Infectious Disease Alert 2005-03-01

Malaria in Peace and War

Malaria remains a serious threat to both tourists and deployed military personnel. Areas once thought to be relatively risk free may later be associated with transmission of malaria, requiring public health vigilance and regular updating of prophylaxis recommendations.

Corticosteroids in the Treatment of Severe Community-Acquired Pneumonia

Hydrocortisone administration to patients with severe community-acquired pneumonia was associated with improved oxygenation, radiographic clearing, hospital length-of-stay, and patient survival.

What a Crab to Diagnose and Monitor Invasive Aspergillosis

Invasive aspergillosis among neutropenic patients could be reliably diagnosed using a commercial test Fungitell to detect the cell wall component (1->3)-ß-D-glucan of certain fungi, including Aspergillus. However, diagnosis was more accurate when both (1->3)-ß-D-glucan and galactomannan were detected.

Antiretroviral Prophylaxis After Nonoccupational Exposure to HIV

The CDC published its first recommendations for management of exposure to HIV in the occupational setting in 1990, at a time when the only available antiretroviral was zidvudine. They first addressed the issue of non-occupational exposure in print in 1998, at which time they, however, concluded that the available evidence for or against post-exposure prophylaxis (PEP) in this setting was inadequate to allow them to make a recommendation applicable to the United States.

Case Study: The Clostridial Connection

A 46-year-old male presented to a San Jose, California, hospital emergency department with with bilateral diplopia dysphagia, dysphonia, and weakness of his proximal arms. He had been seen in several other medical care facilities over the previous days without diagnosis. The patient regularly self-injected with black tar heroin and had been doing so for 8 years.

Updates By Carol A. Kemper

This unusual case report describes an 82-year old diabetic man who presented with an ulcerated nodule over his first metacarpophalangeal joint. He had been bitten by a dog about 3 months earlier, with initially a small scratch that gradually enlarged and ulcerated with purulent drainage.

Pharmacology Watch: The Risk of Aspirin Withdrawal in ACS Patients

Neuropsychiatric Symptoms of Dementia, FDA Actions.

Infectious Disease Alert – March 1, 2005

March 1, 2005