Tropical Diseases, Travel Medicine and Vaccines最新文献

{"title":"Transmission sources and severe rat lung worm diseases in travelers: a scoping review.","authors":"Atibordee Meesing,&nbsp;Sittichai Khamsai,&nbsp;Kittisak Sawanyawisuth,&nbsp;Somsak Tiamkao,&nbsp;Wanchai Maleewong,&nbsp;Panita Limpawattana,&nbsp;Bundit Sawunyavisuth,&nbsp;Chetta Ngamjarus,&nbsp;Watchara Boonsawat","doi":"10.1186/s40794-022-00184-4","DOIUrl":"https://doi.org/10.1186/s40794-022-00184-4","url":null,"abstract":"<p><strong>Background: </strong>Rat lung worm disease (RLWD) has several clinical forms including eosinophilic meningitis (EOM) and two severe forms, eosinophilic meningoencephalitis (EOME) and eosinophilic radiculomyelitis (EORM). It remains unclear whether transmission sources are associated with severe forms of RLWD. This study aimed to evaluate if transmission factors are related to the severity of RLWD among travelers by using a scoping review of case reports.</p><p><strong>Methods: </strong>This was a review using five databases to retrieve case reports and case series of travelers with RLWD. Clinical data and transmission sources of reported cases diagnosed as RLWD were retrieved. The outcome of the study was occurrence of severe forms of RLWD defined as EOME, EORM, and combined EOME/EORM.</p><p><strong>Results: </strong>We retrieved 1,326 articles from five databases and 31 articles were included in the analysis. There were 84 cases eligible from 15 countries. Four cases were excluded. Seventy cases were in EOM group and 10 cases had EOME or EORM. Compared with the EOM group, the EOME, EORM, and combination EOME/EORM group had similar age, sex, and risk factors of consumptions of apple snails, shrimp and prawn, and salad/vegetables. The EOME group had higher proportion of consumption of African snails than the EOM group (60% vs 13.8%). However, only one study reported the consumption of African snails and the heterogeneity between studies and the small sample size impeded direct comparisons between groups.</p><p><strong>Conclusions: </strong>RLWD in travelers can be found in most continents and mostly get infected from endemic countries of RLWD. Further studies are required to evaluate the association between transmission vectors and severity of RLWD.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9912548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10693091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathology of yellow fever autopsy cases.","authors":"Fernando Pereira Frassetto,&nbsp;Sergio Rosemberg","doi":"10.1186/s40794-022-00187-1","DOIUrl":"https://doi.org/10.1186/s40794-022-00187-1","url":null,"abstract":"<p><strong>Background: </strong>Yellow fever is a viral hemorrhagic fever caused by yellow fever virus, a mosquito-borne flavivirus. Despite an effective vaccine, major outbreaks continue to occur around the world. Even though it is not a proven neurotropic virus, neurological symptoms in more severe clinical forms are frequent. The understanding of this apparent paradox is still rarely addressed in literature.</p><p><strong>Methods: </strong>The brains of thirty-eight patients with yellow fever confirmed by RT-PCR, who underwent autopsy, were analyzed morphologically to identify and characterize neuropathological changes. The data were compared with brains collected from individuals without the disease, as a control group. Both cases and controls were subdivided according to the presence or absence of co-concurrent septic shock, to exclude changes of the sepsis associated encephalopathy. To verify possible morphological differences between the yellow fever cases groups, between the control groups, and between the cases and the controls, we applied the statistical tests Fisher's exact test and chi-square, with p values < 0.05 considered statistically significant.</p><p><strong>Results: </strong>All cases and controls presented, at least focally, neuropathological changes, which included edema, meningeal and parenchymal inflammatory infiltrate and hemorrhages, and perivascular inflammatory infiltrate. We did not find an unequivocal aspect of encephalitis. The only parameter that, after statistical analysis, can be attributed to yellow fever was the perivascular inflammatory infiltrate.</p><p><strong>Conclusions: </strong>The neuropathological findings are sufficient to justify the multiple clinical neurologic disturbances detected in the YF cases. Since most of the parameters evaluated did not show statistically significant difference between cases and controls, an explanation for most of the neuropathological findings may be the vascular changes, consequent to shock induced endotheliopathy, associated with stimulation of the immune system inherent to systemic infectious processes. The statistical difference obtained in yellow fever cases regarding perivascular infiltrate can be can be explained by the immune activation inherent to the condition.