Critical Care Units can be noisy at the best of times but on this occasion when I attended, an unplanned intubation was taking place of a patient with community acquired pneumonia (CAP). Microbiologists tend to steer clear of these “noisy” procedures but the team was keen to ask me about escalating the antibiotics because this patient had failed to respond to IV Amoxicillin and IV Clarithromycin, becoming progressively more tired to the point where Critical Care had had to intervene. I asked about any comorbidities, and within the list of other illnesses was the condition myasthenia gravis. I nodded wisely (we Microbiologists like doing this!) and pointed out that the patient had got worse not because of the CAP but because they had been given the wrong antibiotics, in particular Clarithromycin.

My wife won’t be pleased that I share her story with you but I remember it not so fondly after I have received a few calls regarding the same bug... Giardia lamblia. Jenny and I were white water rafting in Nepal, when the raft over turned. We nearly drowned in the washing machine-like swollen Bhote Koshi River, we both resurfaced downstream and scrambled out onto the river bank but she took a few too many gulps of river water. Alive, breathing and a bit shook up but no lasting harm done...she thought!