Current Issue : July-September Volume : 2026 Issue Number : 3 Articles : 5 Articles
Background: The Korea Disease Control and Prevention Agency classifies healthcare workers (HCWs) into five groups based on Mycobacterium tuberculosis exposure risk and potential transmission impact to guide TB screening strategies. However, data on actual exposure frequency and latent tuberculosis infection (LTBI) incidence across these classifications remain limited. Methods: We conducted a retrospective cohort study of HCWs at a tertiary hospital between 2023 and 2024. Baseline LTBI screening was performed for all staff, with annual follow-up testing for Groups 1–4 according to national guidelines. TB exposure history and frequency were investigated and documented by the infection prevention department. LTBI incidence was assessed among HCWs with a negative test in 2023 who underwent repeat testing in 2024. Results: Among 2116 HCWs (27.7% male; mean age, 33 years), TB exposure rates increased with higher risk classification (Group 1: 46.9%, Group 2: 31.3%, Group 3: 18.5%, Group 4: 1.2%, Group 5: 0.6%; p < 0.001), as did the mean number of exposure events per person (1.39, 0.74, 0.31, 0.01, and 0.01, respectively; p < 0.001). The incidence of LTBI was 13/1323 (1.0%). After adjustment, LTBI incidence was associated with ≥2 TB exposure events (adjusted OR, 7.03; 95% CI, 1.87–26.36; p = 0.005), but did not differ significantly by group classification. Conclusions: This study suggests that occupational classification effectively predicts the frequency of TB exposure among healthcare workers. However, LTBI incidence is more closely associated with multiple TB exposure events rather than occupational classification....
Introduction: Neuromeningeal disorders comprise a group of severe infectious and non-infectious pathologies, common and clinically diverse, that affect the central nervous system, primarily including meningitis, encephalitis, and suppurative infections. They are common and diverse, and for the most part, remain a public health concern worldwide and especially in Africa. Objectives: To assess the prevalence of neuromeningeal disorders among patients hospitalized in the Infectious and Tropical Diseases Department (SMIT) at CHNU de Fann, and to describe their epidemiological, clinical, paraclinical, and prognostic characteristics. Patients and Methods: This was a retrospective and descriptive cohort study conducted over five years, from January 1, 2018, to December 31, 2022. It included patients presenting with neuromeningeal disorders. Results: Of the 3567 hospitalized patients, 930 were admitted primarily for neurological symptoms, representing a prevalence of 26.07%. There was a clear male predominance (61.29%), with a sex ratio of 1.58. The mean age of the study population was 40 years 5 - 99 years. Half (50.16%) of the patients came from suburban areas. The informal sector accounted for more than one third of reported cases (37.63%). Married individuals constituted the majority of our study population at 40%. The most frequently observed comorbidities were HIV (25.37%), hypertension (12.68%), diabetes (6.23%), and substance abuse (14%). The most frequent reason for hospitalization was febrile disturbances of consciousness (17.3%). Clinically, the most common signs were headache (61.93%), altered consciousness (69.35%), neck stiffness (40.53%), vomit- ing (40.10%), motor deficit (29.89%), Kernig’s sign (26.12%), and Brudzinski’s sign (21.07%). The main etiologies were severe malaria in its neurological form (23.11%), neuromeningeal tuberculosis (17.84%), and bacterial meningoencephalitis (14.83%). The mean length of hospital stay was 11 days, ranging from a few hours to 100 days. Outcomes were favorable in 62.8% of cases and stationary in 5.80%. The overall case fatality rate was 31.4%. Conclusion: Neuromeningeal diseases are complex but can be effectively managed with prompt and appropriate intervention. However, it is essential to ensure the prevention of neuromeningeal opportunistic infections during HIV infection, as these typically carry a poor prognosis. Management of these conditions requires a multidisciplinary and collaborative approach....
