Eddie Giampiere Díaz Carrión

Médico Infectólogo

[Gabe 🦊 @IdVilchez]

#IDtwitter MRSA calcaneal OM relapses after 6 wk of vanco. Fusion healed; screws removed, bone I&D, but residual OM remains. Deep cultures grow usual MRSA (TMP-SMX-S) at 24 h and pinpoint, nonpigmented, nonhemolytic MRSA at 72 h.
Before oral step-down, what next? @BradSpellberg

[NOMAD @Kababhadu]

@guerreroespejo While Cryptococcus is the best fit. DD
Neurocysticercosis: it lacks the prominent cervical lymphadenopathy & presents with seizures
Tuberculous Meningitis: basal meningeal enhancement& hydrocephalus,
CNS Toxoplasmosis: generally immunocompromised& leptomeningeal enhancement rare

[NOMAD @Kababhadu]

@guerreroespejo triad of ring-enhancing lesions + leptomeningeal enhancement + hydrocephalus in a patient with a subacute/chronic headache and fever is highly suggestive of Cryptococcal Meningitis (cryptococcomas), even in an apparently immunocompetent patient; confirm with CSF India Ink/CrAg.

[Antonio Guerrero @guerreroespejo]

17-year-old girl: 2 months of fever, progressive headache, weakness, weight loss, mild neck stiffness, cervical nodes.

MRI: multiple ring-enhancing lesions, leptomeningeal enhancement (arrows), ventricular enlargement (stars).

Diagnosis?

#Neurology #IDXposts #MedEd
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[Takahiro Matsuo (Taka), MD @TakaMatsuo_ID]

【Perioperative Antibiotics in Head & Neck Surgery】JAMA Netw Open, 2026 Nov @JAMANetworkOpen

👉 Survey, H&N surgeons (N=468)
👉 Routine thyroidectomy prophylaxis: Europe 12%, North America 35%

https://t.co/6Og30UV4nU

#OncoID #IDMedEd #IDFellow

[Clinical Infectious Diseases @CIDJournal]

The Piperacillin-Tazobactam MIC Behaves Like a Prognostic Marker, Not a Pharmacodynamic Exposure

🔁 Repost
🔗 https://t.co/ckrp7SqzsN

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

🆕🔥🔴ROCKET
The largest study to date!
Cefepime vs pip tazo for the treatment of bacteremia in Enterobacterales at moderate risk for clinically significant AmpC "ECK*"
🔺After inverse probability of treatment weighting, 30-day mortality rates between patients treated with pip/tazo and cefepime were not significantly different (HR 1.05, 95% CI 0.57–1.92).
🔺Treatment-emergent resistance was uncommon #IDXposts https://t.co/wUh0pS5g8o

[Hematología Intensa @hematointensa]

GUÍAS ASH 2026: TROMBOCITOPENIA INMUNE EN ADULTOS 🧵

➡️Tratamiento inicial y de segunda línea

📌Ya NO se sugiere esteroide solo como 1ª línea
✅Esteroide + rituximab o + agente trombopoyético

📍Algoritmo de tratamiento

doi: 10.1182/bloodadvances.2026021269

[Medical Info @Medicalinfo111]

Drug-Resistant Tuberculosis (DR-TB):

Treatment Regimens, Second-Line Drugs, Mechanisms of Action, Dosing, Toxicities and Monitoring

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

🆕💥💥🔴Doxycycline and Risk for Pregnancy Loss: A Multi-database, Multi-indication Cohort Study pregnancy with first trimester
Oral Doxycycline use for RTI or acne during early pregnancy was associated with an increased risk for pregnancy loss. Clinicians may use this information to weigh risks and benefits when prescribing doxycycline to reproductive-aged women #IDXposts
https://t.co/cJIaHhysLT

[Dr. AK 🇮🇳 @docakx]

A doctor stuck a needle in his own arm and injected Charlie Sheen's HIV positive blood to prove that he cannot get HIV.

Same doctor swore he'd erased HIV from the island of Comoros. In 2016 he talked one of Hollywood's biggest stars into quitting his HIV meds for goat milk.

Sheen was diagnosed with HIV in July 2011. He started medications (antiretrovirals) the same day. By December that year his viral load was undetectable.

