WuidQ: Washington University ID Questions

[WuidQ: Washington University ID Questions @WuidQ]

25/M p/w 6 mos personality changes. 3 mos ago, developed periodic myoclonic jerks & increased forgetfullness. 1 mo ago, developed cortical blindness. Has not received routine childhood/adult vaccination. Anti-measles Ab 1:256 (serum) & 1:8 (CSF). W/c is true of this condition?

[WuidQ: Washington University ID Questions @WuidQ]

#idgrandrounds
1/2
32 F w multiple sclerosis on rituximab, +10d fever, R knee pain in December. Had dysuria tx w/ TMP/SMX 1 wk prior. No trauma. Exam: swollen/tender R knee. No rash. Purulent synovial fluid: 60,000 cells 70%N. Multiple synovial/blood bacteria/fungal/AFB Cx (-)

[WashU Medicine Division of Infectious Diseases @WashUMedID]

We are ecstatic to welcome our outstanding fellows @AlexHartlage and Drs Hendrix Hixon Meyer and Nordman to @WashUID We can’t wait to work with you! #IDMatch2023 @IgeGeorgeMD @CalineMattar @FungalDoc

[Hilary Babcock @h_babcock]

So proud to know Dr Nigar Kirmani, long time @WashUID fellowship program director and @WUSTLmed ID course master, honored at #IDWeek2023 with the @IDSAInfo Clinical Teacher Award 🎉🎉@WUSTLmed

[Saman Nematollahi @TxID_Edu]

Come and explore @WuidQ framework for fever in returning traveler, it’s amazing

A- adventure (where they went)
B- body (clinical syndrome)
C- chronology
D- defense (vaccine/ppx)
E- exposure (safari?!)
E- eosinophilia

Illness script for #Katayama fever is 🔥🔥🔥

[WashU Medicine Division of Infectious Diseases @WashUMedID]

We have unfilled #IDfellowship spots @WUSTLmed If you are interested in ID consider joining us in beautiful St Louis! World class research, friendly collegial environment and the best profession! #IDTwitter #match2022 #MedTwitter

[Ariella Coler-Reilly🏳️‍🌈 @AriellaStudies]

So excited to do the graphics for this monumental study.

In medical school we're still taught to diagnose fungal infections based on maps from 60+ years ago! A much needed update👇🧵

🙏Thanks to @PBMazi
@arauseomd @JulioCZuniga1 @FungalDoc @CIDJournal
🔗 https://t.co/86kTAXi09X

[WuidQ: Washington University ID Questions @WuidQ]

@Abhishekrth7 It’s from the adage physicians are taught in med school: When you hear hoofbeats, think horse, not zebra (meaning, think of common diseases rather than rare ones). Typhoidal tularemia can present as FUO, a rare manifestation that is difficult to diagnose. Hence the zebra.

[WuidQ: Washington University ID Questions @WuidQ]

𝗜𝗗 𝗖𝗼𝗿𝗲 𝗧𝗼𝗽𝗶𝗰𝘀 𝟭 #idcoretopics
1/20

TICKBORNE INFECTIONS (TBI)

It’s summer (= tick bites 🐞) and we have new faculty, fellows, residents, interns, & students coming from different places.
@grepmeded

This tweetorial is an overview of TBI mainly in the US.

[Takahiro Matsuo (Taka), MD @TakaMatsuo_ID]

Bacterial syndrome pearls by Dr. Escota!

#IDWeek2022 #Boardreview #IDMedEd #Clinicalpearls @MDdreamchaser @WuidQ

[HIV Medicine Association @HIVMA]

Darrell McBride, DO of @GeisingerHealth. Dr. McBride will serve as a Director.

[HIV Medicine Association @HIVMA]

The results are in! 🗳️ @HIVMA is excited to announce the new Officers & Directors, overwhelmingly approved by voting members, to serve on HIVMA's Board of Directors, beginning their roles following @IDWeek2022.
Learn more here: https://t.co/dcYNSy9FqZ
@IDSAInfo

[WuidQ: Washington University ID Questions @WuidQ]

@AvrahamCooperMD @grepmeded Case here

[WuidQ: Washington University ID Questions @WuidQ]

(Part 1 of 2, MCQ in part 2)
28F +4d RUQ pain worse w/ inspiration, 102F fever, no vaginal discharge, rash, or other Sx. Exam: +Murphy's. WBC 7, AST/ALT mildly ⬆️, lipase n/l, (-) preg test. (-) HIV, RPR. RUQ-US: +cholelithiasis. CT: +enhancement of liver capsule 👇.

[WuidQ: Washington University ID Questions @WuidQ]

@hephandeden @AvrahamCooperMD @Inside_TheMatch @grepmeded @WuidQ case ➡️

[WuidQ: Washington University ID Questions @WuidQ]

(Part 1 of 2, MCQ in part 2)
28F +4d RUQ pain worse w/ inspiration, 102F fever, no vaginal discharge, rash, or other Sx. Exam: +Murphy's. WBC 7, AST/ALT mildly ⬆️, lipase n/l, (-) preg test. (-) HIV, RPR. RUQ-US: +cholelithiasis. CT: +enhancement of liver capsule 👇.

[WuidQ: Washington University ID Questions @WuidQ]

Q&A
44M w HIV, not on ART, VL 33k, CD4 119
Febrile, confused w R wrist & B knee arthritis
SF RBC 151k, 62% PMN, no crystals
CSF WBC 191, gluc 37, prot 108
BCx, CSF Cx, SF Cx all +ve
@ID_fellows @gayathriIDdoc @LParraRod @patrickching @MansoorArmaghan @febrilepodcast

[Indiana University Infectious Diseases Fellowship @IUIDfellowship]

#idboardreview A persian farmer with fever, back pain, anemia, thrombocytopenia, inc LDH, S1 septic arthritis, BC Catalase+, small, gray, convex, smooth colonies. No ID by Verigene GP or MALDI. Misleading/tricky gram stain. #idtwitter #idmeded #MedEd

[WuidQ: Washington University ID Questions @WuidQ]

Oops. Didn't link answer and tweetorial correctly. Link here!
https://t.co/lVjwO3TRxP

[WuidQ: Washington University ID Questions @WuidQ]

1/12
Answer: Malassezia (Pityrosporum) folliculitis
Tweetorial to follow
Image in MCQ from https://t.co/J1dnxaCnRv

[WuidQ: Washington University ID Questions @WuidQ]

1/2
MCQ
38M w LVAD for NICM
On suppressive doxycycline for prior MRSA DLI
P/w intensely pruritic rash on back, chest, arms (representative pic next tweet)
⛔️fever/other constitutional symptoms
VS WNL
CBC, CMP WNL
KOH prep of skin scraping showed yeast
Most likely etiologic Dx?

[WuidQ: Washington University ID Questions @WuidQ]

2/2
MCQ
Image credit to follow
@ID_fellows @MansoorArmaghan @gayathriIDdoc @patrickching @DLHong @swinndong @k_vaishnani @IUIDfellowship @BCMIDFellowship

[WuidQ: Washington University ID Questions @WuidQ]

12/12
That's all, folks!

[WuidQ: Washington University ID Questions @WuidQ]

1/12
Answer: Malassezia (Pityrosporum) folliculitis
Tweetorial to follow
Image in MCQ from https://t.co/J1dnxaCnRv

[WuidQ: Washington University ID Questions @WuidQ]

11/12

Tx
Topicals - selenium sulfide shampoo, topical ketoconazole
Systemic - oral fluconazole, itraconazole
Recalcitrant - isotretinoin, photodynamic tx