Infectious Disease

Acute invasive fungal rhinosinus- itis occurs predominantly in immunocompromised patients, such as those with neutropenia and transplant recipients. The diagnosis requires biopsy, but permanent section can be time-consuming and result in a delay in treatment. Ghadiali and colleagues conducted a study to evaluate the accuracy of frozen-section biopsy in this setting.

A 53-year-old woman presented to the emergency department complaining of substernal chest pain that awoke her from sleep. The chest pain was associated with left shoulder numbness, radiating to her back, and was partially alleviated with sublingual nitroglycerin. During this episode, the patient had a cough productive of yellow phlegm and one instance of cough productive of 1 tbs of bright red blood.

A 22-year-old man complained of jaw pain, sore throat, and dysphagia to solids and liquids. A month earlier, he presented to another hospital with similar symptoms; an infection of the lower right third molar (tooth no. 32) was diagnosed, and oral penicillin and hydrocodone were prescribed. He finished the course of the antibiotic but failed to follow up with a dentist.

Heart failure is prevalent in both primary care and cardiology practices. It develops in about 1 in 5 persons during their lifetime and in about 1 in 8 of those who have not sustained a myocardial infarction (MI). Heart failure is also the leading cause of hospitalization in the elderly.

Your Observations About the Man With the Tripod Sign

Photo Finish

How strong is the link between antibiotic use and resistance? Patients with upper respiratory tract infections (URTIs) have come to expect an antibiotic even if their clinical presentation is consistent with a viral infection.

A Photo Quiz to Hone Dermatologic Skills

An 82-year-old man is seen for annual physical examination in the nursing home. He has resided there for 1 year because of the aggregate impact of multiple medical problems including, most prominently, laryngeal swallowing dysfunction associated with vocal cord paralysis.

LONDON -- Bolstering the GI tract with a mix of disease-fighting microbes significantly reduced the incidence of diarrhea associated with antibiotics and Clostridium difficile, according to results of a placebo-controlled trial.

HELSINKI -- About 90% of early signs of cervical cancer in young women can be prevented by an investigational vaccine against human papillomavirus, according to interim data.

SAN FRANCISCO -- The rate of methicillin-resistant Staphylococcus aureus in U.S. hospital patients is now nearly 5% -- dramatically higher than previously thought, according to a nationwide survey of healthcare facilities.

BALTIMORE -- A needle stick injures more than four of every five surgical residents during their training, researchers here said, and about half of the incidents go unreported.

HARTFORD, Conn. -- Echinacea, the irrepressible alternative cold remedy, is ascendant again in the topsy-turvy world of evidence-based medicine.

INDIANAPOLIS -- Although the recent withdrawal of tegaserod from the market has left a hole in the options available to treat irritable bowel syndrome (IBS), there are still many available.

TORONTO -- If avian flu holds the potential for a human pandemic, one possible strategy is to vaccinate the birds.

ATLANTA -- Rapid HIV testing with on-the-spot results during emergency room visits or at community events appears to be a feasible way to identify people who are infected with the virus and don't know it.

TORONTO -- To quantify flu vaccine's effectiveness for children with more specificity, a new surveillance network is able to provide consistent and potentially valuable estimates, CDC researcher said here.

NEW YORK -- Motor symptoms of advanced Parkinson's disease were significantly improved in a small investigational gene-therapy trial, according to investigators here.

DUBLIN -- When alcohol turns fighting into biting, it's a problem for the emergency department.

INDIANAPOLIS -- Community Acquired Pneumonia (CAP) is the sixth leading cause of death in the U.S., yet health care professionals don't always offer immunization to their most vulnerable patients.

ROCHESTER, Minn. -- For smoldering multiple myeloma, the risk of progression to active disease may be predicted by a pair of factors at diagnosis, according to researchers here.

TORONTO -- An investigational oil-and-water adjuvant for flu vaccines -- tested in conjunction with a vaccine against avian flu -- is safe, a researcher said here.

BALTIMORE -- When treating hepatitis B and HIV co-infection, physicians should use caution with the antiviral drug entecavir (Baraclude), researchers here said.

TORONTO -- The trivalent inactivated flu vaccine appeared to outperform the newer live attenuated vaccine in a large study of military personnel, a U.S. Army researcher reported here.

HOUSTON -- Myocardial infarction and other acute cardiac events closely track pneumococcal pneumonia, which suggests a need for multiple admitting diagnoses.

TORONTO -- Highly pathogenic avian flu is rarely transmitted to people and apparently never in a mild or asymptomatic form, a Thai researcher said here.

TORONTO -- The tests used to evaluate influenza vaccines are so unreliable they can vary up to 700-fold from one lab to another, according to a British researcher.

LONDON, Ontario, June 18 -- Although sudden sensorineural hearing loss is typically treated with systemic steroids, little evidence exists to support this or any other treatment, researchers said.

HOUSTON -- Psoriasis patients who had extended exposure to high-dose etanercept (Enbrel) responded without increased infections or other serious adverse effects, researchers reported.