A Case of Cephalic Tetanus in an Elderly Patient with Trismus.

We report a case of a 77-year-old woman who presented to the Emergency Room with a three-day history of oral lesions and jaw tightness. Her physical examination was remarkable for the presence of trismus and white ulcers on the visible portion of the tongue. CT head and neck was unremarkable, and she was discharged with empiric treatment for oral candidiasis.

Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with neurotoxoplasmosis coinfection in a patient with advanced HIV infection.

We describe a patient with advanced HIV infection and Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with Toxoplasma gondii coinfection. A multidisciplinary effort and state-of-the-art diagnostic techniques were required for diagnosis. Our patient is the first reported case of an HIV-infected person with dual Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with neurotoxoplasmosis coinfection.

Lactococcus garvieae endocarditis: report of a case and review of the literature.

Bacterial endocarditis due to Lactococcus garvieae is extremely unusual, and may actually be underreported due to its morphologic and biochemical similarities with enterococci. Only three cases have been reported in the medical literature, and all involved prosthetic valves. We report a case of native valve bacterial endocarditis caused by L.

Performance on the internal medicine second-year residency in-training examination predicts the outcome of the ABIM certifying examination.

For 223 residents from eight teaching hospitals, the results of the second-year in-training examination and the first-sitting certifying examination of the American Board of Internal Medicine were highly correlated. The results of the in-training examination can serve residents as an important measure of their preparedness for certification and can be useful in identifying the need for more intensive self-study strategies during the subsequent one and a half years.