Brazilian Journal of Infectious Diseases最新文献

Disseminated bartonellosis and EBV reactivation in an adolescent treated with upadacitinib 用upadacitinib治疗的青少年弥散性巴尔通体病和EBV再激活

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-05-01 DOI: 10.1016/j.bjid.2025.104536

Vincent Pargny , Emilie Delugre , Raphael Janela , Soumaya Skalli , Abdeljalil Zeggay , Hortense Petat

{"title":"Disseminated bartonellosis and EBV reactivation in an adolescent treated with upadacitinib","authors":"Vincent Pargny , Emilie Delugre , Raphael Janela , Soumaya Skalli , Abdeljalil Zeggay , Hortense Petat","doi":"10.1016/j.bjid.2025.104536","DOIUrl":"10.1016/j.bjid.2025.104536","url":null,"abstract":"<div><h3>Background</h3><div><em>Bartonella henselae</em> is responsible for disseminated infections in immunocompromised patients. Upadacitinib is a JAK inhibitor used since 2021 for the treatment of severe atopic dermatitis in adolescents over 12-years. We report here the case of disseminated Bartonellosis in a 15-year-old male treated with upadacitinib.</div></div><div><h3>Case presentation</h3><div>This patient presented with fever and abdominal pain. Laboratory tests showed inflammation, rhabdomyolysis and acute renal failure. Imaging studies revealed lymphadenopathies, hepatosplenic, renal and pulmonary nodules, pleural and peritoneal effusions and spleen abscesses. <em>Bartonella henselae</em> serology was positive for IgG and IgM. Treatment with doxycycline resolved the symptoms. We detected a concomitant EBV reactivation.</div></div><div><h3>Conclusions</h3><div><em>Bartonella henselae</em> infection should be suspected in immunocompromised patients presenting with fever of unknown origin. Upadacitinib is responsible for rapid immunodepression, which can lead to viral reactivation and severe bacterial infections. Randomized controlled trials are needed to establish a consensus on treatments for the various forms of Bartonellosis.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104536"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Real-world accuracy of SARS-CoV-2 antigen detection compared with qPCR: A cross-sectional study in Toledo - PR, Brazil 与qPCR相比，SARS-CoV-2抗原检测的真实世界准确性：巴西托莱多- PR的横断面研究

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-17 DOI: 10.1016/j.bjid.2025.104520

Carla Adriane Royer , Regis Goulart Rosa , Maicon Falavigna , Jaqueline Carvalho de Oliveira

{"title":"Real-world accuracy of SARS-CoV-2 antigen detection compared with qPCR: A cross-sectional study in Toledo - PR, Brazil","authors":"Carla Adriane Royer , Regis Goulart Rosa , Maicon Falavigna , Jaqueline Carvalho de Oliveira","doi":"10.1016/j.bjid.2025.104520","DOIUrl":"10.1016/j.bjid.2025.104520","url":null,"abstract":"<div><div>Rapid Antigen Tests (Ag-RDTs) for the detection of SARS-CoV-2 is an important diagnostic tool for containing virus spread. However, their accuracy ‒ the proportion of correct results (both true positives and true negatives) ‒ still needs to be proven when used in a real large-scale context. Accordingly, we provide data from a cross-sectional study conducted in Toledo - PR, Brazil, on the accuracy of rapid tests compared with qPCR within the Brazilian Unified Health System. A total of 2882 thousand individuals presenting symptoms suggestive of COVID-19 were screened. Overall, the antigen tests showed a sensitivity, specificity, and accuracy of 59 % (0.56‒0.62), 99 % (0.98‒0.99), and 82 % (0.81‒0.84) respectively. However, a significant difference was found when analysing two brand tests individually. In addition, for patients with a low quantification Cycle (Cq) < 20 (which indicates a high viral load), the agreement between test results was high (90.85 %). However, this agreement decreased significantly when the viral load decreased, dropping to 5.59 % for samples with Cq ≥ 33, which indicates a lower viral load. While rapid antigen tests are a valuable tool in combating virus spread, their accuracy can vary significantly between manufacturers and under conditions of low viral load.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104520"},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increased rates of blaNDM in Pseudomonas aeruginosa in a tertiary care hospital in southern Brazil 在巴西南部的三级保健医院铜绿假单胞菌的白粉病发病率增加

