Infectious Disease

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This patient had unilateral petechiae on the dorsum of the left foot. If the petechiae were symmetric, the first condition on the differential diagnosis would be thrombocytopenia. Here, though, the platelet count was normal. The patient also had a duplex of both the arterial and venous systems that showed complete thrombosis of both the arterial AND venous systems.

Chlamydia trachomatis, serovar L2b-a recently discovered microbe-was the cause of atypical lymphogranuloma venereum in this HIV-positive patient.

This multi-factorial eruption requires topical or systemic antifungal treatment in conjunction with broad-spectrum antibacterial therapy, topical desiccating maneuvers (such as Burrow’s soaks), and discontinuation of OTC interventions that might be worsening the problem.

The patient was a traveling salesman and was concerned that the lesions were bedbug bites. The diagnosis of herpes simplex virus infection was confirmed by viral “culture.” What was this patient's condition?

Herpes zoster is a reactivation of an infection with the varicella zoster virus, manifests as painful vesicular rash.

Chronic Constipation

Skills quiz: Rectus abdominus rupture; IBS; Cholecystitis; Smoking and MS

Grouped vesicles filled with straw colored liquid on an inflamed base that are accompanied by complaints of a tingling sensation and then pain are classic signs and symptoms of a herpes outbreak.

Go-For-The-Glory Quiz

Skills quiz: Chondrodermatitis nodularis helices; Keratoses; OSA; Parotid swelling and HIV; Limbal flush

(AUDIO) There are disparities in the sensitivities and specificities of glucose and lactose hydrogen breath tests used to diagnose small intestine bacterial overgrowth and to distinguish patients with irritable bowel syndrome from healthy individuals. Just how useful are these tests? Insights from an expert here.

If you are worried about whether you may have injected a patient with a tainted vial of methylprednisolone from New England Compounding Center’s (NECC) Framingham, Massachussets facility, you can now obtain detailed information from the FDA that may assuage your concerns.