Update in Infectious Diseases

• Communicable disease
• Drug resistance, microbial
• Human immunodeficiency virus infections
• Hepatitis C
• West Nile virus

Antibiotic resistance, particularly affecting gram-positive cocci such as penicillin-resistant Pneumococcus species and vancomycin-resistant Enterococcus species, is among the hottest topics in the field of infectious disease. This Update describes current treatment recommendations, focusing on pharyngitis, sinusitis, bronchitis, and pneumonia. Among emerging infections, one of the most threatening is that caused by West Nile virus. New aspects of established infectious agents are also addressed, such as the use of neuraminidase inhibitors to treat influenza and long-term outcomes of hepatitis C virus infection and Lyme disease. The subject of HIV and AIDS continues to command attention. Studies in this area have looked at treatment options based on stage of illness, heterosexual HIV transmission, and nevirapine therapy to prevent perinatal transmission, among other topics.

Two examples from the field of infectious diseases in the past year demonstrate the increasing role of nontraditional forms of communicating medical information. First, a report in the New York Times(1) described isolation of the SEN virus, which is a proposed cause of transfusion-associated hepatitis not attributable to known agents and may account for many cases of unexplained chronic liver disease. The virus was discovered at a biomedical research center in Italy and has not been described in the medical literature because of a pending patent. The investigator was advised by corporate lawyers that he had to wait a full year before submitting a detailed scientific report on the virus, including evidence of causality. Second, the Internet is increasingly being used to present timely and clinically relevant information, which ultimately may be peer-reviewed and appear in print. A recent example is a meta-analysis of studies from the past three decades on the antibiotic treatment of …