Alle afleveringen
290 afleveringen, van nieuw naar oud
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TWiP 290: What's Biting You at Night?
16 oktober 2026 · 1 uur 6 min
TWiP solves the case of the patient who developed an intensely itchy, red papular rash after close contact with chickens and their bedding, where small mites were found. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero of the Month: Ogobara Doumbo (Lancet, AJTMH, Lancet)
Letters read on TWiP 290
New Case
Man in 30s with well controlled diabetes, elevated AST ALT liver tests, asymptomatic. Ultrasound of liver, multiple cysts. Born in rural Yemen, grew up on farm with cattle, sheep, donkeys, 3-4 indoor/outdoor dogs, bathroom inside house, frequently swam in fresh water, as adult worked in construction, 2010 moved to capital, in 2017 Moved to US works in Brooklyn.
March 2023 get abnormal lab results. Decide to follow, 1 year later, repeat ultrasound, 3 new lesions 1-2 cm range, triggers abdominal MRI, has enlarged liver 21 cm, hepatic steatosis, cysts. June 2024 has acute right side lower back pain, goes to ED, they say its musculoskeletal. A year later May 2025 goes back to Yemen, develops abdominal discomfort, then resolves.
Oct 2025 develops day of severe diffuse abdominal pain, fever, admitted with wbc elevated, eosinophil 100, liver enzymes normal. CT shows multiple cysts 6.5 x 5 cm, with small internal cysts, few have internal enhancing curvilinear serpiginous material.
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Music by Ronald Jenkees
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TWiP 289: Dogs, Parasites, and an Exhausted Immune System
2 oktober 2026 · 58 min
TWiP explains a single-cell analysis of immune cells in the blood of dogs with canine leishmaniosis, providing a detailed picture of how the immune response changes as the disease progresses. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Single immune cell atlas of canine leishmaniosis (iScience)
Clinical staging in CanL (LeishVet)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 288: Taco Bell and the Case of the Runny Jobbies
21 september 2026 · 1 uur 7 min
TWiP solves the case of the NYC woman in her 30s who developed 3 weeks of significant watery diarrhea after eating at a Taco Bell Restaurant. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 288
Parasite of the month – Parelaphostrongylus tenuis — meningeal worm (brainworm)
Wikipedia entry
P. tenuis in ruminants (Food Animal Pract)
P. tenuis in white-tailed deer (Int J Parasitol Parasites and Wildlife)
TWiP study – information and survey
New Case
Early teen, otherwise healthy, develops rash, for a few weeks, problem at night. All over the body. Helps with backyard chicken coop, plays with chickens. Dad looks through bedding, finds tiny red mobile things. Suggest changing bedding, tell teen not to help with chickens. Then rash disappears in a few days.
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Music by Ronald Jenkees
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TWiP 287: A Vaccine Against Schistosomiasis? SchistoShield Heads to Phase 2
8 september 2026 · 47 min
Mumtaz Balkhi joins TWiP to discuss phase 1 and 1b trials of the schistosomiasis vaccine SchistoShield which demonstrate that it induces functional immune memory responses in US and African populations. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Mumtaz Y. Balkhi
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SchistoShield Phase 1 and 1b results (npj Vaccines)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 286: Pinworms keep coming back! How to stop reinfection in your home
27 augustus 2026 · 1 uur 12 min
TWiP solves the case of the adult female with a 2 year old child who develops anal irritation, but the child and the husband are fine. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 286
Hero – Otto Wucherer
TWiP study – information and survey
New Case
Recent case. Woman in 20s, lives in NYC, goes to urgent care with 3 weeks of significant watery diarrhea, not improving. Otherwise healthy, no travel, works in office in NYC, at some point prior to onset she ate at a Taco Bell. Put on twice a day medication, molecular test of stool confirms diagnosis. Don't know when, or what she ate. Trying to replenish fluid losses. Not immunosuppressed.
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Music by Ronald Jenkees
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TWiP 285: Why Is Cyclospora So Hard to Contain? Parasitologists Explain the 2026 US Outbreak
6 augustus 2026 · 53 min
TWiP reviews our current understanding of the biology of Cyclospora, the parasite currently causing a large multistate outbreak in the US traced to contaminated lettuce, and why it is so difficult to control. Lees meer
Hosts: Vincent Racaniello and Christina Naula
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Current Knowledge of Cyclospora cayetanensis (Comp Rev Food Sci Food Safety)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 284: It's not the pork
27 juli 2026 · 51 min
TWiP solves the case of the 39-year-old man originally from Guatemala, who moved to one of the NYC boroughs in 2023 and presented with headaches for nearly 1 year. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 284
TWiP study – information and survey
New Case
Recent ID consult: MD/PhD mother doing research, married with child 2 yo, female develops anal irritation, husband is fine, child is fine. Parasitic etiology is considered. Referred to academic ID providers, turns out she had this etiology considered, had received some treatment, got a little better, symptoms returned, treated again, got better, symptoms returned. Got some hard to find testing equipment, and confirm suspicion. Treat once, then again in two weeks. Not any better, still irritation. What do we do? HIV neg, no prior medical issues, no travel.
