Infection最新文献

{"title":"Cardiac injury in children with severe hand, foot and mouth disease: risk factors and clinical outcomes.","authors":"Phung Nguyen The Nguyen, Kieu Quoc Thanh, Pham Tien Dung, Nguyen Minh Tien, Tran Minh Nhut, Nguyen Hoang Dung, Tran Thanh Thuc","doi":"10.1007/s15010-026-03014-3","DOIUrl":"https://doi.org/10.1007/s15010-026-03014-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the risk factors and clinical outcomes of cardiac injury in pediatric patients with severe hand, foot, and mouth disease (HFMD).</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study at two tertiary children's hospitals in southern Vietnam, including hospitalized patients with severe HFMD and suspected cardiovascular complications. Cardiac injury was identified according to cardiac enzyme results and findings from electrocardiography and echocardiography. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with cardiac injury.</p><p><strong>Results: </strong>A total of 395 patients were included, with a male predominance, and 96.5% were younger than 36 months. Typical skin rash and herpangina remained the most common clinical manifestations. Intensive care unit admission was required in 72.2% of cases, and 50.9% required endotracheal intubation with mechanical ventilation. Cardiac injury was identified in 7.3% (29/395) of severe HFMD cases with suspected cardiovascular complications. Fever ≥ 39 °C (aOR 10.5, 95% CI 3.4-32.6, p < 0.001), C-reactive protein > 20 mg/L (aOR 3.3, 95% CI 1.3-8.4, p = 0.012), and aspartate aminotransferase > 40 U/L (aOR 4.1, 95% CI 1.7-9.8, p = 0.002) were independent risk factors for cardiac injury. Patients with cardiac injury had higher mortality, longer hospital stays, and a greater incidence of neurological sequelae compared with those without cardiac injury.</p><p><strong>Conclusions: </strong>Cardiac injury in pediatric patients with severe HFMD is associated with adverse clinical outcomes, underscoring the need for early risk stratification and comprehensive cardiac assessment.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181674","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":"Gut microbiota dysbiosis in patients with sepsis: a meta-analysis of microbial diversity and taxonomic abundance.","authors":"Jiaqi Lou, Houchen Liu, Ziyi Xiang, Rui Guo, Yirang Chen, Jiliang Li, Xin Le","doi":"10.1007/s15010-026-03013-4","DOIUrl":"https://doi.org/10.1007/s15010-026-03013-4","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota alterations are frequently reported in sepsis, but their magnitude, consistency, and clinical specificity remain uncertain. We evaluated microbial diversity and taxonomic abundance in patients with sepsis, distinguishing healthy/reference controls from nonseptic clinical comparators.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science Core Collection were searched from inception to 20 September 2026, without language or geographic restrictions, supplemented by targeted retrieval of primary studies and supplementary data. Comparative human observational studies were included. Standardized mean differences (Hedges g) and 95% confidence intervals (CIs) were pooled using random-effects models. Healthy/reference and nonseptic clinical controls were analyzed separately. Subgroup and sensitivity analyses were performed to explore heterogeneity and assess the stability of pooled estimates. Small-study effect tests and meta-regression were restricted to outcomes with sufficient studies.</p><p><strong>Results: </strong>Twenty-three studies comprising 1201 participants were included. Compared with healthy/reference controls, patients with sepsis had lower Shannon diversity (20 studies; g = - 1.12, 95% CI - 1.38 to - 0.85; I² = 59.9%) and lower Firmicutes abundance (g = - 0.78, 95% CI - 1.32 to - 0.24), but higher Proteobacteria (g = 0.96, 95% CI 0.67 to 1.25) and Enterococcus abundance (g = 0.68, 95% CI 0.38 to 0.98). These associations remained statistically significant after correction for multiple comparisons. Estimates for the remaining outcomes were less consistent or imprecise. The reduction in Shannon diversity was smaller against nonseptic clinical controls (eight studies; g = - 0.29, 95% CI - 0.54 to - 0.05) and was not statistically significant after multiplicity correction.</p><p><strong>Conclusions: </strong>Sepsis was associated with reduced gut microbial diversity and alterations in selected bacterial taxa, most consistently in comparisons with healthy/reference controls. Clinical heterogeneity and incomplete control of antibiotic exposure and illness severity limit attribution of these changes to sepsis itself. Prospective studies are needed to establish their prognostic and therapeutic relevance.