HIV and ID Observations

October 13th, 2012

More Questions from “ID in Primary Care” Course

Some additional excellent questions from the course: For someone who has had 3 doses of hepatitis B vaccine but does not have the antibody, should we just go ahead and give another 3 shots? A:  (Per vaccine guru Howard Heller):  The guidelines say to just go ahead and give another 3 shots but if the […]

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October 11th, 2012

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

We do a post-graduate course each year called “ID in Primary Care,” and it’s a great way for us to find out what people in outpatient primary care practice are thinking about from the ID perspective. I told the participants this year I’d post some of their most interesting questions on this site, with the hope […]

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October 8th, 2012

With One Month To Go, Candidates Eke Out Votes Wherever They Can

From the Department of Opportunistic Expediency, we have this brazen pitch from one of our two presidential hopefuls: Romney and Ryan will do more to fight the spread of Lyme Disease … As president, Mitt Romney will ensure that real action is taken to get control of this epidemic that is wreaking havoc on Northern […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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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 […]

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