Infectious Disease Reports

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

doi: 10.3390/idr17020016pmid: 40126322

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.

Travi, Giovanna;Peracchi, Francesco;Merli, Marco;Ravano, Emanuele;Frustaci, Anna;Deodato, Marina;Fanti, Diana;Nava, Alice;Colombo, Valeriana;Bana, Nicholas Brian;Rogati, Carlotta;Raimondi, Alessandro;Moioli, Cristina;Pazzi, Anna Maria;Vecchi, Marta;Motta, Davide;Rossotti, Roberto;Oltolini, Chiara;Crippa, Fulvio;

Abdul-Mutakabbir, Jacinda C.;Abdul-Mutakabbir, Raheem;Casey, Samuel J.

doi: 10.3390/idr17020018pmid: 40126324

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.

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

doi: 10.3390/idr17020019pmid: 40126325

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.

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

doi: 10.3390/idr17020020pmid: 40126326

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.

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

doi: 10.3390/idr17020021pmid: 40126327

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.

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

doi: 10.3390/idr17020022pmid: 40126328

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.

Gregušová, Adriana;Gergel, Michal;Žigrai, Miroslav

doi: 10.3390/idr17020023pmid: 40126329

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.