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167305","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":"Culture results of heart valves resected from patients with active Enterococcus faecalis infective endocarditis undergoing heart valve surgery: insights into duration of antibiotic treatment required to achieve valve sterilisation.","authors":"Simon Briggs, Miriam Wheeler, Siew S C Goh, Brendan Arnold, Patrick O Campbell, Steven McAuley, Hugh McGann, Maxim Bloomfield, Arthur J Morris","doi":"10.1007/s15010-026-03015-2","DOIUrl":"https://doi.org/10.1007/s15010-026-03015-2","url":null,"abstract":"<p><strong>Purpose: </strong>Heart valve culture results from patients with infective endocarditis (IE) provide insights into the antibiotic treatment duration required to achieve valve sterilisation. We aimed to assess the valve culture positivity rates of valves resected from patients with Enterococcus faecalis IE (EFIE).</p><p><strong>Methods: </strong>This was a national retrospective observational cohort study assessing adults with EFIE receiving valve surgery from 2004 to 2023 in Aotearoa New Zealand. We compared the valve culture result with the antibiotic treatment regimen and duration received before surgery.</p><p><strong>Results: </strong>One hundred and nine patients with EFIE met inclusion criteria. The valve culture positivity rate was 95% and 39% for valve samples obtained within 14 days or after 14 days of antibiotic treatment respectively. In addition to amoxicillin and/or benzylpenicillin, 40 patients received ceftriaxone and 38 received gentamicin as the sole pre-surgery synergistic antibiotic. There was no difference in valve culture positivity rates comparing the ceftriaxone and gentamicin synergistic antibiotic groups (P = 0.49).</p><p><strong>Conclusion: </strong>Patients with EFIE who received valve surgery within 14 days of commencing antibiotic treatment had a very high valve culture positivity rate and this rate continued at moderate levels for those who received surgery after 14 days. We observed no difference in valve culture positivity rates when ceftriaxone or gentamicin was used as the sole pre-surgery synergistic antibiotic. The valve samples that remained culture positive after prolonged antibiotic treatment may help explain the higher relapse rate of patients with EFIE who do not receive valve surgery when compared with patients with other causes of IE.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167311","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":"Co-occurrence of viral respiratory pathogens: prevalence, seasonal distribution, and symptomatology in outpatients in Bavaria, Germany, from April 2025 - March 2026.","authors":"Aline I Schöllkopf, Jennifer Flechsler, Rebecca Gerstner, Johannes Lutmayr, Alexander Nikola, Julia Papst, Sandra Schmidt, Veronika Zacherl, Caroline Herr, Ute Eberle, Andreas Sing, Nikolaus Ackermann","doi":"10.1007/s15010-026-03012-5","DOIUrl":"https://doi.org/10.1007/s15010-026-03012-5","url":null,"abstract":"<p><strong>Purpose: </strong>The Bavarian Influenza Sentinel (BIS + C) monitors the circulation of respiratory viruses in outpatients in Bavaria, Germany. After the Covid-19 pandemic, the molecular surveillance program was expanded for improved insight into the rate of viral infections. Only limited information on viral co-infections is yet available, so this study provides an insight into their co-occurrence, seasonal distribution, and symptomatic outcome.</p><p><strong>Methods: </strong>From calendar week 15/2025 to 14/2026, general practitioners and pediatricians collected swab samples from outpatients with acute respiratory diseases, that were tested for twelve viral pathogens using qPCR multiplex systems.</p><p><strong>Results: </strong>At least one virus was found in 58.8% of the outpatients (n = 7,416/12,614) including 4.1% (n = 520) multiple viral detection, primarily in patients younger than 5 years and more frequent in males. The frequency of multiple virus detection ranges from 6.7% in influenza A (n = 118/1,761) to 43.3% in adenoviruses (n = 154/356) positive tested samples. The most common pathogens in multiple detections were entero-/rhinoviruses involved in 11.9% (n = 292/2,459). Differences in the reported symptoms between single- and co-infections have been found, including less muscle/joint pain in influenza A co-infections. The detected Ct values in co-infections compared to mono-infections were lower for SARS-CoV-2, adenoviruses, entero-/rhinoviruses, and coronaviruses.