#idboardreview 20 F w/ SLE on hydroxychloroquine & recently high dose steroids for SLE flare presents w/F, dyspnea, diarrhea, wbc6k, Na133, COVID/RVPneg, procal9, galactomann neg, dx? #meded#idmeded#idtwitter
#Legionella cavitary pneumonia is atypical presentation of Legionnaire’s disease & more commonly w/ impaired cellular immunity due to corticosteroids (particularly high-dose steroid), immunosuppressive therapy, organ transplant & HIV infection; Case Ref idimages
Cavitation seen w/ #Legionella pneumophila serotypes 1,3,4,5,6,8 as well as L. micdadei, L. bozemanae, L. dumoffii, L. longbeachae.
L. pneumophila 1 is main agent of Legionnaire’s disease. Non-serotype 1 & non-pneumophila Legionella occur in severely immunocompromised hosts
#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
#Burkholderia#cepacia is type species of genus Burkholderia & ubiquitous MDR, motile, non–glucose-fermenting, gram-negative organism found in water & soil. Major pathogen in cystic fibrosis & opportunistic pathogen in pts w/ indwelling medical devices & immunosuppression
#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
#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
#Wohlfahrtiimonas#chitiniclastica was first identified in culture from the third-stage larvae of Wohlfahrtia magnifica flies which are known to cause myiasis, commonly in sheep and cattle
#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