ID

Should Physicians Offer The HPV Vaccine To Men And Boys?

March 23, 2012
Should Physicians Offer The HPV Vaccine To Men And Boys?

By Kevin Burns

Faculty Peer Reviewed

On December 22, 2010, the US Food and Drug Administration (FDA) approved the quadrivalent human papillomavirus (HPV) vaccine (Gardasil; Merck, Whitehouse Station, New Jersey) for prevention of anal cancer and anal intraepithelial neoplasia (AIN) for males and females 9 to 26 years old. HPV is the most common sexually transmitted infection in the United States and the high-risk subtypes 16 and 18 are linked to development of cervical, vaginal, vulvar, anal, penile, and oropharyngeal malignancies. The FDA-approved uses for …

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Challenges in the Treatment of TB and HIV Co-Infection

March 16, 2012
Challenges in the Treatment of TB and HIV Co-Infection

By Santosh Vardhana, MD/PhD

Faculty Peer Reviewed

Ms. T is a 32- year-old woman with no past medical history who presents with a three month history of productive cough, shortness of breath, and a twenty pound weight loss. On review of systems, she also reports night sweats. On physical exam, she is cachectic. Pulmonary exam reveals dry bibasilar inspiratory crackles. Rapid HIV test is positive, and CD4 count returns at 46. Chest X-ray reveals bilateral increased interstitial markings at the lung bases as well as …

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Does the BCG Vaccine Really Work?

March 14, 2012
Does the BCG Vaccine Really Work?

By Mitchell Kim

Faculty Peer Reviewed

Mycobacterium tuberculosis, an acid-fast bacillus, is the causative agent of tuberculosis (TB), an infection that causes significant morbidity and mortality worldwide. A highly contagious infection, TB is spread by aerosolized pulmonary droplet nuclei containing the infective organism. Most infections manifest as pulmonary disease, but TB is also known to cause meningitis, vertebral osteomyelitis, and other systemic diseases through hematogenous dissemination. In 2009, there were an estimated 9.4 million incident and 14 million prevalent cases of TB worldwide, with a …

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From The Archives: Why is Syphilis Still Sensitive to Penicillin?

January 13, 2012
From The Archives: Why is Syphilis Still Sensitive to Penicillin?

Please enjoy this post from the Archives, first published on July 30, 2009

By Sam Rougas MD

Faculty Peer Reviewed

It seems that every week a new article in a major newspaper is reporting what most infectious disease physicians have been preaching for several years. Antibiotic resistance is rapidly spreading. Infections such as Methicillin Resistant Staphylococcal Aureus, Extremely Drug Resistant Tuberculosis, and Vancomycin Resistant Enterococcus have journeyed from the intensive care units to the locker rooms of the National Football League. That being said, some …

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Does Culturing the Catheter Tip Change Patient Outcomes?

November 17, 2011
Does Culturing the Catheter Tip Change Patient Outcomes?

By Todd Cutler, MD

Faculty Peer Reviewed

An 82-year-old man is admitted to the intensive care unit with fevers, hypoxic respiratory failure and hypotension. He is intubated and resuscitated with intravenous fluids. A central venous catheter is placed via the internal jugular vein. A chest x-ray showed a right lower lobe infiltrate and he is treated empirically with antibiotics for pneumonia. Blood cultures grow out S. pneumoniae. After four days he is successfully extubated. The night following extubation, the patient has a fever of 100.8 …

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Does Cranberry Juice Prevent Urinary Tract Infections?

November 9, 2011
Does Cranberry Juice Prevent Urinary Tract Infections?

By Jessie Yu

Faculty Peer Reviewed

A healthy 21-year-old female college student presents to clinic after one day of dysuria and increased frequency. You diagnose her with a recurrent urinary tract infection (UTI), and as you hand her a prescription for empiric antibiotic treatment, she asks you if drinking cranberry juice will prevent these in the future…

Drinking cranberry juice to prevent urinary tract infections (UTIs) has been a traditional folk remedy for hundreds of years. Stroll into any New York City pharmacy and you …

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A New Era of Therapy for Hepatitis C

November 4, 2011
A New Era of Therapy for Hepatitis C

By Alexander Jow, MD

Faculty Peer Reviewed

Hepatitis C virus (HCV) is a major public health issue, representing the leading cause of chronic liver disease, death from liver disease, and a principal indication for liver transplantation in the US. It is estimated that 3-4 million people in the world are infected with HCV each year. Globally, 130-170 million people are chronically infected with HCV and more than 350,000 people die from HCV-related liver disease each year. Although the natural history of HCV infection …

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Cholera in Haiti

October 7, 2011
Cholera in Haiti

By Matt Johnson, MD

Faculty Peer Reviewed

In the fall of 2010, after Haiti was razed by a magnitude 7.2 earthquake that left over 316,000 people dead, cholera was injected into the tumult to add to the growing list of Haiti’s struggles . Cholera is an ancient scourge whose origins are believed to come from the Ganges River delta of India . It affects up to 5 million people worldwide, with over 100,000 deaths per year . The cholera outbreak in Haiti was unexpected in …

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Stemming the Tide: The Promise and Pitfalls of HIV Prevention Research

September 28, 2011
Stemming the Tide: The Promise and Pitfalls of HIV Prevention Research

By Benjamin Bearnot

Faculty Peer Reviewed 

Since the discovery of zidovudine (AZT) in the mid-1980s, advances in antiretroviral (ARV) therapy for patients with chronic human immunodeficiency virus (HIV) infection have, until recently, outpaced concomitant improvements in methods for HIV prevention. Over the past few years, HIV prevention research has been building an impressive head of steam. While a completely effective vaccine for HIV prevention has continued to prove elusive, results of a modestly successful (~30% protective) vaccine trial based in Thailand were announced in 2009, …

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Should you Treat a COPD Exacerbation with Antibiotics?

September 3, 2011
Should you Treat a COPD Exacerbation with Antibiotics?

By: Aviva Regev

Mr. S is a 68-year old man with longstanding COPD and a 40-pack-year smoking history.  He presents to clinic with three days of increasing shortness of breath, and complains that he has been coughing up “more junk” than usual.  As I watch him spit a wad of chartreuse sputum into his tissue, I reach for the prescription pad and tell him he’ll need a week of antibiotics.  He wants to know why he can’t just go up on his inhaled medications instead …

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The Treatment For Clostridium Difficile? Transplant!

July 29, 2011
The Treatment For Clostridium Difficile? Transplant!

By Andrea Mignatti , MD

Faculty Peer Reviewed

Among all the new medical therapies, this one will probably not be the most elegant or refined that you will read about. But it just may be one of the most unconventional ones you will come across.

From our experiences working on busy hospital wards, we know that Clostridium difficile colitis is an extremely serious infection that is becoming more prevalent due to the development of new hyper-virulent strains (toxinotype III BI/NAP1/027). It has been …

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Understanding the Zoster Vaccine

July 13, 2011
Understanding the Zoster Vaccine

By Michael Cohen

Faculty Peer Reviewed

The varicella-zoster virus (VZV) is well known to the majority of the population. In children, it strikes as varicella (chickenpox), characterized by pruritic, vesicular lesions in different stages of development dispersed over the body. A self-resolving and generally limited disease, this form of VZV infection is considered to be a nuisance more than a debilitating affliction, but rarely can have severe sequelae. In adults and the elderly VZV more commonly takes the form of zoster (shingles). This disease results …

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