Infectious Disease Reports

Background:Streptococcus pneumoniae is a well-known pathogen responsible for respiratory and invasive diseases; however, central nervous system (CNS) involvement in the form of bacterial myelitis is exceedingly rare, particularly in immunocompetent adults. Moreover, the association between pneumococcal infections and reactive arthritis is scarcely documented. We report an unusual case of pneumococcal myelitis complicated by reactive arthritis in an elderly patient with no evident immunosuppression. Case Presentation: A 68-year-old man with a medical history of hypertension, benign prostatic hyperplasia, multiple disc herniations, and a resected pancreatic neuroendocrine tumour presented to the emergency department with acute urinary retention and fever (38.5 °C). The neurological examination revealed lower limb weakness and decreased deep tendon reflexes. Spinal magnetic resonance demonstrated T2 hyperintense lesions suggestive of longitudinally transverse myelitis. Cerebrospinal fluid (CSF) analysis showed pleocytosis with elevated protein levels; the polymerase chain reaction (PCR) test resulted positive result for Streptococcus pneumoniae. The patient received intravenous antimicrobial and corticosteroid therapy with partial neurological improvement. Within days, he developed acute monoarthritis of the right ankle. Joint aspiration revealed sterile inflammatory fluid, negative for crystals and cultures, supporting a diagnosis of reactive arthritis. The articular symptoms resolved with the use of prednisone. An extensive immunological work-up was negative, and no other infectious or autoimmune triggers were identified. The patient underwent a structured rehabilitation program with gradual improvement in motor function over the following weeks. Conclusions: This case illustrates a rare clinical scenario of pneumococcal myelitis associated with reactive arthritis in a patient without overt immunosuppression. It highlights the importance of considering bacterial aetiologies in cases of acute transverse myelitis and the potential for unusual systemic immune responses such as reactive arthritis. Early recognition and the administration of appropriate antimicrobial and supportive therapies are crucial for improving neurological and systemic outcomes. To our knowledge, this is one of the first reported cases describing the co-occurrence of these two conditions in the context of S. pneumoniae infection.

Background: The Coronavirus Disease 2019 (COVID-19) remains a major global public health issue. People living with HIV (PLHIV) are among the vulnerable groups facing a higher risk of severe outcomes. Combining COVID-19 vaccination with HIV services can improve access and utilization of the vaccine among PLHIV although effective methods of delivery are yet to be ascertained. We conducted a scoping review to identify and describe models for delivering COVID-19 vaccines through HIV care services in low- and middle-income countries (LMICs). Methods: We used PRISMA-ScR guidelines to conduct the review. On 3rd and 4th February 2025, we searched PubMed, Web of Science, Cochrane Library, and EMBASE for studies on integrated COVID-19 vaccine delivery for PLHIV. Results: Three studies from sub-Saharan Africa reported call-back strategy, diverse partnership, and mixed service delivery models for implementing COVID-19 vaccination in HIV care services. Key strategies that were used included building capacity, generating demand, managing the supply chain, and involving stakeholders. The outcomes showed significant increases in vaccination coverage among PLHIV and reduced vaccine wastage. Conclusions: Integrating COVID-19 vaccination into HIV services is practical and effective in LMICs. It makes use of current infrastructure, partnerships, and local innovations.

Background/Objectives: Serological and molecular screening for Hepatitis B virus (HBV) has been essential in reducing the risk of transfusion-transmitted infection, particularly in regions of high endemicity. This retrospective study aimed to analyze the epidemiological profile and laboratory outcomes of 259 blood donors deemed ineligible after initial reactive or inconclusive screening for HBV markers. Methods: Donors were summoned for revaluation at the HEMOPA Foundation, in Belém, Pará, between February 2015 and July 2016. Demographic data, risk factors, and results for HBsAg, anti-HBc, anti-HBs, and HBV DNA obtained at the donation and return time points were collected. Results: The mean age was 37 ± 11.25 years, with a predominance of males (56.8%) and first-time donors (76%). At the return time point, 63.7% presented a profile indicative of resolved HBV infection and 3.5% of active infection, 6.6% were susceptible to HBV infection, and 1.9% presented vaccine-induced HBV immunity. Cases of Occult Hepatitis B Infection (OBI, 0.4%) and Window Period (WP, 0.4%) were also identified. Conclusions: The findings reveal a high prevalence of resolved HBV infection among ineligible donors, particularly first-time donors, and reinforce the importance of combined serological and molecular screening, as well as the need for vaccination and health education strategies for at-risk populations. As a public blood bank located in the Amazon region, we highlight that local epidemiological specificities must be considered in the formulation of public health policies that are sensitive to the regional context.