Journal of Infection and Chemotherapy最新文献

{"title":"Xpert MTB/RIF probe reactivity to non-tuberculosis mycobacteria cultured in MGIT broth samples","authors":"Tatsuya Hioki ,&nbsp;Yoshikazu Mutoh ,&nbsp;Takumi Umemura ,&nbsp;Yoshimi Ishihara ,&nbsp;Masayoshi Ajioka ,&nbsp;Akiko Takaki ,&nbsp;Kinuyo Chikamatsu ,&nbsp;Satoshi Mitarai","doi":"10.1016/j.jiac.2025.102891","DOIUrl":"10.1016/j.jiac.2025.102891","url":null,"abstract":"<div><div>The Xpert MTB/RIF assay can simultaneously detect <em>Mycobacterium tuberculosis</em> (MTB) and rifampicin resistance (RR), though the culture-positive Mycobacteria Growth Indicator Tube (MGIT) broth is not a specified sample type. In clinical settings the assay is sometimes used as an ancillary test to identify MTB and RR in MGIT broth samples, however, limited information is available on the reactivity of the probes to non-tuberculosis mycobacteria (NTM) species. The aim of this study was to assess the results of the Xpert MTB/RIF assay using MGIT broth samples positive for NTM. Of 65 NTM samples tested, 48 (74 %) showed probe signals. Probe reactivity and cycle threshold value differed according to the <em>Mycobacterium</em> species. Ten of 11 (91 %) of <em>Mycobacterium intracellulare</em> samples showed positive Probe A signals, and 23 of 29 (79 %) <em>Mycobacterium avium</em> samples showed positive Probe C signals. Additionally, a sample with <em>M</em>. <em>avium</em> and <em>M</em>. <em>intracellulare</em> co-infection tested false-positive for RR MTB. The proportion of NTM samples that tested positive was higher than that reported previously. These findings could help prevent misinterpretation of Xpert MTB/RIF results.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102891"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734028","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":"Oral gepotidacin for the treatment of uncomplicated urinary tract infection in Japanese female patients: a randomized, active reference, double-blind, double-dummy, Phase 3 trial (EAGLE-J)","authors":"Shingo Yamamoto ,&nbsp;Kenji Fujii ,&nbsp;Yoko Kayama ,&nbsp;Akinori Nimura ,&nbsp;Takao Maenaka ,&nbsp;Marcela Ramirez ,&nbsp;Rudrani Banerjee ,&nbsp;Nicole E. Scangarella-Oman ,&nbsp;Susan Mozzicato ,&nbsp;Shintaro Ura","doi":"10.1016/j.jiac.2025.102829","DOIUrl":"10.1016/j.jiac.2025.102829","url":null,"abstract":"<div><h3>Background</h3><div>Two global Phase 3 trials, EAGLE-2 and EAGLE-3, found gepotidacin non-inferior (and superior in EAGLE-3) to nitrofurantoin for the treatment of uUTI in female participants, with an acceptable safety profile; however, these studies did not include Japanese centers.</div></div><div><h3>Methods</h3><div>EAGLE-J (NCT05630833; jRCT2031220467) was a Phase 3, randomized, double-blind, active reference study evaluating the efficacy and safety of gepotidacin for the treatment of uUTI in Japan. Eligible participants were females aged ≥12 years with ≥2 uUTI symptoms and urinary nitrite or pyuria. Participants were randomly assigned (3:1) oral gepotidacin (1500 mg) or nitrofurantoin (100 mg) twice daily for 5 days. To bridge data, consistency of therapeutic response at test-of-cure (day 10–13) in the gepotidacin arm of EAGLE-J with EAGLE-2/EAGLE-3 was assessed in participants with qualifying nitrofurantoin-susceptible uropathogens (≥10⁵ colony-forming units/mL). Therapeutic success comprised clinical (symptom resolution) and microbiological success (eradication). Consistency was claimed if the therapeutic success rate in EAGLE-J was greater than the consistency threshold predicted from EAGLE-2/EAGLE-3.</div></div><div><h3>Findings</h3><div>Overall, the primary analysis included 108 participants (83 gepotidacin, 25 nitrofurantoin). At test-of-cure, gepotidacin therapeutic success was 83.1 % (69/83), exceeding the consistency threshold (48.2 %). Adverse events were mostly mild-to-moderate; common adverse events were diarrhea (gepotidacin: 60 %, 168/281; nitrofurantoin: 8 %, 7/93) and nausea (gepotidacin: 12 %, 35/281; nitrofurantoin: 2 %, 2/93). No fatalities occurred.