Clifford Raabe Weiss, M.D.
https://www.hopkinsmedicine.org/profiles/results/directory/profile/0015953/clifford-weiss
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Rupture antiviral tablets 100 mg vermox otc, invasion and inflammatory destruction of the intestinal barrier by Shigella: the yin and yang of innate immunity. Ongoing multistate outbreak of Escherichia coli serotype O157:H7 infections associated with consumption of fresh spinach-United States, September 2006. Genetic susceptibility to enteroaggregative Escherichia coli diarrhea: polymorphism in the interleukin-8 promoter region. Major structural differences and novel potential virulence mechanisms from the genomes of multiple Campylobacter species. Summary of the International Symposium and Workshop on Infections due to verocytotoxin (Shiga-like toxin)-producing Escherichia coli. Genome dynamics and diversity of Shigella species, the etiologic agents of bacillary dysentery. Two msbB genes encoding maximal acylation of lipid A are required for invasive Shigella flexneri to mediate inflammatory rupture and destruction of the intestinal epithelium. Apoptosis in acute shigellosis is associated with increased production of Fas/ Fas ligand, perforin, caspase-1, and caspase-3 but reduced production of Bcl-2 and interleukin-2. Effects of diarrhea associated with specific enteropathogens on the growth of children in rural Bangladesh. Dysentery, not watery diarrhoea, is associated with stunting in Bangladeshi children. Hemolytic uremic syndrome after shigellosis: relation to endotoxemia and circulating immune complexes. Intestinal obstruction during shigellosis: incidence, clinical features, risk factors, and outcome. Escherichia coli that cause diarrhea: enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent. An outbreak of enteropathogenic Escherichia coli foodborne disease traced to imported French cheese. Epidemiology of sporadic diarrhea due to verocytotoxin-producing Escherichia coli: a two-year prospective study. Incidence of Escherichia coli O157:H7 in frozen beef patties produced over an 8-hour shift. Detection, isolation, and molecular subtyping of Escherichia coli O157:H7 and Campylobacter jejuni associated with a large waterborne outbreak. Cytokine expression in the renal tubular epithelial cells stimulated by Shiga toxin 2 of Escherichia coli O157:H7. Characteristics of the enteroaggregative Shiga toxin/ verotoxin-producing Escherichia coli O104:H4 strain causing the outbreak of haemolytic uraemic syndrome in Germany, May to June 2011.
Multiplex polymerase chain reaction and microcalorimetry in synovial fluid: can pathogen-based detection assays improve the diagnosis of septic arthritis Identification of pathogens in synovial fluid samples with an automated multiplexed molecular detection system hiv infection experiences generic vermox 100 mg with visa. Septic complications involving hand and wrist in patients with pre-existing rheumatoid arthritis: the role of magnetic resonance imaging and sonography. Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms. C5b-9 forms high molecular weight complexes with bacterial outer membrane constituents on serum-resistant but not on serum-sensitive Neisseria gonorrhoeae. Neisseria meningitidis and Neisseria gonorrhoeae bacteremia associated with C6, C7, or C8 deficiency. Disseminated gonococcal infections in patients receiving eculizumab: a case series. In vitro decreased association of pilated gonococci with mouse peritoneal macrophages. The contrasting mechanisms of serum resistance of Neisseria gonorrhoeae and group B Neisseria meningitidis. Pilus phase variation switches gonococcal adherence to invasion by caveolin-1-dependent host cell signaling. Phosphoethanolamine substitution of lipid A and resistance of Neisseria gonorrhoeae to cationic antimicrobial peptides and complement-mediated killing by normal human serum. Antimicrobial resistance for Neisseria gonorrhoeae in the United States, 1988 to 2003: the spread of fluoroquinolone resistance. Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines. Use of the polymerase chain reaction to study arthritis due to Neisseria gonorrhoeae. Identification of Neisseria gonorrhoeae in synovial fluid using the polymerase chain reaction. Spectrum of gonococcal arthritis: evidence for sequential stages and clinical subgroups. Many opportunities to record, diagnose, or treat injection drug-related infections are missed: a population-based cohort study of inpatient and emergency department settings. Increased mortality and reoperation rates after treatment for septic arthritis of the knee in people who inject drugs: nationwide inpatient sample, 2000-2013. Septic arthritis in intravenous drug abusers: a historical comparison of habits and pathogens. Microbiological culture methods for pediatric musculoskeletal infection: a guideline for optimal use. Similar 30-day complications for septic knee arthritis treated with arthrotomy or arthroscopy: an American College of Surgeons National Surgical Quality Improvement Program Analysis.
