Digital Commons Network^™

Nirsevimab Effectiveness Against Intensive Care Unit Admission For Respiratory Syncytial Virus In Infants - 24 States, December 2024-April 2025, Laura D. Zambrano, Regina M. Simeone, Margaret M. Newhams, Amanda B. Payne, Natasha B. Halasa, Amber O. Orzel-Lockwood, Jemima M. Calixte, Satoshi Kamidani, Hillary Crandall, Melissa A. Cameron, Jennifer E. Schuster, Aline B. Maddux, Kathleen Chiotos, Katherine Irby, Steven L. Shein, Mary Allen Staat, Lora M. Martin, Samina S. Bhumbra, Ryan A. Nofziger, Jigar C. Chauhan, Danielle M. Zerr, Shira J. Gertz, Judith A. Guzman-Cottrill, Michele Kong, Janet R. Hume, Bria M. Coates, Kelly N. Michelson, Tamara T. Bradford, Et Al

School of Medicine Faculty Publications

Respiratory syncytial virus (RSV) is a leading cause of intensive care unit (ICU) admission and respiratory failure among infants (children aged < year) in the United States. In August 2023, CDC’s Advisory Committee on Immunization Practices recommended nirsevimab, a long-acting monoclonal antibody, to protect against RSV-associated lower respiratory tract infection among all infants aged < 8 months born during or entering their first RSV season. Following licensure, nirsevimab effectiveness has been demonstrated against RSV-associated infant hospitalization, but evidence regarding effectiveness against RSV-associated critical illness is limited. In a 27-hospital case-control investigation, nirsevimab effectiveness against both RSV-associated infant ICU admission and acute respiratory failure (illness requiring continuous positive airway pressure, bilevel positive airway pressure, or invasive mechanical ventilation) after hospital admission was evaluated during December 1, 2024-April 15, 2025. Among 457 case-patients who received a positive RSV test result and 302 control patients who received a negative RSV test result admitted to an ICU with respiratory symptoms, 14% and 45%, respectively, had received nirsevimab ≥ 7 days before symptom onset. Nirsevimab was 80% effective (95% CI = 70%-86%) against RSV-associated ICU admission and 83% effective (95% CI = 74%-90%) against acute respiratory failure when received a median of 52 days (IQR = 32-89 days) and 50 days (IQR = 32-86 days) before onset for each respective endpoint. These estimates support the recommendation for use of nirsevimab as a prevention strategy to protect infants against severe outcomes from RSV infection.

Alcohol Use Disorder, Kendall Walker, James Mcnary, Hamilton Farris

School of Medicine Faculty Publications

No abstract provided.

Providencia Rettgeri As An Unusual Pathogen In Diabetic Foot Osteomyelitis: A Case Report And Literature Review, Stephanie N. Campbell, Madeleine Mehaffey, Nikita Gambhir, Amanda L. Killeen

School of Podiatric Medicine Publications

Providencia rettgeri is a Gram-negative bacterium, rarely reported as a cause of diabetic wound infections. Its frequent resistance to β-lactams and carbapenems limits treatment options, especially in immunocompromised patients. We present the case of a 59-year-old unhoused male living with diabetes, peripheral artery disease, and prior bilateral transmetatarsal amputations who presented with a University of Texas 3B diabetic foot ulcer. Magnetic resonance imaging showed osteomyelitis of metatarsals 2–4, and bone biopsy grew Providencia rettgeri and Proteus mirabilis. The patient declined further surgery and was treated with 6 weeks of cefepime and metronidazole, with outpatient wound care, achieving wound closure …

Hpv Prevention In Men: A Narrative Review Of Strategies, Risks, And Public Health Implications, Martin S. Lipsky, Bayler Gunnell, Justin Nguyen, Samantha Lee, Geo Wolfe, Man Hung

