Infectious Disease Topics
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Clostridium difficile Infection — Back to the Future
This study provides strong evidence that the diagnosis of Clostridium difficile infection (as opposed to colonization) should be made on the basis of evidence of toxin production, not the mere presence of the organism as detected by glutamate dehydrogenase testing or the presence of toxin genes.
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Intestinal Fibrosis and Immune Reconstitution in Patients with HIV Infection
Duodenal biopsies in patients naïve to combination antiretroviral therapy (cART) underwent tissue staining and were examined. Intestinal myofibroblast activation was correlated with intestinal fibrotic changes and poor immune reconstitution following cART.
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Chagas — Multifaceted Approach Needed
Prolonged recurrent exposure to Trypanosoma cruzi leads to an increased risk of inflammatory cardiomyopathy, but to decreased congenital transmission of T. cruzi. As housing and vector control improve, concurrent attention to early treatment is needed in order to reduce both cardiomyopathy and congenital infection.
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Procalcitonin and Differentiating Bacterial from Viral Meningitis
ABSTRACT & COMMENTARY: A meta-analysis found an elevated serum procalcitonin to be an accurate test. Details inside.
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Infectious Disease Alert Updates
TB Screening for High-Tech Workers
Cellulitis or Pseudocellulitis?
Screening for Creutzfeldt-Jakob Disease Before Invasive Procedures
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Influenza Vaccination: Updated Information for 2015-16
The CDC has published updates of last year’s recommendations of the Advisory Committee on Immunization Practices for the use of seasonal influenza vaccines. The following is a selection of some of the most pertinent ones.
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Scrub Typhus and the Brain
Scrub typhus infections involve the nervous system in a majority of cases and should be suspected in patients who live in, or are returning from, endemic regions with a compatible clinical syndrome.
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“Only Skin Deep” — Preventing and Managing Dermatologic Problems in Travelers
Skin infections and infestations account for significant concern among returned travelers. Appropriate diagnosis and treatment makes long-term morbidity unlikely.
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Community-acquired Pneumonia Requiring Hospitalization in Adults
An active population-based surveillance of community-acquired pneumonia requiring hospitalization in adults 18 years of age and older was conducted in five hospitals in Chicago and Nashville. The incidence of CAP requiring hospitalization was highest in older adults. Despite extensive diagnostic testing, no pathogen was identified in most patients. Respiratory viruses were identified more frequently than bacteria.
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Risk of Herpes Zoster Increases After Zoster Vaccination in Patients Taking Immunosuppressive Medications
In adults >18 years, taking immunosuppressive medications at the time of zoster vaccination increased the risk for herpes zoster for up to 6 weeks afterward (adjusted odds ratio, 2.99; 95% CI, 1.58-5.70).