Patients infected with the human immunodeficiency virus (HIV) commonly experience diarrhea at some time during their illness. A variety of enteric pathogens are identified in 50-80% of these patients, depending on the intensity of the diagnostic work-up that is done. In addition to the common enteric pathogens, several unusual enteric pathogens are recognized to cause diarrhea especially in HIV...

Routine diagnostic studies can locate the source of gastrointestinal bleeding in the vast majority of persons. In approximately 5 percent of persons, however, the source remains obscure despite sophisticated studies. Our inability to localize the source of bleeding in these individuals illustrates the limits of available diagnostic technology. In an elderly patient who requires repeated diagnos...

Fluoroquinolones, which are widely used to treat community-acquired pneumonia, also have excellent in vitro activity against Mycobacterium tuberculosis. A retrospective cohort study was conducted among adults with culture-confirmed tuberculosis to assess the effect of empiric fluoroquinolone therapy on delays in the treatment of tuberculosis. Sixteen (48%) of 33 patients received fluoroquinolon...

Evidence-based guidelines for the treatment of established fungal infections in the adult haematology/oncology setting were developed by a national consensus working group representing clinicians, pharmacists and microbiologists. These updated guidelines replace the previous guidelines published in the Internal Medicine Journal by Slavin et al. in 2004. The guidelines are pathogen-specific and ...

1327. Factors associated with optimizing empiric antibiotic therapy in six hospitals Daniel Morgan, MD, MS; Nikolay Braykov, BSE; Marin Schweizer, PhD; Daniel Z. Uslan, MD, MS; Theodoros Kelesidis, MD, PhD; Scott a. Weisenberg, MD, MSc, DTM&H; Birgir Johannsson, MD; Heather Young, MD; Joseph Cantey, MD; Eli Perencevich, MD, MS, FIDSA, FSHEA; Edward Septimus, MD, FIDSA, FSHEA; Ramanan Laxminaray...

Pseudomonas aeruginosa is a common pathogen implicated in nosocomial infections with increasing resistance to a limited arsenal of antibiotics. Monte Carlo simulation provides antimicrobial stewardship teams with an additional tool to guide empiric therapy. We modeled empiric therapies with antipseudomonal β-lactam antibiotic regimens to determine which were most likely to achieve probability o...

Severe skin and soft tissue infections (SSTIs) frequently require management in the ICU, in part related to associated septic shock or toxic shock syndrome or associated organ failure. Four fundamental management principles are key to a successful outcome in caring for patients who have severe SSTIs, including (1) early diagnosis and differentiation of necrotizing versus nonnecrotizing SSTI, (2...