American Journal of Tropical Medicine and Hygiene最新文献_第3页

Early Detection of Asymptomatic Human Infections in Vector-Borne Diseases: A Programmatic Model for Enhanced Surveillance. 媒介传播疾病中无症状人类感染的早期检测：加强监测的规划模型。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-21 DOI: 10.4269/ajtmh.25-0750

Sivagnaname Narayanasamy, Yuvarajan Sivagnaname

{"title":"Early Detection of Asymptomatic Human Infections in Vector-Borne Diseases: A Programmatic Model for Enhanced Surveillance.","authors":"Sivagnaname Narayanasamy, Yuvarajan Sivagnaname","doi":"10.4269/ajtmh.25-0750","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0750","url":null,"abstract":"Global control strategies for vector-borne diseases (VBDs) remain largely anchored in the detection and management of symptomatic cases, despite substantial evidence that a considerable proportion of infections-often exceeding 60% in several major arboviral diseases-are asymptomatic or minimally symptomatic. These asymptomatic human reservoirs can sustain low-level pathogen circulation during interepidemic periods and may amplify transmission once ecological, immunological, or entomological thresholds are crossed. Because vector-dependent transmission is shaped by environmental variability, vector density, and host immunity dynamics, reliance on symptom-based surveillance alone risks delayed outbreak detection and missed opportunities to prevent severe health outcomes. Evidence from dengue, Zika, West Nile virus, Japanese encephalitis, chikungunya, and Chandipura virus, as well as parasitic diseases such as malaria and visceral leishmaniasis, illustrates how silent human infections complicate surveillance and undermine outbreak anticipation. We propose the establishment of Enhanced Vector-Borne Disease Vigilance Teams (EVBD-VTs) that would serve as mobile, multidisciplinary units integrated with laboratory networks and sentinel systems to strengthen early detection of asymptomatic infections with epidemic potential. Anchored within a One Health framework and supported by laboratory infrastructure, climate-informed risk assessment, and targeted active case detection, this model seeks to shift VBD control from reactive containment to anticipatory preparedness in an era of ecological change.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759933","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

Socioeconomic Impact of Artemether-Lumefantrine in Malaria Treatment across Sub-Saharan Africa: A Model-Based Historical Analysis with 2022 as Reference Year. 蒿甲醚-氨芳汀治疗撒哈拉以南非洲疟疾的社会经济影响：以2022年为参考年的基于模型的历史分析

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-21 DOI: 10.4269/ajtmh.25-0570

Adnan Atitallah, Platon Peristeris, Davide Lovera, Jennifer Branner, Rajiv Shah, Preetam Gandhi, Jean-Bernard Gruenberger

{"title":"Socioeconomic Impact of Artemether-Lumefantrine in Malaria Treatment across Sub-Saharan Africa: A Model-Based Historical Analysis with 2022 as Reference Year.","authors":"Adnan Atitallah, Platon Peristeris, Davide Lovera, Jennifer Branner, Rajiv Shah, Preetam Gandhi, Jean-Bernard Gruenberger","doi":"10.4269/ajtmh.25-0570","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0570","url":null,"abstract":"Malaria remains one of the most significant global health challenges in sub-Saharan Africa (SSA), resulting in social and economic consequences owing to high morbidity and mortality. This study aims to determine the socioeconomic burden of malaria as well as the socioeconomic benefit of artemether-lumefantrine (AL, Coartem®, Novartis, Basel, Switzerland) treatment of uncomplicated malaria in SSA. A de novo Microsoft® Excel-based model study was considered for societal perspective assessment. The model included malaria prevalence from SSA countries and focused on three age groups: younger than 5 years old, 5-14 years old, and 15 years old and older. The socioeconomic burden was assessed as loss in paid work productivity attributable to the health burden of malaria as measured in disability-adjusted life years (DALYs), whereas the socioeconomic benefit of AL was measured as avoided productivity loss by utilizing a decision tree. Input parameters used for the calculation were obtained from the published literature, public databases, and the Institute for Health Metrics and Evaluation. For 2022, the model reported 30.8 million malaria-related DALYs in those 15 years old and older, which led to a socioeconomic burden of approximately U.S. $82.8 billion. The estimated total socioeconomic benefit of AL compared with the nontreatment scenario was U.S. $24.2 billion. The estimate reflects avoided productivity losses, including productive years of life lost (YLL) and caregiving days required. In conclusion, these findings highlight the substantial socioeconomic burden of malaria and suggest that by avoiding deaths, reducing YLL, and minimizing caregiving days, AL provides a substantial socioeconomic benefit in the SSA region.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759979","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

