Bacterial Infections and Mycoses Commons^™

The Effect Of Empiric Initiation Of Treatment On Outcomes Among Patients Presenting With Extrapulmonary Mycobacterium Tuberculosis Infection In A Community Hospital Setting, Talha Awwal, Faisal Raja Kh, Hanya Awaba, Waseem Anwar, Jinma Ren, Muhammad Aamir Safdar, Saqib Walayat, John J. Farrell

Journal of Community Hospital Internal Medicine Perspectives

Background: Extrapulmonary tuberculosis (EPTB) accounts for ~20% of Mycobacterium tuberculosis infections in Pakistan. Diagnostic delays are common and may worsen outcomes. We evaluated whether empiric treatment initiation improves outcomes among patients with EPTB at a large public hospital in Islamabad, Pakistan. Methods: Retrospective cohort of consecutive EPTB cases at Pakistan Institute of Medical Sciences (January–June 2016). Patients were categorized as clinically diagnosed (symptoms/radiology) or laboratory-supported (histology, microbiology, or biochemical tests). Standard Directly Observed Therapy Short-course (DOTS) based regimens were used. Outcomes were treatment success, failure, loss to follow-up, and mortality; groups were compared using chi-square testing. Results: Of 317 EPTB …

Lungs And Beyond: Seizures As Presenting Symptom In A Patient With Mycobacterium Chimaera Infection, Samar Mehyar, Tripti Adhikari, Shweta Kambali, Harneet K. Ghumman, Avneet K. Ghumman, Parul Sud, Mehrshad Fathian Sabet, Elizabeth Mikhail, Sohrab Singh

Journal of Community Hospital Internal Medicine Perspectives

Mycobacterium chimaera is a slow-growing, non-tuberculous mycobacterium (NTM) that belongs to the Mycobacterium avium complex (MAC). It first emerged as a pathogen after being associated with infections in patients who underwent cardiothoracic surgery when patients were getting exposed to heater cooler units, especially those requiring extracorporeal membrane oxygenation (ECMO) or prosthetic valve placement. We report an atypical presentation of M. chimaera infection in a patient with COPD, but no prior history of cardiac surgery or immunosuppression.

Case Report: Necrotizing Pneumonia, Veroneka Mikhail Md

Rowan-Virtua Research Day

Necrotizing pneumonia is an uncommon but severe complication of community-acquired pneumonia (CAP), characterized by progressive parenchymal liquefaction, cavitation, and destruction of normal lung architecture, and associated with significant morbidity and mortality. Clinicaly, early presentations may be indistinguishable from uncomplicated pneumonia (pna), with fever, cough, pleuritic chest pain, and dyspnea, which can delay recognition in the emergency department. Differential diagnosis for these symptoms is broad and includes uncomplicated pneumonia, septic emboli, lung abscesses, and pleural effusion. However, patients effected with necrotizing pneumonia often exhibit more severe systemic toxicity, rapid progression of respiratory failure, and hemodynamic instability. In this case report, we …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Hyperglycemia And Mycoplasma Pneumoniae Cards Toxin Impacts On Lung Epithelial And Fibroblast Injury And Recovery, Alejandra Y. Delgado, Naila Villagomez, Shuri Magdalene

Posters - 2026

Mycoplasma pneumoniae CARDS toxin induces cytotoxicity and inflammation in lung epithelial cells²·¹⁰·¹¹, while hyperglycemia independently elevates ROS and disrupts fibroblast repair¹·⁵·⁸, contributing to the heightened respiratory infection severity seen in diabetic patients¹. However, the interaction between hyperglycemic conditions and CARDS toxin-induced lung injury remains unexplored.

This study investigates how increasing high-glucose (HG) pre-conditioning modifies CARDS toxin-induced injury and recovery in A549⁶ and IMR-90⁷ cells compared to normal glucose (NG ≈ 5mM) controls. We hypothesized that increasing glucose pre-conditioning concentrations would produce a dose-dependent increase in CARDS toxin-induced oxidative stress¹² and inflammatory cytokine production¹⁵ in IMR-90 and A549 compared with normal …

A Rare And Challenging Polymicrobial Pleural Infection Involving Cupriavidus Pauculus In A Patient With Rheumatoid Arthritis And Multiple Complications, Moiz Ahmed Khan, Syeda Samiya Kamal, Muhammad Muneeb, Summaya Zafar

