A 44-YO♂️, stayed in a rural cottage of France 2 weeks previously: cramping upper abdominal pain with watery diarrhea.
He had passed what he thought were worms in his feces
Eosinophilia
1/6

doi.org/10.1093/cid/ci…
#GITwitter #IDtwitter #microbiology “Worm” specimen brought to clinic by patient (petri dish
The specimens: identified as the larvae of the drone fly, Eristalis tenax
These larvae are 2.5–3 cm in length; the posterior tube gives them the name of “rat-tailed maggots”

INTESTINAL MYASIS CAUSED BY ERISTALIS TENAX LARVA
2/6

doi.org/10.1093/cid/ci…
#parasites #GIPath #Doctor “Worm” specimen brought to clinic by patient (petri dish
Myiasis caused by E. tenax:
✔️rare but have been
✔️reported from various countries including Europe
✔️most often intestinal myiasis, but cases of infestation of the nasal cavity, urinary tract, and vagina have been described.
3/6

#Doctor #MedStudentTwitter
The clinical presentation of intestinal myiasis varies from asymptomatic, with larvae noticed in the stool, to abdominal pain and diarrhea, or anal pruritus.
4/6

doi.org/10.1093/cid/ci…
#resident #medicine #MedicalStudents
Intestinal myiasis in humans is probably an accidental myiasis related to ingestion of contaminated uncooked food or water containing fly larvae.
Most larvae are destroyed by the digestive juice, but others are able to live in the intestinal tract.
5/6

#MedEd #parasitology
Most cases in the literature have been self-limiting.

The patient experienced a spontaneous resolution of his symptoms following the expulsion of the larvae.
6/6

#parasites #Medicina #primarycare

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More from @guerreroespejo

Feb 27
3 años ♀️, padre con lesiones cutáneas similares: lesiones cutáneas polimorfas localizadas en los glúteos, con elementos papulares, vesiculares y pustulosos umbilicados
1/13

🖊️M Roguera y col. @hgermanstrias @aepediatria
DOI: 10.1016/j.anpedi.2022.09.006
#pediatria #infecciosas Lesiones cutáneas en glúteo izquierdo. Detalle de las lesi
@hgermanstrias @aepediatria Se confirmó en el padre la infección por virus de la viruela del mono (MPXV).

PCR de líquido vesicular de las lesiones:➕para MPXV.

VIRUELA DEL MONO (Mpox)
2/13

#MolBiol #virology #virología
@hgermanstrias @aepediatria Se realizó aislamiento de contacto y secreciones respiratorias (aérea y gotas) en el domicilio hasta la curación completa de las lesiones cutáneas (a los 10 días de evolución).
No hubo complicaciones ni nuevas lesiones en el seguimiento.
3/12

#IDtwitter #microbiología
Read 12 tweets
Feb 25
2 meses ♂️, madre VIH+, toxicómana, y chancro perineal indoloro en 2º trimestre del embarazo:
Un mes de rinorrea serosanguinolenta, lesiones dérmicas, FC 180lpm, FR 50rpm, Tª 38,8°C, crepitantes finos en tórax, hepatoesplenomegalia,
1/5

#dermatología #pediatria #infecciosas Queilitis y exantema generalizado macular con hiperqueratosi
🧪CMIA anti-Treponema pallidum :➕
⬇️: glucosa, hemoglobina, plaquetas, albúmina
⬆️:transaminas, bilirrubinemia directa
RX: periostitis en huesos largos
PL: hipoglucorraquia, hiperproteinorraquia, sin pleocitosis y VDRL➕
VDRL materno:➕
2/5

#microbiologia #urgencias Periostitis en huesos largos.
#SIFILIS #CONGÉNITA CON NEUROSÍFILIS Y CHOQUE SEPTICO

Penicilina G sódica cristalina durante 14 días, con adecuada evolución y alta por mejoría clínica.
3/5

🖊️@_jicastillo @samanthap78 @Mascarejazzy col.
DOI: 10.1016/j.anpedi.2022.06.019
#AtencionPrimaria
Read 5 tweets
Feb 23
A 26-YO♂️ no #sexual contacts other than with his male partner: 6-day of fever, malaise, a swollen parotid gland, & ulcerative lesion on the ipsilateral lower lip.

Mild lymphopenia
⬆️GGT & CRP

1/6
doi.org/10.1016/S0140-…
#IDtwitter #dermatology #EarNoseThroat Swelling of left parotid gland (A)  The ulcerative lesion on
PCRs on the throat & ulcer swabs:➕for human #monkeypox (hMPX)
Genomic sequencing: clade IIb variant clustering within the current international mpox virus outbreak

PAROTIDITIS CAUSED BY hMPX virus

2/6
#sexually #maxillofacial #microbiology
7 days after initial presentation, his clinical condition had improved together with a decrease in the parotid swelling and the size of the ulcer.
3/6

#MedTwitter #Doctor #MedStudentTwitter
Read 6 tweets
Feb 22
A 58-YO♂️, DM, fever & L lower quadrant abdominal pain 2 months prior: acute R-sided back pain, & 3/6 diastolic murmur at R upper sternal border.

CT: a R renal infarction & splenic embolism

MR: multiple infarctions
1/7

doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia Enhanced abdominal computed tomography showing right renal i
Transesophageal echocardiography: a vegetation and severe aortic regurgitation.

Blood 🧫: Cardiobacterium hominis

CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7

#IDtwitter #microbiology Transesophageal echocardiogram revealing a large vegetation
The patient received antibiotic therapy and surgical aortic valve replacement, and he was doing well without major complications.
3/7

#infecciosas #MedTwitter #Doctor
Read 7 tweets
Feb 21
Emergence of extensively drug-resistant (XDR) and multidrug-resistant (MDR) #Shigella flexneri serotype 2a associated with #sexual transmission among men who have sex with men (MSM), in #England: a descriptive epidemiological study
1/6
👇
thelancet.com/journals/lanin…
In this study, authors report the emergence and sustained transmission of #XDR and #MDR strains of S flexneri among among MSM, harbouring plasmid-encoded blaCTX-M-27, in England since September, 2021.

There were clinically severe cases, including hospitalisations.
2/6
Comparison to the XDR S. sonnei outbreak revealed epidemiological and #plasmid similarities and provided support for horizontal acquisition events in a community transmitting infection.
3/6
Read 6 tweets
Feb 20
A 71-YO therapy for multiple mieloma, voriconazole for Aspergillus fumigatus sinusitis, prophylaxis with TMP-SMX: febrile neutropenia, nodular lesion on abdominal wall
CT: pulmonary nodule unchanged in last a month
🔬biopsy of pulmonary nodule?
1/8

#Pathologists #haematology Histopathology of the fine-...Image
🔬: Histiocytic process with granular basophilic cytoplasm and Michaelis-Gutmann bodies (arrows), positive for calcium with von Kossa special stain (arrowhead); findings pathognomonic for malakoplakia.

PULMONARY MALAKOPLAQUIA
2/8

doi.org/10.1093/cid/ci…
#pathTwitter
🧫of the pulmonary nodule:➖
🧫biopsy of the abdominal wall lesion: Rhodococcus equi resistant to TMP-SMX, but susceptible to rifampicin, vancomycin, azithromycin, ciprofloxacin, & imipenem.
RHODOCOCCUS EQUI SUBCUTANEOUS ABSCESS
3/8

doi.org/10.1093/cid/ci…
#microbiology
Read 8 tweets

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