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290 afleveringen, van nieuw naar oud
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TWiP 240: A daily history of malaria with Sean Murphy
2 augustus 2024 · 57 min
Sean Murphy joins TWiP to discuss his career and the work of his laboratory to assess the daily natural history of asymptomatic Plasmodium infections in adults and older children in Katakwi, Uganda. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier and Christina Naula
Guest: Sean Murphy
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Daily natural history of Plasmodium infections (Lancet Microbe)
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Music by Ronald Jenkees
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TWiP 239: Cryptosporidiosis from NYC tap water in an AIDS patient
19 juli 2024 · 31 min
TWiP solves the case of the AIDS patient who developed fever and watery diarrhea after drinking NYC tap water, and present a new case for your sleuthing. Lees meer
Hosts: Vincent Racaniello and Daniel Griffin
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Cryptosporidium (TWiP 18)
Letters read on TWiP 239
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New Case
Man in his 70s originally from Mainland China, then Hong Kong who has been living in the US for decades is admitted to the hospital with fever for 6 days. He reports that he saw his primary care physician in Queens and was referred to the hospital after blood work revealed a sodium level of 123 and an increased monocyte count. Pt reports drenching sweats, lots of outdoor activity walking in local parks in Queens. He reports he does not feel particularly sick.
PMH-HTN, BPH
PSH-neg
Social-retired, no wife, has one son, no pets, no exotic exposures or recent travel
VS febrile to 39.5, tachycardia, meets sepsis criteria
PE -unremarkable
Labs, nl wbc, eos-0, elevated neutrophils and monocytes, Na-123, elevated AST, elevated ALT, low platelets, low Hct, CT Chest A/P unremarkableSend your guesses to twip@microbe.tv with TWiP 239 in the subject line
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Music by Ronald Jenkees
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TWiP 238: Eliminating sleeping sickness
5 juli 2024 · 1 uur 37 min
Michael Barrett joins TWiP to discuss progress in the elimination of human African trypanosomiasis caused by Trypanosoma brucei gambiense. Lees meer
Hosts: Daniel Griffin, Dickson Despommier and Christina Naula
Guest: Michael Barrett
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Elimination of human African trypanosomiasis (PLoS NTD)
Hero: David Livingstone
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Send your guesses to twip@microbe.tv with TWiP 237 in the subject line
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Music by Ronald Jenkees
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TWiP 237: Pass the venison, deer with Marilyn Fabbri
21 juni 2024 · 57 min
Marilyn Fabbri joins TWiP to reveal the case of a patient who became very ill after he and a number of friends attended a large dinner where venison and boar were served. Lees meer
Hosts: Daniel Griffin, Dickson Despommier and Christina Naula
Guest: Marilyn Fabbri
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Toxoplasma gondii (TWiP 12)
Parasitic Diseases Lectures #15: Toxoplasmosis
Letters read on TWiP 237
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New Case
Man in his 60s with HIV/AIDS CD4 count less than 50, CD4% less than 5% and elevated viral load (VL) with report of prior CNS toxoplasmosis requiring a craniotomy, disseminated Mycobacterium avium complex (MAC), comes in with fever and very watery diarrhea x 4 days. He reports that he lives in Georgia but comes up to NY for his HIV care and stays in NYC.
Send your guesses to twip@microbe.tv with TWiP 237 in the subject line
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Music by Ronald Jenkees
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TWiP 236: Prime-and-trap vaccine for malaria
1 juni 2024 · 1 uur 13 min
Marion Avril of MalarVx, Inc. joins TWiP to discuss an accelerated prime-and-trap regimen using repRNA-based circumsporozoite vaccine. Lees meer
Hosts: Dickson Despommier and Christina Naula
Guest: Marion Avril
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repRNA-based CSP malaria vaccine (NPJ vaccines)
Hero: Mwelecele Ntuli Malecela
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Send your guesses to twip@microbe.tv with TWiP 235 in the subject line
Send your questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 235: The case of the regurgitated wriggler
17 mei 2024 · 1 uur 16 min
TWiP solves the case of a man in his 50s reporting months of abdominal discomfort, who takes mebendazole and some time afterwards vomits a worm into the sink. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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The giant intestinal worm, Ascaris lumbricoides (TWiP 21)
Parasitic Diseases Lectures #24: Giant Intestinal Worm (YouTube)
Letters read on TWiP 235
Hero: Ernst A. H. Friedheim
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New Case:
I first learned about this case from a colleague at work who tells me that their friend has just gotten really sick. The friend is described as having had multiple illnesses over time but that he has never been as sick as he recently got. He reports that the illness began as a diffuse myalgia with fever, there was some sore throat, noted swelling in the neck, and overwhelming fatigue. He tells some of his friends that he is feeling really terrible and it turns out that some of his friends also feel poorly. It turns out that about a week prior to the onset of his symptoms he and a number of friends attended a large dinner where venison and boar was served.
This individual is then seen in our office. Some testing is done. He feels really terrible and despite being reassured that he should get better without treatment he is given therapy.
Send your guesses to twip@microbe.tv with TWiP 235 in the subject line
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TWiP 234: Hookworms and a leech - parasites suck!
4 mei 2024 · 1 uur 23 min
TWiP discusses hookworm infection and the phase 1 clinical trial for a hookworm vaccine that could one day protect children from the hookworm anaemia, and reduce transmission of this infection. Lees meer
Hosts: Dickson Despommier, Daniel Griffin, and Christina Naula
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Hookworm vaccines in school-aged children in Gabon (Lancet Inf Dis)
Step forward towards hookworm vaccines (Lancet Inf Dis)
Hookworm vaccine protects dogs (FASEB J)
Hero: Muriel Robertson
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Music by Ronald Jenkees
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TWiP 233: Cryptosporidium not cryptocurrency
19 april 2024 · 1 uur 21 min
TWiP solves the case of the physician with no significant previous medical history who is currently doing their fellowship training develops diarrhea, and presents a new clinical case for our astute listeners to solve. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Hero: Keith Vickerman
Letters read on TWiP 233
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New Case study:
I was recently asked about this case while I was off visiting Denmark. A man in his 50s has been reporting months of abdominal discomfort and decides to go discuss this situation with a local pharmacist. He describes this discomfort, some nausea, and some bloating of the abdomen. The pharmacist recommends that he take mebendazole. He takes the mebendazole and some time afterwards he vomits a worm into the sink. The worm does not have any obvious segmentation and appears completely nonsegmented and is moving around. One end is very pointy and the other little less so.
