Infectious Disease Doctors
30 years of experience

Accepting new patients
Washington Square West
Clinical Care Associates
301 S 8th St
Philadelphia, PA 19106
215-829-5354
Locations and availability (4)

Education ?

Medical School Score Rankings
University of Pennsylvania (1980)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
Recognized by Best Doctors in America 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012
Recognized in Philadelphia Magazine's May 2002, 2004, 2010 Top Docs issue
Castle Connolly's Top Doctors™ (2012 - 2013)
Patients' Choice Award (2008 - 2009)
Appointments
University of Pennsylvania
Clinical Associate Professor of Medicine Chief, Infectious Diseases, Pennsylvania Hospital
Associations
American Board of Internal Medicine

Affiliations ?

Dr. Braffman is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • Hospital of the University of PA
    3400 Spruce St, Philadelphia, PA 19104
    • Currently 4 of 4 crosses
    Top 25%
  • Pennsylvania Hospital University PA Health System *
    800 Spruce St, Philadelphia, PA 19107
    • Currently 4 of 4 crosses
    Top 25%
  • University of PA Medical Center/Presbyterian
    51 N 39th St, Philadelphia, PA 19104
    • Currently 3 of 4 crosses
    Top 50%
  • Graduate Hospital
    1800 Lombard St, Philadelphia, PA 19146
    • Currently 1 of 4 crosses
  • Clinical Practices of the University of Pennsylvania
  • Clinical Care Associates of the University of Pennsylvania Health System
  • * This information was reported to Vitals by the doctor or doctor's office.

    Publications & Research

    Dr. Braffman has contributed to 6 publications.
    Title Homograft Aortic Root Replacement During Pregnancy.
    Date August 2002
    Journal The Annals of Thoracic Surgery
    Excerpt

    Operative cardiac interventions have been performed on pregnant women with varying degrees of success since the late 1950s. Currently, reported maternal mortality for cardiac operations is similar to the mortality rate for nonpregnant female patients. However, fetal mortality remains high, at approximately 20%. Aortic root replacement with an aortic homograft in a 34-year-old pregnant woman with bacterial endocarditis at 18 weeks gestation is presented. Fetal echocardiography during and after bypass was employed.

    Title Melioidosis Presenting As an Infected Intrathoracic Subclavian Artery Pseudoaneurysm Treated with Femoral Vein Interposition Graft.
    Date April 2002
    Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
    Excerpt

    We present the first case of in situ replacement of an infected subclavian artery using superficial femoral vein and the fourth reported case of an infected arterial pseudoaneurysm caused by pseudomonas pseudomallei. Sepsis and hoarseness developed in a 58-year-old man after recent travel to Borneo, Indonesia. Indirect laryngoscopy revealed a paralyzed right vocal cord. Computed tomography and arteriography revealed a 6.5-cm pseudoaneurysm of the proximal right subclavian artery. Blood cultures grew pseudomonas pseudomallei. An abnormal cardiac stress test prompted a coronary angiography, which revealed severe coronary artery disease.The patient underwent coronary artery bypass and in situ replacement of the infected subclavian artery pseudoaneurysm with a superficial femoral vein, along with placement of a pectoralis major muscle flap to cover the vein graft. Operative cultures of the pseudoaneurysm grew pseudomonas pseudomallei. The patient was treated with a 6-week course of intravenous ceftazidime and oral doxycycline and then continued on oral amoxicillin-clavulanate. One week after discontinuing intravenous antibiotics, the patient presented to the emergency department with a rapidly expanding, pulsatile mass in the right supraclavicular space. He was taken emergently to the operating room. After hypothermic circulatory arrest was accomplished, the disrupted vein graft and aneurysm cavity were resected and the subclavian artery was oversewn proximally and distally. Parenteral ceftazidime was continued for 3 months and oral amoxicillin-clavulanate (augmentin) was continued indefinitely. There was no evidence of infection clinically or by computed tomographic scan 2 years later. Although autogenous vein replacement of infected arteries and grafts may be successful in the majority of cases, this strategy should probably be avoided when particularly virulent bacteria such as the organism in this case are present.

    Title Parenteral and Oral Fluconazole for Acute Cryptococcal Meningitis in Aids: Experience with Thirteen Patients.
    Date September 1992
    Journal The Annals of Pharmacotherapy
    Excerpt

    OBJECTIVE: Cryptococcus neoformans infections of the central nervous system affect up to ten percent of AIDS patients. Standard therapy with amphotericin B with or without 5-flucytosine has a high rate of failure, relapse, and toxicity. Fluconazole is a new triazole antifungal agent available in both oral and intravenous forms that has shown efficacy in the primary and maintenance treatment of cryptococcal meningitis in AIDS patients. In this open, noncomparative trial, we evaluated the safety and efficacy of intravenous fluconazole followed by oral fluconazole in the treatment of acute cryptococcal meningitis in AIDS patients. METHODS: Thirteen AIDS patients with acute cryptococcal meningitis, or relapse after successful primary therapy, received 400 mg of intravenous fluconazole daily for 12-16 days followed by oral fluconazole 400 mg/d for the duration of primary therapy. If cerebrospinal fluid (CSF) cultures converted to negative within 32 weeks of treatment, the fluconazole dose was decreased to 200 mg/d as maintenance therapy. RESULTS: Fluconazole therapy was successful in six patients (46 percent) and unsuccessful in seven (54 percent). Of the seven patients considered unsuccessful, one demonstrated clinical improvement but remained CSF-culture positive, five were clinical failure and were switched to amphotericin B therapy, and one died after two weeks secondary to cryptococcal meningitis. No patient experienced any adverse reactions necessitating discontinuation of therapy. CONCLUSIONS: In this small group of patients, moderate doses of parenteral and oral fluconazole for acute cryptococcal meningitis in AIDS patients demonstrated failure rates similar to those reported in other studies with fluconazole and with amphotericin B. As there was no difference in initial Karnofsky scores or the severity of disease in treatment successes versus failures, it is difficult to determine who might respond to fluconazole as initial therapy or who should be treated initially with another agent. Further studies and clinical experience are needed.

    Title Efficacy and Tolerance of Intermittent Versus Daily Cotrimoxazole for Pcp Prophylaxis in Hiv-positive Patients.
    Date April 1992
    Journal The American Journal of Medicine
    Title Opportunistic Infections in the Acquired Immunodeficiency Syndrome.
    Date July 1990
    Journal Seminars in Oncology
    Title Zidovudine-induced Hepatotoxicity.
    Date January 1989
    Journal Annals of Internal Medicine

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