Discover and read the best of Twitter Threads about #IDtwitter

Most recents (24)

1/ You’re on rounds when a concerned fellow states “They aren’t clearing their bacteremia. It’s day 5 of therapeutic vancomycin and the daily blood cultures are STILL growing MRSA. What agents can we add on or change to clear this bacteremia?” #IDTwitter #NeoTwitter
2/ Is knowing they are a neonatology fellow, caring for a <30 wk GA, 2-week-old for a disseminated MRSA infection (+blood cx with MRI-confirmed osteomyelitis and a 10mm non-obstructive mass in the RA) enough information? How different can babies be from adults?
3/ A LOT different. As the article is titled “Neonates are not just little children”. Neonates have altered protein binding, larger volumes of distribution, smaller fat and muscle stores and immature kidney and liver function.

pubmed.ncbi.nlm.nih.gov/29745792/
Read 16 tweets
#IDTwitter #SIDPharm #Microbiology

#AMRrounds Team is called about this laboratory confirmed (step 1) urine isolate associated with clinical symptoms consistent with cystitis.

A mechanism of resistance was requested recalling this isolate has no intrinsic resistance (step 2). Image
Quinolones: Nalidixic acid was discovered in 1962 as a byproduct of chloroquine synthesis.

Addition of fluorine (C6) and piperazine or methyl-piperazine (C7) enhanced PK/PD parameters beyond the urinary bladder. Image
Quinolone targets

DNA cleavage and ligand heterotetramer enzymes:

A. Gyrase with subunits GyrA and GyrB
B. Topoisomerase IV with subunits ParC/E in gram-negative organisms and GrlA/B in gram-positive organisms Image
Read 7 tweets
NIH ACTIV-6 #ivermectin early #covid19 treatment results with 1591 randomized participants.
No difference in ER visits, hospitalizations, deaths (all numerically higher with IVM, but no statistical difference).
Time to recovery 11 vs 11.5 days. #idtwitter
medrxiv.org/content/10.110…
Activ-6
Hospitalizations or deaths: n=10 ivermectin vs n=9 placebo

ER visits / hospital / death n=32 IVM vs n=28 placebo
The symptom duration data are interesting. The trial is large enough that it can detect differences that are not clinically meaningful, but there are some subgroups that are interesting. Not conclusive as they are small, but hypothesis generating for verification in future arm
Read 12 tweets
A 51-YO🧔‍♂️, in Turkey: dyspnea, cough & production of yellowish, foul-smelling, & salty sputum

XR & CT (A-D): cavitary lesion containing irregular, serpiginous intracavitary material
1/3

DOI: doi.org/10.4269/ajtmh.…
#IDTwitter #radiology
2nd day of hospitalization: fever, myalgia, & sore throat

CT: subpleural ground glass opacities (fig.)

PCR for #SARSCoV2:➕
Eosinophilia
IFA IgG against Echinococcus granulosus:➕at 1/5,120

RUPTURED PULMONARY HYDATIC CYST COMPLICATED BY COVID-19
2/3

#microbiology #MedEd
Gross examination showed removed cyst (fig.).

Surgery combined with medical therapy remains the standard form of treatment of large cysts with multiple daughter cysts, complicated cysts, etc.
3/3

#parasitology #surgery
Read 3 tweets
A 26-YO👩‍🦰, sexually active: 1-month of right knee and metacarpal arthralgia, tenosynovitis & pustules on her hand, developed an enlarging chest wall mass.

CT: an abscess on her chest wall, requiring drainage.
1/4

DOI: doi.org/10.1503/cmaj.2…
#IDTwitter #MedEd Image
Urine gonococcal nucleic acid amplification test: ➕ was positive,
16S rRNA with gene sequencing of wall fluid:➕for Neisseria gonorrhoeae.

DISSEMINATED GONOCOCCAL INFECTION

Ceftriaxone IV stopped after the abscess had resolved
2/4

#MedicalStudents #microbiology
Neisseria gonorrhoeae is transmitted mainly through unprotected vaginal, anal and oral intercourse
3/4

#MedTwitter #MedStudentTwitter
Read 4 tweets
Lactante 4 meses, dermatitis atópica, su hermana con laringitis aguda: erupción papulosa de evolución a costras en 1 día, predominando sobre placas de eccema preexistentes.

