Clinical Infection in Practice最新文献

{"title":"Lyme arthritis: It’s never too late for joint decision making","authors":"Daniel R. Stevenson ,&nbsp;Abeer Ghuman ,&nbsp;Alexis Jones ,&nbsp;Michael Marks ,&nbsp;Sheila Arvikar ,&nbsp;Christina Petridou ,&nbsp;Anna M. Checkley","doi":"10.1016/j.clinpr.2024.100406","DOIUrl":"10.1016/j.clinpr.2024.100406","url":null,"abstract":"<div><div>A 25-year-old male presented with acute swelling of the left knee consistent with an inflammatory arthritis. He was initially treated with multiple joint aspirations and intra-articular steroid injections followed by disease modifying anti-rheumatic drugs. The patient continued to have escalating flares of inflammatory arthritis over the next 10 months resulting in bony erosions on imaging. Further questioning revealed that he had spent time in upstate New York in the United States two years prior to the onset of the first symptoms. He did not recall any tick bites or erythema migrans rash. The screening <em>Borrelia</em> enzyme linked immunosorbent assay and confirmatory immunoblot IgG were strongly positive on peripheral blood, and <em>Borrelia</em> species DNA was detected in joint fluid. Response to 28 days of oral doxycycline followed by 30 days of intravenous ceftriaxone was unsatisfactory. Following this, anti-TNF treatment (etanercept) was commenced, with an excellent response within 6 weeks. However, this did not completely resolve his synovitis and so after one year<!--> <!-->is being scheduled for a synovectomy. Lyme arthritis should be considered in the differential of an acutely swollen large joint, especially if there has been travel to endemic areas in the United States.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"25 ","pages":"Article 100406"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101406","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 first UK case of congenital Zika syndrome","authors":"Dominic A Haigh ,&nbsp;Lynne Warrander ,&nbsp;Philip Bullen ,&nbsp;Philip Veal ,&nbsp;Christina Petridou","doi":"10.1016/j.clinpr.2024.100407","DOIUrl":"10.1016/j.clinpr.2024.100407","url":null,"abstract":"<div><h3>Background</h3><div>Following the 2015–2016 Zika virus (ZIKV) epidemic in the Americas and Caribbean, cases have globally declined but persist in endemic regions like the Americas and Southeast Asia. While most infections are mild or asymptomatic, ZIKV during pregnancy can cause congenital Zika syndrome (CZS), leading to severe fetal malformations, including microcephaly.</div></div><div><h3>Case report</h3><div>We report the first confirmed case of congenital Zika syndrome (CZS) in the UK. This case involves a 40-year-old Thai woman in her third pregnancy, complicated by a history of gestational diabetes and psoriasis managed with certolizumab. At 20 weeks’ gestation, routine scans identified fetal anomalies, including microcephaly, calcifications, and bilateral talipes. She disclosed first-trimester travel to Thailand, during which she developed a rash.</div><div>She had travelled to both Bangkok and Phuket over a three-week period, between approximately 7–10 weeks’ gestation. A fetal MRI at 22 weeks showed features of congenital Zika syndrome (CZS) with severe abnormalities, including diminished brain development and limb deformities. Due to the poor prognosis, the patient opted for termination at 24 weeks. Fetal blood and amniotic fluid confirmed ZIKV RNA presence. Placental histopathology was unremarkable, and post-mortem was declined.</div></div><div><h3>Results</h3><div>A blood sample was tested for Zika virus (ZIKV) at the Rare and Imported Pathogens Laboratory (RIPL), Porton Down; the ZIKV PCR result was indeterminate, and the IgG was positive. Booking bloods taken shortly after travel were ZIKV PCR positive but IgG negative, demonstrating seroconversion and confirming recent ZIKV infection. Fetal MRI imaging revealed changes consistent with CZS. Fetal blood and amniotic fluid samples taken at the time of fetocide were also ZIKV PCR positive, confirming CZS.</div></div><div><h3>Conclusion</h3><div>This case underscores the importance of up-to-date travel advice during pregnancy, taking a travel history and the consideration of CZS in fetuses with microcephaly and other typical ultrasound features.