Probable Autochthonous Transmission of Mycobacterium lepromatosis in the Pacific Northwestern United States. 美国西北太平洋地区麻风分枝杆菌可能的本地传播。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-21 DOI: 10.4269/ajtmh.26-0034

Gregory S Olson, Khalil J Deveaux, Jason D Simmons, Joshua A Lieberman

{"title":"Probable Autochthonous Transmission of Mycobacterium lepromatosis in the Pacific Northwestern United States.","authors":"Gregory S Olson, Khalil J Deveaux, Jason D Simmons, Joshua A Lieberman","doi":"10.4269/ajtmh.26-0034","DOIUrl":"https://doi.org/10.4269/ajtmh.26-0034","url":null,"abstract":"Mycobacterium lepromatosis (M. lepromatosis), first described in 2008 as another mycobacterial species that causes Hansen's disease, has mainly been reported in Mexico, Central America, and the southern United States; however, its disease spectrum and distribution remain unclear. A diagnostically challenging case that represents a likely autochthonous M. lepromatosis acquisition in the United States is reported in the present study. A 75-year-old immunocompetent man who had not traveled outside the Pacific Northwest developed an erythematous, ulcerating left thigh plaque, followed by three proximal sporotrichoid nodules. Biopsies revealed granulomatous inflammation with negative acid-fast stain results. Broad-range nontuberculous mycobacterial polymerase chain reaction testing identified M. lepromatosis in the sentinel ulcer and possible Mycobacteroides chelonae coinfection in the proximal nodule. The patient improved with multidrug therapy. Clinicians in the United States should keep Hansen's disease in the differential diagnosis, even for patients without international travel. Additional research is needed to clarify the phenotypic spectrum and geographic distribution of this pathogen.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760031","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

Knowledge, Attitudes, and Practices on Leishmaniasis among Healthcare Professionals at Three Tertiary Hospitals in Bhutan: A Cross-Sectional Study. 不丹三所三级医院医疗保健专业人员对利什曼病的知识、态度和做法：一项横断面研究。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-21 DOI: 10.4269/ajtmh.25-0723

Thinley Dorji, Monu Tamang, Kinley Choki, Sangay Tenzin, Choki Dolkar, Ugyen Zangpo

