Tuberculous meningitis due to Mycobacterium africanum in Spain, a case report

Torrellas Bertran, Nuria; Garcia Continente, Gemma; Villarreal, Oscar

doi:10.1016/j.eimce.2024.09.002

array:24 ["pii" => "S2529993X24002041" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2024.09.002" "estado" => "S300" "fechaPublicacion" => "2024-11-01" "aid" => "2845" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2024;42:536-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0213005X24002623" "issn" => "0213005X" "doi" => "10.1016/j.eimc.2024.06.007" "estado" => "S200" "fechaPublicacion" => "2024-07-19" "aid" => "2845" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2024;42:536-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "Carta científica" "titulo" => "Meningitis tuberculosa por Mycobacterium africanum en España, a propósito de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Tuberculous meningitis due to Mycobacterium africanum in Spain, a case report" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1660 "Ancho" => 2133 "Tamanyo" => 189306 ] ] "descripcion" => array:1 [ "es" => "Imágenes de resonancia magnética. Izquierda: secuencia T1 coronal, donde se observa realce meníngeo, de predominio en cisternas de la base. Derecha: secuencia T2 FLAIR axial, nótese el aumento del tamaño ventricular con nivel líquido-líquido en ambas astas occipitales y áreas de hiperseñal en la sustancia blanca periventricular." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nuria Torrellas Bertran, Gemma Garcia Continente, Oscar Villarreal" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Nuria" "apellidos" => "Torrellas Bertran" ] 1 => array:2 [ "nombre" => "Gemma" "apellidos" => "Garcia Continente" ] 2 => array:2 [ "nombre" => "Oscar" "apellidos" => "Villarreal" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2529993X24002041" "doi" => "10.1016/j.eimce.2024.09.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X24002041?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X24002623?idApp=UINPBA00004N" "url" => "/0213005X/unassign/S0213005X24002623/v1_202407190428/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2529993X24002235" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2024.05.013" "estado" => "S300" "fechaPublicacion" => "2024-11-01" "aid" => "2836" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Enferm Infecc Microbiol Clin. 2024;42:539-40" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Measles confirmed case in vaccinated patient: Role of the specific IgG avidity testing" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "539" "paginaFinal" => "540" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Caso confirmado de sarampión en vacunada: papel de la determinación de avidez de IgG específica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Marta Pérez-Abeledo, Fernando Martín, Susana Jiménez, Juan Carlos Sanz" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Marta" "apellidos" => "Pérez-Abeledo" ] 1 => array:2 [ "nombre" => "Fernando" "apellidos" => "Martín" ] 2 => array:2 [ "nombre" => "Susana" "apellidos" => "Jiménez" ] 3 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Sanz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213005X24002519" "doi" => "10.1016/j.eimc.2024.05.005" "estado" => "S200" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X24002519?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X24002235?idApp=UINPBA00004N" "url" => "/2529993X/0000004200000009/v1_202411050502/S2529993X24002235/v1_202411050502/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2529993X24001795" "issn" => "2529993X" "doi" => "10.1016/j.eimce.2024.07.003" "estado" => "S300" "fechaPublicacion" => "2024-11-01" "aid" => "2843" "copyright" => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Enferm Infecc Microbiol Clin. 2024;42:535-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Oral intolerance: new scenario for parenteral antiretroviral therapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "535" "paginaFinal" => "536" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Intolerancia a vía oral: nuevo escenario para la terapia antirretroviral parenteral" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sergio Ferra Murcia, Ana Belén Lozano Serrano, Marta Segura Díaz, Antonio Ramón Collado Romacho" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Sergio" "apellidos" => "Ferra Murcia" ] 1 => array:2 [ "nombre" => "Ana Belén" "apellidos" => "Lozano Serrano" ] 2 => array:2 [ "nombre" => "Marta" "apellidos" => "Segura Díaz" ] 3 => array:2 [ "nombre" => "Antonio Ramón" "apellidos" => "Collado Romacho" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213005X24002635" "doi" => "10.1016/j.eimc.2024.06.005" "estado" => "S200" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X24002635?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X24001795?idApp=UINPBA00004N" "url" => "/2529993X/0000004200000009/v1_202411050502/S2529993X24001795/v1_202411050502/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Tuberculous meningitis due to Mycobacterium africanum in Spain, a case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "536" "paginaFinal" => "538" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Nuria Torrellas Bertran, Gemma Garcia Continente, Oscar Villarreal" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Nuria" "apellidos" => "Torrellas Bertran" "email" => array:2 [ 0 => "ntorrellas@hotmail.com" 1 => "ntorrellas@ssibe.