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Introduction: Deep mycoses acquired by penetrating trauma to the skin can have varied and sometimes atypical morphological presentations resulting in diagnostic dilemmas and delay in treatment onset. Histopathology can be a useful tool in not only diagnosing but also differentiating various deep mycoses. Aims and Objectives: To observe various morphological presentations and histopathological features of deep fungal infections. Materials and Methods: A retrospective multi-centric study was conducted from 2010 to 2020 at 16 centres. The cases with diagnoses of various deep mycoses were included in the study. The patients presenting with cutaneous manifestations were included in the study. Their demographic details, history, presenting signs and symptoms, morphological presentations, histopathological features and treatment details were collected from the case sheets. Results: A total of 124 cases were found from the case records. The most common type was chromoblastomycosis (42) followed by mycetoma (28) and rhinosporidiosis (17). The mean age was 43.76 ± 5.44 years. The average duration of symptoms before presentation was between 2 months to 10 years (average 2.5 ± 1.33 years). Male to female ratio was 1:0.7. Prior history of trauma was recorded in 36 of cases. Chromoblastomycosis cases presented with verrucous to atrophic plaques with black dots on the surface and histopathology findings included pesudoepitheliomatous hyperplasia, epithelioid cell granulomas, copper penny bodies within granulomas and abscesses. Rhinosporidiosis cases had polypoid grape-like lesions in the nose and eyes most commonly with histopathology findings of abundant thick-walled sporangia in dermis packed with thousands of spores. Eumycetoma patients had pigmented, indurated swelling with multiple sinuses discharging black granules and histopathology showed dermal abscesses and foreign body granulomatous reaction with PAS-positive hyphae. Histoplasmosis patients presented with few to multiple nodulo-pustular lesions on skin and palatal ulcers while small basophilic bodies packed in the cytoplasm of histiocytes were noted in histopathology. Phaeohyphomycosis cases presented as deep-seated cystic lesions and biopsy revealed deepithelialized cysts in the dermis or hypodermis with lumen showing necro inflammatory debris and fungal hyphae. Sporotrichosis cases had erythematous, tender nodules and papules either as single lesions or as multiple lesions arranged in a linear fashion and histopathology showed pseudoepitheliomatous hyperplasia of epidermis, loose to well-defined epithelioid cell granulomas and microabscesses. Spores were found in two cases. Cryptococcosis patient had multiple umbilicated lesions resembling giant molluscum contagiosum loose epithelioid cell granulomas and medium-sized spores lying in both intra and extracellularly on histopathology. Penicilliosis patients had nodulo-pustular lesions and histopathology showed an admixture of histiocytes, epithelioid cells, plasma cells, lymphocytes and polymorphs in the dermis with the presence of yeast-like spores in the cytoplasm of histiocytes and epithelioid cells. Entomophthoromycosis cases presented with asymptomatic subcutaneous firm swelling with loss of skin pinchability. Conclusion: Though clinical findings of deep fungal infections are characteristic similar morphology and atypical presentations can be sometimes confusing. Histopathology is useful for confirming the diagnosis. Keywords: Clinical presentation, deep mycoses, histopathology, morphologies, Author(s): Subhra Dhar (corresponding author) [1]; Swetalina Pradhan [2]; Abhijit Saha [3]; Gautam Mazumder [4]; Sudip K. Ghosh [5]; Manas Biswas [6]; Abhishek De [7]; Pradip Srivastava [8]; Amrita Madnani [...]

Introduction Lymphatic filariasis (LF) is a vector-borne disease in humans caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi and B. timori. Infections damage the lymphatic vessels and [...]

The 37th meeting of the International Task Force for Disease Eradication (ITFDE) (1) was convened in a hybrid (virtual and in-person) format at the Carter Center in Atlanta (GA), USA, [...]

Background Trachoma, caused by particular serovars of Chlamydia trachomatis, is the leading infectious cause of blindness. Infection is transmitted by ocular and nasal secretions that are passed from person to [...]

