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Diagnostics
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Accurate Diagnosis and Management of Infectious and Respiratory Diseases
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Accurate Diagnosis and Management of Infectious and Respiratory Diseases

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 1391

Editor

Dr. Marco Goeijenbier

E-Mail Website
Guest Editor
Department of Intensive Care Medicine, Spaarne Gasthuis, Boerhaavelaan 22, 2035 RC Haarlem, The Netherlands
Interests: intensive care; respiratory medicine; virology; infectious disaeses; tropical medicine; immune modulation; coagulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Accurate and timely diagnosis is essential for the effective management of infectious and respiratory diseases, particularly in acute care settings. Rapid advances in diagnostic technologies have significantly expanded the ability of clinicians to identify pathogens, guide targeted treatment, and improve patient outcomes. This Special Issue aims to highlight recent developments in both the diagnosis and management of infectious and respiratory diseases across clinical settings ranging from outpatient care to emergency departments and intensive care units.

Special attention will be paid to syndromic testing strategies, including multiplex molecular panels that enable the simultaneous detection of multiple viral and bacterial pathogens. The growing availability of rapid diagnostic tests allows clinicians to shorten the time to diagnosis, optimize antimicrobial stewardship, and initiate appropriate therapies earlier. Importantly, this Special Issue will address the interpretation of diagnostic results, including the distinction between co-detection of pathogens and true co-infection, and how these findings should influence clinical decision making.

The Special Issue will also explore how diagnostic results translate into treatment strategies, including the use of antiviral therapies, antibiotics, and emerging immunomodulatory treatments. Contributions evaluating how clinical guidelines incorporate diagnostic tools and how testing policies perform in real-world settings are encouraged, and studies addressing implementation, cost-effectiveness, and clinical outcomes related to diagnostic strategies are of particular interest.

By integrating advances in diagnostics, therapeutics, and implementation science, this Special Issue aims to provide a comprehensive overview of strategies to improve the care of patients with infectious and respiratory diseases.

Dr. Marco Goeijenbier
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infectious and respiratory diseases
  • viral and bacterial pathogens
  • multiplex molecular panels
  • rapid diagnostic tests
  • intensive care units

