Diagnostic microbiology and infectious disease最新文献

{"title":"Laboratory markers among children with respiratory tract infection using a multiplex PCR test","authors":"Hiroki Nishikawa ,&nbsp;Taito Kitano ,&nbsp;Daisuke Kitagawa ,&nbsp;Masayuki Murata ,&nbsp;Mai Onishi ,&nbsp;Takahiro Mori ,&nbsp;Soshi Hachisuka ,&nbsp;Tenshin Okubo ,&nbsp;Naohiro Yamamoto ,&nbsp;Masayuki Onaka ,&nbsp;Rika Suzuki ,&nbsp;Madoka Sekine ,&nbsp;Soma Suzuki ,&nbsp;Fumihiko Nakamura ,&nbsp;Sayaka Yoshida","doi":"10.1016/j.diagmicrobio.2025.116922","DOIUrl":"10.1016/j.diagmicrobio.2025.116922","url":null,"abstract":"<div><h3>Background</h3><div>Evidence on the comparative impact of laboratory markers on multiple respiratory viruses is scarce. This study aimed to evaluate the comparative impact of multiple respiratory viruses among symptomatic children on laboratory markers, including C-reactive protein (CRP) levels.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study between April 2018 and August 2024 for children aged 15 years or younger who received a blood and multiplex polymerase chain reaction (PCR) tests from a nasopharyngeal swab. Children with fever or respiratory symptoms underwent multiplex PCR, irrespective of symptom severity. A generalized linear regression model was used to evaluate the impact of the variables on each inflammatory marker.</div></div><div><h3>Results</h3><div>Overall, 3,893 multiplex PCR tests were included in the analysis.</div><div>Pathogen co-detection was not significant for any laboratory marker (e.g., for CRP: Coefficient 0.03 [95 % confidence interval −0.21, 0.28] and <em>p</em>=0.778). Adenoviruses were positively associated with CRP levels (coefficient 0.28 [0.07, 0.50]; <em>p</em>=0.010). SARS-CoV-2 was negatively associated with CRP level (coefficient −0.56 [0.79, −0.32] and <em>p</em>&lt;0.001). Negative multiplex PCR results were associated with higher CRP levels (coefficient, 0.20 [0.00, 0.40]; <em>p</em>=0.046).</div></div><div><h3>Conclusion</h3><div>Our study showed a positive association between adenovirus and negative multiplex PCR test results and a negative association between SARS-CoV-2 and CRP levels. Our study may support a better interpretation of laboratory results and the clinical management of children with respiratory tract infection.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116922"},"PeriodicalIF":2.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Cryptosporidium Threat: Epidemiology, Genetic Diversity, and Prevalence in HIV-Positive Patients in Tehran, Iran","authors":"Saghi Rashidifar ,&nbsp;Mohammad Javad Gharavi ,&nbsp;Naser Harzandi ,&nbsp;Zohreh Momeni ,&nbsp;Malihe Hasan Nezhad","doi":"10.1016/j.diagmicrobio.2025.116918","DOIUrl":"10.1016/j.diagmicrobio.2025.116918","url":null,"abstract":"<div><div>The primary objective of this study was to evaluate the prevalence and genetic diversity of <em>Cryptosporidium</em> infection in 100 HIV-positive patients. In addition, we aimed to investigate the risk factors and clinical outcomes associated with <em>Cryptosporidium</em> infection in patients with HIV in Iran. Moreover, the present study focused on assessing the relationship between <em>Cryptosporidium</em> infection and multiple factors, namely sociodemographic characteristics, clinical symptoms, medication intake, and immunological parameters. Clinical samples including nasopharyngeal (NP) swabs, induced sputum and stool specimens were collected from all patients, and routine clinical evaluations were performed. Three staining techniques were conducted to enhance diagnostic accuracy and determine the most sensitive method for detecting <em>Cryptosporidium</em> oocysts. The DNA recovery was optimized by freeze/thaw cycling, bead beating and sonication pretreatment. Among 100 patients, the presence of <em>Cryptosporidium</em> spp. was confirmed in 9 cases (9 stool, 3 sputum, and 3 NP samples), using the Nested PCR-RFLP technique. Two <em>Cryptosporidium</em> species were identified: 5 cases of <em>Cryptosporidium hominis</em> and 4 cases of <em>Cryptosporidium parvum.