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Diagnosing pulmonary tuberculosis can be a tricky thing. As highlighted previously, the Ziehl-Neelsen smear is not a terribly sensitive methodology and the MTB-PCR sensitivity depends on if the sample is smear positive. Given that pulmonary tuberculosis tends to have a higher bacterial burden, it would be reasonable to think that other diseases without this high
Gram negative bacteremia tends to complicate a variety of infections, including urinary tract infections/pyelonephritis, and intra-abdominal infections. Further, a lot of these patients tend to have severe presentations leading to perhaps overtreatment with IV antibiotic therapy. Until recently, there had been little data to guide uncomplicated gram negative rod bacteremia but there has been a
I’ve been reading quite a bit about antifungals lately and one of the things I realized is the many formulations of amphotericin. Actually, the realization I had was I didn’t know the differences between them. It is a polyene antifungal that has broad spectrum antifungal activity (including Leshmania spp) but it is limited by its
Pulmonary tuberculosis is a global disease that tends to burden underdeveloped countries disproportionally as well people living with HIV. It is a difficult disease to diagnose in the microbiology lab, and as such, there have been various methods deployed in an attempt to diagnose it. While culture is the gold standard, it can take anywhere
Over the past couple of weeks, vitamin D supplementation has been looked at as a potential therapy for COVID-19. Basic science data suggests that vitamin D has an immunomodulatory effects, such as upregulation of oxidative burst in activated macrophages in tuberculosis, or modulation of cytokine profiles that limits excessive production of pro-inflammatory cytokines in viral
HIV-associated Immune Reconstitution Inflammatory Syndrome (IRIS) is a known early complication of initiating ART therapy in those who are profoundly immunosuppressed. Here, immune recovery following ART initiation leads to an inflammatory response against an organism leading to a clinical deterioration a few weeks following ART initiation. You can think of it as follows; you have
Procalcitonin is a precursor of the hormone calcitonin and is released into systemic circulation within 4 hours of inoculation of bacterial endotoxin, In general, cytokines enhance procalcitonin release while interferons, which are released in context of viral infections. Because of this, there has been a push towards using PCT to differentiate bacterial from viral infections
Empiric therapy for patients with pneumonia is not as clear cut as one would think. Guidelines tend to differ in terms of when to start empiric MRSA coverage, with some guidelines recommending initial therapy that covers MRSA in those who are admitted to the ICU (1), while other guidelines suggest to start MRSA therapy if
The spread of syphilis in 1494/1495 in Italy is the first known instance of an outbreak of the disease. It is believed the disease was brought in from the New World by Columbus and his crew members and following the invasion of France in Naples, Italy, the disease began to spread throughout Europe. Known as
Sputum cultures for the diagnosis of pneumonia tends to be a tricky subject. Many times, obtaining an adequate sputum sample can be difficult, as patients may not be able to produce adequate amounts of sputum, there is contamination of oropharyngeal flora that clouds the diagnosis (especially in an aspiration event or those who have underlying
Dr. Germophile 