National Mango Day

Looks like I need to take a trip to Mali! The BBC has a picture gallery of the recent event. Their first picture, copied below, has me positively salivating!

Aha! I feel vindicated.

In a recent post, I took aim at a BusinessWeek article and site comments that insinuated that women doctors were a waste of aim using the changing scope of medicine as their proof. I countered that those same changes were very much welcomed by the young men in medicine as well and that the phenomenon is really one of changing times.

So yesterday, the Wall Street Journal published an article titled, As Doctors Get a Life, Strains Show. They were talking about doctors who have recently completed training in the past decade buckling the trend of how medicine used to be.

And I quote:

Walter Cheng, 32 years old, is in the profession's new guard. Upon graduating from the Johns Hopkins School of Medicine in 2004, he bristled at the notion espoused by some senior physicians that a doctor should put medicine above all else. "I thought, 'I don't really want to be that kind of doctor.'... My family is as important, if not more important, than my career."

Aha! And I do believe Walter is a man! The rest of the article is just as insightful. Going back to my original post, third paragraph to the end pretty much sums it up.

ID Consults Roster #8

In this month, I saw all of about 15 new consults. Whew! What hard work, smirk.

1. BIODEFENSE

• none

2. BONE/JOINT

• Methicillin resistant Staphylococcus aureus and Escherichia coli foot gangrene/osteomyelitis
• Avascular necrosis of bilateral femoral heads, not otherwise specified

3. CARDIAC

• none

4. DERMATOLOGIC

• Cellulitis, not otherwise specifed
• Methicillin sensitive Staphylococcus aureus cellulitis/abscess with toxin production

5. EYES/ORBITS

• none

6. FEVER

• T cell lymphoma (not an infectious disease)
• Neutropenic fevers of unknown etiology over many months!

7. GASTROINTESTINAL

• Coagulase negative Staphylococcus & Morganella morganii infected pancreatic psuedocyst with secondary peritonitis
• Clostridium difficile colitis (4)

8. GENERALIZED INFECTION

• Lyme disease of indeterminate age

9. GENITOURINARY

• Pseudomonas cepacia catheter associated urinary tract infection

10. GYNECOLOGIC

• none

11. HEENT

• none

12. HIV/AIDS

• Adverse effect (nausea) to different formulation of ART

13. NEUROLOGIC

• Presume neuroborelliosis

14. RESPIRATORY

• Methicillin sensitive Staphylococcus aureus & extended spectrum beta-lactamase producing Klebsiella pneumoniae ventilator associated pneumonia
• Extended spectrum beta-lactamase producing Klebsiella pneumoniae colonization (in sputum)
• Extended spectrum beta-lactamase producing Escherichia coli ventilator associated pneumonia
• Community acquired pneumonia, not otherwise specified
• Escherichia coli ventilator associated pneumonia
• Lung nodules of unclear etiology in neutropenic patient with multiple malignancies

15. SEPSIS SYNDROMES

• Salmonella group D sepsis
• Vancomycin resistant enterococcus bacteremia
• Escherichia coli bacteremia
• Coagulase negative Staphylococcus PICC line associated bacteremia

16. SEXUALLY TRANSMITTED INFECTIONS

• none

17. SURGICAL INFECTIONS

• none

18. TRAVEL/TROPICAL

• none

19. VACCINE ADVERSE REACTIONS

• none

ID Consults Roster #7

In this month, I saw about 60 new consults. SIXTY!

1. BIODEFENSE

• none

2. BONE/JOINT

• Prosthetic knee infection, not otherwise specified
• Presumed methicillin resistant Staphylococcus aureus prosthetic hip infection
• Methicillin resistant Staphylococcus aureus prosthetic knee infection
• Vancomycin resistant Enterococcus prosthetic knee infection
• Methicillin sensitive Staphylococcus aureus C4 - C6 osteomyelitis
• Methicillin sensitive Staphylococcus aureus hip septic arthritis in HIV patient
• C4 - C6 osteomyelitis of unclear etiology in normal host
• Coagulase negative Staphylococcus prosthetic hip infection

3. CARDIAC

• Diptheroids as contaminant in pericardial fluid
• Presumed methicillin sensitive Staphylococcus aureus endocarditis in HIV patient
• Methicillin resistant Staphylococcus tricuspid valve endocarditis and pacer infection

