Infectious Research Articles

The Impact of Climate on Human Dengue Infections in the Caribbean

Climate change is no longer a hypothetical problem in the Caribbean but a new reality to which regional public health systems must adapt. One of its significant impacts is the increased transmission of infectious diseases, such as dengue fever, which is endemic in the region, and the presence of the Aedes aegypti mosquito vector responsible for transmitting the disease. (1) Methods: To assess the association between climatic factors and human dengue virus infections in the Caribbean, we conducted a systematic review of published studies on MEDLINE and Web of Science databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. (2) Results: In total, 153 papers were identified, with 27 studies selected that met the inclusion criteria ranging from the northern and southern Caribbean. Rainfall/precipitation and vapor pressure had a strong positive association with dengue incidence, whereas the evidence for the impact of temperatures was mixed. (3) Conclusions: The interaction between climate and human dengue disease in the Caribbean is complex and influenced by multiple factors, including waste management, infrastructure risks, land use changes, and challenged public health systems. Thus, more detailed research is necessary to understand the complexity of dengue within the wider Caribbean and achieve better dengue disease management.

Investigation of the effect of oral ivermectin on systemic inflammatory response and quality of life in scabies patients.

Scabies is a prevalent ectoparasitic infectious disease, caused by the mite Sarcoptes scabiei. As a consequence of the infestation, localised cutaneous inflammation, pruritus and polymorphic skin lesions develop. The primary symptoms of scabies manifest as hypersensitivity-like reactions and immune responses, the precise mechanisms of which remain poorly defined. The objective of this study was to evaluate the effects of oral ivermectin treatment in patients with scabies on the systemic immune response and the patient's quality of life (QoL). Patients admitted to the dermatology outpatient clinic and diagnosed with scabies were administered oral ivermectin treatment following diagnosis at week 0 and 2. Laboratory tests were conducted to measure complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels before treatment and at week 4. The systemic immune-inflammation index (SII) was calculated using the platelet, neutrophil and lymphocyte counts. Additionally, data pertaining to the Dermatological Life Quality Index (DLQI) were recorded. In 119 patients (51 males) diagnosed with scabies, increases in ESR, CRP, and SII values and decreases in inflammatory cell counts and DLQI scores were observed one month after treatment with oral ivermectin. The results of the study showed that the use of oral ivermectin, a scabicidal agent, triggered the inflammatory response and improved the QoL of the patients.

The Effect of COVID-19 and COVID-19 Vaccination on Assisted Human Reproduction Outcomes: A Systematic Review and Meta-Analysis

The most discussed infectious disease is coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Many research endeavors have focused on the effects of the virus on reproductive organs, as these have also been shown to carry the receptors to which the virus attaches. The results of assisted reproductive technology (ART) have been significantly affected by the pandemic, with some in vitro fertilization (IVF) centers being closed due to the risk of further spread of the disease. According to World Health Organization statistics, 17.5% of adults worldwide suffered from fertility problems in 2023; in other words, one in six people in the world have reproductive health problems. As infertility is a growing problem in the modern world and new developments in assisted reproduction are always a topic of profound interest, it is important to understand the impact of SARS-CoV-2 on reproductive health. This systematic review aimed to examine studies describing patients undergoing ART procedures with a COVID-19-positive history and to shed light on the recent evidence on the safety of COVID-19 vaccination in the ART context. A meta-analysis was conducted to confirm the results of the systematic review. The results showed a significant difference in clinical pregnancy rates between the vaccinated and unvaccinated groups and an increased miscarriage rate in those with a COVID-19-positive history. However, no significant difference in clinical pregnancy and birth rates was found in participants with a previous COVID-19 infection. The results show that further studies and research are needed, even though the spread and impact of the virus have decreased. Evidence-based information for individuals and couples undergoing infertility treatment is vital to enable informed decision-making.

Pediatric Morbidity Among Black Haitians in Canada: A Longitudinal Cohort Study.

