TWiP 211: Monoclonal against malaria in Mali
TWiP 211: Monoclonal against malaria in MaliDecember 7, 2022TWiP solves the case of the Man from Hong Kong with Multiple Comorbidities, and discuss safety and efficacy of a monoclonal antibody against malaria in Mali. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Click arrow to playDownload TWiP #211 (51 MB .mp3, 84 minutes) Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Monoclonal antibody against malaria trial (NEJM) Hero: Stephen Hoffman Letters read on TWiP 211 Become a patron of TWiP Case Study for TWiP 211 Man in his 20s originally from Mali who comes in with a dermatological complaint about 1 mo after he returned from spending time in Bamako, Mali with friends and family. Reports this has been going on for months and he is getting very frustrated as he is not getting any answers. He relates that this started with itching over a “blackhead” resembling a pimple that was itchy and very small. Over the subsequent months it started to get larger with ongoing itchiness but no pain. No erythema or warmth in the area. Other lesions developed in addition to the first one. There was no drainage from the skin lesions. He started putting triple antibiotic ointment on his lesions that he bought from a pharmacy. He then went to his primary doctor who prescribed a topical medication and PO antibiotics but this did not help.  He reports that when in Mali he stayed in his house with his parents, siblings, grandmother and other extended relatives – more than 40-50 people under one roof. food made by his family, reports consumption of only cooked meat, no uncooked meat. Ate salads and uncooked vegetables. No contact with any animals, no pets in the home. Denies any contact with any pets or farm animals such as pigs, cows, horses, cattle. Denies swimming in any lakes or ponds. No hiking or outdoor activities. No riding horses. Was sexually active in Mali with women and is HIV negative.  On examination he has a 10 cm lesion over anterior L thigh, with verrucous and vegetative appearance with yellow crusting over central area and heaped up lesion, not undermined. No erythema, warmth or drainage. Has a similar smaller lesion measuring about 3 cm on R flank. Has a 3rd smaller lesion with some mild crusting and about 2cm over R posterior thigh. He ends up getting a biopsy that reveals: HISTOLOGIC FEATURES That ARE NOT DIAGNOSTIC.  THERE IS NO EVIDENCE OF any specific organisms.  THE EXOGENOUS MATERIAL WHICH COULD REPRESENT SOME TYPE OF FOREIGN BODY IS NOT IDENTIFIABLE AS PART OF A FLY OR ARTHROPOD, NOR IS IT TYPICAL OF A SPLINTER AND ITS PRESENCE IN THE SPECIMEN MAKES IT PROBLEMATIC AS TO ITS SIGNIFICANCE. MICROSCOPIC DESCRIPTION: WITHIN THE DERMIS THERE IS A DENSE DIFFUSE MIXED CELL INFLAMMATORY INFILTRATE INCLUDING MANY PLASMA CELLS AND NEUTROPHILS. THERE IS EXOGENOUS MATERIAL.  PAS, GMS, FITE AND GRAM STAINS ARE NEGATIVE FOR INFECTIOUS ORGANISMS. Additional testing is ordered that leads to the diagnosis. He is planning on returning to Mali and perhaps sooner than originally planned if he does not get a diagnosis since he thinks the doctors in Mali would know what he has. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees [...] Read more...
TWiV 959: Clinical update with Dr. Daniel Griffin
TWiV 959: Clinical update with Dr. Daniel GriffinDecember 3, 2022In his weekly clinical update Dr. Griffin discusses effectiveness of influenza vaccination of pregnant women for prevention of maternal and early infant Influenza-associated hospitalizations in South Africa, a multivalent nucleoside-modified mRNA vaccine against all known influenza virus subtypes, single and 2-dose vaccinations with modified vaccinia Ankara-Bavarian Nordic induce durable B cell memory responses comparable to replicating smallpox vaccines, whether the risk of still and preterm birth is affected by the timing of symptomatic SARS-CoV-2 infection during pregnancy, medical masks versus N95 respirators for preventing COVID-19 among health care workers, alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants, real-world evidence of novel treatments for COVID-19 on mortality: a nationwide comparative cohort study of hospitalized patients in the 1st, 2nd, 3rdand 4th wave in the Netherlands, and effectiveness and safety of extended thromboprophylaxis in post-discharge patients with COVID-19. Click arrow to playDownload TWiV 959 (26 MB .mp3, 43 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Effectiveness of Influenza vaccination in pregnant women (OFID) 6:23 Multivalent nucleoside-modified mRNA vaccine against Influenza subtypes (Science) 7:56 Single and 2-dose vaccinations with modified vaccinia Ankara-Bavarian Nordic (JID) 10:00 Is the risk of still and preterm birth affected by the timing of symptomatic SARS-CoV-2 infection? (AJOG) 12:00 Medical masks versus N95 respirators for preventing COVID-19 among health care workers (ACP) 14:24 Bebtelovimab fact sheet for providers (FDA) Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants (bioRxiV) 26:59 Paxlovid patient eligbiliity screening checklist (FDA) Real-world evidence of novel treatments for COVID-19 on mortality (OFID) 31:04 Effectiveness and safety of extended thromboprophylaxis in post-discharge patients with COVID-19 (Thrombosis Research) 38:10 Contribute to our MicrobeTV fundraiser at PWB 41:17 Dr. Griffin’s treatment guide (pdf) Letters read on TWiV 959 41:34 Timestamps by Jolene. Thanks! Intro music is by Ronald JenkeesSend your questions for Dr. Griffin to daniel@microbe.tv [...] Read more...
