Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Community-acquired pneumonia due to Chlamydia pneumoniae is associated with a benign clinical course. Severe, life-threatening pneumonia is rare and occurs only in immunocompromised hosts. We report a case of severe pneumonia complicated by acute hypoxemic respiratory failure due to primary infection with C. pneumoniae in a previously healthy 46-year-old woman.
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A previously healthy 47-year-old man with coccidioidal meningitis had fluconazole treatment failure and developed severe symptoms, multiple cranial nerve palsies, and brain-stem inflammation visible on magnetic resonance imaging (MRI). High-dose voriconazole therapy resulted in gradual resolution of almost all signs and symptoms, normalization of cerebrospinal fluid, and clearing of brain-stem edema seen on MRI. The patient had photosensitivity after 10 weeks of treatment, but this improved when the voriconazole dose was lowered. Continuous voriconazole therapy kept coccidioidal meningitis in complete remission in this patient for >2 years.
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To estimate the incidence of, identify risk factors for, and describe the clinical presentation of travel-associated African tick bite fever (ATBF), a rapidly emerging disease in travel medicine, we prospectively studied a cohort of 940 travelers to rural sub-Equatorial Africa. Diagnosis was based on suicide polymerase chain reaction and the detection of specific antibodies to Rickettia africae in serum samples by multiple-antigen microimmunofluorescence assay, Western blotting, and cross-adsorption assays. ⋯ Game hunting, travel to southern Africa, and travel during November through April were found to be independent risk factors. Our study suggests that ATBF is not uncommon in travelers to rural sub-Saharan Africa and that many cases have a nonspecific presentation.