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Music by Ronald Jenkees
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TWiP 232: Lives of Wolbachia
5 april 2024 · 54 min
TWiP reviews the cellular lives of Wolbachia, a gram-negative bacteria that infects many arthropods and filarial nematodes with very different outcomes – parasitism or mutualism. Lees meer
Hosts: Dickson Despommier, Daniel Griffin, and Christina Naula
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Cellular lives of Wolbachia (Nat Rev Micro)
Hero: Patricia F. Walker
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Music by Ronald Jenkees
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TWiP 231: Scotch in drink and tape
31 maart 2024 · 56 min
TWiP solves the case of the Woman With White Worms, and presents a new clinical case to decipher. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Hero: Ann Bishop
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New Case study:
A physician with no significant PMH who is currently doing their fellowship training develops diarrhea. The diarrhea is significant enough that they are beginning to feel weak, lightheaded, and end up going to the local ER. The physician lives in NYC, works most of the time but did just get back from a week-long vacation in Florida with their long-term partner where they got a chance to swim in the pool and get some sun. They returned feeling well and then noted the onset of the diarrhea. The diarrhea was watery, with some abdominal cramping but no noted blood or actual fever. The stool did not have a strong smell and no floating stools were reported. The physician was given IVF and returned home feeling better but now gets a call that there is a parasite on the stool testing and is recommended to take a medicine they have never heard of 3x per day for 3 days.
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Music by Ronald Jenkees
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TWiP 230: Healing cutaneous leishmaniasis with Maria Adelaida Gomez
1 maart 2024 · 1 uur 1 min
Maria Adelaida Gomez joins TWiP to discuss her career and the work of her laboratory on understanding the healing process during cutaneous leishmaniasis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Maria Adelaida Gomez
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CIDEIM
Healing in cutaneous leishmaniasis (J Immunol)
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Music by Ronald Jenkees
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TWiP 229: The very hungry flatworm
27 februari 2024 · 1 uur 3 min
Eyal joins TWiP to solve the case of the Female Traveler with Intermittent Fever and Ring Enhancements in the Liver. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Eyal Leshem
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Case Study for TWiP 229
Woman in her 40s is referred to me to be seen in the office from one of my colleagues. She reports that she has been having recurrent issues with worms exiting her anus and vagina since 2018. She reports that she lives with her husband and 4 children and they have never reported any issues. She reports that initially she took something over the counter and things resolved. She then a couple years later has this problem again and this time discussed the problem with her housekeeper from El Salvador who gave her an antiparasitic tablet from her home country. This problem has now recurred and she was referred to a GI doctor who she explains laughed at her and suggested she see a psychiatrist. She come in now very upset and tearful. She relates that she has this itching that wakes her up at night and was able to take pictures of something she found on the anus. She has photos as well as a video of a thin white 1 cm motile thing with on end coming to a point.
She reports a normal nonrestrictive diet. She reports no travel outside the US or even outside the local area. No PMH, no PSH, family history of different cancers. She does not work outside the home. She reports no pets. She has an unremarkable exam and labs only notable for low vitamin D.
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Music by Ronald Jenkees
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TWiP 228: Parasitic fountain of youth
6 februari 2024 · 1 uur 9 min
TWiP discusses a tapeworm that causes extreme lifespan extension in infected ant workers, and a candidate antibody drug for prevention of malaria. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Extreme lifespan extension in tapeworm-infected ant workers (Roy Soc Open Sci)
Candidate antibody drug for prevention of malaria
Ceilidh goes viral (YouTube)
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Music by Ronald Jenkees
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TWiP 227: Alpha-gal syndrome
20 januari 2024 · 1 uur 39 min
Jim Small joins TWiP to solve the case of the 41 year old Man with sudden GI distress and itchy hives, followed by a discussion of parasites and childhood stunting. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Jim Small
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Parasites and childhood stunting (Trends Parasitol)
Letters read on TWiP 227
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Music by Ronald Jenkees
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TWiP 226: Successful systems attract parasites
3 januari 2024 · 1 uur 23 min
TWiP reviews some parasite stories of 2023, including progress in the control of malaria and polio, and review a connection between parasites and childhood stunting. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Second malaria vaccine (Nature)
Malaria report 2023 (WHO)
Malaria and climate change (WHO)
Parasites and childhood stunting (Trends Parasitol)
Sea creature spotted off Japan identified (Science)
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Music by Ronald Jenkees
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TWiP 225: Wandering worm with Lee Gottesdiener
20 december 2023 · 1 uur 25 min
Lee Gottesdiener joins TWiP to help solve the case of the 46 Year Old Man with Ongoing Upper Extremity Swelling, and review plant‑based production of a protective vaccine antigen against the bovine parasitic nematode Ostertagia ostertagi. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Vaccine against cow parasite (Vert Farm Daily)
Protective vaccine against bovine parasitic nematode Ostertagia ostertagi
Hero: Dr. Katy Ewer
Letters read on TWiP 225
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Case Study for TWiP 225
41-year-old male mechanical engineer, former Army Ranger trainee, moved from Denver, CO to Chattanooga, TN. He was in his usual state of vigorous health, hiking, doing Spartan races, working on his semi-rural property, and commuting to his place of work daily when about three months previous to his diagnosis, he began having episodes of sudden GI distress with diarrhea, followed by itchy hives in axilla and groin. He treated these episodes with Benadryl and got relief. At 10 PM one evening, he had another such episode, again took Benadryl, but began to experience gradual onset but relentlessly increasing shortness of breath and wheezing. He was taken at high speed to the Emergency Room by his wife. He reported that relaxation with a repetitive, meditative prayer seemed to control the symptoms but said it was like his throat was closing.