Institute on Aging Publications

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, impacting both males and females. In men, HPV causes genital warts, more than 90% of anal cancers, and 60% of oropharyngeal cancers. Given that one in three men are infected with HPV worldwide, there is a pressing need for enhanced public health strategies focusing on prevention. This comprehensive narrative review presents an overview of HPV in men, key risk factors, and primary prevention in men. The most effective preventive measure for HPV in males is vaccination. Males at high risk for HPV include those who smoke, have human immunodeficiency …

Unveiling The Clinical Profiles Of Critically Ill Covid-19 Patients: Insights From Ezhou During The Early Spread, Guohui Yang, Zewen Liu, Tabitha Abraham, Linwei Li, Tingyang Zhou, Qing Zhang, Li Zuo

School of Medicine Publications

The coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan. This article evaluated clinical characteristics, and imaging manifestations in Ezhou, an early locked-down city, 80 kilometers east of Wuhan. We analyzed data from 98 confirmed severe COVID-19 patients in Ezhou Central Hospital between February 1st and March 22nd, 2020. We compared patients' laboratory results, imaging manifestations, and treatments between survival and death groups. Of these 98 confirmed COVID-19 patients, 24 individuals (24.6%) had chronic diseases. The main symptoms of critically ill patients were fever (86.7%), cough (83.7%), and dyspnea (59.1%). Common complications were acute respiratory distress syndrome (ARDS; 49%), …

Sex Differences In Cardiovascular Disease And Associatedfactors In People Living With Hiv: Evidence From All Of Us Program, Hao Zhang, Huiyi Xia, Fanghui Shi, Qingyang Li, Sharon Weissman, Xiaoming Li Ph.D., Xueying Yang

Faculty Publications

Background

People living with HIV (PLWH) face a higher risk of cardiovascular disease (CVD), with significant sex differences in outcomes. However, it is unclear whether these differences are driven by distinct risk factor profiles or by a differential impact of shared risk factors. This study aimed to identify factors associated with CVD among PLWH and to specifically assess for effect modification by sex using a large, diverse nationwide database.

Methods

We utilized data from the All of Us Research Program (AoU). The primary outcome was a composite of coronary artery disease or stroke. We used multivariable logistic regression to identify …

Infection And Nonunion Rates In Open Fractures, Roman M. Natoli, Lucas S. Marchand, Sofia Bzovsky, Jennifer E. Hagen, Mark J. Gage, Christina A. Stennett, Nathan N. O’Hara, Kyle J. Jeray, Brad Petrisor, Sheila Sprague, Gerard P. Slobogean, Jeffrey Wells, Mohit Bhandari, Anthony D. Harris, C. Daniel Mullins, Lehana Thabane, Amber Wood, Gregory J. Della Rocca, Joan Hebden, Lyndsay M. O’Hara, Robert Zura, Christopher Lee, Joseph Patterson, Michael J. Gardner, Jenna Blasman, Jonah Davies, Stephen Liang, Monica Taljaard, The Flow Investigators, The Prep-It Investigators

Orthopaedic Surgery Faculty Publications

Background: Infection and nonunion are common sequelae of open fractures. Studies have shown infection and nonunion rates ranging from 2% to 52% and 12% to 17%, respectively. The present article describes the rates of surgical site infection (SSI) and delayed union/nonunion following open fractures in a large contemporary series of patients from prospective clinical trials with adjudicated outcomes. Methods: A descriptive analysis was performed with use of patient data from the FLOW, Aqueous-PREP, and PREPARE-Open studies. These studies, published within the past 10 years, included multiple international trauma centers and shared definitions for SSI and delayed union/nonunion. SSI and delayed …

Infection And Nonunion Rates In Open Fractures: Description Of 6,042 Fractures From The Flow And Prep-It Trials, Roman M Natoli, Lucas S Marchand, Sofia Bzovsky, Jennifer E Hagen, Mark J Gage, Christina A Stennett, Nathan N O'Hara, Kyle J Jeray, Brad Petrisor, Sheila Sprague, Gerard P Slobogean

Faculty, Staff and Student Publications

Background: Infection and nonunion are common sequelae of open fractures. Studies have shown infection and nonunion rates ranging from 2% to 52% and 12% to 17%, respectively. The present article describes the rates of surgical site infection (SSI) and delayed union/nonunion following open fractures in a large contemporary series of patients from prospective clinical trials with adjudicated outcomes.

