Spontaneous Infection Research Articles

Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

Morphofunctional characteristics of <i>Trichinella spiralis</i> capsules and larvae obtained from the lynx in spontaneous infection and experimental infection of white rats

The purpose of the research is a comparative study of morphological changes in Trichinella spiralis capsules and larvae in the lynx and laboratory animals.Materials and methods. The experiment used striated muscle tissue from spontaneously infected lynxes and from white rats experimentally infected with T. spiralis larvae isolated from wild animals in the Kirov Region. Morphometric studies of T. spiralis capsules and larvae in the lynx muscle tissue were conducted on temporary histologic specimens.Results and discussion. Lemon-shaped (50%) and oval (40%) capsules were found in the entire muscle mass of the white rats, and only 10% of the larvae were round in shape. The lynx was not found to have lemon-shaped capsules; oval (60%) and round (40%) capsules predominated. The studies show that the parasite capsule size and shape indicate the adaptive abilities of T. spiralis to various types of host muscle tissue and their morphological characteristics, and are largely determined by the symplast structure and size.

2280. Surveillance of Life-Long Antibiotics (SOLLA) 2: Patients on Life-Long Antibiotics in an Australian Healthcare Network

Abstract Background There is a range of conditions for which long-term antibiotics are prescribed, most of which lack high quality evidence. Apart from promoting antimicrobial resistance, long-term antibiotics also impact the individual patient, disrupting the normal microbiome, and increasing the risk of infection with multi-resistant organisms (MROs). Previous work conducted at Monash Health, in Victoria, Australia, in 2014 noted great heterogeneity in both indications for prolonged antibiotic courses and the antimicrobial agents used. Methods The current study aimed to reassess prescribing trends within the same health network, across two time periods in 2019 and 2021. Outpatient prescriptions were extracted from the Monash Health pharmaceutical database at two time points, from 1st January 2019 – 30th June 2019, and 1st January 2021 – 30th June 2021. Results From 4,704 outpatient prescriptions, 929 patients were identified as being on either one or more antibiotics for an intended duration of ≥ 12 months. There were a total 536 (57.7%) males and 393 females (42.3%), with a mean age of 58.20 years. Sixty-eight patients died between the two follow-up periods. Data was separated into 3 groups: primary prophylaxis in the setting of immunosuppression (n = 687), secondary prophylaxis for infections deemed incurable (n = 78), and “Other” (n = 164). Six hundred and four patients (88%) on primary prophylaxis were for Pneumocystis jirovecii pneumonia, and 83 (12%) post splenectomy. Trimethoprim/sulfamethoxazole was predominantly prescribed for PJP prophylaxis (n = 583), followed by dapsone (n = 21). Prosthetic joint infections made up 57 (73%) of those on suppressive antibiotics for infections deemed incurable. An array of antibiotics was utilised to treat them, as seen in Figure 1. The “Other” category included those on antibiotics for difficult to treat infections, such as mycobacterial infections (n = 43), chronic airways disease (n = 38), spontaneous bacterial peritonitis (n = 23) and recurrent urinary tract infections (n = 12). Data on comorbidities, hospitalisations and MROs between groups can be viewed in Table 1. Conclusion Further research is needed. Prospective data examining long-term patient outcomes, and patterns of prescribing across different health networks would be of benefit. Disclosures Jillian Lau, MBBS, FRACP, Gilead: Advisor/Consultant|Gilead: Grant/Research Support|MSD: Grant/Research Support|Viiv Healthcare: Advisor/Consultant Ian Woolley, MBBS, FRACP, DTM&H, MD, Gilead: Educational support, investigator for Gilead supported trial|MSD: educational support, participation in a clinical trial|Pfizer: Educational support|ViiV: Educational Programs, Advisory Board member, ViiV sponsored trials

Aeromonas salmonicida, causative agent of salmonid furunculosis, isolated from the freshwater parasitic copepod, Salmincola californiensis.

