Infectious Disease

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

If left untreated, sinusitis can cause significant physical symptoms and can negatively affect quality of life by substantially impairing the daily functioning of sufferers. For children, this can mean learning difficulties at school and for adults, a loss of efficiency at work.

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?---

An 89-year-old woman, who has long lived on the special care (dementia) unit of a nursing home because of advanced Alzheimer disease, is seen to assess possible injuries after a fall. Many prior falls have been ascribed to her lack of safety awareness in negotiating the environment, rather than to neuromuscular, sensory, or cerebellar deficits.

Slowly progressive depigmentation; asymptomatic petechiae; a mildlypruritic, crusty rash--do you know the cause of the disorderspictured here?

Acute parotiditis is characterized by unilateral swelling of the parotid gland with associated erythema and tenderness. Purulent secretions from the Stensen duct may be noted in more than 50% of the cases.

Because the manifestations of Parkinson disease are protean and complex, the diagnosis can be difficult and treatment challenging. However, an awareness of the key clinical features and familiarity with 2 or 3 of the dopaminergic medications can facilitate management.

SAN FRANCISCO -- The debate about mercury in amalgam dental fillings not withstanding, amalgam is superior to composite material in reducing adherence of caries-causing Streptococcus mutans, researcher said here.

SAN FRANCISCO -- Immunogenically enhanced cow's milk may sharply reduce the relapsing diarrhea associated with Clostridium difficile infection, according to a study from Holland.

SAN FRANCISCO -- The antibiotic Tygacil (tigecycline) is highly effective against multidrug resistant strains of acinetobacter, which are an increasing problem in intensive care units, researchers reported here.

SAN FRANCISCO -- Even with appropriate antibiotics, methicillin-resistant Staphylococcus aureus (MRSA) infections relapse about 25% of the time, researchers reported here. And for MRSA-related osteomyelitis, there is a 46% relapse rate.

SAN FRANCISCO -- A porcine wrinkle has emerged in the struggle against community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in The Netherlands, researchers recounted here.

SAN FRANCISCO -- Though antibiotic exposure typically increases the risk of Clostridium difficile colitis, tetracycline may protect against it, researchers reported here.