Mycobacterium mucogenicum bacteremia in an immunocompetent host: A case report and concise review.

Rapidly growing mycobacterium (RGM) bloodstream infections (BSI) have been described in the literature mostly in immunocompromised patients such as those with malignancies. Here, we describe a case of a RGM, Mycobacterium mucogenicum, bloodstream infection in an immunocompetent host who was receiving antibiotics via a peripherally inserted central catheter (PICC).

Progress toward the global control of Neisseria meningitidis: 21st century vaccines, current guidelines, and challenges for future vaccine development.

The control of meningitis, meningococcemia and other infections caused by Neisseria meningitidis is a significant global health challenge. Substantial progress has occurred in the last twenty years in meningococcal vaccine development and global implementation. Meningococcal protein-polysaccharide conjugate vaccines to serogroups A, C, W, and Y (modeled after the Haemophilus influenzae b conjugate vaccines) provide better duration of protection and immunologic memory, and overcome weak immune responses in infants and young children and hypo-responsive to repeated vaccine doses seen with polysaccharide vaccines. ACWY conjugate vaccines also interfere with transmission and reduce nasopharyngeal colonization, thus resulting in significant herd protection. Advances in serogroup B vaccine development have also occurred using conserved outer membrane proteins with or without OMV as vaccine targets. Challenges for meningococcal vaccine research remain including developing combination vaccines containing ACYW(X) and B, determining the ideal booster schedules for the conjugate and MenB vaccines, and addressing issues of waning effectiveness.

Cytomegalovirus prostatitis in a heart transplant recipient.

Cytomegalovirus (CMV) is the most common viral infection affecting the posttransplantation course of organ recipients. However, CMV involvement of the prostate even in immunocompromised hosts is rare. We describe the first case in the heart transplant literature of a 59-year-old heart recipient with CMV prostatitis. An elevated PSA prompted a prostate biopsy revealing an adenocarinoma, chronic prostatitis as well as viral cytopathic effect consistent with CMV infection. CMV PCR in the blood was negative. A few months prior, the patient developed CMV viremia and was treated initially with ganciclovir intravenously and subsequently with valganciclovir and CMV immunoglobulins. The patient did well with brachytherapy and additional anti-CMV agents. We discuss the role of CMV in the prostate and management of CMV prostatitis. Relationships between CMV, prostate cancer and heart transplantation are also outlined.

[Hirsutism]. / Hirsutisme.

Hirsutism is a common medical condition that can lead to major psychological and social distress. Patient's complaint is usually cosmetic in nature, but hirsutism can sometimes signal a serious underlying disorder. Detailed medical history and physical examination help identify patients in whom extensive work-up is warranted. Therapy that is directed at suppressing androgen secretion, inhibiting the conversion of testosterone to dihydrotestosterone, or blocking the effects of androgens on their receptors, can be rewarding both for the treating physician and the patient. This article reviews the different agents used against hirsutism and addresses the evolution of their indications based on published clinical studies.