Se inician en el tronco, incluyen cabeza, área del pañal y vesículas en boca.
1/5

#pediatria #Pediatrics
PCR (para herpesvirus y enterovirus):➕para enterovirus Coxsackie A6

ECCEMA COXSAKIUM

El A6 produce también: erupción vesículo-bullosa erosiva, cuadro Gianotti-Crosti-like y rash purpúrico-petequial

✒️Martín A y col continuum.aeped.es/screens/play/5… @aepediatria #dermatology
2/5
@aepediatria El eccema coxsackium puede producir fiebre con pápulas, vesículas y costras confluyentes en región peribucal, cuello, tronco, antebrazos, pantorrillas y dorso de manos y pies.

Generalmente, una enfermedad autolimitada con buen pronóstico.
3/5

@ContinuumAEP #Pediatrics
Read 5 tweets
1/
TIL about BORSA/MODSA, so cue the #IDTwitter #Tweetorial.

Thanks to the many contributors on @DrDidwania_ID's post on a very interesting variation of Staph aureus that phenotypically matches MRSA, but does not carry the correct genotype.

/thread
2/
Methicillin resistance is usually conferred by an altered penicillin-binding protein (PBP2a) via the gene mecA (or sometimes mecC).

MecA is detected by current molecular testing as a marker of methicillin-resistance for Staphylococcal species

link.springer.com/chapter/10.100…
3/
What is BORSA & MODSA?

BORSA: borderline oxacillin-resistant Staph aureus
MODSA: modified Staph aureus

Just add this to MSSA, MRSA, VISA, and VRSA in the genre of Staph aureus-related acronyms!!

Key article I referenced for this thread: pubmed.ncbi.nlm.nih.gov/28893360/
Read 12 tweets
Niña de 5 años, araña entre las sábanas (1): fiebre de 2 días y placa eritematosa indurada en muslo con crecimiento centrífugo y una escara necrótica central (2)
¼

✏️M. Sendín-Martín y col. @HospitalUVRocio
DOI: 10.1016/j.anpedi.2020.12.005
#pediatria #Pediatrics
@HospitalUVRocio PICADURA DE LA ARAÑA RECLUSA PARDA

Las arañas del género Loxosceles o arañas reclusas o arañas violinistas debido a la morfología dorsal de su cefalotórax tienen una distribución mundial

La lesión se resolvió los días siguientes, sin dejar cicatriz.
2/4

#MedEd #dermatology
@HospitalUVRocio Las arañas reclusas parda causan lesiones necróticas a través de una enzima denominada esfingomielinasa D1. Los síntomas sistémicos incluyen fiebre o náuseas.

De forma infrecuente, signos graves como coagulación vascular diseminada o la rabdomiólisis
3/4
#IDtwitter #MedTwitter
Read 5 tweets
#IDTwitter #SIDPharm #Microbiology

#AMRrounds Team is called about this laboratory confirmed respiratory isolate. AST QC certify the susceptibility profile (Step 1).

Clinical scenario is consistent with CDC criteria for VAP.
Step 2: Review natural/intrinsic resistance.

Example is CLSI M100
Step 3: Review epidemiology of carbapenem resistant Pseudomonas.

From the ERASE-PA Global Surveillance Program (Gill CM, et al. Eur J Clin Microbiol Infect Dis. 2021] carbapenemase positive resistance is low in the USA compared to other countries.
Read 4 tweets
#IDTwitter #SIDPharm #microbiology

#AMRrounds A call is received about this laboratory confirmed blood isolate (step 1).
Step 2: Understand the natural and intrinsic resistance.
Step 3: Review local and regional epidemiology.
Read 4 tweets
#IDTwitter #SIDP #Microbiology

#AMRrounds This laboratory confirmed isolate is reviewed on rounds (step 1).
Step 2: Know the natural (intrinsic) resistance.

P. mirabilis and P. vulgaris are naturally R to polymyxin, nitrofurans, tetracycline, & tigecycline.
Step 3. Review of local and regional antibiogram and epidemiology.

Example is SENTRY surveillance
Read 6 tweets
Recién nacida, bajo peso al nacer: lesiones cutáneas vesículoampollosas anulares, violáceo-grisáceas, de predominio en espalda y miembros, con descamación de🤲y plantas, aspecto séptico, irritabilidad y tremulaciones
½

DOI: 10.1016/j.anpedi.2020.05.012
#pediatria #Pediatrics
Serología para sífilis de madre y RN:
PCR de Treponema pallidum (lesiones y LCR):➕

SÍFILIS CONGÉNITA PRECOZ

2/2
✏️MV Ordoño y col.
analesdepediatria.org/es-sifilis-con…
#microbiology #dermatology #MedEd #IDtwitter
La recien nacida recibió 10 días con penicilina G sódica I.V., con cicatrización de las lesiones del pénfigo sifilítico al nacimiento, persistiendo alopecia residual

