- Coronavirus SARS-CoV1 infection (SARS)
Essential Evidence Topics, 30-Mar-2022
Overall Bottom Line: The most common presenting symptoms of the SARS-CoV1 in 2003 were fever, chills, myalgia, malaise, and cough. Test patients for SARS-CoV1 using PCR only if no other cause of pneumonia can be found 72 hours after starting a workup and - Coronavirus SARS-CoV2 infection (COVID-19)
Essential Evidence Topics, 7-Jan-2022
Overall Bottom Line: EDITOR'S NOTE: This topic has been made freely available and is being updated regularly. We are at times linking to preprint servers and providing direct links to articles where possible, and most of this literature has been made free - Creutzfeldt-Jakob disease
Essential Evidence Topics, 31-Dec-2021
Overall Bottom Line: Maintain a high clinical suspicion for Creutzfeldt-Jakob disease (CJD) in patients who have rapidly progressive dementia with ataxia, new vision or sensory complaints, and/or psychiatric symptoms. Diagnostic tests that can be perfor - Cryptococcal infection
Essential Evidence Topics, 8-Jul-2021
Overall Bottom Line: Suspect Cryptococcus infection in any HIV-positive or immunocompromised patient with meningitis. Cryptococcus can also cause disseminated disease, and isolated pneumonia. Obtain India ink stains, fungal CSF and blood cultures, cyt - Cryptosporidiosis
Essential Evidence Topics, 8-Jun-2021
Overall Bottom Line: Patients typically present with prolonged watery diarrhea. Direct fluorescent antigen detection, enzyme immunoassays, rapid antigen tests, and PCR are available diagnostic tests with good accuracy. Most immunocompetent patients re - Cyclospora
Essential Evidence Topics, 4-Oct-2021
Overall Bottom Line: Cyclospora cayetanensis is an uncommon cause of infectious diarrhea that should be considered in those with diarrhea during known outbreaks, who travel to endemic areas, or who are immunosuppressed with persistent diarrhea. Standar - Cytomegalovirus infection (adult and child)
Essential Evidence Topics, 27-Feb-2022
Overall Bottom Line: Order a strep test, monospot, and CBC in febrile patients with pharyngitis, adenopathy, and fatigue. Cytomegalovirus (CMV) may be asymptomatic or cause a mononucleosis-like syndrome in immunocompetent hosts. Most CMV infections in - Dengue fever
Essential Evidence Topics, 29-Dec-2021
Overall Bottom Line: DF is characterized by acute febrile illness of 2 to 7 days associated with headache, myalgias, rash, and capillary fragility. Dengue fever (DF) is self-limited, while dengue hemorrhagic fever (DHF) is distinguished by hemorrhagic m - Diphtheria
Essential Evidence Topics, 12-Jun-2019
Overall Bottom Line: Suspect diphtheria in patients with severe sore throat, difficulty swallowing, low-grade fever, and a grayish adherent membrane on the nasopharynx. If diphtheria is clinically suspected, take swabs of the nasopharynx and culture on - Ehrlichiosis
Essential Evidence Topics, 1-Mar-2021
Overall Bottom Line: Ehrlichiosis is a serious rickettsial disease transmitted by the lone star tick (Amblyomma americanum ) and the blacklegged tick (Ixodes scapularis); cases have been reported in most states. Early clinical diagnosis is difficult and - Encephalitis
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Suspect encephalitis in patients with acute onset of fever, mental status changes, and headache. CSF analysis is essential for diagnosis. All cases of suspected encephalitis should be treated with acyclovir while an etiology is be - Endocarditis
Essential Evidence Topics, 27-Apr-2021
Overall Bottom Line: Infective endocarditis (IE) should be suspected in a patient with bacteremia that has no clear source (especially if the patient has structural cardiac abnormalities, prosthetic valves, intravenous drug use, or intravenous catheters). - Entameba histolytica infection (amebiasis)
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Consider ordering a stool antigen test or stool PCR test for E. histolytica in patients with diarrhea and other risk factors (e.g., travel to endemic area). Treat symptomatic patients with tinidazole (preferred) or metronidazole to - Epidural abscess
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: Consider epidural abscess and obtain imaging in patients with back pain and fever or neurologic deficit. Obtain ESR and CRP for patients with back pain and risk factors (diabetes mellitus, IV drug use, indwelling catheter, recent sp - Fever of unknown origin
Essential Evidence Topics, 12-Aug-2019
Overall Bottom Line: Thorough history taking and continuous observation is extremely important; repeat history after the physical if there are no clues. Exclude factitious fever and drug-related fever first. Infections (extrapulmonary tuberculosis [TB - Foodborne illness
Essential Evidence Topics, 25-Oct-2021
Overall Bottom Line: In the developed world most episodes of food poisoning are self-limited. Stool cultures are recommended to identify specific pathogens in patients with prolonged or bloody diarrhea, severe dehydration, or systemic illness. Consult - Giardiasis
Essential Evidence Topics, 12-Jan-2021
Overall Bottom Line: Giardiasis is a protozoan infection that most commonly produces an acute or chronic diarrhea, but it may be asymptomatic. Microscopic identification of Giardia cysts or trophozoites is 90% sensitive if 3 stool samples are examined. - Hand, foot, and mouth disease
Essential Evidence Topics, 26-Jan-2022
Overall Bottom Line: Hand, foot, and mouth disease (HFMD) is an enteroviral infection characterized by typical oral lesions, fever, and rash. Consider HFMD in patients with a nonspecific prodrome, stomatitis, and vesicular rash involving the palms and s - Hansen's disease (leprosy)
Essential Evidence Topics, 23-Nov-2021
Overall Bottom Line: Leprosy is a leading cause of permanent physical disabilities due to communicable diseases. Household contacts should receive chemoprophylaxis with a single dose of rifampicin 600 mg. The diagnosis is clinical: definite loss of sen - Hantavirus infection
Essential Evidence Topics, 27-Feb-2022
Overall Bottom Line: Hantaviruses are a group of negative sense RNA viruses, each virus associated with a specific rodent reservoir. There are two main clinical syndromes: hantavirus cardiopulmonary syndrome (HCPS) and hemorrhagic fever with renal syndr
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