HIV and ID Observations

January 21st, 2018

Curbside Consults Complex and Silly, the Medicolegal Angle, and a Whole Podcast About Curbsides

Curbside consults are much on my mind this week for several reasons. First: I received an extremely complex curbside — a case of an HIV patient (from another state) who experienced treatment failure, had developed multi-class resistance, including integrase resistance (hate that), and now faced a tricky treatment regimen. The email was a good 300 words long […]

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May 30th, 2016

The Sanford Guide — 46 Editions Later, Still Going Strong

I recently had a chance to visit Portland, Oregon, which for many will conjure up images of bicycles, hipsters, Mount Hood, roses, organic everything, and craft beers. It’s also the lifelong home of Dr. David Gilbert, the lead editor of The Sanford Guide to Antimicrobial Therapy, an invaluable resource well-known to almost every clinician. Dave was kind […]

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April 22nd, 2015

Seriously — How Much Would You Pay for a Curbside Consult?

Yes, seriously. Let me start with an email exchange I had with a PCP recently: Hi, Paul, quick question 😉 This lady, 49 YO woman from Haiti, asymptomatic, totally healthy. Got TSpot done for immigration purposes, it’s positive with negative chest Xray. Treated with INH 6 months in 2001. She travels to Haiti annually so could had been reexposed, though […]

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December 30th, 2014

Common Curbsides: The Patient with “Recurrent Zoster”

Just in time for the New Year celebration, here’s a curbside consult I’ve received several times, probably because the answer isn’t in most textbooks. As usual, the actual question is slightly edited, as well as lightly (and affectionately) annotated: Hey Paul — Quick question [of course] — I have a patient with a history of irritable bowel, otherwise well, […]

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November 28th, 2012

A Complicated Curbside Consult I Won’t be Doing — But One Day Might Have To

From a local primary care provider comes this email: Any chance you can look at my notes and scanned outside records from 6/22/2010 till today (including Nov 6 notation that details extensive past evaluation, including two previous ID consults) and labs? Briefly: 72 yr old woman with 6 episodes over the last 4 years of prolonged […]

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February 12th, 2012

Impossible Curbside at Medical Grand Rounds

Scene:  Medical Grand Rounds, 5 minutes before the start. Lecture is on coronary artery disease, which may have a link to Infectious Disease even if it isn’t actually caused by Chlamydia pneumoniae or CMV after all. A well-regarded, experienced primary care physician (PCP) approaches. PCP: Hi Paul, I have quick question*. [*Curbsiders often use this exact phrase — and rarely does […]

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