The World Health Organization (WHO) alms to reduce new leprosy cases by 70% by 2030, necessitating advancements In leprosy diagnostics. Here we discuss the development of two WHO's target product profiles for such diagnostics. These profiles define criteria for product use, design, performance, configuration and distribution, with a focus on accessibility and affordability. The first target product profile outlines requirements for tests to confirm diagnosis of leprosy in individuals with clinical signs and symptoms, to guide multidrug treatment initiation. The second target product profile outlines requirements for tests to detect Mycobacterium leprae or M. lepromatosis infection among asymptomatic contacts of leprosy patients, aiding prophylactic interventions and prevention. Statistical modelling was used to assess sensitivity and specificity requirements for these diagnostic tests. The paper highlights challenges in achieving high specificity, given the varying endemicity of M. leprae, and identifying target analytes with robust performance across leprosy phenotypes. We conclude that diagnostics with appropriate product design and performance characteristics are crucial for early detection and preventive intervention, advocating for the transition from leprosy management to prevention. Abstracts in [phrase omitted], Francais, [phrase omitted] and Espanol at the end of each article. [phrase omitted] L'Organisation mondiale de la Sante (OMS) vise a reduire le nombre de nouveaux cas de lepre de 70% d'ici 2030, ce qui necessite un meilleur diagnostic de la maladie. Dans le present document, nous evoquons le developpement de deux profils de produit cible etablis par l'OMS a cette fin. Ces profils definissent des criteres en matiere d'utilisation, de conception, de performances, de configuration et de distribution du produit, en accordant une attention particuliere a l'accessibilite et a l'abordabilite. Le premier profil de produit cible decrit les exigences pour les tests servant a confirmer le diagnostic de la lepre chez les individus qui presentent des signes cliniques et des symptomes, afin d'orienter l'instauration d'un traitement a base de plusieurs medicaments. Le second profil de produit cible decrit les exigences pour les tests servant a detecter une infection a Mycobacterium leprae ou M. lepromatosis parmi les contacts asymptomatiques de patients lepreux, ce qui contribue a l'adoption de mesures prophylactiques et a la prevention. Nous avons eu recours a une modelisation statistique pour evaluer les exigences de sensibilite et de specificite de ces tests diagnostiques. Cet article met en evidence les obstacles a l'atteinte d'un niveau eleve de specificite en raison de l'endemicite variable de M. leprae, et a l'identification d'analytes cibles offrant de bons resultats chez les phenotypes lepreux. Nous concluons qu'un diagnostic reposant sur des caracteristiques de performance et de conception appropriees est essentiel pour detecter rapidement la maladie et intervenir en amont, et nous plaidons pour une prevention plutot qu'une gestion de la lepre. [phrase omitted] La Organizacion Mundial de la Salud (OMS) pretende reducir los nuevos casos de lepra en un 70% para 2030, lo que requiere avances en el diagnostico de la lepra. Aqui se analiza el desarrollo de dos perfiles de productos objetivo de la OMS para este tipo de diagnosticos. Estos perfiles definen los criterios de uso, diseno, rendimiento, configuracion y distribucion de los productos, centrandose en su accesibilidad y asequibilidad. El primer perfil de producto objetivo describe los requisitos de las pruebas para confirmar el diagnostico de la lepra en personas con signos y sintomas clinicos, con el fin de orientar el inicio del tratamiento con multiples farmacos. El segundo perfil de producto objetivo describe los requisitos de las pruebas para detectar la infeccion por Mycobacterium leprae o M. lepromatosis entre los contactos asintomaticos de los pacientes con lepra, para facilitar las intervenciones profilacticas y la prevencion. Se utilizaron modelos estadisticos para evaluar los requisitos de sensibilidad y especificidad de estas pruebas diagnosticas. El articulo destaca las dificultades para lograr una alta especificidad, dada la diferente endemicidad de M. leprae, y para identificar analitos diana con un rendimiento solido en todos los fenotipos de lepra. Concluimos que los diagnosticos con un diseno de producto y unas caracteristicas de rendimiento adecuados son fundamentales para la deteccion precoz y la intervencion preventiva, lo que favorece la transicion del manejo de la lepra a la prevencion., Introduction Leprosy, a neglected tropical disease, is caused by Mycobacterium leprae or less often by M. lepromatosis. (1) The disease is a chronic, moderately infectious condition affecting mostly skin, peripheral [...]

