Review
Medicine, General & Internal
Mengmeng Zhang, Minggui Wang, Jian-Qing He
Summary: This systematic review and meta-analysis evaluated the effects of high-dose rifampin in treating tuberculous meningitis. The results showed increased drug concentrations in plasma and cerebrospinal fluid, good safety profile, but no improvement in survival rates.
FRONTIERS IN MEDICINE
(2022)
Review
Geriatrics & Gerontology
Huan-Jun Lu, Daji Guo, Qian-Qi Wei
Summary: Tuberculous meningitis (TBM) is a severe complication of tuberculosis (TB) with high rates of disability and mortality. Microglia, the core of the immune network in the central nervous system, are directly infected by Mycobacterium tuberculosis (M. tb) and play a complex role in TBM. Host-directed therapy (HDT) has emerged as a potential adjunct therapy for TBM by controlling neuroinflammation. This review discusses the diverse roles of microglia in TBM and potential HDT approaches targeting microglia.
Article
Immunology
Carson M. Quinn, Enock Kagimu, Michael Okirworth, Ananta S. Bangdiwala, Gerald Mugumya, Prashanth S. Ramachandran, Michael R. Wilson, David B. Meya, Fiona Cresswell, Nathan C. Bahr, David R. Boulware
Summary: The study found that FujiLAM has higher sensitivity compared to AlereLAM in diagnosing TBM, and its sensitivity may approach that of Xpert Ultra. FujiLAM has the potential to improve time-to-treatment-initiation for TBM patients.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Ying Luo, Ying Xue, Qun Lin, Liyan Mao, Guoxing Tang, Huijuan Song, Wei Liu, Shiji Wu, Weiyong Liu, Yu Zhou, Lingqing Xu, Zhigang Xiong, Ting Wang, Xu Yuan, Yong Gan, Ziyong Sun, Feng Wang
Summary: The study established a diagnostic model based on a combination of CSF chlorine, CSF nucleated cell count, CSF lymphocyte proportion, and the tuberculosis-specific antigen/phytohemagglutinin (TBAg/PHA) ratio, which showed excellent utility in discriminating between TBM and BM, with high sensitivity and specificity.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Immunology
Angharad G. Davis, Anna J. Dreyer, Christine Albertyn, Mpumi Maxebengula, Cari Stek, Sean Wasserman, Suzaan Marais, Kathleen Bateman, Mark Solms, John Joska, Robert J. Wilkinson, Sam Nightingale
Summary: This study systematically assessed the frequency and nature of cognitive impairment in adult tuberculous meningitis patients and found that it has an impact on functioning and medication adherence.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Clinical Neurology
Kunyi Li, Lijun Wang, Lan Wen, Jian Wang, Maolin Li
Summary: The study aimed to determine the safety and efficacy of intrathecally administered isoniazid (INH) and prednisolone in addition to systemic anti-TB therapy compared with systemic anti-TB therapy alone in adult patients with tuberculous meningitis. The addition of intrathecal INH and prednisolone to systemic anti-TB therapy may result in better outcomes for adult patients with tuberculous meningitis.
NEUROLOGICAL SCIENCES
(2022)
Article
Infectious Diseases
Caleb P. Skipper, Katherine Huppler Hullsiek, Fiona V. Cresswell, Kiiza K. Tadeo, Michael Okirwoth, Mark Blackstad, Nelmary Hernandez-Alvarado, Claudia Fernandez-Alarcon, Stewart Walukaga, Emily Martyn, Jayne Ellis, Kenneth Ssebambulidde, Lillian Tugume, Edwin Nuwagira, Joshua Rhein, David B. Meya, David R. Boulware, Mark R. Schleiss
Summary: This study investigates the association between CMV viremia and mortality in patients with HIV-associated meningitis. The results show that patients with CMV viremia have a higher mortality rate at 18 weeks, and the risk of death increases with the viral load.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Immunology
Fiona Cresswell, David B. Meya, Enock Kagimu, Daniel Grint, Lindsey Te Brake, John Kasibante, Emily Martyn, Morris Rutakingirwa, Carson M. Quinn, Micheal Okirwoth, Lillian Tugume, Kenneth Ssembambulidde, Abdu K. Musubire, Ananta S. Bangdiwala, Allan Buzibye, Conrad Muzoora, Elin M. Svensson, Rob Aarnoutse, David R. Boulware, Alison M. Elliott
Summary: The study showed that high-dose rifampicin can increase serum and cerebrospinal fluid concentrations in tuberculous meningitis patients without excess toxicity. Current international guidelines result in sub-therapeutic CSF rifampicin concentration for Ugandan TBM patients.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Clinical Neurology
Kenneth Ssebambulidde, Jane Gakuru, Jayne Ellis, Fiona V. Cresswell, Nathan C. Bahr
Summary: Diagnosis of TBM remains challenging due to the limitations of current diagnostic methods. A combination of clinical factors and various investigations are utilized for diagnosis. Starting empiric therapy promptly is crucial for good outcomes in many cases.
