Infectious Disease Reports

10 pages, 1571 KiB

Open AccessCase Report

Severe Anaplasmosis with Multi-Organ Failure in a Patient with Splenectomy: A Case Report

by Nithin Karnan, Predrag Jancic, Igor Dumic, Emeka Amadi, Vishnu Kommineni, Jelena Stojsavljevic, Aryan Shiari, Melissa Hart, Ra’ed Jabr and Charles W. Nordstrom

Infect. Dis. Rep. 2025, 17(2), 38; https://doi.org/10.3390/idr17020038 - 21 Apr 2025

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Abstract

Background: Anaplasma phagocytophilum is an emerging tick-borne zoonotic pathogen that typically causes mild infections, which are often successfully managed in outpatient settings. Immunosuppression associated with splenectomy is a well-documented risk factor for severe infections from pathogens such as Babesia microti and encapsulated bacteria. [...] Read more.

Background: Anaplasma phagocytophilum is an emerging tick-borne zoonotic pathogen that typically causes mild infections, which are often successfully managed in outpatient settings. Immunosuppression associated with splenectomy is a well-documented risk factor for severe infections from pathogens such as Babesia microti and encapsulated bacteria. However, splenectomy has not previously been identified as a risk factor for severe anaplasmosis. Case Presentation: This report describes a rare case of severe anaplasmosis complicated by multiorgan failure in a patient who had undergone splenectomy several decades earlier. The clinical course was notable for pneumonia, acute respiratory distress syndrome, acute kidney injury, rhabdomyolysis, atrial fibrillation, and possible myocarditis. Despite the severity of the presentation, prompt initiation of doxycycline led to recovery, albeit with a significantly prolonged hospital stay. Conclusions: Patients with splenectomy might be more likely to develop a serious form of Anaplasmosis infection such as multiorgan failure. Clinicians in tick-borne endemic areas should be aware that non-specific symptoms can indicate anaplasmosis. Full article

(This article belongs to the Section Bacterial Diseases)

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10 pages, 725 KiB

Open AccessArticle

Clinical Characteristics and Outcomes of Patients with Cirrhosis Who Develop Infective Endocarditis

by Erika M. Dorff, Kyle Crooker, Torrance Teng, Tess Hickey, Max HoddWells, Ashwini Sarathy, Sean Muniz, Jennifer Lor, Amy Chang, Devika Singh, Jean Dejace, Elly Riser, Bradley J. Tompkins and Andrew J. Hale

Infect. Dis. Rep. 2025, 17(2), 37; https://doi.org/10.3390/idr17020037 - 21 Apr 2025

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Abstract

Background: Infective endocarditis (IE) is an increasingly common infection that results in significant morbidity and mortality. An important but under-analyzed subpopulation of patients with IE are those with concomitant cirrhosis. This study compared the characteristics and outcomes of patients with and without cirrhosis [...] Read more.

Background: Infective endocarditis (IE) is an increasingly common infection that results in significant morbidity and mortality. An important but under-analyzed subpopulation of patients with IE are those with concomitant cirrhosis. This study compared the characteristics and outcomes of patients with and without cirrhosis who were hospitalized with IE. Methods: The authors conducted a retrospective cohort study in adult patients with IE admitted at a single center from 2010 to 2020, comparing outcomes between those with and without cirrhosis at the time of admission. Results: A total of 22 patients with a history of cirrhosis and 356 patients without a history of cirrhosis were included. Over a quarter (27.3%) of those with cirrhosis experienced a decompensation event within two years of their admission for IE. Clinical features, microbiology, and direct complications from IE were largely similar between groups. There was no significant difference in IE-related mortality rates between groups, although, in an overall survival analysis, the group with cirrhosis did have a higher risk of all-cause mortality at 2 years (HR = 2.85; p = 0.012). Conclusions: This study highlights that IE in patients with cirrhosis may contribute to or trigger decompensation events. Further research is warranted to better understand morbidity outcomes in patients with cirrhosis who develop IE. Full article

(This article belongs to the Section Bacterial Diseases)

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10 pages, 521 KiB

Open AccessArticle

Improved Sixty-Day Mortality in Candidemia with Antifungal Treatment Within 72 Hours of Fever Onset: A Single-Center Retrospective Study in Rural Japan

by Koji Hayashi, Chizuru Hashimoto, Kohei Ueda, Yuka Nakaya, Asuka Suzuki, Maho Hayashi, Mamiko Sato and Yasutaka Kobayashi

Infect. Dis. Rep. 2025, 17(2), 36; https://doi.org/10.3390/idr17020036 - 21 Apr 2025

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Abstract

Introduction: Prognostic factor investigations for candidemia have been conducted in large-scale facilities, leading to significant evidence, including early administration of echinocandin antifungal agents and removal of central venous catheters (CVCs). In departments that provide aggressive chemotherapy or transplantation, candidiasis markers are regularly evaluated, [...] Read more.

Introduction: Prognostic factor investigations for candidemia have been conducted in large-scale facilities, leading to significant evidence, including early administration of echinocandin antifungal agents and removal of central venous catheters (CVCs). In departments that provide aggressive chemotherapy or transplantation, candidiasis markers are regularly evaluated, and preemptive treatments may be initiated. However, in resource-limited facilities, candidemia detection largely relies on vital signs like fever and blood cultures. This study assessed whether evidence from large-scale facilities applies to such settings. Additionally, while prior studies indicate that early antifungal treatment is based on positive blood cultures, no established criteria exist for early administration based on fever as an indicator. Methods: This study analyzed cases of candidemia from blood cultures at Fukui General Hospital (2014–2024). Patients aged 18 or older with at least one positive blood culture for Candida species and clinical signs of infection were included, while contamination cases were excluded. The patients were categorized into survival and death groups based on 60-day survival from fever onset. The variables collected included age, gender, duration from admission to fever onset, time from fever onset to blood culture collection and antifungal treatment initiation, antifungal treatment within 72 h, serum albumin levels, history of cancer, diabetes, empiric echinocandin treatment, CVC insertion, duration of CVC insertion until fever onset, use of total parenteral nutrition, broad-spectrum antibiotic use, and sequential organ failure assessment (SOFA) score. Fever was defined as a body temperature of 38.0 °C or higher, guiding blood culture collection. Results: Of 30 candidemia cases, 29 were analyzed. Survival was significantly associated with younger age (average 73.3 ± 13.3 vs. 83.1 ± 9.1 years, p = 0.038) and antifungal treatment within 72 h of fever onset (9 vs. 3, p = 0.025). CVC use was of marginal significance (8 vs. 13, p = 0.108). There was a significant difference in the duration (in days) of CVC insertion until fever onset (median [IQR]: 15.5 [11.75–19.5] vs. 30.0 [19.0–39.0], p = 0.027). Logistic regression identified early antifungal treatment (OR = 0.065, p = 0.035) and CVC use (OR = 21.8, p = 0.024) as independent predictors of mortality. Conclusions: Early antifungal treatment within 72 h of fever onset and CVC use were independent predictors of mortality in candidemia. The importance of early antifungal treatment was reaffirmed even in smaller facilities. The impact of CVC insertion on 60-day survival cannot be readily generalized due to the limited sample size. Further research is needed to clarify the impact of fever-based antifungal initiation and CVC use on 60-day survival. Full article

