Tropical Travel Trouble 009 Humongous HIV Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - July 7, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs

Tropical Travel Trouble 007 Mega Malaria Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 007 When you think tropical medicine, malaria has to be near the top. It can be fairly complex and fortunately treatment has become a lot simpler. This post is designed to walk you through the basic principals with links to more in depth teaching if your niche is travel medicine, laboratory diagnostics or management of severe or cerebral malaria. If you stubbled on this post while drinking a cup of tea or sitting on the throne and want a fe...
Source: Life in the Fast Lane - April 5, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine malaria Plasmodium plasmodium falciparum plasmodium knowles plasmodium malariae plasmodium ovale plasmodium vivax Source Type: blogs

Longing for the QT
A 58-year-old man presented to the ED with a reported overdose of an unknown medication. The patient was agitated, combative, and altered. Initial vital signs included a heart rate of 115 beats/min, blood pressure of 154/93 mm Hg, respirations of 22/min, and temperature of 99.5°F. The patient was difficult to evaluate because he was agitated, and he was given 5 mg of haloperidol IV and 2 mg of lorazepam IV. The patient continued to be agitated, and was given another 10 mg of haloperidol IV, followed by a repeat dose of 10 mg IV 15 minutes later. The patient then became unresponsive, and his cardiac monitor demonstrated...
Source: The Tox Cave - March 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Outbreak at Konkut University: MERS-CoV infection ?
The School of Veterinary Medicine at Konkut University is surprisingly close to Konkut University Hospital, where a number of patients were recently treated for MERS CoV virus infection.   In the following campus map, the Veterinary School and Hosital are denoted by numbers 15 and 30, respectively; and number 12 identifies the Animal Science School.   Significantly, a paper published by the school in 2007 suggests that at least some of the veterinary staff have been involved in work with camels. [1] Have these patients been tested for MERS CoV viral infection?   Reference: 1. Reference: 1. Abd El-...
Source: GIDEON blog - November 3, 2015 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Diagnosis Epidemiology ProMED Korea MERS-CoV Source Type: blogs

Another DNA-Barcoded Program From GSK
Two more papers have emerged from GSK using their DNA-encoded library platform. I'm always interested to see how this might be working out. One paper is on compounds for the tuberculosis target InhA, and the other is aimed at a lymphocyte protein-protein target, LFA-1. (I've written about this sort of thing previously here, here, and here). Both of these have some interesting points - I'll cover the LFA-1 work in another post, though. InhA, for its part, is the target of the well-known tuberculosis drug isoniazid, and it has had (as you'd imagine) a good amount of attention over the years, especially since it's not the cl...
Source: In the Pipeline - March 18, 2014 Category: Chemists Tags: Infectious Diseases Source Type: blogs

Nerve Damage and Fluoroquinolone Antibiotics
By Diane Fennell The US Food and Drug Administration (FDA) is requiring updated labeling on fluoroquinolone antibiotics that includes a stronger warning of the drugs' potential to cause rapid, and potentially permanent, development of peripheral neuropathy. Peripheral neuropathy, which affects up to 70% of people with diabetes, is a type of nerve damage that can cause symptoms such as pain, numbness, and tingling in the hands, legs, arms, and feet. The condition is a known risk factor of systemic fluoroquinolones, and warnings about the risk were added to the drugs' labels in 2004. After reviewing the FDA Adverse Event ...
Source: Diabetes Self-Management - August 23, 2013 Category: Diabetes Authors: Diane Fennell Source Type: blogs

Certain Antibiotics Linked to Blood Glucose Swings
By Diane Fennell People with diabetes who take a certain class of antibiotics are more likely to experience severe swings in blood glucose, according to new research from Taiwan. Previous research and case reports have raised concern about the possibility of severe high and low blood glucose associated with the use of fluoroquinolones, a class of antibiotics that includes ciprofloxacin (brand name Cipro), levofloxacin (Levaquin), and moxifloxacin (Avelox). One drug in this class, gatifloxacin (Tequin), was removed from the US market due to the risk of blood glucose fluctuations. To assess the risk of severe blood gluc...
Source: Diabetes Self-Management - August 16, 2013 Category: Diabetes Authors: Diane Fennell Source Type: blogs

Case 250
Welcome to Case 250!  Here is a challenging case (in a little more detail than normal) to commemorate this milestone post:A 90-year-old male from Missouri presented with a 3-day history of fever and dyspnea. His medical history included hypertension and splenectomy due to injury. He lived with his wife and reported no recent travel, pet or known tick exposure. On admission, he was febrile (temperature 40˚C) and hypotensive (105/58). Laboratory values of note were elevated leukocytes (13,100 cells/mL; 58% neutrophils), decreased hemoglobin (9.5 g/dL), low platelet count (106,000 cells/mL), increase liver fun...
Source: Creepy Dreadful Wonderful Parasites - March 17, 2013 Category: Pathologists Source Type: blogs