Asian Journal of Research in Infectious Diseases

Histoplasmosis: A Rare Cause of Granulomatous Cutaneous Disease

Ipsita Parida — 2026-01-06

Introduction: Histoplasma capsulatum is the causative agent of the mycotic infection histoplasmosis. Histoplasmosis is uncommon in India. Only 13 of the 144 cases of histoplasmosis in India that were included in a review of reports published between 1994 and 2017 came from Delhi. Up to 17% of histoplasmosis patients have cutaneous lesions, which can range from papules to erythema nodosum. Here, we describe a rare case of granulomatous cutaneous disease diagnosed as primary cutaneous histoplasmosis on histopathology.

Case Report: A 56-year-old male car mechanic presented with a one-and-a-half-month history of small, pinhead-sized raised lesions over the cheeks and forehead, which increased in size and character to involve the chest, abdomen, and both arms. A skin biopsy was done. Microscopically, the biopsy revealed granulomatous inflammation. Various investigations identified intracellular and extracellular fungi in capsulated yeast forms, which were proven to be Histoplasma capsulatum.

Conclusion: An opportunistic fungal infection that is more prevalent in immunocompromised people is histoplasmosis. It has varied presentations, including pulmonary, progressive disseminated, chronic cavitatory, and primary cutaneous forms. Primary cutaneous histoplasmosis is a very rare condition, and we have hereby reported such a case.

Tuberculosis and Diabetes: Prevalence and Mortality Associated Factors at the Department of Infectious and Tropical Diseases of Fann Hospital, Dakar, Senegal

Khardiata Diallo Mbaye — 2026-01-01

Introduction: The rapid progression of the diabetes epidemic in low-income and middle-income countries threatens the efforts made in the fight against tuberculosis. This progression could even hinder the progress achieved toward meeting the Sustainable Development Goals aimed at ending the tuberculosis epidemic by 2030. The association between diabetes and tuberculosis presents certain particularities that have been highlighted by studies.

Objective: To assess the prevalence of diabetes among a population with tuberculosis admitted to the Infectious Diseases Department (SMIT) of Fann Teaching Hospital and to determine the main factors associated with death.

Methodology: A retrospective cross-sectional study, both analytical and descriptive, conducted over a five-year period (2018–2023). We performed a bivariate analysis to study the relationship between death and the different variables. The Chi-square independence test was used to search for statistical associations between these variables. When the p-value was less than 5%, we concluded that statistically significant associations existed.

Results: Out of 4,091 patients hospitalized during our study period, 868 presented with tuberculosis, representing a hospital frequency of 21.21%. We collected 34 cases of patients with a diabetes–tuberculosis association, corresponding to a proportional morbidity of 3.9%. A female predominance was noted (56%) with a sex ratio of 0.78. The mean age was 54 years. Half of the patients came from urban areas, and 41% were unemployed. Regarding comorbidities or underlying conditions, HIV co-infection was found in 32.35%, hypertension in 26.47%, and smoking in 9%. Previous hospitalization was reported in 58.82% of patients. Almost all patients had type 2 diabetes (94%), with diabetes evolving mostly for less than five years. Chronic degenerative complications were found in 12% of patients. The clinical presentation was insidious in 88% of patients, dominated by asthenia, followed by cough (65%) and fever (62%). Multifocal tuberculosis was the predominant form (53%), with pulmonary localization estimated at 85%. At admission, 47% of patients had fasting blood glucose above 1.26 g/L. Diabetes was poorly controlled in 66% of patients with HbA1c > 7%. The Xpert MTB/RIF test was positive in 87.7% (n=21) of tested patients, and sputum smear microscopy was positive in 70% (7 out of 10 tested patients). Thoracic imaging showed predominance of alveolar and interstitial syndromes, with a tendency toward bilaterality (60%) and lesion dissemination (36%). Regarding treatment, insulin therapy was initiated in 26% of cases before hospitalization and 20% during hospitalization. Anti-tuberculosis chemotherapy was administered to 91% of patients. The average hospital stay was 13 days. During hospitalization, 48% of patients developed non-infectious complications, particularly cardio-respiratory (18%). The mortality rate was 47.05%. Factors associated with death were mainly the duration of diabetes (p=0.016) and the presence of complications (p=0.000).

Conclusion: Tuberculosis is frequently associated with diabetes, especially in resource-limited countries, due to the growing number of diabetics in these regions. Consequently, the National Tuberculosis Control Program (PNT) recommends systematic screening for diabetes in all individuals with tuberculosis.

Antimicrobial Resistance Surveillance in Guinea

FA Traore — 2026-01-07

Introduction: The Republic of Guinea has a multisectoral action plan for the surveillance and control of antimicrobial resistance (AMR). The objective of this study was to describe the current status of AMR surveillance in the country.

