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What is the role of therapeutic drug monitoring in antifungal therapy?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Despite an expanding number of therapeutic options for treating invasive fungal infection (IFI), the mortality rate from these infections remains high. Many risk factors for poor outcome from IFI (eg, the compromised immune status of the host) are not modifiable by the treating clinician. Thus, elevated interest exists in any modifiable factor that might improve outcome. Many of the new antifungal agents have marked variability in drug concentration based on either inconsistent absorption or elimination, leading to very wide interpatient variability. Many agents also have a narrow therapeutic index,...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

HIV and the kidneyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Direct effects of HIV-1 infection on the kidney combine with immune and genetic factors, comorbidities, coinfections, and medication toxicities to induce a spectrum of kidney disorders in HIV disease. The most dramatic of these, HIV-associated nephropathy (HIVAN), emerges almost exclusively in persons of African descent and is associated with rapid progression to end-stage renal disease in the absence of antiretroviral therapy (ART). ART modifies the natural history of HIVAN, but the renal benefits of ART may not be limited to HIVAN. ART is often under prescribed or incorrectly dosed in persons with...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Genitourinary manifestations of Epstein-Barr virus infectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the available literature and data regarding EBV in the female genital tract and discusses areas of consensus and controversy. The primary manifestation of EBV seems to be vulvar ulcers, which are underrecognized. Diagnosis relies on appropriate serologic testing. Management includes local care and may require pain and corticosteroid medications. Although EBV is present elsewhere in the female genital tract, its pathogenic role in the cervix, uterus, fallopian tubes, and ovaries is poorly understood. Content Type Journal ArticleDOI 10.1007/s11908-009-0065-8Authors Randi LeighPaul Nyirjesy, Drex...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Update on immune reconstitution inflammatory syndrome: Progress and unanswered questionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The immune reconstitution inflammatory syndrome (IRIS) is characterized by clinical deterioration occurring after the initiation of effective antiretroviral therapy (ART) and results from a disordered and exuberant immune response. The syndrome may present as paradoxical IRIS or unmasking IRIS, depending on whether an opportunistic infection was recognized and treated before ART initiation. Numerous descriptions of IRIS caused by many pathogens were published in the years after the introduction of effective ART. In recent years, with enhanced rollout of ART in resource-limited settings, attention ha...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

New immunosuppressive agents and risk for invasive fungal infectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Increased numbers of invasive fungal infections (IFI) were reported in patients treated with newer immunosuppressive drugs such as tumor necrosis factor (TNF)-α antagonists, the anti-CD52 antibody alemtuzumab, or the interleukin-2 receptor antibody basiliximab. These drugs are administered to patients who have autoimmune inflammatory diseases and lymphoid malignancies, or are recipients of solid organ or allogeneic hematopoietic stem cell transplants. IFI risk is higher in patients receiving TNF-α blockers or alemtuzumab late in the course of disease and in those with a history of IFI. Incidence a...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

MRSA infection of buttocks, vulva, and genital tract in womenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Staphylococcus aureus, although a common commensal bacterium, is a frequent cause of skin and soft tissue infections as well as life-threatening blood stream infections. Resistance to methicillin, which previously was associated with only hospitalized patients, has become a common community-based phenomenon. Less well known is S. aureus vaginal colonization and heterosexual transmission, mainly by skin-mucosa contact. Recognizing the vagina as a reservoir is important and should not be ignored, particularly in women presenting with recurrent genital and buttock boils or if their sexual partner has...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

