Therapeutic Advances in Infectious Disease最新文献

{"title":"Doravirine and islatravir for HIV-1 treatment: A systematic review and meta-analysis with GRADE assessment.","authors":"Muhammad Tayyab Azam, Muhammad Hussain Azam, Muhammad Arif Khan, Muhammad Hassan Azam, Zain Ul Abideen Shahid, Shahzad Ashraf, Syeda Momina Umer, Rabeea Arshad, Hasibullah Aminpoor, Hammad Javaid","doi":"10.1177/20499361261483928","DOIUrl":"10.1177/20499361261483928","url":null,"abstract":"<p><strong>Background: </strong>Two-drug antiretroviral regimens are increasingly explored to simplify HIV-1 treatment while maintaining durable viral suppression. Doravirine combined with Islatravir (DOR/ISL) represents a novel non-integrase strand transfer inhibitor (non-INSTI) regimen. However, comprehensive synthesized evidence remains limited.</p><p><strong>Objectives: </strong>To systematically evaluate the efficacy and safety of fixed-dose Doravirine (100 mg) plus Islatravir (0.25 or 0.75 mg) for HIV-1 treatment in adults.</p><p><strong>Design: </strong>Systematic Review and Meta-Analysis.</p><p><strong>Data sources and methods: </strong>Comprehensive searches of PubMed, Embase, Scopus, Cochrane CENTRAL, ICTRP, and ClinicalTrials.gov were performed to identify RCTs evaluating Doravirine/Islatravir for HIV-1 treatment. The primary outcome was viral suppression (HIV-1 RNA <50 copies/mL) at 48 weeks. Secondary outcomes included immunological and safety endpoints.</p><p><strong>Results: </strong>Seven RCTs (N = 3,589) were included. In primary analyses restricted to the approved 0.25 mg dose (four RCTs, N = 1,639), DOR/0.25 mg ISL achieved non-inferior viral suppression compared to standard ART at 48 weeks (RR = 1.01, 95% CI: 0.97-1.04, p = 0.63), with consistent efficacy across virologically suppressed and treatment-naïve cohorts. DOR/0.25 mg ISL showed no significant differences versus controls in CD4+ cell count (MD = -6.35 cells/µL, p = 0.51) or total lymphocyte count changes (MD = -0.02 x 10⁹/L, p = 0.54). Statistically significant declines in CD4+ and lymphocyte counts were strictly restricted to the discontinued 0.75 mg dose. Overall adverse events and treatment discontinuations due to adverse events were comparable between groups.</p><p><strong>Conclusion: </strong>DOR/ISL provides non-inferior virologic efficacy compared with standard antiretroviral therapy with a favorable safety profile. The 0.25 mg Islatravir dose maintains antiviral efficacy while avoiding the immunologic declines observed with 0.75 mg dose, supporting its suitability as a simplified two-drug regimen.</p><p><strong>Registration: </strong>This review protocol was prospectively registered with PROSPERO (CRD420261321479).</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261483928"},"PeriodicalIF":3.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889174","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":"Author response to comment on: Treatment gaps and risk factors for multidrug-resistant enterobacterales in Belize: A 6-year (2018-2023) nationwide retrospective analysis.","authors":"Innocent Nwachukwu, Camryn Linares, Griseidy Alcoser, Nivi Novelo, Danladi Chiroma Husaini","doi":"10.1177/20499361261487108","DOIUrl":"10.1177/20499361261487108","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261487108"},"PeriodicalIF":3.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876215","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":"Respiratory morbidity in human toxocariasis: A scoping review of the literature.","authors":"Kaweesi Calvin Nantalaga, Alice Nantege, Martha Nabirye","doi":"10.1177/20499361261484796","DOIUrl":"10.1177/20499361261484796","url":null,"abstract":"<p><strong>Background: </strong>Human toxocariasis is among the most common helminthic zoonoses worldwide, and larvae traverse the lungs during visceral migration. Respiratory morbidity among diagnosed patients remains poorly characterised, in contrast to the much larger seroepidemiological literature linking Toxocara seropositivity to asthma.</p><p><strong>Objectives: </strong>To map the reported occurrence and clinical spectrum of respiratory disease in confirmed or probable human toxocariasis, and to identify evidence gaps.</p><p><strong>Eligibility criteria: </strong>Case reports, case series, cross-sectional studies, cohorts and trials reporting a respiratory outcome in confirmed or probable toxocariasis. Seroepidemiological association studies, non-Toxocara larva migrans and reports lacking patient-level respiratory data were excluded.</p><p><strong>Sources of evidence: </strong>MEDLINE (via PubMed) and the Web of Science Core Collection, from database inception to 13 June 2026.