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"25 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101409","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":"Human Metapneumovirus – A clickbait crisis or a real pandemic threat?","authors":"Manali Verma ,&nbsp;Anil Kumar ,&nbsp;Shubham Kumar ,&nbsp;Rachana Mehta ,&nbsp;Ranjana Sah ,&nbsp;Amogh Verma","doi":"10.1016/j.clinpr.2025.100410","DOIUrl":"10.1016/j.clinpr.2025.100410","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"25 ","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348564","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":"Clinical manifestations and outcomes of human mpox infection from 1970 to 2023: A systematic literature review","authors":"Chukwuyem Abejegah ,&nbsp;Kennedy O. Obohwemu ,&nbsp;Mselenge Mdegela","doi":"10.1016/j.clinpr.2024.100397","DOIUrl":"10.1016/j.clinpr.2024.100397","url":null,"abstract":"<div><div>Mpox is an important emerging infectious disease spreading rapidly with a changing geographical, clinical, epidemiological, virological, and clinical manifestations. The identification of clade I virus, the variant associated with severe disease and higher risk of death outside Africa in August 2024 is alarming. It is vital to document its changing epidemiology, clinical manifestations, and outcome to better understand how to prevent and treat the disease. We aimed to describe the clinical features and disease outcome of patients with mpox from 1970 to 2023. We performed a systematic search of peer-reviewed publications and grey literature using PubMed, MEDLINE, CINAHL, and EMBASE, published between 1973 and 2023. Thirty-seven articles met the inclusion criteria. We pooled data from 19 studies with at least 10 cases to enhance the appreciation of the review findings. A clear distinction was observed regarding the age, gender, sexual orientation, and HIV status distribution of mpox cases before and after May 2022. From May 2022 onwards, a high prevalence of mpox, almost exclusively, was observed among individuals identifying as men who have sex with men (MSM) 20–40 years with high-risk sexual behaviour and/or HIV immunosupression. No change in the common clinical manifestations – mucocutaneous rash, fever, lymphadenopathy, headache, and generalized malaise, typically during prodrome. However, certain symptoms such as myalgia/arthralgia, oropharyngitis, proctitis, and depression/anxiety were typically reported from May 2022 onwards. We could not establish from the review if the observed symptomatology change was real or resulting from an observation bias. Notably, a clear change in symptomatology was observed among individuals with immunosuppression who do not necessarily experience the prodromal stage and present with significantly more and larger mucocutaneous lesions that sometimes coalesced to form ulcers. Our pooled data report a CFR of 8.3 % before May 2022 and 1.2 % from May 2022 onwards. We show that mental health in patients with mpox has not received the attention required. There is a need for a strategic and strong approach to revamp mpox services to improve clinical suspicion and treatment, protect individuals most at risk including healthcare workers in high risk areas.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100397"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748639","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":"Evaluating factors influencing mortality, neurological morbidity and length of stay in adults admitted with community-onset brain abscess in a UK tertiary referral centre","authors":"David Hettle ,&nbsp;Ameeka Thompson ,&nbsp;Richard Moon ,&nbsp;Amy Alice Carson ,&nbsp;David Lindsay ,&nbsp;Jennifer Pooley ,&nbsp;Hung-Yuan Cheng ,&nbsp;Mario Teo ,&nbsp;Mahableshwar Albur","doi":"10.1016/j.clinpr.2024.100396","DOIUrl":"10.1016/j.clinpr.2024.100396","url":null,"abstract":"<div><h3>Background</h3><div>Despite advances in diagnostics and therapeutics, morbidity and mortality associated with brain abscess remains high. Until recently no evidence-based guidelines existed, resulting in heterogeneous practice. In this study we explore the impact of host, pathogen and therapy-related factors on clinical outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed adult patients with community-onset brain abscess from October 2016 to April 2020 using hospital databases. Clinical, radiological, biochemical, microbiological, and surgical data was collected. Primary outcome was the 6 month modified Rankin Scale (mRS), secondary outcomes included length of hospital stay (LOS), neurological sequelae, and 1-year mortality. Multivariate logistic regression was used to analyse factors influencing recovery and neurological sequelae; and multivariate Cox regression for LOS.</div></div><div><h3>Results</h3><div>Sixty adults with brain abscess (median age 57 years; 63 % male) were identified. Forty-eight patients (80 %) had a solitary abscess, most commonly in the frontal lobe. A causative organism was identified in 49 of 54 cases (91 %) where samples were collected, with <em>Streptococcus milleri</em> group the most common organism. Median duration of intravenous and oral therapy was 21 and 28 days respectively. Forty-three patients had an mRS of ≤ 2 (slight disability or better) at 6 months, with CRP &gt; 6 mg/l on admission associated with poor outcome (mRS &gt; 2) (p = 0.036). Eight patients (13 %) died within one year. Age &gt; 60 years (p = 0.001), CRP &gt; 6 mg/l (p = 0.048) and prolonged intravenous therapy (&gt;6 weeks) (p = 0.001) were all associated with extended LOS. Seizures on admission (p = 0.017) or presence of risk factors (p = 0.032) were associated with neurological sequelae at 6 months.