HIV and ID Observations

October 11th, 2012

Back to School: Questions at the “ID in Primary Care” Course

We do a post-graduate course each year called “ID in Primary Care,” and it’s a great way for us to find out what people in outpatient primary care practice are thinking about from the ID perspective. I told the participants this year I’d post some of their most interesting questions on this site, with the hope that […]

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June 15th, 2012

ID Learning Unit — The D Test

I suppose it’s not surprising that we’d follow-up the Etest with the D test, though perhaps if I were being alphabetical, the order would have been reversed. The D test is important, because it screens for a form of clindamycin resistance in MRSA that might otherwise not be detected — the “inducible” kind, which can be […]

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June 6th, 2012

A Fun Internet Poll for ID Nerds

Over on Medscape, one of my ID heroes, John Bartlett, has a new series called, “The Medscape Awards in Infectious Diseases” and it looks like a winner. Here’s how it works: The Medscape Awards in Infectious Diseases is a new series that will honor the greatest achievements in the field of infectious diseases during 1980-2012. John G. […]

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February 12th, 2012

Impossible Curbside at Medical Grand Rounds

Scene:  Medical Grand Rounds, 5 minutes before the start. Lecture is on coronary artery disease, which may have a link to Infectious Disease even if it isn’t actually caused by Chlamydia pneumoniae or CMV after all. A well-regarded, experienced primary care physician (PCP) approaches. PCP: Hi Paul, I have quick question*. [*Curbsiders often use this exact phrase — and rarely does […]

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September 17th, 2011

Drinking Coffee Prevents MRSA

I follow the medical literature on coffee very closely. Why?  Because I’m completely addicted — and, judging from the lines at the Starbucks, Dunkin’ Donuts, etc at the airports before early morning flights, I am not alone. (It’s just one cup a day. Any more and say hello to palpitations, jitters, sweats, and long sleepless nights. Is […]

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April 1st, 2011

Clindamycin or Cephalexin for (Mostly) MRSA?

Over on the Journal Watch Pediatrics site, there’s a summary of a study that compared clindamycin with cephalexin for purulent skin infections in kids age 6 months to 18 years.  The results? MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) were isolated from 70% and 19% of children, respectively … The primary outcome — clinical improvement at 48 […]

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January 11th, 2011

Revised DHHS Guidelines, and Some Thoughts on Guidelines in General

As another major snow storm barrels in on us, you might have time over the next 24-48 hours to make some hot chocolate, throw some logs on the fire, and read the spanking-new 2011 Department of Health and Human Services (DHHS) HIV Treatment Guidelines, just posted here on the AIDSinfo web site. (Disclosure: I’m on the […]

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September 6th, 2010

Treating Cellulitis: Getting the Answer Wrong and Right

What’s the right antibiotic choice for cellulitis in the era of community-acquired MRSA? As astutely pointed out by Anne in her comment, the “correct” answer to the recertification question was #4, trimethoprim-sulfamethoxazole, for the following reason: I am not a doctor, I am a test developer. Having exactly zero knowledge about the content here (could be Chinese […]

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September 1st, 2010

Testing your Testing Skills

Have I whined yet about how I’m part of the first Internal Medicine class that was not “grandfathered” through to eternal board certfication?  If not, now I have. So for you fellow test-takers, here’s another one for you, adapted somewhat from this delightful experience I’m required to go through every 10 years.  Oddly, just like the last one reviewed […]

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March 14th, 2010

MRSA Bacteremia Question Redux — and the “Answer”

As noted here, I recently had to answer a question on management of MRSA bacteremia as part of an every-10-year cycle of test-taking. (For more on that joyous process, read this interesting debate here in the New England Journal of Medicine.) The question seemed to have no obvious right answer, so I did what one is explicitly allowed to […]

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