Pub Date : 2026-01-02DOI: 10.1016/j.eimce.2025.503055
Jaime R Torres, Wilmer Villamil Gómez, Octavio Arce García, Francisco Javier Membrillo de Novales
Mayaro virus (MAYV) and Oropouche virus (OROV) cause emerging infections in Latin America. They represent an increasing public health threat in this and other regions due to their geographic spread, rising case numbers, and the identification of complications and fatal cases. This review, developed by specialists from Latin America and Spain, addresses the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of both infections, aiming to provide valuable information for the diagnosis and management of these diseases based on updated scientific evidence. The diagnostic challenges are emphasized, particularly the clinical overlap with other arboviral infections, the lack of commercial diagnostic tools, and the urgent need for active epidemiological surveillance. The risk of undetected outbreaks is highlighted, along with the importance of including these viruses in clinical algorithms-especially in residents or travellers to endemic areas and, specifically for OROV, in pregnant women with suspected arboviral infection.
{"title":"Epidemiology, diagnosis and treatment of Mayaro and Oropouche virus infections: implication for clinical practice and public health.","authors":"Jaime R Torres, Wilmer Villamil Gómez, Octavio Arce García, Francisco Javier Membrillo de Novales","doi":"10.1016/j.eimce.2025.503055","DOIUrl":"https://doi.org/10.1016/j.eimce.2025.503055","url":null,"abstract":"<p><p>Mayaro virus (MAYV) and Oropouche virus (OROV) cause emerging infections in Latin America. They represent an increasing public health threat in this and other regions due to their geographic spread, rising case numbers, and the identification of complications and fatal cases. This review, developed by specialists from Latin America and Spain, addresses the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of both infections, aiming to provide valuable information for the diagnosis and management of these diseases based on updated scientific evidence. The diagnostic challenges are emphasized, particularly the clinical overlap with other arboviral infections, the lack of commercial diagnostic tools, and the urgent need for active epidemiological surveillance. The risk of undetected outbreaks is highlighted, along with the importance of including these viruses in clinical algorithms-especially in residents or travellers to endemic areas and, specifically for OROV, in pregnant women with suspected arboviral infection.</p>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":" ","pages":"503055"},"PeriodicalIF":0.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897075","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503038
María Aznar , Mariana G. López , María José Torres , Eduardo Briones , Juan Francisco Medina , Verónica González-Galán
Introduction
Tuberculosis (TB) in the Virgen del Rocío university hospital health area, included in the Seville Health District, Spain, exceeds the rate of 17 cases/100,000 inhabitants. Within the Mycobacterium tuberculosis complex (MTBC), M. tuberculosis sensu stricto comprises seven phylogenetic lineages (L1–L4 and L7–L9). The objective of this work is to know the circulating lineages in the area.
Methods
Molecular typing and sequencing were performed to identify circulating lineages from 2015 to 2022.
Results
From 2015 to 2019, the following were identified: L4 (95.95%, n = 355), L2 (1.62%, n = 6), and L6 (1.08%, n = 4). From 2020 to 2022: L4 94.62% (n = 123); L1 1.5% (n = 2); L3 1.5% (n = 2) and L2 0.76% (n = 1).
Conclusions
The emergence of different lineages in our area and their recognition are key to contributing to disease control. These findings demonstrate the need to continue surveillance and apply sequencing to understand and control the dynamics of TB transmission.
