“Get rest and drink plenty of fluids,” might not sound like adequately aggressive medical advice. If you’ve dragged yourself out of bed to visit an urgent care or your doctor’s office, you will probably feel somewhat cheated by an admonition to head ri…
Category: Infectious disease
Everything you ever wanted to know about croup
Imagine this scenario. Your two-year-old son has had a runny nose for a day or two and an occasional cough, but seemed no worse to you that everyone else in his preschool class. Two hours after you put him to bed you hear him coughing, only this cough …
Physicians are trapped between patient satisfaction and unnecessary prescribing
I don’t mean to pick on McDonald’s. Insert any other large retail business where customer satisfaction massively trumps every other consideration of the relationship between employee and customer. Telemedicine companies have exploded the past few years…
Be a master at your craft by taking time each day to truly rest
I am bad at taking vacations — really bad. It’s not that I don’t take days off or even travel on days off. It’s my near inability to actually unplug and not bring work with me. Despite recovering from a level of burnout a few years ago that left me con…
Why it’s important to determine who’s truly penicillin-allergic
A true allergic reaction is one of the most terrifying events in medicine. A child or adult who is highly allergic to bee stings or peanuts, for instance, can die within minutes without a life-saving epinephrine injection. But one of the most commonly …
Prescribing unnecessary antibiotics is the path of least resistance
During my urgent care shifts, I see 20 to 30 people with viral upper respiratory infections. They are all feeling miserable, and they just want to feel better. They want an impressive-sounding diagnosis to justify their suffering to themselves, their s…
MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). […]
Flu vaccination in pregnant women reduces risk of hospitalization
Influenza is the leading cause of vaccine-preventable deaths in the United States. Influenza also tops the list of the burden of disease and disability-adjusted life years (DALYs) according to a Eurosurveillance article. The flu is more likely to cause severe illness and harm pregnant women as compared to women who are not pregnant. Changes in the immune […]
MKSAP: 34-year-old man with slow-growing lesions
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old man is evaluated for several slow-growing lesions on his penis. He first noticed the wart-like growths 3 years ago, and they have progressively enlarged. He was treated with topical cryotherapy six times and topical imiquimod over the past year […]
Antibiotics vs. surgery for appendicitis: what one surgeon thinks
Here are a few thoughts about the latest chapter in the never-ending debate about antibiotics vs. surgery for the treatment of uncomplicated appendicitis. You will recall the randomized controlled trial from Finland published in 2015 that found a 27% rate of failure of antibiotics within the first year. Now that the patients have now been followed for […]
