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In a Critical State: Ongoing Barriers to Treatment for Hepatitis C Virus (HCV)

5 Recent advances in hepatitis C virus (HCV) treatment could be described as revolutionary: for uncomplicated patients, treatment is nearly 100% effective, oral only, has a low pill burden, minimal side effects, and results in a cure.1 Comparisons we have heard from clinicians are that HCV is now easier to treat than either diabetes or hypertension. […]

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(A) Ultrasonography of the abdomen. Intra-abdominal pancreatic cyst (7 × 8 cm) with echogenic debris. (B) Axial; (C) Sagittal images: contrast-enhanced computed tomography. Complicated pseudocyst, compression of the common bile duct, and dilated biliary tracts.

Fulminant Emphysematous Pancreatic Pseudocyst: Infected with Normal Skin Flora

A 49-year-old man was alcoholic and had major depressive disorder. He experienced epigastric pain, poor appetite, and weight loss for 1 month. Ultrasonography of the abdomen revealed a pancreatic cyst (7 × 8 cm) with echogenic debris (Figure 1A). Contrast-enhanced computed tomography (CT) of the abdomen showed a complicated pancreatic pseudocyst (Figure 1B), compressed common bile duct, […]

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Ixodes scapularis, the primary vector of Lyme disease in eastern North America. (Image Credit: Public Library of Science, Wiki CC License.)

Borrelia miyamotoi: An Emerging Tick-Borne Pathogen

  As of July 2018, 6 different infections have been recognized to be transmitted by Ixodes scapularis ticks in the United States, the most common of which is Lyme disease. The pathogen responsible for the vast majority of cases of Lyme disease in the United States is Borrelia burgdorferi. Another Lyme borrelia species, however, B. mayonii, has recently been […]

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Should Patients Infected with Borrelia burgdorferi No Longer Be Referred to as Having Lyme Disease?

In 1977, a seminal paper described what was subsequently called Lyme arthritis.1 The name ‘Lyme’ originated from the initial investigation of the disease that was conducted in the Connecticut towns of Lyme, Old Lyme, and East Haddam.1 As more of the clinical manifestations of this illness were discovered, the condition became referred to as Lyme disease.2, 3, 4 In 1983, the […]

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(Left panel) Left upper extremity brachiocephalic arteriovenous fistula with skin degeneration and oozing. (Right panel) Ocular examination findings showing improvement from the time of presentation. Arrow points to hypopyon in each image (resolved by day 4). Intravitreal antibiotics were administered at presentation, and consequent subconjunctival hemorrhage can be seen in the subsequent images.

Keep an Eye on the Eye Symptoms of Your Dialysis Patient

  A 73-year-old man with a history of end-stage renal disease (on hemodialysis for 6 years), hypertension, and diabetes mellitus type 2 presented with worsening pain and swelling of the left upper extremity brachiocephalic arteriovenous fistula. The patient was having night sweats for a few days prior to presentation. He was started on intravenous cephalosporin […]

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The patient's posterior trunk was marked with pink urticarial papules and plaques.

Down the Rabbit Hole: Cutaneous Tuberculosis

The term “going down the rabbit hole,” based on Lewis Carroll’s Alice’s Adventures in Wonderland, is a metaphor for an entry into the unknown, the disorienting, or the mentally deranging. Although the case of a patient with a nonhealing ulcer did not set us on a path with these exact qualities, it did remind us that […]

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