Search Our Scientific Publications & Authors

Genome Res 2019 Apr 16. Epub 2019 Apr 16.

Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California 94143, USA.

Metagenomic next-generation sequencing (mNGS) for pan-pathogen detection has been successfully tested in proof-of-concept case studies in patients with acute illness of unknown etiology but to date has been largely confined to research settings. Here, we developed and validated a clinical mNGS assay for diagnosis of infectious causes of meningitis and encephalitis from cerebrospinal fluid (CSF) in a licensed microbiology laboratory. A customized bioinformatics pipeline, SURPI+, was developed to rapidly analyze mNGS data, generate an automated summary of detected pathogens, and provide a graphical user interface for evaluating and interpreting results. Read More

Int J Epidemiol 2019 Apr 11. Epub 2019 Apr 11.

Johns Hopkins University, Baltimore, Maryland, USA.

Background: Understanding the true burden of emergent diseases is critical for assessing public-health impact. However, surveillance often relies on hospital systems that only capture a minority of cases. We use the example of Nipah-virus infection in Bangladesh, which has a high case-fatality ratio and frequent person-to-person transmission, to demonstrate how healthcare-seeking data can estimate true burden. Read More

Front Neurol 2019 19;10:242. Epub 2019 Mar 19.

Department of Neurology, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL, United States.

Eastern equine encephalitis (EEE) is a severe arboviral neuroinvasive disease with high mortality and neurological sequelae. Treatment for EEE is primarily supportive. Intravenous immunoglobulin (IVIg) and high-dose steroids have been used as empirical therapy for EEE with some case reports of benefit. Read More

Oncologist 2019 Apr 1. Epub 2019 Apr 1.

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Background: Immune checkpoint inhibitors such as pembrolizumab and nivolumab have emerged as active treatment options for patients with many cancers, including metastatic melanoma, but can also cause symptomatic or life-threatening immune-related adverse events, including encephalitis. Epididymitis and orchitis are rare complications of these therapies.

Case Presentation: We describe herein a patient with metastatic melanoma who developed epididymo-orchitis followed by encephalitis while receiving pembrolizumab. Read More

Pediatr Neurol 2019 Feb 13. Epub 2019 Feb 13.

Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address:

Background: Hemispherotomy can be an effective treatment for refractory childhood epilepsy. However, the extent of postoperative brain development after hemispherotomy remains incompletely understood. This study aims to provide an anatomic foundation in assessing development of the contralateral hemisphere, by measuring volumetric growth after hemispherotomy. Read More

Emerg Infect Dis 2019 Apr;25(4):728-738

The California serogroup of orthobunyaviruses comprises a group of mosquitoborne viruses, including La Crosse (LACV), snowshoe hare (SSHV), Tahyna (TAHV), Jamestown Canyon (JCV), and Inkoo (INKV) viruses, that cause neurologic disease in humans of differing ages with varying incidences. To determine how the pathogenesis of these viruses differs, we compared their ability to induce disease in mice and replicate and induce cell death in vitro. In mice, LACV, TAHV, and SSHV induced neurologic disease after intraperitoneal and intranasal inoculation, and JCV induced disease only after intranasal inoculation. Read More

Int J Trichology 2018 Nov-Dec;10(6):286-288

Department of Dermatology, University of California, Irvine, California, USA.

Systemic administration of Janus kinase inhibitors (JAKis) is associated with adverse events, including serious infections, malignancy, and herpes zoster (HZ). Herein, we report a case of a 17-year-old male with alopecia universalis who developed suspected HZ-associated encephalitis (HZAE) during treatment with oral tofacitinib. Oral tofacitinib was immediately discontinued, and the patient was started on antiviral treatment. Read More

Front Immunol 2019 29;10:121. Epub 2019 Jan 29.

Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.

Brain-infiltrating lymphocytes (BILs) were isolated from resected brain tissue from 10 pediatric epilepsy patients who had undergone surgery for Hemimegalencephaly (HME) ( = 1), Tuberous sclerosis complex (TSC) ( = 2), Focal cortical dysplasia (FCD) ( = 4), and Rasmussen encephalitis (RE) ( = 3). Peripheral blood mononuclear cells (PBMCs) were also isolated from blood collected at the time of the surgery. Cells were immunostained with a panel of 20 antibody markers, and analyzed by mass cytometry. Read More

Cell Rep 2019 Feb;26(6):1598-1613.e8

Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA. Electronic address:

Flaviviruses cause systemic or neurotropic-encephalitic pathology in humans. The flavivirus nonstructural protein 1 (NS1) is a secreted glycoprotein involved in viral replication, immune evasion, and vascular leakage during dengue virus infection. However, the contribution of secreted NS1 from related flaviviruses to viral pathogenesis remains unknown. Read More

Front Oncol 2019 22;9. Epub 2019 Jan 22.

Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment, Swedish Neuroscience Institute, Seattle, WA, United States.

Viral encephalitis and glioblastoma are both relatively rare conditions with poor prognoses. While the clinical and radiographic presentations of these diseases are often distinctly different, viral encephalitis can sometimes masquerade as glioblastoma. Rarely, glioblastoma can also be misdiagnosed as viral encephalitis. Read More

PLoS Negl Trop Dis 2019 02 4;13(2):e0007135. Epub 2019 Feb 4.

Center for Vectorborne Diseases, Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America.

West Nile virus (WNV) has been circulating in California since its first detection in 2003, causing repeated outbreaks affecting public, wildlife and veterinary health. Epidemics of WNV are difficult to predict due to the multitude of factors influencing transmission dynamics among avian and mosquito hosts. Typically, high levels of WNV amplification are required for outbreaks to occur, and therefore associated viral strains may exhibit enhanced virulence and mortality in competent bird species resulting in increased mosquito infection prevalence. Read More

Nat Commun 2019 02 1;10(1):549. Epub 2019 Feb 1.

Department of Experimental Immunology, Immunology Frontier Research Center, Osaka University, Osaka 565-0871, Japan.

The genome organizer, special AT-rich sequence-binding protein-1 (Satb1), plays a pivotal role in the regulation of global gene networks in a cell type-dependent manner and is indispensable for the development of multiple cell types, including mature CD4 T, CD8 T, and Foxp3 regulatory T cells in the thymus. However, it remains unknown how the differentiation and effector program of the Th subsets in the periphery are regulated by Satb1. Here, we demonstrate that Satb1 differentially regulates gene expression profiles in non-pathogenic and pathogenic Th17 cells and promotes the pathogenic effector program of encephalitogenic Th17 cells by regulating GM-CSF via Bhlhe40 and inhibiting PD-1 expression. Read More

Med Mycol 2019 Feb;57(Supplement_1):S67-S75

School of Veterinary Medicine, University of California-Davis, Davis, California, USA.

Canine coccidioidomycosis, a systemic fungal infection endemic to arid and semiarid regions of North, Central, and South America, is commonly diagnosed in dogs living in or traveling through lower Sonoran life zones in the states of California and Arizona. Canine and human cases have geographic overlap. Similarities between clinical coccidioidomycosis in dogs and humans include asymptomatic infection, primary respiratory disease and disseminated disease. Read More

Nat Immunol 2019 02 14;20(2):195-205. Epub 2019 Jan 14.

Center for Immunology, Masonic Cancer Center, and the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.

The developmental programs that generate a broad repertoire of regulatory T cells (T cells) able to respond to both self antigens and non-self antigens remain unclear. Here we found that mature T cells were generated through two distinct developmental programs involving CD25 T cell progenitors (CD25 TP cells) and Foxp3 T cell progenitors (Foxp3 TP cells). CD25 TP cells showed higher rates of apoptosis and interacted with thymic self antigens with higher affinity than did Foxp3 TP cells, and had a T cell antigen receptor repertoire and transcriptome distinct from that of Foxp3 TP cells. Read More

J Med Virol 2019 Jun 17;91(6):935-940. Epub 2019 Jan 17.

Department of Animal Medicine, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China.

Neurotropic viruses, such as the rabies virus (RABV) and Japanese encephalitis virus (JEV), induce neuronal dysfunction and complication, causing neuronal damage. Currently, there are still no effective clinical treatments for neuronal injury caused by neurotropic viruses. Memantine, a drug capable of passing through the blood-brain barrier, noncompetitively and reversibly binds to n-methyl- d-aspartic acid (NMDA) receptors. Read More

Clin Pract 2018 Oct 4;8(4):1097. Epub 2018 Dec 4.

Ronald Reagan UCLA Medical Center, University of California, Los Angeles, CA, USA.