{"title":"Identification of lineages and sublineages of the Mycobacterium tuberculosis complex using advanced molecular strategies and WGS in Seville, Spain (2015–2022)","authors":"María Aznar , Mariana G. López , María José Torres , Eduardo Briones , Juan Francisco Medina , Verónica González-Galán","doi":"10.1016/j.eimce.2025.503038","DOIUrl":"10.1016/j.eimce.2025.503038","url":null,"abstract":"<div><h3>Introduction</h3><div>Tuberculosis (TB) in the Virgen del Rocío university hospital health area, included in the Seville Health District, Spain, exceeds the rate of 17 cases/100,000 inhabitants. Within the <em>Mycobacterium tuberculosis</em> complex (MTBC), <em>M. tuberculosis sensu stricto</em> comprises seven phylogenetic lineages (L1–L4 and L7–L9). The objective of this work is to know the circulating lineages in the area.</div></div><div><h3>Methods</h3><div>Molecular typing and sequencing were performed to identify circulating lineages from 2015 to 2022.</div></div><div><h3>Results</h3><div>From 2015 to 2019, the following were identified: L4 (95.95%, n = 355), L2 (1.62%, n = 6), and L6 (1.08%, n = 4). From 2020 to 2022: L4 94.62% (n = 123); L1 1.5% (n = 2); L3 1.5% (n = 2) and L2 0.76% (n = 1).</div></div><div><h3>Conclusions</h3><div>The emergence of different lineages in our area and their recognition are key to contributing to disease control. These findings demonstrate the need to continue surveillance and apply sequencing to understand and control the dynamics of TB transmission.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503038"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897096","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503044
Iñaki Comas
{"title":"Increasing clinical and public health role of Mycobacterium tuberculosis genomics","authors":"Iñaki Comas","doi":"10.1016/j.eimce.2025.503044","DOIUrl":"10.1016/j.eimce.2025.503044","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503044"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957848","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503050
Juliana Esperalba , Maria Arnedo-Muñoz , Ariadna Rando-Segura , Ibai Los-Arcos , Eva Revilla-López , Aroa Gomez-Brey , Patricia Nadal-Barón , Ester Marquez-Algaba , Víctor Monforte , Alberto Sandiumenge , Nieves Larrosa , Tomàs Pumarola , Oscar Len , Andrés Antón
Introduction
Cytomegalovirus (CMV) remains a significant infectious complication in solid organ transplant recipients. Assessing cellular immunity through interferon-gamma (IFN-γ) release assays, such as QuantiFERON®-CMV (QTF-CMV), is useful for guiding prophylactic and therapeutic decisions. Although ELISA is the validated method for QTF-CMV, chemiluminescence immunoassay (CLIA) may offer technical advantages. This study aimed to evaluate the performance of the CLIA-based LIAISON® QuantiFERON®-TB Gold Plus assay in quantifying IFN-γ in QTF-CMV testing, compared to the ELISA-based QuantiFERON®-CMV assay.
Methods
A retrospective study was conducted on 169 stored plasma samples from 85 lung transplant recipients. IFN-γ was quantified using both ELISA (Qiagen®) and CLIA (DiaSorin®). Specific (CMV-NIL) and nonspecific (MIT-NIL) responses were compared using Pearson and Lin's concordance correlation coefficients, Bland–Altman analysis, and ROC curves. Diagnostic agreement was assessed using the Kappa index, sensitivity, specificity, and agreement rates.
Results
CLIA yielded significantly higher IFN-γ values than ELISA for CMV-NIL (+0.41 IU/mL) and MIT-NIL (+0.33 IU/mL). Strong correlation and concordance were observed (r and ρc >0.93). Diagnostic agreement reached 95.86% (Kappa = 0.913), with fewer indeterminate results in CLIA (3.55% vs 4.73%). The optimal CLIA cut-off was 0.2754 IU/mL, achieving 100% sensitivity and specificity compared to ELISA.
Conclusions
CLIA shows excellent agreement with ELISA in QTF-CMV testing and is a reliable and automatable alternative. Its implementation may improve laboratory workflows. Adjusting the cut-off is recommended for optimal diagnostic accuracy.