In the U.S., Black children have disproportionately elevated rates of pediatric morbidity compared with White children, but data are lacking for other countries. We studied the extent to which Black Haitians were at risk of pediatric morbidity in Canada. We analyzed a retrospective cohort of 736,498 children born in Quebec between 2008 and 2020. We identified Black Haitians using the mother tongue and birth country of parents. The outcome was mortality or hospitalization for infectious diseases, allergy, cancer, and other morbidity between birth and 12years of age. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for these outcomes, comparing Haitians with non-Haitians in Cox regression models adjusted for patient characteristics. Compared with non-Haitians, Haitians tended to have a greater risk of pediatric mortality, especially before age 2years (HR 1.56, 95% CI 1.00-2.45). However, Haitian children had a lower risk of hospitalization than non-Haitian children (HR 0.61, 95% CI 0.59-0.63). Haitians were less likely to be hospitalized for infectious diseases, allergies, appendicitis, cancers, fractures, dental caries, and ophthalmologic conditions. Hospitalization rates were low throughout childhood, even though Haitian children were more likely to be born preterm, develop severe neonatal morbidity, and have other adverse outcomes at birth. Haitian children have an elevated risk of neonatal morbidity and early childhood mortality, but lower risk of hospitalization compared with non-Haitians in Canada. The reasons for the disparity are unclear, but greater effort is needed to address potential gaps in healthcare among Black children.

Challenges and Approaches to Establishing Multi-Pathogen Serosurveillance: Findings from the 2023 Serosurveillance Summit.

Multiplex-based serological surveillance is a valuable but underutilized tool to understand gaps in population-level exposure, susceptibility, and immunity to infectious diseases. Assays for which blood samples can be tested for antibodies against several pathogens simultaneously, such as multiplex bead immunoassays, can more efficiently integrate public health surveillance in low- and middle-income countries. On March 7-8, 2023 a group of experts representing research institutions, multilateral organizations, private industry, and country partners met to discuss experiences, identify challenges and solutions, and create a community of practice for integrated, multi-pathogen serosurveillance using multiplex bead assay technologies. Participants were divided into six working groups: 1) supply chain; 2) laboratory assays; 3) seroepidemiology; 4) data analytics; 5) sustainable implementation; and 6) use case scenarios. These working groups discussed experiences, challenges, solutions, and research needs to facilitate integrated, multi-pathogen serosurveillance for public health. Several solutions were proposed to address challenges that cut across working groups.

Tuberculosis Diagnosis: Current, Ongoing, and Future Approaches

Tuberculosis (TB) remains an impactful infectious disease, leading to millions of deaths every year. Mycobacterium tuberculosis causes the formation of granulomas, which will determine, through the host–pathogen relationship, if the infection will remain latent or evolve into active disease. Early TB diagnosis is life-saving, especially among immunocompromised individuals, and leads to proper treatment, preventing transmission. This review addresses different approaches to diagnosing TB, from traditional methods such as sputum smear microscopy to more advanced molecular techniques. Integrating these techniques, such as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP), has significantly improved the sensitivity and specificity of M. tuberculosis identification. Additionally, exploring novel biomarkers and applying artificial intelligence in radiological imaging contribute to more accurate and rapid diagnosis. Furthermore, we discuss the challenges of existing diagnostic methods, including limitations in resource-limited settings and the emergence of drug-resistant strains. While the primary focus of this review is on TB diagnosis, we also briefly explore the challenges and strategies for diagnosing non-tuberculous mycobacteria (NTM). In conclusion, this review provides an overview of the current landscape of TB diagnostics, emphasizing the need for ongoing research and innovation. As the field evolves, it is crucial to ensure that these advancements are accessible and applicable in diverse healthcare settings to effectively combat tuberculosis worldwide.

