#idboardreview 45 F w/ 1 cm nodule located near a scar from a previous mastectomy. +travel to several western & central European countries within the past year. The nodule was removed and tissue sections shown. Dx? #medEd#idmedEd#IDtwitter
#dirofilaria#repens
-definitive hosts include primarily wild and domestic canids, and occasionally felids
-various mosquito vectors from the genera Aedes, Culex, and Anopheles
#dirofilaria#repens exclusive to Old World, infecting 🐕 🐈 across Europe, Asia, Africa. In Europe, Mediterranean region is considered highly endemic (expanding with transmission has been documented as far north as Finland and East into European Russia)
#dirofilaria clinical presentation subcutaneous nodules: often tender, may be fixed or migratory. -occur in various locations mostly exposed area e.g. scalp, arms, legs, eyelids, chest) but occasionally in deeper tissue such as breast, epididymis, spermatic cord, subconjunctiva.
#idboardreview 30 MSM PLWH Cd4 800 VL<20 on ART presents w/ 2wk abd cramps & watery diarrhea. Blood agar: translucent, flat bacterial colony that appeared to spread across plate. Dx? #medEd#idmedEd#IDtwitter
#Shigellosis acute diarrhea, vomiting & abdominal cramps. (1) Stools often contain blood, although some have watery diarrhea. Rarely, severe shigellosis may be complicated by rectal prolapse, intestinal obstruction & colonic perforation. Post infect Reactive arthritis 1-2 wks
#IdBoardReview 30 pt w/ RA on TNFblocker non-healing lesion of finger x several months. Original trauma cut by stone in pond. no improvement w/ courses of cephalexin or clindamycin. S/p I&D growth in 14d. Dx? #medEd#idmedEd#IDtwitter
#Mycobacterium#marinum slow growing #NTM in fresh or saltwater environment. Cutaneous infect due to direct inoculation of a cut w/ organism & subsequent exposure to contaminated water. can be nodular, pustular, or ulcerated & infection of deeper tissues, joints, & bone can occur
immune reconstitution inflammatory syndrome #IRIS exaggerated atypical inflammatory response following initiation of ART either paradoxical worsening or unmasking of a infection
#IRIS memory T cells are redistributed from lymphoid tissue to organs, and the number of CD4+ and CD8+ T cells increases faster than that of regulatory T cells, resulting in an imbalance in the immune system
#Histoplasmosis-associated #IRIS rare with an estimated incidence rate of 0.74 cases per 1000 HIV-infected person-years and may present months after initiation of ART
#idtwitter 30 M on beach vacation now comes w/ rash progressive x24h, fever, headache, myalgia x3d. PE: sun exposed areas scattered confluent raised erythematous & pruritic red plaques w/ vesicles & plaques most at same stage. small ulcers+lip. Dx? #medEd#idmedEd#idtiwtter
actinic #varicella post sun exposure. needs airborne isolation
Actinic #varicella is a rare presentation of primary varicella zoster virus infection. Lesions may be arise in same stage unlike typical varicella