Methods: A descriptive analysis was performed with use of patient data from the FLOW, Aqueous-PREP, and PREPARE-Open studies. These studies, published within the past 10 years, included multiple international trauma centers and shared definitions for SSI and delayed union/nonunion. SSI and delayed …

Gotta Have Somebody: Renal Health And Caregiving Experiences In Rural Florida, Danae Ayra-Barboza

Electronic Theses and Dissertations 2020 - Present

This thesis examines the dynamics of care in the Everglades Agricultural Area (EAA) using the care circle model to highlight common experiences and themes during chronic kidney disease (CKD) management. Combining the theoretical frameworks of structural violence, social suffering, and care allowed the analysis of caregiving dynamics in the EAA, a community distressed by a history of structural violence that manifests today as poverty, environmental pollution, inadequate education, and poor health outcomes. Thematic analysis synthesizing the experiences of the care circles identified four themes: Geographical, logical, and economic constraints to healthcare; Cultural, linguistic, and educational barriers; Informal and formal support …

Advancing Herbal Medicine: The Role Of Nanosomal Technology In Treating Skin Diseases, Pedro Anugerah Aswan, Baitha Palanggatan Maggadani, Wilzar Fachri, Raditya Iswandana

Pharmaceutical Sciences and Research

Herbal medicine has become popular worldwide, especially in developing countries, with around 80% of the population opting for herbal treatments. The perceived benefits of natural remedies, such as affordability and fewer side effects, drive this trend. Herbal therapies effectively manage skin diseases, infections, and common ailments. However, the absorption of bioactive compounds in herbal extracts is often limited. Recent developments in nano-based herbal delivery systems, like nanosomal, show promise in enhancing the efficacy of herbal remedies for topical applications, providing improved solubility, stability, and skin penetration. This review describes various nanosomal studies developed and successfully used to enhance the topical …

Campus Assembly Minutes 11/18 & 11/20/2025, Campus Assembly

Campus Assembly

No abstract provided.

A Week-Long Departmental Scholarship Curriculum For Pediatric Subspecialty Fellows, Amy Creel, Amanda Messer, Robin English

School of Medicine Faculty Publications

BACKGROUND: Scholarly activity is a key requirement in pediatric subspecialty fellowship training. However, clear guidance on how to effectively support fellows in their scholarly endeavors remains limited. OBJECTIVE: This study assesses the impact of a week-long departmental scholarship curriculum designed to enhance fellows' research competencies. METHODS: In 2024, a curriculum was designed and delivered to first-year pediatric subspecialty fellows over 5 days, combining group learning sessions with individualized tasks. Pre- and post-curriculum surveys assessed fellows' confidence and knowledge across key scholarly domains. Daily session evaluations provided additional feedback. Fourteen fellows from 9 pediatric subspecialty programs participated. RESULTS: All first-year fellows …

Staff Education To Reduce The Incidence Of Central Line Infections In The Pediatric Intensive Care Unit, Khldon Hassan Al-Omari

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) staff education project aimed to reduce the incidence of central line-associated bloodstream infections (CLABSI) in the Pediatric Intensive Care Unit (PICU) by educating clinical staff on the importance of hand hygiene and bundle compliance. Despite established guidelines, CLABSI remains a significant issue in healthcare, particularly in PICUs, where patients are at higher risk for infections. The practice-focused question guiding the project was: How does staff education on hand hygiene and CLABSI bundle compliance impact the prevention of CLABSI in the PICU? Twenty-five PICU nurses participated in the educational sessions. Analytical strategies included pretests and …

