(1/3) Critical pearl in inpatient medicine: When a patient is on moderate- to high-dose steroids, fever curve and degree of neutrophilic leukocytosis become unreliable markers of clinical improvement. Why? Steroids can tamp down fever and cause leukocytosis on their own.

Steroids are immunosuppressive because they decrease inflammation. However, acutely, we can use this to our advantage in dampening the immune response against certain infxns. Over time, too much steroid use can be problematic. Acutely, the risk/benefit can be in favor of use.

Hence the summary chart below! 👇 BCM IM Residency BCM ID Fellowship Manny Guajardo Alexander Franklin Amna Ahmed Jesica Hayon Megan Duffey, MD Patti Ashley, MD Eva Amenta Anthony J. Febres A. 🔬🦠🎹

Remember that moderate- to high-dose steroids can tamp down emergence of fever. Therefore, presence of fever in this situation becomes a less reliable indicator of the possibility of infection.

【Lactose non-fermenting GNR】 Let's remember these major important lactose non-fermenting GNR! Oxidase test is the next step to narrow your differentials! #ClinicalPearl by Prathit Kulkarni, MD Level: Intermediate to advanced Importance: ★★★ #IDTwitter #IDMedEd #IDFellow

Some simple tips for educational maximization for teaching attendings: - Bring food on weekends and holidays - Avoid critiquing ppl for missing something in the chart. There’s a lot of info in there, and everyone can occasionally miss something. 1/

Pro tip for all Internal Medicine trainees: When we say that a patient’s lab result is at “baseline,” if it is abnormal, there should be a reason why it’s abnormal. And we should be able to clearly articulate that reason, even if the explanation is simple. 1/

This is well-known in clinical medicine, but just to list it explicitly (because it can sometimes be confusing): WBC counts which are considered inflammatory in different body fluids: Urine: >5-10 CSF: >5 Joints: >2,000 Ascitic fluid: >500 (and >250 PMNs)

Fantastic get-together last night to welcome the new ⁦BCM Department of Medicine⁩ ⁦BCM ID Fellowship⁩ fellows !!! Featuring the legend himself Dr. Daniel Musher!

【Absence of Cerebrospinal Fluid Pleocytosis in Encephalitis】Clinical Infectious Diseases Aug 3 2024 Congrats to @UT_Infectious Dr. Hasbun’s team and Johns Hopkins Department of Medicine! Absence of CSF pleocytosis: 👉24% of HSV-1 👉Acyclovir should not be delayed! doi.org/10.1093/cid/ci… #IDMedEd #NeuroID

Mastering the ECG. 10 Simple Rules of a Normal ECG.

We have an #ID #HIV job opening BCMHouston. Learn more. healthecareers.com/idsa/job/infec… HIV Medicine Association IDSA #IDSA #IDWeek2024 Prathit Kulkarni, MD Eva Clark UTHealth Houston School of Public Health Riti Sharan

Our study showed that switching from commercial to manual diversion did not affect contamination rate but led to a marked reduction in hospital costs. IDWeek BCM IM Residency CommonSpirit Health

Perceptions of hand hygiene versus reality presented by Prathit Kulkarni, MD #IDWeek24

Thanks, Tyler Brehm for presenting our work to develop patient-friendly advice about antibiotic safety #IDweek24

Looking forward to the #MedEd Brown Bag lecture today with BCM Department of Medicine Prathit Kulkarni, MD

Out now in TransplantID Journal! T-SPOT.TB is more likely to produce actionable results than QFT-TB in patients with cancer being screened for latent TB. With Marjorie V Batista MD, TID, PhD Dr Roy Chemaly Prathit Kulkarni, MD Firas El Chaer, MD, MSHCM Georgios Angelidakis MD Anderson Cancer Center #TxID onlinelibrary.wiley.com/doi/10.1111/ti…

Stay informed. Prathit Kulkarni, MD update on Mpox-- available only on BCM Clinician Resources. Watch here: bit.ly/3HoOxIB

Great talk from Prathit Kulkarni, MD on opportunistic infections in patients living with HIV during our HIV Grand Rounds at Eastern Virginia Medical School EVMS Medicine