</div></div><div><h3>Conclusions</h3><div>This study reveals that a complex interaction of factors related to host, pathogen and therapy impacts clinical outcome in patients with brain abscess. While mortality and LOS are well described in previous literature, analysis of the mRS here adds to our understanding of morbidity following a diagnosis of brain abscess.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100396"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658549","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":"Corrigendum to “Mycobacterium avium infection in a patient with metal-on-metal hip prosthesis” [Clin. Infect. Pract., 20(Suppl. 1) (2023) Abstract 80]","authors":"Cecilia Mifsud,&nbsp;Simon Tiberi,&nbsp;Jonathan Ward,&nbsp;Albert Mifsud","doi":"10.1016/j.clinpr.2024.100361","DOIUrl":"10.1016/j.clinpr.2024.100361","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100361"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160866","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":"Mpox 2024: New variant, new challenges, and the looming pandemic","authors":"Amogh Verma ,&nbsp;Mahalaqua Nazli Khatib ,&nbsp;Guru Datt Sharma ,&nbsp;Mahendra Pratap Singh ,&nbsp;Ganesh Bushi ,&nbsp;Suhas Ballal ,&nbsp;Sanjay Kumar ,&nbsp;Mahakshit Bhat ,&nbsp;Shilpa Sharma ,&nbsp;Rodrigue Ndabashinze","doi":"10.1016/j.clinpr.2024.100394","DOIUrl":"10.1016/j.clinpr.2024.100394","url":null,"abstract":"<div><div>The emergence of the clade 1b variant of mpox has transformed the virus into a global health threat, prompting the World Health Organization to declare it a public health emergency. Clade 1b is characterized by enhanced transmissibility, particularly through human-to-human contact, including sexual transmission. This variant has spread rapidly from its epicenter in the Democratic Republic of Congo to neighboring African countries and beyond, with confirmed cases in Europe and Asia. The global response has focused on enhancing surveillance, improving diagnostics, and increasing access to the Jynneos vaccine and antiviral treatments, such as tecovirimat. However, several challenges remain, particularly in resource-limited settings. This review emphasizes the need for robust public health infrastructure, international collaboration, and ongoing research to mitigate the impact of mpox and prepare for future outbreaks.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100394"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526284","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":"Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab","authors":"Nisha A. George ,&nbsp;Melissa Haines ,&nbsp;Vincent Lam ,&nbsp;Julian Tang","doi":"10.1016/j.clinpr.2024.100395","DOIUrl":"10.1016/j.clinpr.2024.100395","url":null,"abstract":"<div><div>We report a case of a 54 year old Sudanese lady admitted with dizziness, visual disturbance and collapse with nystagmus, ataxia, bilateral ptosis, and 3rd cranial nerve palsy on examination. CT and MRI scan of her head showed multiple areas of infarct. A lumbar puncture showed lymphocytosis and was positive for VZV. She was initiated on treatment with IV acyclovir but during the course of her admission, she had recurrent strokes and maintained VZV DNA positivity on repeated lumbar punctures despite being on prolonged treatment. She was diagnosed with refractory varicella encephalitis secondary to varicella zoster virus reactivation, likely resulting from recent rituximab therapy for systemic lupus erythematosus and a mixed connective tissue disorder.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100395"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526282","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":"Paracoccidioidomycosis, cutaneous Leishmaniasis, Sporotrichosis, Chromomycosis, Cutaneous Tuberculosis or Nontuberculous Mycobacteria?","authors":"João Victor Soares Coriolano Coutinho,&nbsp;Taiguara Fraga Guimarães,&nbsp;Renata de Bastos Ascenço Soares","doi":"10.1016/j.clinpr.2024.100391","DOIUrl":"10.1016/j.clinpr.2024.100391","url":null,"abstract":"<div><div>This manuscript presents a rare case of cutaneous tuberculosis, characterized by an extensive array of skin lesions that could easily be mistaken for other infectious diseases, necessitating a thorough investigation.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100391"},"PeriodicalIF":0.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526283","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":"First Marburg virus outbreak in Rwanda: A new public health challenge","authors":"Benjamin Wafula Simiyu ,&nbsp;Rodrigue Ndabashinze ,&nbsp;Sanjit Sah ,&nbsp;Ganesh Bushi ,&nbsp;Rachana Mehta ,&nbsp;Amogh Verma","doi":"10.1016/j.clinpr.2024.100392","DOIUrl":"10.1016/j.clinpr.2024.100392","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445480","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}