Diseases
These species may also be dominant sources of carbapenemase production hiv infection rates massachusetts generic vermox 100 mg amex, but resistance mechanisms are too varied to predict. Current recommendations support the use of in vitro susceptibility rather than mechanism in choosing effective treatment. Some knowledge of local and individual resistance patterns should be used to guide therapy. Consideration should include the increased risk of drug-resistant pathogens in hospital-acquired cases, in men, and in patients ages 65 years or older, and decisions should incorporate the results of urine cultures obtained within the previous 6 months. Our preference for empirical initial therapy for lower tract infection is a fluoroquinolone pending antimicrobial susceptibility studies, but nitrofurantoin and fosfomycin are reasonable choices. Fosfomycin in particular has maintained activity against many multidrug-resistant bacteria. When fosfomycin is used to treat complicated cystitis, there are data to support a regimen of three doses, administered every other day. In general, in the presence of severe renal insufficiency, doses of virtually all antimicrobials must be adjusted. In addition, with renal insufficiency, levels of antimicrobial agent in the urine may be insufficient to inhibit the infecting organism. Renal infection is a special problem in adults with hereditary polycystic disease. Although parenchymal infections respond well to appropriate antibiotics, cyst infections frequently fail to improve and may require antibiotics that diffuse into these closed sites. This computed tomography scan shows an enlarged, inflamed right kidney with air in the parenchyma and subcapsular space. Because of a high mortality rate in spite of appropriate antibiotics and supportive therapy, immediate nephrectomy is frequently indicated for this condition. To reduce the incidence of bacteremia, a urine culture is obtained several days before the procedure and therapy with a third-generation cephalosporin or another appropriate agent is started 12 hours to just before the procedure. The therapy is usually stopped after the procedure, but some practitioners continue the therapy until any urethral catheter is removed. Relapses, especially in the absence of structural abnormalities, could be related to renal infection that may require a longer duration of therapy or to chronic bacterial prostatitis, which is difficult to cure even with long-term therapy. Patients who have a symptomatic relapse should have a urine culture and sensitivity study and be treated with a course of antimicrobial therapy for upper tract infection. In the past, it was demonstrated that a 6-week course of therapy with a -lactam results in a higher cure rate than a 2-week course in patients who relapse after 2 weeks of therapy. Obstructive lesions can be corrected surgically and should be sought in the evaluation of patients with relapsing infection.
The addition of heparin after several days of unsuccessful treatment with antibiotics itself may produce an antipyretic effect antiviral proteins secreted by lymphocytes 100 mg vermox buy fast delivery. Four patients required exploratory laparotomy, and pelvic abscesses were found in 3 of them. These results argue strongly that medical therapy alone often is effective, but no controlled studies on the use of heparin have been done. If medical therapy is unsatisfactory, surgery with drainage of abscesses and, usually, ligation of the implicated venous system must be performed. Some authorities792 believe that ligation of the inferior vena cava or ovarian vein, or both, should be performed in all of these cases, but the evidence for this approach is inconclusive. The incidence of superficial suppurative thrombophlebitis can be reduced by the same preventive procedures that are used for intravenous cannulas in general (see Chapter 300). If clinical signs of sepsis and bacteremia persist despite appropriate antibiotic therapy, an intravascular focus. A specific disease entity first described in 1970 is aneurysm associated with umbilical artery catheterization in neonates. By 1992, 34 cases had been reported, with the following distribution833: descending thoracic aorta, 14 cases; abdominal aorta, 10 cases; iliac arteries, 6 cases; and multiple sites, 4 cases. Four different mechanisms have been postulated to produce infection of the arterial wall: (1) formation of mycotic aneurysms secondary to septic microemboli to the vasa vasorum ("embolomycotic aneurysms"),834 (2) extension from a contiguous infected focus, (3) hematogenous seeding of the intima during bacteremia originating from a distant infection, and (4) trauma to the arterial wall with direct contamination. The source of infection is the cardiac vegetation, with production of arterial emboli that lodge in the vasa vasorum, often at points of bifurcation of the affected artery. An intraluminal thrombus associated with an atherosclerotic vessel also may serve as a nidus for colonization. Luetic arteritis and cystic medial necrosis also have been associated with secondary infection. Infection of the arterial tree has been recognized by pathologists for more than a century. Virchow first showed local dilation of the arterial wall at the site of a septic embolus in 1847. Infection superimposed on an atherosclerotic aorta first was reported by Koch in 1851. These lesions probably are underreported, and pathologic material has been scant in recent years. Aneurysms are more Chapter 80 Endocarditis and Intravascular Infections the term mycotic aneurysm was coined by Osler in 1885 to describe a mushroom-shaped aneurysm that developed in a patient with subacute bacterial endocarditis.
