Febrile Respiratory Symptoms in HIV: Think Flu
Influenza was, by far, the most common specific diagnosis among HIV-infected outpatients who presented with fever and respiratory symptoms; overall disease severity was mild.
By Paul E. Sax, MD
July 2, 2007
Covering:
Klein MB et al., Clin Infect Dis 2007 Jul 15; 45:234-40
The 4-Hour Rule for CAP Antibiotic Administration Backfires
General Medicine Summary and Comment
Free
In one study, it was the patients <$EMPH_O>without<$EMPH_C> pneumonia who got (unnecessary) antibiotics more quickly.
By Abigail Zuger, MD
June 28, 2007
Covering:
Kanwar M et al., Chest 2007 Jun; 131:1865-9
Efficacy of Human Monoclonal Antibodies Against H5N1 Influenza
Infectious Diseases Summary and Comment
Free
Monoclonal antibodies generated from B cells of patients who had survived H5N1 influenza were efficacious in preventing and treating H5N1 infection in a mouse model.
By Thomas Glück, MD
June 27, 2007
Covering:
Simmons CP et al., PLoS Med 2007 May 29; 4:e178
Simple Intervention Improves TB Detection
Infectious Diseases Summary and Comment
Verbal instruction on how to obtain a good sputum sample led to increased smear positivity among patients — particularly women — with suspected TB.
By Mary E. Wilson, MD
June 27, 2007
Covering:
Khan MS et al., Lancet 2007 Jun 9; 369:1955-60
Alisjahbana B and van Crevel R., Lancet 2007 Jun 9; 369:1908-9
Chronic Pulmonary Aspergillosis in Nonneutropenic Patients
Infectious Diseases Summary and Comment
Voriconazole treatment led to clinical and radiologic improvement in 67% and 71% of patients, respectively, and to disease control in 58%.
By Thomas Glück, MD
June 27, 2007
Covering:
Camuset J et al., Chest 2007 May; 131:1435-41
Outcomes of TB Treatment in HIV-Infected Patients
Infectious Diseases Summary and Comment
Relapse rates were significantly higher in TB patients with HIV infection than in those without such infection.
By Neil M. Ampel, MD
June 20, 2007
Covering:
Nahid P et al., Am J Respir Crit Care Med 2007 Jun 1; 175:1199-206
Two Is Better Than One for CAP with Shock
Infectious Diseases Summary and Comment
Combination antibiotic therapy appears to offer survival advantage in treating community-acquired pneumonia with shock.
By Richard T. Ellison III, MD
June 6, 2007
Covering:
Rodríguez A et al., Crit Care Med 2007 Jun; 35:1493-8
Blot S and Depuydt P., Crit Care Med 2007 Jun; 35:1617-8
HSV Bronchopneumonitis in Patients on Prolonged Mechanical Ventilation
Infectious Diseases Summary and Comment
HSV bronchopneumonitis was associated with longer duration of mechanical ventilation and with longer ICU stay; acyclovir treatment did not alter outcomes.
By Neil M. Ampel, MD
June 6, 2007
Covering:
Luyt CE et al., Am J Respir Crit Care Med 2007 May 1; 175:935-42
Sputum Induction Performs Well for TB Diagnosis
General Medicine Summary and Comment
It compares well with both gastric lavage and bronchoscopic bronchoalveolar lavage.
By Abigail Zuger, MD
June 5, 2007
Covering:
Brown M et al., Clin Infect Dis 2007 Jun 1; 44:1415-20
PPIs and Risk for Community-Acquired Pneumonia
General Medicine Summary and Comment
Current PPI use — especially recently initiated use — was associated with higher risk.
By Jamaluddin Moloo, MD, MPH
May 31, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
Pneumococcal Vaccine: The Good, the Bad, and the Uncertain
Conjugated pneumococcal vaccine works, but pockets of disease remain.
By Peggy Sue Weintrub, MD
May 23, 2007
Covering:
Grijalva CG et al., Lancet 2007 Apr 7; 369:1179-86
Singleton RJ et al., JAMA 2007 Apr 25; 297:1784-92
A Noninvasive Method for Diagnosing Pneumocystis Pneumonia
Infectious Diseases Summary and Comment
A ß-D-glucan level >31 pg/mL was found to be a useful marker for the diagnosis of pneumocystis pneumonia.
By Thomas Glück, MD
May 23, 2007
Covering:
Tasaka S et al., Chest 2007 Apr; 131:1173-80
Pneumocystis jiroveci Pneumonia in Renal-Transplant Recipients
Infectious Diseases Summary and Comment
Twenty-two cases occurred in a single renal-transplant program during an 11-month period; the outbreak ended with the institution of antibiotic prophylaxis during month 10.
