{"id":10242,"date":"2021-12-13T13:57:18","date_gmt":"2021-12-13T18:57:18","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=10242"},"modified":"2021-12-18T16:48:31","modified_gmt":"2021-12-18T21:48:31","slug":"id-learning-units-from-inpatient-id-consults","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/id-learning-units-from-inpatient-id-consults\/2021\/12\/13\/","title":{"rendered":"ID Learning Units from Inpatient ID Consults"},"content":{"rendered":"
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Nerve cells in a dog’s olfactory bulb, from Camillo Golgi’s Sulla fina anatomia degli organi centrali del sistema nervoso (1885).<\/p><\/div>\n

Need a break from all-things COVID-19? Feeling OH-verwhelmed by OH-muh-kron?<\/p>\n

(I guess that’s how some pronounce it … or AWE-mee-kron… or\u00a0oh-MIKE-ron … or who knows.<\/a>\u00a0Two things for sure — there’s no “n” after the “m”, and it’s a drag regardless of how it’s pronounced.)<\/p>\n

To cheer everyone up, here’s a palate cleanser of non-COVID-19 ID Learning Units from a stretch on the inpatient ID service earlier in the fall. I’ve been storing them up just for today.<\/p>\n

Here are the criteria for inclusion:<\/p>\n

    \n
  1. Has to be related to a case.<\/li>\n
  2. Has to be posted each consecutive day. (Careful readers will note I missed one so did two on one day. Mea culpa.)<\/li>\n
  3. Has to have a reference.<\/li>\n
  4. Has to be interesting.<\/li>\n
  5. Has to have no patient confidentiality issues.<\/li>\n<\/ol>\n

    And for this batch, it has to be a non-COVID-19 topic. Though some may find it hard to believe, there are other infectious diseases out there — in fact the entire field of ID<\/em> existed before SARS-CoV-2 ever jumped its way to humans and started this dismal pandemic.<\/p>\n

    As always when on service, I’m very grateful to have worked with a couple of highly energetic and smart ID fellows, an ID pharmacy team (faculty and resident) who taught me something daily, plus a medical resident who seems destined (I hope) to be a great future ID doc.<\/p>\n

    Hooray for that!<\/p>\n

    Off we go, each with a bit of commentary about why they were selected:<\/p>\n

    #1:<\/strong><\/p>\n

    \n

    Day #1: NADIA trial — after rx failure, DTG non-inferior to DRV\/r when given with either TDF\/3TC or ZDV\/3TC, despite *extensive* NRTI resistance. Huge implications for management of both viremic and suppressed patients. https:\/\/t.co\/Mjx6EWoH4J<\/a><\/p>\n

    — Paul Sax (@PaulSaxMD) October 13, 2021<\/a><\/p><\/blockquote>\n