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Public discourse concerning current vaccination recommendations has dramatically increased. The current battle is not new, having had a lengthy foreshadowing during the 19th and early 20th centuries. Over a 30-year period, a concerted effort to limit the use of smallpox vaccine grew at the very time typhoid vaccines were being developed and advocated for widespread prevention. As a long time advocate for widespread smallpox vaccination and a supporter of the newly tested typhoid vaccine, Sir William Osler entered the public debate at the beginning of World War I. Osler was asked to address the officers and men in the British army on the need for typhoid vaccination. His speech entitled "Bacilli and Bullets" outlined the medical reasons for getting inoculated against typhoid. Osler's strong support for typhoid vaccination of the British troops was met by opposition in Parliament but not by most of the troops. Osler's arguments in support of vaccination failed to respond to the concept of "conscientious objection," which was central to the antivaccinationists' argument. Similar arguments are being propounded by current antivaccination groups. [ABSTRACT FROM AUTHOR]

We report a case of candidemia associated with manipulation of the common bile duct during endoscopic retrograde cholangiopancreatography. The patient had received parenteral nutrition and prolonged antibiotic therapy before the procedure and before Candida tropicalis was grown from blood cultures. Antifungal therapy resulted in clinical response.