Where all your ID needs are met! Sort of.
If you get nothing from this, just remember: TMP-SMX, fluroquinolones, minocycline. These tend to be good antibiotic options for this bug. Also, make sure if you isolate this from a trach or a endotracheal tube that there are signs of infection before you proceed with treatment as this can colonize plastic! Stenotrophomonas maltophilia is a
Staphylococcus aureus bacteremia is a cause of severe morbidity and mortality, especially when it is complicated by infective endocarditis. The mortality of Staphylococcus aureus bacteremia is 20% (1) and that of infective endocarditis due to Staph aureus is much higher. Guidelines for the treatment of MRSA SAB (2) recommends the use of echocardiography, with TEE
Enterococcal infections and bacteremia incidence have been increasing over the past decades, with enterococcal endocarditis representing 10% of all cases of infective endocarditis (1). This makes it the third most common organism implicated in IE, after Staphylococcus and streptococcus, and it is more prevalent in patients who are not drug abusers. Enterococcal bacteremia by itself
Beta-Lactamases make my head hurt. They are so many of them and they impact the therapeutic options for a lot of the infections that we treat. Due to this resistance mechanism, there has been an influx of new beta-lactam/beta-lactamase combinations (ceftazidime-avibactam, meropenem-vaborbactam, etc) to overcome this phenomena. So first, this is a beta-lactam: The penicillin-binding
Influenza season is right around the corner, and given the current circumstances, it is a terrifying thought to have both COVID and flu running around. Besides causing significant respiratory distress and subsequent ARDS, severe influenza leads to bacterial superinfection with organisms such as Staph aureus and Streptococcal pneumonia. This usually happens in 10-35% of cases
I have a confession to make. I like fluroquinolones. I know. They’re broad spectrum, especially levofloxacin and moxifloxacin. They have pretty good bioavailability (almost 100%), and they cover pseudomonas (ciprofloxacin and levofloxacin) making them good PO stepdown therapy for severe pseudomonas bacteremia. Having said that, if you have spent any time in the internet you
In the past few years, there has been an increasing in the incidence of hypeviscous Klebsiella pneumoniae. This is typically caused by phenotypes associated with K1 and K2 capsule serotypes and is seen in southeast Asia and the classical pathology is that of a liver abscess (why this is I do not know). Recently, a
If I had to choose an enemy to my pretend superhero that enemy would be AIDS-related Kaposi Sarcoma (well, Staphylococcus Aureus but KS is a close second). I’ve seen several cases that did not end up in a good outcome during my training and I can recall only one where everything went well. In the
If I had to name an infection that gives people nightmares, besides COVID as of the time of writing this, would be Mucormycosis. These are moulds of the order Mucorales, which are comprised of multiple species, including Rhizopus spp, Mucor spp, and Lichtheimia spp (formerly of the genera Absidia and Mycocladus). Others include Rhizomucor spp,
As it so happens, someone much smarter than me has already written on this topic, so check out Paul Sax’s post: https://blogs.jwatch.org/hiv-id-observations/index.php/the-curious-case-of-m184v-part-2-and-more/2019/09/08/ There is no doubt that anti-retroviral therapy has been one of the greatest accomplishments in HIV care. Nowadays, HIV is essentially a chronic disease that is easily managed with combined therapy, usually with
Dr. Germophile 