Clinical Infection in Practice最新文献

{"title":"Somatic STAT3 Gain-of-Function (GOF) syndrome underlying susceptibility to Parvovirus B19, Pseudomonas aeruginosa, and Histoplasma capsulatum infections","authors":"Cedric Julien ,&nbsp;Stephane Bernier ,&nbsp;Denis Cournoyer ,&nbsp;Yichun Sun ,&nbsp;Anna Perez ,&nbsp;Joy Agbonze ,&nbsp;Isabelle Angers ,&nbsp;Lucie Roussel ,&nbsp;Gizelle Popradi ,&nbsp;Donald C. Vinh","doi":"10.1016/j.clinpr.2024.100393","DOIUrl":"10.1016/j.clinpr.2024.100393","url":null,"abstract":"<div><div>Infections in overtly immunocompromised persons (e.g. those living with advanced HIV, receiving malignancy-targeting chemotherapy, or recipients of transplants), may present with severe disease. In the absence of overt immunosuppression, unexplained severe disease due to prevalent microbes may reflect an underlying “inborn error of immunity” (IEI). IEI are monogenic penetrant defects of immunity: Classically, the genetic mutation is germline, that is, derived from germ cells, vertically transmitted to offspring in Mendelian fashion (autosomal dominant, autosomal recessive, or X-linked), and present in all cells of the affected individual. IEI may also be caused by naturally-occurring autoantibodies directed to immunologic components (such as cytokines) (<span><span>Casanova et al., 2024</span></span>) or by somatic mutations (<span><span>Aluri and Cooper, 2023</span></span>). Somatic mutations occur when a deleterious genetic variant occurs in the post-zygotic stage of development and can affect any body cell, other than germ cells; they are well-known causes of solid and hematologic malignancies. Somatic IEI syndromes are emerging, typically associated with lymphoproliferative diseases or autoinflammatory disorders. We report the case of a young woman with unexplained severe infections in whom a somatic gain-of-function (GOF) mutation in Signal transducer and activator of transcription 3 (STAT3) was found.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441456","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":"Addressing the Nipah virus threat: A call for global vigilance and coordinated action","authors":"Priyanka Mohapatra ,&nbsp;Mahalaqua Nazli Khatib ,&nbsp;Muhammed Shabil ,&nbsp;Pranchal Rajput ,&nbsp;Naveen Sharma ,&nbsp;Prakasini Satapathy ,&nbsp;Kiran Bhopte ,&nbsp;Diptismita Jena ,&nbsp;Sanjit Sah ,&nbsp;Ganesh Bushi","doi":"10.1016/j.clinpr.2024.100390","DOIUrl":"10.1016/j.clinpr.2024.100390","url":null,"abstract":"<div><div>The Nipah virus, classified by the World Health Organization as a priority pathogen due to its potential to cause epidemics, continues to present substantial challenges to public health systems with its episodic outbreaks and significant mortality rates. This zoonotic virus induces severe respiratory and neurological symptoms, often leading to multiorgan failure and high mortality. In India, the state of Kerala has become a focal point for NiV surveillance following repeated outbreaks that have highlighted the deadly impact of the virus and the urgent need for effective management strategies. Despite advances in diagnostics, the absence of specific treatments and vaccines complicates the effective management of these outbreaks. This article discusses the epidemiological trends, clinical challenges, and strategic imperatives for managing and preventing NiV. It highlights the ongoing transmission dynamics, including the genetic consistency of NiV that suggests a stable but continuously threatening viral reservoir in local bat populations. Moreover, the transmission mechanisms from fruit bats to humans, the pathogenesis within the human body, and the severe health outcomes resulting from infection have been discussed. The public health responses are essentially focused on surveillance, community engagement, and education, which are vital yet challenged by the lack of specific medical countermeasures. There is a need for global collaboration in research and public health preparedness to effectively address the challenges posed by NiV and promptly reduce the impact of future outbreaks.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100390"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441457","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":"I could smell there was something wrong with him: Clinical case of a decade of chronic undiagnosed brucellosis","authors":"F.D. Halstead ,&nbsp;E. Tennant ,&nbsp;B.P. Wordsworth","doi":"10.1016/j.clinpr.2024.100389","DOIUrl":"10.1016/j.clinpr.2024.100389","url":null,"abstract":"<div><h3>Background</h3><div>Brucellosis is a zoonotic infection, typically transmitted by ingestion of unpasteurised dairy products or direct contact with infected animals. It is associated with specific occupations, and travel to endemic countries. There are numerous reports of delayed diagnosis, particularly in non-endemic areas because diagnosis requires a high level of clinical suspicion. However, chronic brucellosis of 10-year duration is rare.