Infectious Disease Puscast #16
Infectious Disease Puscast #16November 29, 2022On episode #16 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 11/9/22 – 11/23/22. Hosts: Daniel Griffin and Sara Dong Click arrow to playDownload Puscast 016 (19 MB .mp3, 32 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Recommendations of the advisory committee on immunization practices for measles, mumps, rubella (CDC) Bacteremia with anaerobic bacteria and association with colorectal cancer (CID) Factors impacting the yield of image-guided biopsy in native vertebral osteomyelitis (OFID) Development of a clinical prediction score to inform tuberculosis treatment among children with HIV (OFID)  First detection and molecular identification of Rickettsia massiliae, a human pathogen (PLOS) Short-course vs long-course antibiotic therapy for children with nonsevere community-acquired pneumonia (JAMA) The timing of preoperative urinary tract infection influences the risk of prosthetic joint infection following primary total hip and knee arthroplasty (JOA) Recurrent candidemia: trends and risk factors among persons residing in 4 US States (OFID) Spread of Sporothrix spp through respiratory droplets from infected cats (Medical Mycology) Comparison of mold active triazoles as primary antifungal prophylaxis in patients with newly diagnosed acute myeloid leukemia (CID) Geographic distribution of dimorphic mycoses in the United States (CID) Knowledge, experiences, and practices of women affected by female genital schistosomiasis in rural Madagascar (PLOS NTDs) Dynamic immune profile in French Toxoplasmosis patients  White-Tailed deer are susceptible to the agent of classical sheep scrapie after experimental oronasal exposure (JID) The Lanzhou Brucella Leak: The largest laboratory accident in the history of Infectious Diseases (CID) Music is by Ronald Jenkees [...] Read more...
TWiV 957: Clinical update with Dr. Daniel Griffin
TWiV 957: Clinical update with Dr. Daniel GriffinNovember 26, 2022In his weekly clinical update Dr. Griffin discusses human monkeypox virus infection in women and non-binary individuals during the 2022 outbreaks, changes in population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States, updates on COVID-19–related mortality, impact of community masking on COVID-19, effectiveness of the COVID-19 vaccines against hospitalization with Omicron sub-lineages BA.4 and BA.5 in England, cardiovascular outcomes after Tixagevimab and Cilgavimab use for pre-exposure prophylaxis against COVID-19, how Paxlovid is associated with decreased hospitalization rate among adults with COVID-19, inside the mind of an anti-paxxer, and angiotensin receptor blockers for the treatment of COVID-19. Click arrow to playDownload TWiV 957 (26 MB .mp3, 43 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Human monkeypox virus infection in women and non-binary individuals (The Lancet) 6:09 Changes in population immunity against infection and severe disease from variants (Medrxiv) 8:48 Updates on COVID-19 related mortality (CDC) 9:30 Impact of community masking on COVID-19 (Science) 13:39 Effectiveness of the COVID-19 vaccines against hospitalization (The Lancet) 15:17 Cardiovascular outcomes after tixagevimab and cilgavimab use for pre-exposure prophylaxis (CID) 23:18 Bebtelovimab fact sheet for providers (FDA) Paxlovid associated with decreased hospitalization among adults (CDC) 26:11 Inside the mind of an Anti-Paxxer (The Atlantic) 28:48 Paxlovid patient eligbiliity screening checklist (FDA) Angiotensin receptor blockers for the treatment of COVID-19 (BMJ) 34:24 Long COVID treatment research study (Stanford) HHS long COVID study (pdf) Biden administration requests long COVID funding (WaP0) Contribute to our MicrobeTV fundraiser at PWB 37:49 Dr. Griffin’s treatment guide (pdf) Letters read on TWiV 957 38:37 Timestamps by Jolene. Thanks! Intro music is by Ronald JenkeesSend your questions for Dr. Griffin to daniel@microbe.tv [...] Read more...
