Ilheus virus is an arbovirus with the potential for central nervous system involvement. Accurate diagnosis is a challenge due to similar clinical symptoms and serologic cross-reactivity with other flaviviruses. Here, we describe the first documented case of a fatal outcome following the identification of Ilheus virus in the cerebrospinal fluid (CSF) of a patient with cerebral encephalitis in Brazil.

Immune reconstitution inflammatory syndrome (IRIS) presents as an exaggerated immune reaction that occurs during dysregulated immune restoration in immunocompromised patients in late-stage human immunodeficiency virus (HIV) infection who have commenced antiretroviral treatments (ART). Virtually any opportunistic pathogen can provoke this type of immune restoration disorder. In this review, we focus on recent developments in the identification of risk factors for Cryptococcal IRIS and on advancements in our understanding of C-IRIS immunopathogenesis. We overview new findings in blood and cerebrospinal fluid which can potentially be useful in the prediction and diagnosis of cryptococcal meningitis IRIS (CM-IRIS). We assess current therapeutic regimens and novel treatment approaches to combat CM-IRIS. We discuss the utility of biomarkers for clinical monitoring and adjusting treatment modalities in acquired immunodeficiency syndrome (AIDS) patients co-infected with Cryptococcus who have initiated ART.

Arbovirus infections are increasingly important causes of disease, whose spectrum of neurological manifestations are not fully known. This study sought to retrospectively assess the incidence of arboviruses in cerebrospinal fluid samples of patients with neurological symptoms to inform diagnosis of central and peripheral nervous system disorders. A total of 255 cerebrospinal fluid (CSF) samples collected from January 2016 to December 2017 were tested for dengue virus (DENV 1-4), Zika virus (ZIKV), and Chikungunya virus (CHIKV) in addition to other neurotropic arboviruses of interest, using genetic and serologic assays. Of the 255 CSF samples analyzed, 3.53% (09/255) were positive for arboviruses presenting mainly as meningitis, encephalitis, and cerebrovascular events, of which ZIKV was detected in 2.74% (7/255), DENV in 0.78% (2/255), in addition to an identified ILHV infection that was described previously. All the cases were detected in adults aged 18 to 74 years old. Our findings highlight the scientific and clinical importance of neurological syndromes associated with arboviruses and demonstrate the relevance of specific laboratory methods to achieve accurate diagnoses as well as highlight the true dimension of these diseases to ultimately improve public health planning and medical case management.

Two polymerase chain reaction (PCR) protocols showed low sensitivity (36% and 53% for TB AMPLICOR and MPB64 nested PCR, respectively), when compared with classic microbiological methods (73% and 54% for Ziehl-Neelsen staining and culture, respectively), in the diagnosis of tuberculous meningitis in 91 patients in southeastern Brazil. Only three PCR-positive, microbiologically negative patients were found. Analysis of sequential cerebrospinal fluid samples by nested PCR detected Mycobacterium tuberculosis DNA up to 29 days after the introduction of antituberculosis chemotherapy.

Mental health challenges are increasingly prevalent among young individuals, particularly within high-stress academic environments such as nursing education. Resilience is critical for maintaining well-being and adapting to university demands. Objective: To assess resilience levels in first-year nursing students at FAMERP (Faculty of Medicine of São José do Rio Preto) upon entry in 2021 and their longitudinal evolution in 2022 and 2023, using the Wagnild and Young Resilience Scale. The study also aims to explore the implications for mental health promotion in young healthcare professionals. Methods: A descriptive, longitudinal, prospective, and quantitative study was conducted with 40 students. Data collection was performed via electronic forms and analyzed using descriptive statistics and specific tests within the R programming language. Results: The predominantly female sample, with a mean age of 19.5 years, exhibited moderate to high resilience levels: mean scores of 132.5 (2021), 135.8 (2022), and 139.2 (2023). A significant reduction in the Perseverance factor (p = 0.0131) was noted. There was a positive correlation between age and resilience scores (r = 0.42; p < 0.01). Discussion: Despite a slight overall increase in resilience, the decline in Perseverance is concerning, indicating potential growing mental health challenges as students progress. Small age differences significantly influence mental health outcomes. This decline may be related to increased academic stress, exposure to emotionally challenging clinical situations, and the cumulative effects of the “costs of caring”. Conclusions: Nursing students exhibit promising resilience levels, yet there is a critical need for interventions targeting Perseverance to enhance academic performance and patient care quality. Social Impact: This study contributes to the development of educational strategies designed to promote resilience, thereby potentially improving the mental health and academic performance of nursing students. By focusing on mental well-being, a more resilient healthcare workforce can be cultivated and better prepared to meet systemic challenges.