Bacterial Infections and Mycoses Commons^™

Temporal Trends Of A Cellular Host Response Test For Sepsis And A Comparison With Selected Biomarkers Of Inflammation And Infection, Matthew S. Berlinger, Matt Sorrells, Christopher B. Thomas, Tonya Jagneaux, James E. Walker, Jennifer Daigle, Heather Quiriarte, Youyoung Kim, Guillaume Spielmann, Debbie Robertson, Susan Park Ochsner, Gideon Avornu, Katherine Fenstermacher, Elijah James Kurien, Camille King, Adenine Cembellin-Kao, Chase Yonamine, Querino Maia, Maciej Obrebski, David N. Hager, Roya Sheybani, Henry T.K. Tse, Ajay M. Shah, Robert Scoggins, Hollis R. O’Neal, Richard Rothman

School of Medicine Faculty Publications

Sepsis, a condition characterized by immune dysregulation, is the leading cause of in-hospital mortality and requires rapid treatment. Assessing immune dysregulation has been challenging. The IntelliSep Index (ISI), a novel biomarker which leverages microfluidic deformability cytometry to assess immune activation, has been evaluated as a test for Emergency Department use but it is unclear how the signal evolves as patient condition evolves. In a 47-patient cohort with hospital stays ≤ 14 days, ISI provided a good indicator of disease progression by blinded physician review. ISI trends correlated with clinical improvement over time. During the first 12 h following presentation, ISI …

Gastric Sarcina Ventriculi: A Report On Two Cases, Yaomin Chen, Yu Liu, Zhiyan Fu

School of Medicine Faculty Publications

: Sarcina ventriculi is a rare Gram-positive coccus that thrives in acidic environments such as the human stomach. It has been increasingly identified in individuals with delayed gastric emptying and has been reported in association with various gastric disorders. However, its exact pathogenic role is not fully understood and remains controversial. : We present two cases of patients, one with a small bowel obstruction and the other with epigastric pain, both diagnosed with Sarcina ventriculi infection by histological examination of gastric biopsies. The patients were managed with a combination of antibiotics and a proton pump inhibitor, resulting in symptom resolution …

Disseminated Diaper Dermatitis With Concomitant Body Rash: A Case Report., Catherine F Alapatt, Eileen Condren, Tanya Kadrmas-Iannuzzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Diaper dermatitis is a rash typically localized to the genital area and may have various etiologies, including irritant and allergic contact dermatitis. In most cases, it resolves on its own with minimal to no medical intervention, and when treatment is necessary, it usually responds promptly. Here, we present a prolonged case of diaper dermatitis accompanied by a nearly full-body rash that was resistant to initial treatment with steroids, antibiotics, and antifungals.

Urgent Implementation Of Point-Of-Care Testing For Group A Streptococcal Infection In A Uk Children’S Emergency Department, Ruth Shorrocks, Philip J. Turner, Thomas Fanshawe, Umasha Ukwatte, Jim Gray, James Taylor, Liliana Graveto, Gail Hayward, Chris Bird

Journal of Pediatric Infectious Diseases

Objective: In late 2022, Western Europe and the United States experienced increased incidences of scarlet fever and life-threatening invasive group A strepto- coccal (iGAS) infections, especially among children. The outbreak was widely reported in the media in the United Kingdom, leading to increased emergency department (ED) attendances and threatened supplies of antibiotics. Our ED rapidly introduced point-of-care testing for GAS pharyngitis with the aim of rationalizing antibiotic prescribing.

Methods: We rapidly implemented the use of a molecular-based (polymerase chain reaction) point-of-care test for all children scoring 3 or higher on the McIsaac clinical prediction rule for GAS pharyngitis in children …

The Incidence Of Peripartum Invasive Group A Streptococcal Infections And Association With Illicit Drug Use, Elizabeth Wagman, Elizabeth Wagman, Rupsa Boelig, Sarah Boudova

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

From M. Chelonae To M. Immunogenum: A Rare Case Of Dual Nontuberculous Mycobacterial Infection, Ifeanyi Kingsley Uche, Nathalia Simonetti, Andrea Murina

School of Medicine Faculty Publications

No abstract provided.

Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin

Pharmacy and Wellness Review

Antimicrobial resistance is an escalating global threat driven by inappropriate antibiotic use and shaped by socioeconomic disparities. Social determinants of health, including limited healthcare access, poverty, low health literacy, and environmental conditions, contribute to higher rates of resistant infections and poorer treatment outcomes in underserved populations. Barriers such as pharmacy deserts, self-medication, and inadequate stewardship infrastructure amplify these risks. Pharmacists, as accessible and highly trained healthcare professionals, play a critical role in combating antimicrobial resistance by optimizing antibiotic use, delivering culturally competent education, and leading antimicrobial stewardship programs across settings. Community and clinical pharmacists are especially well positioned to bridge …

Exploring Anticoagulation Trends As Early Infection Markers In Pediatric Ecmo And Crrt Patients, Samantha Davidson, Jay Rilinger, Jenna Miller, Caroline Holton, Joshua Herigon, Brian Lee

Research Days

This retrospective cohort study at a tertiary pediatric hospital included ICU patients who developed infections after 72 hours on extracorporeal support from 2017-2023. We assessed whether the number of anticoagulation dose changes are linked to acquired infections.

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

Q Fever Pericardial And Pleural Effusions In A Pediatric Patient, Jonathan Ermer, Ben Kazdan, Cooper Bassham, Jacqueline Walker

Research Days

Background: Q fever is a bacterial infection caused by Coxiella burnetii. Q fever commonly presents with flu-like symptoms (fever, chills, fatigue, myalgias) in patients about 2-3 weeks after exposure to farm animals. Less commonly, Q fever can cause severe illness such as myocarditis, pericarditis, or meningitis. We present a rare case of a pediatric patient with pericardial and pleural effusions secondary to Q fever.

Case presentation: History of present illness: The patient is a 9-year-old female who presented as a referral from an outside hospital due to chest pain, shortness of breath, and 2 weeks of fever. The patient started …

A Modified Sir Model Used To Investigate The Relationship Between Congenital And Adult Syphilis, Kaleesta R. Waysman

Honors Thesis

A complex SIR model integrating the relationship between adult and congenital syphilis was developed. The goal of the project was to determine the specific population(s) or control strategies that should be enforced, altered, or removed to decrease the number of children experiencing clinical sequelae due to congenital syphilis. Early clinical sequelae include hydrops fetalis, preterm birth, central nervous system infection, hepatosplenomegaly, hyperbilirubinemia, cholestasis, hemolytic anemia, snuffles, osteochondritis, and lesions or rashes in the palms and soles. Late clinical sequelae include interstitial keratitis, hearing loss, Hutchinson teeth, saber shins, Clutton joints, mulberry molars, and saddle nose. After implementing real-world data into …

Rapidly Developing Bilateral Loculated Streptococcus Pyogenes Empyema In An Immunocompetent Adult: A Case Report, Anish K Shrestha, Matthew Dwumah-Agyen, Boniface Mensah, Yvette Yeboah-Kordieh, Marcos A Wolff, Jennifer A Evans

Journal of Community Hospital Internal Medicine Perspectives

Streptococcus pyogenes is a rare cause of empyema, especially in immunocompetent individuals. The organism expresses various virulence factors leading to rapid progression of the disease. We report a case of rapidly progressing bilateral loculated empyema caused by streptococcus pyogenes in an immunocompetent host without additional risk factors.

Evaluation Of Human Mesenchymal Stromal Cells (Msc) As An Adjuvant Therapeutic For Chronic Lyme Disease, Matthew Teryek

Rowan-Virtua Research Day

Background: Lyme disease, caused by the spirochetal bacterium Borrelia burgdorferi, is the most prevalent vector-borne illness in the Northern Hemisphere. If undiagnosed or untreated, the disease progresses through multiple stages of increasing clinical severity. While antibiotics such as doxycycline and ceftriaxone are the current standard of care, patients with chronic or late-stage Lyme disease may require additional therapeutic interventions.

Rationale: Human mesenchymal stem cells (MSCs) are of growing clinical interest due to their immunomodulatory properties, low immunogenicity, and potential to promote tissue repair. These characteristics position MSCs as promising adjuvant therapies for chronic Lyme disease, with the potential to …

Impact Of Fluid Composition On Mortality And Kidney Injury In Sepsis: A Literature Review, Kush C. Patel, Simran Gandhi, Harmann Singh, Abdullah Noory, Akash M. Patel

Rowan-Virtua Research Day

Background

Fluid resuscitation is a cornerstone of early sepsis management. While normal saline (NS) has been widely used, emerging evidence suggests that balanced crystalloids such as lactated Ringer’s and Plasma-Lyte may offer improved renal outcomes and reduced mortality by avoiding hyperchloremic metabolic acidosis.

