Central nervous system infections caused by Pantoea agglomerans are extremely rare, particularly in immunocompetent adults and outside any neurosurgical context. This Gram-negative bacillus, ubiquitous in the environment, is now recognized as an emerging opportunistic pathogen.We report the case of a 63-year-old woman with no notable medical history, admitted for severe headaches that had been evolving for 15 days and were subsequently associated with nausea, vomiting, photophobia, drowsiness, and fever. Clinical examination revealed a meningeal syndrome without focal neurological signs, with a Glasgow Coma Scale score of 15/15. Laboratory investigations showed leukocytosis and elevated C-reactive protein. Lumbar puncture yielded cloudy cerebrospinal fluid, with neutrophil-predominant pleocytosis, elevated protein level, hypoglycorrhachia, and increased lactate level, suggestive of bacterial meningitis.Cerebrospinal fluid culture on blood agar revealed, after 48 hours of incubation, yellow-pigmented colonies, which were identified by MALDI-TOF mass spectrometry as Pantoea agglomerans. The isolate was susceptible to the tested antibiotics, including ceftriaxone, which was initiated upon admission. Despite this management, the clinical course was rapidly unfavorable, marked by severe meningoencephalitis complicated by fatal cardiorespiratory arrest.This case highlights the rarity and potential severity of neuromeningeal infections caused by P. agglomerans in adults.
Ureaplasma species are common colonizers of the genitourinary and respiratory tracts, yet their role in urogenital disease remains incompletely understood. While frequently detected in asymptomatic individuals, Ureaplasma species have also been implicated in a variety of clinical conditions, though definitive causal relationships are often difficult to establish. At the same time, Ureaplasma species are underappreciated causes of severe opportunistic and systemic infections, particularly in neonates and immunocompromised hosts, where complications such as hyperammonemia can be life-threatening. This snapshot reviews Ureaplasma clinical associations, diagnostic challenges and management considerations in the context of emerging antimicrobial resistance.
Advancements in artificial intelligence (AI) are transforming microbial diagnostics, offering significant opportunities for research-driven innovation in clinical microbiology. Traditional diagnostic methods, while effective, are constrained by time-intensive workflows, inter-operator variability, and limited scalability. AI approaches, particularly machine learning (ML), deep learning (DL), and convolutional neural networks (CNN), are being increasingly applied to address these limitations through high-throughput data analysis and predictive modelling. This review critically examines the current applications of AI in microbial diagnostics, including the automated identification of pathogens from culture images and spectral data. It also covers genomic sequence analysis for antimicrobial resistance prediction and outbreak detection via real-time monitoring algorithms. Importance is placed on the methodological frameworks, dataset requirements, and performance metrics used in recent studies. Challenges such as algorithm interpretability, data standardization, and clinical validation are discussed in the context of research reproducibility and translational potential. The review highlights emerging trends, such as integrative AI systems that combine omics data with electronic health records for precision diagnostics. By synthesizing current evidence and identifying key research gaps, this article aims to guide researchers in developing robust, clinically meaningful AI applications that can ultimately enhance diagnostic accuracy, speed, and public health impacts.
Blastomycosis is a systemic infection caused by the thermally dimorphic fungi Blastomyces spp., endemic throughout much of the midwestern, central, and southeastern United States. Disease is often acquired through inhalation of infectious conidia. Clinical manifestations include pulmonary abnormalities, local cutaneous infection, as well as multi-site disseminated disease. Gold-standard diagnosis relies on morphological identification from fungal culture, supported by direct microscopy of clinical specimens, antibody or antigen detection, and secondary confirmation by additional methodologies such as mass spectrometry or nucleic-acid-based assays. Treatment ranges from oral itraconazole for mild pulmonary disease to amphotericin B for severe or disseminated disease.
As the global population of immunocompromised individuals continues to expand, opportunistic pathogens pose a growing threat to public health. JC virus (JCV) of the family Polyomaviridae has a seroprevalence of 50-80% in humans, where it most frequently establishes latency characterized by lifelong asymptomatic infection. Immunosuppression in JCV-infected individuals may cause viral reactivation and lead to the often-fatal demyelinating central nervous system disease known as progressive multifocal leukoencephalopathy (PML). Death of infected oligodendrocytes causes demyelination in the brain, and neurologic disability. Currently, no JCV/PML-specific therapies are proven effective, and treatment generally attempts at immune restoration to clear JC virus from the brain. Therefore, prompt and accurate identification and diagnosis of PML is imperative to prevent disease in at-risk patient populations. Effective diagnosis of PML requires a multidisciplinary approach, integrating clinical neurologic evaluation, radiologic imaging, virologic laboratory testing, and histopathologic examinations for conclusive diagnosis. This review highlights the current approaches for diagnosis of JCV infection and PML, including emerging molecular and serologic markers as predictors of disease risk and outcomes. We also summarize developments in the therapeutic space, which demonstrate the potential to target JCV through chemotherapeutic and immune-mediated strategies. Ultimately, collaborative efforts across both clinical and research realms are imperative to effectively identify, prevent, and treat opportunistic disease caused by JCV.
