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June 22, 2012

Crislip's Sign

As I have far fewer years to practice ID in front of me than I do behind me, I realize I have yet to have anything named after me. I want to be a verb, like 'to swan' was when I was an intern.  Or at least a noun, like Groshong.  It is my own fault, I suppose, since I have neither the time nor inclination for formal publication in the peer reviewed literature and I have never invented anything.  It is easier, and more fun, to yammer on in the blogosphere.

The patient is an elderly African-American male who, while on dialysis, has the abrupt onset of severe right inguinal pain.  He goes to the ER where they think it is an hernia and reduce it, but the pain persists.  He has nausea and vomiting and a fever to 102 and is admitted.

Late afterno...

Posted By: Mark Crislip  

June 20, 2012

Faltering Fatalism

I used to think that infections were part of the practice in-patient medicine.  You couldn’t cut people and stick in those various and sundry tubes without some of them occasionally getting infected.  The bugs are too virulent and the patient co-morbidities too numerous to get infection rates to zero.

The past decade has demonstrated that fatalism was mostly wrong. ...

Posted By: Mark Crislip  

June 18, 2012

A First I Did Not Want

I have mentioned in the past the ID is like birding, only interesting.  I have my life list, microbes of one sort or another that I have seen.  I do note as I go over these essays from years in the past that I am increasingly unable to remember all the cool cases I have seen and it is a good thing I have this blog to help me keep track.  If you are a young ID doc I would sug...

Posted By: Mark Crislip  

June 13, 2012


ID is the canary in the coal mine of medicine.  When the hospital is slow, ID gets sllllooooooooooowwwwwwww.  Usually this kind of slow occurs in August when everyone is on vacation, but our nosocomial infections rates continue to plummet and with it the total on my W2.  I still have a sufficiency of things to do, but I like seeing acute ill patients.  On occasion an in...

Posted By: Mark Crislip  

June 7, 2012

The Curves Continue to Diverge

Knowledge increases exponentially, I learn linearly. Except for spelling. Net negative over the last 55 years. There is always more I do not know that I do know.  Being a expert is being ignorant with style and easy access to PubMed.

My expertise is greater in those area where I either have an interest or it is a consistent part of my practice.  There are infections that ...

Posted By: Mark Crislip  

June 5, 2012

In Cold Blood

I expect some illnesses to make people ill.  It flabbers my gaster on occasion when patients are remarkably non-toxic from their infection.

The patient has a crush injury when his work transportation falls on him, breaking a smattering of bones. He takes to his bed for a few days, but eventually he is brought in to the ER, of course at the insistence of his wife. I have noted be...

Posted By: Mark Crislip  

June 3, 2012

Will do ID for food

Busy weekend.  6 consults at 4 hospitals.  One had insurance and it was Medicare.  Sigh.  Probably did not even make my gas money.  Good thing dinner and a show Saturday night was inexpensive; if you ever get a change to see Emily Wells, do not pass it up.   Most of what I saw this weekend is a day or two away from a blog entry since cultures and studies to fi...

Posted By: Mark Crislip  

June 1, 2012

One Thing

Yeah.  There is only one thing I trust, and that is the cultures.  When a culture is positive, then, and only then, can you really have a handle on what is happening and why.  Well, perhaps that is a wee bit o' hyperbole, and my wife doesn't read the blog so I can exaggerate.  But a positive culture does help clear muddy water.

The patient has a rocky course: GI...

Posted By: Mark Crislip  

May 30, 2012

First Case Ever

There are services I dread.  I hate it when I get a call from an eye doc.  Eye infections make me nervous and I never know for sure how where to put that extra ‘h’ in ohphthalhmohlohgy. Something like that, I guess.  It is like getting enough ’s’s and ‘i’s in  Mississisiippiii.  

The other service I dread is OB.  Inf...

Posted By: Mark Crislip  

May 25, 2012

Five Months Qualifies for Sustained

Patient has E. fecalis in the blood in January.  Gets 2 weeks of IV ampicillin.  In March has E. fecalis in the blood.  Has a negative TEE for anything on his bovine AV and CT of the abdomen and gets 4 weeks of ampicillin.  This week?  E. fecalis in the blood and an exquisitely painful hip.

The sine qua non of endocarditi...

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 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.
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