#MedTwitter #Doctor #MedStudentTwitter
#resident #medicine #MedicalStudents #pediatric
Read 3 tweets
Cases of Mokeypox by Location (Casos de Viruela del Mono por Lugar) #MonkeyPox #RStats #IDtwitter #ViruelaDelMono #VirueladelSimio #VarioleSinge #VarioleDuSinge #DataScientist #elcarteldeSINADEF #Analytics $BAVA $BAVA.CO $SIGA #AI #100DaysofCode #AWS #TensorFlow #Python🧵(1/2) Image
Cumulative Cases of Monkeypox per Day (Acumulado de Casos de Viruela del Mono por Día) & Statistical Trend in the Count of Cases (Tendencia Estadística en Casos) #MonkeyPox #ViruelaDelMono #VirueladelSimio #VarioleSinge #VarioleDuSinge #IDtwitter $BAVA $BAVA.CO #RStats 🧵(2/2) Cumulative Confirmed Cases ...
Read 3 tweets
16 meses, dermatitis atópica: erupción vesículo-ampollosa, con agrupación distal, con edema (1 y 2), vesiculación y costra central; peribucal y nasal, con costras de aspecto melicérico (3) y erosiones en área del pañal
¼
👇
DOI: 10.1016/j.anpedi.2020.10.012
#pediatria #Pediatrics
PCR (frotis faríngeo, rectal y vesículas):➕para enterovirus. Se identificó Coxsackie, serogrupo A6

ECCEMA COXSACHIUM

Forma de enfermedad mano-pie-boca atípica, por serogrupos menos frecuentes, como Coxsackie A6
2/4

✏️D Pérez-González y col
analesdepediatria.org/es-eccema-coxs…
#pediatric
Esta variante de enfermedad boca-mano-pie presenta erupciones vesículo-ampollosas generalizadas, con predominio en zona perioral, área del pañal y extremidades, especialmente en zonas de dermatitis atópica.
¾

#MedEd #IDtwitter #MedTwitter #Doctor
Read 4 tweets
#MonkeyPox #IDtwitter

My patient with MonkeyPox suspicion is now confirmed by PCR.

I can share with you some important details that I could not before.

➡️ The bottom line of this tweet will be; «We must have a high index of suspicion for ‘atypical’ MonkeyPox cases»

(1/4)
~20-30y man

-May 6-7 ; sexual contacts with positive cases
-May 15; single ~0,5 cm macule ➡️ papule ➡️ vesicle/pustule on the penis. Not painful (❗️)
-May 16; painful left inguinal lymphadenopathy

(2/4)
-May 17; Progression of the single penis lesion. Small crust at the center. Not painful (❗️)

-May 19; Lesion is now ~1,3 cm and mostly crusted with vesicle borders. + 2 or 3 small vesicular «satellite lesions» around it.

(3/4)
Read 5 tweets
1/
The only good thing to come of finding this on my leg last week: I learned enough to write a #tweetorial about it

A 🧵/twitter PSA about what to do if a tick comes for you – & what neuro presentations you can see w/ tick-borne illnesses

#MedTwitter #NeuroTwitter #IDTwitter
2/
After time outside in a non-wooded area, I found this on my leg. I didn’t realize what it was, so I grabbed it & flung it off... only to then find a very active, crawling tick on my counter. 😱

So after freaking out for a moment (or 2), I had to figure out what to do with it.
3/
Memories from med school flashed into my head of what you’re SUPPOSED to do:

1⃣ Remove tick w/ tweezers
2⃣ Grab close to skin & pull tick off without twisting so it doesn’t break apart
3⃣ Disinfect

Since I had already accidentally messed up 1⃣ & 2⃣, I started w/ 3⃣
Read 17 tweets
As the monkeypox virus (MPX) outbreak continues, a lot of data emerging in real-time & being rapidly disseminated (as well as misinformation). I complied the unfolding scientific data (with direct links to papers and threads) on what we (don’t) know so far. #IDTwitter 🧵(1/n)
First, MPXV is not a novel virus. It is a viral zoonosis first discovered in 1958, with the first human infection reported in 1970. It is classified as a high priority pathogen by WHO, cases mostly identified in central & western Africa until now. (2/n) (who.int/news-room/fact…\)
Confirmed and suspected cases of #MonkeyPox now reached 145 among 13 countries with 20 cases in the UK. The main concern is that there are non-travel associated cases in Europe, meaning there is likely unnoticed community transmission. (3/n)
Read 29 tweets
#IDTwitter #SIDPharm #microbiology

Sunday #AMRrounds : A call is received about this laboratory confirmed isolate (Step 1) from a complex burn wound with clinical features consistent with infection.
Step 2: A quick review of the intrinsic resistance is performed on rounds.

