Infectious Disease

ABSTRACT: Painful recurrent ulceration of gingival tissue suggests a secondary intraoral presentation of herpes simplex virus (HSV) infection. Unlike the lesions of HSV, lesions associated with coxsackievirus do not erupt in the anterior mouth but rather on the soft palate and pharynx. Furthermore, unlike HSV infection, coxsackie infections may recur, because there is considerable viral variation. Patients with atrophic or erythematous candidiasis report burning pain and a metallic taste. The typical patient with benign mucous membrane pemphigoid is a woman older than 50 years; the condition usually involves the attached gingiva around the teeth. The lesions of erythema multiforme may erupt on any intraoral mucosa; biopsy may be required to rule out other conditions with similar presentations.

Is it appropriate to routinely order urinalysis for patients in a nursing home (both with and without dementia) when they exhibit behavioral changes but show no signs or symptoms of urinary tract infection (UTI)?

A 49-year-old man presents with recurring facial pain of 6 months' duration. The pain initially occurred several times per week; it now occurs as often as several times per day. The paroxysmal pain is intense and incapacitating but abates within several minutes. It occurs in the right maxillary region and lower jaw and is sharp and lancinating. Hard chewing and teeth cleaning are the usual precipitating events. Between episodes, the patient is asymptomatic, without numbness or deficit in the affected region.

A Photo Quiz to Hone Dermatologic Skills

The association between asthma and pneumococcal disease has been suspected by many clinicians; however, formal investigations confirming an increased risk of pneumococcal disease in patients with asthma are rare.

During a routine checkup, a middle-aged woman asks you whether she should stop wearing moisturizers and makeup that contain sunscreen. She has read that increased sunlight exposure enhances vitamin D production, which may prevent certain types of cancer. What would you tell her?

DALLAS - Women who develop chorioamnionitis during a first pregnancy have twice the risk for the amniotic infection in the next, suggesting a genetic component, researchers reported.

ROCHESTER, N.Y. -- The cyclooxygenase inhibitors -- including aspirin as well as Celebrex (celecoxib) -- may reduce the antibody-producing effect of vaccines, making them less useful in preventing disease, according to researchers here.

RENNES, France -- HIV can infect immune cells in the testis and produce infectious viral particles that, in turn, can re-infect cells in the blood, according to French researchers.

ATLANTA -- The seasonal flu season is here, but tell that to the viruses. The quixotic little pathogens haven't yet flexed their muscles in earnest, according to the CDC.

LOS ANGELES -- After an outpatient tonsillectomy, most patients can go home safely within a couple of hours, according to researchers here, although each case needs to be treated individually.

RIBEIRÃO PRETO, Brazil -- A single presurgical dose of antibiotics is as effective at preventing infection as is 24-hour coverage after surgery, researchers here said.

ATHENS, Greece -- For critical care patients, ultrasound-guided catheterization of the internal jugular vein proved quicker, easier, and safer than the traditional landmark-guided method, researchers here reported.

STOCKHOLM -- Smoking and human papillomavirus (HPV) may work together to increase the risk of cervical cancer in situ, according to researchers here.

WASHINGTON -- Vaccination against influenza or pneumococcal disease is safe and effective in people with rheumatoid arthritis who are taking Humira (adalimumab), a researcher said here.

PHILADELPHIA -- Seasonal asthma exacerbations among children requiring hospitalizations don't seem to correlate with seasonal allergen prevalence, suggesting that other factors may be at work.

TORONTO -- A flu shot appears to increase the relative risk of Guillain-Barré syndrome by 45%, according to researchers here.

PHILADELPHIA -- When a patient with an orthopedic implant develops a rash or inflammatory symptoms, think metal allergy, suggested researchers here.

ST. LOUIS -- High-risk kidney transplant recipients had a lower rate of acute rejection and severe rejection episodes when they received induction therapy with Thymoglobulin (rabbit antithymocyte globulin) compared with Simulect (basiliximab).

NEW YORK -- Veteran television journalist Ed Bradley has died of complications of chronic lymphocytic leukemia (CLL) at the age of 65.

PRAGUE -- For metastatic kidney cancer, neoadjuvant targeted therapy with Avastin (bevacizumab) and Tarceva (erlotinib) is apparently safe and may prolong progression-free survival, researchers said here.

Lung herniation was first describedin the 15th century. A systemto classify hernias as cervical,thoracic, or diaphragmatic and as eithercongenital or acquired was developedin 1847.

KIEL, Germany -- Bilateral pallidal neurostimulation to reduce movement symptoms outdid sham stimulation in patients with primary generalized or segmental dystonia, researchers reported.

CAMBRIDGE, Mass. -- Malaria prophylaxis may require the individualized guidance of a tropical-disease specialist for those embarking on lengthy trips to disease-endemic countries.

NEW YORK -- Uncomplicated diabetes does not affect 10-year heart transplant survival, but patients with diabetes-related renal disease or stroke do not do as well, reported surgeons here.