TWiV 955: Clinical update with Dr. Daniel Griffin
TWiV 955: Clinical update with Dr. Daniel GriffinNovember 19, 2022In his weekly clinical update Dr. Griffin discusses the four things to know about RSV, the burden of respiratory syncytial virus in healthy term-born infants in Europe, the diagnostic accuracy of rapid diagnostic tests for Ebola virus disease, evaluating the accuracy of self-collected swabs for the diagnosis of monkeypox, tecovirimat is effective against human monkeypox virus in vitro at nanomolar concentrations, acute and postacute sequelae associated with SARS-CoV-2 reinfection, clinical course of SARS-CoV-2 infection and recovery in lung transplant recipients, effectiveness of a third BNT162b2 mRNA COVID-19 vaccination during pregnancy, maternal antibody response and transplacental transfer following SARS-CoV-2 infection or vaccination in pregnancy, impact of community masking on COVID-19, Lifting Universal Masking in Schools – Covid-19 Incidence among Students and Staff, systematic review of the clinical effectiveness of Tixagevimab/Cilgavimab for prophylaxis of COVID-19 in immunocompromised patients, comparative effectiveness of sotrovimab and molnupiravir for prevention of severe COVID-19 outcomes in patients in the community, early adoption of anti–SARS-CoV-2 pharmacotherapies among us veterans with mild to moderate COVID-19, evaluation of viral and symptom rebound differences between Paxlovid and untreated COVID-19 participants, monoclonal antibodies for treatment of SARS-CoV-2 infection during pregnancy, twice daily oral zinc in the treatment of patients with COVID-19, cognitive deficits in long Covid-19, severe Neuro-COVID is associated with peripheral immune signatures, autoimmunity and neurodegeneration, and long-lasting symptoms after an acute COVID-19 infection and factors associated with their resolution. Click arrow to playDownload TWiV 955 (28 MB .mp3, 47 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Four things to know about RSV (Gates Foundation) 3:28 The burden of RSV in healthy term-born infants in Europe (The Lancet) 5:25 Diagnostic accuracy of rapid tests for Ebola (CMI) 7:32 Accuracy of self-collected swabs for diagnosis of Monkeypox (CID) 8:16 Tecovirimat is effective against human monkeypox virus in vitro (Nature) Acute and postacute sequelae associated with SARS-CoV-2 reinfection (Nature Medicine) 9:06 SARS-CoV-2 infection and recovery in lung transplant recipients (Transplant Infectious Diseases) 14:49 Effectiveness of third COVID-19 vaccination during pregnancy (Nature Communications) 16:23 Maternal antibody response and transplacental transfer following infection or vaccination (CID) 17:45 Impact of community masking on COVID-19 (Science) Lifting universal masking in schools (NEJM) 20:08 Bebtelovimab fact sheet for providers (FDA) Effectiveness of Tixagevimab/Cilgavimab for prophylaxis of COVID-19 (medRxiv) 25:39 Effectiveness of Sotrovimab and Molnupiravir for prevention of severe COVID-19 outcomes (BMJ) 26:34 Early adoption of Anti–SARS-CoV-2 pharmacotherapies among US veterans (JAMA) 28:17 PAXLOVID patient eligibility screening checklist (FDA) Viral and symptom rebound differences between Paxlovid and untreated COVID-19 participants (medRxiv) 30:18 Monoclonal antibodies for treatment of SARS-CoV-2 during pregnancy (Annals of Internal Medicine) 34:47 Remdesivir fact sheet for providers (Veklury)  Twice daily oral zinc in the treatment of patients with COVID-19 (CID) 35:45 Cognitive deficits in long COVID-19 (NEJM) 37:58 Severe Neuro-COVID associated with peripheral immune signatures, autoimmunity and neurodegeneration (Nature Communications) 40:15 Long-lasting symptoms after an acute COVID-19 Infection (JAMA) 40:50 Contribute to our MicrobeTV fundraiser at PWB 41:34 Dr. Griffin’s treatment guide (pdf) Letters read on TWiV 955 41:59 Timestamps by Jolene. Thanks! Intro music is by Ronald JenkeesSend your questions for Dr. Griffin to daniel@microbe.tv [...] Read more...