Orthohantaviruses are negative-sense, enveloped RNA viruses that are transmitted by host reservoirs, such as rodents, to humans. Human infection occurs through inhalation of aerosolized viral particles from host excreta, such [...]

Rubella virus is a leading cause of vaccine-preventable birth defects. Infection during pregnancy can result in miscarriage, fetal death, stillbirth or a constellation of birth defects, known as congenital rubella syndrome (CRS), which includes cataracts, deafness, heart defects and developmental delay. A single dose of rubella-containing vaccine can provide lifelong protection against rubella. The Global Vaccine Action Plan 2011-2020 set a target to achieve elimination of rubella in at least 5 of the 6 WHO regions by 2020, and rubella elimination is a critical goal of the Immunization Agenda 2030. This report updates a previous report and describes progress towards rubella and CRS elimination in 2012-2022. During this period, the number of WHO Member States that included rubella-containing vaccine (RCV) in their immunization schedules increased from 132 (68%) to 175 (90%), and the percentage of the world's infants were vaccinated against rubella increased from 40% to 68%. The reported number of rubella cases decreased by 81%, from 93 816 in 2012 to 17 407 in 2022. Verification of rubella elimination was achieved in 98 (51%) of 194 countries by 2022, an increase from 84 (43%) countries in 2019. Despite significant progress in introduction of RCV into routine immunization programmes worldwide, nearly 25 million infants annually still do not receive RCV. Nevertheless, the increasing number of countries that have achieved and sustained rubella elimination, even in complex settings, represents progress towards global rubella elimination. L'infection par le virus de la rubeole est l'une des principales causes de malformations congenitales evitables par la vaccination. Lorsqu'elle survient pendant la grossesse, elle peut entrainer une fausse couche, la mort foetale, une mortinaissance ou une constellation de malformations congenitales (notamment cataracte, surdite, malformations cardiaques et retards de developpement) connue sous le nom de syndrome de rubeole congenitale (SRC). Une dose unique de vaccin a valence rubeole peut conferer une protection a vie contre la rubeole. Parmi les cibles fixees dans le Plan d'action mondial pour les vaccins 2011-2020 figurait l'elimination de la rubeole dans au moins 5 des 6 Regions de l'OMS a l'horizon 2020. L'elimination de la rubeole fait en outre partie des objectifs cles du Programme pour la vaccination a l'horizon 2030. Le present rapport actualise les informations fournies dans le rapport precedent et decrit les progres accomplis vers l'elimination de la rubeole et du SRC dans la periode 2012-2022. Au cours de cette periode, les nombre d'Etats Membres de l'OMS ayant inclus le vaccin a valence rubeole (RCV) dans leur calendrier de vaccination a progresse, passant de 132 (68%) a 175 (90%); et le pourcentage de nourrissons dans le monde vaccines contre la rubeole est passe de 40% a 68%. Le nombre de cas notifies de rubeole a recule de 81%, passant de 93 816 en 2012 a 17 407 en 2022. En 2022, l'elimination de la rubeole avait ete verifiee dans 98 (51%) des 194 Etats Membres de l'OMS, contre 84(43%) en 2019. Toutefois, meme si l'introduction du RCV dans les programmes de vaccination systematique a fortement progresse a l'echelle mondiale, pres de 25millions de nourrissons sont encore prives de ce vaccin chaque annee. Le nombre croissant de pays ayant reussi a eliminer durablement la rubeole, meme parmi ceux confrontes a des situations complexes, temoigne neanmoins des progres realises vers l'elimination de cette maladie a l'echelle mondiale., Introduction Rubella virus is a leading cause of vaccine-preventable birth defects and can cause epidemics. Rubella virus infection usually produces a mild febrile rash illness in children and adults; however, [...]