Here, we provide evidence that the freshwater parasitic copepod, Salmincola californiensis, acts as a vector for Aeromonas salmonicida. While investigating the effects of S. californiensis on Chinoook salmon (Oncorhynchus tshawytscha), we tangentially observed that fish infected with the copepod developed furunculosis, caused by A. salmonicida. This occurred despite being reared in pathogen-free well water in a research facility with no prior history of spontaneous infection. We further investigated the possibility of S. californiensis to serve as a vector for the bacterium via detection of fluorescently labelled A. salmonicida inside the egg sacs from copepods in which the fish hosts were experimentally infected with GFP-A449 A. salmonicida. We then evaluated copepod egg sacs that were collected from adult Chinook salmon from a freshwater hatchery with A. salmonicida infections confirmed by either culture or PCR. The bacterium was cultured on tryptic soy agar plates from 75% of the egg sacs, and 61% were positive by PCR. These three separate experiments indicate an alternative tactic of transmission in addition to direct transmission of A. salmonicida in captivity. The copepod may play an important role in transmission of the bacterium when fish are more dispersed, such as in the wild.

IL7RA rs10491434 polymorphism is related to spontaneous HIV infection control in naïve HIV-infected patients: A retrospective study.

Interleukin 7 receptor (IL7R) is vital in the adaptive immune response against human immunodeficiency viruses (HIV). We assessed IL7RA polymorphisms (SNPs) in antiretroviral therapy (ART)-naïve HIV patients for their association with spontaneous HIV infection control. We conducted a retrospective cohort study involving 667 ART-naïve patients categorized by HIV progression (ordinal variable): 150 rapid progressors, 334 moderate/typical progressors, 86 long-term nonprogressors elite controllers (LTNPs-EC), and 97 LTNPs-non-EC. We genotyped three IL7RA SNPs using Agena Bioscience's MassARRAY platform. The association between IL7RA SNPs and spontaneous HIV infection control was evaluated using ordinal logistic regression. Individuals carrying the rs10491434 G allele have a higher likelihood of spontaneous HIV infection control (adjusted odds ratio [aOR] = 1.33; p = 0.023). Moreover, the IL7RA GCT haplotype, consisting of three specific SNPs (rs6897932, rs987106, and rs10491434), demonstrated an association with the control of untreated HIV infection (aOR = 1.34; p = 0.050). Remarkably, the rs10491434 SNP and the IL7RA GCT haplotype exhibited similar aOR values, suggesting that rs10491434 may be primarily responsible for the observed effect of the haplotype. IL7RA rs10491434 G allele is associated with a higher likelihood of spontaneous HIV infection control, indicating its significant role in the pathogenesis of HIV, possibly influencing infection course and viral replication control.

Grass Meal Acts as a Probiotic in Chicken

Probiotics can act as an alternative to antibiotics in animal feeding, but their use is minimal due to their expensive production. Dry grass is rich with bacteria beneficial for animal feeding and can be used as a probiotic. However, data about the quantitative dependence of the grass microbiome on environmental factors and seasons remain insufficient for preparing “grass-meal-based probiotics”. Four grass samples were collected in two geographically remote regions of Russia; their microbiome was characterized by metagenomic sequencing of 16S rDNA libraries and microbiological seeding, and biological testing of the grass meal was carried out on 6 groups of birds containing 20 Ross 308 cross broilers each for a period of 42 days. The positive control group (PC) obtained 16–25 mg/mL toltrazuril (coccidiostatic agent) and 0.5 mL/L liquid antibiotic enrostin (100 mg/mL ciprofloxacin and 106 MU/mL colistin sulfate in the commercial preparation) within the drinking water, while the negative control group (NC) obtained no medicines. Four experimental groups were fed the diet supplemented with 1% grass meal over the period of 7–42 days of life; no commercial medicines were used here. A spontaneous infection with Eimeria was registered in the NC control groups, which caused the loss of 7 chickens. No losses were registered in the PC group or the two experimental groups. In two other experimental groups, losses of coccidiosis amounted to 10% and 15%, respectively. All specimens of the grass meal demonstrated a significant effect on the average body weight gain compared to NC. Taken together, these observations support the hypothesis that the grass meal may substitute toltrazuril for protecting the chickens from parasitic invasion and increase average daily weight gain (ADG) as effectively as the antibiotic enrostin.

