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Jan 6 • 3 tweets • 2 min read
#idboardreview A college football player w/fever & Left leg hot tender erythema from ankle to mid-calf. There is no nodularity, fluctuance, drainage, purulence, or evidence of lymphangitis. Antibiotic choice? #idtwitter #idmeded #meded pic for ref only
non-purulent cellulitis likely due to strep pyogenes so first gen cephalosporins so cephalexin or cefadroxil is reasonable choice
Ref IDSA SSTI guidelines idsociety.org/practice-guide…

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More from @IUIDfellowship

Indiana University Infectious Diseases Fellowship Profile picture
Aug 31, 2022
#idboardreview 17 M w/hx of meningitis s/p course of iv ceftriaxone. Now 2 wks later present with fever, RUQ abd pain. Ultrasound: gallstones that disappeared on repeat imaging in 2 weeks. dx? #idtwitter #idmeded #meded
#Ceftriaxone-associated #pseudocholelithiasis Ceftriaxone, excreted & concentrated in gallbladder bile, can form a precipitate, ceftriaxone–calcium salt, which may cause biliary sludge formation rarely in pts who receive high-dose treatment (≥2 g)
incidence around 20%. #ceftriaxone induced #pseudocholelithiasis occurs within 4–17 days of administration & generally disappear by 10–26 days after ceftriaxone discontinuation 10.1016/s0140-6736(89)90228-6
Read 5 tweets
Indiana University Infectious Diseases Fellowship Profile picture
Aug 30, 2022
#idtwitter #idboardreview by our now faculty @mmcclean1 @CIDJournal @SamirGu02674263 doi.org/10.1093/cid/ci… 58 M Indiana farmer using manuer fertilizer x months w/progressive cough, dyspnea, pleuritic chest pain, chills x11mo: CT: pulm nodules. BC: gram+bacilli #meded
#Rhodococcus hoagii (previously R equi) bacteremia with septic pulmonary emboli
-aerobic gram+coccobacillus
-Cells adopt a coccoid morphology when grown on solid media &
-in liquid media bacilli of varying lengths that often appear beaded in gram-stained preparations are formed
#rhodococcus Diagnosis requires a high index of suspicion, thorough history, and accurate laboratory identification methods. Can be mislabeled as corynebacterium on blood culture or kocuria on vitek
Read 4 tweets
Indiana University Infectious Diseases Fellowship Profile picture
Mar 22, 2022
#IdBoardReview Amazonian farmer w/ multiple skin nodules of L leg x20+yrs (which itch & bleed frequently)started post penetrating injury w/ thorn of a plant. biopsy chronic granulomatous process: dermis w/ thick walled round fungi forming single chains. #IDTwitter #meded
#lobomycosis Ref ajtmh.org/view/journals/…
#lobomycosis
Read 5 tweets
Indiana University Infectious Diseases Fellowship Profile picture
Mar 20, 2022
#idboardreview Pt recent travel to Malaysia, spend time on the beach now w/ this itchy rash x2wks. Also w/ cough, occasional dyspnea, eosinophilia, ill defined reticulonodular infiltrates on chest CT #idtwitter #idmeded #MedEd
cutaneous larva migrans (#CLM) with #Löeffler’s syndrome. Tx w/ albendazole x7d and symptoms resolved Ref ajtmh.org/view/journals/…
Cutaneous larva migrans frequent travel-associated skin diseases on beach destinations in tropics or subtropics. #Ancylostoma braziliense. Most lesions are on lower extremities. Larvae migrate aimlessly within epidermis at rate of 2mm to 2cm/day lacks enzymes to penetrate deeper
Read 5 tweets
Indiana University Infectious Diseases Fellowship Profile picture
Jan 14, 2022
#idboardreview 80 M originally from Philippines w/ yearly travel there, presents w/ fever, abd pain, chills, inc LFTs, +liver abscess. BC+ organism? #meded #idmeded #idtwitter
hypervirulent #klebsiella pneumoniae liver abscess Ref academic.oup.com/ofid/article/7…
Infections with #hypervirulent #Klebsiella pneumoniae isolates most frequently occur among pts with an Asian, Pacific Islander, or Hispanic ethnic background, even in absence of travel to high-prevalence areas (eg, Asian Pacific Rim). Diabetes is also a risk factor
Read 5 tweets
Indiana University Infectious Diseases Fellowship Profile picture
Jan 13, 2022
#idboardreview 40 M originally from Cameroon, also travel to Ghana & Mali, now w/6 mo progressive weakness requiring wheelchair use,lethargy, 30lb wt loss, confusion. CSF lymphocytic pleocytosis. dx? #meded #idmeded #IDtwitter
Human African #trypanosomiasis endemic to sub-Saharan Africa & fatal when untreated. parasite Trypanosoma #brucei transmitted by tsetse fly (Glossina spp) vector
2 dz forms T #brucei #gambiense West/Central Africa: slowly progressive illness leading to progressive sx & death over mo-yrs
-T brucei #rhodesiense eastern/ southern Africa: more acute illness that evolves over a span of wks, leading to death w/in months
Read 9 tweets

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