Journal of Infection and Chemotherapy最新文献

{"title":"Association between allergic bronchopulmonary aspergillosis or Aspergillus sensitization and tuberculosis: A systematic review of 607 cases","authors":"Anuj Ajayababu ,&nbsp;Martin Hoenigl ,&nbsp;Animesh Ray","doi":"10.1016/j.jiac.2025.102792","DOIUrl":"10.1016/j.jiac.2025.102792","url":null,"abstract":"<div><h3>Introduction</h3><div>Although allergic bronchopulmonary aspergillosis (ABPA) is classically described in asthma and cystic fibrosis, pulmonary tuberculosis (PTB) with post-tubercular lung disease (PTLD) has been reported as a likely predisposing factor. It, however, has not been reviewed systematically, which we aimed to achieve in the current systematic review.</div></div><div><h3>Methods</h3><div>We screened the available literature from PubMed, Embase, SCOPUS and Web of Science databases for studies reporting association between ABPA and PTB from the beginning of time to June 30, 2023 and collated the data on association of ABPA and tuberculosis.</div></div><div><h3>Results</h3><div>1176 articles were identified from the initial search, of which 60 articles (27 original articles and 33 case reports) were included in the final analysis. Four patterns were described: ABPA in patients with previous TB (151, 24.9 %), co-existent ABPA and TB (16, 2.6 %), <em>Aspergillus</em> sensitization in patients with prior or current TB (91, ∼15 %) and ABPA misdiagnosed as TB (349, 57.5 %). There was significant heterogeneity in the diagnostic criteria used for ABPA and pulmonary TB. From limited individual data, which could be extracted, observations were: 1) Central bronchiectasis (32.6 %), cavity (22.8 %), fungal ball (12.0 %), mucus plug/high attenuation mucus (HAM) (7.6 %) and consolidation/centrilobular nodules (12.0 %) were the most common radiographic abnormalities. 2) 96.4 % received steroids, 11 % received antifungals mostly for relapse or inadequate response. 3) Adequate treatment response was noted in the limited cohort where it was reported.</div></div><div><h3>Conclusions</h3><div>ABPA is commonly misdiagnosed as TB, but <em>Aspergillus</em> sensitization/ABPA can develop in patients with prior TB. However, significant heterogeneity in diagnostic criteria limits generalizability. Future well-designed prospective studies are required to confirm these associations.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102792"},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purpura fulminans caused by Streptococcus pneumoniae serotype 23A in a young post-splenectomy man: A case report","authors":"Aya Hamasaki ,&nbsp;Tetsuya Yumoto ,&nbsp;Shinnosuke Fukushima ,&nbsp;Hideharu Hagiya ,&nbsp;Bin Chang ,&nbsp;Yukihiro Akeda ,&nbsp;Takashi Hongo ,&nbsp;Kohei Tsukahara ,&nbsp;Hiromichi Naito ,&nbsp;Atsunori Nakao","doi":"10.1016/j.jiac.2025.102791","DOIUrl":"10.1016/j.jiac.2025.102791","url":null,"abstract":"<div><div>Purpura fulminans is a rare but severe complication of septic shock, often associated with <em>Streptococcus pneumoniae</em> infection in asplenic individuals, with high mortality and limb amputation risk. Although pneumococcal vaccines are available, infections caused by non-vaccine serotypes remain a major concern. A 39-year-old man with a history of splenectomy 18 years prior presented with dyspnea, malaise, and gastrointestinal symptoms for two days. He had never received pneumococcal vaccination following his splenectomy. On arrival, he was hypotensive, tachycardic, and exhibited signs of multi-organ failure with severe coagulopathy. Physical examination revealed widespread cyanosis and purpura. Blood cultures yielded penicillin-susceptible <em>S. pneumoniae</em>, later identified as serotype 23A (Sequence Type 5242), which is not included in currently available vaccines in Japan. Despite prompt intensive care, including broad-spectrum antibiotics, vasopressors, continuous renal replacement therapy, and mechanical ventilation, the patient developed progressive skin necrosis at the distal extremities. Ultimately, he required amputation of all 4 limbs. This case underscores the catastrophic consequences of overwhelming post-splenectomy infection due to a non-vaccine <em>S. pneumoniae</em> serotype in an unvaccinated asplenic adult. Early recognition and aggressive management are essential to save lives, but structured, lifelong pneumococcal vaccination and increased awareness among clinicians and patients remain paramount.