Revista Do Instituto De Medicina Tropical De Sao Paulo最新文献

{"title":"Weil's disease: rapid recovery following corticosteroid treatment: a case report.","authors":"Ahmet Melih Şahin, İrem Atçı-Koç, Sinan Çetin","doi":"10.1590/S1678-9946202668035","DOIUrl":"10.1590/S1678-9946202668035","url":null,"abstract":"<p><p>Leptospirosis is a zoonotic infection with a range of clinical findings, ranging from a mild, self-limited illness to a severe, life-threatening disease known as Weil's disease. The role of adjunctive corticosteroid therapy in severe leptospirosis remains controversial. We report a 41-year-old male with a history of intravenous drug use, regular alcohol consumption, and exposure to contaminated freshwater, who presented with fever, myalgia, vomiting, jaundice, thrombocytopenia, and acute kidney injury. Serological testing via the microagglutination test (MAT) was negative at admission, and empirical antibiotic therapy with ceftriaxone was initiated. Despite appropriate antimicrobial treatment and supportive care, including hemodialysis, the patient developed progressive hyperbilirubinemia and persistent thrombocytopenia. A repeat MAT performed one week later confirmed infection with Leptospira interrogans serovar Pomona. Due to ongoing clinical deterioration, methylprednisolone (1 mg/kg/day) was initiated, resulting in a dramatic clinical and laboratory improvement within 24 h. This rapid response suggests a potential role for corticosteroid therapy in selected patients with severe leptospirosis; however, further studies are required to establish its efficacy and safety.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e35"},"PeriodicalIF":1.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13183348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological study of hantavirus in Southern Brazil, 2009-2019.","authors":"Felipe Manoel Gimenez de Oliveira, Paulo Augusto Esteves, Ricardo Evandro Mendes","doi":"10.1590/S1678-9946202668028","DOIUrl":"10.1590/S1678-9946202668028","url":null,"abstract":"<p><p>Brazil has the highest number of hantavirus cardiopulmonary syndrome cases on the American continent, with Santa Catarina being the state with the most notifications. This retrospective longitudinal study aimed to describe the epidemiological profile of 177 hantavirus cases reported in Santa Catarina from 2009 to 2019, using data from the Notifiable Diseases Information System (SINAN). Statistical analyses of socio-demographic, clinical, and epidemiological data revealed that the typical patient was a male of working age with low educational attainment, living in a rural area. The highest incidence occurred in the Santa Catarina West, Midwest, and Mountain regions, strongly associated with agricultural activities. The case fatality rate (CFR) was highest among the 15-19-year age group. Clinical risk factors for death included respiratory signs, increased hematocrit, and the need for mechanical ventilation. Patients who sought early care had a higher CFR, possibly due to the initial difficulty of differentiating hantavirus from other viral diseases. Conversely, regions with higher notification rates showed lower CFRs, suggesting better surveillance. This study highlights critical areas for public health intervention and the key characteristics of hantavirus patients (males in rural areas and adolescents aged 15-19 years in regions with low notification rates) and areas for public health intervention. Training for medical professionals in regions with low notification rates should aim to reduce lethality, especially in regions with low reported cases (Itajai river delta and South), where underreporting may be occurring. Furthermore, the high lethality in adolescents and in patients with non-specific initial symptoms requires greater awareness. This study shows the utility of a governmental database in identifying epidemiological patterns and creating public health strategies tailored to regional specificities.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e28"},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidemia in a tertiary hospital in Southern Brazil.","authors":"Leandre Carmem Wilot, Bianca Dos Santos Blan, Vanice Rodrigues Poester, Cecília Bittencourt Severo, Karine Ortiz Sanchotene, Mônica Campos Dos Santos, Mariana Rodrigues Trápaga, Melissa Orzechowski Xavier","doi":"10.1590/S1678-9946202668027","DOIUrl":"10.1590/S1678-9946202668027","url":null,"abstract":"<p><p>Invasive bloodstream infections caused by Candida spp. significantly impact global health and are associated with high mortality rates. This study describes a five-year retrospective analysis conducted in a tertiary hospital with 213 beds in Rio Grande, Rio Grande do Sul State, Brazil, aiming to provide clinical-epidemiological data on candidemia and the susceptibility profile of isolates in this region. From January 2019 to December 2023, 44 patients (26 adults, 15 neonates, and three pediatric individuals) were diagnosed with candidemia at our hospital and included in this study. Candida species accounted for 4.5% of