A 76-year-old man is seen because of redness below the right eye. Has long-standing “lazy eye” on the left, which is chronically deviated outward. Has lived in nursing home for some years due to self-care deficit from memory loss. No recent eye surgery, conjunctivitis, sinus infection, or periocular trauma.
Infective endocarditis (IE) starts as a vegetation on the valvular structures. The infection can extend to the adjacent periannular areas and erode into nearby cardiac chambers, leading to an aorto-cavitary fistula (ACF).1,2
Ebola virus and Marburg virus are responsible for Ebola hemorrhagic fever (EHF) and Marburg hemorrhagic fever (MHF), respectively.
Microbes collect on fabric, objects, and surfaces in the hospital environment, but what role do they play in disease transmission, and how can a more sterile environment be maintained? The current findings sometimes leave us with more questions than answers. Food for thought was presented at a poster session that focused on nosocomial infections and environmental contamination at the joint 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America 46th Annual Meeting, which convened October 25-28, 2008, in Washington, DC.
Delusional parasitosis and factitious disorder are psychiatric illnesses that are often encountered by clinicians. The differential diagnosis can be tricky, but treatment, which may include referral to a mental health specialist, may be trickier.
Ninety percent of adult cases of encephalitis are caused by herpes simplex virus (HSV) type 1, and HSV type 2 encephalitis is clinically indistinguishable from HSV-1 encephalitis.
Vaccination rates in adults are lower than those in children, but the consequences of lack of immunization in adults are just as significant. Barriers to adult immunization include patients’ lack of knowledge or misconceptions about vaccines and health care providers’ failure to recommend vaccination.1
The CDC recommends that sexually active adolescent girls be screened for Chlamydia trachomatis infection at least annually and that all sexually active women aged 20 to 25 years and women aged 25 years or older who have risk factors also receive an annual screening.1 How well are these screening practices being observed and what are the implications?
Emphysematous pyelonephritis (EPN) is a rare but life-threatening infection characterized by widespread necrosis and production of gas within the kidney.
A 70-year-old man was admitted with a change in mental status and shortness of breath. He had a history of carcinoma of the colon and status postcolectomy with ileostomy. He was receiving long-term total parenteral nutrition, including lipid emulsion, for short-gut syndrome. Other pertinent findings in the medical history included type 2 diabetes mellitus and enterocutaneous fistula.
Methicillin-resistant Staphylococcus aureus (MRSA) must be recognized now as one of the most common causes of infections acquired in the community. The majority of these infections involve the skin and soft tissue structures and confer significant morbidity on those affected.
With the introduction of immunosuppressive drugs, solid organ transplant (SOT) has progressed such that potential recipients significantly outnumber available organs. In 2007, there were 14,394 donors of 28,353 organs, but 98,645 persons were on a waiting list as of March 2008.1
An 18-year-old woman with a history of allergic rhinitis and moderate persistent asthma presented with right-sided nasal congestion of 6 months’ duration.
Clostridia are anaerobic, spore-forming, gram-positive bacilli that are ubiquitious in nature. They can be isolated from soil and the GI tract of animals and humans.1
Catastrophic antiphospholipid syndrome (CAPS), first described by Asherson and colleagues1 in 1992, refers to a clinical scenario in which multiple vascular occlusive events involving small vessels that supply blood to organs occur over a short period.
Over the past 15 years in the United States, HIV/AIDS has become increasingly common among women. In 1990, women made up only 11% of the newly reported cases of AIDS.1 In 2006, 27% of newly reported AIDS cases were in women.2
After drinking a cup of coffee in the lounge of St Gimmick Hospital, Dr Schmeckman accompanied one of his students, Mollie Jeanette, who was beginning her rotation through the hospital’s infectious diseases service, to the microbiology laboratory.
The recent report of an HIV-positive cardiothoracic surgeon in Israel has offered a contemporary perspective on the risks of transmission of HIV in health care settings, specifically surgical settings.
Many policy watchers are anticipating a golden age of science-led policy in health and environment under the presidential leadership of Barack Obama. After 8 years of frustration at bowdlerized reports, derailed rule making, and policies based on stubbornly held beliefs-despite the facts pointing government policies in another direction-it’s time for clearheaded thinking and the best use of sound information to formulate health and environment policy-even when a policy needs to be based on findings that make us uncomfortable. Of course, it’s this last condition that’s the kicker: none of us want to feel anything other than good when a policy is enacted, and that’s not always going to be the case.
For the first 25 years of the AIDS epidemic, HIV testing was treated differently from all other types of medical diagnostic testing. Formal pretest and posttest counseling was required, and patients had to give written informed consent before being tested. The need for testing was focused primarily on assessment of risk, which required the taking of a detailed sexual and drug use history for which few clinicians had the time, training, or inclination. The rationale for this particular form of “HIV exceptionalism” was mostly historical, dating back to times when concerns about stigma; discrimination; and loss of insurance, jobs, or housing outweighed any modest benefit that might have been derived from early medical care.