Although the lymphoma may be known from other sites in the body hiv infection of cns order 100 mg vermox amex, distinguishing lymphoma in the meninges from cryptococcal meningitis or other infectious causes is vital. IgG4-related disease is a chronic, indolent fibroinflammatory disease that can affect any organ. Biopsy of the dura in patients with hypertrophic pachymeningitis associated with IgG4-related disease shows storiform fibrosis with an increased number of plasma cells that are IgG4-positive on immunostaining (IgG4+/IgG+ plasma cell/ratio). Chapter 88 Chronic Meningitis IgG4-Related Hypertrophic Pachymeningitis Sarcoidosis Meningitis Chronic meningitis due to sarcoidosis is a diagnosis of exclusion, with many patients reported to have the diagnosis even in the absence of extraneural signs of sarcoidosis. Treatment with corticosteroids may reveal a fungal or other infectious cause of meningitis. Manifestations include bilateral eye disease, chronic meningitis, and, later in the disease course, skin findings. It causes recurrent episodes of aseptic meningitis and in some cases progressive parenchymal involvement. Diagnosis is made by the presence of recurrent oral ulcerations and at least one of the following: recurrent genital ulcers, eye lesions, skin lesions, or a positive pathergy test. Presenting symptoms may be cranial Delay in diagnosis of tuberculous meningitis is strongly associated with neurologic damage and death. Patients with high fever and rapid decline in consciousness may be candidates for empirical therapy for tuberculous meningitis with a four-drug regimen (see Chapters 39, 87, and 249). Immigrants from countries with a high incidence of tuberculosis and patients with a history of tuberculosis in a household member are at especially high risk. If there are lung lesions, sputum should be smeared and cultured for acid-fast bacteria as well. Repeat weekly lumbar punctures during therapy should show an improvement in hypoglycorrhachia, if present, in the second or third week, along with clinical improvement. If meningitis is due to a fungus, infection may increase and be undetected initially because of the antiinflammatory effects of corticosteroids. Vogt-KoyanagiHarada disease: review of a rare autoimmune disease targeting antigens of melanocytes. Neurological manifestations of cytomegalovirus infection in the acquired immunodeficiency syndrome. Granulomatous meningitis and diffuse parenchymatous degeneration of the nervous system due to an intracranial epidermoid cyst. A comparison of polymerase chain reaction examination of cerebrospinal fluid and conventional cytology in the diagnosis of lymphomatous meningitis. Sensitivity and specificity of cerebrospinal fluid flow cytometry for the diagnosis of leukemic meningitis in acute lymphoblastic leukemia/lymphoma. Isolated central nervous system histoplasmosis presenting with ischemic pontine stroke and meningitis in an immune-competent patient. Candida infection and the central nervous system following neurosurgery: a 12 year review. Candida meningitis in newborn infants: a review and report of combined amphotericin B-flucytosine therapy.
