Infectious Disease Consultation Archive

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.

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?

Infant immunization after a 
blood transfusion

Infant immunization after a 
blood transfusion


Do blood transfusions affect implementation of the routine immunization schedule?

Hepatitis C and eczema

Hepatitis C and eczema


Several dermatologic manifestations of hepatitis C infection have been described.

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?

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?

Onychomycosis diagnosis

Onychomycosis diagnosis

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

Options for onychomycosis

Options for onychomycosis

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

Gynecomastia in a patient on dialysis

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

How to treat lymphedema

What are the most effective therapies available to treat lymphedema?

Choosing the best inflammation marker

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

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?

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?

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?

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?

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.

Bacterial biofilms explained

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

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?

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?

Stubborn onychomycosis

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

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