FRONTIERS IN NEUROLOGY
(2022)
Article
Infectious Diseases
Prakash C. Pandey, Jayantee Kalita, Jayesh Sardhara, Neeraj Jain, Pallavi Prasad
Summary: This case report highlights the diagnostic and management issues associated with neurocysticercosis, and the variability of meningitis symptoms.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2022)
Review
Immunology
Joomee Song, Si-Ho Kim, Yi-Rang Jung, Junsu Choe, Cheol-In Kang, Ju-Hong Min
Summary: The most common diagnoses with elevated CSF-ADA levels were hematologic malignancy, followed by tuberculous meningitis and viral meningitis. There were differences in CSF-ADA levels and lymphocyte-dominant pleocytosis among different diagnoses.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Clinical Neurology
Karen du Preez, Helen E. Jenkins, Peter R. Donald, Regan S. Solomons, Stephen M. Graham, H. Simon Schaaf, Jeffrey R. Starke, Anneke C. Hesseling, James A. Seddon
Summary: Tuberculous meningitis (TBM) is a significant cause of illness and death in children with tuberculosis (TB), but there are currently no estimates of the global burden of pediatric TBM. Due to non-specific symptoms and limited diagnostic tests, children with TBM are often diagnosed late or not at all. Even with diagnosis and treatment, 20% of children with TBM still die and survivors often have significant neurological disabilities. Improved surveillance of pediatric TBM is crucial for prevention, early diagnosis, and improved care.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
An Wen, Shi-Min Liu, Wen-Feng Cao, Yong-Liang Zhou, Chao-Qun Luo, Zheng-Bing Xiang, Fan Hu, Ping Zhang, Er-Ling Leng
Summary: This study aimed to develop a simple diagnostic algorithm based on clinical and laboratory test results as an early predictor of tuberculous meningitis (TBM) in South China. Five characteristics were found to be predictive of TBM, and a new scoring system was developed with a sensitivity of 81.6% and specificity of 93.6%. This system can be used in countries with limited resources.
FRONTIERS IN NEUROLOGY
(2022)
Review
Medicine, General & Internal
Jie Hou, Xin-Jie Liu, Yu He, Yan-An Zhang, Mao-Shui Wang
Summary: This scoping review examines the role of cerebrospinal fluid (CSF) examinations in diagnosing tuberculous meningitis (TBM) in infants. The results show that routine microbiological tools have a limited sensitivity for diagnosing infant TBM, and most CSF features are non-specific and insufficient to predict a diagnosis. Further research is needed to develop new diagnostic tools for infant TBM.
ANNALS OF MEDICINE
(2022)
Article
Multidisciplinary Sciences
Laura J. Whitworth, Rajan Troll, Antonio J. Pagan, Francisco J. Roca, Paul H. Edelstein, Mark Troll, David M. Tobin, Nguyen Hoan Phu, Nguyen Duc Bang, Guy E. Thwaites, Nguyen Thuy Thuong Thuong, Roger F. Sewell, Lalita Ramakrishnan
Summary: The TT homozygosity of the LTA4H gene is associated with higher levels of proinflammatory cytokines in cerebrospinal fluid, and it correlates with the efficacy of dexamethasone in tuberculous meningitis patients. This association extends beyond TT patients to non-TT individuals, suggesting that other genetic variations may also influence the responsiveness to dexamethasone.
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
(2021)
Article
Immunology
Joshua Gillard, Bastiaan A. Blok, Daniel R. Garza, Prashanna Balaji Venkatasubramanian, Elles Simonetti, Marc J. Eleveld, Guy A. M. Berbers, Pieter G. M. van Gageldonk, Irma Joosten, Ronald de Groot, L. Charlotte J. de Bree, Reinout van Crevel, Marien de Jonge, Martijn A. Huynen, Mihai G. Netea, Dimitri A. Diavatopoulos
Summary: This study demonstrates that prior Bacille Calmette-Guerin (BCG) vaccination enhances immune responses to pertussis vaccines. Simultaneous BCG and acellular pertussis (aP) vaccinations do not show the same effect. Biomarkers of trained immunity are identified as the most reliable correlates of the enhanced immune responses.