Syndromes
Outbreak of cholera associated with crab brought from an area with epidemic disease hiv infection and stds vermox 100 mg buy visa. Changing epidemiology of Yersinia enterocolitica infections: markedly decreased rates in young black children, foodborne diseases active surveillance network (foodnet), 1996-2009. An outbreak of Yersinia enterocolitica O:8 infections associated with pasteurized milk. Yersinia enterocolitica outbreak associated with ready-to-eat salad mix, Norway, 2011. Outbreaks of enterotoxigenic Escherichia coli infection in American adults: a clinical and epidemiologic profile. An outbreak of enterotoxigenic Escherichia coli associated with sushi restaurants in Nevada, 2004. Concurrent outbreaks of Shigella sonnei and enterotoxigenic Escherichia coli infections associated with parsley: implications for surveillance and control of foodborne illness. Notes from the Field: large outbreak of botulism associated with a church potluck meal-Ohio, 2015. Outbreak of clinically mild botulism type E illness from home-salted fish in patients presenting with predominantly gastrointestinal symptoms. Botulism associated with commercial carrot juice-Georgia and Florida, September 2006. Botulism associated with commercially canned chili sauce-Texas and Indiana, July 2007. An outbreak of Norwalk virus gastroenteritis associated with eating raw oysters: implications for maintaining safe oyster beds. Bluefishassociated scombroid poisoning: an example of the expanding spectrum of food poisoning from seafood. A large outbreak of scombroid fish poisoning associated with eating escolar fish (Lepidocybium flavobrunneum). An outbreak of Shigella dysenteriae type 2 among laboratory workers due to intentional food contamination. A massive outbreak in Milwaukee of Cryptosporidium infection transmitted through the public water supply. Gastroenteritis due to Norwalk virus: an outbreak associated with a municipal water system. Waterborne gastroenteritis due to the Norwalk agent: clinical and epidemiologic investigation.
When the susceptibility pattern of the infecting organism is known hiv infection rates brazil vermox 100 mg buy with visa, therapy can be altered accordingly. Oral treatment can be used to complete the course of antimicrobial therapy once a response has occurred. The finding of continuing positive blood cultures or persistent high fever and toxicity past the first 3 to 4 days suggests the need for investigation to exclude complications such as urinary obstruction or intrarenal or perinephric abscess formation. The availability of sensitive noninvasive studies has resulted in the early diagnosis of intrarenal or perinephric abscess formation that may respond to antibiotic therapy alone. Uncomplicated Cystitis in Women In the woman with classic symptoms of cystitis, urine dipstick or cultures are not necessary for management. However, if obtained, a negative dipstick or microscopic examination for pyuria would raise great suspicion that the diagnosis of cystitis is incorrect. Women with acute uncomplicated cystitis can be treated with short courses of antibiotic therapy. The advantages of short-course therapy include a lower cost, better adherence, fewer side effects, and perhaps less intensive selective pressure for the emergence of resistant organisms in gut, urethral, or vaginal flora. The different durations of administration are based on comparative clinical trials. In addition to complications related to urinary obstruction from diseases of the prostate in men, chronic bacterial prostatitis may be difficult to cure. For example, in the presence of an infected calculus, relapse from within the calculus is usual after therapy is stopped; the presence of a foreign body, such as a drainage device, makes eradication of infection difficult, probably because of formation of biofilms; and renal insufficiency may result in subinhibitory levels of antibiotic in the urine, as well as more antibiotic side effects. However, excluding pregnancy, no benefit has been demonstrated in Complicated Urinary Tract Infection, Including Infection in Men 980 screening for or treating asymptomatic bacteriuria except in two groups of patients: those with renal transplantation, especially in the early posttransplantation period; and those who will have procedures traumatic to the urethra, in whom elimination of bacteriuria can reduce the occurrence of symptomatic infection. With complete urinary obstruction or ureteral obstruction, the patient may be septic, and prompt relief of the obstruction is important. Accurate initial empirical therapy is paramount in the severely ill patient in whom the urinary tract may be the primary source of illness. Fluoroquinolone resistance rates in many communities are high, and there is little evidence that concentration of the drugs in the urinary tract makes them effective in vivo against resistant organisms. Some patients continue to relapse despite surgical correction of urologic abnormalities. In others, surgical correction may not be indicated or feasible or no abnormality may be found.
