Infectious Disease Commons^™

Real-World Clinical Burden Of Patients Presenting With Vaginitis Symptoms In The United States, Justin Chen, Jenny Tse, Liucheng Shi, Mindy M. Cheng, Rebecca Lillis, Aimee M. Near

School of Medicine Faculty Publications

Background: While vaginitis is a leading cause of primary care visits among women with a gynecologic-related diagnosis, there are limited contemporary data on the healthcare burden. This study describes the real-world healthcare resource utilization (HCRU) of patients presenting with vaginitis symptoms in the United States (US) at symptom presentation and over long-term follow-up. Methods: This retrospective study utilized IQVIA's Longitudinal Prescription (LRx) and Medical Claims (Dx) databases to capture patients presenting with vaginitis symptoms from January 1, 2018 to September 30, 2022. The date of the first diagnosis code for vaginitis or related symptoms was considered the first clinical presentation …

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 …

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 …

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, …

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 …

Aerosolized Transmissible Diseases Guidance Document, J. David Miller, John P. (Jack) Springston Jr., Cheryl L. Marcham, J. David Krause, Ling-Ling Hung, Wane A. Baker

Publications

Prior to COVID-19, pandemic influenza viruses have emerged four times in the previous one hundred years. This includes “Spanish” influenza (H1N1) in 1918, “Asian” influenza (H2N2) in 1957, “Hong Kong” influenza (H3N2) in 1968, and H1N1 “swine” influenza in 2009 (Saunders-Hastings & Krewski, 2016; Taubenberger, 2005). In early May 2024, the first reported human case of avian flu (H5N1) that had also infected cows in the US appeared in the literature (Uyeki et al., 2024). In late August 2024, OSHA released a hazard alert providing information for dairy workers on avian influenza in dairy cattle, together with personal protective equipment …

Persistent Barriers To Implementation Of Long-Acting Injectable Antiretroviral Therapy, Jessica Hack, Adati Tarfa, Harlan Sayles, Nada Fadul

EMET Projects

No abstract provided.

Strategies To Improve Antibody-Mediated Protection Against Herpes Simplex Virus Infections, Matthew D. Slein

Dartmouth College Ph.D Dissertations

No efficacious vaccine exists for herpes simplex virus and the global burden of disease remains high. Antibodies can serve as potent therapeutics to protect high risk populations such as neonates. Although rare, neonatal HSV (nHSV) infections can result in significant mortality and lifelong neurological morbidity even with antiviral therapy. While HSV-specific maternally derived antibodies significantly reduce the risk of neonatal disease in humans, the mechanisms by which they mediate protection have yet to be described. Using a mouse model of neonatal HSV (nHSV) infections we aimed to determine the mechanisms of antibody-mediated protection using monoclonal antibodies (mAbs) targeting two of …

Atypical Dengue Fever With Severe Hematological Manifestations: A Case From The Rio Grande Valley, Elias Arellano Villanueva, Alhasan Asaad, Jose Campo Maldonado

Research Symposium

Background: Dengue fever, a mosquito-borne viral illness, is endemic in tropical regions, including border regions like the Rio Grande Valley while often self-limited, severe presentations such as dengue hemorrhagic fever and dengue shock syndrome highlight its challenges and complexities. This report describes an atypical dengue case with severe hematological manifestations, underscoring the diagnostic challenges and the importance of early recognition, multidisciplinary evaluation, and evidence-based management.

Case Presentation: A 22-year-old Hispanic female with no significant past medical history presented to the ED with hematemesis and fever following her travel to Monterrey, Mexico. Initial symptoms included high fever (107.6°F), chills, diarrhea, vomiting, …

Mycoplasma Hominis–Associated Septic Arthritis Masquerading As Gouty Arthritis, Angelina Liddy, Carolyn Kramer, Devin M. Weber

Division of Infectious Diseases and Environmental Medicine Faculty Papers

Septic arthritis caused by M. hominis is exceptionally rare. Here, we report on a 62-year-old man with a medical history of gout and renal cell carcinoma who presented with persistent knee pain and swelling following partial nephrectomy complicated by an abdominal abscess. Arthrocentesis revealed monosodium urate crystals, leading to the initial diagnosis and treatment of gouty arthritis using intra-articular steroid injections, allopurinol, and colchicine. Initial cultures yielded no growth. However, faint transparent colonies grew after discharge, which were eventually identified as M. hominis. Initial antibacterial therapy targeting suspect Mycoplasma spp. was begun with doxycycline, and the patient ultimately completed 12 …

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Case Report Of Neurosyphilis, Caroline Finnerty, Elizabeth Diaz, Teena Mathew

North Texas Research Forum 2025

This is the case of a 29 year old female who initially presented with generalized joint aches noted to have neurosyphilis. Because of her delayed treatment, this case presents interesting findings that we classically no longer see in syphilis cases due to early detection and treatment. The case looks at the early symptoms as well as late symptoms if syphilis is left untreated. The patient was ultimately treated with IV penicillin with improvement of her symptoms.

