Jonathan Ryder, MD Profile picture
@IUIntMed PGY-3 Resident|Future @UNMC_ID fellow|Interests: ID, MedEd, clinical reasoning, history of med, books, NFL & podcasts|Tweets are my own.
shrivatsa nadiger Profile picture Saurin Kadakia Profile picture 2 added to My Authors
24 May
1/ While on my current GI rotation, I've been reading about Clostridioides difficile because, you know, #IDNerd. I ran across something I had not learned about before:

A Hypervirulent Strain of CDiff!

So naturally, I had to look into this.

/thread #Tweetorial #CDiff #IDTwitter
2/
What is the name of the strain of hypervirulent CDiff?
3/
The hypervirulent strain of CDiff is known as NAP1/B1/027, which stands for North American pulsed-field gel electrophoresis type 1, restriction endonuclease analysis type B1, PCR ribotype O27.

That's a mouthful.

So what's the big deal about this strain?
Read 11 tweets
5 May
1/ "Does DVT/PE cause fever?" 🌡️🤒🌡️🤒🌡️

This #Tweetorial was inspired by a recent @DxRxEdu thread. So I did a deep dive into the evidence behind this dogma and also asked, "if so, how?"

2/ We will start with a poll:

"Does DVT/PE cause fever?"
3/ Dating back to 1959, Israel & Goldstein found fever to be the most common sign in patients with PE (78.9%), 10% with temp >39.5C. They admit infection to be an underlying cause. Additionally, PE made based on CXR & EKG findings & autopsy.

annals.org/aim/article-ab…
Read 22 tweets
1 Feb
1/ Let's differentiate pyogenic from amebic liver abscess in a #Tweetorial today. We will examine DDx, risk factors, microbiology, clinical features, diagnostics, and treatment. This came from my most recent morning report. #IDTwitter #LiverTwitter #MedEd
2/ Differential diagnosis for liver abscess:
Infectious etiologies predominate. Most are pyogenic (bacterial). Amebic (Entamoeba histolytica) and hydatid cyst (Echinococcus) important. Differentiate these from HCC or liver mets. @CPSolvers what am I missing?!
3/ Pathogenesis of pyogenic liver abscess (PLA):
- Biliary obstruction (GB, cancer) most commonly
- Surgical complication, trauma
- Portal vein pyemia from intra-abdominal infection (e.g. appendicitis)
- Hematogenous seeding (endocarditis)
- Cancer tx complication (RFA, TACE)
Read 27 tweets
11 Oct 19
Today I'm going to do a #Tweetorial on non-resolving pneumonia (NRP)! These are a series of pearls on a prior #MorningReport case that I gave earlier this year. We are going to cover definitions, differential diagnosis/schema & workup of NRP #IDTwitter #PulmTwitter
So first off, what is non-resolving pneumonia (NRP)?

It is a bit vague, but it's a lack of resolution of symptoms or radiographic findings over an expected time period despite appropriate antibiotic treatment.
Let's separate this term from "recurrent PNA", which consists of multiple episodes with symptom free intervals & radiologic clearance (e.g. aspiration PNA).

We will avoid the topic of "what is a pneumonia anyway?"
Read 14 tweets