February 12th, 2018

Shingles Vaccine Video, New Name for C. diff, Flu B Rising, and More — A Pre-Valentine’s Day ID Link-o-Rama

We are a Royalty Free Stock Image — proof that sometimes you get what you pay for.

With Valentine’s Day and early spring training baseball both on the horizon this week, it’s obviously time for an extra special ID Link-o-Rama.

On to the links, with a bonus non-ID section and a highly recommended video at the end:

Ok, non-ID section — a few medical, one not medical at all.

Pitchers and catchers, music to my ears!

And take it away, Dr. Fryhofer — nice job on this video!


17 Responses to “Shingles Vaccine Video, New Name for C. diff, Flu B Rising, and More — A Pre-Valentine’s Day ID Link-o-Rama”

  1. Morris Effron says:

    Patient question: if you’ve had the old shingles vaccine, should you get the new shingles vaccine as well for added protection?

    • Paul Sax says:

      Simple answer is “Yes.” A more nuanced answer can be found by fast-forwarding the video to around 3 minutes, where the discussion of “waning efficacy” of the old vaccine is reviewed.

      So the longer ago you had it, the more benefit you’ll get from the new vaccine.


  2. Michael Mi says:

    Great post as always! One name still befuddles me: is it Chlamydophila pneumoniae or Chlamydia pneumoniae? What about psittaci? File this one under things that keep nerdy internists up at night.

  3. Martha Steele says:

    Patient question: Can a 65 yr old HIV+ patient with a CD4 count >900 get RZV. The patient has already gotten ZVL 4 years ago.

    • Paul Sax says:

      Sure thing!

      Here’s what I wrote: “Does the recommendation include our stable, on-therapy HIV patients, who in increasing numbers are over 50? I say yes.”

      There might be some who disagree, but that’s what clinical judgment is for.


  4. Felix Bormann says:

    Got a question about the Influenza. I never heard of the same person getting Influenza A AND B the same season, neither simoultaneously nor subsequently. Doens’t it happen? Isn’t ist tested?
    Over here in Germany we have mostly B this year (59% is the official number), and my personal impression is that of a pretty good protection offered by the vaccine, btw.

  5. Nick S says:

    For patients who test positive for flu on flu swabs & are symptomatic: should I be giving them the flu shot? (The ACIP guidelines don’t help much here; they just list ILI symptoms as a “precaution”)

  6. marvin rabinowitz says:

    maybe i’m a dinosaur, but faxes are hippa compliant. our ehr can print to fax and we receive efax with no paper, the efax received can go into the ehr directly or delted etc..

  7. Leez says:

    Feel free to disagree with me vehemently!

  8. leonard fieber says:

    I got my first vaccine last week since I received the live vaccine 15 years ago. I thought the price would be the most painful component since it isn’t covered by Medicare. I can’t overemphasize how painful that shot was. I could perform most of my daily activities once I was able to put a shirt on. When it came to swimming my daily mile of freestyle which I rarely miss that was delayed for 3 days when I could finally raise my arm.

  9. tom benzoni says:

    Not for publication:

    I have an email from our hospital that details (lightly; you’ll see) a novel way to “spread” C diff.
    Key words also include “encephalopathic” and “rectal tube.” Oh, and some centrifugal physics…

    I can’t ID the facility, for obvious reasons.



  10. Heather says:

    re: CDC has issued dietary advice for Valentine’s Day. 

    this is a wind-up, right? Someone is getting February 14th and April 1st confused?

  11. Mike Angarone says:

    Every physician should read and memorize what is quoted by the anesthesiologist about pain:

    “Pain is a part of life. We cannot eliminate it nor do we want to. The pain will guide you. You will know when to rest more; you will know when you are healing. If I give you Vicodin, you will no longer feel the pain, yes, but you will no longer know what your body is telling you. You might overexert yourself because you are no longer feeling the pain signals. All you need is rest. And please be careful with ibuprofen. It’s not good for your kidneys. Only take it if you must. Your body will heal itself with rest.”


    • Dee says:

      He obviously was not a person who carries the gene for feeling greater pain than the average person, like many redheads do. Too much pain interferes with healing and a patient’s willingness to move at all and therefore bloodflow to the wounded area. There needs to be a balance, not a calous doctor.

  12. Ryan Maves says:

    I make a plea to the microbial taxonomists of the world: if you feel the need to change an organism’s name where there is an important pathogen and a less clinically-relevant variant in the mix (e.g., Pneumocystis, Propionobacterium), please change the name of the latter and not the former. I am not very worried about the names of rodent commensals and soil saprophytes, but “Cutibacterium” and the like are getting in my nerves.

  13. Ramesh Bharadwaj says:

    On the topic of influenza, I am getting a lot of questions on 2nd dose vaccine. Typical scenario is a health care worker who has received their vaccine in September and are concerned about ongoing exposure and waning immunity. The CDC and ACIP do not recommend 2nd dose vaccine in the same season except in certain pediatric population. But some studies suggest that it might be reasonable to go for that second shot.
    What is your take on this?

  14. Massimo Giola says:

    The new name of Clostridium difficile is wrong. It should be Clostridioides difficilis (like Bacteroides fragilis, not fragile), as the suffix -oides should be masculine in Latin, not neuter..

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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