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November 13, 2009


No, I have not yet been arrested.

The only way I know that there are commnets to my blog is I get an email when a comment is posted.  I discovered last night that the feature is busted, I guess, for about a week now. I thought people had given up on me. It will not be functional until maybe  tuesday. 

Given the number of posts I have, I will only check the recent entries for comments, and even then it is hard to remember if the comments are new or not.

Posted By: Mark Crislip  

November 12, 2009

Expect What?

The ID literature is filled with odd case reports.  Organisms that show up in places or patients where the do not belong. It is, at least for me, part of the allure of ID. One never knows what one is going to grow.

The authors of these one off oddities always conclude something to the effect that although no one has ever seen such a case before, ev...

Posted By: Mark Crislip  

November 10, 2009

Next time use a toothpick

In medical school you are taught (at least I was, I don't know what they treat those young whipper snappers today) to ask open ended questions and let the patient tell their story in their own words.

I tend to do that, but often the patient doesn't tell me what I want to know and it is only with direct and specific questions can I get the clues I need to find an answer to the what an...

Posted By: Mark Crislip  

November 8, 2009

Babe Ruth

No, not the candy bar. Mr. Ruth was famous for the number of home runs he hit, but most people do not remember that he also lead the league in strike outs.

I saw a patient with two weeks of fevers and a non productive cough.  He had a renal transplant about 6 months ago and has been doing fine on medications, back to work an...

Posted By: Mark Crislip  

November 6, 2009


I had a busy day today.  There are them what say the swine flu pandemic is a myth generated by big pharma to sell tamiflu and vaccine. I see no reason why this is not true. If it in the interwebs, it can’t  be a lie can it?  So I went around the hospital today sending all the people with 'flu' home, even if it met taking them off the ventilator. Posers.  But when I was...

Posted By: Mark Crislip  

November 4, 2009

Coke Does Not Always Add Life

Young male comes in with pneumonia. He has been ill at home for a week, but gets acutely more short of breath and cannot get out of bed.

The girlfriend calls an ambulance and he is admitted to the hospital heading into septic shock. He tries to die, but thanks to modern ICU support, he survives.

His nasal swab has H1N1, his sputum grows MRSA, and his blood has S. pneumonia...

Posted By: Mark Crislip  

November 3, 2009

Major Strasser has been shot.

Back from IDSA. Four days trying to avoid a pressure sore. It is almost impossible to sit 12 hours a day, I think next year I am going to bring an inflatable donut to sit on.  It will make it, I hope, a little more bearable.  I was rooting against Phiily in the World Series. On Wed they won and there were drunks shouting and honking horns until 3 am.  When they lost the next game...

Posted By: Mark Crislip  

October 28, 2009

I ain't never heard of that bug before, no how.

I have a patient with a long term port for fluids and electrolytes.  She has fevers and a deep, bone cold. Her white cells are low (not an uncommon early  reaction to acute sepsis) and she is admitted for antibiotics and evaluation.

Usually line infections are due to various staphylococci, but a 1.5 days her blood are growing gram negative rods.

OK. Happens.&nbsp...

Posted By: Mark Crislip  

October 25, 2009

Read the Book

First patient is a new kidney transplant with slowly progressive hypoxia over two weeks despite azithromycin, on no PJP prophylaxis, a CXR that shows a slight patchy lower lobe infiltrate but the CT shows diffuse, patchy, multi lobar involvement with tree in bud pattern.  Cough is nonproductive and the patient is totally nontoxic on exam. Labs are normal except for an LDH of 300.

Posted By: Mark Crislip  

October 23, 2009

A Perfect Storm

H1N1 is taking off big time and to judge from the CDC site and google flu trends, the great pacific northwest is the epicenter of H1N1 activity.  Whether due to increased testing or increased cases, we have more H1N1 than anyone.

Lucky us.

Oddly, the pandemic has not affected my clinical work all that much.  Most...

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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