Infectious Disease
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Community-Acquired Pneumonia Guidelines: Updates and Disputes
An update of elements of community-acquired pneumonia guidelines has been published. Of note is that these were not endorsed by the Infectious Diseases Society of America because of disagreement over recommendations for empiric antibiotic administration to some patient subsets with positive tests for respiratory viral infection.
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Fever in the Child Returning from Global Travel
Every year, a significant number of families travel internationally with children, who then have a high rate of febrile illness after returning home. While most travel-acquired infections are self-limited and mild, some diseases may rapidly become fatal, and early recognition and aggressive management can maximize the child’s outcome. This review presents a focused clinical approach to caring for a child returning from international travel with a fever.
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Infectious Disease Updates
Visceral Larva Migrans from Baylisascariasis; Measles Testing of Persons with HIV; Ambulatory Glucose Monitoring a Risk for Bloodborne Pathogens
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Fleas, Typhus, and Texas
Cases of flea-borne typhus are dramatically increasing in Texas.
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Pertussis: Concerning News from Mexico, Brazil, and China
Related to under-immunization of pregnant women and children, pertussis is spreading in several countries within the Americas. Macrolide resistance of Bordetella pertussis is now common in China.
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Meningococcal Conjunctivitis in Military Trainees
Forty-one cases of conjunctivitis due to Neisseria meningitidis occurred in vaccinated military trainees over several months at a Texas facility. Topical treatment alone was successful, and no cases developed invasive infection due to this unencapsulated strain.
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Computerized Order Entry Reduces Antibiotic Use in Low-Risk Patients Hospitalized with SSTIs
A cluster randomized clinical trial assessed the effect of an antibiotic stewardship bundle that included computerized provider order entry (CPOE) prompts vs. routine stewardship on antibiotic selection during the first three hospital days in noncritically ill adults hospitalized with skin and soft tissue infections. CPOE prompts significantly reduced use of extended-spectrum antibiotics without increasing admissions to intensive care units or hospital length of stay.
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Preventing SARS-CoV-2 Infection with an Allergy Nasal Spray
Use of the antihistamine azelastine nasal spray was effective in preventing SARS-CoV-2 infection in young, healthy, vaccinated outpatients.
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Epstein-Barr Virus and Pediatric Sepsis
A recent study of 320 children with sepsis suggests that previous Epstein-Barr virus infection is causally associated with immune dysregulation and fatal outcomes.
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Routine Boosting Against Tetanus and Diphtheria in Adults: A Time to Reconsider
Slifka and colleagues make a strong argument against the routine booster vaccination of adults against tetanus and diphtheria as recommended by the Centers for Disease Control and Prevention.