Infectious Diseases
- Central vision loss in a 44-year-old woman
The patient had a wide range of symptoms and comorbidities, resulting in a complicated differential diagnosis. Careful evaluation eventually led to a focus on sexually transmitted infection.
- Test ordering: Balancing the good for the many with the good for the one
Three articles this month address how we order clinical tests, one on the question of treating the patient with asymptomatic bacteriuria, the others on the advantages and disadvantages of standing orders for “daily labs” for inpatients.
- Does my patient need to be screened or treated for a urinary tract infection?
When patients present with symptoms that suggest but are not clearly diagnostic of urinary tract infection, urine studies should be obtained.
- Another vaccine article? Yes, but a different vaccine
As newer vaccines against Streptococcus pneumoniae have arrived, so have confusing recommendations and guidelines for the sequence and timing of administration.
- Update on pneumococcal vaccination in adults: Simpler is better
Recommendations have been updated in the hopes not only of preventing more cases of invasive pneumococcal disease, but also of making the recommendations easier to follow.
- Mucormycosis presenting as dental pain
A root canal procedure failed to relieve the pain, and 1 week later the patient developed mobility of the left upper teeth.
- Diagnostic stewardship for urinary tract infection: A snapshot of the expert guidance
New guidance on ordering, processing, and reporting urine cultures focuses on reducing unnecessary antibiotic use and the misdiagnosis of urinary tract infection.
- Confusion in a 22-year-old woman, and diagnostic uncertainty
The patient had been complaining of gradual-onset and progressive headache and neck and back pain for 3 weeks.
- Nasal herpes simplex virus infection
Skin changes on the nose in a 37-year-old patient that began after a scratch were concerning for extensive nasal skin necrosis.
- Steroids in the acutely ill: Evolving recommendations and practice
New information has been generated with regard to what causes critical illness-related corticosteroid insufficiency, how to diagnose it, who should receive corticosteroid treatment, and what regimens to use.