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Current Opinion in Infectious Diseases

Dinesh V Jillella, Dolora R Wisco
PURPOSE OF REVIEW: Stroke continuous to be a leading cause of debility in the world. Infections have been associated with stroke, but are not considered as directly causal, and so they are not often included in the traditional stroke workup and management. They are especially important in patients with stroke of undetermined etiology, and in certain patient populations, such as young patients without traditional risk factors, and immunocompromised patients. RECENT FINDINGS: There has been strong evidence for infectious conditions, such as endocarditis, and pathogens, such as varicella zoster in stroke causation, and more supportive evidence is surfacing in recent years of several organisms increasing the stroke risk or being directly causal in stroke...
April 9, 2019: Current Opinion in Infectious Diseases
Dennis L Stevens, Amy E Bryant
No abstract text is available yet for this article.
April 3, 2019: Current Opinion in Infectious Diseases
Catherine B Anders, Tyler M W Lawton, Mary Cloud B Ammons
PURPOSE OF REVIEW: Despite modern advances in medicine, nonhealing wounds are the number one cause of nontraumatic, lower-limb amputation. Nonhealing wounds are characterized by a healing process stalled between inflammation and tissue remodel/repair, a stage characterized by a shift in macrophage functional phenotype. Characterization of diversity in macrophage functional phenotype in wounds and metabolic contributions to macrophage polarization are discussed. RECENT FINDINGS: Macrophage functional diversity in phenotype has recently evolved from duality (classically activated, pro-inflammatory M1 and alternatively activated, anti-inflammatory M2) to include an additional four alternately activated subphenotypes (M2a, M2b, M2c and M2d)...
April 3, 2019: Current Opinion in Infectious Diseases
Catherine F Houlihan, Tehmina Bharucha, Judith Breuer
PURPOSE OF REVIEW: Central nervous system (CNS) infections present an ongoing diagnostic challenge for clinicians, with an aetiological agent remaining unidentified in the majority of cases even in high-income settings. This review summarizes developments in a range of diagnostic methods published in the past 18 months. RECENT FINDINGS: Several commercial assays exist for the detection of viral, bacterial and fungal pathogens using single multiplex PCR. Multicentre validation of the Biofire FilmArray panel illustrated high sensitivity for bacterial and fungal pathogens, but poor results for Cryptococcus species detection...
April 3, 2019: Current Opinion in Infectious Diseases
Michael P Motley, Kasturi Banerjee, Bettina C Fries
PURPOSE OF REVIEW: This review highlights recent developments in the development of monoclonal antibodies to treat bacterial disease, including preclinical advances and the status of current clinical trials. RECENT FINDINGS: Monoclonal antibody (mAb) therapy is becoming increasingly promising in the infectious disease field. Though bacterial exotoxins continue to be a mainstay of mAb targets, searches for protein targets on the surface of bacteria have uncovered new mechanisms of antibody-mediated action against bacteria...
April 3, 2019: Current Opinion in Infectious Diseases
Jean Paul Stahl, Alexandra Mailles
PURPOSE OF REVIEW: HSV is the most frequently identified cause of infectious encephalitis, in Western countries. This article is an update on the topic based on a review of recent studies from 2017 to 2018. RECENT FINDINGS: Acyclovir is still the first line treatment, and no new drugs are currently available for clinical use. The major considerations for HSV encephalitis are as follows: point one, clinical evaluation remains the most important factor, as though CSF HSV PCR has a good sensitivity, in a small proportion of patients the initial testing might be negative...
March 27, 2019: Current Opinion in Infectious Diseases
John J Halperin
PURPOSE OF REVIEW: To review the recent evidence clarifying the symptomatology and diagnosis of nervous system Lyme disease. RECENT FINDINGS: Two-tier testing combining pairs of ELISAs, using C6 or VlsE assays to replace second tier Western blots, may eliminate confusion about test interpretation. Cerebrospinal fluid (CSF) can be informative in diagnosing central nervous system (CNS) Lyme disease, not peripheral nervous system (PNS) disorders. CSF CXCL13 may provide useful adjunctive information in CNS infection; its specificity remains to be defined...
March 27, 2019: Current Opinion in Infectious Diseases
Bodo Linz, Longhuan Ma, Israel Rivera, Eric T Harvill
PURPOSE OF REVIEW: To relate genomic changes to phenotypic adaptation and evolution from environmental bacteria to obligate human pathogens, focusing on the examples within Bordetella species. RECENT FINDINGS: Recent studies showed that animal-pathogenic and human-pathogenic Bordetella species evolved from environmental ancestors in soil. The animal-pathogenic Bordetella bronchiseptica can hijack the life cycle of the soil-living amoeba Dictyostelium discoideum, surviving inside single-celled trophozoites, translocating to the fruiting bodies and disseminating along with amoeba spores...
March 27, 2019: Current Opinion in Infectious Diseases
Karen C Bloch, Samuel S Bailin
PURPOSE OF REVIEW: Fungal infections of the central nervous system (CNS) are relatively uncommon but associated with significant morbidity and mortality. We reviewed recent literature highlighting new approaches to management of these complex patients. RECENT FINDINGS: Fungal infections are increasingly recognized as important causes of CNS disease in both immunocompromised and immunocompetent hosts. Globally, cryptococcal meningitis remains a leading cause of death in HIV-infected persons in resource-limited settings...
March 27, 2019: Current Opinion in Infectious Diseases
Anjana C Karawita, Marcus Z W Tong, Kirsty R Short
PURPOSE OF REVIEW: A delicate balance exists between a protective and detrimental immune response to an invading viral pathogen. Here, we review the latest advancements in our understanding of immunity and immunopathology during H7N9 influenza A virus (IAV) infections and its relevance to disease management and diagnosis. RECENT FINDINGS: Recent studies have highlighted the role of specific leukocytes in the pathogenesis of H7N9 IAV infections and potential diagnostic role that host cytokine profiles can play in forecasting disease severity...
March 18, 2019: Current Opinion in Infectious Diseases
Matteo Bassetti, Nadia Castaldo, Barbara Cadeo, Alessia Carnelutti
PURPOSE OF REVIEW: Prosthetic joint infections (PJIs) represent one of the most disastrous complications in prosthetic surgery, requiring long hospitalization, prolonged antimicrobial treatment and repeated surgical interventions. No gold standard test to formulate diagnosis exist. A combination of high index of suspicion, physical examination, microbiological and biohumoral investigations is required. Therapeutical approach should be based on a multidisciplinary team. In our center, a two-stage approach is preferred...
January 21, 2019: Current Opinion in Infectious Diseases
Nicole R Brenner, Andrew F Shorr
PURPOSE OF REVIEW: To describe the evolving microbiology of various forms of pneumonia and the importance of viruses as etiologic causes of pneumonia. RECENT FINDINGS: Multiple studies utilizing novel diagnostic modalities demonstrate that the prevalence of viruses as causes for pneumonia varies from approximately 10-30% depending on the specific pneumonia type evaluated. Viral pneumonias appear similar in presentation and severity of illness to bacterial causes of pulmonary infection...
January 21, 2019: Current Opinion in Infectious Diseases
Frederick G Hayden, Nahoko Shindo
PURPOSE OF REVIEW: We review antivirals inhibiting subunits of the influenza polymerase complex that are advancing in clinical development. RECENT FINDINGS: Favipiravir, pimodivir, and baloxavir are inhibitory in preclinical models for influenza A viruses, including pandemic threat viruses and those resistant to currently approved antivirals, and two (favipiravir and baloxavir) also inhibit influenza B viruses. All are orally administered, although the dosing regimens vary...
