Infectious Disease&nbsp;&nbsp;&nbsp;

When would you initiate exchange transfusion in babesiosis and significant hemolysis?

Is parasitemia >10% and severe hemolysis with Hb less than 7 enough to initiate this?

Do you take into consideration a patient's serum albumin level in your decision to use ertapenem?

Do you routinely recommend a lumbar puncture for patients with suspected ocular or otic syphilis in the absence of additional CNS symptoms?

Do you routinely treat chronic sacral osteomyelitis when there is no plan for debridement or flap?

What is your approach to recurrent asymptomatic bacteriuria in pregnancy for patients without personal history of recurrent UTIs or pyelonephritis?

Assuming patient already received an initial course of antibiotic treatment in response to a positive urine culture during routine screening early in ...

How do you decide on the timing and number of blood cultures for suspected endocarditis given the differences in recommendations between the ESC guidelines and the Duke Criteria?

The ESC guidelines recommend obtaining at least three sets of blood cultures at 30-minute intervals before starting antibiotic therapy, each with 10 m...

What is your approach to a positive PPD or IGRA in a patient with well-controlled HIV without significant TB risk factors?

Do you add adjunctive gentamicin and/or rifampin for treatment of prosthetic valve Staphylococcus aureus endocarditis?

Do you add gentamicin when treating prosthetic valve endocarditis secondary to viridans group Streptococcus with a penicillin-intermediate isolate (MIC >0.125 - <0.5)?

Would you treat a sputum culture positive for Aspergillus niger despite an atypical CT chest and a negative serum galactomannan in an immunosuppressed patient who is too high risk for bronchoscopy?

0 Answers available

How often do you see bony erosions in patients with Lyme arthritis?

What is your approach to deciding when to stop therapy for cutaneous Mycobacterium chelonae infections?

How do you integrate next-generation sequencing with traditional culture methods to improve the identification of fungal pathogens, especially in cases where routine cultures are negative when evaluating suspected prosthetic joint infections?

How do you approach a patient on anti-TNF with positive Quantiferon (previously negative) with negative chest x-ray and no symptoms?

7 Answers available

What duration of antibiotics do you use in patients with Actinomyces osteomyelitis, i.e., do you stop after 6 weeks or do you give a longer oral antibiotic course?

What infections should we rule out in patients who develop diarrhea on immunotherapy?

Chemotherapy is associated with acquiring C diff colitis. Does immunotherapy share that same risk and necessitate ruling out infection prior to anti-d...

Do add a macrolide for immunomodulatory effect in patients with macrolide-resistant M. abscessus?

Do you routinely perform echocardiography in patients with Staphylococcus aureus bacteremia deemed low risk for metastatic infection, or do you selectively omit it based on specific clinical criteria?

Hendriks, et al., PMID 38576380

Under what circumstances do you consider valacyclovir for the management of VZV disease of the CNS?

When treating pancreatic body/tail lesions that result in significant dose spread to the spleen, what is your threshold to offer pneumococcal, hemophilus influenza, and meningococcal vaccines?

Are there any concerns with live vaccine innoculation and patients who are on denosumab?

Is there a role for suppressive antibiotic therapy when it comes to chronic femoral/tibial osteomyelitis?

In patients with possible Bartonella henselae infection and elevated IgG titer, what is the best way to confirm the diagnosis: tissue biopsy with Warthin-Starry staining, tissue sent for Bartonella henselae PCR, or tissue sent for culture?

How would you approach treatment of latent TB for patients who cannot tolerate rifamycins or isoniazid due to allergy, intolerance, or drug-drug interactions?

Would you use the pneumococcal conjugate-21 vaccine (Capvaxive) instead of the conjugate-20 (Prevnar-20) for routine vaccinations in immunosuppressed patients?

What agent and for how long would you treat a patient with asymptomatic azole-resistant C auris candiduria who is planning to undergo a urological procedure?

Do you routinely recommend IV systemic antibiotic therapy in additional to intravitreal antibiotic therapy for exogenous bacterial endophthalmitis?

