Fruit allergies manifest with a diverse array of clinical presentations, ranging from localized contact allergies and oral allergy syndrome to the potential for severe systemic reactions including anaphylaxis. The scope of population-level prevalence studies remains limited, largely derived from single-center or hospital-based investigations. In this comprehensive review, we conducted a systematic literature search spanning the years 2009 to 2023, with full acknowledgment of potential analytical biases, to provide a global overview of fruit allergy prevalence. The primary mechanistic underpinning of fruit allergies stems from cross-reactivity between aeroallergens and food allergens, a consequence of structurally similar epitopes—a phenomenon recognized as pollen food allergy syndrome (PFAS). In the era of molecular allergology, numerous studies have dissected allergen components with substantial clinical relevance. Within this review, we explore important allergenic molecules found in plant-based foods, scrutinize pertinent cross-reactivity patterns, and offer insights into management recommendations. Additionally, we compare guideline recommendations to enhance clinical understanding and inform decision making.

Background. Omeprazole, a proton pump inhibitor (PPI), is a widely used and generally safe agent for treating acid-related gastrointestinal conditions. However, drug reaction with eosinophilia and systemic symptoms (DRESSs) syndrome has been reported. Objectives. To report a case of omeprazole-induced rapid DRESS syndrome and to review the literature. Methods. Descriptive analysis of one new case and a case series from literature review. Results. We report a case of 82-year-old woman presenting with rapid-onset of DRESS syndrome. The condition was initially suspected to be caused by antibiotic, but the definite diagnosis was eventually omeprazole-induced DRESS syndrome as suggested by the enzyme-linked immune absorbent spot (ELISpot) assay along with the clinical picture. Previous literatures regarding cases of PPI-induced DRESS syndrome were pooled for descriptive analysis. Among 21 PPI cases pooled, esomeprazole was the most commonly implicated PPI (52.4), followed by pantoprazole (19.1), and omeprazole along with lansoprazole (both 14.3). The issue of cross-reactivities amongst PPIs remains uncertain. Nonetheless, in situations in which a PPIs are deemed necessary, a prudent approach could be considering a switch to an alternative agent with distinct chemical structure. Conclusion. PPI is commonly used safely as an agent for acid-related gastrointestinal conditions. However, PPI-induced rapid DRESS syndrome can occur, particularly with prior exposure history. ELISpot is an in vitro test, useful in identifying the culprit agent in patients with delayed-type hypersensitivity reaction.

Background: Respiratory syncytial virus (RSV) is a major cause of acute respiratory infection (ARI) in adults, especially older individuals, yet data on burden in Thailand are limited. This study aimed to describe clinical characteristics and mortality risk factors of RSV‐related hospitalizations in Thai adults. Methods: We conducted a retrospective analysis using Thailand's national hospital database, including adults aged ≥ 18 years hospitalized with RSV‐associated ARIs between June 2016 and September 2024, identified using ICD‐10 codes J12.1, J20.5, J21.0, and B97.4. Demographics, case fatality ratio, and healthcare resource utilization were assessed. Multivariable logistic regression identified predictors of in‐hospital mortality, and Kaplan–Meier analysis estimated 60‐day overall survival by age and comorbidity status. Results: Among 1595 RSV‐related hospitalizations, the mean age was 66.5 years; 72.0% were aged ≥60 years and 78.4% had ≥ 1 comorbidity, most commonly hypertension, diabetes, chronic respiratory disease, and chronic heart disease. The median length of stay (LOS) was 7 days, 17.3% required oxygen therapy, and 8.2% received invasive mechanical ventilation (IMV). The in‐hospital mortality was 9.53%. Mortality was independently associated with age ≥ 75 years (mOR 1.83, p = 0.019), LOS ≥ 7 days (1.95, p = 0.001), IMV (2.94, p < 0.001), pneumonia (4.10, p < 0.001), and acute myocardial infarction (3.05, p = 0.005). The 60‐day survival rate was 88.2%, declining to 84.0% in patients aged ≥ 75 years ( p < 0.001) and 87.1% in those with comorbidities versus 92.2% in those without ( p = 0.013). Conclusions: RSV causes substantial morbidity and mortality in Thai adults, especially those aged ≥ 75 years and with chronic comorbidities, underscoring the need for strengthened RSV surveillance and prevention strategies. Trial Registration: Thai Clinical Trials Registry: TCTR20250929005

Background: Antimicrobial therapy is the cornerstone of treatment for anti–interferon-gamma (IFN-γ) autoantibody-associated immunodeficiency (AOID), but persistent or relapsing infections remain challenging. We evaluated outcomes associated with adjunctive rituximab in patients with AOID. Methods: We conducted a retrospective self-controlled cohort study of adult patients with AOID treated at a tertiary care hospital in Northern Thailand between January 2019 and December 2024. Each patient contributed data from two treatment periods: antimicrobial therapy alone and with adjunctive rituximab. Clinical and laboratory outcomes were compared over three-month observation windows. Results: Among 14 patients with AOID, the mean age was 61.00 ± 8.84 years, and 6 patients (42.86%) were male. NTM infection was present in all patients. Rapidly growing mycobacteria (RGM) infections were the predominant NTM infections in both treatment periods, occurring in 13 patients (92.86%). Compared with the antimicrobial-only period, adjunctive rituximab was associated with a significantly higher likelihood of successful antimicrobial de-escalation (adjusted odds ratio, 5.38; 95% confidence interval [CI], 1.16–25.00; P = .032). Rituximab exposure was also associated with a greater reduction in absolute lymphocyte count (adjusted β, −379 cells/µL; 95% CI, −725 to −33; P = .032) and a modest increase in alkaline phosphatase (adjusted β, 32.8 U/L; 95% CI, 8.7–56.9; P = .008). No rituximab-associated infusion reactions, hypersensitivity reactions, severe infections related to immunosuppression, or deaths were observed. Conclusion: Adjunctive rituximab was associated with a higher likelihood of successful antimicrobial de-escalation without major short-term safety concerns. Further prospective evaluation is warranted.