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16 Mar, 4 tweets, 4 min read
#IDTwitter, #IDFellows and #MedTwitter, You asked, and we listened!



The #IDFellowsCup will now be open to non-ID fellows. Welcome to the bleacher section!

@IDFellowsCup Image
We welcome Rookies (Anyone Pre-ID fellowship), Legends (those post-ID fellowship), and everything in between!
Participation includes the full game experience with questions, badges, and individual leaderboard.

Because this is a Fellows competition, you cannot join an individual team for the cup competition. But you can play as a large group (aka the bleachers).
We have a separate google form to sign up as a non-fellow forms.gle/ynxAr2y9kgyRBi…
and have the capacity for up to 100!

@TheRealDSrini
@k_vaishnani

As always, reach out to @IDFellowsCup with questions!

#IDtwitter #IDFellows #IDFellowsCup

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More from @ID_fellows

Infectious Diseases Fellows Network Profile picture
19 Mar
Hi #IDFellows and #IDTwitter, back with another case: 63F h/o ESRD on HD p/w fever. Blood cx positive for MSSA x 4 days. Blood cx clear on day 5 with Rx Cefazolin. TTE on HD2 without vegetations. What is the best next step?
1/ Let’s talk about when to get a TEE for Staph aureus bacteremia (SAB) to identify infective endocarditis (IE)!

This is a #IDControversy for #IDFellows & #IDTwitter. Let's examine the evidence.
2/ For background, SAB has a high mortality (~20%); determining the presence of IE changes the duration of treatment to 6+ weeks.

The sensitivity of TTE for IE is ~60-65% compared to ~95% for TEE. But TEE has associated costs & procedural risks (sedation, esophageal perf, etc)
Read 16 tweets
Infectious Diseases Fellows Network Profile picture
16 Feb
#IDTwitter #IDFellows
Introducing our new series: “IDFN top 10 articles every fellow should read”🔖

#1: SAB management
by @mmcclean1 @LeMiguelChavez
Reviewers @KaBourgi, @IgeGeorgeMD, @Courtcita, @MDdreamchaser

We know is subjective & expect feedback/future improvements 👇
1. Clinical management of Staphylococcus aureus bacteremia: a review.
pubmed.ncbi.nlm.nih.gov/25268440/
👉 A must read written by Holland et al. where they review the evidence of the management of SAB.
2. Impact of Infectious Disease Consultation on Quality of Care, Mortality, and Length of Stay in Staphylococcus aureus Bacteremia: Results From a Large Multicenter Cohort Study.
pubmed.ncbi.nlm.nih.gov/25701854/
👉ID consult associated with reduced inpatient mortality.
Read 16 tweets
Infectious Diseases Fellows Network Profile picture
20 Nov 20
1/ #IDTwitter and #IDFellows, here is another #IDboardreview question: 20F p/w pharyngitis w/fever. There is no cough. Exam: Cervical adenopathy; tonsillar exudate. Rapid Strep antigen test pos. You start to prescribe her Amoxicillin but there is an allergy alert.
2/ She reports an allergic reaction to penicillin around age 8 or 9. She had a rash but no other symptoms. It resolved following discontinuation of med. She did not receive any treatment. Which of the following would you do next?
3/ Today we are going to talk about everyone’s favorite – #penicillin #allergy!
Read 14 tweets
Infectious Diseases Fellows Network Profile picture
16 Sep 20
1/ Follow up for our #IDFellows and #IDTwitter on an #IDCase - 25 year old female with behcet's disease and chronic pain who presents for positive T Spot done for screening. Started on Rifampin for latent TB Infection. She calls 3 days later with diffuse pain.
2/ Great job, #IDTwitter, honing in on the issue! This was intentionally vague to stimulate discussion. As you alluded to, the key lies in what else she was taking. But first, what might we worry about as adverse effects Rifampin?
3/ Allergic reactions to rifampin are relatively rare though they have been described. However, patients may experience flushing, rash and itching that is unrelated to hypersensitivity. Rifampin can often be continued in these patients. PMID: 10575418
Read 10 tweets
Infectious Diseases Fellows Network Profile picture
1 Sep 20
1/
 Thanks to all that participated in our 1st live #IDFellowCase yest! Here is a wrap-up review tweetorial for reference + those who missed it.

Special thanks to @MDdreamchaser!

If you have feedback OR want to sign up to do a future case, use this form:forms.gle/cV4bRezYUCp6VR…
2/
 A case of 70F with ring-enhancing brain/lung lesions was presented. Here is how @MDdreamchaser walked thru the case:
1⃣Define pt risk of infection (e.g. splenectomy, steroid use)
2⃣Take presenting clinical syndrome
3⃣Tempo of illness: abrupt? gradual?
3/
 In this case, co-occurrence of brain-lung nodules was helpful clue

🖼️Infographic below

Also check out this 🧵 from @WuidQ


⭐️One other pearl. Embolizing disease might include endocarditis, Lemierre's dz, infectious aortitis, infected cardiac thrombus
Read 14 tweets
Infectious Diseases Fellows Network Profile picture
19 Aug 20
1/
 72F with CML had persistent fever ~102F, cough. CT chest with focal consolidation in LLL. Sputum cx: Klebsiella pneumoniae. Serum BDG, GM negative.

Was on Vanc/Cefepime/LAmB, now narrowed to Cefepime + afebrile 24h

Duration of Cefepime?
#IDTwitter #IDMedEd #IDFellows
Today’s #tweetorial is on fever + neutropenia!

Background:
Up to 50% pts with solid tumors & >80% pts with hem malignancy will develop fever during chemo cycle assoc’d with neutropenia
Only 20-30% of these identify clinical infection
Only 10-25% bacteremia
3/
 The very basics:
🔹Here is the classic article from 1966 that demonstrated ⬆️susc to infection as neutrophils<500
🔹Freq and severity of infection inversely proportional to neutrophil count
🔹Risk of severe infection and BSI greatest at ANC <100
pubmed.ncbi.nlm.nih.gov/5216294/
Read 15 tweets

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