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Cystitis: nitrofurantoin is now first line
eTG's 2025 Antibiotic update moved nitrofurantoin to first line for acute cystitis in adults, because so many E. coli are now resistant to trimethoprim. Fosfomycin is second line for non-pregnant women; trimethoprim is still an option if cost or supply gets in the way.
eTG Antibiotic (March 2025 update): Urinary tract infections in adultsThe Perth doctor who swallowed his hypothesis
In the early 1980s most doctors blamed peptic ulcers on stress. Barry Marshall drank a culture of the curved bacteria he and Robin Warren had found in stomach biopsies. A biopsy 10 days later showed gastritis, which then settled. The bug is now called Helicobacter pylori and causes most duodenal ulcers. Marshall and Warren shared the 2005 Nobel Prize.
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Marshall BJ et al. Med J Aust 1985;142:436–9; Nobel Prize in Physiology or Medicine 2005Under the 2025 eTG Antibiotic update, how should antibiotics be used for COPD exacerbations?
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eTG Antibiotic (March 2025 update): Respiratory infections other than pneumonia@scrollmed_etgInfectious Diseases
eTG Antibiotic (March 2025 update): Urinary tract infections in adults@scrollmed_etgInfectious Diseases
eTG Antibiotic (September 2025 update): Endocarditis prophylaxisPrions changed one population's genes
Kuru, a fatal prion disease, spread through mortuary feasts in the Papua New Guinea highlands. Cases fell once the practice stopped. A 2009 study of more than 3,000 people, co-led by Australian researcher Michael Alpers, found that survivors who had been exposed were mostly heterozygous at PRNP codon 129. It also found a new variant, G127V, only in the kuru region and never in people with kuru. It seems to protect against prion disease.
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Mead S et al. N Engl J Med 2009;361:2056–65@scrollmed_etgInfectious Diseases
eTG Antibiotic (December 2025 update): Traumatic woundsYour gut can brew its own alcohol
In auto-brewery syndrome, yeasts or bacteria in the gut ferment carbohydrates into ethanol. People can become drunk without drinking. They often deny alcohol and eat a diet high in sugar or carbohydrate. It is more common with diabetes, obesity and Crohn disease, but can happen in healthy people. Cases have even been described in the mouth and the bladder. It is probably underdiagnosed.
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Painter K, Cordell BJ, Sticco KL. Auto-Brewery Syndrome. StatPearls (NCBI Bookshelf)Under the 2025 eTG update, how should you assess the severity of community-acquired pneumonia in adults?
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eTG Antibiotic (March 2025 update): Community-acquired pneumoniaAn asymptomatic person has a positive HBsAg result. What is the appropriate approach?
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Australian STI Management Guidelines: Hepatitis B@scrollmed_auInfectious Diseases
healthdirect: Ross River virus infectionLeprosy does not spread by a handshake
A handshake, hug or shared meal does not transmit leprosy. Spread is linked to prolonged close contact with an untreated person, probably through respiratory droplets—not the casual contact that stigma often targets.
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WHO: LeprosyThe mosquito clue inside a stomach
In 1897, Ronald Ross found a stage of the malaria parasite in a mosquito's stomach after it fed on an infected person. The discovery helped establish the mosquito's role in malaria transmission.
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Nobel Prize: Ronald Ross, biographical facts@scrollmed_auInfectious Diseases
Australian STI Management Guidelines: Standard Asymptomatic Check-upWhen is pertussis vaccination preferably given during pregnancy?
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Australian Immunisation Handbook: PertussisSmallpox's last natural case
The final known naturally acquired smallpox case occurred in Somalia in 1977. WHO declared the disease eradicated in 1980—a global victory achieved through vaccination and surveillance.
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WHO: SmallpoxWhich addition to first-line treatment for intra-amniotic infection broadens anaerobic coverage in the December 2025 update?
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Therapeutic Guidelines: Antibiotic, December 2025 updateHow many HPV vaccine doses are recommended for an immunocompetent, previously unvaccinated 20-year-old?
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Australian Immunisation Handbook: Human papillomavirusRabies can hide behind a paralytic form
Rabies does not always cause the dramatic agitation associated with its name. Its paralytic form causes gradually developing muscle paralysis and can be misdiagnosed, contributing to under-reporting.
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WHO: RabiesA screening NAAT detects gonorrhoea. What additional specimen should be collected at the treatment visit?
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Australian STI Management Guidelines: Standard Asymptomatic Check-upFor moderate travellers' diarrhoea without increased complication risk, what does the March 2025 update advise?