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9883951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10626031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study.","authors":"Bhawani Yasassri Alvitigala,&nbsp;Lallindra Viranjan Gooneratne,&nbsp;Iresha Dharmasena,&nbsp;Nuwan Premawardana,&nbsp;Manujasri Wimalachandra,&nbsp;Miyuru Weerarathna,&nbsp;Roopen Arya,&nbsp;Ariaranee Gnanathasan","doi":"10.1186/s40794-022-00186-2","DOIUrl":"https://doi.org/10.1186/s40794-022-00186-2","url":null,"abstract":"<p><strong>Background: </strong>Hump-nosed vipers (HNV; Hypnale spp) are one of the medically important venomous snakes in Sri Lanka and South-Western regions of India. The haemostatic dysfunction due to HNV bites is poorly characterized by standard diagnostic tests performed to identify coagulopathy. We aimed to determine the usefulness of rotational thromboelastometry (ROTEM) parameters compared to 20-minute whole blood clotting test (WBCT20) and prothrombin time (PT) in understanding the coagulopathy of HNV bites.</p><p><strong>Methods: </strong>Twenty-three HNV snakebite patients in a prospective study of 127 consecutive snakebites were recruited. After recording details of the clinical presentation, PT/international normalized ratio (INR), WBCT20 and ROTEM delta were performed at presentation.</p><p><strong>Results: </strong>In this preliminary study, none of the patients had clinically apparent bleeding. Coagulopathy was detected by either WBCT20, INR or ROTEM in 13 HNV patients. Eleven had a coagulopathy detectable by ROTEM (either abnormal EXTEM-CT, INTEM-CT or FIBTEM-MCF) but with negative WBCT20. Of them, only two had prolonged INR values. Two patients had positive WBCT20 but with normal ROTEM and INR values. The remaining 10 patients did not show any coagulopathy either by INR, ROTEM or WBCT20.</p><p><strong>Conclusion: </strong>In this preliminary study with small number of sample size, ROTEM parameters appeared to be more sensitive to subtle changes in coagulation compared to WBCT20. The clinical utility of detecting these changes and their usefulness in managing snakebite should be explored further in a larger study.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9806870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10532669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasmodium vivax: the potential obstacles it presents to malaria elimination and eradication.","authors":"Kassahun Habtamu,&nbsp;Beyene Petros,&nbsp;Guiyun Yan","doi":"10.1186/s40794-022-00185-3","DOIUrl":"10.1186/s40794-022-00185-3","url":null,"abstract":"<p><p>Initiatives to eradicate malaria have a good impact on P. falciparum malaria worldwide. P. vivax, however, still presents significant difficulties. This is due to its unique biological traits, which, in comparison to P. falciparum, pose serious challenges for malaria elimination approaches. P. vivax's numerous distinctive characteristics and its ability to live for weeks to years in liver cells in its hypnozoite form, which may elude the human immune system and blood-stage therapy and offer protection during mosquito-free seasons. Many malaria patients are not fully treated because of contraindications to primaquine use in pregnant and nursing women and are still vulnerable to P. vivax relapses, although there are medications that could radical cure P. vivax. Additionally, due to CYP2D6's highly variable genetic polymorphism, the pharmacokinetics of primaquine may be impacted. Due to their inability to metabolize PQ, some CYP2D6 polymorphism alleles can cause patients to not respond to treatment. Tafenoquine offers a radical treatment in a single dose that overcomes the potentially serious problem of poor adherence to daily primaquine. Despite this benefit, hemolysis of the early erythrocytes continues in individuals with G6PD deficiency until all susceptible cells have been eliminated. Field techniques such as microscopy or rapid diagnostic tests (RDTs) miss the large number of submicroscopic and/or asymptomatic infections brought on by reticulocyte tropism and the low parasitemia levels that accompany it. Moreover, P. vivax gametocytes grow more quickly and are much more prevalent in the bloodstream. P. vivax populations also have a great deal of genetic variation throughout their genome, which ensures evolutionary fitness and boosts adaptation potential. Furthermore, P. vivax fully develops in the mosquito faster than P. falciparum. These characteristics contribute to parasite reservoirs in the human population and facilitate faster transmission. Overall, no genuine chance of eradication is predicted in the next few years unless new tools for lowering malaria transmission are developed (i.e., malaria elimination and eradication). The challenging characteristics of P. vivax that impede the elimination and eradication of malaria are thus discussed in this article.