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Infectious Disease Reports
Volume 10
Issue 1
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Infectious Disease Reports is published by MDPI from Volume 12 Issue 3 (2020). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.

Infect. Dis. Rep., Volume 10, Issue 1 (March 2018) – 6 articles

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Review
Opportunistic Infections in End Stage Liver Disease
by Michele Bartoletti, Maddalena Giannella, Sara Tedeschi and Pierluigi Viale
Infect. Dis. Rep. 2018, 10(1), 7621; https://doi.org/10.4081/idr.2018.7621 - 03 Apr 2018
Cited by 7 | Viewed by 666
Abstract
Liver cirrhosis is the 10th most common cause of death in Western world and infection is associated with a high morbidity and mortality, and represents the leading cause of acute liver decompensation. Patients with end-stage liver disease exhibit an important impairment of immune [...] Read more.
Liver cirrhosis is the 10th most common cause of death in Western world and infection is associated with a high morbidity and mortality, and represents the leading cause of acute liver decompensation. Patients with end-stage liver disease exhibit an important impairment of immune system. This condition, called cirrhosis-associated immune dysfunction, summarizes both local and systemic immune system alterations in liver cirrhosis that play a pivotal role in determining both the high incidence of infections and the ominous infections related mortality in this population. Another concerning feature of infections in cirrhotic patients is the growing prevalence of multidrug-resistant or extensively drug-resistant pathogens, which are associated with higher mortality, increased length of in-hospital stay and higher healthcare related costs if compared with infection caused by susceptible strains. Finally, patient with liver cirrhosis have several unique pathophysio-logical characteristics including hypoalbuminemia and reduction binding to proteins; altered distribution; altered clearance of the antimicrobials that can affect the pharmaco-kinetic/pharmacodynamic of antimicrobials. Full article
1469 KiB  
Article
Mexican Patients with HIV Have a High Prevalence of Vertebral Fractures
by José Antonio Mata-Marín, Carla I. Arroyo-Anduiza, María de los Ángeles Berrospe-Silva, Alberto Chaparro-Sánchez, Ana Gil-Avila and Jesús Gaytán-Martínez
Infect. Dis. Rep. 2018, 10(1), 7409; https://doi.org/10.4081/idr.2018.7409 - 03 Apr 2018
Cited by 4 | Viewed by 473
Abstract
Low bone mineral density (BMD) and fragility fractures are common in individuals infected with HIV, who are undergoing antiretroviral therapy (ART). In high-income countries, dual energy X-ray absorptiometrry is typically used to evaluate osteopenia or osteoporosis in HIV infected individuals. However, this technology [...] Read more.
Low bone mineral density (BMD) and fragility fractures are common in individuals infected with HIV, who are undergoing antiretroviral therapy (ART). In high-income countries, dual energy X-ray absorptiometrry is typically used to evaluate osteopenia or osteoporosis in HIV infected individuals. However, this technology is unavailable in low and-middle income countries, so a different approach is needed. The aim of this study was to use X-ray scans of the spine to determine the prevalence of and associated risk factors for vertebral fractures in HIV-infected patients in a tertiary-care hospital in Mexico. We conducted a cross-sectional study of outpatients who were >40 years old and receiving ART at the Hospital de Infectología, La Raza National Medical Center in Mexico City, Mexico. We used semi-quantitative morphometric analysis of centrally digitized X-ray images to assess vertebral deformities in the spine. Anterior, middle and posterior vertebral heights were measured, and height ratios were calculated. For each vertebral body, fractures were graded on the basis of height ratio reductions, and a spine deformity index’ (SDI) value was calculated by summing the grades of the vertebral deformities: An SDI>1 was indicative of a vertebral fracture. We included 104 patients, 87% of whom were men. The median age was 49 years [interquartile range (IQR) 42-52]. Themost common stage of HIV infection, as defined by the Centers for Disease Control,was B2 in 40 (39%) of patients. Forty seven (45%) patients were on ART regimens that included protease inhibitors (PIs) and 100 (96%) being treated with tenofovir. The median time of ART was 6.5 years (IQR1.6-9.0). Of the 104 patients in our study, 83 (80%) had undetectable viral load, as assessed by HIV-1 RNA levels, 32 (31%) showed evidence of a previous fracture, 4 (4%) were co-infected with hepatitis C virus, and 57 (55%) had a history of corticosteroid treatment. The prevalence of vertebral fractures was 25%, 95% confidence interval 17-34%. We assessed whether gender, HCV co-infection, previous corticosteroid use, AIDS, total HIV viral load, and current and previous use of PIs were associated with fractures in our study group, but we did not observe a significant association between any of these factors and vertebral fractures. The prevalence of vertebral fractures was high among HIV-infected patients. We propose that screening for bone disease should be performed in HIV individuals who are at risk of fragility fractures. Furthermore, we suggest that X-ray based assessment of the spine should be considered in patients who are at increased risk of fragility fractures, irrespective of BMD levels, particularly in elderly patients in low and middle income countries. Full article
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Editorial
Unresolved Issue in Hepatitis C: The Role of Liver Non-Parenchymal Cells and Semaphorins
by Adriana Vince and Neven Papic
Infect. Dis. Rep. 2018, 10(1), 7651; https://doi.org/10.4081/idr.2018.7651 - 29 Mar 2018
Cited by 1 | Viewed by 311
Abstract
With broad usage of direct acting antivirals (DAAs) the global epidemics of hepatitis C will probably come to an end in next 20 years. [...]