{"title":"Knowledge, Attitudes, and Practices on Leishmaniasis among Healthcare Professionals at Three Tertiary Hospitals in Bhutan: A Cross-Sectional Study.","authors":"Thinley Dorji, Monu Tamang, Kinley Choki, Sangay Tenzin, Choki Dolkar, Ugyen Zangpo","doi":"10.4269/ajtmh.25-0723","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0723","url":null,"abstract":"Bhutan continues to report sporadic cases of various forms of leishmaniasis and has yet to receive elimination certification for visceral leishmaniasis. In the present study, the knowledge, attitudes, and practices regarding leishmaniasis among healthcare professionals were assessed in tertiary care hospitals in Bhutan. This was a cross-sectional study conducted among healthcare professionals at referral hospitals. The knowledge questions were scored with one point awarded for each correct response. A cumulative score of ≥70% was categorized as good knowledge. There were 343 participants in total, 59 (17.0%) of whom had managed leishmaniasis in their careers. Thirty (6.0%) knew the forms of leishmaniasis reported in Bhutan, 197 (58.2%) knew the case definition, 199 (55.6%) knew the screening test for visceral leishmaniasis, and 192 (54.3%) knew the confirmatory test. A total of 151 (38.8%) participants knew the first-line oral treatment for leishmaniasis. The median knowledge score was 6 of 20 (interquartile range: 5-8). A total of 60 (13.8%) participants had good knowledge. Participants who had read the national guidelines (adjusted odds ratio: 8.04; 95% CI: 2.95-21.86; P <0.001) had higher odds of demonstrating good knowledge. A total of 47 (13.0%) participants reported offering the rK39 test in the past 12 months. The majority demonstrated a willingness to learn and engage in health advocacy, prevention, and control activities. The majority lacked adequate knowledge on the forms of leishmaniasis, screening and diagnostic tests, drugs for management, and case follow-up. The number of screening tests offered to patients was low. The majority of participants were willing to engage in continuing medical education, advocacy, and health education sessions.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760038","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

Burden of Dengue in Pregnant Individuals: A Systematic Literature Review. 孕妇登革热负担：系统文献综述

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-21 DOI: 10.4269/ajtmh.25-0311

Rada Rusu, Anna Durbin, Isabella Clements, Hannah Frost, Danielle Mariner-Goff, Katherine Massey, Molly Murton, Shirley V Sylvester

{"title":"Burden of Dengue in Pregnant Individuals: A Systematic Literature Review.","authors":"Rada Rusu, Anna Durbin, Isabella Clements, Hannah Frost, Danielle Mariner-Goff, Katherine Massey, Molly Murton, Shirley V Sylvester","doi":"10.4269/ajtmh.25-0311","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0311","url":null,"abstract":"Many infectious diseases are known to have increased severity among pregnant people, yet limited data exist on the burden of dengue in this population. This systematic review collated studies conducted from 2010 onward to capture epidemiological data and a variety of pregnancy outcomes of those infected with dengue during gestation. Among the 23 included publications, dengue infections in pregnant individuals were most frequently contracted in the third trimester. Dengue-infected mothers appear to be associated with a higher risk of maternal mortality (0-21.7%), pregnancy loss (0-11.6%), and preterm birth (4.3-37.5%) compared with healthy mothers. However, heterogeneity of data, missing quantitative comparisons of outcomes in dengue-positive and dengue-negative pregnant people, and lack of standardization of study methods and measurement emphasize an evidence gap. As dengue infections continue to rise and transmission boundaries expand, it is imperative to include pregnant people in dengue studies, surveillance, and public health measures.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759874","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

Identification of Mycobacterium leprae and Mycobacterium lepromatosis Cases with Broad-Range Molecular Assays at a Single Large Reference Laboratory. 在单一大型参比实验室用广谱分子测定法鉴定麻风分枝杆菌和麻风分枝杆菌病病例。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-21 DOI: 10.4269/ajtmh.25-0379

Gregory S Olson, Khalil Deveaux, Diana Chiller, Dhruba SenGupta, Brad T Cookson, Jason D Simmons, Joshua A Lieberman

