Infectious Disease Reports最新文献

{"title":"Delineating the Significance of Several Inflammatory Markers in a Lung Tuberculosis Cohort During the Active and Post-Tuberculosis Stages of the Disease: An Observational Study in Cape Town, South Africa (2019 to 2024).","authors":"Chrisstoffel Jumaar, Lindiwe Malefane, Steve Jacobs, Olakunle Sanni, Elize Louw, Nicola Baines, Carmen Payne, Sigrid Schulz, Carl Lombard, Merga Feyasa, David Maree, Shantal Windvogel, Hans Strijdom, Benjamin Botha, Brian Allwood, Gerald J Maarman","doi":"10.3390/idr17030052","DOIUrl":"10.3390/idr17030052","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary tuberculosis (TB) frequently leads to long-term lung complications that contribute to increased mortality. Understanding the pathogenesis of post-TB lung impairments is crucial for improving long-term outcomes in TB patients; yet this area remains poorly researched.</p><p><strong>Methods: </strong>Our study assessed circulatory inflammatory markers in patients who completed TB treatment more than one year before enrolment (population 1) and patients receiving in-hospital treatment for active drug-sensitive TB (population 2).</p><p><strong>Results: </strong>IL-6 was seven times higher in both populations compared to the normal range. IL-8 was below the limit of detection (LOD) in population 1, while it was approximately 2.5 times higher in population 2 compared to the normal range. TNF-α was 21 times higher in population 1 and 19 times higher in population 2 compared to the normal range. CRP was almost 49 times higher in both populations, and IL-1Ra was below the LOD in population 1, while it was ~1.5 times higher in population 2 compared to the normal range.</p><p><strong>Conclusions: </strong>These inflammatory biomarkers correlated well with lung function in the post-TB state, and their high levels suggest a persistent pro-inflammatory state post-TB, which may contribute to post-TB lung disease. More research is warranted to better understand this phenomenon, but these findings may highlight a need to consider anti-inflammatory therapy for patients with post-TB lung disease, especially since these high levels of cytokines can directly contribute to lung damage.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage-Specific Immune Responses to AgB T-Peptides in Patients with Cystic Echinococcosis.","authors":"Settimia Sbarra, Ambra Vola, Francesca Tamarozzi, Saeid Najafi-Fard, Alessandra Ludovisi, Antonella Teggi, Emanuele Nicastri, Fabrizio Albarello, Enrico Brunetti, Delia Goletti, Linda Petrone","doi":"10.3390/idr17030051","DOIUrl":"10.3390/idr17030051","url":null,"abstract":"<p><p><b>Background:</b> The identification of parasite- and stage-specific antigens is crucial for the development of new diagnostic tests for cystic echinococcosis (CE). We previously analysed the interleukin (IL)-4 response to T-specific peptides corresponding to the immunogenic regions of the five antigen B (AgB) subunits, demonstrating that AgB1 is the most immunogenic protein and that the response to all AgB peptides is associated with viable cysts. However, the response in patients with CE3a (WHO-IWGE) cystic stage was not evaluated and no other immunological factors besides IL-4 were included in the analysis. <b>Methods:</b> Four study groups were defined: \"CE3a group\" (transitional cysts), \"CE3b group\" (active cysts), \"CE4/CE5 group\" (inactive cysts), and \"NO CE-group\" encompassing patients with non-CE cysts (controls). Whole blood was stimulated in vitro with the five different T-specific peptide pools corresponding to the five AgB subunits and with a pool containing all five peptides' pools (total pool). IL-4 and other immunological markers were evaluated by ELISA and a multiplex assay, respectively. <b>Results:</b> Twenty-four patients with CE (CE3a-group n = 3; CE3b-group n = 6; CE4/CE5-group n = 15) and 14 subjects with non-CE cysts were enrolled. IL-4 levels in response to AgB1 and AgB3 pools were significantly increased in CE compared to NO CE groups (<i>p</i> = 0.0201, <i>p</i> = 0.0041). Within the CE patients, the highest IL-4 median level was observed in response to the AgB total pool, the AgB3 and AgB4 pools, followed by the AgB1 pool. Moreover, the IL-4 levels in response to the AgB1 pool were found to be significantly higher in the CE3b group compared to the CE4/CE5 group (<i>p</i> = 0.0070), while no differences were found for the CE3a group. As for other cytokines, we found higher IL-7 levels in response to the AgB4 pool in the CE4/CE5 group compared to the CE3b group (<i>p</i> = 0.0012), higher IL-2 levels in response to the AgB1 pool and AgB total pool in CE3b patients compared to controls (<i>p</i> = 0.0016), and higher IL-13 levels in response to the AgB total pool in patients with CE3b and CE4/CE5 cysts compared to NO CE (<i>p</i> = 0.0016; <i>p</i> = 0.0009). <b>Conclusions:</b> These results contribute to a better knowledge of the immune interplay in the presence of CE and may be useful for further exploring the use of recombinant proteins/peptides in cytokine release assays for the diagnosis and follow-up of CE.