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-10 DOI: 10.1016/j.bjid.2025.104523

Patricia Orlandi Barth , Dariane Castro Pereira , Camila Mörschbächer Wilhelm , Kellen Figueira Tragnago , Afonso Luís Barth

{"title":"Increased rates of blaNDM in Pseudomonas aeruginosa in a tertiary care hospital in southern Brazil","authors":"Patricia Orlandi Barth , Dariane Castro Pereira , Camila Mörschbächer Wilhelm , Kellen Figueira Tragnago , Afonso Luís Barth","doi":"10.1016/j.bjid.2025.104523","DOIUrl":"10.1016/j.bjid.2025.104523","url":null,"abstract":"<div><div>Carbapenem-Resistant <em>Pseudomonas Aeruginosa</em> (CRPA) is considered as one of the high priority pathogens by the World Health Organization. As CRPA carbapenemase producers have increased worldwide, the aim of this study was to evaluate the carbapenemase prevalence in CRPA at a tertiary care hospital in Brazil”<em>.</em> All 395 CRPA identified in the period of September 2021 to May 2024 were evaluated by multiplex real-time polymerase chain reaction (qPCR-HRM) for the following carbapenemase genes: <em>bla</em><sub>KPC</sub>, <em>bla</em><sub>NDM</sub>, <em>bla</em><sub>OXA-48-like</sub>, <em>bla</em><sub>IMP</sub>, <em>bla</em><sub>VIM,</sub> <em>bla</em><sub>SPM</sub> and <em>bla</em><sub>GES</sub>. In the first period analyzed (September to December 2021), almost 70 % of the isolates were negative for the 7 tested genes, and the <em>bla</em><sub>NDM</sub> was found in 27.3 % of the CRPA. In the following semesters there was an increase of <em>bla</em><sub>NDM</sub> as follows: January to June of 2022 = 29.8 %; July to December of 2022 = 43.8 %; January to June of 2023 = 42.4 %; July to December 2023 = 58.9 % and January to May of 2024 = 59.5 % of <em>bla</em><sub>NDM</sub>. The prevalence of the other carbapenemases remained low. These results indicated an important increase of the <em>bla</em><sub>NDM</sub> gene, overcoming the CRPA non-carbapenemase producers in our institution.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104523"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tuberculosis parenteral therapeutic regimens for critical patients or non-functional intestinal tract: Brief review and proposal of protocol 危重患者或非功能性肠道的结核肠外治疗方案：简要回顾和方案建议

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-07 DOI: 10.1016/j.bjid.2025.104526

