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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), continues to wreak havoc, threatening the public health services and imposing economic collapse worldwide. Tailoring public health responses to the SARS-CoV-2 pandemic depends on understanding the mechanism of viral replication, disease pathogenesis, accurately identifying acute infections, and mapping the spreading risk of hotspots across the globe. However, effective identification and isolation of persons with asymptomatic and mild SARS-CoV-2 infections remain the major obstacles to efforts in controlling the SARS-CoV-2 spread and hence the pandemic. Understanding the mechanism of persistent viral shedding, reinfection, and the post-acute sequalae of SARS-CoV-2 infection (PASC) is crucial in our efforts to combat the pandemic and provide better care and rehabilitation to survivors. Here, we present a living literature review (January 2020 through 15 March 2021) on SARS-CoV-2 viral persistence, reinfection, and PASC. We also highlight potential areas of research to uncover putative links between viral persistence, intra-host evolution, host immune status, and protective immunity to guide and direct future basic science and clinical research priorities.

Objective Enterococcus species are the third most common organisms causing central line-associated bloodstream infections (CLABSIs). The management of enterococcal CLABSI, including the need for and timing of catheter removal, is not well defined. We therefore conducted this study to determine the optimal management of enterococcal CLABSI in cancer patients. Methods We reviewed data for 542 patients diagnosed with Enterococcus bacteremia between September 2011 to December 2018. After excluding patients without an indwelling central venous catheter (CVC), polymicrobial bacteremia or with CVC placement less than 48 h from bacteremia onset we classified the remaining 397 patients into 3 groups: Group 1 (G1) consisted of patients with CLABSI with mucosal barrier injury (MBI), Group 2 (G2) included patients with either catheter-related bloodstream infection (CRBSI) as defined in 2009 Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection by the Infectious Diseases Society of America (IDSA) or CLABSI without MBI, and Group 3 (G3) consisted of patients who did not meet the CDC criteria for CLABSI. The impact of early (< 3 days after bacteremia onset) and late (3–7 days) CVC removal was compared. The composite primary outcome included absence of microbiologic recurrence, 90-day infection-related mortality, and 90-day infection-related complications. Results Among patients in G2, CVC removal within 3 days of bacteremia onset was associated with a trend towards a better overall outcome than those whose CVCs were removed later between days 3 to 7 (success rate 88% vs 63%). However, those who had CVCs retained beyond 7 days had a similar successful outcome than those who had CVC removal < 3 days (92% vs. 88%). In G1, catheter retention (removal > 7 days) was associated with a better success rates than catheter removal between 3 and 7 days (93% vs. 67%, p  = 0.003). In non-CLABSI cases (G3), CVC retention (withdrawal > 7 days) was significantly associated with a higher success rates compared to early CVC removal (< 3 days) (90% vs. 64%, p  = 0.006). Conclusion Catheter management in patients with enterococcal bacteremia is challenging. When CVC removal is clinically indicated in patients with enterococcal CLABSI, earlier removal in less than 3 days may be associated with better outcomes. Based on our data, we cannot make firm conclusions about whether earlier removal (< 3 days) could be associated with better outcomes in patients with Enterococcal CLABSI whose CVC withdrawal is clinically indicated. In contrast, it seemed that catheter retention was associated to higher success outcome rates. Therefore, future studies are needed to clearly assess this aspect.

BackgroundMass-like lesions are an uncommon presentation of cytomegalovirus (CMV) disease.CaseWe report on a case of disseminated CMV disease with bilateral adrenal pseudotumors in a patient with a history of acute leukemia in remission.ConclusionIn the settings of advanced cancer therapy and organ transplantation, a high index of suspicion for CMV should be maintained for mass-like disease.

Achromobacter xylosoxidans, subspecies denitrificans, is a gram-negative rod recently implicated as an emerging cause of infection in both immunosuppressed and immunocompetent populations. Few cases are reported in literature involving multiple body systems. Diagnosis depends on cultures of appropriate specimens, and management usually is by administration of appropriate antibiotics (usually agents with antipseudomonal activity). We report a rare case of pneumonia due to infection with this organism, in a patient with preexisting bronchiectasis secondary to chronic aspiration.

Mycobacterium neoaurum (M. neoaurum) is an infrequently encountered cause of infection in humans. It is a member of the rapidly growing mycobacteria family. It predominately afflicts those with a compromised immune status and a chronically indwelling vascular access. Isolation of this organism is challenging yet the advent of 16s ribosomal sequencing paved the way for more sensitive detection. No treatment guidelines are available and treatment largely depends on the experience of the treating physician and nature of the isolate. We report a case of M. neoaurum bacteremia in an immune competent host, with a chronically placed peripherally inserted central catheter (PICC line).