</p><p><strong>Conclusion: </strong>The frequency of multi-infections follows the seasonality of the corresponding viruses. Especially children under 5 years of age are affected by co-infections. Among the studied viruses, influenza A showed the lowest relative rate of co-detection, in line with its pronounced seasonality - a pattern that warrants further investigation.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164447","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":"Healthcare pathways and outpatient management prior to community-acquired sepsis hospitalization in Germany, 2016-2019.","authors":"Josephine Storch, Antje Freytag, Norman Rose, Thomas Ruhnke, Bianka Ditscheid, Patrik Dröge, Lisa Wedekind, Ruben Ulbrich, Florian Wolf, Mathias W Pletz, Carolin Fleischmann-Struzek","doi":"10.1007/s15010-026-03011-6","DOIUrl":"https://doi.org/10.1007/s15010-026-03011-6","url":null,"abstract":"<p><strong>Purpose: </strong>Sepsis often presents with non-specific symptoms that delay diagnosis and treatment. This study characterized pre-hospital outpatient and emergency care among patients with community-acquired sepsis (CAS) in Germany prior to hospitalization.</p><p><strong>Methods: </strong>This population-based observational cohort study used de-identified health claims data from over 340,000 AOK-insured adults admitted to hospital between 2016 and 2019 with an ICD-10-GM code for sepsis plus organ dysfunction, with each patient contributing only their first qualifying hospitalization (index case). Patients without ICD-10-GM codes for and suggestive of nosocomial infection were included and their healthcare utilization in the week before admission was categorized into: hospital emergency care (HEC), outpatient care only (OC), or no healthcare utilization (no HCU) (excluding patients exclusively hospitalized in the week prior sepsis hospitalization). Treatment and patient characteristics, sepsis features, and outcomes as documented in health claims data were compared across groups using descriptive and non-parametric statistics.</p><p><strong>Results: </strong>Among 238,247 patients identified with CAS, 12.7% received HEC, 61.8% OC, and 25.5% had no HCU. HEC patients were younger, more severely ill, with higher ICU admission and mortality rates compared to the other groups. In the OC group, most patients (82.3%) had encounters with general practitioners, and 45.1% received OC on the day of admission. The last infection-related encounter occurred on average 2.0 days (SD 2.3) prior to sepsis hospitalization. Among OC patients, 48.7% underwent infection-related laboratory diagnostics, and 11.4% received anti-infective prescriptions.</p><p><strong>Conclusion: </strong>Most patients with CAS had healthcare contact in the week prior to hospitalization, predominantly in outpatient care. The frequent encounters shortly before admission and low rates of anti-infective prescription may suggest opportunities for earlier recognition and better risk stratification, e.g. by strengthening sepsis awareness and diagnostic strategies in outpatient settings.</p><p><strong>Trial registration: </strong>The study was pre-registered in the German Clinical Trials Register (DRKS00031302) on 05/05/2023.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167123","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":"Retrospective two-centre study of human tularemia, Austria.","authors":"Lorenz Schubert, Sarah Stanojevic, Carolina Krauss, Selma Tobudic, Rainer Gattringer, Stefan Winkler","doi":"10.1007/s15010-026-03007-2","DOIUrl":"https://doi.org/10.1007/s15010-026-03007-2","url":null,"abstract":"<p><strong>Purpose: </strong>Tularemia, a zoonotic bacterial infection has re-emerged in many European countries over the last years. Data on the management of tularemia are scarce.</p><p><strong>Methods: </strong>In this two-centre retrospective cohort study, we describe real-world data on the clinical manifestations, diagnostic procedures and management of 51 tularemia patients in East Austria.</p><p><strong>Results: </strong>The patients showed heterogeneous clinical presentation, including glandular infection (n = 17, 33.3%), ulceroglandular infection (n = 23, 45.1%), pulmonary infection (n = 10, 19.6%) and typhoidal infection (n = 1, 2%). Notably, seven cases were culture positive, including one case with positive blood culture. Time to achieve the correct diagnosis was associated with the duration of treatment (β = 0.89, p < 0.001), as well as the need for a surgical intervention (OR 1.04, 95%CI 1.01-1.09, p = 0.04). Moreover, we demonstrate a high rate of treatment failure in patients receiving monotherapy (27%).