Alle afleveringen
290 afleveringen, van nieuw naar oud
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TWiP 140: Blasting Blastocystis
17 oktober 2017 · 1 uur 35 min
The triple TWiP solve the case of the Peace Corp Veteran with Eosinophilia, and discuss the genome sequence of the hyper-prevalent parasitic eukaryote Blastocystis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode:
Genome diversity of Blastocystis (PLoS Biol)
Photo credit
Letters read on TWiP 140
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. Get $30 off your first delivery and FREE SHIPPING by going to blueapron.com/twip.
Case Study for TWiP 140
From Dr. Arthur Mumelo, northern Kenya. One-year-old girl. Brought by mother with skin lesions that developed a week prior. The lesions are five in total – on the forehead, neck, back, chest and right arm. The lesions look like boils/furuncles but keep changing size and appearance – like something is moving under the skin. They are painful and itchy. Child is breastfeeding well. No other complaints. Child was born at Nyahururu County Referral Hospital. Gets vaccinations at Melwa Health Centre (Rural), vaccinations are up to date. They live in a wooden house with a dirt floor, roofed with corrugated iron sheets. The house has two rooms. They sleep on raised beds. There is a big community dam in the neighborhood, with stagnant water throughout the year. They don't use mosquito nets. They have reliable clean water supply from the government. They have one dog but the neighbors' dogs also visit their compound and living area. They hang their clothes on the clothesline after washing; never dry their clothes on the grass. Clothes not hot-ironed. On Examination; Child is breastfeeding well, afebrile, no pallor, no jaundice, not in distress. Occipital lymphadenopathy; tender, mobile. Furuncles on the forehead, chest neck, back and right arm. They are 1-3cm in diameter and 0.5 cm high, tender, have a central punctum from which serosanguineous fluid is discharging. This is a rural…
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TWiP 139: Eggsactly, ova and ova
21 september 2017 · 1 uur 17 min
The TWiPwalas solve the case of the Woman with a Worm in Her Eye, and discuss the role of nitric oxide in the resistance of rats to Schistosoma japonicum. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode:
Nitric oxide blocks schistosome development (PNAS)
Photo credit: Dave the Sheep Shearer
Letters read on TWiP 139
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.
Case Study for TWiP 139
Seen at Columbia Medical Center, a crossover. Woman in 30s returns to US after 2 years in Peace Corp, Cameroon and Gabon. On medical exam 2 years earlier: eosiniphilia noted, no diagnosis reached. Now comes to NYC 2 years later to attend grad school, again eosinophilia noted. Asymptomatic.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 138: Telmophages and the skin parasite landscape
6 september 2017 · 1 uur 23 min
The TWiPsters solve the case of the Child from DR with Poppy Seed Sized Things On His Head Hair Shafts, and reveal how the skin parasite landscape determines the infectiousness of Leishmania. Lees meer
Hosts: Vincent Racaniello and Daniel Griffin
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Links for this episode:
Tr (Cell Host Microbe)
Letters read on TWiP 138
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.
Case Study for TWiP 138
New Yorker, female teenager from an outer boroughs, visual loss in right eye noted during routine eye exam. Not sure when started. Left is 20-20, otherwise feels fine. No surgeries, no noted medical history, no medications, in school, living with family, no toxic habits. Travel: had been upstate NY in past year. No pets. Defect in right eye pupillary reflex, pallor to optic nerve. Serologies: toxocara, HCV, syphilis, all negative. Dilated fundal exam: sees 1850 microns motile worm in the eye. Not on surface, not Loa Loa.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 137: An aberrant encounter
12 augustus 2017 · 1 uur 35 min
The TWiPtoids solve the case of the Man from India with a Neck Lump, and explore the role of a transmissible dysbiotic skin microbiome in inflammation during cutaneous leishmaniasis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode:
Transmissible dysbiotic skin microbiome in cutaneous leishmaniasis (Cell Host Microbe)
Letters read on TWiP 137
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.
Case Study for TWiP 137
Little town in DR, fall of 2016, have already mentioned this patient; little boy 2-3 years old, not behaving well, warned if doesn't behave, los gusanos will eat you! Mother asks Daniel to help son: lately is more irritable, troublesome, not well behaved; notices things in his hair. Has small poppy seed sized things on side of hair shafts. She picks them off in fingers and smashes them. What are they, what do I do? Simple dwelling, dirt floor, walls and tin roof, animals everywhere. No money for medicines, what can she do?
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 136: Daniel throws a softball
11 juli 2017 · 1 uur 39 min
The TWiP Titans solve the case of the Man from Queens with a Blister Burster, and explain the role of inflammatory monocytes during Leishmania infection of the skin. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode:
Inflammatory monocytes and skin Leishmania (PLoS Path)
Dracunculiasis (TWiP 37)
Photo: Daniel using a LifeStraw
Letters read on TWiP 136
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.
Case Study for TWiP 136
Patient seen by Daniel in India, 18 yo Islamic college student, left home, living in dorms in south, Hindu couple prepare meals, called dorm parents. He is being seen because developed lump in left side of neck, 1-2 cm mass. Previously completely healthy, no med/surg, no allergies. Prays multiple times a day, observes dietary restrictions. Afebrile, normal, but has 2 cm firm nontender lump inside interior portion of sternocleido mastoid muscle. Not tender. End of November, rainy season. No screens on dorm windows. No animal contact. Ultrasound done, and was helpful. Noticed in his neck over several weeks.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 135: Embryonated eggs of wisdom
21 juni 2017 · 1 uur 54 min
Dickson returns to the TWiP hosts to solve the case of the Woman from Colorado With Loose Stools, and explain how single-sex infection with female Schistosoma mansoni reduces hepatic fibrosis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode:
ASM Grant Writing Online Course
Single-sex Schistosoma infection (PLoS NTD)
Asterix the Gaul
Letters read on TWiP 135
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.
Case Study for TWiP 135
Patient seen in clinic by Daniel's colleague, living in Queens, needs home care. Man with wound on foot, needed daily care. Living 9 months, recently developed painful blister, he put his foot in water, got great relief, blister opened up. Open lesion did not look normal, there was something in blister. Went to see parasitologist, saw something there, wrapped it around piece of wood. Not previously seen a physician, no surgeries, knew little family history. New to our country, where could he have possibly come from? Rural part of some country. Resource limited region. How many days of treatment will he need?
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 134: Does toxoplasma make you sexy?
