J Glob Infect Dis
· 2022 · PMID 36636299
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Cryptococcosis is a serious systemic mycosis. Its incidence has escalated in the past four decades. causes localized or disseminated infection in immunocompromised and immunocompetent patients. The capsulated form is co...Cryptococcosis is a serious systemic mycosis. Its incidence has escalated in the past four decades. causes localized or disseminated infection in immunocompromised and immunocompetent patients. The capsulated form is commonly encountered which can be diagnosed on an India ink preparation or antigen detection. However, the noncapsulated forms are very rare and require a high index of suspicion for correct diagnosis. Herein, we present a case of cryptococcal meningitis due to a noncapsulated strain in an apparently immunocompetent patient with no proven immunodeficiencies along with review of world literature. Such cases are a diagnostic challenge for the clinician as well as microbiologist.
J Glob Infect Dis
· 2022 · PMID 36636298
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Purpura fulminans (PF) is associated with acute infections such as meningococcal, staphylococcal, streptococcal, and rickettsial infections. However, there are only a few reports of association of PF with rickettsial fev...Purpura fulminans (PF) is associated with acute infections such as meningococcal, staphylococcal, streptococcal, and rickettsial infections. However, there are only a few reports of association of PF with rickettsial fever from India. In this case series of seven adults with PF, four were definitive cases of spotted fever as the ompA real-time polymerase chain reaction was positive. The other three adults were probable cases of spotted fever, as they were positive by immunoglobulin M enzyme-linked immunosorbent assay, and their fever subsided within 72 h of rickettsia-specific therapy. Three of the seven patients had peripheral gangrene. These patients, despite presenting with severe spotted fever, had a favorable outcome. This is attributed to the high index of suspicion and early treatment supported by diagnostic assays.
Plotnikova MA, Klotchenko SA, Lozhkov AA
… +7 more, Lebedev KI, Taraskin AS, Baranovskaya IL, Egorova MA, Ramsay ES, Chebotkevich VN, Vasin AV
J Glob Infect Dis
· 2022 · PMID 36636297
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INTRODUCTION: Respiratory infections, collectively, are one of the World's most common and serious illness groups. As recent observations have shown, the most severe courses of acute respiratory infection, often leading...INTRODUCTION: Respiratory infections, collectively, are one of the World's most common and serious illness groups. As recent observations have shown, the most severe courses of acute respiratory infection, often leading to death, are due to uncontrolled cytokine production (hypercytokinemia). METHODS: The study involved 364 patients with respiratory illness being treated in clinics in St. Petersburg (Russia) in 2018-2019 and 30 healthy controls. Cytokine analysis was carried out in the acute phase of illness (2-3 days from onset of initial symptoms) and in the stage of recovery (days 9-10). The research presented is devoted to the assessment of mRNA expression of specific cytokines (interleukin [IL]-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, tumor necrosis factor-α [TNF-α], and interferon-λ) and MxA in whole blood leukocytes, by means of real-time polymerase chain reaction. RESULTS: In 70% of patients, bacterial or viral pathogens were identified, with influenza viral infections (types A and B) prevailing. Significant increases in the expression of IL-18, TNF, and IL-10 were observed, relative to controls, only with influenza viral infections. We have shown a difference in IL-6 mRNA expression in patients with bacterial or viral pathogens. No statistically significant difference was found in white blood cells IL-4 expression levels between patients and healthy controls. CONCLUSION: Investigation of the nuances of systemic cytokine production, in response to specific viral and bacterial pathogens, makes it possible to assess the risks of developing hypercytokinemia during respiratory infection with agents circulating in the human population and to predict the pathogenicity and virulence of circulating threats.