Antonio Camargo Martins , Márcia Teixeira Garcia , Mariângela Ribeiro Resende

{"title":"Tuberculosis parenteral therapeutic regimens for critical patients or non-functional intestinal tract: Brief review and proposal of protocol","authors":"Antonio Camargo Martins , Márcia Teixeira Garcia , Mariângela Ribeiro Resende","doi":"10.1016/j.bjid.2025.104526","DOIUrl":"10.1016/j.bjid.2025.104526","url":null,"abstract":"<div><div>Standard anti-tuberculosis regimens (Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol [RHZE]) remain challenging for critically ill patients and those with a non-functioning gastrointestinal tract. In Brazil, these challenges are amplified by the lack of Intravenous (IV) rifampicin, isoniazid, and ethambutol, which often results in suboptimal outcomes. This brief communication synthesized evidence on parenteral therapies and proposed a structured, five-step protocol for critically ill patients unable to receive oral drugs. A narrative review of the guidelines and key studies was also conducted. IV formulations of RHZE are approved in only some countries and are not available everywhere. Alternative IV drug classes, such as fluoroquinolones, aminoglycosides, carbapenems, and oxazolidinones, can address malabsorption or intolerance to oral RHZE. However, no standardized regimen exists for this population. Our five-step protocol advises: (1) Characterizing each TB case, (2) determining IV necessity, (3) Consulting specialized TB services, (4) Designing a safe and effective regimen, and (5) <em>Re</em>-evaluating therapy for transition to oral treatment. Given the morbidity and mortality from severe TB in Intensive Care Units (ICU), a formalized approach is essential. Further research and policy initiatives regarding IV first-line drugs are crucial to improve treatment outcomes in this vulnerable group. This strategy unifies practice across diverse clinical settings.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104526"},"PeriodicalIF":3.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786135","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}

引用次数: 0

Gas-forming abscess associated with prosthetic vascular graft infection caused by Bacteroides fragilis 由脆弱拟杆菌引起的假体血管感染相关的气性脓肿

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-02 DOI: 10.1016/j.bjid.2025.104524

Motoshi Iwao , Takehiro Hashimoto , Ryota Tanaka , Kazufumi Hiramatsu , Hiroki Itoh

{"title":"Gas-forming abscess associated with prosthetic vascular graft infection caused by Bacteroides fragilis","authors":"Motoshi Iwao , Takehiro Hashimoto , Ryota Tanaka , Kazufumi Hiramatsu , Hiroki Itoh","doi":"10.1016/j.bjid.2025.104524","DOIUrl":"10.1016/j.bjid.2025.104524","url":null,"abstract":"<div><h3>Introduction</h3><div>Prosthetic Vascular Graft Infection (PVGI) is a rare but serious complication of open surgical repair of abdominal aortic aneurysm. We report a case of gas-forming abscesses associated with PVGI caused by <em>Bacteroides fragilis</em> identified from the drainage fluid and blood cultures.</div></div><div><h3>Case presentation</h3><div>A 67-year-old man with a complaint of worsening low back pain underwent an emergency open surgery due to abdominal aortic aneurysm. On postoperative day 18, an abdominal CT showed gas formation within the aneurysm. Gram staining of the drainage fluid revealed Gram-negative rods and 16S rRNA gene sequencing performed on the fluid identified <em>B. fragilis</em>, although the culture of the fluid was negative. PVGI caused by anaerobic bacteria such as <em>Bacteroides</em> spp. is relatively rare. The sensitivity of 16S rRNA gene sequencing for culture-negative specimens is generally low, but 16S rRNA sequencing-positive rate increases when a Gram stain of specimen is positive.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104524"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748539","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}

引用次数: 0

Contemporary cohort study in adult patients with infective endocarditis 成人感染性心内膜炎的当代队列研究

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-04-02 DOI: 10.1016/j.bjid.2025.104521

Mariana Giorgi Barroso de Carvalho , Thatyane Veloso de Paula Amaral de Almeida , Nicolas de Albuquerque Pereira Feijóo , Rafael Quaresma Garrido , Giovanna lanini Ferraiuoli Barbosa , Wilma Félix Golebiovski , Bruno Zappa , Clara Weksler , Marcelo Goulart Correia , Cristiane da Cruz Lamas