Article
Immunology
Simone J. C. F. M. Moorlag, Esther Taks, Thijs ten Doesschate, Thomas W. van der Vaart, Axel B. Janssen, Lisa Mueller, Philipp Ostermann, Helga Dijkstra, Heidi Lemmers, Elles Simonetti, Marc Mazur, Heiner Schaal, Rob ter Heine, Frank L. van de Veerdonk, Chantal P. Bleeker-Rovers, Reinout van Crevel, Jaap ten Oever, Marien de Jonge, Marc J. Bonten, Cornelis H. van Werkhoven, Mihai G. Netea
Summary: This study found that BCG vaccination had no significant effect in preventing respiratory tract infections, including COVID-19, in older adults. However, it was found that individuals who received the BCG vaccine had stronger antibody responses after COVID-19 infection.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
Eva Laker Agnes Odongpiny, Fiona Cresswell, Arnold Arinaitwe, Vivian Nakate, Joshua Kyenkya, Mohammed Lamorde, Catriona Waitt, David Meya, Agnes Kiragga
Summary: Efforts to achieve zero transmission of HIV to infants born to women living with HIV in sub-Saharan Africa are hindered by high loss to follow-up rates in PVT programs. Injectable ART has been shown to be effective and discreet, with over half of women lost to follow-up in Uganda expressing willingness to use it. Fear of HIV status disclosure through pill bottles has been identified as a key factor influencing willingness to use injectable ART.
Editorial Material
Immunology
Regan S. Solomons, Ronald van Toorn, Fiona V. Cresswell, James A. Seddon
PEDIATRIC INFECTIOUS DISEASE JOURNAL
(2022)
Article
Multidisciplinary Sciences
P. S. Ramachandran, A. Ramesh, F. Creswell, A. Wapniarski, R. Narendra, C. M. Quinn, E. B. Tran, M. K. Rutakingirwa, A. S. Bangdiwala, E. Kagimu, K. T. Kandole, K. C. Zorn, L. Tugume, J. Kasibante, K. Ssebambulidde, M. Okirwoth, N. C. Bahr, A. Musubire, C. P. Skipper, C. Fouassier, A. Lyden, P. Serpa, G. Castaneda, S. Caldera, V Ahyong, J. L. DeRisi, C. Langelier, E. D. Crawford, D. R. Boulware, D. B. Meya, M. R. Wilson
Summary: In this study, the authors combined metagenomics-based pathogen detection with a machine learning classifier based on host gene expression to enhance the diagnosis of tuberculous meningitis (TBM). By integrating these approaches, they achieved high sensitivity and specificity for detecting TBM and its mimics, even in low resource settings.
NATURE COMMUNICATIONS
(2022)
Review
Immunology
Fiona Cresswell, Mohammed Lamorde
Summary: The use of long-acting agents in HIV treatment shows promise in improving treatment outcomes. These regimens have the potential to reduce challenges in HIV treatment by extending the dosing interval and providing convenience and discretion. However, there are various implementation considerations in low-income and middle-income countries.
CURRENT OPINION IN HIV AND AIDS
(2022)
Article
Immunology
Zhaoli Liu, Gizem Kilic, Wenchao Li, Ozlem Bulut, Manoj Kumar Gupta, Bowen Zhang, Cancan Qi, He Peng, Hsin-Chieh Tsay, Chai Fen Soon, Yonatan Ayalew Mekonnen, Anaisa Valido Ferreira, Caspar I. van der Made, Bram van Cranenbroek, Hans J. P. M. Koenen, Elles Simonetti, Dimitri Diavatopoulos, Marien I. de Jonge, Lisa Mueller, Heiner Schaal, Philipp N. Ostermann, Markus Cornberg, Britta Eiz-Vesper, Frank van de Veerdonk, Reinout van Crevel, Leo A. B. Joosten, Jorge Dominguez-Andres, Cheng-Jian Xu, Mihai G. Netea, Yang Li
Summary: Through a multi-omics study, it was found that although minor differences exist in immunological responses, the immune system of convalescent COVID-19 patients largely recovers to the level of healthy individuals.
