Current Opinion in Infectious Diseases最新文献_第2页

Histoplasmosis in children: emerging insights and evolving guidelines. 儿童组织胞浆菌病：新见解和不断发展的指南。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/QCO.0000000000001223

Kate Shapiro, Sandra R Arnold

{"title":"Histoplasmosis in children: emerging insights and evolving guidelines.","authors":"Kate Shapiro, Sandra R Arnold","doi":"10.1097/QCO.0000000000001223","DOIUrl":"10.1097/QCO.0000000000001223","url":null,"abstract":"Purpose of review: This review provides an update on the epidemiology, risk factors, clinical presentation, diagnosis, and management recommendations incorporating recommendations from recent publications including the Infectious Disease Society of America guidelines for the management of pulmonary and disseminated histoplasmosis.Recent findings: Updates to the epidemiology of histoplasmosis indicate a broader geographic range than historically defined. Updated guidelines do not recommend routine treatment for asymptomatic, mild and moderate pulmonary histoplasmosis although itraconazole can be offered for immunocompromised children or for prolonged or worsening symptoms. Liposomal amphotericin B is recommended as initial treatment for severe histoplasmosis syndromes (severe pulmonary and disseminated histoplasmosis). Fibrosing mediastinitis, a late complication of histoplasmosis is treated with stenting of vessels and bronchi. Recent studies demonstrate that rituximab (anti-CD20 monoclonal antibody) may stop progression or lead to regression of progressive fibrosis.Summary: Histoplasmosis has manifold manifestations, many of which are self-limited and do not require treatment. Severe histoplasmosis and its complications should be treated with liposomal amphotericin B followed by itraconazole. Clinical trials are needed to assess the efficacy of rituximab for the treatment of fibrosing mediastinitis.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"505-512"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gnathostomiasis: shifting epidemiology and persistent challenges in diagnosis and treatment. 颌口病：不断变化的流行病学和诊断和治疗的持续挑战。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/QCO.0000000000001224

Watcharapong Piyaphanee, Abigail Hui En Chan, Dorn Watthanakulpanich

{"title":"Gnathostomiasis: shifting epidemiology and persistent challenges in diagnosis and treatment.","authors":"Watcharapong Piyaphanee, Abigail Hui En Chan, Dorn Watthanakulpanich","doi":"10.1097/QCO.0000000000001224","DOIUrl":"10.1097/QCO.0000000000001224","url":null,"abstract":"Purpose of review: Gnathostomiasis is a neglected parasitic infection traditionally endemic in Southeast Asia and Latin America. However, in recent years, the disease has been increasingly reported beyond its traditional endemic regions. This review examines recent evidence on its epidemiology and discusses the challenges in diagnosis and management.Recent findings: Gnathostomiasis is now frequently reported in a broader global context, reflecting changing patterns of human behavior and global travel. Transmission is still associated with behaviors, such as the consumption of raw or undercooked freshwater fish, rather than specific local cuisines. Clinical presentations remain diverse, with a growing number of reports describing ocular involvement and neurologic disease. Although immunoblot assays play a central role in diagnosis, its availability remains limited and diagnostic performance may vary across Gnathostoma species. Therapeutic options remain largely unchanged, with albendazole and ivermectin as the mainstay of treatment. However, some patients still experience incomplete responses or relapses.Summary: Gnathostomiasis is increasingly reported in a broader global context, reflecting changing patterns of exposure and mobility of people. Important gaps remain in both diagnostic capacity and therapeutic effectiveness, particularly in severe disease, highlighting the need for improved diagnostic tools and treatment strategies.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"369-377"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alveolar echinococcosis. 包虫echinococcosis。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-26 DOI: 10.1097/QCO.0000000000001226

