January 11th, 2021

After Ivermectin Controversy, A COVID-19-Free ID Link-o-Rama

Field Cricket, from Fabre’s Book of Insects (1921)

Wow, quite the week for this country of ours. We’re all deeply saddened by the events, very hopeful that the transition in leadership will be peaceful.

And also an eventful week for this little blog. When I wrote “Enter ivermectin — and let the controversy begin,” little did I know.

Amazingly, this is already the second-most widely read post on this site over the past 365 days, and it’s been out less than a week. It’s closing in on number one, which came in early March — that’s when I not-so-boldly predicted we’d see a big increase in COVID-19 cases. Quite the visionary, wasn’t I?

(That was a rhetorical question.)

Anyway, who knew this obscure antiparasitic agent would capture so much attention?

With that controversy out of the way (ahem), allow me to return to non-COVID-19 ID/HIV for a brief time. I’ve been doing inpatient ID consults quite a bit recently, and here are a few of the interesting things that popped up:

Many thanks to ID fellows Drs. Susan Stanley, Alex Tatara, and Zach Nussbaum for providing some of these references. And remember all you fellows out there, you’re more than halfway done with your first year of fellowship!

For next week? Maybe I’ll write about albendazole. Or praziquantel. Or nitazoxanide. Or some other antiparasitic agent. They seem to be quite popular!

Or maybe I’ll just watch this baby bear playing on this golf green.

8 Responses to “After Ivermectin Controversy, A COVID-19-Free ID Link-o-Rama”

  1. Matt Leibowitz says:

    Thanks Paul! These are great cases and references. I’m edging toward saying PJP but the reflex is still PCP. I can’t abide “PJP Pneumonia” or “HIV virus”, however…

  2. Katy Godfrey says:

    Pcn s S. aureus!! Yes!

  3. Jen says:

    This just exemplifies why as outpatients we need treatment recs and studies for COVID as we have seen so many die.
    What can be done early? What about Alinea?

  4. stephen stolzberg says:

    The bear on the golf course made me laugh for the first time in a week (or more).
    Re. covid mutations: how do you measure ‘infectiousness’? is it just increased prevalence?
    and do you expect that we will be seeing more and more mutations?

  5. Mark McCutcheon MD. says:

    More about Nitazoxanide. Flu, COVID

  6. Joel Gallant says:

    Just say NO to “PJP”! Even the people who renamed the organism recommended against changing the abbreviation for the name of the disease it causes. (Stringer JR, et al. Emerging Infectious Diseases 2002;8:891-6).

  7. Matt Labreche says:

    Very skeptical of what the UTI truly adds. Well intentioned, but they used a number of read codes to identify bloodstream infection that would be challenging to link to an untreated episode of cystitis including: listeria speticemia, staphylococcal septicemia, sepsis due to Actinomyces, sepsis due to anaerobic bacteria, Erysipelothrix septicemia, to name just a few. Maybe I’m missing something but it seems the devil is in the details and the study just falls apart in the supplement.

  8. Roberto Esposito says:

    Many years ago, in Italy, we successfully used cotrimoxazole for the treatment of cerebral toxoplasmosis in patients with HIV infection (British Medical Journal 1987; 295:668). Subsequently, during an AIDS Conference, I asked Dr. Jack S. Remington, the world’s leading authority in this field, what did he think. He replied that there was no proof of its effectiveness. More than 33 years later, I am satisfied that my opinion was valid!

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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