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

Development Of A Proposed Selective Medium For The Isolation And Differentiation Of P. Sordellii, Dimyana Bottros

Honors Undergraduate Theses

Clostridium, a genus of anaerobic, spore-forming bacteria, includes clinically and ecologically significant species like Clostridium difficile and Paeniclostridium sordellii. C. difficile causes antibiotic-associated colitis, while P. sordellii is linked to fatal infections and spontaneous abortions. Recent studies found both species in marine sediments, suggesting their role in environmental and wildlife health disturbances, including the 2013 mass mortality of over 300 manatees in the Indian River Lagoon. However, isolating and differentiating P. sordellii is challenging due to the lack of selective media optimized for its growth. This thesis proposes a novel selective medium tailored to P. sordellii’s physiological …

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

Design, Synthesis, And Nmr-Guided Characterization Of A Targeted Covalent Inhibitor-Like Molecule Against Ivyp1 From P. Aeruginosa, Samuel Taylor Moore

Master's Theses

Multi-drug resistance poses a serious threat to future generations and historical antibiotic pipelines; consequently, the medical and economic burdens associated with treating multidrug-resistant bacteria are substantiated. In this context, P. aeruginosa (PA) emerges as one of the most significant healthcare challenges, being a leading cause of resistance-associated mortality worldwide. Despite modern efforts to combat these poor outcomes, drug-resistant cases continue to rise, and the need for novel antibiotic treatment is apparent. To this end, we investigated relevant resistance mechanisms and past antibiotic targets within PA, and in doing so, we identified relationships between peptidoglycan biology and a periplasmic protein, Inhibitor …

Immunization-Related Complex Regional Pain Syndrome: A Systematic Review Of Case Reports, William K Copenhaver, Brandon J Goodwin, Alexa Simonetti, Kunal P. Shah, Nicholas J Averell, David F Lo, Richard T Jermyn

Rowan-Virtua School of Osteopathic Medicine Departmental Research

AIM: Vaccines have been shown to have the highest efficacy in preventing infectious diseases through their ability to induce immunological memory against pathogens. An adverse reaction to a vaccine is an unexpected medical occurrence following immunization. Complex regional pain syndrome (CRPS) is a disease that has undergone much controversy regarding its onset post-vaccination. This systematic review aims to evaluate cases of CRPS post-vaccination to better understand the manifestation of the disease and its potential association with vaccines.

METHODS: A systematic review of case reports was conducted employing the PRISMA 2020 guidelines. Outcomes of interest include type of vaccination, patient age, …

Antibiotics For Acute Watery Or Persistent With Or Without Bloody Diarrhoea In Children: A Systematic Review And Meta-Analysis, Syeda Kanza Naqvi, Mustafa Bin Ali Zubairi, Ayesha Arshad Ali, Ashraf Sharif, Rehana Abdus Salam, Zain Hasnain, Sajid Bashir Soofi, Shabina Ariff, Yasir Bin Nisar, Jai K. Das

Institute for Global Health and Development

Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea.
Methods: We searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus from inception until 20 July 2023 for studies published after the year 2000 assessing antibiotics vs placebo in acute …

Review Of The Diagnosis, Pathophysiology, And Treatment Of Naegleria Fowleri-Induced Primary Amoebic Meningoencephalitis, Terrance Zhang

MCB Articles

Naegleria fowleri is a thermophilic, ubiquitous, free-living amoeba, but is also known as the “brain-eating” amoeba. This is the etiological agent of a rare and fulminant waterborne disease known as Primary Amoebic Meningoencephalitis (PAM) that is acutely fatal in 90-99% of reported cases. Those who come into contact with infested waters are at risk of introducing the amoeba into their upper nasal canal, whence the trophozoite form is known to migrate along the olfactory nerve, through the cribriform plate, and enter the central nervous system. Although the exact pathogenesis of N. fowleri is not known, studies have demonstrated contact-dependent and …

Targeted Maternal Chagas Disease Screening Among Individuals Born In A Chagas-Endemic Country., Alvaro Proaño, Neil C Shah, Sneider A Gutierrez Guarnizo, Monica Miranda-Schaeubinger, Michael Z Levy, Robert H Gilman, Dustin D Flannery

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Chagas disease is a neglected tropical disease caused by the parasite Trypanosoma cruzi that affects 6 million people worldwide. In the United States, Chagas is estimated to affect 43 000 women of reproductive age. Pregnant persons with Chagas are at risk for congenital transmission to the newborn, which accounts for nearly a quarter of all new cases. In 2022, a US multidisciplinary expert working group4 developed recommendations for increased clinician-directed screening for Chagas. They concluded that women of reproductive age who were born in endemic countries should be tested due to vertical transmission risk. In 2024, Clark and Bern outlined …

