Pub Date : 2026-01-08DOI: 10.1016/j.jiph.2025.103102
Akela Ghazawi , Ashrat Manzoor , Maryam AlAzri , Noura AlNuaimi , Ahmed Al Hammadi , Mushtaq Khan
{"title":"COMPREHENSIVE GENOMIC ANALYSIS OF VANCOMYCIN- AND DAPTOMYCIN-RESISTANT ENTEROCOCCUS FAECIUM BACTEREMIA IN A HIGH-RISK PATIENT","authors":"Akela Ghazawi , Ashrat Manzoor , Maryam AlAzri , Noura AlNuaimi , Ahmed Al Hammadi , Mushtaq Khan","doi":"10.1016/j.jiph.2025.103102","DOIUrl":"10.1016/j.jiph.2025.103102","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103102"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jiph.2025.103094
Al Marzooq F , Al Ali N , Ahmed Y , Akhter I , Jog S , Nabi A , Ayoub Moubareck C
{"title":"ANALYSIS OF THE RESISTOME OF MULTI-DRUG RESISTANT GRAM-NEGATIVE PATHOGENS ISOLATED FROM PATIENTS WITH BACTERIAL PNEUMONIA","authors":"Al Marzooq F , Al Ali N , Ahmed Y , Akhter I , Jog S , Nabi A , Ayoub Moubareck C","doi":"10.1016/j.jiph.2025.103094","DOIUrl":"10.1016/j.jiph.2025.103094","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103094"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jiph.2025.103101
Madhan Sugumar , Sujatha Sistla , Meerabai Manoharan , Sree Ramchandra Murthy , Kamini Walia , ICMR AMR Study Group
{"title":"MECHANISMS OF LINEZOLID NON-SUSCEPTIBILITY AMONG ENTEROCOCCUS FAECIUM ISOLATES FROM MULTIPLETERTIARY CARE CENTERS IN INDIA","authors":"Madhan Sugumar , Sujatha Sistla , Meerabai Manoharan , Sree Ramchandra Murthy , Kamini Walia , ICMR AMR Study Group","doi":"10.1016/j.jiph.2025.103101","DOIUrl":"10.1016/j.jiph.2025.103101","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103101"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jiph.2025.103099
Amna Ahmad , Muhammad I. Nasar , Farah Al-Marzooq
{"title":"INVESTIGATION OF CRISPR-CAS SYSTEMS IN PSEUDOMONAS AERUGINOSA AND THEIR ROLE IN ANTIBIOTIC RESISTANCE MECHANISMS","authors":"Amna Ahmad , Muhammad I. Nasar , Farah Al-Marzooq","doi":"10.1016/j.jiph.2025.103099","DOIUrl":"10.1016/j.jiph.2025.103099","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103099"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jiph.2025.103095
Smitha K C , Amna Saeed Al Zehmi , Najla Obaid Mubarak , Ahmed Obaid Al Khadeim , Fouzia Abdul Azeez , Simi Kurian , Sadeq Kewan , Leeba Oomen , Joseph Tannous , Nehad Al Shirawi
{"title":"ENHANCING ICU SAFETY: STRATEGIES TO COMBAT MULTIDRUG-RESISTANT ORGANISMS","authors":"Smitha K C , Amna Saeed Al Zehmi , Najla Obaid Mubarak , Ahmed Obaid Al Khadeim , Fouzia Abdul Azeez , Simi Kurian , Sadeq Kewan , Leeba Oomen , Joseph Tannous , Nehad Al Shirawi","doi":"10.1016/j.jiph.2025.103095","DOIUrl":"10.1016/j.jiph.2025.103095","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103095"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/S1876-0341(26)00010-9
{"title":"Acknowledgement to Reviewers","authors":"","doi":"10.1016/S1876-0341(26)00010-9","DOIUrl":"10.1016/S1876-0341(26)00010-9","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103138"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the COVID-19 pandemic, several divergent mutants including the Omicron (B.1.1.529) BA.1 variant emerged, having a distinct mechanism of emergence compared with pre-existing variants of concern. Apart from playing a major role in causing recurrent epidemic waves, the highly divergent mutants also contributed to changing the fate of the pandemic by exhibiting large differences in phenotypic characteristics among even closely related variants. Given that several different variants emerged during the pandemic, the present study aimed to quantitatively evaluate the risk of emergence of divergent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants and understand the mechanism of such emergence.