Hypothesis

In adult patients with sepsis, initial resuscitation with balanced crystalloids reduces mortality and the incidence of acute kidney injury (AKI) compared to normal saline.

Methods

A literature review was conducted using PubMed and MEDLINE databases focusing on randomized controlled trials and meta-analyses published from 2010–2024. Key studies included the SMART, SALT-ED, BaSICS, and PLUS trials. The …

A Ticking Time Bomb: An Overview Of A Case Report Of Neutropenic Fever Secondary To Tick-Borne Illness, Yasemin Galiboglu, Danielle Thor, Joann Ha, Kristine Wong, Cindy Hou

Rowan-Virtua Research Day

The advent of immunomodulatory therapies and their ever-expanding number of treatment indications necessitates the understanding of their associated complications. Neutropenic fever serves as an example of these complications often encountered in clinical practice. Although neutropenic fever can result from virtually any pathogen, episodes of the syndrome secondary to tick-borne illness remain relatively undocumented in the scientific literature. In the case presented, a 77-year-old female with a pertinent past medical history of smoldering IgG multiple myeloma on active immunosuppressive therapy presented with a first-time episode of neutropenic fever likely secondary to tick-borne illness. Through this overview of a broader report, attention …

Case Report: A Case Of Tracheal Perforation, Cyrus Davati, Eric Maddock

Rowan-Virtua Research Day

Here we present the case of a 93-year-old female with a past medical history of arthritis and dementia who came to the hospital for a change in mental status and decreased responsiveness at home. The patient was intubated at home by EMS secondary to continued respiratory distress. The patient had a history of a productive cough over the past three days. The patient arrived at the emergency department with continued respiratory failure. During the ED evaluation, the patient was noted to have tracheal rupture. The patient was admitted to the ICU for severe sepsis and continued on broad spectrum IV …

An Unusual Cause Of Sepsis: Capnocytophaga Canimorsus, Capnocytophaga, Christopher Dellmyer, Kishan B. Patel

Rowan-Virtua Research Day

Septic shock can be caused by numerous different pathogens. A few of the more common causes are Streptococcus Pneumoniae, Staphylococcus Aureus, Escherichia Coli, Pseudomonas Aeruginosa, and Candida Albicans. Although these are the pathogens involved in the majority of septic shock cases, it is imperative to take the entire clinical picture into account when treating a patient with septic shock. Here we will discuss a seemingly unimpressive dog bite leading to Capnocytophaga canimorsus bacteremia, septic shock and end organ failure.

Case Report: Haemophilus Influenzae Meningitis In A 65 Year Old Female, Kaywan Saed, Russell Mordecai

Rowan-Virtua Research Day

We report a case of a 65-year-old female who presented with fever, altered mental status, and neck stiffness. Cerebrospinal fluid (CSF) analysis confirmed Haemophilus influenzae meningitis. The differential diagnosis of bacterial meningitis in older adults is broad and includes Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, and Haemophilus influenzae. However, in the post-Hib vaccine era, non-typeable H. influenzae has emerged as a significant cause of invasive disease in older adults, particularly in those with underlying comorbidities.

Older patients often present with atypical symptoms, which may delay diagnosis and treatment. In this case, early recognition and prompt administration of empiric antibiotic therapy …

The Impact Of Emergency Room Overcrowding On The Incidence Of Healthcare-Acquired Infections Among Patients, Hayya Ali

Rowan-Virtua Research Day

Emergency department (ED) visits are vital components of healthcare delivery, serving as the primary site for acute medical care, particularly for individuals with urgent medical needs. The ED is among the most crowded hospital units. The fast-paced setting and over-crowdedness of an emergency room have become the reality of every hospital across the United States. Overcrowding causes problems for patients and staff, which include the risk of contracting healthcare-acquired infections. This is due to several factors that in most cases lead to an increase in the number of people within the ED, an increase in mortality and morbidity, and a …

Assessing The Efficacy Of Prolonged Doxycycline Pep Use In High-Risk Populations For Sti Prevention, Lam Doan, Pearl Joslyn, Lizann Sung, Timothy Breiner, Sarah Marotta, Shikhar Rastogi