(This article belongs to the Section Fungal Infections)

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16 pages, 1066 KiB

Open AccessReview

Global Landscape of Infection-Induced Pulmonary Hypertension

by Ghazwan Butrous

Infect. Dis. Rep. 2025, 17(2), 35; https://doi.org/10.3390/idr17020035 - 17 Apr 2025

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Abstract

Introduction: Infectious diseases significantly impact pulmonary vascular disorders, particularly in developing countries where parasitic infections remain prevalent. These infections constitute a substantial yet frequently overlooked contributor to pulmonary hypertension. Discussion: This review examines the prevalence of parasitic lung diseases in regions [...] Read more.

Introduction: Infectious diseases significantly impact pulmonary vascular disorders, particularly in developing countries where parasitic infections remain prevalent. These infections constitute a substantial yet frequently overlooked contributor to pulmonary hypertension. Discussion: This review examines the prevalence of parasitic lung diseases in regions where communicable infections are endemic and highlights their pathophysiological links to pulmonary hypertension. Schistosomiasis and HIV notably increase pulmonary hypertension risk in these areas. While other infectious diseases may also cause pulmonary vascular lesions, most remain insufficiently studied. The review addresses global epidemiological trends, diagnostic challenges, and recent advancements in understanding the multifaceted origins of pulmonary hypertension. Conclusion: The association between parasitic infections and pulmonary hypertension is significant, necessitating a high index of suspicion for pulmonary hypertension in patients with a history of parasitic diseases, especially in endemic regions. More research is needed to understand infection-related pulmonary hypertension mechanisms and reduce its global impact. Full article

(This article belongs to the Special Issue Pulmonary Vascular Manifestations of Infectious Diseases)

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11 pages, 257 KiB

Open AccessArticle

Abnormal Neurologic and Motor Function in Newborns Treated for Congenital Syphilis

by Bruna Silva, Luciana Friedrich, Graziela Biazus, Renata Bueno and Carla Almeida

Infect. Dis. Rep. 2025, 17(2), 34; https://doi.org/10.3390/idr17020034 - 16 Apr 2025

Viewed by 189

Abstract

Background: Congenital syphilis (CS) is a transplacental infection that can lead to many long-term sequelae when not adequately treated; however, knowledge about the motor and neurological signs that newborns (NBs) with CS may present is scarce. Objective: The aim of this study was [...] Read more.

Background: Congenital syphilis (CS) is a transplacental infection that can lead to many long-term sequelae when not adequately treated; however, knowledge about the motor and neurological signs that newborns (NBs) with CS may present is scarce. Objective: The aim of this study was to describe the results of neurological assessment scales and general movements in NBs with CS in the first days of life. Methods: In this case-series, the Hammersmith Neonatal Neurological Examination (HNNE) and General Movements Assessment (GMA) scales were used to evaluate NBs under treatment for CS in a public Brazilian hospital in the first days of life. Results: The sample consisted of 11 NBs, with a mean birth weight of 3140.5 g, and an Apgar score at 5 min of 8.3. Among the 11 mothers, 4 (36.4%) had fewer than six prenatal visits and 5 (45.5%) did not receive any syphilis treatment. All NB (100%) were asymptomatic, with normal long bone X-rays and cerebrospinal fluid analysis. The mean score on the HNNE was 22 (suboptimal/abnormal). Eight NBs (72.7%) showed abnormalities on GMA scale (with six [54.5%] being mildly abnormal and two [18%] definitely abnormal). Only three NBs (27.3%) returned for outpatient follow-up. Conclusions: Neurological and motor evaluations were abnormal in most of the asymptomatic NBs under treatment for CS in the first days of life, when assessed through specific scales (HNNE and GMA). Most mothers did not receive adequate treatment for syphilis during pregnancy, and there were important deficiencies in post-discharge follow-up. Further studies are needed to confirm these findings and investigate whether the observed abnormalities are linked to biological or environmental factors during pregnancy. Full article

21 pages, 1176 KiB

Open AccessPerspective

Convergent Mechanisms in Virus-Induced Cancers: A Perspective on Classical Viruses, SARS-CoV-2, and AI-Driven Solutions

by Thorsten Rudroff

Infect. Dis. Rep. 2025, 17(2), 33; https://doi.org/10.3390/idr17020033 - 16 Apr 2025

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Abstract

This perspective examines the potential oncogenic mechanisms of SARS-CoV-2 through comparative analysis with established cancer-causing viruses, integrating classical virological approaches with artificial intelligence (AI)-driven analysis. The paper explores four key themes: shared oncogenic mechanisms between classical viruses and SARS-CoV-2 (including cell cycle dysregulation, [...] Read more.

