American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Diagnostic Caveats and Clinical Pitfalls in the Overlap of Leprosy and Para-Kala-Azar Dermal Leishmaniasis.","authors":"Rishikesh Kumar, Devendra Prasad Yadav, Sanjay Kumar Chaturvedi, Krishna Pandey","doi":"10.4269/ajtmh.26-0451","DOIUrl":"10.4269/ajtmh.26-0451","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"878-879"},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787127","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":"Severe Disseminated Melioidosis with Pulmonary, Cutaneous, and Osteoarticular Involvement in the Peruvian Amazon.","authors":"Mario Agramonte-Vilca, Stefany Alvis-Sanchez, Debora Rocio Mananita-Terrones, Washington Ortiz-Uribe, Ricardo Muñante-Meneses","doi":"10.4269/ajtmh.26-0185","DOIUrl":"10.4269/ajtmh.26-0185","url":null,"abstract":"<p><p>Melioidosis is a potentially fatal tropical infection caused by Burkholderia pseudomallei. Although well described in Southeast Asia and northern Australia, its burden in South America remains poorly characterized and likely underestimated. A case of severe disseminated melioidosis in a 35-year-old man with poorly controlled diabetes mellitus residing in the Peruvian Amazon is reported here. The patient presented multifocal pneumonia, bacteremia, and septic shock requiring mechanical ventilation and vasopressor support. During hospitalization, he developed cutaneous microabscesses and septic arthritis of the left knee. Burkholderia pseudomallei was isolated from both blood cultures and synovial fluid, confirming hematogenous dissemination. This case highlights the presence of severe melioidosis in the Peruvian Amazon and underscores the need to consider this pathogen in patients presenting with severe sepsis in tropical regions with high environmental exposure and metabolic risk factors. Strengthening microbiological diagnostic capacity is essential to improve detection of this emerging infection in South America.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"734-737"},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787066","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":"Comparison of Three Polymerase Chain Reaction Protocols for the Diagnosis of Leprosy in Ecuador.","authors":"Greta Franco-Sotomayor, Elsy Carvajal, Heidy Juleisy Buenaño Morales, Solon Alberto Orlando, Jose Julian Zúñiga Velarde, Andres Barragan Peña, Ángel Sebastián Rodriguez-Pazmiño, Darwin Paredes-Núñez, Greta Cardenas Franco, Manuel Calvopiña, Miguel Angel Garcia-Bereguiain","doi":"10.4269/ajtmh.26-0175","DOIUrl":"10.4269/ajtmh.26-0175","url":null,"abstract":"<p><p>Leprosy or Hansen's disease remains a public health concern in Ecuador, where diagnosis still relies on clinical evaluation and bacilloscopy. This pilot study evaluated the performance of three polymerase chain reaction (PCR) protocols for detection of Mycobacterium leprae in 31 clinical specimens from patients clinically suspected of leprosy. Two real-time PCR assays (quantitative polymerase chain reaction [qPCR]) and one conventional PCR were compared with bacilloscopy. The two qPCR assays showed identical positivity rates of 32.3% (n = 10/31), whereas the conventional PCR detected only 3.2% (n = 1/31) positives. Overall, PCR positivity was 38.7% (n = 12/31) compared with 25.8% (n = 8/31) for bacilloscopy. The combined reference standard (considering a sample true positive when either bacilloscopy or PCR was positive) diagnosed 45.2% (n = 14/31) of samples as positive. A significant lower sensitivity was observed for conventional PCR compared with qPCR. These findings support the use of qPCR together with bacilloscopy to improve leprosy diagnosis in Ecuador.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"758-761"},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787082","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":"Clinical Practices in the Diagnosis and Treatment of Enterobiasis: A Retrospective Analysis.","authors":"Madeline Fleit, Edward Mitre, Jamie Fraser, Patrick W Hickey","doi":"10.4269/ajtmh.25-0352","DOIUrl":"10.4269/ajtmh.25-0352","url":null,"abstract":"<p><p>Enterobius vermicularis is the most common nematode infection in the United States. Despite this prevalence, few studies have evaluated current clinical practices with regard to diagnosis and management. Price increases in anthelmintics in the United States add a component of cost-conscious care to treatment selection. We conducted a retrospective analysis of 200 patients in the Military Health System with an International Classification of Diseases code diagnosis of enterobiasis from 2011 to 2018. A clinical diagnosis was made in 70.0% of symptomatic patients. A pinworm paddle or cellophane adhesive was ordered in 12.7% of symptomatic cases, with a positivity rate of 41.2%. Diagnostic studies ineffective for the diagnosis of enterobiasis were ordered in 12.0% of symptomatic cases, with the most common being ova and parasite examinations of the stool (10.0%). The most common initial treatment of enterobiasis was albendazole (73.6%) followed by mebendazole (15.0%), pyrantel (10.9%), and ivermectin (0.5%). Empiric retreatment of patients after initial treatment and empiric treatment of household members were prescribed or recommended in 86.0% and 49.7% of cases, respectively. Counseling on decontamination measures to prevent reinfection was documented in 35.2% of cases. This study suggests that there are knowledge gaps in the optimal diagnostic approach to enterobiasis as well as the role of adjunctive measures to prevent a cycle of continuous reinfection, such as empiric retreatment, empiric treatment of household members, and counseling on decontamination measures. Additionally, the prominence of albendazole use relative to pyrantel pamoate represents an opportunity for cost-conscious care.