A 67-year-old male with past medical history of mantle cell lymphoma and atrial fibrillation presented with a truncal rash, bilateral lower extremity weakness, and confusion. Within three days of presentation, his condition rapidly deteriorated with the onset of diffuse flaccid paralysis, aphasia, and severe alteration in mental status. Initial results from serum studies, lumbar puncture, magnetic resonance imaging, and electroencephalogram were not diagnostic. Read More

Transpl Infect Dis 2019 Apr 24;21(2):e13038. Epub 2018 Dec 24.

Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California.

Herpes zoster encephalitis (HZE) is a rare complication of varicella zoster virus (VZV) infection. We report two cases of HZE in solid organ transplant (SOT) recipients and review 10 other cases in the literature. In this review, rash was present in 67% of cases. Read More

Pediatr Infect Dis J 2019 Jan;38(1):37-41

bioMérieux, Durham, NC.

Background: Large epidemiologic studies evaluating the etiologies, management decisions and outcomes of infants and children with meningitis and encephalitis in the United States are lacking.

Methods: Children 0-17 years of age with meningitis or encephalitis as assessed by International Classification of Diseases, Ninth Revision, codes available in the Premier Healthcare Database during 2011-2014 were analyzed.

Results: Six thousand six hundred sixty-five patients with meningitis or encephalitis were identified; 3030 (45. Read More

Open Forum Infect Dis 2018 Nov 17;5(11):ofy259. Epub 2018 Oct 17.

Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California.

We report the case of a 65-year-old patient with pseudolymphoma who developed acute toxoplasmosis following 6 cycles of rituximab and bendamustine therapy. Acute toxoplasmosis in the setting of biological response modifiers, rather than reactivation, is a unique unreported infection. The patient developed severe disease with multi-organ involvement, including retinitis, myocarditis, and myositis. Read More

Emerg Infect Dis 2018 12;24(12)

We summarize and analyze historical and current data regarding the reemergence of St. Louis encephalitis virus (SLEV; genus Flavivirus) in the Americas. Historically, SLEV caused encephalitis outbreaks in the United States; however, it was not considered a public health concern in the rest of the Americas. Read More

Diagn Microbiol Infect Dis 2019 Apr 27;93(4):349-354. Epub 2018 Oct 27.

bioMérieux, Durham, NC; Hofstra Northwell School of Medicine, Hempstead, NY.

A retrospective cohort study design was used to assess the use and costs of diagnostic tests, medication, and total hospitalization costs for pediatric patients with suspected meningitis/encephalitis who received a lumbar puncture (LP) procedure. Related costs were calculated by timing of LP performed and infectious etiology for infants (<1 year) and children (1-17 years). A total of 3030 infants and 3635 children with suspected ME diagnosed between 2011 and 2014 were included in the study. Read More

Transfusion 2019 Feb 14;59(2):623-628. Epub 2018 Nov 14.

Medical and Scientific Affairs, Roche Molecular Systems, Inc., Pleasanton, California.

Background: West Nile virus (WNV) is transmitted to humans through mosquito bites and can be further transmitted to humans through transfusion or transplantation. Because most infected individuals are asymptomatic, blood donor screening is important in areas where WNV is endemic. These studies evaluated the performance of a new test for detection of WNV RNA in blood donations. Read More

Prev Vet Med 2018 Nov 24;160:1-9. Epub 2018 Sep 24.

Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, 66506, United States. Electronic address:

Following a qualitative risk assessment, in which we identified and assessed all viable pathways for the introduction of the Japanese encephalitis virus (JEV) into the United States (US), we identified entry through infected vectors via aircraft and cargo ships as the most likely pathway, and thus considered it further in a quantitative risk assessment (QRA) model. The objective of this study was to evaluate the risk of introduction of JEV in the US via infected mosquitoes transported in aircraft and cargo ships arriving from Asia, using a QRA model. We created a stochastic model to quantify the probability of introduction of at least one infected mosquito in the continental US via aircraft and cargo ships, per at-risk period (March to October) or year, respectively. Read More

MBio 2018 10 30;9(5). Epub 2018 Oct 30.

Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, California, USA

is a pathogenic free-living amoeba that causes a rare but almost always fatal infection of the central nervous system called granulomatous amoebic encephalitis (GAE). Two distinct forms of -a proliferative trophozoite form and a nonproliferative cyst form, which is highly resistant to harsh physical and chemical conditions-have been isolated from environmental samples worldwide and are both observed in infected tissue. Patients suffering from GAE are typically treated with aggressive and prolonged multidrug regimens that often include the antimicrobial agents miltefosine and pentamidine isethionate. Read More

Neurol Clin 2018 Nov;36(4):687-703

Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, NS212A, Campus Box 3206, San Francisco, CA 94158, USA. Electronic address:

Neuroinfectious diseases continue to cause morbidity and mortality worldwide, with many emerging or reemerging infections resulting in neurologic sequelae. Careful clinical evaluation coupled with appropriate laboratory investigations still forms the bedrock for making the correct etiologic diagnosis and implementing appropriate management. The treating physician needs to understand the individual test characteristics of each of the many conventional candidate-based diagnostics: culture, pathogen-specific polymerase chain reaction, antigen, antibody tests, used to diagnose the whole array of neuroinvasive infections. Read More

J Neuroinflammation 2018 Oct 11;15(1):286. Epub 2018 Oct 11.

Department of Neural Development and Disease, Korea Brain Research Institute (KBRI), 61 Cheomdan-ro, Dong-gu, Daegu, 41068, South Korea.

Background: Neuroinflammation is associated with neurodegenerative diseases, including Alzheimer's disease (AD). Thus, modulating the neuroinflammatory response represents a potential therapeutic strategy for treating neurodegenerative diseases. Several recent studies have shown that dopamine (DA) and its receptors are expressed in immune cells and are involved in the neuroinflammatory response. Read More

MMWR Morb Mortal Wkly Rep 2018 Oct 5;67(39):1104-1105. Epub 2018 Oct 5.

Transpl Infect Dis 2019 Feb 15;21(1):e13003. Epub 2018 Oct 15.

Department of Neurology, University of Massachusetts Medical Center, Worcester, Massachusetts.

Background: Human herpesvirus 6 (HHV6) is a cause of post-transplant acute limbic encephalitis (PALE). Seizures are associated with this disorder yet no predictive biomarkers have been identified. The objective of this study was to evaluate lab and neurodiagnostic biomarkers in patients with HHV6 associated PALE. Read More

Clin Infect Dis 2018 Sep 20. Epub 2018 Sep 20.

Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Background: Balamuthia mandrillaris is a free-living ameba that causes rare, nearly always fatal disease in humans and animals worldwide. B. mandrillaris has been isolated from soil, dust, and water. Read More

Vet Pathol 2019 Mar 16;56(2):317-321. Epub 2018 Sep 16.

1 California Animal Health and Food Safety Laboratory, UC Davis, Davis, CA, USA.

Twenty-two feral rock pigeons ( Columba livia) from 10 counties in California with ataxia, torticollis, and difficulty standing and flying were admitted to rehabilitation centers in late winter and spring of 2017 and died or were euthanized. Common necropsy findings included thin body condition, generalized deep red discoloration of organs, and hemorrhagic subcutaneous neck tissues. Meningoencephalitis was observed microscopically in 16 pigeons, and 3 also had protozoal schizonts in the brain. Read More

Am J Trop Med Hyg 2018 Oct;99(4):1074-1079

Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado.

St. Louis encephalitis virus (SLEV), an arthropod-borne flavivirus, can cause disease presentations ranging from mild febrile illness through severe encephalitis. We reviewed U. Read More

J Clin Virol 2018 Oct 23;107:38-47. Epub 2018 Aug 23.

Department of Molecular Medicine, University of Padova, via A. Gabelli 63, 35121, Padova, Italy. Electronic address:

During the last decades, arboviruses that are endemic in Europe have expanded their geographic range and caused an increasing number of human outbreaks. These viruses include West Nile virus, which is expanding its area of circulation in central and southern Europe; Usutu virus, with increasing evidence of a role in human disease; tick-borne encephalitis virus, which is being detected in northern areas and at higher altitudes as a consequence of climate warming; Crimean-Congo hemorrhagic fever virus, which is endemic in Eastern Europe and the Middle East, but has been recently detected in Spain; other viruses, such as California encephalitis virus antigenic group, which circulate in northern and central Europe but whose relevance for human disease in largely unknown. In addition, the rise in global travel and trade has posed Europe to an increased risk of introduction and expansion of exotic arthropod vectors and autochthonous transmission of arboviruses, like dengue and chikungunya viruses, following new introductions from endemic areas. Read More

ACS Chem Neurosci 2019 Jan 31;10(1):132-142. Epub 2018 Aug 31.