Reactive infectious mucocutaneous eruption (RIME) is a rare pediatric condition characterized by severe mucositis, minimal cutaneous involvement, and an infectious rather than drug-induced etiology. Mycoplasma pneumoniae (M. Pneumoniae) represents the most frequently identified trigger, although an increasing number of alternative pathogens have been reported. Its clinical overlap with Stevens–Johnson syndrome (SJS) makes early recognition difficult. We reviewed literature data on the topic and described our center’s experience with three pediatric cases of M. pneumoniae-associated RIME. Medical records, laboratory results, and imaging were systematically analyzed. All patients were male, aged 2 to 12 years and originated from rural communities. Etiologic confirmation was achieved via M. pneumoniae IgM serology and/or polymerase chain reaction. Clinical exam modifications included multi-site mucositis (oral, ocular, genital) with variable skin involvement: absent in one case, a solitary palm ulcer in another, and widespread rash in the third. One patient required two hospitalizations within a six-month interval, confirming the possible relapsing phenotype of RIME. Another patient developed pneumonia, sepsis, and systemic inflammation. All received macrolide therapy, antifungals, mucosal supportive care, and systemic management as indicated. Recovery occurred within 10–21 days, with one patient exhibiting skin hyperpigmentation. These cases illustrate the heterogeneity of RIME, emphasize the importance of prompt recognition, etiology confirmation, and multidisciplinary management. RIME is a rare clinical condition in pediatric population, an uncommon but significant mucocutaneous clinical entity, important to be acknowledged by clinicians as a complication and/or extra-pulmonary manifestation of M. pneumoniae infection....
Background/Objectives: Dalbavancin is approved for pediatric acute bacterial skin and skin structure infections (ABSSSIs), yet real-world practice frequently necessitates offlabel use for deep-seated infections requiring prolonged suppression. While adult data support therapeutic drug monitoring (TDM)-guided maintenance, the pediatric evidence for repeated-dose pharmacokinetics (PK) is limited. We evaluated the efficacy, safety, multidose PK, and pharmacoeconomic impact of dalbavancin in a complex pediatric cohort. Methods: A retrospective study (2023–2025) of enrolled patients < 18 years treated with dalbavancin. A subgroup receiving ≥3 doses underwent PK analysis to assess concentration decay against conservative efficacy targets (4 and 8 mg/L). A pharmacoeconomic analysis compared resource utilization against the standard of care. Results: Sixteen patients (median age 12) were included, primarily treated for Staphylococcus aureus (S. aureus) osteoarticular infections (75%), and frequently device-associated (66.7%). Clinical success was 93.8% (15/16) with no adverse events. A PK analysis (n = 9; 78 samples) ruled out dangerous accumulation but revealed a significant concentration drop at week 4 (mean 6.06 mg/L; p = 0.005). Logistic regression identified the time since the previous dose as the sole predictor of sub-therapeutic levels, with >50% of the patients dropping below 8 mg/L by the fourth week. An analysis showed median net savings of EUR 3215.84 per patient (p = 0.004). Conclusions: Dalbavancin is effective and cost-saving for complex pediatric infections. However, due to distinct pediatric PK, dosing regimens extrapolated from adults may result in sub-therapeutic concentrations by week 4. We recommend TDM around week 3 to tailor dosing or limiting maintenance intervals to a maximum of 4 weeks....
Background and Clinical Significance: Hypoglossal nerve palsy is an uncommon neurological complication of infectious mononucleosis and is only rarely reported. Putative mechanisms include virus-triggered neuritis (Epstein–Barr virus (EBV) or Cytomegalovirus (CMV)) and/or mechanical compression related to cervical lymphadenopathy. Case Presentation: We report two children with infectious mononucleosis and transient unilateral hypoglossal nerve palsy. Case 1 was a 15-year-old boy with 7 days of fever and typical mononucleosis features who developed leftward tongue deviation accompanied by sialorrhea, dysarthria, and dysphagia. Laboratory testing showed marked hepatocellular injury and EBV-specific IgM positivity. Case 2 was a 9-year-old girl with a 24 h history of bilateral lateral cervical lymphadenopathy with overlying inflammatory signs; examination revealed rightward tongue deviation with similar associated symptoms. CMV-specific IgM antibodies were detected on serological testing. Both patients received systemic corticosteroids and empiric intravenous antibiotics, with supportive care. Hypoglossal nerve function fully recovered within 2–4 weeks of treatment initiation. Conclusions: These cases underscore that isolated hypoglossal nerve palsy may complicate EBV- or CMV-associated mononucleosis in children. Although the prognosis is generally favorable, the presentation warrants careful evaluation to exclude alternative causes of lower cranial neuropathies and close follow-up until complete neurological resolution....
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