</div></div><div><h3>Case report</h3><div>A 43-year-old previously well sportsman presented to primary care with acute flu-like symptoms and large joint arthralgia following travel to Southern France with his young family. The initial symptoms resolved, but recurred every few months over the subsequent decade with fever, depression, joint pain and malodorous perspiration. Approximately one year into the infection, a diagnosis of inflammatory polyarthritis was made, which was treated with oral corticosteroidssteroids.</div><div>However, this treatment was ineffective, and over the next nine years the patient experienced recurrent episodes of acute inflammation associated with extensive synovitis and severe erosive disease involving the left ankle and both knees, which eventually required joint replacement surgery.</div><div>Only following further microbiology testing Only during the work up for joint replacement surgery was the diagnosis of septic arthritis established when a small sinus track was identified discharging small amounts of serous fluid. <em>Brucella melitensis</em> was cultured from the ankle and knee joints and confirmed through serology. Following antibiotic treatment joint replacement was undertaken and the patient made an excellent recovery.</div></div><div><h3>Conclusion</h3><div>Although this patient had clinical features compatible with brucellosis, and relevant travel history, this diagnosis (nor any infective cause) was not considered for nearly a decade. Indeed, the initial steroid treatment could have exacerbated the infection.</div><div>We emphasise the importance of considering brucellosis in individuals who present with atypical osteoarticular inflammation, where there is a compatible travel history and for whom conventional microbiology has been negative.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100389"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433180","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":"Detection of vaccine-derived poliovirus type-3 in sewage of Kathmandu Valley, Nepal","authors":"Rachana Mehta ,&nbsp;Amrendra Kushwaha ,&nbsp;Sanjit Sah ,&nbsp;Jack Feehan ,&nbsp;Vasso Apostolopoulos","doi":"10.1016/j.clinpr.2024.100388","DOIUrl":"10.1016/j.clinpr.2024.100388","url":null,"abstract":"<div><div>Enteroviruses include polioviruses, which are classified into three types: type 1, type 2, and type 3. The oral polio vaccine (OPV), which contains attenuated strains of these three types, has been pivotal in reducing polio incidence worldwide. However, OPV can lead to vaccine-derived poliovirus (VDPV) cases, including circulating VDPV1 (cVDPV1), cVDPV2, and cVDPV3. In contrast, the inactivated or ‘killed’ polio vaccine (IPV), effectively prevents poliomyelitis without the risk of causing cVDPV cases. On 26 May 2024, a novel mutated form of poliovirus was detected in sewage samples from Kathmandu, Nepal, indicating an ongoing risk of poliovirus reintroduction and transmission. This finding highlights the importance of robust surveillance and containment measures. Historically, the Salk vaccine (IPV) and the Sabin vaccine (OPV) have been used against poliovirus, each with its advantages and limitations. Moving forward, it is necessary to replace OPV with genetically modified OPV, or new IPV formulations. Enhanced vaccination strategies and continued surveillance are crucial for achieving complete poliovirus eradication and preventing future outbreaks.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100388"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433179","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":"Acute gastroenteritis infection quick reference guide","authors":"Natasha Ratnaraja,&nbsp;On behalf of the Clinical Services Committee, British Infection Association","doi":"10.1016/j.clinpr.2024.100377","DOIUrl":"10.1016/j.clinpr.2024.100377","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100377"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418667","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":"IQRG investigation of skin and soft tissue infection","authors":"Elizabeth L.A. Cross ,&nbsp;Rebecca K. Sutherland ,&nbsp;on behalf of the British Infection Association Clinical Services Committee","doi":"10.1016/j.clinpr.2024.100376","DOIUrl":"10.1016/j.clinpr.2024.100376","url":null,"abstract":"<div><div>The Infection Quick Reference Guide (IQRG) Investigation of Skin &amp; Soft Tissue Infection (SSTI) is a general resource for frontline NHS clinicians to use in caring for adults with SSTIs. It should be used alongside current guidance on managing SSTIs and is not intended for use in diabetic foot infections. The IQRGs are available on the BIA website and are published within and aligned to the Standards for Microbiology Investigations, where appropriate. They are endorsed by both the Royal College of Physicians and the Royal College of Pathologists.