Pub Date : 2022-09-01DOI: 10.33590/emjmicrobiolinfectdis/22-00082
Robert Redwood, Lucas T Schulz, Aurora Pop-Vicas, Michael S Pulia
For decades, infectious disease and public health experts have recognised antimicrobial resistance (AMR) and resulting infections due to multidrug resistant organisms as a persistent and increasingly urgent threat to public health at the local, national, and global level. The years leading up to the COVID-19 pandemic were marked by important victories in the battle against AMR, including a surge in scientific inquiry on the topic, the development of multinational best practice consensus statements, the establishment of regional and global venues to share information, and a partially-funded commitment by world leaders to address the topic in a serious and sustained manner.
{"title":"A Perfect Storm: COVID-19 and Antimicrobial Resistance.","authors":"Robert Redwood, Lucas T Schulz, Aurora Pop-Vicas, Michael S Pulia","doi":"10.33590/emjmicrobiolinfectdis/22-00082","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/22-00082","url":null,"abstract":"For decades, infectious disease and public health experts have recognised antimicrobial resistance (AMR) and resulting infections due to multidrug resistant organisms as a persistent and increasingly urgent threat to public health at the local, national, and global level. The years leading up to the COVID-19 pandemic were marked by important victories in the battle against AMR, including a surge in scientific inquiry on the topic, the development of multinational best practice consensus statements, the establishment of regional and global venues to share information, and a partially-funded commitment by world leaders to address the topic in a serious and sustained manner.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828457/pdf/nihms-1850683.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10148187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-15DOI: 10.33590/emjmicrobiolinfectdis/21-00243
Safia Moin, K. Moorani, H. Qureshi
Background: Aspergillus peritonitis is a rare, potentially fatal complication of continuous ambulatory peritoneal dialysis (CAPD). Several cases of fungal peritonitis (FP) caused by Aspergillus species have been reported worldwide; however, there is a paucity of data from Pakistan. Here, a case of congenital nephrotic syndrome is reported in a patient who progressed to Stage 5 chronic kidney disease when she was 8 years old, which was managed by CAPD and other supportive therapies. The patient developed FP and later succumbed to death despite appropriate management. Early diagnosis and careful interpretation of culture results are, therefore, important for the treatment of these patients. Case presentation: The patient outlined in this case report had congenital nephrotic syndrome, Stage 5 chronic kidney disease, and was on CAPD. She presented with peritonitis. Initially, broad spectrum antibiotics were started, and peritoneal samples did not yield any growth. Later, consecutive peritoneal samples taken from the patient grew Aspergillus terreus, with septate hyphae seen on a direct smear from the sample. Voriconazole was started immediately, and the patients’ catheter was removed. However, the patient’s condition deteriorated and, after prolonged intensive care and high ventilator support, the patient expired. Conclusion: A. terreus is an uncommon and deadly pathogen that does not respond to the commonly used antifungal treatments such as amphotericin B. The treatment of CAPD-related FP requires early diagnosis and the use of newer drugs such as voriconazole or caspofungin.