Do you preferentially avoid use of piperacillin-tazobactam for empiric anti-pseudomonal coverage in hospitalized patients due to risk of nephrotoxicity?

ACORN Randomized Clinical Trial

What steps do you recommend to ensure continued viral suppression and prevent drug resistance in an HIV patient on injectable cabotegravir and rilpivirine who misses their scheduled injection appointment by two weeks?

How would you manage a patient with well controlled HIV on Biktarvy, who is interested in switching to injectable HAART but also has a history of a prior Hepatitis B Infection?

Do you routinely check cefepime levels in patient's with suspected cefepime-induced neurotoxicity?

How would you approach treatment duration for patients with persistent candida species fungemia with a history of a prosthetic heart valve but negative TEE/CT PET and no other identifiable source of infection?

Do you recommend starting anti-fungal prophylaxis for patients on systemic antibiotics who have a peritoneal dialysis catheter that is only currently being accessed for once weekly flushes?

What is your preferred oral regime with duration for treatment of onychomycosis?

How frequently can you repeat the oral course?

Would you transition from IV to oral antibiotics in a solid organ transplant recipient with uncomplicated gram-negative bacteremia?

Nussbaum et al., PMID 38195100

How do you decide between ceftolozane/tazobactam and ceftazidime/avibactam for empiric treatment of an infection due to difficult-to-treat Pseudomonas aeruginosa while awaiting additional susceptibilities?

Do you treat prosthetic joint infections after a two-stage revision arthroplasty with oral antibiotics for the full duration of therapy, assuming a susceptible oral option is available?

What is your approach to management of CIED in a patient with community-acquired Staph aureus bacteremia who clears blood cultures quickly with negative follow up blood cultures within 72 hours of antimicrobial therapy and negative TEE?

Would you still routinely ask for CIED removal, or would you pursue PET/CT for further evaluation and consider keeping CIED if PET/CT negative?

Is there a role for nitazoxanide for treatment of norovirus gastroenteritis in immunocompromised patients?

Is there a role for empiric scabies treatment in itchy patients without clear clinical signs of scabies?

Do you empirically treat itchy patients -with a non specific rash- for scabies without obvious clinical findings for scabies?

5 Answers available

Under which circumstances is there a role for reduction in immunosuppression post-SOT in a patient with recurrent CMV viremia and/or disease?

What is your approach to monitoring of inflammatory markers during treatment of native vertebral osteomyelitis?

Do you give additional pneumococcal vaccines after a dose of PCV20 in patients with asplenia?

Is there a role for routine LP in HIV patients with disseminated histoplasmosis even in the absence of CNS signs/symptoms?

Extrapolating from standard practice for management of cryptococcal antigenemia?

What is your preferred third antimicrobial agent for a patient with treatment-naive pulmonary MAC without cavitary disease and strict contraindications to utilization of rifampin or rifabutin?

Would you recommend starting a moderate-intensity statin in a patient under the age of 40 years old with HIV and a 10-year ASCVD risk estimate below 5%?

The REPRIEVE trial included participants who were between 40 and 75 years old.

What is the preferred four-drug regimen for initial treatment of pan-susceptible tuberculous meningitis, given the need to achieve optimal CNS penetration?

In drawing blood cultures from a central line to evaluate for CLABSI, do you advise drawing separate blood cultures from each port in case of dual or triple lumen line?

If yes, what is the rationale for doing that?

When would you add a third antibacterial agent in addition to macrolide and ethambutol for treatment of a patient with HIV and disseminated MAC?

Is there a role for cefpodoxime for treatment of acute cystitis caused by an Enterobacterales isolate with resistance to cefazolin, but susceptibility to ceftriaxone?

Can cefpodoxime susceptibility be reliably extrapolated from ceftriaxone susceptibility?

In clinical practice, are you using single-dose liposomal amphotericin B for treatment of cryptococcal meningitis for patients living with HIV?

Do you find HZV titers useful in diagnosing shingles sine herpete?

Do you use combination antibiotic therapy for treatment of bacterial endocarditis due to gram-negative bacilli?

