Tag Archives: Infectious disease

Not so Obvious: Acute Herpes Esophagitis

  The gross examination immediately suggested infection with Candida species, but biopsy results pointed to a different culprit. A 29-year-old woman sought care in the emergency department after experiencing sharp epigastric pain over 2 days. She was initially seen at an urgent care center and empirically treated for gastritis with omeprazole. However, her pain progressively worsened and […]

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The Clinical Relevance of Studies on Borrelia burgdorferi Persisters

In North America, Lyme disease is principally caused by Borrelia burgdorferi sensu stricto, hereafter referred to as “B. burgdorferi.” It is acquired by the bite of an infected Ixodes tick. The most common clinical manifestation is a skin lesion, referred to as “erythema migrans,” which is due to cutaneous infection with B. burgdorferi. Other objective manifestations may involve the nervous […]

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False and Misleading Information About Lyme Disease

  Recently, there has been considerable interest in the topic of fake news. For infectious diseases physicians, false and misleading information about the diagnosis and treatment of Lyme disease is not new. It is increasing in frequency and prominence, creating much confusion among primary care physicians and their patients. Persistent, unexplained subjective symptoms such as […]

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doctor uses tablet with patient

‘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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