{"title":"Contemporary cohort study in adult patients with infective endocarditis","authors":"Mariana Giorgi Barroso de Carvalho , Thatyane Veloso de Paula Amaral de Almeida , Nicolas de Albuquerque Pereira Feijóo , Rafael Quaresma Garrido , Giovanna lanini Ferraiuoli Barbosa , Wilma Félix Golebiovski , Bruno Zappa , Clara Weksler , Marcelo Goulart Correia , Cristiane da Cruz Lamas","doi":"10.1016/j.bjid.2025.104521","DOIUrl":"10.1016/j.bjid.2025.104521","url":null,"abstract":"<div><h3>Background</h3><div>Infective Endocarditis (IE) is a serious disease, with high morbidity and mortality. Few case series come from middle- income countries. Our aim is to describe a case series of patients with IE treated at a reference center in Brazil and compare data to other countries.</div></div><div><h3>Methods</h3><div>A retrospective analysis of a prospectively implemented endocarditis database was conducted, including adult patients with definite IE, January 2006‒June 2023. A literature search and summary were done. Statistical analysis was performed using Jamovi®, version 1.2.2.</div></div><div><h3>Results</h3><div>There were 502 episodes of IE; mean age ± SD was 48.4±17.2 years. Community-acquired IE occurred in 64.7 %. Main predispositions were rheumatic valve disease (30.7 %), prostheses (31.5 %), and congenital heart disease (13.9 %). Transthoracic and transesophageal echocardiograms were performed in 85 % and 78 %, respectively. Left-sided IE predominated. Fever occurred in 90.6 %, new murmurs in 50.7 %, and embolism in 45 %. Blood cultures were negative in 33.1 %; frequent pathogens were oral streptococci (15.6 %), <em>Staphylococcus aureus</em> (10.0 %), and enterococci (12.8 %). Main complications were heart failure (58 %), renal failure (32.8 %), and splenic embolization (35.2 %). Surgery was performed in 83.6 %; overall in-hospital mortality was 25 %; surgical mortality was 21.3 %.</div></div><div><h3>Conclusions</h3><div>Blood culture negative left-sided IE predominated. The mortality rate was high but within the range of reported series. Surgery was performed frequently and patients who were operated on had lower mortality.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104521"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748538","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}

引用次数: 0

Risk factors for neurosyphilis in HIV patients: A retrospective cohort study HIV患者神经梅毒的危险因素：一项回顾性队列研究

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-03-28 DOI: 10.1016/j.bjid.2025.104519

Beatriz Arns , Tarsila Vieceli , Eduardo Gomes , Mariana Horn Scherer , Luisa Nakashima , Maria Luisa Santos , Ronara Blos Hepp , Fernanda Greinert , Maria Helena Rigatto

{"title":"Risk factors for neurosyphilis in HIV patients: A retrospective cohort study","authors":"Beatriz Arns , Tarsila Vieceli , Eduardo Gomes , Mariana Horn Scherer , Luisa Nakashima , Maria Luisa Santos , Ronara Blos Hepp , Fernanda Greinert , Maria Helena Rigatto","doi":"10.1016/j.bjid.2025.104519","DOIUrl":"10.1016/j.bjid.2025.104519","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis is a highly prevalent sexually transmitted infection worldwide. Patients living with Human Immunodeficiency Virus (HIV) have a higher risk of developing neurosyphilis. Actual guidelines advise to proceed with lumbar puncture only if neurologic symptoms are present. However, asymptomatic neurosyphilis patients are not rare in the HIV population and other risk factors should be defined to guide screening.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort to evaluate risk factors related to neurosyphilis in HIV patients. Adults with HIV infection and laboratory confirmed syphilis between 2011 and 2021 were included. Patients with no record of syphilis treatment, VDRL titers ≤ 1:4, other neurologic diseases or non-HIV related immunological impairment were excluded. The patients were followed for 2-years after syphilis diagnosis.</div></div><div><h3>Results</h3><div>One-hundred and forty patients (190 syphilis episodes) were included, with mean age of 45.0 ± 9.2-years-old, 111 (79.3 %) were male, 48 (25.8 %) had CD4 count ≤ 350 cells/mm<sup>3</sup> at syphilis diagnosis (median: 522.5 cells/mm<sup>3</sup>; IQR: 315.5‒703.5), 127 (66.8 %) of 172 had a HIV viral load ≤ 400 copies/mm<sup>3</sup> and median serum VDRL titer was 1:64 (IQR: 1:16‒1:128). In multivariate analysis, serum VDRL titers ≥ 1:32 and the presence of neurologic symptoms were associated with neurosyphilis, while HIV viral load ≤ 400 copies/mm<sup>3</sup> was a protective factor.</div></div><div><h3>Discussion</h3><div>In addition to the presence of neurological symptoms, HIV viral load > 400 copies/mm<sup>3</sup> and VDRL titers ≥ 1:32 were shown to be risk factors for neurosyphilis in this study and diagnostic lumbar puncture should be considered in these cases.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104519"},"PeriodicalIF":3.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724088","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}