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Gemma" "apellidos" => "Garcia Continente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Oscar" "apellidos" => "Villarreal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Microbiología, Fundació Hospital de Palamós-SSIBE, Gerona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Diagnóstico por Imagen, Fundació Hospital de Palamós-SSIBE, Gerona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Medicina Familiar y comunitaria, ABS Torroella de Montgrí, Fundació Hospital de Palamós- SSIBE, Gerona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Meningitis tuberculosa por Mycobacterium africanum en España, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1660 "Ancho" => 2133 "Tamanyo" => 189306 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Magnetic resonance images. Left: Coronal T1 sequence showing meningeal enhancement, predominantly in the basal cisterns. Right: Axial T2 FLAIR sequence; note the increase in ventricular size with fluid-fluid level in both occipital horns and areas of hyperintensity in the periventricular white matter." ] ] ] "textoCompleto" => "We present the case of a 30-year-old patient, originally from Gambia and resident in Spain for two years, with no relevant medical history or known allergies. The patient came to Accident and Emergency at Palamós Hospital (regional hospital) with a month-long history of headache, photophobia, febricula and general malaise, accompanied in the previous week by hyporexia, generalised asthenia and night sweats. Initial testing, including complete blood count, urinary sediment and acute phase reactants, was normal.Brain computerised tomography (CT) showed dilation of the supratentorial ventricular system with signs of activity and ependymal effusion. Lumbar puncture revealed cerebrospinal fluid (CSF) glucose levels of 30 mg/dl, proteins 349 mg/dl, leucocytes 350/mm3, polymorphonuclear 72% and ADA 14 U/l, suggesting probable bacterial meningitis complicated by hydrocephalus. The patient was admitted to the Intermediate Care Unit (IMCU), and empirical treatment was started with ampicillin, aciclovir, rifampicin and dexamethasone.Brain magnetic resonance imaging (MRI) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showed findings consistent with acute meningitis with leptomeningeal uptake, ventriculitis and signs of ischaemic complication in the left internal capsule. CSF polymerase chain reaction (PCR) (GeneXpert MTB/RIF Ultra®) was positive for rifampicin-sensitive Mycobacterium tuberculosis complex (MTBC), and tuberculous meningitis was diagnosed. Tuberculosis treatment was adjusted with rifampicin, isoniazid, streptomycin, linezolid and dexamethasone.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>After 72 hours in the IMCU, the patient’s state of consciousness deteriorated (Glasgow Coma Scale 8) and he became haemodynamically unstable, requiring intubation and transfer to the Intensive Care Unit (ICU) in a more specialised hospital (Hospital J. Trueta, in Girona), where treatment was adjusted to rifampicin, isoniazid, pyrazinamide, ethionamide and dexamethasone.In the ICU, the patient developed several complications, including left mydriasis and bradycardia secondary to hydrocephalus, receiving treatment with mannitol and external ventricular drainage (EVD), ventriculitis treated with ganciclovir, tracheobronchitis associated with intubation (due to multi-drug-sensitive Escherichia coli) and EVD infection treated with vancomycin and meropenem, eventually becoming haemodynamically stable but neurologically in a coma. Subsequently, the patient developed pneumonia secondary to bronchial aspiration, and treatment was changed to rifampicin, isoniazid, pyrazinamide and levofloxacin, with little response. The patient eventually died four weeks after his initial admission due to respiratory complications and hydrocephalus.At this same time, at the regional hospital, Lowenstein’s culture was found to be positive and the strain was sent to the reference centre (Vall d’Hebron Hospital) where Mycobacterium africanum (M. africanum) lineage 6 was identified, with the result being received a few days after the patient’s death.The detection of M. africanum in cases of tuberculous meningitis in Spain introduces a new and worrying aspect to the epidemiology of this disease. Tuberculous meningitis represents a medical challenge due to its serious and potentially lethal nature<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> and is a rare manifestation of extrapulmonary tuberculosis.Its prevalence in Spain is low, only making up 1% of all tuberculosis cases, but it has an alarming mortality rate of 40–50%, highlighting the urgency of early diagnosis and treatment. Limitations to the management of tuberculous meningitis<a class="elsevierStyleCrossRefs" href="#bib0015">3,4</a> include its nonspecific clinical presentation, which delays diagnosis, and suboptimal antimicrobial regimens. In addition, although progress has been made with molecular tools, the sensitivity of the available diagnostic techniques is insufficient.M. africanum is a member of the MTBC. It was first described in 1968. Its distribution is variable across Africa; it has demonstrated an ability to adapt and evolve in different ecological environments.