Biofilms are highly structured microbial consortia encased in a self-generated extracellular matrix that provides exceptional tolerance to environmental stressors and antimicrobial agents. Their involvement in chronic, device-associated, and industrial infections has intensified the search for safe alternatives to conventional antimicrobials. Postbiotics defined as non-viable microbial cells, cellular structures, and fermentation-derived metabolites have recently emerged as promising candidates for biofilm control due to their stability, safety, and multi-targeted biological activities. This review consolidates current evidence on the antibiofilm potential of postbiotics, drawing on studies indexed in PubMed, Scopus, and Web of Science. Postbiotics act through several coordinated mechanisms, including quorum-sensing disruption, inhibition of initial adhesion, modulation of extracellular polymeric substances, direct antimicrobial activity, and immunomodulation. These mechanisms collectively interfere with biofilm initiation, maturation, and persistence. Overall, postbiotics represent a compelling and rapidly advancing approach for managing biofilm-associated infections across clinical, industrial, and environmental domains. However, the translation of these findings into practice requires standardized characterization of postbiotic formulations, mechanistic clarification of active components, and well-designed in vivo and clinical studies.
Burkholderia pseudomallei, the “great mimicker” and etiologic agent of melioidosis, is an environmental Gram-negative bacillus highly endemic to Southeast Asia and northern Australia. Clinical manifestations range from localized skin abscess to severe pneumonia and sepsis. While considered rare, the bacterium can remain latent for decades, making melioidosis a critical differential diagnosis for those with exposure risk, both recent and remote. Laboratory identification requires culture under BSL-3 precautions, and treatment mandates a prolonged, biphasic approach to prevent relapse.
Cefiderocol is the first approved siderophore cephalosporin with a broad spectrum of activity against aerobic Gram-negative bacteria, including multidrug-resistant, carbapenem-resistant and difficult-to-treat resistant strains of Enterobacterales and non-fermenting pathogens. It is approved in the USA for the treatment of complicated urinary tract infection and nosocomial pneumonia. FDA cleared manual methods for cefiderocol susceptibility testing include disk diffusion with standard Mueller–Hinton agar and broth microdilution using iron-depleted cation-adjusted Mueller–Hinton broth. Cefiderocol susceptibility rates typically are >90% by breakpoints set by the Clinical and Laboratory Standards Institute and resistance development involves multiple mechanisms. This snapshot manuscript provides further insights into cefiderocol.
Respiratory syncytial virus (RSV) remains a leading cause of acute respiratory tract infections across all age groups, with the greatest burden observed in infants, older adults, and immunocompromised individuals. Despite its clinical importance, the nonspecific presentation of RSV infection continues to hinder accurate clinical diagnosis, reinforcing the need for reliable laboratory methods. Over the past decades, RSV diagnostics have undergone profound advancement: traditional viral culture has been largely replaced by rapid antigen assays, immunofluorescence techniques, and, most importantly, reverse transcription polymerase chain reaction (RT-PCR), which now serves as the gold standard due to its superior sensitivity and ability to detect co-infections. Emerging technologies, including CRISPR-based assays, ultrafast and isothermal amplification platforms, microfluidic systems, bioluminescent biosensors, and host-response biomarkers, offer further opportunities for rapid, sensitive, and decentralized testing. Improved diagnostic accuracy has significantly influenced public health surveillance, clarified high-risk populations, and facilitated timely prevention strategies. These advances have been accompanied by major progress in RSV immunoprophylaxis, including maternal vaccination, vaccines for older adults, and long-acting monoclonal antibodies such as nirsevimab, all of which have demonstrated substantial real-world effectiveness in reducing hospitalisations and severe disease. Modern diagnostic tools and preventive measures are reshaping clinical practice, informing evidence-based management, and strengthening public health preparedness. This review summarizes current perspectives on RSV epidemiology, clinical features, diagnostic methodologies, emerging technologies, treatment approaches, and prevention strategies, highlighting their combined impact on patient care.
Isolated tuberculous splenic abscess (TSA) is rare in an immunocompetent child, even in endemic countries; most studied series and case reports involve the spleen as part of miliary/disseminated tuberculosis or in immunocompromised patients. A 6-year-old female child presented with a history of fever for 25 days. On physical examination, mild splenomegaly was noted. Contrast-enhanced computed tomography (CECT) of the abdomen revealed a mildly enlarged spleen with a solitary splenic abscess. Fine-needle aspiration cytology showed epithelioid cell granulomas surrounded by caseating necrosis. The Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) detected Mycobacterium tuberculosis DNA in the aspirate. No focus of tubercular infection was detected in the lungs. We report a case of isolated tuberculous splenic abscess in a child who presented with febrile splenomegaly and responded well to antitubercular therapy (ATT) alone. Tuberculous splenic abscess should be considered in the differential diagnosis of febrile splenomegaly, especially in regions where tuberculosis is endemic.
Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a major neglected tropical disease of global significance, currently endemic to Mexico, Central, and South America. Additionally, isolated cases have been reported in neighboring countries, specifically the United States, due to autochthonous transmission. Despite its expanding global reach, Chagas disease remains underdiagnosed due to limitations in diagnostic testing and clinical awareness. Early identification increases the likelihood of accurate detection; therefore, laboratory diagnostics play a critical role in improving patient outcomes.
Laboratory screening and diagnostic testing for sexual health is a key driver for management and prevention of sexually transmitted diseases. Selection and interpretation of appropriate assays for transgender patients requires an understanding of the analytical principle of the assay with consideration of the medical interventions being utilized for gender affirming therapy (e.g., surgical interventions or hormone replacement therapy). Current testing recommendations for cisgender individuals may not be appropriate for patients utilizing gender-affirming care as test interpretation may be impacted. This article provides a review of sexual health testing that may be required for transgender patients while highlighting utilization and interpretation challenges for commonly available assays.
Acute bacterial meningitis (ABM) is a severe infection of the meninges leading to inflammation and neurological complications. Cerebellar hemorrhage (CH) is a rare serious complication of ABM. We report a case of CH secondary to ABM in a healthy 50-year-old man who presented with high-grade fever, headache, vomiting and altered consciousness. Initial CT was normal, while MRI revealed hemorrhagic transformation of left cerebellar infarct with additional non-hemorrhagic infarcts. Cerebrospinal fluid culture confirmed Streptococcus agalactiae sensitive to ampicillin and ceftriaxone. He received antibiotics, corticosteroids, and supportive care, achieving neurological improvement within 72 hours. This report highlights an early diagnosis of S.agalactiae that requires prompt recognition and treatment.\
Lophomonas sp. is a multiflagellated protozoan commonly found in the intestines of cockroaches and is increasingly being recognized as a potential respiratory pathogen. We report an unusual case of a 25-year-old male patient from the Eastern Part of India with chronic rhinitis unresponsive to conventional therapy, in whom Lophomonas sp. was identified in nasal secretions. The patient lived in poor hygienic conditions with a significant cockroach infestation. Microscopic examination of nasal discharge revealed motile, multiflagellated protozoa resembling Lophomonas blattarum. This case highlights the importance of considering rare parasitic infections in individuals with chronic upper respiratory symptoms, particularly those with known environmental exposures.
Japanese Encephalitis Virus (JEV) is a flavivirus transmitted by mosquitoes and one of the foremost causes of viral encephalitis infection in Asia, predominantly occurring in children in rural areas. Initially isolated in Japan in 1924, JEV is largely spread by Culex mosquitoes, notably Culex tritaeniorhynchus and Culex gelidus, breeding in paddy fields. The virus has a zoonotic cycle with pigs as amplifying hosts and ardeid birds as reservoirs. JEV outbreaks reach their peak during the monsoon months (July–September). Severe encephalitis may occur with manifestations such as fever, vomiting, seizures, paralysis, and coma. The case fatality rate is approximately 30 %, and survivors can have long-term neurological complications. JEV invades the central nervous system by crossing the blood-brain barrier, causing neuroinflammation and neuronal damage. Diagnosis is made with serological tests and molecular tests. JEV is endemic in India, Nepal, China, Myanmar, Vietnam, and other Asian nations. In India, 1000–2500 cases occur each year, with underreporting suspected. Bihar is a focused area, with Muzaffarpur district having a high incidence. Control is based on vaccination and vector control. Four vaccines are available, but limited coverage underscores the necessity for increased immunization and surveillance.
Citrobacter koseri is a Gram-negative bacillus of the Enterobacteriaceae family, formerly known as Citrobacter diversus. While this pathogen is known to cause severe infections in neonates, cerebral abscesses due to C. koseri in adults are exceptionally uncommon. We present a rare case of a brain abscess in an elderly man caused by C. koseri, successfully treated with ceftriaxone, resulting in a favorable clinical outcome.
Pertussis, or whooping cough, remains a significant global health concern despite widespread vaccination efforts. Caused by Bordetella pertussis and Bordetella parapertussis, its incidence dramatically declined after vaccine introduction in the 1940s but has resurged recently. Factors contributing to this resurgence include waning immunity, vaccine hesitancy, improved diagnostics, and molecular evolution of the pathogen. Infants bear the greatest disease burden, suffering severe complications such as pneumonia and respiratory failure. Adolescents and adults often act as reservoirs, posing risks to unvaccinated newborns. Diagnosing pertussis is challenging due to symptom overlap with other respiratory infections, particularly in infants. PCR and serology are key diagnostic tools. Macrolide antibiotics remain the mainstay of treatment and prophylaxis, though they do not significantly alter disease progression. Preventive measures emphasize vaccination, including booster doses and maternal immunization during pregnancy. Public health efforts must address vaccine hesitancy and ensure comprehensive immunization coverage to mitigate the persistent threat of pertussis. This review explores the pathophysiology, clinical features, diagnosis, treatment, and prevention strategies for pertussis, as well as factors contributing to its recent resurgence in the United States.
