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.
Continue reading “Diagnostic Criteria for Fracture-Related Infection (FRI)”
The criteria that define infections for surveillance purposes were selected to increase the likelihood that the events captured by application of the definitions are true infections. Presentations of infection in older residents of long-term care facilities (LTCFs), may be atypical, so failure to meet surveillance definitions may not fully exclude the presence of infection. For this reason, the surveillance definitions presented here may not be adequate for real-time case finding, diagnosis, or clinical decision making (eg, antibiotic initiation). Separate clinical guidelines address early identification of infections and appropriate initiation of antibiotic therapy in LTCF residents, which are both important for impacting resident outcomes. Continue reading “Revised McGeer Criteria for Respiratory Tract Infection Surveillance (RTIs)”
The definitions for UTI presented here differ substantially from the original surveillance definitions1 for both (A) residents without an indwelling catheter and (B) residents with an indwelling catheter. The revised definitions take into account the low probability of UTI in residents without indwelling catheters if localizing symptoms are not present, as well as the need for microbiologic confirmation for diagnosis. Continue reading “Revised McGeer Criteria for Urinary Tract Infection Surveillance (UTIs)”
Reported symptoms have included fever in 90% of cases, fatigue and a dry cough in 80%, and shortness of breath in 20%, with respiratory distress in 15%. Chest x-rays have revealed signs in both lungs. Vital signs were generally stable at the time of admission of those hospitalised. Blood tests have commonly shown low white blood cell counts (leucopenia and lymphopenia). Continue reading “Surveillance Case Definitions for Human Infection with Novel Coronavirus (Covid-19)”
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.
Continue reading “Definitions of Clostridium difficile Infection (CDI)”