This perspective examines the potential oncogenic mechanisms of SARS-CoV-2 through comparative analysis with established cancer-causing viruses, integrating classical virological approaches with artificial intelligence (AI)-driven analysis. The paper explores four key themes: shared oncogenic mechanisms between classical viruses and SARS-CoV-2 (including cell cycle dysregulation, inflammatory signaling, immune evasion, and metabolic reprogramming); the application of AI in understanding viral oncogenesis; the integration of neuroimaging evidence; and future research directions. The author presents novel hypotheses regarding SARS-CoV-2’s potential oncogenic mechanisms, supported by recent PET/FDG imaging studies showing persistent metabolic alterations. The manuscript emphasizes the transformative potential of combining traditional virological methods with advanced AI technologies for better understanding and preventing virus-induced cancers, while highlighting the importance of long-term monitoring of COVID-19 survivors for potential oncogenic developments. Full article

(This article belongs to the Section Viral Infections)

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14 pages, 1830 KiB

Open AccessSystematic Review

Sickle Cell Disease and Antimicrobial Resistance: A Systematic Review and Meta-Analysis

by Bismark Opoku-Asare, Onyansaniba K. Ntim, Aaron Awere-Duodu and Eric S. Donkor

Infect. Dis. Rep. 2025, 17(2), 32; https://doi.org/10.3390/idr17020032 - 14 Apr 2025

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Abstract

Background/Objectives: Antimicrobial resistance (AMR) is increasingly rising due to antimicrobial overuse and misuse. In sickle cell disease (SCD) care, frequent antibiotic use drives the rapid emergence of AMR, threatening treatment options and patient lives. This systematic review synthesizes data on AMR with [...] Read more.

Background/Objectives: Antimicrobial resistance (AMR) is increasingly rising due to antimicrobial overuse and misuse. In sickle cell disease (SCD) care, frequent antibiotic use drives the rapid emergence of AMR, threatening treatment options and patient lives. This systematic review synthesizes data on AMR with regard to SCD patients for the first time. Methods: A comprehensive database search for articles published in English was conducted in PubMed, Scopus, ScienceDirect, and Web of Science, with no restriction set for the year of publication. The DerSimonian–Laird method was applied to derive the pooled prevalence, while the Mantel–Haenszel method was used to calculate the pooled odds ratio. Results: A total of 18 eligible studies covering 3220 SCD patients published between 1996 and 2024 were included in this review. The common bacterial pathogens reported in the included studies were Streptococcus pneumoniae (10 studies), Staphylococcus aureus (10 studies), and Escherichia coli (4 studies). For S. aureus, the pooled resistance was highest for penicillins (ampicillin = 100%; penicillin = 93.64%; and amoxicillin = 77.82%) followed by cefuroxime (51.23%). The pooled prevalence of methicillin-resistant S. aureus (MRSA) was 19.30%. SCD patients had 2.89 and 2.47 times higher odds of being colonized or infected with penicillin-resistant and erythromycin-resistant S. aureus strains, respectively. For S. pneumoniae, resistance prevalence was highest for co-trimoxazole (81.1%), followed by penicillin (47.08%). The pooled prevalence of multidrug-resistant (MDR) S. pneumoniae isolates was 32.12%. The majority of the studies included (n = 14, 77.8%) were of moderate quality according to the modified STROBE checklist. Conclusions: This review reveals a high prevalence of AMR with regard to SCD patients. SCD patients have an increased risk of resistance to penicillin and co-trimoxazole across several bacterial pathogens. The limited geographical distribution of the included studies underscores the urgent need for expanded AMR research on the subject, especially in regions with high SCD burden. Full article

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17 pages, 998 KiB

Open AccessReview

The Global Burden of Clostridioides difficile Infections, 2016–2024: A Systematic Review and Meta-Analysis

by Rachel A. A. Akorful, Alex Odoom, Aaron Awere-Duodu and Eric S. Donkor

Infect. Dis. Rep. 2025, 17(2), 31; https://doi.org/10.3390/idr17020031 - 14 Apr 2025

Viewed by 297

Abstract

Background: Clostridioides difficile infection (CDI) is a major cause of healthcare-associated infections globally. Understanding variations in CDI incidence and outcomes across settings, populations, and regions is important for guiding prevention strategies. Aim: The aim of this study was to determine the [...] Read more.

Background: Clostridioides difficile infection (CDI) is a major cause of healthcare-associated infections globally. Understanding variations in CDI incidence and outcomes across settings, populations, and regions is important for guiding prevention strategies. Aim: The aim of this study was to determine the global epidemiology of CDI to better understand disease burden across settings and geographic regions. Methods: Relevant publications were identified through searches of major databases, including PubMed, Scopus, and Web of Science, published from 1 January 2016 through 24 July 2024. Random effects models were used to pool estimates, and 95% confidence intervals (CIs) were calculated. Results: A total of 59 studies, representing 24 countries across North America, Europe, the Asia–Pacific region, Latin America, and the Middle East, met the inclusion criteria. The incidence of CDI was highest in hospital-onset healthcare facility settings, with 5.31 cases/1000 admissions (95% CI 3.76–7.12) and 5.00 cases/10,000 patient-days (95% CI 3.96–6.15). Long-term care facilities reported 44.24 cases/10,000 patient-days (95% CI 39.57–49.17). Pediatric populations faced a greater risk, with 4.52 cases/1000 admissions (95% CI 0.55–12.17), than adults did at 2.13 (95% CI 1.69–2.61). Recurrence rates were highest for community-acquired CDI at 16.22%. The death rates for the CDI cases tracked for 30 days and of unspecified duration were 8.32% and 16.05%, respectively. Conclusions: This comprehensive review identified healthcare facilities, long-term care, pediatric populations, and North America as disproportionately burdened. This finding provides guidance on priority areas and populations for targeted prevention through antimicrobial stewardship, infection control, and surveillance. Full article

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21 pages, 3302 KiB

Open AccessSystematic Review

Fusobacterium Species in Osteoarticular Infections in Childhood—A Systematic Review with Data Synthesis and a Case Series in the Acetabular and Hip Joint Regions

by Heide Delbrück, Silvia Schröder, Tom Stapper, Sabine Schacht, Angeliki Pappa, Frank Hildebrand and Miriam Katharina Hertwig

Infect. Dis. Rep. 2025, 17(2), 30; https://doi.org/10.3390/idr17020030 - 10 Apr 2025

Viewed by 180

Abstract

Background: In paediatric osteoarticular infections, microorganism detection is unsuccessful in up to 55% of cases, which is not satisfactory for targeted antibiotic therapy. In particular, anaerobic fusobacteria may be underdiagnosed owing to a lack of knowledge about their properties. Methods: Based [...] Read more.

