Current Opinion in Infectious Diseases最新文献

{"title":"Combination therapy for fungal diseases: the role of immunotherapy in the present and the future.","authors":"Laura Seldeslachts, Simon Feys, Frank L van de Veerdonk, Joost Wauters","doi":"10.1097/QCO.0000000000001220","DOIUrl":"10.1097/QCO.0000000000001220","url":null,"abstract":"<p><strong>Purpose of review: </strong>Invasive fungal infections remain associated with high morbidity and mortality despite advances in antifungal therapy. Current treatments are largely pathogen-directed and fail to address the dysregulated host immune responses that drive severe disease. Together with expanding at-risk populations and environmental changes that promote fungal adaptation, spread, and emergence resistance of fungal pathogens, this underscores the need for complementary immunotherapy.</p><p><strong>Recent findings: </strong>Disease outcome in invasive fungal infections is determined not only by fungal burden but also by host immune dysfunction. Improved understanding of antifungal immunity has led to a growing range of adjunctive immunotherapies. These include both immune-enhancing and immune-restraining approaches, such as cytokine-based therapies, pattern-recognition receptor agonists, immune checkpoint blockade, monoclonal antibodies, vaccines, cellular therapies, small-molecule immunomodulators, and corticosteroids. Accumulating evidence indicates that their efficacy depends on timing and the patient's immune status, underscoring the need for a balanced, context-specific personalized immunomodulation.</p><p><strong>Summary: </strong>Antifungal therapy remains the cornerstone of treatment for invasive fungal diseases, but outcomes depend on drug efficacy and host immunity. Combining antifungals with tailored immunomodulation, whether immune restraining, enhancing, or both, offers a promising way to improve outcomes. Future progress will rely on personalized, immune-guided therapies that restore antifungal immunity while limiting immunopathology.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497181","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}

{"title":"Use of gloves: current evidence vs. current use.","authors":"Diana Vilar-Compte, Pamela Garciadiego-Fossas, Cyntia Ibanes-Gutierrez","doi":"10.1097/QCO.0000000000001216","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001216","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines the gap between evidence-based indications for glove use and current practice, and analyzes sustainability and implementation science strategies to optimize their use.</p><p><strong>Recent findings: </strong>A growing body of literature describes the misuse and overuse of nonsterile gloves in healthcare, along with emerging evidence on the causes of inappropriate use. Gloves account for a substantial proportion of personal protective equipment waste, prompting increased attention to their environmental impact. Recent publications have highlighted the scale of inappropriate use and practical tools to promote more rational, risk-based practices.</p><p><strong>Summary: </strong>Glove use is often driven by a mistaken belief in protection, leading to use without clear indications or proven benefits. Rather than enhancing safety, inappropriate use may increase cross-contamination when gloves are worn for prolonged periods or not changed appropriately. Additionally, glove production and disposal contribute to greenhouse gas emissions, resource depletion, and ecosystem damage. Optimizing glove use requires reframing gloves as a targeted intervention indicated only for specific task-related risks, with timely removal and prioritization of hand hygiene. Campaigns focused on reducing glove use have demonstrated decreased environmental impact and costs without compromising patient safety. These improvements can be achieved through targeted education, behavior change, workflow integration, feedback, and audit strategies.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327405","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}

{"title":"Redefining tissue immunity: lessons from the CNS and beyond.","authors":"Emma C Wall","doi":"10.1097/QCO.0000000000001199","DOIUrl":"https://doi.org/10.1097/QCO.0000000000001199","url":null,"abstract":"","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":"39 3","pages":"177-178"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764018","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}

