International Journal of Infectious Diseases最新文献

{"title":"Delayed patient isolation and associated factors during the mpox outbreak in Uganda, July-December 2024","authors":"Hannington Katumba ,&nbsp;Richard Migisha ,&nbsp;Allan Komakech ,&nbsp;Daniel Wenani ,&nbsp;Joyce Owens Kobusingye ,&nbsp;Emmanuel Mfitundinda ,&nbsp;Jane Frances Zalwango ,&nbsp;Ruth Kaliisa ,&nbsp;Inyeong Park ,&nbsp;Dansan Atim ,&nbsp;Allan N. Muruta ,&nbsp;Benon Kwesiga ,&nbsp;Lillian Bulage ,&nbsp;Ivan Lukabwe ,&nbsp;Alex Riolexus Ario","doi":"10.1016/j.ijid.2025.108346","DOIUrl":"10.1016/j.ijid.2025.108346","url":null,"abstract":"<div><h3>Objective</h3><div>Rapid detection and isolation of mpox mpox patients reduces transmission. We assessed delays in patient isolation and associated factors during the mpox outbreak in Uganda from July to December 2024 to inform response efforts.</div></div><div><h3>Methods</h3><div>We selected all laboratory-confirmed cases isolated at two mpox isolation centers in Uganda from July 24 to December 29, 2024. Time-to-Isolation (TTI) was number of days from symptom onset to isolation, categorized as ‘short’ (0-3 days) or ‘delayed’ (&gt;3 days) based on operational benchmarks for rapid containment of a highly infectious disease and the biological urgency of early isolation of mpox cases. We summarized data from case narratives into descriptive statistics and used multivariable logistic regression to measure the level of association of individual factors with delayed TTI which was the outcome variable. Reasons for short or delayed TTI were obtained from qualitative interviews.</div></div><div><h3>Results</h3><div>Among 832 mpox patients, 709 (91%) had delayed TTI, 473 (57%) were males, 713 (86%) were ≥18 years old, 698 (83%) had not visited a health facility before isolation, and 742 (89%) had self-medicated before isolation. Age ≥18 years (aOR = 2.6, 95% CI = 1.6-4.2) and self-medication (aOR = 5.4, 95% CI = 1.7-17.1) were associated with delayed TTI. Interviewed mpox patients with delayed TTI (n = 9) attributed this to lack of diagnostic skills among healthcare workers and attributed their delayed care-seeking to personal economic concerns. Mpox patients with short TTIs (n = 6) attributed this to prior knowledge about mpox from social media and response teams.</div></div><div><h3>Conclusion</h3><div>Most mpox patients experienced delayed TTI, associated with being older than 18 years and self-medication, and driven by misdiagnosis and individual economic concerns. Targeting risk communication and strengthening frontline diagnostic capacity could improve early case detection and management.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108346"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827777","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":"Clinical practice guidelines for hospital-acquired and ventilator-associated pneumonia: A scoping review","authors":"Diana Manuela Ticona ,&nbsp;Leonardo J. Uribe-Cavero ,&nbsp;Lelis G. Coronel-Chucos ,&nbsp;Alvaro Taype-Rondan","doi":"10.1016/j.ijid.2026.108369","DOIUrl":"10.1016/j.ijid.2026.108369","url":null,"abstract":"<div><h3>Objectives</h3><div>Healthcare-associated pneumonia (HAP), particularly ventilator-associated pneumonia (VAP), remains a major clinical challenge due to its prevalence, mortality, and diagnostic and therapeutic complexity. This study aimed to summarize the characteristics and reliability of clinical practice guidelines (CPGs) for the diagnosis and management of HAP and VAP.</div></div><div><h3>Methods</h3><div>A scoping review was conducted on CPGs published or updated from 2015 to February 2025 based on systematic reviews. Searches were performed in PubMed, Trip Database, the Guidelines International Network, Epistemonikos, Google, and Google Scholar. Two reviewers independently selected and extracted data. The AGREE II tool assessed CPG quality, and recommendations were compared across overlapping topics.