Infectious Disease Consultation Archive
Whole cell pertussis vaccines are more effective than newer, acellular versions.
A young woman presented with symptoms consistent with aseptic meningitis after taking a dose of trimethoprim/sulfamethoxazole.
Reviewing precautions for blood and body fluids will help protect both healthcare workers and the public.
An obese patient with chronic hepatitis C, diabetes, advanced cirrhosis, and fatty pancreas presents with chronic right-to-middle upper-abdomen pain.
What is the best way to handle ear fungus that is resistant to ketoconazole?
Several dermatologic manifestations of hepatitis C infection have been described.
How do you explain to a patient when a positive test results is likely, but inconclusive due to insufficient specimen quality?
How can clinicians determine which patients will benefit most from specialist referral in resource-limited settings?
Were antibiotics the right decision in this clinical scenario?
What is the likelihood of HPV-caused cervical cancer recurrence after loop electrosurgical excision procedure?
What is the best treatment option for an elderly man with a two-year history of onychomycosis?
What is the standard of care for a patient with elevated liver function tests?
What constitutes a reasonable workup for neutropenia in an otherwise healthy young person?
Are there any guidelines for alternatives to cephalosporins in patients allergic to penicillin?
A patient returns after acyclovir fails to resolve a fever blister on the lip. What's the next step?
How can I avoid unnecessary antibiotic use while still satisfying my patients?
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?
What is the most sensitive test to use when trying to diagnose toenail fungus?
What treatment regimen would have the least adverse effect on the fetus?
What is an effective alternative to oral medications or topical ciclopirox (Penlac) for onychomycosis?
Is it common to see renal failure triggered by high doses of topical acyclovir?
A 69-year-old man with multiple health conditions develops gynecomastia after hemodialysis. Are the two related?
What are the most effective therapies available to treat lymphedema?
Which serologic measure of inflammation is the most cost-effective and reliable when monitoring inflammatory 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.
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?
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?
Esophagogastroduodenoscopy, colonoscopy, complement fixation, celiac, sonogram, gynecologic workup and routine labs have all been negative in a teen with a three-year history of recurrent chronic abdominal pain and diarrhea. What steps should be taken next?
An elderly patient presented with an acute reaction of shingles. How soon after treatment is it advisable to administer the zoster vaccine (Zostavax)?
What is the best way to differentiate tonsillopharyngitis from a peritonsillar abscess?
Is there a connection between celiac disease (CD) and inflammation?
A patient is suspected of having hepatic encephalopathy (HE) attributable to liver failure from alcoholism.
A 55-year-old woman who had herpes zoster and takes morphine for post-herpetic neuralgia pain, no longer wants to be on heavy-duty pain medication. What are her alternatives?
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?
While it is true that lower serum ethinyl estradiol and progestin levels have been found in women using combination OCs and antibiotics, these women remain well within the therapeutic window.
Which type of human papillomavirus (HPV) is associated with nonmucosal, condyloma acuminatum-appearing warts found under the pannus in intertriginous areas?
What is the appropriate workup in an otherwise healthy woman aged 75 years with new-onset hair loss?
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?
Is it possible to have a geriatric patient in serious delirium while all labs and urinalysis are within normal limits?
Are health care providers performing proper follow-up for patients who where previously diagnosed with BCG vaccine who have positive skin tests for tuberculosis?
The use of povidine-iodine in wound care is controversial. Several experimental studies have demonstrated concerns regarding its safety and effect on wound healing.
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?
Travel medicine clinicians may consider advising patients to pack a medical kit with antibiotics to self-treat traveler's diarrhea.
Is there a role for suppressive antibiotic therapy in geriatric patients with recurrent urinary tract infections?
What vaccines and vaccination schedule are recommended for splenectomy patients?
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?
Is sertraline effective as an off-label treatment for irritable bowel syndrome?
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.
If a woman has taken OTC phenazopyridine, and urine dipstick results are skewed, is it appropriate to treat empirically with antibiotics based on history and exam findings?
What are bacterial biofilms, and is there a link between these communities and chronic infections? What treatment strategies are recommended?
A clinician contemplates dapsone for granuloma annulare. Should other treatments be considered?
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?
When should an adult with a spasmodic upper-respiratory infection be swabbed for pertussis?
How does one differentiate between infectious and noninfectious perioral dermatitis in the absence of systemic symptoms?
Is the low-toxicity natural agent artemisinin beneficial in malaria prophylaxis?
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?
What is the most effective way to deal with teenagers with repeated sexually transmitted diseases?
Has anyone had success with the QuickVue influenza test kits? Should patients with flulike symptoms be treated with antibiotics regardless of test results?
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?
A six-year-old girl has been suffering from rashes on the face, chest, and trunk that occur for a week or two, then clear only to recur the next month.
My patient's onychomycosis is responding poorly despite treatment with terbinafine and itraconazole. What do you suggest I do next?
Given the number of immigrants from Third World countries, why are medical providers still teaching that BCG vaccine provides lifelong protection against TB?
Can a person have mononucleosis more than once?
Could this case have been handled in a less invasive manner?
Is it best to remove intact blisters on new second-degree burns or leave them alone?
PA questions whether a child would have better immunity to diseases if introduced to day care earlier.