HIV and ID Observations

August 30th, 2015

(Not) Doing the Retinal Exam, and the Importance of Acknowledging Limitations

This past week, the New England Journal of Medicine released one of its excellent instructional videos, detailing how to do direct ophthalmoscopy to examine the retina. That’s the use of one of those hand-held gizmos — an ophthalmoscope, see picture on the right — to look at the back of the eye. As usual, the video was […]

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August 9th, 2015

The Pain — and Potential Power — of Electronic Health Records in One Little Anecdote

Here’s a scintillating series of events that happened recently on our inpatient consult service: Reason for consult: “Treatment of UTI in a 26-year-old pregnant woman with multiple allergies.” Culture result:  Group B strep, resistant to clindamycin and nitrofurantoin. She’s been on the latter. Patient’s allergies as listed on her chart:  Penicillins, cephalosporins, sulfonamides. Plan per OB service: […]

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August 1st, 2015

Ten Reasons to Attend Our “Infectious Diseases in Primary Care” Course

With an up-front apology for the shameless plug — sorry! — here are 10 great reasons to attend our annual postgraduate course. It’s called Infectious Diseases in Primary Care, and takes place October 14-16 here at the Fairmont Copley Plaza Hotel in Boston. All the topics are clinically relevant to day-to-day practice. Look at these topics! There’s a strict […]

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June 20th, 2015

Alex Rodriguez’ Story Reminds Me of a Case of Scientific Misconduct — Until It Doesn’t

If you’ll forgive me a bit of baseball-related rambling, there’s an incredible story going on this year with the resuscitation of Alex Rodriguez, both as a player and, even more remarkably, as a person in the public eye. Or, to quote the play-by-play announcer Michael Kay, who on Friday got it perfectly when he commented on A-Rod’s 3000th hit […]

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June 4th, 2015

A Slightly Less Painful Way to Learn the Three-Letter Abbreviations for HIV Meds

One of the stupid things about being an HIV/ID specialist is the highly arcane code we use to abbreviate HIV treatments. Why was zidovudine originally AZT, and now ZDV? Why is lamivudine 3TC? And tenofovir TDF? Of course there are legitimate biochemical reasons why these are the right abbreviations, but they are lost to most of us who do […]

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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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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 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 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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May 28th, 2014

Some ID Stuff We’re Talking About on Rounds

Just finished two weeks on the inpatient general medical service — hence the radio silence — giving me a chance to work with residents, interns, and medical students. Here’s a smattering of the ID topics we discussed, along with a comment or two: “Common” causes of gram negative soft tissue infection (at least for board exam purposes), and […]

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