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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13 pages, 2028 KB  
Article
Clinician-Reported Respiratory Viral Testing and Intended Management of Community-Acquired Respiratory Viral Infections in Haematology and Haematopoietic Cell Transplantation: An International Exploratory Survey
by Justin R. du Toit, Tobias R. Neijzen, Sjoerd van der Bie, Steven F. L. van Lelyveld, Aart Beeker, Karlijn J. van Stralen, Odette M. Vlek, Estelle R. Verburgh, Eric van Gorp, Jurjen Versluis and Marco Goeijenbier
Diagnostics 2026, 16(17), 2786; https://doi.org/10.3390/diagnostics16172786 - 30 Aug 2026
Viewed by 266
Abstract
Background: Community-acquired respiratory viruses (CARVs) cause significant morbidity and mortality in patients with haematological malignancies and those undergoing haematopoietic cell transplantation (HCT). Despite this, clinical management remains variable. This study evaluated clinicians’ awareness, diagnostic practices, and treatment approaches to major respiratory viruses in [...] Read more.
Background: Community-acquired respiratory viruses (CARVs) cause significant morbidity and mortality in patients with haematological malignancies and those undergoing haematopoietic cell transplantation (HCT). Despite this, clinical management remains variable. This study evaluated clinicians’ awareness, diagnostic practices, and treatment approaches to major respiratory viruses in this high-risk population. Methods: An international electronic survey using non-probability convenience sampling was conducted among haematology, oncology, intensive care and emergency medicine physicians. Four real-life clinical cases were converted into standardised vignettes covering human metapneumovirus (HMPV), respiratory syncytial virus (RSV), human parainfluenza virus (HPIV) and influenza A virus (IAV). The questionnaire assessed reported testing strategies and intended management, including antiviral and immunoprophylactic interventions. Responses were analysed descriptively; no inferential between-group comparisons were performed. Results: Ninety-eight clinicians from 26 countries responded. Diagnostic approaches, including testing indications and panel selection, varied among respondents. For HMPV and HPIV, respondents mainly reported supportive care, immunoglobulin replacement, and infection-control measures in the absence of established pathogen-specific interventions. RSV practice was heterogeneous: systemic ribavirin was considered by 45/96 (46.9%) respondents, including 34/96 (35.4%) when guided by an immunodeficiency score. IAV management was more consistent, with reported availability of vaccination and antiviral therapy and frequent use of post-exposure prophylaxis. Conclusions: Within this international convenience sample, clinicians reported variation in respiratory viral testing and in how results informed intended management. Because sampling was non-probability-based and respondent groups were small and unevenly distributed, the findings should not be interpreted as representative estimates of international practice. IAV testing was most consistently linked to established treatment and prevention, RSV showed greater therapeutic and preventive heterogeneity, and HMPV/HPIV testing primarily informed infection control, monitoring and antimicrobial stewardship. Full article
(This article belongs to the Special Issue Accurate Diagnosis and Management of Infectious and Respiratory Diseases)
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19 pages, 6171 KB  
Article
High-Dimensional Immune Profiling Reveals Innate-Adaptive Rebalancing and Subpopulation Trajectories in Pediatric Severe Mycoplasma pneumoniae Pneumonia
by Chen Shen, Deze Li, Xiaotong Wang, Yang Sun, Huiwen Zheng, Hao Chen, Xin Ni and Shunying Zhao
Diagnostics 2026, 16(15), 2429; https://doi.org/10.3390/diagnostics16152429 - 31 Jul 2026
Viewed by 331
Abstract
Background: Severe Mycoplasma pneumoniae pneumonia (SMPP) presents with heterogeneous clinical complications and imaging manifestations, including pleural effusion (PE), bronchiolitis obliterans (BO), and distinct imaging/bronchoscopic phenotypes. The precise systemic immune subpopulation dynamics underlying these distinct phenotypes remain poorly defined. Methods: We conducted [...] Read more.
Background: Severe Mycoplasma pneumoniae pneumonia (SMPP) presents with heterogeneous clinical complications and imaging manifestations, including pleural effusion (PE), bronchiolitis obliterans (BO), and distinct imaging/bronchoscopic phenotypes. The precise systemic immune subpopulation dynamics underlying these distinct phenotypes remain poorly defined. Methods: We conducted flow cytometric profiling of peripheral blood mononuclear cells (PBMCs) from pediatric patients to compare mild MPP (MMPP-N) and severe MPP subtypes. SMPP patients were stratified into subgroups including those with BO (SMPP&BO, n = 3), PE (SMPP&PE), and three imaging/bronchoscopic phenotypes: Group A (SMPP-GA, mucous plugs), Group B (SMPP-GB, mucosal necrosis), and Group C (SMPP-GC, diffuse bronchiolitis). Composite immune indices and multi-marker discriminant analysis were constructed for secondary analysis. Results: Comprehensive high-dimensional profiling suggested that a fundamental innate-adaptive immune rebalancing may represent a key pathophysiological axis in severe disease. Patients with PE exhibited massive CD16− monocyte expansion (Delta = 40.0%) coupled with CD8+ Teff collapse (Delta = −9.2%). Preliminary data also suggest BO may be marked by CD56−CD11C+ monocyte depletion (Delta = −23.1%, n = 3), warranting further validation. Imaging subgroup profiling revealed that SMPP-GC featured major B-cell maturation alterations (HLADR+CD45RAhigh expansion and CD38+CD25low depletion). Composite indices including the Adaptive Exhaustion Score suggested discriminatory power (AUC = 0.90 for PE vs. uncomplicated SMPP). The Innate-Adaptive Ratio increased progressively with severity (Spearman rho = +0.40, p = 0.0002). Conclusions: SMPP is not immunologically uniform. Innate-adaptive rebalancing underlies complication-specific phenotypes: inflammatory monocyte mobilization with adaptive exhaustion is strongly associated with PE, whereas B-cell maturation alterations characterize diffuse bronchiolitis. These findings identify potential biomarker candidates for patient stratification, though small-cohort observations require extensive validation in larger prospective studies. Full article
(This article belongs to the Special Issue Accurate Diagnosis and Management of Infectious and Respiratory Diseases)
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13 pages, 857 KB  
Article
Detection of Latent Tuberculosis Infection in Patients with Rheumatological Diseases Who Receive Immunosuppressive Therapy