Common Childhood Viral Infectious Diseases with Oral Symptoms

Common Childhood Viral Infectious Diseases with Oral Symptoms

Use of Comparative Genomics To Resolve an Unusual Case of Aminoglycoside Susceptibility in the Melioidosis Pathogen Burkholderia pseudomallei in Bangladesh.

Melioidosis is an emerging tropical infectious disease with a rising global burden caused by the environmental bacterium Burkholderia pseudomallei. It is endemic in Southeast and South Asia, including Bangladesh. A rare aminoglycoside-susceptible B. pseudomallei isolate (Y2019) has recently been reported from a melioidosis patient in Dhaka, Bangladesh. To understand the geographical origins of Y2019, we subjected it and 10 other isolates from Bangladesh to whole-genome sequencing. In a phylogenetic tree with a global set of B. pseudomallei genomes, most Bangladeshi genomes clustered tightly within the Asian clade. In contrast, Y2019 was closely related to ST881 isolates from Sarawak, Malaysian Borneo, a gentamicin-sensitive sequence type, suggesting infection in Borneo. Y2019 also contained the same gentamicin sensitivity conferring nonsynonymous mutation in the drug efflux pump encoding the amrB gene. In the absence of a full travel history, whole-genome sequencing and bioinformatics tools have revealed the likely origin of this rare isolate.

Trend of gastrointestinal and liver diseases in China: Results of the Global Burden of Disease Study, 2019.

China is one of the countries with the largest burden of gastrointestinal and liver diseases (GILD) in the world. The GILD constitutes various causes of mortality and disability. The study aimed to investigate the trend of GILD in China using the Global Burden of Diseases Study 2019 (GBD 2019) data resources from 1990 to 2019. The data on the age-standardized mortality rates (ASMR) and disability-adjusted life years (DALYs) for GILD in China from 1990 to 2019 were collected from the GBD 2019 data resources. Furthermore, the ranking of the main causes of deaths and DALYs, as well as the trends of ASMR, DALYs, years of life lost (YLLs), and years of life lost due to disability (YLDs) per 1,000,000 in GILD were reported. The ASMR and DALYs for stomach cancer, liver cancer, and esophageal cancer, which ranked top three among the GILDs from 1990 to 2019, were gradually decreasing. Significant decreases in the ASMR and DALYs were found in diarrheal diseases and acute hepatitis (A, E, and C). However, noteworthy increases were found in those of colon and rectum cancer (CRC) and pancreatic cancer. Trend of DALYs, mortality, and YLLs rates for most of GILD were decreasing from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trend. The DALYs, mortality and YLLs of most GILD diseases showed decreasing trends from 1990 to 2019, except the burden of CRC and pancreatic cancer with an increasing trends. The result of the GBD 2019 showed that the rates of most GILDs decreased in China; however, gastrointestinal and liver cancer, such as stomach cancer still held the top ranking. Furthermore, the shift from infectious diseases to non-communicable causes among GILD burden is occurring and is likely to continue with many public health strategies implications.

“Microbiology can be . . . ” Student Competition to Develop Resources about Infectious Diseases that Improve Health Literacy