How have you adjusted your practice for treatment of syphilis in light of the penicillin G benzathine shortage?

What is your approach to monitoring blood parasite smears in an immunocompetent patient with babesiosis?

Do you continue smears until documented resolution, or by clinical progress?

What is your approach to antimicrobial prophylaxis in adult patients undergoing treatment for HLH?

Which biomarkers or diagnostic tools do you prioritize to support the decision to start antifungal treatment in septic patients with no clear source of infection but at high risk for fungal infections?

Do you use combination therapy for persistent MSSA bacteremia?

If yes, which combination(s)?

Under what circumstances would you recommend the maternal RSV vaccine for a pregnant patient if nirsevimab will also be available for the infant after birth?

Is there a role for secondary CMV prophylaxis in solid organ transplant patients?

Under what circumstances would you recommend early fecal microbiota transplantation over antibiotic treatment or bezlotoxumab in a patient with recurrent C. difficile infection?

Have you used Karius to aid in the diagnosis of a non-resolving pneumonia, with negative bronchoscopy, biopsy, and other infectious work up in an immunocompetent patient?

Do you routinely ask for removal of a indwelling central line (PICC or tunneled catheter) in a patient with pseudomonal bacteremia from known source with otherwise appropriate clinical improvement on anti-pseudomonal antibiotic therapy?

How exhaustive (especially considering cost) should an immunological workup be for patients with extensive, recurrent, or deep seated Staph aureus infections without obvious immunocompromise (e.g. cancer, diabetes, steroids) or recurrent breaks in skin integrity?

Do you transition to oral antibiotics to treat uncomplicated Staphylococcus aureus bacteremia after patients have improved with intravenous antibiotic therapy?

Have you incorporated the use of linezolid in lieu of vancomycin plus clindamycin for empiric treatment of necrotizing fasciitis?

Do you recommend lifelong antibiotic prophylaxis, or do you prefer a more selective approach based on risk factors in asplenic patients without a history of severe infections?

Is there any role for additional antiviral therapy during rebound from COVID-19 infection after a course of Paxlovid?

Are there clinical circumstances in which there is a role for steroids in treatment of calcified neurocysticercosis associated with perilesional edema and seizures?

Do you administer prophylactic antibiotics to prevent VAP following intubation in patients with acute brain injury?

Do the findings of the PROPHY-VAP trial influence your approach?

How long would you treat an upper urinary tract infection in a patient with acute obstructive pyelonephritis due to a kidney stone status-post urinary stenting without yet removal of the stone?

Do you recommend routine ophthalmologic exam for all patients with hypervirulent Klebsiella pneumoniae bacteremia?

Do you choose an antibiotic with CSF penetration, such as nafcillin over cefazolin, in the setting of MSSA endocarditis with septic emboli to the brain (assuming no concomitant meningitis or brain abscess)?

Do you consider use of convalescent plasma early in disease course in COVID-19 induced ARDS in mechanically ventilated patients?

Do the results of the recent study (Misset et al., PMID 37889107) showing reduction in 28-day mortality in patients with high neutralizing antibody ti...

Is there any utility to trending Histoplasma serology titers to guide duration of therapy or treatment response for pulmonary histoplasmosis with negative urine antigen?

How do you approach a positive Quantiferon/PPD test result in a patient for whom testing is sent without a clinical indication and who does not have a risk factor for TB exposure nor TB reactivation?

Do you routinely offer latent TB treatment in these cases?

What is your approach to duration of fidaxomicin in a patient receiving treatment for first C difficile infection while also receiving concurrent antibiotics for an infection?

Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?

How do you approach restarting cDMARDS/bDMARDS in a patient with active RA after incidence of disseminated CNS VZV infection while on tofacitinib?

For which patients or under which circumstances do you recommend a 9-month over a 6-month course of isoniazid for treatment of LTBI?

Do you routinely refer all patients with cutaneous leishmaniasis with a species associated with mucocutaneous leishmaniasis to ENT for comprehensive nasal/oropharyngeal evaluation, or do you refer only if mucocutaneous involvement is suspected based on careful clinical assessment and/or bedside exam?