The University of Louisville Journal of Respiratory Infections

A 58-year-old female with a 15-year history of rheumatoid arthritis (RA) and a history of treatment consisting of methotrexate, hydroxychloroquine, leflunomide, and chronic prednisolone therapy, presented with fever, productive cough, dyspnea, and left leg cellulitis. She developed septic shock complicated by tension pneumothorax requiring emergency thoracostomy and non-ST-elevation myocardial infarction (NSTEMI). Pleural fluid culture grew Cupriavidus pauculus, a rare environmental gram-negative bacillus, alongside Burkholderia cepacia and Candida parapsilosis, indicating polymicrobial infection which was most likely predisposed by patient's immunosuppressed state from RA and prolonged steroid use. Treatment consisted of trimethoprim/sulfamethoxazole, meropenem, fluconazole, and cardiopulmonary support, and culminated in …

Invasive Aspergillosis In An Immunocompetent Patient, Grant Haden, Alexis Lopez Cruz, Julianna Vecchio, Munanchui Poudel, Sahista Kapadia, Zuhair Ali

Gulf Coast Division GME Research Day 2026

No abstract provided.

The Uncommon Suspect: Cavitary Pulmonary Tuberculosis In A Previously Healthy Adult In Colorado, Nikita Zanko, Cristina Lee, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Invasive Pulmonary Aspergillosis: A Two-Year Journey, Jason Woods, Padmaditya Sureddi, Nga Van, Danielle Ford

North Texas GME Research Forum 2026

BACKGROUND: Highly active anti-retroviral therapy (HAART) has decreased the incidence of opportunistic infections among persons with HIV. Invasive aspergillosis specifically is uncommon among individuals with clusters of differentiation 4 (CD4) count >100 cells/mm3. Furthermore, treatment of aspergillosis in the HIV-infected population has not been examined systematically. We report a patient with CD4 count >200 cells/mm3, compliant with HAART therapy who developed invasive pulmonary aspergillosis (IPA) over the course of two years that was successfully treated through a combination of bronchial artery embolization and liposomal amphotericin.

CASE PRESENTATION: A 56-year-old man from southern Africa with four-year history of HIV-1 on HAART …

Impact Of Sputum Collection Within 24 Hours Of Admission For Patients Hospitalized With Pneumonia, Sally Baker, Madelaine Duarte, Lauren Kirk, Mohamed Faris

South Atlantic Division GME Research Days 2026

No abstract provided.

Diagnostic Accuracy Of Nanopore Sequencing For Detecting Mycobacterium Tuberculosis And Drug-Resistant Strains: A Systematic Review And Meta-Analysis, Timothy Hudson David Culasino Carandang, Dianne Jaula Cunanan, Gail S. Co, John David Pilapil, Juan Ignacio Garcia, Blanca I. Restrepo, Marcel Yotebieng, Jordi B. Torrelles, Kin Israel Notarte

Ateneo School of Medicine and Public Health Publications

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB) infection, remains a significant public health threat. The timeliness, portability, and capacity of nanopore sequencing for diagnostics can aid in early detection and drug susceptibility testing (DST), which is crucial for effective TB control. This study synthesized current evidence on the diagnostic accuracy of the nanopore sequencing technology in detecting MTB and its DST profile. A comprehensive literature search in PubMed, Scopus, MEDLINE, Cochrane, EMBASE, Web of Science, AIM, IMEMR, IMSEAR, LILACS, WPRO, HERDIN Plus, MedRxiv, and BioRxiv was performed. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled …

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 …

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.

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 …

Necrotizing Alternaria Pneumonia In An Immunocompetent Male, Joel Mathews, Jose Aguilar-Martinez, Sean Sojdie, Zain Tariq, Tamer Hudali

North Texas Research Forum 2025

Abstract: Alternaria species is a rare cause of invasive fungal pneumonia, typically described as an opportunistic pathogen, usually seen in immunocompromised patients producing virulent forms of sinus, cutaneous, and ocular infections. Alternaria species sparingly affect immunocompetent individuals and are often managed without any medical interventions. We present a case of invasive fungal necrotizing pneumonia caused by Alternaria alternata species in an immunocompetent 28-year-old male with only a past medical history of well-controlled asthma managed with an as-needed albuterol inhaler. His complaints included worsening foul-smelling productive cough with yellow-dark brown sputum along with subjective fevers, chills, chest pain, and dyspnea for …

The Importance Of Early Source Control: A Case Of Resistant Mrsa, Jack Demirjian, Paul Mathew

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Ribosome Hibernation In Mycobacterium Abscessus And Its Effect On Antibiotic Resistance, Ryan Treen

Electronic Theses & Dissertations (2024 - present)

