Infectious Disease

Sepsis, the body’s self-destructive inflammatory response to severe infection, is the leading cause of death in U.S. hospitals, particularly among the elderly. It starts as mild sepsis, advances to severe sepsis, and all too frequently blossoms into septic shock. More than 1.5 million Americans get sepsis each year. More than 250,000 die of the illness. One in three patients who die in a hospital have sepsis. 62percent ...

Read more...

I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice. With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals. Late one Friday night, I got a call ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old man is evaluated for dark-colored urine for 2 days, swelling of the face and hands for 1 day, and severe headaches this morning. He reports having an upper respiratory tract infection 1 week ago with fever, sore throat, and swollen glands, but had otherwise felt well. Medical ...

Read more...

Earlier this year, I wrote a piece about friends and colleagues of mine who have left HIV clinical practice. Something about it touched a nerve. Admittedly, it was kind of a downer — but it might have been slightly misinterpreted. A lot of the problems my friends cited could have easily applied to almost any area of clinical practice; these challenges were by no means limited to HIV care. They mentioned the ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated in follow-up after being recently diagnosed with HIV infection. She is asymptomatic. Medical history is unremarkable, and she takes no medications; she has not yet started antiretroviral therapy. She received all scheduled childhood immunizations. On physical examination, vital signs are normal. She has shotty cervical ...

Read more...

Recent research from Florida Atlantic University and Cleveland State University have found a direct correlation between preventative health care and the number of paid sick leave days a worker gets. Workers with more than 10 paid sick days annually access preventative care more frequently than those without paid sick days. Preventative care, in turn, leads to better overall mental and physical health. Doctors that are in private practice function ...

Read more...

Many people seem to believe that the Z-pak possesses magical qualities. Patients come in requesting it for the common cold, because it worked for them in the past. Not only do many believe it cures the common cold, but they think it can treat any infection. Have a urinary tract infection? Just ask your doctor to prescribe a Z-pak! Sniffles got you under the weather? Do the same! Anyone who believes ...

Read more...

My patient, a rugged sixty year old with massively muscular forearms, gray chest hair at the V of his denim shirt, and a voice that suggested years of liquor and unfiltered cigarettes, lowered his voice and leaned forward. “I’m not usually scared of anything, but for three nights now, ever since I started taking the Levaquin for this pneumonia, I have had the most horrific nightmares. I can’t even talk about ...

Read more...

Urgent care centers are way ahead in prescribing unnecessary, potentially harmful antibiotics that are doing no one any good – at least no patients any good. The owners of the urgent care centers are the ones who are benefitting. And you and your family are being bilked, misled, and harmed. A recent study published in JAMA Internal Medicine looked at the proportion of antibiotic prescriptions that were made for viral respiratory ...

Read more...