</p><p><strong>Charting methods: </strong>Two reviewers independently screened and charted data, with disagreements resolved by a third. Findings are presented descriptively, without critical appraisal or meta-analysis.</p><p><strong>Results: </strong>Sixty-five studies reporting 989 patients were included, published 1980 to 2026. Case reports predominated (46/65; 70.8%) and only 1/65 (1.5%) originated from sub-Saharan Africa. Any respiratory symptom was documented in 32/46 case reports (69.6%). Across 12 studies of other designs (593 patients), study-level prevalence ranged from 0.0% to 80.7%, and from 0.0% to 66.7% excluding one cohort reporting a non-disaggregable pooled figure. Imaging was reported in 53/65 studies (81.5%), most often nodules (22/53; 41.5%), interstitial infiltrates (16/53; 30.2%) and ground-glass opacity (14/53; 26.4%). Peripheral eosinophilia was present in 58/65 (89.2%) and explicitly absent in 2/65 (3.1%); lung function was reported in 2/65 (3.1%).</p><p><strong>Conclusion: </strong>Respiratory findings were reported in a substantial share of published cases, spanning imaging abnormalities to eosinophilic lung disease; eosinophilia was frequent but not universal. Because the evidence comprises largely case reports from a respiratory-focused search, these proportions describe what has been reported rather than true frequency. Prospective studies in endemic, resource-limited settings are needed.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261484796"},"PeriodicalIF":3.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851562","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":"High-risk HPV detection via GeneXpert in self-collected anal swabs among MSM living with HIV: Insights from a cross-sectional study.","authors":"Amadou Kodio, Almahady Ag Altini, Arè Albert Somboro, Aliou Baldé, Oumar Karembe, Sidi Dienta, Anou M Somboro, Zalihatou Maiga, Oumar Dolo, Fatoumata Tata Traoré, Jane Holl, Sally M Mcfall, Mamoudou Maiga, Emna Ghidaoui, Vincent Calvez, Robert L Murphy, Anne-Geneviève Marcelin, Aude Jary, Almoustapha Issiaka Maiga","doi":"10.1177/20499361261481349","DOIUrl":"10.1177/20499361261481349","url":null,"abstract":"<p><strong>Background: </strong>Men who have sex with men living with HIV (MSMLWHIV) have a high risk of persistent high-risk HPV infection, and rapid tools like Xpert HPV can help expand screening in low-resource settings.</p><p><strong>Objectives: </strong>This study aimed to assess the feasibility of using self-collected anal swabs for detecting high-risk human papillomavirus (HR-HPV) infections in MSMLWHIV, using the Xpert® HPV assay. Additionally, we investigated factors associated with HR-HPV positivity.</p><p><strong>Design: </strong>This was a single-center cross-sectional study conducted from 22^nd May 2024 to 31^st July 2024 among MSMLWHIV in Bamako.</p><p><strong>Methods: </strong>Participants were recruited from the Soutoura NGO in Bamako, Mali. To be eligible, individuals had to be HIV-1 positive, on antiretroviral therapy, 18 years or older, and self-identified as MSM. The prevalence of HR-HPV was reported by sociodemographic characteristics and sexual behaviors. We used a penalized logistic regression model using Firth's method to identify sociodemographic and behavioral factors associated with HR-HPV positivity.</p><p><strong>Results: </strong>A total of 245 MSMLWHIV were initially tested. Of these, 170 yielded successful results and were subsequently included in the study analysis. The participants had a median age of 26 years (IQR 24-29) with the median age of first anal intercourse at 16 years (IQR 16-18). Among the participants, 29% (49/170) identified as bisexual, 42% (72/170) reported never using condoms, 16% (27/170) participated in group intercourse, and 42% (71/170) had at least two different sexual partners in the past six months. Among those successfully tested, 65% (110/170) were positive for HR-HPV, with HPV16 detected in 12% (21/170) of participants. No or primary education and consistent condom use were associated with lower odds of HR-HPV positivity, while the unexpected association observed with smoking should be interpreted with caution.</p><p><strong>Conclusion: </strong>The high HR-HPV prevalence among MSMLWHIV calls for targeted screening and prevention. Although Xpert HPV shows promise, the 31% failure rate with self-collected samples underscores the need for improvements in sample collection procedures and technical performance.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261481349"},"PeriodicalIF":3.