Bloodstream infections (BSI) are a global health issue, leading to high mortality and morbidity among hospitalized patients.

Background Botulism is a rare and potentially fatal neuroparalytic syndrome caused by the gram-positive anaerobe spore-forming bacterium Clostridium botulinum. The microorganism produces a neurotoxin that inhibits the presynaptic release of acetylcholine at the neuromuscular junction, clinically leading to a myasthenic syndrome. Objective To describe the recent outbreak of botulism cases and its demographic, clinical, and laboratory characteristics. Methods We report 4 patients with botulism in the recent outbreak occurred between 2017 and 2019 in the state of Amazon. Results Out of four patients with botulism, three contracted it from eating contaminated food and one had wound botulism. We emphasize the excellent clinical outcome of the different disease presentations in our case series. Conclusion The temporal proximity of these reports may suggest a new rise in the number of cases in the upcoming years. A possible hypothesis is that the rarity of the disease decreased the awareness regarding the primary prevention or even a diagnosis by an untrained physician.

Human Herpesviruses (HHVs) play a significant role in neurological diseases such as encephalitis and meningitis, adding significant morbidity. This study aims to retrospectively analyze the effect of HHVs on patients with neurological symptoms, focusing on the Herpesviridae family’s contributions to central nervous system (CNS) infections. Methods: This retrospective cohort study included 895 patients suspected of viral CNS infections, utilizing molecular diagnosis via qPCR to identify HHVs in cerebrospinal fluid (CSF) samples. This was conducted at a reference tertiary care hospital for infectious diseases in the western Brazilian Amazon from January 2015 to December 2022, focusing on the Herpesviridae family’s clinical repercussions and of Cytomegalovirus in CNS infections. Results: The findings revealed that 7.5% of the analyzed samples tested positive for HHVs, with Human Cytomegalovirus (HCMV) and Epstein–Barr Virus (EBV) being the most prevalent. A significant association was found between HHVs and neurological diseases such as encephalitis and meningitis, especially among people living with HIV/AIDS (PLWHA), highlighting the opportunistic nature of these viruses. The study underscores the critical role of CSF analysis in diagnosing CNS infections and the complexity of managing these infections in HIV patients due to their immunocompromised status. Conclusions: The results emphasize the need for comprehensive diagnostic approaches and tailored treatment strategies for CNS infections in immunocompromised individuals. The study calls for ongoing research and advancements in clinical practice to improve patient outcomes facing CNS infections, particularly those caused by HHVs.

Human immunodeficiency virus (HIV) depletes CD4+ lymphocytes, compromising cellular immunity and increasing susceptibility to opportunistic infections. Additionally, HIV can lead to neurocognitive, motor, and sensory impairments known as HIV-associated neurocognitive disorders (HAND), which encompass symptoms ranging from concentration difficulties and psychomotor slowing to depressive states, irritability, and, in advanced stages, dementia. Cholinesterase inhibitors, commonly used in Alzheimer's disease, are a potential therapeutic option for cognitive decline in HAND. An integrative literature review was conducted using PubMed, Embase, and the Cochrane Library databases to identify relevant studies on the use of cholinesterase inhibitors in individuals diagnosed with HAND. The literature search yielded studies that explore the efficacy and safety of cholinesterase inhibitors in HAND, highlighting both potential cognitive benefits and the need for further evidence. However, findings remain limited and inconclusive regarding robust clinical recommendations. While cholinesterase inhibitors represent a promising therapeutic approach for HAND-related cognitive decline, current evidence is insufficient to support widespread clinical use. Further controlled studies are necessary to establish their efficacy and safety in this specific population.