Enfermedades infecciosas y microbiologia clinica最新文献

{"title":"Gonococcal orbital cellulitis in an adolescent: A diagnostic challenge in determining the transmission pathway","authors":"Samantha Pérez-Cavazos ,&nbsp;Adrián Camacho-Ortiz ,&nbsp;Eduardo Pérez-Alba ,&nbsp;Samanta Denis Ibarra-Treviño","doi":"10.1016/j.eimc.2026.503106","DOIUrl":"10.1016/j.eimc.2026.503106","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Neisseria gonorrhoeae</em> is a well-known cause of conjunctivitis but an exceptionally rare cause of preseptal or orbital cellulitis. While sexual contact is the main mode of transmission, non-sexual routes have been documented, posing a diagnostic challenge. This article reports a case of <em>N. gonorrhoeae</em> orbital cellulitis with an associated abscess in an adolescent female who denied sexual activity and reviews the existing literature on this unusual presentation.</div></div><div><h3>Methods</h3><div>We present the case of a 16-year-old female who was admitted for evaluation of unilateral vision loss and proptosis. Additionally, a literature search of multiple core databases was performed for publications between 1975 and 2025 to identify all documented cases of gonococcal preseptal and orbital cellulitis.</div></div><div><h3>Results</h3><div>A 16-year-old patient was diagnosed with orbital cellulitis and a pre-septal abscess. Gram stain of the purulent eye discharge revealed Gram-negative diplococci, and cultures subsequently confirmed <em>N. gonorrhoeae</em> isolation. The patient responded favorably to treatment with ceftriaxone and doxycycline. Literature review was able to identify only seven documented cases of <em>N. gonorrhoeae</em>-associated orbital cellulitis and nine cases of preseptal cellulitis reported over the last 50 years, highlighting the importance of this clinical entity.</div></div><div><h3>Conclusions</h3><div>This case expands the known clinical spectrum of atypical gonococcal infections. <em>N. gonorrhoeae</em> should be considered in the differential diagnosis of orbital cellulitis in adolescent patients, even when a history of sexual activity is denied. This report underscores the importance of considering alternative transmission routes and utilizing appropriate microbiological diagnostics to ensure timely and effective treatment.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 3","pages":"Article 503106"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147404826","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":"Infección respiratoria aguda por virus respiratorio sincitial en mujeres gestantes (2021-2025)","authors":"Jordi Reina,&nbsp;Alejandro López","doi":"10.1016/j.eimc.2025.503069","DOIUrl":"10.1016/j.eimc.2025.503069","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 3","pages":"Article 503069"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147404494","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":"Abscesos hepáticos: características clínico-epidemiológicas, microbiológicas y predictores de mortalidad","authors":"Daniel Robles de la Osa ,&nbsp;Cristina Sánchez del Hoyo ,&nbsp;Claudia Pérez Urra ,&nbsp;Lidia Hervés González ,&nbsp;Pablo Espinel Pinedo ,&nbsp;Carmen Beatriz Bulnes Labrador ,&nbsp;Laura López Allúe ,&nbsp;Elena González de Castro ,&nbsp;Ángela Martina Montero Moretón ,&nbsp;Fernando Santos Santamarta ,&nbsp;Laura Pérez Citores ,&nbsp;Javier Santos Fernández ,&nbsp;Sergio Maestro Antolín ,&nbsp;Bruno Antonio Moreira da Silva ,&nbsp;Javier Barcenilla Laguna ,&nbsp;Marta Cimavilla Román ,&nbsp;Francisco José Rancel Medina ,&nbsp;María Antonella Rizzo Rodríguez ,&nbsp;Mónica Bru Arca ,&nbsp;Jeisson Andrey Toro Santibáñez ,&nbsp;Antonio Germán Pérez Millán","doi":"10.1016/j.eimc.2025.503052","DOIUrl":"10.1016/j.eimc.2025.503052","url":null,"abstract":"<div><h3>Introduction</h3><div>Liver abscesses are the most common type of visceral abscess. Risk factors include diabetes mellitus, hepatobiliary diseases, liver transplantation, and proton pump inhibitor use. Diagnosis relies on imaging techniques and microbiological cultures. The aim of the study was to evaluate the clinical-epidemiological and microbiological characteristics of liver abscesses and their impact on patient prognosis.