Rubor, Dolor, Calor, Tumor
Blog Address:
August 31, 2009

Self Serving Announcement

My old Rubor Dolor Calor Tumor blog posts are now a podcast.

On iTunes:  A Gobbet o'Pus.

Because the world needs more Mark Crislip (tm).


Posted By: Mark Crislip  

August 26, 2009

Ra's al Ghul was not so far off

I am on vacation this week, so I do not have much to write about. You may get GC or malaria on vacation, but I old and have no risks for either. Golf and hiking is mostly infection free.

Now don't get any ideas about visiting my house while I am on vacation; I am spending most of my time on the front porch with a bottle of Jack Daniels and a cocked shotgun, yelling incoherently about th...

Posted By: Mark Crislip  

August 21, 2009


Septic? Toxic? Cardiogenic? Hemmoragic? Electrical? Maryilyn Manson?
So many ways to go into shock.

Middle aged patient is admitted in what looks like septic shock:  MOSF, DIC, platelets of 30, pressor dependent blood pressure.

Exam, labs and X-rays reveals none of the big three:  UTI, pneumonia or cellulitis.

Not a lot of things cause...

Posted By: Mark Crislip  

August 19, 2009

Bloody Bullae

Hemorrhagic bullae.

If you are an ID doc, Hemorrhagic bullae makes you think of Vibrio vulnificus.   Sometime last century the Annals published the classic (as if medical articles have the same cachet as Dickens or Twain) article on hemorrhagic bullae and the relationship between liver disease, sepsis and V. vulnificus.

My patient has an increas...

Posted By: Mark Crislip  

August 17, 2009

Damned if you do, Damned if you don't

What do you do when all the solutions stink on ice?  Do something? Do nothing?  Both?

Patient has bad (as opposed to the good?) MRSA  endocarditis (yet another) with a large vegetation on the mitral valve and emboli everywhere.  Also, he has seeded both his eyes.

His MRSA is resistant to everything but Vancomycin and that with an MIC of 2.


Posted By: Mark Crislip  

August 16, 2009

Infections Destroys All

Half a lifetime of taking care of infectious diseases and I am still impressed with what acute infections can do.

Allegedly normal 28 year old male, has fevers and is seen in the ER and gets a course of antibiotics.  You know he s going to get worse.  He does.  Fevers, stiff neck, altered mental status, he comes back to the ER.

WBC 25 in the blood, 900 in CS...

Posted By: Mark Crislip  

August 14, 2009

Lookin' Good

Shh.  Gather round.  I am going to tell the secret of looking good as a consultant. Besides the white coat. For years I wore sport coats, but they wore out and it is pricy, even at Goodwill, to get new ones.  So of late I have gone to the white lab coat.  It is slimming and matches my hair.

The patient, a two pint a day vodka drinker is admitted with ETOH withdra...

Posted By: Mark Crislip  

August 11, 2009

Bovis, yet again.

That prosthetic valve endocarditis from a while back that had no name?  It is  Neisseria elongota. Took elong time to identify it. I'm tired. They can’t  all be gems.

75 year old with a new diagnosis of inflammatory bowel disease early this year.

He has had a progressively painful hip since the diagnosis of IBS and failure to thrive.  He has...

Posted By: Mark Crislip  

August 10, 2009

Bovis, part one.

Back when I was a resident, there were Group D Streptococci and they were divided into enterococcal and non enterococcal streptococcus.
Easy.  You only had to remember two things.

The problem with modernity is they have increasingly sophisticated ways of analyzing bacteria and separating them into different groups.

There also used to be S. bovis, a non enterococc...

Posted By: Mark Crislip  

August 8, 2009

S. aureus pays my mortgage.

All but two of my consults this week were due to S. aureus.  If it wasn't for S. aureus I would be standing at a freeway off ramp with a sign that says "Will do ID for Food".

Sine qua non again. Sustained bacteremia is always an important clinical findings as it usually means an endovascular infection.  Only an infection whose focus is in the vascula...

Posted By: Mark Crislip  

« previous 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 next »
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 as The Puswhisperer, Volumes 1 and 2. Really. Perfect for the pus lover in your life.
Because The World Needs More Mark Crislip (tm).
Flies in the Ointment: Essays on Supplements, Complementary and Alternative Medicine (SCAM).
A carefully selected and edited compendium of my best blog posts from The sections have been edited for redundancy, updated for 2017, and classified into themes including my influenza rants.

All on Amazon.

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. Links to his multimedia empire of blogs, podcasts, books, apps and tweets can be found at

    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.
Share This
Add this blog page to your favorite Social Media site.

All material on this website is protected by copyright, Copyright © 1994-2018 by WebMD LLC. This website also contains material copyrighted by 3rd parties.