Ertapenem As An Antibiotic Prophylaxis For Colectomies And Laparotomies: A Systematic Review, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Beatriz Varman, Parker C Towns, Elias A Chamely, Renee W Green, William D Rieger, Susan H Wootton, Lillian S Kao

Library Staff Publications

Introduction: Given concerns for antibiotic resistance, broader spectrum antibiotic agents such as ertapenem are being used for pre-operative prophylaxis. We hypothesize that pre-operative ertapenem prior to laparotomies and colectomies is superior at decreasing surgical site infections (SSIs) compared with other widely used antibiotic agents.

Methods: Medline, Embase, the Cochrane Library, and Web of Science were queried for studies until February 02, 2025. Studies were excluded if they did not evaluate ertapenem as a pre-operative antibiotic prophylaxis in patients undergoing laparotomy or colectomy, the outcome was not SSIs, or it represented a review of prior publications. Three reviewers independently extracted relevant …

Ertapenem As An Antibiotic Prophylaxis For Colectomies And Laparotomies: A Systematic Review, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Beatriz Varman, Parker C Towns, Elias A Chamely, Renee W Green, William D Rieger, Susan H Wootton, Lillian S Kao

Library Staff Publications

Introduction: Given concerns for antibiotic resistance, broader spectrum antibiotic agents such as ertapenem are being used for pre-operative prophylaxis. We hypothesize that pre-operative ertapenem prior to laparotomies and colectomies is superior at decreasing surgical site infections (SSIs) compared with other widely used antibiotic agents.

Methods: Medline, Embase, the Cochrane Library, and Web of Science were queried for studies until February 02, 2025. Studies were excluded if they did not evaluate ertapenem as a pre-operative antibiotic prophylaxis in patients undergoing laparotomy or colectomy, the outcome was not SSIs, or it represented a review of prior publications. Three reviewers independently extracted relevant …

Be Faster Community Of Practice To Increase Rapid Initiation Of Antiretroviral Therapy In Houston, Texas: A Pre-Post Intervention Study, Naomi Sequeira, Bich N Dang, Melanie Goebel, Monisha Arya, Avishek Ghosh-Hajra, Kathryn Fergus, Shital M Patel

Faculty, Staff and Students Publications

Background: Rapid initiation of antiretroviral therapy (Rapid ART) is a key strategy of the Ending the HIV Epidemic (EHE) initiative. The Baylor College of Medicine Extension for Community Healthcare Outcomes (ECHO) Facilitating Antiretroviral Start Earlier (BE FASTER) program was developed to address this call-to-action. The program uses the ProjectECHO tele-mentoring model as an implementation tool in Harris County, a priority EHE jurisdiction. The authors present results on the acceptability and feasibility of the BE FASTER program.

Methods: Multidisciplinary health professionals from 5 Ryan White Part A funded agencies formed the community of practice. The BE FASTER program included 9 monthly …

From Urban Models To Rural Realities: Adapting Hepatitis C (Hcv) Care For Underserved Communities, Caitlin A. Mccain

2025 Fall Honors Capstones Projects - Archive

This literature review examines how Hepatitis C (HCV) screening and care programs can better serve underserved populations, particularly Spanish-speaking rural communities in border states. The research supports the Hep C- Colonias Advancing & Restoring Esperanza (C.A.R.E) program’s mission by incorporating recent findings from 32 studies gathered through PubMed, Medline and Google Scholar. Hep C C.A.R.E expanded from the HepVISTA expansion project provides HCV screening, education, vaccination and linkage to care for uninsured patients at partner sites in Laredo and Maverick County. Results indicate that while HCV elimination is feasible, significant gaps persist among rural uninsured and minority populations. Effective strategies …

The Daily Gamecock: November 2025, University Of South Carolina, Office Of Student Media

2025

No abstract provided.

