Happy new year and "Your LKA questions are now available" day to those who celebrate

Patient with alcohol use disorder, unhoused, presenting with Listeria sepsis. No obvious source. No meningitis symptoms. To LP or not to LP? #idsky

Stop. Smelling. People's. Urine. Signed, your friendly neighborhood ID doc.

Clofazimine? More like Clofazimeme amirite?

Rosalia's "Lux" shoe in for album of the year. Oklou's "Choke enough", Wet leg's "Moisteurizer" and Turnstiles "Never enough" are honorable mentions. Not as good a year as 2024 but pretty good highlights.

‘No Way To Prevent This,’ Says Only Nation Where This Regularly Happens https://theonion.com/no-way-to-prevent-this-says-only-nation-where-this-regularly-happens-3/

Me trying to have a normal Friday on service....sigh...

To the best of my knowledge, the real edge it has over vanco is decreased recurrence rate (at the cost of thousands vs pennies). Am I wrong? #idsky

Oral fosfomycin for non UTI esbl gram neg sepsis. Any data/anecdotes/thoughts? #idsky @bradspellberg.bsky.social

Great discussion!

I know we're all bogged down by bullshit. Burnout is rampant in medicine. The system sucks. But ignore that for a second and remember: what we do is interesting, meaningful and actually matters. Medicine is beautiful. You're fucking awesome.

Deer: Deer Are Fine - Horrifying Planet

A picture is worth a 1000 words. The birth dose of hepatitis B vaccines in the USA eliminated perinatally acquired hepatitis B infection from over 20,000 cases a year before the vaccine was introduced to <20 cases a year. The gaslighting by the current members ACIP is obscene, unethical and cruel.

🚨 >50% of ID fellowships went unfilled—just as the need is surging. Currently on ID consults and seeing unprecedented volumes and an increasingly immunocompromised population at risk for life-threatening infections. I’m worried we’re heading toward fewer specialists when we need them most.

We have an open spot. Come join our awesome family! @febrilepodcast.com

Spotify thinks I'm 21 so...hooray?

Based, goated and...uh...PO pilled

You've heard of "door to balloon" time. But are you aware of the "Taco Bell to the loo" time? #dadjokeforlike4people

🆕🔥🦴 Our 2025 Update to @wiki-guidelines.bsky.social for the Management of Pyogenic Osteomyelitis in Adults 🌟 @bradspellberg.bsky.social 🔗 [link] #idsky www.amjmed.com/article/S000...

Another great Farkas takedown

Reviewing applications for IM . My yearly reminder that I am extremely fortunate and would probably not get into residency in 2025. Holy crap these folks are impressive!

Unless volunteered by the patient without any promoting, I am deeply skeptical of urinary frequency of suprapubic pain as symptoms of cystitis/UTI. Fight me.

Just your weekly reminder

I love Wikipedia with a passion www.mcsweeneys.net/articles/hi-...

Solid advice once more from the onion

Re found this study which I now must have googled appropriately. Are the swedes just more based and goated? Look at that table comparing the guidelines and look at outcomes. At the very least its provocative. academic.oup.com/cid/article/...

🆕🔥State-of-the-Art Review with 🌟s @trubianojason.bsky.social : Antibiotic Allergy—A Multidisciplinary Approach to Delabeling #idsky url: academic.oup.com/cid/article/...

To follow up this post, I looked up some of the available data and ran some numbers. Math isn't my forte so I had my senior partner look over them but please correct me if you see flaws @jonathanrydermd.bsky.social

Someone way smarter than me once posted the MIC math behind the 2g/12 ceftriaxone for strep pneumo meningitis and also a discussion of how many pt would need vanco to treat 1 CRO resistant S.pneumo. Anyone remember? @bradspellberg.bsky.social @jgpharmd.bsky.social

We should have a system like those "Prove you're not a robot" but for UA and culture. Like show me you know what a UTI is for realsies. Multiple choice and essay.

Rejoice! For you are live in a timeline where Jeff Buckley's "Grace" exists.

Hey #idsky. Working on a presentation and wanted to embed this graph but be able to move the lines at the website does. Theres an option to copy an html link. Anyone know how to embed this on powerpoint? ourworldindata.org/grapher/meas...

Because I hate copilot and most of its variations

Uncertainty is ubiquitous in the practice of medicine. A new review characterizes clinical uncertainty and shows how teachers can guide learners to recognize, manage, and communicate uncertainty in practice. Read the full review: nej.md/43xKSQX @gdhaliwal1.bsky.social #MedSky #MedEd

Thank you for the in depth, detailed, borderline Homeric in scale, message about your patient. I don't have time to read the first 8 chapters of War and Peace. At that point, just call me lol

Guilty as charged. And yet she's still a Swifty.

At this point, my non work wardrobe boils down to Warhammer 40k, obscure bands and video game T-shirts. 13 year old me is very proud.

I want to know everything and anything about SBP, an entity that vexes and frustrates me, so I can annoy my hepatologist wife. Hit me with your best stuff #idsky

I've been waiting for a pressing for years. Man I love this record so much.

Antibiotics don't fail. We fail. You have the wrong diagnosis. #idsky

Antibiotics don't fail. We fail. You didn't have source control. #idsky

Great clinical conference today and first day of recruitment! Check out some of our cases from today.

I knew it!!!

I'll admit I started on the 1g/lb hype train when I started lifting. Looks like it's a good thing I never really hit that number.

Common sense!

This retrospective cohort from 🇫🇷showed that oral switch is a suitable option for treating IE, even for POET-ineligible patients ➡️treatment failure HR=0.55 favoring oral, 95%CI 0.27-1.17 ➡️more days alive outside 🏥 in oral group (59 vs 47, p=0.001) doi.org/10.1093/cid/... #IDSky

Is there ANYTHING vancopime can't treat?? #idsky

Life needs a balance patch. The "2 kids, 2 working parents and a mortgage" DLC makes progression too brutal (DLC is overpriced too!). Oh, and stay away from the "Modern politics" community mod. What a shitshow.

I once heard that if you have read 5 books on a subject you are considered close to an expert. At this point I have read 24 Warhammer 40k/Horus Heresy novels and played multiple games. Within the hobby community, this is considered an advanced novice.