Fatal dual infection with Salmonella and Mycobacterium avium complex infection in a patient with advanced acquired immunodeficiency syndrome: a case report

Non-typhoid Salmonella and Mycobacterium avium complex infections are part of the constellation of infections seen with increasing frequency in patients with acquired immuned deficiency syndrome. The incidence has reduced significantly since highly active antiretroviral therapy era, but their critical nature is unchanged. The co-existence of these infections and the accompanied increased mortality is presented in this case report

A curious case of Lyme carditis in an urban hospital

Lyme carditis (LC), a manifestation of early disseminated Lyme disease, most commonly presents with cardiac conduction abnormalities. It is a transient condition with good prognosis but in extremely rare cases may be life-threatening. We describe a 42-year-old man who presented with progressively worsening generalized weakness, presyncope and dyspnea on exertion for 2 weeks after sustaining a tick bite. He subsequently developed a ‘bull’s eye rash’ on his flank 2 days before his presentation. He was found to have symptomatic third-degree AV conduction blockade with a ventricular escape rhythm resulting in a brief cardiac arrest. Intravenous (IV) ceftriaxone was commenced empirically and a temporary transvenous pacemaker was placed. In a few days he showed dramatic, rapid improvement; the pacemaker was removed, and the patient was discharged on oral doxycycline to complete a 24-day course. This case is unique due to its occurrence in an urban hospital where such cases are uncommon. Cardiac arrest, although brief in this case, is a rare occurrence. Lyme carditis was a surprise diagnosis in our hospital due to the patient’s geographical dislocation during the COVID-19 pandemic

Corticosteroids as adjunctive therapy for pneumocystis pneumonia in patients with aids

To the Editor: The National Institutes of Health (NIH)—University of California Expert Panel has concluded (Nov. 22 issue)1 that early adjunctive corticosteroid therapy benefits patients with moderate-to-severe Pneumocystis carinii pneumonia. The consensus panel has recommended the regimen used by the California Collaborative Treatment Group, which provides an initial daily dose of 80 mg of oral prednisone, tapered to 20 mg during a 21-day course.2 An alternative approach, not studied in any of the recent trials, was used by my colleagues and me in one of the early reports of successful adjunctive corticosteroid therapy for P. carinii pneumonia.3 Three patients had. © 1991, Massachusetts Medical Society. All rights reserved.SCOPUS: le.jinfo:eu-repo/semantics/publishe