{"title":"Advanced neuroimaging for central nervous system infections: when, where, how, and why?","authors":"Suyash Mohan, Michael Tran Duong, Brandon Curl, Sanjeev Chawla","doi":"10.1097/QCO.0000000000001191","DOIUrl":"10.1097/QCO.0000000000001191","url":null,"abstract":"<p><strong>Purpose of review: </strong>Central nervous system (CNS) infections remain a major cause of morbidity and mortality worldwide, particularly in children, older adults, and immunocompromised patients. Timely recognition and classification of CNS infections are critical, yet early clinical and cerebrospinal fluid (CSF) findings are often non-specific. This review discusses when advanced neuroimaging adds value beyond conventional neuroimaging, where specific techniques are most useful, and how they can be integrated into pragmatic diagnostic pathways.</p><p><strong>Recent findings: </strong>Multiplanar magnetic resonance imaging (MRI) with contrast is the workhorse for suspected CNS infection, but diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), MR perfusion, and MR spectroscopy (MRS) often change the leading diagnosis or management. DWI reliably distinguishes abscess from many neoplasms and helps detect early cerebritis, ventriculitis, and empyema. High-resolution SWI and vessel wall imaging improve recognition of infectious complications, such as venous thrombosis, microhemorrhage and vasculitis. Quantitative perfusion and MRS can support differentiation of infections from neoplasms and help characterize opportunistic infections in immunocompromised patients. Positron emission tomography (PET) and emerging radiomics and machine learning approaches may refine lesion characterization and treatment response assessment, although further investigation is required.</p><p><strong>Summary: </strong>Advanced neuroimaging should be applied to specific clinical questions rather than used indiscriminately. In meningitis and ventriculitis, MRI with DWI and contrast enhanced T1 weighted images are key to defining complications and guiding urgent intervention. For encephalitis, cerebritis and ring-enhancing lesions, DWI, perfusion and MRS help distinguish abscess from neoplasm, tumefactive demyelination, and atypical infections. In immunocompromised patients, combining structural MRI with SWI, MRS, and metabolic imaging is particularly helpful. Future work must integrate quantitative metrics and AI-driven pattern analysis into multidisciplinary diagnostic algorithms for accurate diagnosis and management of CNS infections.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"263-271"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572614","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}

{"title":"Ischaemia in tuberculous meningitis: update on pathophysiology, clinical predictors and management.","authors":"Georgia Lamb, Reinout van Crevel, Graeme Meintjes, Angharad Davis","doi":"10.1097/QCO.0000000000001194","DOIUrl":"10.1097/QCO.0000000000001194","url":null,"abstract":"<p><strong>Purpose of review: </strong>Tuberculous meningitis (TBM) is a severe manifestation of Mycobacterium tuberculosis infection, associated with high mortality and long-term neurological disability. Cerebral ischaemia and infarction are major contributors to poor outcomes, yet the underlying mechanisms remain incompletely understood. This review summarises current understanding of the pathophysiology, predictors, and emerging therapies for TBM-associated ischaemia, highlighting critical research priorities.</p><p><strong>Recent findings: </strong>Stroke in TBM reflects a complex interplay of neuroinflammation, immunothrombosis, and raised intracranial pressure (ICP). Key emerging mediators include neutrophil extracellular traps, matrix metalloproteinases, pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), platelet hyperactivation, and dysregulated tryptophan metabolism. Advanced neuroimaging, particularly vessel wall imaging, may improve infarction risk prediction and patient stratification, potentially supported by machine learning approaches. Large trials of adjunctive antiplatelet therapy show limited or inconsistent benefit, while small studies suggest anti-TNF therapy may be beneficial.</p><p><strong>Summary: </strong>Despite progress in characterizing inflammation, thrombosis, and vascular injury in TBM, significant gaps remain in understanding mechanisms and timing of stroke. Improved mechanistic insight, integrated translational research, and trials of novel host-directed therapies are needed to prevent stroke and improve neurological outcomes. In parallel, efforts should focus on optimising existing strategies, particularly defining effective approaches to management of raised ICP.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":"39 3","pages":"179-188"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765240","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}

