Infectious Disease

CASE PRESENTATION
Mrs. H was a pleasant 93-year-old African-American woman who presented to her primary care physician for fatigue, pruritis, and weight loss of 40 pounds over 6-8 months. Her medical history included depression, hypertension, arthritis, stroke, and diverticulitis. At the time of her presentation, her medications included paroxetine, hydrochlorothiazide, and aspirin. Mrs. H’s physician did an extensive work-up that revealed a positive HIV enzyme-linked immunosorbent assay (ELISA) and positive rapid plasma reagin (RPR) and venereal disease research laboratory (VDRL) t...

Aging is associated with a decline in function of many body systems, including the urinary tract. Bacteria seem to gain an advantage within the urinary tract of the elderly, and it is not uncommon to find bacteriuria; however, not all of these patients have a true urinary tract infection (UTI). UTI is considered to be the most common infection among the elderly1-3 and the most common cause of bacteremia,4 but patients with bacteriuria who can clearly communicate the absence of urinary tract symptoms have asymptomatic bacteriuria (ASB) and do not require treatment. The prevalence of ASB incr...

INTRODUCTION
Influenza, a lower respiratory tract infection caused by influenza viruses infecting ciliated cells, is associated with up to 300,000 hospitalizations annually in the United States.1 The disease occurs in epidemics in both hemispheres during winter months, but summertime outbreaks do exist.2 Persons with chronic illness and those in long-term care (LTC) settings are at increased risk for complications, including secondary pneumonia.3 Influenza and pneumonia consistently rank as a leading cause of death, of which about 90% of victims are over 64 ye

INTRODUCTION
Influenza is a very common respiratory illness. It usually occurs in 15-25% of the world’s human population each year.1-3 This illness typically has a low death rate, with average overall mortality rates of 0.1% or less. However, influenza carries much higher rates of morbidity and mortality in the elderly and other vulnerable populations,2-5 and thus it is of special interest to geriatricians and public health physicians.

Influenza epidemics have been well documented since Buonissequi described the “grande influenza” in 1357.6 At least 31 influenza pandemic...

Educational Objectives
1. To identify risk factors associated with the development of UTI in older women
2. To understand the management of asymptomatic bacteriuria
3. To be able to recommend antimicrobial treatment for UTI in older women
4. To understand the major side effects and drug interactions associated with antimicrobials used to treat UTI

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkin...