Division of Infectious Diseases

At the center of the 2018 West Nile Virus season, UNMC ID physicians encountered an unusual presentation

In 2018, we experienced a particularly severe West Nile Virus season, with an unusually high amount of neuroinvasive disease. Last summer, our senior ID Fellow Dr. Lindsey Rearigh shared an informational blog post about the disease, and more recently, she and Dr. Sara Bares published a case report in the Journal of Neurovirology describing a a patient with an unusual presentation of West Nile Virus… Continue Reading

Blood culture contamination–it’s a big deal

Blood cultures are a key diagnostic test to detect bacteremia and appropriately treat patients with sepsis and are performed approximately 30 million times in the United States yearly. Unfortunately, contamination of blood cultures occurs in the 0.5% to 5% of samples (approximately 25% of positive blood cultures are due to contamination) which leads to inappropriate antibiotic treatment, additional unneeded tests, extended hospital length of stay,… Continue Reading

PharmToExamTable: What do we know about Etravirine for HIV?

Recently, several of our HIV pharmacist colleagues in our Division of Infectious Diseases at UNMC/Nebraska Medicine, published an invited review in Clinical Pharmacokinetics entitled: Clinical Pharmacokinetics and Pharmacodynamics of Etravirine: An Updated Review.  The first author, Dr. Josh Havens PharmD, wrote this summary describing the review article. What prompted the review? This was an invited review, but there was only one previously completed shortly after… Continue Reading

Special contributor: Dr. Shipra Goel

Dr. Shipra Goel joined us for the summer as an observer in the Infectious Disease Department.  We’re excited to include her contributions to our blog during the month she was with us! My journey to an exciting observership at UNMC was enabled by my passion for infectious diseases (ID) which was virulent enough to infect Dr. Marcelin from 8000 miles away. Thanks to social media,… Continue Reading

Journal Club – Stewardship in Community Hospitals: How should we spend our limited resources? 

Stewardship in Community Hospitals: How should we spend our limited resources?  The following is a review by our ID Fellowship Program Director Dr. Trevor Van Schooneveld from our last Infection Control/Antimicrobial Stewardship Journal Club. He discussed the article by Anderson et al: Feasibility of Core Antimicrobial Stewardship Interventions in Community Hospitals. JAMA Network Open.  2019;2(8):e199369.   Antimicrobial stewardship is important to improving patient care and outcomes and numerous entities… Continue Reading

Treatment of Osteomyelitis – What’s the Evidence for our Strategies?

New UNMC ID publication alert! #ReadUNMCID Recently, the newest member of our Division of Infectious Diseases at UNMC/Nebraska Medicine, Dr. Nicolas Cortes-Penfield published an invited review in Open Forum Infectious Diseases entitled: The History of Antibiotic Treatment of Osteomyelitis.  Dr. Cortes-Penfield wrote this summary describing the review article, which was commissioned after he published a comprehensive blog post (on his blog IDJournalClub.com) about the history… Continue Reading

Going Viral with West Nile  

As we get further into the summer, we are yet again nearing West Nile Virus season, and there are starting to be a few cases reported nationwide. Our senior ID fellow Dr. Lindsey Rearigh wrote an article outlining what to expect with West Nile Virus, how it is transmitted, diagnosed, and treated.  West Nile Virus (WNV) is a mosquito born illness that made its way… Continue Reading

Do you really need to test the poo? Diagnostic stewardship for (outpatient) diarrheal illness

Rapid molecular testing has changed the landscape of diagnostic approaches to many infectious disease syndromes, including diarrheal illnesses. These panels typically have the capacity to diagnose multiple organisms in one test. The FilmArray gastrointestinal pathogen panel (BioFire) tests 22 stool pathogens. Despite the impact of improved clinical efficiency, these tests are often expensive, especially in the outpatient setting, but the convenience of a comprehensive testing… Continue Reading

Does de-escalation of anti-MRSA therapy for culture-negative pneumonia affect patient outcomes?

Nosocomial pneumonia is a common hospital-acquired infection and has a high mortality rate in the critically ill.  Because drug-resistant bacteria like Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) are commonly responsible for these infections, guidelines recommend broad-spectrum empirical therapy that includes anti-MRSA coverage.  Treatment is ideally de-escalated and refined based on culture results.  However, culture negative infections leave a conundrum for clinicians who want to protect their… Continue Reading

Inter-Professional Relationships in HIV Pre-exposure Prophylaxis

We’re excited to feature a recent publication borne from student-faculty collaboration that highlights the importance of interdisciplinary care! Dr. Jordan Broekhuis, the lead author, is one of our former HIV Enhanced Medical Education Track (EMET) students who is now a surgery resident at Beth Israel Deaconess.  He completed his EMET work here at UNMC under the mentorship of Drs. Sara Bares and Susan Swindells.  Their… Continue Reading