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Antibiotic Potential of a Serine Protease from <i>Solanum trilobatum</i> Against <i>Staphylococcus aureus</i> Biofilms.","authors":"Manohar Radhakrishnan, Kanal Elamparithi Balu, Lakshminarayanan Karthik, Raghavendra Sashi Krishna Nagampalli, Eswar Kumar Nadendla, Gunasekaran Krishnasamy","doi":"10.3390/idr17030050","DOIUrl":"10.3390/idr17030050","url":null,"abstract":"<p><strong>Background: </strong>Multi-antibiotic resistance has become an alarming issue in treating bacterial infections in both community and medical environments. Globally, the scientific community has been exploring multi-antibiotic techniques to find new ways to address this challenge. To address this critical challenge and explore alternative antibiotic treatments, we investigated the potential of <i>Solanum trilobatum</i>, an edible and medicinally important herb plant in Ayurvedic medicine.</p><p><strong>Methods: </strong>Our research focused on a 60 kDa serine protease isolated and purified from the leaves of <i>S. trilobatum</i>, which showed evidence of possessing hydrolase activity. In this study, we examined the capability of the purified enzyme to eradicate preformed biofilms of <i>S. aureus</i> in combination with ampicillin. Additionally, we assessed the stability of the enzyme in the presence of metal ions and detergents.</p><p><strong>Results: </strong>Enzyme kinetics revealed a Vmax of 48.63 µM/min and a Km of 14.08 µM, indicating efficient enzymatic activity. Furthermore, the enzyme exhibited maximum activity at physiological pH, suggesting its potential effectiveness under physiological conditions.</p><p><strong>Conclusions: </strong>Our preliminary findings highlight the promising role of this enzyme as a potential agent to combat S. aureus biofilms, especially when used in conjunction with ampicillin, as an alternative antibiotic approach.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological Surveillance and Antimicrobial Susceptibility Observations on Peritoneal Dialysis-Associated Peritonitis in an Outpatient German Reference Center.","authors":"Annemarie Albert, Stefan Richter, Lisa C Costello-Boerrigter, Philipp Stieger, Rainer Peter Woitas, Rüdiger C Braun-Dullaeus, Christian Albert","doi":"10.3390/idr17030049","DOIUrl":"10.3390/idr17030049","url":null,"abstract":"<p><p><b>Background</b>: Peritonitis is a relevant complication in peritoneal dialysis (PD). The initial empirical antibiotic therapy depends on the center-specific distribution of microorganisms and the microbial susceptibility profiles. However, data on the locoregional germ spectrum in Germany are insufficient regarding the current recommended empirical antibiotic regimens of either cefepime as monotherapy or the combination of cefazolin and ceftazidime. <b>Methods</b>: This retrospective single-center study of routine clinical patient data analyzes the range of infecting organisms causing PD-associated peritonitis and their corresponding antimicrobial resistances during the 2015 to 2022 timeframe. We used Ordinary Least-Squares regression to model trends in the detection of microbiological spectrum samples. The 'reporting of studies conducted using observational routinely collected health data' (RECORD) statement was acknowledged. <b>Results</b>: There were 80 documented peritonitis episodes with 99 causal etiologies sampled. Of those, eighty-seven were bacterial, three were fungi (3%), eight had no microbial growth (8%), and one more had missing data. The largest group of microorganisms detected were Gram-positive bacteria (N = 56, 56.6%), predominantly sampled as Staphylococcacea, Enterococcaceae, and Streptococcaceae (<i>Staphylococcus aureus</i>, 14.1%). Gram-negative bacteria were found in 31.3% of samples (N = 31), predominantly Enterobacteriaceae (<i>Escherichia coli</i>, 9%). In total, 34 different microorganisms were identified. On one occasion, methicillin-resistant <i>Staphylococcus epidermidis</i> and one sample of multi-resistant <i>Serratia