Infectious Disease

BETHESDA, Md. -- The bumpy road to an HIV vaccine is leading researchers to try non-traditional avenues and to consider vaccines that -- unlike the classic paradigm -- would offer only partial protection.

CHICAGO -- A protocol for sepsis treatment in the emergency department may improve survival, researchers said here.

HELSINKI, Finland -- When babies born prematurely with a low birth weight become young adults, they are likely to have higher levels of insulin resistance, glucose intolerance, and higher blood pressure than those born at term, researchers here reported.

FORT SAM HOUSTON, Tex. -- The source of hard-to-treat infections in U.S. soldiers injured in Iraq, Kuwait, and Afghanistan remains a mystery, according to military researchers say.

COLUMBIA, MO -- Prenatal exposure to the mercury-containing preservative thimerosal in Rh immunoglobulin (RhIg) does not increase a child's risk for an autism spectrum disorder, said investigators here.

LYON, FRANCE -- Smoking and alcohol are independent risk factors for head and neck cancer, but a dose-dependent relationship was observed only for smoking, said researchers here.

LOUISVILLE, Ky. -- Hospitalized patients with community-acquired pneumonia should get drugs that cover both typical and atypical pathogens, international researchers have recommended.

ROTTERDAM, The Netherlands -- Through age five, children born at full term but with a low birth weight were more likely to have respiratory symptoms, but not asthma, researchers here reported.

LOS ANGELES -- A peptide that protects rhesus monkeys from HIV-1 infection does just the opposite when its structure is reversed, researchers here say.

PERTH, Australia -- Preterm babies given probiotics to pump up beneficial bacteria may be less likely to suffer necrotizing enterocolitis, according to a meta-analysis.

CAMBRIDGE, Mass. -- Small peptide segments -- typically only 19 amino acids in length -- govern the switch from a normal protein to a self-perpetuating infectious prion, according to researchers here.

SEATTLE -- The quadrivalent human papilloma virus (HPV) vaccine (Gardasil) is nearly 100% effective in preventing disease from two major cancer-causing strains, two industry-sponsored studies reported.

BALTIMORE -- The human papilloma virus -- known to cause a range of anogenital cancers -- is also associated with a dramatically increased risk of some throat cancers, according to researchers here.

HOUSTON -- Patients with hepatitis C virus infection may have a 20% to 30% increased risk of developing non-Hodgkin's lymphoma, researchers here reported.

BALTIMORE -- For patients with hepatitis C, the likelihood of surviving over a three-year period after a liver transplant has not improved in 10 years, said researchers here.

SEATTLE -- Immunogenicity from the live attenuated herpes zoster vaccine (Zostavax) -- unlike herpes -- is not forever, post-marketing data suggest.

BOSTON -- An investigational orally delivered mucosal vaccine appears to offer significant protection against prion-related infections, at least in mice, investigators reported here.

ATLANTA -- If a flu pandemic materializes, Americans should avoid crowds and close contact, rather than relying on facemasks and respirators, the CDC said today.

LONDON -- More than a third of the HIV-positive gay men in England may be HIV-positive and not know it, according to researchers here.

FLORENCE, Italy -- An ultrasound measurement of liver thickness predicted portal hypertension in patients with hepatitis C-related cirrhosis, researchers here found.

NASHVILLE, Tenn. -- The rate of invasive pneumococcal disease among children with sickle cell disease has fallen by more than 90% since the introduction of a new vaccine, researchers here say.

BOSTON -- Six months of rituximab (Rituxan) for relapsing-remitting multiple sclerosis lesions appears to reduce active lesions significantly and retard relapses, investigators reported here.

PARIS -- Cystic fibrosis patients may develop bone density deficits in the first years of life regardless of nutritional status or disease severity, researchers here found.

abstract: Pulmonary alveolar proteinosis (PAP) is characterized by the accumulation of lipoproteinaceous material in the alveoli. The most common symptoms are dyspnea on exertion and nonproductive cough. Weight loss, fatigue, chest pain, and hemoptysis have also been reported. Chest radiographs typically show bilateral, symmetrical airspace disease with an ill-defined nodular or confluent pattern, which gives a "bat wing" appearance, as is seen in heart failure. Pulmonary function tests usually demonstrate mild restrictive disease. Findings on examination of sputum specimens or bronchoalveolar lavage fluid can suggest the diagnosis; however, open lung biopsy is the diagnostic gold standard. Whole lung lavage remains the standard of care for PAP and is warranted in patients with severe dyspnea and hypoxemia. Subcutaneous human recombinant granulocyte-macrophage colony-stimulating factor appears to be a promising alternative to whole lung lavage for symptomatic patients. (J Respir Dis. 2007;28(5):177-184)

The results of this study suggest that ß-lactam antibiotics are safe to use in patients with a history of penicillin allergy if penicillin skin test results are negative.

An obese 52-year-old woman with a 5-year history of type 2 diabetes mellitus had odynophagia and dysphagia for several days. She described the sensation as food "sticking" in her chest. She also complained of vaginal itching, polyuria, and polydipsia. The only remarkable finding on physical examination was candidal vaginitis. The patient did not smoke cigarettes or drink alcoholic beverages, and there was no history of recent weight loss.

A 33-year-old woman with a history of severe asthma requiring multiple intubations was brought to the emergency department. She had completed a 14-day course of prednisone 3 days earlier. Since then, she had had increasing dyspnea that acutely worsened after she used her albuterol nebulizer that morning. Her other asthma medications were theophylline and fluticasone. Her history included one episode of bilateral pneumothoraces secondary to barotrauma, which required chest tube insertion.

A 77-year-old African American man with type 2 diabetes mellitus and coronary artery disease presented to the emergency department with acute scrotal swelling and pain. His testicles were erythematous with focal areas of necrosis and associated tissue destruction. Similar skin changes were apparent in the lower abdominal and inguinal regions.

Methicillin-resistant Staphylococcus aureus (MRSA) became a "bug" to be reckoned with nearly 50 years ago. At that time, however, it targeted only patients who were exposed to infection in the hospital.In recent years, the epidemiology of MRSA has significantly changed. The pathogen is now a major culprit in community-acquired infections.

A 38-year-old woman with a history of injection drug use presented with progressive pain in the left arm and neck and fever (temperature, up to 38.8°C [102°F]) of 9 days' duration. Physical findings included subcutaneous crepitus, erythema, and swelling of the left arm, chest, and neck. White blood cell count was 27,000/µL with 91% neutrophils. Chest radiographs showed gas in the subcutaneous and soft tissue of the neck, arm, and chest . Necrotizing fasciitis was suspected.