Discover and read the best of Twitter Threads about #idboardreview

Most recents (24)

#idboardreview A college football player w/fever & Left leg hot tender erythema from ankle to mid-calf. There is no nodularity, fluctuance, drainage, purulence, or evidence of lymphangitis. Antibiotic choice? #idtwitter #idmeded #meded pic for ref only
non-purulent cellulitis likely due to strep pyogenes so first gen cephalosporins so cephalexin or cefadroxil is reasonable choice
Ref IDSA SSTI guidelines…
Read 3 tweets
🧵1/3 #IDtwitter first trivia of 2023!#TxID

45 F w/Hx of hypertensive nephropathy complicated by ESDR s/p kidney transplant 7 mo ago, on tacrolimus & MMF. CMV D+R-, who after completing prophylaxis w/ valganciclovir for 6mo is admitted with 3 wks of watery diarrhea
2/3 Colonoscopy findings consistent with CMV colitis. Initial CMV DNAemia 800 IU/mL. Patient’s immunosuppressive regimen is reduced, and she is treated with ganciclovir 5 mg/kg IV every 12 hours.
3/3 After one week, despite medical treatment diarrhea persists, with up to 6-8 episodes daily.

A repeated CMV DNAemia is 805 IU/mL. What would you do next? 🤔 #IDboardreview
Read 7 tweets
#idboardreview 17 M w/hx of meningitis s/p course of iv ceftriaxone. Now 2 wks later present with fever, RUQ abd pain. Ultrasound: gallstones that disappeared on repeat imaging in 2 weeks. dx? #idtwitter #idmeded #meded
#Ceftriaxone-associated #pseudocholelithiasis Ceftriaxone, excreted & concentrated in gallbladder bile, can form a precipitate, ceftriaxone–calcium salt, which may cause biliary sludge formation rarely in pts who receive high-dose treatment (≥2 g)
incidence around 20%. #ceftriaxone induced #pseudocholelithiasis occurs within 4–17 days of administration & generally disappear by 10–26 days after ceftriaxone discontinuation 10.1016/s0140-6736(89)90228-6
Read 5 tweets
#idtwitter #idboardreview by our now faculty @mmcclean1 @CIDJournal @SamirGu02674263… 58 M Indiana farmer using manuer fertilizer x months w/progressive cough, dyspnea, pleuritic chest pain, chills x11mo: CT: pulm nodules. BC: gram+bacilli #meded
#Rhodococcus hoagii (previously R equi) bacteremia with septic pulmonary emboli
-aerobic gram+coccobacillus
-Cells adopt a coccoid morphology when grown on solid media &
-in liquid media bacilli of varying lengths that often appear beaded in gram-stained preparations are formed
#rhodococcus Diagnosis requires a high index of suspicion, thorough history, and accurate laboratory identification methods. Can be mislabeled as corynebacterium on blood culture or kocuria on vitek
Read 4 tweets
🧵 #IDtwitter , the #ImagesinID files bring us this tongue lesion 🔍 🗂 #IdBoardReview #MedTwitter

44 year old male, HIV (+), non adherent to antiretroviral therapy (CD4 120) presents for evaluation of this lesion: Image credits: Academia Esp...
🤔 The most likely microorganism responsible for this finding is:
🪡1/5 B) Treponema Pallidum

This patient presents with a syphilitic gumma in the setting of tertiary syphilis

Although gummatous disease is uncommon, HIV patients have an increased risk of developing gummas most frequently in the oral cavity, skin or a viscera.
Read 7 tweets
🤔 📖 📱

Is Twitter The New ID Textbook?

Bugs, Drugs, and Social Media – Twitter as a Tool for Advancing the Field of Infectious Diseases

My #ECCMID2022 slides as a 🧵 1/n
Many ingredients in the kitchen of social media can be combined to create different products which supports advancing ID through SM.

Each activity can support one or multiple domains of 🧠 Blooms Taxonomy.

Get creative with your recipes to create new fun stuff! 2/n
One of the best accounts out there on SM @DGlaucomflecken - huge reach in short period, recent ASP skit in vertical video, very entertaining & original, uses several SM platforms.

REMEMBERING domain: ⚠️ beware inappropriate meropenem prescribing.