Non-tuberculosis mycobacteria (NTM) represent a diverse repertoire of species, most of which are ubiquitous in the environment. Some NTM species, such as Mycobacterium abscessus, can cause life-threatening infections in people with underlying medical conditions. The clinical incidence of such infections is on the rise, posing an emerging threat to public health. M. abscessus is characterized by intrinsic and acquired antibiotic resistance, complicating treatment strategies. Most chemotherapeutic approaches for M. abscessus infection target the bacterial ribosome, necessitating a better understanding of the physiological processes which confer this resistance. Multiple mycobacterial species respond to zinc-limiting conditions by inducing remodeling and hibernation …

To Be Or Not Tb, Gerald Chang, Leidy Huie Martinez Md, Carlos Correa Md, Jose Melendez Md, Brittany Puebla Ms, Yeissen Godinez Md

HCA-NSU MD Research Day

Introduction: Tuberculosis (TB) is an aerosol-transmitted disease that primarily affects the lungs, with active infection presenting as fever, night sweats, weight loss, and productive cough. While it is prevalent worldwide, there may be a lower degree of clinical suspicion in developed countries where it remains uncommon. Therefore, it is important to focus on certain risk factors (travel history, immunosuppression, certain living conditions) in the patient workup. The purpose of this case report is to discuss the presentation and management of a patient with active TB presenting atypically. Case Description: The 47yo male patient with a recent history of pneumonia presented …

Pleural Effusions In Patients Diagnosed With Pneumonia In Urgent Care Clinics, Nathan C. Dean, Jacqueline R. Eve, Allison M. Butler, James H. Hart, Theadora Sakata, Karen E. Connor, Edward A. Stenehjem, Y.C.G. Lee

The University of Louisville Journal of Respiratory Infections

Introduction: Pleural effusions in patients with community-acquired pneumonia have been associated with worse outcomes in emergency department and hospital inpatient populations, but the incidence of effusions and their outcomes in outpatient urgent care clinics is unknown. This observational cohort study describes patients diagnosed with pneumonia and pleural effusions on upright 2-view chest X-rays performed in urgent care clinics.

Methods: We extracted electronic health record data from January 2019 through December 2020 on all patients over 12 years old with an International Statistical Classification of Diseases 10^th revision diagnosis of pneumonia entered by the treating clinician, plus “possible” or “likely” …

Medmicromaps, A Novel Decision-Tree Guide For Infectious Diseases Differential Diagnoses, And Evaluation Of Pre- And Post-Pandemic User Engagement By Preclinical Medical Students, Jason Ceballos, Tavsimran Luthra, Lucia Garces-Torres, Valerie Lentz, Jack Nelson, Claudia Carceles-Roman, Ian Holyoak, Jane Harrington

International Journal of Emerging and Disruptive Innovation in Education : VISIONARIUM

Background: Medical education has undergone major changes in the past 5 years to adapt to the digital-centered student population with diverse learning preferences. To address the challenges of shifting delivery modalities, multimedia resources were created to provide interactive e-learning material on infectious diseases for year 2 medical students.

Methods: Medical students at a USA-accredited Caribbean medical school were provided with supplemental e-learning materials including animations, illustrations, diagnostic algorithms aka MedMicroMaps, and Case-Based tutorials. Participants were classified by semester and lecture delivery: In-person: Cohort 1 (n=526); Virtual: Cohort 2 (n=651); and Hybrid: Cohort 3 ( …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

The Transmission Of Oropharyngeal Squamous Cell Carcinoma, Kunjal Patel, Aleesha Thomas

Mako: NSU Undergraduate Student Journal

The existence of Oropharyngeal Squamous Cell Carcinoma (OPSCC) has recently been found to have correlations with the Human Papillomavirus. HPV-associated OPSCC exhibits a unique method of infection and transmission and has made this branch an emerging disease in the recent decade. This systematic review of the literature was conducted to further explore research into Oropharyngeal Squamous Cell Cancer (OPSCC). Commonly referred to as “throat cancer”, this growth originates in the oropharynx. Symptoms of this condition include sore throat, lumps in the neck, and difficulty with swallowing. OPSCC has many variants but has shown a strong association with Human Papillomavirus (HPV), …

A Common Complaint With An Unexpected Diagnosis: A Case Of Mycobacterium Avium Complex Pulmonary Abscesses, Maryam Fallahi, Mark Cheneler, Qazi Haider, Madhukanth Reddy

North Texas GME Research Forum 2024

Introduction: Mycobacterial infections are an atypical organism for pulmonary infections. These infections are classically separated in tuberculous (MTB) and nontuberculous (NTM) groups due to their differing pathogenicity and microbiologic therapy regimens. MTB is typically treated with a 4-drug therapy known as RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) however NTM is typically treated with 3- or 4-drug therapy with a backbone of rifampin, macrolide, and ethambutol. Due to the long courses of therapy required for NTM, stringent diagnostic criteria of clinical, radiologic, and microbiologic findings are required. Despite meeting all 3 criteria for diagnosis, not every patient is a candidate for …