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819516","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":"Determinants of visceral leishmaniasis among patients admitted to selected public hospitals in Guji and Borena Zones, southern Oromia, Ethiopia: An unmatched case-control study.","authors":"Abera Siyum, Lina Yitayew, Gemechis Tuke, Alo Edin, Bekam Yambo, Anteneh Fikrie Tekola","doi":"10.1177/20499361261477170","DOIUrl":"https://doi.org/10.1177/20499361261477170","url":null,"abstract":"<p><strong>Background: </strong>Visceral leishmaniasis (VL) remains a significant public health concern in East Africa, with an estimated 30,000 cases reported annually. Ethiopia is among the most affected countries in the region, with the southern part of the country bearing a substantial share of the disease burden. Despite the high endemicity of VL in these areas, evidence regarding the factors contributing to disease occurrence among at-risk populations remains limited.</p><p><strong>Objectives: </strong>This study aims to identify the determinants of visceral leishmaniasis among patients admitted to selected public hospitals in Guji and Borena Zones, Southern Oromia, Ethiopia, in 2022.</p><p><strong>Design: </strong>A facility-based unmatched case-control study was conducted from April 15 to June 15, 2022.</p><p><strong>Methods: </strong>The study was conducted among randomly selected 335 (67 cases and 268 controls) patients in Nagele Borena and Yabelo General Hospitals of Guji and Borena Zones from April 15 to June 15/2022. A pretested and structured face-to-face interviewer administered questionnaire and chart review were used to collect the data. Data was entered into Epi Data version 4.6.0 and exported to SPSS version 25.0 for analysis. Bi-variable and multi variable binary logistic regression model were used to identify the determinants of VL. Adjusted odds ratio with 95% Confidence level and p-value of <0.05 were used to declare statistically significant associations.</p><p><strong>Result: </strong>A total of 335 study participants comprising 67 cases and 268 controls were included, with an overall response rate of 100%. In this study, presence of a dog in the household (AOR=7.2; 95%CI:3.6-18.1), presence of acacia trees around the home (AOR = 8.3; 95% CI: 4.2-17.1), presence of domestic animals in the household (AOR = 6.8; 95% CI: 2.3-16.7), no formal education (AOR = 3.6; 95% CI: 1.1-12.2), and termite hill around the home (AOR = 3.2; 95% CI: 2.02-9.3) were significantly associated with VL.</p><p><strong>Conclusion and recommendation: </strong>Our study identified several determinants of VL, that no formal education, presence of dog in the household, termite hill around the home, presence of domestic animals in the household and acacia trees around the home. Therefore, strengthening community awareness and promoting environmental risk-reduction strategies, including minimizing exposure to domestic animals, termite hills, and acacia trees in close proximity to households, may help reduce the risk of visceral leishmaniasis in the study area.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261477170"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760998","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 outcomes, environmental exposure factors, and antibiotic resistance patterns of extensively drug-resistant (XDR) typhoid fever in Pakistan: A prospective observational study.","authors":"Hamna Khalid, Abdul Rehman Shahid, Eman Ahmad, Noshaba Razaq, Fatima Binte Muhammad, Laiba Irfan Ghauri, Sehrish Khan, Muhammad Dawood Nazir, Noof K Binashikhbubkr","doi":"10.1177/20499361261474659","DOIUrl":"https://doi.org/10.1177/20499361261474659","url":null,"abstract":"<p><strong>Background: </strong>Extensively drug-resistant (XDR) typhoid fever is a major public health concern in Pakistan, with limited treatment options and rising morbidity. There is a limited amount of evidence available on the role of the environmental factors that may impact the severity of the disease in adults.</p><p><strong>Objectives: </strong>To evaluate clinical outcomes, antimicrobial resistance patterns, and environmental factors associated with disease severity among adults with XDR typhoid fever in Northern Punjab, Pakistan.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>A prospective observational study was conducted from January 2024 to January 2025 at a tertiary care hospital in Northern Punjab. The enrollment occurred among adult patients (18- 60 years) with blood culture-confirmed XDR <i>Salmonella enterica</i> serovar Typhi infection using consecutive sampling. Clinical characteristics, susceptibility to antimicrobials, and environmental exposure were recorded. Severity of the disease was defined based on clinically significant complications and adverse outcomes. The chi-square test and Fisher exact test were used to analyze the associations, followed by multivariable logistic regression analysis to adjust for potential confounders.