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Music by Ronald Jenkees
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TWiP 283: Warming up to cryptosporidiosis
7 juli 2026 · 1 uur 1 min
TWiP reviews the projected impact of climate change on the burden of Cryptosporidium in Mali, Kenya, and The Gambia. Lees meer
Hosts: Vincent Racaniello and Christina Naula
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Impact of climate change on Cryptosporidium (J Inf Dis)
Letters read on TWiP 283
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 282: Does he live in New York?
24 juni 2026 · 54 min
TWiP solves the case of the nonbinary patient in his 30s with a history HIV/AIDS presenting with 3 weeks of subjective fevers, chills, generalized weakness and voluminous ostomy output. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Parasite of the Month: Leucochloridium paradoxum (the green-banded broodsac)
Letters read on TWiP 282
TWiP study – information and survey
New Case
39-year-old man originally from Guatemala, who moved to one of the NYC boroughs in 2023 and currently lives with his siblings and cousins, presented with headaches. He reports headaches for several months, possibly nearly 1 year. Over the past 2 weeks, he has had intermittent numbness on the left side of his face and in his left arm and foot, with difficulty standing due to sensory changes in his feet. He states these symptoms are new. He reports a fall related to the numbness but denies balance problems. He denies fever or chills. He has intermittent nausea and vomiting but denies diarrhea, abdominal pain, or other complaints. He works as a busboy in a restaurant and states that he only cleans and does not prepare food. In Guatemala, he used to eat street tacos containing pork and beef, sometimes with undercooked meat. He is a former smoker who quit 4 years ago after smoking for 10 years. He drinks alcohol 3–4 times per week, typically 2–4 drinks per occasion, but not daily. He reports no sexual activity for 1–2 years.
General: no acute distress
HEENT: NC/AT, anicteric, vEEG
Neck: supple, normal ROM
Lungs: clear to auscultation bilaterally
Heart: S1, S2 present, normal rate/rhythm
Abdomen: Soft. Nondistended. Nontender.
Neuro: AAOx3, no obvious focal deficits
Extremities: No cyanosis. No edema.\
Skin: Warm. Dry. No visible rash.
Psychiatric: Appropriate affect and mood for situation.CT HEAD WO IV CONTRAST-Cystic structures scattered along the suba…
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TWiP 281: Ants under the influence
22 juni 2026 · 58 min
TWiP reviews gene expression in wood ants infected with the larval lancet fluke, which causes them to leave their nest and attach to a flower until they are eaten by a grazing mammal. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Gene expression in wood ants infected with lancet fluke (Mol Ecol)
Visualisation of the master manipulator in the brain of its ant host (Sci Rep)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 280: The wriggling diagnosis
29 mei 2026 · 57 min
TWiP solves the case of the 3 yo child, who recently immigrated to the US from Central America, in the ER with acute right lower quadrant abdominal pain and a rather active serpiginous wormlike 'thing' wiggling away in the child's appendix. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Rudolf Ludwig Carl Virchow (1821-1902)
Letters read on TWiP 280
TWiP study – information and survey
New Case
3 yo child who recently immigrated to the US from Central America is brought in to the ER with acute right lower quadrant abdominal pain. The mother is concerned about the pain as well as nausea and vomiting. This is acute and the ER provider is concerned that this might be an acute surgical emergency. They order an US in this child and they are surprised to see a rather active serpiginous wormlike 'thing' wiggling away in the child's appendix. I was sent the Ultrasound video which I really enjoyed. What to do?
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Music by Ronald Jenkees
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TWiP 279: Tolling for hookworms
1 mei 2026 · 51 min
TWiP reviews a phase 2 clinical trial of a recombinant vaccine against N. americanus glutathione S-transferase-1, an enzyme that performs a crucial enzymatic step in
hookworm blood feeding. Lees meerHosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Phase 2 hookworm vaccine clinical trial (Lancet Inf Dis)
Phase 2 Schistosoma vaccine clinical trial (Vaccines)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 278: Trichinella from eating bear eyeballs
24 april 2026 · 56 min
TWiP solves the case of the male in his 20s from Hokkaido, Japan, who developed fatigue and rash, followed by fever and myalgia 6 days later, after eating a raw bear eyeball. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Sir Nicholas White (1951 – 2026) (Guardian, Lancet)
Letters read on TWiP 278
TWiP study – information and survey
New Case
3 yo child who recently immigrated to the US from Central America is brought in to the ER with acute right lower quadrant abdominal pain. The mother is concerned about the pain as well as nausea and vomiting. This is acute and the ER provider is concerned that this might be an acute surgical emergency. They order an US in this child and they are surprised to see a rather active serpiginous wormlike 'thing' wiggling away in the child's appendix. I was sent the Ultrasound video which I really enjoyed. What to do?
