Infectious Disease

FDA Approves New Flu Vaccine: Drug Trio Increases Kidney Risk; Spotting Problem Drinkers; Migraines and Blood Clots; New Class of Diabetes Drug

Here, HIV/AIDS specialist, Dr Susan Ball, answers 6 questions about HIV infection that primary care clinicians commonly ask.

Topical treatment for oral candidiasis is not as effective when there is esophageal involvement. Topical treatments include nystatin, amphotericin B solution, and miconazole tablets. Systemic therapy given orally includes the azoles, of which fluconazole remains the most effective commonly prescribed. Voriconazole is effective against some resistant strains of Candida. Echinocandins, a newer class of drugs, inhibit cell wall synthesis.

This is a case in which we believe vancomycin and piperacillin/tazobactam caused DIHS with lung involvement in form of bilateral pleural effusions, a very rare presentation.

The patient received standard acyclovir dosage for first outbreak genital herpes: 200 mg orally, 5 times daily, for 10 days total. At this point, there is no way to predict how often or how severe future recurrences will be.

Medication is seldom necessary. Education is the key element of therapy. An explanation of the process and a discussion of possible triggers-lack of sleep, stress, missed meals etc-is the most key intervention.

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.

New insights into how clinicians might approach treatment for patients with IBD highlighted the recent Crohn’s & Colitis Foundation’s Clinical & Research Conference.

The goals of therapy for patients with inflammatory bowel disorder include inducing and maintaining a steroid-free remission, preventing and treating the complications of the disease, minimizing treatment toxicity, achieving mucosal healing, and enhancing quality of life.

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

This is the true story of how the Battle of Britain was won, how penicillin was discovered, how the largest pharmaceutical company in the world got its start-and how democracy was saved.

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.

All patients with IBD should receive aggressive ongoing assessment of their inflammatory state and its response to immunomodulators, anti-TNF drugs, and other agents.

Even the most experienced and skilled gastroenterologists in the country are struggling to make science-based decisions in this area.

These agents remain the mainstay of therapy for the majority of patients with the disease.

Diabetes-related complications include retinopathy, neuropathy, ulcerations.

The confluence of small, scaly, hyperpigmented patches on the chest (and often neck and upper back) is classic for tinea versicolor.

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?

Epstein Barr virus activates potentially immunopathogenic and neuropathogenic proteins in cells deriving from peripheral blood mononuclear cells and astrocytes.

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

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.

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

The authors present a case of rupture of the rectus abdominis muscle with subsequent rectus sheath hematoma-an uncommon and often misdiagnosed cause of acute abdominal pain.

Emphysematous cholecystitis is a rare condition that is the result of infection with Clostridium perfringens and other gas-producing organisms including Escherichia coli, Bacteroides fragilis, and Klebsiella species.