Infectious disease clinics of North America
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Infect. Dis. Clin. North Am. · Dec 1988
ReviewSystemic fungal infections: diagnosis and treatment. I. Paracoccidioidomycosis.
Paracoccidioidomycosis is the designation for the disease caused by the dimorphic fungus Paracoccidioides brasiliensis. It is a disease of great importance in Latin America and constitutes an important diagnosis for consideration in patients from endemic areas who have pulmonary or systemic disease compatible with fungal infection. In the laboratory, basic work has uncovered important interactions between the fungus and the human sex steroid system. These studies may have important implications in our approach to this and other infectious diseases.
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Otorrhea, or discharge from the ear, may be associated with otitis media or otitis externa. Each episode of otorrhea requires examination of the external ear canal and middle ear to determine the origin and extent of disease, a complete understanding of the pathogenesis, and a therapeutic approach that considers the microbiology and the extent of tissue invasion. This review focuses on infections of the middle ear and external ear commonly associated with otorrhea. The pathogenesis, clinical manifestations, methods of diagnosis, and medical and surgical therapies are presented.
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Infect. Dis. Clin. North Am. · Mar 1988
Review Comparative StudyThe sore throat. Pharyngitis and epiglottitis.
Sore throat can be caused by different microorganisms and diseases. Most cases of acute pharyngitis are caused by group A streptococcus or viruses; however, uncommon organisms may be suggested by other clinical information or the persistence of symptoms. A thorough history and physical examination are essential for the appropriate selection of diagnostic tests for sore throat. ⋯ Sore throat caused by viruses usually resolves spontaneously. Cases that persist should be thoroughly re-evaluated, with alternative causes being considered. Acute epiglottitis is a medical emergency and requires treatment with appropriate antibiotics for Hemophilus influenzae type b and intubation.
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Infect. Dis. Clin. North Am. · Dec 1987
ReviewAcute and chronic prostatitis: diagnosis and treatment.
Several distinct types of prostatitis, or prostatitis syndromes, are now recognized. The most common types include acute and chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. ⋯ Patients with prostatodynia typically have sterile cultures and normal prostatic secretions but demonstrate an acquired voiding dysfunction on video-urodynamic testing. Since nonbacterial types of prostatitis have no recognized infectious cause, treatment using antimicrobial agents is ineffective and unwarranted.
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The urinary tract undergoes profound physiologic and anatomic changes during pregnancy that facilitate the development of symptomatic urinary tract infections in women with bacteriuria. While the adverse effects of asymptomatic bacteriuria on maternal and fetal health continue to be debated, it is clear that asymptomatic bacteriuria is the major risk factor for developing symptomatic urinary tract infection and that symptomatic infections are associated with significant maternal and fetal risks. Because the majority of symptomatic urinary tract infections develop in women with bacteriuria earlier in pregnancy, treatment of bacteriuria is undertaken to prevent symptomatic infections. ⋯ Short-course therapy is as effective as prolonged therapy and should be followed with a repeat culture to document clearing of the bacteriuria. Failure to eliminate bacteriuria with repeated therapy or recurrence with the same organism is indicative of renal parenchymal infection or a structural abnormality. All women with persistent bacteriuria or recurrent infection should have follow-up cultures and a complete urologic evaluation after delivery.