</p><p><strong>Conclusion: </strong>We highlight the heterogeneous clinical presentation of tularemia patients in Austria. Further we demonstrate that timely diagnosis and a prompt implementation of an appropriate antimicrobial therapy may contribute to shorter treatment durations and a reduced need for surgical intervention.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147040","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":"Influenza vaccine effectiveness against hospitalization in children aged 6-72 months: a test-negative study in the Southern Italy, 2022-2026.","authors":"Francesca Fortunato, Angelo Campanozzi, Angelo Acquafredda, Matteo Mariano, Valeria Delli Carri, Tiziana Rollo, Loris Micelli, Dalila Tedeschi, Rosa Prato, Domenico Martinelli","doi":"10.1007/s15010-026-02995-5","DOIUrl":"https://doi.org/10.1007/s15010-026-02995-5","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza is an important cause of hospitalization in young children, yet real-world evidence on vaccine effectiveness (VE) against severe outcomes remains limited in Italy. We estimated influenza VE against influenza-associated hospitalization among children aged 6-72 months in the district of Foggia, Southern Italy.</p><p><strong>Methods: </strong>We conducted a test-negative case-control study among children hospitalized for acute respiratory infection and tested for influenza during the 2022-2023 to 2025-2026 influenza seasons. Cases were influenza-positive children and controls were influenza-negative children. VE was estimated as (1 - odds ratio) x 100; adjusted VE was derived from multivariable logistic regression models.</p><p><strong>Results: </strong>The study included 935 children, of whom 207 were influenza-positive cases and 728 were influenza-negative controls. Adjusted VE was 62.5% (95% CI: 34.4%-78.5%) for receipt of at least one influenza vaccine dose and 61.9% (95% CI: 29.3%-79.4%) for full vaccination. By vaccine type, adjusted VE was 80.3% (95% CI: 43.8%-93.1%) for at least one dose of LAIV and 50.9% (95% CI: 6.9%-74.2%) for at least one dose of IIV. Season-specific adjusted VE was highest in 2024-2025, reaching 92.2% (95% CI: 65.6%-98.2%) for at least one dose and 90.7% (95% CI: 58.5%-97.9%) for full vaccination.</p><p><strong>Conclusions: </strong>Influenza vaccination was associated with a reduced risk of influenza-associated hospitalization among children aged 6-72 months, with the strongest protection observed during the 2024-2025 season. These findings support continued efforts to improve pediatric influenza vaccination uptake.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148240","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":"Orf virus infection in a sheep owner: a case report and literature review.","authors":"Noemi Schaefer, Julia M Braun, Patrick Kasteleiner, Livia Schrick, Annika Brinkmann, Andreas Nitsche, Stephan Forchhammer, Tina Ganzenmueller","doi":"10.1007/s15010-026-03009-0","DOIUrl":"https://doi.org/10.1007/s15010-026-03009-0","url":null,"abstract":"<p><p>Orf virus (ORFV) is a zoonotic parapoxvirus, that primarily affects sheep and goats worldwide. It can be transmitted to humans through direct skin contact with infected animals and typically leads to self-limiting nodules or blisters at the site of inoculation, which resolve spontaneously after approximately six weeks without specific antiviral treatment. Here, we present the case of a 56- year-old sheep owner, who acquired ORFV infection while shearing sheep.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149740","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":"Mycoplasma pneumoniae infections in the Post-COVID era: recent advances from pathogenesis to clinical management.","authors":"Yan Li, Zhifeng Wu, Tianzhi Xiang, Baihuan Duan, Zihan Liu, Peng Liu, Yanan Wei, Peng Ling","doi":"10.1007/s15010-026-02990-w","DOIUrl":"https://doi.org/10.1007/s15010-026-02990-w","url":null,"abstract":"<p><p>M.pneumoniae is a major cause of human respiratory infection whose pathogenicity relies on adhesion proteins, secreted virulence factors, and immune evasion mechanisms. This review contextualizes these strategies within the broader phylogeny of clinically relevant Mycoplasma species while addressing the