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Correspondence
Relationship between Cerebrospinal Fluid Glucose and Serum Glucose
To the Editor: Levels of glucose in the cerebrospinal fluid (CSF) are used to discriminate bacterial meningitis from viral meningitis. Children with bacterial meningitis typically have low levels of CSF glucose because of glycolysis by both white cells and the pathogen and impaired CSF glucose…
- February 9, 2012
- N Engl J Med 2012; 366:576 - 578
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The relationship between levels of serum and cerebrospinal fluid glucose in children is carefully examined in this study, which included more than 19,000 children.
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Perspective
The Emerging Threat of Untreatable Gonococcal Infection
It is time to sound the alarm. During the past 3 years, the wily gonococcus has become less susceptible to our last line of antimicrobial defense, threatening our ability to cure gonorrhea and prevent severe sequelae. Gonorrhea is the second most commonly reported communicable disease in the United…
- February 9, 2012
- Bolan G.A., Sparling P.F., Wasserheit J.N.
- N Engl J Med 2012; 366:485 - 487
Gonorrhea, which disproportionately affects marginalized populations, is the second most commonly reported communicable disease in the United States. Over the past 3 years, the gonococcus has shown decreased susceptibility to our last line of antimicrobial defense.
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Correspondence
Staphylococcus aureus Reactivation Osteomyelitis after 75 Years
To the Editor: In 1934, a 10-year-old girl was hospitalized at the Children's Hospital of Boston for 1 1/2 years for Staphylococcus aureus osteomyelitis of the left femur. This was the preantibiotic era, so she did not receive any antibiotic therapy at that time but, instead, underwent multiple…
- February 2, 2012
- N Engl J Med 2012; 366:481 - 482
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In this case report, Staphylococcus aureus was found to persist in an 85-year-old woman 75 years after the successful treatment of osteomyelitis during her childhood.
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Case Records of the Massachusetts General Hospital
Case 3-2012 — A Newborn Boy with Vomiting, Diarrhea, and Abdominal Distention
Presentation of Case. Dr. Rebecca C. Bell (Pediatrics): A 6-day-old boy was admitted to this hospital because of vomiting, diarrhea, and abdominal distention. The patient was born at another hospital to a teenaged primigravida by vaginal delivery after a full-term, uncomplicated gestation. The…
- January 26, 2012
- Melendez E., Goldstein A.M., Sagar P., Badizadegan K.
- N Engl J Med 2012; 366:361 - 372
A 6-day-old boy was admitted to the hospital because of vomiting, diarrhea, and abdominal distention, which had begun earlier that day and worsened. On admission, he showed signs of sepsis. Imaging showed narrowing of the rectosigmoid colon.
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Clinical Implications of Basic Research
Diet and Intestinal Immunity
"You are what you eat." A couple of recent studies underscore the relevance of this adage to the immune system. New studies by Kiss et al. and Li et al. show how certain dietary components derived from vegetables interact with intestinal immune receptors and thereby regulate the organogenesis of…
- January 12, 2012
- Tilg H.
- N Engl J Med 2012; 366:181 - 183
Cruciform vegetables may be critical to intestinal health and immunity. It turns out that these vegetables contain ligands of the aryl hydrogen receptor which, when bound, turn on genes that mediate intestinal immune defense.
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Images in Clinical Medicine
Madura Foot
Figure 1.
- January 5, 2012
- Pickert A.J. and Nguyen X.
- N Engl J Med 2012; 366:e2
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A woman was referred to the dermatology department for evaluation of swelling and nodules in the right foot, which had been present for 11 years. The nodules were painful, drained material periodically, and made weight-bearing difficult.
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Special Article
The Relationship between Hospital Admission Rates and Rehospitalizations
Unplanned readmissions after hospitalization are costly and reflect suboptimal patient outcomes. Policymakers have focused on reducing readmissions as a way to both lower costs and improve outcomes. Evidence of suboptimal care at hospital discharge and shortly thereafter, has prompted clinical…
- December 15, 2011
- Epstein A.M., Jha A.K., Orav E.J.
- N Engl J Med 2011; 365:2287 - 2295
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Hospital readmission rates are thought to reflect the quality of transitional care. In this study, readmission rates for congestive heart failure and pneumonia were associated with overall hospitalization rates. Interventions may best be focused on reducing incentives to use hospital services.