<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a> It is exclusively pathogenic for humans. The various lineages and sublineages of M. africanum (L5, L6 and L9) are located in specific areas of Africa. L6 strains are prevalent in countries such as Guinea Bissau, Sierra Leone and Gambia.Considering that M. africanum is predominant in Africa and that the patient had resided in Spain for the previous two years, it is likely that he had become infected in his country of origin, but that he had remained asymptomatic. Being an immunocompetent patient with no previous history of tuberculosis or signs of pulmonary involvement at the time of his illness, it is of note that meningitis was the first sign of tuberculosis reactivation.The finding of M. africanum is an indicator of transmissibility and latent tuberculosis infection (LTBI). In our clinical case, the application of recommendations<a class="elsevierStyleCrossRef" href="#bib0035">7</a> for the screening of LTBI, developed by healthcare professionals and epidemiologists, which include strategies for systematic detection and treatment in risk groups, could have facilitated early detection and appropriate treatment, possibly avoiding the fatal outcome. Preventing active TB through LTBI treatment is a critical component of the WHO’s strategy to eliminate TB.Creating strategies is crucial to reduce transmission and establish epidemiological links that prevent the spread of the disease." "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1660 "Ancho" => 2133 "Tamanyo" => 189306 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Magnetic resonance images. Left: Coronal T1 sequence showing meningeal enhancement, predominantly in the basal cisterns. Right: Axial T2 FLAIR sequence; note the increase in ventricular size with fluid-fluid level in both occipital horns and areas of hyperintensity in the periventricular white matter." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous meningitis: more questions, still too few answers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.E. Thwaites" 1 => "R. van Toorn" 2 => "J. Schoeman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(13)70168-6" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2013" "volumen" => "12" "paginaInicial" => "999" "paginaFinal" => "1010" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23972913" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous meningitis: pathogenesis, immune responses, diagnostic challenges, and the potential of biomarker-based approaches" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.M. Manyelo" 1 => "R.S. Solomons" 2 => "G. Walzl" 3 => "N.N. Chegou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.01771-20" "Revista" => array:3 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2021" "volumen" => "59" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous meningitis: where to from here?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Donovan" 1 => "G.E. Thwaites" 2 => "J. Huynh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QCO.0000000000000648" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Infect Dis" "fecha" => "2020" "volumen" => "33" "paginaInicial" => "259" "paginaFinal" => "266" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32324614" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous meningitis: progress and remaining questions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Huynh" 1 => "J. Donovan" 2 => "N.H. Phu" 3 => "H.D.T. Nghia" 4 => "N.T.T. Thuong" 5 => "G.E. Thwaites" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(21)00435-X" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2022" "volumen" => "21" "paginaInicial" => "450" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35429482" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The species Mycobacterium africanum in the light of new molecular markers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Niemann" 1 => "T. Kubica" 2 => "F.C. Bange" 3 => "O. Adjei" 4 => "E.N. Browne" 5 => "M.A. Chinbuah" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.42.9.3958-3962.2004" "Revista" => array:5 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2004" "volumen" => "42" "paginaInicial" => "3958" "paginaFinal" => "3962" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculosis caused by Mycobacterium africanum: knowns and unknowns" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.L. Silva" 1 => "B Cá" 2 => "NS Osório" 3 => "PNS Rodrigues" 4 => "AR Maceiras" 5 => "M Saraiva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.ppat.1010490" "Revista" => array:3 [ "tituloSerie" => "PLoS Pathog" "fecha" => "2022" "volumen" => "18" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:1 [ "host" => array:2 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Recomanacions per al cribratge de la infecció tuberculosa latent a Catalunya" "fecha" => "2023" "editorial" => "Subdirecció General de Vigilància i Resposta a Emergències de Salut Pública" "editorialLocalizacion" => "Barcelona" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://hdl.handle.net/11351/9629" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000004200000009/v1_202411050502/S2529993X24002041/v1_202411050502/en/main.assets" "Apartado" => array:4 [ "identificador" => "63562" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000004200000009/v1_202411050502/S2529993X24002041/v1_202411050502/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X24002041?idApp=UINPBA00004N"]

