HIV and ID Observations

March 21st, 2015

ID Learning Unit: Coagulase-Negative Staph, and the “Anti-Zebra” Residents’ Report

At the risk of betraying a deep streak of nerdiness, I confess to being a huge fan of Residents’ Report. This infatuation goes back to my medical student days, when the occasional chance to watch the Chief Medical Resident — who seemed the smartest doctor on the planet — lead a discussion of an interesting case inspired […]

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March 8th, 2015

Measles Vaccine Videos and the Challenge of Changing Someone’s Mind

I suspect most of you have already been treated to this highly amusing video about the measles outbreak from Jimmy Kimmel — a comedy segment featuring real-life doctors, imagine that. Not your typical late-night comedy show performers, but they forcefully (and obscenely) get their message across. If you have just returned from a tropical island where the internet connection was iffy, however, […]

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March 1st, 2015

Really Rapid Review — CROI 2015, Seattle

For the 3rd time in its illustrious history, the Conference on Retroviruses and Opportunistic Infections (CROI) returned to Seattle this past week for it’s 22nd meeting. For those of us living in the North Pole, 50 degrees and drizzle never felt so wonderful! (See image below for graphic representation — that’s my dog Louie wondering what happened to his world. […]

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February 21st, 2015

Fusobacterium, Pharyngitis, and the Limits of Limiting Antibiotics

A paper on pharyngitis in young adults, just published in the Annals of Internal Medicine, is creating a controversy in the intersecting worlds of primary care and Infectious Diseases. The first author is Robert Centor, of the famous Centor criteria that assess the likelihood of group A strep. He’s been writing about our need to expand […]

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February 15th, 2015

Should Antibiotics be Part of End-of-Life Care?

There’s been some truly outstanding work done recently on end-of-life care, and how we deal with it — or more accurately, how we typically don’t deal with it until the very last moment, at which time often many unfortunate decisions and events occur. Here are three I can strongly recommend: Roz Chast’s Can’t We Talk About Something More Pleasant? is probably the […]

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February 8th, 2015

Snowstorms-a-Plenty ID Link-o-Rama

A few items to discuss as we settle in for yet another Boston megastorm: The measles outbreak continues to bring forth excellent commentaries on the selfishness of vaccine-refusers, with this one from Frank Bruni one of my recent favorites. Question: Will it take a hospitalization — or even worse, a death — of an American child with measles to stop this […]

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January 28th, 2015

Quick Question: Should We Still Be Recommending This Year’s Flu Vaccine?

From a football-obsessed primary care provider, written to me on one very snowy day in New England: Hi Paul, I’ve been reading about this year’s flu vaccine, and how ineffective it is. Not surprisingly, my patients have been hearing this too, and it has only increased their reluctance to go through with it. Should I just […]

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January 21st, 2015

No Response

Not surprisingly, it’s a sad, sad day at the Brigham. Yesterday a man walked into the hospital and shot one of our cardiac surgeons, then shot himself. Both died. Amidst the grief, horror, and shock that we all are feeling, I was also reminded of the year I spent working in England before going to medical school. Somewhat to my […]

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January 18th, 2015

Opposition to HCV Screening Raises a Few Interesting Points — But Has Some Really Wacky “Facts”

Over in the British Medical Journal, there’s a provocative editorial entitled, “Is widespread screening for hepatitis C justified?” Based on the title alone, you can guess the authors’ answer to that question — a resounding “No!” By taking this position, of course, they are opposing some very data-driven and well-respected arbiters of policy and clinical practice. These include not […]

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January 7th, 2015

Are the STI Screening Guidelines for Gay Men Overkill? (And Pedro Video.)

Our “healthcare system” recently distributed a set of guidelines entitled, Primary care for gay men: screening and treatment recommendations. It included, among other things, recommendations for screening for sexually transmitted infections (STIs) and anal cancer. The former it adopted from CDC guidelines, which are this this: Screening at least once a year for syphilis, chlamydia, and gonorrhea for all sexually […]

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