Rowan-Virtua Research Day

First recommended in October 2022, doxycycline post-exposure prophylaxis (DoxyPEP) has been increasingly used as a treatment for multiple sexually transmitted infections (STIs). To evaluate the efficacy of prolonged DoxyPEP use in high risk populations - men who have sex with men (MSM) and transgender women - for STIs, different sources addressing various aspects of DoxyPEP, its efficacy in STI prevention, and the potential consequences of its widespread use in terms of antimicrobial resistance were examined. Across 9 studies, DoxyPEP was found to decrease the incidence of bacterial STIs, specifically, syphilis, chlamydia, and gonorrhea with varying efficacy, especially for gonorrhea. Furthermore, …

Case Report: When Confusion Signals A Crisis: Rethinking The Diagnosis Of Meningitis In Geriatric Sepsis, Asma Zahid

Rowan-Virtua Research Day

We report the case of an 88-year-old female who presented with altered mental status, initially suspected to have urosepsis but ultimately diagnosed with streptococcal meningitis. The patient had a history of lethargy and anorexia over the past few days and was found to have sepsis. Despite initial focus on urosepsis, blood cultures revealed Streptococcus, and cerebrospinal fluid analysis confirmed bacterial meningitis. This case highlights the potential for meningitis to be overlooked in elderly patients with suspected sepsis, underscoring the importance of broad diagnostic considerations and early intervention. This case highlights the importance of considering meningitis in elderly patients presenting with …

Case Report: Dissecting Retroperitoneal Abscess With Gas Formation, David F. Koziel Jr.

Rowan-Virtua Research Day

Presenting as a case to the emergency department was a 53-year-old male with a complaint of diffuse abdominal pain and focal right flank pain at site of recent percutaneous abscess drain site performed exactly one month prior. This followed hospitalization in the preceding year for complicated multifocal intra-abdominal infections requiring surgical interventions including exploratory laparotomy and surgical debridement for intra-abdominal abscess and scrotal abscess formation. Despite prior aggressive management and extensive coverage with broad-spectrum antibiotics, this patient was found to have fulminant recurrance of infection in the right retroperitoneal space with an expanding abscess dissecting through the retroperitoneal structures into …

Use Of Procalcitonin In Therapeutic Decisions In The Pediatric Intensive Care Unit, Pierre Tissières, Elisabeth Esteban Torné, Johannes Hübner, Adrienne Randolph, Corsino Rey Galán, Scott Weiss

Department of Medicine Faculty Papers

Procalcitonin (PCT) is frequently used by clinicians in children with suspected bacterial infections and sepsis. However interpretation in the critically ill child may be challenging due to the complexity of underlying conditions and its impact on PCT values. Herein, we propose a guidance for the use of procalcitonin in critically ill children, supported by a comprehensive analysis of the literature, to help the clinician for interpreting PCT in the various clinical conditions encountered in pediatric intensive care units. We describe the importance of the clinical context, timing of measurement and evidence on PCT values in diagnosing sepsis and to guide …

24 Hours Of Postoperative Oral Antibiotics For Same-Day Discharge After Hip And Knee Arthroplasty Has Low Rate Of Prosthetic Joint Infection, Phillip Mckegg, Colton L. Clymer, Hamza Raja, Alexander Driessche, Gabriel Boudagh, W. Trevor North Md, Michael A. Charters Md

Medical Student Research Symposium

Title: 24 Hours of Postoperative Oral Antibiotics for Same-Day Discharge After Hip and Knee Arthroplasty Has Low Rate of Prosthetic Joint Infection

Authors: Phillip C. McKegg, MS, Colton Clymer, BS, Hamza Raja, BS, Alexander Driessche, MSE, Gabriel Boudagh, BS, W. Trevor North, MD, Michael A. Charters, MD

Introduction:

There is no clear consensus on postoperative antibiotic protocols for same-day discharge hip and knee arthroplasties. This study evaluates prosthetic joint infection (PJI) rates in patients discharged with 24 hours of oral antibiotics after surgery.

Methods:

A retrospective review was conducted on 1,843 patients who underwent primary hip or knee …

Clinical Characteristics And Outcomes Of Pediatric Staphylococcal Scalded Skin Syndrome (Ssss) At An Inner-City Tertiary Care Center, Nina Kb Gust Md, Ashley Frei Bs, Rebecca M. Adams Bs, Elika Ridelman Phd, Christina Shanti Md, Ronald Thomas Phd, Jocelyn Y. Ang Md

Medical Student Research Symposium

Introduction

Staphylococcal Scalded Skin Syndrome (SSSS) is a blistering skin condition caused by a toxin-producing staphylococcus species. Epidemiologic studies on pediatric SSSS in the United States are limited, with a reported incidence of 7.67 cases per million children and 45.1 per million infants. Immature renal function, lack of protective antibodies, and increased exotoxin target desmoglein-1 are hypothesized to increase incidence in younger children. We aimed to determine clinical and microbiological characteristics of pediatric SSSS and factors that could help predict disease severity.

