HIV and ID Observations

July 7th, 2019

In Praise of Experienced ID Fellows — and a Dozen On-Service ID Learning Units

A few weeks ago, I cautioned ID fellows about underestimating their hospital’s interns and residents. My message — you were like them not so long ago; they didn’t suddenly all lose their brainpower when you graduated. This ungenerous opinion of house staff may be especially held by experienced fellows, as the accumulating workload of the year […]

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June 30th, 2019

Antibiotic Development Is Broken, Brothers in ID Practice, and This Year’s Winner of the ID-Related Social Media Award

I am currently rounding on the inpatient ID service, the new ID fellows arrive shortly, and Louie needs intensive doggy psychotherapy after yesterday’s strong thunderstorms here in Boston. Busy times! As a result, today’s post has no unifying theme. But what it lacks in cohesiveness it more than compensates in value, as here are three highly interesting […]

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April 28th, 2019

Even More Fun with Old Medical Images

Loyal readers of this site might note that we periodically stray from incisive, topical coverage of our exciting field of Infectious Diseases, and venture off into subjects that may or may not be ID-related. And good news for fans of this approach, because today it’s time to release our third episode of Fun with Old Medical Images.  […]

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April 22nd, 2019

Two New Trials of Combination Therapy for MRSA Bacteremia Answer Some Questions — and Raise Several New Ones

Every clinically active ID specialist, hospitalist, and cardiologist realizes that treatment of bacteremia due to methicillin-resistant Staph aureus (MRSA) is no easy task. In fact, it’s a problem so difficult that persistent bacteremia due to MRSA deserved highlighting here as an “Unanswerable Problem in Infectious Diseases”. I wrote that over 5 years ago, and you know what? […]

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April 7th, 2019

New York Times Highlights the Problem of Antimicrobial Resistance — and the Tricky Issue of Disclosure

Right there, on the homepage of today’s New York Times, our national paper of record — Sunday edition, no less! — appears this headline: A Mysterious Infection, Spanning the Globe in a Climate of Secrecy Most of this piece is about Candida auris, the highly resistant fungus that targets our most vulnerable patients — those with weakened […]

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March 24th, 2019

Tetanus Case, No More MAC Prophylaxis, Playing in Dirt, and Low-Level Viremia — A National Puppy Day ID Link-O-Rama

In honor of spring (March 20), and the very important National Puppy Day (March 23), here are a bunch of ID and HIV-related recent items for consideration, contemplation, and perusal: A life-threatening case of tetanus in an unvaccinated boy highlights the personal and financial cost of the anti-vaccine movement. How deeply embedded are these false beliefs? The […]

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March 18th, 2019

Just 1 Month of TB Preventive Therapy Works for People with HIV in TB-Endemic Regions — How About Other People in Other Places?

There’s a look our patients frequently give us when we tell them that preventive therapy for tuberculosis involves 9 months of treatment. If I were to put that look into words, they would be: Yikes, Doc, 9 months is waaay too long — you must be out of your mind. It’s the “9 months?!?!” face. We’ve […]

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February 24th, 2019

Why Choose Infectious Diseases as a Medical Specialty? Here’s the Beginning of My Story, with Bonus Podcast

Forgive the autobiographical nature of this post, but here’s a recap on how I started down the the path to becoming an ID doctor. To begin, understand that my first year of medical school was rough going. In hindsight, this wasn’t surprising. After majoring in English during college (with a minor in the Harvard Lampoon to develop good […]

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February 10th, 2019

Six Musings Triggered by the Latest Measles Outbreak

In 2018, there were 372 cases of measles in the United States, the largest number since 2014. This year, we’ve already had 79 cases, many from a large outbreak in the Pacific Northwest — where anti-vaccine proponents recently protested efforts to restrict nonmedical vaccine exemptions. A few ruminations triggered by this outbreak. 1. The vaccine is extraordinarily […]

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February 3rd, 2019

An “Interview” with the OVIVA Study of Oral vs. IV Antibiotics for Osteomyelitis

An “interview” inspired by publication of a landmark clinical trial. All responses written by me — but be assured, they are based on reading the paper, the accompanying editorial, the supplemental appendix, hundreds of comments on Twitter (some of them from the study investigators), and even a few generous comments from the the senior author in […]

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