Past history includes variable exercise and cold-induced asthma treated with an inhaler as a child, with only rare episodes in adulthood related to high exposure to allergens like cat dander. Family history is not contributory. Diet was omnivorous. They had one dog, a labradoodle named Raphael, which they chose because he was "hypoallergenic."
In the Emergency Department, he was treated with bronchodilators, intramuscular epinephrine, and antihistamines, and the symptoms abated.
The experienced ED physician ord…
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TWiP 224: Neglected tropical diseases roadmap with Chuck Knirsch
12 december 2023 · 58 min
Chuck Knirsch returns to TWiP to discuss the Neglected Tropical Diseases Roadmap published by WHO, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups. Lees meer
Chuck Knirsch returns to TWiP to discuss the Neglected Tropical Diseases Roadmap published by WHO, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups.
Hosts: Vincent Racaniello, Dickson Despommier, and Chuck Knirsch
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Neglected Tropical Diseases Roadmap (WHO)
World malaria report 2023 (WHO)
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TWiP 223: Voluminous diarrhea
28 november 2023 · 1 uur 28 min
TWiP solves the case of the Haitian female with AIDS and voluminous diarrhea, and review the pathogenesis, epidemiology, prevention and treatment of malaria and Chagas disease. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Malaria (Lancet)
Chagas disease (AJTMH)
Hero: Joe Cook
Letters read on TWiP 223
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Case Study for TWiP 223
46 yo man with minimal pmh, elevated cholesterol, ongoing right upper extremity swelling, 5-10 years intermittently. Goose egg swelling on hand, foot. Lasts for hours, every few months. Go to ER, right upper extremity. Lives in NYS suburbs, Is vet and epidemiologist. Has done extensive travel, Liberia, Ghana, DRC, Uganda, Rwanda, 2 week duration. Doing work, fair amount of animal contact with bats, rodents, birds. PE unremarkable except for swelling of right arm. Blood work unremarkable. 2.5 yr later notice prickling irritation under right eyelid, think they see undulation under skin.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 222: Balamuthia in the brain with Natasha Spottiswoode
31 oktober 2023 · 1 uur 8 min
At the meeting of the American Society for Tropical Medicine and Hygeine in Chicago, Natasha joins TWiP to solve the case of the Man with a Generalized Seizure and Infectious Forms in the Brain. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Natasha Spottiswoode
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Treatment of Balamuthia encephalitis with nitroxoline (Emerg Inf Dis)
Letters read on TWiP 222
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Case Study for TWiP 222
Haitian creole speaking, cachetic female in her 50s w/ hx HIV (noncompliant on medication), migrating from Haiti brought in by her daughter for dysphagia, cough x days, associated with NBNB vomiting, oral thrush extending to soft palate, concerning for oropharyngeal candidiasis. Weeks of nonresolving diarrhea. Admitted for failure to thrive and deconditioning, found to be Parainfluenza 3 positive), undergoing TB rule out. Diarrhea is voluminous, pt is dehydrated, there has been significant weight loss and lethargy over the last few weeks.
MHx:
HIV
Shx:
Lives in haiti
Remarried, Last sexual encounter 2 years ago.
Denies illicit drug use. Drinks alcohol
Allergies: No Active Allergies
Labs return with CD4 count in the 50s, elevated viral load. CD4 55/3%
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 221: Delusional parasitosis
2 oktober 2023 · 1 uur 23 min
Michelle and Alexander join TWiP to solve their case of the 36 Year Old Male with shortness of breath, stinging pain in the extremities, fatigue, abdominal cramps, and bowel irregularities, and discuss host cell invasion by Trypanosoma cruzi. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guests: Michelle Naegeli and Alexander Grieb
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cAMP-dependent invasion by Trypanosoma cruzi (PLoS NTDS)
Letters read on TWiP 220
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Case Study for TWiP 221
This is the case of a man in his 50s, with no remarkable prior medical history, who received care at a hospital in northern California, USA, after experiencing a generalized seizure. Magnetic resonance imaging (MRI) demonstrated a solitary left temporal lobe T2 hyperintensity with gadolinium rim enhancement and surrounding edema. After receiving treatment with dexamethasone and levetiracetam, he was transferred to an academic medical center.
Examination by neurology consultants noted disorientation, inattention, moderate aphasia (difficulty communicating), and mild right hemiparesis. Cerebrospinal fluid (CSF) testing revealed increased nucleated cells up to 80/UL (60% lymphocytes, 17% neutrophils, 23% monocytes), protein concentration 38 mg/dL, and glucose concentration 100 mg/dL.
They proceed to do a brain biopsy from the left temporal lobe lesion with cultures from the brain biopsy sample that did not grow bacteria, fungi, or mycobacteria. They performed metagenomic next-generation sequencing (mNGS) on a CSF sample and sent brain biopsy samples for universal broad-range PCR amplicon sequencing (uPCR) for bacteria, fungi, Mycobacterium tuberculosis, and nontuberculous mycobacteria. which is preliminarily reported as showing well-formed granulomata with acute inflammation. Rereview of neuropathology raised concern for certain round infectious forms that are about 50um in size wit…
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TWiP 220: Denies any bug bites
21 augustus 2023 · 1 uur 37 min
TWiP solves the case of the Hiker from Queens who Denies Bug Bites, and reveal two different malaria experimental vaccines that target different parts of the parasite life cycle. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Malaria transmission-blocking vaccine (Lancet Inf Dis)
mRNA vaccine against malaria (Nat Immunol)
Letters read on TWiP 220
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Case Study for TWiP 220
Sent by Michelle and Alexander from the First Vienna Parasitology Passion Club
A 36 year old male presents to the local ED with shortness of breath. Additional symptoms included a stinging pain in different parts of his extremities, fatigue, abdominal cramps and bowel irregularities. On exam he was resting comfortably and his vitals were normal, but the patient appears very distressed by his symptoms. His left eye showed signs of irritation, including redness and swelling. A detailed history reveals travel to the Caribbean about 4 years ago and several short trips to central and east Africa, all between 5 and 10 years ago. His initial labs were grossly unremarkable and a chest x-ray showed no abnormalities. The patient himself suspected a specific parasitic etiology of his symptoms, so we performed a number of serologies and stool examinations in search of parasitic diseases. None of the tests revealed evidence of an ongoing infection.