</p><p><strong>Results: </strong>Among 110 patients, meropenem (98.2%) and azithromycin (96.4%) showed the highest antimicrobial susceptibility. Contaminated drinking water, poor sanitation, street food and season of diagnosis were also significantly associated with severe disease (p<0.05).</p><p><strong>Conclusion: </strong>XDR typhoid fever in Northern Punjab was characterized by extensive antimicrobial resistance, while poor sanitation, contaminated drinking water, street food consumption, and season of diagnosis were significantly associated with severe disease. There is an immediate need to strengthen water, sanitation, antibiotic stewardship, and vaccination strategies.</p><p><strong>Registration: </strong>Not applicable.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261474659"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763288","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":"Community awareness, perception, and preventive practices towards rabies in Ethiopia: A systematic review and meta-analysis.","authors":"Gebremeskel Kibret Abebe, Wagaw Abebe","doi":"10.1177/20499361261473789","DOIUrl":"https://doi.org/10.1177/20499361261473789","url":null,"abstract":"<p><strong>Background: </strong>Rabies is a major global public health problem, with case fatality rate approaching 100% once clinical symptoms appear, causing severe neurological complications and significant social and economic burdens. Ethiopia bears a high burden of rabies, with the disease remaining endemic and contributing to considerable vaccine-preventable deaths, largely due to low community awareness, inadequate preventive practices, and limited access to timely post-exposure prophylaxis. Although studies have examined community knowledge, attitudes, and preventive practices regarding rabies in Ethiopia; however, the reported findings vary across studies.</p><p><strong>Objectives: </strong>This review was conducted to estimate the pooled prevalence and identify associated factors of community knowledge, attitudes, and preventive practices related to rabies prevention in Ethiopia.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>A comprehensive and systematic literature search was conducted in PubMed/MEDLINE, EMBASE, ScienceDirect, Semantic Scholar, Google Scholar, the Cochrane Library, and the National Institute for Health and Care Excellence (NICE), together with relevant grey literature to identify studies reporting on community knowledge, attitudes, and preventive practices regarding rabies in Ethiopia. Data on prevalence estimates and associated determinants were extracted using Microsoft Excel and subsequently analyzed using Stata version 17.0. A random-effects model was applied to estimate the pooled prevalence, and subgroup analyses were performed to explore potential sources of heterogeneity among the included studies. Publication bias was assessed through visual inspection of funnel plots and Egger's regression test. The methodological quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) critical appraisal checklist.</p><p><strong>Results: </strong>A total of 27 studies involving 11,964 participants were included in the final analysis. The pooled estimates of good knowledge, favorable attitudes, and good preventive practices toward rabies were 60.36%, 58.56%, and 54.62%, respectively. Individuals living in urban areas, formal education and previous exposure to rabies were positively associated with good knowledge of rabies prevention.</p><p><strong>Conclusions: </strong>Community awareness, attitudes, and preventive behaviors toward rabies in Ethiopia remain suboptimal, with disparities among rural populations and individuals with lower educational status. The findings highlight the need for focused education intervention, improved availability of vaccination and post-exposure services, and enhanced collaboration through the One Health approach. Future efforts should focus on scaling up community awareness and preventive behaviors to support rabies control.</p><p><strong>Registration: </strong>Not registered.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261473789"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766396","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":"Antiviral strategies against human norovirus: Molecular targets, therapeutics, and vaccine development.","authors":"Sadia Islam, Sabbir Alam Zia, Simonto Mirza, Md Moshiur Rahman, Md Abdullah All Shafi, Md Hamed Hasan, Abdullah Al Mamun","doi":"10.1177/20499361261473798","DOIUrl":"https://doi.org/10.1177/20499361261473798","url":null,"abstract":"<p><p>Human norovirus (HuNoV) is a leading cause of acute viral gastroenteritis worldwide and represents a major unmet challenge in antiviral drug and vaccine development. HuNoV is a non-enveloped, positive-sense RNA virus characterized by extensive genetic diversity and rapid evolution, which