ISSN: 2529-993X

The Journal Enfermedades Infecciosas y Microbiología Clínica is the official publication of the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) (Spanish Society of Infectious Diseases and Clinical Microbiology). It has as its aim to respond to the challenges currently posed by everything associated with infectious diseases, from a clinical, microbiological and public health perspective. The Journal follows a rigorous selection process of the manuscripts published through the review by the best experts in each area of knowledge of the specialty. The quality of the material published is the main aim of the Editors, as well as to provide readers with the latest and most relevant information in the world of infectious diseases. Enfermedades Infecciosas y Microbiología Clínica includes the following sections: original articles, critical reviews, scientific letters, and a section dedicated to continuing medical education, which each year deals with a specific subject and a series of specific topics of the specialty, prepared by invited authors of recognised experience. The Journal is included in Science Citation Index Expanded, Medline/PubMed, and SCOPUS.

See more Open Access Option

Indexed in:

Index Current Contents/Clinical Medicine, JCR, SCI-Expanded, Index Medicus/Medline, Excerpta Medica/EMBASE, IBECS, IME, CANCERLIT, SCOPUS

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

2.6

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

2.1

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.355

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.381

View more metrics

Journal Information

Previous article | Next article

Vol. 42. Issue 9.

Pages 536-538 (November 2024)

Lee este artículo en Español

Export reference

Download PDF

Article

These are the options to access the full texts of the publication Enfermedades Infecciosas y Microbiología Clínica (English Edition)

Member

Socio de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica

Para acceder a la revista

Es necesario que lo haga desde la zona privada de la web de la SEIMC, clique aquí

Para realizar los cursos formativos

La actividad estará abierta para socios de la SEIMC. IMPORTANTE, recuerde que requiere registro previo gratuito. Empezar aquí

Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”

Subscribe to

Enfermedades Infecciosas y Microbiología Clínica (English Edition)

More information

Purchase

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now

Contact

Phone for subscriptions and reporting of errors

From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.

Calls from Spain

932 415 960

Calls from outside Spain

+34 932 415 960

E-mail

atencionalcliente@elsevier.com

Publish in

Enfermedades Infecciosas y Microbiología Clínica

Tools

Indexed in:

Follow us:

Subscribe:

Article

Subscribe to our newsletter