all sepsis-causing agents (44/971). The overall incidence was 2.2 cases per 1,000 hospitalizations; however, when stratified by hospitalization unit, this rate reached 26 per 1,000 hospitalizations in the neonatal intensive care unit (NICU), followed by 13 per 1,000 hospitalizations in the intensive care unit (ICU). The mortality rate reached 92% among ICU patients and 40% among NICU patients. C. albicans was the most prevalent species (57%), while C. parapsilosis was the most common non-albicans species (∼30%). Resistance to at least one of the three antifungal classes tested was detected in 13% of the isolates. This study underscores the substantial impact of candidemia in ICU settings in a tertiary hospital in Southern Brazil, emphasizing the importance of improved awareness and surveillance to enhance diagnosis, control, prevention, and monitoring of antifungal resistance, aiming to reduce incidence and mortality rates.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e27"},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycobacterium kansasii in cancer patients: a 13-case series.","authors":"Patrícia Rodrigues Bonazzi, Giovanni Mollo Baia, William Kazunori Sekiguchi, Adriana Satie Gonçalves Kono Magri, Raquel Keiko de Luca Ito, Karim Yaqub Ibrahim, Odeli Nicole Encinas Sejas, Edson Abdala","doi":"10.1590/S1678-9946202668029","DOIUrl":"10.1590/S1678-9946202668029","url":null,"abstract":"<p><p>Mycobacterium kansasii comprises one of the most common and most pathogenic nontuberculous mycobacteria, particularly in immunocompromised individuals. This retrospective observational study aimed to describe the epidemiology, clinical characteristics, and outcomes of M. kansasii infections in 13 cancer patients from Instituto do Cancer do Estado de Sao Paulo, Brazil, from January 2011 to September 2023. Of the 19 initial positive cultures, 13 fully met diagnostic criteria for M. kansasii infections. Solid tumors occurred the most (69.2%), and only 38.4% of patients were undergoing chemotherapy at diagnosis. Smoking was the most frequent previous characteristic in these cases (76.9%). Fever (53.4%), cough (46.1%) and dyspnea (30.7%) were the most common symptoms. Multiple nodules (46.1%) and cavities (46.1%) were the most common radiological findings. Overall, seven patients (53.8%) received at least 12 months of therapy. One-year overall mortality totaled 38.4-22.2% in patients with solid tumors and 75% in patients with hematologic malignancies. In conclusion, M. kansasii infections were predominantly pulmonary in this series of cancer patients, which showed a high frequency of other respiratory comorbidities, especially smoking. Mortality occurred in several patients, particularly among those with hematological malignancies.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e29"},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasmidial virulence of Rhodococcus equi and its implications of livestock infections for human health: a possible foodborne pathogen?","authors":"Márcio Garcia Ribeiro, Alexandre Naime Barbosa, Juliano Gonçalves Pereira, Fábio Sossai Possebon, José Paes de Almeida Nogueira Pinto, Fábio Vinícius Ramos Portilho, Thaís Spessotto Bello, Patrik Júnior de Lima Paz, Marcelo Fagali Arabe Filho, Letícia Colin Panegossi, Alec Utida Reznik, Larissa Onuki Zeferino, Maria Clara Trindade, Nícolas Garcia Ribeiro, Shinji Takai","doi":"10.1590/S1678-9946202668023","DOIUrl":"10.1590/S1678-9946202668023","url":null,"abstract":"<p><p>Rhodococcus equi, a versatile and adapted opportunistic in nature bacterium, infects animals and humans. This soil-borne microorganism widely occurs in farms. Its dissemination occurs by feces from domestic animals (particularly horses, cattle, and pigs). In the last decades, bacterial virulence has been strongly attributed to plasmid-encoded virulence-associated proteins (VAPs). To date, three virulence plasmid types have been recognized: pVAPA, pVAPB, and pVAPN, which are considered host- or livestock-adapted. The pVAPA type is related to equine isolates (horse-type), the pVAPB type is associated with pig isolates (porcine-type), whereas the pVAPN type occurs in domestic ruminants (bovine and caprine) (ruminant-type). Nonetheless, pathogenic R. equi possessing the three virulent plasmid types can infect humans. Inhaling aerosol particles from the environment of equids represents the first route traditionally considered for the transmission of R. equi to humans, although an epidemiological lack of transmission remains in human infections because some patients with rhodococcosis have no history of contact with livestock or their environment on farms. However, all pVAPs types have been found in humans infected by R. equi (predominantly living with HIV), which could be presumably transmitted to patients by the ingestion of contaminated undercooked or raw meat from slaughtered pigs, cattle and, occasionally, horses, representing a probably route of the transmission of the pathogen from livestock-to-humans that could partially explain infections in humans without a history of contact with cattle, pigs, horses, or their farm environments.