Full article
133 KiB  
Case Report
Abdominal Rectus Muscle Pyomyositis: Report of a Case and Review of the Literature
by Tilemachos Fountoukis, Nikolaos Tsatsanidis, Maria Tilkeridou, Ioannis Konstantinou, Pantelis Fytas and Ioannis Skandalos
Infect. Dis. Rep. 2018, 10(1), 7522; https://doi.org/10.4081/idr.2018.7522 - 29 Mar 2018
Cited by 8 | Viewed by 588
Abstract
Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus. Predisposing factors for pyomyositisinclude immunodeficiency, trauma, injection drug use, concurrent infection and malnutrition. The diagnosis, staging of the disease and differential diagnosis are established by ultrasound, CT and [...] Read more.
Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus. Predisposing factors for pyomyositisinclude immunodeficiency, trauma, injection drug use, concurrent infection and malnutrition. The diagnosis, staging of the disease and differential diagnosis are established by ultrasound, CT and MRI. Treatment involves surgical drainage and antibiotic therapy. We report a case of abdominal rectus muscle pyomyositis, which constitutes, as far as we know, thesecond reported in bibliography, while Prevotella disiens is firstly reported as causative agent. Full article
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Case Report
Syphilis Infection in an HIV Patient Presenting with Leukemoid Reaction: Case Report and Review of the Literature
by Athina Lioni, Markela-Pagonitsa Zorzou, Christina Kollia, Dimitrios Loulakis, Fotini Ntziora, Fotini Stergiou, Maria Boboli and Maria Chini
Infect. Dis. Rep. 2018, 10(1), 7410; https://doi.org/10.4081/idr.2018.7410 - 29 Mar 2018
Cited by 1 | Viewed by 485
Abstract
Leukemoid reaction (LR) is an uncommon though dreadful sign for the treating physician, as it is related to increased mortality. In the few series that have addressed its incidence and clinical significance, infectious causes count for about half of the cases of LR, [...] Read more.
Leukemoid reaction (LR) is an uncommon though dreadful sign for the treating physician, as it is related to increased mortality. In the few series that have addressed its incidence and clinical significance, infectious causes count for about half of the cases of LR, the rest accounting for cancer, drugs or rarer causes. In the HIV setting, it represents an even rarer event, owing probably to the impaired granulocytic response of AIDS patients to bacterial agents. However no report exists as to the incidence of LR to the immune-restored HIV patients adequately treated with antiretroviral therapy (ART). Syphilis is a well known cause of mild lymphocytosis, though only one report of LR exists in the congenital setting. We hereby report a case of an HIV patient adequately treated with ART, who presented with LR with a lymphomonocytic preponderance after infection with treponema pallidum. Full article
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Case Report
Meningitis, Spondylodiscitis, Pneumonia and Septic Shock with Streptococcus pneumoniae in a Previously Healthy Woman with Isolated IgG2-, IgG3-, IgA-Deficiency and Monoclonal Gammopathy of Undetermined Significance
by Shahin Gaini, David Gudnason, Bjarni á Steig and Jenny Jónsdóttir Nielsen
Infect. Dis. Rep. 2018, 10(1), 7310; https://doi.org/10.4081/idr.2018.7310 - 29 Mar 2018
Cited by 2 | Viewed by 385
Abstract
A 66 years old Caucasian woman with pneumococcal meningitis was treated and discharged after an uncomplicated course. Five months later she was readmitted withfever and right side abdominal pain and diagnosed with pneumococcal spondylodiscitis. One year later she was treated fora severe chest [...] Read more.
A 66 years old Caucasian woman with pneumococcal meningitis was treated and discharged after an uncomplicated course. Five months later she was readmitted withfever and right side abdominal pain and diagnosed with pneumococcal spondylodiscitis. One year later she was treated fora severe chest X-ray confirmed left lobar pneumonia. Two years later she was diagnosed with a pneumococcal pneumonia inher left lung with septic shock. An immunedeficiency screen revealed slightly reduced IgA levels, low IgG2 levels, low IgG3 levels and high IgG1 levels. No other immunedefects were identified. She did not respondserologically on vaccination with 13-valentconjugate and 23-valent polysaccharide pneumococcal vaccines. Further evaluations revealed a positive M-component inher blood and a bone marrow biopsy diagnosed her to have monoclonal gammopathy of undetermined significance. To protecther against future life threatening pneumococcal infections she was started on treatment with intravenous immunoglobulin. The case report illustrates the importance of thorough evaluation of patients with unusual infectious disease entities or unusual frequency of infections in individual patients. To optimize prophylactic measures and active treatment options in the individual patient, it is important to identify underlying causes of diseases and immune deficiencies that potentially can lead to life threatening infections. This is illustrated inour case by an undiagnosed monoclonal gammopathy of undetermined significancein an apparently healthy woman with atleast three life threatening documented pneumococcal infections in a two-year period and poor pneumococcal vaccine response Full article
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