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Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children.

PURPOSE OF REVIEW: Pulmonary cytomegalovirus (CMV) infection is a potential lethal disease in children, but it remains a diagnostic challeng … well as other immune dysregulation disorders. Lung CMV infections in children are more prevalent in immunocompromised hosts and premature newborns. Lung CMV infections should prompt further investigation into conditions altering immune mechanisms usually in place to contain CMV infections. Common clinical and radiological patterns such as hypoxemia and ground-glass pulm …

Airway delivery of interferon-γ overexpressing macrophages confers resistance to Mycobacterium avium infection in SCID mice.

Mycobacterium avium (M. avium) causes significant pulmonary infection, especially in immunocompromised hosts. Alveolar macrophages (AMs) represent the first line of host defense against infection in the lung. Interferon gamma (IFN-γ) activation of AMs enhances in vitro killing of pathogens such as M. avium We hypothesized that airway delivery of AMs into the lungs of immunodeficient mice infected with M. avium will inhibit M. avium growth in the lung and that this macrophage function is in part IFN-γ dependent. In this study, normal BALB/c and BALB/c SCID mice received M. avium intratracheally…

Familial CD45RA- T cells to treat severe refractory infections in immunocompromised patients.

BACKGROUND: Immunocompromised patients are susceptible to high-risk opportunistic infections and malignant diseases. Most antiviral and antifungal drugs are quite toxic, relatively ineffective, and induce resistance in the long term. The transfer of pathogen-specific Cytotoxic T-Lymphocytes has shown a minimal toxicity profile and effectiveness in treating Cytomegalovirus, Adenovirus, Epstein - Barr virus, BK Virus and Aspergillus infections, but this therapy have the main limitations of regulatory issues, high cost, and absence of public cell banks. However, CD45RA- cells containing pathogen-

SIP-SRS Imaging of Cell Wall Synthesis Identifies a Synergy between Micafungin and Amphotericin B.

Candida species causes life-threatening infections in immunocompromised individuals and presents a formidable challenge in clinical practice. This challenge is exacerbated by the growing prevalence of drug resistance, particularly against the last resort antifungals such as amphotericin B (AmB). The fungal cell wall, known for its dynamic reorganization in response to growth demands and host threats, are recognized as a key drug target. In this study, stable isotope probe-assisted SRS microscopy (SIP-SRS) is harnessed to directly visualize and interrogate the dynamics of fungal cell wall synth

SARS-CoV-2 drug resistance and therapeutic approaches.

In light of the transition of COVID-19 from a pandemic to an endemic phase, there is still a dire need to address challenges associated with drug resistance, particularly among immunocompromised and high-risk populations. This review explores the current state of research on SARS-CoV-2 drug resistance and underscores the ongoing need for effective therapeutic strategies. It critically evaluates existing knowledge on resistance mechanisms and therapeutic options, aiming to consolidate information and highlight areas for future research. By examining the complex interactions between the virus an

Subglottic abscess: an unusual presentation of laryngeal candidiasis.

This case report details an unusual presentation of laryngeal candidiasis in an elderly and immunocompetent man who attended the emergency department with stridor, dysphagia and sore throat due to a subglottic lesion that was subsequently revealed to be an abscess. Conservative management with antibiotics and steroids was initiated. His airway deteriorated, necessitating tracheostomy under local anaesthetic, microlaryngoscopy, incision and drainage of the left subglottic collection and biopsy of the left subglottic region. Biopsies showed no evidence of neoplasia, and intraoperative pus swabs

Successful maintenance therapy with moxifloxacin for disseminated nocardiosis caused by Nocardia farcinica in a patient with Cushing's syndrome.

Nocardia species are aerobic, Gram-positive actinomycetes often causing opportunistic infections, particularly in immunocompromised hosts. Nocardia farcinica is notable for disseminated nocardiosis (DN), frequently involving the lungs and central nervous system (CNS). Cushing's syndrome (CS), characterized by hypercortisolemia, further predisposes patients to severe infections. We report a 73-year-old woman with ACTH-dependent CS due to a pituitary adenoma who developed DN with pleuropulmonary, CNS, and gluteal abscesses. Diagnosis was confirmed through cultures and MALDI-TOF MS, identifying N…

Cervical Osteomyelitis With Paraspinal Abscess Caused by Salmonella Typhi in an Immunocompetent Adult: A Case Report.