diverse extrapulmonary manifestations of M. pneumoniae. Current challenges in managing M. pneumoniae infections are multifaceted. The post-pandemic resurgence reflects a population-level immune debt resulting from prolonged non-pharmaceutical interventions, with test positivity rising sharply after restrictions were lifted and driving pneumonia outbreaks across age groups. Macrolide resistance remains persistently high in East Asia and is emerging at variable rates in other regions; routine diagnostics cannot detect resistance in real time, complicating first-line empirical therapy. Vaccine development continues to face obstacles including antigenic variation mediated by recombination between repetitive genomic sequences, the IL-17 A paradox wherein protective Th17 responses also drive vaccine-enhanced disease, and the inability of systemic vaccines to induce mucosal secretory IgA and tissue-resident memory T cells. In response, we evaluate emerging diagnostics-including metagenomic sequencing, CRISPR-Cas platforms, and host biomarkers-and discuss resistance-guided therapies involving doxycycline, quinolones, and novel agents like lefamulin and omadacycline. We further analyze vaccine development hurdles alongside the potential of mRNA-LNP platforms targeting conserved adhesin epitopes. Our findings indicate that the lag between mechanistic insight and clinical implementation remains the most pressing challenge. Future research must shift from simple mechanistic elucidation to addressing real-world clinical dilemmas, including distinguishing colonization from infection through integrated pathogen-host evaluation, exploring synergistic use of antibiotics and immunomodulators targeting the IL-17 A pathway, advancing vaccine design that circumvents IL-17 A-mediated immunopathology via conserved epitope selection and mucosal delivery, and establishing real-time surveillance networks integrating genomics and clinical phenotypes. Collectively, this work provides a practical roadmap spanning molecular pathology to clinical practice for the precise management of M. pneumoniae infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147112","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":"Role of ¹⁸F-FDG PET/CT in monitoring treatment response in extrapulmonary tuberculosis: a retrospective observational study.","authors":"Jorge Boán, Marta Hernández-Solís, Álvaro Galiana, Pilar Hernández-Jiménez, Adolfo Gómez-Grande, José María Aguado, María Asunción Pérez-Jacoiste Asín","doi":"10.1007/s15010-026-02977-7","DOIUrl":"https://doi.org/10.1007/s15010-026-02977-7","url":null,"abstract":"<p><strong>Background: </strong>Monitoring treatment response in tuberculosis (TB) remains a major clinical challenge, particularly in extrapulmonary forms. 18-F Fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET/CT) has emerged as a potential adjunctive tool, enabling quantification of metabolic activity. We report our experience using ¹⁸F-FDG PET/CT for monitoring treatment response in extrapulmonary TB.</p><p><strong>Methods: </strong>We performed a retrospective observational study at a tertiary hospital in Spain, including adult patients diagnosed with extrapulmonary TB who underwent a baseline ¹⁸F-FDG PET/CT and at least one follow-up scan from January 2014 to April 2026. Clinical, microbiological, and radiological data were reviewed alongside changes in maximum standardized uptake value (SUVmax) across serial PET/CT studies.</p><p><strong>Results: </strong>Twelve patients were included, most commonly with lymphatic (41.7%) or bone involvement (33.3%). At the end of the initially planned treatment, seven patients (58.3%) showed a marked (> 50%) reduction in SUVmax. Clinical outcomes were favourable in all seven. In contrast, the remaining five (41.7%) showed persistent or increased metabolic uptake. Among these, two had favourable clinical outcomes, suggesting sterile inflammation. The other three patients had an unfavourable clinical evolution with persistent symptoms. In two of them, new targeted biopsies demonstrated an alternative diagnosis.</p><p><strong>Conclusion: </strong>¹⁸F-FDG PET/CT may effectively assist clinicians in monitoring treatment response in complex scenarios with a suboptimal or unfavourable clinical response. However, persistent hypermetabolism must be interpreted cautiously, as it may reflect sterile inflammation or alternative diagnoses rather than ongoing infection.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136547","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}