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102791"},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful allogeneic hematopoietic stem cell transplantation for AML with pulmonary mucormycosis under isavuconazole","authors":"Rina Hosoda ,&nbsp;Sayaka Suzuki ,&nbsp;Saaya Hosoda ,&nbsp;Rino Sugimoto ,&nbsp;Miku Umeda ,&nbsp;Kentaro Hara ,&nbsp;Masaya Maegaki ,&nbsp;Yuzuru Hosoda ,&nbsp;Takayuki Shinohara ,&nbsp;Takashi Umeyama ,&nbsp;Yoshitsugu Miyazaki ,&nbsp;Kazutoshi Shibuya ,&nbsp;Koji Kawamura","doi":"10.1016/j.jiac.2025.102790","DOIUrl":"10.1016/j.jiac.2025.102790","url":null,"abstract":"<div><div>Invasive pulmonary mucormycosis (IPM) is a rare fungal infection, which can be fatal in immunocompromised patients, particularly in those with hematological malignancies. Although liposomal amphotericin B (≥5 mg/kg) administration following complete surgical resection is recommended, many cases remain incurable. A 70-year-old man with <em>FLT3-ITD</em> mutated acute myeloid leukemia achieved complete remission after the second induction therapy with gilteritinib. During the period of myelosuppression following the initial treatment, he developed IPM in the left lung. Bronchoscopy revealed <em>Lichtheimia corymbifera</em>. Surgical resection was initially not possible because of pleural adhesions due to inflammation caused by mucormycosis. Based on the isavuconazole (ISCZ) treatment, we performed allogeneic hematopoietic stem cell transplantation (allo-HCT), resulting in successful engraftment without IPM progression. Complete surgical resection was performed 1 year after allo-HCT. However, mucormycosis relapsed in the contralateral lung 2 months after ISCZ discontinuation. Re-treatment with ISCZ was effective. This case suggested that allo-HCT could be successfully performed in selected patients with unresectable IPM when effective antifungal therapy is administered. Early neutrophil recovery and close clinical monitoring are essential. To the best of our knowledge, this is the first reported case of ISCZ treatment in an allo-HCT patient with unresectable IPM. ISCZ could be a safe and effective anti-Mucorales therapy in the allo-HCT setting.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102790"},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of and risk factors for side effects associated with antibiotic treatment for pneumonia","authors":"Nobuyoshi Hamao ,&nbsp;Isao Ito ,&nbsp;Satoshi Konishi ,&nbsp;Naoya Tanabe ,&nbsp;Issei Oi ,&nbsp;Yoshiro Yasutomo ,&nbsp;Seizo Kadowaki ,&nbsp;Toyohiro Hirai","doi":"10.1016/j.jiac.2025.102789","DOIUrl":"10.1016/j.jiac.2025.102789","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the incidence of side effects associated with beta-lactam antibiotics commonly used in pneumonia treatment and the risk factors for each side effect.</div></div><div><h3>Methods</h3><div>Patients with community-acquired or healthcare-associated pneumonia were prospectively enrolled between June 2002 and December 2012. Patients were administered with beta-lactam antibiotics in the treatment of pneumonia. All side effects observed during the antibiotic treatment were recorded. Multivariate analysis was performed to identify independent risk factors for each side effect.</div></div><div><h3>Results</h3><div>A total of 1162 patients were enrolled in this study. The antibiotics used for treatment were ampicillin/sulbactam in 362, piperacillin/tazobactam in 111, cefotiam in 89, ceftriaxone in 140, cefepime in 130, imipenem/cilastatin in 110, meropenem in 97, and others in 123 cases. Diarrhea, elevated liver enzyme levels, and skin rash were observed in 174 (15.0 %), 52 (4.5 %), and 28 (2.4 %) patients, respectively. In multivariate analysis, female sex (p &lt; 0.05) and use of either piperacillin/tazobactam (p &lt; 0.05), cefepime (p &lt; 0.05), or imipenem/cilastatin (p &lt; 0.05) were significantly associated with diarrhea. Use of cefotiam (p &lt; 0.05) or meropenem (p &lt; 0.05) were significantly associated with elevated liver enzyme levels. No significant risk factors were found for skin rashes.