Background: In paediatric osteoarticular infections, microorganism detection is unsuccessful in up to 55% of cases, which is not satisfactory for targeted antibiotic therapy. In particular, anaerobic fusobacteria may be underdiagnosed owing to a lack of knowledge about their properties. Methods: Based on three of our own cases and a systematic literature review regarding paediatric osteoarticular fusobacterial infections, we extracted characteristic variables and synthesised them in terms of frequencies and mean comparisons. We followed the CARE and PRISMA guidelines. Results: In our three patients with hip area infections (aged 11, 12, and 16 years; two males and one female; two with Fusobacterium nucleatum [FNU] and one with Fusobacterium necrophorum [FNE]), we only detected FNU with PCR. The patient with an FNE infection showed a septic and protracted course with six surgical interventions and secondary coxarthrosis during the follow-up. The FNU infections were milder and healed without sequelae. In the literature, there are no articles with more than 3 cases; overall, we identified 38 case reports and 3 case series with a total of 45 patients. Across all synthesised cases (73% boys), the age was 9.2 ± 4.1 years. Most patients (42%) were affected by hip joint arthritis, with or without accompanying acetabular or femoral osteomyelitis, followed by knee joint arthritis, with or without osteomyelitis, in 24% of patients. In 49% of cases, there was an ear, nose, and throat focus. Depending on the affected structure, arthrotomy (33%), arthroscopy (11%), bone (24%), and soft tissue (9%) debridement were performed, with 34% of the procedures having to be performed several times. Penicillins, metronidazole, and clindamycin were the most used antibiotics. In 32 cases (71%), the authors reported healing without sequelae. Conclusions: When samples are collected in the operating theatre for paediatric osteoarticular infections, orthopaedic surgeons should also ensure correct anaerobic sampling and consider the possibility of performing PCR. A typical child with an osteoarticular fusobacterial infection is a boy of approximately 10 years of age with an infection in the hip area and a previous infection in the ENT area. Full article

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15 pages, 3901 KiB

Open AccessArticle

Multi-Year Analysis of Respiratory Viral Dynamics Reveals Significance of Rhinovirus in Young Children with Severe Respiratory Illness

by Juan Raphael Caldera, Tawny Saleh, Trevon Fuller, Shangxin Yang and Karin Nielsen-Saines

Infect. Dis. Rep. 2025, 17(2), 29; https://doi.org/10.3390/idr17020029 - 3 Apr 2025

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Abstract

Objectives: We aimed to analyze the landscape of viral respiratory illnesses (VRIs) in a large metropolitan area in Southern California with a focus on the COVID-19 pandemic. Methods: We conducted a retrospective cohort study within the UCLA Health System, which evaluated [...] Read more.

Objectives: We aimed to analyze the landscape of viral respiratory illnesses (VRIs) in a large metropolitan area in Southern California with a focus on the COVID-19 pandemic. Methods: We conducted a retrospective cohort study within the UCLA Health System, which evaluated children aged 0–5 years who received comprehensive respiratory viral panel (cRVP) testing during August–February of 2018–2023. The patient demographics, disease severity, and clinical course were specifically compared during the pandemic. Predictors of significant VRI were determined by multivariate logistic regression. Results: A total of 1321 children underwent cRVP testing, and 753 positive subjects were identified during the study period. Rhinovirus (RV) was by far the most frequent virus detected across 5 years, even during the COVID-19 pandemic, followed by respiratory syncytial virus (RSV). Along with RSV and human metapneumovirus, RV was identified as an independent risk for significant disease and occurred irrespective of co-infection with other viruses. Conclusions: RV was the most common viral pathogen in young children, even during the height of the COVID-19 pandemic, and was an independent driver of moderate-to-severe disease, particularly in children with comorbidities. Ethnic disparities were also observed as a risk for significant disease, underscoring the need for targeted interventions and heightened clinical vigilance in pediatric populations. Full article

(This article belongs to the Section Viral Infections)

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10 pages, 1925 KiB

Open AccessCase Report

Usual Interstitial Pneumonia Pattern and Mycobacteria Lung Diseases: A Case Series

by Maria Angela Licata, Giorgio Monteleone, Enrico Schiavi, Maria Musso, Paola Mencarini, Annelisa Mastrobattista, Serena Maria Carli, Carlotta Cerva, Giacomo Sgalla, Luca Richeldi, Fabrizio Palmieri and Gina Gualano

Infect. Dis. Rep. 2025, 17(2), 28; https://doi.org/10.3390/idr17020028 - 3 Apr 2025

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Abstract

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of conditions that can cause fibrosis of the lung interstitium, resulting in respiratory failure and death. Patients with an ILD, particularly idiopathic pulmonary fibrosis (IPF) or connective tissue disease-associated ILDs (CTD-ILDs), are prone to [...] Read more.

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of conditions that can cause fibrosis of the lung interstitium, resulting in respiratory failure and death. Patients with an ILD, particularly idiopathic pulmonary fibrosis (IPF) or connective tissue disease-associated ILDs (CTD-ILDs), are prone to develop chronic pulmonary infections such as tuberculosis (TB) and non-tuberculous mycobacterial pulmonary disease (NTM-PD). Methods: This case series examines the management of three ILD patients with a usual interstitial pneumonia (UIP) pattern and concomitant NTM-PD or TB at National Institute for Infectious Diseases “Lazzaro Spallanzani” in Rome, Italy, over three years (2019–2022). Results and Conclusions: Multi-disciplinary discussion (MDD) was crucial to define the therapeutic approach due to the increased risk of side effects and drug interactions. Our work underscored how a comprehensive diagnostic evaluation, enriched by MDD, is useful for optimizing the management and reducing drug-related adverse effects and interactions in ILD patients with cavitary lesions. Full article

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10 pages, 1828 KiB

Open AccessCase Report

Effective Management of a Skin and Soft Tissue Infection Caused by Community-Acquired MRSA Through Triple-Targeted Therapy Along with Aggressive Source Control: A Case Report

by Matteo Laratta, Stefano Agliardi, Matteo Sola, Stefano Spina and Roberto Fumagalli