Extensive Spinal Epidural Abscess Evacuated With Unilateral Interlaminar Approach (With Operative Video): Illustrative Case, George A. Crabill, Jack A. Leoni, Kaleb Derouen, Jamieson Glasser, Wesley Shoap, Gabriel Tender

School of Medicine Faculty Publications

BACKGROUND: The authors present the case of a patient with an extensive lumbosacral spinal epidural abscess (SEA) that was successfully evacuated in its entirety with a unilateral interlaminar approach. This is an alternative to wide bony decompression at multiple segments. The surgical approach described decompresses the neural elements while maintaining spinal integrity. OBSERVATIONS: Partial removal of the ligamentum flavum can provide an interlaminar corridor that is sufficient to evacuate extensive SEAs in select patients. LESSONS: This case illustrates a surgical approach that successfully evacuates extensive lumbosacral SEA while respecting spinal integrity. https://thejns.org/doi/abs/10.3171/CASE25646.

Multiomic Analysis Reveals A Key Bcat1 Role In Mtor Activation By B Cell Receptor And Tlr9, Rui Guo, Yizhe Sun, Matthew Y Lim, Hardik Shah, Joao A Paulo, Rahaman A Ahmed, Weixing Li, Yuchen Zhang, Haopeng Yang, Liang Wei Wang, Daniel Strebinger, Nicholas A Smith, Meng Li, Merrin Man Long Leong, Michael Lutchenkov, Jin Hua Liang, Zhixuan Li, Yin Wang, Rishi Puri, Ari Melnick, Michael R Green, John M Asara, Adonia E Papathanassiu, Duane R Wesemann, Steven P Gygi, Vamsi K Mootha, Benjamin E Gewurz

Faculty, Staff and Student Publications

B lymphocytes play major adaptive immune roles, producing antibodies and driving T cell responses. However, how immunometabolism networks support B cell activation and differentiation in response to distinct receptor stimuli remains incompletely understood. To gain insights, we systematically investigated acute primary human B cell transcriptional, translational, and metabolomic responses to B cell receptor (BCR), TLR9, CD40-ligand (CD40L), IL-4, or combinations thereof. T cell-independent BCR/TLR9 costimulation, which drives malignant and autoimmune B cell states, highly induced transaminase branched chain amino acid transaminase 1 (BCAT1), which localized to lysosomal membranes to support branched chain amino acid synthesis and mTORC1 activation. BCAT1 inhibition …

Application Of Freezetb, A Targeted Nanopore Sequencing Assay, For Identification Of Drug Resistance And Lineages Among Pulmonary Tuberculosis Cases In Alaska, Bryce Inman, Jeremy Butler, Soren George-Nichol, Ganna Kovalenko, Theresa Savidge, Yvette Vergnetti, Catherine Pongratz, Elizabeth Bee, Andrew R Dinardo, Alexander Kay, Anna Mandalakas, Eric Bortz, Tara E Ness

Faculty, Staff and Students Publications

Alaska has the highest incidence of tuberculosis (TB) in the United States, with 8% mortality while undergoing TB treatment. With a quarter of TB cases lacking sputum culture to enable drug resistance testing, FreezeTB aimed to develop tools tailored to meet the challenges in Alaska while being translatable to other settings. We designed a rapid and cost-effective laboratory workflow and software to identify drug-resistant mutations in Mycobacterium tuberculosis using targeted next-generation sequencing (tNGS). FreezeTB, a Fast, Reliable, Economical Evaluation tool to Zap Endemic Tuberculosis, amplifies 22 gene loci associated with resistance to 16 anti-tuberculosis drugs. M. tuberculosis isolates from Alaska …