</div></div><div><h3>Conclusion</h3><div>Broad-spectrum antibiotics tended to cause diarrhea more frequently. The use of cefotiam and meropenem was associated with increased liver enzyme levels.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 9","pages":"Article 102789"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Azygos vein thrombosis and vertebral osteomyelitis: A rare variant of Lemierre syndrome","authors":"Emiri Muranaka ,&nbsp;Kanta Kurasawa ,&nbsp;Naoya Matsuda ,&nbsp;Chiharu Kimeda ,&nbsp;Chikato Mannoji ,&nbsp;Ryota Hase","doi":"10.1016/j.jiac.2025.102785","DOIUrl":"10.1016/j.jiac.2025.102785","url":null,"abstract":"<div><div>Lemierre syndrome, traditionally defined as septic thrombophlebitis of the internal jugular vein following an oropharyngeal infection, is most commonly caused by <em>Fusobacterium necrophorum</em>. We report an unusual variant of this syndrome in a 29-year-old male who presented with <em>F. necrophorum</em> bacteremia following tonsillar infection, complicated by vertebral osteomyelitis of the T10 vertebral body, azygos vein thrombosis, and septic pulmonary emboli (infected emboli that lodge in the lungs). The patient developed severe thrombocytopenia, consistent with the thrombogenic properties of <em>F. necrophorum</em>. Initial treatment with intravenous cefepime and metronidazole was administered, followed by ampicillin-sulbactam, and subsequently switched to oral clindamycin due to a drug eruption. The patient completed a 12-month course of antibiotics with full clinical recovery and no evidence of relapse at 20-month follow-up after treatment completion. While the classical definition of Lemierre syndrome focuses on internal jugular vein involvement, our case supports a broader conceptualization that encompasses septic thrombophlebitis at various vascular sites. This atypical presentation highlights the importance of thorough radiological evaluation in patients with persistent oropharyngeal symptoms and unexpected systemic manifestations, even when the classic internal jugular vein thrombosis is absent. The unique combination of thoracic vertebral osteomyelitis and azygos vein thrombosis represents an extremely rare manifestation with significant implications for diagnosis and management.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102785"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated gonococcal infection developing two days after initial eculizumab administration in a patient with neuromyelitis optica spectrum disorder: A case report and literature review","authors":"Yusuke Nishida ,&nbsp;Daisuke Ono ,&nbsp;Mayuko Kawamura ,&nbsp;Takayuki Kawamura ,&nbsp;Kazuyuki Mimura ,&nbsp;Hikoaki Fukaura ,&nbsp;Eiyu Ebata ,&nbsp;Sachie Koyama ,&nbsp;Yasuhiro Ebihara ,&nbsp;Hideaki Oka","doi":"10.1016/j.jiac.2025.102782","DOIUrl":"10.1016/j.jiac.2025.102782","url":null,"abstract":"<div><div>Disseminated gonococcal infection (DGI) is a rare complication of <em>Neisseria gonorrhoeae</em> infection. Eculizumab, a complement C5 inhibitor used in conditions such as paroxysmal nocturnal hemoglobinuria, increases the risk of invasive <em>Neisseria</em> spp. infections. Although previous reports have described DGI in eculizumab-treated patients, evidence involving individuals with neuromyelitis optica spectrum disorder (NMOSD) is limited, and all cases occurred weeks to months after treatment initiation. In the present case, the patient received a quadrivalent meningococcal vaccine before receiving eculizumab. Two days after the first dose, the patient presented with fever, chills, and headache. Laboratory findings revealed leukocytosis and mildly elevated C-reactive protein levels, with unremarkable urinalysis and cerebrospinal fluid results. Blood cultures revealed the presence of <em>N. gonorrhoeae</em>, confirming DGI. A blood test on day 5 revealed a CH50 level of 6.0 U/mL. Screening for other