Coccidioidomycosis diagnosed in South Carolina.

Primary care physicians in the Eastern United States rarely consider coccidioidomycosis in the differential diagnosis of pulmonary infections or febrile illnesses. However, the mobility of the population mandates consideration of this diagnosis, particularly in patients with fever and cough that do not resolve rapidly and in patients with adenopathy on chest radiography. In this report, we describe two unrelated cases encountered during a single week in a South Carolina internal medicine practice.

Brucellosis in two hunt club members in South Carolina.

We report two cases of brucellosis in members of a hunt club, both of whom had killed and dressed wild boars. Serologic studies usually suffice for screening patients with suspected or possible brucellosis; however, and as illustrated by our index case, one should ask the laboratory to dilute serum out beyond the customary 1:160 titer if results are negative yet the clinical suspicion high. Hunters should be advised to wear gloves prior to dressing wild mammals.

Antiviral treatment of human immunodeficiency virus infection: update for 2003.

Highly-active Antiretroviral Treatment (HAART) nowadays consists of 21 approved drugs in the USA. The medications belong to four classes: (1) Nucleoside/nucleotide analogues, (2) Non-nucleoside reverse transcriptase inhibitors, (3) Protease inhibitors, and (4) a fusion inhibitor. At least three effective drugs are required to reduce the viremia, aiming at nondetectable, and thus, raise the immune reserve, i.

Fatal immune restoration disease in human immunodeficiency virus type 1-infected patients with progressive multifocal leukoencephalopathy: impact of antiretroviral therapy-associated immune reconstitution.

Immune reconstitution resulting from use of highly active antiretroviral therapy in patients infected with human immunodeficiency virus type 1 (HIV-1) has been associated with a significant decrease in infectious morbidity and with improved survival. Occasionally, patients with quiescent disease due to human cytomegalovirus or nontuberculous mycobacteria may experience paradoxical worsening due to "dysregulated" restitution of the immune system (that is, immune restoration disease [IRD]). Acquired immunodeficiency syndrome-related progressive multifocal leukoencephalopathy (PML) is uncommon and often improves with immune recovery.