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September 20, 2017

The sandfly is the vector but the gerbil is the reservoir.

There is mansplaing: "a portmanteau of the word man and the informal form splaining of the verb explaining and means "to explain something to someone, characteristically by a man to woman, in a manner regarded as condescending or patronizing."

Lucy had some splaining to do (not really), Ricky had mansplaining.

I hope I never mansplain, but I suspect I am increasingly into idsplaining. I'm not arrogant, I am condescending and patronizing as I explain why vancomycin and pipercillin-tazobactam are so very stupid for acute cellulitis. Again. 

The patient hiked Greece and Albania and after lea...

Posted By: Mark Crislip  

September 18, 2017

That is no way to die

As some patients age and develop a disease that will eventually kill them they occasionally opt for no treatment. It is a reasonable decision.

I recently had a patient in their late 80's with metastatic pancreatic cancer. She decided against treating her cancer. Fair enough. But then she developed Streptococcus gallolyticus subsp. pasteurianus aortic valve endocarditis, perhaps...

Posted By: Mark Crislip  

September 13, 2017

Check Another One Off The List

I have said before that ID is like birding, only interesting. I have my life list of diseases I have seen, have yet to see, and a few (smallpox, measles) I hope never to see.

While Oregon is perhaps the best place on earth to live, as a source of Infectious Diseases it can be dull. We have little of interest in the Great Pacific NW to interest an ID doc. I have to wait for my patients t...

Posted By: Mark Crislip  

September 11, 2017


Over the summer vacation I let my beard grow back. It is 95% white. That's fine. Grey hair is hereditary: you get it from your children. Every medical group advertisement needs the old grey man. I am ready to be typecast. And being old has its advantages. A patient today said he could not believe how young all his doctors were and it was nice to have an old, experienced, doctor.  I get tha...

Posted By: Mark Crislip  

September 6, 2017

Journey or Destination

Just a small town doc, living in a lonely world

He took the ID train going anywhere

Just a city boy, born and raised in NE PDX

He took the ID train going anywhere

A clin...

Posted By: Mark Crislip  

August 30, 2017

NSAIDS: Anti inflammatory is a bad thing

The patient is a young male, no medical problems, who has a day and a half of progressive fevers, rigors, diffuse myalgias, and left thigh pain.

He had been backpacking in the great Pacific NW, in the remaining wilderness that is not on fire. Man has it been smokey in the valley this yearn as the West goes up in flames. It is more like

Posted By: Mark Crislip  

August 28, 2017

Roman Names

While I do have the best job in the world, vacation is better. A week in Bend. Hiking, biking, golfing, eating, drinking, complete with seeing totality.

And today? In all my years I have never had a patient tell me at the end, doc, I wish I had spent more time at work. Why am I doing this? Oh yeah. Two kids in higher education.

But it really is a great job; one of the few where ...

Posted By: Mark Crislip  

August 14, 2017


The patient was a mystery and I always learn a few things investigating a mystery, even if I have no final answer. The patient is a young male admitted with MOSF and sepsis. No past medical history, no risks for anything unusual. The two characteristics of note were a diffuse erythroderma that eventually peeled and low calcium. So toxic shock syndrome, right?

Except nary a S. aureus...

Posted By: Mark Crislip  

August 7, 2017

Progressive Primary?

 “TB or not TB, that is the congestion. Consumption be done about it? Of cough, of cough. But it takes a lung, lung time.” Woody Allen

The patient presents to the ER with a month of consumption: fevers, malaise, weight loss, mild shortness of breath, and a nonproductive cough.

She has been on inflixamab for a decade with good...

Posted By: Mark Crislip  

August 2, 2017

More Myths

They, whoever they are, have long asserted that half of all that is learned in medical school will be found later to not be true. Sure. We learn, things change, medicine advances. Except in the world of alternative medicine, of course, which is as resistant to change as it is data.

One of the interesting variations on the theme is medical myths; ideas that everyone thinks are true but e...

Posted By: Mark Crislip  

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About This Blog

For the Benefit of Mr Kite, there will be ID tonight. Infectious Diseases! Antibiotics! Viruses and Bacteria and Fungi! Oh my! Exclamation marks!!!!!! No trampolines, nor will any band be playing at 10 to 6. And Henry the Horse died of the Strangles. Sorry. That's the problem with infections.

The endless excitement that is the daily practice of Infectious Diseases in a Portland teaching hospital! The need for meta data!

Every day I make infectious disease rounds in the hospital and see at least one cool case or learn something new. 25 years and I still do not know everything. Why be selfish and keep all of that wonder and knowledge to myself? This blog will be a mostly qod account of days events, a cool ID case, a referenced pearl, and a minimum of 1 horrible, yet ultimately feeble, attempt at humor.

While usually written in the present tense, the cases are not necessarily current and all identifying information is altered or obscured as long as it is not absolutely pertinent to the case. Can't have a female with prostate infection for example.

I write these at night or in spare moments. There is always someone who will quibble about spelling, punctuation or grammar. My response is live with it. It's a blog, not Mandel.

Read and listen to more of me at my multimedia empire linked below.

The first 2 years blog posts have been collected and edited and are available on Amazon as The Puswhisperer, Volumes 1 and 2. Really. Perfect for the pus lover in your life.
Because The World Needs More Mark Crislip (tm).

Disclosure: Mark A. Crislip, MD, has disclosed the following relevant financial relationships:
Received income in an amount equal to or greater than $250 from: Pusware LLC
Have a 5% or greater equity interest in: Pusware LLC (owner)

  • Mark Crislip

    Mark Crislip, MD, has been practicing in infectious diseases in Portland, Oregon, since 1990. He is nobody from nowhere, but he has an enormous ego that leads him to think someone might care about what he has to say about infectious diseases. And so he blogs and podcasts and writes on the most endlessly fascinating specialty in all of medicine.

    Mark A. Crislip, MD, has disclosed the following relevant financial relationships: Owner, Pusware LLC. He as not talked to a drug rep in over 25 years and does not even eat the pizza provided at conferences. But he is for sale for the right price. Please. Someone. Buy me.

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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