- N Engl J Med 2022; 387:641-650
A 25-year-old woman was evaluated for worsening headaches, photophobia, nausea, vomiting, and blurred vision. MRI revealed hydrocephalus and leptomeningeal enhancement. CSF analysis revealed neutrophilic pleocytosis.
- N Engl J Med 2022; 387:261-269
A 34-year-old woman presented with hypercortisolism resulting from a metastatic pancreatic neuroendocrine tumor. Chest CT revealed patchy consolidation with cavitation and tree-in-bud opacities. Management decisions were made.
- N Engl J Med 2022; 386:1933-1944
A 57-year-old man with polyarteritis nodosa was evaluated for cough and pulmonary opacities. Chest CT revealed multifocal clustered centrilobular nodules and opacities in a tree-in-bud pattern. A galactomannan test was positive. Diagnostic tests were performed.
- N Engl J Med 2022; 386:e49
A 53-year-old landscaper presented with a 4-month history of red, raised, itchy skin lesions on his left lower back and buttock. On examination, numerous verrucous nodules and plaques with crusting were seen.
- N Engl J Med 2022; 386:1109-1120
Cryptococcal meningitis is a major complication of HIV infection. In this phase 3, randomized, controlled trial in sub-Saharan Africa, a single dose of liposomal amphotericin B induction therapy combined with fluconazole and flucytosine for cryptococcal meningitis was shown to be noninferior to standard induction therapy with amphotericin B deoxycholate and...
- N Engl J Med 2022; 386:1179-1181
Cryptococcal meningitis is one of the most common and serious human immunodeficiency virus (HIV)–related opportunistic infections among adults in sub-Saharan Africa, leading to an estimated 135,900 deaths every year.1 Under the best conditions, cryptococcal meningitis is a challenge to manage and involves high-quality medical and nursing care and...
- N Engl J Med 2022; 386:463-477
FUO despite a high-quality workup after a reasonable amount of time has elapsed to rule out self-limited fevers remains a challenge. The clinician must pay close attention to the patient history, aided by the development of molecular diagnostic tests, to distinguish infections from other causes.
- N Engl J Med 2021; 385:2077-2077
A 6-year-old boy presented with a rash on his scalp and hair loss. Areas of bright green fluorescence were seen on Wood’s lamp examination. Infection with Microsporum canis was identified on molecular testing.
- N Engl J Med 2021; 385:1995-2001
A 50-year-old woman with sarcoidosis presented with pain in the left upper quadrant and hypoxemia. The oxygen saturation was 85% while she was breathing ambient air, and crackles were present in both lungs. Chest radiography revealed consolidations in the middle and lower lobes with diffuse ground-glass opacities. A diagnostic test...
- N Engl J Med 2021; 385:1699-1699
A 49-year-old woman with a history of kidney transplantation presented with headache and umbilicated skin papules. Levels of cryptococcal antigen in the serum and cerebrospinal fluid were high. A skin biopsy was performed, and a diagnosis of disseminated cryptococcosis was confirmed.
- N Engl J Med 2021; 385:1496-1509
Aspergillosis is an opportunistic fungal infection that poses a particular risk for patients with neutrophil defects and causes diverse clinical syndromes. This review addresses our current understanding of aspergillosis and advances in diagnosis and treatment.
- N Engl J Med 2021; 385:1141-1143
This interactive feature about the treatment of endocarditis offers a case vignette accompanied by two essays supporting a full 6-week course of intravenous antibiotics or a switch from intravenous to oral antibiotics after several weeks.
- N Engl J Med 2021; 384:2317-2330
Patients with cirrhosis are at increased risk for serious infections, including spontaneous bacterial peritonitis, multidrug-resistant infection, and infection with gut microorganisms. In-hospital mortality exceeds 50%. Empirical antibiotic coverage is used until a precise diagnosis can be made.
- N Engl J Med 2021; 384:e95
A 53-year-old man presented with fever and sudden onset of lower-leg paralysis. Imaging revealed a 9-cm ascending aortic pseudoaneurysm and multiple arterial emboli. Cultures of intraoperative tissue grew the dematiaceous mold C. alcornii.
- N Engl J Med 2021; 384:e69
A 51-year-old woman who had undergone bone marrow transplantation presented with pleuritic pain. Lung imaging revealed an area of ground-glass opacity surrounded by consolidation. Bronchoalveolar lavage was performed, and a diagnosis of mucormycosis was made.
- N Engl J Med 2021; 384:1053-1053
Decreased urinary output developed in a 42-year-old man who was receiving trimethoprim–sulfamethoxazole for Pneumocystis jirovecii pneumonia. Urine microscopy revealed fan-shaped crystals. A diagnosis of sulfonamide-crystal–induced acute kidney injury was made.
- N Engl J Med 2020; 383:2572-2580
A 24-year-old man was admitted to the hospital with a 3-week history of headache and a positive test for SARS-CoV-2 RNA. MRI showed multiple small hyperintense foci in the caudate nuclei and putamina. On lumbar puncture, the opening pressure was higher than 55 cm of water; the CSF white-cell count...