Journal of Global Infectious Diseases最新文献

Introduction: Monkeypox, a zoonotic disease caused by the monkeypox virus, has emerged as a significant global public health concern, particularly due to outbreaks in non-endemic regions. While cutaneous lesions are its hallmark, oral manifestations like mucosal lesions, ulcers, and enanthema may precede other symptoms, posing unique diagnostic challenges. This review aimed to assess the prevalence, clinical features, and implications of oral manifestations of monkeypox, emphasizing their importance in medical and dental practice.

Methods: A scoping review following PRISMA-ScR guidelines analyzed studies on oral symptoms of monkeypox published from 2005 to 2024. Comprehensive searches of databases like PubMed, Scopus, Web of Science, and Embase were carried out and MeSH terms such as "oral lesions," "monkeypox," and "stomatitis" were used. Three independent reviewers extracted data on clinical presentations, prevalence, and implications for dental care.

Results: Oral lesions, including ulcers, vesicles, sore throats, and necrosis on the tongue, gingiva, and buccal mucosa, are key diagnostic markers of monkeypox. Prevalence rates varied widely (7-100%), with higher rates evident in immunocompromised individuals and pediatric populations, with smaller studies often reporting higher rates. Lesions typically lasted 7-14 days, extending to three weeks in severe cases and were associated with secondary infections, pain and dysphagia particularly in immunocompromised individuals. Management included hydration, analgesics, and, in some cases, antiviral therapy like tecovirimat. The findings emphasize the need for standardized reporting of oral symptoms to enhance diagnostic accuracy and clinical care.

Conclusion: Oral manifestations of monkeypox are critical diagnostic and transmission markers. Dental practitioners should consider monkeypox in the differential diagnosis of unexplained oral ulcers, particularly in high-risk populations. Heightened awareness and standardized reporting can optimize diagnosis, care, and epidemic control efforts.

Introduction: Tuberculosis (TB) remains a significant global health challenge despite numerous innovations in diagnostic methods. Accurate early identification is essential for effective TB management and prevention of disease spread.

Methods: This study combined bibliometrics and network meta-analysis (NMA) to evaluate publication trends and compare the sensitivity and specificity of various TB screening tools against the gold standard, culture. Literature searches were conducted in seven databases over the period 2014-2024. Data were analyzed using a random-effects model with adjustment for quality of evidence using Confidence in NMA.

Results: Of the 22 studies that met the inclusion criteria, 13 diagnostic tools were compared in 34 direct and 44 indirect comparisons. Culture remained the method with the best accuracy. TB molecular bacterial load assay (TB-MBLA), mNGS, and RT-Mycobacterium tuberculosis (RT-MTB) performed closest to culture in terms of sensitivity and specificity, making them promising candidates for TB screening. No significant incoherence was found, but there was high inconsistency and heterogeneity.

Conclusion: This study highlights that molecular methods provide rapid detection and superior diagnostic performance compared to conventional methods, while also necessitating consideration of specificity factors and the risk of overdiagnosis. These findings highlight the urgent need to prioritize affordable, rapid, and scalable TB screening tools such as TB-MBLA and RT-MTB in low-resource, high-burden settings to improve early detection and reduce transmission.

Introduction: Differentiating candidemia from bacteremia in intensive care unit (ICU) patients is critical for effective treatment but is often delayed by reliance on conventional diagnostics like blood cultures. This study evaluates the diagnostic utility of interleukin-6 (IL-6), C-reactive protein (CRP), and soluble triggering receptor expressed on myeloid cells^-1 (sTREM-1), individually and in combination, for distinguishing these bloodstream infections (BSIs).

Methods: This prospective observational study included 74 ICU patients with BSIs admitted to a university-affiliated hospital between September 2023 and August 2024. Biomarker levels were measured on the 2^nd day of ICU admission. Diagnostic performance was assessed using the Mann-Whitney U test, logistic regression, and receiver operating characteristic curve analysis.

Results: Of the 74 patients, 54 (72.9%) had bacteremia and 20 (27.1%) had candidemia. IL-6 and sTREM-1 levels were significantly higher in candidemia (P < 0.001), whereas CRP alone did not show discriminatory power (P = 0.981). The combined biomarker model achieved an area under the curve of 0.818, demonstrating superior diagnostic performance compared to individual markers.

Conclusions: IL-6 and sTREM-1 are effective biomarkers for distinguishing candidemia from bacteremia, with CRP providing additional value in a multibiomarker model. This approach may enhance diagnostic precision and improve clinical decision-making in ICU settings.

Introduction: With Antiretroviral therapy (ART), life expectancy in people living with HIV/acquired immunodeficiency syndrome (PLHA) has improved, shifting focus to complications like liver fibrosis. Contributing factors include HIV, ART-related metabolic changes, chronic inflammation, and co-infections (hepatitis B virus [HBV]/hepatitis C virus). However, HIV's independent role in fibrosis without traditional risk factors remains unclear. This study estimated liver fibrosis prevalence among PLHA in North India and identified associated risk factors.

