Chasing Bugs

Finding the best ID cases around Twitter for ID doctors, fellows and med students
#MedTwitter #IDTwitter
My alter ego @gilboa_mayan

[Critical Care & Emergency Medicine PSN @sscpCCEmpsn]

📢 We’re continuing our review of updates from the SSC 2026.

Today’s post will focus on Hemodynamic Management and highlight the key recommendations.

Check out the attached summary for a quick overview.

#Sepsis #CriticalCare #PharmICU #ClinicalPharmacy #ICU #SSC2026

[Norah Asiri 🔬 @NA_Microbiology]

🦠 BACTERIOLOGY| Leptospira interrogans

Leptospira interrogans is a thin, tightly coiled spirochete responsible for leptospirosis, a zoonotic disease transmitted through contact with water or soil contaminated by infected animal urine.

[Internal Medicine @pgMedicine]

Lyme disease clinical manifestations

[NEJM @NEJM]

Fournier’s gangrene is a rare, rapidly progressive necrotizing fasciitis of the perineum, genitals, or perianal region.

Most cases begin with a known portal of entry or occur after trauma or surgical procedures in the affected region. The infection is typically polymicrobial, involving anaerobic and aerobic bacteria.

The clinical picture is characterized by rapid progression and high mortality, ranging from 7.5 to 88%. Factors contributing to higher mortality include delayed diagnosis, extensive tissue involvement, and the presence of coexisting conditions.

Prompt recognition is critical owing to the aggressive nature of the infection and associated high mortality.

SGLT2 inhibitors have been associated with an increased risk of Fournier’s gangrene. A postmarketing analysis (2013–2019) identified 55 cases among patients taking SGLT2 inhibitors. In contrast, 18 cases were reported among patients taking other antidiabetic agents between 1984 and 2019.

SGLT2 inhibitors block glucose reabsorption in the proximal renal tubules, which leads to glycosuria. The resulting glucose-rich urine creates a favorable environment for bacterial growth and infections in the perineal region, an area with multiple microbial sources. In addition, challenges in maintaining local hygiene and dryness, along with relatively limited vascularization, increase susceptibility to soft-tissue infections in this region, including Fournier’s gangrene.

Given the expanding use of SLGT2 inhibitors in clinical practice, clinicians should be aware of the association between SGLT2 inhibitors and Fournier’s gangrene, even though diagnosis is very rare. They should discuss this risk with patients and monitor for signs of infection. No clear temporal relationship exists; cases of Fournier’s gangrene have occurred years after initiation of therapy.

Learn more and test your diagnostic and therapeutic skills in “Cutting to the Chase,” a new Interactive Medical Case: https://t.co/DmpVBE3DyU

#MedicalEducation

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

En #InternJInfectDis ENS. CLÍNICO #ITUcomplicada (📸👇🏻)donde #meropenem 7 días🆚Meropenem 3 días ➕ #FosfoTrometamol día 4 y 6 en #Enterobacterales R CFP 3 Gen.👉🏻 MISMA curación clínica👌🏻y ➖estancia🏥📉
Opción para #DESESCALAR🪜💊y #AhorroCarbapenemes
🔗🆓https://t.co/WOZMC22sLQ

[Norah Asiri 🔬 @NA_Microbiology]

🦠 BACTERIOLOGY | Bartonella quintana

Bartonella quintana is a Gram-negative facultative intracellular bacterium and the causative agent of Trench Fever, a disease historically associated with soldiers living in crowded and unsanitary conditions.

[Michael Calderwood, MD, MPH @CalderwoodMD]

More is not always better. Adding vancomycin to cefazolin as surgical prophylaxis in patients undergoing arthroplasty does not improve outcomes in patients not known to be MRSA colonized. Outcomes WORSE for knee arthroplasty. Just don't. https://t.co/r9ZzYpZJXS #IDWeek2024

[Gabe 🦊 @IdVilchez]

#IDtwitter in this case of a large liver cyst described as simple, would you tap immediately, wait for echinococcus and amoeba serology or consider PAIR? Patient From Caribbean Island

[Julia Hankins, PhD, D(ABMM) @JuliaDHankins]

Some small colonies were found growing on a blood agar plate only around the colonies of Staph aureus. Once subcultured by itself, it only grew on chocolate agar. It was found to be PYR+ LAP+ Gram positive cocci in chains.

Who am I?

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

Fantastic review 🌟@TheTxIDjournal @UNMC_ID @EStohs @AnumAbbasMD
Updates in the approach to febrile neutropenia in hematologic malignancy patients receiving chemotherapy and recipients of hematopoietic cell transplantation (HCT) & cellular therapies[CAR)-T
https://t.co/pA67cco26A

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

🆕️⚡️🔥 @CIDJournal @ErinMcCreary
Antibiotic Myths for the Infectious Diseases Clinician
With 🌟s @tmjones6 @IDPharmacist @JGPharmD
@aprildyerid @The_Real_LDA @ShaeferSpires #IDTwitter
https://t.co/UXXXtUSAoN

[Sam Ghali, M.D. @EM_RESUS]

This is a very important #ECG pattern that you must be able to recognize!

What’s the diagnosis?

[Daniella Levine Cava @MayorDaniella]

I have ordered the lowering of County flags in Miami-Dade to honor the innocent lives lost due to terrorist attacks in Israel. We stand with Israel and all nations that champion democracy.

Together, we must work to create a world without violence and for peace among nations.🕊️

[Daniella Levine Cava @MayorDaniella]

Tonight, we turn away from darkness and light up blue in solidarity with Israel.

Thank you to @portmiami and our partners at @CruiseNorwegian and @RoyalCaribbean for illuminating in the name of peace and unity. 🇮🇱💙

[Antonio Guerrero @guerreroespejo]

31-y-o👨HIV +, CD4+ 60/mm3, from El Salvador: headache, confusion, fever, & gait instability

MR: mass (A & B, T2 and T1, contrast material)

Brain aspirate: (C)
1/4

DOI: 10.1056/NEJMicm1703763

#Neuro #parasitology #pathology

[Journal of Brown Hospital Medicine @BrownJHM]

A patient presented with tingling and numbness in his hands & feet. He reported consuming armadillo meat on a regular basis. Basic labs were normal. Exam w/hand deformity as shown below. What is the likely diagnosis? #medEd

[Journal of Brown Hospital Medicine @BrownJHM]

Dyspnea & unilateral painless eyelid swelling. Diagnosis? (Image: CDC) #MedEd

[@X @MoreXGrok]

A child with sepsis

👉treated with multiple courses of antibiotics including intravenous vancomycin

Developed these lesions

Diagnosis?

[Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 @ABsteward]

More reassuring data!
🆕️⚡️⚡️Multi-institutional analysis Short (med 8d ) was non-inferior in terms of clinical outcomes to prolonged (med 15d) -course antibiotics for treatment of pseudomonas aeruginosa BSI in hem-onc pts with FN @BradSpellberg #IDXposts
https://t.co/UqY2ZPeiOZ

[Brad Spellberg @BradSpellberg]

You may be wondering, how can 1 vaccine improve survival for blood and lung infections caused by MRSA, VRE, ESBL E. coli, carbapenem R Acineto, Pseudomonas, and Klebsiella? 2 words for you:
TRAINED IMMUNITY!
The future of vaccines!