Read 11 tweets
#IdBoardReview Amazonian farmer w/ multiple skin nodules of L leg x20+yrs (which itch & bleed frequently)started post penetrating injury w/ thorn of a plant. biopsy chronic granulomatous process: dermis w/ thick walled round fungi forming single chains. #IDTwitter #meded
Read 5 tweets
#idboardreview Pt recent travel to Malaysia, spend time on the beach now w/ this itchy rash x2wks. Also w/ cough, occasional dyspnea, eosinophilia, ill defined reticulonodular infiltrates on chest CT #idtwitter #idmeded #MedEd
cutaneous larva migrans (#CLM) with #Löeffler’s syndrome. Tx w/ albendazole x7d and symptoms resolved Ref…
Cutaneous larva migrans frequent travel-associated skin diseases on beach destinations in tropics or subtropics. #Ancylostoma braziliense. Most lesions are on lower extremities. Larvae migrate aimlessly within epidermis at rate of 2mm to 2cm/day lacks enzymes to penetrate deeper
Read 5 tweets
🧵 1/5 Hello #IDtwitter. Here is our weekly #IDtrivia 📖 #IDboardreview #TxID #MedEd

37 y/o F PMHx of lupus nephritis complicated by ESRD s/p living-donor kidney transplant 5 months ago, who presents with 3 days Hx of dysuria, hematuria, pelvic pain and subjective fever
2/5 She denies recent lupus flares. Patient is taking tacrolimus, mycophenolate, prednisone and TMP-SMX. Vaccinated against COVID-19x3. No sexually active for the past year. PreTransplant HIV,CMV,HepBC, adenovirus, Toxo and trypanosoma serologies (-) for both patient and donor.
3/5 On presentation BP 140/90 HR 78 RR 16 T 101 O2Sat98% RA. Hydrated mucous membranes. Clear chest to auscultation, normal heart sounds. Abdominal scar healed no signs of infection. Tenderness to palpation of hypogastrium. No CVA tendernesses.
Read 5 tweets
🧵1/5 #IDtwitter, this is our weekly #IDtrivia 📚

39y/M with no PMH, presents to the ED for evaluation of fatigue, anorexia, and diarrhea of 3 weeks duration. ROS is positive for weight loss, night sweats and an intermittent maculopapular rash located on his chest
2/5 Patient denies recent travel, sick contacts. He works as a bus driver. Sexually active with cis male partners, no condom use, takes PrEP occasionally. Hx of treated syphilis, last HIV and QuantiFERON-TB 6 months ago negative
3/5 On presentation BP88/68 HR90 RR20, T98.7,lethargic, AOx3. Chest clear to auscultation,normal heart sounds, abdomen tender to palpation of mesogastrium. He also had a diffuse rash (pic) (Image credit cureus)
Read 10 tweets
#idboardreview 80 M originally from Philippines w/ yearly travel there, presents w/ fever, abd pain, chills, inc LFTs, +liver abscess. BC+ organism? #meded #idmeded #idtwitter
hypervirulent #klebsiella pneumoniae liver abscess Ref…
Infections with #hypervirulent #Klebsiella pneumoniae isolates most frequently occur among pts with an Asian, Pacific Islander, or Hispanic ethnic background, even in absence of travel to high-prevalence areas (eg, Asian Pacific Rim). Diabetes is also a risk factor
Read 5 tweets
#idboardreview 40 M originally from Cameroon, also travel to Ghana & Mali, now w/6 mo progressive weakness requiring wheelchair use,lethargy, 30lb wt loss, confusion. CSF lymphocytic pleocytosis. dx? #meded #idmeded #IDtwitter
Human African #trypanosomiasis endemic to sub-Saharan Africa & fatal when untreated. parasite Trypanosoma #brucei transmitted by tsetse fly (Glossina spp) vector
2 dz forms T #brucei #gambiense West/Central Africa: slowly progressive illness leading to progressive sx & death over mo-yrs
-T brucei #rhodesiense eastern/ southern Africa: more acute illness that evolves over a span of wks, leading to death w/in months
Read 9 tweets
#idboardreview patient on chronic steroids with bilateral lung nodules and skin lesions. Skin AFB stain shown. dx? #meded #idmeded #IDtwitter
#Nocardia species form long, branching, beaded filaments. Organisms that stain with #modified #AFB:
Mycobacterium species
Legionella micdadei (in specimens only)
Nocardia species
Rhodococcus species
Tsukamurella species &
Gordonia species
Read 3 tweets
#idboardreview 60 F recent travel to Cairns, Australia, had multiple🦟 bites, 1wk later fever, fatigue, headache, myalgia & arthralgia of hands, wrists, feet & ankles. +itchy papular rash on her face, neck and trunk.Dx? #meded #idmeded #IDTwitter Image
Read 6 tweets
#idboardreview Peritoneal dialysis pts with exit site infection outbreak. Aqueous Chlorhexidine with gram negative bacteria. dx? #meded #idmeded #idtwitter ImageImage
#Burkholderia #cepacia is type species of genus Burkholderia & ubiquitous MDR, motile, non–glucose-fermenting, gram-negative organism found in water & soil. Major pathogen in cystic fibrosis & opportunistic pathogen in pts w/ indwelling medical devices & immunosuppression
Read 7 tweets
#idboardreview 60 M 6 months post heart transplant on atovaquone px presents w/ cough, dyspneax10d. CT b/l nodules w/ cavities, l leg mass aspirated. Dx? #meded #idmeded #IDTwitter ImageImage
Risk factors of #nocardia in #SOT

