Infectious Disease Features News

The role of biofilms in chronic infections

The role of biofilms in chronic infections

Bacteria in contact with living tissues form layers that resist penetration by the immune system or antibiotics, but promising treatments abound.

Missed blood test results

Missed blood test results

A patient's positive hepatitis B results were overlooked for 7 years.

A case of G6PD deficiency

A case of G6PD deficiency

Patients with G6PD should avoid triggers of oxidative stress.

A clinician and patient mistake

A clinician and patient mistake

It is well-accepted that healthcare practitioners have a duty to their patients, but do patients have a duty as well?

Healthcare issues of the LGBT community: What the primary care clinician should know

Healthcare issues of the LGBT community: What the primary care clinician should know

A greater understanding of the healthcare issues specific to the lesbian, gay, bisexual, and transgender community may improve the quality of care.

Stat Consult: Lyme disease

Stat Consult: Lyme disease

The Lyme disease spirochete, Borrelia burgdorferi, is an obligate parasite and the most common tick-borne infection in North America and Europe.

Stat consult: Zika virus

Stat consult: Zika virus

Between 75% and 80% of Zika virus infections are asymptomatic.

Cryptogenic organizing pneumonia

Cryptogenic organizing pneumonia

Patients with COP generally have positive outcomes following a definitive diagnosis and the initiation of appropriate treatment.

A side effect of the flu vaccine?

A side effect of the flu vaccine?

A clinician questions wonders if there is a connection between cardiac arrhythmia and the flu vaccine.

Signs and symptoms of hepatitis C virus infection

Signs and symptoms of hepatitis C virus infection

Education of high risk populations and regular testing are crucial steps clinicians can take to stem the spread of hepatitis C infection.

In the wake of the Ebola crisis, PAs in Liberia face professional challenges

In the wake of the Ebola crisis, PAs in Liberia face professional challenges

Physician assistants in Liberia have played a key role in their country's health care during times of crisis, but they still face professional challenges.

Flu vaccine in pregnant women

Flu vaccine in pregnant women

A clinician expresses concerns about potentially misleading flu vaccination information for pregnant women.

Stat Consult: Norovirus 
infection

Stat Consult: Norovirus 
infection

Norovirus is the leading cause of both sporadic and epidemic gastroenteritis worldwide.

A clinician's guide for managing patient perceptions of the flu vaccine

A clinician's guide for managing patient perceptions of the flu vaccine

By presenting research on the safety and efficacy of the flu vaccine, clinicians can successfully promote vaccination to patients in their care.

Initiating antiretroviral therapy in HIV patients with CD4 T-cell counts >500 cells/mcL

Initiating antiretroviral therapy in HIV patients with CD4 T-cell counts >500 cells/mcL

Recommendations for initiation of antiretroviral therapy (ART) in asymptomatic adults with HIV are generally based on CD4 T-cell counts.

Laser therapy for onychomycosis of the toenails

Laser therapy for onychomycosis of the toenails


What is the mechanism of action for laser treatment for onychomycosis of the toenails?

Cold and cough 
symptom relief

Cold and cough 
symptom relief

Safe and effective over-the-counter and herbal treatments are available for patients with viral upper respiratory infections.

Stat Consult: Influenza 
in children

Stat Consult: Influenza 
in children

Learn how to diagnose and treat influenza in children.

The CDC's statistics on influenza—fact or hype?

The CDC's statistics on influenza—fact or hype?


Clinicians debate the fact or hype present in the CDC's most recently released statistics on influenza death rate.

Stat Consult: Influenza in adults

Stat Consult: Influenza in adults

Learn how to diagnose and treat influenza in adults.

Influenza: How serious is it?

Influenza: How serious is it?

Providers should educate their patients on the prevalence of influenza, its potential complications, and the available prevention options.

Fever and tachycardia after a liver transplant

Fever and tachycardia after a liver transplant

A 29-year-old woman, 12 years post-liver transplant, presents with fever and tachycardia and had recently reported fatigue, weakness, and abdominal pain.

Stat Consult: Acute bronchitis

Stat Consult: Acute bronchitis

Learn how to diagnosis and treat acute bronchitis.

Obtaining a sexual
 history in MSM

Obtaining a sexual
 history in MSM

Understanding the nontraditional terminology used by men who have sex with men will help form a successful patient-provider relationship.

