregnancy complicated by untreated maternal primary syphilis. The fetus had been diagnosed antenatally with NIHF, heart failure, and massive ascites. Postnatally, the infant required early ascitic drainage and subsequently underwent surgery for congenital intestinal obstruction in the context of ileal stenosis. Neonatal serological testing revealed a positive rapid plasma reagin (RPR) and a reactive Treponema pallidum Hemagglutination Assay (TPHA). Management of congenital syphilis was carried out according to the standardized national clinical protocol. The collected data were compared with those reported in the existing literature to assess clinical significance. Results. The neonate showed a favorable clinical evolution following multidisciplinary management, including intensive care support, anti-infective therapy, and surgical correction of the intestinal obstruction. Progressive improvement allowed successful postoperative recovery and discharge in satisfactory condition. Conclusions. Early identification of the infectious etiology of fetal hydrops is essential for the implementation of appropriate management and the improvement of neonatal outcomes. Close collaboration between maternal–fetal medicine, neonatology, and pediatric surgery is crucial in managing such complex cases.

Healthcare-associated bloodstream infections in children: epidemiology, risk factors and prevention strategies

Thu, 01 Jan 2026 00:00:00 GMT

Healthcare-associated bloodstream infections in children: epidemiology, risk factors and prevention strategies Marga, Irina Introduction. Health care-associated bloodstream infections represent a major public health concern, significantly impacting morbidity, mortality, and the overall cost of pediatric medical care. Materials and methods. A literature review was conducted based on systematic searches in PubMed, SCOPUS, and Web of Science, following PRISMA guidelines. Results. The incidence of healthcare-associated bloodstream infections ranges from 2 to 25 cases per 1,000 central venous catheter days, with higher rates reported in pediatric and neonatal intensive care units, where patients are frequently exposed to risk factors such as central venous catheter use, mechanical ventilation, and immunosuppression. Pediatric patients with health care-associated bloodstream infections experience significantly longer hospital stays compared to those without infection (25 vs. 7 days, P < 0.0001). In pediatric intensive care units, the average length of hospital stay due to these infections varies between 11.40 and 21.10 days, while in neonatal intensive care units, it ranges from 4 to 27.80 days. Mortality associated with these infections among children varies between 15% and 50%, depending on the severity of infection and underlying comorbidities. Additionally, health care-associated bloodstream infections lead to increased use of medical resources and generate substantial additional costs for the healthcare system-costs that are, in fact, largely preventable. Conclusions. Evidence-based strategies, such as strict hand hygiene and standardized protocols for medical device use, can significantly reduce the incidence of these infections.

Tick-borne mix infection diagnosis, challenges, and current practices

Thu, 01 Jan 2026 00:00:00 GMT

Tick-borne mix infection diagnosis, challenges, and current practices Sofronie, Olga; Bălan, Greta Introduction. Tick-borne infections (TBIs) are increasingly recognized as a public health concern in North America and Europe, with Lyme disease being the most notable. The Centers for Disease Control and Prevention (CDC) acknowledges that official statistics likely underestimate the true incidence of TBIs due to diagnostic challenges and underreporting. Co-infections, where multiple pathogens are transmitted through a single tick bite or multiple bites, complicate diagnosis and treatment, leading to more severe symptoms and longer illness durations. Studies indicate a significant percentage of Lyme disease patients also have co-infections, with babesiosis being a common co-infection. Materials and methods. A comprehensive narrative literature review was conducted using PubMed and Scopus, resulting in 52 manuscripts. Additional reports from the CDC and European Centre for Disease Prevention and Control (ECDC), as well as relevant academic books, were included to meet the study’s objectives. The Elicit platform was utilized to enhance reference identification and information synthesis. Results. The paper provides an overview of tick-borne co-infections, emphasizing the diagnostic challenges posed by overlapping and nonspecific symptoms. It discusses various diseases, including Lyme disease, babesiosis, anaplasmosis, ehrlichiosis, Rocky Mountain spotted fever, and tick-borne encephalitis, detailing their causative organisms, vectors, clinical features, and common co-infections. The review critically examines diagnostic methods such as serological tests, molecular tests, and blood smears, highlighting issues like the „window period” false negatives/positives, and differentiating active from past infections. It also explores emerging technologies and biomarkers, including multiplex assays and next-generation sequencing, which enhance detection capabilities but face challenges in data analysis and standardization. Conclusions. Accurate diagnosis is crucial to manage these infections effectively, particularly in vulnerable populations. The rise in co-infections and inadequate testing presents a significant public health challenge, necessitating improved surveillance and diagnostic approaches.

Follicular lymphoma and its transformation to diffuse large B-cell lymphoma - a brief introduction to disease biology

Thu, 01 Jan 2026 00:00:00 GMT

Follicular lymphoma and its transformation to diffuse large B-cell lymphoma - a brief introduction to disease biology Negara, Ivan; Arnaut, Oleg; Buruiană, Sanda Introduction. Follicular lymphoma (FL) is a slow-growing B-cell lymphoma with a generally favorable prognosis. Nevertheless, its clinical course is heterogeneous, with a significant subset of patients experiencing early progression or histological transformation into diffuse large B-cell lymphoma (DLBCL), both considered to be high-risk events associated with treatment resistance and markedly inferior outcomes. Importantly, clinical risk factors have limited value in predicting these complications. This review outlines the key biologic features of FL, discussing how the novel molecular biology approaches can explain the clinical heterogeneity and high-risk disease evolution of FL. Materials and methods. A focused literature review was conducted using the PubMed/MEDLINE database to identify studies on follicular lymphoma and its histological transformation to diffuse large B-cell lymphoma. Priority was given to original research or review articles investigating genetic, epigenetic, transcriptional, or microenvironmental determinants of FL. Results. Evidence from early cytogenetic and DNA sequencing studies established BCL2 deregulation as an initiating lesion in FL, with further genetic alterations in epigenetic regulators like KMT2D, EZH2, CREBBP/EP300 occurring early on and persisting throughout the disease course. Studies of transformed FL samples indicate that aggressive evolution is associated with acquisition of additional genetic lesions, such as those affecting the cell cycle regulators CDKN2A/2B and TP53. More recently, integrated genomic, transcriptomic and spatial resolved techniques have demonstrated substantial transcriptional heterogeneity within individual genetic subclones, suggesting that the genotype alone does not determine the phenotype of the malignant cells and supporting a pathogenetic model in which clinical trajectories reflect the combined effects of genomic evolution, transcriptional cell state, and tumor-microenvironment crosstalk. Important findings, including greater infiltration with LAG3+ CD8+ T cells in cases of histological transformation to DLBCL and upregulation of transcriptional programs that promote stromal expansion and B-cell receptor signaling in cases of early FL relapse, indicate that integrated profiling represents a promising avenue for identifying the biomarkers and treatment targets that are specific to high-risk disease. Conclusions. Continued research concentrated on multiomic profiling of both malignant and non-malignant tumor compartments is essential in order to reveal the mechanisms of FL heterogeneity and translate these data into practical biomarkers and therapeutic strategies.