Discover and read the best of Twitter Threads about #idbr

Most recents (7)

#MayoIDFellowship Core Curriculum Lecture series

Dr. Wengenack asked our fellows to identify this fungi with “spaghetti and meatballs” appearance. #IDBR #MayoIDQ

Microbiologists identify #Malassezia as the “spaghetti and meatball” yeast that causes the prototypical recurrent skin disease, tinea / pityriasis versicolor, characterized by hypo/hyperpigmented plaques and scales, often seen over the back, chest, and neck.
#Malassezia species are obligatory lipophilic and requires oil for growth.

BONUS point!
Name the major zoophilic species of Malassezia that does NOT require lipids for growth.
Read 3 tweets
Weekend Digest

Name the Pathogen

5 Clues:

- #Chitlins
- #Iron sepsis
- Mesenteric #adenitis
- Reactive #arthritis
- Terminal #ileitis Image
#Yersinia enterocolitica

It is #zoonotic and is acquired by exposure to contaminated food.

When #IDBR says #chitlins (#chitterlings), you say Y. enterocolitica

Chitlins are food made of pork intestines (where Y enterocolitica resides)…
#Yersinia enterocolitica

Enterobacteriaceae #GNB that causes #enterocolitis, diarrhea (often bloody), terminal #ileitis, mesenteric #adenitis, and RLQ pain that may be mistaken as #appendicitis (#pseudoappendicitis)
Read 6 tweets
Weekend Digest

Name the pathogen

5 clues

GNB with musty odor
Clenched fist injury
Culture negative endocarditis
Needle licker osteomyelitis
Toothpick septic arthritis Image
#Eikenella corrodens

Part of human oral flora

Component of polymicrobial infection related to human bites.

#IDBR buzzword is clenched-fist injury – when it is inoculated to injured knuckle of a clenched fist that strikes teeth of an opponent.…
#Eikenella corrodens is the “E” in HACEK – agents of culture negative endocarditis

HACEK organisms can now be cultured with current culture techniques, hence they should no longer be called “culture negative” pathogens!
Read 9 tweets
Weekend Digest

Name the pathogen.

Pain and discomfort when you pee
But Hans Christian Gram cannot see
Try to kill me with Doxy
Moxi chaser sets you symptom-free. Image
#Mycoplasma #genitalium

“Cause of #NGU not visible by Gram stain and treated with two-stage approach using #doxycycline followed by #moxifloxacin chaser!”

Fellows, this is #IDBR material, definitely!
#Mycoplasma #genitalium

Men: persistent / recurrent non-gonococcal urethritis (NGU) / non-chlamydia urethritis

Women: cervicitis, PID, preterm delivery, spontaneous abortion, infertility

Many infections are asymptomatic!
Don’t forget: rectal / pharyngeal infection
Read 5 tweets
45M CC: tender mass on left thigh that started as an “insect bite” 4 days ago. No F/C. PE: tender fluctuant 2-cm mass with surrounding erythema.

After I&D of abscess in the clinic, what do you recommend?
2014 IDSA guideline recommends incision and drainage of purulent SSTI (abscess)

Antibiotics vs MRSA / S. aureus as an adjunct to I&D if:
2. Failed initial Ab Rx
3. Impaired host defense

Any new data since then?…
After 2014 IDSA guideline, placebo-controlled RCTs were published on use of antibiotics (TMP SMX or clindamycin) for uncomplicated SSTI abscess ... (next)…
Read 5 tweets
Weekend Digest

Name the pathogen!

H & E stain of heart tissue of a 27M who developed severe intractable heart failure 2 months after an allogeneic bone marrow transplant for acute leukemia.

Clue: consumption of food / water contaminated with feces of snakes
1. Sarcocystis hominis, suihominis, nesbetti, others
2. Zoonotic: 2 forms for human infection
3. Intestinal and muscular sarcosystosis
4. Dx: intestinal (O/P), muscular (biopsy)
5. Rx: not well defined; TMP-SMX, albendazole, others…
Intestinal #Sarcocystosis
1. Ingestion of sarcocyst (S. hominis / beef, suihominis / pork) in tissue
2. Sarcocyst digested —> bradyzoites —> intestinal infection / gametes —> oocysts / sporocyst detected in stool
3. Self limited. No Rx needed…
Read 5 tweets
70M with swollen R 5th digit, hand and forearm. No fever / chills.

MRI: complex multi-compartment fluid collection with extensive flexor and extensor tenosynovitis

Debridement. Culture (photo).

What is your diagnosis and Rx?
#MayoIDQ MCQ to follow... Image
Elderly man with swollen right hand and forearm. MRI: complex fluid collection, extensive tenosynovitis. Debridement performed. Culture is shown (photo prior tweet).

Which of the following is the exposure associated with this infection?
Beaver dam and blastomyces

When #IDBR says #beaverdam - you think #BLASTOMYCOSIS…
Read 9 tweets

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