2024年 · 第04卷第03期

The aim of this consensus is to standardize the prevention, diagnosis, and treatment of chronic hepatitis B in children and to achieve the goal of "eliminating viral hepatitis as a major public health threat by 2030" issued by the World Health Organization. Formulated by organized experts of the Chinese Society of Infectious Diseases and Chinese Society of Hepatology, Chinese Medical Association; Group of Infectious Diseases, Chinese Pediatric Society, Chinese Medical Association; and the National Clinical Research Center for Infectious Diseases (Beijing), the consensus provides the latest evidence and recommendations for the prevention, diagnosis, and treatment of chronic hepatitis B in children.

Monkeypox (mpox) is a rare viral zoonotic disease, endemic to Central and West Africa, caused by the monkeypox virus, an orthopoxvirus similar to the variola virus (smallpox). Although sporadic travel-associated cases have historically occurred outside Africa, in May 2022, mpox began spreading globally in multiple nonendemic countries across several continents. In 2024, there has been an increase in globally reported confirmed cases of mpox and deaths from mpox, making it a public health emergency of international concern. The reasons for the unusual global spread are under investigation but likely relate to increased travel and waning population immunity to orthopoxviruses. Transmission now appears to be mainly through close, intimate contact, especially among men who have sex with men. Mpox is usually a self-limited disease. Although limited approved antiviral treatments are available, such as tecovirimat, which the European Medicines Agency approved in January 2022 for the treatment of mpox, their widespread availability and effectiveness in the current outbreak remain to be investigated. Public health control measures include surveillance, case identification/isolation, contact tracing, and targeted vaccination of contacts at high risk of exposure. However, challenges remain in curtailing the current unprecedented outbreak. Critical knowledge gaps include animal reservoir(s) responsible for initial spillover events, viral mutations that may enhance transmissibility, optimal diagnostics for noninvasive specimens, effective antiviral therapies, next-generation vaccines providing longer-term immunity, and building global capacity for outbreak response. This review summarizes the current literature on mpox virology, epidemiology, pathogenesis, clinical manifestations, diagnostics, treatment, prevention, and public health control measures. Ongoing investigation and research are needed to better understand mpox’s evolving epidemiology, pathogenicity, transmissibility, and ecology to guide strategies for containing the outbreak and preventing future global emergence.

Infection and vaccination can provide protective immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the emergence of SARS-CoV-2 variants has persisted, leading to breakthrough infections. Owing to the original antigenic sin (OAS), variant breakthrough infection or vaccination potentially induces a stronger antibody response against the ancestral strain than to subsequent variants, as in the case of influenza. Thus, overcoming OAS is important for the development of future vaccine designs. This review summarizes the recent findings on OAS in the antibody response to SARS-CoV-2 and its variants, with an emphasis on future vaccine designs.

Mycoplasma hominis is an opportunistic microorganism that colonizes the genitourinary tract and causes genitourinary infections. However, pulmonary infections caused by M. hominis have rarely been reported in immunocompetent individuals. Herein, we report a rare case of an immunocompetent adult male with M. hominis pneumonia who presented with multiple pulmonary nodules that progressed to a cavitary mass with a halo sign. The presence of M. hominis infection was confirmed using multiplex polymerase chain reaction (mPCR) of the bronchoalveolar lavage fluid. The patient demonstrated no response to the initial levofloxacin therapy; however, the symptoms subsequently improved after the administration of moxifloxacin. M. hominis may be an underestimated causative agent of community-acquired pneumonia of unknown etiology in immunocompetent adults, and the involvement of the organism should be especially suspected in sexually active patients. Molecular diagnostic methods, such as mPCR, can be used to identify the etiology of atypical pneumonia. Appropriate antibiotics are crucial for effective treatment.

The genus Citrobacter commonly found in water and soil as well as the intestinal and urinary tracts of animals and humans. Although Citrobacter infections are infrequently diagnosed in environmental contexts, the rising incidence of nosocomial manifestations underscores the importance of considering this organism in the differential diagnosis of hospital-acquired infections. We present a case of patient with septic arthritis of the shoulder who had been originally admitted for the management of acute-on-chronic congestive heart failure exacerbation and severe sepsis. On hospital day 1, joint aspiration cultures and Gram stain confirmed the presence of Citrobacter koseri, a pathogen not commonly associated with septic arthritis, and ceftriaxone was administered to target it. On hospital day 7, antibiotic was transitioned to levofloxacin, every other day for 4 weeks. The patient was discharged to an acute rehabilitation facility after a 14-day hospital stay. This case stresses the importance of maintaining a broad differential diagnosis for any patients who present with fever and joint inflammation or swelling, especially in a postoperative setting.