</div></div><div><h3>Interpretation</h3><div>Gepotidacin therapeutic success at test-of-cure was consistent between EAGLE-J and EAGLE-2/-3. Gepotidacin has potential as a valuable oral treatment option for uUTI in Japan. No new safety signals were identified.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102829"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318130","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":"Pharmacokinetics of daptomycin during low-flow continuous renal replacement therapy in critically ill Japanese patients","authors":"Kazuro Ikawa ,&nbsp;Mana Taguchi ,&nbsp;Takeshi Ide ,&nbsp;Norifumi Morikawa ,&nbsp;Kenta Takeda","doi":"10.1016/j.jiac.2025.102883","DOIUrl":"10.1016/j.jiac.2025.102883","url":null,"abstract":"<div><h3>Introduction</h3><div>Daptomycin is used to treat systemic and life-threatening infections caused by methicillin-resistant <em>Staphylococcus aureus</em> in critically ill patients receiving continuous renal replacement therapy (CRRT). However, the pharmacokinetics of daptomycin during low-flow CRRT have not been examined; thus, the appropriate dosing adjustment in Japan remains uncertain.</div></div><div><h3>Methods</h3><div>The daptomycin concentrations in plasma and effluent samples of adult Japanese patients receiving continuous venovenous hemodiafiltration (n = 4) and continuous venovenous hemodialysis (n = 2) were measured by liquid chromatography. The data were analyzed and used to estimate pharmacodynamic exposure and concentrations to profile daptomycin regimens.</div></div><div><h3>Results</h3><div>The pharmacokinetics of daptomycin was described using two-compartment model. In the six CRRT patients (effluent flow rate, 0.825 ± 0.038 L/h), the parameter estimates were: volume of distribution of the central compartment, 8.09 ± 3.76 L; volume of distribution of the peripheral compartment, 6.23 ± 2.58 L; intercompartmental clearance, 4.63 ± 1.98 L/h; total clearance, 0.439 ± 0.172 L/h; sieving coefficient, 0.0995 ± 0.0295; extrinsic clearance by CRRT, 0.0815 ± 0.0223 L/h; intrinsic clearance of the patient, 0.357 ± 0.173 L/h; area under the concentration-time curve (AUC) for 24 h, 597.6 ± 196.1 mg‧h/L. Simulated daptomycin regimen for the exposure target (AUC ≥666 mg‧h/L) was 5.36 ± 2.46 mg/kg every 24 h, achieving the safety target (the minimum concentration ≤24.3 mg/L).</div></div><div><h3>Conclusion</h3><div>These results help to define the pharmacokinetics of daptomycin during low-flow CRRT, while also helping to consider dosing regimens for critically ill Japanese patients receiving CRRT.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102883"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687611","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":"Impact of timing in prospective audit and feedback on broad-spectrum antibiotic use: a comparison between third-day and seventh-day interventions","authors":"Hisako Machida ,&nbsp;Yoshiki Kusama ,&nbsp;Daisuke Onozuka ,&nbsp;Atsuko Sunada ,&nbsp;Satoshi Kutsuna","doi":"10.1016/j.jiac.2025.102896","DOIUrl":"10.1016/j.jiac.2025.102896","url":null,"abstract":"<div><div>Prospective audit and feedback (PAF) is a key component of antimicrobial stewardship (AS) programs and has been shown to reduce the use of broad-spectrum antibiotics. However, the optimal timing of PAF intervention remains unclear.</div><div>This quasi-experimental, single-center study investigated the impact of changing PAF timing from day 3 to day 7 after initiating empirical broad-spectrum antibiotics. Monthly days of therapy (DOT) for carbapenems (CAR), piperacillin-tazobactam (PIP/TAZ), and cefepime (PEF) were extracted from 2016 to 2024. Annual susceptibility rates of <em>Pseudomonas aeruginosa</em> and the time from blood culture submission to susceptibility results were also evaluated. Interrupted time series analysis assessed changes in DOT, while other data were descriptively analyzed.</div><div>DOT for CAR and PIP/TAZ decreased significantly post-intervention (CAR: −0.68, P &lt; 0.001; PIP/TAZ: −0.29, P = 0.031), despite no significant change in trend slopes. PEF showed no significant changes. Susceptibility rates of <em>P. aeruginosa</em> remained stable. Notably, 28.3 % of blood culture results exceeded 4 days to report, and 95 % were available by day 7.