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10608072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19: how can travel medicine benefit from tourism's focus on people during a pandemic?","authors":"Irmgard L Bauer","doi":"10.1186/s40794-022-00182-6","DOIUrl":"10.1186/s40794-022-00182-6","url":null,"abstract":"<p><p>In 2020, COVID-19 affected every aspect of life around the globe. The spread of SARS-CoV-2 through travel led to lockdowns, travel bans and border closures, crippling the tourism industry. Without tourists, there would be no tourism industry-and no travel medicine. Therefore, scholars started to research the human aspect of tourism immediately to develop strategies for economic recovery. The resulting insights are useful for travel medicine not only to see how tourism dealt with a medical crisis but also to understand travellers better who may be seeking health advice during and after a pandemic.This article presents tourism research of 2020 covering risk perception and travel intentions including mass-gatherings, the use of technology to protect from infection, impacts on tourism workers, residents' reactions to potentially infected travellers, discrimination, and racism. A potential fork in the road to tourism's future may have implications for travel health practitioners. Research recommendations conclude the paper. Understanding the industry response during the early days of panic and uncertainty may help prepare not only appropriate guidelines for travellers but also clearer instructions for tourism, transportation, and hospitality in anticipation of the next pandemic.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10678639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of vaccination against Covid-19 one year after its introduction in Brazil.","authors":"Jadher Percio, Cibelle Mendes Cabral, Francieli Fontana Sutile Tardetti Fantinato, Dalva Maria de Assis, Lely Stella Guzmán-Barrera, Wildo Navegantes de Araújo","doi":"10.1186/s40794-022-00183-5","DOIUrl":"10.1186/s40794-022-00183-5","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, several efforts have been made to develop, distribute and administer safe and effective vaccines to reduce morbidity and mortality and control the Covid-19 pandemic. This study aimed to analyze the effect of vaccination against Covid-19, one year after its introduction in Brazil.</p><p><strong>Methods: </strong>An ecological study that analyzed the general effect of vaccination against Covid-19 on disease morbidity and mortality indicators among the Brazilian population aged 18 years or older per epidemiological week (EW), comparing the pre and postvaccination period. Morbidity and mortality indicators were calculated from secondary databases (hospitalization rate, severity, case fatality rate and mortality) and vaccination coverage by age groups (18 to 59 years and 60 years or older). Morbimortality trends were estimated using the JoinPoint model and their association with vaccine coverage using the Poisson model.</p><p><strong>Results: </strong>The average weekly percentage change (AWPC) of morbidity and mortality indicators reduced after the introduction of Covid-19 vaccination: hospitalization rate (from 15.3% to -6.0%), severity (from 0.4% to -0.2%), case fatality rate (from 0.3% to -0.2%) and mortality (from 20.5% to -4.3%). The following indicators were inversely associated with the increase in vaccine coverage against Covid-19: hospitalization (IRR: 0.974), mortality (IRR: 0.975) and lethality for people aged 60 years or older (IRR: 0.997).</p><p><strong>Conclusions: </strong>In spite of the three epidemic waves and the circulation of variants of concern, the general effect of vaccination against Covid-19 in reducing the trend of morbidity and mortality from the disease in Brazil was demonstrated. These findings contribute to a better understanding of the mass vaccination program against Covid-19 and may inform future public health policies.