Infection最新文献

{"title":"Clinical features, course, and risk factors of infection-associated secondary hemophagocytic lymphohistiocytosis.","authors":"Michael Ruzicka, Thomas Wimmer, Hans-Joachim Stemmler, Stephanie-Susanne Stecher, Hendrik Schulze-Koops, Fabian Hauck, Marion Subklewe, Michael von Bergwelt-Baildon, Karsten Spiekermann","doi":"10.1007/s15010-025-02559-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02559-z","url":null,"abstract":"<p><p>Hemophagocytic lymphohistiocytosis (HLH) is an orphan disease characterized by excessive inflammation and poor outcome. We sought to further characterize clinical features, courses, and risk factors of secondary HLH (sHLH) triggered by infection (iHLH). 28 (43.1%) of 65 adult sHLH cases treated at our hospital from 2012-2024 were infection-associated. iHLH patients were mostly male (71.4%). Infectious agents most frequently detected were EBV (57.1%) and leishmania (14.3%). The median time to diagnosis was 13 [6.0;24.8] days. iHLH patients had a mortality rate of 39.3% (median follow-up time: 735 [336;1140] days), worse survival than patients with autoimmune-triggered (hazard ratio: 3.33 (1.01-11.10), p = 0.049), and better survival than patients with paraneoplastic HLH (hazard ratio: 0.19 (0.10-0.84), p = 0.002). Elevated levels of soluble interleukin-2 receptor (sIL2R; > 6,000 I/U), low thrombocyte counts (< 40 G/l), and a history of malignant disease were associated with adverse outcomes. Protracted time to diagnosis was associated with severe disease courses and with leishmaniosis. Further, sIL2R levels correlated positively with prolonged aPTT and thrombocytopenia, and hypertriglyceridemia with elevated INRs. Patients with an elevated sIL2R:ferritin ratio were more likely to have a history of malignant comorbidities. Taken together, sIL2R, thrombocytopenia, and a history of malignant disease are important prognostic factors of iHLH. Patients with high sIL2R levels or hypertriglyceridemia may be at higher risk of bleeding, and patients with elevated sIL2R:ferritin ratios should be assessed for possible malignant comorbidities. Lastly, increased awareness of the disease and newly emerging pathogens (i.e. leishmania) may shorten the time to diagnosis, and thus reduce severe courses of iHLH.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging oral and systemic health: exploring pathogenesis, biomarkers, and diagnostic innovations in periodontal disease.","authors":"Max Foroughi, Mahmoud Torabinejad, Nikola Angelov, David M Ojcius, Keykavous Parang, Marcus Ravnan, Jerika Lam","doi":"10.1007/s15010-025-02568-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02568-y","url":null,"abstract":"<p><strong>Purpose: </strong>This narrative review explores the multifaceted links between periodontal diseases (gingivitis and periodontitis) and systemic health conditions, including cardiovascular disease, diabetes, adverse pregnancy outcomes, Alzheimer's disease, cancers, rheumatoid arthritis, and respiratory infections. It aims to synthesize evidence on how local oral infections exert systemic effects and evaluate the potential of diagnostic technologies to monitor these interactions.</p><p><strong>Methods: </strong>This narrative review synthesizes current scientific literature on periodontal disease pathogenesis, focusing on key pathogens (e.g., Porphyromonas gingivalis, Fusobacterium nucleatum) and their roles in driving local and systemic inflammation via virulence factors and microbial dysbiosis. It examines biomarker-based diagnostic approaches (e.g., IL-1β, TNF-α, microbial DNA) in saliva, blood, and gingival crevicular fluid (GCF) and evaluates current and emerging diagnostic tools (e.g., ELISA, PCR, lateral flow assays, biosensors, microfluidics).</p><p><strong>Results: </strong>The review highlights that periodontal pathogens contribute to systemic disease through complex mechanisms including persistent inflammation (driven by cytokines like IL-1β, TNF-α), endotoxemia (via LPS, noting pathogen-specific structural variations impacting immune response), molecular mimicry, and immune modulation. Current diagnostic methods provide valuable information but often face limitations in speed, portability, and multiplexing capability needed for comprehensive point-of-care assessment. Emerging technologies, particularly multiplex platforms integrating biosensors or microfluidics, demonstrate significant potential for rapid, user-friendly analysis of multiple biomarkers, facilitating earlier detection and personalized risk stratification, especially in high-risk populations.