Lyme disease-the most common arthropod-borne illness in the United States-has become entrenched in the Northeast, upper Midwest, and northern California, and it is spreading to other regions of the country. Diagnosis and management remain a significant challenge because of the diverse manifestations of the disease and the limitations of current tests.
This infection is usually caused by Candida albicans, whichis often present in body folds. Candidiasis is common in persons with diabetes and in obese persons. Other predisposing factors are the use of antibiotics, topical corticosteroids, or immunosuppressive drugs; poor nutrition; and immunosuppression.
Tinea pedis, or athlete's foot, is common in elderly persons. It manifests as maceration in the interdigital web folds and as scaly plaques on the plantar surfaces of the feet. A potassium hydroxide evaluation can establish the diagnosis. Tinea pedis is commonly associated with xerosis. It is best treated with a topical antifungal agent; treatment can be aided by a keratolytic such as lactic acid 12% cream.
Routine blood work revealed liver function abnormalities in a 55-year-old woman. She had recently undergone extensive dental work that resulted in severe pain; to relieve the pain she took oxycodone and acetaminophen, 3 to 4 g/d, for more than a week. She has not taken any acetaminophen for the past 5 days.
Oral candidiasis, or thrush, is not uncommon in elderly persons. It can be related to poor dentition or immunosuppression, particularly as a result of oral corticosteroid use.
The incidence offluoroquinoloneresistantgonorrheacontinues torise in the UnitedStates, and the CDC isnow urging physicians toprescribe cephalosporinsfor patients with gonococcalinfections.
The prevalence of onychomycosis increases with age; it is less than 1% in persons younger than 19 years and rises to about 18% in those who are 60 to 79 years. The infection is more common in men than in women. Among the predisposing factors are diabetes mellitus, psoriasis, a family history of onychomycosis, use of immunosuppressive drugs, and peripheral vascular disease.
abstract: Inflammatory bowel disease (IBD) can have a variety of extraintestinal manifestations, including pulmonary disease. Bronchial involvement is the most common, but other manifestations include upper airway disease; parenchymal involvement, such as bronchiolitis obliterans with organizing pneumonia (BOOP) and interstitial lung disease; and serositis, including pleural effusions and pericarditis. Patients with BOOP may present with fever, dyspnea, cough, and pleuritic chest pain. Chest radiographs show bilateral patchy airspace opacities or a diffuse process; CT scans often demonstrate the opacities to be pleural-based. Corticosteroids appear to be effective in the management of certain pulmonary manifestations of IBD, such as BOOP and pulmonary infiltrates with eosinophilia. (J Respir Dis. 2007;28(6):227-234)
What is the most likely cause of these painful plantar ulcers? Can youidentify this well-demarcated rash that arose at the site of vein grafting?
PHILADELPHIA -- In the frantic moments after being bitten by a poisonous snake, many people try first aid that does more harm than good, according to an emergency medicine specialist here.
ATLANTA -- The Georgia man with extensively drug-resistant tuberculosis (XDR-TB) who sparked an international hunt for contacts is asymptomatic and feeling well, officials said today.
SAN FRANCISCO -- Extensively drug resistant tuberculosis (XDR-TB) continues to be unearthed around the globe, with implications for U.S. clinicians, researchers said here.
ATLANTA -- For the first time in four decades, the CDC has quarantined a man as a public health risk, the government announced today. The Georgia man is infected with extensively drug resistant tuberculosis (XDR-TB).
ROCKVILLE, Md., May 29 -- A possible parasitic contamination of a solution for soft contact lens wearers has triggered a national recall.
CHICAGO -- Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) may target certain vulnerable populations and does not displace community-acquired methicillin-sensitive S. aureus.
HO CHI MINH CITY, Vietnam -- Antibodies from human survivors of an infection with the highly pathogenic avian influenza H5N1strain appear to offer mice protection against the virus.
ANAHEIM, Calif. -- Quinolone antibiotics for prostate-biopsy prophylaxis are showing signs of increased resistance.
WASHINGTON -- Bacterial overgrowth in the gut, a factor in irritable bowel syndrome, may also be at work in restless legs syndrome and antibiotics can help both conditions, one small study suggests.
ATLANTA -- Clinicians need to act quickly and appropriately to minimize morbidity and mortality of U.S. patients with malaria, CDC researchers said.
WASHINGTON -- This special report from Stanton M. Paddock, a MedPageToday contributing photographer, presents Ted Bader, M.D., of University of Oklahoma, discussing infection of Hepatitis C in Vietnam veterans.
BUFFALO, N.Y. -- An increased risk of tongue cancer in men has been associated with chronic peridontitis, independent of smoking status, researchers here reported.
WASHINGTON -- Forget that time-honored advice to diverticulosis patients to shun hard-to-digest foods like nuts and popcorn, said investigators here. Popcorn may actually be beneficial.
WASHINGTON -- The best new liver for a patient with hepatitis C related cirrhosis appears to be one from an HCV-infected donor, researchers reported here.
WASHINGTON -- Satins may improve liver function in patients with chronic hepatitis C, according to a small pilot study that challenges the widely accepted belief that the agents are hepatotoxic.
LONDON -- A single oral dose of vitamin D may give the immune system enough ammunition to fight off tuberculosis for six weeks after exposure, researchers here found.