48 Spontaneous infection in the cystic fibrosis rat model is linked to gastrointestinal obstruction

48 Spontaneous infection in the cystic fibrosis rat model is linked to gastrointestinal obstruction

Spontaneous Clostridium perfringens Meningitis and Brain Abscess in a Neonate.

This case describes a neonate who presented with spontaneous Clostridium perfringens meningitis and brain abscess. The abscess was drained, and the infant completed a 6-week course of antibiotics. Throughout this time the infant remained well with no need for intensive care. C. perfringens central nervous system infections are associated with trauma and poor outcomes. This case highlights that the spectrum of disease can include spontaneous infection with a relatively mildly clinical course demonstrating the importance of 16s polymerase chain reaction in culture-negative cases and its role in detecting rare causes of central nervous system infections such as C. perfringens .

Trichinellosis dissemination among wild carnivores in the Republic of Kazakhstan: A 10-year study.

Trichinellosis is caused by a species of roundworm called Trichinella and is an invasive disease causing severe medical, veterinary, and socioeconomic problems worldwide. More than 100 mammalian species are Trichinella hosts. Among domestic animals, pigs and dogs are prone to trichinellosis. An essential aspect of controlling the spread of infection is to identify the number and level of infections in wild carnivores in the country. However, the number, habitats, and movements of wild animal Trichinella hosts in Kazakhstan have not been reported yet. This study aimed to monitor the wild animal habitat nearby the settlements for tracking the trichinellosis speading among carnivores. Wild carnivorous animals were captured in seven regions of the Republic of Kazakhstan. The carcasses of corsacs, wolves, foxes, wild boars, and badgers were studied. Muscle tissue samples from spontaneously infected wild animals were collected. The digestion method in "GASTROS-2M" was used to isolate Trichinella spp. from animal muscles. The species of the parasite was determined by a polymerase chain reaction for 5S spacer of Trichinella ribosomal DNA with subsequent sequencing by Senger. Statistical analysis methods were performed for average value in Microsoft Excel 2010. The results of the research showed that among 155 animals wolves (20.4%) and foxes (26.7%) were the most infected with invasive Trichinella larvae. The invasion intensity was 503.6% in foxes and 289.7% in wolves. However, badgers (164%), wild boars (0%), and corsacs (0%) presented lower invasion levels. Using specific primers, larvae samples were identified as Trichinella nativa. The results of monitoring revealed the spread of trichinosis among wild animals: wolves, foxes, badgers. The Karaganda, Kostanay, Western Kazakhstan, and Akmola regions had the largest distribution of wild animals infected with trichinellosis. In total, 20% of the 155 studied animals were infected. The greatest invasion intensity was typical for wolves, foxes and badgers. It is necessary to monitor the spread of trichinellosis among wild carnivores to control the epidemiological situation and reduce the level of spontaneous infection among animals. Regular monitoring of habitats and carnivores must be conducted within the country and in the border areas.

Posterior Fixation Without Debridement for Vertebral Body Osteomyelitis and Discitis: A 10-Year Retrospective Review.

