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Infectious Diseases

Surgical site infection: Knowledge of the likely pathogens is key

Roy A. Borchardt, PA-C, PhD, Kenneth V. I. Rolston, MD May 18, 2012

Postoperative complications, including surgical site infections, can prolong hospitalization, delay healing, and increase health care costs.

Pathogenesis, diagnostic testing, and management of mononucleosis

Stacey Singer-Leshinsky, MS Ed, RPA-C May 03, 2012

Because Epstein-Barr virus is highly contagious and linked to various complications and malignancies, familiarity with transmission risks and the differential diagnosis is essential.

Tuberculosis screening: Prevention in the patient with immunosuppression

Kelly M. McConn, PA-C, George M. Viola, MD, MPH April 10, 2012

Identifying patients with latent TB is paramount because reactivation is possible any time the immune system becomes depressed.

Vomiting and periumbilical pain from an unexpected source of infection

Mara Hall, PA-C, Bettie Coplan, MPAS, PA-C April 09, 2012

The triad of abdominal pain, fever, and vomiting in this 11-year-old girl led the pediatrician to refer her to the emergency department (ED) for evaluation of possible appendicitis.

A neck mass in a patient with fever and sore throat

Michael R. Slaughter, MPAS, PA-C March 15, 2012

The initial diagnosis was viral illness, but blood cultures that came back positive for Fusobacterium necrophorum mandated further evaluation.

Urinary tract infection: Consistent therapy to  reduce resistance

Roy A. Borchardt, PA-C, PhD, Kenneth V. I. Rolston, MD March 13, 2012

A recent update to the clinical practice guidelines for the treatment of UTI hopes to establish a long overdue consensus regarding optimal approaches to this common infection.

Antimicrobial stewardship:  A proactive approach to combating resistance

Roy A. Borchardt, PA-C, PhD, Kenneth V. I. Rolston, MD February 09, 2012

Until new antimicrobials with novel mechanisms can be developed, we must use antibiotic stewardship to safeguard the efficacy of the medications we have.

The SNAP treatment approach for children with acute otitis media

Kristina D. Mancini, MS, PA-C, Ellen D. Mandel, DMH, MPA, MS, PA-C February 01, 2012

AOM usually resolves spontaneously, and the SNAP approach takes advantage of that,  helping children to avoid antibiotic side effects and combating antibiotic resistance.

Chikungunya virus: An emerging condition in the industrialized world

Alicia Weitzel, BS, Paul P. Rega, MD, FACEP; Christopher E. Bork, PhD, EMT-B, FASAHP January 23, 2012

Once found only in developing tropical nations, CHIKV has spread to the world at large.  With proper management and close communication with authorities, it can be contained.

HIV/AIDS:  Improved  outcomes, less disparity

CHAC, the Clinical and Health Affairs Commission of the AAPA January 11, 2012

The goal of the National HIV/AIDS Strategy for the United States is to rededicate attention to HIV/AIDS management in the areas of prevention, outcome improvement, and elimination of disparities.

Battling influenza: Universal vaccination is the primary weapon

Roy A. Borchardt, PA-C, PhD, Kenneth V. I. Rolston, MD January 09, 2012

This update on seasonal influenza focuses on early treatment and reducing disease burden through vaccination, with special attention to cancer patients.

Clostridium difficile: A new look at an old but increasingly deadly infection

Jacqueline S. Barnett, MSHS, PA-C January 03, 2012

Despite all that is known about risk factors and prevention, hypervirulent strains of this organism are causing disease in populations that once were considered low risk.

Rhinocerebral mucormycosis: A rare fungal infection linked to diabetes

Sarah Asman, MPA, PA-C, Mehrdad M. Behnia, MD, FACP, FCCP December 05, 2011

Although usually prevented by the immune system, this disease is common in patients who are immunocompromised. As in this case, early detection and treatment are key.

Fusobacterium otitis causes a case of  hydrocephalus and fatal meningitis

Erin N. Arrington; M. Michael Behnia, MD November 15, 2011

A delay in the administration of antimicrobial therapy resulted in lethal complications. To reduce the high morbidity and mortality rates, clinicians must begin early treatment.

Understanding the appropriate and effective use of vancomycin

Elizabeth duPreez, PharmD November 09, 2011

Vancomycin should be dosed aggressively early on, with a loading dose given that is sufficient for rapid achievement of target concentrations.

What caused the rash  on this  high school  athlete?

Olga Saprygina Forman, PA-C, MPAS September 07, 2011

A high school athlete develops a number of multiplying pink and slightly translucent papules on the right and left sides of the neck.

Toxoplasmosis and malaria

Gina Brown, MPAS, PA-C May 18, 2011

This article reviews the general features, clinical assessment, diagnosis, and treatment of toxoplasmosis and malaria.

Dengue fever: Potentially fatal, and now emerging in the United States

Kyrus Eileen Patch, MS, PA-C March 28, 2011

Long thought to be endemic only in other parts of the world, dengue is the focus of an  investigation in Key West, Florida, site of a recent outbreak.

A 52-year-old woman reports right upper quadrant pain, weakness, and fever

Kishore Kuppasani, MS, MPA, PA-C, Smita Mahendrakar, MD January 28, 2011

Wide-ranging symptoms were difficult to connect until a leaky basement provided the telltale clue.

Previously healthy man is afflicted with dyspnea, weight gain, and orthopea

Matthew J. Graziano, MPAS December 28, 2010

A man who had frequent contact with animals reported the recent development of respiratory symptoms and signs of heart failure.

A chigger bite activates a dormant  infection in an outdoorsman

Tracy Earl, PA-C December 06, 2010

The patient attributed pain and swelling of two fingers to a chigger bite, but the real cause of his symptoms remained a mystery.

Tendinopathy resulting from the use of fluoroquinolones: Managing risks

Heidi E. Doyle, PA-C December 01, 2010

Although well-tolerated by most patients, fluoroquinolones can produce this serious  condition.

Multiple potential infectious causes of hematuria complicate this diagnosis

Timothy V. Johnson, MD, Jennifer DeLong, PA-C; Viraj A. Master, MD, PhD, FACS October 11, 2010

Gross hematuria triggers an in-depth evaluation that demonstrates how important it is for clinicians to keep multiple possibilities in mind.

Travel-related infections: Diagnosis and treatment of exotic fevers

Katherine GeeBah Footracer, MS, PA-C, CMT October 06, 2010

Patients rarely seek pretravel medical care, so PAs should be aware of common illnesses patients may present with after foreign travel.

What is MRSA?

September 30, 2010

The causes and treatment of methicillin-resistant Staphylococcus aureus are discussed. A patient handout with frequently asked questions is included.

New-onset status epilepticus develops after a motor vehicle collision

Kishore Kuppasani, MS, MPA, PA-C, Vivek K. Vadehra, MD; Alluru S. Reddi, MD, PhD September 29, 2010

Despite suffering no head trauma, the patient began to experience new-onset  seizures from an unexpected and surprising source.

Pneumococcal disease: Swinging away at a dangerous killer

Marie-Michèle Léger, MPH, PA-C, Susan J. Rehm, MD September 03, 2010

Tens of thousands of American adults needlessly suffer and die from pneumococcal disease every year. The time has come for PAs to advocate for better vaccination coverage for this dangerous disease.