1/ A great part of our newest ep. is the discussion about immigrant & refugee health assessments. Check out the great image from our guests @AliceCLehman@LeaGoren@thie0149 ! 👇
2/ Children born outside of the US are vulnerable to increased morbidity due to the lack of awareness of their migration journey and indications for screening/tx. @AliceCLehman outlined some of the definitions that are often used
3/ A key point from @AliceCLehman: refugee children are provided predeparture screening/treatment, which is coordinated with the International Office of Migration -- but immigrant/migrant children do not always undergo the same screens; may have variable predeparture environments
4/ Here are images of the domestic or arrival screening from the episode graphic as well as the @AmerAcadPeds Immigrant Child Health Toolkit
7/ Your local health departments or institutions/clinics may also have resources for specifically providing care to these families. For example, here is the page from the MN Dept of Health health.state.mn.us/communities/ri…
8/ Hope this 🧵 was helpful, more learning and another graphic to come from our UMN team!
3/ There are 2 algorithms - do you know what your lab uses?
📘Trad'l starts with nontrep test ➡️then uses trep test to confirm dx
◀️Reverse sequence starts with TT➡️then use NTT to stage your pt
Use this diagram to help sort the possible scenarios 👇
2/💉Bacille-Calmette-Guerin (BCG) immuniz. against TB is a group of related live vaccines derived from attenuated M.bovis.
🌏Used in >100 countries, most widely administered vaccine in world
🧠Given to ⬇️incidence of TB meningitis + miliary dz in children
1/ Liver abscess is estimated to occur in about 1/3 of patients with CGD. In the episode, we discussed how a liver abscess may have distinct characteristics in the setting of CGD
2/ PLA in CGD:
📌septate mass surrounded by a thick pseudocapsule
📌Inside=dense inspissated fluid.
📌Can be homogenously enhancing on imaging while small, but then develop mult locules separated by thick enhancing septations with intense halo/rim of enhancement around abscess
2/ A lot of info for 1 page but a few 🗝️points:
🔸Pyogenic+amebic liver abscess can be indistinguishable on imaging
🔸Echinococcus: check out the WHO classification
🔸Ddx mul small solid nodular liver lesions has a wide ddx. For ID, includes TB/Bartonella/Disseminated fungal inf
3/ Here is a nice summary article tackling liver infection imaging + potential pitfalls:
The authors had a flowchart to help think about ddx based on imaging ➡️their 1st branch point = dominant cystic lesion or multiple small solid nodular lesions?