#idboardreview 50 M s/p renal transplant 50 days ago, present w/ fever, seizures, pneumonia, skin lesions. Biopsy with wide ribbon aseptate hyphae, typical fruiting head on SABDX, LPCB stain. dx? #meded #idmeded #idtwitter ImageImageImage
#Cunninghamella bertholletiae characteristic sporangiophores with swollen terminal vesicles and ovoid sporangioles
#Mucormycosis aggressive, angioinvasive fungal infection that afflicts immunocompromised pts. Its acquired primarily via inhalation of environmental sporangiospores or via direct inoculation during trauma.
#mucormycosis most common cultured confirmed cases: #Rhizopus(47%), Mucor species(18%), #cunninghamella(7%), #apophysomyces 5%), #saksenaea (5%) #rhizomucor (4%) with other species (8%). Tx amphotericin f/b oral posa or isavuconazole if feasible

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More from @IUIDfellowship

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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high calcineurin inhibitor trough levels in month before dx

use of tacrolimus

corticosteroid dose at time of dx

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length of stay in ICU after SOT

academic.oup.com/cid/article/63…
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6 Dec
#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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#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
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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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R.f poor oral hygiene, pharyngitis, & mucosal ulcerations
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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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