引用次数: 0

Gestational and congenital syphilis in the state of Rio de Janeiro, Brazil, 2021‒2023 巴西里约热内卢州妊娠期和先天性梅毒，2021-2023年

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-03-28 DOI: 10.1016/j.bjid.2025.104522

Rosa Maria Soares Madeira Domingues , Marcos Augusto Bastos Dias , Ana Paula Esteves Pereira , Paula Mendes Luz , Emilia M. Jalil , Angela Cristina Vasconcelos de Andrade Rabello , Ruth Khalili Friedman , Maria do Carmo Leal

{"title":"Gestational and congenital syphilis in the state of Rio de Janeiro, Brazil, 2021‒2023","authors":"Rosa Maria Soares Madeira Domingues , Marcos Augusto Bastos Dias , Ana Paula Esteves Pereira , Paula Mendes Luz , Emilia M. Jalil , Angela Cristina Vasconcelos de Andrade Rabello , Ruth Khalili Friedman , Maria do Carmo Leal","doi":"10.1016/j.bjid.2025.104522","DOIUrl":"10.1016/j.bjid.2025.104522","url":null,"abstract":"<div><div>Gestational (GS) and congenital syphilis (CS) are important public health problems in Brazil. This study aims to estimate the prevalence of GS, the incidence of CS and the rate of vertical transmission (VT) of syphilis, as well as to evaluate the management indicators of GS in the State of Rio de Janeiro (RJS), the Brazilian state with the highest detection rate of GS and incidence of CS in 2022. A hospital-based, cross-sectional study was carried out in public and private hospitals located in RJS, in the period 2021–2023, with interviews with 1,923 women, analysis of prenatal care (PNC) cards and hospital records. The GS management indicators, the prevalence of GS, the incidence of CS and the rate of VT were estimated with the respective 95 % confidence intervals (95 % CI), according to the source of financing for hospitalizations for childbirth or abortion care. PNC was reported by 93.7 % of women, 82.7 % had the first test for syphilis and 52.6 % the second. The prevalence of GS was estimated at 14.5 % (95 % CI 9.2 %- 22.2 %), with higher values in women with public financing (18.2 % public; 3.6 % private). Nearly one-third-of women with GS were diagnosed only during hospitalization for childbirth or abortion care and 13.4 % were appropriately treated during PNC. The incidence of CS was estimated at 53.1 per 1,000 live births (68.4 per 1,000 public; 9.7 per 1,000 LB private) with a VT rate of 33.5 %, with no difference according to the source of financing. The detection rate of GS and the incidence rate of CS were double those reported to the Brazilian Notifiable Diseases Information System. Several missed opportunities for the control of CS were identified. Women with public financing had a higher prevalence of GS and incidence of CS, and should be the priority target of control strategies.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104522"},"PeriodicalIF":3.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724149","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}

引用次数: 0

Unmasking Prototheca wickerhamii: A rare case of cutaneous infection and its implications for clinical practice 揭露维克哈米氏原鞘：一个罕见的皮肤感染病例及其临床意义

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-03-27 DOI: 10.1016/j.bjid.2025.104525