Intouch Week Of November 17, 2025, New York Medical College

InTouch

• NYMC Celebrated Among 2025 Doctors of Distinction Honorees
• NYMC Receives Vibrant Mural Collection from Biagio “Gino” Civale
• Siqi You Selected as NYS Representative in the State of the States and AUCD Data Ambassador Program
• Graduate Student Association Welcomes a New Executive Board
• NYMC Public Health Students and Alumni Shine at APHA Conference
• EHS Hosts Multi-Agency Biosafety and WMD Tabletop Exercise
• NYMC and TU Set to Host Webinar Series: “Ninety Minutes: The Medical Magazine of the Web”
• Touro Dental Health’s 8th Annual Smiles for Veterans Day Sees More Veterans This Year Than Ever Before
• Student Spotlight: Rahim Hirani is the Recipient …

Microplastic Variability In Wetland Sediments And Vegetation: A Case Study Of Spruce Bluff Preserve, Fl, Juana Maria Baudrix

Electronic Theses and Dissertations 2020 - Present

Plastic pollution has become an imminent threat to the environment and human health. This study explores the occurrence, distribution, and retention mechanisms of microplastics (MPs) in Spruce Bluff Preserve, a 97-acre freshwater wetland ecosystem located along the eastern bank of the St. Lucie River in Port St. Lucie, FL. Understanding MP dynamics in transitional freshwater ecosystem is crucial for environmental management efforts given Florida’s heavily fragmented and managed landscape. This research specifically examined the relationship between wetland vegetation and MP retention in sediments across different ecological zones within the preserve. Surface sediment samples were collected along 8 transects of varying …

Intersectional Stigma And Resilience In The Uptake Of Cervical Cancer Prevention Services In Nigeria: A Qualitative Study, Agatha Eileen Wapmuk, Titilola Abike Gbaja-Biamila, Ekenechukwu Kokelu, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Cervical cancer is one of the leading causes of death among women in Africa, but stigma often delays cervical cancer prevention. We explore the perceptions, enablers and nurturers through the lens of intersectional stigma in the uptake of cervical cancer prevention services in Nigeria.

METHOD: Indepth interviews and focus group discussions were conducted among women aged 30-65 years and girls aged 9-26 years in Lagos, Nigeria. Data were analysed thematically. Using the relationships and expectation domain of the PEN-3 cultural model, we identified perceptions, enablers and nurturers related to the uptake of primary and secondary cervical cancer prevention services …

Antimicrobial Resistance And Transmission Risk Of Foodborne Escherichia Coli In Wet Markets, Sisi Li, Wei Zhou, Zhijin Zhou, Bin Wang, Chengjun Qiu, Zhangsheng Zhang, Qi Zhang, Yun Sun, Xu Xu, Tao Shen, Jianzhong Han, Daofeng Qu

Journal of Food Science and Biotechnology

[Objective ] To evaluate the antimicrobial resistance and transmission risk of foodborne Escherichia coli in wet markets,this study isolated E.coli from pork,aquatic products,vegetables,and wastewater collected from three wet markets in Hangzhou,Zhejiang.[Method ] The isolates were identified by 16S rRNA sequencing,and their antimicrobial resistance phenotypes were determined via the disk diffusion method.PCR was employed to detect antimicrobial resistance genes and integrons in the isolates.The antimicrobial resistance characteristics of E.coli were analyzed,and conjugation experiments were performed to assess the potential for horizontal transfer of antimicrobial resistance genes.Co-occurrence network analysis was conducted to evaluate the transmission risk of antimicrobial resistance among the isolates.[Result …

Alirocumab In Dexamethasone-Induced Metabolic Syndrome: Therapeutic Benefits And Potential Hepatic Risks Through Rxr-Α / P-Akt Modulation, Miad A. Aljuhani, Mohamed S. Abdel-Bakky

