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CIEE83

CIEE83 Member

291 Points 1,329 Visits 579 Posts
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  • Re: When people don't vaccinate their kids

    The rabies story is very strange. The shortest known incubation period for rabies is 9 days, but it’s usually longer. The closer the bite or exposure is to the brain or spinal cord, the shorter the incubation period. You’d think a scratch on the hand would have had a longer incubation period. It makes me wonder if this child was bitten while the bat was in the house. It’s possible (actually likely)not to feel or notice a bat bite, which is why anyone who sleeps in a house with a bat needs vaccination — unless the bat is available for testing.
  • Re: when to see the MD if you have the flu?

    It’s possible for a viral illness to cause a fever lasting 5 days, but it’s not usual. Also since she got better and then developed a fever, I think it would be worth checking to rule out a bacterial pneumonia. Flu makes people more vulnerable to this.

    Laryngitis is typically a viral symptom that is not treatable. Tamiflu does next to nothing and probably shouldn’t be given to people who don’t have a risk of complications from flu (e.g., old or young age, chronic illnesses like asthma, etc.) It can be helpful as prophylaxis for vulnerable relatives of flu sufferers. And the antibiotic of choice for bronchitis is no antibiotic— this has been the case in the 20 years since I graduated from med school, although lots of people still prescribe for this diagnosis. There are enough downsides to antibiotic treatment that I wouldn’t want to take them unless they were going to be helpful.
  • Re: Yale 2022 Applicants Discussion

    For those of you planning to feel crushed— you might find this essay weirdly comforting: https://mathwithbaddrawings.com/2015/09/30/why-ive-stopped-doing-interviews-for-yale/
  • Re: C-Difficile infection

    Also— c. diff. is highly contagious in hospital settings. It is less so at home, because you really need 2 conditions to come down with infection: first, exposure to the bug, and second, antibiotic treatment to remove the healthy bacteria from the gut. I agree with taking precautions at home, but c. diff. almost never occurs without antecedent antibiotic treatment.
  • Re: C-Difficile infection

    This discussion is going a little bit off the rails. Most c. diff. infections are cured with a single course of flagyl and do not result in hospitalization, year-long illnesses, or need for infectious disease or GI consultation. I’m a primary care doctor. In 20 years, I have never seen someone reqiuire hospitalization for c. diff except in a small handful of cases where the healthcare providers ignored patient complaints of severe diarrhea for days (a week, really). I have seen 1 or 2 cases with a single recurrence. I have no patients who required fecal transplant or vanco taper. I do discuss c. diff. when explaining to patients why I don’t want to give antibiotics unnecessarily.