PulmCrit (EMCrit)

Pneumocystic Jirovicii Pneumonia (previously Pneumocystic Carinii Pneumonia) remains an important opportunistic infection in critical care.  Improved treatment for HIV has reduced the frequency of PJP due to AIDS, but meanwhile the development of increasingly sophisticated immunosuppressive regimens for other patient populations has increased the incidence of non-HIV PJP.  New diagnostic tests are improving our ability […]

Early in the COVID epidemic, it became clear that the virus often causes a cytokine storm, leading to immunopathological organ damage.   The first major study to suggest benefit from steroid in COVID was a retrospective study by Wang et al. released in early March, which found reduced mortality among COVID patients with ARDS who were […]

Vocal cord dysfunction is a masquerader of life-threatening pathologies (most notably asthma and anatomic upper airway obstruction).  Vocal cord dysfunction itself is not dangerous, but if not properly diagnosed it may lead to considerable iatrogenic harm (e.g. multiple unnecessary intubations for “asthma”).  On the flip side, incorrect diagnosis of vocal cord dysfunction is also dangerous, […]

Invasive pulmonary aspergillosis was traditionally conceptualized as a rare infection restricted to profoundly immunocompromised patients.  However, over the past decade, it’s become increasingly clear that invasive aspergillosis can also occur as a nosocomial superinfection among patients who aren’t immunocompromised (especially following influenza).  This opens a can of worms regarding how to sift out colonization versus […]

Janus kinases (JAKs) are named after Janus, the Greek god of beginnings, gates, transitions, and duality.  They’re named after Janus because they contain a mirror-image structural element.  However, given their role within the immune system as a multi-functional gateway for cytokine systems, the name seems apt.  The cytokine storm induced by COVID-19 has received considerable […]