Sexual assault—Intervention in primary care

Sexual assault—Intervention in primary care

Recognizing red flag symptoms, such as anxiety, depression, and increased substance use, is important in helping victims who are reluctant to report the assault.

Pertussis vaccine efficacy

Pertussis vaccine efficacy


Whole cell pertussis vaccines are more effective than newer, acellular versions.

Trimethoprim/sulfamethoxazole-
induced aseptic meningitis

Trimethoprim/sulfamethoxazole-
induced aseptic meningitis


A young woman presented with symptoms consistent with aseptic meningitis after taking a dose of trimethoprim/sulfamethoxazole.

An adolescent with more than a cold

An adolescent with more than a cold


A 12-year-old child complains of having a slight sore throat and fatigue, but his mother becomes concerned when the child's symptoms worsen three days later.

Stat Consult: Measles

Stat Consult: Measles

Review the basics on measles, including risk factors, symptoms, treatment, and prevention.

Rebuilding health infrastructure in war-torn South Sudan

Rebuilding health infrastructure in war-torn South Sudan

Health tutor David Manana heads the Clinical Officer training program at the Maridi Health Sciences Institute.

Meningococcal meningitis: Managing outbreaks among adolescents and young adults

Meningococcal meningitis: Managing outbreaks among adolescents and young adults

Each year clusters of meningitis cases break out in the U.S. in the fall and winter months, particularly among adolescents and young adults.

Lysine for treating herpes simplex virus

Lysine for treating herpes simplex virus

Despite a less-than-robust efficacy profile, lysine supplementation is a safe and inexpensive remedy to try in patients with recurrent HSV outbreaks.

Breaking the silence about congenital cytomegalovirus

Breaking the silence about congenital cytomegalovirus

Congenital cytomegalovirus is a very common cause of birth defects, yet many primary-care providers are not well-informed about this infection.

Recommitting to universal precautions in the Ebola era

Recommitting to universal precautions in the Ebola era


Reviewing precautions for blood and body fluids will help protect both healthcare workers and the public.

A New Jersey nurse practitioner fights HIV in Africa

A New Jersey nurse practitioner fights HIV in Africa

Deborah Winters, NP, used skills she learned in the United States to help create the Ethiopia HIV/ART Nurse Specialist (HANS) Training Program Evaluation.

Don't overlook the resurgence of rubella

Don't overlook the resurgence of rubella


The current infectious-disease focus is on ebola and enterovirus D68, but an old foe, rubella, is once again demanding attention.

Pain in a person with hepatitis C and a fatty pancreas

Pain in a person with hepatitis C and a fatty pancreas


An obese patient with chronic hepatitis C, diabetes, advanced cirrhosis, and fatty pancreas presents with chronic right-to-middle upper-abdomen pain.

Provider/pharmacist collaboration reduces flu visits

Provider/pharmacist collaboration reduces flu visits

A key element of the collaborative practice agreement is communication.

Q&A: Over-the-counter medicine use during flu season

Q&A: Over-the-counter medicine use during flu season


The Clinical Advisor asked infectious-diseases specialist Michael E. Klepser, PharmD, about the role over-the-counter agents play in seasonal influenza.

Motivational interviewing helped a teen practice safe sex

Motivational interviewing helped a teen practice safe sex

Sometimes patients just need to hear their own stories out loud to help make better choices.

Addressing teen pregnancy in a school-based health center

Addressing teen pregnancy in a school-based health center

A new program that focused on education both male and female patients about contraception decreased pregnancy rates in an inner-city school.

Double-check a strep test

Double-check a strep test

Study authors found that a throat culture may be useful after a negative RADT finding.

Hypertonic saline effective in bronchiolitis

Hypertonic saline effective in bronchiolitis

Of the patients, 42.6% treated with normal saline required hospital admission, compared with 28.9% of the hypertonic saline group.

USPSTF: Screen high-risk groups for HBV

USPSTF: Screen high-risk groups for HBV

Patients at risk for HBV infection include HIV-positive individuals, injection-drug users, and household contacts of those with HBV.

Written reminder of risky sex

Written reminder of risky sex

Providing patients with a copy of their lab reports emphasizes the seriousness of STDs.

Tick-removal advice

Tick-removal advice


A simple trick to get ticks to let go.

Treating antifungal-resistant ear infection
s

Treating antifungal-resistant ear infection
s

What is the best way to handle ear fungus that is resistant to ketoconazole?