</div></div><div><h3>Methods</h3><div>Retrospective observational study conducted on 132 patients diagnosed with liver abscesses from 2011 to 2022 in a single hospital in Spain. Clinical, laboratory, and microbiological variables were compared, assessing mortality predictors using logistic regression and survival by treatment strategy using Cox regression.</div></div><div><h3>Results</h3><div>Female sex and biliary disease increase the risk of multiple liver abscesses. Liver abscess cultures are more effective for diagnosis than blood cultures. Polymicrobial blood cultures are more common in patients with a history of colorectal cancer. Early percutaneous drainage reduced hospitalization time, and broad-spectrum antibiotic therapy decreased the need for surgery. The in-hospital mortality rate was 15.1%, and was independently associated with diabetes mellitus, abscess size, and polymicrobial infection; surgery was linked to a higher mortality risk compared with drainage.</div></div><div><h3>Conclusions</h3><div>Liver abscess cultures are crucial for guiding antibiotic therapy, particularly given the high prevalence of polymicrobial infections. Mortality is linked to specific comorbidities and microbial findings. Early drainage and broad-spectrum antibiotics improve clinical outcomes.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 3","pages":"Article 503052"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147404841","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":"Desarrollo de indicadores de humanización en la atención a la persona con infección bacteriana grave: propuesta y validación","authors":"Julio Zarco Rodríguez ,&nbsp;Jaime Lora-Tamayo Morillo-Velarde ,&nbsp;Laura Morata Ruiz ,&nbsp;Irantzu Rosselló Taberna ,&nbsp;Xavier Oleart Martínez","doi":"10.1016/j.eimc.2025.503036","DOIUrl":"10.1016/j.eimc.2025.503036","url":null,"abstract":"<div><h3>Introduction</h3><div>The care of patients with severe bacterial infections presents clinical, organizational, and human challenges. This study proposes a system to objectively assess the quality of humanized care in this context.</div></div><div><h3>Methods</h3><div>Using a multidisciplinary approach, unmet needs were identified and five strategic lines, twenty subdimensions, and a set of evaluation indicators were defined. The proposal was validated through a pilot in two hospitals.</div></div><div><h3>Results</h3><div>The indicators were designed to be applicable in different hospital settings to assess aspects such as treatment, care coordination, and communication. The pilot confirmed the feasibility of implementation and their usefulness for improvement planning.</div></div><div><h3>Conclusions</h3><div>The proposed indicator system is a useful tool to support progress toward more humanized and objectively measurable care for patients with severe bacterial infections.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503036"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096099","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":"Tecovirimat hepatotoxicity in a man with Mpox infection","authors":"Diana Ruiz-Cabrera ,&nbsp;Francisco Montoya ,&nbsp;Joaquín Sáez-Peñataro ,&nbsp;José Riera ,&nbsp;Pablo Manuel Vargas ,&nbsp;Ester López-Suñé ,&nbsp;María López-Pont ,&nbsp;Marina Martinez-Illán ,&nbsp;Alba Catala ,&nbsp;Montse Tuset ,&nbsp;Irene Fuertes ,&nbsp;Xavier Forns ,&nbsp;Jose Luis Blanco","doi":"10.1016/j.eimc.2025.503030","DOIUrl":"10.1016/j.eimc.2025.503030","url":null,"abstract":"<div><h3>Introduction</h3><div>In the context of the global Mpox outbreak from 2022 to 2024, tecovirimat has been widely used for Mpox treatment, initially demonstrating good tolerance and low toxicity. However, recent studies suggest limited efficacy in reducing Mpox lesions.</div></div><div><h3>Methods</h3><div>We present the first reported case of significant hepatocellular injury associated with tecovirimat in a patient with Mpox. Pharmacovigilance databases were reviewed to identify any previously reported cases and a literature review was conducted to support the plausibility of this adverse drug reaction.</div></div><div><h3>Results</h3><div>A 53-year-old man without HIV infection presented with Mpox involving mucocutaneous lesions and suspected encephalitis. Forty-eight hours after initiating tecovirimat, a two-fold increase in liver enzymes was observed. After one week, peak values were recorded: AST 881<!