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10424615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilising community volunteers can increase the detection and referral of Buruli ulcer cases in endemic communities in Southeast, Nigeria.","authors":"Chihurumnanya Alo, Ijeoma Nkem Okedo-Alex, Ifeyinwa Chizoba Akamike, Adaoha Pearl Agu, Ifeyinwa Maureen Okeke, Chidinma Ihuoma Amuzie, Nneamaka C Alo","doi":"10.1186/s40794-022-00181-7","DOIUrl":"10.1186/s40794-022-00181-7","url":null,"abstract":"<p><strong>Background: </strong>Buruli ulcer (BU) is a debilitating neglected tropical disease which causes disability and mostly affects inhabitants in impoverished settings where access to medical care is challenging. This study aims to determine the effect of training community members as volunteers for or in the detection and referral of people who have Buruli ulcer to the hospital.</p><p><strong>Methods: </strong>The following study is a before and after study in the BU-endemic Local Government Areas (LGA) of Ebonyi State. A cluster random sampling technique was used to select 90 volunteers from three LGAs (30 from each LGA). In each LGA, the volunteers underwent a one-day training and six months field work to identify all those who have any form of ulcer on any part of their bodies. A short questionnaire was used to capture socio-demographic characteristics of the patient, site of the ulcer, duration of the ulcer, initial appearance of the ulcer, referral to hospital, result of laboratory investigation, and treatment received. The data was analysed using the Statistical Package for Social Sciences (SPSS) for Microsoft Windows version 20 software. The Z test statistic was used to compare the number of referred BU patients before and after the intervention by LGA. The Chi square test was used to examine the association between the dependent and independent variables.</p><p><strong>Results: </strong>The mean age of volunteers was 39 ± 9.5 while mean age of the patients was 42.3 ± 17.1. Most of the ulcers were on the legs (79.4%) and lasted 1-5 years (65.6%). There was a significant increase in the proportion of BU suspects identified by the community volunteers in all 3 LGAs (Afikpo north (p =  < 0.001), Abakaliki (p = 0.02), Ikwo (p = 0.001). The duration of the ulcer was associated with the detection and referral of the patients with higher levels of detection and referral among those whose ulcer had lasted 1-5 years in two of the LGAs (P < 0.001).</p><p><strong>Conclusion: </strong>We recommend that program managers and stakeholders integrate and scale up the services of trained community health volunteers for the rapid detection of Buruli ulcer cases in rural endemic communities. Awareness and sensitization campaigns on BU preventive measures should be intensified.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40447265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic protothecosis in an immunocompetent patient.","authors":"Alvano Trespalacios Sierra,&nbsp;Bárbara Arroyo-Salgado,&nbsp;Jesús Rodriguez-Blanco,&nbsp;Ingrid Tibocha Gordon,&nbsp;María Cristina Martínez-Ávila","doi":"10.1186/s40794-022-00180-8","DOIUrl":"https://doi.org/10.1186/s40794-022-00180-8","url":null,"abstract":"<p><strong>Background: </strong>Although uncommon, there is increasing interest and public health concerns of the pathogen Prototheca spp, a ubiquitous achlorophilic microalgae that can affect both humans and animals. High mortality rates have been reported in immunocompromised patients with disseminated infection, but no data is available in the immunocompetent population.</p><p><strong>Case presentation: </strong>We present the case of a 59-year-old man from rural area of Colombia who was admitted to the intensive care unit due to decompensated heart failure that was difficult to medically manage, with development of septic shock and isolation of Prototheca wickerhamii from blood culture. Fluconazole and Amphotericin B were given with successful outcome.</p><p><strong>Conclusions: </strong>To date, protothecosis and its virulence factors and pathogenesis remain to be fully understood, in our case the isolation of this microalga and its implication of exacerbating chronic conditions such as heart failure is unclear. The medical-scientific community is invited to study this microorganism to determine effective management strategies, as well as its timely identification, treatment, and control, to avoid fatal outcomes.