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"827-832"},"PeriodicalIF":1.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787108","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":"Management of Generalized Adult Tetanus with Intermittent Intrathecal Baclofen Bolus: Overcoming Infrastructural Limitations in a Resource-Limited Setting.","authors":"Kashish Jindal, Chackappen Aymanom, Mukesh Bairwa, Ravi Kant, Akhilesh Kumar","doi":"10.4269/ajtmh.26-0220","DOIUrl":"10.4269/ajtmh.26-0220","url":null,"abstract":"<p><p>Generalized tetanus presents a formidable therapeutic challenge, especially when refractory to conventional management. Standard treatment involves toxin neutralization, muscle spasm control (sedation and magnesium sulfate), and supportive care. However, refractory cases often necessitate prolonged intensive care and risk secondary complications. Intrathecal baclofen (ITB), a gamma-aminobutyric acid type B agonist that reduces spinal hyperexcitability, is highly effective. Although continuous ITB infusion is the established gold standard, its implementation is often constrained in resource-limited environments due to high equipment and technical demands. We studied three patients with severe, conventional treatment-resistant generalized tetanus. A history of incomplete booster immunization among these patients leaves them vulnerable. Unable to use a continuous pump for ITB, we turned to intermittent bolus ITB injections as a pragmatic clinical strategy. Administered with meticulous caution, this bolus approach-often requiring repeat, titrated doses-proved successful in achieving promising control of the dangerous muscle spasms while monitoring closely for complications.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"741-744"},"PeriodicalIF":1.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757726","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":"Shewanella algae Necrotizing Fasciitis and Septic Shock after Elective Cosmetic Surgery: A Potential Emerging Infection.","authors":"Eryn Percenti, Rebecca Nowacki, Adam Fennell, Elora Friar, Anthony Cannella","doi":"10.4269/ajtmh.25-0747","DOIUrl":"10.4269/ajtmh.25-0747","url":null,"abstract":"<p><p>Shewanella is a Gram-negative bacillus found in marine environments throughout the world. Its role in human pathogenesis has mostly been described in patients with seawater exposures and immunocompromising conditions. We present a case of a previously healthy young woman who presented with fever and weakness 4 days after routine elective plastic surgery. Violaceous bullae were found from her bilateral breasts tracking down to her right thigh, corresponding to surgical sites. Despite linezolid and meropenem administration, the patient had hemodynamic instability, requiring intubation and vasopressor support. Necrotizing fasciitis was diagnosed and underwent emergent surgical debridement. Blood cultures grew Shewanella algae, with intraoperative cultures growing S. algae, Pseudomonas aeruginosa, and Candida parapsilosis. After 11 additional wound debridements and adjustment of antimicrobial therapy, her necrotizing fasciitis resolved; however, she was left with multiple deformities. Although the mechanism of acquisition of this infection is unclear, S. algae should be considered when treating necrotizing wound infections.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"738-740"},"PeriodicalIF":1.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758382","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":"Mentors Perspectives on Advancing Global Health Research through Better Mentorship.","authors":"Davidson H Hamer, Elizabeth Fine, Yemane Berhane, Claudia Hawkins, Joseph Makhema, Jacqui Miot, Sailesh Mohan, Aneesa Moolla, Mosa Moshabela, Candida Moshiro, Sikhulile Moyo, Robert L Murphy, Jonah Musa, Nisha Nadesan-Reddy, Thumbi Ndung'u, Folasade Ogunsola, Collins Ouma, Douglas J Perkins, Christopher R Sudfeld, Bruno Sunguya, Elvis K Tiburu, Nicola Wearne, Alemayehu Worku, Wafaie W Fawzi","doi":"10.4269/ajtmh.26-0182","DOIUrl":"10.4269/ajtmh.26-0182","url":null,"abstract":"<p><p>Effective mentorship is essential for advancing global health research, particularly in low- and middle-income countries (LMICs). This review synthesizes expert perspectives from a highly experienced group of global health research mentors. We identify the characteristics and core competencies of effective global health mentors, emphasizing adaptability, cultural competence, and equitable collaboration. Special attention is paid to addressing barriers faced by underrepresented groups in academia, highlighting the role of mentorship in career advancement and enhancing workforce diversity. We describe a variety of mentoring models, e.g., one-to-one, peer, group, and virtual, and mentoring tools and frameworks, evaluating their relevance to diverse global health contexts. This review emphasizes their potential for customization in LMICs and provides guidance for structuring effective mentor-mentee communication. Recognizing that sustainable impact extends beyond individual relationships, we present strategies for developing institutional mentorship programs, drawing on lessons from Ethiopia and Kenya. Key recommendations include capacity-building for mentors and mentees, institutional ownership of mentoring activities, mentor-mentee matching, accessible training, and regular evaluation linked to recognition and career advancement. The transition from structured mentorship to professional independence merits special consideration, including mechanisms for fostering ongoing collegiality and long-term career support. Our findings underscore the importance of structured, intentional mentorship for building research capacity, driving academic productivity, and advancing global health equity. We advocate for sustained investment by individuals and institutions, recommending adaptable mentorship frameworks and supportive cultures to foster emerging global health leaders. By institutionalizing best practices, global health research mentorship can contribute decisively to stronger health systems worldwide.