Clinical reasoning for performance of transesophageal echocardiography in veterans with bacteremia.

This study examined physicians' reasoning about obtaining transesophageal echocardiography (TEE) in cases of bacteremia (SAB). In 221 cases of SAB over 5 years, the most common reasons for not performing TEE were clinical response to antibiotics, negative TTE results, and the expectation that TEE would not change management.

Persistent bacteraemia caused by in the gall bladder.

bacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult is important, and awareness of potential sites of infection is critical and can be life-saving.

A high value care curriculum for interns: a description of curricular design, implementation and housestaff feedback.

Purpose: Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns.

Design: Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford.

Trypanosoma brucei infection in a HIV positive Ugandan male.

Human African Trypanosomiasis, or African Sleeping Sickness, is a parasitic infection caused by Trypanosoma brucei (gambiense or rhodesiense), and one of the declared neglected tropical diseases. Sleeping sickness has high fatality rates and is a continued threat in several African countries. We present characteristic clinical and microbiologic features of a fatal case of African Sleeping Sickness in an HIV-infected individual.

Time to clearance of Chlamydia trachomatis ribosomal RNA in women treated for chlamydial infection.

Background: The dynamics of chlamydia clearance after treatment administration for chlamydial urogenital infection are unknown. We estimated the time to clearance of Chlamydia trachomatis (CT) ribosomal RNA (rRNA) after administration of azithromycin for cervical chlamydial infection using APTIMA Combo 2 (Gen-Probe, Inc., San Diego, CA, USA).

Validation of Microcapillary Flow Cytometry for Community-Based CD4+ T Lymphocyte Enumeration in Remote Burkina Faso.

Background: CD4+ T lymphocyte enumeration plays a critical role in the initiation and monitoring of HIV-infected patients on antiretroviral therapy. There is an urgent need for low-cost CD4+ enumeration technologies, particularly for use in dry, dusty climates characteristic of many small cities in Sub-Saharan Africa.

Design: Cross-sectional study.

Is spinal tuberculosis contagious?

While pulmonary Mycobacterium tuberculosis infections are recognized for their public health implications, less is known about the infectiousness of extrapulmonary tuberculosis, specifically, spinal tuberculosis or Pott's disease. We present a case of spinal tuberculosis with concomitant active pulmonary tuberculosis in the absence of chest radiographic abnormalities or symptoms, and review the literature regarding infectiousness of concomitant spinal and pulmonary tuberculosis.