Bacillus pumilus (B. pumilus) is a ubiquitous spore-forming bacteria that has rarely been implicated in extraintestinal infections, mostly in immunocompromised hosts. The authors report a case of B. pumilus cellulitis with bacteremia in a person who injects drugs living with human immunodeficiency virus-hepatitis C virus (HIV-HCV) co-infection. Although similar cases have been reported for some species of the genus, namely Bacillus anthracis (B. anthracis) and Bacillus cereus (B. cereus), this case reinforces the importance of considering other Bacillus spp. as potential pathogens in skin and soft tissue infections and bloodstream infections related to intravenous drug use.

A 44-year-old woman with chronic hepatitis C virus (HCV) infection was referred by a primary care doctor and admitted to our hospital because of worsening dyspnea on exertion and right atrial and ventricular enlargement. The patient was diagnosed with pulmonary arterial hypertension (PAH) associated with portal hypertension induced by chronic HCV infection. This diagnosis was based on a cardiological examination and findings related to liver cirrhosis with portal hypertension. After the prescription of anti-PAH medicine and a slight improvement in her respiratory symptoms, 12-week direct-acting antiviral (DAA) treatment for HCV was started. Serum HCV RNA levels rapidly decreased and HCV elimination was confirmed 24 weeks after completing DAA treatment. Before confirmation of a sustained virological response at 24 weeks after completing DAA treatment, a remarkable improvement in her cardiac markers was found in a right heart catheter study. This study was performed 6 weeks after the end of DAA administration. Therefore, we considered that HCV infection was involved in the development of PAH and that elimination of HCV by interferon-free treatment was important for this patient.

Although chronic hepatitis C virus (HCV) infection affect 185 million people world-wide, pathomechanism of liver damage is still unclear. Electron microscopy can reveal liver injury in very early stage and help understanding the mechanisms that is crucial in the pathogenesis of chronic hepatitis C. We present the morphological changes in the liver of HCV infected 24-year-old female patient, using light and transmission electron microscopy. Examination by TEM revealed wide range of specific subcellular abnormalities in hepatocellular ultrastructure. The most common observed changes were ring-shaped nuclei with intranuclear inclusion, megamitochondria, and \"membranous web\" structures - the hallmark of RNA-viruses infection.

OBJECTIVE: Given the heavy burden of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections in correctional facilities, we examined knowledge about these infections among case workers and correctional officers in penal institutions in Puerto Rico.
METHODS: We used data from a cross-sectional study of state prisons, commissioned by the Puerto Rico Department of Correction and Rehabilitation, to assess knowledge about HCV and HIV (10 items each) among 256 case workers and correctional officers from 18 penal institutions selected in the prison system. Total scores for each scale ranged from 0 to 10 points, with higher scores reflecting more knowledge.
RESULTS: Of 256 participants, 64.8% were males, 39.6% were aged 30-39 years, and 70.3% were case workers. The percentage of correct responses for knowledge items ranged from 8.5% to 97.0% for HCV infection and from 38.7% to 99.6% for HIV infection. The vast majority (>96%) of participants knew that injection drug users should be tested for HCV infection and that sharing of needle injection equipment and multiple sex partners increase the risk of HIV infection. However, misconceptions about routes of transmission for these viral infections were found, with larger gaps in knowledge for HCV infection. Mean knowledge scores for HCV and HIV infections were 4.20±0.17 and 6.95±0.22, respectively, being significantly (p<0.05) higher for case workers.
CONCLUSIONS: The findings about HCV and HIV knowledge in an important segment of the correctional system staff support the urgent need for increasing educational opportunities for correctional staff.