You are evaluating a 55-year-old male with significant past medical history of non-insulin diabetes, recently treated Lyme disease, and immigrant from India 25 years prior who is presenting with a 2-week duration of persistent fevers, chills, malaise and myalgias. After a week inpatient with an overall negative microbiology and rheumatologic work-up, his fevers are persistent … Continue reading How do you define FUO?
Category: Infectious Disease
A 35-year-old male with history of asthma presents with new onset fever, fatigue and non-productive cough. Her symptoms and workup matched that of a COVID-19 illness script. After being admitted due to some level of respiratory distress and for close monitoring with appropriate airborne precautions, her COVID-19 PCR test comes back positive. You discuss with … Continue reading What drugs are being investigated for COVID-19?
You are on the wards taking care of a patient that was admitted for sepsis. The infectious source was unclear. He may have had a slight infiltrate suggesting a pneumonia. His urine was clean. His CT thorax and abdomen was unremarkable. After overall stability for two days, his initial blood cultures obtained in the ED … Continue reading How do you approach enterococcal bacteremia?
By now we should have all heard the news. The novel coronavirus, recently labeled by the WHO as COVID-19 (COrona VIrus Disease 2019), outbreak has caused more deaths than SARS and continues to have a growing incidence of infection in the US. In fact on January 30, 2020 the WHO declared the outbreak a public health emergency of international concern (PHEIC). … Continue reading Are you prepared to discuss the novel Coronavirus?
There are few oncologic emergencies that require an understanding of management at your fingertips. The approach to antibiotics for neutropenic fever is relatively simple so let's review, starting with some basics. DEFINITIONS What is defines 'Fever' and 'Neutropenia' in Neutropenic Fever? Fever ≥ 38.3 or ≥ 38 sustained over 1 hour period. Avoid axillary temperatures … Continue reading How do you approach antibiotics in febrile neutropenia?
Diagnosis Q. When do you suspect a Clostridium Difficile Infection (CDI)? Symptoms of unexplained and new onset ≥3 unformed stools in 24 hours plus high clinical suspicion. ex. Recent use of certain antibiotics increases risk for CDIs. https://media.giphy.com/media/lOgyStVYDNPwqoonVG/giphy.gif Q. What is the best diagnostic test/method for C Difficile? Stool toxin + NAAT; GDH + toxin … Continue reading How do you manage C. Difficile Infections?
In 2019, the American Thoracic Society/Infectious Disease Society of America (ATS/IDSA) revised their guidelines towards the evaluation and management of Community Acquired Pneumonia (CAP). Regardless of the criticisms regarding the quality of evidence, there are quite a few recommendations I think are worth noting for my co-residents. Evaluation First, recall 2007 recommendations on classifying CAP … Continue reading How are we managing CAP in 2019?