Our cardiac surgeons just made up a new word.
If you are sick with positive blood cultures with Strep species, you now have Strepticemia!!
Kind of obsessed.
#IDTwitter
A fellow-less consult Saturday: 12 new patients, incoming pages from 2 of our ERs, outgoing calls to 3 community hospital micro labs (2 of which changed my plan of care!!), and a 3pm Starbucks run.
Oh, I also put an offer on a house π«£
Never a dull moment on ID!
#IDTwitter
Me when I see my nieceβs toy stethoscope in the background of our video call: βwill you listen to daddyβs heart for me?β
2-year-old: βI wash my hands firstβ
GUYS, she pretend washed at the play kitchen sink before auscultating! Might have an ID doc on our hands.
#IDTwitter
After 1 year (almost) of being an ID attending and while on my 10th inpatient consult block, I hit a threshold for the first time: 30 patients on the consult list π¬
Man, things are BUSY in July.
#IDTwitter
Me: plans to launch a bone and joint ID service next month
First week of consult service: over 50% of general ID consults are bone and joint
aand now weβre rethinking what diagnoses we are going to take.
Our multidisciplinary limb salvage service will be up and running soon π€
Shout out to
@GCRTA
for getting me to work quickly and safely while my car is in the shop!
(Please ignore my wind and rain hair. The weather isnβt too good here in the CLE today)
When you spend 5 days convincing your attending it could be TB, start empiric therapy, and then the AFB PCR returns positive for Mycobacterium tuberculosis
I wasnβt sure what kind of pastry decoration to make, so I settled on an ID Wellington to mark the occasion of starting my first attending consult week tomorrow
#nerd
#foodie
#IDTwitter
Definition of βthe kitchen sinkβ
My stewie self is trying not to rage
Oh, also they are trying to rule out TB..
Never a dull moment on ID consults.
#IDTwitter
Wonderful day to find this article that was just published!
We performed our first PMA at my hospital today! (and a paper I wrote in residency is cited in this) π€
Percutaneous mechanical aspiration in patients with right-sided infective endocarditis: An analysis of the nationalβ¦
β€οΈβπ₯NIS study. Need trial data β‘οΈ indications, efficacy and safety in select patients.
@MayoClinicINFD
@MayoCVFellows
Super grateful for the opportunity to speak to colleagues from around the state at the Infectious Disease Society of Ohio meeting this morning!! Hope everyone liked starting their morning with diabetic feet and antimicrobial stewardship π¦Άπ΅πΌββοΈ
Question for
@DGArmstrong
or anyone else interested in podiatric ID: are there any standards for collecting cultures in the OR? Like always get margins or post-lavage cultures for a toe amp/TMA? Tissue vs bone?
Everything Iβm reading just sounds like itβs dealerβs choice
@ABsteward
Thanks for sharing! We are now rolling out an algorithm for providers admitting DFI patients. Basically it is going to be cefazolin or amp-sul unless they have a MRSA risk factor (add vanc) or a resistant GNR risk factor (start cefepime or pip-tazo instead). More to come
I love that the resident working in the cardiac ICU thought that I would know what this means... π
Shout out to the cards fellow for the quick refresher on Swan numbers this afternoon
#IDTwitter
Dexmedetomidine does NOT treat behavioral disorders.
Dexmedetomidine does NOT treat behavioral disorders.
Dexmedetomidine does NOT treat behavioral disorders.
Dexmedetomidine does NOT treat behavioral disorders.
Dexmedetomidine does NOT treat behavioral disorders.
Got asked kinda last minute to cover consult service today and tomorrow even though I wasnβt originally supposed to start inpatient until mid-September.
First inpatient attending day in the books ππ
Doctor phoned in an antibiotic: doxycycline 50mg tablets, qty. 28. Drugstore price, with BlueCross insurance: $358. For a generic antibiotic!
I yelped in protest. Pharmacist suggested I ask the doc to switch to doxycycline 50mg CAPSULES, qty. 28. Identical medication. Price:
On my clinic schedule just for one day:
-HIV rapid start
-HIV 1 week follow-up after rapid start
-HIV 1 month follow-up after rapid start
Why do we still have so many new diagnoses in the year 2023?!
#HIVPrevention
#PrEP
#IDTwitter
#IDTwitter
When you have an HIV patient who is virologically suppressed and with acceptable CD4 count starting chemotherapy/immunotherapy for malignancy, do you start PJP prophylaxis?