</em> The phylogenetic tree was constructed using sequencing data and was compared against genotypes available in GenBank. Data were analyzed using SPSS statistical software version 19 and analysis of variance (ANOVA test). We found that age, educational attainment, and adherence to treatment had significant relationships with opportunistic infections incidence (<em>P</em> &lt; 0.01). Patients with HIV who had a CD4+ <em>T</em> cell count &lt; 200 cells/µL were more susceptible to developing opportunistic infections (<em>P</em> &lt; 0.001). Furthermore, HIV-positive patients with cryptosporidiosis exhibited significantly higher frequencies of weight loss and gastrointestinal symptoms.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116918"},"PeriodicalIF":2.1,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fatal case of fungemia due to Fusarium thapsinum in a patient with lung cancer","authors":"Raquel Marcos-Rodríguez ,&nbsp;Paloma Sobrino-Gómez ,&nbsp;Laura Alcázar-Fuoli ,&nbsp;Ana Alastruey-Izquierdo ,&nbsp;Rafael Ceballos-Atienza ,&nbsp;Fernando Cobo","doi":"10.1016/j.diagmicrobio.2025.116907","DOIUrl":"10.1016/j.diagmicrobio.2025.116907","url":null,"abstract":"<div><div><em>Fusarium thapsinum</em> is an uncommon cause of invasive fungal disease. Only one case of a hematological patient has been described previously. Most of cases of <em>Fusarium</em> infection is keratitis affecting healthy people, but fungemia is usually produced in immunossupressed patients, especially in those with neutropenia and/or hematological malignancies. The treatment of this infection is difficult due to the fact that these fungi show high MICs to almost all antifungal drugs. We report a case of <em>F. thapsinum</em> fungemia with a fatal outcome, in a patient with lung cancer. The patient developed fever, mucositis and fungemia, and she rapidly worsened and died as a consequence of this infection.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116907"},"PeriodicalIF":2.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of five colorimetric methods for rapid detection of multidrug-resistant Mycobacterium tuberculosis isolates","authors":"Kubra Yildirim","doi":"10.1016/j.diagmicrobio.2025.116903","DOIUrl":"10.1016/j.diagmicrobio.2025.116903","url":null,"abstract":"<div><h3>Aims</h3><div>Tuberculosis (TB) continues to pose a major threat to global public health, particularly due to the increasing prevalence of antimicrobial resistance. This study aimed to evaluate the performance of five different colorimetric drug susceptibility testing (DST) methods, including a newly developed assay.</div></div><div><h3>Methods</h3><div>A total of 56 clinical <em>Mycobacterium tuberculosis</em> strains with varying resistance profiles, along with two ATCC reference strains, were tested against four first-line anti-TB antibiotics: isoniazid (INH), rifampicin (RIF), streptomycin (STR), and ethambutol (EMB). The assays NRTA, CRTA, CVDTA, MGDTA, and a newly developed disk-based resazurin tube assay (DBRTA) were performed in Middlebrook 7H9 broth at standard critical drug concentrations. Results were compared against the BACTEC MGIT 960 system as the reference method.</div></div><div><h3>Results</h3><div>The DST results were obtained within 7 to 14 days. The overall agreement with the reference method was 96.87 % for NRTA, 95.08 % for CRTA, 93.75 % for both CVDTA and MGDTA, and 95.53 % for DBRTA.</div></div><div><h3>Conclusions</h3><div>Colorimetric assays, especially DBRTA, offer cost-effective, rapid, and scalable solutions for MDR-TB detection. Their simplicity and affordability make them particularly suitable for routine use in resource-limited settings, contributing to improved TB management and global control efforts.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116903"},"PeriodicalIF":2.