marcescens</i> were identified. Methicillin-resistant <i>Staphylococcus aureus</i> and vancomycin-resistant enterococci were not detected. Fungi were found in three peritonitis episodes. Regression analyses did not indicate changes in the general microbiological spectrum during the observational timeframe. The center-specific peritonitis rates were below the recommended rates of the International Society for Peritoneal Dialysis for all years studied. <b>Conclusions</b>: The recommended empiric therapy was suitable at our center, with a few exceptions for non-specific pathogens and for those with β-lactamases or enterococci. When there is no clinical response to empiric therapy, alternative antibiotics should be considered accordingly. The retrospective data are limited to the reported outcome measures.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Appearance of Osteomyelitis of the Foot and Disseminated Subcutaneous Abscesses During Treatment for Disseminated Tuberculosis Infection in an Immunocompetent Patient: Case Presentation of a Paradoxical Reaction and Literature Review.","authors":"Luca Santilli, Benedetta Canovari, Maria Balducci, Francesco Ginevri, Monia Maracci, Antonio Polenta, Norma Anzalone, Lucia Franca, Beatrice Mariotti, Lucia Sterza, Francesco Barchiesi","doi":"10.3390/idr17030046","DOIUrl":"10.3390/idr17030046","url":null,"abstract":"<p><p><b>Background:</b> The appearance of new clinical manifestations (for example, subcutaneous or skin abscesses) during anti-tuberculosis treatment is generally indicative of therapeutic failure. The cause of therapeutic failure may be the presence of a drug-resistant <i>Mycobacterium</i> infection or to the failure to achieve a sufficient concentration of the drugs in the bloodstream. <b>Case report:</b> Here, we report the case of a 25-year-old man suffering from tuberculosis infection with lymph-node and pulmonary involvement and an atypical response to specific therapy. Two weeks after starting four-drug antitubercular treatment, the patient began to experience fever, pain and functional impotence in the left foot and ankle, with subsequent evidence of ankle and tarsal osteomyelitis. Four weeks after starting treatment, the patient presented with several widespread, painful subcutaneous abscesses on the trunk, back and right lower limb. Drainage was performed from the ankle and from one of the abscesses, and polymerase chain reaction (PCR) showed a positive result for <i>M. tuberculosis</i> in both samples, with the absence of resistance to drugs. Anti-tubercular medications were continued, with resolution of the pulmonary and bone involvement but with persistence of subcutaneous abscesses, although subsequent drainages showed the absence of mycobacterium tuberculosis. <b>Conclusions:</b> We describe an unusual presentation of paradoxical reaction in the form of osteomyelitis and subcutaneous abscesses in an immunocompetent TB patient, and we reported other similar cases of paradoxical reactions described in the literature in the last ten years, which demonstrate the importance of considering paradoxical reactions in patients who present with new or worsening signs and symptoms after starting tuberculosis treatment.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of VZV Reactivation and Effectiveness of Vaccination with Recombinant Adjuvanted Zoster Vaccine in Allogeneic Hematopoietic Stem Cell Recipients-A Single-Center Analysis.","authors":"Ewa Karakulska-Prystupiuk, Magdalena Feliksbrot-Bratosiewicz, Maria Król, Agnieszka Tomaszewska, Wiesław Wiktor Jędrzejczak, Grzegorz Władysław Basak","doi":"10.3390/idr17030048","DOIUrl":"10.3390/idr17030048","url":null,"abstract":"<p><strong>Background: </strong>Secondary immunodeficiencies in allo-HSCT (allogeneic hematopoietic stem cell transplantation) recipients increase the risk of viral reactivation, making vaccinations a vital issue. There is a paucity of data on the use of recombinant vaccine against herpes zoster (RZV) after allo-HSCT.</p><p><strong>Methods: </strong>This analysis included 149 recipients of allo-HSCT, transplanted in 2012-2022, mainly due to hematological malignancies (>95%). RZV was used from 2021 to 2023 according to the current recommendations of ACIP. The ELISA method was used to assess the VZV IgG antibody titers.