Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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The interpretation of serological results for patients who had Lyme disease many years ago is not well defined. We studied the serological status of 79 patients who had had Lyme disease 10-20 years ago and did not currently have signs or symptoms of active Lyme disease. ⋯ Of the 39 patients who had had Lyme arthritis, 6 (15%) currently had IgM responses and 24 (62%) still had IgG reactivity to the spirochete. IgM or IgG antibody responses to B. burgdorferi may persist for 10-20 years, but these responses are not indicative of active infection.
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Extending the useful life of antimicrobial drugs through appropriate use-that is, use that maximizes therapeutic impact while minimizing toxicity and the development of resistance-is an important component of efforts to prevent and control the emerging threat of antimicrobial resistance. The major paradigms of antimicrobial drug use involve acute infections in outpatients, acute infections in inpatients, chronic infections, and agriculture/veterinary medicine. ⋯ For acute respiratory infections in outpatients, data from intervention trials suggest that concurrent multifaceted interventions may be effective in promoting appropriate drug prescribing. The next challenge is to extend these interventions to larger populations by incorporating them into routine medical practice.
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Review Case Reports
Necrotizing fasciitis due to Streptococcus pneumoniae after intramuscular injection of nonsteroidal anti-inflammatory drugs: report of 2 cases and review.
Two cases of pneumococcal necrotizing fasciitis (NF) occurred after intramuscular injections of nonsteroidal anti-inflammatory drugs; another 5 cases reported in the literature fulfilled the criteria for NF involving Streptococcus pneumoniae. Conditions associated with alterations of immune function could be identified in 6 of the 7 cases; 2 patients died despite surgical and antimicrobial treatment.
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Case Reports
Trichosporon asahii, a non-Candida yeast that caused fatal septic shock in a patient without cancer or neutropenia.
Trichosporon asahii (formerly Trichosporon beigelii) is an emerging fungal pathogen seen particularly in immunologically compromised patients. There are now approximately 100 reported cases of hematogenously disseminated infections with this life-threatening yeast, and no effective antifungal therapy is available. The present case is unusual because the patient did not have neutropenia or evidence of a malignancy.