</div><div>As causality cannot be inferred from this observational design, the mechanism underlying the observed reduction in DOT remains uncertain. Nevertheless, adjusting PAF timing may be feasible in settings with limited stewardship resources. Further studies are needed to determine the most effective timing of PAF interventions and to assess generalizability to other institutions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102896"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774669","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":"Zoonotic aortic graft infection by Streptococcus equi","authors":"Haruka Karaushi ,&nbsp;Akihiro Yoshitake ,&nbsp;Yuta Kanazawa ,&nbsp;Noriyuki Watanabe ,&nbsp;Mieko Tokano ,&nbsp;Masafumi Seki ,&nbsp;Kotaro Mitsutake","doi":"10.1016/j.jiac.2025.102900","DOIUrl":"10.1016/j.jiac.2025.102900","url":null,"abstract":"<div><div>A 69-year-old woman with hypertension had undergone total arch replacement with an open stent graft 7 years prior. She was referred to our hospital for evaluation after experiencing fever (&gt;38 °C) and cough. Chest radiography revealed a prominent aortic arch, and contrast-enhanced computed tomography demonstrated aortic arch enlargement and peri-graft fluid collection containing air. These findings indicated graft infection and prompted immediate intervention. Blood cultures grew <em>Streptococcus equi</em> subspecies <em>zooepidemicus</em>, a zoonotic pathogen associated with horses. Notably, the patient worked as a horse trainer. On hospital day 6, she developed severe hemoptysis due to an aortobronchial fistula caused by stent graft infection and underwent emergency re-replacement of the aortic arch. Intraoperative specimens also yielded the same pathogen. Consequently, she was treated with ampicillin, and her postoperative course was uneventful. Although rare, zoonotic pathogens can cause vascular graft infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102900"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781349","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":"Antibiotic-associated encephalopathy induced by cefmetazole in a hemodialysis patient: Case report","authors":"Toshiyuki Nakanishi ,&nbsp;Taku Harada ,&nbsp;Satoshi Kutsuna","doi":"10.1016/j.jiac.2025.102882","DOIUrl":"10.1016/j.jiac.2025.102882","url":null,"abstract":"<div><div>Antibiotic-associated encephalopathy (AAE) is a rare but significant neurological complication of β-lactam antibiotics, particularly in patients with renal impairment. While cefepime, ceftazidime, and ceftriaxone are well-documented causes, cefmetazole (CMZ) has not been widely recognized for neurotoxicity. We report an 82-year-old Japanese man with end-stage renal disease on chronic hemodialysis who developed altered mental status and myoclonus five days after starting intravenous CMZ for prostatic abscess. Electroencephalography (EEG) revealed triphasic waves consistent with non-convulsive status epilepticus. Neuroimaging and cerebrospinal fluid analysis showed no evidence of infection or stroke. Symptoms resolved within 48 hours of CMZ discontinuation. A Naranjo score of 5 supported a diagnosis of CMZ-induced AAE. This case underscores the potential neurotoxicity of CMZ and emphasizes the importance of early recognition of AAE in patients with renal dysfunction.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102882"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696048","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":"Longitudinal monitoring of Toxoplasma gondii antibodies in people with HIV in Japan","authors":"Tokio Hoshina ,&nbsp;Tomomi Miyamoto ,&nbsp;Makiko Miyajima ,&nbsp;Kwangyole Lee ,&nbsp;Tetsuya Horino ,&nbsp;Hirotaka Kanuka ,&nbsp;Masaki Yoshida","doi":"10.1016/j.jiac.2025.102867","DOIUrl":"10.1016/j.jiac.2025.102867","url":null,"abstract":"<div><h3>Introduction</h3><div>While the decline of <em>Toxoplasma gondii</em> IgG (TpIgG) titers over time has been documented in HIV-negative populations, the long-term trajectory of TpIgG in people with HIV (PWH) receiving antiretroviral therapy (ART) remains poorly understood. Moreover, potential associations with ART and CD4-positive lymphocyte count have not yet been clarified.