4. DERMATOLOGIC

• Cellulitis, not otherwise specified
• Methicillin sensitive Staphylococcus aureus soft tissue infection associated with epidural catheter
• Escherichia coli and methicillin resistant Staphylococcus aureus diabetic foot ulcer
• Diabetic heel ulcer, not otherwise specified
• Varicella zoster in immunocompetent patient
• Frostbite/Gangrene of lower extremities, multiple pathogens

5. EYES/ORBITS

• none

6. FEVER

• Fever of unknown etiology in transitional cell bladder cancer patient
• Neutropenic fevers of unclear etiology

7. GASTROINTESTINAL

• Peritoneal catheter associated peritonitis in ESRD patient, not otherwise specified
• Clostridium difficile colitis (2)
• Pancreatitis

8. GENERALIZED INFECTION

• Drug induced rash and headache
• Persistent leukocytosis (years) of unexplained etiology

9. GENITOURINARY

• BK polyomavirus associated hemorrhagic cystitis in bone marrow transplant recipient
• Catheter associated urinary tract infection, not otherwise specified
• Citrobacter freundii urinary tract infection
• Escherichia coli urinary tract infection
• Enterococcus spp. urinary tract infection

10. GYNECOLOGIC

• Tubo-ovarian abscess, not otherwise specified

11. HEENT

• none

12. HIV/AIDS

• Streptococcus pneumoniae community acquired pneumonia
• Methicillin sensitive Staphylococcus aureus bacteremia/septic athritis/presumed endocarditis

13. NEUROLOGIC

• Presumed viral meningitis
• Presumed bacterial meningtitis, altered anatomy
• Viral meningitis
• Varicella zoster meningitis

14. RESPIRATORY

• Presumed cavitatory pneumonia not otherwise specified (vs. lung cancer)
• Presumed ventilator associated pneumonia, no pathogens isolated
• Hospital acquired pneumonia, not otherwise specified
• Serratia marcesens ventilator associated pneumonia
• Methicillin sensitive Staphylococcus aureus pneumonia, presumed post-influenza
• Streptococcus pneumoniae community acquired pneumonia with parapneumonic effusion in newly diagnosed HIV patient
• Streptococcus pneumoniae, Haemophilus influenzae & Aspergillus spp (not niger/flavus/fumigatus) in BAL fluid in patient with prior non-small cell lung cancer with new nodule
• Aspiration pneumonia, not otherwise specified, in advanced parkinsonism

15. SEPSIS SYNDROMES

• High grade methicillin resistant Staphylococcus aureus bacteremia with increasing vancomycin MIC > 2.o
• Methicillin sensitive Staphylococcus aureus bacteremia (3); typically line associated
• Streptococcus pneumoniae sepsis
• Candida albicans fungemia with Eikenella corrodens & coagulase negative Staphylococcus bacteremia
• Methicillin resistant Staphylococcus aureus bacteremia (2); typically line associated
• High grade coagulase negative Staphylococcus bacteremia after recent AV graft placement
• Candida albicans fungemia associated with tunnelled line for dialysis

16. SEXUALLY TRANSMITTED INFECTIONS

• none

17. SURGICAL INFECTIONS

• Escherichia coli anstomotic leak after hiatal hernia repair
• Methicillin sensitive Staphylococcus vascular graft infection
• Coagulase negative Staphylococcus & Enterobacter cloacae mediastinitis after esophagectomy for esophageal cancer
• Micrococcus and Candida albicans mediastinitis after esophageal repair after spontaneous rupture
• Extended spectrum beta-lactamase producing Escherichia coli and Bacteroides fragilis pelvic abscess after ureteral stent repair
• Coagulase negative Staphylococcus superficial surgical wound infection after placement of AV graft
• Wound infection soon after vascular graft placement (days - weeks) (2)

18. TRAVEL/TROPICAL

• none

19. VACCINE ADVERSE REACTIONS

• none

ID Consults Roster #6

In this month, I saw about 20 new consults.