Methods
Upon identifying the emergence of phylogenetically distinct variants in “Omicron-like events” that have been recognized to date, a time-to-event analysis was carried out to estimate the monthly hazard rate of emergence. Four statistical models were established and compared using the Akaike Information Criterion.
Results
The model using the number of hospitalized cases was determined to be the best fit. The risk of Omicron-like events is not independent of time; instead, the monthly risk of emergence is likely to increase over time due to an increasing number of infection events.
Conclusions
Ongoing virus genomic surveillance is vital, and possible prevention among immunosuppressed individuals should be considered.
{"title":"Modeling the emergence of divergent mutants of SARS-CoV-2, “Omicron-like events”: A time-to-event analysis","authors":"Haruka Hayashi, Yuta Okada, Taishi Kayano, Katsuma Hayashi, Tetsuro Kobayashi, Hiroshi Nishiura","doi":"10.1016/j.jiph.2026.103140","DOIUrl":"10.1016/j.jiph.2026.103140","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, several divergent mutants including the Omicron (B.1.1.529) BA.1 variant emerged, having a distinct mechanism of emergence compared with pre-existing variants of concern. Apart from playing a major role in causing recurrent epidemic waves, the highly divergent mutants also contributed to changing the fate of the pandemic by exhibiting large differences in phenotypic characteristics among even closely related variants. Given that several different variants emerged during the pandemic, the present study aimed to quantitatively evaluate the risk of emergence of divergent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants and understand the mechanism of such emergence.</div></div><div><h3>Methods</h3><div>Upon identifying the emergence of phylogenetically distinct variants in “Omicron-like events” that have been recognized to date, a time-to-event analysis was carried out to estimate the monthly hazard rate of emergence. Four statistical models were established and compared using the Akaike Information Criterion.</div></div><div><h3>Results</h3><div>The model using the number of hospitalized cases was determined to be the best fit. The risk of Omicron-like events is not independent of time; instead, the monthly risk of emergence is likely to increase over time due to an increasing number of infection events.</div></div><div><h3>Conclusions</h3><div>Ongoing virus genomic surveillance is vital, and possible prevention among immunosuppressed individuals should be considered.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103140"},"PeriodicalIF":4.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.jiph.2026.103130
Chao-Chin Chang , Tzu-Chi Chang , Chia-Lin Chang
Background
Containment policies, also known as non-pharmaceutical interventions (NPIs), are crucial in managing emerging infectious diseases; however, their broader economic, social, and health impacts remain insufficiently understood. Previous studies have largely relied on aggregate indices, masking policy-specific effects and limiting their usefulness for preparedness and adaptive governance.
Methods
This study investigates how disaggregated containment measures affected international trade and the continuity of essential goods as a component of public health resilience. Using data from 182 countries during 2020–2021, we analyzed nine NPIs from the Oxford COVID-19 Government Response Tracker and international trade statistics across four product categories. Two indices, a conventional arithmetic mean and a novel entropy-weighted index, were constructed to capture policy intensity and cross-country heterogeneity. Panel regression models with fixed- and random-effects specifications were used to assess policy impacts.
Findings
Containment policies had heterogeneous effects on trade. Workplace closures were associated with trade resilience through digital adaptation, whereas stay-at-home orders and transport suspensions disrupted food and agricultural trade, revealing vulnerabilities in supply chains critical to health security. International travel restrictions correlated positively with goods trade, reflecting substitution from service- to goods-based activities. The entropy-weighted index outperformed the arithmetic mean by capturing policy variability, especially during 2020 early crisis phase.