Stat Consult: Upper-respiratory infection

Stat Consult: Upper-respiratory infection

A quick review of medical treatment for upper-respiratory infections, using the best global evidence.

Antibiotic failure and weight in obese patients

Antibiotic failure and weight in obese patients

Frequent infections in obese patients lead to more frequent use of antibacterial medications in this population than in those who are not obese.

Hepatitis C and eczema

Hepatitis C and eczema


Several dermatologic manifestations of hepatitis C infection have been described.

What's the lifespan of mononucleosis?

What's the lifespan of mononucleosis?

A short review of the human herpesvirus mononucleosis, testing options and recurrence.

Testing for multiple STDs

Testing for multiple STDs

How do you explain to a patient when a positive test results is likely, but inconclusive due to insufficient specimen quality?

When to refer hepatitis C patients for specialist treatment

When to refer hepatitis C patients for specialist treatment

How can clinicians determine which patients will benefit most from specialist referral in resource-limited settings?

An unexpected finding during a routine Pap smear

An unexpected finding during a routine Pap smear

I tried to keep my voice steady, as I described what looked like an inch-long piece of cooked linguine attached to the patient's buttock.

Acute pharyngitis in an adult

Acute pharyngitis in an adult

Were antibiotics the right decision in this clinical scenario?

HPV recurrence risk in monogamous relationships

HPV recurrence risk in monogamous relationships

What is the likelihood of HPV-caused cervical cancer recurrence after loop electrosurgical excision procedure?

A cocktail for uncomplicated UTI

A cocktail for uncomplicated UTI

A three-part solution with OTC-ingredients can help prevent future urinary tract infections.

A 'viral syndrome' with an uncommon source

A 'viral syndrome' with an uncommon source

A patient with an unidentifiable, nonspecific viral illness is hospitalized and deteriorates rapidly.

Strawberry tongue cues provider to rare condition

Strawberry tongue cues provider to rare condition

'You don't have to remember it all, just enough to know you need to find out the rest.'

Adult immunizations by medical indication

Adult immunizations by medical indication

Up-to-date CDC recommendations for vaccines for adults with specific medical conditions.

Adolescent catch-up immunization schedule

Adolescent catch-up immunization schedule

Up-to-date CDC recommendations for patients aged 4 months through 18 years who start late or are more than one month behind on immunizations.

Adult vaccine contraindications and precautions

Adult vaccine contraindications and precautions

Up-to-date information from the CDC on contraindications and precautions for adult vaccines.

Adult immunization schedule

Adult immunization schedule

Current CDC immunization schedule and footnotes for vaccinating adults.

Childhood immunization schedule

Childhood immunization schedule

Current CDC immunization schedule and footnotes for vaccinating children aged 0 through 18 years.

Antifungal therapy in the elderly

Antifungal therapy in the elderly

What is the best treatment option for an elderly man with a two-year history of onychomycosis?

Standard of care for patients with elevated liver enzymes

Standard of care for patients with elevated liver enzymes

What is the standard of care for a patient with elevated liver function tests?

Clinical evaluation of 
peptic ulcer disease

Clinical evaluation of 
peptic ulcer disease

Most often caused by use of nonsteroidal anti-inflammatory drugs or 
bacterial infection, peptic ulcer disease usually presents as epigastric pain.

Assessing ­peritonsillar abscesses

Assessing ­peritonsillar abscesses

This infection manifests as a collection of pus and is often a complication of tonsillitis that may require referral to a specialist or hospitalization.

Diagnosing neutropenia

Diagnosing neutropenia

What constitutes a reasonable workup for neutropenia in an otherwise healthy young person?

Swine flu crisis stirs vaccine debate

Swine flu crisis stirs vaccine debate

In response to a federal initiative, a school clinician immunizes a child—but without parental consent.

Vaccinations to 
protect adolescents

Vaccinations to 
protect adolescents

Often at increased risk for disease transmission, many teens and preteens
 do not receive the recommended immunizations in a timely manner.

How to suppress gagging during a strep test

How to suppress gagging during a strep test

A simple technique can help stifle patients' gag reflex.

Sexual risk behavior 
among older adults

Sexual risk behavior 
among older adults

Societal changes and pharmaceutical advances have led to a rise in sexual 
activity in this population, and clinicians must adapt to a new reality.