1. BIODEFENSE

• none

2. BONE/JOINT

• Proteus mirabilus gangrene of left 5th toe
• Chronic osteomyelitis not otherwise specified
• Methicillin resistant Staphylococcus aureus ischial osteomyelitis
• Ilial osteomyelitis in HIV patient, not otherwise specified

3. CARDIAC

• Methicillin resistant Staphylococcus aureus endocarditis and pacer infection
• Streptococcus agalactiae vascular graft infection

4. DERMATOLOGIC

• Cellullitis, not otherwise specified
• Methicillin sensitive Staphylococcus aureus wound infection (2)

5. EYES/ORBITS

• none

6. FEVER

• none

7. GASTROINTESTINAL

• Presumed spontaneous bacterial peritonitis
• Presumed Clostridium difficile associated diarrhea
• Clostridium difficile colitis (2)
• Vancomycin resistant enterococcus & Candida glabrata peri-rectal abscess

8. GENERALIZED INFECTION

• none

9. GENITOURINARY

• Asymptomatic pyuria in a spinal cord injury patient (countless!)
• Chronic foley associated recurrent urinary tract infection
• Asymptomatic bacteruria in a spinal cord injury patient (countless!)
• Pseudomonas aeruginosa urinary tract infection
• Pseudomonas aeruginosa & vancomycin resistant enterococcus nephrostomy site infection

10. GYNECOLOGIC

• none

11. HEENT

• none

12. HIV/AIDS

• Ischial osteomyelitis, not otherwise specified

13. NEUROLOGIC

• none

14. RESPIRATORY

• Methicillin resistant Staphylococcus aureus pneumonia
• Haemophilus influenzae & Streptococcus pneumoniae pneumonia

15. SEPSIS SYNDROMES

• Methicillin resistant Staphylococcus aureus bacteremia
• Enterococcus bacteremia with Candida albicans fungemia
• Streptococcus agalactiae bacteremia

16. SEXUALLY TRANSMITTED INFECTIONS

• none

17. SURGICAL INFECTIONS

• Pseudomonas aeruginosa & vancomycin resistant Enterococcus nephrostomy site infection
• Streptococcus agalactiae vascular graft infection
• Methicillin sensitive Staphylococcus aureus saphenous vein harvest site infection

18. TRAVEL/TROPICAL

• none

19. VACCINE ADVERSE REACTIONS

• none

ID Consults Roster #5

In this month, I saw about 40 new consults.



1. BIODEFENSE

• none

2. BONE/JOINT

• Methicillin sensitive Staphylococcus aureus L2 osteomyelitis
• Methicillin sensitive Staphylococcus aureus L4-L5 osteomyelitis
• Chronic osteomyelitis
• Sacral decubitis ulcer/osteomyelitis not otherwise specified
• Methicillin resistant Staphylococcus aureus chronic osteomyelitis of distal tibia
• Methicillin resistant Staphylococcus aureus finger septic arthritis
• ESBL producing Escherichia coli foot osteomyelitis
• Jaw osteomyelitis, not otherwise specified
• Hip osteomyelitis, not otherwise specified

3. CARDIAC

• Methicillin sensitive Staphylococcus aureus tricuspid valve endocarditis with septic emboli to brain & spleen
• Presumed methicillin resistant Staphyloccus aureus endocarditis
• Presumed Streptococcus endocarditis

4. DERMATOLOGIC

• Preseptal cellulitis
• Cellulitis not otherwise specified
• Dissemeninated varicella (herpes zoster)
• Decubitus ulcer of the heel

5. EYES/ORBITS

• Preseptal cellulitis

6. FEVER

• none

7. GASTROINTESTINAL

• Methicillin sensitive Staphyloccus aureus & vancomycin resistant Enterococcus acute cholecystitis
• Presumed Clostridium difficile colitis
• Acute cholecystitis not otherwise specified
• Vancomycin resistant enterococcus cholecystitis
• Infected pancreatic psuedocyst not otherwise specified
• Methicillin resistant Staphylococcus aureus infected pancreatic psuedocyst
• Acute on chronic pancreatitis in HIV/AIDS patient, not otherwise specified

8. GENERALIZED INFECTION

• none

9. GENITOURINARY

• Escherichia coli urosepsis
• Urinary tract infection in HIV patient, not otherwise specified

