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Background: Outpatient parenteral antimicrobial therapy (OPAT) is safe, effective and increasingly available. While OPAT in Norwegian healthcare has been rare, a new continuous ambulatory delivery device (CADD) allowing multiple daily dosing treatments has been innovated making OPAT more accessible., Objectives: To describe the clinical outcome and safety using CADD in an OPAT setting., Methods: Adult patients in need of parenteral antibiotic treatment were offered OPAT and discharged with a programmable digital infusion pump allowing multiple daily dosings., Results: Altogether, 170 patients were included in the study, among which 21% of all patients (36 of 170) were readmitted to hospital while receiving OPAT or within 30 days after end of intravenous antibiotics. None of the 170 patients died due to OPAT and allergies were not noticeable as a problem., Conclusions: We have developed a safe and clinically effective programme offering OPAT in accordance with Norwegian antibiotic treatment guidelines., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Tick-borne encephalitis (TBE) is usually diagnosed based on the presence of TBE virus (TBEV)-specific IgM and IgG antibodies in serum. However, antibodies induced by vaccination or cross-reactivity to previous flavivirus infections may result in false positive TBEV serology. Detection of TBEV RNA may be an alternative diagnostic approach to detect viral presence and circumvent the diagnostic difficulties present when using serology. Viral RNA in blood is commonly detectable only in the first viremic phase usually lasting up to two weeks, and not in the second neurologic phase, when the patients contact the health care system and undergo diagnostic work-up. TBEV RNA has previously been detected in urine in a few retrospective TBE cases in the neurologic phase, and furthermore RNA of other flaviviruses has been detected in patient saliva. In this study, blood, saliva and urine were collected from 31 hospitalised immunocompetent patients with pleocytosis and symptoms of aseptic meningitis and/or encephalitis, suspected to have TBE. We wanted to pursue if molecular testing of TBEV RNA in these patient materials may be useful in the diagnostics. Eleven of the 31 study patients were diagnosed with TBE based on ELISA detection of TBEV specific IgG and IgM antibodies. None of the study patients had TBEV RNA detectable in any of the collected patient material., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Quarsten et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The diagnosis of intracerebral fungal abscesses may be difficult due to the paucity of laboratory tests and similar radiological appearance to other lesions., Case Presentation: We present an immunocompromised woman in her forties who was admitted with a diagnosis of bacterial meningitis. MRI examination showed findings suggestive of fungal abscesses, and a subsequent lumbar puncture showed PCR positive for non-fumigatus Aspergillus. The patient received antifungal treatment and had satisfactory clinical, biochemical and radiological response. Consecutive MRI examinations over the following weeks showed gradual decrease of abscesses, with almost complete resolution within 12 weeks., Interpretation: Adequate management of brain abscesses requires correct identification of the causative agent, so that proper treatment can be initiated as soon as possible. MRI plays an important role in distinguishing between pyogenic and fungal brain abscesses. Headaches or focal neurological deficits in immunocompromised patients should cause CNS fungal infection to be considered.