In other patients anti viral hand wash cheap vermox 100 mg online, mucus plugs or foreign bodies may predispose to atelectasis and chronic pneumonia, and therapeutic bronchoscopy may be necessary to expand the atelectatic lung. Lobectomy or pneumonectomy should be considered in a patient with chronic destructive pneumonia, multiple macroabscesses or microabscesses involving an entire lobe or lung, and a ventilation-perfusion scan indicating nonfunction of the involved lung. Chapter 70 Chronic Pneumonia Bronchoscopy and Surgery Corticosteroids the use of glucocorticosteroids for the treatment of a patient with chronic pneumonia is controversial. If the cause of the illness is an infectious agent, particularly a bacterium or fungus, steroids are not routinely indicated. However, some experts advocate a short course of glucocorticosteroid therapy, along with antituberculosis therapy for patients with advanced pulmonary tuberculosis and severe inanition. Lymphomatoid granulomatosis: a single institution experience and review of the literature. Leflunomide-induced interstitial pneumonitis might be a representative of disease-modifying antirheumatic drug-induced lung injury. Pulmonary infections associated with non-tuberculous mycobacteria in immunocompetent patients. Blastomyces helicus, a new dimorphic fungus causing fatal pulmonary and systemic disease in humans and animals in Western Canada and United States. Approach to fungal infections in human immunodeficiency virus-infected individuals: pneumocystis and beyond. Comparison of computed tomographic findings in pulmonary mucormycosis and invasive pulmonary aspergillosis. Improved diagnosis of acute pulmonary histoplasmosis by combining antigen and antibody detection. Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases. Epidemiology and etiology of wegener granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome and goodpasture syndrome: vasculitides with frequent lung involvement. Pulmonary manifestations of the Churg-Strauss syndrome and related idiopathic small vessel vasculitis syndromes. Interstitial lung disease in systemic autoimmune rheumatic diseases: a comprehensive review. Radiographic imaging of bronchioloalveolar carcinoma: screening, patterns of presentation and response assessment. Hodgkin lymphoma presenting as multiple cavitary pulmonary nodules with associated mediastinal adenopathy and neck mass. Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches. Interstitial lung damage due to cocaine abuse: pathogenesis, pharmacogenomics and therapy.
Chronic Stenotrophomonas maltophilia infection and exacerbation outcomes in cystic fibrosis fiebig stages hiv infection order 100 mg vermox with amex. Allergic bronchopulmonary aspergillosis in cystic fibrosis-state of the art: Cystic Fibrosis Foundation Conference. Anti-IgE therapy for allergic bronchopulmonary aspergillosis in people with cystic fibrosis. Pancreatic insufficiency, growth, and nutrition in infants identified by newborn screening as having cystic fibrosis. Clinical and genetic characteristics of meconium ileus in newborns with and without cystic fibrosis. Altered muscle activation patterns in symptomatic women during pelvic floor muscle contraction and Valsalva manouevre. Recommendations for management of liver and biliary tract disease in cystic fibrosis: Cystic Fibrosis Foundation Hepatobiliary Disease Consensus Group. Renal calcium handling in cystic fibrosis: lack of evidence for a primary renal defect. Lower respiratory infection and inflammation in infants with newly diagnosed cystic fibrosis. Lower airway inflammation in infants with cystic fibrosis detected by newborn screening. Classifying severity of cystic fibrosis lung disease using longitudinal pulmonary function data. Respiratory microbiology of patients with cystic fibrosis in the United States, 1995 to 2005. Nontuberculous mycobacteria: the changing epidemiology and treatment challenges in cystic fibrosis. Use of culture and molecular analysis to determine the effect of antibiotic treatment on microbial community diversity and abundance during exacerbation in patients with cystic fibrosis. Interspecies signaling promoting polymicrobial community development during cystic fibrosis airway infection. Presence of Pseudomonas aeruginosa influences biofilm formation and surface protein expression of Staphylococcus aureus. Selection for Staphylococcus aureus small-colony variants due to growth in the presence of Pseudomonas aeruginosa. Seasonal onset of initial colonisation and chronic infection with Pseudomonas aeruginosa in patients with cystic fibrosis in Denmark. Randomized trial of biofilm testing to select antibiotics for cystic fibrosis airway infection. Standard versus biofilm antimicrobial susceptibility testing to guide antibiotic therapy in cystic fibrosis.