by Anna Starshinova, Adilia Sabirova, Alexey Maslyanskiy, Irina Grigorieva, Raul Sharipov, Ravil Tukfatullin, Aleksandr Panteleev, Michail Nazarenko and Dmitry Kudlay
Diagnostics 2026, 16(12), 1883; https://doi.org/10.3390/diagnostics16121883 - 17 Jun 2026
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Abstract
Background/Objectives: Latent tuberculosis infection (LTBI) is a persistent immune response to Mycobacterium tuberculosis antigens in the absence of clinically active tuberculosis. It is now established that progression from LTBI to active tuberculosis is directly associated with immune dysregulation, which frequently occurs [...] Read more.
Background/Objectives: Latent tuberculosis infection (LTBI) is a persistent immune response to Mycobacterium tuberculosis antigens in the absence of clinically active tuberculosis. It is now established that progression from LTBI to active tuberculosis is directly associated with immune dysregulation, which frequently occurs in immune-mediated diseases requiring treatment with immunosuppressive agents. The aim of this study was to identify LTBI in patients with rheumatological diseases receiving immunosuppressive therapy using contemporary immunodiagnostic methods. Materials and Methods: A retrospective, prospective, group-control study was conducted, analyzing the results of immunodiagnostics in patients with rheumatological diseases on immunosuppressive therapy and without established contact with tuberculosis patients (n = 44; main group). The control group consisted of healthy individuals (n = 51) with no history of tuberculosis contact, clinical or radiological manifestations of the disease, or signs of chronic pathology exacerbation. Both groups were predominantly female (72.7% in the main group and 62.8% in the control group). The mean age in the patient group was 49.1 years (95% CI [44.77; 53.43]). Rheumatoid arthritis was diagnosed in 29.6% (13) of patients (95% CI [16.06; 43.03]). Articular syndrome was observed in at least 72.7% (32) of patients (95% CI [59.57; 85.89]). In 54.6% (24) of cases (95% CI [39.83; 69.26]), patients received biologic immunosuppressive therapy as basic treatment. In 15.9% (7) of cases (95% CI [5.10; 26.72]), patients received conventional synthetic disease-modifying antirheumatic drugs (DMARDs). Of these, 71.43% (5) (95% CI [35.24; 92.44]) underwent comprehensive examination to exclude active tuberculosis prior to biologic therapy initiation. For immunodiagnostics, all subjects underwent an interferon-gamma release assay (IGRA) and/or testing with a recombinant tuberculosis antigen (ATR) sample, with dynamic assessment of test results. All patients with positive immunodiagnostic results underwent multidetector computed tomography of the chest organs. The level of LTBI in the comparison groups was defined as the percentage of positive immunological test results at a significance level of p < 0.05. Statistical data processing was performed using Microsoft Excel 2019. Results: In the main group, positive immunodiagnostic results were recorded in 20.5% (9) of cases (95% CI [8.54; 32.37]), which is significantly higher than in the control group of healthy individuals (5.8% (3), 95% CI [1.41; 16.54]). This reflects statistically significant differences in immunological test results between groups receiving and not receiving immunosuppressive therapy (χ2 = 4.545, p = 0.034). Dynamic evaluation of the ATR sample revealed positive results in 21.7% (5) of cases (95% CI [4.88; 38.60]), with four out of five patients demonstrating positive conversion. In the third assessment, positivity was observed in 33.33% (5) of cases (95% CI [9.48; 57.19]), which was higher than in the first (χ2 = 1.025, p = 0.312) and second assessments (χ2 = 0.629, p = 0.428), although these differences were not statistically significant. Notably, in two out of five patients, the ATR test result changed from negative to positive. Conclusions: In patients with rheumatological diseases receiving immunosuppressive therapy, LTBI was detected in 20.5%, which is significantly higher than in healthy individuals (5.8%, p = 0.034). Furthermore, there was an increase in the proportion of positive tests over time (up to 21.7% and 33.3% on immunotherapy), suggesting an increasing risk of progression to active tuberculosis infection. Full article
(This article belongs to the Special Issue Accurate Diagnosis and Management of Infectious and Respiratory Diseases)
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Ultrasonographic Demonstration of Severe Right-Sided Colitis in Concurrent Enterohemorrhagic Escherichia coli O157 and Campylobacter jejuni Infection
by Kousuke Kubota, Koji Hayashi and Yohei Midori
Diagnostics 2026, 16(18), 3041; https://doi.org/10.3390/diagnostics16183041 (registering DOI) - 19 Sep 2026
Abstract
A previously healthy 23-year-old woman presented with acute diarrhea, abdominal pain, and bloody mucoid stool following raw beef consumption, with a fever of 37.8 °C. On admission, her vital signs were unremarkable. Blood tests revealed elevated C-reactive protein, hypokalemia, and hypoproteinemia. Abdominal ultrasonography [...] Read more.
A previously healthy 23-year-old woman presented with acute diarrhea, abdominal pain, and bloody mucoid stool following raw beef consumption, with a fever of 37.8 °C. On admission, her vital signs were unremarkable. Blood tests revealed elevated C-reactive protein, hypokalemia, and hypoproteinemia. Abdominal ultrasonography clearly demonstrated severe right-sided colitis characterized by marked circumferential bowel-wall thickening (~2 cm), loss of normal wall stratification, and continuous involvement from the ascending to proximal transverse colon. To avoid unnecessary radiation exposure in this young, clinically stable patient, computed tomography (CT) was omitted. Stool culture yielded enterohemorrhagic Escherichia coli (EHEC) O157 and Campylobacter jejuni. While ultrasonography effectively delineated the severity and continuous extent of colitis, imaging alone could not differentiate between these pathogens or identify the concurrent coinfection. Furthermore, this dual infection presented a major therapeutic challenge: guidelines suggest macrolides for severe Campylobacter enteritis, but antimicrobials are strictly discouraged in EHEC O157 infection due to the risk of hemolytic uremic syndrome (HUS). Managed conservatively with fluid replacement and probiotics without antimicrobial therapy, she recovered uneventfully and was discharged on hospital day 9. This case highlights the primary diagnostic utility and safety of ultrasonography in evaluating acute right-sided colitis and underscores the importance of cautious supportive care when navigating conflicting therapeutic guidelines in rare gastrointestinal coinfections. Full article
(This article belongs to the Special Issue Accurate Diagnosis and Management of Infectious and Respiratory Diseases)
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