- Cryptococcal choroiditis in advanced AIDS with clinicopathologic correlation. [Journal Article]
- AJAm J Ophthalmol Case Rep 2018; 10:51-54
- CONCLUSIONS: This case highlights the clinical, imaging, and histopathologic findings of cryptococcal choroiditis and provides a review of the updated treatment recommendations for disseminated infection in a patient with advanced AIDS. Although currently fundoscopy has proven most useful in directing the diagnostic algorithm in choroiditis in the setting of advanced immunosuppression, OCT may provide insight into the spread of Cryptococcus within the eye.
- A Novel de Novo Mutation in the CD40 Ligand Gene in a Patient With a Mild X-Linked Hyper-IgM Phenotype Initially Diagnosed as CVID: New Aspects of Old Diseases. [Journal Article]
- FPFront Pediatr 2018; 6:130
- Mutations in the CD40 ligand (CD40L) gene (CD40LG) lead to X-linked hyper-IgM syndrome (X-HIGM), which is a primary immunodeficiency (PID) characterized by decreased serum levels of IgG and IgA and n...
Mutations in the CD40 ligand (CD40L) gene (CD40LG) lead to X-linked hyper-IgM syndrome (X-HIGM), which is a primary immunodeficiency (PID) characterized by decreased serum levels of IgG and IgA and normal or elevated IgM levels. Although most X-HIGM patients become symptomatic during the first or second year of life, during which they exhibit recurrent infections, some patients exhibit mild phenotypes, which are usually associated with hypomorphic mutations that do not abrogate protein expression or function. Here, we describe a 28-year-old man who initially presented with recurrent infections since the age of 7 years, when he exhibited meningitis caused by Cryptococcus neoformans. The patient had no family history of immunodeficiency, and based on clinical and laboratory presentation, he was initially diagnosed with common variable immunodeficiency (CVID). In subsequent years, he displayed several sporadic episodes of infection, including pneumonia, pharyngotonsillitis, acute otitis media, rhinosinusitis, fungal dermatosis, and intestinal helminthiasis. The evaluation of CD40L expression on the surface of activated CD3+CD4+ T cells from the patient showed decreased expression of CD40L. Genetic analysis revealed a novel de novo mutation consisting of a 6-nucleotide insertion in exon 1 of CD40LG, which confirmed the diagnosis of X-HIGM. In this report, we describe a novel mutation in the CD40L gene and highlight the complexities of PID diagnosis in light of atypical phenotypes and hypomorphic mutations as well as the importance of the differential diagnosis of PIDs.
- Mathematical Modelling of Bacterial Meningitis Transmission Dynamics with Control Measures. [Journal Article]
- CMComput Math Methods Med 2018; 2018:2657461
- Vaccination and treatment are the most effective ways of controlling the transmission of most infectious diseases. While vaccination helps susceptible individuals to build either a long-term immunity...
Vaccination and treatment are the most effective ways of controlling the transmission of most infectious diseases. While vaccination helps susceptible individuals to build either a long-term immunity or short-term immunity, treatment reduces the number of disease-induced deaths and the number of infectious individuals in a community/nation. In this paper, a nonlinear deterministic model with time-dependent controls has been proposed to describe the dynamics of bacterial meningitis in a population. The model is shown to exhibit a unique globally asymptotically stable disease-free equilibrium ℰ0, when the effective reproduction number ℛVT ≤ 1, and a globally asymptotically stable endemic equilibrium ℰ1, when ℛVT > 1; and it exhibits a transcritical bifurcation at ℛVT = 1. Carriers have been shown (by Tornado plot) to have a higher chance of spreading the infection than those with clinical symptoms who will sometimes be bound to bed during the acute phase of the infection. In order to find the best strategy for minimizing the number of carriers and ill individuals and the cost of control implementation, an optimal control problem is set up by defining a Lagrangian function L to be minimized subject to the proposed model. Numerical simulation of the optimal problem demonstrates that the best strategy to control bacterial meningitis is to combine vaccination with other interventions (such as treatment and public health education). Additionally, this research suggests that stakeholders should press hard for the production of existing/new vaccines and antibiotics and their disbursement to areas that are most affected by bacterial meningitis, especially Sub-Saharan Africa; furthermore, individuals who live in communities where the environment is relatively warm (hot/moisture) are advised to go for vaccination against bacterial meningitis.