</div></div><div><h3>Methods</h3><div>This single-center, cross-sectional study was conducted between 2021 and 2022 at Jikei University Hospital. TpIgG titers were measured by ELISA in PWH who visited the hospital during the study period and were compared with results from our previous cross-sectional survey performed in 2015–2016. Clinical information, including CD4 profiles and duration of ART, was extracted from medical records to evaluate correlations with longitudinal changes in TpIgG titers. In addition, historical TpIgG measurements recorded outside of the 2015–2016 and 2021–2022 surveys were retrieved from medical records to provide extended longitudinal observations.</div></div><div><h3>Results</h3><div>Among 416 PWH enrolled, 7.2 % (30/416) tested positive for TpIgG in 2021–2022, with no significant demographic differences between TpIgG-positive and -negative groups. In 22 participants with paired measurements from 2015 to 2016 and 2021–2022, TpIgG titers showed a significant decline over time (p = 0.00593). While antibody trajectories were generally downward, correlation analyses revealed no significant associations between TpIgG changes and nadir CD4 count, CD4 recovery, or ART duration.</div></div><div><h3>Conclusions</h3><div>TpIgG titers significantly declined during long-term ART, with no clear correlation to immunological parameters. Continued monitoring and further research are warranted to clarify the clinical implications of these antibody dynamics.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102867"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587592","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":"Chronic pulmonary coccidioidomycosis complicated with meningitis: A case report","authors":"Ryo Mizushima ,&nbsp;Yuki Moriyama ,&nbsp;Akira Watanabe ,&nbsp;Keigo Ueno ,&nbsp;Takayuki Shinohara ,&nbsp;Yoshitsugu Miyazaki ,&nbsp;Norio Ohmagari","doi":"10.1016/j.jiac.2025.102870","DOIUrl":"10.1016/j.jiac.2025.102870","url":null,"abstract":"<div><div>We encountered a case of chronic pulmonary coccidioidomycosis complicated with meningitis in a 53-year-old African-American veteran with a history of staying in Arizona, United States of America. The patient was referred from another hospital with complaints of cough, blood-stained phlegm, hemoptysis, and headache. Chronic pulmonary coccidioidomycosis was suspected based on the presence of multiple pulmonary cavity lesions on computed tomography (CT) and a relevant exposure history, and the diagnosis was confirmed by serological antibody tests (coccidioidomycosis IgG, positive; coccidioidomycosis IgM, negative). Treatment was initiated with oral fluconazole (FLCZ) 400 mg daily, but there was no improvement in symptoms, and CT revealed gradual enlargement of the pulmonary cavitary lesions. Therefore, the oral FLCZ dose was increased to 800 mg; however, the patient developed worsening headache, and subsequent cerebrospinal fluid analysis revealed a slight increase in cell count with positive IgG, negative IgM, and negative polymerase chain reaction results. Suspecting meningitis, the oral FLCZ dose was further increased to 1200 mg, leading to marked improvement in symptoms at the following visit. In coccidioidomycosis, an increase in any antibody titer should be considered an indicator of active infection. In addition, if headache develops during the course of the disease, appropriate treatment for meningitis should be initiated even if cerebrospinal fluid findings are minimal.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102870"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596680","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":"Carbapenem resistant gram negative bacteremia in intensive care unit patients: Development and validation of a nomogram-based 30-day mortality risk prediction model","authors":"Nesrin Türker ,&nbsp;Ozge Eren Korkmaz ,&nbsp;Figen Kaptan Aydogmus ,&nbsp;Nur Miray Ayhan Geniş ,&nbsp;Tuba Müderris ,&nbsp;Murat Aksun","doi":"10.1016/j.jiac.2025.102902","DOIUrl":"10.1016/j.jiac.2025.102902","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant Gram-negative bloodstream infections (CR-GNB BSIs) are increasingly prevalent in intensive care units (ICUs) and associated with high mortality. Accurate early risk stratification tools are lacking.