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e23"},"PeriodicalIF":1.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotypic virulence profiles and mobile genetic elements related to invasiveness in Neisseria gonorrhoeae strains.","authors":"José Victor Bortolotto Bampi, Saidy Vásconez Noguera, Sania Alves Dos Santos, Ana Paula Marchi, Marina Farrel Côrtes, Joyce Vanessa da Silva Fonseca, Ivan Lira Dos Santos, Flávia Rossi, Maria Luiza Bazzo, Gwenda Hughes, Igor Borges, Silvia Figueiredo Costa","doi":"10.1590/S1678-9946202668025","DOIUrl":"10.1590/S1678-9946202668025","url":null,"abstract":"<p><p>Neisseria gonorrhoeae (NG) has become an increasing global health threat due to drug resistance and potentially invasive disease. In this study, we assessed the genotypic profile in both invasive and non-invasive NG strains from patients at University of Sao Paulo Faculty of Medicine Clinics Hospital, Brazil. We analyzed the NG genotypic profiles and clinical data from 25 patients hospitalized at Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP) from January 2017 to March 2020. A total of 25 isolates underwent whole genome sequencing, of which 10 (40%) were collected from sterile sites like blood and classified as invasive. Invasive and noninvasive specimens were clustered in 5 STs and 11 STs, respectively, sharing 3 STs in common. We identified resistance markers for macrolides (mtrR) in 40% of isolates and 92% exhibited at least one resistance marker for beta-lactams (penA, blaTEM-1B, or blaTEM-135), predominantly PBP1 and PBP2 alterations. Resistance genes blaTEM-1B (7%vs.50%, p=0.023) and tetM (13%vs.80%, p=0.002) were more frequently found in invasive disease isolates, always accompanied by the mobile genetic elements pJD4 and pEP5289, respectively. Associated with these elements were two toxin encoding genes (vapD and zeta1/2) previously described as possible virulence factors and resistance genes for beta-lactams and tetracyclines. Results revealed that invasive strains of NG are genotypically clustered and frequently harbor two plasmids which may be associated with invasive disease. Resistance markers for beta-lactam as PBP1 and PBP2 alterations warn against a future potential resistance to this class.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e25"},"PeriodicalIF":1.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 pandemic in the hotel industry: the application of hygiene and safety protocols by hotel employees.","authors":"Cláudia Regina Rodrigues Sarralheiro Butuhy, Expedito José de Albuquerque Luna","doi":"10.1590/S1678-9946202668024","DOIUrl":"10.1590/S1678-9946202668024","url":null,"abstract":"<p><p>This study sought to understand how the application of hygiene and safety protocols by hotel companies in Sao Paulo city, Brazil, occurred during the COVID-19 pandemic. The first objective of the study was to find, based on the information provided by employees who worked in certain hotels via questionnaires from March 2020 to December 2022, which protocols were applied in the studied period and which measures were definitively incorporated into the hygiene schemes of these hotels. Secondly, this study aimed to assess how the interaction and adaptations to the implemented hygiene protocols took place to find the measures that have become hygiene habits in everyday life. The literature on the applied health protocols during the pandemic was reviewed. A cross-sectional descriptive study was conducted with 421 respondents. This study found a significant association between sex and the adoption of protective measures during the pandemic. Women adhered more to protective measures than men, and this association remained after the pandemic. Employees who worked in the food and beverage area contracted COVID-19 more often than employees in other hotel areas. Those with higher education levels received more doses of COVID-19 vaccines than those with lower levels of education. Finally, this study found a direct relationship between the quality standard of the hotels and the frequency of training received by employees and a high adherence to vaccination against COVID-19 that was lower at higher educational levels.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e24"},"PeriodicalIF":1.