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Nancy F Crum

Publications and source records attributed to Nancy F Crum.

44 records · Page 3Linked to original sources
PubMed2003

Correlates of human herpesvirus-8 seropositivity among U.S. military members recently infected with human immunodeficiency virus.

BACKGROUND: Human herpesvirus 8 (HHV-8), the cause of Kaposi's sarcoma, is common among HIV-infected persons. The exact route of transmission of HHV-8 in various populations is still debated. GOAL: The goal was to define the correlates of HHV-8 infection among men recently infected with human immunodeficiency virus. STUDY DESIGN: Three hundred forty-two HIV-infected U.S. military men were evaluated using a questionnaire regarding potential risk factors and laboratory data, including HHV-8, herpes simplex virus 2 (HSV-2), syphilis, hepatitis B, and hepatitis C serologies. RESULTS: The seroprevalence of HHV-8 was 32%. HHV-8 was significantly associated with hepatitis B seropositivity (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.5-4.1), and black ethnicity was negatively associated with HHV-8 (OR, 0.6; 95% CI, 0.3-0.9) in the multivariate analysis. HHV-8 was not associated with drug use or hepatitis C seropositivity. Among men who have sex with men (MSM), HHV-8 infection correlated with hepatitis B seropositivity (OR, 2.2; 95% CI, 1.1-4.3) and HSV-2 (OR, 2.6; 95% CI, 1.4-4.9). Among heterosexuals, the correlates of HHV-8 were different; blacks as compared with whites (OR, 0.3; 95% CI, 0.1-0.8) and married versus single status (OR, 0.4; 95% CI, 0.2-0.9) were associated with a lower rate of HHV-8 infection. Among heterosexuals, hepatitis B, HSV-2, and sexual behaviors were not associated with HHV-8. CONCLUSION: This study suggests that the seroprevalence of HHV-8 is increased in both MSM and heterosexual men with HIV infection, and that the route(s) of HHV-8 acquisition might be different between MSM and heterosexuals.

Adolescent↗
PubMed2003

A cluster of disseminated coccidioidomycosis cases at a US military hospital.

We recently evaluated a cluster of cases of disseminated coccidioidomycosis referred to the Naval Medical Center San Diego. Between March and June of 2002, seven cases were diagnosed and treated. In a 5-year record review (March 1997-February 2002), we found only seven cases of disseminated disease attributable to Coccidioides immitis at the same institution. This report of seven cases over a 3-month period represents a 20-fold increase in the number of complicated C. immitis infections. All cases were non-Caucasians, had disseminated disease to bone and/or skin without meningeal involvement, and had a delay of 1.5 to 6 months from symptom onset until the diagnosis of coccidioidomycosis. Four of our cases occurred in previously healthy, young active duty members, emphasizing the importance of this mycosis in U.S. military personnel.

Adolescent↗
PubMed2003

Sweet's syndrome masquerading as facial cellulitis.

Sweet's syndrome, or acute febrile neutrophilic dermatosis, is a cutaneous condition that typically occurs as tender red plaques or nodules. However, atypical presentations may occur and, in our case, Sweet's syndrome masqueraded as facial cellulitis and soft tissue infections of the extremities in a sporotrichoid pattern. Despite treatment with broad-spectrum antibiotics, the cutaneous lesions progressed. Results of skin biopsy specimens of the facial plaque and a nodule on the right upper extremity were diagnostic of Sweet's syndrome. Simultaneous to diagnosis, the patient also was found to have acute myelogenous leukemia (AML).

Antineoplastic Agents↗
PubMed2002

Update on Listeria monocytogenes infection.

Listeria monocytogenes is a gram-positive bacillus that causes meningitis, encephalitis, bacteremia, and febrile gastroenteritis. Most disease occurs in immunosuppressed individuals. Recent seroepidemiologic studies show that the infection is foodborne. Due to the increasing number of immunosuppressed individuals at risk for listeriosis, as well as the persistence of substantial foodborne outbreaks, L. monocytogenes has gained worldwide attention as an important pathogen. Heightened surveillance and quality control by the food industry have been instituted, leading to a reduction in the number of cases and deaths from this infection in the past decade. However, due to the ubiquity of the organism in the environment, outbreaks and sporadic disease continue to occur. The standard therapy for listeriosis is a combination of ampicillin and gentamicin or, for patients who are intolerant of b-lactam agents, trimethoprim-sulfamethazole. Despite the availability of therapy, the mortality rate remains high in those with T-cell immunodeficiencies.

Adult↗
PubMed2002

Stenotrophomonas maltophilia endocarditis.

Stenotrophomonas maltophilia is a gram-negative bacillus that is increasingly associated with serious nosocomial infections, especially in immunocompromised patients; however, the occurrence of endocarditis due to this organism is rare. This report describes a case of S. maltophilia endocarditis associated with a central venous catheter. The literature on Stenotrophomonas endocarditis is reviewed. Given the high morbidity and mortality of these infections, early antibiotic therapy utilizing trimethoprim-sulfamethoxazole, along with a second agent and removal of prosthetic devices, is recommended.

Drug Therapy, Combination↗
PubMed2002

Group A streptococcal toxic shock syndrome developing in the third trimester of pregnancy.

BACKGROUND: Group A streptococcal (GAS) toxic shock syndrome (TSS) is an uncommon, but life-threatening infection during pregnancy and should be considered in rapid onset of shock. Most cases described in the literature have occurred in the puerperium. We report a case of GAS TSS occurring during the third trimester of pregnancy in a previously healthy woman. CASE: A 31-year-old female, who was 34 weeks pregnant, presented with fevers and a prodromal 'flu-like' illness. She rapidly developed shock and multiorgan failure. Blood cultures revealed GAS bacteremia and the patient met criteria for streptococcal TSS. Despite her eventual recovery, her infant died on postpartum day 15 as a consequence of the mother's TSS. CONCLUSIONS: This case is unusual in that there were no identifiable initiating events or source of the streptococcal infection, and the TSS developed during pregnancy rather than after delivery. Early recognition of GAS infections is important given the rapid onset and high morbidity and mortality associated with these infections. This is the first reported case utilizing intravenous immunoglobulin for GAS TSS in the puerperium.

Adult↗