Amaike C, Afolaranmi TO, Amaike BA
… +2 more, Agbo HA, Abiodun O
J Glob Infect Dis
· 2022 · PMID 36237570
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INTRODUCTION: Among people living with HIV (PLHIV), fertility desire which is the desire to have more children is increasing due to the improvement in quality of life and survival resulting from anti-retroviral treatment...INTRODUCTION: Among people living with HIV (PLHIV), fertility desire which is the desire to have more children is increasing due to the improvement in quality of life and survival resulting from anti-retroviral treatment and also improved sexual and reproductive health services. Fertility desires can result in increased risk of HIV transmission, especially in unprotected heterosexual intercourse. There is limited information regarding the fertility desires and predictors among PLHIV in our environment. METHODS: This study was aimed at assessing the fertility desires and predictors in PLHIV in Northcentral Nigeria. Study was descriptive cross-sectional. Semi-structured interviewer administered pretested questionnaires was used to get information from 170 PLHIV accessing care in a secondary health-care facility selected by the systematic sampling technique. Data were analyzed using the SPSS software version 23.0. At 95% confidence interval (CI), a < 0.05 was considered to be statistically significant. Chi-square and logistic regression. RESULTS: Fertility desire was found among 64.1% of the respondents. Younger age (odds ratio [OR] = 0.2270; 95% CI = 0.0662-0.7791, = 0.0184), having no child or a smaller number of children (OR = 0.0432; CI = 0.0046-0.4050; = 0.0059) and suppressed viral loads (OR = 4.1069; CI = 1.1650-14.4784; = 0.0280) were the predictors for fertility desire. CONCLUSION: This study showed that PLHIV had high fertility desires but do not know any safe method of conception, hence intensified effort should be made by primary care providers and other health-care workers to include sexual and reproductive health counselling during routine HIV clinic visits to enable PLHIV make informed decision about their fertility desires.
J Glob Infect Dis
· 2022 · PMID 36237568
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INTRODUCTION: Tuberculosis (TB) remains a deadliest infectious disease. Lack of rapid test with low cost is one of the important challenges to eradicate the TB. The objective of the study was to analyze the laboratory co...INTRODUCTION: Tuberculosis (TB) remains a deadliest infectious disease. Lack of rapid test with low cost is one of the important challenges to eradicate the TB. The objective of the study was to analyze the laboratory costs of conventional and newer molecular tests, for diagnosis of presumptive multidrug-resistant TB (MDR-TB) patients. METHODS: A detailed laboratory cost of various conventional tests (Ziehl - Neelsen [ZN] microscopy, light-emitting diode-fluorescent microscopy [LED-FM], culture and drug susceptibility testing [DST] using solid Lowenstein-Jensen media and liquid media [BACTEC MGIT 960]) was compared with rapid methods (GenoType MTBDR line probe assay [LPA] and GeneXpert MTB/RIF assay). Laboratory cost was also calculated in terms of cost per TB and MDR-TB case detected by using different diagnostic scenarios. RESULTS: Cost per test for ZN microscopy, LED-FM, LPA, GeneXpert MTB/RIF assay, solid culture plus DST, liquid culture plus DST was found as $2.5 (INR 156.8), $2.0 (INR128.9), $18.6 (INR1210), $13.8 (INR 895.2), $21.5 (INR 1396.6), and $29.1 (INR 1888.2), respectively. The laboratory cost for detecting TB and MDR-TB by diagnostic scenarios involving molecular DST was found to be less as compared to involving only conventional liquid culture-based test. CONCLUSIONS: The implementation of rapid molecular tests with selective use of liquid culture-based DST may be less in cost as compared to the use of culture-based DST alone, at high burden reference TB laboratory.
Alfadhli A, Alboraie M, Afifi M
… +1 more, Dangi A
J Glob Infect Dis
· 2022 · PMID 36237565
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INTRODUCTION: -induced chronic infection is associated with peptic ulcer, chronic gastritis, gastric cancer, and increasing antibiotic resistance. We aimed to evaluate the efficacy of clarithromycin-based triple therapy...INTRODUCTION: -induced chronic infection is associated with peptic ulcer, chronic gastritis, gastric cancer, and increasing antibiotic resistance. We aimed to evaluate the efficacy of clarithromycin-based triple therapy and non-bismuth based quadruple therapy for eradicating in patients with chronic gastritis in Kuwait. METHODS: We enrolled a total of 603 treatment-naive dyspeptic patients with gastric biopsy-proven chronic gastritis secondary to in a prospective, open-label, randomized study. Patients were randomized into two groups: a group received the standard triple therapy (omeprazole, amoxicillin, and clarithromycin) for 14 days and a group received quadruple therapy (omeprazole, amoxicillin, clarithromycin, and metronidazole) for 14 days. All patients were tested for the eradication of by carbon-13 urea breath test 1 month after eradication therapy. RESULTS: The overall eradication rate was 63.2%. The eradication rates in intention-to-treat (ITT) and per protocol (PP) population were 58.4% and 64.6%, respectively, in triple therapy group. In the quadruple therapy group, the eradication rates in ITT and PP population were 68.0% and 78.5%, respectively, with a statistically significant higher eradication rate in patients treated by quadruple therapy than the triple therapy ( < 0.01). Multivariate logistic regression analysis revealed that treatment regimen was the only significant predictor for successful eradication. The most common adverse events were abnormal taste, headache, dizziness, and abdominal pain. CONCLUSION: Non-bismuth based quadruple therapy is more effective than standard clarithromycin-based triple therapy for eradicating in patients with chronic gastritis.ClinicalTrials.gov Identifier: NCT04617613.