Abstract Disclosure: T. Avanessian: None. Q. Li: None. M. Luzuriaga: None. H. Awadh: None. Introduction: Pituitary abscess is a rare and potentially life-threatening cause of hypopituitarism. It is often associated with immunosuppressed states such as HIV. It typically presents with nonspecific symptoms, including fever, headache, visual disturbances, and endocrinologic abnormalities such as panhypopituitarism and diabetes insipidus. Diagnosis is supported by the characteristic brain MRI findings. We present a case of a pituitary abscess in a patient with AIDS and neurosyphilis. Case Report: A 28-year-old HIV-positive female was admitted to the ICU after being found unresponsive. On-site, her blood glucose was 18 mg/dL. There was clear evidence of a drug overdose. Seven weeks prior, she had been hospitalized for a generalized maculopapular rash and left eye vision loss. Syphilis was confirmed by serologic testing, and cerebrospinal fluid (CSF) analysis revealed 3 WBCs, elevated protein (51 mg/dL), and negative VDRL. Brain MRI identified a 1.3 x 1.7 x 1 cm rim-enhancing lesion in the pituitary gland without optic chiasm compression, raising suspicion for a pituitary abscess. She was treated with broad-spectrum antibiotics, including Penicillin G. Ophthalmologic evaluation confirmed ocular syphilis, with MRI findings of asymmetric enhancement in the left ocular uveal tract consistent with chorioretinitis and panuveitis.An abnormal cosyntropin stimulation test, along with an ACTH level of 2.8 pg/mL, confirmed central adrenal insufficiency. A low-normal free T4 supported the diagnosis of central hypothyroidism. The patient did not have diabetes insipidus. A repeat brain MRI showed resolution of the pituitary abscess. Hypoglycemia resolved after the initiation of hydrocortisone and levothyroxine. Conclusion: Panhypopituitarism often persists even after the resolution of the pituitary abscess, and most patients will require lifelong hormone replacement therapy. While neurosyphilis as a cause of pituitary abscess is extremely rare, it can occur in immunosuppressed individuals, such as those with HIV or a history of drug use. Presentation: Monday, July 14, 2025

Coastal fisheries constitute an important source of employment and income for many coastal communities in Tangier. However, and despite its importance, there is little information available about their socioeconomic characteristics. Hence, this study was aimed to improve the knowledge about the socioeconomic and livelihood status of the fishermen in the port of Tangier. The work is totally based on a diagnosis of socioeconomic indicators derived from data obtained through a structured questionnaire carried out during 2018 to fishermen of coastal fishing. Fishermen have gaps in education and awareness about the issues related to the sustainability of resources. The great importance of this coastal fishery in the fishermen's household income is observed. In spite of the commercial value of the caught species by coastal fishing, income net profit is somewhat acceptable, and the wealth produced by this fishery has hardly impacted on the quality of the fishers' lives.

Marchica lagoon offers very favourable conditions for practice of artisanal fishing which is the main socioeconomic activity carried out in this coastal ecosystem. However, artisanal fishing there suffers from a lack of control and management due to the absence of a data collection system on the various biological and socioeconomic aspects of this fishery. Thus, it considers serious threaten their sustainability. The main purpose of the paper to give a comprehensive account of artisanal fishing and its socioeconomic aspects in the Marchica lagoon, through a survey carried out at five sites around the lagoon. It has been found that there a low level of education among fishermen. The fishermen practiced two gears, pound net and trammel net. The economical analysis showed that the total annual gross product per boat is about 15766,80 USD, which gives an average monthly income of about 1148, 10USD par boat. Therefore, the wealth produced by these fisheries have a real impact on the quality of the fishermen live. Hence, ensure sustainable development of this fishery.

Artisanal fisheries in Moroccan Mediterranean generally lack management and planning, thus development. Recently, some of these fisheries had received an attention in field of infrastructure, however, there is lake of data on socioeconomic conditions of these fisheries. The main objective of this article is an update of the state of knowledge of socioeconomic of the artisanal fishers, by means of a case study in Belyounech, Fnideq, Martil and Kaa Asras areas, through a diagnosis based on analysis of socioeconomic indicators derived from data obtained through a structured questionnaire. The data analyses revealed there was a high illiteracy rate and a low level of education among fishers. This community of fishers had lack of awareness about the issues related to the sustainability of resources. Despite species of a high commercial value, Income Net Profit is somewhat not satisfactory, thus, the wealth produced by these fisheries have no real impact on the quality of the fisher's lives, hence, do not ensure sustainable development of this activity.

Abstract Background Syphilis is an ulcerative sexually transmitted genital infection caused by Treponema pallidum, which is a member of the order Spirochaetales, family Spirochaetaceae, and genus Treponema. The incidence rate of Syphilis has been steadily rising since 2000; from 2.1 cases per 100,000 population to up to 7.5 cases per 100,000 population in 2014–2015 (the highest rate since 1994). In the state of West Virginia, we have witnessed an increase in the number of cases from 0.5 cases per 100,000 population in 2011, to 5.9 cases per 100,000 population in 2015. Systemic symptoms can include cardiovascular and neurological manifestations. We report to your attention four cases of syphilis mainly with neurological and ocular manifestations. Methods We report a series of four cases of neurosyphilis we encountered between 2013 and 2016. Main presentation of all four cases was ocular; primarily redness and photophobia. Diagnosis was confirmed by standard ophthalmological examination with positive initial rapid plasma regain titers (RPR) and fluorescent treponemal antibody absorption testing (FTA-ABS). The cerebrospinal fluid venereal disease research laboratory test (CSF-VDRL) was positive in two of the four cases (in which lumbar puncture was performed). Two of the four cases suffered from an overt immunodeficiency (HIV and laryngeal cancer on chemotherapy) and subjects of all four cases confessed to high-risk sexual behaviors. All four cases were managed with continuous infusions of Penicillin G potassium 24 million International Units for 14 days with variable response. Results Response to treatment was variable in that initial complete resolution was achieved in one patient (Case #3), another (Case #1) was retreated in 6 months due to rising RPR titers on follow-up with subsequent improvement. Two patients were lost to follow-up (Cases #2 and #4). Conclusion Sir William Osler reportedly said: “He who knows syphilis knows medicine”. The steady rise in the incidence of Syphilis warrants that health care providers consider such a diagnosis in the evaluation of suggestive neurological and ocular manifestations in predisposed patients. We also stress on the importance of follow-up to detect failure of initial treatment. Disclosures All authors: No reported disclosures.