Infectious Disease

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ATLANTA -- A rabies-therapy protocol that saved an unvaccinated Wisconsin teenager from death in 2004 has not rescued two other youngsters, the CDC reported.

How long does immunity against polio last in a person vaccinated with oral poliovirus vaccine (OPV)? With inactivated poliovirus vaccine (IPV)?

Topical corticosteroids remain the mainstay of treatment, especially in patients with erythematous, acutely inflamed psoriatic plaques. The topical immunomodulators tacrolimus and pimecrolimus are used to treat psoriasis, although neither has FDA approval for this indication. Unlike corticosteroids, immunomodulators do not cause skin atrophy, irreversible striae, acne, or tachyphylaxis. Newer topical vehicles of delivery (eg, foam clobetasol propionate) and newer drug combinations (eg, once-daily calcipotriene/betamethasone dipropionate ointment) may improve efficacy and reduce side effects. Reserve systemic therapy for patients with moderate to severe psoriasis. Until more long-term safety data become available, be cautious about prescribing biologic agents for patients at risk for infection (particularly tuberculosis) and malignancy.

A 60-year-old man was hospitalized with fever and hypotension secondary to recurrent cellulitis of the left leg. He had a history of polysubstance abuse and hepatitis C. Elephantiasis nostras verrucosa was diagnosed based on bilateral nonpitting edema and hyperkeratotic verrucous lesions in the pretibial area. The patient's erythrocyte sedimentation rate and white blood cell count showed evidence of infection; osteomyelitis of the left fifth metatarsal head was suspected.

A 63-year-old man with myelodysplasia presented with oral thrush, intranasal dryness, and congestion that developed 2 months earlier. Intranasal saline rinse and sleeping with the head elevated temporarily relieved the nasal symptoms.

BIRMINGHAM, England -- A cluster of six matching cases of tuberculosis here in 2005 originated from one person's exposure to bovine TB, strongly suggesting human-to-human spread, British researchers reported.

RIO DE JANEIRO -- The novel investigational drug raltegravir was highly effective at reducing the level of virus in their blood of extremely sick HIV patients, many of them with AIDS, according to researchers here.