Samad SA, Jethani J, Kumar L
… +3 more, Choudhary A, Brijwal M, Dar L
J Glob Infect Dis
· 2022 · PMID 36237564
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INTRODUCTION: Respiratory syncytial virus (RSV) is a common cause of morbidity among hematopoietic stem cell transplant (HSCT) recipients, with RSV-associated lower respiratory tract infection carrying high mortality rat...INTRODUCTION: Respiratory syncytial virus (RSV) is a common cause of morbidity among hematopoietic stem cell transplant (HSCT) recipients, with RSV-associated lower respiratory tract infection carrying high mortality rates. There have been no large studies till date, describing the incidence, clinical features, and outcomes of RSV infection among adult HSCT recipients in India. METHODS: A prospective cohort of 100 adults who underwent HSCT was followed up for a maximum period of 18 months starting from the date of transplantation for any episode of respiratory tract infectious disease (RTID). Respiratory samples were collected for laboratory confirmation of the presence and subtyping of RSV by real-time reverse transcriptase-polymerase chain reaction. RESULTS: The study population comprised of 66% (66/100) males and 34% (34/100) females. Autologous HSCT recipients constituted 78% (78/100) and allogeneic HSCT recipients constituted 22% (22/100) of the study population. The incidence of RSV-RTID among adults after HSCT was 0.82/100 patient months. Most cases occurred during the winter season and the predominant subtype was RSV-A (9/11, 81.8%). Lower RTID was the most common clinical diagnosis made at presentation (9/11, 81.8%). Female gender was predictive of RSV-RTID (log rank = 0.002). All the RSV-RTID episodes recovered completely without targeted therapy. CONCLUSION: RSV is a significant cause of morbidity among adult HSCT recipients in India. Prophylaxis and treatment measures need to be instituted after a proper risk-benefit assessment. Longitudinal studies with larger sample sizes are needed to confirm these results.
J Glob Infect Dis
· 2022 · PMID 36237562
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A 52-year-old woman presented with a tender swelling in the right axilla, fever, a headache, nausea, and general weakness. On examination, she was found to have lymphangitis on the right arm and red papules on the 1 and...A 52-year-old woman presented with a tender swelling in the right axilla, fever, a headache, nausea, and general weakness. On examination, she was found to have lymphangitis on the right arm and red papules on the 1 and 2 fingers of the right hand. She had had prepared wild rabbit stew 5 days before disease onset. Serology and an ultrasound of the right axilla confirmed the diagnosis of ulceroglandular tularemia. The lymphadenitis did not resolve after streptomycin treatment so an incision was made and 30 cc of purulent fluid drained. Over the course of the next 3 months, the fluid continued to drain. A radiographic fistulography was performed and it revealed a short main channel with a few long channels of varying caliber branching out from it, all terminating in a conglomerate of necrotic axillary lymph nodes. The lesions healed spontaneously and completely over the following 12 months without additional antibiotic therapy. Radiographic fistulography can help plot the course of the fistula/fistulas and demonstrate the anatomic features of the lesion in resource poor settings.
Psonis JJ, Michelen Y, Banerjee K
… +2 more, Fries BC, Sae-Tia S
J Glob Infect Dis
· 2022 · PMID 36237561
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Hypervirulent (hv) is a common cause of pyogenic liver abscesses in Asia but is quite uncommon in North America. Among the cases described in North America, only occasional reports have described molecular strain typing...Hypervirulent (hv) is a common cause of pyogenic liver abscesses in Asia but is quite uncommon in North America. Among the cases described in North America, only occasional reports have described molecular strain typing to confirm the K1 strain as the causative agent. We report a 56-year-old Hispanic female with no previous intra-abdominal pathology and no recent travel, who presented with subacute abdominal pain and developed bacteremia and monomicrobial pyogenic liver abscess due to a community-acquired K1 serotype isolate. In this case, the infection was recognized early, so the patient was successfully treated with percutaneous drainage and prolonged antibiotic therapy. Hv can cause severe invasive disease with high morbidity and mortality, and the recent emergence of multidrug resistance in these strains poses a serious threat to public health. In addition, the isolation of a K1 strain from a cryptogenic liver abscess in a Hispanic patient with no epidemiologic risk factors raises concern for a wider spread of the hypervirulent strain beyond Asian populations. Therefore, a high index of suspicion for hv infection in the Hispanic population can be crucial as the hypervirulent strain is likely to cause severe metastatic infection with significant morbidity and mortality.
