Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Although the nation's blood supply is safer than ever, a small risk of transfusion-transmitted infection remains. Present strategies to further reduce the risk, such as the donor medical evaluation or laboratory testing, will not likely eliminate this risk. A different approach involves treating donated blood to eliminate its infectivity. ⋯ Toxicity, mutagenicity, and safety margins seem to be adequate, and damage to blood proteins or cellular elements is minimal. Clinical trials of pathogen-inactivated platelets have been completed in Europe and in the United States, and phase III clinical trials of pathogen-inactivated red blood cells are underway in the United States. If these encouraging results are sustained, the risk of transfusion-transmitted disease may be nearly eliminated.
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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.