</div></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418666","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":"Investigation of sepsis in adult hospital patients; Infection quick reference guide","authors":"Jo Salkeld ,&nbsp;Anna L. Goodman","doi":"10.1016/j.clinpr.2024.100381","DOIUrl":"10.1016/j.clinpr.2024.100381","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100381"},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418665","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":"Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa","authors":"Junko Takata ,&nbsp;Victoria J. Sinclair ,&nbsp;Holly Hendron ,&nbsp;Robert Wilson ,&nbsp;Laura Wilkins ,&nbsp;Charlotte Miles ,&nbsp;Jessica Larwood ,&nbsp;Alanna Wall ,&nbsp;Oliver Bannister ,&nbsp;Monique I. Andersson ,&nbsp;Susanne H. Hodgson","doi":"10.1016/j.clinpr.2024.100387","DOIUrl":"10.1016/j.clinpr.2024.100387","url":null,"abstract":"<div><h3>Background</h3><p>Infections of the external ear canal (EAC) exist as a spectrum of disease from severe otitis externa (SOE) to necrotising otitis externa (NOE), but distinguishing between these is challenging. The UK consensus case definition (UKCCD) was established in 2022, but had not yet been assessed in clinical practice.</p></div><div><h3>Methods</h3><p>All consecutive adult patients undergoing CT to investigate a diagnosis of possible NOE between November 2018 and October 2019 were prospectively included in the cohort. Clinical diagnosis at baseline and the end of 12 months follow-up were compared to the diagnosis defined by UKCCD.</p></div><div><h3>Results</h3><p>55 patients were included in the analysis. 27 % (15/55) had an initial clinical diagnosis of NOE, of which 47 % (7/15) did not have changes on CT consistent with NOE. Only 9 % (5/55) patients had an MRI scan performed within 7 days of the baseline CT. At the end of 12 months, 9 % (5/55) patients had a change in diagnosis to or from NOE. All cases diagnosed as NOE by UKCCD had a clinical diagnosis of ‘NOE’ at baseline, while no cases clinically diagnosed as NOE were mislabelled by UKCCD as ‘not NOE’. All cases that had a change of diagnosis in the 12-month period or had an initial CT with no changes consistent with NOE, were captured by the UKCCD category of ‘possible NOE’. Median duration of antibiotics of clinically defined NOE cases were 14 days of intravenous (IQR: 7.3–23.8), 28 days of oral (IQR: 21.0–40.3), and 49.5 days combined (IQR: 29.8–67.3).</p></div><div><h3>Conclusion</h3><p>UKCCD has excellent clinical concordance with clinical diagnosis. Further work is warranted to assess its utility for risk stratification of patients presenting with severe infections of the EAC in a larger cohort.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100387"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170224000475/pdfft?md5=6ea86e58bb8a2d8b80f79daa6a4a9d8a&pid=1-s2.0-S2590170224000475-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272005","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":"What do Infection Specialists do? Defining the types of clinical consultation activity undertaken within Infection services","authors":"Ann L. Noble","doi":"10.1016/j.clinpr.2024.100386","DOIUrl":"10.1016/j.clinpr.2024.100386","url":null,"abstract":"","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100386"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170224000463/pdfft?md5=55b326ae0c71c32d4047986a977dbdf4&pid=1-s2.0-S2590170224000463-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272004","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":"Critical evaluation of endotoxin contamination in intravenous solutions: A call for enhanced regulatory oversight and quality control","authors":"K.T. Muhammed Favas ,&nbsp;Guru Datt Sharma ,&nbsp;Sanjit Sah","doi":"10.1016/j.clinpr.2024.100385","DOIUrl":"10.1016/j.clinpr.2024.100385","url":null,"abstract":"<div><p>The recent identification of bacterial endotoxins in Ringer’s Lactate (RL) from a manufacturing batch by M/s. Vision Parenteral Pvt. Ltd. has raised significant concerns regarding the safety of intravenous solutions. These endotoxins, originating from Gram-negative bacteria, can trigger severe systemic inflammatory responses, worsening conditions like haemorrhagic shock and leading to organ dysfunction and increased mortality. The interaction between RL and endotoxins is particularly problematic, as it can exacerbate inflammation, disrupt fluid balance, and complicate metabolic and immune responses. This situation underscores significant gaps in pharmaceutical manufacturing practices and highlights the urgent need for stricter regulatory oversight and quality control. The healthcare community must reassess the use of RL in clinical settings, particularly in cases where endotoxin contamination could pose a significant risk, to protect patient health and safety.</p></div>","PeriodicalId":33837,"journal":{"name":"Clinical Infection in Practice","volume":"24 ","pages":"Article 100385"},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590170224000451/pdfft?md5=492f1ec41771cc0617bdd293398b0c79&pid=1-s2.0-S2590170224000451-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163335","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}