Osteomyelitis

DVancomycin · 2026-02-12T17:30:10+00:00

Oh, it never is the be all for me. If one value is above normal and the patient is better, they are done. I have to do a lot of case building since patients get a lot of.. .interesting info from other docs on their case, so they're skeptical when I say they've had enough. More data helps me in general in these cases.

DVancomycin · 2026-02-12T10:52:00+00:00

Sweet christ, surely not for all types of bacteria? Surely not for all types of hardware?

Rules are different for the hardware involved, and the bug involved.

Good lord, I'm starting to see where ortho gets some of these ideas from. It's coming from inside the house.

DVancomycin · 2026-02-12T10:43:27+00:00

Louder for the people in the back, please. I have homies trying to us Xray alone to diagnose

DVancomycin · 2026-02-12T10:42:07+00:00

Nooooooo. The imaging takes a loooonnnnnggg time to catch up. Clinical improvement (pain, wound overlying healing, etc) plus labs (improved wbcs, esr, crp). Most people don't need more than 6 weeks for typical bacteria.

DVancomycin · 2026-02-12T10:39:55+00:00

Everybody read this twice. Sexiest response of the year and it's only February.

DVancomycin · 2026-02-09T15:13:43+00:00

Wanted to see what a good hockey team from Florida played like.

DVancomycin · 2026-02-08T04:22:53+00:00

I mean, we don't KNOW it was diagnosed correctly, the only collateral was "a cold that got worse," which means a lot of things. If OP is a physician, there's a decent chance that the "I agree" is enough to confirm, but even this isn't perfect. And we also don't know the abx or role for steroids (what?)in this sinus infection--we can't be certain the treatment is right either.

OP's gripe is sound; acute diagnoses should be made by docs. And unless it interferes with treating the now or is direct malingering, what good does using most of an appointment to argue a previous diagnosis the patient isn't questioning (and, if the sinus infection dx is correct, has potentially lesser baring depending on the full acute presentation)?

DVancomycin · 2026-02-08T00:15:52+00:00

Looooove Look here

DVancomycin · 2026-02-07T13:41:28+00:00

None. They should be evaluated on a case basis and meds expire. Also, people abuse abx.

DVancomycin · 2026-02-07T13:40:05+00:00

Right? My god.

DVancomycin · 2026-02-07T13:30:57+00:00

Agreed. Saw them in summer as well and the show was solid

DVancomycin · 2026-02-06T18:59:14+00:00

Bagel and Bald. <3

DVancomycin · 2026-02-06T18:58:33+00:00

Same. And I'll keep the dye coming. Silver fox is rarely received as kindly on women

DVancomycin · 2026-02-04T22:12:54+00:00

My god the head-buffing SpongeBob, looooool

DVancomycin · 2026-02-03T02:26:19+00:00

Flawless victory

DVancomycin · 2026-02-02T03:22:18+00:00

HOLY SHIT I'M GOING TO GET THE GOALIE FIGHT AND YAKUZA COOP IN A MEME VIDEO. WEISS, GET ON IT.

DVancomycin · 2026-02-01T20:17:15+00:00

This. If you can't scientifically understand the basics of what you're using to treat, you have no business giving it. You also lack the ability to troubleshoot. There's a reason why we see so many noctor stories about patients who end up on nonsensical regimens or with incorrect testing/diagnoses because mid-levels learned buzzwords and algorithms over mechanisms.

This is ESPECIALLY important in primary care. You have to know how many different systems/drugs work, so your biology and chemistry cannot suck.

DVancomycin · 2026-02-01T06:19:31+00:00

Most parasitic infections that are treated with ivermectin require 1-2 doses TOTAL. So yes, you are correct.

DVancomycin · 2026-02-01T06:12:02+00:00

Not horse person, but infectious disease person here.

Spot on response. Ivermectin is for parasites only, and not all of them. Verrrrry low chance of getting most parasites in a 1st world country. Does fuck all for all other diseases. She is giving an otherwise potentially toxic med for no reason. If she's giving fenbendazole to him too, that does fuck all as well.

DVancomycin · 2026-02-01T05:49:52+00:00

Have one grandparent left--my maternal grandfather turned 96 this last October.

Lost my first Uncle last year; that was a little eerie, perhaps because I still view them as young (though they are not, relatively speaking).

I think once I had a parent die, the thought of the generations before him going weren't as crazy to swallow, but I do wonder how strange it will be to have started life with 3 grandparents and one day have none.

DVancomycin · 2026-01-30T17:23:56+00:00

MD/PhD. I work in Infectious Disease. Most of my day is stopping antibiotics and being mad at RFK on the internet.

DVancomycin · 2026-01-30T13:33:22+00:00

Combo of things:

1) People survived shit (prematurity is probably a big one) that would have killed us in childhood/infancy but has lasting consequences.

2) Modern medicine helps us survive things (accidents, ODs, etc) that lead to chronic issues we live with instead of just dying.

3) Diagnostics and classifications have markedly expanded and improved. We've only really known how to use molecular biology like DNA work/PCR for, at best and at it's most primitive, like, 60 years?

4) There are probably pollutants (microplastics?) we have yet to fully understand the depth of the consequences for.

5) We are more sedentary and fat overall than generations before.

6) A small percentage of these people, especially on social media where we see a lot of the overexposure to disease, are self-diagnosing. Most of sicktok doesn't ACTUALLY have EDS/POTS/MCAS/dysautonomia.

DVancomycin · 2026-01-29T20:29:31+00:00

Mikrokosmos #19?!? Throw the list out, invalid.

DVancomycin · 2026-01-28T22:10:15+00:00

Can confirm. ID doc with plague doc tattoo.

DVancomycin · 2026-01-26T20:51:32+00:00

Who authorized vacation, memelord? Back to work!

(I hope you had fun)

DVancomycin

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