Methods: A cross-sectional study was conducted over 18 months at a tertiary ART center, including 354 PLHA. Liver fibrosis was assessed using FibroScan^® and categorized into stages F0-F4. Laboratory tests included liver function, lipid profile, fasting glucose, glycated hemoglobin, and CD4 count. Metabolic syndrome was defined using the modified Adult Treatment Panel III of the National Cholesterol Education Program criteria. Statistical methods included Chi-square tests, Spearman correlation, and logistic regression.

Results: The mean liver stiffness was 6.27 ± 1.87 kPa. Fibrosis stages included: F0-F1 (81.4%), F2 (13.6%), F3 (4.5%), and F4 (0.6%). Among HIV monoinfected patients without conventional risk factors, 12% had significant fibrosis, compared to 34% with risk factors (P < 0.001). Metabolic syndrome was the strongest independent predictor (Odds ratio = 27.86, P < 0.001). A negative correlation was observed between high-density lipoprotein and liver stiffness (ρ = -0.29, P < 0.001). No significant association was found with ART regimen, CD4 count, or viral load.

Conclusion: Liver fibrosis was present in 18.7% of PLHA. Metabolic syndrome, diabetes, and HBV were key contributors. Routine fibrosis screening should be part of HIV care.

Introduction: Because of insufficient number of standardized negative-pressure isolation rooms to manage coronavirus disease 2019 (COVID-19), rapid deployment of a temporary isolation ward in our hospital was required. This report is intended to share our experience in the rapid deployment of a temporary isolation ward during a COVID-19 outbreak.

Methods: We constructed a temporary hospital ward with 22 negative-pressure single-bed patient rooms to take care of COVID-19 patients. One-way traffic control for healthcare workers (HCWs) was designed. The temperature, humidity, and air changes per hour in each room were monitored. Each fan above ceiling of the nurse station was equipped with two ultraviolet-C (UV-C) 254 nm lamps to sterilize the environment and provide fresh air. All HCWs in the unit were tested for COVID-19 once a week by reverse transcriptase-polymerase chain reaction (RT-PCR) of nasopharyngeal samples.

Results: During the period of May 31-June17, 2021, 55 patients with COVID-19 were admitted to this isolation ward, which was constructed in 2 days. The mean air changes per hour of the patient room were 11 times, and the temperature and humidity were 20.6°C and 74%, respectively. The pressure differential between the patient rooms and the corridor was 3 Pascals (Pa), lesser in the rooms. All of 966 PCR tests performed for HCWs were negative.

Conclusion: The temporary COVID-19 isolation unit, constructed in 2 days, was effective for patient care and protection of HCWs.

Dermatophytosis and Hansen's disease in themselves are highly prevalent and endemic infections of tropical countries. However, the cases of mixed infections are rarely reported. The possibility of superficial fungal infection in leprosy may be explained by the general immunocompromised state of the patients here, we report a very startling case of dual infection or co-localization of leprosy patches with tinea who presented to our tertiary level setup. This case highlights the importance of a proper detailed clinical examination with microbiological investigations to avoid misdiagnosis and missing of such rare cases of mixed infections in the endemic regions.

Introduction: The West Nile virus (WNV) has become a global concern, triggering major outbreaks in the United States and other regions. Effective surveillance and early detection are essential for controlling its spread. This study aims to assess the global landscape of WNV research, identify emerging trends, and analyze collaborative networks in the field.

Methods: A comprehensive search was conducted in the Scopus database on July 14, 2024, covering publications from January 2019 to July 2024 that included specific keywords in their titles or abstracts. Metadata from 2305 documents were extracted and analyzed using SciVal and Bibliometrix, applying various indicators and metrics to evaluate research trends and collaborations.

Results: The most prominent authors and institutions in this field include Ute Ziegler of the Friedrich-Loeffler Institute in Germany, Giovanni Savini of the Instituto Zooprofilattico Experimentale di Abruzzo e Molise in Italy, and Sylvie Lecollinet of the National Food Safety Agency, de l'Environnement et du Travail in France. The journals most central to WNV research include viruses and pathogens, the Journal of Medical Entomology, Vector-Borne and Zoonotic Diseases, and PLOS Neglected Tropical Diseases. The thematic evolution of WNV research reveals various key themes over time. Most publications were concentrated in the first quartile (Q1), although a decreasing trend was observed in the number of publications over time in all quartiles. The USA had the largest number of corresponding authors.

Conclusion: These findings provide a comprehensive view of the scope, influence, and impact of WNV research, highlighting the importance of international collaboration in this field.

The authors present a case of neonatal amebiasis in a 5-month-old girl who exhibited symptoms including vomiting, refusal to feed, abdominal distension, and mucoid, bloody stools. Sigmoidoscopy revealed multiple aphthous ulcers, and a colonic biopsy was submitted with clinical suspicion of eosinophilic colitis. The histologic examination of the biopsy, however, confirmed the diagnosis of amebic colitis through identification of trophozoites of Entamoeba histolytica. The infant, who was likely infected by her caregiver or mother, was successfully treated with intravenous metronidazole. This report aims to raise awareness about the possibility of amebiasis in infants, particularly in endemic regions; thus, it should be kept as a differential in cases presenting with such symptoms.