New concepts in understanding genital herpesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Herpes simplex virus (HSV)-2 is a lifelong infection that causes recurrent genital ulcers and, rarely, disseminated and visceral disease. HSV-1 infection is an increasingly important cause of genital ulcers. HSV infections are the most common cause of genital ulcers in adults, but acquisition and chronic infection are more commonly asymptomatic than symptomatic. Both the symptomatic and asymptomatic forms of HSV are of clinical consequence for several reasons. HSV-2 infection enhances HIV-1 acquisition and transmission. In addition, sexual and perinatal transmission can occur during asymptomatic vir...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Antibiotic consideration in bacterial vaginosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Bacterial vaginosis (BV) is a syndrome characterized by the loss of indigenous vaginal lactobacilli and massive polymicrobial anaerobic vaginal overgrowth of elusive etiology. Although progress has occurred in defining the composition of the vaginal microbiome using DNA amplifications, rapidly accumulating data have not resulted in therapeutic advantage. Treatment options remain limited and outcome often unsatisfactory, particularly regarding the frequent recurrence of symptomatic disease, leading to enormous frustration among patients and practitioners. This review does not address the important is...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Update on invasive opportunistic mycoses: Clinical trials review, 2008–2009Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article summarizes five of the most relevant clinical trials related to prevention and treatment of opportunistic fungal infections in adult patients published between 2008 and 2009. Content Type Journal ArticleDOI 10.1007/s11908-009-0060-0Authors Andreas H. Groll, Children’s University Hospital Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology Albert-Schweitzer-Strasse 33 48129 Münster Germany Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Prophylaxis of invasive mycoses in solid organ transplantationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Solid organ transplantation is emerging as a lifesaving procedure for increasing numbers of patients, and invasive fungal infections are a significant cause of mortality and morbidity for patients undergoing such procedures. Risks for developing these infections are continuing to evolve, leading to shifts in the epidemiology of invasive mycoses occurring after transplantation. Targeting preventive efforts to select solid organ transplantation groups at highest risk for invasive fungal infections is critical to optimizing prophylaxis strategies. The epidemiology of posttransplantation fungal infectio...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Risk-based antifungal prophylaxis in hematologic malignancy and stem cell transplantationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses recent developments in antifungal prophylaxis, focusing on those expected to affect patient management. Significant advances have occurred in understanding risk stratification and assessment of individual patient risk for drug-drug interactions, toxicity, or variations in pharmacokinetics; choice of antifungal prophylaxis strategy, drug, dose, route, and regimen; therapeutic drug monitoring; cost effectiveness of prophylaxis; and the significance of breakthrough IFI. Research over the coming decade is likely to fundamentally alter antifungal prophylaxis by allowing clinicians to make individuali...
Source: Current Infectious Disease Reports - November 5, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Literature alertEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/BF03160473 Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 3 Journal Issue Volume 3, Number 5 / October, 2001 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

The increasing role of Acinetobacter species as nosocomial pathogensEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Among gram-negative organisms playing a significant role in nosocomial infections, Acinetobacter species have attracted increasing attention in intensive care units during the past two decades. Acinetobacter species are implicated in a wide spectrum of infections (eg, bacteremia, nosocomial pneumonia, urinary tract infections, secondary meningitis, superinfections in burn patients). One of the most striking features of Acinetobacter species is their extraordinary ability to develop multiple resistance mechanisms against major antibiotic classes. They have become resistant to broad-spectrum β-lactams ...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Web alertEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleDOI 10.1007/BF03160468 Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 3 Journal Issue Volume 3, Number 5 / October, 2001 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Linezolid versus oxacillin-dicloxacillin for treatment of complicated skin and soft tissue infectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/BF03160469Authors Barry J. Hartman Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 3 Journal Issue Volume 3, Number 5 / October, 2001 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