Interpretation
Disaggregating NPIs reveals that policy design, timing, and institutional context shape both trade performance and health resilience. Integrating information-sensitive metrics such as entropy weighting can improve surveillance and preparedness frameworks. Policymakers should balance epidemiological effectiveness with the protection of essential trade flows to ensure equitable and adaptive pandemic governance.
{"title":"Trade and containment policies during COVID-19: Disaggregated evidence for adaptive public health governance","authors":"Chao-Chin Chang , Tzu-Chi Chang , Chia-Lin Chang","doi":"10.1016/j.jiph.2026.103130","DOIUrl":"10.1016/j.jiph.2026.103130","url":null,"abstract":"<div><h3>Background</h3><div>Containment policies, also known as non-pharmaceutical interventions (NPIs), are crucial in managing emerging infectious diseases; however, their broader economic, social, and health impacts remain insufficiently understood. Previous studies have largely relied on aggregate indices, masking policy-specific effects and limiting their usefulness for preparedness and adaptive governance.</div></div><div><h3>Methods</h3><div>This study investigates how disaggregated containment measures affected international trade and the continuity of essential goods as a component of public health resilience. Using data from 182 countries during 2020–2021, we analyzed nine NPIs from the Oxford COVID-19 Government Response Tracker and international trade statistics across four product categories. Two indices, a conventional arithmetic mean and a novel entropy-weighted index, were constructed to capture policy intensity and cross-country heterogeneity. Panel regression models with fixed- and random-effects specifications were used to assess policy impacts.</div></div><div><h3>Findings</h3><div>Containment policies had heterogeneous effects on trade. Workplace closures were associated with trade resilience through digital adaptation, whereas stay-at-home orders and transport suspensions disrupted food and agricultural trade, revealing vulnerabilities in supply chains critical to health security. International travel restrictions correlated positively with goods trade, reflecting substitution from service- to goods-based activities. The entropy-weighted index outperformed the arithmetic mean by capturing policy variability, especially during 2020 early crisis phase.</div></div><div><h3>Interpretation</h3><div>Disaggregating NPIs reveals that policy design, timing, and institutional context shape both trade performance and health resilience. Integrating information-sensitive metrics such as entropy weighting can improve surveillance and preparedness frameworks. Policymakers should balance epidemiological effectiveness with the protection of essential trade flows to ensure equitable and adaptive pandemic governance.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103130"},"PeriodicalIF":4.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Staphylococcal pneumonia is a serious cause of morbidity and mortality in children worldwide, particularly in resource-limited settings. This study aimed to investigate the national epidemiology, clinical outcomes, and mortality-associated factors of pediatric staphylococcal pneumonia in Thailand.
Materials and methods
A nationwide retrospective study was conducted using the National Health Security Office (NHSO) database. All hospital admissions of children aged 1 month to < 18 years diagnosed with staphylococcal pneumonia (ICD-10-TM code J15.2) between 2015 and 2023 were included. Demographics, comorbidities, complications, interventions, and outcomes were analyzed. Multivariable logistic regression was used to identify factors independently associated with mortality.
Results
A total of 1718 admissions were analyzed. Annual admissions peaked at 249 in 2016 and were lowest at 129 in 2022. Most admissions were male (61.5 %) and infants under 1 year (34.2 %). Intubation was required in 60.9 % of cases, and 10.5 % underwent surgical interventions. The hospital mortality rate was 10.6 %. Factors associated with higher mortality included congenital heart disease (adjusted odds ratio [AOR] 3.57; 95 % CI 2.27–5.61), malignancy (AOR 4.13; 95 % CI 1.87–9.10), malnutrition (AOR 3.13; 95 % CI 1.45–6.75), acute respiratory distress syndrome (ARDS) (AOR 4.26; 95 % CI 2.23–8.14), septic shock (AOR 3.85; 95 % CI 2.52–5.90), acute renal failure (AOR 4.46; 95 % CI 2.72–7.30), disseminated intravascular coagulation (DIC) (AOR 2.13; 95 % CI 1.18–3.83), and need for endotracheal intubation (AOR 9.98; 95 % CI 4.50–22.15).
