I enjoyed Satish Gopal’s new essay in JAMA, entitled “Global Health: What’s in It for Us?” In the essay, he explores why we do the international work we do, in the context of his daughter’s bout with cerebral malaria. This is the nightmare of many of us with children and who do global health work. Thankfully, his daughter was cured of malaria and did fine, … Continue reading Global Health: What’s in It for Us?
Penicilliosis is a cause of life-threatening illness in people from Southeast Asia, China, and India who are living with HIV. This dimorphic fungus was recently renamed Talaromyces (previously Penicillium) marneffei. What is the best initial treatment for this devastating disease? A recent study from Vietnam determined that it is Amphotericin, not itraconazole. Continue reading Treatment of HIV-Associated Talaromycosis
A man from Laos presented with abdominal pain, fever, melena, hemoptysis, and rash. The diagnosis in this case was ultimately Strongyloides stercoralis hyperinfection. We must remember to test and empirically treat for this parasite. Continue reading A Man from Laos
Three years ago, the West African Ebola epidemic set off a worldwide panic and the biggest global-health security crisis in years. Then Zika struck and the reality of those transmittable disease threats was brought even closer to home in the United States, with more than 5,000 cases reported and America still on high alert. Yet today, an even greater potential threat to the world is … Continue reading Yellow Fever in Brazil
A 58-year-old man with rheumatoid arthritis presented to the emergency room with fevers and drenching night sweats. He was found to have granulomatous hepatitis and his Coxiella burnetii serologic tests were positive. He had no livestock exposures. What is Q fever? Q fever is a worldwide zoonotic disease caused by the intracellular bacterium C. burnetii. How would I get infected? Infection begins with the inhalation … Continue reading Histology Rings True
Yesterday, I read with interest Donald McNeil Jr’s article in the New York Times, entitled Deadly ‘Superbugs’ Pose a Huge Threat, W.H.O. Says. I quickly wrote a letter to the Times arguing that the omission of drug-resistant tuberculosis (TB) from the W.H.O’s list of ‘superbugs’ was a serious oversight. TB is spread by the airborne route, unlike the other pathogens listed, which are predominantly … Continue reading Deadly ‘Superbugs’ Pose a Huge Threat, W.H.O. Says
Leptospirosis goes by many names. Mud fever, sewerman’s flu, and swamp fever are just a few of the monikers for the illness caused by Leptospira. As the names indicate, the disease is associated with filth, and in the developed world, it is rare. But in the Grand Concourse neighborhood of the Bronx, where the conditions in some of the buildings have long been called “unlivable” by … Continue reading Leptospirosis strikes Bronx, all too familiar with rats