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Music by Ronald Jenkees
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TWiP 277: Rif-ing on river blindness
22 april 2026 · 1 uur 4 min
TWiP 277: Rif-ing on river blindness Lees meer
April 21, 2026
TWiP reviews the global, regional, and national burden of Chagas disease, and comparison of doxycycline and rifampicin for the treatment of onchocerciasis.
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Burden of Chagas' disease (Lancet Inf Dis)
Doxycycline vs rifampicin in treatment of river blindness (Open For Inf Dis)
The kissing bug by Daisy Hernandez
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 276: Travel history is the key
23 maart 2026 · 1 uur 17 min
TWiP solves the case of the man in his 60s experiencing weight loss, fatigue, and loss of appetite. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Bailey K. Ashford
Letters read on TWiP 276
TWiP study – information and survey
New Case
Male in his 20s from Hokkaido, Japan, developed fatigue and rash, followed by fever and myalgia 6 days later. He was a group of five individuals on a hunting trip prior to this and reports that 3 friends are just fine but one other individual developed similar symptoms. He reports that they had been hunting the Ussuri brown bear, which is larger and more aggressive than the Asian black bear. They had been successful and all five of them had consumed well cooked bear meat. He does share that he is aware of infectious risk from eating bear and thus the meat was well cooked. He and the one fellow hunter who did get sick were unique in that they each ate one of the eye balls raw. This is a tradition that is felt to give the consumer the great vision that these animals are purported to have.
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Music by Ronald Jenkees
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TWiP 275: Novel malaria vector control
12 maart 2026 · 42 min
TWiP reviews the effectiveness of long-lasting spatial repellent emanators against malaria in humanitarian crisis settings in northern Nigeria, and Dengue suppression by male Wolbachia-infected mosquitoes. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Spatial emanators for malaria control (Lancet Inf Dis)
Dengue suppression with Wolbachia-infected mosquitoes (NEJM)
Singapore Environmental Health Institute (TWiV 630)
TWiP study – information and survey
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TWiP 274: Four tablets for bloating
17 februari 2026 · 48 min
TWiP solves the case of the 40 year old male who travels to India and develops intestinal bloating and diarrhea. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Glenn L. Hoffmann
Fish and seafood consumption (Our World in Data)
Wild fish vs aquaculture (Our World in Data)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 273: Intestinal parasites in dogs
6 februari 2026 · 1 uur 6 min
TWiP reviews intestinal parasites in dogs and their association with clinical manifestations of canine visceral leishmaniasis. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Intestinal parasites in dogs (Vet Parasitol)
Zoonotic protozoal diseases of companion animals (Clin Micr Rev)
Canine visceral leishmaniasis in stray and owned dogs in Brazil (Acta tropica)
Zoonotic protozoal diseases of companion animals (Clin Micr Rev)
Canine visceral leishmaniasis (Leish Vet, pdf)
Immune Responses in leishmaniasis (Trop Med Inf Dis)
Canine leishmaniasis in the US (Today's Vet Prac)
TWiP study - information and survey
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Music by Ronald Jenkees
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TWiP 272: Don't look and you won't find
15 januari 2026 · 58 min
TWiP solves the case about the man with positive Strongyloides serology who is waiting for a kidney transplant. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Chronic strongyloidiasis (Australian Family Physician)
Hero: Gwendoleen Rees (Wikipedia)
TWiP study – information and survey
Letters read on TWiP 272
New Case
40 year old man travels to India, is only there for a week before he develops problems. Bloating, diarrhea. Weathers the storm. Returns to US. Stool sent for testing. Some interesting results. Comes back positive for Hymenolepis nana, Blastocystis hominis, Giardia intestinalis. Recommended he take four tablets. Flatulence. HIV negative. He ate food that were prepared in the home but also out. Delhi area.
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Music by Ronald Jenkees
Dear TWiP listeners,
Have you ever wondered how TWiP shapes your understanding of science? We have! To find out more, Christina and the team are running a survey based study to learn more about how TWiP contributes to your scientific literacy and trust in science. Listen to the segment in this episode (TWiP 267) where Christina discusses the study's aims and scope.
Anyone who listens to TWiP can participate. The survey is anonymous and we do not collect personal data that could identify you. There are no potential disadvantages or harms in taking part, other than using a few minutes of your time. You will receive no direct benefit from taking part in this study. However, the information that is collected during this study will give us a better understanding of who our listeners are, and why they choose to listen to TWiP. We can use this understanding to make TWiP even better!