Conclusion
Pediatric staphylococcal pneumonia remains a significant clinical burden in Thailand, with high complication and mortality rates. Targeted interventions, particularly in high-risk populations, are essential to improve outcomes.
背景和目的葡萄球菌性肺炎是全世界儿童发病和死亡的一个严重原因，特别是在资源有限的地区。本研究旨在调查泰国儿童葡萄球菌性肺炎的全国流行病学、临床结果和死亡相关因素。材料与方法利用国家卫生安全办公室（NHSO）数据库进行了一项全国性的回顾性研究。纳入2015年至2023年期间所有住院诊断为葡萄球菌肺炎（ICD-10-TM代码J15.2）的1个月至 18岁儿童。分析了人口统计学、合并症、并发症、干预措施和结果。使用多变量逻辑回归来确定与死亡率独立相关的因素。结果共分析入院人数1718人。2016年全年入学人数达到249人的峰值，2022年最低，为129人。入院患者以男性（61.5% %）和1岁以下婴儿（34.2% %）居多。60.9% %的病例需要插管，10.5% %的病例需要手术干预。住院死亡率为10.6% %。与高死亡率相关的因素包括先天性心脏病（调整优势比[AOR] 3.57; 95 % CI 2.27-5.61）、恶性肿瘤（AOR 4.13; 95 % CI 1.87-9.10）、营养不良（AOR 3.13; 95 % CI 1.45-6.75）、急性呼吸窘迫综合征（ARDS） （AOR 4.26; 95 % CI 2.23-8.14）、感染性休克（AOR 3.85; 95 % CI 2.52-5.90）、急性肾功能衰竭（AOR 4.46; 95 % CI 2.72-7.30）、弥散性血管内凝血(AOR 2.13；95 % CI 1.18-3.83)，需要气管插管（AOR 9.98; 95 % CI 4.50-22.15）。结论在泰国，儿童葡萄球菌肺炎仍然是一个重要的临床负担，其并发症和死亡率都很高。有针对性的干预措施，特别是针对高危人群的干预措施，对于改善结果至关重要。
{"title":"Epidemiology, clinical outcomes and mortality-associated factors of staphylococcal pneumonia in hospitalized Thai children: A nationwide retrospective analysis 2015–2023","authors":"Sirapoom Niamsanit , Phanthila Sitthikarnkha , Leelawadee Techasatian , Suchaorn Saengnipanthkul , Pope Kosalaraksa , Kaewjai Thepsuthammarat , Rattapon Uppala","doi":"10.1016/j.jiph.2025.103127","DOIUrl":"10.1016/j.jiph.2025.103127","url":null,"abstract":"<div><h3>Background and aims</h3><div>Staphylococcal pneumonia is a serious cause of morbidity and mortality in children worldwide, particularly in resource-limited settings. This study aimed to investigate the national epidemiology, clinical outcomes, and mortality-associated factors of pediatric staphylococcal pneumonia in Thailand.</div></div><div><h3>Materials and methods</h3><div>A nationwide retrospective study was conducted using the National Health Security Office (NHSO) database. All hospital admissions of children aged 1 month to < 18 years diagnosed with staphylococcal pneumonia (ICD-10-TM code J15.2) between 2015 and 2023 were included. Demographics, comorbidities, complications, interventions, and outcomes were analyzed. Multivariable logistic regression was used to identify factors independently associated with mortality.</div></div><div><h3>Results</h3><div>A total of 1718 admissions were analyzed. Annual admissions peaked at 249 in 2016 and were lowest at 129 in 2022. Most admissions were male (61.5 %) and infants under 1 year (34.2 %). Intubation was required in 60.9 % of cases, and 10.5 % underwent surgical interventions. The hospital mortality rate was 10.6 %. Factors associated with higher mortality included congenital heart disease (adjusted odds ratio [AOR] 3.57; 95 % CI 2.27–5.61), malignancy (AOR 4.13; 95 % CI 1.87–9.10), malnutrition (AOR 3.13; 95 % CI 1.45–6.75), acute respiratory distress syndrome (ARDS) (AOR 4.26; 95 % CI 2.23–8.14), septic shock (AOR 3.85; 95 % CI 2.52–5.90), acute renal failure (AOR 4.46; 95 % CI 2.72–7.30), disseminated intravascular coagulation (DIC) (AOR 2.13; 95 % CI 1.18–3.83), and need for endotracheal intubation (AOR 9.98; 95 % CI 4.50–22.15).</div></div><div><h3>Conclusion</h3><div>Pediatric staphylococcal pneumonia remains a significant clinical burden in Thailand, with high complication and mortality rates. Targeted interventions, particularly in high-risk populations, are essential to improve outcomes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103127"},"PeriodicalIF":4.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.jiph.2025.103128
Fanwei Liu , Siqi Sun , Yonghu Zhang , Fang Wang , Xiou Yang , Bingli Zhang , Sitong Fan , Hongyu Jia