Do you adhere to the standard 5-day minimum treatment duration for community-acquired pneumonia, or have you used shorter courses for certain low-risk patients?

Have you used oral vancomycin as prophylaxis for C difficile infection in patients admitted for allogeneic hematopoietic cell transplant?

What is your approach to treatment of patients with fulminant C difficile infection who required ileostomy creation or colectomy?

Is there a role for oral vancomycin in these patients, or is oral vancomycin redundant if other routes of administration are being used (i.e intracolo...

What is your approach to antiviral treatment of HSV acute retinal necrosis?

Is there a role for oral antiviral therapy alone (as opposed to induction with IV) and for what duration? And is there a role for ongoing suppressive ...

Is there a risk of hepatitis C activation with rituximab in a patient who has a history of HCV treated with antivirals and who is in sustained viral response?

How do you counsel HIV patients with an undetectable viral load on breastfeeding?

What is your approach to use of D-mannose for prevention of recurrent uncomplicated cystitis?

Especially in light of the results of the randomized clinical trial published on 8/2024 in Jama Internal Medicine by Hayward et al., PMID 38587819.

Do you periodically check a urine culture for patients without dysuria but who have a history of struvite kidney stones and urinary tract infections with urease producing organisms?

Do you use oral fosfomycin as a treatment option for uncomplicated cystitis due to ESBL producing E coli?

For which patients could you consider direct oral amoxicillin challenge as opposed to skin testing for penicillin allergy de-labeling?

For how long would you treat Klebsiella aerogenes folliculitis of the face manifesting as a cystic lesion?

Would you combine antibiotics with isotretinoin?

Do you recommend antibiotic prophylaxis for an ESKD patient with a tunneled dialysis catheter who is planned for a dental procedure?

What is your approach to counseling patients regarding re-initiation of anti-TNF therapy after completion of treatment for non-disseminated pulmonary histoplasmosis?

Would it be safe to resume and if so, when?

Do you prescribe linezolid to patients who are concomitantly on an SSRI?

7 Answers available

Do you consider late latent syphilis adequately treated if a patient receives a 10-14 day course of IV ceftriaxone for another indication?

Or would you still offer penicillin G benzathine once weekly concurrently?

Would you give treatment to a male patient with subjective dysuria but no objective pyuria with Ureaplasma urealyticum detected by PCR from urine?

For how long do you recommend treatment for latent tuberculosis prior to initiation of anti-TNF therapy?

6 Answers available

How long would you treat a patient with recent history of TAVR presenting with E faecalis bacteremia with unclear source with TEE showing thickened valves but no obvious vegetation?

How long do you treat an isolated bacterial liver abscess which has either undergone percutaneous drainage or for which an indwelling drain is placed?

How long do you treat uncomplicated gram-negative rod bacteremia in solid organ transplant recipients?

Is history of GBS a contraindication for all future flu vaccines?

What is your approach to the use of Paxlovid for patients with risk factors for severe Covid-19 infection but who have received SARS-CoV-2 vaccines in light of the EPIC-SR trial findings?

EPIC-SR Trial

How do you apply the CDC PrEP guidelines for cisgender women, particularly when faced with underreported risk behaviors or uncertain partner HIV status?

What is your approach to duration of systemic antibiotics for treatment of isolated bacterial endophthalmitis in the absence of bacteremia or other deep-seated metastatic foci of infection?

What is your approach to a patient with undetectable MMR titers checked prior to or during immunosuppression and a history of MMR vaccination in childhood?

Is there a role for booster vaccination and if so, how do you approach the timing when a patient is already on a biologic for immunosuppression?

When do you discontinue contact precautions in patients known to be colonized with ESBL producing Enterobacterales?

How long do you continue PJP prophylaxis in a patient with GPA who is able to wean steroids and remains only on rituximab for maintenance therapy?

How do you treat a patient with a gram-negative infection with resistance to imipenem but sensitivity to meropenem and negative for Carbapenem resistant organism by xpert Carba-R-assay?

Have you incorporated the use of steroids for patients with severe community-acquired pneumonia?

