Patrick Lillie
@pjlillie.bsky.social
ID doc (TB / haem-onc) bit of research on the side, fell walking when chance allows
Interesting effects on pre malignant conditions from shielding / vaccination in a variety of different conditions. CLL isn’t great for vaccine responses….
November 12, 2025 at 9:48 AM
Interesting effects on pre malignant conditions from shielding / vaccination in a variety of different conditions. CLL isn’t great for vaccine responses….
Place Fell overlooking Ullswater - it is a great scene
September 25, 2025 at 4:46 AM
Place Fell overlooking Ullswater - it is a great scene
Agree - being able to tailor regimens to the individual case in front of you from shorter through to longer is key, either with biomarkers / response to treatment
September 11, 2025 at 8:39 AM
Agree - being able to tailor regimens to the individual case in front of you from shorter through to longer is key, either with biomarkers / response to treatment
Quite, there’s a reason many of us extend treatment in severe disease…
September 9, 2025 at 7:07 PM
Quite, there’s a reason many of us extend treatment in severe disease…
True, but I suppose most of us tend to over treat MDR / XDR TB so unlikely (esp in xdr cases) to not use it if littke eise. And it’s still in the leprosy guidelines
September 9, 2025 at 6:20 PM
True, but I suppose most of us tend to over treat MDR / XDR TB so unlikely (esp in xdr cases) to not use it if littke eise. And it’s still in the leprosy guidelines
Only use it when few other options but there is some evidence
www.medrxiv.org/content/10.1...
www.nejm.org/doi/full/10....
www.medrxiv.org/content/10.1...
www.nejm.org/doi/full/10....
Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis | NEJM
For decades, poor treatment options and low-quality evidence plagued care for patients with rifampin-resistant tuberculosis. The advent of new drugs to treat tuberculosis and enhanced funding now p...
www.nejm.org
September 9, 2025 at 5:52 PM
Only use it when few other options but there is some evidence
www.medrxiv.org/content/10.1...
www.nejm.org/doi/full/10....
www.medrxiv.org/content/10.1...
www.nejm.org/doi/full/10....
But apart from that, what has doxycycline ever done for us?
August 24, 2025 at 9:25 AM
But apart from that, what has doxycycline ever done for us?
Because you’re not allowed to say cockwomble on TV?
August 19, 2025 at 6:46 AM
Because you’re not allowed to say cockwomble on TV?
Certainly worth trying, worked in some people quite nicely
July 17, 2025 at 7:50 AM
Certainly worth trying, worked in some people quite nicely
LP then crack on with induction treatment, then probably long term suppression given the lymphoma isn’t going away
July 16, 2025 at 7:44 PM
LP then crack on with induction treatment, then probably long term suppression given the lymphoma isn’t going away
Blood cultures done? Has their lymphoma been treated (and if so with what?) Titre of the crypto antigen? Given their immune status and findings I’d probably get an LP then treat with Ambisome +\- flucytosine (not been able to get it for ages here). Interested to see what people do…
July 16, 2025 at 6:41 PM
Blood cultures done? Has their lymphoma been treated (and if so with what?) Titre of the crypto antigen? Given their immune status and findings I’d probably get an LP then treat with Ambisome +\- flucytosine (not been able to get it for ages here). Interested to see what people do…
Reasonably extensive disease and previous NTM treatment so will prob do co-trim + Moxi for 4-6 weeks then drop to co-trim if improving. Imipenem mentioned in lots of guidance but it’s awkward to use hence asking about erta / other options
July 2, 2025 at 9:40 PM
Reasonably extensive disease and previous NTM treatment so will prob do co-trim + Moxi for 4-6 weeks then drop to co-trim if improving. Imipenem mentioned in lots of guidance but it’s awkward to use hence asking about erta / other options
Thanks, as not had any treatment yet and extensive disease on CT I’m prob going to do co-trim and Moxi initially then drop to co-trim mono when improving
July 2, 2025 at 9:38 PM
Thanks, as not had any treatment yet and extensive disease on CT I’m prob going to do co-trim and Moxi initially then drop to co-trim mono when improving
I tend to be cautious with using co-trim and linezolid together over marrow suppression but certainly happy to use linezolid if probs with co-trim
July 2, 2025 at 9:36 PM
I tend to be cautious with using co-trim and linezolid together over marrow suppression but certainly happy to use linezolid if probs with co-trim
No Smith playing but it is an encouraging sign
June 25, 2025 at 8:02 PM
No Smith playing but it is an encouraging sign
How long have they had IV so far? If they can tolerate the number of tabs orally then I’d stick at that dose orally with a repeat scan at 4 weeks to see what’s what (assuming undrained abscess)
June 18, 2025 at 8:32 AM
How long have they had IV so far? If they can tolerate the number of tabs orally then I’d stick at that dose orally with a repeat scan at 4 weeks to see what’s what (assuming undrained abscess)
Yeah, a bio marker / combination that predicts low risk of relapse would be brilliant
June 13, 2025 at 5:32 PM
Yeah, a bio marker / combination that predicts low risk of relapse would be brilliant