Dr. Joel  Hirschberg   image

Dr. Joel Hirschberg

1540 Rt. 202 Suite 14
Pomona NY 10970
845 640-0400
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 026451
NPI: 1235378894
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Unusual infections due to Listeria monocytogenes in the Southern California Desert. - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
During the past 22 years, 14 patients have been hospitalized with infection due to Listeria monocytogenes at the Eisenhower Medical Center, a regional 300-bed hospital in the desert southwest of Southern California. A large number of patients are retired, elderly, and have underlying and often systemic disease.Blood agar and routine media were inoculated with liquid from a sterile site such as blood, cerebrospinal fluid, or joint fluid and observed daily for growth. Appropriate biochemical studies were used to speciate the organism.While bacteremia and meningitis constitute 75% of infections in most studies, they made up only 36% of patients in the current study. Listeriosis occurred mostly in patients with infected aortic aneurysms and brain abscesses, and in prosthetic joint infections. While mortality is generally stated to be around 45% in patients with listeriosis, it was 35% in this study. However, there were no deaths in five patients with bacteremia or meningitis inferring that organ involvement poses a greater hazard for survival.Listeriosis usually presents as a bacteremia or meningitis due to a food-borne invasive infection. In the desert of Southern California most cases are seen in older patients with underlying disease and present with infected aortic aneurysms, prosthetic joints, and brain abscesses. They represent a greater threat to survival due to organ involvement.
Infective endocarditis associated with spondylodiscitis and frequent secondary epidural abscess. - Surgical neurology
Although many patients with IE complain of joint, muscle, and back pain, infections at these sights are rare. Indeed, in patients with back pain and endocarditis, less than 4% actually demonstrate spondylodiscitis.We recently encountered 4 patients with this complication, one each caused by Staphylococcus aureus, Streptococcus bovis, Streptococcus mitis, and Enterococcus faecalis, and wondered whether the nature of the infecting organism determined the development of spondylodiscitis and epidural abscess. In a literature review, 36 patients with endocarditis and spondylodiscitis were identified. Only 9 (25%) were caused by Streptococcus viridans and the remainder by staphylococci, enterococci, and other streptococci. Usually more than 50% of all cases of IE were caused by Streptococcus viridans, although more recent studies would indicate an incidence of about 40%.We conclude that spondylodiscitis with epidural abscess is more likely to occur in those patients with endocarditis who are infected by organisms with pyogenic potential.
Cellulitis and septic arthritis caused by Campylobacter fetus and Campylobacter jejuni: report of 2 cases and review of the literature. - Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
Bacteremia caused by gram-negative bacteria occasionally causes soft tissue infections, including cellulitis and septic arthritis. We describe 1 patient each with Campylobacter fetus cellulitis and septic arthritis and review the world literature with regard to C. fetus and C. jejuni infections at these sites. Altogether, 14 patients with cellulitis (12 due to C. fetus and 2 due to C. jejuni) and 20 patients with septic arthritis (15 due to C. fetus and 4 caused by C. jejuni) have been described. Most infections, particularly those causing cellulitis, are found in elderly men with underlying systemic disease. Most patients are febrile but less than half manifest a leukocytosis. There were only 3 deaths in this series of 33 patients. The newer macrolides, including azithromycin and clarithromycin, are considered the drugs of choice, particularly with C. jejuni, while soft tissue infections caused by C. fetus respond nicely to many beta-lactams, particularly to cephalosporins and carbapenems, as well as to macrolides and quinolones.
Actinomyces odontolyticus bacteremia. - Emerging infectious diseases
We describe two immunosuppressed female patients with fever and Actinomyces odontolyticus bacteremia, a combination documented once previously in an immunocompetent male patient. The patients were treated with doxycycline and clindamycin; these drugs, with beta-lactams, are effective treatment for A. odontolyticus infections.

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1540 Rt. 202 Suite 14 Pomona, NY 10970
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