HIV and ID Observations

April 22nd, 2019

Two New Trials of Combination Therapy for MRSA Bacteremia Answer Some Questions — and Raise Several New Ones

Every clinically active ID specialist, hospitalist, and cardiologist realizes that treatment of bacteremia due to methicillin-resistant Staph aureus (MRSA) is no easy task. In fact, it’s a problem so difficult that persistent bacteremia due to MRSA deserved highlighting here as an “Unanswerable Problem in Infectious Diseases”. I wrote that over 5 years ago, and you know what? […]

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July 15th, 2018

On-Service Digest, July 2018 — with Special Section Just for Staph aureus

I’m currently on-service for the inpatient ID consult team, and this is July. At a teaching hospital.  Here’s where some would play scary music. After all, the interns and fellows have just started! YIKES! But no scary music for me — I love working with the July newbies. Because whatever they lack in experience or efficiency, they more than make up […]

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July 1st, 2018

Why Do Our Patients Think They Have Spider Bites?

We are currently in peak tick season here in the Northeastern United States. It might be hard for clinicians elsewhere to understand just how profoundly this changes our assessment of fevers and rashes. But consider this — ordering the trio of Lyme antibody, Anaplasma PCR, and Babesia PCR is as much a part of the routine […]

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October 29th, 2017

Cellulitis, Lyme, VZV, MRSA, TB, Tdap: Great Questions from ID in Primary Care

We’ve just finished our annual course Infectious Diseases in Primary Care, and once again our attendees — all busy clinicians — asked some excellent questions. Below, a small sample: What is the drug of choice for cellulitis in outpatients who are allergic to penicillin? Importantly, this is about cellulitis — not abscesses — which means most are […]

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November 20th, 2016

Seven ID/HIV Things to Be Grateful For This Holiday Season, 2016 Edition

I know, I know — you read that title and thought, “Grateful now? He must be out of his mind.” But with the (unsurprising) concession that I too felt that watching the election returns was akin to witnessing a slowly developing and incomprehensible train wreck, I remind you that the expression of gratitude is well known to make you happier. […]

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July 31st, 2016

Summertime Pre-Olympics ID Link-o-Rama

If you’re wondering what to do between the end of the presidential conventions, the baseball trade deadline tomorrow, and the start of the Summer Olympics, here are a few ID/HIV related items to contemplate: Non-travel related Zika arrives in Florida. Start getting used to seeing more of that obscure word “autochthonous”.  The uncertainty was not whether Zika cases would occur here — that […]

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August 17th, 2015

Dog Days of Summer ID Link-o-Rama

A few ID/HIV items of note to consider as you gather up your sunscreen, flip flops, towels, and sand toys and head off to the beach: Interesting review of the impact of low socioeconomic status in the recent outbreak of Legionnaires’ Disease in the South Bronx. It’s just like (almost) every infection — the combined effects of crowding, poor sanitation, and […]

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October 19th, 2014

Almost Filovirus-Free (That is, Ebola-Free) ID Link-o-Rama

If you’re an ID doctor right now, the filovirus of the moment Ebola is consuming a big chunk of all of your non-clinical time — and this is particularly true for those heavily involved in Infection Control, who are spending every waking hour responding to public hysteria, to various clinicians who seem to have all the answers, and to ever […]

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January 30th, 2014

Unanswerable Questions in Infectious Diseases: Persistent MRSA Bacteremia

Ok, here’s a favorite of adult ID specialists everywhere — a real tough one. The case goes something like this: Older person, many medical problems. Probably is on hemodialysis, with the vascular surgeons having some difficulty with access. There’s diabetes, of course, and cardiovascular disease, and oh yeah, a mechanical aortic valve that’s around 10 years […]

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September 13th, 2013

Clindamycin vs. TMP/SMX for Soft Tissue Infections: A Clinical Trial That Needs Some Marketing

At ICAAC this week — the ID conference with the most inscrutable acronym out there — Loren Miller from UCLA presented a clinical trial on treatment of skin and soft tissue infections that has widespread clinical applications, yet may receive little if any attention. And why is that? Simply because the drugs (clindamycin and trimethoprim/sulfamethoxazole) have been off-patent […]

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