@IdVilchez
Vanco+pip-tazo rivals or exceeds diazepam for anxiolysis of the person entering the orders in the EMR. Thatβs why itβs always used. Itβs not really for its anti microbial effect, but for its neuropsychiatric, self-medication effect.
Youβre telling me THIS is just part of the line up of speakers for the HIV conference this fall in CLE, and Iβm on service and canβt go?!
@PaulSaxMD
,
@CarlosdelRio7
, and a primary reason why I am an HIV doctor today, Joan Duggan?! So sad to miss this. Everyone needs to register!!
Oh just the typical consult Saturday. Leave work exhausted before all notes are done so I can make it to the grocery store. Notice the man in front of me at checkout and realize itβs Rob McClure. Fangirl and let him know how much I love his work!
β₯οΈ CLE theater
@playhousesquare
Find me a better dermatology consult.
Our whole team has been giggling all morning
Iβll forgive them for suggesting airborne, contact, AND droplet for VZV.
Some days ID consult service is full of cellulitis and C diff and then other days an HIV/AIDS + TB combo walks in the door, and youβve never felt more exhilarated.
Man, ID is the best.
#IDTwitter
I have no clue what this Epic message means, but it says that it was sent to orthopedic and podiatry providers. Bone and joint service is really taking off!!
Does this come with a pay raise?
#IDTwitter
*Opens this article because the topic is very relevant to a patient I am currently managing*
*Sees
@BDubbMD
's name on the author list π
woot woot, go Bryan!!
Weekend before starting consult service = getting 12+ days of meal prep done. There was more that I kinda forgot about until after I took the picture π
#IDTwitter
#mealprep
Just realized tomorrow is my last day of fellow clinic with one of my preceptors, and I am not okπ’
buuuut she'll officially be my division director in about a month, so I guess that makes it better
#MedEd
#IDTwitter
@ErinKarl_MD
My favorite was in an email from an applicant getting ready to interview the next day for residency! Umm not a good first impression at all
I didnβt make it to
#IDWeek
but had
@Cortes_Penfield
βs PowerPoint emailed to me at 8 oβclock this morning by someone who did!
Glad to see oral antibiotics for OM featured ππ
@galactic_baby
How I survived residency:
-meal prep (make sure to have good Tupperware, enough dishes/silverware, mostly everything dishwasher safe)
-blackout curtains
-Membership at Massage Envy (best thing I did tbh)
πJust published π
@CIDJournal
@iwgdf
/
@IDSAInfo
2023
IWGDF/IDSA Guidelines on the diagnosis and treatment of diabetes related foot infections PS: Published/posted May 2023 ,now if you like the IDSA/CID style
#IDXposts
Yesterday,
@utmedicalcenter
received its first allotment of the Pfizer-BioNTech COVID-19 Vaccine. Front line team members were among the first to receive the vaccine including current Internal Medicine Resident Chief Dr. Morgan Morelli.
#igotmine
#healthcareleaders
I would like to count how many times a smoke detector goes off in my apartment building...
So far we are at 6 this afternoon. Like what are you doing in there??
3 months until I move to my own place π
AIDS + Mycobacterium kansasii
And then today we added disseminated Histo into the mix! How many more OIs will we find?
Never a dull moment on ID consult service
#IDTwitter
First time experiencing the
@AlaskaAir
boarding process. I was in βbeautiful group Bβ βΊοΈβΊοΈ
Shoutout to the flight attendant for placing my extremely large poster in the closet up front!! MVP of the night
#SHEASpring2023
@RNSuperHero
I thought every hospital did this?
Favorites as code team leader in residency:
-Inpatient family member passed out in the room (labor and delivery)
-Patient with epilepsy had a seizure in a waiting room
-Person with COPD struggling to get up the stairs outside
So many others
Guess I wonβt be getting that $10k toward $$$ med school loans. But at the end of the day, Iβll be able to pay it off. Thinking about those who have a much larger financial struggle
Our full case report on an XDR Pseudomonas corneal ulcer associated with Ezricare artificial tears is officially published by AAC!! If you have interest in gram negative resistance or whole genome sequencing be sure to check out the supplement
#IDTwitter
Heading home after a wonderful
#SHEASpring2023
. It was my first but definitely not my last. I feel like I met my people while there. Yay antimicrobial stewardship!
@HelenPharmD
Congrats!! I did my internal medicine residency there and loved that hospital and the ID division π 2 of my best friends and my ID mentor are ID docs there!
Feel free to reach out if you have questions about the hospital or the area!
On the second day of Christmas, ID consults have to me, two infectious disease mimics
(I mean I'm pretty they don't have infections, remainder of the workup will tell!)
#IDTwitter