</p><p><strong>Results: </strong>VZV reactivation was diagnosed in 49 out of 149 (33%) patients before vaccination, including 5 (3%) patients with reactivation within the first year after transplantation and the remaining 44 (30%) within the subsequent three years. At that time, the majority of patients were not receiving acyclovir prophylaxis. The most common clinical manifestation of reactivation was involvement of intercostal nerves, diagnosed in 40 (81%) patients. Twenty-one recipients (median age: 41) received two doses of RZV (at a median time of 34 months after transplantation, range 12-84 months), the majority of them at an interval of 1 month. The serological post-vaccination response was confirmed in 12 recipients, with a ratio of 2.38-8.3 (median 5.095). The median number of total CD3+CD4+cells in vaccinated patients was 451/μL. Despite vaccination, four patients (19%, three with confirmed serological response) developed herpes zoster.</p><p><strong>Conclusions: </strong>Herpes zoster occurred mainly in the late period after allo-HSCT after completion of acyclovir prophylaxis in over 30% of recipients. The preliminary results indicate that RZV vaccination after allo-HSCT was safe and more than 80% effective at preventing HZ, but some vaccinated individuals did experience HZ.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review.","authors":"Diego Alejandro Cubides-Diaz, Valentina Negrette-Lazaro, Viviana Poveda-Hurtado, Juan Pablo López-Salazar, Carlos Mauricio Calderón-Vargas, Carlos Arturo Álvarez-Moreno","doi":"10.3390/idr17030047","DOIUrl":"10.3390/idr17030047","url":null,"abstract":"<p><strong>Background: </strong><i>Pneumocystis jirovecii</i> primarily causes pneumonia in immunosuppressed individuals, particularly those living with advanced HIV/AIDS. Extrapulmonary dissemination is uncommon, with bone marrow involvement described in only a handful of cases globally. Bone marrow infection occurs in the setting of severe immunosuppression, poses diagnostic challenges, and carries a high mortality rate.</p><p><strong>Methods: </strong>We describe the case of a 34-year-old man newly diagnosed with HIV/AIDS, presenting with severe immunosuppression and <i>Pneumocystis jirovecii</i> pneumonia. The patient initially improved with cotrimoxazole and corticosteroids, but was readmitted shortly after discharge with abdominal pain, diarrhea, and worsening pancytopenia. A bone marrow biopsy revealed <i>Pneumocystis jirovecii</i> cysts, confirming disseminated infection. Concomitant Kaposi sarcoma involving the skin and gastrointestinal tract was also diagnosed. Despite antimicrobial therapy, the patient's condition worsened, leading to multisystem organ failure and death two months later.</p><p><strong>Conclusions: </strong>This case highlights a rare presentation of disseminated <i>Pneumocystis jirovecii</i> infection with bone marrow involvement in a patient with advanced HIV/AIDS. Although infrequent, this complication should be considered in individuals with <i>Pneumocystis jirovecii</i> pneumonia who develop persistent cytopenias and systemic symptoms. Diagnosis depends on histopathologic confirmation, which may lead to under-recognition. Early suspicion and individualized management are essential, though the optimal treatment approach for extrapulmonary infection remains undefined.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Genetic Characterization of Distinct Ebola Sudan Outbreaks in Uganda.","authors":"Francesco Branda, Massimo Ciccozzi, Fabio Scarpa","doi":"10.3390/idr17030044","DOIUrl":"10.3390/idr17030044","url":null,"abstract":"<p><p><b>Background</b>. Sudan virus (SUDV) has caused multiple outbreaks in Uganda over the past two decades, leading to significant morbidity and mortality. The recent outbreaks in 2022 and 2025 highlight the ongoing threat posed by SUDV and the challenges in its containment. This study aims to characterize the epidemiological patterns and phylogenomic evolution of SUDV outbreaks in Uganda, identifying key factors influencing transmission and disease severity. <b>Methods</b>. We conducted a retrospective observational study analyzing epidemiological and genomic data from SUDV outbreaks in Uganda between 2000 and 2025. Epidemiological data were collected from official sources, including the Ugandan Ministry of Health and the World Health Organization, supplemented with reports from public health organizations. Genomic sequences of SUDV were analyzed to investigate viral evolution and identify genetic variations associated with pathogenicity and transmissibility. <b>Results</b>. The 2022 outbreak involved 164 confirmed cases and a case fatality rate (CFR) of 33.5%, with significant geographic variation in case distribution. The 2025 outbreak, still ongoing, was first detected in Kampala, with evidence of both nosocomial and community