In light of published data from the CAPE COD trial...

Is there a role for repeat surveillance blood cultures in patients with prosthetic valve endocarditis without associated cardiac abscess after a 6 week course of antibiotic treatment without surgical intervention?

Is there a role for chronic suppressive oral or inhaled therapy for recurrent Burkholderia cepacia pneumonia causing frequent hospitalizations in a patient with severe bronchiectasis with or without underlying cystic fibrosis?

How do you approach a patient who has anterior uveitis and is referred for evaluation of ocular TB with a positive Quantiferon gold (as part of their workup) in countries with low TB incidence?

What is your approach to treatment of macrolide-sensitive localized bone/joint MAC disease?

Does a low serofast RPR titer (such as 1:1 or 1:2) in the setting of a remote history of appropriately treated latent syphilis in a patient with now uveitis of yet unknown etiology referred from ophthalmology for possible ocular syphilis make a diagnosis of ocular syphilis less likely?

What is your approach to guiding ophthalmologists regarding our clinical suspicion for ocular syphilis and does the quantification of the titer help i...

In addition to ampicillin, is there any benefit to the addition of either gentamicin or bactrim when treating a patient with listeria meningitis?

Are contact precautions effective at preventing MRSA transmission in healthcare settings?

What is your approach to anal pap screening among MSM with HIV, and if routinely recommend, starting at what age (assuming access to HRA)?

Have you applied the POET trial to clinical practice?

Does your institution have formal policies or work flows to reduce unnecessary IGRAs ordered for patients on biologics?

What is current best practice with regards to antibacterial prophylaxis in patients with hematologic malignancy and resolved neutropenic fever (>72 hours)?

How long do you continue antibiotics after cholecystostomy tube placement for acute cholecystitis?

Since the COVID-19 pandemic, increasingly we see management of acute cholecystitis with cholecystostomy tubes as opposed to surgery, even amongst pati...

What approaches can we take to initiate therapy and improve survival rates in patients with HLH?

What isolation policies are Rheumatology offices employing for both staff and patients diagnosed with COVID-19 given the new CDC guidelines?

CDC Healthcare Guidance CDC Isolation and Work Restriction Guidance CDC Immunocompromised Guidance

Do you use standard dose or "meningitis dosing" of antibiotics when treating epidural abscesses, in the absence of CNS symptoms?

What antibiotic, antifungal and antiviral prophylaxis you give post CAR-T therapy, and what is the duration?

In which patients do you prefer daily standard three-drug therapy for non-cavitary pulmonary MAC as opposed to three times a week dosing?

Do you repeat a lumbar puncture in a patient living with HIV diagnosed with and treated for neurosyphilis and if so, when?

What duration of therapy do you use for treatment of Legionella pneumonia in an immunocompetent host without associated empyema or extrapulmonary infection?

In patients with HTLV-1 associated acute T-cell leukemia, is there any clear benefit of adding antivirals?

If yes, would you go with Zidovudine monotherapy versus combining with interferon-alpha? And what would be the preferred dose and duration?

Do you favor timely bronchoscopy for diagnostics over close surveillance in mildly symptomatic patients with CT findings suspicious for NTM infection who are not able to expectorate?

Is there a role for beta-lactams as step-down oral therapy for uncomplicated gram-negative bacteremia?

If so, what antibiotic regimens do you use?

6 Answers available

Do you recommend testing for HPV in patients with oral lichen planus?

Should checking a urinalysis with reflex to culture be part of the standard work up for fever in an ICU patient with a urinary catheter?

Can non-16/18 HPV types cause ASCUS and squamous cervical metaplasia on biopsy within 3 months of acquisition, or would it take longer?

What is the preferred treatment regimen for cardiovascular syphilis, specifically syphilitic ostial coronary artery disease?

How do you approach biologic initiation in patients with inflammatory arthritis and repeatedly indeterminate Quantiferon?

5 Answers available

How do you approach ongoing screening for TB in patients with a history of treated latent TB, but who have ongoing use of DMARDs and/or biologics given Quantiferon testing and PPD can remain positive?

