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Seronegative West Nile Virus Infection in a Patient Treated with Rituximab for Rheumatoid Arthritis

Seronegative West Nile virus infection has been described in organ transplant recipients and patients with cancer receiving rituximab in combination with other immunosuppressive therapies. We describe the first reported case of seronegative West Nile virus meningoencephalitis in a patient receiving rituximab for rheumatoid arthritis. A 49-year-old woman from Colorado with a history of rheumatoid arthritis […]

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elder woman in eye exam

Eyes Are Useless When the Mind Is Blind: Anton-Babinski Syndrome

Anton-Babinski syndrome is a condition in which patients deny vision loss despite objective evidence. They further confabulate to support their stance. Cortical blindness is the loss of vision caused by a unilateral or bilateral lesion in the occipital cortex in the presence of normal anterior visual pathway. Anton syndrome is most commonly due to bilateral […]

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Telemedicine Specialty Support Promotes Hepatitis C Treatment by PCPs

The Department of Veterans Affairs is the largest US provider of hepatitis C treatment. Although antiviral regimens are becoming simpler, hepatitis C antivirals are not typically prescribed by primary care providers. The Veterans Affairs Extension for Community Health Outcomes (VA-ECHO) program was launched to promote primary care–based hepatitis C treatment using videoconferencing-based specialist support. We […]

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‘Urinary Tract Infection’ and the Microbiome

The current paradigm for managing uncomplicated “urinary tract infection” (“UTI”) is deeply flawed. “UTI” is ambiguously defined, and coupled with a belief that “bacteria are not normal inhabitants of the urinary tract,”1 the diagnosis often leads to unnecessary, harmful antibiotic treatment. Although bacteriuria identified by standard clinical cultures (which we will call standard bacteriuria) is central […]

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Stubborn Creatures: Dormant Staphylococcus aureus

A healthy 70-year-old woman was admitted with a 3-day history of a pus-emitting wound on her left shin, in the absence of trauma. She was afebrile, and examination was normal excepting a warm, erythematous and tender area over her left distal tibia with a central swollen area discharging pus. Hemoglobin was 11.7 g/dL, white blood […]

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