Biofilm, Bacteria and Darwinism


The antibiotics era is approximately sixty years old and though antibiotics have life-saving properties there has been concern about the over use of antibiotics creating resistance making it nearly impossible to treat infections in the future because infectious bacteria will be resistant to conventional antibiotic therapy.

The main focus of resistant antibiotic development is antibiotic stewardship, in other words using antibiotics for appropriate bacterial infections and not just CYA (Cover You’re a$$) for the viral infection being seen in the urgent care setting. Another focus of antibiotic resistance is to reduce transmission from patient to patient in the hospital setting by using strict isolating techniques depending on the organism and the site of infection. Continue reading Biofilm, Bacteria and Darwinism

What is the Zika Virus?

         How Did the Zika Virus Get Here?

by Dr. Andrew Pugliese

           The Zika virus epidemic is a perfect example of how pandemic can start. It was originally described in Uganda back in the late 40’s and in the last 70 years has now made its way to the Southern United States. Florida has now declared a Zika state of emergency because of nine reported cases. It is spread by mosquitoes like other viruses such as Dengue and Yellow Fever, but, there have been documented cases of the virus being sexually transmitted. The disease itself is not life threatening and mild, unless you’re pregnant then there is the potential for microcephaly to occur through mother to baby transmission. That’s the scary part, because there is no vaccine at this time. Continue reading What is the Zika Virus?

Biofilm and Lyme Disease: Guerrilla Warfare

Lyme Disease, Biofilm, POTS and Choline Deficiency

by Dr. Andrew Pugliese

       Here are four topics that exist separately, yet may be interconnected and may lead to the reason why many chronic Lyme Disease sufferers need prolonged and aggressive therapies. As always, we must remember that Lyme disease does not behave in a conventional manner, because it is not a conventional microorganism. In Raphael B. Stricker’s 2007 article “Counterpoint: Long Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease” published in Clinical Infectious Diseases, he wrote how Borrelia burgdoferi has 21 plasmids. Continue reading Biofilm and Lyme Disease: Guerrilla Warfare

Understanding Chronic Bacterial Prostatitis

Tools to Create a Better Diagnosis for Prostatitis

by Dr. Andrew Pugliese

        Chronic prostatitis is divided into two major categories; chronic bacterial prostatitis and chronic non-bacterial prostatitis. According to the literature, chronic bacterial prostatitis is a rare condition, and that bacteria is found in only 5% of the patients with symptoms of chronic prostatitis. Antibiotic therapy is usually a fluroquinolone like Cipro or Levaquin. Another antibiotic used in chronic bacterial prostatitis is Bactrim. This is based on what is usually cultured from the prostatic secretions which are mostly gram negative enteric, such as E. coli and Enterobacter.   If there is no response to antibiotic therapy, then muscle relaxers or alpha blockers are recommended for symptomatic relief. Continue reading Understanding Chronic Bacterial Prostatitis

Life with Common Variable Immune Deficiency

Indisposed But Not Inanimate

Guest Post by Cat Latuszek

           There are a lot of questions I get asked on a frequent basis, the most common (and least insulting) of which is “how do you do it?

            I will readily admit that it’s a far cry from the “how are you even still alive?” question I felt like my immunologist was asking me on a daily basis for a week in June of 2014. What started out as my getting fed up with recurring ear infections, sinus infections and pneumonia had ended in a scratch test that showed I was allergic to absolutely nothing and an immunoglobulin panel that showed undetectable levels of IgG, IgA and IgM. Further blood testing also revealed that I had a severe B cell deficiency and what little was there was all in a premature state. The “how are you even still alive?” question was answered by the fact I had a pretty high T-cell count, the only part of my adaptive immune system that was even still working and its level was possibly due to the fact I was rocking my sixth ear infection in six months when the blood was drawn. Continue reading Life with Common Variable Immune Deficiency

Hypersomnia, Narcolepsy’s Cousin

Why Work-Ups are so Critical for Proper Diagnosis

by Dr. Andrew Pugliese

           Several months back a college senior came to see me because of excessive fatigue and sleepiness. It appeared that, as she got older, her symptoms worsened to the point where she was involved in a car accident because she nodded off while driving and rear-ended the vehicle in front of her. In addition, she was having difficulty at work and had fallen asleep while on the phone with co-workers and clients. Continue reading Hypersomnia, Narcolepsy’s Cousin

There’s a Fungus Among Us

Interaction Between Fungus & Bacteria

A Case of Scedosporium apiospermum

by Dr. Andrew Pugliese

        A 64 year-old otherwise healthy woman underwent a nasal spetoplasty in April of this year and soon afterwards developed a hematoma that progressed to an abscess. Despite multiple debridements and several courses of oral antibiotics, the abscess progressively worsened. Several cultures revealed only normal oropharyngeal flora. The last culture done showed Scedosporium apiospermum, a saprophytic fungus that has become increasing involved in causing soft tissue infections in humans especially those who are immunocompromised or have some other underlying illness. Continue reading There’s a Fungus Among Us

Overuse of Antibiotics Can Cause Infection

Understanding the Risks Behind an Infection is so Critical

How a Kluyvera ascorbata UTI was Developed

by Dr. Andrew Pugliese

             Several weeks back an OB/GYN colleague called me about one of her patients with a very unique problem. She saw a young woman with a documented Urinary Tract Infection (UTI) who was not responding to oral treatment. The reason for no response was that the woman’s infection was due to Kluyvera ascorbata and that there were no oral antibiotics sensitive to this particular organism. It was, however, sensitive to ceftriaxone and the patient responded very well to IV treatment. Continue reading Overuse of Antibiotics Can Cause Infection

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