{"title":"Tissue resident memory T cells in respiratory infections.","authors":"Karen N McCarthy, Kingston H G Mills","doi":"10.1097/QCO.0000000000001201","DOIUrl":"10.1097/QCO.0000000000001201","url":null,"abstract":"<p><strong>Purpose of review: </strong>We review the latest evidence that respiratory tissue resident memory T (T RM ) cells are key to local and immediate adaptive immunity to bacterial and viral infections of the respiratory tract and the implication for the design of new or improved vaccines.</p><p><strong>Recent findings: </strong>Recent research on respiratory T RM cells in mouse models have focused our view of T RM cells as frontline, antipathogen sentinels and provided new insights into the induction, function, regulation and maintenance of these cells at mucosal sites. Novel sampling techniques for recovery of immune cells from human nasal mucosa and lungs have enabled detailed studies on human respiratory T RM cells, which have led to significant advances in our understanding of the function and tissue adaptation of T RM in the human respiratory tract.</p><p><strong>Summary: </strong>Emerging insights into the biology of T RM differentiation and persistence are directly informing the rational design of next-generation vaccines aimed at enhancing mucosal immunity, with nasal delivery consistently shown to elicit robust T RM responses in the lung, nose and other mucosal sites.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"201-207"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688363","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}

{"title":"Neurological manifestations of respiratory viral infections.","authors":"Irene Mora Castaño, Rodrigo Hasbun","doi":"10.1097/QCO.0000000000001189","DOIUrl":"10.1097/QCO.0000000000001189","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes current evidence on the general epidemiology, routes of central nervous system (CNS) invasion, clinical manifestations, diagnostic approaches, and treatment considerations associated with neurological complications of respiratory viral infections. Greater awareness of the neurological impact of respiratory viral infections is crucial to improving patient outcomes and mitigating long-term burden of these diseases.</p><p><strong>Recent findings: </strong>Recent studies have reinforced the association between respiratory viral infections and a broad spectrum of neurological complications. Evidence accumulated during and after the coronavirus disease 2019 (COVID-19) pandemic has expanded this awareness, and emerging data suggest that immune-mediated mechanisms such as glial cell activation, rather than direct viral neurotropism alone, play a central role in CNS injury. Although diagnostic limitations still exist, some advances have been made to increase specificity of resources available for clinicians, particularly PCR and immunologic profiling. Furthermore, vaccination against certain respiratory viruses may reduce the risk of subsequent neurodegenerative disease, highlighting the potential impact of preventive strategies on long-term neurological burden.</p><p><strong>Summary: </strong>Establishing causality between respiratory viral infections and subsequent neurological dysfunction remains challenging given the ubiquitous nature of many respiratory viruses and their capacity to cause lifelong latent or persistent infection. Even though some efforts have been made to optimize diagnosis and treatment, addressing these challenges will require further coordinated efforts across clinicians, researchers and healthcare policymakers.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"218-226"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688789","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}

{"title":"Updates on diagnosis and management of parasitic infections of the central nervous system.","authors":"Hector H Garcia, Miguel M Cabada, Christina Coyle","doi":"10.1097/QCO.0000000000001190","DOIUrl":"10.1097/QCO.0000000000001190","url":null,"abstract":"<p><strong>Purpose of review: </strong>Parasitic infections of the human nervous system are frequently overlooked as causes of neurological morbidity, mostly because of lack of diagnostic awareness from clinicians in developed countries. Although limited and unfunded, research in neuroparasitoses leads to improved diagnostic and treatment approaches, and improvements in immunological, molecular and imaging techniques provide new insights in these neglected infections. This review succinctly describes most parasitic infections affecting humans and highlights new information available in the literature.</p><p><strong>Recent findings: </strong>Despite the fact that primary research reports in parasitic neuroinfection are sparse, a body of information on new diagnostic techniques, clinical manifestations, and more recent therapeutic approaches is now available, with particular emphasis in molecular techniques including deep sequencing, and minimally invasive surgical techniques.</p><p><strong>Summary: </strong>This review provides a quick overview of most parasitic infections affecting the human nervous system, and summarizes updated information on current diagnostic and treatment approaches, providing a comprehensive reference, of particular use for clinicians working in settings where neuroparasitoses are infrequent.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"240-248"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572650","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}