{"title":"Aspergillus terreus Peritonitis in a Child on Continuous Ambulatory Peritoneal Dialysis: A Case Report from Pakistan","authors":"Safia Moin, K. Moorani, H. Qureshi","doi":"10.33590/emjmicrobiolinfectdis/21-00243","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/21-00243","url":null,"abstract":"Background: Aspergillus peritonitis is a rare, potentially fatal complication of continuous ambulatory peritoneal dialysis (CAPD). Several cases of fungal peritonitis (FP) caused by Aspergillus species have been reported worldwide; however, there is a paucity of data from Pakistan. Here, a case of congenital nephrotic syndrome is reported in a patient who progressed to Stage 5 chronic kidney disease when she was 8 years old, which was managed by CAPD and other supportive therapies. The patient developed FP and later succumbed to death despite appropriate management. Early diagnosis and careful interpretation of culture results are, therefore, important for the treatment of these patients.\u0000\u0000Case presentation: The patient outlined in this case report had congenital nephrotic syndrome, Stage 5 chronic kidney disease, and was on CAPD. She presented with peritonitis. Initially, broad spectrum antibiotics were started, and peritoneal samples did not yield any growth. Later, consecutive peritoneal samples taken from the patient grew Aspergillus terreus, with septate hyphae seen on a direct smear from the sample. Voriconazole was started immediately, and the patients’ catheter was removed. However, the patient’s condition deteriorated and, after prolonged intensive care and high ventilator support, the patient expired.\u0000\u0000Conclusion: A. terreus is an uncommon and deadly pathogen that does not respond to the commonly used antifungal treatments such as amphotericin B. The treatment of CAPD-related FP requires early diagnosis and the use of newer drugs such as voriconazole or caspofungin.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48439016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-28DOI: 10.33590/emjmicrobiolinfectdis/21.00056
Inês Rego de Figueiredo, J. Ferrão, S. Dias, R. Alves, A. Taulaigo, Mário Ferraz, S. Castro, A. M. Antunes, Cláudia Mihon, A. Lladó, Heidi Heidi Gruner, A. Panarra
Background: Although hospital admission is frequently due to the exacerbation of chronic diseases, most often it is caused by an underlying infectious process. Patients often have several admissions per year, making them at risk for recurrent infections, increased morbidity, and the emergence of resistant strains of microorganisms. Methods: This is a retrospective, descriptive study of all patients with an infectious disease diagnosis, who were admitted to the medical ward of a tertiary hospital during a 5-year period. Information was collected from electronic medical files regarding gender, age, autonomy, comorbidities, primary diagnosis, in-hospital length of stay, and mortality as well as microbiological data surveillance. Results: A total of 355 patients fulfilled the inclusion criteria. Amongst the sample analysed, the average age was 78.10±12.47 years. Of the patients, 57.2% (203) were female, with most patients considered as dependent according to Katz score. The average Charlson Comorbidity Index (CCI) score was 6.28±2.74, increasing with age. The main diagnostic categories were respiratory (191 patients: 137 with pneumonia and 49 with acute bronchitis) and urinary tract (138 patients: 69 with pyelonephritis and 66 with cystitis). Urinary tract infections were more frequent in females and in dependent patients. Only 37.8% of infections had a microbiologic isolate: Escherichia coli (28.4%), Pseudomonas aeruginosa (12.7%), and Klebsiella pneumoniae (8.2%). The overall mortality was 6.77%. Conclusions: The frequent in-hospital admission due to infectious diseases makes it imperative to characterise and follow-up on evolution of the disease itself in order to better know the characteristics of community-acquired diseases, establish routes of transmission and outbreak identification, microbiology patterns, and resistance towards further improving empiric therapy.
{"title":"Trends in Infectious Diseases: A Retrospective 5-year Study","authors":"Inês Rego de Figueiredo, J. Ferrão, S. Dias, R. Alves, A. Taulaigo, Mário Ferraz, S. Castro, A. M. Antunes, Cláudia Mihon, A. Lladó, Heidi Heidi Gruner, A. Panarra","doi":"10.33590/emjmicrobiolinfectdis/21.00056","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/21.00056","url":null,"abstract":"Background: Although hospital admission is frequently due to the exacerbation of chronic diseases, most often it is caused by an underlying infectious process. Patients often have several admissions per year, making them at risk for recurrent infections, increased morbidity, and the emergence of resistant strains of microorganisms.\u0000\u0000Methods: This is a retrospective, descriptive study of all patients with an infectious disease diagnosis, who were admitted to the medical ward of a tertiary hospital during a 5-year period. Information was collected from electronic medical files regarding gender, age, autonomy, comorbidities, primary diagnosis, in-hospital length of stay, and mortality as well as microbiological data surveillance.