{"title":"Implementing CLIA for QuantiFERON®-CMV testing: Optimizing cellular immune response against cytomegalovirus","authors":"Juliana Esperalba , Maria Arnedo-Muñoz , Ariadna Rando-Segura , Ibai Los-Arcos , Eva Revilla-López , Aroa Gomez-Brey , Patricia Nadal-Barón , Ester Marquez-Algaba , Víctor Monforte , Alberto Sandiumenge , Nieves Larrosa , Tomàs Pumarola , Oscar Len , Andrés Antón","doi":"10.1016/j.eimce.2025.503050","DOIUrl":"10.1016/j.eimce.2025.503050","url":null,"abstract":"<div><h3>Introduction</h3><div>Cytomegalovirus (CMV) remains a significant infectious complication in solid organ transplant recipients. Assessing cellular immunity through interferon-gamma (IFN-γ) release assays, such as QuantiFERON®-CMV (QTF-CMV), is useful for guiding prophylactic and therapeutic decisions. Although ELISA is the validated method for QTF-CMV, chemiluminescence immunoassay (CLIA) may offer technical advantages. This study aimed to evaluate the performance of the CLIA-based LIAISON® QuantiFERON®-TB Gold Plus assay in quantifying IFN-γ in QTF-CMV testing, compared to the ELISA-based QuantiFERON®-CMV assay.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted on 169 stored plasma samples from 85 lung transplant recipients. IFN-γ was quantified using both ELISA (Qiagen®) and CLIA (DiaSorin®). Specific (CMV-NIL) and nonspecific (MIT-NIL) responses were compared using Pearson and Lin's concordance correlation coefficients, Bland–Altman analysis, and ROC curves. Diagnostic agreement was assessed using the Kappa index, sensitivity, specificity, and agreement rates.</div></div><div><h3>Results</h3><div>CLIA yielded significantly higher IFN-γ values than ELISA for CMV-NIL (+0.41<!--> <!-->IU/mL) and MIT-NIL (+0.33<!--> <!-->IU/mL). Strong correlation and concordance were observed (<em>r</em> and <em>ρ</em><sub>c</sub> >0.93). Diagnostic agreement reached 95.86% (Kappa<!--> <!-->=<!--> <!-->0.913), with fewer indeterminate results in CLIA (3.55% vs 4.73%). The optimal CLIA cut-off was 0.2754<!--> <!-->IU/mL, achieving 100% sensitivity and specificity compared to ELISA.</div></div><div><h3>Conclusions</h3><div>CLIA shows excellent agreement with ELISA in QTF-CMV testing and is a reliable and automatable alternative. Its implementation may improve laboratory workflows. Adjusting the cut-off is recommended for optimal diagnostic accuracy.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503050"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957888","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503033
Irati Arregui García , Iñaki Beguiristain , Miguel Fernández-Huerta , Jesús Castilla , María Eugenia Portillo Bordonabe
Background
The aim of this study was to analyse the changes in the incidence of invasive pneumococcal disease (IPD) before, during, and after the SARS-CoV-2 pandemic.
Methods
Cases of IPD detected through active epidemiological surveillance in Navarre, Spain, from 2018 to 2024 were analysed. Incidence rates were compared across three periods: pre-pandemic (2018–2019), pandemic (2020–2022), and post-pandemic (2023–2024) overall and by age groups and serotypes
Results
From 2018 to 2024, a total of 437 IPD cases were diagnosed in Navarre. The incidence of IPD decreased from 11.6 to 5.6 cases per 100,000 persons during the pandemic period and return to 13.0 cases per 100,000 persons in the post-pandemic period. The incidence decreased across all age groups in both, serotypes included and not included in the 13-valent pneumococcal conjugate vaccine (PCV13). Serotype 3 was the most frequent in the three periods, representing 20.3% of all cases. In the post-pandemic period, 35.2% of cases were due to serotypes included in the PCV-13, 45.7% in the PCV-15 and 64.2% in the PCV-20.
Conclusions
During the SARS-CoV-2 pandemic, the incidence of IPD decreased across all age groups for both, PCV13-included and not included serotypes. In the post-pandemic period, incidence returned to pre-pandemic levels. Whole-genome sequencing techniques helped to serotyping of S. pneumoniae, and thus, complemented epidemiological surveillance.