Marija Stojković, Thomas Junghanss, Kim G Gehling

{"title":"Alveolar echinococcosis.","authors":"Marija Stojković, Thomas Junghanss, Kim G Gehling","doi":"10.1097/QCO.0000000000001226","DOIUrl":"10.1097/QCO.0000000000001226","url":null,"abstract":"Purpose of review: Alveolar echinococcosis is a wildlife zoonotic disease. Clinically and radiologically, it presents in a manner similar to hepatic malignancy. The aim of our review is to summarize the current standard of clinical management of alveolar echinococcosis. We also want to raise awareness and promote an integrated approach for this neglected tropical disease (NTD).Recent findings: Data suggest increased prevalence of alveolar echinococcosis in some parts of the world. This may be due to intensified surveillance, spread of the disease, decreasing control efforts or a combination of these. Development of new diagnostics and treatment modalities is very slow, constrained by lack of investment into research.Summary: Treatment options for alveolar echinococcosis have not changed in decades. Cure is only available for early and limited hepatic disease amenable to R0-surgical resection. Advanced disease, ineligible for surgery, is treated with benzimidazoles with a parasitostatic effect on Echinococcus multilocularis. The prognosis of alveolar echinococcosis ranges from excellent to poor depending mainly on the extent of hepatopathy induced by irreversible damage to the biliary and vascular system of the liver. Benzimidazole intolerance dramatically worsens prognosis, as parasitic growth cannot be suppressed in inoperable patients.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":"39 5","pages":"387-395"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of neonates born to mothers with reactive serologic tests for syphilis. 梅毒血清学试验阳性母亲所生新生儿的处理。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-26 DOI: 10.1097/QCO.0000000000001234

Abigail Z Nishikawa, W Christopher Golden, Alexa J Brumfiel, Sameer B Chand, Pablo J Sánchez

{"title":"Management of neonates born to mothers with reactive serologic tests for syphilis.","authors":"Abigail Z Nishikawa, W Christopher Golden, Alexa J Brumfiel, Sameer B Chand, Pablo J Sánchez","doi":"10.1097/QCO.0000000000001234","DOIUrl":"10.1097/QCO.0000000000001234","url":null,"abstract":"Purpose of review: The dramatic resurgence of maternal and congenital syphilis in the United States highlights the need for their optimal management as syphilis in pregnancy can result in substantial neonatal morbidity and mortality. This review summarizes current epidemiology and discusses guidance on the management of neonates born to mothers with reactive serologic tests for syphilis.Recent findings: Timely communication with local health department professionals is essential for optimal management of mothers with reactive serologic tests for syphilis and their neonates. Knowledge of maternal syphilis treatment history by partnering with local jurisdictions can circumvent much of the incertitude surrounding neonatal management. All neonates born to mothers with reactive serologic tests for syphilis should be tested using a nontreponemal ('lipoidal antigen') test. However, a reactive test may only indicate maternal nontreponemal IgG antibodies that are transferred transplacentally to the fetus. Therefore, neonatal management depends on maternal history and treatment for syphilis as well as clinical, laboratory, and radiographic findings in the neonatal evaluation. Existing management algorithms are complex, highlighting the need for a more practical, yet safe, approach.Summary: A neonatal management guideline is proposed that may simplify the management of neonates born to mothers with reactive serologic tests for syphilis while advocating for expanded use of single-dose benzathine penicillin G therapy.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"458-466"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oropouche virus: viral evolution, epidemiological trends, and challenges for control. Oropouche病毒：病毒进化、流行病学趋势和控制的挑战。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-06-08 DOI: 10.1097/QCO.0000000000001212

Ralph Huits, Maria D Mileno, Francesca F Norman

引用次数: 0

The return of measles: a dangerous comeback. 麻疹卷土重来：危险的卷土重来。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-07-22 DOI: 10.1097/QCO.0000000000001222

