Over the past 15 years in the United States, HIV/AIDS has become increasingly common among women. In 1990, women made up only 11% of the newly reported cases of AIDS.1 In 2006, 27% of newly reported AIDS cases were in women.2
Infections In Medicine Journal
After drinking a cup of coffee in the lounge of St Gimmick Hospital, Dr Schmeckman accompanied one of his students, Mollie Jeanette, who was beginning her rotation through the hospital’s infectious diseases service, to the microbiology laboratory.
Otological complications associated with varicella-zoster
virus infection are common; however, tympanic membrane
involvement is rarely reported. We describe a patient with
herpes zoster in whom hemorrhagic otitis media with tympanic
membrane perforation developed. To our knowledge,
this is the first report of an HIV-infected patient with this
unusual presentation. [Infect Med. 2008;25:561-562]
A34-year-old man with HIV/AIDS presented to the emergency department with fatigue, dyspnea on exertion, headache, subjective fevers, and chills of 1 month's duration. He also had blurry vision and a pruritic facial rash of 2 weeks' duration. He admitted to being noncompliant with antiretroviral therapy for the past 18 months and was not taking other medications at the time of presentation.
Highlights of upcoming recommendations of the Infectious Diseases Society of America (IDSA) for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections and community-associated urinary tract infections (CA-UTIs) were presented at the joint 48th Annual Interscience Conference of Antimicrobial Agents and Chemotherapy/ IDSA 46th Meeting, which took place in Washington, DC, from October 25 to 28. The recommendations are scheduled to be finalized and officially disseminated in the spring of 2009. Some salient points are summarized here.
Bacteremia caused by viridans streptococci frequently presents
in a subacute fashion and can lead to complicated infections.
It usually manifests from an oral source and may result in
seeding of the heart valves. We describe a case of viridans
streptococci bacteremia that developed after a dental procedure
and was complicated by endocarditis and vertebral osteomyelitis.
Symptoms and signs that may heighten suspicion for
complicated bacteremia caused by viridans streptococci are
discussed. [Infect Med. 2008;25:552-555]
Opportunistic Fungal Infections, Part 3: Cryptococcosis, Histoplasmosis, Coccidioidomycosis, and Emerging Mould Infections
Immunocompromised hosts are at high risk for opportunistic
infections caused by endemic fungi such as Cryptococcus,
Histoplasma, and Coccidioides. Moulds other than Aspergillus
also are being implicated in opportunistic fungal infections in
immunocompromised patients. Infections attributed to
Zygomycetes and Fusarium and Scedosporium species are being
reported with increased frequency. Because infection with these
organisms cannot be distinguished from aspergillosis on
radiographic imaging or histological examination, culture is
required to confirm the diagnosis. Therapeutic success may
hinge on correct identification of the infectious organism.
Although many physicians are not up to speed on
the CDC 2006 recommendations on HIV screening,
institution of routine voluntary testing in
health care settings does enhance identification of undiagnosed
cases of HIV infection. Furthermore, patients-
especially those in high-risk groups-are generally receptive
to the opportunity to be screened for HIV infection.
These were the findings from several studies on HIV
testing that were presented during a poster session at the
joint 48th Annual Interscience Conference on Antimicrobial
Agents and Chemotherapy and 46th Annual Meeting
of the Infectious Diseases Society of America, which took
place in Washington, DC, from October 25 to 28, 2008.
Mycobacterium goodii infection is uncommon and probably
occurs via disruption of skin and bone integrity or the
introduction of a foreign body into viscera, namely implantation
of a prosthetic device. We describe a case of nosocomial,
total knee arthroplasty–associated M goodii infection that
required combined antibiotic and surgical therapy for clinical
management. An infection control investigation revealed that
the source of the organism might have been the water in the
operating room scrub faucets. [Infect Med. 2008;25:522-525]
Posaconazole, indicated for prophylaxis of invasive Aspergillus and Candida infections in immunosuppressed patients aged 13 years or older and for treatment of oropharyngeal candidiasis (Table 1), is like other triazole antifungals in that it blocks ergosterol biosynthesis. 1 Its chemical structure is most similar to that of itraconazole (Figure), which may confer efficacy even against strains resistant to fluconazole and voriconazole.2