Infection

Acute Dx: What Cause of Sudden Illness?

This condition, also known as squamous cell carcinoma in situ, manifests in two thirds of patients as a solitary asymptomatic, slowly enlarging, erythematous, scaly 3-mm to 3-cm hyperkeratotic plaque that is crusted, fissured, or ulcerated.

SEATTLE -- Surgery to correct obstructive sleep apnea (uvulopalatopharyngoplasty) is more likely to have complications if the condition is severe, a concurrent retrolingual procedure is done, BMI is high, or there are medical comorbidities, found a VA study.

TORONTO -- Infectious disease specialists cited a report of Clostridium difficile disease in healthy young women, some of them pregnant, as a sign of an alarming shift of the infection to the community.

TORONTO -- Necrotizing fasciitis may be caused by methicillin-resistant Staphylococcus aureus, especially in areas where community-acquired MRSA is prevalent, researchers reported here.

ROCKVILLE, Md. -- The FDA has approved the anti-angiogenic agent Avastin (bevacizumab), in combination with Taxol (paclitaxel) and Paraplatin (carboplatin), as first line therapy for non-small-cell lung cancer.

NIAGARA-ON-THE-LAKE, Ontario -- The investigational novel antibiotic telavancin is as effective as vancomycin in treating complicated skin and skin structure infections caused by Gram-positive bacteria, researchers said today.

BOSTON -- National standards for hospital room decontamination do not completely prevent transmission of antibiotic-resistant infections, according to a federally sponsored study.

SAN FRANCISCO -- The long-suspected spread of onychomycosis and other dermatophytic fungal infections among family members has been confirmed, researchers reported here.

TAMPA, Fla. -- Patients with severe refractory anemia caused by myelodysplastic syndrome (MDS) with a 5q31 deletion could reduce or halt transfusion dependency after treatment with Revlimid (lenalidomide), reported investigators here.

ATLANTA -- While forecasting a bountiful supply of flu vaccine this season, the CDC reported that vaccination rates remain persistently low among the two major high-risk groups, young children and the Medicare set.

LONDON -- A large study of the causes of cerebral palsy found that mothers had a strikingly high rate of urinary tract or other infections during pregnancy.

MIAMI -- Lucentis (ranibizumab) is an effective treatment for neovascular age-related macular degeneration, according to a pair of large controlled trials.

BALTIMORE -- An investigational hay fever vaccine appears to reduce the symptoms of ragweed allergy for up to two years after a course of only six injections, according to researchers here.

MILAN, Italy -- A commonly used antibiotic effectively treats lymphoma of the soft tissue, lachrymal glands, and conjunctiva of the eye, according to researchers here.

SAN FRANCISCO -- HIV patients in their 50s do not have a higher prevalence of metabolic syndrome than others of that age, researchers reported here.

ATLANTA -- Preterm birth is the leading cause of infant mortality in the U.S., according to CDC researchers, accounting for at least a third of all babies' deaths in 2002.

SAN FRANCISCO -- One trouble with washing hands is that they won't stay virus-free. But a combination of ethanol and organic acids can transform a pair of hands into a rhinovirus-killing machine for up to four hours.

SAN FRANCISCO -- Children who receive Tamiflu (oseltamivir) within one day of influenza diagnosis are half as likely to develop pneumonia as a complication, researchers said here.

SAN FRANCISCO -- In highly treatment-experienced HIV patients, an investigational integrase inhibitor sharply reduced viral loads compared with placebo, researchers reported here.

Allopurinol, commonly used to treat patients with gout, has been known to cause hypersensitivity reactions. We report a case of drug-induced delayed multiorgan hypersensitivity syndrome secondary to allopurinol use. To the best of our knowledge, this is the first reported case of diffuse alveolar hemorrhage in a patient presenting with allopurinol-induced rash with eosinophilia and systemic symptoms.

A 65-year-old woman presented to her primary care physician with a 3-month history of worsening cough, now productive of copious blood-tinged secretions. She also reported a recent onset of fever and dyspnea. She denied any chest pain, chills, night sweats, and weight loss.

Abstract: There is solid evidence that a positive association exists between nasal allergy and acute or chronic sinusitis in both adults and children. Patients with perennial allergic rhinitis--especially those with significant sensitivity to molds and/or house dust mites--are particularly susceptible to acute sinusitis. It therefore seems reasonable to assume that controlling rhinitis by controlling allergens in the home environment will minimize recurrences of acute sinusitis. Conversely, many patients with chronic sinusitis also have nasal allergy. Thus, management of nasal allergy should be included in the treatment strategy for chronic sinusitis. (J Respir Dis. 2006; 27(10):435-440)

An 87-year-old man with dementia was brought to the emergency department because of progressive swelling of the right cheek of 3 days' duration. The patient--a nursing home resident--required total care for activities of daily living because of a prior stroke. In addition, he had type 2 diabetes mellitus and hypertension. His current medications included hydrochlorothiazide (12.5 mg/d), 70/30 insulin (30 units bid), and clopidogrel (75 mg/d).

ABSTRACT: Signs that strongly suggest Parkinson disease (PD) include unilateral hand tremor, slowed or decreased movement, and gait changes. Postural alterations include leaning forward or asymmetric shoulder height; the arm may not swing when the patient walks, or it may be held flexed at the elbow. Patients may report increasing difficulties in occupational and social functioning. Mimics of PD include essential tremor, normal pressure hydrocephalus, other neurodegenerative diseases, and drug-induced parkinsonism. Most patients report such nonmotor symptoms as sleep disturbances, visual difficulties, bowel and bladder problems, fatigue, depression, and anxiety. Cognitive impairment in many patients takes the form of slowing of memory and difficulty with visual spatial tasks and executive function. A more realistic treatment goal than tremor eradication is improved overall mobility.

In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection (Box).

ABSTRACT: There is solid evidence that a positive association exists between nasal allergy and acute or chronic sinusitis in both adults and children. Patients with perennial allergic rhinitis--especially those with significant sensitivity to molds and/or house dust mites--are particularly susceptible to acute sinusitis. It therefore seems reasonable to assume that controlling rhinitis by controlling the home environment will minimize recurrences of acute sinusitis. Conversely, many patients with chronic sinusitis also have nasal allergy. Thus, management of nasal allergy should be included in the treatment strategy for chronic sinusitis.

For several months, a 56-year-old woman has noticed slowly progressive thickening of the skin on her volar wrists and shoulders that is associated with pruritus and loss of pigment. There is no personal history of trauma and no family history of similar lesions. She has taken the same statin for the past 3 years.

I have recently seen several patients who were treated for infections by emergency department physicians and who were given oral corticosteroids along with antibiotics. My understanding of the action of corticosteroids is that they suppress the immune system. If this is true, why would they be given to someone who already has an infection?

In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection