ID

Case of the Month: Vertebral Osteomyelitis and Psoas Abscess with Acinetobacter Baumanii: Report of an Unusual Case

April 6, 2011
Case of the Month: Vertebral Osteomyelitis and Psoas Abscess with Acinetobacter Baumanii: Report of an Unusual Case

By Michael C. Brabeck, MD,  Adam Davis, MD, and Shaun Rodgers, MD

Faculty Peer Reviewed

 Case:

A 56-year-old male was admitted to Bellevue Hospital Center with chronic back pain and a three month history of subjective fevers, decreased appetite, and a thirty pound weight loss. His past medical history was remarkable only for chronic alcohol abuse. He denied other substance abuse. There were no previous health care facility exposures, and the patient had no history of military service. The physical examination upon admission was notable …

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The Resurgence of Pertussis: Is Lack of Adult Vaccination to Blame?

February 23, 2011
The Resurgence of Pertussis: Is Lack of Adult Vaccination to Blame?

By Ijeoma Ejigiri, Class of 2011

Faculty Peer Reviewed

Whooping cough. 100 day cough.  Pertussis.  These are the various names for the disease caused by the bacterium Bordetella pertussis.  This small gram-negative coccobacillus, transmitted via respiratory droplets, is responsible for causing coughing paroxysms followed by a long inspiratory gasp, during which the characteristic high-pitched “whoop” occurs.  These coughing paroxysms can last for ten weeks or longer, hence the moniker “100 day cough.”   The paroxysmal phase is usually preceded by a prodromal illness that is typically …

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Should You Eradicate Helicobacter Pylori Prior to Chronic NSAID Treatment?

January 19, 2011
Should You Eradicate Helicobacter Pylori Prior to Chronic NSAID Treatment?

By Joshua Smith, MD

Faculty Peer Reviewed

CASE:  A 54-year-old Asian female with no significant past medical history presents to her primary care physician with the complaint of several weeks of pain in her fingers bilaterally along with pronounced, worsening morning stiffness.  She is subsequently diagnosed with rheumatoid arthritis (RA), and the decision is made to start her on long-term, high-dose non-steroidal anti-inflammatory drugs (NSAIDs).  Given the link between NSAIDs and peptic ulcer disease (PUD), should this patient first be tested, and if positive, treated …

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Myths and Realities: Does Vitamin C Work for the Common Cold?

January 7, 2011
Myths and Realities: Does Vitamin C Work for the Common Cold?

By Carolyn Bevan,  MD

Faculty Peer Reviewed

It starts with a tickle in your throat.  You feel a bit more tired after a day’s work, maybe your forehead feels a little warm.  You try to will it away, but over the next few days, it hits you: the congestion, runny nose and annoying cough.  Much to your dismay, you have a cold.  Determined not to give in without a fight, you drag yourself to the nearest drug store and buy the first mega-dose vitamin C …

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Meeting Perspectives: The 2010 Infectious Disease Society of America (IDSA) Meeting

December 22, 2010
Meeting Perspectives: The 2010 Infectious Disease Society of America (IDSA) Meeting

Neal H. Steigbigel, M.D.

The recent IDSA meeting reviewed many important and interesting findings.  Topics spanned a wide array of subjects, many of which are of importance and interest to all physicians.  These subjects included:

Treating severe Clostridial Difficile infection with fecal transplantation Isolation for extended spectrum beta lactamase (ESBL’s) bacteremia Update in multi-resistant gram negative infections Update on Pneumococccal infections Treatment dilemmas in immunocompromised hosts Update on invasive fungal infections

This high quality meeting has many simultaneous sessions and therefore one individual cannot cover …

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The Polymyxins: Why am I using them all the time, and what are they?

December 8, 2010
The Polymyxins: Why am I using them all the time, and what are they?

By Jon-Emile S Kenny

Faculty Peer Reviewed

A 65-year-old female with locally advanced rectal cancer is admitted to the ICU, hypotensive and febrile.  Her PICC line is removed and blood cultures drawn.  Fourty-eight hours later all cultures return ESBL Klebsiella with susceptibility only to polymyxin.