\u0000\u0000Results: A total of 355 patients fulfilled the inclusion criteria. Amongst the sample analysed, the average age was 78.10±12.47 years. Of the patients, 57.2% (203) were female, with most patients considered as dependent according to Katz score. The average Charlson Comorbidity Index (CCI) score was 6.28±2.74, increasing with age. The main diagnostic categories were respiratory (191 patients: 137 with pneumonia and 49 with acute bronchitis) and urinary tract (138 patients: 69 with pyelonephritis and 66 with cystitis). Urinary tract infections were more frequent in females and in dependent patients. Only 37.8% of infections had a microbiologic isolate: Escherichia coli (28.4%), Pseudomonas aeruginosa (12.7%), and Klebsiella pneumoniae (8.2%). The overall mortality was 6.77%.\u0000\u0000Conclusions: The frequent in-hospital admission due to infectious diseases makes it imperative to characterise and follow-up on evolution of the disease itself in order to better know the characteristics of community-acquired diseases, establish routes of transmission and outbreak identification, microbiology patterns, and resistance towards further improving empiric therapy.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45261719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-10DOI: 10.33590/emjmicrobiolinfectdis/21-00222
D. Chakraborty, Shouvik Choudhury, S. Lahiry
Despite dynamic drug and vaccine development processes to reduce the disease burden of COVID-19, the treatment options are still very limited. Vasoactive intestinal peptide (VIP) has a diversified physiological action with specific features of lung protection-related activities. VIP inhibits severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gene replication in human monocytes and the viral replication in Calu-3 cells, thus further reducing the generation of proinflammatory mediators. Aviptadil, a synthetic form of VIP, is the only pulmonary therapeutic agent to have been granted ‘fast track’ status by the U.S. Food and Drug Administration (FDA) and to be allowed into both Phase II and III clinical trials. Initial binding of Aviptadil with non-structural protein (nsp) 10 and nsp16, which may inhibit the 2’-O-methyltransferase activity of the SARS-CoV-2 nsp10 and nsp16 complex. Aviptadil has already proved to be an effective option in the treatment of severe respiratory failures due to sepsis and other related lung injuries. Interim analysis results of this drug used in respiratory failure caused by SARS-CoV-2 has evolved a new hope in regard to safety and efficacy. The final results from a recently completed trial, as well as all currently ongoing trials, will clarify the class effect of this drug in the treatment of COVID-19 in future days.
尽管有动态的药物和疫苗开发进程，以减轻COVID-19的疾病负担，但治疗选择仍然非常有限。血管活性肠肽(Vasoactive intestinal peptide, VIP)具有多种生理作用，具有特定的肺保护功能。VIP可抑制人单核细胞中的SARS-CoV-2基因复制和Calu-3细胞中的病毒复制，从而进一步减少促炎介质的产生。Aviptadil是维普的一种合成形式，是唯一一种被美国食品和药物管理局(FDA)授予“快速通道”地位的肺部治疗药物，并被允许进入II期和III期临床试验。阿维他尔与非结构蛋白(nsp) 10和nsp16的初始结合，可能抑制SARS-CoV-2 nsp10和nsp16复合物的2 ' - o -甲基转移酶活性。阿维他地尔已经被证明是治疗因败血症和其他相关肺损伤引起的严重呼吸衰竭的有效选择。该药物用于SARS-CoV-2呼吸衰竭的中期分析结果，在安全性和有效性方面产生了新的希望。最近完成的一项试验以及目前正在进行的所有试验的最终结果将在未来几天阐明这种药物在治疗COVID-19中的类别效果。
{"title":"Aviptadil: Class Effect of a Synthetic Vasoactive Intestinal Peptide as a Treatment Option in Patients with COVID-19 with Severe Respiratory Failure","authors":"D. Chakraborty, Shouvik Choudhury, S. Lahiry","doi":"10.33590/emjmicrobiolinfectdis/21-00222","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/21-00222","url":null,"abstract":"Despite dynamic drug and vaccine development processes to reduce the disease burden of COVID-19, the treatment options are still very limited. Vasoactive intestinal peptide (VIP) has a diversified physiological action with specific features of lung protection-related activities.\u0000\u0000VIP inhibits severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gene replication in human monocytes and the viral replication in Calu-3 cells, thus further reducing the generation of proinflammatory mediators. Aviptadil, a synthetic form of VIP, is the only pulmonary therapeutic agent to have been granted ‘fast track’ status by the U.S. Food and Drug Administration (FDA) and to be allowed into both Phase II and III clinical trials. Initial binding of Aviptadil with non-structural protein (nsp) 10 and nsp16, which may inhibit the 2’-O-methyltransferase activity of the SARS-CoV-2 nsp10 and nsp16 complex.\u0000\u0000Aviptadil has already proved to be an effective option in the treatment of severe respiratory failures due to sepsis and other related lung injuries. Interim analysis results of this drug used in respiratory failure caused by SARS-CoV-2 has evolved a new hope in regard to safety and efficacy. The final results from a recently completed trial, as well as all currently ongoing trials, will clarify the class effect of this drug in the treatment of COVID-19 in future days.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47320309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-19DOI: 10.33590/emjmicrobiolinfectdis/20-00215
Laura Christopher, T. Rohr-Kirchgraber, Saralyn Mark