24 mei 2017 · 1 uur 19 min
Daniel and Vincent solve the case of the Haitian Girl Who Failed To Thrive, and visit two studies that address the question of whether infection with Toxoplasma gondii alters human behavior. Lees meer
Hosts: Vincent Racaniello and Daniel Griffin
Links for this episode:
ASM Grant Writing Online Course
Is Toxoplasma infection related to brain and behavior impairments? (PLoS One)
Toxoplasma infection and sexual attraction (Evol Psychol)
TWiP 21 - The giant intestinal worm, Ascaris lumbricoides
Candiru (Wikipedia)
Image credit
Letters read on TWiP 134
Case Study for TWiP 134
Woman in 30s, coming in Colorado to be seen, reports foul smelling loose stools multiple times each day, cramping and nausea. Started a few weeks ago. No fever, summer, no unusual travel, skiing up in mountains, hiking, backpacking. Originally from NE, moved to Colorado one year before. Often drinks from streams. Treats water with iodine. On overnight trips pack food and cook on stoves. Sticky stools, trouble wiping clean. Yes, my stools do float. Color, not as dark. Well formed. No medical problems, no surgeries, no allergies. Takes no medications. Lives alone in private home. Drinks beer, no other toxic habits. None of her friends report similar problems. Sexually active, does not always use protection. Physical exam: unremarkable.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 133: Tape test
13 mei 2017 · 1 uur 37 min
Daniel and Vincent solve the case of the Woman With Anal Area Discomfort, and discuss the multiple functions of a clathrin adapter protein in formation of rhoptry and microneme secretory organelles of Toxoplasma gondii. Lees meer
Hosts: Vincent Racaniello and Daniel Griffin
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Links for this episode:
Journal of Microbiology and Biology Education SciComm Issue (link)
TWiP 19: Enterobius vermicularis, the pinworm
Multiple roles of Toxoplasma gondii clathrin adaptor AP1 protein (PLoS Path)
Image credit
Letters read on TWiP 133
Case Study for TWiP 133
Seen while working in remote mountain makeshift mobile clinic in Dominican Republic, on Haitian border. Traveled 3 h by pickup truck, remote mountain town, womens centers. Set up makeshift mobile clinic in this center. Mother concerned about 6 yo girl, failure to thrive compared with sister, protuberant belly, frequent abdominal discomfort, going on over 1 year. No surgeries, no meds, first time ever seeing medical person. Mother and sister are family. Three children in family. Father does timber work. Very impoverished region, living in dirt floor home, drinking untreated water from local stream, go to bathroom outside, could be contamination. Diet: carbohydrate, plantains, rice, beans. On exam: lungs clear, heart fine, belly protuberant, liver and spleen not enlarged, some edema. Mother said noticed long motile worm in girls feces. Firm belly, not painful to her.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 132: Salted crab som tum
29 april 2017 · 1 uur 32 min
The TWiP-tastic peeps solve the case of the Thai Man Coughing Up Blood, and reveal potential therapies for trypanosomiasis that are inhibitors of protein import into glycosomes. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
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Links for this episode:
Inhibitors of protein import into trypanosome glycosomes (Science)
Hookworm (TWiP #22)
Photo by Nita
Letters read on TWiP 132
Case Study for TWiP 132
Young NYC woman with son (10), chief complaint of discomfort and itchiness in anal area. Has tried to look but nothing abnormal. Married, no complaints from husband or child. Two older kids have no complaints. But son has also been scratching in anal area. Everything fine 3 months ago, sister came to visit with 3 young pre-school children, may have caught something from them. No past med or surg history, no allergies. No meds, work out of home, no toxic habits, no recent travel. Have dog. Do lots of volunteering with children. History of sushi consumption. She does not like raw fish but son does. Worse itching at night. Going on for a number of weeks. Reports being under a lot of stress recently due to family.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 131: Entomophagy
15 april 2017 · 1 uur 39 min
Jonathan from the podcast Arthro-Pod joins the TWiPerati to solve the case of the Peruvian Woman With Inguinal Insect Bite, and discuss warm autoimmune hemolytic anemic that develops after babesiosis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Guest: Jonathan Larson
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Links for this episode:
Jonathan Larson (Twitter, Google Plus)
Arthro-Pod podcast
Warm hemolytic anemia after babesiosis (NEJM)
Tickborne diseases of the US (CDC)
Image credit
Letters read on TWiP 131
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 131
Thailand. 39 yo man reports 7 months of coughing up bright red blood, several times with mucus. Otherwise feels well. Big fan of salted crab som tum. Fisherman, lives with family. Healthy, no past med/surg problems. No meds. On seeing him: afebrile, chest xray abnormal: area of increased opacification. Not a smoker. No toxic habits.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 130: Paige Turner
1 april 2017 · 1 uur 46 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPniks solve the case of the Man With AIDS, and explore how secretion of extracellular vesicles influences the social motility of Trypanosoma brucei.
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Links for this episode:
T. brucei exosomes and social motility (PLoS Path)
Image credit
Parasites Without Borders
Letters read on TWiP 130
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 130
Back in Peru. 24 yo female seen in ER, lives in rural area outside of big city, adobe house in highlands, thatched roof, dirt floor, 3000 meters. Quite ill with skin lesion for 48 h. 2 days before was pulling on pjs, felt sharp sudden pain in right upper leg. Next day found small living creature in pajamas, inguinal region. Developed red lesion, enlarged, developed black central dot. Then begins vomiting, comes to hospital. No fever, breathing fast 20, hr 70, bp 160/10, on exam see in right inguinal region an enlarging, necrotic area 1-2 cm, starting to look sick. Whites at 26000, left shift, 200 platelets, eosinophils 4%, bilirubin 3.5, creatinine 4.9 (going into renal failure, not making much urine). Hematocrit 14, BUN 59.7, CPK 227, RBCs and leukocytes in urine. No health problems, no surgeries, first interaction with health system. No toxic habit. Brings in the small creature!
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 129: Human kindness, river blindness
15 maart 2017 · 1 uur 45 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP Masters solve the case of the Australian Wildlife Carer, and review evidence that nodding syndrome may be caused by an autoimmune reaction to the parasitic worm that causes river blindness.
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Links for this episode:
Nodding syndrome an autoimmune disease? (Sci Transl Med)
Nodding syndrome: Preventable and treatable (Sci Transl Med)
River Blindness lyrics (Google Play)
Image credit
Letters read on TWiP 129
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 129
Young male in 30s, presents to ER with male partner, NY area, chief complaint over 1 month significant diarrhea, watery, non bloody. Abdominal cramping. Feels poorly, low energy, fever. Some vomiting, lost noticeable amount of weight, can't stay hydrated. Past: AIDS positive, not on meds, last CD4 <50, viral load elevated and uncontrolled. Non contributory family history, no meds. Social history: had worked in office, can no longer; lives with male partner; occasional alcohol, no pets, no other significant exposures. Partner also AIDS, also not on therapy. Physical: febrile, 38.5C, 115 bp, 95/65, 18 resp, thin male, clearly uncomfortable. Oral thrush in buccal mucosa. No subungual saliva. Lungs clear, abdomen diffusely tender, increased bowel sounds. Labs: elevated creatinine, BUN, decreased sodium, elevated WBC count with significant eosinophilia. No pets or houseplants.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 128: It's over 9000!
4 maart 2017 · 1 uur 48 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPerati solve the case of the Man Who Sat in Feces, and discuss a study on how Dickson's favorite parasite induces the formation of a collagen capsule.
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Links for this episode:
Induction of collagen synthesis by Trichinella (Vet Parasitol)
Letters read on TWiP 128
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 128
Daniel doesn't expect anyone to get this. From Australia, 80 yo retired teacher from Atherton, northheast Australia, presents to clinic with generalized weakness, concern of chronic lyme or Q fever. Seen by neurologist, concern about motor neuron disease. 18 months of illness, insidious onset of limb (arms and legs) weakness. No issues with speaking, swallowing or breathing; no weight loss; no fever, sweat, chill. History of osteoarthritis, joint replacements; myocarditis; vertigo; allergic to pen and dox. Father, rhematoid arthritis, brother colon cancer. On a number of medications. Does extensive travel, when not traveling, is a volunteer carer in Australia (abandoned wildlife), over the past three years. Lives with husband. Marsupials, hand feeds puggles and juvenile spiny anteaters, has pet cockatoo. No history of polio, HIV negative. Neuro exam: diffuse non tender muscle with no rash. Normal upper and lower limb tone, strength is symmetrically reduced proximally. Reflexes good at knees, normal sensation to all modalities. Normal cranial nerve exam. Test results: has eosinophilia, elevated muscle enzymes, EMG shows myopathic changes, nerve conduction normal. Stop statin therapy, no change. This is a rare parasite.