Ambler class C BL gene AmpC for beta-lactam resistance and LPS-modifying genes for polymyxin resistance.
Step 3: A review of the local and regional antibiogram is performed as well as a review of the current epidemiology of carbapenemase-producing Enterobacterales.

doi.org/10.1093/infdis…
Read 6 tweets
Happy Friday!!
As I prepare for a panel discussion on PCN allergies and de-labeling, I learned, or re-learned, some interesting facts.
Here are five that may (or may not) be new to you:

1) Approximately 75% of PCN allergy labels are applied by the age of 3.
2) However, rashes in children correlated temporally with PCN administration <3% of the time.

3) 2 in 5 adults will be re-labeled as PCN allergic and/or avoid PCNs despite successful challenge/de-labeling. Patient pocket cards have shown to prevent this.
4) Oral amoxicillin challenge successfully de-labels all PCNs as it contains the basic PCN structure and aminoPCN side chain compared to PEN ST. PEN ST misses those with selective aminoPCN hypersensitivities, which seem to be more reported in 🇪🇺 and 🇦🇺
Read 4 tweets
-----KING PSEUDOMONAS------(after @DGlaucomflecken)
--A short #tweetorial on why Pseudomonas is so evil—
#medtwitter #IDTwitter
@ThinkingCC @iceman_ex @avkwong @ABsteward
/1 Image
Let's start with why it's green?
/2
Pseudomonads produce pyocyanin and pyoverdine that give it greenish colour on agar. Hence the name "aeruginosa" meaning "copper rust". Frank Pseudomonas pus can also look greenish for the same reason.
/3 Image
Read 25 tweets
#IDTwitter #SIDP #microbiology

AMR/AST Rounds: A call is received about this urine isolate also found in the blood.

You are requested to teach the students, residents, and fellows antibiogram reading.

The microbiology lab QC confirms identification (Step 1).
Step 2: Isolate has natural resistance to AMX/AMP via chromosomal SHV-1 (inhibited by CLAV greater that SULB).

Step 3: Local and regional epidemiology is reviewed for data.
Step 4: Key agents or markers for resistance mechanisms.

The higher MIC to CRO compared to CAZ suggests this is CTX-M rather than TEM-3 or SHV-2.
Read 4 tweets
#IDTwitter #SIDP #microbiology

AMR & Interpretive Antibiogram Reading: A call is received about this respiratory isolate.

Step 1: The microbiology lab ensures this is the correct identification for this microorganism.
Step 2: Know the intrinsic and acquired resistance of the microorganism.
Step 3: Search data for local and regional epidemiology if possible from hospital or regional antibiogram or peer-reviewed literature.

Example is SENTRY surveillance 2014-2019.
Read 4 tweets
2⃣'s a party3⃣'s a charm🔸#COVID19 Vaccines Newsroom #3🔸😷#immunocompromised & hosp 🏥, teens, MIS-C,🤰🔸w/ @aetiology @DrOnyemaOgbuagu @SVermund🔸🏆#CME from @NJHealthMedEd @BonumCe 🔗bit.ly/3rFA28H🔸Supported by an edu grant @JanssenUS twitter.com/i/broadcasts/1…
2/Last #webinar in #COVID19💉series🔚
Get ur🆓#CME while u can⌛️
CMEℹ️👉bit.ly/3rFA28H

⚠️Please answer⚠️
🟢 PRE-polls before 📽️👇
🔴 POST-polls after👇
🟠or🔗 bit.ly/3uRgMqD for #CME

😷#MedTwitter #IDTwitter #ObGynTwitter HCPs
🟢What are your credentials❓
3/ 🏆#CME credit provided by @NJHealthMedEd
🤝In partnership w/ @BonumCe
👇Newsroom #3 CME info 👇 Image
Read 12 tweets
Late breaker session at #ECCMID2022 on acute hepatitis cases of unknown origin in children.
So far, 169 cases have been reported from 11 countries since first case was identified in 31 March. 17 have required liver transplant & at least one death has been reported. #IDTwitter
Almost all cases had high transaminases, majority of children have been hospitalised. No common exposure has been identified, no link to COVID19 vaccination. Adenovirus F41 was identified in several cases, but it doesn’t fully explain the clinical severity observed. #ECCMID2022
But there are still many uncertainties about acute hepatitis cases observed. Especially the # of cases, exact age group, clinical presentation, uncertain test results as not all cases were tested for adenovirus, risk factors and transmission routes remain unclear. #ECCMID2022
Read 15 tweets

Related hashtags

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!