- Lipid Droplets in the Basal Cistern and Ventricles. [Journal Article]
- IMIntern Med 2018 May 18
- Intermittent Pili-Mediated Forces Fluidize Neisseria meningitidis Aggregates Promoting Vascular Colonization. [Journal Article]
- CellCell 2018 May 15
- Neisseria meningitidis, a bacterium responsible for meningitis and septicemia, proliferates and eventually fills the lumen of blood capillaries with multicellular aggregates. The impact of this aggre...
Neisseria meningitidis, a bacterium responsible for meningitis and septicemia, proliferates and eventually fills the lumen of blood capillaries with multicellular aggregates. The impact of this aggregation process and its specific properties are unknown. We first show that aggregative properties are necessary for efficient infection and study their underlying physical mechanisms. Micropipette aspiration and single-cell tracking unravel unique features of an atypical fluidized phase, with single-cell diffusion exceeding that of isolated cells. A quantitative description of the bacterial pair interactions combined with active matter physics-based modeling show that this behavior relies on type IV pili active dynamics that mediate alternating phases of bacteria fast mutual approach, contact, and release. These peculiar fluid properties proved necessary to adjust to the geometry of capillaries upon bacterial proliferation. Intermittent attractive forces thus generate a fluidized phase that allows for efficient colonization of the blood capillary network during infection.
- Safety and immunogenicity of fractional dose intradermal injection of two quadrivalent conjugated meningococcal vaccines. [Journal Article]
- VVaccine 2018 May 16
- CONCLUSIONS: Fractional intradermal vaccination against meningococcal disease with quadrivalent conjugate vaccine appears to be safe and effective in our small dose finding study. Tetanus toxoid conjugated vaccine (Nimenrix®) shows a trend towards higher antibody levels compared to CRM197-conjugated vaccine (Menveo®). The 1/5th fractional dose of MenACWY-TT appears to result in higher antibody levels than does the 1/10th dose. These results can be used for a larger non-inferiority study. This trial was registered in clinicaltrials.gov under NCT01782066.
- Tuberculous meningitis: a roadmap for advancing basic and translational research. [Journal Article]
- NINat Immunol 2018 May 18
- Threshold level of Riemerella anatipestifer crossing blood-brain barrier and expression profiles of immune-related proteins in blood and brain tissue from infected ducks. [Journal Article]
- VIVet Immunol Immunopathol 2018; 200:26-31
- Riemerella anatipestifer (R. anatipestifer) is a Gram-negative bacterium that crosses the blood-brain barrier (BBB) and causes meningitis with neurological symptoms in infected ducks. A threshold lev...
Riemerella anatipestifer (R. anatipestifer) is a Gram-negative bacterium that crosses the blood-brain barrier (BBB) and causes meningitis with neurological symptoms in infected ducks. A threshold level of bacteremia must be reached before the BBB can be breached. In this study, the bacterial burden and expression profiles of immune-related proteins in blood and brain tissue samples from R. anatipestifer-infected ducks were investigated. The data showed that R. anatipestifer could cross the BBB with low-level bacteremia of 7.5 × 102 CFU/ml in infected blood. Analysis of immune-related proteins revealed that IL-4, IL-17A, IL-17D, TLR3, TLR4, TLR7, and TGF-β in blood, as well as IL-1β, IL-2, IL-4, IL-17A, IL-17D, IL-17F, TLR3, TLR4, and TGF-β in brain tissue were upregulated at an early stage in infection. The expression levels of Th1 and Th17-specific cytokines were significantly higher than those of Th2-specific cytokines, which indicated that mainly Th1 and Th17 immune responses were induced during R. anatipestifer infection.
- Rheumatoid meningitis developed in patient with stable rheumatoid arthritis and myasthenia gravis-detailed analysis of intracranial inflammation using flow cytometry. [Journal Article]
- JNJ Neuroinflammation 2018 May 18; 15(1):151
- CONCLUSIONS: RM is not a simple reflection of the immune status of RA, as the pathogenesis seems related to, at least in part, CSF-specific immunological dysregulation.
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- Primary bacterial ventriculitis in adults, an emergent diagnosis challenge: report of a meningoccal case and review of the literature. [Journal Article]
- BIBMC Infect Dis 2018 May 18; 18(1):226
- CONCLUSIONS: Primary bacterial ventriculitis is a real diagnosis challenge. Larger indications of MRI for bacterial meningitis, particularly in cases with an atypical presentation or poor evolution would certainly increase the number of diagnosis.