Send your case diagnosis, questions and comments to twip@microbe.tv
Music by Ronald Jenkees
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TWiP 127: Kava not Cava
15 februari 2017 · 1 uur 20 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPsters solve the case of the Peace Corps Volunteer with a Liver Lesion, and discuss the dependence of Leishmania survival on the gut microbiome of the sandfly.
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Links for this episode:
Leishmania depends on sandfly gut microbiome (mBio)
Kava (Wikipedia)
Letters read on TWiP 127
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 127
The last of our trio for the Peace Corp, an eosinophilia case. 29 yo pc volunteer in Rwanda, male, 3 weeks of feeling poorly. Starts with rash on lower back and upper legs, maculopapular rash. Fatigue later, cough, then diarrhea, 51% eosinophils (9000). No significant exposure to fresh water. Stool sent for oandp. Said sat down and got something on behind, realized later was feces, this was where rash developed. OandP seeing larva in stool. HIV neg, no med issue, no surgeries, no Kava.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 126: A virus walks into a parasite
4 februari 2017 · 1 uur 16 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP Trinity solve the case of the Peace Corps volunteer with diarrhea, and reveal how immunizing against a virus ameliorates exacerbated leishmaniasis.
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Links for this episode:
Viral vaccine prevents exacerbated leishmaniasis (PLoS NTD)
For whom the trich tolls (TWiP 47)
A virus in a parasite in a human (virology blog)
Virologists in the mist (TWiV 128)
Letters read on TWiP 126
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 126
Another Peace Corps volunteer in Fiji. 24 yo male, several days of fever, headache, dry cough, rash. Feels poorly, starts diarrhea. No blood or mucus, no vomiting but abdominal discomfort. Heart rate over 100. At private nearby hospital for evaluation: no prior med probs or surgeries. Social history: MSM, not always protected, drinks every weekend. Home blown away by cyclone. Alcohol: drinks beer, a lot. White rice, split peas, bread diet. Fan of cava, also drank unfiltered water. He is admitted, continues to feel poorly. Continued fevers, localized abdominal pain RUQ. On exam he has tender palpable liver, elevated WBC 17.8, eosinopenia, 0 cells. AST/ALT slightly above normal. Dengue, chick, lepto, blood all negative. Ultrasound of liver: shows 8x8 cm mixed echogenic lesion in right lobe. HIV negative.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 125: Third time's a charm
21 januari 2017 · 1 uur 35 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPonderers solve the case of the Timber Worker with Severe Shaking Chills, and describe an experimental malaria vaccine comprising attenuated sporozoites produced by genetic engineering.
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Links for this episode:
Genetically engineered P. falciparum sporozoite vaccine (Sci Transl Med)
Parasitology Superhero: Francesco Redi
Image credit: Betsy Weissbrod
Letters read on TWiP 125
This episode of TWiP is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what's on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip.
Case Study for TWiP 125
Thanks to the Peace Corps - 24 yo female serving in Cameroon, teaching English and science at local school. Been in country 5 months, first 3 lived with host family, now in own home in community with electricity, 12 hr from Yaounde, capital. Reports intermittent diarrhea, loose stools, abdominal discomfort. No prior problems, no problems in family. No meds. No drinking or smoking. Lots of animals present, roam into class. Eating all local fare, cooks some, or buy locally. Eats fish, vegetables, no fish. Sleeps in house with mosquito nets. Not sexually active, AIDS negative. Young kids at school 6-12 yo, 20 in room. Does not eat at school. Not clear if water is treated. Not on antimalarials. Going on for a few a few weeks. No fever, no rash.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 124: RPAing with the tryps
5 januari 2017 · 1 uur 40 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The prolific podcast-shedding Hosts solve the case of the Global Health Intern with a snakelike lesion on her foot, and reveal the role of a single-stranded DNA binding protein in differentiation of trypanosomes.
Become a patron of TWiP.
Links for this episode:
RPA protein and differentiation of T. cruzi (PLoS NTD)
Image credit
Letters read on TWiP 124
Case Study for TWiP 124
28 yo male from referral hospital near thai-burma border. Fever and chills 2 days, feels poorly, small amount of dark urine. Severe shaking chills, 1x per day, no rash. No diarrhea, difficulty breathing. Seen by local health care volunteer, went to hospital then tertiary hospital in Bangkok. Exposure history to pigs, dogs, insects, etc. Involved in timber industry and farming, sleeping out at night with no cover, clothes and sandals. No meds. Not married, family lives with him. Family is fine. Sleep in dwelling but no screens. No toxic habits, HIV negative, sexually active but not brothels. High fever, low bp, rapid heart rate, breathing rapidly, scleral icterus, dry mucus membranes, neck supple, lungs clear. 2/6 systolic murmur. Abdomen soft but tender, enlarged liver and spleen. Many cuts, bruises, bug bites. Labs: low platelets, low hematocrit, low glucose. Blood smear: abnormal, 5-10% infected RBCs with multiple band forms.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 123: What we know is confusing
21 december 2016 · 2 uur 2 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPanorama solve the case of the Dutch Woman with Wormy Objects in Her Stool, dissect a study on cytoadhesion of malaria infected red blood cells, and introduce Parasitology Superheroes.
Become a patron of TWiP.
Links for this episode:
Myiasis (Wikipedia)
Cytoadhesion of Plasmodium in severe malaria (PLoS Path)
Image credit
Letters read on TWiP 123
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
Case Study for TWiP 123
Nurse in early 20s, recent grad, decides to spend year in global health internship in western DR/Haitian border. On her foot has skin issue: told is fungal infection, using antifungal cream, is getting worse. Several days, only on one foot. Healthy, no past med/surg/allergies, no meds, no HIV, lives with local family. Daughter, wife, husband, cat. No toxic habits. Originally from US, swims, walks barefoot to and from, shoes off in house. Easts local food, exposure to dogs, cats, sister. Very itchy, but not open; rash area is raised. Blistery in certain areas, involves different areas in different days, snakelike.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 122: If the thunder don't get you, the lightning will
6 december 2016 · 1 uur 53 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPniks docs solve the case of the Female from Peru with Epistaxis, and discuss the effect of community deworming on immunosuppression.
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Links for this episode:
Community deworming and immune hyporesponsiveness (PNAS)
Paul C. Beaver (one, two)
Photo by Oscar Adam Oscarson
Letters read on TWiP 122
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
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Case Study for TWiP 122
First of a series of cases with a theme, a 23 yo female international aid worker, chief complaint of diarrhea. Dutch descent, born in US, been in rural area of western DR, close to Haitian border. It's been raining, houses have tin roofs, other flat concrete, rainwater pours off. Child comes by with mangoes, she buys one, washes it in rain water from the roof. Bites open mango, peels it, eats mango. The same night she is not feeling well, loose stools, abdominal discomfort. Next day, goes with group to border town; then has full fledged diarrhea. Looks into toilet, sees white objects 1 cm in length on stool, and they are moving. Uniform width, thinner than long, wormy looking. Has been participating in other activities in this area, swims in l… -
TWiP 121: A parasite without borders
16 november 2016 · 1 uur 31 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPanosome docs solve the case of the Mali Man with Profuse Diarrhea, and review the presence of Trypanosoma cruzi in vectors, canids, and humans along the Texas-Mexico border.
