Impact of cascade reporting of antimicrobial susceptibility on fluoroquinolone and meropenem consumption at a Veterans' Affairs medical center.

Objective: To determine whether cascade reporting is associated with a change in meropenem and fluoroquinolone consumption.

Design: A quasi-experimental study was conducted using an interrupted time series to compare antimicrobial consumption before and after the implementation of cascade reporting.

Setting: A 399-bed, tertiary-care, Veterans' Affairs medical center.

Human immunodeficiency virus associated thrombotic thrombocytopenic purpura, a clinical conundrum.

HIV complicates the diagnostic and therapeutic approaches to idiopathic thrombotic thrombocytopenic purpura (TTP), prompting debate in the literature regarding the benefit of plasma exchange versus simple plasma infusion. Herein we present a case of HIV-TTP, initially treated conservatively with plasma infusion but because of progressive neurologic decline, required urgent plasma exchange for resolution of hematologic derangements and neurologic sequelae. Based on the available literature, there appears to be a spectrum of HIV-associated TTP disorders.

Rituximab treatment for thrombotic thrombocytopenic purpura associated with human immunodeficiency virus failing extensive treatment with plasma exchange: a report of two cases.

In an urban area with a 3% prevalence of HIV infection, two women presented in a 1-year period with AIDS and thrombotic thrombocytopenic purpura (TTP). TTP was diagnosed in each patient based on the presence of thrombocytopenia, schistocytes, and markedly elevated lactate dehydrogenase (LDH) activity. Initial treatment with plasma exchange resulted in resolution of these abnormalities.