Weekend Digest

Name the Pathogen

Five Clues
1. Tumbling #GPB
2. #Pregnancy
3. #Delicatessen
4. #Meningoencephalitis
5. #Ampicillin + #gentamicin Image
#Listeria monocytogenes

High-risk foods: unpasteurized cheeses, hot dogs and deli/lunchmeats.

High-risk groups:
- pregnant women
- newborns
- older adults
- people with weakened immune systems
#Listeriosis in pregnancy
1. Febrile gastroenteritis
2. Bacteremia
3. CNS infection uncommon

Most common in 3rd trimester

Listeria can cross placental barrier —> fetal death, premature birth, infected newborn

Granulomatosis infantiseptica

#Listeria monocytogenes #ClinicalPearls
1. Food: deli meats
2. Risk: pregnant, ICH, young/old
3. Febrile gastroenteritis, bacteremia, meningoencephalitis
4. Rx: ampicillin +/- gentamicin
5. Do not use steroids in listeria meningitis (increase mortality)

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More from @MayoClinicINFD

Jun 15, 2023

Summertime in Minnesota: a man presented with one month fever, chills, jaundice, anemia and this peripheral blood smear (photo). No travel history. What is your diagnosis? Case presented by Dr. Silpita Katragadda @Atiplis Image
This patient who is s/p splenectomy was diagnosed with #babesiosis.

Rx: #atovaquone + #azithromycin

3 wks later: worsening anemia
Labs: LDH 2205, reticulocyte 18%, haptoglobin not detected.
Babesia PCR + / smear (-)

What is the likely cause?
Case diagnosis:
#Babesiosis-associated warm autoimmune antibody hemolytic anemia

A unique syndrome of recrudescent clinical hemolysis 2-4 weeks after the initiation of antiparasitic treatment, in the absence of parasitemia on peripheral-blood smear.
Read 6 tweets
Jan 15, 2022
Weekend Digest

Name the Pathogen

Five Clues
1. Gram-positive bacillus with tumbling motility
2. Food safety
3. Age, pregnancy and steroids
4. Rhombencephalitis
5. Ampicillin+Gentamicin Image
#Listeria monocytogenes

Decaying plant matter

Processed/unprocessed food (deli meats, hotdog, soft cheese, pate, fruits, greens/salads)

Oral route —> intestinal mucosa penetration —> systemic infection
#Listeria monocytogenes and food safety!

Listeria survives in refrigeration temperature

Sporadic isolated cases
Occasional outbreaks due to food contamination (see link for recent outbreak)

Read 8 tweets
Nov 20, 2021
Weekend Digest

Name the Pathogen

5 Clues:

- #Chitlins
- #Iron sepsis
- Mesenteric #adenitis
- Reactive #arthritis
- Terminal #ileitis Image
#Yersinia enterocolitica

It is #zoonotic and is acquired by exposure to contaminated food.

When #IDBR says #chitlins (#chitterlings), you say Y. enterocolitica

Chitlins are food made of pork intestines (where Y enterocolitica resides)

#Yersinia enterocolitica

Enterobacteriaceae #GNB that causes #enterocolitis, diarrhea (often bloody), terminal #ileitis, mesenteric #adenitis, and RLQ pain that may be mistaken as #appendicitis (#pseudoappendicitis)
Read 6 tweets
Nov 18, 2021
Images of Infectious Diseases

46F with diabetes presents with orbital apex syndrome. Imaging and histopathology shown. What is your differential diagnosis? #MayoIDQ to follow @StephanieGrach @ZYetmar @omarabusaleh15 Image
2/ #MayoIDQ
46F with uncontrolled DM and recent DKA is admitted because of left sided HA for a month. PE: orbital apex syndrome. Head imaging shown. ENT/neurosurgery proceeded with debridement. Pathology shown. Which one of the following choices is most correct?
Case diagnosis: Rhinocerebral #mucormycosis due to #Rhizopus in a person with poorly controlled diabetes mellitus

Surgical debridement
Liposomal #Amphotericin B

Later: transitioned to #Posaconazole upon clinical control and improvement
Read 6 tweets
Nov 13, 2021
Weekend Digest

Name the pathogen

5 clues

GNB with musty odor
Clenched fist injury
Culture negative endocarditis
Needle licker osteomyelitis
Toothpick septic arthritis Image
#Eikenella corrodens

Part of human oral flora

Component of polymicrobial infection related to human bites.

#IDBR buzzword is clenched-fist injury – when it is inoculated to injured knuckle of a clenched fist that strikes teeth of an opponent.

#Eikenella corrodens is the “E” in HACEK – agents of culture negative endocarditis

HACEK organisms can now be cultured with current culture techniques, hence they should no longer be called “culture negative” pathogens!
Read 9 tweets
Nov 6, 2021
Weekend Digest

Name the pathogen.

Pain and discomfort when you pee
But Hans Christian Gram cannot see
Try to kill me with Doxy
Moxi chaser sets you symptom-free. Image
#Mycoplasma #genitalium

“Cause of #NGU not visible by Gram stain and treated with two-stage approach using #doxycycline followed by #moxifloxacin chaser!”

Fellows, this is #IDBR material, definitely!
#Mycoplasma #genitalium

Men: persistent / recurrent non-gonococcal urethritis (NGU) / non-chlamydia urethritis

Women: cervicitis, PID, preterm delivery, spontaneous abortion, infertility

Many infections are asymptomatic!
Don’t forget: rectal / pharyngeal infection
Read 5 tweets

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