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Infections In Medicine Journal

Infections In Medicine Journal

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]

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.

Opportunistic fungal infections are increasingly common in
patients who undergo hematopoietic stem cell transplant
(HSCT). Voriconazole is frequently used in allogeneic
SCT recipients who receive immunosuppressant therapy for
graft versus host disease to prevent invasive aspergillosis.
Indications for voriconazole use include invasive aspergillosis,
candidemia, Scedosporium apiospermum infection, and fusariosis.
We describe a case in which disseminated Fusarium infection
developed in an HSCT recipient who was receiving voriconazole
therapy. [Infect Med. 2008;25:528-530]

Morbidity and mortality attributed to Candida and Aspergillus
infections can be quite high in immunocompromised hosts.
The epidemiology and clinical manifestations as well as clinical
pearls on prevention of infections caused by Candida and
Aspergillus
are discussed in this second installment of a 3-part
series on opportunistic infections in immunosuppressed
patients. [Infect Med. 2008;25:498-505]

Herpes zoster is a painful, blistering rash that typically manifests in a dermatomal distribution and is caused by reactivation of varicella-zoster virus infection. A classic presentation of herpes zoster involving the right T4 dermatome is illustrated in Figure 1. The patient was a 90-year-old man who experienced severe pain on the right side of his neck and chest followed by development of maculopapular lesions. The lesions, which ranged from macular to vesicular, resolved with no scarring or postherpetic neuralgia following 10 days of therapy with oral acyclovir and intramuscular injections of γ-globulin.

A 28-year-old man presented with a 1-year history of nodular, plaque-like, nontender, pruritic lesions on his face, ears, elbows, and feet. He was born in Mexico but had been residing in the United States for the past 6 years. He worked in construction, was an active smoker, and denied use of alcohol or illicit drugs. The patient had not been taking any oral medications and had no recent history of trauma.

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