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30 Sep, 6 tweets, 5 min read
#idboardreview 25 M 1 wk post vacation in california mountain cabin: febrile x3d then felt better for 7d and now having fevers again, chills, myalgia, dyspnea progressed to ARDS. wbc3k, Hb11, plt20k, peripheral smear shown. Dx? vector? reservior? #idmeded #IDTwitter Image
#borrelia #hermsii vector: tick, reservoir: rodents
-In USA: spirochete in bloodstream: agents of tick borne relapsing fever #TBRF including B. hermsii
-Spirochetes: genera Spirochaeta, Treponema, Borrelia, Leptospira
-Other regions Borrelia recurrentis louse-borne relapsing F
cdc.gov/relapsing-feve… #LBRF #borrelia
Occasionally a macular rash or scattered petechiae may be present on trunk & extremities. Less frequently, jaundice, hepatosplenomegaly, meningismus, and photophobia. #borrelia #hermsii #TBRF ImageImage
#borrelia #hermsii transmitted via bite of #Ornithodoros #ticks. These ticks typically feed <30min at night.
Rodents are vertebrate reservoirs & cabins located at elevations 2k-7k feet in coniferous forests are sites.
#TBRF

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Indiana University Infectious Diseases Fellowship Profile picture
9 Dec
#idboardreview 60 F recent travel to Cairns, Australia, had multiple🦟 bites, 1wk later fever, fatigue, headache, myalgia & arthralgia of hands, wrists, feet & ankles. +itchy papular rash on her face, neck and trunk.Dx? #meded #idmeded #IDTwitter Image
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#idboardreview 60 M 6 months post heart transplant on atovaquone px presents w/ cough, dyspneax10d. CT b/l nodules w/ cavities, l leg mass aspirated. Dx? #meded #idmeded #IDTwitter ImageImage
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patient age

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academic.oup.com/cid/article/63…
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#idboardreview Pt w/ LE venous insufficiency found in his camper unconscious and covered in feces and maggots: septic shock, wbc 35k, Cr 6, blood culture w/ gram negative non-motile bacteria. Dx? #meded #idmeded #idtwitter Image
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#idboardreview 60 F with Myelodysplastic syndrome presents w/ L knee pain, rash on unilateral sole, PET: L iliac artery uptake. Knee fluid 80k 98% PMN, gram stain gram negative cocobacilli. dx? #meded #idmeded #idtwitter ImageImage
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Indiana University Infectious Diseases Fellowship Profile picture
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#idboardreview 50 M Texan welder w/ diarrhea, cough, dyspnea x2d, presented to ED, sepsis and rapid progression to resp fail & death <8hrs after presentation. CT necrotizing pneumonia. +GPR #idtwitter #meded #idmeded ImageImage
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