sexually transmitted infections was negative. Antimicrobial susceptibility testing revealed elevated minimum inhibitory concentrations (MICs) for penicillin G, ciprofloxacin, azithromycin, and minocycline, whereas the MIC for ceftriaxone remained low. The patient received intravenous ceftriaxone for 14 days. Following the patient's refusal to continue eculizumab therapy, the patient has chosen inebilizumab, resulting in stable management of NMOSD symptoms. The patient has been attending outpatient appointments approximately every two months, and no recurrence of gonococcal infection has been observed for at least 2 years. This is a case of DGI in a patient with NMOSD, and the earliest reported onset of DGI following eculizumab initiation. Clinicians should remain vigilant for invasive gonococcal infections, even shortly after initiating complement-inhibiting therapy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 9","pages":"Article 102782"},"PeriodicalIF":1.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide surveillance of antibacterial susceptibility in bacterial respiratory pathogens in Japan, 2022–2023","authors":"Issei Tokimatsu ,&nbsp;Yuji Fujikura ,&nbsp;Tetsuya Matsumoto ,&nbsp;Hiroki Tsukada ,&nbsp;Makoto Miki ,&nbsp;Yoshitomo Morinaga ,&nbsp;Junko Sato ,&nbsp;Satoshi Takahashi ,&nbsp;Naoki Hasegawa ,&nbsp;Hideji Yanagisawa ,&nbsp;Takaaki Sasaki ,&nbsp;Natsuko Tamaru ,&nbsp;Hiroshi Takahashi ,&nbsp;Daisuke Kurai ,&nbsp;Yoshifumi Uwamino ,&nbsp;Makoto Kudo ,&nbsp;Yuko Nagano ,&nbsp;Akira Youkou ,&nbsp;Satoshi Kawasaki ,&nbsp;Atsushi Tabata ,&nbsp;Takashi Shinzato","doi":"10.1016/j.jiac.2025.102781","DOIUrl":"10.1016/j.jiac.2025.102781","url":null,"abstract":"<div><div>The emergence and spread of antimicrobial resistant (AMR) have become a major global concern. This nationwide surveillance study, conducted by the Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Clinical Microbiology from 2022 to 2023, examined the antimicrobial susceptibility of respiratory pathogens. A total of 1057 bacterial isolates from 28 medical institutions, predominantly tertiary medical centers, were analyzed. Major pathogens included <em>Staphylococcus aureus</em>, <em>Streptococcus pneumoniae</em>, <em>Haemophilus influenzae</em>, <em>Moraxella catarrhalis, Klebsiella pneumoniae</em>, and <em>Pseudomonas aeruginosa</em>. Findings revealed increasing resistance rates, with a notable rise in extended-spectrum β-lactamase (ESBL)-producing <em>K. pneumoniae</em>. Susceptibility to penicillin, cephalosporins, and carbapenems varied, with specific declines observed in several antibiotics relative to prior surveillance data. No metallo-β-lactamase (MBL)-producing <em>P.</em> aeruginosa strains were detected. These findings underscore the need for rigorous antimicrobial stewardship and continuous surveillance to curb the spread of resistant pathogens in Japan.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102781"},"PeriodicalIF":1.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: false-negative Xpert MRSA/SA BC result due to spa gene deletion in a patient with methicillin-resistant Staphylococcus aureus bacteremia","authors":"Tatsuki Mura ,&nbsp;Miyako Aso ,&nbsp;Kae Kawamura ,&nbsp;Kazumi Kanaya ,&nbsp;Nobuhiko Ueda ,&nbsp;Yoshitsugu Iinuma","doi":"10.1016/j.jiac.2025.102780","DOIUrl":"10.1016/j.jiac.2025.102780","url":null,"abstract":"<div><div>Rapid diagnostic tests like the Xpert MRSA/SA BC assay are valuable for the early detection of <em>Staphylococcus aureus</em> (SA) and methicillin-resistant <em>S. aureus</em> (MRSA) in positive blood cultures. However, genetic variations in target regions can lead to false-negative results. We report a case of an 80's male with MRSA bacteremia where the Xpert MRSA/SA BC assay initially yielded false-negative results for both SA and MRSA. Subsequent culture confirmed MRSA, and whole-genome sequencing identified deletions within the <em>spa</em> gene, the target used for SA identification in the assay. This case highlights the importance of integrating molecular results with traditional culture methods, especially in cases of discordance, as genetic variants can impact the accuracy of rapid molecular assays.