Infect. Dis. Rep. 2025, 17(2), 27; https://doi.org/10.3390/idr17020027 - 24 Mar 2025

Viewed by 381

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of healthcare-associated infections in Europe. It has become increasingly prevalent in community settings, causing skin and soft tissue infections (SSTIs). Managing community-acquired (CA) MRSA infections is challenging due to its high virulence and resistance [...] Read more.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of healthcare-associated infections in Europe. It has become increasingly prevalent in community settings, causing skin and soft tissue infections (SSTIs). Managing community-acquired (CA) MRSA infections is challenging due to its high virulence and resistance to common antibiotics, and prevention outside the hospital setting is complex. Combination therapy has demonstrated efficacy in the treatment of severe MRSA infections. Furthermore, surgical source control is critical in treating CA-MRSA infections, involving removing the primary infection site to interrupt bacterial replication. Timeliness and a correct surgical approach are essential for successful treatment outcomes and improved quality of life. Methods: This report details the case of a 15-year-old athlete who was admitted to the intensive care unit with septic shock caused by CA-MRSA. Results: Despite initial treatment, his condition rapidly worsened. A computed tomography (CT) scan identified multiple abscesses (in the lungs, limbs, thyroid, and subscapular region) along with other complications. To achieve adequate tissue concentrations at all affected sites, a triple-targeted antimicrobial therapy was initiated and adjusted based on therapeutic drug monitoring (TDM). At the same time, daily surgical debridement was performed. The patient responded significantly to this treatment, and blood cultures eventually returned negative. Conclusions: A multidisciplinary approach involving early source control, tailored antimicrobial therapy, and, if monotherapy fails to control infection, combination therapy is advisable to treat life-threatening CA-MRSA infections. Full article

(This article belongs to the Section Bacterial Diseases)

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5 pages, 188 KiB

Open AccessEditorial

Advances in the Management of Infectious Diseases

by Rabeea F. Omar, Sylvie Trottier, Sachiko Sato, Marc Ouellette and Michel G. Bergeron

Infect. Dis. Rep. 2025, 17(2), 26; https://doi.org/10.3390/idr17020026 - 14 Mar 2025

Viewed by 449

Abstract

The landscape of infectious diseases has dramatically evolved since the 1970s and the advent of antimicrobials, which heralded a new era in medical history [...] Full article

(This article belongs to the Special Issue Prevention, Diagnosis and Treatment of Infectious Diseases)

13 pages, 812 KiB

Open AccessArticle

Unhealthy Food Consumption Is Associated with Post-Acute Sequelae of COVID-19 in Brazilian Elderly People

by Guilherme José Silva Ribeiro, Rafaela Nogueira Gomes de Morais, Olufemi Gabriel Abimbola, Nalva de Paula Dias, Mariana De Santis Filgueiras, André de Araújo Pinto and Juliana Farias de Novaes

Infect. Dis. Rep. 2025, 17(2), 25; https://doi.org/10.3390/idr17020025 - 13 Mar 2025

Viewed by 460

Abstract

Background/Objectives: The factors associated with post-acute sequelae of COVID-19 (PASC) are not yet fully understood in developing countries. Our objective was to investigate the relationship between food consumption and the occurrence of PASC in Brazilian elderly people. Methods: This cross-sectional study [...] Read more.

Background/Objectives: The factors associated with post-acute sequelae of COVID-19 (PASC) are not yet fully understood in developing countries. Our objective was to investigate the relationship between food consumption and the occurrence of PASC in Brazilian elderly people. Methods: This cross-sectional study included 1322 elderly people aged 60 or over, infected with SARS-CoV-2 in 2020, living in the state of Roraima in Brazil. Using the Brazilian National Food and Nutrition Surveillance System (SISVAN, in Portuguese) tool, food consumption markers were evaluated. The persistence of post-acute sequelae of COVID-19 was assessed three months after SARS-CoV-2 infection. Poisson regression with robust variance was performed to estimate the prevalence ratio (PR) with a 95% confidence interval (95% CI). Results: Fruit consumption [PR 0.92; 95% CI: 0.85–0.99] was associated with a lower occurrence of PASC, with a significant interaction in individuals aged 60 to 69 years old, not hospitalized, and those without chronic kidney disease. In addition, the consumption of sugar-sweetened beverages [PR 1.23; 95% CI: 1.12–1.35], sandwich cookies, sweets, and treats [PR 1.12; 95% CI 1.03–1.22] was positively associated with the occurrence of PASC in the elderly people, with a significant interaction in individuals living in the capital and without hypercholesterolemia. Conclusions: Unhealthy food consumption was associated with PASC in Brazilian elderly people. An improvement in the diet quality of elderly people is necessary to minimize health complications in PASC. Full article

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3 pages, 173 KiB

Open AccessEditorial

Phage Therapy for Mycobacteria: Overcoming Challenges, Unleashing Potential

by Christoffel Johannes Opperman and Adrian J. Brink

Infect. Dis. Rep. 2025, 17(2), 24; https://doi.org/10.3390/idr17020024 - 12 Mar 2025

Viewed by 558

Abstract

Bacteriophage (phage) therapy is emerging as a promising alternative to traditional antibiotics for treating drug-resistant mycobacterial infections, including Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM) [...] Full article

8 pages, 1832 KiB

Open AccessCase Report

Syphilitic Cholangiopathy Mimicking Primary Sclerosing Cholangitis

by Adriana Gregušová, Michal Gergel and Miroslav Žigrai

Infect. Dis. Rep. 2025, 17(2), 23; https://doi.org/10.3390/idr17020023 - 6 Mar 2025

Viewed by 507

Abstract

Introduction: Syphilis is a sexually transmitted disease with variable symptoms, often imitating various other disorders. Syphilis progresses through primary, secondary, latent, and tertiary stages, each with distinct clinical manifestations. A sudden rise in serum hepatic enzyme levels and imaging findings that mimic sclerosing [...] Read more.

