Stefano Di Bella

Head of Infectious Diseases, Trieste University Hospital · Professor, University of Trieste · C. difficile · S. aureus bacteremia · AMR · #IDTwitter

[Stefano Di Bella @DiBellaMD]

🔎 Clinical Challenge #9

Look at the skin. Then at the eyebrows.

56M, diffuse erythematous lesions + numb hands and feet.
One subtle sign points to the diagnosis. Yours? 👇

Case: https://t.co/NvWLUN8Cjh

#ClinicalChallenge #IDTwitter #MedEd #Dermatology

[Stefano Di Bella @DiBellaMD]

1709: a London chronicle describes a "No-Nose Club", gentlemen disfigured by #syphilis meeting monthly to share the stigma. The wealthy wore silver or ivory noses.

Our #MedHistory piece in #JEADV:
https://t.co/Gt6FAHmfJo

#HistMed #IDTwitter #STI #Dermatology #MedTwitter

[Stefano Di Bella @DiBellaMD]

📏 What can neck circumference reveal that BMI misses?

In 397 hospitalized #COVID19 patients, a larger neck was associated with a 2.5× higher adjusted 30-day mortality hazard—independent of BMI.

https://t.co/Fl2FnEFLFW

#IDTwitter #MedTwitter #CriticalCare #Obesity

[Stefano Di Bella @DiBellaMD]

@ASMicrobiology strongyloides

[Stefano Di Bella @DiBellaMD]

💊 Old β-lactam, new Italian data! 🇮🇹

🔬 Multicentre temocillin UTI cohort:
📊 93.3% clinical success (28/30 patients) at treatment end.
✨ Small study, encouraging signal.

🔗 https://t.co/QVzypIcewV

#Temocillin #UTI #ESBL #AMR #OPAT #IDTwitter #AntimicrobialStewardship

[Stefano Di Bella @DiBellaMD]

@franciscojlk Agree: persistence is a phenotype, not just a lab result. Tolerance explains why a "susceptible" MRSA still fails. Repeat cultures at 48-72h and source control are key.

[Stefano Di Bella @DiBellaMD]

🦴 Spondylodiscitis with neurological deterioration: decompression does not always mean stabilization.
In selected patients without mechanical instability, decompressive laminectomy was associated with neurological improvement, pain relief and no delayed arthrodesis.
📄 https://t.co/srHcytBcUk
#Spondylodiscitis #SpinalInfection #Neurosurgery #IDtwitter

[Stefano Di Bella @DiBellaMD]

Sweet syndrome beyond the skin.

A striking case with ulcerated cutaneous lesions and extensive oral involvement. Mucosal manifestations are uncommon in Sweet syndrome and may substantially broaden the differential diagnosis.

Ragonesi S et al. Dermatology Reports, 2026.
https://t.co/TseNLNzUhr
#SweetSyndrome #Dermatology

[Stefano Di Bella @DiBellaMD]

Tongue tremor can be a clue to tick-borne encephalitis.

Reported in ~30% of patients during the neurological phase of TBE.

🎥 Video from a patient with TBE in northeastern Italy.

🔗 https://t.co/lhvXYj3oLE

#TBE #InfectiousDiseases

[Stefano Di Bella @DiBellaMD]

🧠 New review: Tick-Borne Encephalitis in the 21st Century🌍 Epidemiology & climate change
🧪 Diagnosis
💊 Treatment gaps
💉 Vaccination & prevention
🌿 One Health perspective📄 Full-text PDF: https://t.co/qXTJo7lXue #TickBorneEncephalitis #OneHealth #InfectiousDiseases

[Stefano Di Bella @DiBellaMD]

Syphilis changed fashion. Yes, really. 👀

Wigs could conceal hair loss, while facial patches may have hidden scars or skin lesions.

From syphilis to plague, TB, HIV/AIDS and COVID-19, infections have repeatedly shaped how we dress.

https://t.co/Iqw1sz99kj

[Stefano Di Bella @DiBellaMD]

🚨 Campylobacter spp. bacteremia 🦠🩸

Happy to share our new systematic review & meta-analysis:
✅ 25 studies
✅ 2,480 patients
✅ case-fatality risk: 5%
Higher mortality was associated with C. fetus, immunocompromised status & chronic liver disease.
👏 Congrats to the team!
🔗 https://t.co/mSZZh1aGpR

[Stefano Di Bella @DiBellaMD]

🦠 Ecthyma gangrenosum: don’t miss it

A small necrotic skin lesion in a neutropenic patient can be the only sign of a life-threatening infection.