Salmonella Typhi infection typically presents as gastrointestinal illness but may rarely lead to severe systemic complications. Osteomyelitis is a recognized, although uncommon, extraintestinal manifestation that most often occurs in immunocompromised individuals or those with hemoglobinopathies. We report a rare case of cervical vertebral osteomyelitis and paraspinal abscess caused by S. Typhi in a previously healthy 37-year-old male. Initial imaging with CT and MRI revealed deep cervical and paraspinal abscesses with inflammatory changes suggestive of osteomyelitis, but no spinal canal invol

Cryptosporidium parvum multidrug resistance protein confers resistance to toxic gut microbial metabolite.

Cryptosporidium parvum subtypes differ in pathogenicity, but the underlying factors are largely unknown. We show that two genetically similar C. parvum isolates grow equally well in vitro but differ in pathogenicity in immunocompromised mice. Reduced oocyst shedding of the avirulent strain was restored by antibiotic treatment, suggesting susceptibility to colonization resistance imparted by the microbiota. This resistance was associated with a gene encoding a parasite ABC transporter and enhanced infectivity. Molecular analyses indicate that the ABC transporter belongs to a multidrug resistanc

Lung infections due to emerging fungal pathogens.

PURPOSE OF REVIEW: This review highlights the epidemiology, pathogenesis and clinical management of pulmonary infections caused by emerging fungal organisms. RECENT FINDINGS: Emerging fungal infections have arisen as a result of population and environmental changes. An enlarging pool of immunocompromised hosts on triazole antifungal prophylaxis has led to an increased incidence of non- Aspergillus molds, such as Fusarium , Scedosporium and Lomentospora spp. Advances in diagnostic capabilities led to the identification of the Emergomyces genus and non- dermatitidis Blastomyces species, which h…

Fungal Endocarditis: A Rare Case of Multiple Arterial Embolization.

Fungal endocarditis is a rare and fatal condition, with a mortality of up to 75%, affecting immunocompromised hosts with a predisposing condition, namely, a history of previous cardiac or noncardiac surgery. Embolization is frequent, accounting for 44% of cases, and as the most common site is the brain, it can cause leptomeningitis, parenchymal granulomas, or abscesses. This case report describes a man with aortic valve replacement one year ago and a recent carotid endarterectomy who was admitted with fever and neurological deficits. The workup permitted a diagnosis of fungal endocarditis, and…

Investigating Cryptosporidium spp. Using Genomic, Proteomic and Transcriptomic Techniques: Current Progress and Future Directions.

Cryptosporidiosis is a widespread disease caused by the parasitic protozoan Cryptosporidium spp., which infects various vertebrate species, including humans. Once unknown as a gastroenteritis-causing agent, Cryptosporidium spp. is now recognized as a pathogen causing life-threatening disease, especially in immunocompromised individuals such as AIDS patients. Advances in diagnostic methods and increased awareness have led to a significant shift in the perception of Cryptosporidium spp. as a pathogen. Currently, genomic and proteomic studies play a main role in understanding the molecular biolog

COVID-19 Associated Rhino-Orbital-Cerebral Mucormycosis: A Proposed Classification and Treatment Strategies.

OBJECTIVES: Mucormycosis is a rare fungal disease, which was known to affect only immunocompromised hosts, but during the COVID-19 pandemic, a surge in the cases of rhino- orbital-cerebral mucormycosis have been reported; however, the cause is still unknown. As the disease was a rare entity, there was no classification considering the spread and proper management at various stages. METHODS: Extensive literature search with the terms "mucormycosis," "invasive fungal sinusitis," "COVID-19 associated mucormycosis," and "mucormycosis in COVID-19" was conducted on Pubmed, Scopus, and Embase databa…

Infections in Alcoholic Hepatitis.