Cephalosporins in patients allergic to penicillin

Are there any guidelines for alternatives to cephalosporins in patients allergic to penicillin?

Determining the cause of a refractory lip blister

Determining the cause of a refractory lip blister

A patient returns after acyclovir fails to resolve a fever blister on the lip. What's the next step?

Identifying the cause of bilateral ear pain

Identifying the cause of bilateral ear pain

Consider unusual causes of chronic or recurrent ear pain.

Antibiotic overuse must be avoided

Antibiotic overuse must be avoided

How can I avoid unnecessary antibiotic use while still satisfying my patients?

Gargling sore throats away

Gargling sore throats away

A nurse practitioner shares a homemade gargling solution for patients with pharyngitis.

Should fatty liver be considered in spontaneous bleeding?

Should fatty liver be considered in spontaneous bleeding?

A who takes acetaminophen for chronic neck and back pain awakens to a bloody nose and blood-soaked pillow. Could liver disease be to blame?

Managing UTIs in women

Managing UTIs in women

Urinalysis and physical exam determine if the infection is complicated or uncomplicated, primary or recurrent and guide treatment strategy.

Treating the older adult with HIV

Treating the older adult with HIV

Clinicians need to be prepared for the unique challenges presented by the growing number of older patients with HIV.

Onychomycosis diagnosis

Onychomycosis diagnosis

What is the most sensitive test to use when trying to diagnose toenail fungus?

Managing infants with bronchiolitis

Managing infants with bronchiolitis

The symptoms of this common lung infection usually dissipate after a week, but some cases can become severe and require hospitalization.

Sudden neurologic symptom onset 
in an adolescent

Sudden neurologic symptom onset 
in an adolescent

Dizziness, photophobia, nausea and 
an unsteady gait develop following a 
routine annual check up.

Group B strep treatment during pregnancy

Group B strep treatment during pregnancy

What treatment regimen would have the least adverse effect on the fetus?

What to do with a positive hepatitis C test

What to do with a positive hepatitis C test

If the treatment goal of viral eradicatication cannot be met, strive to slow disease progression, lower risk of liver cancer, and improve quality of life.

Marigold: Calendula may help mitigate dermatitis, other ailments

Marigold: Calendula may help mitigate dermatitis, other ailments

Medicinal properties of marigold-derived compounds include antiviral, anti-inflammatory and antitumor effects.

Options for onychomycosis

Options for onychomycosis

What is an effective alternative to oral medications or topical ciclopirox (Penlac) for onychomycosis?

Acute renal failure related to topical acyclovir

Acute renal failure related to topical acyclovir

Is it common to see renal failure triggered by high doses of topical acyclovir?

How do you handle the parents?

How do you handle the parents?

A steadfast clinician gets into trouble when she examines a minor without express verbal consent.

Oral involvement of ­systemic diseases

Oral involvement of ­systemic diseases

Oral manifestations are often an early signal of systemic disease, so ­recognizing them can point the way to a prompt diagnosis.

The best tests for hepatitis C

Hepatitis C virus (HCV) antibody remains active even in an individuals treated successfully or those who clear the virus. Learn how to avoid unnecessary referrals.

HAART meds: Implications for the older adult patient

HAART meds: Implications for the older adult patient

Patients infected with HIV are living longer, which means they have more age-related comorbidities that require other medications as well.

Antibiotic eye drop reminder

A simple tip to improve antibiotic eye drop adherence among women, who sometimes miss applications because they wear clothes without pockets.

Gynecomastia in a patient on dialysis

A 69-year-old man with multiple health conditions develops gynecomastia after hemodialysis. Are the two related?

A routine check-up 
reveals a significant 
genetic abnormality

A routine check-up 
reveals a significant 
genetic abnormality

A corrections officer came into the primary care office for a routine physical and left with an unexpected diagnosis.

Helicobacter pylori: Toward effective eradication

Helicobacter pylori: Toward effective eradication

When choosing among the available treatment options, consideration must be given to local prevalence and antibiotic resistance.

Growing skin plaques with scale

Growing skin plaques with scale

Two patients present to the dermatology clinic with scaly pruritic lesions on the forearm. Can you differentiate between the two?

How to treat lymphedema

What are the most effective therapies available to treat lymphedema?

What causes a metallic taste and burning tongue?

What are the differential diagnoses for a woman aged 60 years with a metallic taste in her mouth and the sensation of a burning tongue?

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