HIV and ID Observations

October 25th, 2014

What Makes An Ideal Applicant for a Fellowship in Infectious Diseases?

We’re at the tail end of the ID fellowship interview process, and am pleased to report we’ve seen some outstanding applicants. They know that our field is the most interesting in medicine, and they view our recent “Epidemic of Epidemics” — to coin a phrase from John Bartlett to describe all this activity (Ebola, MERS, Enterovirus D68, […]

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October 19th, 2014

Almost Filovirus-Free (That is, Ebola-Free) ID Link-o-Rama

If you’re an ID doctor right now, the filovirus of the moment Ebola is consuming a big chunk of all of your non-clinical time — and this is particularly true for those heavily involved in Infection Control, who are spending every waking hour responding to public hysteria, to various clinicians who seem to have all the answers, and to ever […]

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October 15th, 2014

Second U.S. Healthcare Worker with Ebola Further Underscores Urgent Need for Enhanced Preparedness — and Perhaps Designated Care Centers

If you’re like most of us, when you heard that a healthcare worker in Dallas had been diagnosed with Ebola virus disease, you assumed that the exposure occurred during his first visit to the hospital. That is, before he was diagnosed with Ebola, and before infection precautions had been instituted. But no, it happened after he was […]

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October 12th, 2014

Approval of Sofosbuvir/Ledipasvir Was Expected, but Still Is a Huge Advance

As expected, the FDA just approved the first single-pill treatment for hepatitis C genotype 1, a tablet containing 400 mg of sofosbuvir (SOF) and 90 mg of ledipasvir (LDV). For those not following this story closely, sofosbuvir is the pan-genotypic NRTI polymerase inhibitor approved last December to much rejoicing — and controversy about the price. Ledipasvir […]

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October 6th, 2014

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

Just wrapped our our annual postgraduate course, “Infectious Diseases in Primary Care,” where each year we get together with primary care providers (doctors, nurses, PAs) and review what we hope are the most clinically relevant topics in ID. And each year we get a great bunch of questions, some of which I’ve listed below (along with […]

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September 24th, 2014

Quick Question: How Do I Fill Out This Tricky Patient Job or School Form?

From a long-term and highly respected colleague comes this challenging query: Hi Paul, One of my HIV pts, doing wonderfully well, is planning to enroll in a nursing program. She does not want to disclose her HIV status (fine with me), but the hospital requests a list of current meds which, of course, would blow her […]

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September 13th, 2014

In These Challenging Times for ID Doctors, a Little Comic Relief

I was passing a colleague in the hall the other day — he’s a general internist by training, now an important hospital administrator — and he briefly stopped me to get my take on the flurry of ID-related news bombarding the world right now. Him:  Hey, Paul, good to see you. Me:  Hi Jerry. Him:  Quite […]

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September 7th, 2014

It’s OK to Limit Who Prescribes HCV Therapy, but Insurers Shouldn’t Be Deciding

Some insurers would like to limit the prescribing of HCV treatment to gastroenterologists, hepatologists, or infectious diseases specialists. Not surprisingly, this doesn’t sit well with either the HIV Medicine Association (HIVMA) or the American Academy of HIV Medicine (AAHIVM), both of which have long acknowledged that some of the most seasoned HIV providers are generalists: “There is no medical […]

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September 3rd, 2014

How to Choose a Case for ID Case Conference

As August becomes September, ID fellows across the land are becoming increasingly skilled, heading rapidly upwards on that steep learning curve that is the first year of fellowship. With one-sixth of the year already in the books, it’s a wonderful thing to see. One potential downside to this accumulating knowledge, however, is that they start to become […]

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August 16th, 2014

Dietary Advice From Your Friendly ID Doc: Don’t Eat Garden Slugs

From the pages of Open Forum Infectious Diseases, comes this cautionary case report: Toxocariasis After Slug Ingestion Characterized by Severe Neurologic, Ocular, and Pulmonary Involvement I encourage you to read the full paper, but the short story is that a previously healthy 71-year-old man was admitted to a hospital in France with fever, cough, headaches, confusion, […]

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