</div></div><div><h3>Objectives</h3><div>To develop and internally validate a nomogram-based model predicting 30-day mortality in ICU patients with CR-GNB BSIs.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult ICU patients with CR-GNB BSIs at a tertiary hospital in western Turkey (January 2020–October 2024). Demographic, clinical, laboratory, and microbiological data were collected. Patients were randomly split into training (70 %) and validation (30 %) cohorts. Univariable and multivariable logistic regression analyses identified independent mortality predictors, which were incorporated into a nomogram. Model discrimination, calibration, and decision-curve utility were evaluated.</div></div><div><h3>Results</h3><div>A total of 281 patients were included (median age 66 years; 60.9 % male); 30-day mortality was 58 %. <em>Acinetobacter spp</em>. predominated (51.6 %), followed by <em>Klebsiella spp</em>. (42.3 %) and <em>Pseudomonas spp</em>. (6.1 %). Independent predictors of 30-day mortality included older age, immunosuppression, hypoalbuminemia, elevated white blood cell count, and absence of microbiological cure. The nomogram demonstrated excellent discrimination (AUC 0.895 training; 0.854 validation), good calibration (mean absolute error 0.022–0.059), and meaningful clinical net benefit across intermediate risk thresholds.</div></div><div><h3>Conclusions</h3><div>We developed and internally validated a nomogram using routine clinical and laboratory variables to predict 30-day mortality in ICU patients with CR-GNB BSIs. This tool may support early prognostic assessment at bedside and guide individualized management. Prospective multicenter validation is warranted.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102902"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856988","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":"Parvovirus B19 infection induces pure red cell aplasia after lung transplantation","authors":"Yusuke Okamoto ,&nbsp;Kenichi Ishiyama ,&nbsp;Akira Matsumoto ,&nbsp;Yusuke Tsuda ,&nbsp;Miki Nagao ,&nbsp;Masahiro Hirata ,&nbsp;Masakazu Fujimoto ,&nbsp;Hironori Haga ,&nbsp;Yojiro Yutaka ,&nbsp;Akifumi Takaori-Kondo","doi":"10.1016/j.jiac.2025.102901","DOIUrl":"10.1016/j.jiac.2025.102901","url":null,"abstract":"<div><div>A man in his 50's with a history of acute lymphoblastic leukemia underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) over 20 years earlier and later developed bilateral giant pulmonary bullae, presumed secondary to pulmonary chronic graft-versus-host disease (cGVHD), requiring bilateral lung transplantation. Six months after lung transplantation, he developed rapid-onset severe normocytic anemia with reticulocytopenia. Cytomegalovirus (CMV) reactivation was initially suspected, and antiviral therapy was commenced, but the anemia persisted. Subsequent Polymerase chain reaction (PCR) testing revealed parvovirus B19 viremia, and bone marrow examination demonstrated erythroid hypoplasia with giant proerythroblasts, confirming parvovirus B19–associated pure red cell aplasia (PRCA). Treatment with intravenous immunoglobulin (IVIG) led to rapid hematologic improvement and complete recovery without recurrence.</div><div>This case underscores the importance of considering parvovirus B19 infection as a potential cause of anemia in immunocompromised individuals, especially following solid organ transplantation, where overlapping viral infections and immunosuppressive agents complicate diagnosis. Early recognition and prompt IVIG therapy can result in excellent outcomes and prevent unnecessary interventions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102901"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786657","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}