Integrative Infectious Diseases

Had my doubts about this one..... I bet quitting sugar, improving the microbiome by eating mainly fresh vegetables and improving collateral circulation by adding 20 mins/day of any form of exercise would have MORE than a "modest" benefit.

Thank you to the peer reviews that made it possible for me to make this list second year in a row. Continuing to grow my professional skills, this year in New Zealand, with the goal to provide quality care for all my patients and be the best doctor I can be. #superdoctors2019 #nytimes #grateful #infectiousdiseasedoctors #womeninmedicine #somedocs

Day 1 at the Sexual health Clinic in New Zealand! As I learn the landscape of HIV / STI in my new environment I see several differences Incidence is quite low. Rates among heterosexual in some areas higher than MSM community. Meds are limited and doctors need special permission to prescribe them, but they are funded and available. This is true for PreP as well, making it difficult for primary care docs to start Prevention antivirals. Emphasis on nutrition,stress control a...nd social connection/family for better health outcome. What's not different? 1)STIGMA. 2)ADHERENCE BARRIERS to keeping with daily treatment. 3)Rising rates of STD's including Gonococcal and Syphilis cases. 4) Patients asking when is the cure coming? It was very nice to be able to share my experience with the patients when they asked "about all those new meds in America". As dysfunctional as our health system is we really are very fortunate in some regards. Looking forward to collaborating with such knowledgeable colleagues in bringing quality care to patients living with this disease on the other side of the world. #infectiousdiseasedoctors #locumslife #sexualhealth #somedocs #newzealandmedicine #hivawareness #endaids #knowyourstatus #lifeisanstd #knowledgispower #undetectableequalsuntransmittable

OH HOW I MISSED THIS!.... Even the smell of the lab is soothing for me..There's something about seeing the culprit under the microscope. We ID docs ALWAYS nag about cultures and the reason is that you get SO much information this way. It's invaluable to solving a case! This is Streptococcus pnemoniae. First slide in blood then CSF- cerebrospinal fluid! Two of the places it should NEVER be in!! This is the feared infection with this bacterium and the reason why doctors recom...mend the "pneumonia shot". It's not to prevent 'pneumonia' alone (which can occur for many other reasons) , as much as the devastating effects of the Pneumococcus! This infection is more likely and much worse in "elderly "immunocompromised * those with chronic health issues (diabetes, lung diseases, etc). There are two different vaccines- each interacting differently with your immune system and offering different strains protection. Good news is immunity lasts several years so you don't need vaccine doses very often. If you fall in one of the categories listed, please please please demand your shot! Conozcan el Neumococo- una bacteria devastadora cuando infecta la sangre y líquido cefaloraquideo. Esto ocurre en personas immunocomprometidas, enfermedades crónicas y mayores de 60 años. Afortunadamente existe una vacuna! Importante aplicarse la vacuna conocida como "vacuna de neumonía" #microbiology #vaccinessavelives #sabbaticalyear #locumslife #womeninmedicine #somedocs #infectiousdiseasedoctors #microscopyart #detectivewoman #scienceissexy

While NYC deals with C.auris, I am seeing different species I had only seen in old textbooks. Candida pulcherrima. This yeast described in 1901 by Lindner is named after Pulcherrimin the red pigment produced by it in special growth conditions. There is a lot of talk about "Candida" in wellness sites but as Infectious disease doctors in a hospital, the candida we see is quite different. It's acute, life threatening and an EMERGENCY! The conditions leading to this acute infe...ction are heavy immunosuppression from chemotherapy or drugs used to prevent transplant rejection, intravenous feeding when people can't eat through the normal route, having indwelling catheters in place, prolonged exposure to BROAD intravenous antibiotics. The good side is that the two syndromes don't overlap. Having dysbiosis doesn't lead to this life threatening infection generally because the conditions are very different. I think these differences are why many clinicians brush off the "overgrowth" associated with dysbiosis described by so many people in the office setting. I find they are both real entities but the management for the two is night and day. I love being able to treat both because the science does cross-pollinate. #candida #dysbiosis #fungalinfection #hospitallife #infectiousdiseasedoctors #womeninmedicine #somedocs #integrativemedicine & #westernmedicine #candidaovergrowth #microbiology #microbiomehealth #petridish #microlab