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Mayo Clinic Infectious Diseases Profile picture
Mayo Clinic Infectious Diseases
@MayoClinicINFD
A Trusted Global Leader in Infectious Diseases Practice, Research and Education
5 subscribers
Jun 15, 2023 • 6 tweets • 2 min read
#MayoIDCaseConference

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 2/
 #IDBR #MayoIDQ
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?
Jul 30, 2022 • 4 tweets • 3 min read
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
Jan 15, 2022 • 8 tweets • 5 min read
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 2/
 #Listeria monocytogenes

Soil
Decaying plant matter

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

Oral route —> intestinal mucosa penetration —> systemic infection
Nov 20, 2021 • 6 tweets • 6 min read
Weekend Digest

Name the Pathogen

5 Clues:

- #Chitlins
- #Iron sepsis
- Mesenteric #adenitis
- Reactive #arthritis
- Terminal #ileitis Image 2/
 #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)

ncbi.nlm.nih.gov/pmc/articles/P…
Nov 18, 2021 • 6 tweets • 6 min read
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?
Nov 13, 2021 • 9 tweets • 6 min read
Weekend Digest

Name the pathogen

5 clues

GNB with musty odor
Clenched fist injury
Culture negative endocarditis
Needle licker osteomyelitis
Toothpick septic arthritis Image 2/
 #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.

doi.org/10.1016/S0363-…
Nov 6, 2021 • 5 tweets • 4 min read
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 2/
 #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!
Nov 5, 2021 • 6 tweets • 2 min read
Images of Infectious Diseases

“Food gets stuck in my Adam’s apple”

A 68 year old man presents with weight loss and dysphagia for 6 weeks. Upper endoscopy is shown. What is your diagnosis? #MayoIDQ and case details to follow Image 2/
 68M. No PMH. 6w gradual dysphagia to solids with 20 lb weight loss. No F/C/sweats. PE: cachexia. WBC 4.7 Cr 0.9 CXR normal. HBV(-). Rx fluconazole.

Per your suggestion: HIV VL 56K CD4 26. Patient willing to start ART immediately. Genotype pending. You suggest which one?
Oct 10, 2021 • 9 tweets • 4 min read
Images of Infectious Diseases

2 months after visiting family and friends in Manila:

39M. No PMH. One week of fever, chills, cough, pleuritic chest pain, RUQ pain.

Now complains of blurred vision due to endophthalmitis.

Your DDx? #MayoIDQ and case details to follow… Image 2/
 39M. No PMH. HIV-. No IDU.
PE: jaundice, endophthalmitis, no dental issues, b/l rales, new systolic murmur, tender RUQ
WBC 18.3 Alk phos 250.
CT chest / abdomen (photo)
TEE: mitral valve vegetation
Which of the following is the most likely pathogen? #MayoIDQ
Oct 2, 2021 • 9 tweets • 6 min read
Weekend Digest

Name the pathogen.

5 clues

Airborne precautions
Cough, coryza, conjunctivitis
Secondary bacterial pneumonia
Vitamin A deficiency
#VaccinesWork Image 2/
 #Measles #morbillivirus
Single stranded RNA virus
#Paramyxoviridae

Humans are the only known natural hosts for the virus

Disease: measles
Sep 18, 2021 • 5 tweets • 4 min read
Weekend Digest

Name the pathogen

5 Clues
#Lymphocytosis
#Macrolide
Posttussive #vomiting
Respiratory #droplet
#VaccinesWork Image 2/
 #Bordetella pertussis

Fastidious gram-negative coccobacillus

Transmit: respiratory droplets - highest transmission during the catarrhal stage
Sep 11, 2021 • 7 tweets • 3 min read
Weekend Digest

Name the pathogen

5 Clues

Gram-positive bacillus.
Spore.
Food. Wound. Iatrogenic.
Drooping eyelids.
Preserved sensory function. Image 2/
 #Clostridium #botulinum
Spore-forming Gram-positive bacillus
Ubiquitous: vegetable, soil, seafood

Neurotoxin: A-H (A, B, E cause human disease)

Toxin binds to receptor in presynaptic terminal —> blocks neurotransmitter release (blocks cholinergic neuromuscular innervation)
Sep 4, 2021 • 4 tweets • 2 min read
Weekend Digest
Name the pathogen!

5 Clues:
Rodents.
Triathlon.
Conjunctival suffusion.
Jaundice.
Jarisch-Herxheimer. Image 2/
 #Leptospira

Spiral-shaped bacteria

Zoonotic: rodents important reservoir

Enters though skin breaks, mucosa, conjunctiva

Freshwater. Floodwater. Rainfall.