This is an academic study and we aim to disseminate our findings to the wider public, including you. For example, we'll have a conve…
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TWiP 271: The silent lesion
23 december 2025 · 50 min
TWiP explores female genital schistosomiasis and associated genital infections in Southern Malawi, a neglected tropical disease. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Female genital schistosomiasis in Malawi (Parasitology)
Mainstreaming female genital schistosomiasis (Parasitology)
Female genital schistosomiasis (WHO)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 270: They bake my noodle
28 november 2025 · 57 min
TWiP solves the case about the man with abnormal brain MRI, and presents a new case for your solving about a man with some electrolyte issues related to his end-stage renal disease. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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TWiP study – information and survey
Letters read on TWiP 270
New Case
A man in his 20s is admitted to the hospital with some electrolyte issues related to his end-stage renal disease. Infectious disease is consulted as he has a report of a recent positive strongyloides serology test that was done as part of his pre-transplant evaluation. He reports no international travel, no interesting exposures.
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Music by Ronald Jenkees
Dear TWiP listeners,
Have you ever wondered how TWiP shapes your understanding of science? We have! To find out more, Christina and the team are running a survey based study to learn more about how TWiP contributes to your scientific literacy and trust in science. Listen to the segment in this episode (TWiP 267) where Christina discusses the study's aims and scope.
Anyone who listens to TWiP can participate. The survey is anonymous and we do not collect personal data that could identify you. There are no potential disadvantages or harms in taking part, other than using a few minutes of your time. You will receive no direct benefit from taking part in this study. However, the information that is collected during this study will give us a better understanding of who our listeners are, and why they choose to listen to TWiP. We can use this understanding to make TWiP even better!
This is an academic study and we aim to disseminate our findings to the wider public, including you. For example, we'll have a conversation about the findings on a future episode of TWiP, we plan conference presentations and publ…
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TWiP 269: Peripatetic Martin Grobusch
21 november 2025 · 1 uur 4 min
TWiP travels to Toronto, CA for the American Society for Tropical Medicine and Hygiene conference where they meet up with Martin Grobusch to discuss his career and his work. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Martin Grobusch
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Primaquine for blocking malaria transmission (Lancet Inf Dis)
Pulmonary tuberculosis, Sierra Leone (New Microb New Inf)
TWiP study – information and survey
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Music by Ronald Jenkees
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TWiP 268: A loyal parasite
9 november 2025 · 1 uur
TWiP discusses a 41-year long human infection with Schistosoma mansoni, and CRISPR screens that reveal genes essential for Cryptosporidium survival in the host intestine. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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41 year old Schistosoma infection (J Travel Med)
Genes essential for Cryptosporidium survival in host intestine (Nat Comm)
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Music by Ronald Jenkees
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TWiP 267: It dropped from her scalp
21 oktober 2025 · 54 min
TWiP solves the case about the female who traveled to Brazil and upon returning home felt movements under her scalp on the back of her head, and present another case for your solving, a man with abnormal brain MRI. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Eyal Leshem
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Life cycle of Dermatobia hominis (CDC)
Letters read on TWiP 267
TWiP study - information and survey
New Case
Man in his 40s, married with 2 children, on Eliquis for a prior DVT, diet-controlled diabetes, who is admitted for evaluation of an abnormal brain MRI. He left AMA but then developed vomiting and returned.
CT- Large peripherally enhancing mass lesion in the deep left cerebral hemisphere is associated with considerable vasogenic edema/infiltrative nonenhancing tumor. Mass effect results in left-to-right subfalcine herniation and entrapment of the right lateral ventricle. Findings are typical for glioblastoma. Intracranial abscess tumefactive multiple sclerosis and brain metastasis may mimic this appearance. Recommend supplemental imaging evaluation including gadolinium-enhanced MR brain.
MRI- Dominant heterogeneously enhancing mass in the left basal ganglia/peri-insular region measuring 3.1 cm AP by 2.8 cm TR by 2.9 cm cc, with surrounding vasogenic edema resulting in mass effect and midline shift, as detailed above, concerning for high grade glial neoplasm versus metastasis. Additional leptomeningeal nodule in the right postcentral sulcus. Additional smaller peripherally enhancing lesion in the right lateral temporal region with suggestion of leptomeningeal component and measures approximately 0.8 x 0.8 cm, with mild surrounding vasogenic edema.