--> <!-->U/L, ALT 656<!--> <!-->U/L, and LDH 1011<!--> <!-->U/L. By the third week, thrombocytopenia (nadir 106,000/mm³) and prolonged prothrombin time (lowest value 55.3%) developed, consistent with moderate liver injury per the US DILIN severity index. Tecovirimat was discontinued on day 7 due to suspected drug-induced liver injury. A thorough evaluation ruled out alternative causes of hepatic damage. Following discontinuation, liver function tests gradually improved, and by week six post-initiation, complete resolution of hepatocellular injury and liver dysfunction was achieved without sequelae.</div></div><div><h3>Conclusions</h3><div>This case highlights the need for caution when prescribing tecovirimat, particularly given its uncertain clinical efficacy, and stresses the importance of close monitoring for potential hepatotoxic effects.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503030"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096098","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":"Clinical evaluation of a rapid antigen detection test for the diagnosis of tinea unguium","authors":"Lucía Argente-Colás ,&nbsp;Miren Urmeneta ,&nbsp;Sayoa Hernán-Gómez ,&nbsp;Ana Navascués-Ortega ,&nbsp;María-Eugenia Portillo ,&nbsp;Miguel Fernández-Huerta","doi":"10.1016/j.eimc.2025.503067","DOIUrl":"10.1016/j.eimc.2025.503067","url":null,"abstract":"<div><h3>Introduction</h3><div>Currently, diagnosis of dermatophyte onychomycosis relies on direct microscopic examination (DME) and fungal cultures of nail material. Herein, we aim to evaluate the clinical performance of the rapid antigen detection (RAD) assay PreventID Dermatophyte in comparison to conventional methods for the diagnosis of <em>tinea unguium</em>.</div></div><div><h3>Methods</h3><div>Between February and July 2024, 48 nail samples, collected at the Navarra University Hospital, Spain, were included in the evaluation. In addition to DME and culture, the RAD test was executed. In case of discrepancies, the qPCR assay Novaplex™ Dermatophyte was utilized.</div></div><div><h3>Results</h3><div>Overall, the RAD test performed well, comparable to DME or culture, with concordances of 80.9% and 80.0%, respectively. The existence of falsely-negative and falsely-positive results reinforces the use of complementary diagnostic procedures, such as DME and culture, for confirmatory testing.</div></div><div><h3>Conclusions</h3><div>In conclusion, the PreventID Dermatophyte test provides rapid and reliable results with acceptable performance.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503067"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096076","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":"Respiratory syncytial virus infection in non-severely immunocompromised adults: Clinical features and outcomes from a tertiary university hospital in Argentina","authors":"Emilse Daniela Diaz Lobo ,&nbsp;Emilio Felipe Huaier Arriazu ,&nbsp;Mariana Vaena ,&nbsp;Diana Hongn ,&nbsp;Jessica del Valle Molina ,&nbsp;Diego Hernan Giunta ,&nbsp;Gabriela Alejandra Blugerman ,&nbsp;Marisa del Lujan Sanchez","doi":"10.1016/j.eimc.2025.503076","DOIUrl":"10.1016/j.eimc.2025.503076","url":null,"abstract":"<div><h3>Introduction</h3><div>Respiratory syncytial virus (RSV) is an increasingly recognised cause of morbidity and mortality in older adults. However, data on RSV burden in Latin American countries remain limited. We aim to describe the clinical characteristics and outcomes of RSV infection in non-severely immunocompromised adults receiving care at a tertiary hospital in Argentina.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study including adults aged ≥60 years, or ≥50 with comorbidities, diagnosed with RSV between January 2013 and December 2019. The primary outcome was clinical status at days 0, 7, and 30 after diagnosis. Secondary outcomes included 30-day mortality, hospitalisation, ICU admission, and healthcare utilisation.