HIV and ID Observations

January 27th, 2019

For Our Stable HIV Patients, Why Are We Still Sending All These Lab Tests So Often?

Interesting query from a colleague recently: I’m a community ID doc in the trenches (the measles trenches at present) with an HIV question. Why do we still check CBCs & chem panels every 3-6 months in our HIV patients? Particularly our well-controlled, virologically-suppressed patients? This strikes me as a tremendous waste. I haven’t been in practice that long, […]

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January 22nd, 2019

Unanswerable Questions in Infectious Diseases — Treatment Duration in Endocarditis: 4 Weeks, 6 Weeks, Other?

Time to get back to some tough clinical decisions. It’s been a while. We’ve done The Abdominal Collection and Duration of Antimicrobial Therapy, Persistent MRSA Bacteremia, and The Positive Cultures for Candida in an ICU Patient. However, that series of posts appeared here in early 2014, which means it’s been 5 years with no “Unanswerable Questions.” Lest you think that […]

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January 13th, 2019

Are We ID Doctors Really So Unhappy Outside of Work?

Medscape released their 2019 Physician Lifestyle & Happiness Report, and the results aren’t pretty for a certain cognitive specialty, one commonly abbreviated “ID.” Out of 29 medical and surgical specialties, infectious diseases physicians ranked second to last when responding to a 7-point scale rating on their happiness. Only neurologists were gloomier than we were during their off-hours. Rheumatologists […]

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January 6th, 2019

Rabies After Trip to India, Aortic Dissections with Quinolones, a Vaccine for Candida, Koala Bites, and More: A Welcome-to-2019 ID Link-o-Rama

As 2018 tips over into 2019, here are a bunch of ID- and HIV-related studies that, for one reason or another, haven’t made their way to this site yet — but still yearn for your attention: Cases of infective endocarditis have increased since release of the 2007 dental prophylaxis guidelines. Recall that those guidelines only recommended prophylaxis […]

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December 16th, 2018

ID Doctors Are Lousy Golfers, and Time to Pick Your Favorite Cartoon Caption

Some might wonder how people who take care of patients, who deal with illness and suffering on a regular basis, can find humor in medicine. Alternatively, one could take the opposite perspective — with so much misery around all the time, how could we survive without humor? Clearly the folks at The BMJ are in the latter camp, […]

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December 12th, 2018

Two Weeks of Attending on the ID Consult Service, with One-A-Day ID Learning Units

For those of us who don’t do inpatient medicine all the time, the “blocks” doing inpatient Infectious Diseases consults are a stark reminder of just how complex and challenging the case material can be. Think about it — if a hospitalized patient has a straightforward ID problem, we are not getting involved. No one consults ID […]

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November 25th, 2018

Does Experiencing Childhood Illness Make Someone Stronger? How One Person Turned Adversity into Remarkable Success

Many people growing up with chronic illness become resilient. Whether it’s Crohn’s Disease, or cystic fibrosis, or diabetes, or the sequelae of an accident, or whatever condition they have, they impressively live their life just like the rest of us — occasionally regressing or slowing down only during a flare of the illness. But then there’s an […]

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November 18th, 2018

HIV and HCV Treatment, Shorter Antibiotic Courses, Malaria-Sniffing Dogs, and Other ID and HIV Reasons to Be Grateful, 2018 Edition

As noted here before, I’m a big fan of Thanksgiving, a great excuse to get together with family and friends, and to eat a gargantuan amount of food.* (*On this last point, non-U.S. citizens will wonder how this differs from any other time we “Americans” get together. Indeed, we are the Land of Giant Portions. Ever eat […]

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October 28th, 2018

New Flu Drug Offers Convenience, Fast Activity, and a Novel Mechanism — at a Price

Last week, the FDA approved a new drug for treatment of influenza, baloxavir marboxil (Xofluza). The drug is indicated for treatment of symptomatic influenza in patients 12 years of age or older. As with existing treatments, it should be started within 48 hours of symptom onset. In a comparative clinical trial in otherwise healthy outpatients, baloxavir and oseltamivir […]

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October 15th, 2018

Outpatient Antibiotic Prescribing Boosts Patient Satisfaction Scores, Rewarding Bad Medical Practice

A recent study confirms what every busy clinician already knows. Many patients seeking care for respiratory infections expect to receive an antibiotic. When they get one, they’re happier than if they don’t. Among 8437 patients seeking care for a respiratory tract infection in a direct-to-consumer telemedicine service, 66% received an antibiotic. The rate of prescriptions prescribed by […]

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