Introduction: Syphilis is a sexually transmitted disease with variable symptoms, often imitating various other disorders. Syphilis progresses through primary, secondary, latent, and tertiary stages, each with distinct clinical manifestations. A sudden rise in serum hepatic enzyme levels and imaging findings that mimic sclerosing cholangitis, both associated with a positive response to targeted antibiotic treatment, may indicate a diagnosis of acute syphilitic hepatitis. Case Presentation: We report a case of early syphilis in the secondary stage, manifesting as sclerosing-cholangitis-like changes shown on ultrasonography, MR, and CT. Narrow-spectrum antibiotic therapy with procaine benzylpenicillin led to a consistent decrease in and normalization of levels of serum bilirubin and other markers of hepatic injury. Repeated sonography and MR cholangiography showed minimal residual changes in the intrahepatic biliary tree. Conclusions: Infection with Treponema pallidum is one of the rare causes of secondary cholangitis. As the incidence of syphilis is rising worldwide, it should be considered as a differential diagnosis, especially for patients with high-risk sexual behavior and for whom there are laboratory findings of cholestatic or mixed cytolytic and cholestatic hepatitis, particularly if associated with exanthema, pharyngitis, and lymphadenopathy. Full article

(This article belongs to the Section Sexually Transmitted Diseases)

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11 pages, 2171 KiB

Open AccessSystematic Review

Clinical, Functional, and Hemodynamic Profile of Schistosomiasis-Associated Pulmonary Arterial Hypertension Patients in Brazil: Systematic Review and Meta-Analysis

by Camila M. C. Loureiro, André L. Scheibler Filho, Vitor M. A. S. Menezes, Ricardo A. Correa, Rudolf K. F. Oliveira, Claudia Mickael, Joan F. Hilton and Brian B. Graham

Infect. Dis. Rep. 2025, 17(2), 22; https://doi.org/10.3390/idr17020022 - 4 Mar 2025

Cited by 1 | Viewed by 605

Abstract

Background: Schistosoma-associated pulmonary arterial hypertension (Sch-PAH), a complication of hepatosplenic schistosomiasis, is still underdiagnosed and undertreated. Sch-PAH is the third-most common cause of pulmonary arterial hypertension (PAH) in Brazil, and it is estimated that there are around 60,000 afflicted individuals. However, there is [...] Read more.

Background: Schistosoma-associated pulmonary arterial hypertension (Sch-PAH), a complication of hepatosplenic schistosomiasis, is still underdiagnosed and undertreated. Sch-PAH is the third-most common cause of pulmonary arterial hypertension (PAH) in Brazil, and it is estimated that there are around 60,000 afflicted individuals. However, there is a lack of data on these patients, especially in endemic areas. Therefore, this study aimed to describe baseline demographic data, hemodynamic severity of disease, and functional impairment of Sch-PAH patients at diagnosis. Methods: For this systematic review, five databases (Embase, PubMed, SciELO, LILACS, and Cochrane) were searched to identify candidate publications reporting clinical, hemodynamic, and functional data at diagnosis of Sch-PAH patients referred to a PAH reference center in Brazil. Studies were excluded if they enrolled patients under the age of 18, the diagnosis was not confirmed by right heart catheterization (RHC), consisted of case reports, or did not report original data. Risk of bias was assessed using the Newcastle–Ottawa Scale and an adapted version for cross-sectional studies. Single-arm meta-analysis with a random-effect model was performed for each variable. Results: From 459 studies identified through systematic database searching, five studies were selected for this meta-analysis. The majority of the included patients were women (67%), New York Heart Association (NYHA) functional class III/IV (57%), mean age 49 years (95% confidence interval [95% CI], 46–52), 6 min walk distance 392 m (95% CI, 291–493), mean pulmonary arterial pressure (mPAP) 59 mmHg (95% CI, 56–61), pulmonary vascular resistance (PVR) 12 WU (95% CI, 11–13) and cardiac index (CI) 2.57 L/min/m² (95% CI, 2.25–2.88). Conclusions: In summary, Sch-PAH has clinical characteristics similar to other forms of PAH, including connective tissue disease and idiopathic PAH. Additional studies or a unified registry would be essential for a better understanding of this relevant disease in Brazil. Full article

(This article belongs to the Section Infection Prevention and Control)

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11 pages, 237 KiB

Open AccessArticle

Endothelial Dysfunction Markers Correlate with the Time Since Completion of Tuberculosis Treatment and the Number of Previous Tuberculosis Episodes

by Chrisstoffel Jumaar, Steve Jacobs, Carmen Payne, Olakunle Sanni, Elize Louw, Nicola Baines, David Maree, Benjamin Botha, Merga Belina Feyasa, Hans Strijdom, Brian Allwood and Gerald J. Maarman

Infect. Dis. Rep. 2025, 17(2), 21; https://doi.org/10.3390/idr17020021 - 28 Feb 2025

Cited by 1 | Viewed by 470

Abstract

Background: Despite “successful” treatment, some lung tuberculosis (TB) patients develop long-term lung impairments that includes damage to the parenchyma and reduced function, which may predispose them to diseases like pulmonary hypertension. However, this is not well understood. Therefore, we investigated whether previous or [...] Read more.

Background: Despite “successful” treatment, some lung tuberculosis (TB) patients develop long-term lung impairments that includes damage to the parenchyma and reduced function, which may predispose them to diseases like pulmonary hypertension. However, this is not well understood. Therefore, we investigated whether previous or current TB patients would display elevated biomarkers of endothelial dysfunction and vascular remodeling. Methods: We performed assays for ADMA, VCAM-1, VEGF, angiopoietin-1, TBARS, NT-pro-BNP, and cardiac troponin-I. We further stratified the patients based on 1, 2, 3, and >3 previous TB episodes, and 1–5 yrs, 5–10 yrs, 10–15 yrs and >15 yrs after the last TB treatment completion. We also assessed correlations between the biomarkers and the number of previous TB episodes or the time since the completion of the last TB treatment. Results: ADMA was 70 times higher, VEGF was 2000 times higher and angiopoietin-1 was 6500 times higher than the normal range. NT-pro-BNP and cardiac troponin-I were undetected, and TBARS levels were low. There was a positive linear relationship between the number of previous TB episodes and angiopoietin-1, and between VEGF and the number of previous TB episodes. ADMA, VCAM-1 and TBARS exhibited a weak and negative linear association with the number of previous TB episodes. A negligible negative linear association was observed between the time since the completion of the last TB treatment and angiopoietin-1, VEGF and ADMA. Conclusions: Therefore, having >1 previous TB episode, despite the successful completion of TB treatment, associates with an increased risk of endothelial dysfunction/angiogenesis or vascular remodeling. Full article

