HIV and ID Observations

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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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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January 2nd, 2019

How Did Our Medical Notes Become So Useless?

Among the many complaints about electronic medical records (EMRs), the death of the useful medical note ranks very high. Notes are too long, too complex, and filled with unhelpful words. It’s often impossible to glean what the clinician thinks is going on, or what’s planned. Ever get a note from an urgent care clinic on a patient […]

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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 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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November 12th, 2018

Sharing Radiology Images Across EMRs Is Frustratingly Terrible — and It Doesn’t Have to Be This Way

In the United States, any person who has tried getting their own (or their patient’s) radiology images from another hospital or practice will find this brief anecdote painful: https://twitter.com/sarahkliff/status/1059518100821983233 Here are several obvious reasons why the CD-ROM — briefly the darling of large-data transfer — is a truly terrible way to share radiology images in 2018: They […]

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October 21st, 2018

A Day in the Life of the Academic Assistant Professor of Medicine Who Wakes Up at 5:30 a.m. to Get Her Kids to School, Takes the Bus to Work, Answers Emails, Completes Online Required Modules, and Fills Out Disability Forms for Her Patients

(Inspired by a recent peculiar article about a Bay Area tech superstar.) Dr. Camilla Gormley is always on the move. From the moment her alarm wakes her at 5:30 a.m. to prepare breakfast and school lunches for her three kids, to the time 16-plus hours later when she can finally rest her head on her pillow, Dr. […]

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