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Therapeutic Guidelines: Antibiotic, March 2025 updateSoil microbes helped fight parasitic worms
A soil microorganism isolated by Satoshi Ōmura helped launch a major antiparasitic breakthrough. William Campbell identified the culture's activity against worms; the resulting avermectin work led to ivermectin.
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Nobel Prize 2015: Avermectin and artemisinin, scientific backgroundWhich statement best describes latent tuberculosis infection?
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healthdirect: TuberculosisPenicillin's Nobel was shared three ways
Penicillin's Nobel recognition was not Fleming's alone. The 1945 medicine prize was split equally between Alexander Fleming, Ernst Boris Chain and Howard Walter Florey for its discovery and therapeutic effects.
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Nobel Prize in Physiology or Medicine 1945@scrollmed_auInfectious Diseases
healthdirect: Murray Valley encephalitisA worm with no vaccine to defeat it
Guinea-worm eradication does not rely on a vaccine or a curative medicine: neither is available. Prevention instead targets transmission through safer drinking water, filtering water and keeping infected people from contaminating water sources.
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WHO: Dracunculiasis@scrollmed_auInfectious Diseases
ACSQHC: Antimicrobial Stewardship Clinical Care Standard@scrollmed_auInfectious Diseases
Australian Immunisation Handbook: Respiratory syncytial virus@scrollmed_etgInfectious Diseases
Therapeutic Guidelines: Antibiotic, September 2025 update@scrollmed_auInfectious Diseases
Australian STI Management Guidelines: Hepatitis B@scrollmed_etgInfectious Diseases
Therapeutic Guidelines: Antibiotic, March 2025 update@scrollmed_auInfectious Diseases
Australian Immunisation Handbook: Preparing for vaccination@scrollmed_etgInfectious Diseases
Therapeutic Guidelines: Antibiotic, March 2025 updateWhich treatment approach can cure almost all people with hepatitis C?
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Australian STI Management Guidelines: Hepatitis CAn infection can turn eyelashes inward
Repeated trachoma infections can scar the inner eyelid until the lashes turn inward and scrape the eye. This mechanical damage can injure the cornea and cause permanent sight loss.
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WHO: Trachoma@scrollmed_auInfectious Diseases
CDNA: Series of National Guidelines@scrollmed_auInfectious Diseases
Australian Immunisation Handbook: Catch-up vaccinationFor PPROM prophylaxis with amoxicillin or ampicillin, which macrolide is now an alternative to erythromycin?
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Therapeutic Guidelines: Antibiotic, December 2025 updateSyphilis has a childhood-disease cousin
The bacterium behind yaws is a close genetic relative of the syphilis organism. Yaws mainly affects children in tropical communities and spreads when infected lesions contact minor skin injuries.
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WHO: YawsWhich drug now ranks alongside flucloxacillin as first-line directed treatment for methicillin-susceptible S. aureus infection?
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Therapeutic Guidelines: Antibiotic, March 2025 updateFor vaginal chlamydia and gonorrhoea NAAT screening, which specimen is preferred over first-pass urine?
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Australian STI Management Guidelines: Standard Asymptomatic Check-upA weed behind a malaria breakthrough
Tu Youyou's investigation of traditional herbal remedies led her to sweet wormwood. In the 1970s, she extracted artemisinin, a substance that inhibits malaria parasites and became the basis of life-saving medicines.
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Nobel Prize: Tu Youyou, biographical facts@scrollmed_auInfectious Diseases
healthdirect: Japanese encephalitisWhich presentation is compatible with Buruli ulcer?
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healthdirect: Buruli ulcerWhich condition increases the risk of illness from melioidosis after environmental exposure?
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healthdirect: MelioidosisWhat is the recommended Shingrix schedule for an immunocompetent adult aged 60 years?
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Australian Immunisation Handbook: ZosterPork is not how brain cysts are acquired
Undercooked infected pork can give someone an intestinal Taenia solium tapeworm. Cysticercosis, including brain infection, instead follows swallowing the tapeworm's eggs through faecal contamination.
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WHO: Taeniasis/cysticercosisWhat is the usual route of Q fever transmission to humans?
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healthdirect: Q feverSyphilis is diagnosed during pregnancy. Which response is most appropriate?
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Australian STI Management Guidelines: Syphilis@scrollmed_auInfectious Diseases
Australian STI Management Guidelines: SyphilisYou're all caught up
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