The role of protein C in sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract During the past 15 years, several anti-inflammatory treatments have failed to reduce mortality in patients with severe sepsis. However, recent evidence indicates that coagulation abnormalities in sepsis may play a major role in the pathogenesis of multiple organ failure and the high mortality rate in patients with severe sepsis. Interestingly, blockade of the coagulant pathway can inhibit both procoagulant and proinflammatory pathways in sepsis. Protein C, a natural anticoagulant, interrupts several of the pathophysiologic pathways in sepsis. Acquired protein C deficiency is present in the majority ...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Polymorphisms in tumor necrosis factor and other cytokines as risks for infectious diseases and the septic syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract An increasing number of genetic association studies have implicated polymorphisms of cytokine genes as host genetic factors influencing susceptibility to infectious disease, primarily using a candidate gene approach based on knowledge of disease pathogenesis. The application and limitations of association studies are reviewed together with the impact of recent advances in single nucleotide polymorphism mapping on strategic approaches to defining genetic susceptibility loci. It often remains unclear whether associated genetic polymorphisms are themselves functionally relevant or acting only as marker...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Genetic analysis of host responses in sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract During much of the past century, the microbe itself stood at the heart of microbial pathogenesis. Little thought was devoted to the host per se, though it was granted that differences in susceptibility to certain infections did exist between individuals, and between different ethnic groups. During the past 20 years, extraordinary strides in our grasp of mammalian genetics have made the host side of the equation far more approachable. A restricted collection of genes now presents itself as the likely repository for genetic differences that foretell susceptibility to infectious disease. The Toll-like ...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Bactericidal/permeability-increasing protein in host defense and its efficacy in the treatment of bacterial sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The 55-kD bactericidal/permeability-increasing protein (BPI) is a neutrophil-derived polypeptide belonging to a family of lipid and endotoxin binding proteins. BPI is composed of two functionally distinct structural domains: a potently antibacterial and antiendotoxin ∼ 20-kD aminoterminal half, and an opsonic carboxy-terminal portion. In multiple animal models, a recombinant amino-terminal fragment of BPI (rBPI21) is nontoxic and protects against gram-negative bacteria and endotoxin. In humans, rBPI21 is also nontoxic and nonimmunogenic and has undergone phase II/III clinical trials with apparent t...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Recombinant bactericidal/permeability-increasing protein reduced morbidity in children with severe meningococcal sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/BF03160474Authors Neal H. Steigbigel Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 3 Journal Issue Volume 3, Number 5 / October, 2001 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Hepatitis C virus infection in HIV-infected patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The hepatitis C virus (HCV) is a spherical enveloped RNA virus of the Flaviviridae family, classified within the Hepacivirus genus. Since its discovery in 1989, HCV has been recognized as a major cause of chronic hepatitis and hepatic fibrosis that progresses in some patients to cirrhosis and hepatocellular carcinoma. In the United States, approximately 4 million people have been infected with HCV, and 10,000 HCVrelated deaths occur each year. Due to shared routes of transmission, HCV and HIV co-infection are common, affecting approximately one third of all HIV-infected persons in the United States. ...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Recent considerations in recurrent cellulitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Cellulitis is a frequently diagnosed syndrome that causes considerable morbidity. For a subset of patients, recurrent bouts of infection impact their quality of life. Most cases are due to b-hemolytic streptococci or Staphylococcus aureus. Inclusion of interdigital space (toe web) or mucosal (anal) swab cultures may increase the ability to define pathogens among patients with lower extremity cellulitis. The pathogenesis of cellulitis is complex, and more work is needed so that novel therapies and vaccines can be developed to improve treatment and prevention of this disorder. Content Type Journal A...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Fungal infections of the bones and jointsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Osteoarticular complications may occur with a variety of invasive fungal infections, and seem to be increasing with growing use of prosthetic joints and as the immunosuppressed patient population increases. Epidemiology, pathogenesis, presentation, and management strategies differ somewhat among the different fungal species. This review focuses on recent developments in diagnostic and management approaches for patients with osteoarticular mycoses, and outlines specific treatment strategies for the different species. Content Type Journal ArticleDOI 10.1007/BF03160470Authors Melissa D. JohnsonJoh...