During the COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2, healthcare professionals across the world have been at high risk of transmission because of their direct contact with infected patients. In October 2020, the International Council of Nurses (ICN) confirmed that 1,500 nurses had died from COVID-19 in 44 countries and estimated that healthcare worker COVID-19 fatalities worldwide could be more than 20,000. To ensure protection of healthcare personnel, properly fitting personal protective equipment (PPE) must be worn. In a ‘one size fits all’ world, the differences between the fit of PPE for men and women can have devastating consequences. An N95 respirator mask is a component of PPE outlined by the Centers for Disease Control and Prevention (CDC) for protection against COVID-19; however, N95 masks do not offer protection if they do not fit properly. Fit testing is performed to ensure an adequate seal of the mask on the wearer. A single-institution retrospective review was performed on fit testing results for male versus female wearers in an attempt to elucidate a difference in failure rates. Females failed at a significantly higher rate than their male counterparts (6.67% female, 2.72% male; p=0.001), and the reason reported was often due to being ‘small-boned’ (p<0.0001). Sex-related differences in proper PPE fit are not new; however, the COVID-19 pandemic has made the situation more acute, and sex-specific N95 mask designs must be developed quickly, as the pandemic shows little signs of abating.
{"title":"The PPE Pandemic: Sex-Related Discrepancies of N95 Mask Fit","authors":"Laura Christopher, T. Rohr-Kirchgraber, Saralyn Mark","doi":"10.33590/emjmicrobiolinfectdis/20-00215","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20-00215","url":null,"abstract":"During the COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2, healthcare professionals across the world have been at high risk of transmission because of their direct contact with infected patients. In October 2020, the International Council of Nurses (ICN) confirmed that 1,500 nurses had died from COVID-19 in 44 countries and estimated that healthcare worker COVID-19 fatalities worldwide could be more than 20,000. To ensure protection of healthcare personnel, properly fitting personal protective equipment (PPE) must be worn. In a ‘one size fits all’ world, the differences between the fit of PPE for men and women can have devastating consequences. An N95 respirator mask is a component of PPE outlined by the Centers for Disease Control and Prevention (CDC) for protection against COVID-19; however, N95 masks do not offer protection if they do not fit properly. Fit testing is performed to ensure an adequate seal of the mask on the wearer. A single-institution retrospective review was performed on fit testing results for male versus female wearers in an attempt to elucidate a difference in failure rates. Females failed at a significantly higher rate than their male counterparts (6.67% female, 2.72% male; p=0.001), and the reason reported was often due to being ‘small-boned’ (p<0.0001). Sex-related differences in proper PPE fit are not new; however, the COVID-19 pandemic has made the situation more acute, and sex-specific N95 mask designs must be developed quickly, as the pandemic shows little signs of abating.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46854665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-19DOI: 10.33590/emjmicrobiolinfectdis/20-00243
Pankil Doshi, Yash Sanghvi, J. Doctor, Vaibhavi Parsaniya
Mucormycosis is an invasive fungal infection caused by opportunistic fungi of the phylum Glomeromycotan, subphylum Mucormycotina, mainly affecting individuals with immunosuppression. Cutaneous mucormycosis is the third most common clinical form of the disease preceded by pulmonary and rhinocerebral mucormycosis. The usual factors predisposing to this infection are individuals who are immunocompromised with conditions like HIV, haematological malignancies, and diabetes mellitus, but a significant proportion of patients are immunocompetent. The agents of mucormycosis are abundantly present in nature and are transmitted to the skin by direct inoculation. It may be due to needle sticks, stings, and bites by animals, motor-vehicle accidents, natural disasters, and burn injuries. The clinical presentation is non-specific, but an indurated plaque that rapidly evolves to necrosis (eschar) is a common finding. The infection can invade locally, and also penetrate into the adjacent fat, muscle, fascia, and bone, or become disseminated. It is difficult to diagnose because of the non-specific presentation of mucormycosis. Biopsy and culture should be performed. Treatment consists of multidisciplinary management, including surgical debridement, use of antifungal drugs (amphotericin B and posaconazole), and reversal of underlying risk factors, when possible. Mortality rates are significant, ranging from 4% to 10% in localised mucormycosis infection, but are lower than the other forms of the disease. The authors present a case here of a 38-year-old immunocompetent male with cutaneous mucormycosis at the interscapular region.