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of oral myiasis in a non-tropical region: the role of systemic vulnerability.","authors":"Gökçe Kızılkale Kayıkcı, Ayşe Yılmaz, Furkan Arabacı, Hale Ahsen Yardibi Demir, Mesut Özsoy","doi":"10.1590/S1678-9946202668026","DOIUrl":"10.1590/S1678-9946202668026","url":null,"abstract":"<p><p>Myiasis is a rare parasitic infection caused by the larvae of Diptera flies, which infest the tissues of humans or animals and are typically found in warm, humid climates. Oral myiasis is uncommon in healthy individuals and typically occurs when adult flies lay eggs or larvae near the mouth or on open wounds. Malnutrition, immunodeficiency, poor oral hygiene, dental problems, neurological or psychiatric conditions, and alcoholism are the main risk factors. In this report, we present a case of oral myiasis that occurred in a patient with multiple comorbidities, including malnutrition, immunological and neurological dysfunction (lung carcinoma, cirrhosis, cachexia, Parkinson's disease). The patient was admitted to our intensive care unit while intubated because of confusion, respiratory failure, and sepsis, in which oral myiasis was identified. Due to the patient's comorbid conditions, ivermectin could not be administered. A conservative approach was used, including daily cleaning with diluted hydrogen peroxide and povidone-iodine, together with mechanical removal of the larvae. The infestation was completely resolved within three days. This case shows that oral myiasis may develop in non-tropical settings when systemic vulnerability exists. It highlights the importance of regular oral exams and mouth care for high-risk patients.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e26"},"PeriodicalIF":1.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue haemorrhagic fever: an evaluation of host innates immune factors in hepatic lesions and their correlation with immunopathogenesis.","authors":"Carla Pagliari, Geovanna Menezes Marcoli, Luciane Kanashiro-Galo, Evandro Sobroza de Mello, Leda Viegas de Carvalho, Ricardo Penny, Juarez Simões Quaresma, Pedro Fernando da Costa Vasconcelos, Mirian Nacagami Sotto","doi":"10.1590/S1678-9946202668021","DOIUrl":"10.1590/S1678-9946202668021","url":null,"abstract":"<p><p>Dengue fever challenges public health worldwide. The numerous factors associated with dengue fever severity and mortality risk include host characteristics such as patient age, comorbid conditions, previous dengue virus (DENV) infections, and biochemical biomarkers. Type I IFNs are essential cytokines in orchestrating innate and adaptive immune responses against viral invasion, and their regulation is mediated by IRF-2, which prevents excessive IFN expression. In vitro studies have shown DENV evasion strategies that affect IFN-I production but few have considered the in-situ interrelationship between IFN-I and the virus. This study aims to find elements of innate immunity that induce the anti-viral response and their correlation with the detected alterations in liver lesions. Liver specimens from individuals who died due to dengue were selected according to clinical and laboratory data and serological diagnosis. The specimens were subjected to histological and immunohistochemical evaluation of cells expressing IFN-I, RIG-1, IRF-2, and STING. Viral antigens were detected by an anti-DENV. A high number of cells expressed RIG-1 and IRF-2 when compared to IFN-I and STING. In severe cases of dengue, DENV may play a role in its pathogenesis with properties that induce non-effective immune responses. The virus can evade effective immune responses by impairing the early activation of innate immunity. This immune dysregulation may contribute to the progression of more severe manifestations and seems to play a role in the pathogenesis of hepatic involvement.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e21"},"PeriodicalIF":1.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fatal case report of sepsis caused by Robinsoniella sp.","authors":"Meijia Huang, Hongjuan Zhang, Xinyue Li, Xiangchentao Zhang, Yunmin Xu","doi":"10.1590/S1678-9946202668022","DOIUrl":"10.1590/S1678-9946202668022","url":null,"abstract":"<p><p>Robinsoniella species are anaerobic, spore-forming, Gram-positive bacilli that are rarely associated with human infections because of their slow growth and the limitations of conventional identification methods. We describe a fatal case of sepsis in an 84-year-old woman with hypertension, diabetes, and chronic renal insufficiency. During hospitalization, she developed impaired consciousness, polymicrobial infections, and multiple organ failure. Despite aggressive antimicrobial and supportive treatment, her condition deteriorated, leading to death. This study identified a Robinsoniella isolate (designated Rp5645) by 16S rRNA gene sequencing, showing 98.35% similarity to R. peoriensis PPC31. As this value falls below the accepted species-level threshold, Rp5645 may represent a novel Robinsoniella species. Unfortunately, the isolate lost viability before further genomic or phenotypic studies could be performed. This outcome illustrates the technical challenges in recovering and preserving fastidious anaerobes and underscores the crucial role of rapid molecular identification in confirming rare pathogens. This case broadens the clinical spectrum of Robinsoniella infections and highlights its potential pathogenic capacity, particularly in older or immunocompromised patients. It also emphasizes the need for timely molecular characterization to prevent the loss of valuable data from uncommon clinical isolates.</p>","PeriodicalId":54466,"journal":{"name":"Revista Do Instituto De Medicina Tropical De Sao Paulo","volume":"68 ","pages":"e22"},"PeriodicalIF":1.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}