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Clinical Implications of Basic Research
Suppressing Immunosuppression after Stroke
Pneumonia is a major cause of death after acute cerebral ischemia. A recent study by Wong and colleagues provides some insight into susceptibility to infection after stroke. Specifically, they found that infections after stroke are promoted by noradrenergic-mediated dysfunction of a small subset of…
- December 1, 2011
- Meisel C. and Meisel A.
- N Engl J Med 2011; 365:2134 - 2136
There is growing evidence that acute injury of the central nervous system, including stroke, impairs the immune system. A recent study implicates the postischemic activation of a particular type of lymphocyte, by noradrenergic signaling, as a mediator of impairment.
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Case Records of the Massachusetts General Hospital
Case 35-2011 — A 33-Year-Old Woman with Postpartum Leukocytosis and Gram-Positive Bacteremia
Presentation of Case. Dr. Edwin C. Huang (Obstetrics and Gynecology): A 33-year-old woman was admitted to the intensive care unit (ICU) at this hospital 16.5 hours post partum because of leukocytosis and gram-positive rods in the blood. The patient had received routine prenatal care at this…
- November 17, 2011
- Soper D.E., Lee S.I., Kim J.Y., McDonald A.G.
- N Engl J Med 2011; 365:1916 - 1924
- CME
A 33-year-old woman was admitted to the ICU 16.5 hours post partum because of leukocytosis and gram-positive rods in the blood. Diagnostic test results were received, and management decisions were made.
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Editorial
Deconstructing a Lethal Foodborne Epidemic
Beginning in early May 2011, northern Germany was the principal site of a massive epidemic of bloody diarrhea and the hemolytic–uremic syndrome caused by Shiga-toxin–producing Escherichia coli. By the time the outbreak ended in early July, there were reports of more than 4000 illnesses, 800…
- November 10, 2011
- Blaser M.J.
- N Engl J Med 2011; 365:1835 - 1836
Beginning in early May 2011, northern Germany was the principal site of a massive epidemic of bloody diarrhea and the hemolytic–uremic syndrome caused by Shiga-toxin–producing Escherichia coli. By the time the outbreak ended in early July, there were ...
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Original Article
German Outbreak of Escherichia coli O104:H4 Associated with Sprouts
Human infection with Shiga-toxin–producing Escherichia coli is a major cause of postdiarrheal hemolytic–uremic syndrome. This life-threatening disorder, which is characterized by acute renal failure, hemolytic anemia, and thrombocytopenia, typically affects children under the age of 5 years.…
- November 10, 2011
- Buchholz U., Bernard H., Werber D., et al.
- N Engl J Med 2011; 365:1763 - 1770
In May 2011, an outbreak of the hemolytic–uremic syndrome associated with Shiga-toxin–producing Escherichia coli O104:H4 occurred in northern Germany. In this report, the investigation identified sprouts as the likely transmission vehicle.
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Original Article
Epidemic Profile of Shiga-Toxin–Producing Escherichia coli O104:H4 Outbreak in Germany
On May 19, 2011, the Robert Koch Institute, Germany's national-level public health authority, was informed about a cluster of three cases of the hemolytic–uremic syndrome in children admitted on the same day to the university hospital in the city of Hamburg. On May 20, a team from the Robert Koch…
- November 10, 2011
- Frank C., Werber D., Cramer J.P., et al.
- N Engl J Med 2011; 365:1771 - 1780
An epidemic of foodborne infection with Escherichia coli associated with a high rate of the hemolytic–uremic syndrome and caused by a novel E. coli strain (O104:H4) recently occurred in Germany. This final report updates epidemiologic, clinical, and microbiologic information.
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Original Article
Host and Pathogen Factors for Clostridium difficile Infection and Colonization
Clostridium difficile is the leading cause of health care–associated infectious diarrhea. After exposure to C. difficile, some patients remain asymptomatic, whereas others have illness ranging from mild diarrhea to fulminant colitis. Outbreaks of C. difficile infection in North America and Europe…
- November 3, 2011
- Loo V.G., Bourgault A.-M., Poirier L., et al.
- N Engl J Med 2011; 365:1693 - 1703
- CME
In this prospective cohort study of patients admitted to hospitals in Quebec and Ontario, 2.8% of patients had Clostridium difficile infection and 3.0% had asymptomatic C. difficile colonization during hospitalization. Most patients with C. difficile infection had the NAP1 strain.
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Original Article
Treatment of Neonatal Sepsis with Intravenous Immune Globulin
Infection is a major cause of death in newborn infants. Neonatal infection and inflammation are associated with serious complications, including brain damage and disability, particularly among preterm infants.– Polyvalent IgG immune globulin may help to prevent or treat infection, particularly in…