</p><p><strong>Conclusion: </strong>Periodontal diseases significantly impact systemic health via intricate microbial and inflammatory pathways. The complexity of these interactions necessitates moving beyond conventional diagnostics towards integrated, advanced technologies. Implementing rapid, multiplex biomarker detection platforms within a multidisciplinary healthcare framework holds the potential to revolutionize early detection of linked conditions, improve personalized management strategies, and ultimately reduce the systemic burden of periodontal disease.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid diagnosis of acute pediatric respiratory infections with Point-of-Care and multiplex molecular testing.","authors":"Jane M Caldwell, Claudia Mily Espinosa, Ritu Banerjee, Joseph B Domachowske","doi":"10.1007/s15010-025-02553-5","DOIUrl":"https://doi.org/10.1007/s15010-025-02553-5","url":null,"abstract":"<p><p>Acute infections of the respiratory tract are very common in pediatric patients, with an estimated global incidence of 17.2 billion cases in 2019. Accurate and timely diagnosis and treatment of acute respiratory infections can prevent progression to more serious pathologies, especially in the young, elderly, immunocompromised, and other high-risk groups. Due to the significant increase in the number of multiplex molecular tests available, there are now many diagnostic options which generate results within minutes or hours, many of which can be performed at point-of-care or near-patient rather than being sent out to a centralized laboratory. Rapid molecular single- or multiplex testing conducted at point-of-care or near-patient offers the potential to improve timely and accurate diagnosis, decrease inappropriate antibiotic use, decrease reliance on chest radiographs, improve timely antiviral administration, reduce the length of hospital stay, reduce the number of clinical visits, and, ultimately, improve patient outcomes. Optimal use of user-friendly multiplex molecular panels also has the potential to improve regional and global disease surveillance and to fill gaps that exist in our understanding of the epidemiology of respiratory infections. These potential benefits, however, come with limitations. For example, use of multiplex PCR assays is not always a cost effective approach. Despite their potential, there are clinical and/or laboratory circumstances where their use becomes cost prohibitive. Another recognized limitation of multiplex PCR assays is that the pathogen detected may not be the cause of a patient's current symptom complex. Such false positive results may occur because the assays are designed to detect pathogen-specific nucleic acid (which may be residual from a prior illness), rather than replication competent pathogens, or because some pathogens can be present without causing symptomatic infection. Further study is needed to determine optimal use of these tests across different patient groups and settings. Incorporating recommendations for best practice use of multiplex molecular assays into clinical guidelines helps offer a framework for their most appropriate use in the diagnosis of pediatric acute respiratory infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micro- and nanoplastics reduce the phagocytosis and intracellular killing of E. coli by THP1-Blue™ NFκB monocytes.","authors":"Florian Edbauer, Hans-Christoph Ludwig, Marie Julia Moritz, Roland Nau, Jana Seele","doi":"10.1007/s15010-025-02565-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02565-1","url":null,"abstract":"<p><strong>Purpose: </strong>Micro- and nanoplastic particles occur ubiquitously in the environment and have been detected in various organs in animals and humans. We studied, how micro- and nanoplastic influence phagocytosis and intracellular killing of live bacteria in human monocytes.