Tag Archives: infection

Antibiotics for treatment of bilateral leg swelling or redness

Updated guidelines from the American Academy of Dermatology does not recommend routine use of antibiotics for the treatment of bilateral swelling and redness of the legs  unless there is clear evidence of infection.

Don’t routinely use antibiotics to treat bilateral swelling and redness of the lower leg unless there is clear evidence of infection

Most cases of bilateral leg swelling are due to venous insufficiency.

Enterovirus D68 update

Enterovirus D68 (EV-D68) is one of many non-polio enteroviruses. Enterovirus D68 (EV-D68) infections are thought to occur less commonly than infections with other enteroviruses. EV-D68 was first identified in California in 1962. Compared with other enteroviruses, EV-D68 has been rarely reported in the United States for the last 40 years.

EV-D68 Infections Reported

Hospitals in Missouri and Illinois are seeing more children than usual with severe respiratory illness caused by enterovirus D68. Several other states are investigating clusters of children with severe respiratory illness, possibly due to enterovirus D68. CDC is watching this situation closely and helping the states with testing of specimens.


EV-D68 has been reported to cause mild to severe respiratory illness. However, the full spectrum of EV-D68 illness is not well-defined.


EV-D68 is not frequently identified, so it is less studied and the ways it spreads are not as well-understood as other enteroviruses. EV-D68 causes respiratory illness, and the virus can be found in respiratory secretions such as saliva, nasal mucus, or sputum. The virus likely spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.


  • There is no specific treatment for EV-D68 infections.
  • Many infections will be mild and self-limited, requiring only treatment of the symptoms.
  • Some people with severe respiratory illness caused by EV-D68 may need to be hospitalized and receive intensive supportive therapy.
  • No antiviral medications are currently available for treating of EV-D68 infections.


  • There are no vaccines for preventing EV-D68 infections.
  • You can help protect yourself from respiratory illnesses by following these steps:
  • Wash hands often with soap and water for 20 seconds, especially after changing diapers
  • Avoid touching eyes, nose and mouth with unwashed hands
  • Avoid kissing, hugging, and sharing cups or eating utensils with people who are sick
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick

Laboratory Testing

Test to be ordered is “Enterovirus Molecular by PCR” from  ARUP .  Will be a Miscellaneous test in Paragon. 

Specimen: Respiratory-bronch wash, BAL, Nasopharyngeal aspirate, sputum or tracheal aspirate.  Volume is 1.5ml.


Salmonella Typhimurium: JPXX01.0146 cases in Northern Illinois

This is a memo from the McHenry County Health Department:

This memo is to update McHenry County healthcare providers of an ongoing investigation of an outbreak of Salmonella Typhimurium with the same fingerprint of JPXX0.0146 by the McHenry County Department of Health (MCDH) in cooperation with Lake, Kane, and Cook counties as well as the Illinois Department of Public Health. Continue reading

Notice to Public Health Officials and Clinicians: Recognizing, Managing, and Reporting Chikungunya Virus Infections in Travelers Returning from the Caribbean


On December 7, 2013, the World Health Organization (WHO) reported the first local (autochthonous) transmission of chikungunya virus in the Americas. As of December 12th, 10 cases of chikungunya have been confirmed in patients who reside on the French side of St. Martin in the Caribbean. Laboratory testing is pending on additional suspected cases. Onset of illness for confirmed cases was between October 15 and December 4. At this time, there are no reports of other suspected chikungunya cases outside St. Martin. However, further spread to other countries in the region is possible. Continue reading

cluster of staphylococcus aureus

Wounds: when and how to culture them

Wound cultures are important to assist in the diagnosis of infection in a wound. An improperly collected they can create more problems than solve by:

  • Making an inaccurate diagnosis – calling a case a surgical site infection when it is not
  • Leading to unecessary admission, treatment and potential side effects and complications of treatment

Continue reading

Use of PCV7 vaccination reduces invasive pneumococcal disease – NEJM

Since the introduction of 7-valent pneumoccal vaccine (PCV 7) in the US immunization schedule there has been a steady decline in the number of invasive pneumococcal disease as reported in the July 11th issue of the New England Journal of Medicine by Griffen et al.
The annual rate of hospitalization for pneumonia among children younger than 2 years of age declined by 551.1 per 100,000 children (95% confidence interval [CI], 445.1 to 657.1), which translates to 47,000 fewer hospitalizations annually than expected on the basis of the rates before PCV7 was introduced. The rate for adults 85 years of age or older declined by 1300.8 per 100,000 (95% CI, 984.0 to 1617.6), which translates to 73,000 fewer hospitalizations annually. For the three age groups of 18 to 39 years, 65 to 74 years, and 75 to 84 years, the annual rate of hospitalization for pneumonia declined by 8.4 per 100,000 (95% CI, 0.6 to 16.2), 85.3 per 100,000 (95% CI, 7.0 to 163.6), and 359.8 per 100,000 (95% CI, 199.6 to 520.0), respectively. Overall, we estimated an age-adjusted annual reduction of 54.8 per 100,000 (95% CI, 41.0 to 68.5), or 168,000 fewer hospitalizations for pneumonia annually. [1]


  1. CDC parental guide to pneumococcal vaccination
  2. CDC vaccine information statement