He is HIV negative and not sexually active at the moment. He has no pets and no other recent travel history. He eats a normal diet and has been out of work for two years.
Thank you for the opportunity to participate in this fantastic project! All the best,
Michelle and Alexander from the First Vienna Parasitology Passion Club
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWIP 219: Sick as a dog
24 juli 2023 · 1 uur 4 min
TWiP solves the case of the 19 month old Female Having Issues, and discusses the finding that selection for insecticide resistance can promote Plasmodium falciparum infection in Anopheles mosquitoes. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Insecticide resistance in mosquitoes promotes Plasmodium infection (PLoS Path)
Letters read on TWiP 219
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Case Study for TWiP 220
73 y/o M w/ no significant PMhs who is referred to ED for fever, lethargy and progressive weakness as for the past 2 weeks. Thursday of the prior week he went to his PCP and blood work was performed. CBC demonstrated RBC inclusions. Labs also demonstrated anemia, thrombocytopenia, mildly elevated total bili and ALT. He was started on PO azithromycin and atovaquone on Saturday, however, he has not noted much improvement. He was seen in our office Monday and reports intermittent fever to 102, continued chills . Additional symptoms include dark urine, chills, occasional diaphoresis. Normally patient rides his bike 15 miles a day and runs 3 miles per day but states now he barely has the energy to walk a few feet and is now in a wheelchair. He report that he regular goes for Runs in parks in Queens.
He denies any bug bites, tick bites, rashes, blood transfusions in the past year.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 218: Malaria parasite evades mosquito
30 juni 2023 · 1 uur 22 min
TWiP solves two cases this week, the Man with Issues after COVID-19, and the Man with Left Arm Weakness, then describe how the malaria parasite evades mosquito immunity by glutaminyl cyclase–mediated posttranslational protein modification. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Links for this episode
Malaria parasite evades mosquito immunity (Proc Natl Acad Sci USA)
Letters read on TWiP 218
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Case Study for TWiP 218
A fun twist for today. Did I mention recently I was spending time with Paul Calle at the Central Park and instead of Jeff Bezos showing up for Dinner Chevy Chase was there.
Here we have the case of a 19 month old female who seems to be having some issues. Lots of increased respiratory effort even with minimal exertion. Some issue with loose stools and then followed by the onset of facial swelling. No sig PMH or PSH, fairly confident there is not smoking or drinking of alcohol and certainly not HIV+. On exam the increased respiratory effort that is audible.
Directed testing reveals canine coccidia and giardia in the stool.
So what is going on? Should I be worried about my daughter who has had lots of exposure?
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 217: ChatGPT solves the case
5 juni 2023 · 1 uur 28 min
TWiP solves the case of the Man With Dog Exposure, and discuss rapid and spontaneous post-partum clearance of Plasmodium falciparum related to expulsion of the placenta. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
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Post-partum clearance of P. falciparum (J Inf Dis)
Letters read on TWiP 217
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Case Study for TWiP 217
We have two cases today!
A man in his 60s who provides IT support for a bank and all done via zoom and remote work is referred to me. He reports having issues after COVID diagnosis Sept 5th, 2022. He had 4 vaccine doses and with diagnosis was treated with Paxlovid. Feel better than about week 3 wakes up with URI symptoms for about one week and by the 28th was improving. He had cold agglutinins detected. Referred to ophtho by his primary with some eye discomfort and noted to have elevated intra-ocular pressure elevation. Sleep and fatigue were a problem but slowly improving. Cognitive issues noted but improving.
He reports an issue a few years prior to this current problem where he developed fever, a sore throat, tender lymph nodes in the neck both in front and in the back. This resolved after about a week but was then followed by months of fatigue, sleep disturbances and not feeling well. He reports no specific dietary preferences and reports no cat exposures. He saw several physicians and one did a number of blood tests.
A man in his late 30s presented to an ER at an outside hospital prior to ultimately being transferred to an academic center in NYC.. He reports onset of left arm weakness that prompted him to come to the ER. He reports on pointed questioning that he had COVID about one month prior and felt he had fully recovered. He did have a headache that preceded the onset of weakness. The OSH triggers their stroke protocol and perform a head CT which reveals a hypodense lesion on the right side of the brain not cons…
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TWiP 216: A challenging case
1 mei 2023 · 1 uur 33 min
Eyal joins TWiP to solve the case of the case of the Feverish Patient from Israel, and reveals his training and experience with travel medicine in Israel. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Eyal Leshem
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Letters read on TWiP 216
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Case Study for TWiP 216
This is a case from one of my colleagues in North West China. Many years ago when I was asked to teach at Kunming University I had a plan to climb in the beautiful Tianshan mountains and again a second time when I ended up distracted at the southern edge of the Gobi desert and instead spent time in a Tibetian monastery. Stories for another day. For today we have:
A man right around age 30 who presented with right lower extremity weakness, numbness and issues with bowel and bladder function. When he was just a few years old he had reported dog exposure and had a lesion removed from his liver. No reported dog exposure since he was young. He is found to have a mass in the right upper buttock. His wbc is normal but ESR and CRP are elevated. He has a CT which reveals cystic lesions and significant destruction of L5 through the sacrum and coccyx.
What could this be and what is recommended as next steps.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 215: A mobile piece of spaghetti
30 maart 2023 · 1 uur 43 min
TWiP solves the case of the case of the boy in Uganda with a mobile piece of spaghetti in the gallbladder, and reviews papers on female genital schistosomiasis in rural Madagascar, and a volatile sex attractant of tsetse flies. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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•Female genital schistosomiasis in rural Madagascar (PLoS NTD)
•A volatile sex attractant of tsetse flies (Science)
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Case Study for TWiP 215
This case was shared with my by a former student of the Diploma in Tropical Medicine and Hygiene course I coordinate, Prof Eyal Leshem, who is the Director of the Institute for Travel and Tropical Medicine at the Sheba Medical Center in Tel Aviv and Clinical Associate Professor at the School of Medicine at Tel Aviv University, Israel. This case is of a 24 year old male who presented to the emergency room at the end of February with a 4 day history of fever, starting three weeks after he returned from a long trip.