{"title":"Cutaneous Mucormycosis of the Interscapular Region in an Immunocompetent Patient","authors":"Pankil Doshi, Yash Sanghvi, J. Doctor, Vaibhavi Parsaniya","doi":"10.33590/emjmicrobiolinfectdis/20-00243","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20-00243","url":null,"abstract":"Mucormycosis is an invasive fungal infection caused by opportunistic fungi of the phylum Glomeromycotan, subphylum Mucormycotina, mainly affecting individuals with immunosuppression. Cutaneous mucormycosis is the third most common clinical form of the disease preceded by pulmonary and rhinocerebral mucormycosis. The usual factors predisposing to this infection are individuals who are immunocompromised with conditions like HIV, haematological malignancies, and diabetes mellitus, but a significant proportion of patients are immunocompetent. The agents of mucormycosis are abundantly present in nature and are transmitted to the skin by direct inoculation. It may be due to needle sticks, stings, and bites by animals, motor-vehicle accidents, natural disasters, and burn injuries. The clinical presentation is non-specific, but an indurated plaque that rapidly evolves to necrosis (eschar) is a common finding. The infection can invade locally, and also penetrate into the adjacent fat, muscle, fascia, and bone, or become disseminated. It is difficult to diagnose because of the non-specific presentation of mucormycosis. Biopsy and culture should be performed. Treatment consists of multidisciplinary management, including surgical debridement, use of antifungal drugs (amphotericin B and posaconazole), and reversal of underlying risk factors, when possible. Mortality rates are significant, ranging from 4% to 10% in localised mucormycosis infection, but are lower than the other forms of the disease. The authors present a case here of a 38-year-old immunocompetent male with cutaneous mucormycosis at the interscapular region.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44026209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-19DOI: 10.33590/emjmicrobiolinfectdis/21-00001
Cody Riggle, C. Brissette
Lyme borreliosis or Lyme disease affects thousands of people globally each year, and, with nervous system involvement, this disease can lead to the development of Lyme neuroborreliosis (LNB). If not diagnosed and treated properly, LNB can lead to serious life-long health implications for affected patients. The clinical manifestations and treatment regimens are relatively well-studied, but much remains unknown about the disease’s pathogenesis and epidemiology. In this review, the authors elucidate the knowns and unknowns of LNB.