Materials and Methods: This was a retrospective study based on data collected from AMR sentinel surveillance laboratories during the first half of 2024. The national surveillance network is composed of 13 laboratories. Bacterial identification and antimicrobial susceptibility testing were performed using conventional methods and the automated VITEK® 2 Compact system.

Results: During the study period, 8,355 samples were analyzed, and 2,832 bacterial isolates were identified by Gram staining. A total of 1,197 antimicrobial susceptibility tests were performed. Most samples originated from the regional hospital laboratories of N’zérékoré (1,603) and Kankan (1,343), as well as from the national hospitals Donka (1,434) and Ignace Deen (1,154) in Conakry. Urine samples accounted for the majority of biological specimens analyzed (77%), while blood samples represented only 1%. The main bacterial strains isolated were Escherichia coli (54%), Klebsiella pneumoniae (27%), and Staphylococcus aureus (14%). Acquired resistance of these isolates to the tested antibiotics was 96% for penicillin, 24% for ceftriaxone, 14% for imipenem, 40% for meropenem, and 7% for ertapenem.

Conclusion: Strengthening AMR surveillance in Guinea requires increasing the number of sentinel sites, improving the skills of stakeholders, securing sustainable funding, and raising awareness among prescribers and the general population to promote the rational use of antibiotics.

Prevalence and Determinants of Metabolic Syndrome among Adults Living with HIV on Antiretroviral Therapy at a Tertiary Hospital in Burkina Faso

Lassane ZOUNGRANA — 2026-01-09

Background: The advent of highly active antiretroviral therapy (HAART) has transformed HIV infection into a chronic manageable condition, but has introduced new metabolic complications, particularly metabolic syndrome (MetS). Understanding the prevalence and determinants of MetS in HIV-positive populations in sub-Saharan Africa remains crucial for optimizing long-term care.

Objective: To determine the prevalence of metabolic syndrome and identify associated factors among people living with HIV (PLWH) receiving antiretroviral therapy at the Day Hospital of Yalgado Ouédraogo University Hospital Center in Burkina Faso.

Methods: A cross-sectional descriptive study was conducted from October 2022 to November 2023 among 641 HIV-positive adults aged 18 years and above on antiretroviral therapy for at least one year, without severe comorbid conditions. MetS was assessed using the International Diabetes Federation (IDF) 2005 criteria. Data included sociodemographic characteristics, anthropometric measurements, clinical parameters, immunovirological markers, and biochemical profiles. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with MetS.

Results: The mean age was 49.78 years, with 74.73% female participants. MetS prevalence was 40.72% by IDF criteria and 30.42% by NCEP-ATP III criteria. Mean HIV infection duration was 12.37 years, with 68.02% infected for 10 years or more. In multivariate analysis, significant risk factors for MetS included advanced age (OR=1.14, p=0.001), female gender (OR=1.28, p=0.012), HIV infection duration of 10 years or more (OR=1.79, p=0.030), BMI of 25 kg/m² or higher (OR=1.26, p<0.001), personal history of hypertension (OR=4.01, p<0.001), diabetes (OR=6.14, p<0.001), obesity (OR=1.90, p<0.001), presence of dyslipidemia (OR=3.96, p<0.001), and higher last CD4 count (OR=1.78, p=0.005). Protective factors included AZT-based therapy (OR=0.57, p=0.033) and current regimens TLD (OR=0.98, p<0.001) and ABC/3TC/DTG (OR=0.56, p=0.016). Marginally associated regimens included D4T/3TC+NVP (OR=1.63, p=0.050) and AZT/3TC+LPV/r (OR=2.96, p=0.023).

Conclusion: MetS prevalence among PLWH in Burkina Faso is substantial and associated with both traditional risk factors and HIV-specific factors including infection chronicity and antiretroviral regimen type. Comprehensive metabolic screening and personalized therapeutic strategies are essential for optimizing long-term outcomes in this population.

Isolation of Multidrug-Resistant Escherichia coli O157:H7 from Pig Farms in Northern Côte d’Ivoire: A Preliminary Study

M’BARI Kiffôpan Benjamin — 2026-01-10

Resistance of Gram-negative bacteria to the recommended and available antimicrobial drugs is a growing public health problem in different locations worldwide, leading to increased morbidity and mortality in patients. This study was conducted in the Korhogo Department to enhance the understanding of Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) in local swine populations. A total of 200 rectal swabs were collected from pigs across four sub-prefectures. Isolation of STEC O157:H7 was performed on a chromogenic selective medium. Subsequently, 62 isolates obtained were tested for antimicrobial susceptibility against nine agents using the standard disk diffusion method. Following analysis, 62 of the 200 samples tested were positive, yielding an overall prevalence of 31%. The study further revealed that, aside from the sampling location, neither sex nor age had a significant effect on the prevalence of this bacterium. Antibiotic susceptibility testing demonstrated that 100% of the isolates were sensitive to gentamicin, colistin, and ceftriaxone. Conversely, all isolates exhibited complete (100%) resistance to the six other antibiotics tested. The study confirms a high prevalence of E. coli O157:H7 in pig farms, alongside a high level of resistance to commonly used antimicrobials. Further research is needed to better understand the epidemiology and transmission dynamics of this zoonotic agent.