</div></div><div><h3>Results</h3><div>Six CPGs were identified. All used the GRADE approach, but only three included a Summary of Findings (SoF) table, and none applied the Evidence to Decision (EtD) framework. Four achieved an AGREE-II overall score ≥70%. Fourteen key topics were identified; in eight, recommendations were consistent, in five, they varied, and in one, they were contradictory.</div></div><div><h3>Conclusions</h3><div>CPGs for HAP and VAP showed notable variability in methodological rigor and recommendations. Limited use of SoF tables and EtD frameworks reduced transparency, highlighting the need for improved guideline development to support evidence-based practice.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108369"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933240","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":"Fatal Mycobacterium tilburgii disseminated infection in a patient with cryptic interleukin-12Rβ1 deficiency: A case report","authors":"Sophie Eon ,&nbsp;Jean Baptiste Giot ,&nbsp;Frederic Frippiat ,&nbsp;Vanessa Mathys ,&nbsp;Jean Radermacher ,&nbsp;Constance Paquot ,&nbsp;Raphael Schils","doi":"10.1016/j.ijid.2026.108386","DOIUrl":"10.1016/j.ijid.2026.108386","url":null,"abstract":"<div><div>We report the case of an immunocompromised patient with previously unrecognized Mendelian susceptibility to mycobacterial disease due to interleukin-12Rβ1 deficit, who developed fatal disseminated <em>Mycobacterium tilburgii</em> infection. Mycobacterial invasion caused severe neurologic complications, including refractory status epilepticus, leading to death, despite therapies, including surgical interventions.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108386"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948677","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 detection of bacteria in periprosthetic joint infection via microfluidic qPCR chip","authors":"Zeyu Feng ,&nbsp;Quanbo Ji ,&nbsp;Qingyuan Zheng ,&nbsp;Runkai Zhao ,&nbsp;Yufan Zhang ,&nbsp;Xiaohe Shen ,&nbsp;Pengcheng Li ,&nbsp;Xiwei Zhang ,&nbsp;Lin Hao ,&nbsp;Yan Wang ,&nbsp;Guoqiang Zhang","doi":"10.1016/j.ijid.2025.108334","DOIUrl":"10.1016/j.ijid.2025.108334","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the microbiological detection efficacy and turnaround time of a microfluidic quantitative real-time PCR (qPCR) platform for periprosthetic infection (PJI) patients.</div></div><div><h3>Design or Methods</h3><div>This study included PJI patients with Staphylococcus aureus or Staphylococcusepidermidis and patients with aseptic failure (AF) from our clinical center. We analyzed the microbiological detection efficacy and turn-around-time of three bacterial detection methods: joint fluid culture, qPCR, and the microfluidic chip.</div></div><div><h3>Results</h3><div>A total of 310 patients were included in the study, comprising 106 PJI patients and 204 AF patients. CRP, ESR, synovial white blood cell and synovial PMN percentages in the PJI group were significantly higher than those in the AF group (P &lt; 0.001). Compared to joint fluid culture (7011.3 ± 3013.0 min) and qPCR (131.7 ± 7.9 min), the microfluidic chip showed a significantly shorter turnaround time (59.4 ± 4.2 min, P &lt; 0.001). Additionally, low-load Staphylococcus aureus or Staphylococcus epidermidis which below the positive threshold were detected in some PJI or AF patients.</div></div><div><h3>Conclusion</h3><div>The microfluidic chip offers microbiological detection efficacy and time advantages for detecting Staphylococcus aureus and Staphylococcus epidermidis compared to joint fluid culture and traditional qPCR.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108334"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810098","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":"Anti-interferon-α antibodies and HBsAg seroclearance during peginterferon-α therapy in chronic hepatitis B","authors":"Chuan Jiang ,&nbsp;Da Cheng ,&nbsp;Wenting Peng ,&nbsp;Jinqing Liu ,&nbsp;Feilan Yang ,&nbsp;Ying Jiang ,&nbsp;Shifang Peng ,&nbsp;Lei Fu","doi":"10.1016/j.ijid.2026.108370","DOIUrl":"10.1016/j.ijid.2026.108370","url":null,"abstract":"<div><h3>Aims/Background</h3><div>To identify predictors of hepatitis B surface antigen (HBsAg) seroclearance in chronic hepatitis B (CHB) patients treated with Peginterferon-α (Peg-IFNα) and to assess the association between anti-interferon-α (anti-IFNα) antibody development and treatment outcomes.