- September 29, 2011
- The INIS Collaborative Group
- N Engl J Med 2011; 365:1201 - 1211
The potential role of IV immune globulin in the management of neonatal sepsis has been suggested by several retrospective studies. In this international study involving 3493 infants with sepsis, IV immune globulin was not found to have any clinical benefit.
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Original Article
Genetic Basis for In Vivo Daptomycin Resistance in Enterococci
The treatment of enterococcal infections has become an enormous challenge for clinicians because these organisms frequently exhibit resistance to the standard drugs of choice — namely, ampicillin, vancomycin, and aminoglycosides (with high-level resistance to aminoglycosides). In addition, there…
- September 8, 2011
- Arias C.A., Panesso D., McGrath D.M., et al.
- N Engl J Med 2011; 365:892 - 900
Daptomycin is a novel antimicrobial agent with activity against vancomycin-resistant enterococci. In this report, the authors elucidate the mechanism of resistance to daptomycin by vancomycin-resistant enterococci and show that it is related to genetic alterations.
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Editorial
What Has Kept the Antibiotic Miracle Alive?
Being a germ isn't easy. Bacteria need tightly scripted genomes orchestrating precise functions to compete in a crowded microbial world. A lone strain may infect a sterile site in a bigger organism and escape competition, but it may then attract a lethal host response and antibiotic therapy. The…
- September 8, 2011
- O'Brien T.F.
- N Engl J Med 2011; 365:953 - 955
Being a germ isn't easy. Bacteria need tightly scripted genomes orchestrating precise functions to compete in a crowded microbial world. A lone strain may infect a sterile site in a bigger organism and escape competition, but it may then attract a lethal ...
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Clinical Practice
Care of the Adult Patient after Sexual Assault
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage. A 20-year-old…
- September 1, 2011
- Linden J.A.
- N Engl J Med 2011; 365:834 - 841
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- CME
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This article reviews the treatment of patients presenting for care after sexual assault, including guidance for evidence collection in case of prosecution, psychological support for the victim, and prevention of pregnancy and sexually transmitted infections.
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Original Article
Brief Report: Open-Source Genomic Analysis of Shiga-Toxin–Producing E. coli O104:H4
Escherichia coli is a widespread commensal of the mammalian gut and a versatile pathogen. Enterovirulent strains of E. coli are classified into a number of overlapping pathotypes, which include Shiga-toxin–producing, enterohemorrhagic, and enteroaggregative varieties. Enteroaggregative E. coli…
- August 25, 2011
- Rohde H., Qin J., Cui Y., et al.
- N Engl J Med 2011; 365:718 - 724
The authors sequenced the genome of an isolate of E. coli obtained from a German girl with bloody diarrhea and shared the data online with other researchers, facilitating rapid assembly of the genome.
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Original Article
Origins of the E. coli Strain Causing an Outbreak of Hemolytic–Uremic Syndrome in Germany
In early May 2011, an outbreak of diarrhea with associated hemolytic–uremic syndrome began in northern Germany; cases have subsequently been reported in 15 other countries. As of July 22, a total of 3167 cases of non–hemolytic–uremic syndrome Shiga-toxin–producing Escherichia coli (16…
- August 25, 2011
- Rasko D.A., Webster D.R., Sahl J.W., et al.
- N Engl J Med 2011; 365:709 - 717
- Interactive/Multimedia
The authors sequenced the genome of an isolate of the E. coli strain causing the outbreak of bloody diarrhea and the hemolytic–uremic syndrome (HUS) in Germany. This genome differed from those of other O104:H4 enteroaggregative E. coli known to cause diarrhea but not HUS.
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Original Article
Azithromycin for Prevention of Exacerbations of COPD
Acute exacerbations of chronic obstructive pulmonary disease (COPD) result in frequent visits to physicians' offices and emergency rooms and numerous hospitalizations and days lost from work; they also account for a substantial percentage of the cost of treating COPD.– Patients who have acute…
- August 25, 2011
- Albert R.K., Connett J., Bailey W.C., et al.
- N Engl J Med 2011; 365:689 - 698
- CME
Exacerbations of chronic obstructive pulmonary disease (COPD) are a source of substantial morbidity. In this randomized, controlled trial involving patients with moderately severe COPD, daily treatment with azithromycin for 1 year was associated with fewer exacerbations.
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Medical Meetings Conferences and Meetings