Jing Li , Zeyu Huang , Ruzhi Zhang

{"title":"Unmasking Prototheca wickerhamii: A rare case of cutaneous infection and its implications for clinical practice","authors":"Jing Li , Zeyu Huang , Ruzhi Zhang","doi":"10.1016/j.bjid.2025.104525","DOIUrl":"10.1016/j.bjid.2025.104525","url":null,"abstract":"<div><div><em>Prototheca</em>, an opportunistic pathogenic algae widely found in nature, has emerged as a potential public health concern. Most cases occur in immunocompromised individuals, with infections in immunocompetent patients being relatively rare. Due to their non-specific clinical presentation and limited awareness among clinicians, <em>Prototheca</em> infections are often misdiagnosed, resulting in delayed treatment. Recent advances in species identification and antifungal susceptibility testing have provided important tools for diagnosis and therapy. Here, we report a case of recurrent facial infection in a 76-year-old immunocompetent man. Skin biopsy revealed an infectious granuloma, and fungal culture identified yeast-like colonies. Fluorescence staining and scanning electron microscopy revealed abundant spores, while metagenomic sequencing confirmed the infection as <em>Prototheca wickerhamii</em>. The patient was successfully treated with long-term itraconazole and dipotassium glycyrrhizinate capsules. This case highlights the importance of early and accurate diagnosis in the management of <em>Prototheca</em> skin infections and reviews the therapeutic strategies used.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 3","pages":"Article 104525"},"PeriodicalIF":3.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706506","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}

引用次数: 0

Evaluating long-term MRSA colonization and household spread: Insights from a community-based study 评估长期MRSA定植和家庭传播：来自社区研究的见解

IF 3 4区医学

Brazilian Journal of Infectious Diseases Pub Date : 2025-02-26 DOI: 10.1016/j.bjid.2025.104518

Taniela Marli Bes , Robson Eduardo Soares , Roberta Ruedas Martins , Lauro Perdigao-Neto , Diego Mongelos , Luisa Moreno , Andrea Moreno , Gerson Salvador de Oliveira , Silvia Figueiredo Costa , Anna Sara Levin

{"title":"Evaluating long-term MRSA colonization and household spread: Insights from a community-based study","authors":"Taniela Marli Bes , Robson Eduardo Soares , Roberta Ruedas Martins , Lauro Perdigao-Neto , Diego Mongelos , Luisa Moreno , Andrea Moreno , Gerson Salvador de Oliveira , Silvia Figueiredo Costa , Anna Sara Levin","doi":"10.1016/j.bjid.2025.104518","DOIUrl":"10.1016/j.bjid.2025.104518","url":null,"abstract":"<div><div>Methicillin-Resistant <em>Staphylococcus Aureus</em> (MRSA) is commonly transmitted among hospitalized patients through direct contact or contaminated objects. However, the dynamics of household transmission of MRSA remain unclear, posing challenges for effective prevention. This study evaluates the persistence of MRSA colonization in asymptomatic carriers over a period of at least 17-months and examines the potential for intra-household transmission. We conducted home visits to seven families, each with at least one MRSA-colonized member, to collect nasal swabs from all household members. Phenotypic and genotypic profiles of the isolates were determined through culture, antimicrobial susceptibility testing, and PCR. We compared these new samples with previous samples from a recent study involving the same individuals to assess spontaneous clearance of MRSA. A total of 25 samples were collected, with 56 % (14) identified as <em>S. aureus</em> and 44 % (11) as non-S. aureus; among the <em>S. aureus</em> isolates, four were MRSA. We observed spontaneous clearance of MRSA in six of the original cases. Unexpectedly, there was limited intra-household transmission of MRSA, although all families with MRSA colonization had at least one member with a history of skin disease. In the family where colonization persisted, one individual had recurrent cutaneous abscesses, suggesting a possible link to sustained colonization.</div></div>","PeriodicalId":56327,"journal":{"name":"Brazilian Journal of Infectious Diseases","volume":"29 2","pages":"Article 104518"},"PeriodicalIF":3.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488645","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}

引用次数: 0