November 3, 2020

Anaplasmosis

Epidemiology Incidence:
  • Overall annual incidence rose from 1.4 to 6.1 cases per million in the United States between 2000 and 2010 (Ismail 2017)
  • In endemic areas, the incidence rate is suggested to be more than 50 cases per 100,000 (Ismail 2017)
Age:
  • Median age is 51 years of age with greater than 95% of cases reported in Caucasian patients (Ismail 2017)
Gender:
  • Slight male to female predominance (Demma 2006)

November 2, 2020

Tick Borne Illness Tick-borne disease surveillance studies have shown increasing prevalence, transmission, and disease burden over the last decade. Tick-borne illnesses remain a public health threat and the true incidence remains unknown and is thought to be underrepresented. Although Lyme Disease is the most frequently reported tick-borne disease in the United States, the incidence of four other tick-borne diseases is noted to be increasing in the United States:
  1. Anaplasmosis (Nov 3rd, 2020)
  2. Ehrlichiosis (Nov 4th, 2020)
  3. Rocky Mountain Spotted Fever (Nov 5th, 2020)
  4. Babesiosis (Nov 6th, 2020)
In this five-part post, we will review the salient features of these other emerging tick-borne illnesses to increase recognition of these disease entities. This overview will serve to lay a foundation and summarize shared features of tick-borne illnesses prior to diving into each specific disease.

October 28, 2020

Take Home Points
  • Measles is highly infective: One infected person can infect approximately 10-20 unvaccinated people
  • 2 doses of MMR is 97% protective
  • Unvaccinated people can acquire measles from travel to endemic areas with low vaccination rates
  • There is a large amount of misinformation on the internet
  • Misinformation uses fear based messaging and the power of story
  • The evidence is overwhelming > 23,000,000 patients showing no evidence of any link between autism and MMR
  • Anecdotes are not evidence but vulnerable patients may be more susceptible to story then statistics
  • We should add anecdote as a tool to counsel patients

October 19, 2020

Background: Spontaneous coronary artery dissection (SCAD), once thought of as a rare “zebra” diagnosis that was universally fatal, is now being increasingly recognized as a cause of acute coronary syndrome (ACS), particularly in women due to increased vigilance, greater utilization of coronary angiography and advanced imaging. Despite these advances, SCAD still remains one of the most enigmatic syndromes in cardiology. It carries a high misdiagnosis and mistreatment rate with lack of consensus on investigation or treatment. Here we review the salient features of SCAD to increase awareness of this disease entity and further our understanding of this unique disease process.

October 14, 2020

Take Home Points
  • Trauma resulting in a retrobulbar hemorrhage can lead to orbital compartment syndrome which is a vision threatening injury
  • Diagnosis is made clinically based on the presence of an afferent pupillary defect, vision loss and an intraocular pressure > 40 mm Hg
  • Treatment is with a lateral canthotomy - a simple but mentally daunting procedure