Surgical treatment of vertebral osteomyelitis, discitis, and epidural abscesses is indicated in the setting of failure of antibiotic therapy, neurological deficits, epidural abscess, or spinal instability/deformity. Historically, surgical treatment mandated aggressive debridement and spinal stabilization. However, there is growing evidence that direct debridement may not be necessary and may contribute to morbidity. The purpose of this study was to evaluate the efficacy of posterior instrumentation without debridement in treating spinal infections. A retrospective medical record review was performed to identify patients treated with posterior instrumentation for spontaneous spinal infections. Success of treatment was determined based on postoperative ambulatory status, surgical complications, and need for revision surgery. Twenty-seven patients treated with posterior-only long-segmented rigid fixation without formal debridement of infected material were included. The most common indications for surgical intervention included spinal instability (67%), neurologic compromise (67%), and failure of prolonged antibiotic treatment (63%). There were no recurrent deep infections in 21 of 22 patients who had long-term follow-up. Four patients required revision surgery, and 3 additional patients requested elective hardware removal. Postoperatively, 70% were ambulatory with no assistive devices postoperatively. Vertebral osteomyelitis/discitis are challenging medical problems. Single-stage long-segment fusion without formal debridement combined with antibiotics is effective in the management of spontaneous spinal infections. The present study suggests that acute instrumentation without anterior debridement is associated with a resolution of infection and improvements in neurologic deficits in patient with spontaneous spine infections.

Current State of the Issue of Hemorrhagic Fever with Renal Syndrome in the Rostov Region

Hemorrhagic fever with renal syndrome (HFRS) is registered in various geographical regions of the Russian Federation and occupies one of the leading positions among natural-focal human diseases in Russia. The aim of the study was to assess the epidemiological situation on HFRS in the Rostov Region. Materials and methods. Laboratory diagnostics of field material (samples from wild rodents) for the presence of antigens of HFRS pathogens and screening of blood sera from donors, residents of the region, for the presence of class G antibodies to viruses that cause HFRS were carried out by enzyme immunoassay during 2020 and 2021. Results and discussion. Hantavirus antigens were identified in five administrative districts of the Region in 2020, infection with HFRS virus in small mouse-like rodents was 7.1 %. In 2021, spontaneous infection of carriers was detected in 2.8 % of the samples, found in four districts of the Region. The presence of the virus markers was recorded in populations of five species of mouse-like rodents: house mouse, wood mouse, common vole, small wood mouse, yellow-bellied mouse. Among healthy population, class G antibodies were registered in 6.8 % in the surveyed territories in 2020, and 4.5 % in 2021. Detection of virus markers in carriers and the presence of a natural immune layer of the population as regards HFRS agents suggest the existence of a natural HFRS focus in the Rostov Region.

Emphysematous pyelonephritis and sepsis in a diabetic female patient caused by extended-spectrum beta-lactamase-producing Escherichia coli – case report

Emphysematous pyelonephritis (EPN) is a rare, severe, spontaneous gas-forming infection of renal parenchyma and its surrounding areas. EPN was detected in diabetic patients. A 49-year-old female with type I diabetes mellitus presented with severe thrombocytopenia, acute kidney injury (AKI) and was in need of haemodialysis treatment. She had impaired liver function tests, with active urine sediment, indicating severe upper urinary tract infection with suspected sepsis. The contrast enhanced CT scan of the abdomen showed multiple areas of air density in renal parenchyma and perirenal regions, suggestive of left-side EPN. The blood and urine cultures reported growth of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli. The final diagnosis of emphysematous pyelonephritis complicated with severe sepsis and AKI was established. The patient was managed conservatively with wide-spectrum antibiotics, fluid resuscitation, consistent blood sugar control, and haemodialysis treatment. Percutaneous drainage techniques (PCD) and nephrectomy were postponed because of the initial clinical response to the antibiotics treatment. However, the patient experienced sudden clinical deterioration and died only a few hours after the established diagnosis. An autopsy was not performed upon the patient’s family’s request. EPN should be highly suspected in poorly controlled diabetic patients with urinary tract infection and should be promptly recognized and aggressively treated. The patients with multiple risk factors had high mortality, even with timely diagnosis and combined (conservative and surgical) treatment.