{"title":"Identification of Mycobacterium leprae and Mycobacterium lepromatosis Cases with Broad-Range Molecular Assays at a Single Large Reference Laboratory.","authors":"Gregory S Olson, Khalil Deveaux, Diana Chiller, Dhruba SenGupta, Brad T Cookson, Jason D Simmons, Joshua A Lieberman","doi":"10.4269/ajtmh.25-0379","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0379","url":null,"abstract":"Definitively diagnosing Hansen's disease (HD) is challenging, but molecular methods can provide species identification of the causative mycobacteria (Mycobacterium leprae and Mycobacterium lepromatosis). Most studies have investigated targeted assays, and the performance of broad-range molecular approaches remains unknown. This study evaluated a multilocus (hsp65, 16S ribosomal RNA, and rpoB) broad-range polymerase chain reaction (PCR) assay in detecting HD-associated mycobacteria at a single large reference laboratory in the United States from 2009 to 2024. We identified 148 positive samples from 137 patients submitted from 26 states. Mycobacterium lepromatosis was identified in 8 of 137 patients (5.8%), and M. leprae was identified in the rest. Although most samples were skin biopsies (∼90%), 10 samples (7.9%) represented atypical locations, including bone marrow and liver. Half of all samples were identified by only a single target (n = 72/146 samples, 49.3%), and rpoB was the most likely to be positive (n = 123/146 samples, 84.2%). Overall, broad-range PCR successfully identified HD-associated mycobacteria, including M. lepromatosis, from skin and atypical anatomic sites, and it should be considered more frequently in the evaluation of suspected cases.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759936","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

Pervasive Intestinal Carriage with Multiple Species of Extended-Spectrum Cephalosporin-Resistant Enterobacterales in Children Admitted for Severe Acute Malnutrition at a Tertiary Hospital in Malawi. 马拉维一家三级医院收治的严重急性营养不良儿童中普遍存在多种广谱头孢菌素耐药肠杆菌的肠道运输

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-16 DOI: 10.4269/ajtmh.25-0724

Thomas Holowka, Arrington Ashford, Trieu-Vi Khuu, Alisher Bimagambetov, Courtney N Dial, Alexander Kondwani, Amazing-Grace Tepeka, Kevin Alby, Jonathan J Juliano, Anthony J Garcia-Prats, Tisungane Mvalo, Bryan J Vonasek, Emily J Ciccone, Luther A Bartelt

{"title":"Pervasive Intestinal Carriage with Multiple Species of Extended-Spectrum Cephalosporin-Resistant Enterobacterales in Children Admitted for Severe Acute Malnutrition at a Tertiary Hospital in Malawi.","authors":"Thomas Holowka, Arrington Ashford, Trieu-Vi Khuu, Alisher Bimagambetov, Courtney N Dial, Alexander Kondwani, Amazing-Grace Tepeka, Kevin Alby, Jonathan J Juliano, Anthony J Garcia-Prats, Tisungane Mvalo, Bryan J Vonasek, Emily J Ciccone, Luther A Bartelt","doi":"10.4269/ajtmh.25-0724","DOIUrl":"10.4269/ajtmh.25-0724","url":null,"abstract":"Malnutrition is a leading risk factor for community-derived Enterobacterales bacteremia, which has a high rate of mortality in children in sub-Saharan Africa (SSA). International guidelines recommend the use of antibiotics, such as amoxicillin, for children with uncomplicated severe acute malnutrition (SAM), as well as parenteral broad-spectrum antibiotics, such as cephalosporins, for children with SAM who are admitted to the hospital. However, rising rates of infection with extended-spectrum cephalosporin-resistant Enterobacterales (ESCR-E) in SSA call this practice into question. To determine ESCR-E colonization rates, culture-based screening was performed on stool specimens collected from a cohort of children admitted to a hospital in Lilongwe, Malawi, for SAM. Of 188 individuals screened, 80.3% were positive for ESCR-E colonization, and 38.3% were colonized with multiple ESCR-E species. These findings reveal that high rates of ESCR-E colonization exist in some populations of malnourished children in SSA, and guideline-directed empiric antibiotic treatment may need to be reevaluated in this setting.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697286","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

Genomic Characterization of a Locally Transmitted Leishmania mexicana Isolate from Texas. 德克萨斯州本地传播的墨西哥利什曼原虫分离株的基因组特征。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-16 DOI: 10.4269/ajtmh.25-0744

Juan David Ramírez, Luz H Patiño, Binita Nepal, Sarah M Gunter, Eva H Clark, Dawn M Wetzel