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Links for this episode:
T. cruzi in vectors, canids, humans at Mexican border (PLoS NTD)
Tetracapsuloides bryosalmonae (Wikipedia)
T. cruzi in US (Clin Micro Rev)
Image credit
Letters read on TWiP 121
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
Case Study for TWiP 121
Back to Peru. 55 yo female from highland central valley area near Cuzco. Works in farming, no prior skin lesions but has multiple hypopigmented scars on exposed extremities (trauma during working), now reports many years of bloody nasal discharge. Seen in Lima by Daniel in outpatient clinic. No other medical problems, no surgeries, no allergies, everyone in family fine, husband and kids. Still working. No travel except to see doctor. Exam in right nare: ulcerated lesion inside nose, muco-cutaneous lesion. Simple test will decide. No anemia, no fever. Not eosinophilic, labs normal, HIV negative.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 120: When they die they calcify
10 november 2016 · 1 uur 40 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP triumvirate solve the case of the Thai Woman with Facial Swelling, and explain how Th17 T cells protect against the intracellular parasite Trypanosoma cruzi.
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Links for this episode:
Th17 cells protect against Trypanosoma cruzi (PLoS Path)
Plasticity of helper CD4+ cells (Science)
Image credit
Letters read on TWiP 120
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
Case Study for TWiP 120
A 48 yo man from Mali comes to hospital ER in Washington Heights in NY with profuse watery diarrhea. Born in Mali, came to US at 18, working in US as long haul truck driver for 30 y, frequently visits Mali, recently to attend his father's funeral. Got symptoms one week after return (was there for 3 weeks). 3 liters diarrhea/day. No past med/surg history, not seen doctor in long time. No allergies. Unknown what father died of, Mother in Mali is ok. No medications. Some alcohol, marijuana use. Does report that has exposure to professional female sex workers, no condoms. Temp of 39 C, bp down 80/40, heart over 110, rapid breathing high 20s, cachectic. Wasted. Fungating lesion perianally. Undergoes HIV testing, clade B. T cells <100.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 119: A kinder and gentler case
25 oktober 2016 · 1 uur 28 min
Hosts: Vincent Racaniello and Daniel Griffin Lees meer
Vincent and Daniel solve the case of the Family with Eosinophilia, and discuss HIV-1 infection and genome integration in the blood fluke Schistosoma mansoni.
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Links for this episode:
Family cluster of eosinophilia (Clin Inf Dis)
Dientamoeba fragilis (Wikipedia)
Parasites without borders
HIV integrates into Schistosoma genome (PLoS Path)
Image credit
Letters read on TWiP 119
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.
Case Study for TWiP 119
This one will be kinder and gentler case. Back in Thailand but could be in several places. 25 yo Thai woman from Bangkok, to hospital, chief complaint facial swelling. Eats typical Thai diet (see previous episodes!) Som tum, etc fish that is not cooked. Migratory - moves around face. Not tender, but mild itchiness. For about a week, no pain. Healthy, no past med/surg history, family all fine. HIV negative, no drugs, no travel. On examination, has swelling on right side, 3-4 cm raised, little redness, firm, does not feel like fluid filled. No fever, no GI problems, no bloods. WBC up, eosinophils up.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 118: Crispr capers with Toxoplasma
6 oktober 2016 · 1 uur 35 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPinella solve the case of the Woman from Guinea, and describe the use of CRISPR/Cas9 to identify essential apicomplexan genes.
Links for this episode:
Malarias in Guinea (CDC)
Genome-wide CRISPR screen in Toxoplasma (Cell)
Plasmodium parasitemia associated with increased Ebola survival (Clin Inf Dis)
Image credit
Letters read on TWiP 118
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.
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Case Study for TWiP 118
Little bit of a twist - a human family with eosinophilia. Conveyed by good friend/colleague ID physician. Australia, NSW, 45 yo Dad, having problem with mild abdominal distention. Seen by doc in Sydney, CBC shows eosinophil count of 10,500. Wife of same age reports feeling fine, but gets CBC and also shows eosinophils of 5,200. Two daughters, 17 and 19, no symptoms, bloods: 900 and normal eosinophils. One week prior to dads symptoms, sister in law came (also in NSW) and stayed, developed severe diarrhea, discomfort, bloating, weight loss, eosinohils 4,700. Eat raw fish (not known if fresh or salt) purchased at local markets. No overseas travel or out of urban environment. No pets, no home grown foods. Went back to previous labs and found normal eosinophil levels. Full workup for strongyloides, all negative. No HIV. No toxic habits, no remarkable medical history.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 117: Parasitic puzzles
26 september 2016 · 1 uur 51 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The parasite prophets solve the case of the Thai Man with Abdominal Distention, and discuss the finding that metastatic leishmaniasis dependent on a virus can be prevented by blocking IL-17A.
Links for this episode:
TWiP 27: Trematodes
Leishmaniavirus and IL-17A dependent leishmaniasis (PLoS Path)
Image credit
Letters read on TWiP 117
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
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Case Study for TWiP 117
Woman 66 yo born in Guinea, grew up the moved to US past 10 years, just retired. Lives in Washington Heights. Mother having issues in Guinea, so went back for 3 months in 2016. Just came back a week ago, reporting headache, fever, feeling poorly. Staying in big city, with Mom (80s). Has own private toilet in nice home. No screens or bednets. Married for 40 years, recently divorces. Has had 10 children. Not sexually active. Starts with high fever, breaks, then 2 days later another for several hours, goes to ER. Given Ebola screening questions, negative, do some blood work, send her back out. 2-3 days later high fever, double vision, headache, comes to Columbia ER. No diarrhea, no urination discomfort. Has backache, feels that mouth is dry. Was admitted. Past med history: high bp, cholesterol, diabetes; not overweight; appendix out; has unknown reaction to novocaine. No smoking, drinking. Physical: 39.4 temp, 14-16 breath rate, heart rate over 100, rapid he…
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TWiP 116: One drug to rule them all
11 september 2016 · 1 uur 46 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPtoids solve the case of the Thai Fisherman with Chronic Diarrhea, and reveal a potential new drug for treatment of leishmaniasis, Chagas diseases, and sleeping sickness.
Links for this episode:
Capillaria philippensis (Wikipedia)
Proteasome inhibitor for three parasitic diseases (Nature)
Image credit
Letters read on TWiP 116
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
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Case Study for TWiP 116
This week's case involves no math. 36 year old Thai man from the northeast part of the country. Comes in with abdominal distention. Eats a normal Thai diet - Som Tam, Koi Pla, lots of rice. Feels well, came in because he is getting yellowing of skin and whites of eyes - jaundiced. Previously healthy, no prior med prob or surgery. No diseases running in family. Fisherman in the northeast (freshwater). Wife and many children, monogamous, HIV negative. Lives in jungle area, near river, many dogs, chickens, monkeys, goats, cows, pigs. Bathroom is outside. No fever, thin. Distention going on for months. Getting bigger. Exam: jaundiced, has large palpable non-tender mass below liver on his right side. No enlarged liver or spleen. No travel.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 115: The Cuscuta Factor
27 augustus 2016 · 1 uur 37 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPlets solve the sad case of the Boy Who Went Swimming, and explain why the tomato is resistant to the plant parasite Cuscuta.
Links for this episode:
Detection of plant parasite by a tomato receptor (Science)
Dodder (Wikipedia)
Mixed messages (TWiP 77)
Image credit
Letters read on TWiP 115
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.
