Explore the vast range of titles available.

A surge in RSV infections occurred across the United States in late 2022. In this report, multiple RSV lineages are identified as contributing to the surge.

Abstract Objectives Epstein-Barr virus (EBV) causes different clinical presentations in immunocompetent and immunocompromised persons, and thus indications for testing vary between these populations. We reviewed our institution’s EBV DNA testing across these populations to understand its clinical utility and appropriateness. Methods We conducted a retrospective chart review of adult patients with positive EBV nucleic acid amplification (NAAT) testing from November 2022 to 2023. We recorded demographics, indications for testing, EBV-related diagnosis, laboratory results, and whether testing influenced patient treatment. Results Of 3560 EBV NAAT tests, 187 (5.3%) were positive, representing 124 unique adult patients (51 immunocompetent and 73 immunocompromised). Reactivation of EBV was the most common diagnosis in both populations, followed by acute EBV infection in the immunocompetent and non-posttransplant lymphoproliferative disorder malignancies in the immunocompromised. In immunocompromised patients, positive tests led to treatment changes more frequently than in immunocompetent patients (27.4% vs 11.7%, P = .06). Testing affected clinical management in 0% to 2% of cases when sent for sepsis/shock and nonspecific viral syndromes compared to 37% to 49% of cases when sent for posttransplant and malignancy screening/monitoring. Discussion EBV NAAT testing infrequently influenced clinical management in immunocompetent individuals but had a notable impact in immunocompromised patients, particularly those undergoing posttransplant or malignancy screening. This underscores the need for targeted testing to optimize resource utilization and cost-effectiveness.

A Man with Arthritis and RashA 46-year-old man was evaluated in the rheumatology clinic because of joint pain and swelling. The examination was notable for rash, nasal crusting, and alopecia. A diagnosis was made.

Candida auris is an emerging, often multidrug-resistant pathogen with important public health implications. Infections are associated with high mortality, and prevention of transmission requires stringent infection control measures, making C. auris a potential barrier to transplantation. We describe the first donor-derived C. auris transmission in a lung transplant recipient.

A clinical case is presented to discuss a framework for use of advanced diagnostics for central nervous system infections. Advantages, limitations, and diagnostic stewardship strategies are discussed for each modality: multiplex molecular meningitis/encephalitis panel, plasma microbial cell-free DNA sequencing, and cerebrospinal fluid metagenomic next generation sequencing.

A 32-year-old woman presented with fatigue, myalgias, and palpitations. The cardiac rhythm was irregularly irregular, and an electrocardiogram showed findings suggestive of grouped beating. A diagnosis was made.

A Woman with End-Stage Liver Disease and HeadacheA 56-year-old woman with liver disease was admitted with headache, confusion, and abdominal tenderness. On hospital day 5, blurred vision in the right eye occurred. A diagnosis was made.

We describe a case of mpox characterized by a circularly distributed facial rash but no identified risk factors. Fomite transmission of monkeypox virus from contaminated linen at a massage spa was suspected. Clinicians should consider mpox in patients with consistent clinical syndromes, even in the absence of epidemiologic risk factors.

A 56-year-old woman was admitted in the spring of 2020 because of fever, myalgias, diarrhea, and a dry cough. Six weeks earlier, she had had contact with a person with SARS-CoV-2 infection. She had mild ground-glass opacities on chest CT, as well as elevated aminotransferase levels and thrombocytopenia. A diagnostic test was performed.

An 11-year-old girl with eczema was evaluated for chest pain and arm pain. Imaging showed multiple bone and liver lesions. The erythrocyte sedimentation rate was higher than 130 mm per hour. A diagnosis was made.