Tuberculous meningitis (TBM) typically presents with neurological symptoms. Voiding dysfunction in TBM is usually attributed to spinal cord involvement. We report a rare case of possible TBM co-existing with possible prostatic tuberculosis, presenting primarily with urinary symptoms in the absence of spinal pathology. A 69-year-old male presented with a two-year history of progressive urinary retention, urgency, and frequency. Initial management for benign prostatic hyperplasia was ineffective. He subsequently developed fever, headache, and dizziness. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis and elevated protein. Despite extensive testing, including CSF culture, Xpert MTB/RIF, and metagenomic next-generation sequencing (mNGS), no pathogen was identified. However, a history of untreated testicular tuberculosis, pulmonary nodules on CT, and a prostatic nodule on MRI raised suspicion of disseminated tuberculosis. A clinical diagnosis of possible TBM was made based on a Marais score of 11. An intensive anti-tuberculosis regimen including moxifloxacin and linezolid led to complete resolution of neurological and urinary symptoms. This case suggests that voiding dysfunction in TBM patients may stem from concurrent genitourinary tuberculosis rather than spinal cord involvement. It highlights the importance of considering hematogenous dissemination from latent genitourinary foci in elderly patients and the utility of the Marais criteria for the diagnosis of TBM when microbiological evidence is elusive.
{"title":"Possible tuberculous meningitis presenting with predominant voiding dysfunction in an elderly patient: A case report","authors":"Fanwei Liu , Siqi Sun , Yonghu Zhang , Fang Wang , Xiou Yang , Bingli Zhang , Sitong Fan , Hongyu Jia","doi":"10.1016/j.jiph.2025.103128","DOIUrl":"10.1016/j.jiph.2025.103128","url":null,"abstract":"<div><div>Tuberculous meningitis (TBM) typically presents with neurological symptoms. Voiding dysfunction in TBM is usually attributed to spinal cord involvement. We report a rare case of possible TBM co-existing with possible prostatic tuberculosis, presenting primarily with urinary symptoms in the absence of spinal pathology. A 69-year-old male presented with a two-year history of progressive urinary retention, urgency, and frequency. Initial management for benign prostatic hyperplasia was ineffective. He subsequently developed fever, headache, and dizziness. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis and elevated protein. Despite extensive testing, including CSF culture, Xpert MTB/RIF, and metagenomic next-generation sequencing (mNGS), no pathogen was identified. However, a history of untreated testicular tuberculosis, pulmonary nodules on CT, and a prostatic nodule on MRI raised suspicion of disseminated tuberculosis. A clinical diagnosis of <strong>possible TBM</strong> was made based on a Marais score of 11. An intensive anti-tuberculosis regimen including moxifloxacin and linezolid led to complete resolution of neurological and urinary symptoms. This case suggests that voiding dysfunction in TBM patients may stem from concurrent genitourinary tuberculosis rather than spinal cord involvement. It highlights the importance of considering hematogenous dissemination from latent genitourinary foci in elderly patients and the utility of the Marais criteria for the diagnosis of TBM when microbiological evidence is elusive.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103128"},"PeriodicalIF":4.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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