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Case Study for TWiP 115
This week's case is more challenging, but with a better outcome than last time. Thailand: 32 year old Thai man from southern coastal part of country, comes to ID hospital in Bangkok with two months of watery diarrhea. Rapid onset. Looks emaciated, protuberant belly. Ten times per day, has trouble flushing feces in toilet, floats. Eats normal fare, boat noodles, fish, rice, vegetables. Som tam - fish sauce from raw fish. Also with salted crab, not well cooked. No unusual past med history, healthy fisherman, no medication. Married with kids, everyone healthy. No bad habits. Monogamous. HIV negative. Liver, spleen not enlarged. Abdominal xray with contrast: loss of villi. Good appetite. No abdominal pain. Too weak to work. No vomiting.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 114: Plant potions perturb Plasmodium
12 augustus 2016 · 1 uur 38 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP troika solve the case of the Female from the Bronx, and reveal how feeding on different plants affects mosquito capacity to transmit malaria.
Links for this episode:
Plant mediated effects on malaria transmission (PLoS Path)
Image credit
Letters read on TWiP 114
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.
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Case Study for TWiP 114
12 year old boy brought to hospital ER by parents with severe headache, stiff neck, fever, decreased alertness. No rashes. Has been healthy with no prior medical problems. No one else in family is ill. In summer, boy has been engaged in usual summertime activities: soccer, swimming in warm freshwater, playing outside. Undergoes lumbar puncture for CSF: start on meningitis treatment. No surgeries, no allergies. Not on any meds. Lives with Mom, Dad, few brothers. No substance abuse. Not a geographically limited illness. Has had bug bites - lots of mosquito bites. Dogs around as well. Symptoms began a day or two before hospital visit. Eats whatever family eats, food is cooked. Exam: 39.4C, bp low, heart rate up, resp up, decreased responsiveness, stiff neck, looks ill. WBC elevated, neutrophil predominant, eosinopenia. CSF glucose low, cells increased, no bacteria, fungi, acid fast bacilli on stain. CT scan, diffuse swelling of brain. Doing poorly, not a good outcome.
Send your case diagnosis, questions and comments to tw…
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TWiP 113: Flying pigs
23 juli 2016 · 1 uur 41 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
Guest: Jason Zucker
The TWiP ternion solve the case of the Man from Mexico, and discuss a transgenic toxoplasma vaccine for chickens using Eimeria tenella.
Links for this episode:
Transgenic Eimeria as a toxoplasma vaccine (Sci Rep)
Image shows cysticercus of T. solium in brain (Parasitic Diseases, 5th Ed)
Letters read on TWiP 113
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
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Case Study for TWiP 113
22 yo female comes to clinic in Bronx, reports one week of vaginal discharge and itching. Looks bad, yellowish. Sexually active with boyfriend. He has no symptoms. Some discomfort on urination. Healthy, no prior surgeries, no allergies. Mother with diabetes, father has high bp. Takes oral contraceptive pills. Not employed, lives with mother and sisters. Substance abuse: some on occasion, marijuana and alcohol, no i.v. No pets. Diet: lot of fast food. Physical exam: slightly heavy, normal but vaginal exam: discharge, thick, slight yellow light green color, no strong odor, some redness to vaginal walls, no changes to cervix. 2 weeks from last menstrual period.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 112: A NOD to a tricky helminth
25 juni 2016 · 1 uur 38 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP trio solve the case of the Woman from Washington Heights, and reveal how helminth infection protects mice deficient in the Crohn's disease gene NOD2 from intestinal disease by inhibiting colonization with an inflammatory bacterial species.
Subscribe to TWiP (free) in iTunes, by the RSS feed or by email
Links for this episode:
Helminth infection promotes colonization resistance (Science)
NOD2 (Wikipedia)
Image credit
Letters read on TWiP 112
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
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Case Study for TWiP 112
A case here at CUMC, 59 yo male, past medical history of childhood polio, presents with worsening lower extremity weakness, bowel and urinary incontinence. 2 year before worsening back pain, weakness, could not work. Cannot walk up one flight of stairs since 1 month; 1 week prior to admission had fever, no headaches, diarrhea, cough, or any other symptoms. Splits time between Washington Heights and Mexico. Construction worker. Rural town in southern Mexico, 10 months of the year. Worked in the corn growing area. Has been exposed to bugs. Stopped working in cornfields 20 years ago. Has son and daughter, visits them. Lives with wife, stays in Mexico, she is fine. HIV negative. Eats home prepared foods, no dietary restrictions. Physical exam: not febrile, vital signs all good, neurological: upper strength good, weakness in hip flexors, ⅗; quadriceps, but ⅕ in lower extremities ⅖ in right. Sensory has decreased as well. Possibly spinal lesion. Labs: elevated glucose, ESR 33, CRP 2.2, whites 8, 30.6 hematocrit, guaiac negative. Imaging: MRI …
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TWiP 111: Bug bites
3 juni 2016 · 1 uur 25 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP trio solve the case of the bug bites all in a row, and talk about a secreted Toxoplasma protein that is central to the parasite's manipulation of host cells.
Subscribe to TWiP (free) in iTunes, Google Play Music, by the RSS feed or by email
Links for this episode:
Pigeon mites feed on humans at night (EPA)
Secreted Toxoplasma protein (mBio)
Image credit
Letters read on TWiP 111
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
Case Study for TWiP 111
82 yo woman living in Washington Heights NYC 10 days of watery diarrhea, not smelly, does not float. Wakes her up at night. No fever, sweats at night. Losing some weight, appetite. No recent travel. Born in DR early 1930s, moved to US age 30. Sometimes goes back but not for several years. Springtime. Lives with extended family, only one sick. Eats whole assortment of cooked foods, rice, beans, fresh fruits. Drinks tap water. Not working. No pets. Stays mostly inside. History of reflux, high blood pressure, cognitive decline, diagnosed with temporal giant cell arteritis. Put on prednisone, doing better. Has had gall bladder removed. HIV negative. Extended family works in city, no taxi drivers. Belly uncomfortable for >week. Temp 38.1, BP 116/78, HR 105, breathing 12/min. Exam: looks ill, has diffusely tender abdomen, decreased bowel sounds. Liver, spleen not enlarged. Oriented. Has rash on abdomen: odd patchy distribution, looks like multiple thumbprints, front of belly, extending from umbilicus. White count 8, 78 polys, 14 lymphs, 4 mono, 1 eosinophil. Sodium 129, BUN 15, Creat 0.6. Urine histoplasma negative, TB test negati…
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TWiP 110: Malaria at the Bronx Zoo
21 mei 2016 · 1 uur 30 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
Guest: Paul Calle
The TWiP trio visit the Bronx Zoo where Paul solves the case of the Four Year Old with Pulmonary Edema, and talks about his career as the Chief Veterinarian and Director of the Zoological Health program for the Wildlife Conservation Society.
Links for this episode:
Bronx Zoo
Avian malaria (Wikipedia)
Letters read on TWiP 110
Video of this episode at YouTube
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
Case Study for TWiP 110
This week's case involves humans. Young woman, 40s, concerned about bug bites. Several weeks ago her 13 year old daughter woke up in morning, reported bug bites. Several small, red, raised itchy areas, 3-4 in a line, just above belt line. They go on vacation in Europe, no problems. Upon return, several weeks later the Mother woke up with a similar pattern. Then second daughter has the same problem. Family lives in NY metropolitan area, which is an epicenter for this problem. Always on trunk, not on arms or legs. No travel before the first daughter's bug bites. Husband does not report any problems. Family spends a lot of time outdoors, live in suburban wooden area.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 109: Blame it on Mother
13 mei 2016 · 1 uur 9 min
Hosts: Vincent Racaniello and Daniel Griffin Lees meer
Guest: Paul
Daniel and Vincent solve the case of the Truck Driver from India, discuss why parasites resistant to an antimalarial drug are not transmitted by mosquitoes, and introduce Paul who presents a new case study.