</p><p><strong>Methods: </strong>Cells of the human reporter cell line THP1-Blue™ NFκB were pre-treated with different concentrations of micro- and nanoplastic (diameter 1 μm and 100 nm) and then incubated with Escherichia coli DH5α. Phagocytosis and intracellular killing was studied using an antibiotic protection assay. The activation of the NFκB promoter was quantified by measuring the production of alkaline phosphatase. Cytokines were measured by enzyme immunoassay. Cell viability was determined by trypan blue staining and lactate dehydrogenase measurement. Electron microscopic images were taken to localize micro- and nanoplastic.</p><p><strong>Results: </strong>Micro- and nanoplastic particles were rapidly internalized by monocytes. They reduced phagocytosis of E. coli in a concentration- and time-dependent manner. Exposure to micro- and nanoplastic also reduced the intracellular killing of bacteria in a concentration-dependent manner. Plain plastic particles did not induce NFκB synthesis and IL1β and IL6 release. At concentrations inhibiting phagocytosis, micro- and nanoplastic was not cytotoxic. Endotoxin stimulated phagocytosis of bacteria. High concentrations of plastic particles reduced the stimulatory effect of endotoxin on phagocytosis of bacteria, but not the effect on NFκB synthesis.</p><p><strong>Conclusion: </strong>Exposure to micro- and nanoplastic reduced the ability of phagocytes to internalize and kill bacteria. High plastic concentrations decreased the endotoxin-stimulated phagocytosis of bacteria. Hence, exposure to plastic particles may reduce the host`s immune defence against bacterial pathogens.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antigen-specific chemokine CCL3 as a biomarker for distinguishing between recent and remote tuberculosis infection.","authors":"Chunyan Chang, Zichun Ma, Weicong Ren, Wei Wang, Haohan Liu, Rujie Zhong, Shanshan Li, Mengqiu Gao, Yu Pang","doi":"10.1007/s15010-025-02571-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02571-3","url":null,"abstract":"<p><strong>Background: </strong>Identifying recent tuberculosis (TB) infection individuals and administering TB preventive therapy (TPT) are critical strategies for controlling TB. However, current diagnostics fail to identify these individuals at high risk for developing active TB. Herein, we aimed to explore the candidate biomarkers to distinguish recent TB infection from remote TB infection individuals.</p><p><strong>Methods: </strong>Close contacts of TB patients were continuously recruited. A total of 121 participants meeting study inclusion criteria were assigned to screening and validation cohorts, consisting of 45 participants assigned to screening cohort, and 76 participants assigned to validation cohort. The inflammation-related protein biomarkers in Mtb antigen-stimulated blood plasma were measured in the screening cohort using the Olink targeted proteomics. The candidate biomarkers were verified in validation cohort with the customized Luminex-based multiplex microbead array.</p><p><strong>Results: </strong>Quantitative proteomics analysis reveals that significant differences in Mycobacterium tuberculosis (Mtb) antigen-stimulated blood plasma levels of CCL3, CCL20, CCL23 and TNF-α between remote and recent TB infection group. The different response profiles of memory immune cells to Mtb antigens could stem from activation of the NF-κB signaling pathway. The levels of CCL3, CCL20 and TNF-α were predictive of recent TB infection group, of which CCL3 exhibited the best performance with an AUC value of 0.859, yielding a sensitivity and specificity of 86.4% and 75%, respectively.</p><p><strong>Conclusions: </strong>The Mtb antigen-specific assay utilizing CCL3 exhibits superior diagnostic performance and could potentially enhance diagnostic accuracy for identifying recent TB infection patients among LTBI individuals.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of mortality of enterococcal bacteraemia and the role of source control interventions; a retrospective cohort study.","authors":"Virgile Zimmermann, Nicolas Fourré, Laurence Senn, Benoit Guery, Matthaios Papadimitriou-Olivgeris","doi":"10.1007/s15010-025-02561-5","DOIUrl":"https://doi.org/10.1007/s15010-025-02561-5","url":null,"abstract":"<p><strong>Purpose: </strong>To identify predictors of mortality among patients with enterococcal bacteraemia.