Internal Medicine
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Spotted Fever Rickettsioses and Meningoencephalitis
Researchers reviewed 19 cases of meningoencephalitis associated with spotted fever rickettsioses. Fever was present in all cases. Rash was present in 100% of pediatric patients but in only 50% of adult patients. Cerebrospinal fluide pleocytosis was present in 88% of patients. Ninety percent of patients required ICU admission, and only 46% of patients recovered completely.
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Febrile Urinary Tract Infection in Young Infants — Value of Spinal Fluid Analysis
Practices vary significantly as clinicians evaluate and manage febrile infants younger than 2 months of age. A retrospective review suggests that meningitis is extremely unlikely in well-appearing babies with initial laboratory results suggestive of urinary tract infection, and that cerebrospinal fluid analysis may not be necessary.
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Urinary Tract Infection With Bacteremia in Young Infants: Duration of Parenteral Therapy
The duration of parenteral antimicrobial therapy for bacteremic urinary tract infection in young infants varies between practitioners and centers. A retrospective review suggests that extending parenteral treatment beyond seven days does not alter outcomes.
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Vaping and Severe Acute Pneumonitis
As of Aug. 27, 2019, 215 cases of severe pulmonary disease possibly related to vaping have been reported to the CDC. Evidence to date suggests the illness is a form of acute lipoid pneumonia likely related to inhalation of lipid materials. -
Difficult Airway Intubation With Flexible Bronchoscope as a Guide
In this prospective study, use of a flexible bronchoscope as a flexible stylet and a Glidescope to provide visual guidance while intubating patients in the operating room was associated with shorter time to intubation than the use of Glidescope alone.
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Organ Donation: Perspective for the Intensivist
Organ donation and transplantation are important and lifesaving procedures.The complexities of management include determination of death, communication with families, pre-procurement optimization of potential donors, and bereavement support for families.
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Appropriate Cardiac Testing in an Inappropriate World, Part 2: Cardiac Tests
This article addresses specifics of the cardiac testing options, considering their appropriate indications, choices of approach, risks, and costs.
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Darolutamide Tablets (Nubeqa)
Darolutamide should be prescribed to patients with nonmetastatic, castration-resistant prostate cancer.
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Carpal Tunnel Syndrome in the Extreme Elderly
Carpal tunnel syndrome (CTS), when seen in the very elderly, usually is severe and is not reliably diagnosed by ultrasound. Nerve conduction studies and electromyography are the most sensitive and specific tests to make accurate diagnosis of CTS.
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No Antibiotic Prescription Required
Acquisition of antibiotics without a prescription can be easy in the United States.