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8 Dec, 7 tweets, 5 min read
#idboardreview Peritoneal dialysis pts with exit site infection outbreak. Aqueous Chlorhexidine with gram negative bacteria. dx? #meded #idmeded #idtwitter ImageImage
#Burkholderia #cepacia wwwnc.cdc.gov/eid/article/26…
#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
#burkholderia contamination is implicated in disinfectants & meds included intrinsically or extrinsically contaminated chlorhexidine, povidone–iodine, benzalkonium chloride, IV fluids or drugs, sodium docusate, eye drops, alcohol-free mouthwash & nebulized salbutamol & albuterol
#burkholderia #cepacia cdc.gov/hai/organisms/…
#burkholderia #cepacia journals.asm.org/doi/10.1128/CM…
#burkholderia #cepacia ImageImageImage

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More from @IUIDfellowship

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
#RossRiverVirus Ref eurosurveillance.org/content/10.280…
#RossRiverVirus @CDCgov cdc.gov/ross-river-vir…
Read 6 tweets
Indiana University Infectious Diseases Fellowship Profile picture
7 Dec
#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
#Nocardia #ignorata wwwnc.cdc.gov/eid/article/26…
Risk factors of #nocardia in #SOT

high calcineurin inhibitor trough levels in month before dx

use of tacrolimus

corticosteroid dose at time of dx

patient age

length of stay in ICU after SOT

academic.oup.com/cid/article/63…
Read 7 tweets
Indiana University Infectious Diseases Fellowship Profile picture
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
#Wohlfahrtiimonas #chitiniclastica bacteremia Ref wwwnc.cdc.gov/eid/article/27… in this case identified w/ MALDI-TOF; Image Ref jgid.org/article.asp?is…
#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
Read 5 tweets
Indiana University Infectious Diseases Fellowship Profile picture
5 Dec
#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
Endovascular Infection #Kingella #kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient Ref wwwnc.cdc.gov/eid/article/26…
#Kingella kingae gram-negative coccobacillus,normal flora of upper respiratory tract. Causative agent of osteoartricular infections in kids<4 years. Rarely HACEK IE in adults
R.f poor oral hygiene, pharyngitis, & mucosal ulcerations
Read 6 tweets
Indiana University Infectious Diseases Fellowship Profile picture
4 Dec
#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
#Bacillus #cereus causing #anthrax #pneumonia cdc.gov/mmwr/volumes/7…
#bacillus #pneumonia imaging Ref bccdc.ca/health-info/di… semanticscholar.org/paper/Bacillus…
Read 10 tweets
Indiana University Infectious Diseases Fellowship Profile picture
3 Dec
#IdBoardReview sudden onset of fever, bronchitis, pneumonia, severe resp illness outbreak in pts of all ages/immune status that attended a game last week. BAL pleomorphic gm- bacteria. What type of isolation? #IDtwitter #idmedEd #medEd Image
Inhalation #tularemia bioterrorism needs standard precautions as
Not transmitted from person to person
cdc.gov/infectioncontr…
#tularemia emergency.cdc.gov/agent/tularemi…
Read 5 tweets

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