April 2019: Current Opinion in Infectious Diseases
Silvia Corcione, Tommaso Lupia, Francesco G De Rosa
PURPOSE OF REVIEW: Breast surgery is considered a clean surgical procedure; nevertheless, infection rates are often higher than those reported after other similarly considered clean surgeries (e.g., thyroid, hernia). Acute bacterial skin and soft tissue infections, mostly surgical site infections and implant-associated infections are commonest events that could complicate postoperative care. RECENT FINDINGS: Risk of infection is closely related to surgery procedure itself and patients host factors...
April 2019: Current Opinion in Infectious Diseases
Sarah Neill, Nathan Dean
PURPOSE OF REVIEW: Our purpose is to describe aspiration pneumonia/pneumonitis as a spectrum of infectious/noninfectious diseases affecting the lung. We summarize diagnosis, risk factors, treatment, and strategies for prevention of aspiration. RECENT FINDINGS: Aspiration is present in normal individuals, and disease manifestation depends on the chemical characteristics, frequency, and volume of inoculum. Anaerobes, though present, are no longer the predominant microbes isolated in aspiration pneumonia...
April 2019: Current Opinion in Infectious Diseases
Lucy B Palmer
PURPOSE OF REVIEW: Two recent large randomized placebo-controlled clinical trials of adjunctive inhaled therapy for the treatment of ventilator-associated pneumonia failed to show a mortality effect or more rapid resolution of pneumonia symptoms. Does the failure of these studies to reach their endpoints suggest the end of inhaled therapy? This review will explain why inhaled therapy may still have an important role in the treatment of ventilated patients. RECENT FINDINGS: The recent interest in inhaled antimicrobial therapy is driven by the global emergence of increasingly resistant bacteria to systemic therapy...
April 2019: Current Opinion in Infectious Diseases
David M Jacobs, Ursula Pandit, Sanjay Sethi
PURPOSE OF REVIEW: Acute exacerbations are a major cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD) with evidence suggesting at least 50% of exacerbations involve bacteria that benefit from antibiotic treatment. Here, we review the most relevant data regarding the use of antibiotics in exacerbations of COPD and provide insights on the selection of initial antibiotic therapy for their treatment. RECENT FINDINGS: Identification of bacterial exacerbations still relies on clinical assessment rather than laboratory biomarkers...
April 2019: Current Opinion in Infectious Diseases
Ilker Uçkay, Martin Berli, Parham Sendi, Benjamin A Lipsky
PURPOSE OF REVIEW: Systemic antibiotic therapy in persons with a diabetic foot infection (DFI) is frequent, increasing the risk of promoting resistance to common pathogens. Applying principles of antibiotic stewardship may help avoid this problem. RECENT FINDINGS: We performed a systematic review of the literature, especially seeking recently published studies, for data on the role and value of antibiotic stewardship (especially reducing the spectrum and duration of antibiotic therapy) in community and hospital populations of persons with a DFI...
April 2019: Current Opinion in Infectious Diseases
Garyphallia Poulakou, Styliani Lagou, Sotirios Tsiodras
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are among the most common infections in outpatients and the most frequent infectious cause of referrals to emergency departments in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology of SSTIs. RECENT FINDINGS: Staphylococcus aureus and streptococci predominate and methicillin-resistant S. aureus (MRSA) poses additional challenges; community-acquired-MRSA in some areas is superseding methicillin-susceptible S...
April 2019: Current Opinion in Infectious Diseases
Paola Del Giacomo, Angela Raffaella Losito, Mario Tumbarello
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) with a wide spectrum of disease severity ranging from uncomplicated to potentially lethal are still a leading cause of morbidity and mortality. The burden of carbapenem-resistant gram-negative bacteria (CR-GNB) in SSTIs is increasing. Luckily, the armamentarium of drugs available is recently expanding as well. The present review looks at data on the role CR-GNB in SSTIs and on the old and new drugs available for the treatment of carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas, and Acinetobacter...
April 2019: Current Opinion in Infectious Diseases
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