</div></div><div><h3>Results</h3><div>Of 262 patients included (median age: 82 years), 77.5% were hospitalised at diagnosis. The most common symptoms were cough (62.2%) and dyspnea (58.0%), with abnormal chest imaging in 55.8% of cases. Lower respiratory tract infection (LRTI) was present in 63.7% and severe LRTI in 53.4%. At 30 days, only 57.3% had fully recovered. The 30-day all-cause mortality was 7.6%. ICU admission occurred in 27.1% of patients. Factors associated with worse clinical outcomes included age &gt;85 years, history of heart disease, hypoxemia, abnormal imaging, and ICU admission.</div></div><div><h3>Conclusions</h3><div>RSV infection in adults is associated with a significant clinical burden and considerable functional impairment. At 30 days post-diagnosis, only 57.3% of patients had been discharged and returned to normal activities. These findings underscore the need for improved preventive strategies and strengthened surveillance in this population.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503076"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096075","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":"An unexpected opportunistic infection in a patient with diffuse large B-cell lymphoma","authors":"Claudia Beatriz Pérez González ,&nbsp;Isabel Fradejas Villajos ,&nbsp;Lucía Villalón Blanco ,&nbsp;Leonor Moreno Núñez","doi":"10.1016/j.eimc.2025.503061","DOIUrl":"10.1016/j.eimc.2025.503061","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503061"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096068","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":"Dengue serotypes and their severity correlation: A hospital-based observational study","authors":"Anju Dinkar ,&nbsp;Jitendra Singh","doi":"10.1016/j.eimc.2025.503074","DOIUrl":"10.1016/j.eimc.2025.503074","url":null,"abstract":"<div><h3>Introduction</h3><div>Dengue virus (DENV) infection can present a range of clinical manifestations, from mild fever to severe complications. Emerging data suggest that specific viral serotypes may influence disease severity. This study aimed to evaluate the circulating DENV serotypes and their correlation with clinical outcomes in hospitalized patients.</div></div><div><h3>Methods</h3><div>A retrospective, cross-sectional study was conducted at a tertiary care center in northern India from August 2022 to January 2023. Laboratory-confirmed dengue cases (<em>N</em> <!-->=<!--> <!-->356) were included, and serotyping was performed via nested reverse transcription-polymerase chain reaction (nested RT-PCR). Demographic, clinical, and biochemical data were analyzed. Statistical comparisons and relative risk analyses were performed to identify associations between serotypes and disease severity, including mortality predictors.</div></div><div><h3>Results</h3><div>Out of the 111 dengue cases, 7 had mixed serotypes. Among the remaining 104 patients, DENV-2 was the predominant serotype (71.2%), followed by DENV-3 (26.9%), DENV-1 (1.9%), and mixed serotypes (6.3%) infections. Overall, 71.2% of patients presented with warning signs, and 28.8% progressed to severe dengue. The highest severe dengue cases were observed in DENV-2 (33.8%) and in mixed DENV-2 &amp; 3 infections (100%). DENV-2 was significantly associated with severe manifestations such as plasma leakage (RR<!--> <!-->=<!--> <!-->24.73, <em>p</em> <!-->&lt;<!--> <!-->0.001), hemorrhagic rash, and elevated transaminases. Mortality (21.6%) occurred exclusively in DENV-2 and mixed DENV-2 and 3 infections. Predictors of mortality included thrombocytopenia, leucopenia, elevated SGPT/SGOT, and hypoalbuminemia.</div></div><div><h3>Conclusion</h3><div>DENV-2 is the principal serotype associated with severe dengue and adverse outcomes in this region. Early identification of serotype and key laboratory parameters can improve risk stratification and clinical management, with implications for surveillance and public health response.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503074"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096074","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":"CMV-specific cellular immunity in solid organ transplantation: Challenges and opportunities for clinical implementation","authors":"Estela Giménez ,&nbsp;Eliseo Albert","doi":"10.1016/j.eimc.2025.503078","DOIUrl":"10.1016/j.eimc.2025.503078","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"44 2","pages":"Article 503078"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096067","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}