Is Community-Acquired SAB complicated SAB? Probably

It seems I can never get around talking about staphylococcus aureus. I believe it was Paul Sax who mentioned that an infectious disease fellowship is essentially a staphylococcus fellowship, since you see all different types of complications. Many institutions have implemented automatic infectious disease consultation for anyone with staphylococcus aureus bacteremia (SAB), as it has

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The Kaposi’s Sarcoma Mimic – Cats, Peliosis, and Cat-Scratch Disease

Literature review on any “old timey” organism can be kind of a pain since I am convinced microbiologists get drunk every so often to reclassify clinically relevant organisms. This is the case for Bartonella. Originally described as bartonia, which is an erythrocyte-adherent organism similar to organisms of the genus of Rochalimacae, including Rickettsia quintana, was

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The Utility of the Neutrophil-to-Lymphocyte Ratio

The complete blood count is one of the more commonly ordered test, along with the basic metabolic profile. The CBC gives you a ton of useful information when it comes to the etiology of anemia (not just from the hemoglobin/hematocrit, but also the mean corpuscular volume, red cell distribution width, etc), coagulation, and inflammation. The

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Katayama Fever – Acute Schistosomiasis

The above is the Katayama Ki or “Katayama memoir” written by Dr Fujii in 1847 which describes the first recorded case of schistosomiasis japonica in the world. The initial description was based on patients from Katayama district, in the Hiroshima prefecture (yes, that Hiroshima).   Subsequently, a committee was formed to evaluate the disease and

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Cefepime-Induced Neurotoxicity

It should come to the surprise to no one that antibiotics tend to be the class of medications most commonly prescribed. From the “z-pack” to “augmentin” and the quinolones, they are a mainstay for outpatient and inpatient medicine. On the inpatient side, it is common to see the combination of vancomycin and piperacillin-tazobactam as an

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Handling Cryptococcal Meningitis Opening Pressure

During residency, I had the opportunity to do a global health elective where I spent a month in Lima, Peru rotating through Cayetano. I spent the majority of the time in the Tropical Medicine ward, where tuberculosis was everywhere. One of the more vivid memories was a patient with AIDS and cryptococcal meningitis. The residents

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The Semi-Procalcitonin in Bacteremia

Trying to figure out if a febrile patient showing up to the ED is having a bacterial infection is a conundrum. The main concern is bacteremia, since it confers higher mortality depending on the type of bacteremia a patient has. Inflammatory markers such as CRP and the neutrophil-to-lymphocyte ratio are relatively useful surrogates that may

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The Trojan Horse of Antibiotics

I reckon it’s time to write about new antibiotics. I do not like beta-lactamases. Mostly due to their ability to confuse clinicians, however also because it makes it difficult to pick an antibiotic for certain infections. I have written extensively about these, so look at this post. In general, carabepenemases and cephalosporinases within class A

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Straight from the Horse’s Lung: Rhodococcus Equi

Originally described as a pathogen in 1923, Corynebacterium equi was isolated from the lungs of ten foals (aka a young horse) who had pneumonia (1). Its name was later changed to rhodococcus (aka red coccus), and can be mistaken for mycobacterium spp due to its sometimes acid-fast appearance (2). It is known to infect horses,

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Monkey see, Monkey do: The Monkeypox Comeback

“A term that has been used in a number of systems of classification is variola vera. It is this idea of true or typical smallpox so often forming the subject of illustrations in text-books of medicine that has fixed in the minds of practitioners a single picture of what smallpox should look like. The literature

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