By Neil M. Ampel, MD
May 23, 2007
Covering:
de Boer MGJ et al., Clin Infect Dis 2007 May 1; 44:1143-9
Hughes WT., Clin Infect Dis 2007 May 1; 44:1150-1
Do PPIs Increase Risk for CAP?
Infectious Diseases Summary and Comment
In a large population-based case-control study, the use of proton-pump inhibitors was associated with increased risk for community-acquired pneumonia.
By Daniel J. Diekema, MD, MS
May 23, 2007
Covering:
Gulmez SE et al., Arch Intern Med 2007 May 14; 167:950-5
Population Effects of Infant Pneumococcal Vaccine
General Medicine Summary and Comment
Admission rates for all-cause infant pneumonia fell sharply after this vaccine was introduced.
By Bruce Soloway, MD
May 22, 2007
Covering:
Grijalva CG et al., Lancet 2007 Apr 7; 369:1179-86
Antibiotic Prescriptions for Viral URIs: We’re Making Progress!
Emergency Medicine Summary and Comment
Prescriptions decreased by 20% from 1993 through 2004.
By Diane M. Birnbaumer, MD, FACEP
May 18, 2007
Covering:
Vanderweil SG et al., Acad Emerg Med 2007 Apr; 14:366-9
Oral Decontamination and VAP
Infectious Diseases Summary and Comment
Oral decontamination with antiseptics decreased the risk for ventilator-associated pneumonia but did not reduce mortality rates or duration of ICU stay.
By Stephen G. Baum, MD
May 16, 2007
Covering:
Chan EY et al., BMJ 2007 Apr 28; 334:889
Brun-Buisson C., BMJ 2007 Apr 28; 334:861
Community-Acquired MRSA plus Influenza Can Cause Life-Threatening Pneumonia
Emergency Medicine Summary and Comment
This severe illness can be fatal within 4 days of respiratory symptom onset.
By Diane M. Birnbaumer, MD, FACEP
May 11, 2007
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2007 Apr 13; 56:325-9
How Common Are Atypical Pathogens in Community-Acquired Pneumonia?
General Medicine Summary and Comment
Atypical pathogens were identified in about 20% to 30% of CAP cases worldwide.
By Allan S. Brett, MD
May 10, 2007
Covering:
Arnold FW et al., Am J Respir Crit Care Med 2007 May 15; 175:1086-93
Should Infants with Bronchiolitis Have Chest X-Rays?
Infectious Diseases Summary and Comment
Chest radiography increases antibiotic use for infants with bronchiolitis.
By Robert S. Baltimore, MD
May 2, 2007
Covering:
Schuh S et al., J Pediatr 2007 Apr; 150:429-33
Patterns of Airway Colonization in Ventilated Patients
Infectious Diseases Summary and Comment
Culture of upper-airway specimens may be useful in diagnosing suspected VAP because the responsible pathogens colonize the entire respiratory tract as a monoclonal population.
By Thomas Glück, MD
May 2, 2007
Covering:
Berdal JE et al., Clin Microbiol Infect 2007 May; 13:476-80
Antimicrobial Resistance in Pseudomonas
Infectious Diseases Summary and Comment
Sequential sampling reveals that resistance develops in <$EMPH_O>Pseudomonas<$EMPH_C> strains within 6 to 10 days after antibiotic exposure and sometimes persists for lengthy periods thereafter.
By Thomas Glück, MD
May 2, 2007
Covering:
Reinhardt A et al., Antimicrob Agents Chemother 2007 Apr; 51:1341-50
Neuraminidase Inhibitor Resistance in Influenza B
Infectious Diseases Summary and Comment
Infection with neuraminidase-resistant influenza B virus — and possibly transmission of resistant virus — has been recognized in Japan.
By Richard T. Ellison III, MD
April 25, 2007
Covering:
Hatakeyama S et al., JAMA 2007 Apr 4; 297:1435-42
Baculovirus-Derived Influenza Vaccine Is Safe and Immunogenic
Infectious Diseases Summary and Comment
A trivalent influenza vaccine containing baculovirus-expressed hemagglutinin proteins appears safe and immunogenic in healthy adult volunteers.
By Richard T. Ellison III, MD
April 25, 2007
Covering:
Treanor JJ et al., JAMA 2007 Apr 11; 297:1577-82
Community-Acquired Pneumonia
Infectious Diseases Clinical Practice Guideline Watch
This guideline unifies the approach to CAP management and emphasizes implementation strategies rather than changes in antimicrobial regimens.
By Stephen G. Baum, MD
April 25, 2007
Covering:
Mandell LA et al., Clin Infect Dis 2007 Mar 1; 44:S27-72