Saudi Toxicology Journal

Background: Metabolic syndrome (MetS) elevates the risk of developing cardi-ovascular diseases and type 2 diabetes., driven by insulin resistance (IR), inflammation, and metabolic dysregulation. The PI3K/AKT pathway shows a key part in glucose and lipid metabolism. Alirocumab, a PCSK9 inhibitor, lowers LDL-C and improves IR but may cause hepatotoxicity. Aims: This study examines ali-rocumab’s effects on dexamethasone-induced MetS in rats, focusing on its metabolic benefits and potential liver toxicity. Methods: Over 30 days, 40 male Albino rats were distributed into control, Alirocumab, Dexamethasone, and Dexa-methasone+Alirocumab groups, with the latter receiving Dexamethasone to induce metabolic syndrome followed by Alirocumab administration. Results: …

Forecasting Pediatric Emergency Department Arrivals: Evaluating The Role Of Exogenous Variables Using Deep Learning Models, Egbe Etu Etu, Jordan Larot, Kindness Etu, Joshua Emakhu, Sara Masoud, Imokhai Tenebe, Gaojian Huang, Satheesh Gunaga, Joseph Miller

Faculty Research, Scholarly, and Creative Activity

Background Forecasting pediatric emergency department (ED) demand remains a critical challenge in healthcare operations. This study aimed to identify exogenous variables influencing pediatric ED visits and evaluate the performance of different forecasting models. Method Using a retrospective observational design, we analyzed 192,347 pediatric ED visits across nine hospitals in Southeast Michigan between 2017 and 2019. Patient data were aggregated into daily arrival counts and enriched with exogenous variables such as weather, air quality, pollen, calendar, Google search trends, and chief complaints. Feature selection was performed using XGBoost and SHapley Additive exPlanations to identify the most influential predictors. Three forecasting models …

A Rare Case Of Spondylodiscitis Due To Actinotignum Schaalii In A Patient With Crohn’S Disease, Austin Tiesenga, Thomas R. , Birris, William Schreiner, David Malaka, Michael S. Wang

Journal of Community Hospital Internal Medicine Perspectives

We report a case of a 55-year-old male with a history of Crohn’s Disease who presented for acute on chronic worsening back pain. He was found to have spondylodiscitis with adjacent myositis secondary to an uncommon urinary tract infection pathogen, Actinotignum schaalii. He underwent an interventional radiology disc biopsy and open surgical biopsy with culture. He was successfully treated with a six-week course of IV daptomycin and ceftriaxone.

Bullous Myringitis In An Adult With Chronic Noise Exposure, Oluchi Ndulue, Faisal Elali, Sahibjot Sandhu, Michal Preis, Michael Marcelin

Journal of Community Hospital Internal Medicine Perspectives

Bullous Myringitis (BM) is an acute painful infection in which vesicles or bullae form on the tympanic membrane. It is rare in adults and could be present with acute otitis media (AOM) if the middle ear is involved. This case report details a 55-year-old male with a history of recurrent childhood ear infections, chronic military noise exposure, smoking, and Crohn’s disease presenting with severe right ear pain, hearing loss, and fever. Examination revealed signs of AOM with perforations in the tympanic membrane and purulent drainage. Initial management included antibiotics and analgesics, but symptoms progressed, requiring further investigation. Imaging showed complete …

A Not Too Fragile Bacteroides, Siddartha Guru, Nadim Jaafar, Rahul Sharma, Poonam Bai

Journal of Community Hospital Internal Medicine Perspectives

We present a rare case of Bacteroides fragilis vertebral osteomyelitis, in a 20-year-old female with no underlying medical conditions. She presented with a three-week history of lower back pain, myalgias, rigors, and night sweats. The patient was febrile and tachycardic, with borderline low blood pressures. Her initial labs showed elevated inflammatory markers with no leukocytosis. MRI of the thoracic and lumbar spine demonstrated T12/L1 discitis/osteomyelitis with phlegmonous changes and concerns for epidural abscess, causing mild to moderate spinal stenosis. Bacteroides fragilis grew in an anaerobic bottle, and a CT-guided biopsy of the T12/L1 lesion grew Bacteroides fragilis. E-test sensitivities revealed …