Fracture-related infection (FRI) is a severe complication following bone injury and can pose a diagnostic challenge. There is a spectrum of clinical presentations of FRI and differentiating them from noninfected causes can be difficult. In the early postoperative period, classical clinical symptoms of infection, such as pain, redness, warmth, or swelling, overlap with features of normal fracture healing. Later, more subtle clinical presentations such as fracture nonunion or persistent pain can be attributable to both infective and noninfective conditions. The complexity and variety of FRI may have hindered the establishment of uniform diagnostic criteria.
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Testing for H. pylori is recommended in patients with peptic ulcer disease, gastric cancer, or gastric mucosa–associated lymphoid tissue lymphoma (MALToma). Other recommended indications for testing include dyspepsia, prolonged use of nonsteroidal antiinflammatory drugs or aspirin, unexplained iron-deficiency anemia, and immune thrombocytopenia. Continue reading “Indications for Testing for Helicobacter pylori Infection”
Since the first cases of acquired immunodeficiency syndrome (AIDS) were reported in the United States in 1981, surveillance case definitions for human immunodeficiency virus (HIV) infection (the cause of AIDS) and AIDS have undergone several revisions to respond to diagnostic advances. Continue reading “Revised Surveillance Case Definition for HIV Infection”
The revised clinical staging and immunological classification of HIV are designed to assist in clinical management of HIV, especially where there is limited laboratory capacity. Continue reading “WHO Immunological Classification for Established HIV Infection”
Endoscopy is the gold standard for diagnosis of peptic ulcer disease. Apart from exclusion of malignant disease, detection of H pylori infection with histology or rapid urease tests is essential to the subsequent treatment plan. Continue reading “Helicobacter pylori Infection in Peptic Ulcer Disease”
Patients with severe disease may develop a colonic ileus or toxic dilatation and present with abdominal pain and distension but with minimal or no diarrhea. Complications of severe C. difficile colitis include dehydration, electrolyte disturbances, hypoalbuminemia, toxic megacolon, bowel perforation, hypotension, renal failure, systemic inflammatory response syndrome, sepsis, and death.
Clostridium difficile (C. difficile) is a Gram-positive, sporeforming bacterium usually spread by the fecal-oral route. It is non-invasive and produces toxins A and B that cause disease, ranging from asymptomatic carriage, to mild diarrhea, to colitis, or pseudomembranous colitis. CDI is defined as the acute onset of diarrhea with documented toxigenic C. difficile or its toxin and no other documented cause for diarrhea.
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Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.
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Chronic HBV infection is a necroinflammatory disease of the liver caused by persistent infection with HBV, and can be categorized as hepatitis B e antigen (HBeAg) positive or negative. Inactive hepatitis B surface antigen (HBsAg) carriers have HBV infection of the liver without significant, ongoing necroinflammatory disease. HBV infection is resolved when there is no further virologic, biochemical, or histologic evidence of active viral infection or disease.
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Cierny and Mader classified osteomyelitis based on the affected portion of the bone, the physiologic status of the host and the local environment. This classification lends itself to the treatment and prognosis of osteomyelitis; stage 1 (medullary osteomyelitis) can usually be treated with antibiotics alone, while stages 2, 3 and 4 (superficial, localized and diffuse osteomyelitis) usually require aggressive debridement, antimicrobial therapy and subsequent orthopedic reconstruction.
Continue reading “Cierny-Mader Staging System for Long Bone Osteomyelitis”