transmission. Phylogenomic analysis revealed the presence of two main genetic groups, representing Sudan and Uganda, respectively. The genetic variability of the Ugandan cluster is higher than that observed in Sudan, suggesting a greater expansion potential, which aligns with the current outbreak. Epidemiological findings indicate that human mobility, weaknesses in the health system, and delays in detection contribute to the amplification of the outbreak. <b>Conclusions</b>. Our findings underscore the importance of integrated genomic and epidemiological surveillance in understanding SUDV transmission dynamics. The recurrent emergence of SUDV highlights the need for improved outbreak preparedness, rapid response mechanisms, and international collaboration. Strengthening real-time surveillance and enhancing healthcare system resilience are critical to mitigating the impact of future outbreaks.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Rickettsia parkeri</i> Rickettsiosis Resembling Sweet Syndrome: A Differential Diagnosis for Critical Discussion.","authors":"Lucas S Blanton, Sarah E Muir, Nicole L Mendell, David H Walker","doi":"10.3390/idr17030045","DOIUrl":"10.3390/idr17030045","url":null,"abstract":"<p><p><b>Introduction:</b> Spotted fever group (SFG) rickettsioses are tick-transmitted infections caused by Gram-negative, obligately intracellular bacteria in the genus <i>Rickettsia</i>. They present as an acute undifferentiated febrile illness, and they are often accompanied by rash and/or eschar. Although the rash of SFG rickettsioses usually consists of macules and papules, some, like in <i>Rickettsia parkeri</i> rickettsiosis, can also manifest with papulovesicular or pustular lesions. <b>Case:</b> We herein present a case of SFG rickettsiosis, due to <i>R. parkeri</i>, that masqueraded as Sweet syndrome (the prototype neutrophilic dermatosis) after the initial results of a shave biopsy. Further investigation of the biopsy specimen by immunohistochemical and PCR analysis would eventually confirm SFG rickettsiosis, with <i>R. parkeri</i> being detected by real-time PCR. <b>Discussion:</b><i>Rickettsia parkeri</i> is transmitted by the Gulf Coast tick (<i>Amblyomma maculatum</i>) and is an increasingly recognized cause of SFG rickettsiosis in the United States. <i>Rickettsia parkeri</i> should be considered in those with an acute undifferentiated febrile illness with lesions that are pustular or papulovesicular, as prompt recognition and empirical administration of doxycycline results in the rapid resolution of symptoms.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of COVID-19 Symptom Rebound After Treatment with Remdesivir.","authors":"Kalpana Gupta, William J O'Brien, Judith Strymish, Anna Chen, Katherine Linsenmeyer, Rebecca Madjarov, Michael E Charness","doi":"10.3390/idr17030043","DOIUrl":"10.3390/idr17030043","url":null,"abstract":"<p><strong>Background/objectives: </strong>Recent in vitro data suggest that remdesivir might be less likely than nirmatrelvir-ritonavir to be associated with COVID-19 rebound. We compared the incidence of symptom rebound in our remdesivir-treated cohort with rates reported in the literature for nirmatrelvir-ritonavir.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of VA Boston Healthcare System patients who were nursing home residents or inpatients treated with remdesivir for mild to moderate COVID-19 that met clinical criteria for nirmatrelvir-ritonavir treatment between 05/2022 and 10/2024. Electronic health records were reviewed for evidence of symptom rebound in daily clinical evaluations and outside hospital care notes for 15-20 days after the diagnosis of COVID-19. Rates for nirmatrelvir-ritonavir were identified via a literature review.</p><p><strong>Results: </strong>Among 194 patients treated with remdesivir, 39 were excluded due to concurrent antiviral use, hypoxia, or ICU-level care. The average age of the remaining 155 patients was 75.1 ± 11.9 years; 147 patients (95%) were male. Evidence of symptom rebound was found in 1 of 155 (0.6%) remdesivir-treated patients, which is a rate lower than that reported in all 12 studies of nirmatrelvir-ritonavir symptom rebound during the Omicron era.</p><p><strong>Conclusions: </strong>Our finding of low rates of COVID-19 symptom rebound after treatment with remdesivir are consistent with the hypothesis that rebound may be less frequent after treatment with remdesivir than with nirmatrelvir-ritonavir.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"17 3","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}