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating saliva for SARS-CoV-2 detection: A practical alternative","authors":"Nusrat Sultana ,&nbsp;Partha Protim Biswas ,&nbsp;Tania Islam Resma ,&nbsp;Nusrat Fatema ,&nbsp;Rabeya Sharmin ,&nbsp;Afroza Akbar Sweety ,&nbsp;Amirul Huda Bhuiyan ,&nbsp;Asish Kumar Ghosh ,&nbsp;Sultana Shahana Banu","doi":"10.1016/j.diagmicrobio.2025.116902","DOIUrl":"10.1016/j.diagmicrobio.2025.116902","url":null,"abstract":"<div><div>Accurate and rapid detection of SARS-CoV-2 is critical for controlling the spread of COVID-19, particularly among asymptomatic carriers. This study evaluates saliva as a viable alternative to nasopharyngeal swabs (NPS) for SARS-CoV-2 detection using real-time RT-PCR and rapid antigen testing (RAT). A total of 201 paired NPS and saliva samples were collected and analyzed. Saliva-based RT-PCR demonstrated 100 % (95 % CI, 94.64 % to 100 %) sensitivity and 97.10 % (95 % CI, 92.74 % to 99.2 %) specificity, with an overall accuracy of 98.05 % (95 % CI, 95.44 % to 99.47 %), closely aligning with NPS results. Similarly, saliva-based RAT exhibited comparable diagnostic performance to NPS-based RAT, with sensitivity and specificity of 100 % (95 % CI 90.51-100 %) and 99.39 % (95 % CI 96.67-99.98 %) respectively. When compared to the gold standard NPS real-time RT-PCR, the sensitivity of RAT using saliva and NPS samples was found to be 69.07 % (95 % CI, 58.88 % to 78.08 %) and 69.79 % (95 % CI, 59.57 % to 78.75 %), respectively. Notably, for cases with cycle threshold (Ct) values ≤30, saliva RAT achieved 97.30 % (95 % CI, 85.84 % to 99.93 %) sensitivity, highlighting its effectiveness in detecting infectious cases. Therefore, saliva offers a practical alternative to NPS for large-scale screening, particularly in resource-limited settings, due to its non-invasive nature, ease of self-collection, and high diagnostic accuracy</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116902"},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of mitochondrial gene markers for molecular diagnosis of Echinococcus granulosus sensu lato in clinical samples","authors":"Sumeeta Khurana ,&nbsp;Reena Yadav ,&nbsp;Anupma Dhaka ,&nbsp;Abhishek Mewara ,&nbsp;Lileshwar Kaman ,&nbsp;Ajay Duseja ,&nbsp;Naveen Kalra","doi":"10.1016/j.diagmicrobio.2025.116904","DOIUrl":"10.1016/j.diagmicrobio.2025.116904","url":null,"abstract":"<div><div>Cystic echinococcosis (CE), caused by <em>Echinococcus granulosus sensu lato (s.l.)</em>, remains a significant public health concern, particularly in regions reliant on livestock farming. Early and accurate diagnosis is essential for effective disease management, yet traditional diagnostic methods such as imaging and serological assays often lack specificity and sensitivity. Molecular diagnostics, particularly polymerase chain reaction (PCR), offer a promising alternative by enabling the direct detection of <em>E. granulosus s.l.</em> DNA in clinical samples. This study evaluates the diagnostic performance of four primer sets targeting mitochondrial genes—Cytochrome c oxidase subunit 1 (Cox1), Mitochondrial NADH dehydrogenase subunit 1 (NAD1) and Mitochondrial 12s ribosomal RNA (12s rRNA). All primer sets achieved 100% positivity in hydatid cyst fluids and tissues, confirming their utility in detecting <em>E. granulosus s.l.</em> DNA. However, specificity varied, with NAD1 and 12S rRNA primers demonstrating excellent specificity, while Cox1.1 and Cox1.2 exhibited cross-reactivity with <em>Taenia solium</em> and <em>Dirofilaria</em> spp., respectively. Sensitivity analysis revealed NAD1 as the most sensitive marker, detecting as little as 305 fg/µl of parasite DNA. These findings underscore the importance of genetic marker selection in optimizing PCR-based diagnostics. While NAD1 and 12S rRNA primers showed strong potential for clinical application, further refinement of Cox1 primers is necessary to minimize false positives. Our study highlights the power of molecular diagnostics in improving CE detection and emphasizes the need for continuous assay optimization to ensure accurate and reliable parasite identification in endemic settings.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116904"},"PeriodicalIF":2.