They do a biopsy and pathology comes back as: – Brain tissue with extensive necrosis acute chronic inflammation, and rare microorganisms (on permanent section)
-Brain, designated "left brain les…
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TWiP 266: Wraps and ivermectin for malaria
6 oktober 2025 · 1 uur 1 min
TWiP explains research showing that treatment of baby wraps with an insect repellent, and oral dosing with ivermectin, are both effective measures to prevent malaria. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Treated baby wraps prevent malaria (NEJM)
Oral ivermectin prevents malaria (NEJM)
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Music by Ronald Jenkees
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TWiP 265: Things that jump are cleaner than things that squat
26 september 2025 · 41 min
TWiP solves the case about the parasite check in summer camp, and presents a new case about a woman who traveled to Brazil and developed furuncles on the back of her head. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Francesco Redi
Wikipedia: https://en.wikipedia.org/wiki/Francesco_Redi
Linda Hall Library, Kansas: https://www.lindahall.org/about/news/scientist-of-the-day/francesco-redi/
Habermehl, G., (1994). Francesco Redi—Life and work, Toxicon 32 (4) https://doi.org/10.1016/0041-0101(94)90292-5.
Letters read on TWiP 265
New Case
From Eyal Leshem, a returning case "provider"
43 years old female who travelled to Brazil on May 2025 for a two week dance class. The dance school is located in a farm two hour drive West of Rio de Janeiro.
Upon return to Israel she started feeling pricking and "movements" and under her scalp on the back of her head. She noted three non-healing furuncles on the back of her head A month after she returned movement and pricking in the back of her scalp increased, the furuncles enlarged and produced serous discharge. Several days before her ED visit she thinks an "object" dropped from the back of her scalp, but being outdoors, she could not locate the object.
On physical examination she is afebrile and her vitals are normal, and on the back of her head two indurated were detected under the hair on the back of her head. Serous discharge was produced by pushing the furuncles. A non-surgical office procedure led to immediate recovery and confirmed the diagnosis.
What was the parasite? What was the procedure?
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Music by Ronald Jenkees
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TWiP 264: Toxoplasma changes your brain
29 augustus 2025 · 44 min
Vincent and Daniel discuss research showing that Toxoplasma gondii infection of the brain alters extracellular vesicle production and the communication between neurons and astrocytes. Lees meer
Hosts: Vincent Racaniello and Daniel Griffin
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T. gondii infection of neurons (PLoS Path)
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Music by Ronald Jenkees
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TWiP 263: Tick-tock
21 augustus 2025 · 58 min
TWiP solves the case of the world travelers with poppy-seed size dots embedded in their skin, then present a new case about parasite check in summer camp. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Dr Laurence Tetley
Letters read on TWiP 263
New Case
It is the first day of summer camp and the children are lined up for a parasite check. Some of the children have certificates that allow them to bypass the screening. Some of the parents are upset about this process commenting that this is not required by the state and report this could not be a problem for their children. One by one the children have their scalps examined and 2 of the children are asked to step to the side. The parents of these two children are contacted and told that they must address the identified concern before they can attend the camp. They are treated with a topical therapy on their hair with repeat in 1 week. The upset parents have several questions that hopefully our listeners can address.
-what is this all about?
-is anyone suggesting this is a hygiene issue?
-what is the most sensitive way to look for this problem?
-how do we know it is cured?
-feel free to talk about the life cycleBecome a patron of TWiP
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Music by Ronald Jenkees
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TWiP 262: Do schistosomes affect behavior?
29 juli 2025 · 1 uur 4 min
TWiP reviews research suggesting that schistosome infection affect behavior through the gut-brain axis, and Chuck Knirsch joins to reminisce about Dickson Despommier. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Chuck Knirsch
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Does schistosome infection affect behavior? (PLoS NTD)
Hero: Harold Brown (NY Times)
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Music by Ronald Jenkees
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TWiP 261: A case for Dr. Hickam
4 juli 2025 · 1 uur 12 min
TWiP solves the case of the pregnant woman from Tanzania with dehydration and 3 weeks of bloody stool, a situation that would confuse Ockam but not Dr. Hickam. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Hero: Dame Bridget Ogilvie (Interview and Wiki)
Letters read on TWiP 261
New Case
I feel like the back section of our book has been a bit neglected. The new PD 8th Edition is posted on our website so please download a copy and extra points to anyone who can tell us what that is on the cover.
Three individuals are involved here with a rather impressive travel history. We have a mom, a daughter and a son who reach out for guidance. Initially one of them found something small dark and about the size of a poppy seed embedded in their skin. This led to a more involved investigation where they found that all three had similar findings but some of these were larger, some a bit larger, one was actually described as mobile. They all feel fine and report no skin rashes. They have a number of concerns about what these are, if they might carry disease, what to do about removing them and should there be testing or treatment. The interesting travel and exposure history. They report that just prior to this they spent a week on a remote island off the coast of Scotland with extensive hiking in tall grass and boggy areas with deer, rabbits, and lots of sheep. An Island called Harris and Lewis and then just that Saturday hiking in wooded areas around Loch Ness and in the Cairngorns. Sunday out hiking and running on Long Island and then Wednesday when these mystery objects were found they had just been hiking and going for a run in Cape Cod. They report on Cape Cod the trail they followed had a fallen tree and they had to crawl underneath it prompting this skin inspection.