Author(s): Diana Marcela Grajales-Urrego[sup.1], Fabián Mantilla-Sylvain[sup.2], Mariam Carolina Rolon-Cadena[sup.1], William Mauricio Basto-Borbón[sup.3] and Johanna Ãlvarez-Figueroa[sup.1,4] Background Invasive fungal infections are important causes of morbidity and mortality in immunocompromised patients. In [...], Background Mucormycosis is a highly lethal opportunistic fungal disease caused by ubiquitous molds of the order Mucorales, with Rhizopus, Lichtheimia and Mucor being the most common genera. This rare disease primarily affects immunocompromised patients, with presentations ranging from rhino-orbito-cerebral infections to disseminated mucormycosis with angioinvasion, leading to thrombosis and tissue infarction. Gastrointestinal mucormycosis is the least common clinical presentation and is believed to be secondary to spore ingestion. It can involve multiple components of the gastrointestinal tract, such as the stomach, liver, ileum, and colon, with nonspecific manifestations, including pain, nausea, vomiting, and abdominal distension. The initial clinical presentation may even manifest as gastrointestinal bleeding due to gastric ulceration or intestinal perforation. Case presentation Here we present the case of a 48-year-old male patient with a 9-year history of human immunodeficiency virus (HIV) infection who was hospitalized in the context of febrile neutropenia and whose acute respiratory infection was documented; therefore, antibiotic treatment was initiated. However, due to persistent febrile peaks and peripheral blood showing documentation of multilineage cytopenias, a bone marrow biopsy was performed, compatible with presenting features of marrow myelodysplasia. During hospitalization, the patient presented left flank abdominal pain, and an abdominal computed tomography (CT) scan revealed signs of intussusception of a small bowel loop at the distal jejunum level, leading to intestinal obstruction with ischemic progression, requiring ileectomy (60 cm). Histopathological analysis of the resected intestine revealed severe transmural ischemic changes associated with venous thrombosis due to fungal structures, with histochemical studies demonstrating the presence of zygomycete (Mucor) fungal structures, leading to the initiation of treatment with amphotericin B. However, despite treatment, the patient experienced progressive clinical deterioration with persistent fever and ventilatory failure, with follow-up tests showing absolute neutropenia and blood cultures positive for yeast, leading to death 52 days after admission. Conclusions The diagnosis of intestinal mucormycosis may be delayed due to the lack of specificity of the signs and symptoms. Pathologists as well as histopathological studies are essential for timely treatment. Keywords: Mucormycosis, Gastrointestinal mucormycosis, Human immunodeficiency virus, Acute myeloid leukemia, Intestinal ischemia, Venous thrombosis.

Background 3D cell culture models have recently garnered increasing attention for replicating organ microarchitecture and eliciting in vivo-like responses, holding significant promise across various biological disciplines. Broadly, 3D cell culture encompasses organoids as well as single- and multicellular spheroids. While the latter have found successful applications in tumor research, there is a notable scarcity of standardized intestinal models for infection biology that mimic the microarchitecture of the intestine. Hence, this study aimed to develop structured multicellular intestinal spheroids (SMIS) specifically tailored for studying molecular basis of infection by intestinal pathogens. Results We have successfully engineered human SMIS comprising four relevant cell types, featuring a fibroblast core enveloped by an outer monolayer of enterocytes and goblet cells along with monocytic cells. These SMIS effectively emulate the in vivo architecture of the intestinal mucosal surface and manifest differentiated morphological characteristics, including the presence of microvilli, within a mere two days of culture. Through analysis of various differentiation factors, we have illustrated that these spheroids attain heightened levels of differentiation compared to 2D monolayers. Moreover, SMIS serve as an optimized intestinal infection model, surpassing the capabilities of traditional 2D cultures, and exhibit a regulatory pattern of immunological markers similar to in vivo infections after Campylobacter jejuni infection. Notably, our protocol extends beyond human spheroids, demonstrating adaptability to other species such as mice and pigs. Conclusion Based on the rapid attainment of enhanced differentiation states, coupled with the emergence of functional brush border features, increased cellular complexity, and replication of the intestinal mucosal microarchitecture, which allows for exposure studies via the medium, we are confident that our innovative SMIS model surpasses conventional cell culture methods as a superior model. Moreover, it offers advantages over stem cell-derived organoids due to scalability and standardization capabilities of the protocol. By showcasing differentiated morphological attributes, our model provides an optimal platform for diverse applications. Furthermore, the investigated differences of several immunological factors compared to monotypic monolayers after Campylobacter jejuni infection underline the refinement of our spheroid model, which closely mimics important features of in vivo infections. Keywords: Multilayered spheroid, 3D cell culture, Intestinal mucosa, Infection model, Author(s): Angelina Kraski[sup.1], PaweÅ MigdaÅ[sup.2], Robert Klopfleisch[sup.3], Clara Räckel[sup.1], Jutta Sharbati[sup.4], Markus M. Heimesaat[sup.5], Thomas Alter[sup.6], Carlos Hanisch[sup.7], Greta Gölz[sup.6], Ralf Einspanier[sup.1] and Soroush Sharbati[sup.1] Background For many years, cell [...]