</div></div><div><h3>Methods</h3><div>CHB patients receiving Peg‑IFNα were categorized by serological response: 12-week responders (12W‑SR), 24-week responders (24W‑SR), and 24-week non‑responders (24W‑NSR). Independent predictors were determined using multivariate logistic regression, and the relationship between changes in anti-IFNα antibody and treatment response was analyzed.</div></div><div><h3>Results</h3><div>A total of 77 CHB patients were included: 20 (26.0%) 12W-SR, 21 (27.3%) 24W-SR, and 36 (46.8%) 24W-NSR. Lower baseline HBsAg independently predicted HBsAg clearance at week 12, while lower baseline HBsAg and younger age predicted clearance by week 24. In the 24W‐NSR group, anti‐IFNα IgG and IgM rose from baseline to weeks 12 and 24, with IgM increases most pronounced, whereas antibody titers remained stable in responder groups. At week 24, anti‐IFNα IgM showed a modest positive correlation with HBsAg and a moderate negative correlation with hepatitis B surface antibody.</div></div><div><h3>Conclusion</h3><div>CHB patients with lower baseline HBsAg or younger age achieved higher HBsAg clearance within 24 weeks. An early and pronounced rise in anti-IFNα IgM was associated with poor response to Peg-IFNα and may serve as an early warning marker.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108370"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917723","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":"Determinant factors of mortality among patients diagnosed with relapsing fever in a resource-limited setting in Ethiopia","authors":"Seblewongel Birhanemeskel Haileselassie ,&nbsp;Molla Asnake Kebede ,&nbsp;Missgana Worku Belete ,&nbsp;Girma Daniel Bushiso ,&nbsp;Rediet Solomon Arega ,&nbsp;Selam Bogale Gissa ,&nbsp;Selemon Gebrezgabiher Asgedom","doi":"10.1016/j.ijid.2025.108320","DOIUrl":"10.1016/j.ijid.2025.108320","url":null,"abstract":"<div><h3>Objectives</h3><div>Relapsing fever (RF) remains a major public health concern in Ethiopia, causing severe illness and high mortality despite global declines since the 1940s. Mortality may reach 70% without treatment, yet research on outcomes and risk factors is limited in resource-limited settings. This study, conducted at Yekatit-12 Hospital Medical College, aimed to evaluate the clinical features, complications, and determinants of death among patients with RF, addressing a critical knowledge gap in Ethiopia.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted among patients aged 14 years and older with blood film-confirmed relapsing fever between September 2021 and February 2023. A structured data collection tool was used to extract clinical, demographic, and laboratory information. Patient characteristics were described using descriptive statistics, while multivariable logistic regression was used to determine the independent predictors of mortality, and results were presented as adjusted odds ratios (AOR) with 95% confidence intervals.</div></div><div><h3>Results</h3><div>A total of 119 male patients were included, with a mean age of 24.1 years. Most were daily laborers (42.0%) or homeless (39.5%). The leading symptoms were fever (85.5%), chills (67.2%), respiratory distress (54.6%), and altered mental status (46.2%). Complications were observed in 88.2% of cases, most commonly anemia (74.7%), acute respiratory distress syndrome (69.7%), shock (60.5%), and Jarisch–Herxheimer reaction (36.1%). Mortality was 45.4% (n = 54), primarily from multi-organ failure (64.8%) and respiratory failure (25.9%). Independent predictors of death were symptom duration &gt;5 days before admission (AOR = 3.1; 95% CI: 1.24-7.9), Jarisch–Herxheimer reaction (AOR = 2.8; 95% CI: 1.09-7.64), multi-organ failure (AOR = 3.8; 95% CI: 1.23-11.6), and requirement for mechanical ventilation (AOR = 2.7; 95% CI: 1.05-7.1).