{"title":"Invasive pneumococcal disease before, during and after the SARS-CoV-2 pandemic","authors":"Irati Arregui García , Iñaki Beguiristain , Miguel Fernández-Huerta , Jesús Castilla , María Eugenia Portillo Bordonabe","doi":"10.1016/j.eimce.2025.503033","DOIUrl":"10.1016/j.eimce.2025.503033","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to analyse the changes in the incidence of invasive pneumococcal disease (IPD) before, during, and after the SARS-CoV-2 pandemic.</div></div><div><h3>Methods</h3><div>Cases of IPD detected through active epidemiological surveillance in Navarre, Spain, from 2018 to 2024 were analysed. Incidence rates were compared across three periods: pre-pandemic (2018–2019), pandemic (2020–2022), and post-pandemic (2023–2024) overall and by age groups and serotypes</div></div><div><h3>Results</h3><div>From 2018 to 2024, a total of 437 IPD cases were diagnosed in Navarre. The incidence of IPD decreased from 11.6 to 5.6 cases per 100,000 persons during the pandemic period and return to 13.0 cases per 100,000 persons in the post-pandemic period. The incidence decreased across all age groups in both, serotypes included and not included in the 13-valent pneumococcal conjugate vaccine (PCV13). Serotype 3 was the most frequent in the three periods, representing 20.3% of all cases. In the post-pandemic period, 35.2% of cases were due to serotypes included in the PCV-13, 45.7% in the PCV-15 and 64.2% in the PCV-20.</div></div><div><h3>Conclusions</h3><div>During the SARS-CoV-2 pandemic, the incidence of IPD decreased across all age groups for both, PCV13-included and not included serotypes. In the post-pandemic period, incidence returned to pre-pandemic levels. Whole-genome sequencing techniques helped to serotyping of <em>S. pneumoniae,</em> and thus, complemented epidemiological surveillance.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503033"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897137","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503049
Verónica Andrade-Amaráz, José Pedro Elizalde-Díaz
Introduction
Dengue virus infection remains a major public health challenge in tropical regions, with heterogeneous progression to severe disease.
Methods
We conducted a prospective longitudinal study of 362 laboratory-confirmed dengue patients, stratified by sex and the presence of warning signs. Serial hematological, hepatic and renal markers were collected over 96 h (at 24 h, 48 h, 72 h, and 96 h after symptom onset) to analyze their dynamic evolution.
Results
Patients with warning signs persisting beyond 48 h exhibited progressive hematological and hepatic deterioration, unlike those without warning signs. This was characterized by progressively declining platelet and neutrophil counts, elevated hematocrit, and rising AST/ALT levels. These worsening trends were more pronounced in women, who also showed a higher prevalence of warning signs (32% vs 25% in men).
Conclusion
The persistence of warning signs beyond 48 h represents a clinically relevant threshold for hematological and hepatic deterioration, supporting the need for protocolized monitoring – including serial platelet counts, hematocrit, and liver enzymes – during this critical window to enable early intervention in high-risk patients.
{"title":"Dengue warning signs persisting post-48 h demand monitoring to avert severe complications","authors":"Verónica Andrade-Amaráz, José Pedro Elizalde-Díaz","doi":"10.1016/j.eimce.2025.503049","DOIUrl":"10.1016/j.eimce.2025.503049","url":null,"abstract":"<div><h3>Introduction</h3><div>Dengue virus infection remains a major public health challenge in tropical regions, with heterogeneous progression to severe disease.</div></div><div><h3>Methods</h3><div>We conducted a prospective longitudinal study of 362 laboratory-confirmed dengue patients, stratified by sex and the presence of warning signs. Serial hematological, hepatic and renal markers were collected over 96<!--> <!-->h (at 24<!--> <!-->h, 48<!--> <!-->h, 72<!--> <!-->h, and 96<!--> <!-->h after symptom onset) to analyze their dynamic evolution.</div></div><div><h3>Results</h3><div>Patients with warning signs persisting beyond 48<!--> <!-->h exhibited progressive hematological and hepatic deterioration, unlike those without warning signs. This was characterized by progressively declining platelet and neutrophil counts, elevated hematocrit, and rising AST/ALT levels. These worsening trends were more pronounced in women, who also showed a higher prevalence of warning signs (32% vs 25% in men).</div></div><div><h3>Conclusion</h3><div>The persistence of warning signs beyond 48<!--> <!-->h represents a clinically relevant threshold for hematological and hepatic deterioration, supporting the need for protocolized monitoring – including serial platelet counts, hematocrit, and liver enzymes – during this critical window to enable early intervention in high-risk patients.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503049"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957852","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503046
José Miguel Gómez Verdú , Sergio Alemán Belando
{"title":"Reply to “Factors associated with glucocorticoid dosing in treating patients with noncritical COVID-19 pneumonia: Insights from an artificial intelligence-based CT imaging analysis”","authors":"José Miguel Gómez Verdú , Sergio Alemán Belando","doi":"10.1016/j.eimce.2025.503046","DOIUrl":"10.1016/j.eimce.2025.503046","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503046"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957890","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 : 2026-01-01DOI: 10.1016/j.eimce.2025.503051
María Asunción Pérez-Jacoiste Asín , Andrea Navarro Flores , Anatolio Alonso Crespo , Ana Pérez-Ayala , Irene Losada Galván , Begoña de Dios , Pilar Hernández-Jiménez , Manuel Gil-Mosquera , Francisco Jiménez-Morillas , Carlos Lumbreras , Manuel Lizasoain , Juan María Herrero-Martínez
Introduction
The number of cases of malaria is increasing in Spain due to tourism and migration. Unfamiliarity with this disease may lead doctors to misrecognize its severity and over-/under-treat it. We aimed to analyse the adequacy of treatment according to malaria severity.