WED-336 - Applicability of EASL clinical guidelines recommendations of empiric antibiotic treatment for spontaneous bacterial infections in patients with cirrhosis in South America

WED-336 - Applicability of EASL clinical guidelines recommendations of empiric antibiotic treatment for spontaneous bacterial infections in patients with cirrhosis in South America

Trends in Antibody Titers after SARS-CoV-2 Vaccination—Insights from Self-Paid Tests at a General Internal Medicine Clinic

Background: The rise in antibody titers against the novel coronavirus (SARS-CoV-2) and its duration are considered an important indicator for confirming the effect of a COVID-19 vaccine, and self-paid tests of antibody titer are conducted in many facilities nationwide. Methods: The relationship between the number of days after the second and third dose of vaccines, age, and antibody titer was determined from the medical records of general internal medicine clinics that conducted self-paid testing of the SARS-CoV-2 antibody titer using Elecsys Anti-SARS-CoV-2 S (Roche Diagnostics); the relationship between the number of days after two or more doses of vaccines and antibody titer was also determined. We also examined the antibody titers in cases of spontaneous infection with SARS-CoV-2 after two or more doses of the vaccine. Results: Log-transformed SARS-CoV-2 antibody titers measured within 1 month from the second or third dose of vaccine showed a negative correlation with age (p < 0.05). In addition, the log-transformed antibody titers also showed a negative correlation trend with the number of days after the second dose of vaccine (p = 0.055); however, there were no significant correlations between the log-transformed antibody titers and the number of days after the third dose of vaccine. The median antibody titer after the third vaccination was 18,300 U/mL, more than 10 times the median antibody titer after the second dose of vaccine, of 1185 U/mL. There were also some cases of infection after the third or fourth dose of vaccine, with antibody titers in the tens of thousands of U/ml after infection, but the patients still received further booster vaccinations after the infection. Conclusions: The antibody titers after the third vaccination did not attenuate after a short follow-up period of one month, while they tended to attenuate after the second vaccination. It is considered that many people in Japan received further booster vaccinations after spontaneous infection, even though they already had antibody titers in the tens of thousands of U/mL due to "hybrid immunity" after spontaneous infection following two or more doses of vaccine. The clinical significance of the booster vaccination in this population still needs to be thoroughly investigated and should be prioritized for those with low SARS-CoV-2 antibody titers.

Longitudinal Changes in IgG-Type SARS-CoV-2 Antibody Titers after COVID-19 Vaccination and a Prominent Increase in Antibody Titers When Infected after Vaccination.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody titers level and duration of elevated levels are considered important indicators for confirming the efficacy of coronavirus disease 2019 (COVID-19) vaccines. The objective of this study was to demonstrate the changes in antibody titers after the second and third doses of the COVID-19 vaccine, and to determine the antibody titers in cases of spontaneous infection with SARS-CoV-2 after vaccination. From June 2021 to February 2023, IgG-type SARS-CoV-2 antibody titers were measured in 127 participants, including 74 outpatients and 53 members of staff, at the Osaka Dental University Hospital (64 males and 63 females, mean age 52.3 ± 19.0 years). Consistent with previous reports, the SARS-CoV-2 antibody titer decreased with time, not only after the second dose but also after the third dose of the vaccine if there was no spontaneous COVID-19 infection. We also confirmed that the third booster vaccination was effective in increasing the antibody titer. A total of 21 cases of natural infections were observed after administering two or more doses of the vaccine. Thirteen of these patients had post-infection antibody titers exceeding 40,000 AU/mL, and some cases continued to maintain antibody titers in the tens of thousands of AU/mL even after more than 6 months had passed since infection. The rise in and duration of antibody titers against SARS-CoV-2 are considered important indicators for confirming the efficacy of novel COVID-19 vaccines. A longitudinal follow-up of antibody titers after vaccination in larger studies is warranted.