Methods

A retrospective chart review was performed for admitted patients under 18 years old diagnosed with SSSS from …

Streamlining The Journey Of Research Into Clinical Practice: Making Your Patients And Practice Flourish Evaluation And Treatment Of Pyogenic Spondylodiscitis Of The Spine: Ao Spine Knowledge Forum Trauma And Infection, Sebastian F. Bigdon, Emiliano Vialle, Charlotte Dandurand, Julian Scherer, Gaston Camino-Willhuber, Andrei F. Joaquim, Harvinder S. Chhabra, Mohammad El-Sharkawi, Richard Bransford, Charles G. Fisher, Klaus J. Schnake, Gregory D. Schroeder

Rothman Institute Papers

Study DesignLiterature Review with clinical recommendations.ObjectiveTo highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.MethodsFive influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.ResultsFive studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, …

Increasing Risk Of Postlung Transplant Hospitalizations For Infection: An Analysis Of Recent Trends, Shi Nan Feng, Armaan F. Akbar, Alice L. Zhou, Andrew Kalra, Sean Agbor-Enoh, Christian A. Merlo, Errol L. Bush

SKMC Student Presentations and Publications

BACKGROUND: Despite advancements in lung transplantation (LT), infection remains a major cause of morbidity and mortality following LT. We examined trends in hospitalizations for infection in the first year after LT.

METHODS: We identified adult LT recipients in the United States (March 1, 2018-March 9, 2023) using the Organ Procurement and Transplantation Network database. We categorized transplants into 3 eras to account for the Composite Allocation Score allocation policy change and coronavirus disease 2019: March 2018 to March 2020, March 2020 to March 2022, and March 2022 to March 9, 2023. One-year post-LT survival was compared using Kaplan-Meier survival analysis …

Ultrasound-Triggered Release Of Vancomycin From A Novel Spinal Device: Antibiotic Release And Efficacy In Vivo, Lauren J. Delaney, Priscilla Machado, Ji-Bin Liu, Rachel Evans, Asia Winslow, Neil Zhao, Christopher K. Kepler, Rajkishen Narayanan, Teeto Ezeonu, Viren Soni, Gagan Kaushal, Rachel Hilliard, Thomas P. Schaer, Noreen J. Hickok, Flemming Forsberg

Department of Orthopaedic Surgery Faculty Papers

Post-surgical spinal infection occurs in up to 20 % of patients, despite aggressive peri-operative antibiotic treatments. To improve prophylaxis, we have designed and evaluated an ultrasound-activated prophylactic antibiotic release system to combat post-surgical bacterial survival. Polylactic acid (PLA) clips (1 cm³) were 3D-printed with an interior reservoir (0.8 cm³) for carrying drug payload, specifically vancomycin (VAN). Under IACUC approval, clips were surgically implanted into the spines of sheep (n = 9) and swine (n = 2) by removing the spinous process at several levels of the lumbar spine. In the sheep, clips were insonated and the …

A Longer Duration Of Intravenous Antibiotic Treatment For Patients With Early Periprosthetic Joint Infections Is Not Associated With A Lower Failure Rate, Janneke Meijer, Alex Soriano, Wierd Zijlstra, Bas Ten Have, Saad Tarabichi, Paul Jutte, Javad Parvizi, Marjan Wouthuyzen-Bakker

Rothman Institute Papers

BACKGROUND: In recent years, many studies have demonstrated the efficacy of an early switch to oral antibiotics after surgical treatment in orthopedic-related infections. However, large analyses on periprosthetic joint infections (PJIs) are lacking.

MATERIAL AND METHODS: We conducted a retrospective observational multicenter study in patients diagnosed with an early post-operative PJI, defined as one occurringdebridement, antibiotics, and implant retention (DAIR). Patients from Europe and the USA were included. We took advantage of the fact that an early oral antibiotic switch is routine practice in Europe as opposed to a long duration of intravenous (IV) antibiotic treatment in the USA. Failure …

Emphysematous Cystitis In A 60-Year-Old Female Who Had Reported No Medical Care For Decades, Taylor O'Brien, Scott Scher, Brian Wexler, Daniel Breznau, Karen Joseph

West Florida Division GME Research Day 2025

No abstract provided.