A 62-year-old man with skin rash and an abnormal chest radiograph.

A 62-year-old man developed a scalp rash 2 months ago, followed by bilateral eyelid swelling. The nonpruritic rash then spread to involve most of his skin. He also had fatigue, muscle weakness, mild muscle soreness with activity, and dysphagia for solid foods for the last 3 weeks.

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America.

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis.

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America.

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis.

Lower limb cellulitis and its mimics: part II. Conditions that simulate lower limb cellulitis.

Several common conditions can mimic cellulitis, creating a potential for misdiagnosis and incorrect management. The most common disorders mistaken for lower limb cellulitis include venous eczema, lipodermatosclerosis, irritant dermatitis, and lymphedema. The dermatologist is often consulted when a patient has failed to respond to therapy, and a thorough knowledge of the differential diagnosis is essential.

Lower limb cellulitis and its mimics: part I. Lower limb cellulitis.

An aging population and obesity have both contributed to a rising incidence of lower limb cellulitis; the most important predisposing factors include older age, obesity, venous insufficiency, saphenous venectomy, and edema. Streptococci are the most commonly implicated pathogen, and often reside in the interdigital toes spaces. Any disruption of the skin surface can allow the organism to invade.

Hypersensitivity pneumonitis: a historical, clinical, and radiologic review.

Most cases of hypersensitivity pneumonitis develop only after many years of inhaling allergens, which include microbes, animal or plant proteins, and certain chemicals that form haptens. The initial clinical presentation is either episodes of acute illness with dyspnea and prominent constitutional symptoms, such as fever, or an insidious onset of dyspnea, coughing, and weight loss, sometimes with superimposed acute episodes. The histopathologic process consists of chronic inflammation of the bronchi and peribronchiolar tissue, often with poorly defined granulomas and giant cells in the interstitium or alveoli.

Blue (or purple) toe syndrome.

Unlabelled: The blue (or purple) toe syndrome consists of the development of blue or violaceous discoloration of one or more toes in the absence of obvious trauma, serious cold-induced injury, or disorders producing generalized cyanosis. The major general categories are: (1) decreased arterial flow, (2) impaired venous outflow, and (3) abnormal circulating blood. Depending on its pathogenesis, the discoloration may be blanching or nonblanching.

Topical and oral antibiotics in wound care.

Treating clinically uninfected venous leg ulcers or superficial diabetic foot ulcers with systemic antimicrobial agents does not accelerate healing, even when pathogens grow from cultures of the wounds. Topical antibiotics do not prevent infections following routine dermatologic surgical procedures or minor wounds in an emergency department, but they are effective in reducing infections following minor trauma in children.

Antimicrobial prophylaxis in dermatologic surgery.

Antimicrobial prophylaxis is rarely appropriate for dermatologic surgery. Dermatologic procedures seldom cause bacteremia, and they have been implicated as a cause in only an extremely small number of cases of endocarditis or infections of vascular grafts or orthopedic prostheses. Accordingly, systemic prophylactic antibiotics are not indicated in patients undergoing dermatologic surgery who have valvular heart disease, vascular grafts, or orthopedic prostheses.

Antimicrobial therapy for skin infections.

The most common skin infections are caused by Staphylococcus aureus, group A streptococci (Streptococcus pyogenes), or the normal skin flora. An antistaphylococcal oral antibiotic is the preferred treatment for nonbullous and bullous impetigo, and a therapeutic agent that is effective against both S aureus and streptococci is appropriate for most cases of cellulitis. For furuncles, carbuncles, cutaneous abscesses, and inflamed epidermal cysts, the most important therapy is incision and drainage, and in most cases there is no need for antimicrobial therapy.

The early history of coccidioidomycosis: 1892-1945.

Coccidioidomycosis was first discovered by a medical student in Argentina in 1892, and knowledge about the infection mostly arose from observations of clinicians and scientists in California, primarily at Stanford University Medical Center. Some discoveries came by chance. Many others arose from careful epidemiologic and clinical investigations in the San Joaquin Valley during the 1930s, when people migrated there from the "Dust Bowl" of the Midwest, and during the 1940s, when the events of World War II brought military recruits, prisoners of war, and persons of Japanese descent to camps and other areas of endemicity.

Death of an Arabian Jew.

A 69-year-old Judean man presents with chronic low-grade fever, pedal edema, and abdominal pain. His condition deteriorates over several weeks with the appearance of shortness and foulness of breath, pruritus, convulsions of every limb, and gangrene of the genitalia. Just before he dies, he orders dozens of the leading men of his kingdom imprisoned and instructs his sister to kill them all after he is gone.

Leptospirosis presenting as diffuse alveolar hemorrhage: case report and literature review.

The literature on diffuse alveolar hemorrhage heavily emphasizes the causal role of vasculitides. We present a patient with diffuse alveolar hemorrhage caused by leptospirosis. Although the pathology in leptospirosis occurs secondary to a vasculitic process, this disease is not listed as a cause of diffuse alveolar hemorrhage in the review literature.