#idboardreview 40 F multiple sclerosis on natalizumab presents w/ coordination difficulties and cognitive impairment. MRI non-enhancing subcortical white matter frontal lesions hyperintense on T2 & hypointense on T1. Diagnosis? #medEd #idmedEd #IDtwitter
#progressive multifocal leukoencephalopathy (PML) increase risk with #natalizumab
#PML Ref P&P ID Mandell
#PML is a rare but often lethal and untreatable disorder of CNS with large white-matter lesions typically occurring in immunocompromised patients: HIV & impaired cellular immunity from other causes, anti–α4-integrin tx w/ natalizumab
#PmL pathogenesis primary infection w/ JC virus is asymptomatic & becomes latent. 39% healthy ppl have +pcr in tonsillar tissue. +pcr in urine so kidney also site of latency. Also detected in bone marrow & brain.
#JCV infects oligodendrocytes & astrocytes in brain & rarely spinal cord: lyric lesion that destroys mylein sheath

• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Indiana University Infectious Diseases Fellowship

Indiana University Infectious Diseases Fellowship Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @IUIDfellowship

27 Feb
#idboardreview 70 F presents w/ fever, myalgia, dyspnea: CXR RLL pneumonia/effusion, resp fail leading to death. Her dog recently died who was seen with rabbit caracass. Diagnosis? #medEd #idmedEd #idtwitter Image
#tularemia transmission via tick (dog tick, wood tick & lone star tick) or deer fly bite, handling infected animals, inhaled contaminated aerosole or dust (mowing over animals), contaminated water, potential for bioterrorism
Read 9 tweets
25 Feb
#idboardreview 50 F recent dental infection presents 4d of fever, R headache, L weakness. MRI ring enhancing lesion & aspirate w/ GPC ‘balls of yarn’ 🧶 diagnosis? #medEd #idmedEd #IDtwitter
#streptococcus #anginosus species brain abscess from odontogenic source
MRI demonstrate a ring enhancing lesion in R frontal lobe with vivid central restricted diffusion. The enhancing component has a complete low T2 rim #brain abscess Ref: radiopaedia.org/cases/cerebral…
Read 8 tweets
24 Feb
#idboardreview 50 M unstable housing presents w/ fever, hip & knee pain and swelling. Knee aspirate shows gram negative rod in chains w/ lateral bulbar swelling. Diagnosis? #medEd #idmedEd #IDTwitter Image
#Streptobacillus moniliformis, the etiologic agent of rat-bite fever
#Streptobacillus moniliformis highly pleomorphic, filamentous GNR nonmotile, non–acid-fast; may be fusiform & develop lateral bulbar swellings. 2 variants: L form: cell wall deficient nonpathogenic. Spontaneous conversion between 2 forms may be responsible for clinical relapses
Read 13 tweets
18 Feb
#IdBoardReview 20 F pet store worker presents w/ fever, headache, nausea, vomiting, abd pain & bloody diarrhea. They got new puppies last wk. Stool gram stain shown R to macrolide & FQ. Diagnosis? #medEd #idmedEd #IDTwitter
MDR #campylobacter #jejuni outbreak due to puppies exposed to antibiotics cdc.gov/mmwr/volumes/6…
#campylobacter Incubation period is typically 2-5days. Sx: diarrhea (frequently bloody), abdominal pain, fever, nausea, and sometimes vomiting. More severe illness can occur, including bloodstream infection and symptoms mimicking acute appendicitis or ulcerative colitis.
Read 10 tweets
17 Feb
#idboardreview 30 F 2nd/3rd molar pain now presents w/ fever, rapid bilateral cardboard swelling of neck, mouth open w/ tongue touching the palate. Diagnosis? #medEd #idmeded #IDTwitter
#ludwigs #angina loose term for infections of sublingual, submaxillary & submandibular spaces, always bilateral, rapid indurated cellulitis w/o lymphadenopathy w/o abscess. Behind from floor of mouth
#ludwigs #angina 50-90% dental source mostly 2/3rd msndibular molars. Brawny, woody, cardboardlike submandibular swelling that doesn’t pit. Mouth open due to swelling of tongue.
Read 8 tweets
16 Feb
#idboardreview 29 M from Cameroon 🇨🇲 w/ cough, dyspnea, hemoptysis & eosinophilia. Lung biopsy shown. Diagnosis? #medEd #idmedEd #IDtwitter Image
#ascariasis prominent alae, large excretory canals, coelomyrian muscle structure & intestine lined with microvilli
Read 7 tweets

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/month or $30/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!

Follow Us on Twitter!