How do you approach ongoing screening for TB in patients with history of treated latent TB, but have ongoing use of DMARDs and/or biologics given quan...

For patients on PrEP, is there a role for HIV RNA PCR screening in addition to 4th generation antigen/antibody testing?

What is your approach to working up diarrhea in an immunocompromised patient?

Do you typically adjust or hold immunosuppression in a well-controlled RA patient who is being treated for Mycobacterium avium-intracellulare (MAI)?

What is your approach to starting antiretroviral therapy in a patient living with HIV who is diagnosed with cryptococcal meningitis?

What else do you consider in the differential diagnosis for pulmonary-renal syndromes if there is low clinical and serologic evidence of AAV, Goodpasture's or other rheumatologic disease (SLE, RA, APS, Scleroderma)?

Do you utilize post-vaccination IgG titers to detect common variable immunodeficiency in patients who are about to start or are actively on B cell depleting therapy?

For AML patients, when do you stop antiinfective agents?

At the time of count recovery or do you continue it throughout induction and consolidation?

Do you use steroids in the management of PJP pneumonia with severe hypoxia in HIV negative patients?

Data on the role of steroids in HIV negative patients with PJP has been conflicting.

Given recent data for use of doxycycline as post-exposure STD prophylaxis, how have you applied its use in clinical practice?

For how long do you treat an early spinal hardware infection secondary to MSSA after operative washout and retention of hardware?

Do you treat patients with HIV-AIDS and positive cryptococcal antigenemia but negative CSF cryptococcal antigen with standard meningitis treatment given the potential for the postzone effect?

When should vaccines be given if not received prior to the start of high dose radiation (40-50 Gy) to the spleen?

How do you manage a patient with severe RA or SLE that worsens after stopping immunosuppressants due to having chronic foot ulceration?

Do you consider anti-viral prophylaxis in patients taking JAK inhibitors who have recurrent uncomplicated Zoster infection, but would prefer not changing therapy?

What is your approach to vaccinations and titers for patients with myeloma, who are immunosuppressed and do not have appropriate antibody responses to vaccines?

E.g., for a patient with myeloma, s/p induction therapy, and high-dose chemotherapy, followed by autologous rescue with inappropriate antibody respons...

What is your approach to determining the need for continued isolation in the dialysis unit for an ESKD patient who had a positive hepatitis B surface antigen one year ago but who now has a negative HbsAg in the absence of treatment?

What is the recommended treatment regimen for Mycoplasma genitalium in a pregnant woman?

Is there ever a role for the use of CMV immune globulin for treatment of CMV viremia and/or disease?

How do you approach immunosuppression in patients with a positive Interferon Gamma Release Assay and prior intravesicular BCG treatment for bladder cancer?

Assuming no symptoms of TB, should patients be treated for latent TB prior to starting TNF inhibitors or other immunosuppressive agents?

Do you treat Stenotrophomonas maltophilia bacteremia with combination therapy and if so, what is your preferred combination of antibacterials?

For how long do you treat uncomplicated CRE bacteremia in an immunocompetent patient?

What is your approach to monitoring patients with the indeterminate form of Chagas disease?

Do you have a preference between Quantiferon Gold and T-spot TB for screening in patients starting immunosuppressive agents?

Would you consider stepping down from an echinocandin to azole therapy prior to the end of an initial six-week course for fluconazole-susceptible Candida albicans endocarditis in the absence of valve surgery?

Do you use letermovir as CMV prophylaxis in solid organ transplant patients?

In patients taking biologics who are planning joint replacement and are known MRSA carriers do you perform decolonization prior to surgery?

0 Answers available

Given recent data from the REPRIEVE trial, how will you adapt your practice with regards to prescribing statins to patients living with HIV?

How do you approach a well controlled HIV patient with diffuse cutaneous kaposi sarcoma who failed to respond to radiation, paclitaxel and monthly liposomal doxorubicin?

Does management of NMDA receptor encephalitis change in a patient with HIV/AIDS?

Would you anticoagulate a patient with splenic infarctions in the setting of CMV viremia?

