Primary cutaneous nocardiosis caused by Nocardia nova with possible Apremilast contribution.

Primary cutaneous nocardiosis accounts for 5-8 % of all nocardiosis cases and represents a diagnostic dilemma among immunocompetent and immunocompromised hosts. Herein, we present a case of a 30-year-old male with history of psoriasis with recent addition of Apremilast. Patient received intralesional triamcinolone injections for psoriatic plaques on the hands and abdomen prior to traveling to warm climate vacation. While on vacation, patient developed hand swelling and painful, red nodules on the dorsal hands and abdomen, sites where he received intralesional injections. Patient was empirically given doxycycline, but continued to develop new nodules. An abdominal lesion was biopsied for H&E and tissue culture. Tissue culture revealed beaded gram-positive rods identified as Nocardia nova by MALDI-TOF. Patient was switched to trimethoprim-sulfamethoxazole with significant improvement. This case represents an atypical primary cutaneous nocardiosis with Nocardia nova most likely in the setting of intralesional steroid injections and possible contribution of Apremilast.

Correction: SARS-CoV-2 in the Amazon region: A harbinger of doom for Amerindians.

[This corrects the article DOI: 10.1371/journal.pntd.0008686.].

SARS-CoV-2 in the Amazon region: A harbinger of doom for Amerindians.

As the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic continues to expand, healthcare resources globally have been spread thin. Now, the disease is rapidly spreading across South America, with deadly consequences in areas with already weakened public health systems. The Amazon region is particularly susceptible to the widespread devastation from Coronavirus disease 2019 (COVID-19) because of its immunologically fragile native Amerindian inhabitants and epidemiologic vulnerabilities. Herein, we discuss the current situation and potential impact of COVID-19 in the Amazon region and how further spread of the epidemic wave could prove devastating for many Amerindian people living in the Amazon rainforest.

A serological assay to detect SARS-CoV-2 seroconversion in humans.

SARS-Cov-2 (severe acute respiratory disease coronavirus 2), which causes Coronavirus Disease 2019 (COVID19) was first detected in China in late 2019 and has since then caused a global pandemic. While molecular assays to directly detect the viral genetic material are available for the diagnosis of acute infection, we currently lack serological assays suitable to specifically detect SARS-CoV-2 antibodies. Here we describe serological enzyme-linked immunosorbent assays (ELISA) that we developed using recombinant antigens derived from the spike protein of SARS-CoV-2. Using negative control samples representing pre-COVID 19 background immunity in the general adult population as well as samples from COVID19 patients, we demonstrate that these assays are sensitive and specific, allowing for screening and identification of COVID19 seroconverters using human plasma/serum as early as two days post COVID19 symptoms onset. Importantly, these assays do not require handling of infectious virus, can be adjusted to detect different antibody types and are amendable to scaling. Such serological assays are of critical importance to determine seroprevalence in a given population, define previous exposure and identify highly reactive human donors for the generation of convalescent serum as therapeutic. Sensitive and specific identification of coronavirus SARS-Cov-2 antibody titers may, in the future, also support screening of health care workers to identify those who are already immune and can be deployed to care for infected patients minimizing the risk of viral spread to colleagues and other patients.

A serological assay to detect SARS-CoV-2 seroconversion in humans.

Here, we describe a serological enzyme-linked immunosorbent assay for the screening and identification of human SARS-CoV-2 seroconverters. This assay does not require the handling of infectious virus, can be adjusted to detect different antibody types in serum and plasma and is amenable to scaling. Serological assays are of critical importance to help define previous exposure to SARS-CoV-2 in populations, identify highly reactive human donors for convalescent plasma therapy and investigate correlates of protection.

Case Report: Mucosal Leishmaniasis in New York City.

The six previously reported civilian cases of mucosal leishmaniasis (ML) diagnosed in the United States have all represented imported New World ML. We describe two new patients with ML diagnosed in New York City-a Syrian immigrant with a nasal mass (Leishmania tropica), the first report of Old World ML in the United States, and an American ecologist who worked in Bolivia and had been treated for cutaneous infection 23 years before developing lesions (L. (Viannia) braziliensis) initially of the uvula, soft palate, and posterior pharynx and subsequently the larynx.