The European Association of Establishments for Veterinary Education emphasizes the importance of communication skills and teamwork for student success in clinical practice. Traditionally, many veterinary curricula lacked standardized formal training in acquiring these essential skills. Effective communication and collaborative teamwork are not only crucial for fulfilling the clinical responsibilities of the veterinary profession but also play a pivotal role in the broader societal context. Veterinarians, in their social role, serve as scientific communicators for the community. This role involves conveying scientific concepts, even complex ones, with a particular emphasis on their significance for public health, reaching a diverse audience. Currently, there is a growing public health necessity to improve health literacy, which refers to the ability to access, understand, appraise, and use information to support healthy choices by society, especially for topics like infectious diseases and vaccination. This became more evident during the global COVID-19 pandemic. This teaching tip describes the development, organization, and broad outcomes of a student competition introduced during a standard veterinary medicine course to design novel resources on microbiology and infectious disease-enhancing health literacy. Three separate events were organized during the academic years 2020–2023. The third-year veterinary medicine students attending the 3-month course on infectious diseases of small animals participated in a student competition aimed at promoting creativity and innovation. Their task was to develop novel resources that delivered informative content to the public concerning microbiology and infectious diseases. Participation was voluntary and students participated in groups of 5–6. Overall, 125 students created 22 projects on microbiology and infectious diseases that were able to enhance health literacy. This approach allowed students to engage with the content and convey foundational knowledge to others in an easily accessible way. This skill of communicating with the public using easy-to-understand language is essential for success in the veterinary medicine profession. The resources produced, such as drawings, comics, games, and videos, constitute informative sources. Thus, they were published online on a scientific journal to disseminate knowledge of infectious diseases to a broader audience.

Mortality Risk Factors at Time on ED Admission in Elderly Patients with Infectious Diseases

Background: As elderly individuals often exhibit heightened vulnerability to infections due to factors such as compromised immune systems, chronic illnesses, and age-related physiological changes, understanding the characteristics and risk factors associated with infectious diseases in this population is crucial. The aim of the present study was to evaluate the characteristics of elderly patients with infectious disease in ED admission and to identify risk factors that influence in-hospital mortality. Material and Method: In this study, we enrolled 448 adult patients diagnosed with infectious diseases such as pneumonia, urinary tract infection, gastroenteritis, meningitis, and cellulitis. The participants were directly admitted to our Emergency Department (ED) from their homes or their relatives' residences between November 1, 2014, and May 31, 2015. We investigated patient’s vital signs, disease signs, source of infection, length of staying at hospital, length of staying at emergency service, mortality related scores, laboratory data, treatment and prognosis. Results and Conclusion: The rate of emergency care admissions with an infectious etiology was found as 17%. Average age of patients was 76±8 with 180 (40%) of them being female and 268 (60%) of them being male. Mortality rate was found as 23%. Cox regression analysis concluded that for 65 years or older patients, risk factors that effected mortality were; septic shock, cardiac disease and presence of malignancy, absence of COPD/Asthma, higher pCO2 and lower HCO3 at the time of admission to the emergency service. Calculating MEDS score and APACHE 2 score at admission to the emergency department and intensive care unit can facilitate early intervention, improving recovery prospects. Further research and clinical strategies may benefit from these identified predictors to improve the management and outcomes of elderly patients with infectious diseases in the ED.

Design of RNA Polymerase Inhibitors as Therapeutics for Tuberculous Meningitis.

Tuberculosis is an infectious disease caused by Mycobacterium tuber-culosis. The current treatment protocols for pulmonary tuberculosis are quite effective, even though the treatment requires 3-6 months. The current treatment protocols for extrapulmonary tuberculosis are based on the same drugs that are used for pulmonary tuberculosis. However, the success rates are much lower for certain types of extrapulmonary tuberculosis, such as tubercu-lous meningitis. Tuberculous meningitis is one of the very few diseases attributable to bacteria that have a very high short-term mortality rate among diagnosed patients, even after treatment with antibiotics that are effective for pulmonary tuberculosis. For example, rifampicin is highly effective for the treatment of pulmonary tuberculosis, but its effectiveness for the treatment of tuberculous meningitis is much lower. The reason for the lower effectiveness of rifampicin against tuberculous meningitis is that it has low Blood-Brain Barrier (BBB) permeability, which results in lower concentrations of the drug at the required sites in the central nervous system. In this work, ligands having increased BBB permeability and pharmacokinetic and pharmacodynamic properties, either similar to or better than that of rifampicin, have been de-signed. The BBB permeability of the designed molecules was assessed by using pkCSM, a ma-chine-learning model. Pharmacokinetic properties, drug-likeness, and synthesizability were as-sessed by using SWISS-MODEL. The binding affinity of the designed drugs was assessed by using AutoDock Vina. A customized scoring function, StWN score, was used for a quantitative weighted assessment of all the properties of interest to rank the designed molecules. In this study, drug-like ligands have been designed that have been predicted to have high BBB permeability as well as high affinity for RNA polymerase  ofMycobacterium tuberculosis. The best ligands generated by the tools employed were selected as potential drugs to address the current need for better options for the treatment of tuberculous meningitis.

