Top Tweets for #IDfellowcase
Great case! I've saved the #IDFellowCase graphics in an archive @ https://t.co/K9aXv81djQ
You can find this KICS case from @NNolanMD and KS/KSHV slides here: https://t.co/nb3OyY0XL1
@divya_kondapi @mangarone23 @swinndong @k_vaishnani @LemuelNonMD @EvaClarkMD @ramya_ramaswami Indeed! Thank you for sharing your case @divya_kondapi. Your case, plus the one featured here and the case presented by @ID_fellows 👇 highlight the importance of having an illness script on when to suspect KICS and what tools are needed to dx it.
https://t.co/67iOt0MslM
@k_vaishnani @WuidQ @ID_fellows @TxID_Edu @VarunPhadke2 @SAIRABT @ncabrera Nice throwback to #IDFellowCase w/ @NNolanMD ! Could be KSHV driven lymphoproliferative process like Castleman vs KICS; would also wonder about KS➡️IRIS?
Would still consider disseminated mycobact inf and AFB bcx. Add CMV VL too.May need to think about LN bx depending on course
Missed #IDFellowCase? You can review it by typing #IDFellowCase into your search bar and scrolling thru
#IDFellowCase
So your results are back and we have a final diagnosis!!
A few picked up on the rash, and our splenic biopsy demonstrated peliosis (see pics below)
⭐️⭐️We still need your help, stay tuned for a little learning and more questions!⭐️⭐️
I really adore the scratching post I added in this graphic #IDMedEd #IDTwitter #IDFellowCase
Hope that combining #IDFellowCase and the newest @febrilepodcast with @MedEdMomma can help you think about the broad spectrum of Bartonella infections in both adults and kids!
#IDFellowCase
Quick overview of Bartonella henselae, which probably initially brings to mind cat scratch disease -- but keep in mind the atypical presentations
....more on this in a minute!
@k_vaishnani @adolfo7777 @WuidQ @IDFellowsCup Woohoo! I was hoping that this #IDFellowCase could tie in to #IDFellowsCup and @febrilepodcast 😊 Gotta get that #IDMedEd spaced learning in
@ID_fellows @adolfo7777 @WuidQ @IDFellowsCup taught me that verruga peruana can present after asymptomatic/subclinical phase. Most common form is miliary skin lesions (not wart-like lesions as I previously thought). #IDFellowCase
#IDFellowCase
Got it! This page highlights Carrion’s disease & biphasic illness pattern with Oroya fever and verruga peruana
@adolfo7777 mentioned this in ddx earlier! Any other pearls?
#IDMedEd #IDTwitter
A tweetorial on the topic from @wuidq as well
https://t.co/n39ttlbbUH
(1/2) 30/M w fever, confusion, jaundice. Fever 5d ago w myalgia. 1d prior, +AMS/jaundice. Returned 3 wks ago fr the Andes mountains in Peru, took Malarone, +vaccines, had +arthropod bites. WBC 8, Hgb 4.5, plt 180. ALT 68, TB 6 (0.8 direct), haptoglob <30. Blood smear shown:
#IDFellowCase
Great job everyone!
⭐️Q5⭐️
Speaking of Bartonella, let’s end on a related topic/trivia question! Follow-up graphic to come!
See question below
#IDMedEd
As @LParraRod mentioned, important to think about the host and immunosuppression, which may also impact your duration of therapy. Ex:
Getting ART on board
Consideration of extended therapy depending on chemo/transplant IS, etc #IDFellowCase
#IDfellowcase
Tx recs for Bartonella rely on anecdote & expert opinion
Possible durations👇many use dual therapy for severe dz but rif hard w/DDIs + HIV meds
W/peliosis+OM in this case, likely looking at least 3-4 mo with at least doxy
Following tweets have some refs!
#IDFellowCase
Here are some reviews of treatment for bartonellosis:
📌https://t.co/5VzXhOv7yU
📌https://t.co/qi5nkJ6t4I
📌
#IDfellowcase
Tx recs for Bartonella rely on anecdote & expert opinion
Possible durations👇many use dual therapy for severe dz but rif hard w/DDIs + HIV meds
W/peliosis+OM in this case, likely looking at least 3-4 mo with at least doxy
Following tweets have some refs!
@ID_fellows Doxy would be OK too +/- rifamycin (would have to think about interaction with biktarvy though #idfellowcase
@KrutiYagnikDO #IDFellowCase Great, you brought up combination therapy - which many would be thinking about with severe disease as you said!
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