Infectious Disease Alert – November 1, 2004
November 1, 2004
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Influenza A Resistant to Oseltamivir
Kiso and colleagues in Japan collected serial upper respiratory tract samples from children receiving oseltamivir for treatment of influenza A (H3N2), for isolation of the virus. Mutations in neuraminidase were identified in virus obtained from from 9 of 50 (18%) immunocompetent children treated with oseltamivir. Eight of the 9 contained mutations previously identified as conferring resistance to oseltamivir, while the ninth had a novel mutation. -
Empiric Therapy in the Persistently Febrile Patient With Neutropenia: Caspofungin vs Liposomal Amphotericin B
Overall, caspofungin was at least as effective as liposomal amphotericin B for empiric therapy in persistently febrile neutropenic patients. Caspofungin therapy was associated with greater survival 7 days after the end of therapy, greater efficacy in treatment of baseline fungal infections, and it was better tolerated. -
Novel Naked Pneumococcal Naval Eye Infection: An Outbreak of Conjunctivitis
An outbreak of conjunctivitis caused by a macrolide resistant unencapsulated pneumococcus occurred among naval trainees who were receiving azithromycin as prophylaxis against atypical pneumonia. -
Lassa Fever
A 38-year-old man returned to the United States from west Africa, where he had spent the last 4 months in Liberia and Sierra Leone where he owned farms. Two days before his August 2004 return, he developed fever, chills, and severe sore throat, and shortly after his arrival, he was hospitalized with, in addition to these complaints, diarrhea and back pain. Lassa fever was considered, and administration of ribavirin was planned, but the patient died before receiving this antiviral medication. The diagnosis of Lassa fever was confirmed by serum antigen detection, immunohistochemical staining of postmortem liver tissue, virus isolation in cell culture, and genome sequencing. -
Reptile-Associated Salmonellosis in Children
A retrospective review of 1387 cases of salmonellosis revealed that almost half of cases in children younger than 5 years of age were associated with contact with a reptile. -
Persisters: Bacterial Cells That Ignore Antibiotics
Exposure of E. coli to ampicillin results in selection of a preexisting population of persister cells. Persistence may also be induced by ampicillin exposure via activation of the SOS response. -
Updates
Longer-Term Symptoms of WNV Fever; Hepatitis E Hits Iraq; Maggot You Another Appetizer?; SARS and the Environment. -
Binders
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Readers are Invited
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Pharmacology Watch: The FDA and Merck Fielding Concerns About Vioxx
Erythromycin and the Risk of Sudden Death; Vaccine Shortage Putting Americans At Risk; FDA Actions. -
Clinical Briefs in Primary Care supplement