Links for this episode:
Atovaquone resistant parasites not transmitted by mosquitoes (Science)
Image credit
Letters read on TWiP 109
This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and nonfiction series from the world's best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.
Send your case diagnosis, questions and comments to twip@microbe.tv
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TWiP 108: B1 cells and Leishmania, insider traitors
23 april 2016 · 1 uur 31 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The case of the Man from Assam is solved, and phagocytosis of Leishmania by B-1 cells is brought to you by the Three Twipeteers on this episode of TWiP.
Subscribe to TWiP (free) in iTunes, Google Play Music, by the RSS feed or by email
Links for this episode:
Kalazar detect (pdf)
Phagocytosis of Leishmania promastigotes by B-1 cells (Parasite Immunol)
Image credit
Letters read on TWiP 108
This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016
Case study for TWiP 108
Todays case is a 26 yo male longhaul truck driver from northern tiger country of India. Comes into hospital at end of rainy season with 6 days of fever, chills, muscle aches, small loose stools, vomiting, trouble breathing, cough, decreased urine output. Lives in mud hut with coconut leaf roof. No one else in family is sick (wife, two children). Significant animal and insect exposure (dogs, cows, monkeys). Got sick after coming home from a trip up north. No significant medical probs, no surgery. Really sick. Pain everywhere. Occasionally drinks palm wine. Some yellowing of eyes. Has lost a little weight. Ketonic breath. Exam: 39 fever, bp 100/71, 126 heart rate, 24 resp rate. Looks distressed, not fully sharp. Nothing focal on lung exam. Belly tender, esp upper right, spleen enlarged. Liver is tender but not enlarged. Some labs: bun elevated 102, creatinine elevated, Hg decreased 11, platelets 9000 (down), white count 10.3 no eosinophils. LDH 8000 AST/ALT normal, bilirubin 21. Never been this sick.
Send your diagnosis to twip@microbe.tv
Send your questions and comments to twip@microbe.tv
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TWiP 107: Parasites leave a bad taste in my gut
11 april 2016 · 1 uur 33 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPtastic trio solves the case of the Surfer from Switzerland, and reveal how taste-chemosensory tuft cells in the gut regulate immune responses to parasites.
Links for this episode:
Taste-chemosensory cells and parasite gut immunity (Science)
Image credit
Letters read on TWiP 107
This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016
Case study for TWiP 107
Todays case is a fun case about a 45 year old gentleman from Assam India, with sixteen years of fever, abdominal pain, darkening of skin, yellowing of eyes. Farmer, does not have much energy. Works barefoot in fields. Fever occurs every other day. Prior medical problems, nothing out of the ordinary. No surgeries, no meds, has never seen physician. Married, kids, no extramarital affairs, HIV negative, eats mostly cooked vegetables. Lives in concrete house, no screens, mosquito netting. Other people in area have similar problems. Water comes from pump, fill plastic jugs. Been in Assam sick his whole life, finally came to regional med center for evaluation. Underweight. No pets. Dogs around, avoids dogs. Cows, monkeys are around. Fair appetite. Exam: febrile, in face can see darkening which is increasing, also extremities. Whites of eyes are yellow (jaundiced). Striking is has a very large liver, spleen. Elevated bilirubin. Some increased liver enzymes. No physical scarring or lesions.
Send your diagnosis to twip@microbe.tv
Send your questions and comments to twip@microbe.tv
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TWiP 106: Trematode stormtroopers in snail wars
26 maart 2016 · 2 uur 1 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP triumvirate solves the case of the Missionary in Kenya, and review the finding of a soldier caste in flatworms that parasitize snails.
Links for this episode:
Social organization in parasitic flatworms (J Parasitol)
Image credit
Letters read on TWiP 106
This episode is sponsored by ASM Agar Art Contest
Case study for TWiP 106
This week's case comes from an ophthalmologist colleague Florian in Switzerland. Swiss female, early 20s, returns after surfing vacation in northern Africa. Accommodations were rustic, lots of animal and insect exposure, right on the beach. No screens. Had loose stools there, now left eye is bothering her, eyelid swollen, eye red. This happened after return. Thinks she has seen things moving around in her eye. Opthalmologist gave eyedrops, now looking for second opinion. Healthy, no med/surg/allergies, no meds, student lives alone, occasional alcohol. No AIDS. Surfing in Morocco. Lots of insect bites. Little tiny things moving around in eye, on surface when she looks in mirror. All blood work was negative. Florian inspects her eye, surprised to see several tiny mobile objects, headed towards lacrymal ducts. Is able to grab one, about 1 mm long, plucks three off.
Send your diagnosis to twip@microbe.tv
Send your questions and comments to twip@microbe.tv
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TWiP 105: Survival of the fattest
12 maart 2016 · 1 uur 53 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPanosomes solve the case of the Young Man from Anchorage, and discuss how cestode parasites increase the resistance of brine shrimp to arsenic toxicity.
Links for this episode:
Trichinella life cycle (pdf)
When parasites are good for health (PLoS Path)
The Origin of AIDS by Jacques Pepin
Letters read on TWiP 105
Case study for TWiP 105
This week's case involves a 32 yo male with several concerns. Spent 6 weeks doing religious missionary work in Kenya, performed baptisms in Lake Victoria.Waist deep in water, no shoes. Took malaria drugs, ate lots of interesting foods: cichlids, ugali, corn based food, flavored with greens; stew with some sort of meat, beef and goat. Five weeks after return developed rash with fever, shortness of breath. Three of four friends who were with him in Kenya reported similar symptoms. The fourth who did not get sick did not go in water, nor did he eat very much. No medical/surgical history, no drugs. Had some sexual activity while there. Elevated white count, 70% eosinophils. Chest CT shows nodules in lungs. Doc told him, allergy, you will be fine. The water he went into is near a village, there are rodents nearby, and a runoff.
Send your diagnosis to twip@microbe.tv
Send your questions and comments to twip@microbe.tv
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TWiP 104: La maladie du sommeil
27 februari 2016 · 1 uur 42 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
Guest: Michael Libman
Michael returns to help the TWiP trio solve the case of the Delusional African Expatriate, and discuss the association of natural and induced antibodies in mice with differential susceptibility to secondary cystic echinococcosis.
Links for this episode:
T. brucei life cycle (pdf)
Natural and induced antibodies in echinococcosis (Immunobiol)
The collaborative cross
Letters read on TWiP 104
Case study for TWiP 104
This week's case involves a young man in his thirties, admitted in hospital in Anchorage AK in early June. Chief complaint, severe muscle pain and tenderness. Usually healthy guy, 1 week ago had bad case of diarrhea with belly pain and vomiting, lasted a full week. Now has fever. Concerned because wife now is having diarrhea. Unremarkable history, unknown family history. HIV negative. All childhood vaccinations. Does not eat raw meat. No meds, does seasonal work, social drinker. Came back from successful hunt, got a black bear. Dressed in field, cooked at home really well. Wife also ate bear meat. Bear meat is in freezer. No vegetables. Also eats salmon which he caught the previous season, then frozen. Drinks water from the stream when he hunts. Physical exam: hot, 38.5, bp 115/75, pulse 105, breathing comfortably. Anxious, swelling around both eyes. Sclera not noted. Labs: WBC elevated 14,000, 30% eosinophils; chemistries fine; muscle enzymes LDH, CK elevated.