Katia C Halabi

{"title":"The return of measles: a dangerous comeback.","authors":"Katia C Halabi","doi":"10.1097/QCO.0000000000001222","DOIUrl":"10.1097/QCO.0000000000001222","url":null,"abstract":"Purpose of review: Measles has reemerged as a significant global public health threat, with increasing morbidity and mortality associated with declining vaccination rates. This review summarizes current global outbreaks, history of measles, vaccination and elimination status, vaccine hesitancy, and outbreak response and lessons learned highlighting different novel digital epidemiological tools.Recent findings: Measles continues to surge worldwide with an estimated 11 million infections in 2024, which is more than prepandemic levels. Developing and developed countries are both facing measles outbreaks, with the United States at risk of losing measles elimination status. Recent studies have showed that worldwide percentages of two-dose measles vaccination were lower than 95% that is required to interrupt measles transmission in all WHO regions. Novel epidemiological tools such as interactive simulators, real-time use of dynamic models, serosurveillance, and others are transforming measles outbreak response and enable earlier outbreak detection, tracking, and targeted public health interventions.Summary: Vaccine hesitancy is one of the top global health threats and developing a tailored evidence-based approach is necessary to establish and maintain measles elimination.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"500-504"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing antifungal management in immunocompromised paediatric patients: current gaps and future directions. 优化儿童免疫功能低下患者的抗真菌管理：目前的差距和未来的方向。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-07-22 DOI: 10.1097/QCO.0000000000001221

Laura Ferreras-Antolin, Suba Guruprasad, Adilia Warris

{"title":"Optimizing antifungal management in immunocompromised paediatric patients: current gaps and future directions.","authors":"Laura Ferreras-Antolin, Suba Guruprasad, Adilia Warris","doi":"10.1097/QCO.0000000000001221","DOIUrl":"10.1097/QCO.0000000000001221","url":null,"abstract":"Purpose of review: This review examines the critical knowledge gaps limiting optimal management of invasive fungal diseases (IFDs) in immunocompromised paediatric patients and proposes a research agenda to address these deficiencies.Recent findings: Novel immunomodulatory therapies, including chimeric antigen receptor T-cell therapy, bispecific antibodies, and immune checkpoint inhibitors, are creating new at-risk paediatric populations whose susceptibility to IFDs remains poorly characterized. IFDs in these populations may present differently and beneficial effects from antifungal prophylaxis is not clear. Diagnostic challenges persist due to nonspecific imaging findings, limited performance of fungal biomarkers, and difficult invasive sampling given small sample volumes and procedural risks in children. Therapeutic management still relies on evidence extrapolated from adults, creating uncertainty around optimal antifungal selection, dosing strategies and treatment duration. Age-dependent pharmacokinetic and pharmacodynamic differences add substantial complexity, while newer antifungal agents are only becoming available in a delayed fashion for paediatric use.Summary: Critical research priorities vary from identifying which paediatric populations benefit most from antifungal prophylaxis, to developing more accurate and less invasive diagnostics, defining TDM targets, and developing child-friendly and optimized treatment regimes. Addressing these knowledge gaps through dedicated paediatric research, clinical trials and observational studies is essential for this vulnerable population.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"491-499"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tropical sprue: a forgotten entity. 热带豆芽：一个被遗忘的实体。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/QCO.0000000000001227

Balakrishnan S Ramakrishna

{"title":"Tropical sprue: a forgotten entity.","authors":"Balakrishnan S Ramakrishna","doi":"10.1097/QCO.0000000000001227","DOIUrl":"10.1097/QCO.0000000000001227","url":null,"abstract":"Purpose of review: Tropical sprue, once a major cause of malabsorption syndromes, is declining in prevalence. As a consequence of its rarity, and the absence of specific diagnostic tests, diagnosis of this condition is often delayed or missed. The purpose of this review is to draw attention again to this condition and to its overlap with postinfectious irritable bowel syndrome.Recent findings: Sporadic case reports of diagnosis in travelers to endemic countries as well as reports of its continuing occurrence in endemic countries indicate the need for continuing diagnosis of the disease. Most recently, the COVID pandemic saw a large number of patients with postinfection gastrointestinal symptoms that lasted longer than 6 months and were accompanied by malnutrition. These events deserve deeper investigation and resurrect coronaviruses as one possible cause of tropical sprue. Diagnosis of the disease is another evolving area and the original diagnostic criteria have to be modified in view of the lack of access to formal tests of absorption in most laboratories.Summary: Sporadic reports of nonceliac enteropathy with response to antibiotic treatment indicate that the disease needs to be considered in the differential diagnosis of malabsorption in the appropriate clinical context.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"444-449"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emergence of alveolar echinococcosis in Canada: a warning for the USA. 加拿大肺泡包虫病的出现：对美国的警告。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-26 DOI: 10.1097/QCO.0000000000001229