(This article belongs to the Special Issue Pulmonary Vascular Manifestations of Infectious Diseases)

15 pages, 2594 KiB

Open AccessArticle

Comprehensive Analysis of Influenza Viruses’ Trends in Italy: Insights from a Nationwide and Regional Perspective

by Francesco Branda , Nicola Petrosillo , Dong Keon Yon , Massimo Ciccozzi and Fabio Scarpa

Infect. Dis. Rep. 2025, 17(2), 20; https://doi.org/10.3390/idr17020020 - 27 Feb 2025

Cited by 1 | Viewed by 715

Abstract

Background. Influenza remains a significant public health issue, with seasonal trends varying across regions. This study provides a comprehensive analysis of influenza virus trends in Italy, leveraging epidemiological and virological data from the Istituto Superiore di Sanità (ISS). The primary objective is [...] Read more.

Background. Influenza remains a significant public health issue, with seasonal trends varying across regions. This study provides a comprehensive analysis of influenza virus trends in Italy, leveraging epidemiological and virological data from the Istituto Superiore di Sanità (ISS). The primary objective is to assess influenza activity at both national and regional levels, highlighting variations in incidence rates and viral subtype circulation during the 2023/2024 season. Methods. We conducted a systematic approach to data collection, processing, and visualization, utilizing influenza surveillance data from ISS. Incidence rates, subtype distribution, and co-circulating respiratory viruses were analyzed to identify key trends. Results. Our findings reveal a significant increase in influenza cases during the 2023/2024 season, with incidence rates surpassing pre-pandemic levels. Notably, changes in the circulation of influenza A(H3N2) and influenza B were observed, alongside the presence of other respiratory viruses such as RSV and rhinovirus. Conclusions. This study underscores the importance of real-time surveillance, transparent data sharing, and advanced visualization tools in guiding public health responses. By integrating lessons from COVID-19, we highlight the necessity of standardized surveillance frameworks to enhance preparedness for future seasonal outbreaks and potential pandemics. Full article

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20 pages, 2636 KiB

Open AccessReview

COVID-19 and Parasitic Co-Infection: A Hypothetical Link to Pulmonary Vascular Disease

by Peter S. Nyasulu, Jacques L. Tamuzi, Rudolf K. F. Oliveira, Suellen D. Oliveira, Nicola Petrosillo, Vinicio de Jesus Perez, Navneet Dhillon and Ghazwan Butrous

Infect. Dis. Rep. 2025, 17(2), 19; https://doi.org/10.3390/idr17020019 - 27 Feb 2025

Viewed by 597

Abstract

Background/Objectives: Before the Coronavirus disease 2019 (COVID-19) era, the global prevalence of pulmonary arterial hypertension (PAH) was between 0.4 and 1.4 per 100,000 people. The long-term effects of protracted COVID-19 associated with pulmonary vascular disease (PVD) risk factors may increase this prevalence. [...] Read more.

Background/Objectives: Before the Coronavirus disease 2019 (COVID-19) era, the global prevalence of pulmonary arterial hypertension (PAH) was between 0.4 and 1.4 per 100,000 people. The long-term effects of protracted COVID-19 associated with pulmonary vascular disease (PVD) risk factors may increase this prevalence. According to preliminary data, the exact prevalence of early estimates places the prevalence of PVD in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at 22%, although its predictive value remains unknown. PVD caused by COVID-19 co-infections is understudied and underreported, and its future impact is unclear. However, due to COVID-19/co-infection pathophysiological effects on pulmonary vascularization, PVD mortality and morbidity may impose a genuine concern—both now and in the near future. Based on reported studies, this literature review focused on the potential link between COVID-19, parasitic co-infection, and PVD. This review article also highlights hypothetical pathophysiological mechanisms between COVID-19 and parasitic co-infection that could trigger PVD. Methods: We conducted a systematic literature review (SLR) searching peer-reviewed articles, including link between COVID-19, parasitic co-infection, and PVD. Results: This review hypothesized that multiple pathways associated with pathogens such as underlying schistosomiasis, human immunodeficiency virus (HIV), pulmonary tuberculosis (PTB), pulmonary aspergillosis, Wuchereria bancrofti, Clonorchis sinensis, paracoccidioidomycosis, human herpesvirus 8, and scrub typhus coupled with acute or long COVID-19, may increase the burden of PVD and worsen its mortality in the future. Conclusions: Further experimental studies are also needed to determine pathophysiological pathways between PVD and a history of COVID-19/co-infections. Full article

(This article belongs to the Special Issue Pulmonary Vascular Manifestations of Infectious Diseases)

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18 pages, 559 KiB

Open AccessArticle

Utilizing an Educational Intervention to Enhance Influenza Vaccine Literacy and Acceptance Among Minoritized Adults in Southern Californian Vulnerable Communities in the Post-COVID-19 Era

by Jacinda C. Abdul-Mutakabbir, Raheem Abdul-Mutakabbir and Samuel J. Casey

Infect. Dis. Rep. 2025, 17(2), 18; https://doi.org/10.3390/idr17020018 - 26 Feb 2025

Viewed by 589

Abstract

Background/Objectives: Since the COVID-19 pandemic began, vaccination rates for preventable diseases, including influenza, have significantly dropped among racially and ethnically minoritized (REM) individuals in the United States. This study explored the effects of a community-based educational intervention designed to improve influenza vaccine literacy [...] Read more.

