-Induced Rash and Mucositis in a Previously Healthy Man: A Case Report and Brief Review of the Literature.

We describe a case of a 33-year-old-male with induced rash and mucositis and review the literature on this newly described syndrome.

Thymoma associated paraneoplastic encephalitis (TAPE), a potential cause of limbic encephalitis.

A 59-year-old man presents with expressive aphasia and short term memory deficits. Shortly thereafter, he started developing staring spells and intermittent right hand spasms, preliminarily thought to be simple partial seizures. Subsequent MRI brain imaging was highly suggestive of herpes simplex virus (HSV) encephalitis; however, HSV PCR from cerebrospinal fluid was negative.

Sticky Business: a syndrome of mucoid bacterial spread.

A 70-year-old man presented with acute wrist pain concerning for septic arthritis. Shortly thereafter, he developed acute monocular vision loss and was diagnosed with endogenous endophthalmitis. Subsequent imaging revealed numerous visceral abscesses and a mycotic abdominal aortic aneurysm.

Painful rash with hoarseness: an atypical presentation of syphilis.

Syphilis is a sexually transmitted disease that can affect multiple organ systems, with central nervous system involvement at any stage. We present a 53-year-old woman with an unusual truncal rash with painful anogenital lesions, accompanied by patchy alopecia, oral lesions, photophobia and hoarseness. She was found to have positive serological tests for syphilis with cerebrospinal fluid findings suggestive of neurosyphilis.

A survey of resident opinions on peer evaluation in a large internal medicine residency program.

Background: Starting in the 1960s, studies have suggested that peer evaluation could provide unique insights into the performance of residents in training. However, reports of resident resistance to peer evaluation because of confidentiality issues and the possible impact on their working relationships raised concerns about the acceptability and utility of peer evaluation in graduate medical education. The literature suggests that peers are able to reliably assess communication, interpersonal skills, and professionalism and provide input that may differ from faculty evaluations.

General principles of antimicrobial therapy.

Antimicrobial agents are some of the most widely, and often injudiciously, used therapeutic drugs worldwide. Important considerations when prescribing antimicrobial therapy include obtaining an accurate diagnosis of infection; understanding the difference between empiric and definitive therapy; identifying opportunities to switch to narrow-spectrum, cost-effective oral agents for the shortest duration necessary; understanding drug characteristics that are peculiar to antimicrobial agents (such as pharmacodynamics and efficacy at the site of infection); accounting for host characteristics that influence antimicrobial activity; and in turn, recognizing the adverse effects of antimicrobial agents on the host. It is also important to understand the importance of antimicrobial stewardship, to know when to consult infectious disease specialists for guidance, and to be able to identify situations when antimicrobial therapy is not needed.

A multi-institutional survey of internal medicine residents' learning habits.

Background: Resident physicians are expected to demonstrate medical knowledge. However, little is known about the residents' reading habits and learning preferences.

Aim: To assess residents' reading habits and preferred educational resources.

An outbreak of Mycobacterium chelonae infections in tattoos.

Nontuberculous mycobacteria infections may occur after cutaneous procedures. Review of the medical records of patients who developed a rash within a tattoo revealed 6 patients with skin infections caused by Mycobacterium chelonae after receiving tattoos by one artist at a single tattoo establishment. The interval between tattoo placement and the skin findings was 1 to 2 weeks.

Methicillin-resistant Staphylococcus aureus prostatitis.

Prostatitis is a common condition that is associated with a poor quality of life. A recent National Institutes of Health Consensus Panel classified prostatitis into the categories of acute bacterial, chronic bacterial, chronic nonbacterial, and asymptomatic. Bacterial prostatitis is usually caused by Escherichia coli and other gram-negative bacteria, but it is not frequently caused by Staphylococcus aureus.

Vestibular toxicity due to inhaled tobramycin in a patient with renal insufficiency.

Inhaled tobramycin is being used increasingly in patients with cystic fibrosis and other forms of bronchiectasis for treatment of bronchial colonization with Pseudomonas aeruginosa. The goal of inhaled antibiotics is to provide maximal concentrations at the site of infection without risking systemic toxicity. We report an unusual case of reversible vestibular toxicity due to inhaled tobramycin in a patient with renal failure who was undergoing hemodialysis.