Category: Infectious Disease
Keywords: necrotizing fasciitis (PubMed Search)
Posted: 8/4/2008 by Rob Rogers, MD
(Updated: 8/14/2024)
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Necrotizing Fasciitis Pearl
A few things to remember about treating necrotizing soft tissue infections:
So, when shot-gunning the antibiotics in a patient with a really bad soft tissue infection (not the run of the mill cellulitis) consider adding Clindamycin to the regimen.
Infectious Disease Society of America, 2006
Category: Infectious Disease
Keywords: diabetes, osteomyelitis, temperature, white blood cell count (PubMed Search)
Posted: 7/1/2008 by Mike Winters, MBA, MD
(Updated: 8/14/2024)
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Does this Patient with Diabetes have Osteomyelitis?
Butalia S, Palda VA, Sargeant RJ, et al. Does this patient with diabetes have osteomyelitis of the lower extremity? JAMA 2008;299:806-13.
Category: Infectious Disease
Keywords: Food Poisoning, Diarrhea (PubMed Search)
Posted: 6/14/2008 by Michael Bond, MD
(Updated: 8/14/2024)
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Now that we have entered the session of cookouts, picnics, and family get togethers I thought I would review some of the more common causes of food poisoning and the typical foods that they are found in.
Bacteria | Foods Typically Found In | Onset of Symptoms |
Staphylococcus aureus | Meat and seafood salads, sandwich spreads and high salt foods. | 4-6 hours |
Salmonella | Meat; poultry, fish and eggs and now tomatoes | 12 to 24 hours. Assoociated with fever |
Clostridium perfringens | Meat and poultry dishes, sauces and gravies. | 12 to 24 hours. |
Vibrio parahaemolyticus | Raw and cooked seafood. | 12 to 24 hours. Associated with fever |
Bacillus cereus | Starchy food. Typically Chinese Fried Rice in test questions | 12 to 24 hours. |
Campylobacter jejuni | Meat, poulty, milk, and mushrooms. | 24 hours |
Category: Infectious Disease
Keywords: meningitis, fluoroquinolone (PubMed Search)
Posted: 2/25/2008 by Michael Bond, MD
(Emailed: 3/1/2008)
(Updated: 8/14/2024)
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It has become standard that close contacts of individuals being treated for bacterial meningitis be treated prophalacticly with antibiotics to prevent additional cases. Fluoroquinolones, in particular ciprofloxicin, have been the drug of choice as a single dose provided adequate protection.
Now the CDC is reporting the first cluster of fluoroquinolone-resistant meningococcal disease in North America have been documented along the Minnesota-North Dakota border. As of now, the CDC still recommends ciprofloxacin for all parts of the country except for a 34-county area in the Minnesota-North Dakota area. In that area the CDC is recommending rifampin, ceftriaxone or azithromycin be used.
This needs to be followed closely as the resistant organism is extremely likely to spread across the country and it will probably this time next year when nobody can use ciprofloxacin anymore.
Category: Infectious Disease
Keywords: Dermatology, Rash, (PubMed Search)
Posted: 2/17/2008 by Michael Bond, MD
(Updated: 8/14/2024)
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Category: Infectious Disease
Keywords: Ludwig, Angina (PubMed Search)
Posted: 1/13/2008 by Michael Bond, MD
(Updated: 8/14/2024)
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Ludwig’s Angina:
Ludwig’s angina is most commonly a polymicrobial disease of mixed aerobic / anaerobic bacterial origin. Dental disease is the most common cause of Ludwig’s angina.
Diagnosis is usually made after obtaining a CT scan of the Neck and upper chest.
Once the diagnosis is made, treatment should consist of broad spectrum antibiotics and surgical evaluation by ENT or Oral Surgery for possible I&D. Aggressive management of the patient’s airway is a must, and the patient should be intubated early in the course of the illness if there is any sign of airway compromise. Nasal intubation may be preferred by ENT/Oral Surgery.
Typical Antibiotics include a Penicillin with clindamycin or metronidazole.
Ludwig’s Angina Trivia:
Category: Infectious Disease
Keywords: MRSA, resistant bacteria, sepsis, antiobiotics, baltimore (PubMed Search)
Posted: 10/17/2007 by Dan Lemkin, MS, MD
(Updated: 8/14/2024)
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A recent study came out which confirms what we already knew... that MRSA infections are no longer confined to ICUs but are spreading to the community. What the new study does show, is that it affects particular populations disproportionately and Baltimore City, more than any other study population. The full article is attached below, or can be obtained for free from the JAMA website.
"Unadjusted incidence rates of all types of invasive MRSA ranged between approximately 20 to 50 per 100 000 in most ABCs sites but were noticeably higher in 1 site (site 7, Baltimore City) (TABLE 2)." "... we calculated interval estimates excluding site 7 (Baltimore City) to allow the reader to interpret a range of estimates reflecting different metropolitan areas. Regarding the high observed incidence rates reported by site 7, we conducted an evaluation to determine whether these results were valid, including a review of casefinding methods, elimination of cases to include only those with zip codes represented in the denominator, contamination in any laboratory, and other potential causes for increased rates; however, none were in error." |
0710170948_jama_mrsa.pdf (129 Kb)
Category: Infectious Disease
Keywords: community acquired pneumonia, CURB-65, empiric antibiotics (PubMed Search)
Posted: 9/18/2007 by Mike Winters, MBA, MD
(Updated: 8/14/2024)
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Category: Infectious Disease
Keywords: TB, PPD, Conversion (PubMed Search)
Posted: 7/12/2007 by Michael Bond, MD
(Emailed: 7/8/2007)
(Updated: 8/14/2024)
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Category: Infectious Disease
Posted: 4/12/2013 by Andrea Tenner, MD
(Emailed: 8/14/2024)
(Updated: 8/14/2024)
Click here to contact Andrea Tenner, MD
General Information:
-As of April 5th, 14 confirmed cases of a new influenza A virus (H7N9) have occurred in China. Six of those have died.
-Presumed transmission via infected poultry in bird markets, and thus far no person-to-person transmission has occurred.
-Likely susceptible to oseltamavir or inhaled zanamivir
Area of the world affected:
-China
Relevance to the US physician:
- Suspect in patients with a respiratory illness and appropriate travel history.
- Refer to CDC within 24 hours if test positive for flu A but cannot be subtyped
- If H7N9 is suspected, patients should be under droplet and airborne precautions
Bottom Line:
No human-to-human transmission from H7N9 thus far, but the possibility exists. Any unsubtypeable influenza A patient should be placed on droplet and airborne precautions and oseltamavir or zanamivir started immediately.
University of Maryland Section of Global Emergency Health
Author: Andi Tenner, MD, MPH
http://www.who.int/csr/don/2013_04_04/en/index.html
http://emergency.cdc.gov/HAN/han00344.asp