Short Versus Long Antibiotic Duration in Bacteremia.

Background: is a common pathogen associated with bloodstream infections, respiratory infections, peritonitis, infective endocarditis, and meningitis. Literature assessing duration of antibiotic therapy for a bacteremia secondary to common infection is scarce, leading to variability in practice. Therefore, this study evaluated the effectiveness of short (5-10 days) versus long (11-16 days) antibiotic durations for bacteremia.

HHV-6 Infection in a 19-Year-Old Liver Transplant Recipient - Much More Than Roseola!

Human herpesvirus 6 (HHV-6) infections, most commonly occurring during childhood, are frequently mild and self-limited. However, immunosuppression due to transplantation may cause reactivation of HHV-6 with manifestations ranging from fever and skin exanthem to pneumonitis, hepatitis, encephalitis, and myelitis. Because these infections may be devastating for liver transplant recipients leading to transplant organ fibrosis and failure, it is imperative that internists recognize the manifestations, establish early diagnosis, institute appropriate therapy, and make timely referrals to transplant specialists.

Quantifying Gram-Negative Resistance to Empiric Treatment After Repeat ExpoSure To AntimicRobial Therapy (RESTART).

Background: Antibiotic exposure is a primary predictor of subsequent antibiotic resistance; however, development of cross-resistance between antibiotic classes is also observed. The impact of changing to a different antibiotic from that of previous exposure is not established.

Methods: This was a retrospective, single-center cohort study of hospitalized adult patients previously exposed to an antipseudomonal β-lactam (APBL) for at least 48 hours in the 90 days prior to the index infection with a gram-negative bloodstream or respiratory infection.

An Approach for Diagnosing and Treating Neurosyphilis: A Case Report.

Neurosyphilis is a disease caused by systemic infection with , which infiltrates the central nervous system and preganglionic dorsal roots. This process presents as neurological deficits and can occur any time during the infection course, but usually takes many years. Neurosyphilis is rare in the developed world where antibiotics are readily available to treat the early stages of syphilis.

I can't hear you, you said I had what?: A case report and literature review.

We report the case of a 46-year old African American woman who presented to the emergency department with one week of progressive bilateral deafness associated with worsening gait abnormalities, visual changes, and confusion. She was diagnosed with Wernicke encephalopathy (WE) attributed to alcohol abuse; her symptoms, including hearing loss, improved with thiamine replacement. WE, a condition due to thiamine deficiency, commonly affects those with alcohol use disorder or gastric bypass history.

Rash decisions can be life-saving: a case of disseminated histoplasmosis in an immunocompromised patient.

Histoplasmosis is the most prevalent endemic mycosis in the United States with the highest incidence in the Mississippi and Ohio River Valleys. Most infections are asymptomatic or self-limited. However, in immunocompromised patients, severe and progressive disseminated infection can occur.

Acute Liver Failure due to Disseminated Varicella Zoster Infection.

Acute liver failure (ALF) can be due to numerous causes and result in fatality or necessitate liver transplantation if left untreated. Possible etiologies of ALF include ischemia, venous obstruction, medications, toxins, autoimmune hepatitis, metabolic and infectious causes including hepatitis A-E, varicella-zoster virus (VZV), cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV), and adenovirus with VZV being the most rarely reported. Pathognomonic skin lesions facilitate diagnosis of VZV hepatitis, but definitive diagnosis is secured with liver biopsy, tissue histopathology, culture, and specific VZV polymerase chain reaction (PCR).

Pleural coccidioidomycosis presenting as spontaneous pneumothorax.

is a fungus endemic to Southwestern USA and Northern Mexico which can be asymptomatic or result in a well-defined clinical syndrome of community-acquired pneumonia. On rare occasion, coccidioidomycosis may have atypical presentations as in our patient, a 25-year-old man admitted with a 2-month history of progressive dyspnoea and cough. He was found to have a large right-sided pneumothorax with exudative pleural effusion which did not resolve following thoracentesis.

A single-institution experience with a brucellosis outbreak in the United States.

Human cases of brucellosis in the United States are primarily limited to imported infections or reservoirs. We describe a brucellosis outbreak involving 8 patients treated at a single hospital in the United States. Standardized precautionary microbiology processes and coordinated collaboration among hospital departments and local health departments assisted in optimally managing this disease at our institution.