1/18
Let's get this right, you'll get a lot of consults for suspected HIT. Most of them won't turn out to be HIT but you must know what to do in case it is HIT !
Is every TCP in a patient receiving heparin, HIT?
NOOOO, obviously NOT
The incidence is <1% of all pts on heparin😮
2/18
Nov 8, 2022 • 5 tweets • 3 min read
You know you are a #hematologist when you see more fungal pneumonia than bacterial pneumonia😭
🔸Why are they so common?
IMMUNOSUPRESSION !
🔸The most common cause?
ASPERGILLUS FUMIGATUS
🔸Treatment of choice?
VORICONAZOLE
Let's run through some common radiological findings👇🏻
Image 👇🏻 shows a "HALO SIGN"
The central "nodule" contains the fungal hyphae, the "halo" around represents hemorrhage caused by the angio-invasiveness of the fungus.
This is an EARLY FINDING !!
It is NOT SPECIFIC for IPA, can be seen in GPA etc.
Has the largest genome of any known human virus [200 genes]
Most humans harbour latent CMV, infection aquired in childhood.
Site of latency in humans-❓
In murine models- hepatic sinusoidal cells.
2/n
May 16, 2021 • 10 tweets • 7 min read
Want to know why #Mucormycosis is more common post #COVID19 and not so common after leukemia's or other illnesses treated with steroids ?
Read on !!
These are the major reasons in my opinion:
1. The NUMBER of #COVID19 pts is far GREATER than the number of leukemia pts we treat in a year. Thus a lot more people are getting steroids at this point in time and thus a lot more are at risk of steroid related complications.
May 15, 2021 • 6 tweets • 3 min read
So there are a lot of people asking about the risk factors for #mucor post #covid.
The biggest risk factor isn't the steroid itself, it's the hyperglycemia that it causes. If the sugars are well controlled using insulin the risk is almost negligible. So STOP freaking out !!
The 2nd major risk factor is prolonged NEUTROPENIA but that's a problem in our #Hematology patient population and not in #covid patients, so we can safely ignore that for now.