Questions discussed in this category
Data on the role of steroids in HIV negative patients with PJP has been conflicting.
For example, baseline QT prolongation, elderly age group, or underlying heart disease?
https://www.cdc.gov/std/treatment-guidelines/neurosyphilis.htm
Is parasitemia >10% and severe hemolysis with Hb less than 7 enough to initiate this?
Assuming patient already received an initial course of antibiotic treatment in response to a positive urine culture during routine screening early in ...
The ESC guidelines recommend obtaining at least three sets of blood cultures at 30-minute intervals before starting antibiotic therapy, each with 10 m...
Chemotherapy is associated with acquiring C diff colitis. Does immunotherapy share that same risk and necessitate ruling out infection prior to anti-d...
Hendriks, et al., PMID 38576380
ACORN Randomized Clinical Trial
How frequently can you repeat the oral course?
Nussbaum et al., PMID 38195100
Would you still routinely ask for CIED removal, or would you pursue PET/CT for further evaluation and consider keeping CIED if PET/CT negative?
Do you empirically treat itchy patients -with a non specific rash- for scabies without obvious clinical findings for scabies?
Extrapolating from standard practice for management of cryptococcal antigenemia?
The REPRIEVE trial included participants who were between 40 and 75 years old.
If yes, what is the rationale for doing that?
Can cefpodoxime susceptibility be reliably extrapolated from ceftriaxone susceptibility?
Do you continue smears until documented resolution, or by clinical progress?
If yes, which combination(s)?
Do the findings of the PROPHY-VAP trial influence your approach?
Do the results of the recent study (Misset et al., PMID 37889107) showing reduction in 28-day mortality in patients with high neutralizing antibody ti...
Do you routinely offer latent TB treatment in these cases?
Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?
Is there a role for oral vancomycin in these patients, or is oral vancomycin redundant if other routes of administration are being used (i.e intracolo...
Is there a role for oral antiviral therapy alone (as opposed to induction with IV) and for what duration? And is there a role for ongoing suppressive ...
Especially in light of the results of the randomized clinical trial published on 8/2024 in Jama Internal Medicine by Hayward et al., PMID 38587819.
Would you combine antibiotics with isotretinoin?
Would it be safe to resume and if so, when?
Or would you still offer penicillin G benzathine once weekly concurrently?
Is there a role for booster vaccination and if so, how do you approach the timing when a patient is already on a biologic for immunosuppression?
In light of published data from the CAPE COD trial...
What is your approach to guiding ophthalmologists regarding our clinical suspicion for ocular syphilis and does the quantification of the titer help i...
Since the COVID-19 pandemic, increasingly we see management of acute cholecystitis with cholecystostomy tubes as opposed to surgery, even amongst pati...
CDC Healthcare Guidance
CDC Isolation and Work Restriction Guidance
CDC Immunocompromised Guidance
If yes, would you go with Zidovudine monotherapy versus combining with interferon-alpha? And what would be the preferred dose and duration?
If so, what antibiotic regimens do you use?
How do you approach ongoing screening for TB in patients with history of treated latent TB, but have ongoing use of DMARDs and/or biologics given quan...
At the time of count recovery or do you continue it throughout induction and consolidation?
E.g., for a patient with myeloma, s/p induction therapy, and high-dose chemotherapy, followed by autologous rescue with inappropriate antibody respons...
Assuming no symptoms of TB, should patients be treated for latent TB prior to starting TNF inhibitors or other immunosuppressive agents?
Additionally, is it correct to assume that IV therapies might be preferred vs oral treatment given alterations in GI absorption in PLE?
Patient previously failed abatacept and Rituximab.
What’s your threshold to get the three AFBs and place the patient in airborne isolation?
(Patient with active RA despite hydroxychloroquine)
How do you approach which risk to accept given that steroids have evidence for use in COVID-19 while is suggestion for harm in using steroids in influ...
Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?
Do you recommend any changes to their personal hygiene practices? or changes to their environment?
Infection is not part of the criteria for starting treatment both in UpToDate and in NCCN guidelines.
Hepatitis screening labs revealing Hep B ag and core positivity with positive PCR
Would you switch to itraconazole or perform fungal cultures?
When would you consider repeating the course of treatment?
Does treatment with B-cell depletion and/or negative anti-spike antibody status despite COVID mRNA vaccination influence your decision?
How do you decide how long to continue?
Can experts comment on fungal pneumonia risk with individual BTK inhibitors as seen in ELEVATE-RR and whether this impacts their management decisions?
Is there a role for empiric antibiotics if there is history of opportunistic infection?
For example, healthcare workers who require these vaccines for employment
Do you stop methotrexate or adjust the dose?
Does your recommendation differ between autologous and allogeneic transplants?
Does your recommendation differ in allogeneic transplant recipients wh...
Is it at neutrophil recovery, at documentation of CR on bone marrow biopsy, or is there a different point in time?
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Papers discussed in this category
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Arthritis Care Res (Hoboken), 2021 Jul
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Clin Microbiol Infect, 2018 Feb 07
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Clin Infect Dis, 2005 Jan 21
Pediatr Transplant, 2014 Sep 08
J Clin Oncol, 2021 Apr 30
Pediatr Infect Dis J, 2014 Nov
Bone Marrow Transplant, 2006 Mar
Perit Dial Int, 2022 Mar
PET Clin, 2020 Feb 11
Rheumatology (Oxford), 2022 Jul 22
The Journal of thoracic and cardiovascular surgery, 2017-12
Tex Heart Inst J, 2022 Nov 1
Circulation, 2020 Dec 17
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JACC Case Rep, 2022 May 04
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Arthritis Care Res (Hoboken), 2016 Jan
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JAMA, 2023 Jul 03
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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019 Sep 13
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Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2023 May 11
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Lancet (London, England), 2021 Mar 27
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Infection & chemotherapy, 2021 Jun
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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2006-07-15
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The Lancet. Neurology, 2009-08
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