If so, for how long?

Are there instances when you do not recommend tunneled dialysis catheter exchange in patients on hemodialysis who are found to have bacteremia?

How would you approach immunomodulatory treatment for systemic lupus associated protein losing enteropathy (PLE) in a patient whose clinical course has been complicated by significant infection?

Additionally, is it correct to assume that IV therapies might be preferred vs oral treatment given alterations in GI absorption in PLE?

Are there any non-beta-lactam antibiotic options for treatment of neurosyphilis in non-pregnant adults?

After a course of treatment for neurosyphilis, do you administer an additional IM dose of penicillin G one week after finishing the course of IV penicillin therapy?

How long do you continue surveillance with imaging and sputum cultures in a patient with NTM with no indications for treatment?

How would you approach the use of JAK inhibitors in a patient with stable RA who is now starting treatment for pulmonary MAC infection?

Patient previously failed abatacept and Rituximab.

What is the risk of serious bacterial infection in a febrile solid tumor patient who has not yet started cancer-directed therapy and has normal cell counts with no central line?

When would you consider percutaneous mechanical aspiration of vegetation in right-sided endocarditis?

Does your approach to treating latent tuberculosis differ in a patient on anti-fibrotic therapy?

Do you rule out TB in patients with AIDS and lobar pneumonia?

What’s your threshold to get the three AFBs and place the patient in airborne isolation?

Do you routinely monitor imaging or pulmonary function in patients with pulmonary TB after the completion of therapy?

What is the optimal timing for Zoster vaccine administration for a patient who recently recovered from herpes zoster infection and is now planning to start B-cell depletion therapy?

How do you approach management of patients with active RA and recurrent non-severe C.diff?

(Patient with active RA despite hydroxychloroquine)

How do you approach the workup for a patient with persistently elevated inflammatory markers (CRP and ESR) whose history and exam do not point to a clear cause?

Do patients on eculizumab or ravulizumab require repeat vaccination against meningococcal infection after a certain interval?

Are you using the microbial cell-free DNA “Karius” test to aid in the diagnosis of an atypical pulmonary infection such as PJP or NTM?

Do you use steroids in patients with respiratory failure who are infected with both influenza and COVID-19?

How do you approach which risk to accept given that steroids have evidence for use in COVID-19 while is suggestion for harm in using steroids in influ...

Do you routinely isolate and test for TB in a patient incidentally found to have a miliary pattern of nodules on chest CT?

What is the antifungal prophylaxis regimen that you use in patients on peritoneal dialysis who are receiving antibiotics?

What is your approach to therapy in patients with progressive Scedosporium pulmonary infection who are not candidates for surgical debridement?

What is your approach to BK hemorrhagic cystitis not responding to cidofovir?

How do you approach treatment of RA with methotrexate in a patient with treated Hepatitis C and normal liver function?

Do you recommend continuous antibiotic prophylaxis for patients on complement inhibitors such as eculizumab?

Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?

Do you treat Candida spp isolated from a bronchoalveolar lavage?

What topical or oral treatments do you recommend for patients with recurrent MRSA infections?

Do you recommend any changes to their personal hygiene practices? or changes to their environment?

Would you consider prophylactic antifungal treatment prior to immunosuppressive therapies in a patient with previously treated pulmonary coccidiomycosis and residual parenchymal changes?

Do you ever stop tobramycin prophylaxis in a patient with chronic bronchiectasis previously colonized with pseudomonas?

Do you recommend IVIg and/or cytoreduction for patients with IgM MGUS with reciprocal depression in IgG and recurrent infections?

Infection is not part of the criteria for starting treatment both in UpToDate and in NCCN guidelines.

Do you hold IV iron in the setting of active infection?

Which medications have the lowest risk of tuberculosis reactivation in patients with uncertain tuberculosis history and active rheumatologic disease?

What is your approach to the treatment of PML-IRIS in patients with HIV who have progressed to AIDS?

How do you approach DMARD therapy in patients with rheumatoid arthritis and chronic hepatitis B?

