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Central nervous system infections associated with neurologic devices
Purpose of review To review recent data on the epidemiology, microbiology, diagnosis, and management of central nervous system (CNS) infections associated with neurologic devices. Recent findings The increasing use of implanted neurologic devices has led to an increase in associated infections. Cerebrospinal fluid (CSF) inflammation may be present after a neurosurgical procedure, complicating the diagnosis of CNS infection. Newer biomarkers such as CSF lactate and procalcitonin show promise in differentiating infection from other causes of CSF inflammation. Molecular diagnostic tests including next-generation or...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Neuroradiology of infectious diseases
Purpose of review Early diagnosis of central nervous system (CNS) infections is crucial given high morbidity and mortality. Neuroimaging in CNS infections is widely used to aid in the diagnosis, treatment and to assess the response to antibiotic and neurosurgical interventions. Recent findings The Infectious Diseases Society of America (IDSA) guidelines have clear recommendations for obtaining a computerized tomography of the head (CTH) prior to lumbar puncture (LP) in suspected meningitis. In the absence of indications for imaging or in aseptic meningitis, cranial imaging is of low utility. In contrast, cranial...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Neurologic aspects of coronavirus disease of 2019 infection
Purpose of review Central and peripheral nervous system manifestations of coronavirus disease 2019 (COVID-19) have been frequently reported and may cause significant morbidity and mortality. This review details the latest evidence on the neuropathogenesis and neurologic complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Recent findings Commonly reported neurologic complications include toxic-metabolic encephalopathy, acute cerebrovascular disorders, seizures, and anoxic-brain injury. These complications represent secondary injury due to COVID-19 related hypoxia, sepsis, hype...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Central nervous system infections after solid organ transplantation
Purpose of review Significant advances to our understanding of several neuroinfectious complications after a solid organ transplant (SOT) have occurred in the last few years. Here, we review the central nervous system (CNS) infections that are relevant to SOT via a syndromic approach with a particular emphasis on recent updates in the field. Recent findings A few key studies have advanced our understanding of the epidemiology and clinical characteristics of several CNS infections in SOT recipients. Risk factors for poor prognosis and protective effects of standard posttransplant prophylactic strategies have been...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Editorial: What's hot in neurologic infections?
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

The intracellular phase of extracellular respiratory tract bacterial pathogens and its role on pathogen-host interactions during infection
Purpose of review An initial intracellular phase of usually extracellular bacterial pathogens displays an important strategy to hide from the host's immune system and antibiotics therapy. It helps the bacteria, including bacterial pathogens of airway diseases, to persist and eventually switch to a typical extracellular infection. Several infectious diseases of the lung are life-threatening and their control is impeded by intracellular persistence of pathogens. Thus, molecular adaptations of the pathogens to this niche but also the host's response and potential targets to interfere are of relevance. Here we discuss exam...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri Diavatopoulos Source Type: research

Bacterial RTX toxins and host immunity
Purpose of review RTX toxin action often defines the outcome of bacterial infections. Here, we discuss the progress in understanding the impacts of RTX toxin activities on host immunity. Recent findings Bordetella pertussis CyaA activity paralyzes sentinel phagocytic cells by elevating cellular cAMP levels and blocks differentiation of infiltrating monocytes into bactericidal macrophages, promoting also de-differentiation of resident alveolar macrophages into monocyte-like cells. Vibrio cholerae multifunctional autoprocessing repeats-in-toxins (MARTX), through Rho inactivating and α/β-hydrolase (ABH) domain ac...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri Diavatopoulos Source Type: research

Mucosal immunity to severe acute respiratory syndrome coronavirus 2 infection
Purpose of review Despite its crucial role in protection against viral infections, mucosal immunity has been largely understudied in the context of coronavirus disease 2019 (COVID-19). This review outlines the current evidence about the role of mucosal immune responses in the clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, as well as potential mucosal mechanisms of protection against (re-)infection. Recent findings The angiotensin-converting enzyme 2 cellular entry receptor for SARS-CoV-2 is most highly expressed in the upper respiratory tract and most SARS-CoV-2 shedding occ...
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri Diavatopoulos Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Infectious Diseases)
Source: Current Opinion in Infectious Diseases - May 2, 2021 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTIONS Source Type: research

