Largest measles epidemic in North America in a decade--Quebec, Canada, 2011: contribution of susceptibility, serendipity, and superspreading events.

Background: The largest measles epidemic in North America in the last decade, occurred in 2011 in Quebec, Canada, where rates of 1- and 2-dose vaccine coverage among children 3 years of age were 95%-97% and 90%, respectively, with 3%-5% unvaccinated.

Methods: Case patients identified through passive surveillance and outbreak investigation were contacted to determine clinical course, vaccination status, and possible source of infection.

Results: There were 21 measles importations and 725 cases.

Management of patients with primary central nervous system lymphoma treated with high-dose methotrexate.

Primary central nervous system lymphoma (PCNSL) is a rare, extranodal form of non-Hodgkin lymphoma that most commonly presents with neurologic changes. Comprehensive workup to diagnose PCNSL and rule out nodal non-Hodgkin lymphoma is critical to the development of an appropriate plan for therapy. Past PCNSL treatments have included whole-brain radiation or steroids, but high-dose methotrexate (MTX) has emerged as initial therapy.