10. GYNECOLOGIC

• none

11. HEENT

• none

12. HIV/AIDS

• Pneumocystis jerovecii pneumonia
• Cryptococcemia with cryptococcus meningitis
• Presumed community acquired pneumonia
• Urinary tract infection, not otherwise specified
• Presumed meningitis
• EBV associated polyradiculopathy
• COPD exarcebation
• Acute on chronic pancreatitis

13. NEUROLOGIC

• Cryptococcus meningitis
• Meningitis in HIV patient, not otherwise specialized
• EBV associated polyradiculopahthy in HIV patient
• Presumed chemical meningitis

14. RESPIRATORY

• Pneumocystitis jerovecii pneumonia in HIV/AIDS patient
• Varicella (Herpes zoster) pneumonia
• Presumed community acquired pneumonia in HIV/AIDS patient
• COPD exarcebation in HIV/AIDS patient

15. SEPSIS SYNDROMES

• Methicillin sensitive Staphylococcus aureus bacteremia (4)
• Methicillin resistant Staphylococcus aureus bacteremia
• Group B Streptococcus bacteremia
• Cryptococcemia
• Enterococcus line related infection
• Escherichia coli urosepsis
• ESBL producing Enterobacter cloacae bacteremia

16. SEXUALLY TRANSMITTED INFECTIONS

• none

17. SURGICAL INFECTIONS

• L tibial hardware associated infection, s/p ORIF
• Enterococcus hardware associated infection
• Methicillin resistant Staphyloccus aureus hardware associated infection

18. TRAVEL/TROPICAL

• none

19. VACCINE ADVERSE REACTIONS

• none
  
  

ID Consults Roster #4

In this month, I saw about 30 new consults.

1. BIODEFENSE

• none

2. BONE/JOINT

• Methicillin resistant Staphylococcus aureus prosthetic knee infection (2)
• Methicillin resistant Staphylococcus aureus diabetic foot osteomyelitis
• Presumed methicillin resistant Staphylococcus aureus C2-C4 prevertebral space infection
• Chronic osteomyelitis

3. CARDIAC

• Group B Streptococcus presumed endocarditis
• Coagulase negative Staphylococcus pacer infection

4. DERMATOLOGIC

• Escherichia coli peri-rectal abscess
• Methicillin resistant Staphylococcus aureus femoral pseudoaneurysm infection, post-op
• Methicillin resistant Staphylococcus aureus buttock abscess
• Methicillin resistant Staphylococcus aureus abscess, likely community acquired
• Group B Streptococcus & Methicillin sensitive Staphylococcus aureus diabetic foot ulcer
• Scrotal herpes zoster
• Cellulitis, not otherwise specified (2)
• Mycoplasma chelonae/abscessus complex foot cellulitis
• Great toe paronychia

5. EYES/ORBITS

• Herpes ophthalmicus in HIV patient

6. FEVER

• Presumed acute retroviral syndrome

7. GASTROINTESTINAL

• Clostridium difficile colitis

8. GENERALIZED INFECTION

• none

9. GENITOURINARY

• Escherichia coli urinary tract infection (2)
• Escherichia coli urosepsis with prostatic abscess
• Methicillin resistant staphylococcus aureus and Enterococcus faecalis urosepsis
• "Dirty urine" in paraplegic patient with chronic urinary catheter

10. GYNECOLOGIC

• none

11. HEENT

• none

12. HIV/AIDS

• Presumed acute retroviral syndrome

13. NEUROLOGIC

• none

14. RESPIRATORY

• Pseudomonas aeruginosa ventilator associated pneumonia
• Haemophilus influenzae hospital acquired pneumonia
• Amp-C producing Enterobacter cloacae pneumonia

15. SEPSIS SYNDROMES

• Methicillin resistant Staphylococcus aureus bacteremia (2)
• Methicillin sensitive Staphylococcus septic shock syndrome
• Enterococcus faecalis bacteremia
• Group B Streptococcus bacteremia
• Escherichia coli bacteremia

16. SEXUALLY TRANSMITTED INFECTIONS

• none

17. SURGICAL INFECTIONS

• Methicillin sensitive Staphylococcus aureus R femoral pseudoaneurysm infection, post-op

18. TRAVEL/TROPICAL

• none

19. ADVERSE VACCINE REACTIONS

• none