Methods
Single-centre retrospective study at “Hospital 12 de Octubre” (Madrid). We identified all patients over 16-years-old with symptomatic malaria from January 2015 to December 2023. The severity of malaria was defined according to WHO criteria. Parenteral artesunate was the treatment of choice for severe malaria. Oral artemisinin combination or atovaquone/proguanil were used for non-severe malaria.
Results
We identified 64 patients (median age 39.5 years (IQR 32,25–47), 75% Visiting Friends and Relatives. Malaria was severe in 15 patients (23.4%). Antimalarial treatment was adequate to severity in 46 patients (71.8%). Three cases classified as severe malaria received oral treatment while 15 cases apparently non-severe received parenteral artesunate. Those who received oral treatment for severe malaria had been misclassified (mild epistaxis, chronic renal insufficiency, and 3.5% parasitaemia in an immigrant). Among those treated parenterally for non-severe malaria, four had oral intolerance and in the remaining eleven, there was an overuse of artesunate. The main reason for artesunate overuse was the presence of thrombocytopenia (median platelet-count: 33,000/mm3, IQR: 28,000–51,000/mm3).
Conclusions
Antimalarial treatments were mostly adequate, especially in severe cases. The most common reason for artesunate overuse was the presence of thrombocytopenia, which is not included in the WHO criteria for severe malaria.
{"title":"Appropriateness of malaria treatment according to World Health Organization criteria for severe malaria in a non-endemic country","authors":"María Asunción Pérez-Jacoiste Asín , Andrea Navarro Flores , Anatolio Alonso Crespo , Ana Pérez-Ayala , Irene Losada Galván , Begoña de Dios , Pilar Hernández-Jiménez , Manuel Gil-Mosquera , Francisco Jiménez-Morillas , Carlos Lumbreras , Manuel Lizasoain , Juan María Herrero-Martínez","doi":"10.1016/j.eimce.2025.503051","DOIUrl":"10.1016/j.eimce.2025.503051","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of cases of malaria is increasing in Spain due to tourism and migration. Unfamiliarity with this disease may lead doctors to misrecognize its severity and over-/under-treat it. We aimed to analyse the adequacy of treatment according to malaria severity.</div></div><div><h3>Methods</h3><div>Single-centre retrospective study at “Hospital 12 de Octubre” (Madrid). We identified all patients over 16-years-old with symptomatic malaria from January 2015 to December 2023. The severity of malaria was defined according to WHO criteria. Parenteral artesunate was the treatment of choice for severe malaria. Oral artemisinin combination or atovaquone/proguanil were used for non-severe malaria.</div></div><div><h3>Results</h3><div>We identified 64 patients (median age 39.5 years (IQR 32,25–47), 75% <em>Visiting Friends and Relatives</em>. Malaria was severe in 15 patients (23.4%). Antimalarial treatment was adequate to severity in 46 patients (71.8%). Three cases classified as severe malaria received oral treatment while 15 cases apparently non-severe received parenteral artesunate. Those who received oral treatment for severe malaria had been misclassified (mild epistaxis, chronic renal insufficiency, and 3.5% parasitaemia in an immigrant). Among those treated parenterally for non-severe malaria, four had oral intolerance and in the remaining eleven, there was an overuse of artesunate. The main reason for artesunate overuse was the presence of thrombocytopenia (median platelet-count: 33,000/mm<sup>3</sup>, IQR: 28,000–51,000/mm<sup>3</sup>).</div></div><div><h3>Conclusions</h3><div>Antimalarial treatments were mostly adequate, especially in severe cases. The most common reason for artesunate overuse was the presence of thrombocytopenia, which is not included in the WHO criteria for severe malaria.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503051"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897106","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号