{"title":"Implications and Aspects of Lyme Neuroborreliosis","authors":"Cody Riggle, C. Brissette","doi":"10.33590/emjmicrobiolinfectdis/21-00001","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/21-00001","url":null,"abstract":"Lyme borreliosis or Lyme disease affects thousands of people globally each year, and, with nervous system involvement, this disease can lead to the development of Lyme neuroborreliosis (LNB). If not diagnosed and treated properly, LNB can lead to serious life-long health implications for affected patients. The clinical manifestations and treatment regimens are relatively well-studied, but much remains unknown about the disease’s pathogenesis and epidemiology. In this review, the authors elucidate the knowns and unknowns of LNB.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47231873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-19DOI: 10.33590/EMJMICROBIOLINFECTDIS/20-00276
Safia Moin, F. Mahmood, J. Farooqi, Faheem Naqvi, Romana Idress, K. Jabeen, A. Zafar
Objective: This study describes a case of disseminated phaeohyphomycotic lymphadenitis in a young female with delayed diagnosis and good clinical response after appropriate treatment. Methods: A 32-year-old female presented with erythematous to violaceous papules with oozing discharge bilaterally in her inguinal region for a few months. History revealed tuberculous meningitis 4 years earlier treated with first line anti-tuberculous therapy for 18 months, and 2 years previously she developed pigmented discharging lymph nodes bilaterally in her axillae. The histopathology of the biopsy of the axillary nodes showed chronic granulomatous inflammation with multiple branching septate fungal hyphae. She received amphotericin B for 21 days but without improvement. Biopsy from the inguinal lesions was sent for histopathology and culture. Results: Histopathology of the biopsy material showed chronic granulomatous inflammatory process with multinucleate giant cells, epithelioid cells, histiocytes, and lymphocytes with multiple branching septate fungal hyphae. Gram stain revealed moderate septate hyphae with numerous pus cells. Culture on Sabouraud dextrose agar yielded velvety olive–black colonies in the fourth week. Microscopic slide examination of culture material was suggestive of Cladophialophora species. The patient was started on voriconazole, which was continued for 6 months, and showed clinical improvement. Conclusion: Incomplete investigation of infectious lesions may delay diagnosis. Furthermore, clinical presentations are greatly influenced by the immune status of the host. Both histopathological and microbiological assessments are equally important for making a conclusive diagnosis. Anti-fungal therapy may delay the growth of fungi that normally grow within a week; thus, a longer incubation time may be warranted for fungal smear-positive samples.
{"title":"Disseminated Phaeohyphomycotic Lymphadenitis with Cladophialophora Species","authors":"Safia Moin, F. Mahmood, J. Farooqi, Faheem Naqvi, Romana Idress, K. Jabeen, A. Zafar","doi":"10.33590/EMJMICROBIOLINFECTDIS/20-00276","DOIUrl":"https://doi.org/10.33590/EMJMICROBIOLINFECTDIS/20-00276","url":null,"abstract":"Objective: This study describes a case of disseminated phaeohyphomycotic lymphadenitis in a young female with delayed diagnosis and good clinical response after appropriate treatment. \u0000Methods: A 32-year-old female presented with erythematous to violaceous papules with oozing discharge bilaterally in her inguinal region for a few months. History revealed tuberculous meningitis 4 years earlier treated with first line anti-tuberculous therapy for 18 months, and 2 years previously she developed pigmented discharging lymph nodes bilaterally in her axillae. The histopathology of the biopsy of the axillary nodes showed chronic granulomatous inflammation with multiple branching septate fungal hyphae. She received amphotericin B for 21 days but without improvement. Biopsy from the inguinal lesions was sent for histopathology and culture. \u0000Results: Histopathology of the biopsy material showed chronic granulomatous inflammatory process with multinucleate giant cells, epithelioid cells, histiocytes, and lymphocytes with multiple branching septate fungal hyphae. Gram stain revealed moderate septate hyphae with numerous pus cells. Culture on Sabouraud dextrose agar yielded velvety olive–black colonies in the fourth week. Microscopic slide examination of culture material was suggestive of Cladophialophora species. The patient was started on voriconazole, which was continued for 6 months, and showed clinical improvement.\u0000Conclusion: Incomplete investigation of infectious lesions may delay diagnosis. Furthermore, clinical presentations are greatly influenced by the immune status of the host. Both histopathological and microbiological assessments are equally important for making a conclusive diagnosis. Anti-fungal therapy may delay the growth of fungi that normally grow within a week; thus, a longer incubation time may be warranted for fungal smear-positive samples.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49189833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.33590/microbiolinfectdis/19-00190
Xi Fu, Yu Sun
The prevalence of asthma has increased in the past few decades in most developed and developing countries. Large-scale, cross-sectional epidemiological studies have reported several factors associated with asthma prevalence and severity, including parental asthma, tobacco smoking, preterm delivery, virus infection, and air pollution. However, a puzzling problem is that the time trends in the prevalence of these risk factors cannot explain the rise in asthma. For example, the prevalence of smoking and clinical pneumonia have been decreasing globally in the past few decades. Recent progress in high-throughput sequencing technology has promoted the progress of microbiome research and established associations between human and indoor microbiomes, and many metabolic, cognitive, and immune diseases including asthma and allergies. In this review, the authors systematically summarise the current literature, standard practice, and analysis pipeline in the field of indoor microbiome and asthma. The strength and limitation of different analytical approaches are discussed, including the utilisation of relative and absolute abundance in the associated studies. The authors discuss new frameworks of integrated microbiome research from different ecological niches, functional profiling from multiomics data, and how these new insights can facilitate understanding of asthma mechanisms and even the development of new personalised treatment strategies for the rising asthma epidemic.