Critical Airway Obstruction Secondary To Acute Necrotizing Tracheitis, Vishesh Persaud, Austin Makadia, S Choudhury, A Chohan, Abhay Vakil

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Ribosome Hibernation Factor Induces Antibiotic Persisters Of Mycobacterium Tuberculosis In Neutrophil-Rich Lung Lesions, Jamie Corro

Electronic Theses & Dissertations (2024 - present)

Mycobacterium tuberculosis (Mtb), the etiological agent of tuberculosis, is a prescient global health threat and the leading cause of death by an infectious agent. Treatment of Mtb infection involves administering 2-4 antibiotics for a minimum of 6 months. This extended drug regimen is required to target a subpopulation of persistent bacilli. As their name implies, these bacteria can “persist” by acquiring nonhereditary and transient antibiotic tolerance. Although the precise mechanism is unknown, it’s often attributed to slowing cellular growth and metabolic processes. During zinc deprivation, bacteria can remodel their ribosomes by replacing their zinc-binding paralogues containing the CXXC motif (C+) …

A Case Report Of A Primary Cerebral Abscess Due To Nocardia Asteroides In An Immunocompetent Patient, Ileana Elita Mendez, Nicole Marie Barreto, Alan Lanurias, Luis Alberto Rosas

Research Symposium

Background: Brain abscesses caused by Nocardia are rarely reported and have high mortality. It usually affects patients who are immunocompromised and initiates as a lung infection that disseminates hematogenously, though it can also affect those immunocompetent. Cerebral nocardiosis imitates brain tumors, which can delay the initiation of the appropriate antibiotic therapy.

Case Description: We present a case of a 64-year-old immunocompetent male with multiple cerebral abscesses who presented with headaches, left-sided weakness, and ataxia. Upon imaging, multiple brain lesions were revealed. The patient underwent craniotomy and drainage of the mass. He was initially empirically treated, though cultures later grew Nocardia …

Additive Effects Of Cyclic Peptide [R4w4] When Added Alongside Azithromycin And Rifampicin Against Mycobacterium Avium Infection, Melissa Kelley, Kayvan Sasaninia, Arbi Abnousian, Ali Badaoui, James Owens, Abrianna Beever, Nala Kachour, Rakesh Kumar Tiwari, Vishwanath Venketaraman

Pharmacy Faculty Articles and Research

Mycobacterium avium (M. avium), a type of nontuberculous mycobacteria (NTM), poses a risk for pulmonary infections and disseminated infections in immunocompromised individuals. Conventional treatment consists of a 12-month regimen of the first-line antibiotics rifampicin and azithromycin. However, the treatment duration and low antibiotic tolerability present challenges in the treatment of M. avium infection. Furthermore, the emergence of multidrug-resistant mycobacterium strains prompts a need for novel treatments against M. avium infection. This study aims to test the efficacy of a novel antimicrobial peptide, cyclic [R4W4], alongside the first-line antibiotics azithromycin and rifampicin in reducing M. avium survival. Colony-forming unit (CFU) …

On The Respiratory Syncytial Virus Vaccine, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Use Of Osteopathic Manipulative Medicine To Treat Common Pediatric Conditions: A Literature Review, Sonya Priven, Emily Meale, Danielle Cooley

Rowan-Virtua Research Day

Context: Doctors of Osteopathic Medicine (DOs) are physicians who are trained in the practice of osteopathic manipulative treatment (OMT). OMT is a form of manual manipulation that can be applied to the patient’s body to aid the body in its own healing properties. The overprescribing and overuse of medication is currently a problem, as it can result in adverse consequences such as antibiotic resistance. Exploring OMT as either an alternative or as a complementary therapy in the pediatric population is beneficial in potentially curbing antibiotic use and improving symptoms and disease-related processes.

Objective: To explore OMT as a therapy for …

Case Report: Cavitary Pneumonia In A 28 Year Old Male, Dan Zaayenga, Katelyn Courtney

Rowan-Virtua Research Day

Cavitary pneumonia can be caused by several different mechanisms. Such causes include suppurative necrosis (pyogenic lung abscess), caseous necrosis (tuberculosis), ischemic necrosis (pulmonary infarction) cystic dilatation of lung structures (ball value obstruction and Pneumocystis pneumonia) as well as malignant processes. Causes are subject to both environmental factors and host susceptibility. The most common cause of infectious process is tuberculosis with its propensity to cause extensive caseous necrosis. The potential for secondary infection after an individual develops a cavitary pneumonia is also great as it provides a shelter for various pathogens the flourish in an environment otherwise usually well-guarded by host …