The Trouble with MDR and XDR-TB – New Drugs Needed

Pulmonary tuberculosis is one of those infections that is difficult enough to treat under the best circumstances, as it requires the patient to take four drugs for an extended period of time. The development of resistance to any of the core drugs complicates matters, as it forces physicians to use other types of medications that

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Weekly Articles: 3/28/2021

Janiaud P, Axfors C, Schmitt AM, et al. Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis. JAMA. 2021;325(12):1185–1195. doi:10.1001/jama.2021.2747 This is a meta-analysis consisting of all RCTs published in peer-reviewed journals as well as pre-prints evaluating convalescent plasma in confirmed or suspected COVID patients. Primary outcomes

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Hypervirulent Klebsiella Infection – It’s So Sticky!

Klebsiella pneumoniae is an organism that is typically seen as the cause of pneumonia in people with diabetes and alcoholics, and it also causes nosocomial bacteremia and urinary tract infections. This is a fairly common organism to deal with in the inpatient setting, however one particular type of Klebsiella has been more frequently described in

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Weekly Articles 3/14/2021

Richard G Wunderink, Antoine Roquilly, Martin Croce, Daniel Rodriguez Gonzalez, Satoshi Fujimi, Joan R Butterton, Natasha Broyde, Myra W Popejoy, Jason Y Kim, Carisa De Anda, A Phase 3, Randomized, Double-Blind Study Comparing Tedizolid Phosphate and Linezolid for Treatment of Ventilated Gram-Positive Hospital-Acquired or Ventilator-Associated Bacterial Pneumonia, Clinical Infectious Diseases, 2021;, ciab032, https://doi.org/10.1093/cid/ciab032 This is

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How Trench Warfare Lead to the Discovery of Bartonella Quintana – Among Other Things

(While I do not anticipate this to alter the post, I should note that one name that has published several articles into B. quintana is Didier Raoult. If that name sounds familiar, he was the guy who published a large case series of patients with COVID-19 who were treated with HCQ and kickstarted the HCQ

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Candida Score – The Forgotten (Child of) Scoring System(s)

Disseminated candida infections kill. It shouldn’t be terribly surprising. In the ICU, ongoing fevers despite antibiotic therapy is usually taken as a sign of invasive candidiasis and is the impetus for antifungal therapy. Risk stratifying patients for candidal infections can be difficult, given the myriad of comorbid conditions that are associated with these infections. Despite

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Candidal Endocarditis – Looking for Sasquash

Infective endocarditis is a rare enough disease in and of itself that many folks won’t see much of in their lifetimes, though the rise in IV drug abuse means this may not be the case in the future. Staphylococcus aureus and streptococci, as well as enterococci, tend to be the most common organisms associated with

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Weekly Articles 2/22/2021

Albin OR, Henig O, Patel TS, Valley TS, Pogue JM, Petty LA, Mills JP, Brancaccio A, Martin ET, Kaye KS. Clinical Implications of Microbiologic Treatment Failure in the Setting of Clinical Cure of Bacterial Pneumonia. Clin Infect Dis. 2020 Dec 15;71(12):3033-3041. doi: 10.1093/cid/ciz1187. PMID: 31832641; PMCID: PMC7819508. This is a retrospective study of 441 patients

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Hyperammonemia Syndrome – Ureaplasma and Mycoplasma spp Infections

Hyperammonemia is the accumulation of ammonia within the blood that leads to cerebral edema, herniation, and death in patients with inborn errors of metabolism and hepatic failure. These are the types of patients where we would commonly see such accumulation of ammonia. In absence of liver failure, inborn errors of metabolism, urea cycle disorders, or

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