Illness and Diseases

C. difficile toxins may be the ultimate protection strategy against CDI. Both passive immunity with monoclonal antibodies and active vaccines are currently undergoing clinical trials involving humans. The use of 2 intravenously administered monoclonal antibodies directed against toxins A and B when added to standard CDI treatment with vancomycin or metronidazole in a phase 2 […]

More recently, whey protein in immunized cow’s milk, which contains high levels of secretory IgA, has been used clinically for CDI recurrence prevention and CDI primary treatment. Results remain inconclusive, because the CDI recurrence prevention trial (2 weeks of daily anti- C. difficile whey protein after standard CDI therapy) resulted in a recurrence rate of […]

Non‐antimicrobial, or “outside the box,” approaches to CDI treatment and prevention can be divided into 3 groups: intraluminal toxin binders or neutralizers, biotherapeutics to restore the protective microbiota, and antibodies (active and passive) to improve CDI immunity (Table 1). The attraction of these approaches is that they all avoid the continued suppression of normal bacterial […]

Intravenous tigecycline has been reported as an effective treatment for severe CDI in one small series (4 patients) and one case report. Tigecycline was used as adjunctive treatment for these patients who had failed to respond to metronidazole and vancomycin, or, in one case, tigecycline was used as primary treatment. Fecal concentrations of tigecycline may […]

Rifaximin has FDA approval for indications other than CDI but has also been used to treat CDI. Rifaximin was compared with vancomycin in a small study (20 patients) that showed comparable cure rates. Recently, rifaximin has been used as an adjunct agent to treat patients with multiple CDI recurrences. We used a 2‐week course of […]

Antimicrobials have been the agents of choice for treatment of Clostridium difficile infection (CDI) for >30 years, primarily metronidazole and vancomycin. Antimicrobials have been highly successful and are likely to continue to play a major role in the treatment of patients who already have CDI. However, there remain several areas of CDI treatment that are […]

To our knowledge, P. marneffei has never been described as a CNS pathogen. P. marneffei was isolated from the meninges of 1 patient in a review of 155 published penicilliosis cases and from 3 of 20 CSF specimens in a case series of 80 patients with penicilliosis from Thailand. However, the clinical features of those […]

Outcomes. Three patients survived and had experienced improvement of symptoms at hospital discharge, 1 was transferred to another hospital for tuberculosis treatment after his condition deteriorated, 12 died within 24–72 h after hospital admission, and 5 were taken from the hospital to die at home, which is common practice in Vietnam. Patients taken home to […]