Department of Pathology , Keck School of Medicine of the University of Southern California , Los Angeles , California 90033 , United States.

Anti-NMDA ( N-methyl-d-aspartate) receptor (anti-NMDAR) encephalitis is one of the most common paraneoplastic encephalitides. It occurs in both sexes, across all age ranges, and may occur in the presence or absence of an associated tumor. Its pathogenesis and clinical presentation relate to the presence of IgG1 or IgG3 antibodies targeting the NR1 subunit of the NMDA receptor, leading to a disinhibition of neuronal excitatory pathways. Read More

J Vet Diagn Invest 2018 Sep 21;30(5):784-788. Epub 2018 Aug 21.

California Animal Health & Food Safety Laboratory System, University of California-Davis, Turlock Branch, Turlock, CA (Crispo, Cooper, Bickford, Stoute).

Infectious coryza, caused by Avibacterium paragallinarum, is an acute respiratory disease of poultry that can result in substantial morbidity, mortality, and economic losses. In March 2017, the Turlock branch of the California Animal Health and Food Safety laboratory system encountered an unusual clinical and pathologic presentation of infectious coryza in 6 live, 29-d-old, commercial broiler chickens that were submitted for diagnostic investigation. Antemortem evaluation revealed severe neurologic signs, including disorientation, torticollis, and opisthotonos. Read More

Prim Care 2018 Sep;45(3):393-407

Department of Family Medicine, Loma Linda University School of Medicine, 1200 California Street, Suite 240, Redlands, CA 92374, USA.

Mosquito-borne diseases have become more common as previously geographically isolated diseases have spread globally. Chikungunya, dengue, Japanese encephalitis, malaria, West Nile, yellow fever, and Zika are a few of the common and emerging viral diseases spread by mosquitoes. A thorough patient history, physical, and knowledge of diagnostic testing based on symptom duration is important to make a quick and accurate diagnosis. Read More

Am J Transl Res 2018 15;10(7):2137-2147. Epub 2018 Jul 15.

Division of Nephrology and Hypertension, Department of Physiology and Biophysics, University of California Irvine, USA.

Chronic kidney disease (CKD) results in various central nervous systems (CNS) disorders including cognitive dysfunction, depression, anxiety, movement disorders, seizures and encephalopathy. Uremic retention products, oxidative stress, inflammation and impaired blood-brain barrier have been implicated as the major mediators of CKD-induced CNS disorders. However, mechanisms of CKD-induced cerebral tissue oxidative stress, inflammation and impaired blood brain barrier have not been fully elucidated and were explored. Read More

J Family Med Prim Care 2018 Mar-Apr;7(2):275-283

Medical Laboratory Specialist, Etobicoke, Toronto, Ontario, Canada.

Nipah virus (NiV) encephalitis first reported in "Sungai Nipah" in Malaysia in 1999 has emerged as a global public health threat in the Southeast Asia region. From 1998 to 2018, more than 630 cases of NiV human infections were reported. NiV is transmitted by zoonotic (from bats to humans, or from bats to pigs, and then to humans) as well as human-to-human routes. Read More

J Neuroimaging 2018 Nov 5;28(6):601-607. Epub 2018 Aug 5.

University of California at San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, Department of Radiology and Biomedical Imaging, San Francisco, CA.

Background And Purpose: HIV infection of the central nervous system (CNS) is a nearly universal feature of untreated systemic HIV infection. While combination antiretroviral therapy (ART) that suppresses systemic infection usually suppresses CNS (CNS) HIV infection, exceptions have been reported with discordance between CSF and blood HIV RNA concentrations such that CSF demonstrates higher HIV concentrations than blood, referred to as CSF HIV escape. Rarely, CSF HIV escape presents with neurological symptoms, called neurosymptomatic escape. Read More

Front Med (Lausanne) 2018 17;5:176. Epub 2018 Jul 17.

All India Institute of Medical Sciences, New Delhi, India.

In an interesting investigation by Khoury-Hanold et al. (1), genital infection of mice with herpes simplex virus 1 (HSV1) were reported to cause multiple pelvic organ involvement and obstruction. A small subset of mice succumbed after the first week of HSV1 infection. Read More

Vaccine 2018 08 26;36(35):5222-5225. Epub 2018 Jul 26.

