Am I going there? Am I going to look into a topic that one of my attendings literally wrote the guidelines for? I guess I am. Cryptococcus is a yeast that is typically found everywhere there is bat/pigeon droppings or contaminated soil, as well as in certain tree species throughout the world. The most common
Neutropenic fever, defined as a single temperature 38.3C (101F) OR 38.0C (100.4F) for one hour in patients whose granulocyte count are <500 cells OR <1000 cells with an expected decline to <500 over the next 48 hours. This is actually a fairly frequent occurrence in those who undergo intensive chemotherapy, especially in hematological malignancies, which
HIV therapy has undergone many iterations. Long gone are the days of AZT and semi-literal drug cocktails and we have entered into an era where HIV treatment is as easy as just getting one pill per day with Triumeq, Biktarvy, and Atripla which include three-active components. Newcomer, Cabotegravir, may change the game going forward as
I have a love-hate relationship with the urinalysis. It is one of the cheapest and quickest way to get a good idea of what is going on in the kidney, from its less used specific gravity, to the more well known microscopic examination that may involve the presence of casts, it is a widely available
I am a fan of world war I. The biggest cluster in history (where two cousins were basically texting each other prior to the breakout of the war) led to the demise of several monarchies, the rise of new superpowers, and the grim reality of how modern warfare was going to play out going forward.
The hits keep coming and they don’t stop coming. I’ve had a bit of a lull lately, but am back to bring short, and hopefully, sweet post. Daptomycin has become a go-to antibiotic for MRSA infections, namely bacteremia, as organisms with resistance to vancomycin have risen in the past few years. The 2006 Fowler study
I recently wrote about the fact that all pneumonia are aspiration events. Depending on the colonization of the oropharynx and the volume of aspirate material plays a role in the development of subsequent disease. It stands to reason that, if we are able to figure out what is colonizing the oropharynx, we may be able
Extended spectrum-beta lactamase producing organisms are those gram negatives that make beta-lactamases that inhibit third and fourth generation cephalosporins. As such, things such as piperacillin-tazobactam tends to show up as susceptible in antibiograms, however there has been a push lately towards the use of carbapenems as therapy for infections with these organisms. It seems kind
So, you are thinking about starting antibiotics to cover for pseudomonas? That is great. Piperacillin-tazobactam or cefepime are great choices. Perhaps ceftazidime is another one if you are feeling a bit wild. Piperacillin-tazobactam covers anaerobes while the other 2 do not, however metronidazole is a nice addition to the latter 2. Either way, these all
Aspiration of any content is one of those nebulous things we tend to treat, no matter what. The idea is that aspiration of any oropharyngeal contents into the lungs represents an establishment of a new infection and, thus, it needs to be treated. I think the term aspiration pneumonia is actually misunderstood, and it may
Dr. Germophile 