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melioidosis presenting as a solitary atypical liver abscess: A case report and review of the literature","authors":"Mihiri Chami Wettasinghe ,&nbsp;Sameera Kumarasinghe ,&nbsp;June Bernard ,&nbsp;Nuwan Darshana Wickramasinghe ,&nbsp;Anuradha Colombage","doi":"10.1016/j.diagmicrobio.2025.116901","DOIUrl":"10.1016/j.diagmicrobio.2025.116901","url":null,"abstract":"<div><div>Melioidosis, caused by <em>Burkholderia pseudomallei</em>, can present from asymptomatic infection to severe disseminated abscesses. Hepatic involvement is typically seen in disseminated cases, with isolated liver abscesses being uncommon. We present a case of a 42-year-old male with a three-week fever and newly diagnosed diabetes mellitus<em>.</em> His white cell count and CRP were elevated. Abdominal ultrasound showed a heterogeneous mass in liver segment IV, with central cystic lesions. CT revealed an isolated liver abscess with a honeycomb appearance and extra-hepatic extension. A provisional diagnosis of melioidosis was made. The patient was treated with IV meropenem 1 g tds, followed by oral co-trimoxazole 960 mg bd for three months, extended one more month after radiological resolution. Melioidosis was confirmed by an Indirect Hemagglutination Assay (IHA) with a titre of 1:320 at eight weeks. This case highlights the importance of clinical suspicion and early recognition of rare manifestations of melioidosis for timely diagnosis and treatment.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116901"},"PeriodicalIF":2.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro activity of amikacin combined with meropenem, colistin and ceftazidime/avibactam against genetically distinct multidrug-resistant K. pneumoniae, A. baumannii and S. marcescens isolates using three methods","authors":"Saidy Vásconez Noguera ,&nbsp;Marina Farrel Côrtes ,&nbsp;Ana Paula Marchi ,&nbsp;Joyce Vanessa Fonseca ,&nbsp;Flavia Rossi ,&nbsp;Cláudia Maria Dantas de Maio Carrilho ,&nbsp;Anna Sara Levin ,&nbsp;Silvia Figueiredo Costa ,&nbsp;Lauro Vieira Perdigão Neto","doi":"10.1016/j.diagmicrobio.2025.116888","DOIUrl":"10.1016/j.diagmicrobio.2025.116888","url":null,"abstract":"<div><div>Purpose: To evaluate <em>in vitro</em> efficacy of amikacin combined with meropenem, colistin, and ceftazidime/avibactam against diverse multidrug-resistant isolates of <em>K. pneumoniae</em> (n = 40), <em>A. baumannii</em> (n = 20), and <em>S. marcescens</em> (n = 12), using three methods. Methods: Antimicrobial combinations were tested via Epsilometer strip crossing, disk approximation, and <em>time-kill</em> assays. Results: Amikacin combined with colistin and ceftazidime/avibactam showed synergy in 70,0 % (28/40) and 75,0 % (9/12) of <em>K. pneumoniae</em> and <em>S. marcescens</em> isolates. Meropenem showed limited activity in 25,0 % (5/20) of <em>A. baumannii</em> isolates. Minor errors were observed in &lt;50,0 % of isolates, notably with a 25,0 % error rate for amikacin and colistin using disk approximation. Presence of aminoglycoside-modifying enzyme (AMEs) and <em>bla</em>OXA-23 genes in <em>A. baumannii</em>, and AMEs and ESBL genes in Enterobacterales showed low synergy. Conclusion: Amikacin combined with colistin and ceftazidime/avibactam showed promise against Enterobacterales MDR infections but limited efficacy against <em>Acinetobacter</em>, influenced by resistance genes. E-test can be useful for routine laboratory.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116888"},"PeriodicalIF":2.