Zika Virus Infection and Its Devastating Consequences.

The arrival of Zika virus in the Americas in recent years brought with it a dramatic increase in the rates of microcephaly in regions of Northeastern Brazil. It was from this region of the of the world that we began to understand that this flavivirus (once considered a less severe version of dengue) could have devastating consequences when the infection occurred in pregnant women who did not yet have immunity. We now understand that Zika Congenital Syndrome can have additional effects outside of the central nervous system, but its most lasting consequences are related to the brain infection in utero.

Corrigendum to "Community-Acquired Cavitary Pseudomonas Pneumonia Linked to Use of a Home Humidifier".

[This corrects the article DOI: 10.1155/2017/5474916.].

Community-Acquired Cavitary Pseudomonas Pneumonia Linked to Use of a Home Humidifier.

Pseudomonas aeruginosa is an opportunistic pathogen that rarely causes pneumonia in otherwise healthy patients. We describe a case of community-acquired P. aeruginosa pneumonia in a previously healthy individual who likely acquired the infection from a home humidifier.

Chagas disease in Latin American immigrants with dilated cardiomyopathy in New York City.

Chagas disease-associated cardiomyopathy is clinically similar to other causes of cardiomyopathy and, therefore, the diagnosis can be easily overlooked. We found a 13% point prevalence of Chagas disease in a sample of New York City immigrants with dilated cardiomyopathy.

Disseminated histoplasmosis presenting as AIDS cholangiopathy.

Histoplasma capsulatum is a common opportunistic pathogen that often causes disseminated infection among AIDS patients from endemic areas. Virtually any organ system can be affected, but biliary involvement has not been described. We report the first case of AIDS cholangiopathy associated with H. capsulatum.

Disseminated cryptococcosis resulting in miscarriage in a woman without other immunocompromise: a case report.

We present an unusual case of disseminated cryptococcosis involving the lungs, placenta, and gall bladder in an apparently immunocompetent pregnant woman. The infection resulted in spontaneous abortion. The patient's condition only improved after cholecystectomy and several weeks of antifungal therapy. An in-depth evaluation revealed no central nervous system involvement or immunocompromising condition other than pregnancy.

The HIV-positive traveler.

Antiretroviral therapy has led to a substantial increase in the life expectancy and quality of life for human immunodeficiency virus (HIV)-positive patients. Increasingly, physicians are asked to counsel them before international travel to regions in which infectious diseases are more prevalent. The pretravel evaluation requires an accurate assessment of the patient's level of immune compromise as well as an understanding of the risks involved in travel to tropical countries. We review the safety and efficacy of travel medicine-related vaccines, important considerations when selecting antimalarial prophylaxis, and strategies for management of traveler's diarrhea. The prevention of sexually transmitted infections while abroad also is an important public health intervention for both the traveler and the potential sexual partners abroad. Beyond the health-related issues in international travel, HIV-positive patients may confront some significant legal hurdles in crossing international borders. We provide guidance in navigating the diverse and complex issues that arise for the HIV-positive traveler.

Disseminated tuberculosis presenting with finger swelling in a patient with tuberculous osteomyelitis: a case report.

BACKGROUND: Extrapulmonary manifestations of tuberculosis have become increasingly important in the era of HIV/AIDS. CASE PRESENTATION: We describe a case of tuberculosis (TB) dactylitis in a patient with AIDS who originated from the Ivory Coast. The diagnosis was established by direct visualization of acid-fast bacilli on joint fluid and bone biopsy of the proximal phalanx. Imaging of the chest revealed multiple bilateral nodules. Confirmation of the diagnosis was made by isolation of Mycobacterium tuberculosis from sputum and bone cultures. CONCLUSION: Tuberculosis should be considered in patients with unusual soft tissue or skeletal lesions, especially when an immunosuppressive condition is present. Ziehl-Neelsen staining and culture of tissue obtained via surgical biopsy offer the most direct approach to diagnosis.