Infectious Disease

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For a week, a 39-year-old woman with a history of intravenous heroin use had generalized pain, fever, chills, and a nonproductive cough. She rated the pain at 10 on a scale of 1 to 10; it was sharp, constant, and unrelieved by heroin. She also reported dyspnea at rest, pleuritic chest pain, and a 15-lb weight loss over the past month. She had no significant medical history or drug allergies, smoked a half pack of cigarettes per day, and denied alcohol use.

A recent editorial in The New York Times heralded the conclusion, from 2 large sub-Saharan African studies, that male circumcision dramatically suppresses HIV acquisition rates as the "most important development in AIDS research since the debut of antiretroviral drugs."1 The editorial went on to state that while a "real [AIDS] vaccine is years away . . . we know its near equivalent [now] exists."1But Anthony Fauci, director of the National Institute for Allergy and Infectious Disease, was more circumspect. "These results could be negated by a small decrease in condom use or the addition of more sexual partners," he cautioned.2

SEATTLE -- For women, infection with a common sexually transmitted disease sharply increases the risk of contracting HIV, according to researchers here.

ST. LOUIS -- In a finding with potential antibioterror implications, a key protein's absence appears to slow the deadly attack of pneumonic plague, potentially making it susceptible to antibiotic treatment, according to researchers here.

MAINZ, Germany -- A novel antifungal agent has emerged from two randomized trials as effective and safe in preventing invasive fungal disease after chemotherapy or treatment for graft-versus-host disease.

BUENOS AIRES -- Patients with relapsing-remitting multiple sclerosis who also had parasitic worm infections had significantly better clinical courses than non-infected MS patients, investigators here found on a small study.

PITTSBURGH -- Small children with persistent middle-ear effusion who did not get immediate insertion of tympanostomy tubes developed as well as peers given rapid treatment when they grew to ages nine to 11 years, investigators here reported.

BOSTON -- Universal one-time melanoma screening of adults ages 50 or older by dermatologists would cost about ,000 per quality-adjusted life year gained, which compares favorably with the cost of breast or colon cancer screening.

BOSTON -- For women in developing countries who are HIV-positive, a dose of Viramune (nevirapine) during labor to prevent mother-to-child viral transmission does not preclude the safe renewed use of Viramune-based antiretroviral therapy after a six-month delay.