Publications by authors named "Julu Bhatnagar"
Article Synopsis
- * Between July 2023 and January 2024, California reported six RMSF cases linked to exposure in Tecate, Mexico, raising concerns as it was previously not identified as a high-risk area, and three of these cases were fatal.
- * Effective detection of RMSF cases necessitated collaborative efforts among various public health agencies, highlighting the need for increased awareness among healthcare providers to enable quicker diagnoses and treatments on both sides of the U.S.-Mexico border.
Article Synopsis
- - Bartonella quintana can lead to serious health issues, including endocarditis and chronic infections, and is mainly spread by body lice, particularly in homeless populations.
- - A case study in the U.S. highlighted two kidney transplant recipients who contracted the infection from an organ donor who was homeless; one case was atypical while the other showed mild symptoms.
- - Timely detection and treatment allowed both recipients to recover, emphasizing the importance of assessing organ donors' living conditions, specifically those with a history of homelessness or lice infestations, for potential B. quintana infections in transplant recipients.
Article Synopsis
- Bartonella quintana infection can cause serious health issues like bacillary angiomatosis and culture-negative endocarditis, mainly affecting individuals who are homeless.
- In a study conducted in New York City between January 2020 and November 2023, five cases of left-sided, culture-negative endocarditis were identified in unsheltered homeless persons using molecular methods.
- Most patients had serious complications and a history of body louse exposure, highlighting the need for clinicians to consider housing status and potential lice infestation when diagnosing and treating suspected cases.
Background: Borealpox virus (BRPV, formerly known as Alaskapox virus) is a zoonotic member of the Orthopoxvirus genus first identified in a person in 2015. In the six patients with infection previously observed BRPV involved mild, self-limiting illness. We report the first fatal BRPV infection in an immunosuppressed patient.
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- Hantavirus pulmonary syndrome (HPS) and non-HPS hantavirus infection are tracked as nationally notifiable diseases in the U.S., with diagnostics based on symptoms and lab results between 2008 and 2020.
- A study merged epidemiological data and diagnostic lab results from the CDC to analyze the occurrence and genetic diversity of hantavirus in the U.S., revealing that the majority of cases were in western states, particularly the Four Corners region.
- Findings highlight a seasonal spike in cases between March and August and reveal discrepancies between commercial and CDC lab tests, suggesting a need for better diagnostic tests to align results.
A dog presented with deep pyoderma on the paw, following treatment with ciclosporin and prednisone for immune-mediated haemolytic anaemia. Cytological evaluation, skin biopsy, aerobic culture, next-generation DNA sequencing and PCR were used to detect the first reported case of Burkholderia gladioli in a dog.
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- The study examines the pathology and tissue involvement of the Monkeypox virus (MPXV) in severely ill or deceased patients, emphasizing its impact on immunocompromised individuals.
- Researchers analyzed samples from 22 patients, finding extensive viral presence in tissues, including lesions in the digestive tract and lungs, along with various complications like necrosis and bronchopneumonia.
- The findings highlight the prevalence of coinfections, the severe implications for treatment, and the need for improved biosafety protocols in medical settings dealing with mpox cases.
Article Synopsis
- Adenovirus has been linked to hepatitis in immunocompromised children, but not typically in healthy ones; this changed in April 2022 when unexplained hepatitis cases surfaced in the USA and UK, prompting national surveillance by the CDC.
- The study focused on children under 10 with unexplained hepatitis and elevated liver enzymes, collecting detailed medical data, caregiver interviews, and specimen testing to identify causes.
- A total of 377 cases were documented from October 2021 to September 2022, with a median patient age of 2.8 years and a fairly equal distribution of males and females.
Article Synopsis
- In 2021, four organ transplant recipients in the USA developed encephalitis linked to a common donor, prompting an investigation into the cause.
- Researchers used various testing methods, including metagenomic next-generation sequencing, and discovered yellow fever virus in one recipient's cerebrospinal fluid, confirming recent infections in all recipients.
- The investigation highlighted the importance of waiting at least 2 weeks after receiving a yellow fever vaccine before donating blood to prevent transfusion-related infections.
Article Synopsis
- * A case study of an 8-year-old dog unveiled painful nodules on its ears, leading to a finding of severe dermatitis and presence of mycobacterial bacteria resistant to certain staining techniques.
- * The study suggests that while CLG is usually tied to non-tuberculous mycobacterial infections, the involvement of members of the Mycobacterium tuberculosis complex (MTBC) raises public health concerns due to its potential transmission from dogs to humans and other animals.
Article Synopsis
- A recent investigation into acute hepatitis cases in southeastern U.S. children found human adenovirus type 41 in all 9 affected individuals, with 56% undergoing molecular genotyping.
- Among these cases, 2 children progressed rapidly to pediatric acute liver failure (PALF) and underwent liver transplantation, which is rare for this condition.
- The study highlights the clinical details, laboratory findings, and the successful post-transplant outcomes, emphasizing the need for early medical intervention and the potential for liver transplantation in severe adenovirus-related cases.
Article Synopsis
- In late 2021 and early 2022, a number of previously healthy children developed acute hepatitis alongside human adenovirus infections, prompting an investigation at Children's of Alabama hospital.
- Out of 15 children with acute hepatitis, 9 (60%) had unknown causes, and 8 of these tested positive for human adenovirus, suggesting a potential link.
- Liver biopsies revealed varying degrees of hepatitis but not direct evidence of the virus; however, some children recovered with care while 2 required liver transplants.
