Dr Cilia Nazef, Infectious diseases Fellow at the University of South Florida Morsani College of Medicine, explores how Pneumocystis jirovecii, a fungal infection typically affecting immunocompromised patients, can also affect patients suffering from hypercortisolism. Dr. Nazef begins by examining different cases of Pneumocystis jirovecii Pneumonia (PJP) in patients with Cushings disease. Next, she further explains the immunologic basis behind how the hypercortisol state induces immunosuppression. Dr. Nazef closes by examining the basis for PJP prophylaxis in Cushings disease patients, and the shortcomings of the current literature in advocating prophylaxis options.
Archives
HIV in Older Patients
Dr. Todd Wills, Professor of Medicine with the Morsani College of Medicine at the University of South Florida, reviews the unique complications and issues that can occur in the elderly HIV patient. Dr. Wills begins by reviewing the epidemiology of HIV by age group, including the fact that the HIV positive population is growing older with time. Dr. Wills also discusses issues regarding polypharmacy and medication tolerability in the older patient. Next, the speaker relates how the high prevalence of chronic diseases affect the HIV positive patient’s prognosis. HIV positive elderly patients can suffer not just from frailty, but from cardiovascular disease, diabetes, osteoporosis, and cancer. Dementia can also affect an elderly HIV paitent’s overall wellness and compliance with antiviral therapy. Dr. Wills also covers the assessment of bone density in elderly HIV positive patients. Lastly, Dr. Wills discusses HIV positive patient life expectancy in the modern age of antiretroviral therapy. The lecture is updated for 2024.
Getting to the HAART of HIV Drug Interactions
Dr. Sung Soo Kim, ID clinical pharmacist, presents a talk on the spectrum of HIV therapy and ART (Antiretroviral Therapy)-related adverse drug interactions. Dr. Kim begins by describing the mechanisms by which HIV therapy-related adverse drug interactions occur. Next, he discusses the various classes of antiretrovirals and their specific drug interactions, including integrate inhibitors, NNRTIs, NRTIS, and Protease Inhibitors. Dr. Kim closes by discussing the consequences of unmanaged drug-drug interactions in patients on ARTs as well as the available drug-drug interaction resources available to the clinician.
ID Management of Hematologic Malignancies and Stem Cell Transplants
Dr. Olga Klinkova covers essential information regarding the management of infectious complications of hematologic malignancies. Topics covered include the initial evaluation of patients, neutropenic fever, neutropenic enterocolitis, and antimicrobial prophylaxis. Next, Dr. Baluch discusses ID management of stem cell transplants, CAR-T therapy, and when it is necessary to administer antimicrobial prophylaxis in these patients. The lecture is updated as of 2024.
What to Do With a Positive Blood Culture in 2024
Dr. Richard Oehler, Professor of Medicine at the Division of Infectious Diseases at the University of South Florida Morsani College of Medicine, presents a review of bacteremia. Dr. Oehler begins by reviewing the epidemiology, personal and institutional costs of bacteremia. He then discusses blood culture collection and how false positive blood cultures occur. With the recent blood culture bottle shortage of 2024, he emphasizes the new concept of “blood culture stewardship”–when it is most appropriate to order a blood culture versus when it may be unnecessary. Next, Dr. Oehler reviews automated blood culture systems and other related identification technology, with a focus on new methods of blood culture isolate identification such as multiplex PCR and Maldi-TOF. The speaker then contrasts gram positive and gram negative bacteremia in general and by organism. The management of a positive blood culture with regard to treatment and source control is discussed. Lastly, ways to reduce the incidence of bacteremia are shared.
HIV-Associated Opportunistic Infections
Dr. Jackie Sherbuk, Assistant Professor of Medicine at the USF Morsani College of Medicine, presents this case-based review of the opportunistic infectious syndromes associated with HIV-AIDS. The speaker covers PJP prophylaxis and treatment, HIV pulmonary disease, and cryptococcal meningitis. Dr. Sherbuk also discusses IRIS (Immune Response Inflammatory Syndrome) and its effect on the AIDS patient when antiretrovirals are started. Lastly, Dr. Sherbuk covers HIV esophageal disorders, Histoplasmosis, Coccidioidomycosis, and Mycobacterium avian-complex-related syndromes.
Antiretroviral Therapy In Clinical Practice: A Case-based Approach
Dr. Jackie Sherbuk, Assistant Professor of Medicine at the Morsani College of Medicine Division of Infectious Diseases, presents this case-based review of the use of antiretroviral therapy in HIV/AIDS patients. Dr. Sherbuk begins by reviewing and available antireturovial options, including those that are considered first line. She also covers the use of antiretrovirals in special groups, including expectant mothers, elite controllers, treatment experienced patients, HBV/HIV connected patients, and patients with chronic renal insufficiency. Lastly, Dr. Sherbuk discusses the nuances of using co-formulated combinations of antiretrovirals and mentions the newer long-acting injectable preparations.
Intro to HIV in the Human Host
The Essentials of Antibiotic Dosing
Pharmacotherapy specialist Kristin Zeitler, PharmD, from Tampa General Hospital in Tampa, FL, presents this talk on the basics of antimicrobial therapy management for hospital patients. Dr. Zeitler begins by emphasizing the important of the ID clinical pharmacist. She then compares and contrasts Pharmacokinetics (PK) , the way drugs move through the body, with Pharmacodynamics (PD), the relationship between serum drug concentration and the therapeutic/toxic effects of the drug. PK/PD effects of antimicrobials are then further explored. Dr. Zeitler goes on to discuss Vancomycin dosing strategies, the effects of serum albumin on serum antimicrobial drug levels, drug penetration into the site of interest, drug dosing strategies for patients with renal insufficiency, and the effects of obesity and critical illness on antimicrobial dosing strategies.
HIV Test and Treat: Initiating Antiretroviral Therapy
Dr. Shylah Moore-Pardo, Infectious Diseases clinician and Assistant Professor at the University of South Florida, reviews antiretroviral initiation in HIV positive patients. In a case-based format, Dr. Pardo begins by discussing the interpretation of HIV test results. Next, she highlights several unique positive test scenarios. Dr. Pardo then reviews the characteristic serological patterns of acute HIV infection. The impact of False Positive HIV testing is also explained. Also covered are patients known as elite-controllers and long-term non-progressers who are more tolerant of HIV infection. Dr. Pardo then goes on to describe essential components of the initial HIV positive patient encounter. She then relates recommended test and treat strategies compatible with current guidelines. Lastly, she covers the next steps in management for future patient visits.