I sat on the venerable call-room couch staring mindlessly at the cluttered, nauseating walls repeating the word ‘polymyxin’ like an endless antimicrobial mantra.  What strange dosing it has, and an even more peculiar name.

The polymyxins (B and E – …

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Grand Rounds: Influenza Pandemic

November 18, 2010
Grand Rounds: Influenza Pandemic

Summary by Lakshmi Tummala, MD

The Medical Grand Rounds lecture on October 6, 2010 titled “Influenza 2010: Update after the 2009 Pandemic was presented by Dr. Alicia Fry, M.D., MPH an epidemiologist from the United States Centers for Disease Control and Prevention. I’m sure that those of us who were fortunate enough to be on the wards at that time recall the wonder of seeing a small piece of history unfold firsthand. Now, let’s take the journey again with Dr. Fry, from reports of the …

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Mystery Quiz- The Answer

November 13, 2010
Mystery Quiz- The Answer

Dana Clutter, MD

Edited by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

Faculty peer reviewed

The answer to the mystery quiz is bacillary angiomatosis (BA). BA is a disease that most frequently affects individuals infected with the human immunodeficiency virus (HIV) and typically presents with multiple cutaneous papules and nodules. Visceral manifestations also occur and can involve the bone, lungs, lymph nodes, spleen, liver (termed peliosis hepatis) and the central nervous system.(1) Since the relatively recent first description of the disease …

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How do you Manage the Adult with Perinatally Acquired Hepatitis B?

October 22, 2010
How do you Manage the Adult with Perinatally Acquired Hepatitis B?

Nathaniel Rosso Smilowitz, MD

Faculty Peer Reviewed

Hepatitis B virus is a DNA hepadnavirus affecting 1.25 million people in the United States and nearly 400 million worldwide.  The virus is transmitted perinatally, sexually, and percutaneously, and is endemic in many countries in South East Asia, Central Asia, and Africa.  When exposure occurs early in life, the likelihood of chronic infection is high; up to 90% of cases of vertical transmission result in the persistence of the viral envelope protein, the hepatitis B surface antigen (HBsAg), …

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From the Archives: Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

October 14, 2010
From the Archives: Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

Please enjoy a post from the Clinical Correlations Archives, first posted 1/22/09

Commentary by Melanie Maslow, MD, FACP, Associate Professor of Medicine, NYUSOM, Chief, Infectious Diseases, New York Harbor Healthcare System, NY

Faculty Peer Reviewed

Cellulitis is an acute spreading infection of the skin extending to the deep subcutaneous tissue characterized by pain, swelling, erythema and warmth. Cellulitis in the non-neutropenic patient, in the absence of bite wounds, salt or fresh water exposure, and coexisting ulcers is usually caused by Gram-positive pathogens, the most common …

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Circumcision as Primary Protection?

October 8, 2010
Circumcision as Primary Protection?

Emily Taylor, MD

Faculty Peer Reviewed

The earliest documented evidence of circumcision is in artwork from the Sixth Dynasty in Egypt (2345-2181 BC) found in a wall relief from Saqqara in Lower Egypt. Circumcised North Americans were described by Columbus upon arrival to the continent; circumcision was practiced by Australian aboriginals, native South Americans, and Pacific Islanders. It is unknown if circumcision was common amongst some earlier ancestor of all these peoples, or if it evolved independently in societies that lived in dry, sandy areas, …

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The Challenge of Measles Control

September 15, 2010
The Challenge of Measles Control

By Taher Modarressi

Faculty Peer Reviewed

Measles remains one of the leading causes of preventable child mortality worldwide, despite the development of an effective vaccine in the 1960s. Even as late as the early 1990s, measles continued to infect tens of millions of people and claimed over a million lives each year (51]. Although mortality dropped by 78% from 2000 to 2008 due to aggressive control initiatives, the disease is still responsible for 164,000 deaths annually . Morbidity and mortality is mostly due to …

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