FACTOR ANALYSIS OF HOUSEHOLD SEWERAGE OWNERSHIP

Wastewater or sewage can have major and important effects on the environment and humans, especially resulting in pollution and infectious diseases. In general, households in Indonesia dispose of their waste directly into the sewer and without shelter. This study aims to determine the factors associated with household SPAL ownership in the Trimoharjo Health Center Working Area. Quantitative research design with a cross-sectional approach. The sampling technique used purposive sampling. The sample obtained was 100 respondents. Data collection using questionnaires. Bivariate data analysis using chi-Square test and multivariate logistic regression. The results showed that there was a relationship between knowledge (p value 0.000), the role of officers (p value 0.001) and the role of community leaders (p value 0.021) on household SPAL ownership. There was no relationship between attitude (p value 0.93), socioeconomic status (p value 0.06) and home ownership status (p value 1.00) towards household SPAL ownership. The most dominant factor with household SPAL ownership was knowledge (OR 0.026). It can be concluded that there is a relationship between knowledge, the role of officials and the role of community leaders in household SPAL ownership

Deaths in jail: a retrospective analysis of autopsies performed at the Legal Medicine Unit of Pavia (1999-2022)

IntroductionThe high rate of incarceration, now exceeding 11.5 million people worldwide, has raised concerns about the conditions within penal institutions, such as the consequences of incarceration on the person. This retrospective study aims to investigate the issue of death in custody, exploring the relationship between incarceration, health vulnerabilities, and death from the forensic pathologist’s point of view.MethodsWe analyzed, from a forensic, clinical and toxicological perspective, 86 cases of deaths in detention facilities in North-Western Italy from 1999 to 2022.ResultsThe analysis has shown that suicide, mainly committed by hanging, plastic bag suffocation and butane intoxication, represents the leading type of violent death (52%), followed by accidental deaths (16%). On the other hand, cardiovascular diseases are the leading cause of natural deaths (42%), followed by infectious diseases (especially HIV-related).DiscussionThe present study identifies the most frequent and critical situations and risk factors related to death in custody and the profile of the inmate who is at a higher risk of death, allowing to highlight the issues to be addressed from a public health point of view. On the whole, it calls for comprehensive reforms, aligned with international human rights standards, addressing mental and physical care gaps, improving correctional officers' education, and training, and focusing on rehabilitation with well-being and dignity.

Diagnostic utility of ultrasonography for thoracic and abdominal bacterial and parasitic diseases in ruminants: a comprehensive overview

This review article describes the roles of ultrasound in assessing thoracic and abdominal infectious diseases, mainly bacterial and parasitic ones that affect farm animals, including cattle, camels, sheep, and goats. Ultrasonography is a non-invasive imaging technique used to diagnose infectious diseases affecting the cardiovascular, respiratory, digestive, urinary, and hepatobiliary systems. In cases of thoracic and abdominal infections, ultrasound typically reveals abnormalities in echogenicity and echotexture, the presence of unusual artifacts, and mass formation exerting pressure on surrounding structures. Inflammatory and degenerative changes within the viscera can be identified ultrasonographically by comparing the echogenicity of affected areas with that of the surrounding normal parenchyma, such as in fascioliasis. Bacterial and parasitic infections often result in capsular mass lesions with anechoic contents, as observed in hydatid cysts and cysticercosis, or varying echogenic contents, as observed in liver abscesses. Effusions within the pericardium, pleura, and peritoneum are common ultrasonographic findings in infectious thoracic and abdominal diseases. However, these effusions' echogenicity does not always allow for clear differentiation between transudates and exudates. The routine use of ultrasonography in the evaluation of the chest and abdomen in affected or suspected ruminants is highly beneficial for detection, guiding therapeutic decisions, assessing prognosis, and aiding in the eradication of highly contagious diseases that cause significant economic losses.