Send your diagnosis to twip@microbe.tv
Send your questions and comments to twip@microbe.tv
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TWiP 103: Scroll down, please
13 februari 2016 · 1 uur 8 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
Guest: Michael Libman
The TWiP-scholars solve the case of the Housewife from Kolkata, discuss mutations in the IL17 gene associated with cerebral malaria, and hear a case presentation from guest Michael Libman.
Links for this episode:
IL-17 mutations and risk of cerebral malaria (Inf and Imm)
Echinococcosis (CDC)
Echinococcus life cycle (pdf)
Letters read on TWiP 103
Case study for TWiP 103
This week's case concerns a 42 yo male, refugee in Canada, from DRC, former Zaire, where there is unending civil war. Upper middle class, professor of French at university. Had been imprisoned, tortured, lived in jungle for a few years, reached refugee camp in Tanzania, moved to Canada. Came to health care system 15 months after arrived. Was sent to psych, unstable emotionally, delusions, hallucinations, depression, post traumatic issues. Was under psych care for ~1 yr, did not improve, became worse. Sent to hospital. History: talked about having minor injury, hurt lower back, pain there bothering him. Some anemia (normochromic), basic hem/chem/urine/liver nothing remarkable. Physical exam, nothing remarkable. HIV negative. Some evidence for chronic inflammatory condition: sed rate 60 (elevated), had diffuse increase in IgG, IgM. Developed some low level autoantibodies; anti-nuclear, p-anka, anti-neutrophil cytoplasmic antibodies. Slightly elevated fever for a few days, then few days or week with no fever. No eosinophilia. Radiology: on CT did have some mediastinal, aortic, axillae, lymphadenopathy. Prob screened in Africa for malaria and treated; prob also got ivermectin. Also got head MRI: not completely normal, classic nonspecific midbrain abnormality. Diffuse mild edema. Weight loss remarkable. No visual problems.
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TWiP 102: Nursing eosinophils
6 februari 2016 · 1 uur 40 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiPyzoites solve the case of the Uncommon Parasite, and discuss the role of eosinophils in promoting the growth of Trichinella in skeletal muscle.
Links for this episode:
Eosinophils and IL-4 support nematode growth (PLoS Path)
Balantidiasis (CDC)
Letters read on TWiP 102
Case study for TWiP 102
This week's case involves a 24 yo housewife, from a village outside of Calcutta. Comes into a tertiary care hosp, 6 months coughing up blood, fever, no weight loss. Drinks rainwater, milks her cow. Dogs everywhere, no livestock except cows. Eats meat, well cooked. No extramarital encounters. Husband well. 4 children. Cistern for drinking water is covered. No health issues. Reports salty, clear mucus. No blood in stool, no changes in stool. Exam: looks healthy, lungs clear. Lab tests: White count of 9000, 12% eosinophils (elevated). So she has eosinophilia. Chest X-ray and CT: lesion on left side in xray. CT: shows 4 cm cavity, with air pocket on left side, mid-lung. HIV negative. Dusty soil, birds.
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TWiP 101: Is it round or is it flat?
23 januari 2016 · 1 uur 51 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The doctors TWiP solve the case of the Woman with White Worms, and explain the role of a secreted growth factor from a carcinogenic parasite in wound healing and angiogenesis.
Links for this episode:
Wound healing growth factor from carcinogenic parasite (PLoS Path)
Opisthorchis (CDC)
Opisthorchis life cycle (CDC)
Image credit
Letters read on TWiP 101
Listener Pick
Ramon - Ancient Rome was infested with parasites
Case study for TWiP 101
This week's case involves an uncommon parasite. Young girl, <10 y, brought in by parents from rural area to regional hospital with fever, diarrhea for 2 weeks. No blood in stool. Parents: few weeks prior to problems, young girls went with family on wild pig hunting trip. With guns. Girl did consume pig on trip, all meat was very well cooked. Was involved with preparation of meat with Mother only. No one else got sick. No surgery, no allergies. Both parents have diabetes. Has four brothers. Some weight loss. This is outside the US. Physical exam: low grade fever, diffuse mild abdominal discomfort, slight microcytic anemia, size of cells is slightly smaller than normal. WBC: normal, except no eosinophils. Blood cultures negative. Stool examination is where we get our answer.
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TWiP 100: Driving past a milestone
9 januari 2016 · 1 uur 53 min
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Lees meer
The TWiP trifecta solves the case of the Woman from Bolivia with Belly Pain, and discuss a method for population modification of malaria mosquitoes using a Cas9-mediated driver gene.
Links for this episode:
Cas9-mediated drive for population modification of malaria mosquito (PNAS)
FAQ: Gene drives (pdf)
Image credit
Letters read on TWiP 100
Case study for TWiP 100
This week's case is a 27 yo female, native NY, referred to outpatient at CU after seeing OBGYN, told had seen worms in stool and underwear. Inch or two in length, pale white, round, moving, 2-3 weeks of constant abdominal bloating. Sexually active. No particular diet. Travel: works for NGO, refugee camp in Ethiopian-Sudan border, southern Sudan. Last visit month ago. Noticed worms when she got back from last trip. Eats what local people eat. Raw food popular there: kitfo, raw steak tartare, with melted butter. Made from local beef. Did not take malaria prophylaxis, did not avoid local water, does wear sandals. College graduate. Nothing remarkable in family. CBC, liver, metabolic: all normal. Stool not normal: loose, no mucus or blood.
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TWiP 99: You get your polar bear from your nana
5 december 2015 · 1 uur 40 min
The TWiP trifecta solves the case of the Professor Who Went to Brazil, and discuss an amazing case of a tapeworm that turned into a tumor in an AIDS patient. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Do young doctors need more sleep? (Slate)
H. nana tumor in AIDS patient (NEJM)
Hymenolepiasis (CDC)
H. nana lifecycle (CDC/Wikipedia)
Image credit
Letters read on TWiP 99
Case study for TWiP 99
This week's case is a 53 yo woman visiting family in US, comes in with intense belly pain, right upper part of belly. Has become strict vegetarian after having breast cancer, on raw vegetable diet (carrots, collect plants in local markets). From Bolivia. Lives in agricultural area, avoids sheep, fearful of dogs. Housekeeper. Married, lives with husband. Noticed pain when came to US. Breast cancer: localized, removed lesion, no therapy, months ago. No allergies, family healthy. No insect bites, lives in concrete house. Physical exam: not febrile, right upper quadrant is very tender, some liver enlargement. CBC: 10,000 white count, mostly eosinophils, liver function: AST, ALT, AlkPhos all normal. Neuro exam: normal. Five months before this diet, she did have normal diet. Some meat, drank milk.
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Contact
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TWiP is a MicrobeTV production
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TWiP 98: Resistance is not futile
31 oktober 2015 · 1 uur 37 min
The TWiP-lets reveal Balamuthia infection in the Children from Peru, and discuss resistance to pyrethroids revealed by RNA sequencing of Anopheles mosquitoes. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Balamuthia (CDC)
Pyrethroid resistance in Anopheles (Parasit Vectors)
Voltage-gated sodium channels
Pyrethroid (Wikipedia)
Image credit
Letters read on TWiP 98
Case study for TWiP 98
This week's case is a Professor clinician, teacher, researcher. In his 50s, he presents with lesion on big toe, anterior portion, tip, nodular. No surrounding redness, area is itchy. Has a small central black area the size of pencil tip, concerned because feels is getting larger over last week. Spooky. Travels, last in Brasil, had been for a few weeks, noticed toe issue a week after returned. Spent time on beach, but wore flip flops. Different types of beaches, crowded and not crowded. Went with wife. Healthy man, no prior medical problems.
