Inpatient Consultations

About the Program

The Division of Infectious Diseases supports specialists at Massachusetts General Hospital and Massachusetts Eye and Ear, including consultations on pediatric and transplant patients, patients with HIV infection and general infectious disease problems.

Our adult inpatient consultation services are divided into General Infectious Diseases, Transplant and Immunocompromised Host and Infectious Diseases at Mass. Eye and Ear.

Our consultation is distinguished by its timeliness (same day whenever necessary) as well as by its comprehensive and coordinated nature. We communicate initially and at all important junctures with the services that consult us, as well as with other providers involved in the care of the patient. We are often the service that coordinates communication around multispecialty care of complicated inpatients.

General Infectious Diseases

We have always offered a transition to longitudinal outpatient care of infectious disease problems. In the last few years, we have established systems for an earlier and more seamless transition. Specifically, we seek to identify patients who will require ongoing care early. In some cases, they will be followed near home, and we work with the Mass General case manager and their Mass General and local providers to establish a plan for follow up.

In cases in which care will be continued here, our fellows and staff communicate with an identified nurse and nurse practitioner in our outpatient practice during the inpatient hospitalization. An outpatient appointment is established before discharge and conveyed directly to the patient or patient’s family and the team.

If we are to follow the home intravenous antibiotic therapy, a schedule of visits and laboratory monitoring is designed and conveyed to the patient, team and home care company. We encourage our service to put an initial consultation note as well as a last day note in the computer system, summarizing the plans for outpatient care.

We believe these systems have aided in a safe and early transition from hospital to home care for patients with infectious disease problems.

Transplant and Immunocompromised Host Service

Our transplant and immunocompromised host service, directed by Jay Fishman, MD, has always worked in a multidisciplinary fashion with others involved in the care of these complicated patients. This has contributed to the overall success of our hospital’s growing programs in these areas, including new programs in living related liver and lung transplantion, stem cell transplantation, allo and auto bone marrow transplantation, and transplantation with a tolerance induction protocol.

On the solid organ transplant service, we round twice daily with the transplant teams in order to deliver preventive care and consultation. We also round once a week with the bone marrow transplant service. In the last few years, we have developed and disseminated protocols for the infectious disease care of both solid organ and bone marrow transplant patients, for the treatment of fever and neutropenia, and for the rational use of antifungal therapy.

Infectious Diseases at Mass. Eye and Ear

Marlene Durand, MD, is the director of our infectious disease service at Mass. Eye and Ear. Dr. Durand's expertise in this area is highly sought after by the clinicians at the infirmary, and increasingly by physicians and patients in the region and in the country. They and a small group of physicians from our division provide same day consultation for inpatients at the infirmary. Given the increasingly ambulatory nature of practice at Mass. Eye and Ear, they often see outpatient consults the same day, either in the office of the consulting physician or in our infectious disease outpatient practice on Cox 5 at Mass General. The systems already described support the outpatient care of these patients.