An immunocompromised patient with a history of multiple hip implant revisions extended courses of empiric antibiotic treatment, and a retained metallic rod in the femoral medullary canal was transferred for diagnostic studies and treatment. A high suspicion of fungal infection and utilization of extended and specific fungal cultures were the diagnostic keys for infection with Trichosporon inkin...

e22168 Background: CUP are an heterogeneous family of neoplasms with a dismal prognosis, with empiric chemotherapy as the recommended treatment. The aim of this study was to evaluate the feasibility of a 500-mRNA microarray to identify the tissue of origin in patients with CUP. METHODS Diagnostic biopsy formalin-fixed, paraffin-embedded (FFPE) specimens from 22 patients with CUP were prospect...

BACKGROUND Complicated skin and skin structure infections (cSSSIs) are a common reason for hospitalization. Inappropriate empiric therapy prolongs the hospital stay. Strategies that help clinicians target empiric therapy underlie antibiotic stewardship. We developed an algorithm to identify mixed (gram-positive+gram-negative organisms) cSSSI at hospital admission. METHODS We performed a retro...

BACKGROUND While the majority of healthcare in the US is provided in community hospitals, the epidemiology and treatment of bloodstream infections in this setting is unknown. METHODS AND FINDINGS We undertook this multicenter, retrospective cohort study to 1) describe the epidemiology of bloodstream infections (BSI) in a network of community hospitals and 2) determine risk factors for inappro...

This study describes vancomycin prescribing patterns in an average complexity hospital and compare the guidelines proposed by the Hospital Infection Control Practices Advisory Committee (HICPAC). The study was conducted in a 256-bed secondary-care hospital. Data were collected of all patients given vancomycin from March 2003 to February 2004, using a standardized chart-extraction form designed....

BACKGROUND Limited data exist on the effectiveness of ceftriaxone plus doxycycline in the treatment of patients hospitalized with community-acquired pneumonia (CAP). METHODS We performed a retrospective cohort study of all adults hospitalized for pneumonia between January 1999 and July 2001 at an academic medical center. Outcomes were compared for patients with CAP treated with ceftriaxone pl...

Cancer of unknown primary site is a common clinicopathologic syndrome representing a very heterogeneous group of patients with metastatic cancers and clinically undetectable primary tumor sites. The standard treatment for these patients for the last 15 years has been empiric "broad-spectrum" chemotherapy. In recent years, improved immunocytochemistry and the emergence of gene expression profili...