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"683-693"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710931","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":"Fishnet Entrapment of Samar Cobras (Naja samarensis) in Rural Eastern Visayas: Rethinking Community-Level Snakebite Prevention in the Philippines.","authors":"John Raphael R Jimenea, Mikhaela Anne Therese A Bargamento, Chinelo M Cardaño, Ea Kristine Clarisse B Tulin, Yoshihiro Aoki","doi":"10.4269/ajtmh.26-0339","DOIUrl":"10.4269/ajtmh.26-0339","url":null,"abstract":"<p><p>Snakebite envenomation remains a substantial public health burden in the Philippines, particularly in the Eastern Visayas, where the Samar cobra (Naja samarensis) is endemic. In rural communities without trained snake handlers or formal relocation services, residents may install perimeter barriers against venomous snakes. We report three incidents of N. samarensis entrapment on a residential fishnet fence in Barangay Pangasugan, Baybay City, Leyte, between July 2025 and March 2026. All three snakes died of entanglement; no human envenomation occurred, in part because no resident attempted removal. The fishnet had been installed with the explicit intent of trapping, not merely deterring, snakes, a strategy carrying substantial risk of secondary envenomation. These observations reflect not resident negligence but a structural gap in community-level snakebite prevention. We argue for locally led snake rescuer training, structured education, environmental risk reduction, and improved antivenom positioning, integrated with the WHO 2030 snakebite roadmap.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"860-864"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711103","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":"Chronic Melioidosis Presenting with Pneumonia, Empyema, and Splenic Abscess.","authors":"Yamei Zheng, Xiaozhou Yao, Min Wang, Tian Xie","doi":"10.4269/ajtmh.26-0143","DOIUrl":"10.4269/ajtmh.26-0143","url":null,"abstract":"<p><p>Melioidosis is an emerging tropical infectious disease with diverse clinical manifestations and a high fatality rate. We report a rare case of chronic melioidosis manifesting as pulmonary infection, empyema, and splenic abscess. The patient presented with recurrent chest pain, cough, and abdominal discomfort for 11 months, initially misdiagnosed as common bacterial infection. Computed tomography imaging revealed pulmonary infection, left pleural effusion, and multiple abnormal low-density lesions in and around the spleen. Pleural effusion culture identified Burkholderia pseudomallei. Management included thoracic puncture and catheter drainage, an intensive phase of intravenous ceftazidime, followed by an eradication phase with oral trimethoprim/sulfamethoxazole. The patient showed clinical and radiological improvements. Clinicians should consider chronic melioidosis in patients with pneumonia and parapneumonic pleural effusion accompanied by splenic abscesses, particularly in patients with diabetes mellitus from endemic areas. Early recognition, definitive diagnosis, and tailored antimicrobial therapy are essential to prevent the progression of severe pneumonia and sepsis.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"729-733"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711168","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":"Giant Vietnamese Centipede Envenomation with Persistent Toxicologic Sequelae.","authors":"Varun Vohra, Sarah Hughson, Zach Schumm","doi":"10.4269/ajtmh.26-0328","DOIUrl":"10.4269/ajtmh.26-0328","url":null,"abstract":"<p><p>Centipedes are among the largest terrestrial arthropods. Modified walking appendages called forcipules are connected to venom glands and used for predation and defense. Centipede envenomations in humans are relatively rarely reported; however, they can produce clinically significant effects. Most clinical cases are attributed to the genus Scolopendra. Scolopendra dehaani (S. dehaani), the giant Vietnamese centipede, is the largest of the Asian centipedes. A paucity of clinical literature exists on envenomation by S. dehaani, originally considered a subspecies of Scolopendra subspinipes but now identified as an independent species. A 55-year-old man was envenomated on his left index finger by S. dehaani and reported excruciating pain with progressive erythema and edema. He required multiple doses of opioids and a parenteral antihistamine with gradual, yet incomplete, symptom improvement. The centipede was morphologically identified as S. dehaani. Three months post-envenomation, the patient reported residual numbness and swelling and a relatively limited range of motion in the affected finger.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":"856-859"},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711130","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}