</div></div><div><h3>Conclusion</h3><div>In Ethiopia, relapsing fever affects young, socioeconomically disadvantaged men, with high complication and mortality rates. Delayed treatment, Jarisch–Herxheimer reaction, multi-organ failure, and requiring mechanical ventilation during admission were predictors of mortality in mens, highlighting the importance of early diagnosis, antibiotics, and critical care.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108320"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793846","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":"Spatial inequities in childhood vaccination coverage in South Korea: A nationwide spatiotemporal analysis, 2017-2023","authors":"Joonsu Jang ,&nbsp;Byung Chul Chun","doi":"10.1016/j.ijid.2025.108351","DOIUrl":"10.1016/j.ijid.2025.108351","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify clusters of undervaccination and regional determinants in South Korea.</div></div><div><h3>Methods</h3><div>We conducted an ecological spatiotemporal study of complete vaccination coverage among 3‐ and 6‐year‐olds in all 250 municipalities from 2017 to 2023. Global Moran’s I and Getis‐Ord Gi* detected spatial autocorrelation and local hotspots with low coverage. Bayesian spatiotemporal models examined associations between municipal coverage and area‐level variables.</div></div><div><h3>Results</h3><div>Distinct geographical inequities in childhood vaccination were identified: from 2017 to 2022, low coverage for 3‐year‐olds clustered in parts of Seoul and southwestern regions, while hotspots for 6‐year‐olds were concentrated in the southwest and parts of Seoul during 2018-2020 and shifted across regions from 2021 to 2023. In Bayesian spatiotemporal models, municipalities with higher National Health Insurance premiums and a greater share of traditional Korean medicine institutions were associated with lower complete vaccination coverage.</div></div><div><h3>Conclusion</h3><div>Even in a high‐coverage and high‐income setting, this study found significant spatial inequities in childhood vaccination. Regional pockets with low coverage are associated with complex socioeconomic and healthcare contexts. Thus, a universal vaccination strategy can overlook important local vulnerabilities. These findings highlight the need for targeted local interventions and sustained monitoring to ensure equitable vaccination coverage.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108351"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846596","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":"Streptococcus dysgalactiae subsp. equisimilis bacteremia: Emm types and clinical characteristics—a 4-year prospective study","authors":"Miia Saukkosaari ,&nbsp;Janne Aittoniemi ,&nbsp;Reetta Huttunen ,&nbsp;Tapio Seiskari ,&nbsp;Hanne-Leena Hyyryläinen ,&nbsp;Tiina Luukkaala ,&nbsp;Sari Rantala","doi":"10.1016/j.ijid.2025.108313","DOIUrl":"10.1016/j.ijid.2025.108313","url":null,"abstract":"<div><div><em>Objectives:</em> The incidence of <em>Streptococcus dysgalactiae</em> subspecies <em>equisimilis</em> (SDSE) bacteremia is increasing worldwide, yet studies linking <em>emm</em> types to clinical data remain limited. This study aimed to investigate associations between <em>emm</em> types, clinical manifestations, and disease severity in patients with SDSE bacteremia.</div><div><em>Methods:</em> We prospectively studied 159 SDSE bacteremia episodes in Pirkanmaa, Finland (November 2015 to November 2019). Severe disease was defined as intensive care unit treatment and/or death within 30 days of hospital admission.</div><div><em>Results:</em> While <em>emm</em> type stG480 has remained the most common, stG62647 has increased over tenfold to become the second most prevalent. <em>Emm</em> type stC74a was associated with intensive care unit treatment (odds ratio [OR] 5.8 [95% confidence interval (CI) 1.3-26)]), severe disease (OR 5.2 [95% CI 1.4-19]), and predominance of male patients (OR 8.5 [95% CI 1.1-67]). Surgical interventions were linked to <em>emm</em> type stG62647 (OR 2.8 [95% CI 1.1-7.3]). Potential associations between <em>emm</em> type and clinical manifestations were observed: stG643 with endocarditis, stG62647 with foreign-body infections, stG2078 with abscesses, and stG485 with unknown focus.