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As treatments for HIV-1 infection have become more effective, better tolerated, and more conveniently administered, treatment success has increased, but many factors influence treatment response. In addition to issues concerning when to initiate HAART and how to optimize therapeutic potency, challenges related to resistance to antiretroviral therapy in treatment-experienced patients as well as patient demographics and adherence affect antiviral response. [Infect Med. 2008;25:294-298]

A 39-year-old woman presented with dry cough, which she had had for 3 months. She had mild intermittent asthma and a 5 pack-year smoking history. Her symptoms started after an upper respiratory tract infection and persisted despite multiple courses of antibiotics, decongestants, and corticosteroids.

Microscopic colitis is a noninfectiouscolitis that is characterizedby chronic nonbloodydiarrhea and macroscopicallynormal colonic mucosa. Extraintestinalmanifestationsare rarely seen. In this report,we describe a nonspecific interstitialpneumonitis in a patientwith lymphocytic colitis.

Cryptococcus neoformansmost commonly infects personswith an underlying T-cellimmunodeficiency. It hasbeen nicknamed the "sugarcoatedkiller" because it cancause a devastating disseminatedillness in immunosuppressedpatients. C neoformansrarely causes primaryinfection in an immunocompetentpatient. We present acase of pulmonary cryptococcosisthat occurred in an otherwisehealthy man.

Venous thromboembolism (VTE) continues to be a common and potentially life-threatening problem, with an estimated incidence of at least 1 in 1000 persons per year.1,2 VTE includes both deep venous thrombosis (DVT) and the resultant pulmonary embolism (PE). PE occurs in as many as 50% of patients with proximal DVT.3

• The evaluation of cough remains an important clinical problem for primary care physicians and pulmonologists alike. In the past 5 years, the American College of Chest Physicians,1 the British Thoracic Society,2 and the European Respiratory Society3 have published comprehensive guidelines to assist in standardizing the approach to cough evaluation. While determining the cause of cough can be vexing initially, prospective studies have shown that the cause can be established in more than 90% of patients.

A previously healthy 58-year-old man presented to the emergency department with a 4-week history of gradually progressive dyspnea, facial flushing, and night sweats. Three weeks before presentation, he received the diagnosis of acne rosacea from an outside physician and was given topical treatments, with no relief in symptoms. One week before presentation, he began to notice swelling of the face, neck, and right arm and dysphagia (initially with solids, then progressing to liquids).

When untreated, inhalational anthrax typically resultsin a rapidly fatal illness. Evidence suggests that both theanthrax vaccine and prophylaxis with ciprofloxacin or doxycyclineare effective in preventing illness after inhalational anthraxexposure. The current anthrax vaccine appears to have anadverse-effect profile that is similar to that of other adult vaccines.For patients with active infection, the CDC recommendsa multi-antibiotic regimen that should include doxycycline ora fluoroquinolone and 2 additional antibiotics that have proteinor RNA synthesis inhibition, such as rifampin and clindamycin.Monoclonal antibodies directed against anthrax toxinsmay also play a role in treating active infection. (J Respir Dis.2008;29(6):249-254)

Traveler's diarrhea (TD) occurs in persons traveling fromindustrialized countries to less developed regions of the world.Because of the growing ease of travel and an increasinglyglobalized economy, TD is becoming more common. Increasingantibiotic resistance among causative bacterial organisms andalso emergence of new pathogens are additional challenges inthe management of TD. Enterotoxigenic and enteroaggregativepathotypes of Escherichia coli are the principal causes of TD.This review discusses the epidemiology of these pathogens, aswell as elements of prevention, diagnosis, and management.[Infect Med. 2008;25:264-276]

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In the early years of the HIV/AIDS epidemic, the physicians and nurses who provided care to patients with this puzzling and clearly complex infection identified the benefits of specialized knowledge of the virus and management of the symptoms associated with its attack on the immune system.

“It’s a completely different mechanism of action to what we have currently under development and what the field has under development,” said Dr Zeda Rosenberg, IPM’s CEO. “It’s pretty early in the life cycle for HIV. Most of us feel that for a microbicide to be really effective, it has to get at the infection in its earliest time points.”

My patient is a 26-year-old woman who has severe aphthous ulcers. These ulcers first appeared after a motor vehicle accident in which the patient saw her fiancé die.

The 15th Conference on Retroviruses and Opportunistic Infections (15th CROI) was held in Boston from February 3 to 6, 2008. There were more than 1000 oral and poster presentations at this conference and, as is usually the case, some were quite important.

Young adults are usually not considered to be susceptible to debilitating neurological disease, unless of course the brain injury is incurred as a result of trauma.

A 37-year-old HIV-infected white woman with a CD4+ cell count of 29/µL and an HIV RNA level of 538,000 copies/mL presented with a 2-month history of pruritic blistering eruptions on the dorsal aspects of her hands and feet and hyperpigmentation of the face.

Fusion inhibitors are novel antiretroviral agents, administered as subcutaneous injections, approved for use in treatment-experienced HIV-infected patients.