</p><p><strong>Methods: </strong>This retrospective study was conducted at the Lausanne University Hospital, Switzerland and included adult patients with enterococcal bacteraemia from 2014 to 2023.</p><p><strong>Results: </strong>During the study period, 768 enterococcal bacteraemia episodes were included. The predominant species was Enterococcus faecalis (427 episodes; 56%). Sepsis or septic shock were present in 351 (46%) episodes. The overall 30-day mortality rate was 19% (148 episodes). The Cox multivariable regression model showed that age > 60 years (aHR: 1.75, 95% CI: 1.05-2.90), nosocomial infection (1.78, 1.19-2.65), sepsis or septic shock (3.67, 2.48-5.45), and not performing source control interventions within 48 h, in patients on or discussing of transitioning to limitations of care (5.91, 3.13-11.14) were associated with 30-day mortality. Conversely, infectious diseases (ID) consultation within 48 h (0.40, 0.28-0.57), appropriate antimicrobial therapy within 48 h (0.54, 0.34-0.86), and source control interventions performed within 48 h (0.22, 0.14-0.36) or not warranted (0.54; 0.34-0.86) were associated with survival. Among the 737 episodes without limitation of care, the Cox multivariable regression model showed that nosocomial infection (1.78, 1.19-2.67), sepsis or septic shock (3.76, 2.42-5.82), were associated with 30-day mortality. Conversely, ID consultation within 48 h (0.44, 0.30-0.65), appropriate antimicrobial therapy within 48 h (0.51, 0.30-0.86), and source control interventions performed within 48 h (0.25, 0.16-0.40) or not warranted (0.40; 0.26-0.61) were associated with survival.</p><p><strong>Conclusions: </strong>Our findings underscore the pivotal role of early management of enterococcal bacteraemia, including ID consultation, appropriate antimicrobial treatment initiation and performance of source control interventions.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding: \"Ceftazidime-avibactam versus polymyxins in treating patients with carbapenem‑resistant Enterobacteriaceae infections: a systematic review and meta‑analysis\".","authors":"Tanya Babich, Leonard Leibovici, Vered Daitch","doi":"10.1007/s15010-025-02563-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02563-3","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meropenem plasma concentrations in critically ill patients treated with the novel multi organ replacement therapy ADVOS.","authors":"David Totschnig, Theresa Mader, Thomas Stimpfl, Klaus Breinbauer, Cristina Groza, David Stücklschwaiger, Stephanie Neuhold, Emanuela Friese, Johannes Holbik, Martina Delivuk, Tom Ripplinger, Marcell Leber, Clemens Ott, Wolfgang Hoepler, Aritz Perez Ruiz de Garibay, Christoph Wenisch, Otto Frey, Alexander Zoufaly, Marianna Traugott","doi":"10.1007/s15010-025-02554-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02554-4","url":null,"abstract":"<p><strong>Background: </strong>Optimal dosing of antibiotics in critically ill patients treated with the novel multi organ replacement therapy ADVOS (ADVanced Organ Support) based on albumin dialysis is unclear. This study aims to provide real life data on meropenem plasma concentrations after prolonged infusion in patients treated with ADVOS and a critically ill control group with and without continuous veno-venous hemodiafiltration (CVVHDF).</p><p><strong>Methods: </strong>We retrospectively analyzed plasma concentrations of meropenem obtained as part of our standard of care therapeutic drug monitoring in the intensive care unit. Meropenem was administered as a prolonged infusion over 3 h. We measured peak and trough levels, pre-and post-filter levels of meropenem using high performance liquid chromatography. We calculated the meropenem clearance and compared the measured clearance with predicted clearance based on creatinine, calculated by the MeroEasy tool.</p><p><strong>Results: </strong>In total, 159 measurements across 16 patients were analyzed. Meropenem trough concentrations were highest in the CVVHDF group with a median of 23.5 mg/L, followed by the ADVOS (median 9.3 mg/L) and control group (median 7.6 mg/L). No trough levels were below the lower limit of 2 mg/L in the CVVHDF and ADVOS groups. Meropenem machine clearance by CVVHDF was calculated to be 1.8 (± 0.5) L/h and 3.5 (± 1) L/h for ADVOS.