Recreational water activities. Triathlon. Swimming. Wading.

Rice farmers. Abattoir workers.
Aug 28, 2021 • 5 tweets • 3 min read
Weekend Digest

Name the pathogen!

5 Clues: TMP-SMX, levofloxacin, minocycline, ceftazidime, ticarcillin-clavulanic acid Image 2/
 #Stenotrophomonas #maltophilia

Ubiquitous. Soil. Water. Plants.

Hospital environment.

Adheres to foreign materials. #biofilm formation
Aug 22, 2021 • 6 tweets • 4 min read
Images of Infectious Diseases
58M. NYC. No PMH.

1 mo ago: high dose prednisone, rituximab, plasma exchange for presumed paraneoplastic autoimmune polyneuropathy.

Now: PET-CT. Biopsy (shown)

ROS: fever, cough, chest pain
What is the DDx? Case details #MayoIDQ to follow… Image 2/
 No travel. No farm exposure. No pets.
Work up:
CXR RML opacity
WBC 13.7. 94%N.
HIV neg.
Galactomannan negative
Histoplasma serology negative
BDG >500
What is the most likely pathogen? #MayoIDQ
Aug 7, 2021 • 5 tweets • 3 min read
Weekend Digest

Name the pathogen and its treatment
(Photo CDC) 2/
 #Plasmodium #falciparum
1. Anopheles bite
2. Endemic regions / returning travelers: 12-14 day incubation period
3. Fever +/- severe symptoms (see next)
4. Dx: blood smear, rapid diagnostic Ag or Ab test
5. Rx: chloroquine, artemisin-based combination Rx (depends on region)
Aug 2, 2021 • 7 tweets • 4 min read
Images of Infectious Diseases

A young man presents to the ER because of leg numbness. While undergoing evaluation, he had a seizure. CT head is shown (photo). #IDTwitter what is your differential diagnosis?

Case details #MayoIDQ MCQ to follow… Image 2/
 36M migrant from Mexico
No PMH. HIV negative.
CC: leg numbness
ED: witnessed seizure
WBC 16. Cr 0.7. AST 35.
CT (photo)

Which one of the following is least likely the correct answer about this condition? #MayoIDQ
Jul 31, 2021 • 6 tweets • 3 min read
Weekend Digest

Name the pathogen and its treatment. Image 2/
 #Prototheca
1. Unicellular achlorophyl algae
2. Exogenous transmit (e.g., trauma inoculation)
3. Cutaneous/bursitis (indolent/ chronic); disseminated in ICH
4. Dx yeast-like; sporangia w endospores in daisy-like pattern / septation
5. Rx ampho B / azole
doi.org/10.1128/JCM.02…
Jul 17, 2021 • 9 tweets • 6 min read
Weekend Digest

Name the pathogen and its treatment.

Clues:
1. Grows within protozoa
2. Decorative fountains
3. Hotel stay during travel
4. Cough + diarrhea
5. Antigen test 2/
 #Legionella species

Aerobic “intracellular” GNB
>60 species

L. #pneumophila serogroup 1 - most common cause of human illness (water exposure)

L. #longbeachae (ANZ / soil, potting mix and compost exposure)
Jun 3, 2021 • 12 tweets • 4 min read
Images of Infectious Diseases

42M on obinutuzumab for CLL. 4 mo ago: mild COVID-19 - no specific Rx. 3 mo ago: SARS-CoV-2 mRNA vaccine.

CC: 2 mo on/off fever, cough, dyspnea. NP SARS-CoV-2 PCR neg. Rx as CAP w doxycycline - no response.

CT chest. DDx? Work up? #MayoIDQ next Image 2/
 Four months after mild COVID-19, an ICH man with CLL on obinutuzumab presents with prolonged / recurrent doxycycline-non responsive CAP. CT chest shown. See prior tweet for other details. Which of the following is the most likely diagnosis? #MayoIDQ
Apr 3, 2021 • 7 tweets • 4 min read
Weekend Digest

An Korean immigrant presented with early stage cholangiocarcinoma.

H & E stained tissue biopsy shown.

Name the pathogen and mechanism of infection. 2/
 Case Diagnosis:
#Clonorchis sinensis - oriental liver fluke

“The eggs of Clonorchis are practically indistinguishable from those of #Opisthorchis” (photo credit: CDC)