Infectious Disease Features News

Case Study: Abdominal Pain, Malaise, and a Bruise on the Leg

Case Study: Abdominal Pain, Malaise, and a Bruise on the Leg

A 44-year-old man presents to the hospital with generalized abdominal pain, malaise, subjective low-grade fever, and a bruise on his left shin. He has an extensive medical history including HIV, hypertension, diabetes, and GERD, but he denies vomiting or diarrhea.

Case Study in Diabetes: Fungal Infections

Case Study in Diabetes: Fungal Infections

A 68-year-old patient with type 2 diabetes presents to a urologist to evaluate funguria, and a CT scan showed right hydroureteronephrosis.

Case Study: Headache, Back Pain, and Fever

Case Study: Headache, Back Pain, and Fever

A 25-year-old woman presents to the emergency department with a chief complaint of headache, back pain, and fever, while also experiencing some vaginal itching and discharge.

Acute infectious diarrhea: a clinical approach

Acute infectious diarrhea: a clinical approach

The first step for managing a patient with diarrhea is to determine the severity of dehydration according to the estimated volume loss and the symptoms and signs noted on physical examination.

The race to develop a universal influenza vaccine

The race to develop a universal influenza vaccine

NIH's National Institute of Allergy and Infectious Diseases is researching ways to develop a universal influenza vaccine against multiple strains.

The flu pandemic of 1918: 100 years later

The flu pandemic of 1918: 100 years later

In 1918, between 50 and 100 million people are thought to have died from the great influenza pandemic, representing as much as 5% of the world's population.

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.

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.

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?

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.

Human papillomavirus vaccination not linked to increase in sexually transmitted infections in adolescent females

Human papillomavirus vaccination not linked to increase in sexually transmitted infections in adolescent females 


The HPV vaccination is not associated with an increase in sexually transmitted infections in adolescent females, study results suggest. The vaccine is recommended for all children 11 to 12 years old.

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.

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.

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.

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.

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.

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?

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.

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?

Acute pharyngitis in an adult

Acute pharyngitis in an adult

Were antibiotics the right decision in this clinical scenario?

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?

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.

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.

Antibiotic overuse must be avoided

Antibiotic overuse must be avoided

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

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?

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.

Options for onychomycosis

Options for onychomycosis

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

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.

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?

Demystifying the liver and its diseases

Demystifying the liver and its diseases

An understanding of the liver and its functions will provide the tools to perform a basic workup of patients suspected of having hepatic disease.

Choosing the best inflammation marker

Which serologic measure of inflammation is the most cost-effective and reliable when monitoring inflammatory disease?

Updated information 
on MRSA infections

Updated information 
on MRSA infections

The number of hospital-acquired MRSA infections is down; however, 
community-acquired MRSA infections continue to rise.

Diagnosing nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is rapidly emerging as one of the most common "incidental findings" identified with radiographic testing. One in four adults is found to have the condition when undergoing abdominal ultrasound.

Mysterious stomach pain when coughing

Could a liver infarct be the cause of a patient's dull, intermittent pain in the right-upper-quadrant? Or is something else to blame?

Stat Consult: Influenza in 
children

Stat Consult: Influenza in 
children

A quick review of influenza A and influenza B viruses in children, providing information on the infections' epidemiology and associated complciations, as well as tips for diagnosis, treatment and prevention.

Is this rash related to terbinafine?

A patient taking terbinafine for onychogryphosis developed a fine pruritic rash over sun exposed body areas while on vacation. Could the drug be to blame?

Practice antibiotic stewardship to preserve benefits

Practice antibiotic stewardship to preserve benefits

Considered "magic bullets" when they first arrived on the scene, antibiotics must be used appropriately to protect their effectiveness.

Can a gluten-free diet tame inflammation?

Is there a connection between celiac disease (CD) and inflammation?

Confirming suspicions of hepatic encephalopathy

A patient is suspected of having hepatic encephalopathy (HE) attributable to liver failure from alcoholism.

Efficacy of cephalexin after raising dosage

Is there any evidence that changing a patient's cephalexin dose from 500 q.i.d. to 1,000 b.i.d. has decreased efficacy in terms of infection control?

Discussing vaccine hesitancy with parents

Discussing vaccine hesitancy with parents

Parents today are more likely than ever to have questions or concerns about the safety of immunizations, and clinicians must be prepared to have effective discussions about the benefits and risks of vaccination.

Differentiating between types of intertriginious warts

Which type of human papillomavirus (HPV) is associated with nonmucosal, condyloma acuminatum-appearing warts found under the pannus in intertriginous areas?

New-onset alopecia in women

What is the appropriate workup in an otherwise healthy woman aged 75 years with new-onset hair loss?

Is simultaneous vaccination always necessary?

In adolescents aged 11 to 14 years, must the human papillomavirus; meningococcal (MCV4); tetanus, diphtheria, and pertussis (Tdap); and, if needed, varicella vaccines be given simultaneously?