Harnessing the potential of the NALT and BALT as targets for immunomodulation using engineering strategies to enhance mucosal uptake

Mucosal barrier tissues and their mucosal associated lymphoid tissues (MALT) are attractive targets for vaccines and immunotherapies due to their roles in both priming and regulating adaptive immune responses. The upper and lower respiratory mucosae, in particular, possess unique properties: a vast surface area responsible for frontline protection against inhaled pathogens but also simultaneous tight regulation of homeostasis against a continuous backdrop of non-pathogenic antigen exposure. Within the upper and lower respiratory tract, the nasal and bronchial associated lymphoid tissues (NALT and BALT, respectively) are key sites where antigen-specific immune responses are orchestrated against inhaled antigens, serving as critical training grounds for adaptive immunity. Many infectious diseases are transmitted via respiratory mucosal sites, highlighting the need for vaccines that can activate resident frontline immune protection in these tissues to block infection. While traditional parenteral vaccines that are injected tend to elicit weak immunity in mucosal tissues, mucosal vaccines (i.e., that are administered intranasally) are capable of eliciting both systemic and mucosal immunity in tandem by initiating immune responses in the MALT. In contrast, administering antigen to mucosal tissues in the absence of adjuvant or costimulatory signals can instead induce antigen-specific tolerance by exploiting regulatory mechanisms inherent to MALT, holding potential for mucosal immunotherapies to treat autoimmunity. Yet despite being well motivated by mucosal biology, development of both mucosal subunit vaccines and immunotherapies has historically been plagued by poor drug delivery across mucosal barriers, resulting in weak efficacy, short-lived responses, and to-date a lack of clinical translation. Development of engineering strategies that can overcome barriers to mucosal delivery are thus critical for translation of mucosal subunit vaccines and immunotherapies. This review covers engineering strategies to enhance mucosal uptake via active targeting and passive transport mechanisms, with a parallel focus on mechanisms of immune activation and regulation in the respiratory mucosa. By combining engineering strategies for enhanced mucosal delivery with a better understanding of immune mechanisms in the NALT and BALT, we hope to illustrate the potential of these mucosal sites as targets for immunomodulation.

Two roads diverged in a cell: insights from differential exosome regulation in polarized cells

Exosomes are extracellular vesicles involved in intercellular signaling, carrying various cargo from microRNAs to metabolites and proteins. They are released by practically all cells and are highly heterogenous due to their origin and content. Several groups of exosomes are known to be involved in various pathological conditions including autoimmune, neurodegenerative, and infectious diseases as well as cancer, and therefore a substantial understanding of their biogenesis and release is crucial. Polarized cells display an array of specific functions originated from differentiated membrane trafficking systems and could lead to hints in untangling the complex process of exosomes. Indeed, recent advances have successfully revealed specific regulation pathways for releasing different subsets of exosomes from different sides of polarized epithelial cells, underscoring the importance of polarized cells in the field. Here we review current evidence on exosome biogenesis and release, especially in polarized cells, highlight the challenges that need to be combatted, and discuss potential applications related to exosomes of polarized-cell origin.