He reports traveling in India during October of the past year. From November to early January, he stayed in Papua New Guinea, from where he traveled to Thailand, returning to Israel in early February. On admission he reports a daily fever up to 40 degrees C, which I think is 104 Fahrenheit. He also mentions an itchy rash and dry cough.
We learn a bit more about this patient. In Thailand, he received a five-day course of doxycycline due to a febrile illness, which resolved after treatment. During his stay in Papua New Guinea he hiked in the jungle, was bitten by multiple insects and also report finding leeches attached to his lower legs. One insect bite on his hip took a while to heal. He also reports swimming in multiple rivers. While travelling, he did not have unprotected sexual encounters but he admits to eating street food and home made food regularly. He received pre-…
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TWiP 214: Tropical medicine excursions with Kay Schaefer
27 februari 2023 · 1 uur 12 min
Kay Schaefer joins TWiP to solve the case of the German Male with Hematuria, and discusses Tropical Medicine Excursions, which provides patient-oriented training courses for healthcare professionals who wish to improve their clinical skills in tropical medicine and travelers' health in the endemic regions of Uganda, Tanzania and Ghana. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Kay Schaefer
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TROPMEDEX
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Case Study for TWiP 214
Still in Uganda but now in a clinic in Entebbe. A boy, less than age 10, who grows up in very limited conditions, dirt floor home with other siblings presents with recurrent right upper abdominal pain, fevers, and first undergoes blood work that shows eosinophilia. He has an abdominal ultrasound performed which shows what looks like a mobile piece of spaghetti in the gallbladder with dilated ducts. He also has a stool examination performed.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 213: One deadly snail with Jessie Stone, MD
4 februari 2023 · 1 uur 21 min
Jessie Stone joins TWiP to solve the case of the Boy With a Swollen Belly, and discusses Soft Power Health, a clinic that she founded in Uganda to provide healthcare for people in need. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Guest: Jessie Stone
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•Soft Power Health
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Case Study for TWiP 213
A 49 y.o. German male is seen with significant gross hematuria. He reports no travel outside Europe but does report that he visited France twice, 7 years before and 1 year before. He reports swimming in the Solenzara River in the southeastern part of the island, near a busy campsite. He might have gone into the Gravona River in western Corsica near Ajaccio, at a turtle park and near a campsite, and at the Tavignano River. The patient also reported swimming in the Restonica River. He reports never swimming in the Cavu River and using GPS data from his smartphone and camera, he reconstructed his bathing sites precisely and this history was confirmed.
Exam was unremarkable. Complete blood count was unremarkable and did not show eosinophilia.
This complaint triggered cystoscopy and biopsies that were sent for histological analysis. These findings triggered referral to the Tropical Medicine department at LMU Hospital Munich.
Now in the next episode we will have a guest to discuss this case as well as tell us a bit about themselves. I am hoping people will tell us what they think this might be but then perhaps do a bit of research and go into a little more detail.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 212: The Man from Mali with Shauna Gunaratne
26 december 2022 · 1 uur 28 min
Shauna Gunaratne joins TWiP to solve the case of the Man from Mali with Painless Skin Lesions, and discuss her plans for a tropical medicine institute in New York City. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Shauna Gunaratne
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Case Study for TWiP 212
14 year old boy with a history of slow progressive development of abdominal ascites over years. Appears wasted and malnourished. Afebrile, no history of weight loss or night sweats, no history of TB exposure, HIV negative. Had an older brother who died the year before of apparently the same disease. Had lived early life by the shores of lake Victoria. Currently has really impressive abdomen.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 211: Monoclonal against malaria in Mali
7 december 2022 · 1 uur 24 min
TWiP solves the case of the Man from Hong Kong with Multiple Comorbidities, and discuss safety and efficacy of a monoclonal antibody against malaria in Mali. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Monoclonal antibody against malaria trial (NEJM)
Hero: Stephen Hoffman
Letters read on TWiP 211
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Case Study for TWiP 211
Man in his 20s originally from Mali who comes in with a dermatological complaint about 1 mo after he returned from spending time in Bamako, Mali with friends and family. Reports this has been going on for months and he is getting very frustrated as he is not getting any answers. He relates that this started with itching over a "blackhead" resembling a pimple that was itchy and very small. Over the subsequent months it started to get larger with ongoing itchiness but no pain. No erythema or warmth in the area. Other lesions developed in addition to the first one. There was no drainage from the skin lesions. He started putting triple antibiotic ointment on his lesions that he bought from a pharmacy.
He then went to his primary doctor who prescribed a topical medication and PO antibiotics but this did not help.
He reports that when in Mali he stayed in his house with his parents, siblings, grandmother and other extended relatives – more than 40-50 people under one roof. food made by his family, reports consumption of only cooked meat, no uncooked meat. Ate salads and uncooked vegetables. No contact with any animals, no pets in the home. Denies any contact with any pets or farm animals such as pigs, cows, horses, cattle. Denies swimming in any lakes or ponds. No hiking or outdoor activities. No riding horses.
Was sexually active in Mali with women and is HIV negative.