Clinical and microbiological characteristics of bacterial infections in patients with cirrhosis. A prospective cohort study from Argentina and Uruguay

Introduction and Objectivesthere is insufficient data regarding bacterial infections in patients with cirrhosis to support recommendations for empiric antibiotic treatments, particularly in Latin America. This study aimed to evaluate bacterial infection's clinical impact and microbiological characteristics, intending to serve as a platform to revise current practices. Materials and Methodsmulticenter prospective cohort study of patients with cirrhosis and bacterial infections from Argentina and Uruguay. Patient and infection-related information were collected, focusing on microbiology, antibiotic susceptibility patterns, and outcomes. Results472 patients were included. Spontaneous bacterial infections and urinary tract infections (UTIs) were registered in 187 (39.6%) and 116 (24.6%) patients, respectively, representing the most common infections. Of the 256 culture-positive infections, 103 (40.2%) were caused by multidrug-resistant organisms (reaching 50% for UTI), and 181 (70.7%) received adequate initial antibiotic treatment. The coverage of cefepime and ceftriaxone was over 70% for the empirical treatment of community-acquired spontaneous infections, but ceftazidime´s coverage was only 40%. For all UTI cases and for healthcare-associated or nosocomial spontaneous bacterial infections, the lower-spectrum antibiotics that covered at least 70% of the isolations were imipenem and meropenem. During hospitalization, a second bacterial infection was diagnosed in 9.8% of patients, 23.9% required at least one organ support, and 19.5% died. Conclusionsshort-term mortality of bacterial infections in patients with cirrhosis is very high, and a high percentage were caused by multidrug-resistant organisms, particularly in UTIs. The information provided might serve to adapt recommendations, particularly related to empirical antibiotic treatment in Argentina and Uruguay. The study was registered in Clinical Trials (NCT03919032).

Unusual symptoms of iron deficiency anemia (2 clinical observations)

Iron deficiency is a leading cause of anemia, the most common malnutrition worldwide, affecting 42% of children worldwide. Most often, iron deficiency occurs in children of the first year of life and adolescents; its prevalence in adolescents has pronounced gender differences. In Russia, it is much more common in girls in 17.231.0% of cases, which is 1.6 times higher than in boys. The presence of delayed adverse effects of iron deficiency at an early age has been established, therefore, timely correction of sideropenic conditions in young children is important for the prevention of long-term consequences of a childs development. The article presents two clinical cases of iron deficiency anemia in adolescent girls who had iron deficiency in the first year of life. On the example of the first clinical observation, we observe the development of alopecia against the background of severe sideropenia as part of the epithelial syndrome with iron deficiency anemia of moderate severity. Iron deficiency in this case is multifactorial maternal anemia during pregnancy, spontaneous subarachnoid hemorrhage, shunt infection, and uncorrected iron deficiency in the first two years. The second clinical example illustrates iron deficiency anemia of mixed genesis in a teenage girl, which was the result of insufficient iron stores at birth, alimentary insufficiency, aggravated against the background of heavy, prolonged menstruation. In this case, there is no hair loss, despite the more severe course of anemia, a long refractory period with iron therapy. The data of clinical cases confirm the significance of low iron stores at birth in the risk of developing iron deficiency anemia in puberty. During the examination of children, the need to take into account the state of the gastrointestinal tract in the algorithm for diagnosing the state of the gastrointestinal tract (detection of malabsorption, blood loss) was shown.

Airway epithelial cell-specific deletion of HMGB1 exaggerates inflammatory responses in mice with muco-obstructive airway disease.