</p><p><strong>Conclusion: </strong>Our results suggest that ADVOS treatment in critically ill patients receiving a high dose meropenem regimen (2 g IV q8h) does not lead to underdosing. Some trough values were even within potentially toxic levels, especially in the CVVHDF group, highlighting the importance of therapeutic drug monitoring.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone- a prospective cohort study.","authors":"Jonathan Vas Nunes, Lars Wassill, Giulia Mönnink, Abdul-Mac Falama, Hanna Mathéron, Amara Conteh, Maxwell Sesay, Aminata Sesay, Håkon Bolkan, Martin P Grobusch, Frieder Schaumburg","doi":"10.1007/s15010-025-02548-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02548-2","url":null,"abstract":"<p><strong>Purpose: </strong>There is a high burden of chronic ulcers in Sierra Leone. However, (early) diagnosis and treatment are challenging. Data on endemicity of Mycobacterium ulcerans is limited to WHO reports from 2008 to 2011.</p><p><strong>Methods: </strong>Patients presenting with wounds at Masanga Teaching Hospital were included in a prospective cohort study and scored following the WHO clinical list for Buruli ulcer (BU). Wounds were screened for M. ulcerans by selective culture on solid and liquid media and loop-mediated isothermal amplification (LAMP) of the M. ulcerans specific IS2404.</p><p><strong>Results: </strong>Between July 2019 and November 2020, 159 patients were included. The median age was 41 years (range: 2-92), 34% (54/159) were female and 56% (89/159) were literate. The median duration of a wound before admission was 12 months (range: 0-720 months), 87% (137/159) of lesions were below the knee. Wounds of 37% (58/159) of the patients were clinically scored as '(very) likely to be Buruli ulcer'. Seven out of 72 patients tested by LAMP were positive for IS2404, two showed specific melting curves. None of the wound swabs yielded a positive culture for M. ulcerans. Ninety-eight (62%) patients had a wound-related surgery during this study, 101 (63%) of patients were improving or healed at the time of discharge.</p><p><strong>Conclusions: </strong>The prevalence of BU based on the WHO scoring system is high in Sierra Leone. National and international awareness, training of healthcare workers, development of in-country bacteriology as well as the furthering of robust molecular and immunological assays could reduce the burden of this neglected tropical disease.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis, management and prevention of loiasis: guideline of the German Society for Tropical Medicine, Travel Medicine, and Global Health (DTG).","authors":"Michael Ramharter, Stefan Schlabe, Marc P Hübner, Pia Michelitsch, Florian Kurth, Sabine Bélard, Tamara Nordmann, Saskia Dede Davi","doi":"10.1007/s15010-024-02443-2","DOIUrl":"https://doi.org/10.1007/s15010-024-02443-2","url":null,"abstract":"<p><p>Loiasis is a complex filarial infection endemic in Central Africa and parts of West Africa. Loa loa is transmitted by the deer fly Chrysops dimidiata and C. silacea. The clinical manifestation of the disease is highly variable ranging from asymptomatic infection, symptomatic disease, to life-threatening complications. The diagnosis of L. loa infection is challenging due to a significant proportion of occult infections and a lack of reliable point of care tests. While diethylcarbamazine is the gold standard for curative treatment in many non-endemic countries, its use is limited in endemic regions due to its propensity for severe adverse drug reactions that may occasionally lead to life threatening complications. Alternative treatment regimens have specific indications and limitations in the treatment of loiasis. In this guideline, issued by the German Society for Tropical Medicine, Travel Medicine, and Global Health, recommendations for the diagnosis, management, treatment, and prevention of loiasis are provided based on the currently available best evidence, and gaps in our understanding are highlighted.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}