Kyasanur Forest Disease in India: Epidemiology, Transmission Ecology, Clinical Spectrum, Diagnostics and One Health Control

Husaina Jhabuawala — 2026-01-03

Background: This narrative review synthesizes current evidence on Kyasanur Forest Disease (KFD), a tick-borne viral hemorrhagic fever endemic to India. Caused by Kyasanur Forest disease virus (KFDV), a member of the tick-borne encephalitis virus serocomplex, KFD represents an emerging zoonotic threat with expanding geographic distribution across the Western Ghats.

Methods: A comprehensive literature review was conducted using PubMed, Web of Science, and Scopus databases, covering publications from 1957 to 2024. Peer-reviewed original studies, surveillance reports, and relevant reviews were included and synthesized narratively to integrate evidence on epidemiology, transmission ecology, pathophysiology, clinical spectrum, diagnostics, and prevention strategies.

Results: In humans, KFD typically manifests after a 3–8-day incubation period with acute febrile illness, headache, myalgia, and severe prostration. Approximately 20% of patients develop a biphasic illness, with a subset progressing to neurological involvement during the second phase. The overall reported case fatality rate ranges from 3–5%. Diagnosis relies primarily on serological assays (IgM/IgG ELISA) and molecular detection by RT-PCR during early illness. Ecologically, KFDV circulates through enzootic cycles involving Haemaphysalis ticks and multiple vertebrate hosts, with monkey epizootics serving as sentinel indicators of local transmission. Geographic expansion has been associated with ecological disruption, deforestation, and increased human–tick interactions.

Conclusions: Kyasanur Forest Disease remains an evolving zoonotic challenge driven by environmental change and complex transmission dynamics. Effective control requires strengthened One Health–oriented surveillance, improved vaccination coverage, and integration of viral genomic monitoring with clinical and ecological data to support early detection and targeted prevention.

Herpes Simplex Virus Type 1 (HSV-1) in Burn Patients Prevention Versus Treatment: Finding The Right Balance

Karti Sara — 2026-01-10

Herpes simplex virus type 1 (HSV-1) is an under-recognized but clinically important pathogen in the burn population. Burn injury causes a unique and sustained alteration of innate and adaptive immunity and destroys the dermal barrier that normally contains mucocutaneous herpesvirus reservoirs; these factors predispose to HSV-1 reactivation and primary or secondary infection of burns and graft sites. HSV-1 in burn patients may present as delayed wound healing, necrotic graft loss, fever of unclear source, or atypical vesiculoulcerative lesions and can be mistaken for bacterial infection or ischemic tissue necrosis. Management options fall broadly into prevention (infection control, screening, and antiviral prophylaxis) and treatment (topical and systemic antivirals, surgical management, and management of antiviral resistance).

The evidence base is limited and heterogeneous: case reports and small series document clinically significant wound HSV-1 infection causing graft failure and worsened scarring, systematic reviews summarize the inconsistency of outcome data, and randomized trials in related critically ill populations have questioned the benefit of routine preemptive systemic antiviral strategies. Prophylactic acyclovir is widely used in facial resurfacing and is practiced in some burn centers particularly for facial burns and in patients with large TBSA burns or prolonged intubation but no multicenter randomized trial has established a universal recommendation specifically for burn patients. Conversely, early targeted treatment of confirmed HSV-1 infection with systemic acyclovir or, in resistant cases, foscarnet, is associated with rapid clinical improvement and salvage of grafts in published series.

Practical decision-making therefore requires balancing the (low) risk and cost of prophylaxis and the rare but serious consequences of HSV wound disease, while accounting for local HSV prevalence, patient risk factors (facial burns, immunosuppression, prolonged mechanical ventilation, steroid use), diagnostic capacity (PCR, immunohistochemistry), and stewardship concerns (resistance, nephrotoxicity).

In this article we synthesize contemporary evidence, review diagnostic and therapeutic options, discuss prevention strategies, and propose a pragmatic, risk-stratified algorithm for clinicians in burn units to achieve the optimal prevention–treatment balance for HSV-1 in burn patients.