contribute to recurrent outbreaks in the absence of effective licensed therapeutics. Despite substantial progress in understanding HuNoV molecular biology, effective antiviral strategies remain limited, in part due to historical limitations in experimental model systems and the virus's ability to evade host antiviral responses. Recent advances in HuNoV in vitro culture systems, particularly human intestinal enteroids, and inhibitor screening platforms have improved the identification of antiviral candidates, while parallel efforts in vaccine development have yielded immunogenicity data in preclinical and early-stage clinical studies. However, significant challenges persist, including antigenic diversity, strain-specific immunity, and limited correlates of protection. This review provides a critical analysis of the molecular mechanisms governing HuNoV infection, immune evasion, and replication, with a focused emphasis on key antiviral targets, inhibitory strategies, and therapeutic development. Moreover, this review outlines key limitations and future directions for the development of effective therapeutic and preventive measures against HuNoV infection.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261473798"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765796","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":"Diabetic immune dysfunction and severe influenza: A comprehensive narrative review with clinical implications.","authors":"Alejandro Chapa-Rodriguez, Elizabeth Onyeaso, Purnachander Vangala","doi":"10.1177/20499361261476159","DOIUrl":"https://doi.org/10.1177/20499361261476159","url":null,"abstract":"<p><p>Diabetes mellitus is among the strongest independent risk factors for severe influenza, hospitalization, and influenza-associated acute respiratory distress syndrome (ARDS). The mechanistic basis of this association, and its clinical implications for immunomodulatory therapy, has been examined extensively in basic immunology and virology but is rarely synthesized for the practicing intensivist. This narrative review synthesizes the mechanistic basis by which diabetes predisposes to severe influenza and to translate the established pathogen-driven versus host-driven lung injury framework into a bedside-relevant heuristic for immunomodulatory decision-making. PubMed/MEDLINE and the Cochrane Library were searched from inception through April 2026, integrating evidence across innate and adaptive immunology, viral pathogenesis, and clinical trial data. The review was guided by the SANRA framework. Diabetes plausibly impairs early antiviral containment through disruption of type I interferon signaling, alveolar macrophage function, neutrophil-mediated barrier defense, and CD8⁺ T-cell responses, predominantly demonstrated in vitro and in murine models with supportive observational human data. The resulting prolonged viral replication, superimposed on baseline endothelial vulnerability, may contribute to rapid, severe lung injury. The framework applies most directly to type 2 diabetes; mechanistic differences between type 1 and type 2, and between acute glucose-driven and chronic structural mechanisms, are addressed. Available observational and meta-analytic evidence consistently associates corticosteroids with worse outcomes in influenza pneumonia. Selective adjunctive strategies, most notably mTOR inhibition with sirolimus and combination clarithromycin-naproxen-oseltamivir, show early hypothesis-generating signals but require confirmatory trials. This synthesis is intended as hypothesis-generating, not definitive.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261476159"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762765","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":"Rare manifestation of melioidosis with suppurative pericarditis: A case report and mini review.","authors":"Ssu-Han Pan, Chien-Feng Li, Wei-Yao Wang","doi":"10.1177/20499361261475457","DOIUrl":"https://doi.org/10.1177/20499361261475457","url":null,"abstract":"<p><p>Melioidosis is a serious infectious disease caused by <i>Burkholderia pseudomallei</i>, a bacterium endemic to tropical regions, including Taiwan. The disease can involve multiple organs; however, cardiac involvement, particularly cardiac tamponade, is rare. To date, only four cases of melioidosis presenting with cardiac tamponade have been reported in the literature. Here, we report an extremely rare case of melioidosis complicated by pericardial effusion and cardiac tamponade, which was successfully treated with pericardiocentesis and appropriate antimicrobial therapy.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261475457"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762132","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}