-lots of questions here…
What might these be and how do we identi…
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TWiP 260: Daily rhythms
24 juni 2025 · 1 uur 6 min
TWiP explains how circadian clocks of parasite and vector circadian mediate efficient malaria transmission. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Clocks mediate malaria transmission (Nat Micro)
Hero: Dame Bridget Ogilvie (Wiki)
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Music by Ronald Jenkees
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TWiP 259: Know your knowlesi
2 juni 2025 · 57 min
TWiP solves the case of the man in the Malaysian city of Kucheng who presents with daily fevers and shaking chills, and serve a new clinical puzzle for you to solve. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 259
New Case
Another case from Northern Tanzania, up by the border of Kenya. 32 yo pregnant woman admitted to the hospital, dehydrated, reporting 3+ weeks of diarrhea. Second trimester, second pregnancy, reports stools are sticky and it is hard to get herself clean. She also noticed blood mixed in the stool. No fever, no chills, but she feels weak. While many in the area get their water from boreholes, rivers and rainfall she reports getting hers from a nearby river. She lives with her husband and one child who is 2 years old. She is HIV negative and reports she had been in good health otherwise. She looked tired and worn down when she arrived in the hospital but is already feeling better. Her blood work is notable for a low hemoglobin and elevated creatinine. Stool studies are sent and Ockam would be confused but Dr Hickam would know what to do.
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Music by Ronald Jenkees
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TWiP 258: The deeper, the rounder
13 mei 2025 · 1 uur 3 min
TWiP describes how a gut commensal protozoan influences respiratory disease outcomes by shaping pulmonary immunity, and body shape variation in lice that parasitize diving hosts. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Gut commensal shapes pulmonary immunity (Cell)
The deeper the rounder (Sci Rep)
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Music by Ronald Jenkees
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TWiP 257: Malaya and Malaysia
20 april 2025 · 51 min
TWiP solves the case of the man in the Malaysian city of Kucheng who presents with left arm swelling, and presents a new case for you to decipher. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 257
New Case
We are still in Kuching, Malaysia in the northern part of the Island of Borneo. This is the Sarawak portion of Malaysia. A man in his late 30s is admitted to the hospital in December with daily fevers that last for several hours and shaking chills. He had previously been healthy with no medical problems. He lives in the city and works in an office, however, in the few weeks prior to getting admitted he was visiting the jungle. Apparently not too far outside of Kuching, one can go up into the jungle and see Orangutans. He had gone into the jungle but this was 2 weeks prior to the onset of symptoms. Since then he reports no unusual exposures. He lives with his wife and children and they are all healthy. A few days prior to admission he noted fever, chills, and a headache. He is a little nauseated but no vomiting.
On exam he has a fast heart rate and appears ill. His respiratory rate is increased and he is not febrile on admission but later does have fever. No enlargement of the liver or spleen on exam. Otherwise unremarkable.
His labs are notable for low white blood cells, anemia, and a platelet count of less than 50k per microL. His coagulation studies are abnormal, serum creatinine is elevated, and there is elevation of his serum aminotransferases.
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Music by Ronald Jenkees
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TWiP 256: Amazing antimalarial drug resistance
4 april 2025 · 1 uur 3 min
TWiP explains a study that carries out selection of Plasmodium falciparum in the presence of inhibitors to identify determinants of drug resistance, and a paleoparasitological analysis of a 5th–16th c. CE latrine. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Naegleria fowleri acquired at splash pad (MMWR)
Determinants of P. falciparum drug resistance (Science)
Paleoparasitological analysis of 5th–16th c. CE latrine (Parasitol)
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Music by Ronald Jenkees
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TWiP 255: Katayama fever
22 maart 2025 · 57 min
Michelle Labrunda joins TWiP to solve the case of the Georgian in Guinea with fever and dry cough, and describe a new case for you to solve. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Michelle Labrunda
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Letters read on TWiP 255
New Case
A man who is on eculizumab, a recombinant humanized monoclonal antibody that targets complement protein C5 which serves as a terminal complement inhibitor, comes in with left arm swelling. He lives in a city in the north part of the island of Borneo. He is being managed by a doctor in the Malaysian City of Kuching. Now the doctor caring for this man is married to an Infectious Disease expert and she raises concerns that this might be due to a parasitic disease. She is told by the husband that the disease of which she is thinking is not present in the region. She is not swayed and admits him for nightly blood smears which are negative. She then does a rapid immunochromatographic dipstick test that is positive. He lives in a community outside the city and they go to that village and find others with limb swelling issues who are also positive on antigen testing. He is treated with an antibiotic, not antiparasitic for 4 weeks and the arm improves. Hint: this is not Wuchereria Bancrofti.