On examination he has a 10 cm lesion over anterior L thigh, with verrucous and vegetative appearance with yellow crusting over ce…
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TWiP 210: Is there a doctor on board? with Aisha Khatib
3 november 2022 · 1 uur 35 min
From ASTMH2022 in Seattle, Aisha joins the TWiP team to talk about her training and her career, including delivering a baby on an airplane, and they solve the Case of the Heartsick Guatemalan Septuagenarian. Lees meer
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Guest: Aisha Khatib
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Aisha delivers baby on airplane (The Varsity)
Helminth infections during pregnancy (J Travel Med)
SARS-CoV-2 transmission during air travel (Curr Op Inf Dis)
Letters read on TWiP 210
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Case Study for TWiP 210
We are consulted about a rash. A male in his mid 60s originally from Hong Kong with PMH of T2DM, Hypertension, BPH, Hepatitis B infection, COPD (not on home o2), current smoker, ESRD with right chest cath on dialysis (MWF) presented to the ED c/o progressive SOB and DOE for 1 week. 2 weeks prior the patient missed 1 session of hemodialysis. Progressively worsening SOB, DOE, orthopnea began to develop starting one week ago with an associated productive cough with white sputum. Last dialysis was session was 3 days PTA. Pt also began developing nausea and vomiting for 3 days x12 times last week. Pt also started developing diarrhea. Pt has states to have a notable generalized pruritic rash for 3 months that has been worsening. He reports he has been seen by dermatology and was told that the rash is due to certain allergies from food and has been using an unknown cream for 1 month that does not relieve his symptoms. Pt recently admitted for management of bleeding permacath and acute hypoxic respiratory failure likely 2/2 COPD requiring intubation and vent support. Denies recent travel, recent antibiotic use, or sick contacts…but his nephrologist reaches out and is concerned about a certain diagnosis as he says three other patients that come for dialysis have recently been diagnosed with a certain diagnosis.
On exam ee has a diffuse symmetrical rash and is scratch…
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TWiP 209: A worm in paradise
27 september 2022 · 1 uur 9 min
The TWiP team solves the case of the Woman From Hawaii With Allodynia and abdominal pain, bilateral hip and leg pain, dizziness, and diffuse hyperesthesia. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Accidental host (TWiP 207)
Hero: Dan Colley
Letters read on TWiP 209
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Case Study for TWiP 209
Man in his early 70s with PMH sig for HTN, DM-II, HLD, BPH is admitted to the hospital after coming from Guatemala to visit his son. He feels faint with standing and is noted to have a HR in the 40s and does not feel well when he stands. He is also noted to have diarrhea, but this has been going for an unclear period of time. On EKG he is noted to have a RBBB.
PMH HTN, DM-II, HLD, BPH PSH neg
Allergies NKADR
Social -no toxic habits reported, reports living in Guatemala City but grew up in the rural areas. Enjoys fruit juice
FH-noncontrib
Exam: slow heart rate, orthostatic
A number of blood and stool tests are collected and he is referred to a tertiary care center for implantation of a cardiac pacemaker. At the tertiary care center the patient is seen by an Infectious Disease Specialist and a number of tests are ordered by the Infectious Disease Consultant but they are canceled by Cardiologist who writes in their note "no concern for an infectious process". Now one of the tests collected at the first hospital returns with an interesting result that is later confirmed by a second test.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 208: A red herring
18 augustus 2022 · 1 uur 4 min
The TWiP team solves the case of the Woman Who Vomited Up a Worm, and discuss how malaria transmission intensity can modify the effectiveness of the RTS, S/AS01 vaccine in Africa. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Malaria intensity modifies vaccine effectiveness (J Inf Dis)
Letters read on TWiP 208
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Case Study for TWiP 208
An adult female resident of Hawai'i presented to the emergency department (ED) with several days of fever, abdominal pain, urinary hesitancy, and generalized itchiness. white blood cell [WBC] count 14,000 cells/mL) without eosinophilia. Urinalysis suggested a urinary tract infection and she was treated for acute UTI and discharged home.
The following day she returned to the ED because of worsening abdominal pain, bilateral hip and leg pain, dizziness, diffuse hyperesthesia, and allodynia (Pain from stimuli which are not normally painful) (worse on her feet and legs.) Urine culture from her initial ED visit grew normal urogenital flora. Her leukocytosis increased and she now had eosinophilia (WBC count 15,500 cells/mL; absolute eosinophil count 574). Laboratory evaluation was otherwise unremarkable. CT scans of the brain, abdomen, and pelvis were normal.
She was hospitalized and her allodynia worsened despite treatment with analgesics. She also developed a sensation of "electric eels swimming through [her] body. Electromyography and nerve conduction studies were normal. The patient underwent a lumbar puncture and CSF examination was notable for eosinophilic meningitis with 138 WBCs and 13% eosinophils (absolute eosinophil count 18).
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 207: Accidental host with Claire Panosian, MD
1 juli 2022 · 1 uur 42 min
Claire joins the TWiP team to discuss her training and experience as an infectious disease physician, and her transition to science communication, then we solve the case of the Honduran Male with Seizures. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Claire Panosian
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Letters read on TWiP 207
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Case Study for TWiP 207
Woman in 20s, spent time in Kenya 6 months prior, vomited up a worm. 0.5 cm in length. Sent to lab. Was moving. Earlier that day she went out with friends to sushi place, ate fish. Developed horrible abdominal pain, then vomited.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 206: Bacteria protect mosquitoes from parasites
30 mei 2022 · 1 uur 21 min
The TWiP team solves the case of the Ghanian Women With Leg Swelling, and relate how Anopheline mosquitoes are protected against parasite infection by tryptophan catabolism in gut microbiota. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Bacteria protect mosquitoes from parasite infection (Nat Microbiol)
Letters read on TWiP 206