Severe alcoholic hepatitis (sAH) is defined by a modified discriminant function ≥32 or model for end-stage liver disease (MELD) >20. Patients with sAH are in an immunocompromised state attributed to cirrhosis-related immunoparesis and corticosteroid use. Individuals with sAH often develop severe infections that adversely impact short-term prognosis. Currently, the corticosteroid prednisolone is the only treatment with proven efficacy in sAH; however, the combination of corticosteroid treatment and altered host defense in sAH has been thought to increase the risk of acquiring of bacterial, oppo

Disseminated Cryptococcal Infection of the Lumbar Spine in an Immunocompetent Man.

Cryptococcus (C) neoformans infection mainly occurs in immunocompromised hosts, especially those with AIDS, and skeletal infection is a rare presentation of cryptococcosis. We report a rare case of disseminated cryptococcal infection of the lumbar spine in an immunocompetent man caused by Cryptococcus neoformans var. grubii. The lesion position first appeared on upper right lung and then spread to the fourth lumbar vertebra. The result of periodic acid-Schiff (PAS) and Gomori's methenamine silver (GMS) staining of the tissue sample matched cryptococcal infection, but multiple culture was negat…

Pulmonary aspergillosis: diagnosis and treatment.

Aspergillus species are the most frequent cause of fungal infections of the lungs with a broad spectrum of clinical presentations including invasive pulmonary aspergillosis (IPA) and chronic pulmonary aspergillosis (CPA). IPA affects immunocompromised populations, which are increasing in number and diversity with the advent of novel anti-cancer therapies. Moreover, IPA has emerged as a complication of severe influenza and coronavirus disease 2019 in apparently immunocompetent hosts. CPA mainly affects patients with pre-existing lung lesions and is recognised increasingly frequently among patie

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… IPA in other immunocompromised hosts Data about the performance of culture and nonculture diagnostic tests of IPA among patients with other immunosuppressive conditions ( e.g. auto-immune diseases, corticosteroid therapy, treatment with Bruton tyrosine kinase inhibitors) are lacking. …

Imiquimod Targets Toxoplasmosis Through Modulating Host Toll-Like Receptor-MyD88 Signaling.

Toxoplasma gondii is a prevalent parasite of medical and veterinary importance. Tachyzoïtes and bradyzoïtes are responsible for acute and chronic toxoplasmosis (AT and CT), respectively. In immunocompetent hosts, AT evolves into a persistent CT, which can reactivate in immunocompromised patients with dire consequences. Imiquimod is an efficient immunomodulatory drug against certain viral and parasitic infections. In vivo, treatment with Imiquimod, throughout AT, reduces the number of brain cysts while rendering the remaining cysts un-infectious. Post-establishment of CT, Imiquimod significantl

A Case of Scedosporium aurantiacum Infection in the United States.

Scedosporium aurantiacum is one of the emergent opportunistic fungal pathogens among immunocompromised hosts. Colonization of S. aurantiacum can also occur in patients with underlying lung diseases such as cystic fibrosis. S. aurantiacum is highly resistant to multiple antifungal agents, and management of the infected patients can be very challenging compared to those infected with other species of Scedosporium. Clinical cases have been geographically restricted mostly in Australia with a small number of cases identified in Europe and Japan. Although clinical isolates of S. aurantiacum from th…

The complement system in Aspergillus fumigatus infections and its crosstalk with pentraxins.

Aspergillosis is a life-threatening infection mostly affecting immunocompromised individuals and primarily caused by the saprophytic fungus Aspergillus fumigatus. At the host-pathogen interface, both cellular and humoral components of the innate immune system are increasingly acknowledged as essential players in the recognition and disposal of this opportunistic mold. Fundamental hereof is the contribution of the complement system, which deploys all three activation pathways in the battle against A. fumigatus, and functionally cooperates with other soluble pattern recognition molecules, includ

Tongue lesion due to Cryptococcus neoformans as the first finding in an HIV-positive patient.

BACKGROUND: Cryptococcosis is a severe universally distributed mycosis which mainly affects immunocompromised hosts. This mycosis is caused by yeasts of two species complex of the genus Cryptococcus: Cryptococcus neoformans and Cryptococcus gattii. Meningeal cryptococcosis is the most frequent clinical presentation of this disseminated mycosis. The oral mucosa involvement is extremely unusual. CASE REPORT: We present a case of cryptococcosis with an unusual clinical form. The patient was assisted because she had an ulcerated lesion on the lingual mucosa. Encapsulated yeasts compatible with Cr…