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33513511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonization with extended-spectrum beta-lactamase-producing Escherichia coli and traveler's diarrhea attack rates among travelers to India: a systematic review and meta-analysis.","authors":"Basilua Andre Muzembo,&nbsp;Kei Kitahara,&nbsp;Ayumu Ohno,&nbsp;Keinosuke Okamoto,&nbsp;Shin-Ichi Miyoshi","doi":"10.1186/s40794-022-00179-1","DOIUrl":"https://doi.org/10.1186/s40794-022-00179-1","url":null,"abstract":"<p><strong>Background: </strong>India is an attractive destination for travelers. Unfortunately, numerous reports exist on traveler's diarrhea (TD) and fecal colonization with extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) among international travelers visiting India. Here, we systematically reviewed studies published on the acquisition of ESBL-EC and TD attack rates among international visitors to India.</p><p><strong>Methods: </strong>Design: Systematic review and meta-analysis. A systematic search was performed using Google Scholar, PubMed, EMBASE, Web of Science, and gray literature from 2000 to December 2021, for studies containing data for ESBL-EC acquisition or TD experience related to a trip to India. Random effects models were used to compute the prevalence of ESBL-EC acquisition and TD attack.</p><p><strong>Results: </strong>The literature search yielded a total of 5023 records. Of these, 31 met our inclusion criteria for systematic review and only 17 could be meta-analyzed (9 for TD, and 8 for ESBL-EC). The overall pooled attack rate of TD was 39% (95% confidence interval, CI: 25-53%). In studies where travelers' memory was used to diagnose TD, the pooled attack rate of TD was slightly higher (42%, 95% CI: 21-64%) compared to those where TD was objectively documented (33%, 95% CI: 17-49%). There were significant risks to be colonized with ESBL-EC among the travelers who experienced TD. The pooled rate of ESBL-EC colonization was 72% (CI: 67-78%). Most ESBL-EC produced CTX-M-15 enzyme. Furthermore, most of the travelers who acquired ESBL-EC were from highly industrialized countries recruited from travel clinics: Canada (n = 80), Germany (n = 69), Netherlands (n = 20), Sweden (n = 18), Japan (n = 10), Finland (n = 8), USA (n = 7), Spain (n = 5), and Denmark (n = 3).</p><p><strong>Conclusions: </strong>TD pooled attack rate and ESBL-EC acquisition among international travelers visiting India were high in this study. However, we cannot make generalizations based upon this TD pooled attack rate for the current situation, due to a lack of current data. Our study highlights that travelers should be advised on TD to ensure that they do not disregard the risk of contracting TD and be better prepared as a result. It also illustrates the importance of international travel in acquiring antibiotic-resistant Escherichia coli.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9525155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40387033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel related histoplasmosis - a diagnostic challenge in a patient with tumor necrosis factor alpha (TNF-α) inhibitor therapy.","authors":"Eveline Hofmann,&nbsp;Konrad Mühlethaler,&nbsp;Matthias Pollak,&nbsp;Daniel Ott,&nbsp;Nora Bienz,&nbsp;Stefan Zimmerli,&nbsp;Cédric Hirzel","doi":"10.1186/s40794-022-00178-2","DOIUrl":"https://doi.org/10.1186/s40794-022-00178-2","url":null,"abstract":"<p><strong>Introduction: </strong>In a non-endemic setting, disseminated histoplasmosis is a rare travel-related health problem of immunosuppressed returnees from endemic regions.</p><p><strong>Methods: </strong>We describe the case of a 68-year-old man with rheumatoid arthritis and tumor necrosis factor alpha (TNF-α) inhibitor treatment-related immunodeficiency, who suffered from disseminated histoplasmosis after traveling to Brazil. Based on this case, we discuss challenges and pitfalls associated with the diagnosis of disseminated histoplasmosis in a non-endemic setting.</p><p><strong>Results: </strong>The disease mimicked a hemophagocytic lymphohistiocytosis (HLH) like syndrome. Histoplasma capsulatum was microscopically detected in bronchoalveolar fluid and bone marrow aspirate smears, but was initially misclassified as Leishmania spp., another class of pathogens, which may cause HLH like syndromes in immunocompromised individuals.</p><p><strong>Discussion: </strong>Since the clinical symptoms of histoplasmosis are nonspecific and physicians in non-endemic regions might not be familiar with this disease pattern, there is a risk of delayed diagnosis of travel related cases. Taking a thorough travel history is key in unclear cases of illness in immunocompromised patients.</p>","PeriodicalId":23303,"journal":{"name":"Tropical Diseases, Travel Medicine and Vaccines","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}