{"title":"Genomic Characterization of a Locally Transmitted Leishmania mexicana Isolate from Texas.","authors":"Juan David Ramírez, Luz H Patiño, Binita Nepal, Sarah M Gunter, Eva H Clark, Dawn M Wetzel","doi":"10.4269/ajtmh.25-0744","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0744","url":null,"abstract":"Cutaneous leishmaniasis, which is caused by Leishmania species transmitted by sandflies, is increasingly recognized in subtropical, higher-resource regions, including the southern United States. The first whole-genome sequence of Leishmania mexicana (L. mexicana) is reported from an autochthonous US case in a 3-year-old boy from Ellis County, Texas, with no travel history. Genomic DNA was sequenced using Illumina (San Diego, CA) technology. Phylogenomic analysis of nuclear and mitochondrial single-nucleotide polymorphisms (SNPs) confirmed the isolate as L. mexicana, clustering within the L. mexicana complex. The parasite displayed a predominantly disomic karyotype, with chromosome 30 exhibiting trisomy. A total of 172 genes were identified, with notable copy number variation and 9,920 SNPs unique to this genome, highlighting substantial genetic diversity. These variants affected genes involved in host-pathogen interactions, metabolism, and signaling. Overall, this study emphasizes the need for molecular surveillance in regions where competent sandfly vectors are present.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697342","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

Rassi Score for Secondary Prevention of Sudden Cardiac Death in Chagas Heart Disease. 查加斯心脏病心源性猝死二级预防的Rassi评分。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-16 DOI: 10.4269/ajtmh.26-0215

Henrique Horta Veloso, Alejandro Marcel Hasslocher-Moreno, Roberto Magalhães Saraiva

引用次数: 0

Nocardia asiatica Lymphadenitis in a Lung Transplant Recipient Following Travel. 旅行后肺移植受者的亚洲诺卡菌淋巴结炎。

IF 1.6 4区医学

American Journal of Tropical Medicine and Hygiene Pub Date : 2026-04-16 DOI: 10.4269/ajtmh.25-0374

Rafael Rocha, Leonardo Araújo-Andrade, Carlos Gonçalves, Diogo Silva, Filipa Ceia, Lurdes Santos

{"title":"Nocardia asiatica Lymphadenitis in a Lung Transplant Recipient Following Travel.","authors":"Rafael Rocha, Leonardo Araújo-Andrade, Carlos Gonçalves, Diogo Silva, Filipa Ceia, Lurdes Santos","doi":"10.4269/ajtmh.25-0374","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0374","url":null,"abstract":"We report a case of lymphocutaneous nocardiosis in a 73-year-old male lung transplant recipient after traumatic soil exposure abroad. The patient traveled from Portugal to Brazil to undergo lung transplantation and, 3 months later, while receiving immunosuppressive therapy (with prednisolone, mycophenolate mofetil, and tacrolimus), sustained a nasal laceration after a fall onto soil-contaminated ground in Brazil. A persistent ulcerated facial lesion subsequently developed and was initially misdiagnosed as sporotrichosis, leading to treatment with itraconazole. Despite partial improvement, the patient later developed progressive bilateral parotid and submandibular lymphadenopathy. After returning to Portugal, imaging revealed necrotic cervical lymph nodes. Fine-needle aspiration specimens tested positive for Nocardia spp. by polymerase chain reaction, and Nocardia asiatica was isolated and identified by MALDI-TOF and 16S rRNA sequencing. Pulmonary and central nervous system involvement were excluded. Antifungal therapy was discontinued and trimethoprim-sulfamethoxazole initiated, resulting in progressive clinical improvement. This case underscores the importance of considering nocardiosis in transplant recipients with cutaneous lesions and lymphadenopathy after soil exposure, particularly in settings where other endemic infections may bias initial diagnostic assumptions, and emphasizes the importance of microbiological confirmation.","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697345","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