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Recombinant granulocyte colony-stimulating factor as adjunctive therapy for limb-threatening diabetic foot infectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/BF03160480Authors Barry J. Hartman Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 3 Journal Issue Volume 3, Number 5 / October, 2001 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 22, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Hemodynamic resuscitation in septic shock: Cardiovascular support and adjunctive therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on the cardiovascular support of the septic shock patient, and the current evidence to guide decisions on the use of corticosteroid therapy and recombinant human activated protein C. Content Type Journal ArticleDOI 10.1007/s11908-009-0051-1Authors Brian M. Fuller, Washington University School of Medicine Department of Anesthesia, Division of Critical Care, Division of Emergency Medicine 600 South Euclid Campus Box 8072 St. Louis MO 63110 USAR. Phillip Dellinger Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issu...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Severe hospital-acquired pneumonia: A review for cliniciansEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article summarizes the current state of knowledge concerning severe HAP with an emphasis on recent advances in its diagnosis, treatment, and prevention. Content Type Journal ArticleDOI 10.1007/s11908-009-0050-2Authors John DallasMarin Kollef, Washington University School of Medicine Division of Pulmonary and Critical Care Medicine Campus Box 8052 660 South Euclid Avenue St. Louis MO 63110 USA Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume 11, Number 5 / September, 2009 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Respirator management of sepsis-related respiratory failureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The first description of acute respiratory distress syndrome (ARDS) in adults appeared in 1967 and was characterized by dyspnea, hypoxemia, diffuse alveolar infiltrates, and reduced respiratory system compliance. ARDS and acute lung injury (ALI) syndrome have no specific treatment, only supportive care: treating the underlying cause, when possible, and using mechanical ventilation. Historically, mechanical ventilation applied normal/large tidal volumes and low levels of positive end-expiratory pressure (PEEP). Experimental data showed that a high-volume, high-pressure ventilation strategy may lead t...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Management of human and animal bite wound infection: An overviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Animal and human bite wounds can lead to serious infections. The organisms recovered generally originate from the biter’s oral cavity and the victim’s skin flora. Anaerobes were isolated from more than two thirds of human and animal bite infections. Streptococcus pyogenes is often recovered in human bites, Pasteurella multocida in animal bites, Eikenella corrodens in animal and human, Capnocytophaga spp, Neisseria weaveri, Weeksella zoohelcum, Neisseria canis, Staphylococcus intermedius, nonoxidizer-1, and eugonic oxidizer-2 in dog, Flavobacterium group in pig, and Actinobacillus spp in horse and ...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Hepatitis B in HIV: Available treatment options and approach to therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract In the past 5 years, three new drugs were approved for hepatitis B, bringing the total number of therapies to five nucleos(-t)ide analogues and two interferons. Some of these drugs are also active against HIV. As the complexity of hepatitis B treatment increases, it becomes important for practitioners to be familiar with the potency, resistance patterns, and response rates for each hepatitis B agent. In this article, the efficacy in HIV and the best regimens for coinfected patients are discussed for those needing treatment for both infections. A particular emphasis is placed on cross-resistance amon...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Tight glucose control: Sweet or sour?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11908-009-0058-7Authors Jean-Louis Vincent, Université Libre de Bruxelles Department of Intensive Care, Faculty of Medicine Bruxelles Belgium Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume 11, Number 5 / September, 2009 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Suppurative lymphadenitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Suppurative lymphadenitis is an important and common form of soft tissue infection. Most acute cases of suppurative lymphadenitis are caused by Staphylococcus aureus or by Streptococcus pyogenes. Empiric antibiotic therapy is frequently successful in the early stages of the disease process, but increasing prevalence of methicillin-resistant S. aureus in particular has necessitated a shift in antibiotic choice that is dictated primarily by specific local resistance patterns. Several other organisms and noninfectious inflammatory processes may give rise to a clinical syndrome suggestive of suppurative ...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Advances in human clinical trials of vaccines to prevent HIV/AIDS and other HIV prevention interventionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article explores these disappointing and surprising outcomes, reviews earlier efficacy studies and more recent discovery research, and provides a critical analysis of the field. Other HIV prevention interventions are considered because their successful implementation may dramatically alter the milieu for future HIV vaccine field trials, particularly impacting study designs and increasing sample sizes if incidence falls. Content Type Journal ArticleDOI 10.1007/s11908-009-0056-9Authors Mark J. Mulligan, Emory University Division of Infectious Diseases 603 Church Street Decatur GA 30030 USA Journal Curren...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Management of diabetic foot infections in an era of increasing microbial resistanceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Diabetic foot infections cause substantial morbidity, incur significant costs, and may lead to amputation. Resistant organisms, particularly methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative organisms, are becoming more prevalent. Optimal management of diabetic foot infections is multimodal, and includes not only antimicrobial therapy but also biomechanical support and offloading, local wound care, glycemic control, assessment and treatment of underlying vascular disease, and surgical therapy when warranted. Antimicrobial therapy should be targeted at the likel...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Severe community-acquired pneumonia and PIRO: A new paradigm of managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Appropriate antibiotic management and aggressive supportive therapy is not enough to improve survival in severe community-acquired pneumonia (sCAP), a systemic syndrome involving infectious organisms, inflammation, and coagulation systems. A sepsis severity staging system focused on predisposition, insult, deleterious response, and organ failure (PIRO) provides a useful basis for risk stratification and therapy. A new paradigm of management is suggested based on early identification of patients at risk, aggressive management, modulation of host response, and need for adjunctive therapy. The CAP-PIRO...