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Music by Ronald Jenkees
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TWiP 254: Our hero Dickson
9 maart 2025 · 1 uur 1 min
TWiP explains a study which finds that tissue spaces are reservoirs of antigenic diversity for Trypanosoma brucei, then remembers our departed colleague Dickson Despommier. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Tissue spaces are reservoirs of antigenic diversity for T. brucei (Nature)
Understanding trypanosome antigenic variation (Emerg Top Life Sci)
Tissue resident T. brucei (PLoS Path)
Hero – Dickson Despommier
Despommier Photo Art
Parasitology Course (YouTube)
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Music by Ronald Jenkees
TWiP explains a study which finds that tissue spaces are reservoirs of antigenic diversity for Trypanosoma brucei, then remembers our departed colleague Dickson Despommier.
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Tissue spaces are reservoirs of antigenic diversity for T. brucei (Nature)
Understanding trypanosome antigenic variation (Emerg Top Life Sci)
Tissue resident T. brucei (PLoS Path)
Hero – Dickson Despommier
Despommier Photo Art
Parasitology Course (YouTube)
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Send your questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 253: Sub-Saharan somnolence
22 februari 2025 · 1 uur 2 min
TWiP solves the case of the man with somnolence and something extra-erythrocytic, and presents a new puzzle for you to solve. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 253
New Case
26-year-old female with no past medical history. Patient is from Georgia in the US and is volunteering in Hérico, Guinea (town in the Lélouma Prefecture in the Labé Region of northern-central Guinea). She arrived in Guinea in December 2023. She was taking doxycycline for malaria prophylaxis and says that she has not missed any doses
On October 2024 she presented with fever and dry cough. Lab work was done and follow up planned for the following day. The patient slept poorly, was febrile to 104 and had ongoing cough. The next day she went to the hospital and was evaluated in the ER for acute febrile illness of unclear etiology.
In the hospital, VS were 97.9F, BP 105/70, P 94 Oxy sat 98%, normal physical exam.
She was started on Augmentin and Coartem.
Pause here to think about the differential at this point and maybe some more history and what testing you might want
WBC 14, Hb 13, HCT 40, PLT 285, Neut abs 8, Eos Abso0.80; BUN/creat normal, AST normal; ALT 44, GGT 125
Stool parasite screen + for some sort of eggs, malaria smear negative, CXR with b/l infiltrates
She was given a medication (vomited 30 min after dose received). She then received a second dose of medication 5 hours after the first) and was discharged. The following day the patient returned to the ER, stating that she felt worse. Her temperature had climbed to 104 overnight, and she developed watery diarrhea and nausea. There were no additional episodes of vomiting. She was given an additional dose of a medication, ibuprofen, and started on ceftriaxone 1 gm IV Q12 hrs. During the day she continued to have low grade fevers and developed abdominal pain. Tha…
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TWiP 252: For malaria vaccine, mosquito is the needle
10 februari 2025 · 54 min
TWiP discusses a study of the safety and immunogenicity of a late liver-stage attenuated malaria parasite delivered by mosquito bite. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Live attenuated malaria vaccine (NEJM)
Plasmodium metabolism during hepatic development (Cell)
Heroes – Jimmy and Rosallyn Carter, and the Carter Center
The Carter Center Guinea Worm Eradication Programme
Guinea Worm data visualisations (Our World in Data)
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Music by Ronald Jenkees
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TWiP 251: Case of the facial ulcer
17 januari 2025 · 57 min
TWiP solves the case of the woman who went to Belize and notices a lesion on her face, and presents a new clinical case for you to solve. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 251
New Case
Recent case, Arusha hospital, 1800 m, 28 yo comes in, has been visiting game parks. Developing fevers, malaise, bad headaches, body aches, somnolent. Blood smears negative, no malaria. Repeat blood smear, see something extra-erythrocytic. This gives them the diagnosis. HIV neg, no toxic habits, no history. Symptom onset about a week ago. Rest of family is ok.
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Music by Ronald Jenkees
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TWiP 250: Gut bacteria help Trichinella suppress colitis
3 januari 2025 · 52 min
TWiP reviews a study showing that the gut microbiota is essential for suppression of colitis by Trichinella spiralis. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Gut bacteria and Trichinella suppression of colitis (PLoS NTD)
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Music by Ronald Jenkees
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TWiP 249: A virus and a parasite
20 december 2024 · 56 min
TWiP solves the case of the middle-aged man with eosinophilia and a history of sexual activity with paid sex workers in Okinawa, and presents a new case for you to solve. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Letters read on TWiP 249
New Case
Woman in 30s or 40s goes to Belize and after returning notices a lesion on her face. She goes to see several physicians and despite a number of topical creams the ulcer on her face does not heal. She is then referred to our office where a certain parasitic infection is considered and we involve our friends at Columbia to help us with the diagnosis..