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102780"},"PeriodicalIF":1.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective observational study of the nosocomial outbreak caused by human rhinovirus A34","authors":"Miyako Fujita ,&nbsp;Takeshi Kinjo ,&nbsp;Wakaki Kami ,&nbsp;Wakako Arakaki ,&nbsp;Daijiro Nabeya ,&nbsp;Moriyasu Kohama ,&nbsp;Jun Tohyama ,&nbsp;Hiroya Oki ,&nbsp;Daisuke Motooka ,&nbsp;Shota Nakamura ,&nbsp;Kazuko Yamamoto ,&nbsp;Jiro Fujita","doi":"10.1016/j.jiac.2025.102778","DOIUrl":"10.1016/j.jiac.2025.102778","url":null,"abstract":"<div><h3>Background</h3><div>Past reports of nosocomial outbreak due to human rhinovirus (HRV) in adults are limited. We report a case of nosocomial outbreak of HRV-A34 in a long-term care facility with a literature review.</div></div><div><h3>Methods</h3><div>Multiplex real-time polymerase chain reaction assay (Allplex™ RV Essential Assay) was used for the detection of HRV. After whole genome sequencing (WGS), genomic data of HRV-A strains obtained from the GenBank database were used for phylogenetic comparison with outbreak strains.</div></div><div><h3>Results</h3><div>A nosocomial outbreak of HRV occurred between August 22 and September 4, 2021. During the outbreak, 17 patients had respiratory symptoms and 14 patients were positive for HRV. Additionally, HRV was detected in nine asymptomatic patients. The attack rate reached 58 %. HRV was identified five days after the onset of index case and the outbreak was terminated in 13 days. There were no significant differences on their median age (37 vs 44 years old, p = 0.1221) and sex (male gender 61 % vs 39 %, p = 1.000) between symptomatic and asymptomatic HRV patients. No patients developed pneumonia and died. WGS showed that outbreak strains were genetically identical and belonged to the HRV-A34. Literature review showed past outbreaks were caused by either HRV-A or HRV-C, and the mortality rate was reported to be 22 % at highest. The present report is the first case of nosocomial outbreak of HRV-A34.</div></div><div><h3>Conclusion</h3><div>Although nosocomial HRV infection is difficult to suppress, even with strengthened infection control measures, prompt identification of HRV is important. HRV should not be underestimated, especially in long-term care facilities.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 9","pages":"Article 102778"},"PeriodicalIF":1.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymerase chain reaction fails to detect mixed malaria infections in siblings from Ethiopia","authors":"Ashton D. Hall ,&nbsp;Daniel A. Whitehurst ,&nbsp;Joel E. Mortensen ,&nbsp;Kristina Prus ,&nbsp;Mary A. Staat ,&nbsp;Elizabeth P. Schlaudecker ,&nbsp;Nina S. Prasanphanich","doi":"10.1016/j.jiac.2025.102777","DOIUrl":"10.1016/j.jiac.2025.102777","url":null,"abstract":"<div><div>Malaria remains a significant public health concern in sub-Saharan Africa, particularly in Ethiopia where <em>Plasmodium falciparum</em> and <em>Plasmodium vivax</em> are co-endemic. Most cases in the United States are acquired abroad and imported. Peripheral blood smears remain the gold standard of diagnosis, but their relatively low sensitivity and reliance on skilled interpretation have led to the growing use of polymerase chain reaction (PCR)-based diagnostics. We report cases of malaria in two pediatric siblings who had recently returned from Ethiopia, where PCR initially failed to detect <em>P. vivax</em>. Recurrent symptoms eventually led to diagnosis of <em>P. falciparum/P. vivax</em> co-infection by PCR and blood smear. This case highlights the limitations of current malaria diagnostics, which may fail to detect mixed infections and lead to delayed or incomplete treatment. Clinicians should maintain a high index of suspicion for malaria in patients returning from co-endemic regions, as mixed infections may emerge after a prolonged period without re-exposure to an endemic area.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 9","pages":"Article 102777"},"PeriodicalIF":1.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}