{"title":"Recent advances in flavivirus encephalitis.","authors":"Clément Viguier, Jean-Michel Mansuy, Guillaume Martin-Blondel","doi":"10.1097/QCO.0000000000001195","DOIUrl":"10.1097/QCO.0000000000001195","url":null,"abstract":"<p><strong>Purpose of review: </strong>Flaviviruses are an increasing public health concern, responsible for a broad spectrum of human disease ranging from asymptomatic or mild febrile illness to severe neuroinvasive infections such as encephalitis. Flavivirus encephalitis is associated with substantial mortality and long-term neurological sequelae, yet no specific antiviral therapy is currently available. Diagnosis remains challenging because of transient viremia and serological cross-reactivity, and preventive strategies are unevenly implemented. This review summarizes recent advances in the diagnosis, prognostic assessment, treatment, and prevention of flavivirus-associated encephalitis.</p><p><strong>Recent findings: </strong>Recent studies have reshaped diagnostic strategies through improved viral detection, including multimatrix molecular testing and metagenomic approaches, alongside better characterization of host-response markers in cerebrospinal fluid. Recent work has substantially refined understanding of host susceptibility, highlighting preexisting antitype I interferon autoantibodies as a major driver of severe disease across neurotropic flaviviruses, and identifying several biomarkers with potential prognostic value. Neuroimaging work has refined MRI pattern recognition across flaviviral encephalitis, with limited but evolving prognostic implications. While management remains largely supportive, the therapeutic pipeline is increasingly diverse, with growing interest in host-directed strategies.</p><p><strong>Summary: </strong>Flavivirus encephalitis represents a major clinical challenge driven by host vulnerability, diagnostic complexity, and the absence of validated therapies. Integrating recent advances in diagnostics, risk stratification, and prevention is essential, while ongoing therapeutic development offers cautious optimism for future management.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":" ","pages":"189-200"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688394","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}

{"title":"Global bacterial meningitis guidelines: from policy to action.","authors":"Luisa F Alviz, Rodrigo Hasbun, Kiran T Thakur","doi":"10.1097/QCO.0000000000001200","DOIUrl":"10.1097/QCO.0000000000001200","url":null,"abstract":"<p><strong>Purpose of review: </strong>Bacterial meningitis remains a leading cause of preventable mortality and long-term neurological disability worldwide, despite the availability of effective diagnostics, antimicrobials, and vaccines. Historically, management has relied on regional and disease-specific recommendations that varied in scope and lacked global adaptability across diagnosis, treatment, and long-term care. The 2025 World Health Organization (WHO) Global Guidelines on Meningitis Diagnosis, Treatment, and Care represent the first comprehensive effort to harmonize management across diverse health system contexts. This review synthesizes how this global policy recommendations can be translated into clinical and public health action, particularly in resource-limited and outbreak-prone settings.</p><p><strong>Recent findings: </strong>Emerging literature emphasizes the need to standardize management algorithms and expand the focus beyond acute treatment, recognizing meningitis as a condition with long-term functional and quality-of-life consequences that require structured follow-up evaluations. Persistent implementation barriers are also highlighted, including limited diagnostic capacity, inconsistent antimicrobial access, workforce constraints, and systemic inequities that disproportionately affect low- and middle-income countries.</p><p><strong>Summary: </strong>The WHO guidelines provide a unified clinical and policy framework spanning prevention, acute management, and long-term care. Their impact will depend on effective implementation, health system strengthening, and research supporting context-adapted strategies to reduce global meningitis mortality and disability.</p>","PeriodicalId":10880,"journal":{"name":"Current Opinion in Infectious Diseases","volume":"39 3","pages":"272-279"},"PeriodicalIF":4.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765214","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}