high calcineurin inhibitor trough levels in month before dx

use of tacrolimus

corticosteroid dose at time of dx

patient age

length of stay in ICU after SOT…
Read 7 tweets
#idboardreview Pt w/ LE venous insufficiency found in his camper unconscious and covered in feces and maggots: septic shock, wbc 35k, Cr 6, blood culture w/ gram negative non-motile bacteria. Dx? #meded #idmeded #idtwitter Image
#Wohlfahrtiimonas #chitiniclastica bacteremia Ref… in this case identified w/ MALDI-TOF; Image Ref…
#Wohlfahrtiimonas #chitiniclastica was first identified in culture from the third-stage larvae of Wohlfahrtia magnifica flies which are known to cause myiasis, commonly in sheep and cattle
Read 5 tweets
#idboardreview 60 F with Myelodysplastic syndrome presents w/ L knee pain, rash on unilateral sole, PET: L iliac artery uptake. Knee fluid 80k 98% PMN, gram stain gram negative cocobacilli. dx? #meded #idmeded #idtwitter ImageImage
Endovascular Infection #Kingella #kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient Ref…
#Kingella kingae gram-negative coccobacillus,normal flora of upper respiratory tract. Causative agent of osteoartricular infections in kids<4 years. Rarely HACEK IE in adults
R.f poor oral hygiene, pharyngitis, & mucosal ulcerations
Read 6 tweets
#idboardreview 50 M Texan welder w/ diarrhea, cough, dyspnea x2d, presented to ED, sepsis and rapid progression to resp fail & death <8hrs after presentation. CT necrotizing pneumonia. +GPR #idtwitter #meded #idmeded ImageImage
Read 10 tweets
#IdBoardReview sudden onset of fever, bronchitis, pneumonia, severe resp illness outbreak in pts of all ages/immune status that attended a game last week. BAL pleomorphic gm- bacteria. What type of isolation? #IDtwitter #idmedEd #medEd Image
Inhalation #tularemia bioterrorism needs standard precautions as
Not transmitted from person to person…
Read 5 tweets
#idboardreview A pt wearing same contact lens for 3 months presents with cloudy vision, photophobia and increasingly exquisite pain in one eye not improved w/topical and oral abx and antivirals. dx? #idmeded #meded #idtwitter ImageImage
Read 3 tweets
#idboardreview 60 M asymptomatic who recently travelled to Ethiopia underwent screening colonoscopy and this worm was found. Dx? #meded #idmeded #idtwitter Image
The nematode (roundworm) #Trichuris trichiura, also called the human #whipworm Ref @CDCgov…
Read 3 tweets
#idboardreview 50 M s/p renal transplant 50 days ago, present w/ fever, seizures, pneumonia, skin lesions. Biopsy with wide ribbon aseptate hyphae, typical fruiting head on SABDX, LPCB stain. dx? #meded #idmeded #idtwitter ImageImageImage
#Cunninghamella bertholletiae characteristic sporangiophores with swollen terminal vesicles and ovoid sporangioles
Read 8 tweets
#idboardreview 25 F w/ gross hematuria x 1 mo. Previous remote travel to Kenya & swimming in fresh water lake +eosinophilia, thickening of bladder. Sandy patches appearance in cystoscopy. #IDtwitter #idmeded #meded ImageImage
Morbidity caused by #schistosome infections is induced by host reaction to eggs of Schistosoma rather than by adult worm itself. Hematuria is classic symptom of urogenital schistosomiasis & often w/urinary frequency, burning micturition, and suprapubic pain or discomfort
Read 9 tweets

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