* Context.--Many studies have depended on qualitative antibody assays to investigate questions related to COVID-19 infection, vaccination, and treatment. Objective.--To evaluate immunoglobulin G (IgG) levels in vaccinated individuals over time and characterize limitations of qualitative and quantitative antibody assays. Design.--Longitudinal serum samples (n = 339) were collected from 72 health care workers vaccinated against COVID-19. SARS-CoV-2 IgG levels before, during, and after vaccination were measured by using a qualitative anti-spike protein IgG assay and a quantitative anti-S1 IgG assay. Assay results were compared to understand antibody dynamics related to vaccination. Results.--Qualitative testing demonstrated 100% seroconversion after the first vaccine dose, peak IgG levels after the second vaccine dose, and a progressive 50% decline during the next 8 months. Quantitative testing demonstrated that IgG levels during and after vaccination were above the analytical measurement range. Conclusions.--Qualitative testing demonstrates expected changes in SARS-CoV-2 IgG levels related to sequential vaccine doses and time since antigen exposure. However, proportional changes in the associated numerical signals are very likely inaccurate. Adoption of standardized quantitative SARS-CoV-2 antibody testing with a broad analytical measurement range is essential to determine a correlate of protection from COVID-19 that can be scaled for widespread use. (Arch Pathol Lab Med. 2024;148:e36-e39; doi: 10.5858/arpa.2023-0014-OA), Serologic antibody testing is commonly used as a surrogate marker for the adaptive immune response. The potential clinical and epidemiologic utility of SARS-CoV-2 antibody testing is undermined by several factors, [...]

The COVID-19 pandemic that began in 2019 remains uncontained, and fatalities and multiple waves of infection continue to occur worldwide (1). The causative agent, SARS-CoV-2, has been detected in humans [...]

Dengue virus (DENV) is not endemic in the continental United States (1); most cases occur among travelers to DENV-endemic areas (2). In Florida, USA, DENV infections are primarily reported among [...]

Natural infections and experimental studies have indicated that diverse species of mammals can be infected with SARS-CoV-2 (1). The angiotensin-converting enzyme 2 receptor of white-tailed deer is closely homologous to [...]

Peripheral intravenous catheters (PVCs) and central venous catheters (CVCs) are frequently used in hospitalized patients. Estimates from global device sales illustrated that [approximately equal to] 1.2 billion PVCs are used [...]

Auritidibacter ignavus is an aerobic gram-positive, rod-shaped bacterium that was described by Yassin et al. in 2011 after isolation from an ear swab specimen (1). Thus far, all published cases [...]

In May 2022, an outbreak of mpox disease, caused by infection with monkeypox virus (MPXV) clade IIb (formerly West Africa clade), was identified in the United States (1). Since that [...]

Nocardia is a genus of aerobic, filamentous, beaded, gram-positive bacteria ubiquitous in the environment, especially in soil, decomposing organic matter, and water. Nocardia spp. are opportunistic pathogens in immunocompromised hosts [...]