New strategies against obesity comorbidities

New strategies against obesity comorbidities

Obese adults are at risk for many serious health conditions, including diabetes, coronary heart disease, hypertension, stroke, obstructive sleep apnea (OSA), depression and liver disease.

Therapeutic strategies for bacterial conjunctivitis

Therapeutic strategies for bacterial conjunctivitis

Resistance has compromised the effectiveness of all ophthalmic antibiotics, but new topical treatment options are available.

Brewer's yeast: Medical uses in cancer, therapy for premenstrual syndrome and antibiotic-associated diarrhea

Brewer's yeast: Medical uses in cancer, therapy for premenstrual syndrome and antibiotic-associated diarrhea

Brewer's yeast, or Saccharomyces cerevisiae, is specifically grown as a nutritional substance rich in chromium, selenium, proteins and B-complex vitamins.

Burning rash spreads from the trunk to the rest of the body

Burning rash spreads from the trunk to the rest of the body

A Fite stain leads to the correct diagnosis of these lesions in a man originally from Micronesia.

Tips for tracking Tdap vaccination status

Current FDA indications for tetanus, diptheria and pertussis vaccine call for only one dose between ages 11 and 64 years. What strategies or processes have been employed to communicate to the patient whether he or she has received the one-time-only tetanus shot?

Chemoprophylaxis for traveler's diarrhea

Travel medicine clinicians may consider advising patients to pack a medical kit with antibiotics to self-treat traveler's diarrhea.

Treatments for recurrent UTI in elderly patients

Treatments for recurrent UTI in elderly patients

Is there a role for suppressive antibiotic therapy in geriatric patients with recurrent urinary tract infections?

Post-splenectomy vaccination recommendations

What vaccines and vaccination schedule are recommended for splenectomy patients?

Extended therapy for hepatitis C

Is it reasonable to extend interferon and ribavirin therapy to 72 weeks to increase a patient's chance of achieving sustained viral response to hepatitis C?

MMR vaccination for health-care workers

Clinicians asks advice for appropriate vaccine procedure for health care workers who received childhood vaccines, but cannot supply documentation and no longer have immunity to measles, mumps or rubella.

Clinical certification programs: Which are right for you?

With ongoing changes in the healthcare field, certification demonstrates an advanced level of knowledge and skills in a specialty practice area.

Bacterial biofilms explained

What are bacterial biofilms, and is there a link between these communities and chronic infections? What treatment strategies are recommended?

Licorice

Licorice

Medically, licorice traditionally has been used as a general anti-inflammatory, antitussive, GI soothant, and for respiratory support. The potential for antiviral activity and hepatocellular protection in cases of hepatitis C has also been discussed.

Community health nursing

Primarily working in clinics that serve low-income and homeless demographics, as well as the underinsured and uninsured, community health nurses (CHNs) play integral roles in caring for vulnerable populations.

Antibiotics may benefit some patients with acute otitis media

Amoxicillin-clavulanate studied in children who met strict criteria for AOM diagnose.

Does herpes indicate child abuse?

How can I determine if HSV-1 in a 2-year-old girl is the result of abuse or exposure from a vaginal birth of an HSV-positive mother?

MRSA infections not limited to hospitals

MRSA infections not limited to hospitals

The Infectious Diseases Society of America's first treatment guidelines on this topic focus on the management of community-acquired infections.

When is it OK for a clinician to return to work after MRSA?

What treatment and/or confirmatory testing are required before a health-care professional who has been diagnosed with MRSA infection can resume working with patients?

Multiple STDs in a teenager

What is the most effective way to deal with teenagers with repeated sexually transmitted diseases?

Expelling the myths of the midwife

Many people think seeing a midwife means forgoing to the comfort and convenience of modern health care. Find out here why it's not.

Flu-test effectiveness

Has anyone had success with the QuickVue influenza test kits? Should patients with flulike symptoms be treated with antibiotics regardless of test results?

Safety of herbal vaginal products

Some of my patients with abnormal Pap smears attributable to the high-risk HPV virus claim to have "healed" their cervixes with herbal vaginal suppositories. Are these products safe and/or effective?

Oral lesions caused by human papillomavirus

Oral lesions caused by human papillomavirus

Commonly found in the oral cavity, HPV lesions may persist or relapse spontaneously and occasionally require surgical excision.

Stubborn onychomycosis

My patient's onychomycosis is responding poorly despite treatment with terbinafine and itraconazole. What do you suggest I do next?

Lab worker stabbed with dirty needle

Lab worker stabbed with dirty needle

Was the staff at fault for not warning that the patient was HIV-positive and had hepatitis C?

CDC releases 2010 influenza prevention recommendations

The CDC Advisory Committee on Immunization Practices has released its 2010 recommendations for the prevention and control of influenza.

DNA-based HPV test more effective than cytology

Evidence from a new randomized trial suggests that HPV DNA-based testing may reduce the rate of invasive cervical cancer compared with cytology.

Treating HIV infection in primary care

Treating HIV infection in primary care

Much has changed since the first case of AIDS was identified. Updated guidelines discuss transmission, diagnosis, risk screening, and adherence.

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