Background/Objectives: Since the COVID-19 pandemic began, vaccination rates for preventable diseases, including influenza, have significantly dropped among racially and ethnically minoritized (REM) individuals in the United States. This study explored the effects of a community-based educational intervention designed to improve influenza vaccine literacy and acceptance among vulnerable REM individuals. Methods: The intervention included four 45 min interactive educational sessions on the influenza vaccine. The session attendees (18+) were invited to participate in a pre-/post-intervention study where an anonymous survey measured their post-COVID-19 pandemic attitudes, knowledge, and behaviors regarding the influenza virus and vaccine. To assess the effect of the intervention on vaccine literacy, we used a Mann–Whitney U test to test for differences between the pre-/post-intervention survey responses to seven knowledge-based questions. Descriptive statistics were employed to assess the impact of intervention on vaccine acceptance. Results: A total of 116 participants completed the pre-intervention survey, and 90 (78%) completed the post-intervention survey. All (100%) identified as REM, and 99% lived in highly vulnerable areas. Only 43% believed they were at risk for viral infection before the intervention, but 60% said the intervention helped them reassess their risk. We found significant differences in vaccine literacy when comparing the pre-/post-intervention survey responses, particularly regarding guideline-based vaccine recommendations (p < 0.05). Before the intervention, 65% of the participants indicated a high likelihood of receiving the influenza vaccine. In contrast, after the intervention, 81% of respondents indicated a high likelihood of being vaccinated, and 72% indicated that they were “extremely likely” to receive the immunization. Conclusions: Community-based educational interventions can have a positive impact on influenza vaccine literacy and acceptance among vulnerable REM populations in the post-COVID-19 era. Full article

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9 pages, 1143 KiB

Open AccessArticle

Effectiveness and Tolerability of Dual Antiviral Therapy in Immunosuppressed Patients with Protracted SARS-CoV-2 Infection

by Giovanna Travi, Francesco Peracchi, Marco Merli, Emanuele Ravano, Anna Frustaci, Marina Deodato, Diana Fanti, Alice Nava, Valeriana Colombo, Nicholas Brian Bana, Carlotta Rogati, Alessandro Raimondi, Cristina Moioli, Anna Maria Pazzi, Marta Vecchi, Davide Motta, Roberto Rossotti, Chiara Oltolini, Fulvio Crippa, Enrico Minetti, Chiara Vismara, Roberto Cairoli and Massimo Puoti Show full author list Hide full author list

Infect. Dis. Rep. 2025, 17(2), 17; https://doi.org/10.3390/idr17020017 - 26 Feb 2025

Viewed by 529

Abstract

Background: Immunosuppressed patients still exhibit a high mortality rate due to SARS-CoV-2 infection, up to 21%. Persistent viral load replication and protracted viral symptoms result in a high risk of developing pneumonia, a potential risk of antiviral resistance, and a subsequent delay of [...] Read more.

Background: Immunosuppressed patients still exhibit a high mortality rate due to SARS-CoV-2 infection, up to 21%. Persistent viral load replication and protracted viral symptoms result in a high risk of developing pneumonia, a potential risk of antiviral resistance, and a subsequent delay of onco-hematological treatments. Methods: Hematological patients and kidney transplant patients with SARS-CoV-2 infection, treated at GOM Niguarda Hospital (Milan) with combined antiviral therapy (remdesivir plus nirmatrelvir/ritonavir at standard doses) between November 2022 and March 2024, were retrospectively reviewed. Results: Thirty-four patients were analyzed. Twenty-four (71%) patients had pneumonia. The median duration of SARS-CoV-2 positivity before antiviral treatment was 40 (10–34) days. The median treatment duration was 11 (10–10) days. All patients went through clinical resolution. Thirteen patients were exposed to a new immune-chemotherapy cycle early after antiviral treatment (median 13, IQR 6–12 days), while five resumed a standard immunosuppressive regimen immediately after viral clearance. No relapse or recurrence of symptoms was reported for up to 226 (106–318) days of follow-up. Antiviral therapy was well tolerated, and no adverse events were observed. The 30-day overall survival was 94%, while the 90-day survival was 88%. No patient died of SARS-CoV-2 infection. Conclusions: The administration of nirmatrelvir/ritonavir and remdesivir lead to the complete resolution of SARS-CoV-2 pneumonia with no side effects in this cohort. The combination of these two antivirals may be a safe option in immunosuppressed population at risk of severe complications and prolonged SARS-CoV-2 infection in order to treat severe clinical presentation and to avoid viral recurrence after chemotherapy. Full article

(This article belongs to the Section Viral Infections)

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14 pages, 1444 KiB

Open AccessArticle

Imported Typhoid Fever in Romania Between 2010 and 2024

by Dragos Stefan Lazar, George Sebastian Gherlan, Simin Aysel Florescu, Corneliu Petru Popescu and Maria Nica

Infect. Dis. Rep. 2025, 17(2), 16; https://doi.org/10.3390/idr17020016 - 25 Feb 2025

Viewed by 461

Abstract

Background/Objectives: Although a “forgotten” disease in developed countries, typhoid fever remains a significant global health problem, especially in regions with inadequate sanitation and overcrowding. Despite medical advances, this systemic bacterial infection, caused by Salmonella Typhi, continues to affect millions worldwide. Accurate diagnosis and [...] Read more.

Background/Objectives: Although a “forgotten” disease in developed countries, typhoid fever remains a significant global health problem, especially in regions with inadequate sanitation and overcrowding. Despite medical advances, this systemic bacterial infection, caused by Salmonella Typhi, continues to affect millions worldwide. Accurate diagnosis and timely treatment are crucial to prevent severe complications and mortality. Even though antibiotic therapy is effective, the emergence of drug-resistant strains is a growing challenge. Methods: We present a series of cases encountered in a tertiary infectious disease hospital in Romania over 15 years. Results: The hospitalised patients were mainly from Sub-Saharan Africa and the Indian subcontinent; the median time between the onset of the first symptoms and hospital admission was 15 days. The symptoms encountered along with fever were headache, chills, cough, diarrhoea and tachycardia, an unusual feature in the clinical picture of this disease. Aneosinophilia (the absence of peripheral eosinophilic granulocytes) was the most frequently encountered laboratory finding, followed by increased serum transaminases and inflammatory syndrome. Conclusions: S. Typhi was generally identified from blood culture, demonstrating, except in one case, resistance to ciprofloxacin and, in several cases, multi-drug resistance (MDR). In this series of cases, all strains were sensitive to ceftriaxone. Full article

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Infect. Dis. Rep., Volume 17, Issue 2 (April 2025) – 23 articles

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