</div><div><em>Conclusions:</em> These results emphasize the importance of <em>emm</em> types in connection with disease severity and clinical manifestations.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108313"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850037","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":"Nontuberculous mycobacterial pulmonary disease risk in tuberculosis survivors: A nationwide Korean cohort study","authors":"Hayoung Choi ,&nbsp;Kyuna Lee ,&nbsp;Kyungdo Han ,&nbsp;Dong Wook Shin ,&nbsp;Hyun Lee","doi":"10.1016/j.ijid.2026.108387","DOIUrl":"10.1016/j.ijid.2026.108387","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the risk of incident non-tuberculous mycobacterial pulmonary disease (NTM-PD) following pulmonary tuberculosis (TB) in a nationwide longitudinal Korean cohort.</div></div><div><h3>Methods</h3><div>Using data from the Korean National Health Insurance Service and the Korean Disease Control and Prevention Agency (2013-2017), we identified 13,547 individuals with drug-susceptible pulmonary TB and 40,641 age- and sex-matched controls. Multivariable Cox models were used to evaluate the risk of NTM-PD.</div></div><div><h3>Results</h3><div>Over a median follow-up of 5.4 years (292,138 person-years), the incidence rate was 1.19 per 1000 person-years (PY) in the post-TB cohort and 0.10 per 1000 PY in controls (<em>P</em> &lt; 0.01). Prior pulmonary TB was associated with a significantly higher risk of NTM-PD (adjusted hazard ratio [HR] 7.67; 95% CI, 4.60-12.76). Within the post-TB cohort, bronchiectasis increased the risk of NTM-PD (adjusted HR 3.66; 95% CI, 2.09-6.40), whereas female sex (adjusted HR 0.41; 95% CI, 0.18-0.91), overweight status (adjusted HR 0.27; 95% CI, 0.11-0.67), and light smoking (&lt;20 pack-years; adjusted HR 0.11; 95% CI, 0.03-0.49) were negatively associated with NTM-PD risk.</div></div><div><h3>Conclusion</h3><div>Individuals with prior pulmonary TB have a markedly elevated risk of NTM-PD. Targeted surveillance and early diagnostic strategies for NTM-PD in TB survivors may improve outcomes.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108387"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948738","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":"Disseminated human parvovirus B19 encephalitis and pure red cell aplasia unmasking immune dysregulation in angioimmunoblastic T-cell lymphoma","authors":"Chutchaiwat Savetamornkul,&nbsp;Pimjai Niparuck,&nbsp;Darunee Chotiprasitsakul","doi":"10.1016/j.ijid.2026.108390","DOIUrl":"10.1016/j.ijid.2026.108390","url":null,"abstract":"<div><h3>Background</h3><div>Acute encephalitis caused by human parvovirus B19 (PVB19) is an uncommon clinical manifestation observed in both immunocompetent and immunocompromised individuals. Angioimmunoblastic T-cell lymphoma (AITL) is a distinct subtype of lymphoma characterized by aberrant immune dysregulation, predisposing patients to opportunistic infections even in the absence of chemotherapy.</div></div><div><h3>Case Presentation</h3><div>A 66-year-old woman with newly diagnosed, treatment-naïve AITL presented with acute confusion, dysarthria, and severe anemia. Cerebrospinal fluid (CSF) analysis and neuroimaging findings were non-specific. PVB19 DNA was subsequently detected in both the CSF and serum. A bone marrow biopsy confirmed PVB19-associated pure red cell aplasia (PRCA). Intravenous immunoglobulin therapy resulted in a declining viral load and clinical improvement. The patient’s clinical course was complicated by multiple subsequent infections, and she ultimately died five months after discharge.</div></div><div><h3>Conclusion</h3><div>This case highlights the immunodeficiency caused by AITL, which predisposes patients to opportunistic infections. PVB19 infection should be considered for patients presenting with unexplained encephalitis, particularly in those with underlying immunocompromised conditions.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"164 ","pages":"Article 108390"},"PeriodicalIF":4.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984775","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}