Hepatitis screening labs revealing Hep B ag and core positivity with positive PCR

How do you approach patients with onychomycosis that does not respond to terbinafine and prolonged courses of fluconazole?

Would you switch to itraconazole or perform fungal cultures? When would you consider repeating the course of treatment?

How do you approach the timing of COVID-19 vaccination for patients with multiple sclerosis on B-cell depleting therapies?

Do you recommend routine use of Evusheld for pre-exposure prophylaxis for patients on immunosuppression?

Does treatment with B-cell depletion and/or negative anti-spike antibody status despite COVID mRNA vaccination influence your decision?

Is there a role for regular hepatitis and TB screening in patients on chronic immunosuppressive therapy in the absence of new risk factors or exposures?

What infectious prophylaxis do you use for patients with newly diagnosed multiple myeloma?

How do you decide how long to continue?

How do you think about biologic use in patients with underlying HIV infection?

Do you hold tocilizumab for patients who are diagnosed with Covid and are with mild to moderate symptoms or non-hospitalized?

Is there a role for antibody testing to confirm vaccine response for patients on rituximab after COVID-19 vaccination?

When would you consider checking JC virus prior to initiating biologic therapy?

Do you routinely offer fungal prophylaxis for patients on BTK inhibitors?

Can experts comment on fungal pneumonia risk with individual BTK inhibitors as seen in ELEVATE-RR and whether this impacts their management decisions?

How are you timing the third dose of the COVID-19 mRNA vaccine in patients on rituximab?

How long would you treat with antimycobacterials before starting biologic DMARD in a patient with latent TB and active rheumatoid arthritis?

In which patients with oncologic or hematologic disorders are you recommending a 3rd dose of mRNA COVID vaccine?

How would you approach chronic isolated severe non-cyclic neutropenia with negative bone marrow and rheumatologic work-up?

Is there a role for empiric antibiotics if there is history of opportunistic infection?

How would you manage an active rheumatoid arthritis patient on suppressive antibiotic therapy for ocular HSV who has abnormal liver function tests?

Do you treat HIV/AIDS-associated CNS vasculitis with antiretrovirals alone or in combination with steroids?

How would you recommend dosing the MMR or other live vaccines for patients with rheumatoid arthritis on immunosuppressive medications such as anti-TNF alpha therapy?

For example, healthcare workers who require these vaccines for employment

How do you treat RA in patients with pulmonary mycobacterium avium complex (MAC) infections?

Are there particular concerns related to the use of B-cell depletion therapies such as rituximab for rheumatic disease during the COVID-19 pandemic?

How would you manage methotrexate therapy in an active rheumatoid arthritis patient undergoing treatment for latent TB with rifampin?

Do you stop methotrexate or adjust the dose?

When are you recommending bone marrow transplant recipients receive the SARS-CoV-2 vaccine?

Does your recommendation differ between autologous and allogeneic transplants? Does your recommendation differ in allogeneic transplant recipients wh...

How do you approach the evaluation of patients referred for chronic lyme disease and counsel patients regarding this entity?

How does a history of splenectomy alter how you counsel patients on the infection risk of TNF inhibitors or other biologics?

Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?

5 Answers available

Which immunosuppressed patients with SLE would benefit from antibiotic prophylaxis to prevent pneumocystis pneumonia?

Would you hold all immunosuppressive medications for the first month of LTBI treatment, or just biologics?

How would you attempt to determine the etiology of intracranial hemorrhage in a patient with newly diagnosed lupus and an active viral infection?

Do you avoid any specific biologic therapies in HIV positive patients?

Should tuberculosis screening be performed before beginning methotrexate for treatment of rheumatoid arthritis?

In what situations do you check for HIV status in your workup for inflammatory arthritis?

What is your approach to dental prophylaxis for patients on biologics?

How do you manage patients who are Hepatitis B core antibody positive/surface antigen negative and starting a biologic DMARD (other than rituximab)?

During induction therapy for acute leukemia, when do you decide to discontinue the antimicrobial prophylaxis?

Is it at neutrophil recovery, at documentation of CR on bone marrow biopsy, or is there a different point in time?