Preferences for home vs hospital care among low-risk patients with community-acquired pneumonia hiv infection kidney disease 100 mg vermox order with mastercard. Outcomes in patients with community-acquired pneumonia admitted to the intensive care unit. Community acquired pneumonia: aetiology and usefulness of severity criteria on admission. Validation of a predictive rule for the management of communityacquired pneumonia. Development and validation of a clinical prediction rule for severe community-acquired pneumonia. Validation of a clinical prediction model for early admission to the intensive care unit of patients with pneumonia. Outcomes of patients hospitalized with community-acquired, health care-associated, and hospital-acquired pneumonia. Healthcareassociated pneumonia does not accurately identify potentially resistant pathogens: a systematic review and meta-analysis. Predictors of Pseudomonas and methicillin-resistant Staphylococcus aureus in hospitalized patients with healthcare-associated pneumonia. Pneumonia and lower respiratory infections in nursing home residents: predictors of hospitalization and mortality. Two outbreaks of severe respiratory disease in nursing homes associated with rhinovirus. Infectious disease outbreaks in nursing homes: an unappreciated hazard for frail elderly persons. Clinical features of severe Mycoplasma pneumoniae pneumonia in adults admitted to an intensive care unit. Aetiological diagnosis of community acquired pneumonia: utility of rapid microbiological methods with respect to disease severity. Nonsevere community-acquired pneumonia: correlation between cause and severity or comorbidity. A microbiologic study of lung aspirates in consecutive patients with communityacquired pneumonia. Clinical characteristics of Chlamydia pneumoniae infection as the sole cause of community-acquired pneumonia. Differences in the features of aspiration pneumonia according to site of acquisition: community or continuing care facility. Hospitalacquired pneumonia and ventilator-associated pneumonia: recent advances in epidemiology and management. Role of colonization of the upper intestinal tract in the pathogenesis of ventilator-associated pneumonia.
Bengerd, 57 years: Intracisternal inoculation of three different pneumococcal isolates resulted in pronounced differences in the pathophysiologic profiles 24 hours after challenge. Depending on the extent of disease, there may be an associated mass effect with displacement of midline structures.
Kliff, 35 years: A phase 2, randomized, double-blind, multicenter trial to evaluate the safety and efficacy of three dosing regimens of isavuconazole compared with fluconazole in patients with uncomplicated esophageal candidiasis. Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment.
Rendell, 49 years: Patients do not give a history suggesting acute pulmonary histoplasmosis before the diagnosis of meningitis. The general physical examination also provides important clues that assist in the diagnosis of encephalitis.
Cole, 52 years: Histochemical studies revealed that bacterial adherence is increased by the removal of glycosaminoglycan, a surface mucopolysaccharide that seems to be responsible for the natural resistance to adherence. Group A beta-haemolytic streptococcal infection and HenochSchnlein purpura with cardiac, renal and neurological complications.
Darmok, 22 years: Paroxysms of knifelike pain are precipitated by voluntary or respiratory movements. The early cerebritis stage is characterized by an acute inflammatory infiltrate with visible bacteria on Gram stain and marked edema surrounding the lesion.
Mannig, 29 years: A double-blind, randomized, placebo-controlled trial of Lactobacillus acidophilus for the treatment of acute watery diarrhea in Vietnamese children. Multicenter randomized controlled trial of withdrawal of inhaled corticosteroids in cystic fibrosis.
Leon, 65 years: Prolonged macrolide therapy is given for 3 months; doxycycline has been used in macrolideintolerant patients, and rifampin may be added as a second agent in severely ill patients. Ten- to 14-day courses are recommended in patients requiring hospitalization or parenteral therapy.
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