Optimizing Disease Surveillance Through Pooled Testing with Application to Infectious Diseases

AbstractPooled (or group) testing has been widely used for the surveillance of infectious diseases of low prevalence. The potential benefits of pooled testing include savings in testing time and costs, reducing false positive tests, and estimating models or making predictions from limited observed data information (e.g., only initial pooled responses). However, realizing these benefits often critically depends on the pool size used. Statistical methods introduced in the literature for optimal pool size determination have been developed mainly to accommodate simpler pooling protocols or perfect diagnostic assays. In this article, we study these issues with the goal of presenting a general optimization technique. We evaluate the efficiency of the estimators of disease prevalence (i.e., the proportion of diseased individuals in a population) while accounting for testing costs. Then, we determine the optimal pool size by minimizing the measures of optimality, such as screening efficiency and estimation efficiency. Our findings are illustrated using data from an ongoing screening application at the Louisiana Department of Health. We show that when a pooling application is properly designed, substantial advantages can be realized. We provide an package and a software application to facilitate the implementation of our optimization techniques. Supplementary materials accompanying this paper appear online.

Innate immune sensing of cell death in disease and therapeutics.

Innate immunity, cell death and inflammation underpin many aspects of health and disease. Upon sensing pathogens, pathogen-associated molecular patterns or damage-associated molecular patterns, the innate immune system activates lytic, inflammatory cell death, such as pyroptosis and PANoptosis. These genetically defined, regulated cell death pathways not only contribute to the host defence against infectious disease, but also promote pathological manifestations leading to cancer and inflammatory diseases. Our understanding of the underlying mechanisms has grown rapidly in recent years. However, how dying cells, cell corpses and their liberated cytokines, chemokines and inflammatory signalling molecules are further sensed by innate immune cells, and their contribution to further amplify inflammation, trigger antigen presentation and activate adaptive immunity, is less clear. Here, we discuss how pattern-recognition and PANoptosome sensors in innate immune cells recognize and respond to cell-death signatures. We also highlight molecular targets of the innate immune response for potential therapeutic development.

Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment

Coronary artery aneurysm or ectasia (CAAE) is a term that includes both coronary artery ectasia (CAE) and coronary artery aneurysm (CAA), despite distinct phenotypes and definitions. This anomaly can be found in 0.15–5.3% of coronary angiography. CAE is a diffuse dilatation of the coronary artery at least 1.5 times wider than the diameter of the normal coronary artery in a patient with a length of over 20 mm or greater than one-third of the vessel. CAE can be further subdivided into diffuse and focal dilations by the number and the length of the dilated vessels. Histologically, it presents with extensive destruction of musculoelastic elements, marked degradation of collagen and elastic fibers, and disruption of the elastic lamina. Conversely, CAA is a focal lesion manifesting as focal dilatation, which can be fusiform (if the longitudinal diameter is greater than the transverse) or saccular (if the longitudinal diameter is smaller than the transverse). Giant CAA is defined as a 4-fold enlargement of the vessel diameter and is observed in only 0.02% of patients after coronary. An aneurysmal lesion can be either single or multiple. It can be either a congenital or acquired phenomenon. The pathophysiological mechanisms responsible for the formation of CAAE are not well understood. Atherosclerosis is the most common etiology of CAAE in adults, while Kawasaki disease is the most common in children. Other etiological factors include systemic connective tissue diseases, infectious diseases, vasculitis, congenital anomalies, genetic factors, and idiopathic CAA. Invasive assessment of CAAE is based on coronary angiography. Coronary computed tomography (CT) is a noninvasive method that enables accurate evaluation of aneurysm size and location. The most common complications are coronary spasm, local thrombosis, distal embolization, coronary artery rupture, and compression of adjacent structures by giant coronary aneurysms. The approach to each patient with CAAE should depend on the severity of symptoms, anatomical structure, size, and location of the aneurysm. Treatment methods should be carefully considered to avoid possible complications of CAAE. Simultaneously, we should not unnecessarily expose the patient to the risk of intervention or surgical treatment. Patients can be offered conservative or invasive treatment. However, there are still numerous controversies and ambiguities regarding the etiology, prognosis, and treatment of patients with coronary artery aneurysms. This study summarizes the current knowledge about this disease’s etiology, pathogenesis, and management.