Kar M, Dubey A, Patel SS
… +3 more, Siddiqui T, Ghoshal U, Sahu C
J Glob Infect Dis
· 2022 · PMID 35910826
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INTRODUCTION: Infections associated with catheter in the upper urinary tract (CUUT), which include the double-J stent and the percutaneous nephrostomy (PCN) tube, get particularly infected in patients with specific risk...INTRODUCTION: Infections associated with catheter in the upper urinary tract (CUUT), which include the double-J stent and the percutaneous nephrostomy (PCN) tube, get particularly infected in patients with specific risk factors for developing an infection. METHODS: A retrospective observational study was carried out by compiling data from the hospital information system of a tertiary care center from 2019 to 2021 to evaluate infections in patients with catheter in the upper urinary tract. RESULT: A total of 200 pus samples of double-J stent (96 pus samples) and PCN tube (104 pus samples) were included in our study. Among patients with nephrostomy tube, the most frequently isolated microorganisms were , followed by spp. In those with a double-J stent, , followed by were the most commonly isolated microorganisms. We found 55.72% of cases of -producing carbapenemases in patients with a percutaneous catheter. 66.07% of in patients with double-J and nephrostomy stents are extended-spectrum beta-lactamase-producing bacteria. The percentage of cultures with multiple-drug resistance (MDR) microorganisms was 38.54% in patients with double-J stents and 37.75% in nephrostomy tubes. The presence of prior urinary tract infection ( = 0.010), presence of urinary catheter before admission ( = 0.005), increased time with single urinary catheter ( < 0.001), and increased length of hospital stay ( = 0.036) were risk factors for isolation of MDR microorganisms. CONCLUSION: spp. and are commonly infecting both the CUUT. infections are more commonly infecting the nephrostomy tubes. MDR microorganisms are frequent, mainly in patients with prior urinary tract infection, presence of urinary catheter before admission, and prolonged use of a single catheter.
J Glob Infect Dis
· 2022 · PMID 35910825
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has been rarely mentioned as a causative organism of thoracic empyema in previous literature. Here, we reported two cases (a 66-year-old male farmer and a 57-year-old male security guard) presenting with fever and pleuri...has been rarely mentioned as a causative organism of thoracic empyema in previous literature. Here, we reported two cases (a 66-year-old male farmer and a 57-year-old male security guard) presenting with fever and pleuritic chest pain. Their chest computed tomography scans revealed pleural effusion which was frank pus confirmed through thoracentesis. The result of pus culture isolated suitable to diagnose melioidosis. These patients were treated successfully with appropriate antibiotics without chest tube drainage. Although uncommon, melioidosis could present exclusively as thoracic empyema.
J Glob Infect Dis
· 2022 · PMID 35910824
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INTRODUCTION: is an anaerobic bacillus whose main target is the erythrocyte. This bacterium transmitted by the body louse notably infected the soldiers of the First World War from where the name of this disease: fever o...INTRODUCTION: is an anaerobic bacillus whose main target is the erythrocyte. This bacterium transmitted by the body louse notably infected the soldiers of the First World War from where the name of this disease: fever of the trenches. The 90s marked the return of this bacterial infection. infection in the homeless was reported in the literature with a high incidence in these populations worldwide. This upsurge of cases justified this study for a better understanding of infections. METHODS: We conducted a systematic review to evaluate the seroprevalence of infection by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to collect scientific papers from PubMed and Google Scholar based on combining keywords. RESULTS: The review included 45 articles published from April 1996 to March 2020 with 84 subpopulations of 21 countries from 4 continents; among them, 61 subpopulations had a positive rate from 0.2% to 65%. These subpopulations were divided into four main groups: homeless people, healthy people, blood donors, and symptoms/diseases. Homeless people were the main target of this infection, and three factors related to susceptibility were homeless period, age, and alcoholism. 6/11, 12/20, and 32/41 subpopulations of healthy people, blood donors, symptoms/diseases, respectively, had a positive percentage. However, factors of exposure in these three groups were not mentioned. Other reservoirs, vectors, and transmitted routes were identified to partially explain the worldwide spread of the infection, and it is important to have more further investigations to identify potential risk factors. This will help to limit contamination and prevent effectively. CONCLUSIONS: This serological overview indicated the importance of infection that has emerged in multiple regions, touched worldwide populations.