Category: Infectious disease

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…

Why is the toilet seat the gold standard for germs?

Google that phrase, and you will come up with lots of hits. The following is a partial list of things that have been found to have more germs than a toilet seat: Kitchen cutting boards, sponges and sinks, refrigerators, spatulas, pet food bowls, clean …

Are antibiotics needed for your child with an ear infection?

The common practice in this country (although not everywhere — Europe, for example) has long been to treat all acute middle ear infections (otitis media) with antibiotics. This is not necessarily needed. We now know that for many children another…

The horrors of the diseases that vaccines prevent

In October of 2016, I returned to Bernard Mevs Hospital in Port Au Prince, Haiti. Hurricane Matthew, a category 4 hurricane, had touched down near Jeremie only four days prior. Hurricane Matthew caused significant devastation with over 2 million people…

The breakthroughs and failures of medicine

There is a pervasive tendency to turn to medicine looking for magic. Patients and health care professionals alike generally expect medicine to be able to cure diseases, alleviate symptoms, and relieve suffering. Historically, medicine has met and excee…

The rise and fall of measles vaccinations

Ten years ago it would not have been worth my time to write about measles nor yours to read about it. In the year 2000, thanks to a very effective 2-shot childhood vaccination program using a combined measles-mumps-rubella (MMR) vaccine, the U.S. was d…

Should adults receive another dose of MMR?

While the vast majority of measles cases in the U.S. and worldwide are occurring in unvaccinated children, a fair percentage is also occurring in adults.  With more-widespread transmission of measles, it’s becoming more important for all of us – yes, t…