FRONTIERS IN IMMUNOLOGY
(2022)
Review
Clinical Neurology
Kenneth Ssebambulidde, Jane Gakuru, Jayne Ellis, Fiona V. Cresswell, Nathan C. Bahr
Summary: Diagnosis of TBM remains challenging due to the limitations of current diagnostic methods. A combination of clinical factors and various investigations are utilized for diagnosis. Starting empiric therapy promptly is crucial for good outcomes in many cases.
FRONTIERS IN NEUROLOGY
(2022)
Article
Medicine, General & Internal
Manon Alkema, X. Zen Yap, Gerdie M. de Jong, Isaie J. Reuling, Quirijn de Mast, Reinout van Crevel, Christian F. Ockenhouse, Katharine A. Collins, Teun Bousema, Matthew B. B. McCall, Robert W. Sauerwein
Summary: Malaria infection caused by Plasmodium falciparum through mosquito bites induces stronger inflammation response in healthy volunteers compared to intravenous administration of infected red blood cells.
Article
Immunology
Laniyati Hamijoyo, Edhyana Sahiratmadja, Nadia G. Ghassani, Guntur Darmawan, Evan Susandi, Reinout van Crevel, Philip C. Hill, Bachti Alisjahbana
Summary: Tuberculosis incidence and mortality are high in SLE patients in Indonesia. Risk factors for developing TB include methylprednisolone pulse, age ≤ 25 at SLE diagnosis, and tuberculosis household contact. TB preventive therapy may be beneficial for SLE patients in tuberculosis-endemic settings.
OPEN FORUM INFECTIOUS DISEASES
(2022)
Article
Medicine, Research & Experimental
Nyanda Elias Ntinginya, Lindsey te Brake, Issa Sabi, Nyasatu Chamba, Kajiru Kilonzo, Sweetness Laizer, Irene Andia-Biraro, Davis Kibirige, Andrew Peter Kyazze, Sandra Ninsiima, Julia A. Critchley, Renee Romeo, Josephine van de Maat, Willyhelmina Olomi, Lucy Mrema, David Magombola, Issakwisa Habakkuk Mwayula, Katrina Sharples, Philip C. Hill, Reinout van Crevel
Summary: This study aims to examine the efficacy and safety of TB preventive therapy in people with DM who have LTBI. The study will randomize 3000 eligible adults with DM and LTBI to receive either a 12-week course of rifapentine and isoniazid or a placebo. The primary outcome is the occurrence of definite or probable TB disease. This study is significant as it provides important evidence for better global TB control.
Article
Medicine, General & Internal
Harsita Patel, Amalia Sintou, Rasheda A. Chowdhury, Stephen Rothery, Alma Octavia Iacob, Sanjay Prasad, Peter P. Rainer, Federico Martinon-Torres, Vanessa Sancho-Shimizu, Chisato Shimizu, Kirsten Dummer, Adriana H. Tremoulet, Jane C. Burns, Susanne Sattler, Michael Levin
Summary: This study investigated the presence of anticardiac autoantibodies in MIS-C or COVID-19 vaccine-induced myocarditis and found no evidence of antibody binding to cardiac tissue in these conditions. This suggests that the cardiac pathology in MIS-C and vaccine-induced myocarditis is unlikely to be driven by direct anticardiac antibody-mediated mechanisms.
Article
Rheumatology
Lara D. Veeken, Merel A. A. Opdam, Lise M. Verhoef, Calin Popa, Reinout van Crevel, Alfons A. den Broeder
Summary: This study aims to determine the infection incidence in a large real-life population of RA patients using RTX, with special focus on (ultra-)low dosing and time since last infusion. The results showed that the risk of infection was lower with a dose of 200 mg, and infections seemed to occur more frequently in the first two months after infusion, suggesting an association with peak concentration.
Letter
Immunology
Claire Norcross, Loice Achieng Ombajo, Sheetal Kassim, Nigel Garrett, Fiona Cresswell, Eugene Ruzagira
Article
Microbiology
Ralf Stemkens, Maarten Cobussen, Wouter Hoefsloot, Erik de Laat, Reinout van Crevel, Rob E. Aarnoutse, Jakko van Ingen
Summary: Treatment of skin and soft tissue infections caused by nontuberculous mycobacteria can be challenging. Negative pressure wound therapy with instillation and dwell time of topical antibiotics can be a successful and well-tolerated treatment option.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2023)