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Music by Ronald Jenkees
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TWiP 248: Toxoplasma reduces Alzheimer's disease
6 december 2024 · 1 uur 7 min
TWiP reviews the observation that infection of Azlheimer's disease mice with Toxoplasma gondii reduces brain amyloid density globally and regionally. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Toxoplasma reduces amyloid in brain (J Inf Dis)
Hero: Theodor Hiepe (Parasitol Res)
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Music by Ronald Jenkees
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TWiP 247: Manhattan mystery malady
18 november 2024 · 58 min
TWiP solves the case of the Manhattan man with pain on urination or ejaculation, and presents a new case for you to solve. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Hero: Charles Louis Alphonse Laveran
Letters read on TWiP 247
New Case
A middle-aged male is referred to evaluation because of eosinophilia. This man is married, living here in the NY tristate area, and this was picked up on 'routine blood work' by his primary care doctor. This man had been in the military, serving as a marine, with time spent in Okinawa, Japan. This individual does report sexual activity with paid sex workers while in Okinawa but has been monogamous with his current wife for many years. A number of investigations are done with a test coming back showing serological evidence of a prior parasitic infection and he was treated with an antiparasitic medicine with resolution of the eosinophilia. The eosinophilia returned and he was referred to us. Blood work is now down showing evidence of a viral infection that might explain why the eosinophilia returned after treatment. Pt is HIV negative. This was prior to the COVID-19 pandemic. He is on no medications and in general feels fine.
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Music by Ronald Jenkees
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TWiP 246: Everything spiral: a worm in a hurry
1 november 2024 · 1 uur 24 min
TWiP taps into Dickson's knowledge of Trichinella to discuss an outbreak in humans who consumed rare bear meat, and the impact of globalization and climate change on the epidemiology of the species. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Outbreak of human trichinellosis (CCDR)
Impact of climate change on Trichinella (Food Waterborne Parasit)
Letters read on TWiP 246
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Music by Ronald Jenkees
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TWiP 245: Flying purple people eater with Ben LaBrot
18 oktober 2024 · 1 uur 16 min
Founder of Floating Doctors Ben LaBrot joins TWiP to solve the case of the 1 year old in northeastern Panama with a fatal leg infection, followed by a discussion of the history and mission of Floating Doctors. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Ben LaBrot
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Floating Doctors
Letters read on TWiP 245
New Case
A man in his early 20s comes in reporting pain when he urinates or ejaculates. He reports that he is sexually active. He does confide that he has been in a relationship with a woman but he had a sexual encounter outside this relationship about 2 weeks ago when they were on a break and he did not wear protection. He feels like he needs to urinate more often and describes thin white discharge from the penis. He reports that he has no history of any sexually transmitted infections and had no medical issues prior to this.
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Music by Ronald Jenkees
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TWiP 244: Engineering Toxoplasma
5 oktober 2024 · 50 min
Lilach Sheiner joins TWiP to talk about her career and her work on engineering Toxoplasma gondii secretion systems for intracellular delivery of multiple large therapeutic proteins to neurons. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Christina Naula
Guest: Lilach Sheiner
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Engineering T. gondii for protein secretion (Nat Micro)
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Music by Ronald Jenkees
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TWiP 243: Don't blame it on Mexico
20 september 2024 · 1 uur 6 min
TWiP solves the case of the Woman with White Worms, and submits a new case involving a 1 year old in northeastern Panama with a fatal leg infection. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Enterobius, the pinworm (TWiP 19)
Hero: Mary Pritchard
New Case
This case comes from Panama mid summer 2024. A provider for Floating Doctors working in the coastal region in northeastern Panama. This case involves a one year old, so the history is a bit difficult, but there may have initially been a scratch or some sort of break in the skin. Otherwise healthy but over a period of time this area expands and becomes a deep necrotic wound on the leg. Several other nearby wounds develop and become deep and infected. By the time this one year old is seen by the provider much of the leg appears eaten away. This is just the tip of the iceberg as a number of others develop similar wounds in the area. No prior medical history.
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Music by Ronald Jenkees
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TWiP 242: Worms impair COVID vaccines
6 september 2024 · 48 min
TWiP reviews a study showing that intestinal helminth infection impairs vaccine-induced T cell responses through an IL-10 pathway, which compromised protection against antigenically drifted SARS-CoV-2 variants. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin and Christina Naula
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Worms impair COVID vaccines (Sci Trans Med)
Heligmosomoides image (Wiki Commons)
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Music by Ronald Jenkees
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TWiP 241: There once was a patient from China
20 augustus 2024 · 1 uur 15 min