A man in his 70s with a complex medical history, including cadaveric renal transplant, presented with recurrent urinary tract infections. Investigation revealed recurrent urinary pathogens, including and persistent BK viruria. Cystoscopy revealed a pedunculated mass in the right posterior-lateral wall, inferior to the transplant urethral orifice, and biopsy of this mass showed invasive small cell carcinoma with a prominent adenocarcinoma component.
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- - The study analyzed 72 mink affected by SARS-CoV-2 outbreaks on US farms, discovering respiratory damage similar to that seen in humans with COVID-19, including bronchiolitis in 74% of mink found dead.
- - Testing methods showed that conventional reverse transcription-PCR (cRT-PCR) was more effective at detecting SARS-CoV-2 in upper respiratory tract tissues than in lung specimens, indicating the virus primarily affects the nasal area.
- - The presence of the viral receptor ACE2 was noted in the nasal epithelium, suggesting that mink could serve as a useful model for studying SARS-CoV-2 infection and its effects in humans.
Article Synopsis
- A case study in the U.S. details a neonate born at 25 weeks of gestation who died four days after birth, linked to maternal asymptomatic SARS-CoV-2 infection and preeclampsia.* -
- Autopsy findings revealed severe lung damage and localized presence of SARS-CoV-2 in the neonate's lungs, heart, and liver, indicating the virus's impact on various organs.* -
- The study suggests that the severe outcomes in this neonate were likely due to in utero transmission of the virus, highlighting potential risks of COVID-19 during pregnancy.*
Background: Minimally invasive tissue sampling (MITS) is an alternative to complete autopsy for determining causes of death. Multiplex molecular testing performed on MITS specimens poses challenges of interpretation, due to high sensitivity and indiscriminate detection of pathogenic, commensal, or contaminating microorganisms.
Methods: MITS was performed on 20 deceased children with respiratory illness, at 10 timepoints up to 88 hours postmortem.
Project (VEZ), an intensified surveillance of pregnant women with symptoms of the Zika virus disease (ZVD) in Colombia, aimed to evaluate the relationship between symptoms of ZVD during pregnancy and adverse pregnancy, birth, and infant outcomes and early childhood neurodevelopmental outcomes. During May-November 2016, pregnant women in three Colombian cities who were reported with symptoms of ZVD to the national surveillance system, or with symptoms of ZVD visiting participating clinics, were enrolled in Project VEZ. Data from maternal and pediatric (up to two years of age) medical records were abstracted.
View Article and Find Full Text PDFBackground: Human adenovirus (HAdV) infections can lead to high mortality in solid organ transplant (SOT) recipients, with rare reports of donor-derived infection.
Methods: Two renal transplant recipients with HAdV-11 infection who received kidneys from the same donor are described. Whole-genome sequencing (WGS) was performed.
Background: Hand, foot, and mouth disease (HFMD), classically a childhood viral infection, has an atypical and severe clinical presentation in adults. Coxsackievirus A6 is a leading cause of atypical HFMD, but current diagnostic methods utilizing formalin-fixed, paraffin-embedded skin biopsy specimens often lack sensitivity and specificity.
Methods: Formalin-fixed, paraffin-embedded skin biopsies from seven case patients with clinical and histopathological suspicion of atypical HFMD were evaluated by coxsackievirus A6 (CVA6) immunohistochemistry, enterovirus-specific conventional reverse transcriptase-PCR with subsequent Sanger sequencing targeting the 5'UTR, and CVA6-specific real-time PCR targeting the VP1 gene.
We combined viral genome sequencing with contact tracing to investigate introduction and evolution of severe acute respiratory syndrome coronavirus 2 lineages in Santa Clara County, California, from 27 January to 21 March 2020. From 558 persons with coronavirus disease 2019, 101 genomes from 143 available clinical samples comprised 17 lineages, including SCC1 (n = 41), WA1 (n = 9; including the first 2 reported deaths in the United States, with postmortem diagnosis), D614G (n = 4), ancestral Wuhan Hu-1 (n = 21), and 13 others (n = 26). Public health intervention may have curtailed the persistence of lineages that appeared transiently during February and March.
View Article and Find Full Text PDFSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shares common clinicopathologic features with other severe pulmonary illnesses. Hantavirus pulmonary syndrome was diagnosed in 2 patients in Arizona, USA, suspected of dying from infection with SARS-CoV-2. Differential diagnoses and possible co-infections should be considered for cases of respiratory distress during the SARS-CoV-2 pandemic.
View Article and Find Full Text PDFBackground: The coronavirus disease 2019 (COVID-19) pandemic continues to produce substantial morbidity and mortality. To understand the reasons for the wide-spectrum complications and severe outcomes of COVID-19, we aimed to identify cellular targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tropism and replication in various tissues.
Methods: We evaluated RNA extracted from formalin-fixed, paraffin-embedded autopsy tissues from 64 case patients (age range, 1 month to 84 years; 21 COVID-19 confirmed, 43 suspected COVID-19) by SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR).
Article Synopsis
- - Public health officials in the US have been investigating a national outbreak of e-cigarette or vaping-related lung injuries (EVALI) since August 2019, with focus on understanding the pathological findings through biopsies and autopsies submitted to the CDC.
- - Between August and November 2019, lung samples from 10 biopsy and 13 autopsy cases were analyzed. Most subjects had a history of vaping and exhibited respiratory symptoms, with findings consistent with acute lung injuries like diffuse alveolar damage.
- - Of the cases evaluated, 21 met the criteria for EVALI, with significant histological evidence found in biopsies, revealing various lung damage patterns; however, some autopsy results showed other lung issues not