From Infection To Encapsulation; A Case Report On Encapsulating Peritoneal Sclerosis, Clinical Challenges And Management, Sidra Memon Md, Jacob Seth Psomiadis Md, Syed Uzair Mahmood, Jennifer Hoffman Md

Advances in Clinical Medical Research and Healthcare Delivery

Encapsulating Peritoneal Sclerosis (EPS) is a rare but deadly sequlae of peritoneal dialysis resulting in intraperitoneal inflammation and fibrosis. The disease itself can present in a variety of ways and is associated with significant morbidity and mortality. Here we present the case of a man in his 50's with a history of chronic peritoneal aspergillus as well as end-stage renal disease on peritoneal dialysis that had multiple admissions for abdominal fluid collections as well as bowel obstruction. After a multidisciplinary approach, the patient was diagnosed with encapsulating peritoneal sclerosis and then started the recommended therapy of tamoxifen and prednisone.

Acute Syphilitic Posterior Placoid Chorioretinopathy: A Case Report, Kendra R. Null Od, Danielle E. Toms Od, Elizabeth M. Phillips Od, Candice A. Law Od, Ms

Optometric Clinical Practice

Abstract

Background: Acute syphilitic posterior placoid chorioretinopathy is a rare manifestation of ocular syphilis that can significantly impact the patient’s vision. However, it has been shown to have a good prognosis with the appropriate diagnosis and treatment of the underlying systemic syphilis infection. In addition to discussing the details of the case, this report also highlights the systemic staging, diagnosis, and treatment of syphilis. Case Report: This case features a 60-year-old Caucasian male diagnosed and treated for acute syphilitic posterior placoid chorioretinopathy after a recent diagnosis of syphilis. Conclusion: With the incidence rates of syphilis infections increasing, it is imperative …

Houston, We Have A Problem: Diagnostic Difficulties In The Aids Patient With Tuberculosis Infection, Hector D. Preciado, Maria E. Torres, Muhammad A. Siddiqui, Liza Salloum, Lee Gelpi, Jose E. Campo Maldonado

Research Colloquium

Background: Tuberculosis (TB) is the leading cause of infectious death worldwide with 1.5 million deaths annually and nearly 1/4th of the world’s population (1.7 billion) infected with latent tuberculosis infection (LTBI) in 2014. Its diagnosis conventionally relies on tuberculin skin testing (TST), and Interferon-Gamma Release Assay (IGRA) which relies on the production of Interferon Gamma (IFN-y) in response to Mycobacterium tuberculosis (MTB) specific antigens. IGRA is a useful tool for detecting latent TB disease, and can be used as an adjunct for the diagnosis of active TB cases. Increases in IFN-y levels might support the diagnosis of a new TB …

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” …

Unveiling The Complexity Of Nocardia Septic Arthritis In An Immunocompromised Patient: A Case Report, Steven A. Kessler, Meghan R. Mansour, Ali Khreisat, Mamon Tahhan

HCA Healthcare Journal of Medicine

Background

Nocardiosis is the systemic manifestation of Nocardia infection, often found in immunocompromised individuals. Nocardia are transmitted via inhalation or skin wounds, disseminating hematogenously to organs and rarely, joints. We present a patient with immunosuppression who developed gout of the knee with superimposed Nocardial septic arthritis and a possible subsequent systemic infection.

Case Presentation

A 74-year-old man presented with left lower extremity swelling and pain. He was taking immunosuppressive medication for antineutrophilic cytoplasmic antibody-positive vasculitis. A week prior, an arthrocentesis test was positive for gout. He received prednisone without improvement. A repeat arthrocentesis was positive for Nocardia farcinica septic arthritis. …

A Clinical Review On Spinal Epidural Abscess: Epidemiology, Pathophysiology, Diagnosis, And Management For Emergency Medicine And Hospitalist Physicians, Madeline A. Guy, Jeffrey S. Guy

HCA Healthcare Journal of Medicine

Spinal epidural abscess (SEA), a critical surgical emergency, demands prompt recognition and intervention to prevent severe complications and fatalities. The incidence of SEA is notably increasing, particularly among individuals with diabetes, intravenous drug use, or a history of invasive spinal procedures. Although SEA can manifest through various clinical symptoms, the presence of its classic triad—back pain, fever, and neurological deficits—is noteworthy despite its occurrence in only 10% to 13% of cases. Identifying this triad is vital due to its high specificity for SEA, which is essential to guiding swift diagnostic and therapeutic actions in a condition where early intervention is …