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Pub Date : 2020-06-01DOI: 10.33590/emjmicrobiolinfectdis/20-00050
O. Grundmann
The human gut microbiome has garnered much attention over the past two decades with important discoveries linking it to human health and disease. The commensal bacterial flora evolves due to the influence of a number of factors including diet, pathogen exposure, environmental toxicants, disease states, and a challenged microenvironment that requires balancing with the host itself. However, the composition of bacterial species can impact and contribute to the development of local and systemic inflammation. Among the factors attributed to intestinal inflammation are dysbiosis caused by pathogenic bacteria, following decreased host immunity or loss of intestinal barrier function. Dysbiosis can also be triggered by antibiotic therapy or the use of other medications that allow for colonisation of pathogenic bacteria, such as proton pump inhibitors. The imbalance with commensal bacteria leads to the generation of proinflammatory mediators and a reduction of host immune defences, due to a lack of short-chain fatty acid generation needed for energy production to maintain barrier and immune function. The initially localised inflammation results in further dysbiosis as former commensal bacteria are able to breach the barrier and cause systemic immune responses. Low-grade systemic inflammation is a hallmark of inflammatory bowel disease. Because a specific dysbiosis is common in patients with inflammatory bowel disease, it can serve as an early diagnostic marker in its development. Furthermore, faecal microbiome transplants have shown promising benefits in patients with ulcerative colitis and Crohn’s disease.
{"title":"Gastrointestinal Inflammation and the Gut Microbiome: An Evolving Conceptual Framework with Implications for Diagnosis and Therapy in Inflammatory Bowel Disorders","authors":"O. Grundmann","doi":"10.33590/emjmicrobiolinfectdis/20-00050","DOIUrl":"https://doi.org/10.33590/emjmicrobiolinfectdis/20-00050","url":null,"abstract":"The human gut microbiome has garnered much attention over the past two decades with important discoveries linking it to human health and disease. The commensal bacterial flora evolves due to the influence of a number of factors including diet, pathogen exposure, environmental toxicants, disease states, and a challenged microenvironment that requires balancing with the host itself. However, the composition of bacterial species can impact and contribute to the development of local and systemic inflammation. Among the factors attributed to intestinal inflammation are dysbiosis caused by pathogenic bacteria, following decreased host immunity or loss of intestinal barrier function. Dysbiosis can also be triggered by antibiotic therapy or the use of other medications that allow for colonisation of pathogenic bacteria, such as proton pump inhibitors. The imbalance with commensal bacteria leads to the generation of proinflammatory mediators and a reduction of host immune defences, due to a lack of short-chain fatty acid generation needed for energy production to maintain barrier and immune function. The initially localised inflammation results in further dysbiosis as former commensal bacteria are able to breach the barrier and cause systemic immune responses. Low-grade systemic inflammation is a hallmark of inflammatory bowel disease. Because a specific dysbiosis is common in patients with inflammatory bowel disease, it can serve as an early diagnostic marker in its development. Furthermore, faecal microbiome transplants have shown promising benefits in patients with ulcerative colitis and Crohn’s disease.","PeriodicalId":72900,"journal":{"name":"EMJ. Microbiology & infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49033072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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