Toxoplasma gondii is a parasite that causes opportunistic infection in helpless people. It may have met its match. The cost of treating toxoplasmosis, a rare but extant infection, just shot up exponentially. Drug-resistant strain, you ask? Have physicians in infectious disease gone mercenary, you wonder? No. A change in ownership. Daraprim (pyrimethamine) is a nifty drug that kills parasites. It’s been around for eons. I still recall its name from my ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 22-year-old man is evaluated for diarrhea and weight loss. The patient has a 3-week history of foul-smelling, large-volume, watery stools associated with abdominal bloating. There is no visible blood or mucus in the stools. He reports a 4.5-kg (10-lb) weight loss, which he attributes to a poor appetite. One month before ...

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It was a week into my elderly patient's hospital admission when he began to have fever and profuse diarrhea, some 10 to 12 bowel movement a day. The diagnosis was not hard to make: a stool test showed he had C. difficile. Another patient, a thin women in her late 40s who had become paraplegic after a gunshot wound decades ago, came in from a nursing home when her urinary catheter ...

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shutterstock_117645061 Imagine the United States of America when a simple skin infection from a scrape causes a 10 percent chance of dying.  Out of every 1,000 women who give birth, nine will die, and out of the 1,000 infants born,  up to 30 percent will die.   It is difficult to imagine, but these are the alarming statistics prior to antibiotics in the early ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is admitted to the emergency department with a 1-day history of headache and epistaxis. He has had type 1 diabetes mellitus requiring insulin for 30 years and two episodes of ketoacidosis in the past year. On physical examination, temperature is 36.0 °C (96.8 °F), blood pressure is 100/70 mm Hg, ...

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Antibiotic resistance is an alarming and increasing threat to global public health. According to the Centers for Disease Control and Prevention (CDC), two million people a year become infected with bacteria resistant to antibiotics and lead to 23,000 deaths in the United States alone. Simply put, the bugs are getting stronger and smarter, our antibiotic arsenal has not kept pace, and we have overused our antibiotic resources in a manner ...

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Want to learn about sepsis?  This video from the residents at UCLA-Kern Medical Center teaches you, Justin Timberlake style. Get your sepsy on!

shutterstock_189429203 Desiree wrote in, “My 15-month daughter and a few other kids at her daycare were just diagnosed with hand-foot-mouth disease. I would like to hear how common it is, what treatments (or ways to soothe) you find helpful, and how you would differentiate this from measles or chickenpox.  For example, my little one has blisters all over her body, not just H-F-M.  ...

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shutterstock_239583778 There was once a woman whom I met for the first time when she came to the ER, on death's door, metaphorically. I told her and her family just how seriously ill she was, and how slim the chances of survival. We all agreed on that day to take a shot at it -- at survival, that is -- despite lousy ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman is evaluated for redness that developed over her right leg at the site of a mosquito bite. She is otherwise healthy and takes no medications. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 120/70 mm Hg, pulse rate is 70/min, and respiration rate is 14/min. There ...

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