ID

Salmonella Update

March 21, 2009
Salmonella Update

Commentary by Sherley Abraham MD, PGY-3

The CDC reports there have been 666 cases and 9 deaths associated with Salmonella Typhimurium infections. The outbreak began September 1st, 2008 and has spread across 45 states, including 30 cases in New York. The source has been traced back to peanut butter and peanut paste made at the production company in Blakely, Georgia which is owned and operated by the Peanut Corporation of America. There is a nationwide product recall which can be found on the…

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Mystery Quiz- The Answer

March 10, 2009
Mystery Quiz- The Answer

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

The answer to the mystery quiz is allergic bronchopulmonary aspergillosis (ABPA). The CXR shows right upper lobe opacities, two of which appear round (Image 3, arrow) and another tubular (Image 3, arrowhead), and a left upper lobe opacity which has the characteristics of subsegmental atelectasis (Image 3, double arrows). The CT scan, performed ten days after the CXR, shows central bronchiectasis of the RUL (Image 4, arrows); tubular branching shadows (Image 6, arrow) as…

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Diseases 2.0: Sepsis

February 5, 2009
Diseases 2.0: Sepsis

Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment

Commentary by Andrew McKinstry MD PGY-1

Faculty Peer Reviewed

For anyone who has stepped into an ICU, the septic patient is a familiar sight. Despite advances in research and management, including goal directed therapy and recombinant human activated protein C (Xigris), sepsis continues to be a major cause of mortality in the critical care setting, with an estimated 215,000 deaths annually, and costing roughly 16.7 billion dollars per year. Despite these staggering…

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

January 22, 2009
Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

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 being the beta-hemolytic streptococci and S .aureus, including methicillin-sensitive (MSSA) and methicillin-resistant…

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Grand Rounds: “Combating the Poverty Associated Tropical Diseases”

December 3, 2008
Grand Rounds: “Combating the Poverty Associated Tropical Diseases”

 

Commentary by Alpana Marwaha MD PGY-3

Please also see the clinical vignette presented before last week’s grand rounds.

This week, the Department of Medicine Grand Rounds was presented by Dr. Peter Hotez MD, PhD and chair of the Department of Microbiology and Tropical Medicine at GW Medical Center. The talk was entitled, “Combating The Poverty Associated Tropical Diseases.”

 

There are a staggering 1.4 Billion people living at wages below $ 1.25 per day known as the “The Bottom Billion.”…

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Grand Rounds: “Bacterial Meningitis”

September 11, 2008
Grand Rounds: “Bacterial Meningitis”

Commentary by  Stephen Carpenter MD, PGY-2

Dr. Vincent Quagliarello, Professor of Medicine at Yale University, delivered his Medicine Grand Rounds lecture entitled “Bacterial Meningitis in Adults: Principles and Practice in 2008” on Wednesday, September 3rd, 2008. He began with some of the history of the disease and noted that despite all the medical advances, bacterial meningitis still has a mortality rate of 27% and an even higher rate of 54% in poorer nations where high rates of HIV infection confound the problem.…

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Case Presentation: Acute Rheumatic Fever

August 29, 2008
Case Presentation: Acute Rheumatic Fever

Commentary by Bani Chander MD, PGY-3. and Ben Bergman MD, PGY-3

Please also see last week’s Class Act Post on the pathogenesis of Rheumatic Heart Disease 

A 34-year-old Hispanic male presents with the chief complaint of chest pain. The patient had been well until 10 days prior to admission, when he developed a severe sore throat accompanied by fever, rigors, and diffuse myalgias. There was no associated cough. Three days later, he visited his primary care physician at an outside facility and was prescribed…

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Class Act: Pathogenesis of Rheumatic Heart Disease

August 14, 2008
Class Act: Pathogenesis of Rheumatic Heart Disease

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

Commentary by Matt Stein MS-4; Reviewed by Harold Horowitz MD, Professor, NYU Division of Infectious Diseases and Immunology

In general, acute rheumatic fever (ARF) is a delayed sequela of a group A streptococcus (GAS) pharyngeal infection. Following an initial throat infection, which is often either untreated or incompletely treated, there exists a latent period of two…

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Class Act: What is the risk of microbial keratitis in overnight wear of soft contact lenses?

July 11, 2008
Class Act: What is the risk of microbial keratitis in overnight wear of soft contact lenses?

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. These posts focus on evidenced based answers to clinical questions related to patients seen by our students in the clinics or on the wards. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

Commentary by Frank Siringo, NYU Medical Student

Soft contact lens wear is the primary risk factor for microbial keratitis, a potentially vision-threatening infection of the cornea, with a…

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Breaking news: FDA issues new Boxed Warning for Fluoroquinolones

July 10, 2008
Breaking news: FDA issues new Boxed Warning for Fluoroquinolones

Commentary by Marilena S. Antonopoulos, PharmD, Pharmacology Editor

On July 8th, the FDA notified the manufacturers of fluoroquinolone antimicrobial drugs that a Boxed Warning in the product labeling and a Medication Guide for patients concerning the increased risk of tendinitis and tendon rupture is necessary. The FDA conducted a new analysis of the available literature and post-marketing adverse event reports which reconfirms that the use of fluoroquinolones is associated with an increased risk of tendon rupture.

The risk of developing fluoroquinolone-associated tendinitis and tendon rupture…

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Admission screening cultures for MRSA: Is it time?

July 9, 2008
Admission screening cultures for MRSA: Is it time?

Commentary by Howard Leaf, M.D. Assistant Professor, Division of Infectious Diseases and Immunology 

Pressure continues to build for healthcare facilities to act to decrease hospital-acquired infections, particularly those associated with MRSA. This is partly data-driven, with one study reporting that 25% of patients acquiring MRSA colonization during a hospitalization subsequently become infected . The call to act is also partly a political response to concerns in the lay press about “superbugs” wreaking havoc both in hospitals and in the community. Seven states have…

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Neutropenic Precautions Demystified

June 13, 2008
Neutropenic Precautions Demystified

Commentary by Rachana Jani MD, PGY-1 and Neal Steigbigel MD, Professor of Medicine (Infectious Diseases/Immunology)

Rachana Jani MD:  Walking onto an oncology floor, one cannot help but notice the precautionary signs that segregate these patients from the rest of the hospital. “No fresh fruits or flowers.” “Neutropenic isolation, please see nurse before entering.” The idea of neutropenic precautions first emerged in the 1960s when myelosuppressive therapy came to the forefront of cancer treatment. It only made sense that patients with an impaired immune…

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