We report a severe case of Staphylococcus lugdunensis (S. lugdunensis) keratitis presenting as suppurative keratitis in a 77-year-old woman. The patient's chief complaint was eye pain and decreased visual acuity in her right eye. Suppurative keratitis with a severe corneal abscess was diagnosed by a slit-lamp ophthalmic examination. The causative organism was identified as S. lugdunensis by bac...

This article is a brief overview of empiric antibiotic selection for sepsis and septic shock. The article includes a differential diagnosis of the mimics of sepsis and stresses a strategy for avoiding problems associated with antibiotic resistance. Although early appropriate empiric therapy is the cornerstone of sepsis and septic shock therapy, nonantibiotic interventions are critical as well. ...

OBJECTIVES We aimed to construct widely useable summary measures of the net impact of antibiotic resistance on empiric therapy. Summary measures are needed to communicate the importance of resistance, plan and evaluate interventions, and direct policy and investment. DESIGN, SETTING AND PARTICIPANTS As an example, we retrospectively summarised the 2011 cumulative antibiogram from a Toronto ac...

BACKGROUND The purpose of this study was to determine the most cost-effective strategy for managing suspected urinary tract infections in otherwise healthy adult women presenting to their primary care physician with dysuria and no symptoms or signs of pyelonephritis. Several office-based management strategies are considered: empiric therapy, use of dipstick analysis, use of complete urinalysis,...

BACKGROUND Empirical combination antibiotic regimens consisting of a β-lactam and an aminoglycoside are frequently employed in the pediatric population. Data to demonstrate the comparative benefit of empirical β-lactam combination therapy relative to monotherapy for culture-proven Gram-negative bacteremia are lacking in the pediatric population. METHODS We conducted a retrospective cohort stu...

STUDY OBJECTIVES To describe the variation in clinical practice strategies for the treatment of suspected ventilator-associated pneumonia (VAP) in a population of critically ill patients, and to determine whether initial empiric treatment with certain antibiotics, monotherapy vs combination antibiotic therapy, or appropriate vs inappropriate antibiotic therapy is associated with survival, lengt...

The emergence of multidrug-resistant (MDR) uropathogens is making the treatment of urinary tract infections (UTIs) more challenging. We sought to evaluate the accuracy of empiric therapy for MDR UTIs and the utility of prior culture data in improving the accuracy of the therapy chosen. The electronic health records from three U.S. Department of Veterans Affairs facilities were retrospectively r...

Peritoneal fluid eosinophilia can be caused by many factors. It has been noted in helminthic infection or allergic diseases and can occur especially at the initiation of continuous ambulatory peritoneal dialysis (CAPD). We show the case of a 53-year-old woman undergoing CAPD who was initially treated for bacterial peritonitis with antibiotics. Finally, she revealed an eosinophilic peritonitis m...

One of the major challenges facing oncologists today is invasive fungal infection. Difficult to diagnose and deadly when missed, invasive fungal infection--primarily by Candida and Aspergillus organisms--is the major infectious cause of death associated with chemotherapy-induced myelosuppression. In this review, the problem will be described and evidence-based approaches to management, includin...