Germs

Background: Typhoid fever (TF) is a systemic infection caused by Salmonella enterica serovar Typhi, typically associated with regions where sanitation and access to clean water are inadequate. Although rare in non-endemic countries, TF remains a diagnostic consideration in travelers returning from endemic areas with febrile illness. Case report: We present the case of an 18-year-old female who developed TF following recent travel to Nigeria. The initial clinical presentation, including fever, dysuria, and abdominal pain, led to a misdiagnosis of acute pyelonephritis. Malaria, arboviral infections, acute viral hepatitis, and parasitic diseases were systematically ruled out through clinical evaluation, serological testing, and parasitological analysis. The clinical course was marked by fever, abdominal pain, somnolence, and hematological and hepatic abnormalities. Blood cultures confirmed the diagnosis, with the isolate verified and serotyped by the National Center of Infectious and Parasitic Diseases. Targeted antimicrobial treatment with ceftriaxone and levofloxacin resulted in full recovery, with no evidence of relapse or chronic carriage over a three-month follow-up period. Conclusions: This case highlights the critical importance of a structured differential diagnostic approach and microbiological confirmation in febrile patients with relevant travel history. In non-endemic settings, where TF may be underrecognized, early recognition, pathogen identification, and appropriate antimicrobial therapy remain essential to favorable outcomes and public health safety.

It is with both gratitude and anticipation that I write these words, looking back on almost 15 years of continued publication and marking the transition of Germs into a new chapter through our collaboration with MDPI [...]

We are pleased to announce that, beginning with Volume 15, Issue 4 (2025), Germs (ISSN: 2248-2997) will now be published by MDPI [...]

Introduction: Doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) is recommended for both ART initiation and switch in virologically suppressed patients. We report early real-world outcomes after DOR/3TC/TDF introduction in Belgrade, Serbia. Methods: We conducted a single-center retrospective study at the Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, including all adults who initiated or switched to DOR/3TC/TDF between May 2024 and April 2025. Demographics, comorbidities, prior ART, adverse events, and laboratory data (CD4, HIV-1 RNA, triglycerides, total and LDL cholesterol) were abstracted from electronic records. Results: Of 260 participants, 75 were treatment-naïve and 185 switched regimens; median follow-up was 7 months (IQR: 1-11 months). In naïve patients, CD4 counts increased (458.2±312.0 to 580.7±262.8 cells/µL; p=0.007) and viral load fell to undetectable in 82.8% (24/29; p=0.002). In switch patients, CD4 counts remained stable (665.0±317.5 to 660.5±268.0; p=0.891) and suppression was maintained, with rates of undetectable viral load rising from 83.2% to 93.1% (p=0.013). No significant short-term changes were observed in triglycerides, total cholesterol, or LDL. No virological failures occurred; one discontinuation due to rash was recorded. Conclusions: In routine care in Belgrade, once-daily DOR/3TC/TDF was well tolerated and effective: naïve patients achieved rapid suppression with CD4 gains, and switch patients maintained high rates of undetectable viral load without adverse lipid shifts. These findings support DOR/3TC/TDF as a practical option in the Serbian setting.