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TWiP 97: The seven year itch
17 oktober 2015 · 1 uur 27 min
The paratenic hosts reveal a case of scabies in the Traveling Salesman, and discuss a role for natural antibody in protection from infection with Plasmodium. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Parasite Nobel Prizes 2015
Ivermectin story (Nat Rev Micro)
Ivermectin target (Brain Res)
Gut microbiota and Plasmodium protection (Cell)
Natural antibody (virology blog)
Image credit
Letters read on TWiP 97
Case study for TWiP 97
Daniel has two cases this week. Two people with similar presentations. A 12 yo girl in Peru presented for care with painless dark brown area on right knee. Has brothers and sisters, often play together. No trauma, but area is expanding. Months later develops cognitive changes. Second case is a 5 yo boy from the coastal region of Peru brought in by Mother, has red swollen area on face. Mom says while playing scratched nose, swelling right cheek, eye, nasal obstruction, no response to antibiotics. MRI of both show infiltrating process. Girl, left side of brain, middle cerebral artery territory. Boy in frontal region, midline area. Thus both skin lesions associated with infiltrating process in brain. Came into clinic months after lesions started, and lesions still present.
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TWiP 96: Salivary pharmacopeia
3 oktober 2015 · 1 uur 43 min
The TWiPanosomes solve the case about the Young Woman who Went to Belize, and relate how sandfly saliva skews the immune response and increases risk of cutaneous leishmaniasis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Sandfly exposure and risk of cutaneous leishmaniasis (J Inf Dis)
TWiP 14: Leishmania
Image is L. longipalpis (credit)
Letters read on TWiP 96
Case study for TWiP 96
Daniel's patient for this week is male patient referred for consultation by OB-GYN: his wife is pregnant, has been admitted and is about the give birth. It is her first pregnancy. There are concerns about the husband's skin problem and whether it is a threat to his pregnant wife. No lesions on woman, husband recently developed itchy skin problem on his hands. Bilateral. Small papules on webs of fingers, brown lines, blood clots at ends, has clearly scratched the lesions. Skin between fingers is involved. Travels, often stays in cheap hotels. Beds not clean. Last trip 1 month before symptoms. Midwest travel. Family history of heart disease. Sales occupation. No animal exposure. Travels to medium to large cities.
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TWiP 95: Arsenic and Leishmania
19 september 2015 · 1 uur 45 min
Vincent, Dickson, and Daniel solve the case about the 33 year old Chinese male with watery diarrhea, and discuss whether arsenic in drinking water might lead to treatment failures for Leishmania infections. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
TWiP 17: Entamoeba histolytica
Arsenic exposure and Leishmania treatment outcomes (PLoS NTD)
TWiP 14: Leishmania
Letters read on TWiP 95
This episode is sponsored by ASMGAP.
Case study for TWiP 95
Daniel's patient for this week is a 28 yo single female, returns from beach vacation with new boyfriend. Two weeks in Central America (Belize). Often found secluded beaches. Good health, noticed upon her return had small nodules/papules on front of thighs. Thought were insect bites, became very itchy. Noticed serpiginous red lines forming, radiating out from bumps. Felt things moving in her skin. Benadryl did not help. Daniel say something similar occurs in Lima. Healthy, no allergies, surgeries, no relevant family history, using barrier contraception, sexually active. Only drinks alcohol socially. Boyfriend did not report symptoms. She did lie on sand, used thin fabric. Stayed in hotel. There were wild dogs on beach. During her stay she ate ceviche. No intestinal symptoms.
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TWiP 94: Loa hanging fruit
5 september 2015 · 1 uur 42 min
Vincent, Dickson, and Daniel solve the case about the man from El Salvador, discuss the use of tyrosine kinase inhibitors to treat onchocerciasis and filariasis. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Targeting filarial tyrosine kinases (J Inf Dis)
Onchocerciasis on TWiP 24
Filariasis on TWiP TWiP 25
Image shows c-abl kinase bound to imatinib (red)
Image credit
What good are ticks?
Letters read on TWiP 94
Case study for TWiP 94
Daniel's patient was seen in the clinic. He is a 33 yo chinese male, from Chinatown NYC, for several months on and off has had watery diarrhea, headaches. Tried reflexology, chiropractic therapy, with no results. Has traveled quite a bit, been in Chile (was there a few months before). Came to US when young. Grew up in the US. In Chile, has had many sexual partners, >50, of both sexes, also has done many drugs. Two years ago was diagnosed with chronic HIV, CD4 count 685, on ARVs triple therapy, virus loads are well controlled. Has had syphilis, nose job, no medication allergies. Lives with family. On exam, afebrile, looks well. Symptom onset a few months after last Chile visit. Is an addventurous eater.
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TWiP 93: A fishy tale unfolds
8 augustus 2015 · 1 uur 29 min
Vincent, Dickson, and Daniel solve their fishy tale, and present a new case study for your consumption. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Freezing and the quality of sushi (Clin Inf Dis)
Anisakis biology (CDC)
Image credit
Letters read on TWiP 93
Case study for TWiP 92
April 2015 a 177 lb 5ft10in 39 yo man seen as outpatient in ID clinic, reports 2 y ago had issues with constipation on and off; throat hurts; feels closing when lies down. For several years has had skin irritation on upper chest and arms. Tried to donate blood, was rejected, told to see doctor.
Emigrated to US from El Salvador 2002, married, reports no extramarital sex, smokes 2-3 cigs/day, now quit; had drinking issue in past, no more; was agricultural worker in rural part of El Salvador; has history of asthma, on a number of medicines, including steriod nasal spray, inhaler, no visual problems, healthy appearing, not allergic to medicines. Family history: mother heart attack and diabetes; father peptic ulcer disease.
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TWiP 92: Kleptohaemodeipnonism
4 juli 2015 · 1 uur 40 min
Vincent, Dickson, and Daniel discuss how fluctuation in the price of guinea pig food could help transmission of the agent of Chagas disease, and present a new case study for your consumption. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Ascaris on TWiP 21
Ascaris lumbricoides life cycle (jpg)
Child with distended abdomen due to Ascaris (jpg)
Bottlenecks and Chagas disease (Proc Biol Soc)
Letters read on TWiP 92
Case study for TWiP 92
A 20 yo Japanese female student went to the emergency room with severe abdominal pain. nausea, had vomited. Had just enjoyed homemade sushi an hour or two previuosly. She prepared the sushi: rice, salmon, tuna rolls. Salmon was local, caught by boyfriend. Tuna from store, sushi grade. No past medical history, mother with anemia. Takes oral contraceptives. No toxic habits. No travel. Monogamous. Temp 100.2, bp 140/90, hr high 90s, breathing upper teens. Physical exam normal except appears distressed in pain, belly extended, tender in left upper quadrant. Friends ate sushi but no one else got sick. All guests ate both types of fish.
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TWiP 91: Born to deform
20 juni 2015 · 1 uur 29 min
Vincent, Dickson, and Daniel review how Viagra might be used to block transmission of Plasmodium falciparum, and introduce a new case study. Lees meer
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin
Links for this episode:
Malaria life cycle (jpg)
cAMP regulates gametocyte infected erythrocyte deformability (PLoS Path)
P. falciparum in bone marrow (Blood)
Image credit
Letters read on TWiP 91
Contact
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