HIV and ID Observations

October 2nd, 2012

The Drug-Resistant Gonorrhea: How Much of a Threat?

By now, all ID docs know about the ceftriaxone-resistant Neisseria gonorrhoeae. Or, more accurately, we’ve read about it, since the vast majority of gonorrhea cases are treated in emergency rooms, STI clinics, college health facilities, and various primary care settings — not places that most ID doctors typically work. Plus, hardly anyone does susceptibility testing or […]

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September 24th, 2012

Quick Question: An Etiquette Column for ID Specialists

(First in what will undoubtedly be a recurring series.) Hi Paul: What do you do when someone in a non-medical setting gets something really wrong, and it’s in our field? Here’s why I’m asking: I was picking up my 9-year-old son from school the other day, and his teacher reported to me that they were worried […]

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September 19th, 2012

It’s Time to Dump the HIV Western Blot

Hard to believe, but we have to get rid of the HIV Western blot — at least as our HIV confirmatory test. Here’s why (case adapted from several seen the past few years; I’m sure most of you have seen similar): 30-year-old man, high risk for HIV. He’s worried he might have become infected due to recent […]

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September 11th, 2012

Are Fluoroquinolones Really More Dangerous Than Other Antibiotics?

In today’s New York Times, health writer Jane Brody slams quinolone antibiotics: Part of the problem is that fluoroquinolones are often inappropriately prescribed. Instead of being reserved for use against serious, perhaps life-threatening bacterial infections like hospital-acquired pneumonia, these antibiotics are frequently prescribed for sinusitis, bronchitis, earaches and other ailments that may resolve on their own or can be […]

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September 8th, 2012

People Fear EEE and West Nile, but not Influenza — Can Someone Explain Why?

OK, here’s a quick quiz — match the viral infection with the average annual US deaths: 1.  Eastern Equine Encephalitis A.  36,000, mostly in the elderly 2.  Influenza B.  < 10, mostly in the elderly I know, it was an easy one — 1 goes with B, and 2 with A. Here’s a good reference for more on […]

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August 25th, 2012

On HCV, These Questions Three

In the fastest-moving area of ID drug development, answers are eagerly sought to the following questions three: What does the bad news on BMS-986094 — formerly INX-189 — mean for other investigational HCV nucleotides? Severe cardiotoxicity, fatal in one case, has ended the drug’s development. Importantly, nothing similar has thus far been observed  with the structurally-similar IDX184, but that drug […]

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August 17th, 2012

Beeper, An Enthusiastic Farewell!

August 17, 2012, is the first day in over 25 years that I left for work without clipping a beeper to my belt. Yes, our hospital now offers paging through cell phones. Eureka! As I’ve written before, it was a long time coming. Here are some advantages: Spares the embarrassment of wearing a circa-1980s device around non-MD colleagues. Portrays a […]

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August 15th, 2012

Brush with Greatness: Atul Gawande

I was an English major in college, so when my acceptance to medical school (miraculously) arrived, several people gave me books written by doctors about their experience in the medical profession. “See,” these gifts implied, “Just because you’re going to medical school doesn’t mean you need to become a science drone. Doctors can write too!” Sure, doctors […]

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August 8th, 2012

Must-Read Piece: “Imagine a World Without AIDS”

With all the hoopla at last month’s International AIDS Conference about ending AIDS and curing AIDS and bringing us an AIDS-free generation, there was plenty of ink spilled on the topic. Ironically, the attention the meeting received was inversely proportional to its scientific content, which was actually fairly light on a content-per-day scale. The meeting probably […]

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July 26th, 2012

Pigs are Flying: Written Consent No Longer Needed for an HIV Test in Massachusetts

Let the record show that as of July 26, 2012, a person in Massachusetts can legally get an HIV test without signing a written consent. Hooray. There, that wasn’t so hard, was it?

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