HIV and ID Observations

October 29th, 2017

Cellulitis, Lyme, VZV, MRSA, TB, Tdap: Great Questions from ID in Primary Care

We’ve just finished our annual course Infectious Diseases in Primary Care, and once again our attendees — all busy clinicians — asked some excellent questions. Below, a small sample: What is the drug of choice for cellulitis in outpatients who are allergic to penicillin? Importantly, this is about cellulitis — not abscesses — which means most are […]

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October 22nd, 2017

Price’s “Quarantine” Comment a Startling Example of Remaining HIV Stigma and Ignorance

In case you missed it, Betty Price, a Georgia state representative, said the following last week: [youtube https://www.youtube.com/watch?v=mFTGZyVnzo0] If you head over to the Youtube page with the above video, and read the comments (yes, I know, wading in such waters can give one a dim view of humankind), you’ll see she’s hardly alone in holding this […]

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October 15th, 2017

The Best Antiretroviral Therapy for Pregnant Women? The Controversy Continues

There’s considerable controversy in an area of HIV medicine that one would think should be all but solved by now. It’s what HIV treatment we should give pregnant women. The issue isn’t how to prevent the virus from being transmitted to the newborn — suppress the virus in mom, baby doesn’t get it — it’s what’s safest […]

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October 9th, 2017

What Should We Do About Persistent Low-level Viremia?

Here’s a most entertaining email about a tricky case (some details changed for the usual reasons), with my annotations in brackets: Subject: Regimen intensification? Hi Paul: Long-time reader, first time caller. [Love that intentional mixed metaphor — should we start a radio talk show?] We have a pt who was on TDF/FTC/EFV for a decade. He was […]

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October 1st, 2017

With Several Wrong Predictions Behind Me, Here’s One I Got Right

As I’ve mentioned before, I’ve been wrong on several predictions that ultimately came to pass. Whoppingly wrong. A partial list: Cameras in cellphones are a short-lived gimmick. My kids still tease me about that one. Buying clothing — and especially shoes — on the internet will never catch on. C’mon, you can’t try things on! How do you know […]

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September 24th, 2017

Need a Positive Test for Something, Anything? We’ve Got You Covered!

(Inspired by various unvalidated, non-FDA approved lab tests.) Fatigued? Achey? Having difficulty concentrating? Don’t have quite the “zip” you used to have when you were young? If you suffer from any of these symptoms and are frustrated by unrevealing medical work-ups and negative blood tests, you’ve come to the right place. For at DNA-Dx, we’ll find that positive test […]

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September 17th, 2017

Subunit Zoster Vaccine Soon to Be Approved — Should Patients Wait for It?

For the last year or so, conversations with patients about getting the zoster vaccine have gone something like this: Patient: So should I get the shingles vaccine? I saw an ad for it on TV. Me:  Well, yes … and no. Patient (confused — he/she has never heard me say anything but an enthusiastic “Yes!” to […]

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September 4th, 2017

Meropenem-Vaborbactam, Zika Cases Decline, Gas Station Nachos, and More — An End-of-Summer ID Link-o-Rama

There’s so much interesting ID material out there. The only solution — an ID Link-o-Rama, especially curated for the long Labor Day weekend. (Actually, not really, but that sounded good.) Off we go! Even if it doesn’t provide 100% protection, the flu vaccine may reduce the severity of influenza. Good to have this paper handy as clinics start to […]

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August 27th, 2017

Who’s Most Likely to Leave an Out-of-Office Message While on Service?

Once upon a time, I used being on service as a convenient excuse for not writing very much — or certainly, not writing very much of importance — on this site. The on-service time also allowed me to poke gentle fun at my colleagues, several of whom always turn on an “out-of-office” message when they attend on the inpatient ID […]

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August 20th, 2017

Two Quick Thoughts Inspired by Inpatient ID Consults, and An Inspirational Baseball Poster

A couple of quick thoughts for those of us doing inpatient care these days: Thought One:  Is daptomycin now preferred over vancomycin in most clinical settings?  It’s taken a while, but we’re getting there — close to that Gladwelllian “tipping point”.  Allow this recap of vancomycin’s problems: The growing recognition that higher drug levels — the levels we […]

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