HIV and ID Observations

October 14th, 2019

Common Questions About the Shingles Vaccine — Answered Here!

Here’s an interesting email from my friend and ID-colleague Dr. Carlos Del Rio (shared with his permission): Went Tuesday to see my PCP for a routine visit and had my second dose of Shingrix that day. I had gotten my first dose about 3 months ago and had severe chills and even a fever of 38.5 […]

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April 29th, 2018

ID Learning Unit: Clinically Important Streptococcal Infections You Need to Know

As mentioned last week, I’m currently attending on the general medical service, a chance to brush up on non-ID clinical skills, and more importantly, to work with smart, energetic house staff and medical students. Not surprisingly, there’s a wide range of clinical ID on this service, and this year we’ve had a rash of streptococcal infections. (Get […]

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March 21st, 2015

ID Learning Unit: Coagulase-Negative Staph, and the “Anti-Zebra” Residents’ Report

At the risk of betraying a deep streak of nerdiness, I confess to being a huge fan of Residents’ Report. This infatuation goes back to my medical student days, when the occasional chance to watch the Chief Medical Resident — who seemed the smartest doctor on the planet — lead a discussion of an interesting case inspired […]

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June 6th, 2013

ID Learning Unit — Aminoglycosides

You young whippersnappers out there may not believe it, but we once used aminoglycosides all the time — literally every day on inpatient medical and surgical services, especially in the ICUs. They were an inevitable part of “triples” (e.g., amp/gent/clinda), a broad-spectrum combination given to almost every critically ill patient way back when — think right around […]

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May 21st, 2013

ID Learning Unit — “Isolator” Blood Cultures

Here’s a little secret about those brilliant ID consults we do on patients with mysterious fevers: Sometimes we don’t know what’s going on either. I know, I know — shocking. But now that the secret is out, I can tell you something we do know, and that’s how to recommend lots of tests — the more obscure, […]

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May 16th, 2013

ID Learning Unit — Antibiotics with Excellent Oral Absorption

Guaranteed:  Every day at a hospital near you, a patient is receiving antibiotic therapy for an infection, and the orders include the following: A slew of various oral medications, both continued from outpatient care and started anew on admission. An intravenous antibiotic. The odd thing about this combination is that there are many antibiotics with excellent […]

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June 24th, 2012

ID Learning Unit — Choosing a Quinolone

We love quinolones on medical services, and it’s easy to understand why. Advantages: Ideal spectrum for several common infections, including community-acquired pneumonia, UTIs, and more complex infections when combined with other drugs Great oral absorption Few drug-drug interactions Once- or twice-daily dosing Generally well tolerated Reasonable cost But how do you choose between them? Below, in […]

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June 18th, 2012

ID Learning Unit — Serologic Tests for Syphilis

Diagnosing syphilis is tricky for lots of reasons, including: The protean disease manifestations, many of which were best described in older medical literature — and hence not known to people who don’t read words on paper (vs a screen) very often. You can’t visualize the bug (Treponema pallidum), unless you happen to have a darkfield microscope […]

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June 15th, 2012

ID Learning Unit — The D Test

I suppose it’s not surprising that we’d follow-up the Etest with the D test, though perhaps if I were being alphabetical, the order would have been reversed. The D test is important, because it screens for a form of clindamycin resistance in MRSA that might otherwise not be detected — the “inducible” kind, which can be […]

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June 12th, 2012

ID Learning Unit — The Etest

Every year I attend on the general medical service, so it gives me a chance to work directly with the medical residents — and to brush up on my non-ID-related Internal Medicine. In exchange for what they teach me, each day on rounds I try to tell them about at least one ID-related thing that they […]

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