Stephen D Vaughan, Jamie L Rothenburger, Kinga Kowalewska-Grochowska

{"title":"Emergence of alveolar echinococcosis in Canada: a warning for the USA.","authors":"Stephen D Vaughan, Jamie L Rothenburger, Kinga Kowalewska-Grochowska","doi":"10.1097/QCO.0000000000001229","DOIUrl":"10.1097/QCO.0000000000001229","url":null,"abstract":"Purpose of review: Locally acquired human alveolar echinococcosis has been rare in North America outside Alaska, yet recent Canadian observations indicate a meaningful increase and epidemiologic shift in North America. This review synthesizes data surrounding the recent spike in human alveolar echinococcosis cases in Canada.Recent findings: Since 2013, an increasing number of alveolar echinococcosis cases have been identified in Canada with incidentally detected hepatic masses. Dog ownership and rural exposures feature prominently. Contributory factors include the new establishment of the European-like Echinococcus multilocularis (Em) haplotype in wildlife and domestic dogs (definitive hosts), high peri-urban coyote numbers and infection prevalence, and rising clinician awareness. Specific diagnosis relies primarily on histopathology, confirmed with serology and Nucleic Acid Amplification Test (NAAT). Heightened awareness amongst radiologists and pathologists plays a pivotal role in improving patient outcomes. Management includes multidisciplinary collaborations involving resection when feasible and long-term albendazole treatment.Summary: Alveolar echinococcosis in Canada is an emerging infectious zoonotic disease and remains under-recognized. A high index of suspicion is required, particularly for patients thought to have liver cancer. Early recognition combined with Em-specific diagnostics leads to timely treatment that reduces morbidity and mortality. A One Health approach integrating human, veterinary, and wildlife health data is needed to improve understanding of this disease.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"378-386"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Malaria rapid diagnostic tests: performance, pitfalls, and progress. 疟疾快速诊断检测：性能、缺陷和进展。

IF 4.5 3区医学

Current Opinion in Infectious Diseases Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/QCO.0000000000001228

Laura C Steinhardt, Jimee Hwang

{"title":"Malaria rapid diagnostic tests: performance, pitfalls, and progress.","authors":"Laura C Steinhardt, Jimee Hwang","doi":"10.1097/QCO.0000000000001228","DOIUrl":"10.1097/QCO.0000000000001228","url":null,"abstract":"Purpose of review: Malaria rapid diagnostic tests (RDTs) have revolutionized malaria diagnosis in endemic settings. RDTs are simple to use and accurate for clinical cases, although sensitivity is reduced at parasite densities below 200 parasites/μl. However, increasing prevalence of hrp2/3 gene deletions in certain areas threaten utility of histidine-rich protein 2 (HRP2)-based RDTs, and lingering HRP2 antigenemia can generate false-positive results after parasite clearance. This review summarizes current performance of malaria RDTs, threats to their validity, and recent innovations to improve their performance and continued role in malaria diagnosis.Recent findings: Most World Health Organization (WHO) prequalified RDTs perform well for clinical diagnosis, with only occasional exceptions, including a recently reported issue affecting several countries. RDT sensitivity is generally related to malaria transmission intensity, with higher proportions of false-negative results in lower-transmission areas. Newly prequalified lactate dehydrogenase (pLDH)-based RDTs perform well for both Plasmodium falciparum in areas with >5% hrp2/3 gene deletions and for Plasmodium vivax diagnosis. Several point-of-care alternatives to RDTs, including micro-fluidic devices, hemozoin-detecting devices, and automated hematology analyzers, have shown promising results in small studies, but require larger-scale trials before widespread use.Summary: RDTs remain a critical tool in clinical diagnosis of malaria, and newer pLDH-based tests perform well in areas where hrp2/3 gene deletions threaten validity of HRP2-based RDTs.","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"429-437"},"PeriodicalIF":4.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0