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Twenty-first century therapy? Short-course treatment of pediatric hematogenous septic arthritisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11908-009-0059-6Authors Mark S. Pasternack, Massachusetts General Hospital Infectious Disease Division Boston USA Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume 11, Number 5 / September, 2009 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - August 17, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Bacterial endophthalmitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Endophthalmitis refers to bacterial or fungal infection of the vitreous and/or aqueous humors of the eye. Bacterial endophthalmitis occurs most commonly after eye surgery or penetrating ocular trauma (exogenous endophthalmitis), but may also occur from hematogenous seeding during bacteremia (endogenous endophthalmitis). The presentation is usually acute, with eye pain and decreased vision. In exogenous endophthalmitis, infection is confined to the eye. There is no fever and minimal, if any, peripheral leukocytosis. Treatment includes direct injection of antibiotics into the vitreous, and vitrectomy ...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Coccidioidal meningitis: Update on epidemiology, clinical features, diagnosis, and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article summarizes the pathogenesis, epidemiology, clinical manifestations, diagnostic studies, and treatment of coccidioidal meningitis, and highlights new information regarding this devastating infection. Content Type Journal ArticleDOI 10.1007/s11908-009-0043-1Authors Janis E. Blair, Mayo Clinic Division of Infectious Diseases 5777 East Mayo Boulevard Phoenix AZ 85054 USA Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume 11, Number 4 / July, 2009 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Newer antiretroviral agents and how to use themEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Several relatively new antiretroviral drugs have been approved or are under investigation. These include nucleoside and nonnucleoside reverse transcriptase inhibitors, protease and integrase strand transfer inhibitors, CCR5 antagonists, and an entirely new class of maturation inhibitors. Although most of these drugs were developed for patients with drug-resistant HIV-1, some have demonstrated a potential role for those starting treatment for the first time. This review incorporates data from the most recent treatment guidelines, peer-reviewed publications, and recent presentations at research meetin...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Prevention counseling for HIV-infected persons: What every clinician needs to knowEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The absence of adequate and regular prevention counseling during routine clinical encounters translates into missed opportunities for HIV prevention. HIV care providers have considerably more contact with patients than clinicians in other disciplines. These contacts should be translated into opportunities to provide HIV prevention messages to patients and should be a priority for all clinicians caring for HIV-positive patients. Coincidental preventive care for HIV-positive patients is inherently unproductive because of the absence of reinforcing messages. In a recent meta-analysis, HIV-positive indi...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Bacterial meningitis vaccines: Not just for kidsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Bacterial meningitis remains a feared diagnosis that may lead to significant mortality and morbidity in both the developed and developing world; case fatality rates range from 10% to 50% among all age groups. Several vaccines are available (including the Haemophilus influenzae type B polysaccharide conjugate vaccine) that have proven effective in reducing the incidence of bacterial meningitis. Although a 23-valent pneumococcal polysaccharide vaccine has been available for some time, use of the 7-valent pneumococcal conjugate vaccine (PCV) has demonstrated a dramatic reduction in the incidence of inv...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Antiretroviral therapy for treatment-naïve patients: A review of recent literature and the updated guidelinesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article addresses the optimal timing of antiretroviral therapy initiation and the optimal drug choices for initial regimens, with a focus on recent data and published guidelines issued by the US Department of Health and Human Services and the International AIDS Society-USA. Content Type Journal ArticleDOI 10.1007/s11908-009-0046-yAuthors Jennifer A. JohnsonPaul E. Sax, Harvard Medical School Division of Infectious Disease, Brigham and Women’s Hospital 75 Francis Street Boston MA 02115 USA Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 ...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Diagnosis and management of mycotic aneurysmsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract We reviewed all papers most recently reported in the literature related to infected arterial aneurysms (IAAs) affecting the aorta and vascular beds other than the aorta. In this article, we report on vascular beds other than the aorta. As is the case for aortic IAAs, infected non-aortic aneurysms are rarely encountered. The majority of recent studies are limited to case reports and small series of unusual infected aneurysms. A comprehensive review of this entity was performed based on the available literature from January through December 2008 in all languages. Available reports were analyzed with r...