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyses of Human papillomavirus, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2 and coinfections among male outpatients in Kunming, China","authors":"Xiangcong Wei ,&nbsp;Xinlong Huang ,&nbsp;Yafei Huang ,&nbsp;Ting Su ,&nbsp;Qiuting Duan ,&nbsp;Jinxiu Wan ,&nbsp;Yi Sun ,&nbsp;Ya Xu","doi":"10.1016/j.diagmicrobio.2025.116896","DOIUrl":"10.1016/j.diagmicrobio.2025.116896","url":null,"abstract":"<div><div>Sexually transmitted infections (STIs) such as <em>human papillomavirus</em> (HPV), <em>Ureaplasma urealyticum</em> (UU), <em>Chlamydia trachomatis</em> (CT), <em>Neisseria gonorrhoeae</em> (NG), and <em>herpes simplex virus type</em> 2 (HSV-2) significantly affect male reproductive health. Coinfections among these pathogens may aggravate disease severity, yet data on their prevalence among male outpatients remain scarce. In this study, we investigated the prevalence of UU, HSV2, NG, CT, and HPV infections and coinfections in the external genitalia of male outpatients in Kunming, Yunnan. HPV genotyping was performed using PCR and Sanger sequencing, while other pathogens were detected using real-time quantitative PCR. Relevant medical records were obtained from the hospital information system. Statistical analyses were conducted to examine associations between coinfections and clinical characteristics. The prevalence rates for UU, HSV-2, NG, CT, and HPV infections in the external genitalia of male outpatients were 33.31 %, 27.04 %, 23.11 %, 11.70 %, and 8.25 %, respectively. The most common coinfection was NG+UU (14.81 %), followed by CT+UU (4.02 %) and CT+NG (1.45 %). Coinfection rates for HSV2 with UU, CT, and NG were 5.35 %, 0.58 %, and 2.03 %, respectively. HPV coinfection rates with UU, CT, NG, and HSV2 were 3.30 %, 0.62 %, 3.57 %, and 0.00 %, respectively. The five most common HPV subtypes were HPV 43, 52, 56, 58, and 33. This study highlights the high prevalence of STIs and coinfections among male outpatients in Kunming, underscoring the urgent need for improved screening and prevention strategies to address these widespread health concerns.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 1","pages":"Article 116896"},"PeriodicalIF":2.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical varicella zoster virus CNS infections: Diagnostic challenges and the role of multiplex PCR","authors":"Keh-Sen Liu ,&nbsp;Po-Yu Liu ,&nbsp;Chien-Hao Tseng ,&nbsp;Chia-Wei Liu ,&nbsp;Wei-Hsuan Huang ,&nbsp;Hsien-Po Huang ,&nbsp;Chia-Ru Li ,&nbsp;Tzu-An Yang ,&nbsp;Hsin-Hui Wang ,&nbsp;Ting-Kuang Yeh","doi":"10.1016/j.diagmicrobio.2025.116893","DOIUrl":"10.1016/j.diagmicrobio.2025.116893","url":null,"abstract":"<div><h3>Introduction</h3><div>Varicella zoster virus (VZV) can cause central nervous system (CNS) infections, including meningitis and meningoencephalitis. This study describes the clinical and laboratory characteristics of VZV CNS infections diagnosed by multiplex PCR, a diagnostic tool with increasing global availability.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted at a tertiary hospital in Taiwan and included patients diagnosed with VZV meningitis or meningoencephalitis from May 2023 to May 2024. VZV DNA in cerebrospinal fluid was detected using multiplex PCR. Data were collected from electronic health records, and statistical analysis was performed using SPSS 20.0.</div></div><div><h3>Results</h3><div>Fifteen patients were included, 7 with meningoencephalitis and 7 with meningitis. Shingles was present in 66.7 % of patients. Notably, 40 % of patients had no pleocytosis in cerebrospinal fluid. The median hospital stay was significantly longer for meningoencephalitis patients (25.8 days) compared to meningitis patients (11.9 days, <em>p</em> = 0.018).</div></div><div><h3>Conclusion</h3><div>This study highlights the prevalence of atypical presentations in VZV CNS infections, including cases without cutaneous manifestations and those lacking cerebrospinal fluid pleocytosis. The findings underscore the critical role of multiplex PCR in diagnosing VZV meningitis and meningoencephalitis, particularly in cases with atypical presentations. The study also reveals the more severe nature of meningoencephalitis, as evidenced by longer hospital stays. These results challenge traditional diagnostic approaches and emphasize the need for a high index of suspicion for VZV in all cases of suspected viral CNS infection, regardless of initial clinical or cerebrospinal fluid findings.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"113 2","pages":"Article 116893"},"PeriodicalIF":2.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}