#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

#tularemia cdc.gov/mmwr/volumes/6…

#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

Indiana University Infectious Diseases Fellowship

@IUIDfellowship

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

Indiana University Infectious Diseases Fellowship

@IUIDfellowship

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

#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

Indiana University Infectious Diseases Fellowship

@IUIDfellowship

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

Indiana University Infectious Diseases Fellowship

@IUIDfellowship

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