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Case Study for TWiP 206
42 yo Spanish speaking male, originally from capital city of Honduras. Admitted to hospital after seizure. Grew up in Honduras, 20 year history of seizures. Now in NYC area. Treated with carbamazepine, 2x a day. Has not filled scrip for 3 months. Fast heartrate, o2 sat fine, no fever. No surgery, no toxic habits. Unremarkable physical exam. Undergoes blood work and head imaging. CBC normal, normal diff, slight elevation in blood glucose. Imaging of head reveals non-specific coarse calcification. Eats regularly.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 205: Two for the price of one
4 mei 2022 · 1 uur 33 min
The TWiP team solves the case of the Pregnant Ghanian Living Near a River, and reveal emodepside, a drug for treatment of onchocerciasis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Download TWiP #205 (56 MB .mp3, 93 minutes)
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Emodepside for onchocerciasis (PlOS NTD)
Hero: Dr. Mwelecele Ntuli Malecela
Letters read on TWiP 205
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Case Study for TWiP 205
Two women, 80s and 50s. Former had 9 children, lives in Ghanian village with large lagoon, many mosquitoes. Concerned about chronic swelling of left leg, groin area for much of her life. Walks barefoot. 50 yo with 4 children, both legs started to swell, cold, mosquito bites. With time left leg becomes hard, swollen, disfigured. Has gone to hospital for ulceration. Common problem in her village, mostly women but some men. Problems getting access to medications.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 204: Near a fast-flowing river
28 maart 2022 · 1 uur 31 min
The TWiP team solves the case Two Ghanians Near A Fast-Flowing River, and discuss a promising new drug for treatment of African trypanosomiasis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Oral fexinidazole for African trypanosomiasis (Lancet)
Hero: Madeline Albright
Letters read on TWiP 204
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Case Study for TWiP 204
Pregnant woman, 20 yo, living in eastern Ghana near Volta River delta. Often in river. In second trimester. Comes in with abdominal pain, bloody diarrhea. Ovoid forms seen in stool, 160 microns, have single lateral projections. Other ovoid forms 45×30 microns which contain polar bodies.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 203: True, true, and unrelated
23 februari 2022 · 1 uur 19 min
The TWiP team solves the case of the Shopkeeper with Thirst, Rash, and low Blood Oxygen, then review a study on the effect on survival to adulthood in Tanzania of mosquito net use in early childhood. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Mosquito net use in Tanzania (NEJM)
Michiaki Takahashi (Wikipedia)
Letters read on TWiP 203
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Case Study for TWiP 203
Two individuals, same issue. Small village in Ghana, near fast flowing river. Teenaged boy, father farmer. Boy develops severe itchy rash on right leg. Light and dark areas. They live nearby, father farms near river. After school they swim in river then travel. Father in 70s, has 2-3 cm nodule on left knee, second on in groin area, no other problems. Has some visual issues. Nodules are firm, fixed to the skin.Both have positive diagnostic skin snip.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 202: 80 microns and ovoid
23 januari 2022 · 1 uur 16 min
Sara from the Febrile Podcast joins the TWiP team at The Incubator to solve the case of the Man With an Egg Laden Colonic Mass, and Daniel presents a new puzzle for us to solve. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Sara Deng
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Febrile podcast
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Letters read on TWiP 202
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Case Study for TWiP 202
Man 60 yo shopkeeper in Rohingya Camp displaced Myanmar natives. 3 months getting up at night, urinating, thirsty, losing weight. Develops rash on elbows, abdomen, very itchy. Rest of family has rash as well. Starts headache, fever, cough, trouble breathing, seeks medical care. O2 sat is in 80s. Past med/surg healthy individual, heavy smoker, HIV negative. Living in dwelling with tin roofs, dirt floors, many people crowded. Elevated WBC count; elevated glucose.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 201: Tiny and hairy
8 december 2021 · 1 uur
The TWiP team solves the case of the Man with a Cat and Ring Enhancing Lesions, and discuss domestic mammals as reservoirs for Leishmania donovani on the Indian subcontinent. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Reservoirs for Leishmania (Transboundary Emerg Dis)
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Letters read on TWiP 201
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Case Study for TWiP 201
Older male, >65, abdominal pain over last several months, getting worse, otherwise feels well. No change in weight. Past medical, surgical unremarkable. Social: grew up in rural inland China. As adult lived in large city. Always active and healthy, eating fish and leafy vegetables. Move to US 10 years before illness. No pets. No toxic habits. HIV negative. Unremarkable exam. Labs: elevated white count, platelets low, not anemic. Differential on white count: neutrophils predominant. Gets belly CT: reveals mass in colon. Colonoscopy done, mass resected. Pathology: shows adenocarcinoma, but also eggs in sample. Slightly ovoid, 80 microns.
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Music by Ronald Jenkees
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TWiP 200: Parasites without borders
4 november 2021 · 1 uur 22 min
The TWiP team solves the case of the Gentleman from New York with Intestinal Issues, and review a 20 year study of butterflies, their associated parasitoid wasp and Wolbachia introduced into an island community. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Accidental parasitoid introduction (Mol Ecol)
Hero: Gerald Keusch
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Letters read on TWiP 200
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Case Study for TWiP 200
Man in 30s with HIV-AIDS, presents with lower extremity weakness, headache, fever, ends up in hospital. Lives with wife and her cat, doesn't take his medications. CD4 less than 100. Told to take medicine every day, one 3x week, one weekly. Does not drink alcohol, only eats well cooked meat. Born and raised in San Juan. Has had multiple sexual exposures with multiple women over years. Thin coating on tongue, lungs bowel normal. Has weakness in lower extremities. Skin unremarkable. Labs: CT shows multiple ring enhancing lesions with surrounding edema, also on MRI.