Four years later he got tired of the daily pills and flew to Mexico to meet Samir Chachoua. This guy who is not licensed in the US, pushed his "nemesis theory": every disease has an antidisease. Goats with arthritis carry a virus called CAEV that supposedly destroys HIV. Sheen stopped his real meds and tried the goat-milk treatment.

Chachoua then drew fluid from a swelling on Sheen's elbow and said he was injecting it into himself to prove the cure worked. Sheen later said the doctor's back was turned. He never clearly saw the needle go in and thought it might have been switched.

On The Dr. Oz Show, Sheen walked on stage and said he had just received bad news. His viral load had shot back up. He was infectious again. Oz confronted him with the numbers and the fact that Chachoua had no US license. Sheen restarted his antiretrovirals on the plane home and was undetectable again within months.

He later called Chachoua a liar and a "grand work of fiction." He said guys like this are dangerous and that he was not trading his meds for arthritic goat milk. Lab studies only showed that CAEV antibodies cross-react with HIV proteins in a test tube. They do not kill the virus. Comoros never had a big epidemic for him to erase. Prevalence was already under 0.1 percent, and new cases kept appearing.

The real meds worked. The goat milk did not.

[C.Alberto Ortega @albertoortegana]

A 21-year-old woman presents with chronic, painless, non-pitting swelling of both lips, predominantly affecting the upper lip. She has no history of allergies, angioedema or trauma.

**What is the most likely diagnosis?**

What clinical features and differential diagnoses would support your answer?

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

Enterococcus faecalis is increasing as a cause of infective endocarditis in adults with prosthetic valves or transcatheter aortic valves.
🆕💥🟢 Review:: Enterococci as Emerging Pathogens in Infective Endocarditis and Cardiac Device Infections: Future Implications #IDXposts
https://t.co/iPjvcgk2x2

[Takahiro Matsuo (Taka), MD @TakaMatsuo_ID]

【Mucormycosis beyond the classic host】Front Fungal Biol, 2026

👉Case series, Greek tertiary center 🇬🇷
👉Trauma, burns, mortality 67%
👉Rapid necrosis/thrombosis, consider biopsy

https://t.co/4XWWU4dIve

#IDMedEd #IDFellow
#Mucormycosis

[Clinical Infectious Diseases @CIDJournal]

Empirical Antifungal Treatment of Critically Ill Patients With Influenza-Associated Acute Respiratory Distress Syndrome: A Bayesian Perspective

🔁 Repost
https://t.co/xIS84kOkFS

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

En #ClinMicrobiolRev #REVISION🙇🏻‍♂️📚 #Blactamicos y #Blactamicos/inhibidores Blactamasas FRENTE a enterobacterales #CARBAPENEMAS🛡️🧬✂️ recientemente aprobados✅ y en investigación👩🏻‍🔬
INTERESANTÍSIMA dado el aumento (especialmente #NDM) en últimos años📈
🔗 🆓https://t.co/F264xxtNj2

[Brad Spellberg @BradSpellberg]

@IdVilchez @BaileyAgeeRx No I do not test MICs. High vanco MIC vanishingly rare. But based on this recent experience, I am now going to be trying FQ+rif in the future for persistence.
https://t.co/g80sper4q6

[Bailey Agee, PharmD @BaileyAgeeRx]

#IDTwitter #IDXposts

MRSA tricuspid endocarditis (~1.6 by 1.8 cm veg) with persistently positive blood cultures on D5. Currently day 8 therapy of vancomycin, d3 of ceftaroline. CT surgery planning intervention soon.

Do you ask for susceptibilities on persistently positive MRSA culture?

[Antonio Guerrero @guerreroespejo]

35-year-old man on TMP-SMX: annular, scaly, blistering, violaceous 5-cm plaque with an erythematous rim on the left anterior chest.

6 months earlier: identical lesion at the same site after the same drug; healed with hyperpigmentation.

Diagnosis?

#Dermatology #MedEd
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[Dr sthanu subramanian @drsthanus]

What is the most likely diagnosis of this patient in his 40s, associated with these findings and symptoms of eye and ear pain?