Think Pseudomonas aeruginosa → act fast with empirical therapy.

🚀 Early recognition saves lives.

📄 Read more: https://t.co/LVkKKK6K5k

#InfectiousDiseases #Neutropenia #Pseudomonas #ClinicalPearls

[Stefano Di Bella @DiBellaMD]

🍄 Cancer… or fungus?

A nodular skin lesion in a kidney transplant patient raised suspicion for malignancy.
🔬 Grocott-Gomori staining revealed the real culprit → rare cutaneous Scedosporium infection.
👏 Great work by Dr Martin Iurilli & colleagues.
⚠️ Take-home: biopsy early. Think beyond cancer.

📖 Case 👉 https://t.co/GXkVMk8sRX
#InfectiousDiseases #MedMycology #Transplant #ClinicalReasoning

[Stefano Di Bella @DiBellaMD]

🦠🔥 NEW PAPER | Sepsis & the Gut 🧬
Sepsis is not just pathogen vs host ⚔️
👉 the gut is a key driver 🧠➡️🦠

🧬✨ Butyrate
🧱 strengthens gut barrier
🛡️ modulates immunity
❤️🫁🧠 protects organs
📈 improves outcomes (preclinical data)
🚨 Immunometabolism, not hype

🔗 https://t.co/FOEz4tB9dq
#Sepsis #GutMicrobiota #Butyrate #Immunometabolism #CriticalCare 🔬🔥

[Stefano Di Bella @DiBellaMD]

💉🧠 Subcutaneous antibiotics: when and how to use them?
New review in Clinical Infectious Diseases 📘
✅ Safe in fragile patients
🏠 Ideal for OPAT & home care
🚫 Less need for venous access
⚙️ A pragmatic antibiotic stewardship option

🔑 Using antibiotics better can be as innovative as new drugs.
🔗 https://t.co/DD97NDxwXI
#InfectiousDiseases #AntibioticStewardship #OPAT #ClinicalPharmacology #CID

[Stefano Di Bella @DiBellaMD]

🗓️ Save the date | March 20, 2026
📍 Trieste, Italy
“The Physician’s Eye, the Sign of Disease”
A journey through medicine, history, and art — from paleopathology to iconodiagnostics.
🎓 Free registration
📌 Cattinara Hospital – Teaching Center

#HistoryOfMedicine #MedicalHumanities #ArtAndMedicine #Paleopathology #Iconodiagnostics #Trieste

[Stefano Di Bella @DiBellaMD]

🆕📄 New Letter published in JAMA
🩺 In response to a recent Review on prostatitis, we highlight the role of MRI in suspected prostatic abscess, especially in subacute and chronic presentations.
🧠📊 Compared with CT, MRI offers superior soft-tissue contrast, earlier detection of small or multiloculated abscesses, better assessment of extraprostatic spread, and 🚫☢️ no ionizing radiation—a relevant aspect for younger patients and follow-up imaging.
🔗👉 Read the Letter here:
https://t.co/IGyJhoIRAr
hashtag#JAMA 📘 hashtag#Prostatitis 🩺 hashtag#ProstaticAbscess 🧫 hashtag#MRI 🧲 hashtag#Radiology 📡 hashtag#Urology 🧠 hashtag#InfectiousDiseases 🦠

[Stefano Di Bella @DiBellaMD]

📄 New paper out! 🚀
Our 6-year real-world OPAT experience with elastomeric pumps shows:
✅ High clinical effectiveness
🛡️ Safe and well tolerated
💊 Supports carbapenem-sparing strategies
�� –92% costs vs inpatient care
🔍 Real-life evidence that OPAT can be patient-centered, sustainable, and stewardship-driven.
👉 https://t.co/uW8XfJwfYV
hashtag#OPAT hashtag#InfectiousDiseases hashtag#AntimicrobialStewardship hashtag#RealWorldData hashtag#HealthcareInnovation hashtag#CostSaving 💡