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Music by Ronald Jenkees
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TWiP 199: Chagas kisses Cruzi and Brucei bites
13 oktober 2021 · 1 uur 8 min
The TWiP team solves the case of the Traveler to Tanzania with a Purple Lesion, and discuss Mosquirix, the first vaccine approved for Plasmodium parasites. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Historic malaria vaccine (Nature)
Efficacy and safety of RTS,S/AS01 (Lancet)
Letters read on TWiP 199
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Case Study for TWiP 199
Gentleman in 40s, repeated intestinal issues, diagnosed with Giardia and treated, a year later again, again not feeling well. Stool testing shows Blastocystis and Endolimax nana. Lives in NYC area, single, active socially with different partners, no other medical problems, does take PREP for AIDS. Exam and labs normal except for stools. HIV negative. Treated with metronidazole, no impact on symptoms. Coincides with successful encounters.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 198: Cyclospora in the dining room with the salad bar
14 september 2021 · 1 uur 15 min
The TWiP quadfecta solves the case of the Traveler With Watery Diarrhea, and reveals that a heat-shock response regulated by a transcription factor protects human malaria parasites from the high temperatures of fever. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Malaria parasite resists fever due to heat shock response (Nat Micro)
Malaria beats the heat (Nat Micro)
Letters read on TWiP 198
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Case Study for TWiP 198
31 yo woman, previously healthy, traveled to Tanzania, went on 11 day long safari. One week later, at home, developed fever and severe headache, went into hospital. Thick blood smears negative, physical exam normal, small purple lesion near buttocks. Started on treatment for African tick bite fever. Did not get better, lesion grew in size. Biopsy of lesion, nothing remarkable on microscopy. Improved, sent home, 10 days another bout of fever that went down in 2 days. Lesion healed. PCR for plasmodium, Borrelia negative, but seroconverted for Rickettsia. Went home, a week later another 3 day bout of fever.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 197: An adventurous eater
16 augustus 2021 · 1 uur 4 min
TWiP solves the case of the Adventurous Eater with Areas of Swelling, and discusses an experimental Trypanosoma vivax vaccine comprising an invariant flagellum antigen. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
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Experimental T. vivax vaccine (Nature)
Letters read on TWiP 197
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Case Study for TWiP 197
Gentleman in late 20s, has for weeks had watery diarrhea that is not getting better. Recently took trip to Oaxaca, Mexico. Stayed at nice hotel, all fruits, vegetables, salads well cleaned. Always ate at hotel. Developed diarrhea there. Went with three others, stayed at same place. No prior surgeries, no family history, no medications, no toxic habits. Daniel recommends one test and that gives diagnosis and therapy and he resolves.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 196: Naked eye entomologist
12 juli 2021 · 56 min
TWiP solves the case of the Homeless Man With Skin Issues, and discusses an experimental mRNA based malaria vaccine. Lees meer
Hosts: Vincent Racaniello and Daniel Griffin
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Entomophagy (TWiP 131)
Malaria mRNA vaccine (NPJ vaccines)
Letters read on TWiP 196
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Case Study for TWiP 196
30 yo woman having areas of swelling in different parts of body, blood work shows elevated eosinophils. History: prior had been travelling around SE Asia. Had some loose stools on return, some tingling in fingers, otherwise fine. Adventurous eater, fish, pickled fish, salads. Previously in good health, no surgeries, all in family healthy. No meds. Lives alone. Went to Indonesia and Thailand. Toxic habits: no smoking, drinks periodically, HIV negative. On exam: swollen area on arm, biopsy is done. Pathologist report: cross section has what appears to be larval nematode.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 195: Shocking diseases in attractive NY accents
1 juni 2021 · 1 uur 21 min
Christina returns to the TWiP trifecta to solve the case of the Beachgoer with Red Lines on Her foot, and an experimental malaria vaccine based on the junctional region of the circumsporozoite protein displayed on a virus-like particle. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Guest: Christina Naula
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VLP-based malaria vaccine (Cell)
Promise of a malaria vaccine (Ann Rev Micro)
Hero: Maria Mota
Letters read on TWiP 195
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Case Study for TWiP 195
Gentleman in 60s, does not have permanent home, comes in with skin issues. Pruritis all over. Wearing heavy coat, unwashed polyester shirt. 1 cm diameter patches, erythematous, areas where open from scratching. Cover much of torso. Solve case by examining his clothes.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 194: Eye had a corneal scraping
24 april 2021 · 1 uur 13 min
TWiP solves the case of the Long Island Man with Unilateral Eye Pain, followed by a discussion of how enteric helminth coinfection enhances host susceptibility to West Nile virus by a tuft cell-IL-4 receptor signaling axis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Guest: Christina Naula
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Helminth infection enhances West Nile viruses pathogenesis (Cell)
Hero: Franz Von Lichtenberg
Letters read on TWiP 194
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Case Study for TWiP 194
Woman in 40s, on return from Puerto Rico where she often went. Went to local beaches, brought their dogs. Noticed problem on foot, raised red serpiginous lines, slowly moving all over the foot. Bloodwork showed elevated eosinophils.
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Music by Ronald Jenkees
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TWiP 193: A serpiginous trail
29 maart 2021 · 1 uur 16 min
Audun returns to help solve the case of the Ecuadorean Gentleman Treated for COVID-19, followed by a discussion of the interaction of Blastocystis with the intestinal microbiota and the immune system, and of course a new clinical case from Daniel. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Guest: Audun Lier
Download TWiP #192 (46 MB .mp3, 76 minutes)
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Blastocystis interactions with gut microbiota and immune system (PLoS Path)
Hero: Lucy Engel Graves Taliaferro
Letters read on TWiP 193
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Case Study for TWiP 193
Male, 50s, seen by physician for unilateral eye pain, blurred vision, watery drainage. Soft contact lens wearer. Given eye drops, oral medication, sent for another opinion when does not resolve. Has hypertension, hyperlipidemia, no surgeries, no allergies, is on hypertension/statin med. Works in store. No toxic substance use. HIV negative. Lives on large piece of land with his own well, away from city, own septic tank. Left eye is very red. Ophthalmologist report: decreased visual acuity in left eye, injection of conjunctiva, edema, erosions, send corneal scrapings for culture. Swims in Long Island Sound. No travel history. No pets.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 192: Towel off vigorously
15 februari 2021 · 1 uur 1 min
The TWiPers solve the case of the Teenager in Malawi with Red Urine, then Audun joins to present our clinical case for this episode. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Guest: Audun Lier
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Hero: George B. Craig
Letters read on TWiP 192
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Case Study for TWiP 192
Older gentlemen with chills, muscle aches, headaches, shortness of breath, family members same symptoms. Hypertension, diabetes. From rural Ecuador, worked in timber industry, worked on farm. No pets. COVID positive. Treated with steroids, ab. Got worse over next two weeks. Developed bloodstream infection and pneumonia. Saw serpiginous trail on diagnostic agar plate of sputum sample. Started on treatment and recovered. No eosinophils on admission, later developed eosinophilia.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 191: Dickson's ocular anomaly
11 januari 2021 · 1 uur 20 min
The TWiPers solve the case of the Rural Man from North Carolina with Blurred Vision, and discuss the results of single-cell RNA sequencing of Schistosoma mansoni. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode
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RNAseq atlas of S. mansoni (Science)
Hero: Kathleen Hussey
Letters read on TWiP 191
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Case Study for TWiP 191
Visit in Malawi, capital, teenage son of USAID worker urine has started to turn red. New to Malawi. On weekends go 2.5 hr east to lake and place to swim, Lake Malawi. Given pills, taken morning and night, clears up. Rest of family has been swimming in Lake Malawi. All in family are healthy.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees