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The drug rifabutin may prevent Mycobacterium avium (M. avium) complex infections in some AIDS patients. This infection strikes many AIDS patients and causes considerable complications. Researchers evaluated the effectiveness of rifabutin in preventing M. avium complex infections in two studies. All the patients studied had AIDS and CD4 cell counts less than 200 per cubic millimeter. A total of 1,146 patients were randomized to take either 300 milligram of rifabutin each day or a placebo, or inactive substance. They were followed for several years. In both studies, only 8% to 9% of the patients taking rifabutin developed an M. avium complex infection, compared to 17% to 18% of those taking a placebo. Survival rates were essentially similar in the two studies.

AIDS patients who have completed treatment for cryptococcal meningitis may have less risk of a relapse if they are subsequently treated with fluconazole rather than amphotericin B. Cryptococcal meningitis is an inflammation of the brain and spinal cord caused by infection with the fungus Cryptococcus neoformans. Out of 189 AIDS patients successfully treated for cryptococcal meningitis, 78 received an intravenous infusion of one milligram (mg) of amphotericin B per kilogram (kg) of body weight once a week, and 111 received 200 mg of fluconazole a day by mouth. Patients were followed for an average of 286 days. Two patients (2%) who received fluconazole had a relapse of cryptococcal disease during treatment, compared to 14 patients (18%) treated with amphotericin B. Patients in the fluconazole group had a lower risk of relapse one year after starting treatment than those in the amphotericin B group. Patients treated with amphotericin B had more drug-related side effects and bacterial infections than patients treated with fluconazole.

The article presents a case study of a 57-year-old man with a history of diabetes mellitus and psoriasis who complaint of malaise, perianal papule and occasional bright red blood per rectum.

Background: Prevention of surgical site infections is critical in deep brain stimulation (DBS). In the present study, we tested the ability of a self-administered preoperative alcohol-based (70% ethyl alcohol) preparation to reduce the rate of postoperative infection after DBS surgery., Methods: This Institutional Review Board-approved retrospective review was conducted at our institution between January 2005 and October 2007 (mean follow-up, 23 months). The participants comprised a consecutive sample of 172 patients with movement disorders who underwent DBS surgery at our institution. Starting in January 2007, all patients were required to use the alcohol-based preparation. These patients (n = 48) were instructed to self-administer the wash on the night before surgery and the morning of surgery. Before this time, no self-administered wash was used (n = 122)., Results: There was no difference in preoperative skin cleansing between the 2 groups, and all patients received intravenous antibiotics immediately before and after surgery for 24 hours. We compared the rate of postoperative infection in the 2 groups and reviewed other possible factors underlying infection. We found 11 cases of infection (6.47%), all in the group without the preoperative antiseptic wash. The infection rate was 9.02% in the group without the preoperative wash and 0 in the group with the preoperative wash (P < .029). There was no difference between the 2 groups in terms of mean age, duration of operative procedure, or number of microelectrode tracts attempted., Conclusions: Our results support the incorporation of this self-administered antiseptic wash into our standard antiseptic protocol for patients undergoing DBS surgery., (Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)