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Update on rabies diagnosis and treatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The diagnosis of rabies depends on recognizing the clinical picture, because a history of an animal bite may be present or absent. Laboratory tests, particularly when based on detection of rabies virus antigen or RNA in tissues or fluids, often confirm the diagnosis. Negative laboratory tests do not exclude the diagnosis unless they are performed on brain tissues. Preventive therapy, including wound cleansing and active and passive immunization after a recognized exposure, is well established and highly efficacious. No established therapy exists that is effective for patients with rabies encephalomy...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Cardiac complications of infective endocarditisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on new data related to several complications, and summarizes the indications, timing, and type of valve surgery recommended in the management of IE. Several recent studies using propensity score techniques have resulted in disparate conclusions and underscore the need for randomized prospective studies to better address whether and when surgery should be performed in patients with IE. Mitral valve repair is an exciting new development in surgical methodology and probably will have increased application over the next two decades. Excellent reviews related to periannular abscesses, fistulae, acute c...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Cardiac assist device infectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Cardiac assist devices have emerged as an increasingly important option for circulatory support in patients with advanced congestive heart failure. Infection has been the leading cause of death with use of ventricular assist devices for the past 25 years, and continues to be a major cause of morbidity and mortality in this population. Infections may involve the internal (blood-containing) components, or occur on the external device surfaces. The pump pocket and the percutaneous driveline are particularly vulnerable. In this article we review the pathogenesis, epidemiology, clinical course, and appro...
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Vaccination for the prevention of pneumococcal meningitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11908-009-0038-yAuthors Allan R. Tunkel, Drexel University College of Medicine Philadelphia USA Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume 11, Number 4 / July, 2009 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Prevention of catheter-related infection: Evidence-based medicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11908-009-0037-zAuthors Donald P. Levine, Wayne State University Division of General Internal Medicine Detroit USA Journal Current Infectious Disease ReportsOnline ISSN 1534-3146Print ISSN 1523-3847 Journal Volume Volume 11 Journal Issue Volume 11, Number 4 / July, 2009 (Source: Current Infectious Disease Reports)
Source: Current Infectious Disease Reports - June 15, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

HIV infection in the elderlyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract The prevalence of HIV in patients over the age of 50 years is increasing. Although older patients may achieve equal or better virologic suppression at equal rates compared with younger patients, the immunologic benefit of highly active antiretroviral therapy (HAART) in older patients may be reduced compared with younger patients. Comorbidities are more common in older patients than younger patients and can impact management of HIV in these patients. Providers must be cognizant of drug-drug interactions and side effects of HAART regimens when selecting an antiretroviral regimen in older HIV patients....
Source: Current Infectious Disease Reports - May 1, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Immunopathogenesis of AIDSEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Twenty-five years after the discovery of HIV as the cause of AIDS, tremendous progress has been made in reducing the morbidity and mortality associated with this disease. However, there is still neither a cure nor a vaccine for HIV infection. This shortcoming is likely a consequence of our incomplete understanding of the mechanisms of AIDS pathogenesis, particularly with regard to the interaction between the virus and the host immune system. In this article we review a series of recent advances in specific areas of HIV immunopathogenesis research: virus-host cell interactions; immune responses to HI...
Source: Current Infectious Disease Reports - May 1, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals

Current and future prospects for a vaccine for nontypeable Haemophilus influenzaeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Nontypeable Haemophilus influenzae is an important human respiratory tract pathogen that causes about 30% of otitis media in infants and children. This proportion is increasing as a result of pneumococcal conjugate vaccines. Because of the morbidity associated with otitis media, a strong rationale exists to develop strategies to prevent these infections. A challenge to developing a vaccine for nontypeable H. influenzae is the antigenic heterogeneity of several major surface antigens and the genetic heterogeneity among strains. Several research groups have identified conserved surface proteins and tes...
Source: Current Infectious Disease Reports - May 1, 2009 Category: Infectious Diseases Tags: Current Infectious Disease Reports Source Type: journals