High mobility group box 1 (HMGB1), a ubiquitous chromatin-binding protein required for gene transcription regulation, is released into the extracellular microenvironment by various structural and immune cells, where it is known to act as an alarmin. Here, we investigated the role of airway epithelium-specific HMGB1 in the pathogenesis of muco-obstructive lung disease in Scnn1b-transgenic (Tg+) mouse, a model of human cystic fibrosis (CF)-like lung disease. We hypothesized that airway epithelium-derived HMGB1 modulates muco-inflammatory lung responses in the Tg+ mice. The airway epithelium-specific HMGB1-deficient mice were generated and the effects of HMGB1 deletion on immune cell recruitment, airway epithelial cell composition, mucous cell metaplasia, and bacterial clearance were determined. The airway epithelium-specific deletion of HMGB1 in wild-type (WT) mice did not result in any morphological alterations in the airway epithelium. The deficiency of HMGB1 in airway epithelial cells in the Tg+ mice, however, resulted in significantly increased infiltration of macrophages, neutrophils, and eosinophils which was associated with significantly higher levels of inflammatory mediators, including G-CSF, KC, MIP-2, MCP-1, MIP-1α, MIP-1β, IP-10, and TNF-α in the airspaces. Furthermore, as compared to the HMGB1-sufficient Tg+ mice, the airway epithelial cell-specific HMGB1-deficient Tg+ mice exhibited poor resolution of spontaneous bacterial infection. The HMGB1 deficiency in the airway epithelial cells of Tg+ mice did not alter airway epithelial cell-specific responses including epithelial cell proliferation, mucous cell metaplasia, and mucus obstruction. Collectively, our findings provide novel insights into the role of airway epithelial cell-derived HMGB1 in the pathogenesis of CF-like lung disease in Tg+ mice.

Non-perinatal listeriosis: Changes in frequency, clinical spectrum and prognostic factors

IntroductionListeria monocytogenes infection is a severe disease affecting mainly aged people and patients with immune depression. The incidence of listeriosis seems to be increasing. In the present study cases of listeriosis from two hospitals are analyzed with the aims of studying changes in its incidence, clinical forms of presentation and possible factors associated with mortality. MethodsRetrospective multicentric study of patients with culture-proven listeriosis in two university hospitals in Madrid between 1977 and 2021. Epidemiological and clinical variables, as well as factors for immune depression, complementary studies and treatments were registered. Factors associated with mortality were analyzed. ResultsA total of 194 cases of listeriosis were analyzed. The incidence of listeriosis among in-patients increased through the study period, with a significant drop in the number of cases in 2020. The most common clinical presentations were isolated bacteriemia (37.1%) and central nervous system involvement (CNS) (36.6%). Symptoms of gastroenteritis occurred in 21% of cases. Other focal infections were present in 16.5% of patients, the most frequent were spontaneous bacterial peritonitis (8.2%), cholecystitis (2.1%), respiratory infection (1.5%) and vascular prothesis infection (1.5%). In-hospital mortality was 24.7%. Independent factors associated with mortality at admission were age (Odds Ratio [OR] 1.027, 95% confidence interval [IC95%] 1.003–1.056) and a diagnosis of a solid tumor (OR 3.525, IC95% 1.652–7.524). ConclusionsThis study confirms an increasing incidence of listeriosis in our millieu. The most common clinical presentations were isolated bacteriemia and central nervous system involvement. In-hospital mortality was associated with age and the diagnosis of a solid tumor.

Acute Lymphoblastic Leukemia, Invasive Aspergillus Fungal Pneumonia and Complications: A Pandora’s Box

Acute lymphoblastic leukemia is a malignancy associated with overproduction of immature lymphocyte population. There is a progressive replacement of bone marrow and other lymphoid organs by abnormal cells. The common symptoms include fatigue bruising spontaneous bleeding and infections. This is more common in children. A patient with leukemia is at an increased risk for infections both as a result of disease itself and due to complications associated with chemotherapy. Neutropenia is the major determinant for development of infections. Radiologic lsquoHalo signrsquo is characteristically observed in angio-invasive fungal pneumonia. Early institution of antifungal regimen based on this sign results in improved outcomes.Multiple complications are observed in leukemia such as development of vascular aneurysms hemorrhagic complications cellular infiltration and tumor cell lysis syndrome. Radiology plays an important role in the early diagnosis and guided interventions. A multidisciplinary approach results in improved outcomes.