Search

In July 2022, the World Health Organization declared the global monkeypox outbreak a public health emergency (1). Monkeypox virus (MPXV) is transmitted through close or direct contact with skin lesions [...]

Viral infections have become an important public health issue in South America during the past 2 decades. Outbreaks of arboviral disease, such as dengue, chikungunya, Zika, and yellow fever, have [...]

Patients who undergo hematopoietic stem‐cell transplantation (HSCT) are more susceptible to developing severe forms of COVID‐19 with an increased risk of mortality. The aim of this study was to analyze, by performing a systematic review and meta‐analysis, all studies that evaluated COVID‐19 in HSCT adult recipients and present clinical characteristics and outcomes. Studies were eligible for inclusion if they: (I) described the clinical characteristics of COVID‐19 in adult (aged 18 years old or above) HSCT recipients; (II) described outcomes of COVID‐19 in this population, mainly lethality; (III) were full‐text articles. We searched MedLine, Embase, SCOPUS, LILACS and Web of Science for full‐text studies that evaluated COVID‐19 in adult HSCT patients until 26 Apr 2023. Two independent reviewers screened the articles and extracted the data. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data was used to assess quality of the included studies. Meta‐analysis was performed and the pooled prevalence of severe/critical disease and of death with a 95% CI was calculated with the random‐effects model. Sixteen studies were included; seven (43.7%) were multicenter. Most of the studies were from Europe (37.5%). All of them had a low risk of bias using the JBI Checklist. A total of 1186 patients were included. Allogeneic HSCT patients were the majority in most studies, with a total of 861 patients (72.5%). The symptomatic rate was 79.4%. The pooled prevalence of severe/critical COVID‐19 was 24.0% (95% CI 0.13–0.36; I2 = 94%; n = 334/990). The pooled prevalence of death for the entire population was 17% (95% CI 0.13–0.22; I2 = 76%; n = 221/1117), 17% (95% CI 0.12–0.23; I2 = 67%; n = 152/822) for allogeneic‐HSCT and 14% (95% CI 0.08–0.22; I4 = 65%; n = 48/293) for autologous‐HSCT. In conclusion, frequently the infection of SARS‐CoV‐2 in HSCT was symptomatic and lethality is higher than in general population. Thus, it is essential to focus on the implementation of measures to mitigate the risk of SARS‐CoV‐2 infection in this population, as well as to carefully assess HSCT recipients who develop COVID‐19. [ABSTRACT FROM AUTHOR]

We describe monkeypox virus (MPXV) transmission from a patient to a healthcare worker through needlestick injury. A lesion appeared at the inoculation site 5 days after injury. Blood tested MPXV-positive by PCR before symptoms worsened; blood remained MPXV-positive at discharge 19 days after symptom onset. Postexposure prophylaxis could prevent potential MPXV bloodborne transmission. [ABSTRACT FROM AUTHOR]

Tuberculous meningitis (TBM) is a severe infection of the central nervous system, particularly in developing countries. Prompt diagnosis and treatment are necessary to decrease the high rates of disability and death associated with TBM. The diagnosis is often time and labour intensive; thus, a simple, accurate and rapid diagnostic test is needed. The adenosine deaminase (ADA) activity test is a rapid test that has been used for the diagnosis of the pleural, peritoneal and pericardial forms of tuberculosis. However, the usefulness of ADA in TBM is uncertain. The aim of this study was to evaluate ADA as a diagnostic test for TBM in a systematic review. A systematic search was performed of the medical literature (MEDLINE, LILACS, Web of Science and EMBASE). The ADA values from TBM cases and controls (diagnosed with other types of meningitis) were necessary to calculate the sensitivity and specificity. Out of a total of 522 studies, 13 were included in the meta-analysis (380 patients with TBM). The sensitivity, specificity and diagnostic odds ratios (DOR) were calculated based on arbitrary ADA cut-off values from 1 to 10 U/l. ADA values from 1 to 4 U/l (sensitivity >93% and specificity <80%) helped to exclude TBM; values between 4 and 8 U/l were insufficient to confirm or exclude the diagnosis of TBM ( p = 0.07), and values >8 U/l (sensitivity <59% and specificity >96%) improved the diagnosis of TBM ( p < 0.001). None of the cut-off values could be used to discriminate between TBM and bacterial meningitis. In conclusion, ADA cannot distinguish between bacterial meningitis and TBM, but using ranges of ADA values could be important to improve TBM diagnosis, particularly after bacterial meningitis has been ruled out. The different methods used to measure ADA and the heterogeneity of data do not allow standardization of this test as a routine. [ABSTRACT FROM AUTHOR]