Department of Population Health and Disease Prevention, University of California, 653 E. Peltason Drive, Irvine, CA 92697, United States. Electronic address:

Subacute sclerosing panencephalitis (SSPE) is a neurodegenerative disease caused by measles virus. We estimate SSPE age-specific mortality in the United States, 1979-2016. The general decline in SSPE mortality reflects that of measles. Read More

Vet Med (Auckl) 2017 6;8:31-36. Epub 2017 Jul 6.

Schubot Exotic Bird Health Center, Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX,

Parrot bornavirus (PaBV), the etiologic agent of proventricular dilatation disease (PDD), is a major cause of concern in the avian health community. Within an infected flock, some birds will develop PDD and succumb to disease, while others remain healthy. Until now, there has been no study describing the results of long-term infection in apparently healthy carriers. Read More

Lancet Neurol 2018 Sep 23;17(9):733-735. Epub 2018 Jul 23.

Weill Institute for Neurosciences, MS and Neuroinflammation Clinic, University of California, 94158, San Francisco, CA, USA. Electronic address:

Sci Rep 2018 Jul 25;8(1):11209. Epub 2018 Jul 25.

BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Centre, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Previously, we reported that Zika virus (ZIKV) causes ocular complications such as chorioretinal atrophy, by infecting cells lining the blood-retinal barrier, including the retinal pigment epithelium (RPE). To understand the molecular basis of ZIKV-induced retinal pathology, we performed a meta-analysis of transcriptome profiles of ZIKV-infected human primary RPE and other cell types infected with either ZIKV or other related flaviviruses (Japanese encephalitis, West Nile, and Dengue). This led to identification of a unique ZIKV infection signature comprising 43 genes (35 upregulated and 8 downregulated). Read More

Emerg Infect Dis 2018 08;24(8)

The epidemiology of Coxiella burnetii infection in the United States is not well characterized. We report a case-patient with C. burnetii endocarditis and meningitis. Read More

Open Forum Infect Dis 2018 Jun 16;5(6):ofy114. Epub 2018 May 16.

Zhejiang-California International Nanosystems Institute, Zhejiang University, Hangzhou, China.

Background: Metagenomic sequencing has shown tremendous promise in solving difficult infectious diseases cases. In this study, we utilized this technology to help guide the care of a critically ill patient with severe pneumonia, fever of unknown origin, and subsequent encephalitis in the intensive care unit (ICU).

Methods: Shotgun metagenomic sequencing was performed on the patient's blood, bronchoalveolar lavage (BAL), and cerebral spinal fluid by using an Illumina MiniSeq sequencer. Read More

Lancet 2018 06;391(10139):2500-2501

International Vaccine Institute, Seoul 08826, South Korea; Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK. Electronic address:

Parasitol Res 2018 Sep 30;117(9):2895-2900. Epub 2018 Jun 30.

Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, 66-1 Hon-cho, Hirosaki, 036-8564, Japan.

Balamuthia mandrillaris is a free-living amoeba that lives in soil and water near human settlements. B. mandrillaris was first isolated from a mandrill baboon that died at the San Diego Zoo Wildlife Park in California in 1986, and the first human infection was reported in 1990. Read More

Pharmacoepidemiol Drug Saf 2018 Aug 3;27(8):921-925. Epub 2018 Jun 3.

Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.

In light of waning immunity to pertussis following receipt of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine, maintaining protection may require repeated Tdap vaccination. We evaluated the safety of repeated doses of tetanus-containing vaccine in 68 915 nonpregnant adolescents and adults in the Vaccine Safety Datalink population who had received an initial dose of Tdap. Compared with 7521 subjects who received a subsequent dose of tetanus toxoid, reduced diphtheria (Td) vaccine, the 61 394 subjects who received a subsequent dose of Tdap did not have significantly elevated risk of medical visits for seizure, cranial nerve disorders, limb swelling, pain in limb, cellulitis, paralytic syndromes, or encephalopathy/encephalitis/meningitis. Read More

Inflamm Bowel Dis 2018 09;24(10):2258-2265

Pfizer Inc., Collegeville, Pennsylvania.

Background: Tofacitinib is an oral, small molecule Janus kinase inhibitor that is being investigated for ulcerative colitis (UC). Tofacitinib is approved for rheumatoid arthritis and psoriatic arthritis, where it has been shown to increase herpes zoster (HZ) risk. We evaluated HZ risk among UC patients using tofacitinib. Read More