Category: Infectious disease

Please stop the over-diagnosis of UTIs

I admitted an elderly woman to the hospital recently.  The previous week, she had presented to the emergency department (ED) with chest pain and shortness of breath.  For some unknown reason, a urinalysis was obtained and was found to be abnormal.  The…

Doctors shouldn’t feel guilty about sick days

It’s 2 a.m. And I’m in the emergency room. There are beads of sweat dripping from my forehead. One of my nurses comments that I just don’t look quite right. I can feel the urge to vomit and know where the nearest trash can is at all t…

The erroneous belief that the elderly have the healing power of younger individuals

A wise professor of medicine always told me as a young physician, “Eighty-year olds are to be revered and not messed with.”   This is especially true for those 90 or older.  Here in South Florida, there is always some senior citizen telling us today’s …

MKSAP: 19-year-old man with lightheadedness and nightly fevers

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 19-year-old man is hospitalized with a 6-day history of lightheadedness and nightly fevers. He also reports sore throat, headache, joint an…

Why developing new antibiotics is a losing battle

“We believe that the current entrepreneurial development model for antibiotics is broken and needs to be fundamentally transformed.” This provocative opinion is from a recent editorial in the New England Journal of Medicine. The introductio…

Why the flu shot cannot give you the flu (and why you should get one now)

Flu vaccination prevents millions of flu-related illnesses and deaths annually, but vaccination rates are low for many reasons. During the 2018-2019 flu season, the Centers for Disease Control and Prevention reported that about 45% of U.S. adults recei…

Is the National Institutes of Health stifling academic freedom?

An episode pitting top administrators at the National Institutes of Health (NIH) against senior scientists at the organization serves as a vital reminder of the importance of academic freedom and the need to communicate and express concerns about scien…

MKSAP: 64-year-old woman with severe COPD

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old woman is evaluated during a posthospital visit for severe COPD with an FEV1 of 30% of predicted. She has been admitted three ti…

Questions about the measles outbreak you were afraid to ask

There have been over 1,000 cases of measles in the first half of 2019–the most since 1992, according to the CDC. For comparison, 2018 had 372 cases. With New York at the center of the outbreak, it’s reasonable to have questions–from how to know if you’…

MKSAP: 38-year-old woman with fever and flank pain

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old woman undergoes follow-up evaluation in the office. She was evaluated in the emergency department 3 nights ago with fever and f…