Applying the lessons learned from coronavirus disease 2019 to improve pneumonia management
Purpose of review Coronavirus disease 2019 (COVID-19) has produced an extraordinary amount of literature in a short time period. This review focuses on what the new literature has provided in terms of more general information about the management of community-acquired pneumonia (CAP). Recent findings Measures taken to reduce the spread of COVID-19 have caused a significant drop in influenza worldwide. Improvements in imaging, especially ultrasound, and especially in the application of rapid molecular diagnosis are likely to have significant impact on the management of CAP. Therapeutic advances are so far limited...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

When should we use corticosteroids in severe community-acquired pneumonia?
Purpose of review This review aims to evaluate the evidence and recommendations for the prescription of corticosteroids as adjunctive therapy in patients with severe community-acquired pneumonia. Recent findings Corticosteroids have been prescribed with the objective to attenuate the marked and persistent activation of the immune system. However, some causes of community-acquired pneumonia, namely viral, are associated with unexpected low levels of cytokines and depressed cellular immunity. As a result, several recent randomized controlled trials and large prospective observational studies repeatedly showed that...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Nebulized antibiotics for ventilator-associated pneumonia: methodological framework for future multicenter randomized controlled trials
Purpose of review Although experimental evidence supports the use of nebulized antibiotics in ventilator-associated pneumonia (VAP), two recent multicenter randomized controlled trials (RCTs) have failed to demonstrate any benefit in VAP caused by Gram-negative bacteria (GNB). This review examines the methodological requirements concerning future RCTs. Recent findings High doses of nebulized antibiotics are required to reach the infected lung parenchyma. Breath-synchronized nebulizers do not allow delivery of high doses. Mesh nebulizers perform better than jet nebulizers. Epithelial lining fluid concentrations d...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Novelty and nuance in the intensive care unit: new options to combat multidrug resistant pneumonia
Purpose of review To describe the increasing burden of multidrug resistant (MDR) Gram-negative pathogens in severe pneumonia and to examine the clinical trials supporting a role for novel agents for the treatment of this infection. Recent findings MDR Gram-negative bacteria cause an increasing proportion of severe pneumonias. Although the epidemiology of resistance varies across the globe, all regions have seen an evolution in resistance, especially among Enterobacterales spp, Pseudomonas aeruginosa, and Acinetobacter bumannii. Fortunately, several clinical trials have established the role for multiple new antib...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Noninvasive ventilation and high-flow oxygen therapy for severe community-acquired pneumonia
Purpose of review We review the evidence on the use of noninvasive respiratory supports (noninvasive ventilation and high-flow nasal cannula oxygen therapy) in patients with acute respiratory failure because of severe community-acquired pneumonia. Recent findings Noninvasive ventilation is strongly advised for the treatment of hypercapnic respiratory failure and recent evidence justifies its use in patients with hypoxemic respiratory failure when delivered by helmet. Indeed, such interface allows alveolar recruitment by providing high level of positive end-expiratory pressure, which improves hypoxemia. On the ot...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research

Pneumonia in older adults
Purpose of review The purpose of this review is to address the relevant issues surrounding older adults with community-acquired pneumonia (CAP) today. Recent findings Approximately 1 million people>65 years have CAP in the US per year, which is more than previously reported (or realized). Older adults are vulnerable to the increasing prevalence of viral CAP, as the SARS-CoV-2 pandemic emphasizes, but pneumococcus is still the most common pathogen to cause CAP. Racial disparities continue to need to be addressed in order to improve early and late outcomes of older adults with CAP. Summary The epidemiolog...
Source: Current Opinion in Infectious Diseases - March 11, 2021 Category: Infectious Diseases Tags: RESPIRATORY INFECTIONS: Edited by Michael S. Niederman Source Type: research