American Association for the Study of Liver Diseases

The following courses will be offered in Atlanta, unless otherwise indicated: "Hepatitis Single Topic Conference: HCV Direct Antiviral Agents (DAA): Concepts, Development and Optimal Use" (March 16 and 17); "The Henry M. and Lillian Stratton Basic Research Single Topic Conference: Mitochondria and Hepatotoxicity" (June 8 and 9); "Clinical Research Single Topic Conference: Acetaminophen Poisoning" (June 9 and 10); and "63rd Annual Meeting of the American Association for the Study of Liver Diseases: The Liver Meeting 2012" (Boston, Nov. 9-13).

Contact AASLD, 1001 North Fairfax St., Suite 400, Alexandria, VA 22314; or call (703) 299-9766; or see http://www.aasld.org .

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Browse Bacterial Infections

Showing 1 to 20 of 1467 Articles

Filter Results

Relationship between Cerebrospinal Fluid Glucose and Serum Glucose

The Emerging Threat of Untreatable Gonococcal Infection

Staphylococcus aureus Reactivation Osteomyelitis after 75 Years

Case 3-2012 — A Newborn Boy with Vomiting, Diarrhea, and Abdominal Distention

Diet and Intestinal Immunity

Madura Foot

The Relationship between Hospital Admission Rates and Rehospitalizations

Suppressing Immunosuppression after Stroke

Case 35-2011 — A 33-Year-Old Woman with Postpartum Leukocytosis and Gram-Positive Bacteremia

Deconstructing a Lethal Foodborne Epidemic

German Outbreak of Escherichia coli O104:H4 Associated with Sprouts

Epidemic Profile of Shiga-Toxin–Producing Escherichia coli O104:H4 Outbreak in Germany

Host and Pathogen Factors for Clostridium difficile Infection and Colonization

Treatment of Neonatal Sepsis with Intravenous Immune Globulin

Genetic Basis for In Vivo Daptomycin Resistance in Enterococci

What Has Kept the Antibiotic Miracle Alive?

Care of the Adult Patient after Sexual Assault

Brief Report: Open-Source Genomic Analysis of Shiga-Toxin–Producing E. coli O104:H4

Origins of the E. coli Strain Causing an Outbreak of Hemolytic–Uremic Syndrome in Germany

Azithromycin for Prevention of Exacerbations of COPD

Medical Meetings Conferences and Meetings

American Association for the Study of Liver Diseases

Trends: Most Viewed (Last Week)