A Case of Multidrug-Resistant (MDR) Tuberculosis and HIV Co-Infection.

Pulmonary tuberculosis (TB) infection is a public health concern in the United States. Mycobacterium tuberculosisantimicrobial resistance is a global public health concern. We present a case of a young man from Venezuela who presented to a hospital in New York and was newly diagnosed with pulmonary tuberculosis, human immunodeficiency virus (HIV), and syphilis. His TB isolate was found to be resistant to multiple anti-TB drugs, presenting unusual challenges in treating multidrug-resistant TB with HIV co-infection.

Adverse events of subcutaneous loop recorders: Insights from the MAUDE database.

BACKGROUND: Complications using internal cardiac monitors (ICM) have been reported at a low rate. Targeted analyses of complications have not been well described in the literature. OBJECTIVE: To investigate and describe complications associated with ICM events reported to the FDA's Manufacturer and User Facility Device Experience (MAUDE) database. METHODS: Our team reviewed all reported events for the Reveal LINQ loop recorder submitted to the MAUDE database over 7 years (1/1/2013-12/31/2019). A 5% random selection of reports was audited by two researchers to ensure report validity. Two cardiologists manually reviewed death and incongruent events for final interpretation. RESULTS: 12,652 records were obtained during the observed time period. A total of 15,587 device complications were reported. Of this, undersensing (n = 4509, 28.93%), premature discharge of battery (n = 3262, 20.93%), oversensing (n = 2788, 17.89%), and other sensing issues (n = 1532, 9.83%) were most commonly reported. Patient adverse events were reported 1,030 times. Pain or discomfort (n = 275, 26.70%), site infection (n = 213, 20.68%), erosion (n = 138, 13.40%), and impaired healing (n = 49, 4.76%) were most commonly reported to affect patients. Death was reported four times; after expert review, no reports justified the device or procedure as a reasonable cause. CONCLUSION: Several non-life-threatening ICM complications were commonly noted from the analysis. This study supports the safe use of ICMs. A better understanding of the complication profile will help providers select patients, provide informed consent, and expected management.

Blastomyces dermatitidis: Antibody Detection in Sera from Dogs with Blastomycosis with Yeast Lysate Antigens Produced from Human and Dog Isolates.

Dogs are common hosts to the fungal organism Blastomyces dermatitidis, which causes the systemic disease blastomycosis. The goal of our study was to compare the reactivity of two B. dermatitidis yeast lysate antigens prepared from dog isolates (ERC-2, Wisconsin; T-58, Tennessee) and two lysate antigens prepared from human isolates (B5931 and B5896, Minnesota) against 48 serum specimens from dogs with confirmed blastomycosis using the indirect enzyme-linked immunosorbent assay (ELISA). Secondarily, we used three different ELISA substrates (Ultra TMB: A, SureBlue: B, and SureBlue Reserve: C) to compare the effectiveness of each substrate. Mean absorbance values ranged from 0.446 (B) to 0.651 (C) for the B5931 antigen and from 0.393 (B) to 0.540 (C) for the ERC-2 antigen in Trial 1. In Trial 2, the absorbance values ranged from 0.628 (B) to 0.909 (A) for the B5896 antigen and from 0.828 (B) to 1.375 (C) for the T-58 antigen. In Trial 1, the lysate antigen prepared from the human isolate B5931 exhibited the highest absorbance value and in Trial 2 the lysate prepared from the dog isolate T-58 was the most reactive. The overall results thus indicated that the T-58 lysate was the optimal reagent when used to detect antibody with the Sure-Blue Reserve substrate. Our laboratory is continuing to study B. dermatitidis antigen and substrate combinations for the reliable immunodiagnosis of blastomycosis in humans and animals.