Infectious Disease Puscast #15
Infectious Disease Puscast #15November 15, 2022On episode #15 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 10/27/22 – 9/9/22. Hosts: Daniel Griffin and Sara Dong Click arrow to playDownload Puscast 015 (23 MB .mp3, 38 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Clinical presentation and severity of adenovirus detection alone vs adenovirus co-detection with other respiratory viruses in US children (JPID)Effectiveness of different antimicrobial strategies for staphylococcal prosthetic joint infection (OFID)Clinical impact of ceftriaxone resistance in E. coli bloodstream infections (OFID) Adjunctive Gentamicin and Rifampin in staphylococcal prosthetic valve Endocarditis (OFID)Diagnostic performance of physician gestalt for bacteremia in patients in the process of being admitted with suspected infection (OFID)Effectiveness of quinolone prophylaxis in pediatric acute leukemia and hematopoietic stem cell transplantation (OFID)Risk factors for Vancomycin drug reaction with Eosinophilia and Systemic symptoms syndrome (JAMA)Prospective evaluation of the fungitell 1>3 beta-d-glucan assay as a diagnostic tool for invasive fungal disease (Wiley)Safety and efficacy of a monoclonal antibody against malaria in Mali (NEJM)Hospitalizations associated with strongyloidiasis in the United States (CID) Prophylactic benznidazole treatment fails to prevent Trypanosoma cruzi infection in dogs (PLOS NTD)Baker’s dozen of top antimicrobial stewardship intervention publications for hospitalized patients (OFID)Baker’s dozen of top antimicrobial stewardship intervention publications in non-hospital care settings in 2021 (OFID)Medical student debt and the US ID workforce (CID) Music is by Ronald Jenkees [...] Read more...
TWiV 953: Clinical update with Dr. Daniel Griffin
TWiV 953: Clinical update with Dr. Daniel GriffinNovember 12, 2022In his weekly clinical update Dr. Griffin discusses high demand for Amoxicillin causing shortages amid child RSV surge, epidemiologic and clinical features of children and adolescents aged <18 years with monkeypox, low risk of SARS-Cov-2 transmission by fomites, nucleocapsid antigenemia is a marker of acute SARS-CoV-2 infection, impact of community masking on COVID-19,  protection against Omicron from vaccination and previous infection in a prison system, Nirmatrelvir and the risk of post-acute sequelae of COVID-19, Bebtelovimab for high-risk outpatients with early COVID-19 in a large US health system, imprinted SARS-CoV-2 humoral immunity induces convergent Omicron RBD evolution, can SARS-CoV-2 trigger new onset of autoimmune disease in adults? A case-based review, and retrospectively modeling the effects of increased global vaccine sharing on the COVID-19 pandemic. Click arrow to playDownload TWiV 953 (33 MB .mp3, 55 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode High demand for Amoxicillin causing shortages amid RSV surge (Washington Post) 3:39Epidemiologic and clinical features of children & adolescents with monkeypox (CDC) 6:18Low risk of SARS-Cov2 transmission by fomites (IDSA) 12:44Nucleocapsid Antigenemia Is a marker of acute SARS-CoV-2 Infection (JID) 15:45Impact of community masking on COVID-19 (Science) 17:00Remdesivir fact sheet for providers (Veklury) Protection against Omicron from vaccination & previous infection in prison system (NEJM) 18:39Nirmatrelvir and the risk of post-acute sequelae of COVID-19 (medRxiv) 23:36Bebtelovimab for high-risk outpatients with COVID-19 (OFID) 32:05Imprinted SARS-CoV-2 immunity induces convergent Omicron evolution (bioRxiv) 33:53PAXLOVID patient eligibility screening checklist (FDA)Can SARS-CoV-2 trigger new onset of autoimmune disease in adults? (Cell) 40:46Bebtelovimab fact sheet for providers (FDA) Modeling the effects of global vaccine sharing on the COVID-19 pandemic (Nature) 42:14Contribute to our MicrobeTV fundraiser at PWB 45:08Dr. Griffin’s treatment guide (pdf)Letters read on TWiV 953 45:56Timestamps by Jolene. Thanks! Intro music is by Ronald JenkeesSend your questions for Dr. Griffin to daniel@microbe.tv [...] Read more...
TWiV 952: Jake Scott put the ID in COVID-19
TWiV 952: Jake Scott put the ID in COVID-19November 6, 2022Infectious Disease physician Jake Scott joins TWiV to provide a west coast clinical perspective on the evolution of the COVID-19 pandemic with respect to the impact of vaccines, antivirals, variants of concern and mortality. Hosts: Vincent Racaniello, Alan Dove, Rich Condit,  and Kathy Spindler Guest: Jake Scott Click arrow to playDownload TWiV 952 (63 MB .mp3, 104 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Support MicrobeTV with a Spike t-shirt (Vaccinated.us) with promo code MicrobeTVOmicron variant reproduction ex vivo (Nature) 16:21Clinical outcomes with Omicron (Nat Med) 23:02Low neutralizing antibodies induced by bivalent booster (NEJM) 30:38Antibody responses to bivalent booster (bioRxiV)Spike T cell responses not enhanced by bivalent booster (Sci Immunol)Pandemic end will not be televised (BMJ) 28:06Conflation of infection and disease (Twitter) 53:16Letters read on TWiV 952 1:09:24Timestamps by Jolene. Thanks! Weekly Picks 1:30:22 Kathy – 10 moments for Jazz at Lincoln Center Orchestra Residency (Item 7) and Alan’s pick from TWiV 931 The Kissing Bug by Daisy HernandezRich – Wilderness Safaris Photographic Competition 2022Alan – Massachusetts Science Education Leadership Association, and the talk I gave to them last weekVincent – Andrea Camillieri and his protagonist Inspector Montalbano Listener Pick Frank – Economics for the Future: Beyond the SuperorganismDebby – As routine vaccination rates fall, polio survivor hopes her story reverses urgent trend Intro music is by Ronald JenkeesSend your virology questions and comments to twiv@microbe.tv [...] Read more...
TWiV 951: Clinical update with Dr. Daniel Griffin
TWiV 951: Clinical update with Dr. Daniel GriffinNovember 5, 2022In his weekly clinical update Dr. Griffin discusses Influenza incidence and vaccine effectiveness during the southern hemisphere influenza season in Chile, Nirsevimab for prevention of RSV infection in healthy late-preterm and term infants, severe Monkeypox in hospitalized patients, reinfections with different SARS-CoV-2 Omicron subvariants, impact of community masking on COVID-19 in Bangladesh, unadjuvanted intranasal spike vaccine elicits protective mucosal immunity against sarbecoviruses, antibody responses to Omicron BA.4/BA.5 bivalent mRNA vaccine booster shot, immunogenicity of bivalent mRNA vaccine boosters, long-term gastrointestinal sequelae following COVID-19, evaluation of an automated text message–based program to reduce use of acute health care resources after hospital discharge, and how in adults with COVID-19, melatonin was assessed for effects on inflammatory markers, clinical signs and symptoms, and mortality. Click arrow to playDownload TWiV 951 (30 MB .mp3, 50 min)Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Influenza incidence and vaccine effectiveness (CDC) 4:54Nirsevimab for prevention of RSV (NEJM) 7:05Severe Monkeypox in hospitalized patients (CDC) 11:08Reinfections with different SARS-CoV-2 Omicron subvariants (CDC) 14:35Impact of community masking on COVID-19 (Science) 18:30Vaccine elicits protective immunity against sarbecoviruses (Science) 21:35Antibody responses to bivalent mRNA vaccine booster shot (Biorxiv) 24:15Immunogenicity of bivalent mRNA vaccine boosters (Biorxiv) 25:41Long-term gastrointestinal sequelae following COVID-19 (CGH) 37:58Remdesivir fact sheet for providers (Veklury) Bebtelovimab fact sheet for providers (FDA)Evaluation of an automated text message–based program (JAMA) 40:23Melatonin assessed for effects on inflammatory markers in COVID patients (Heliyon) 41:14PAXLOVID patient eligibility screening checklist (FDA)Contribute to our MicrobeTV fundraiser at PWB 43:38Dr. Griffin’s treatment guide (pdf)Letters read on TWiV 951 44:39Timestamps by Jolene. Thanks! Intro music is by Ronald JenkeesSend your questions for Dr. Griffin to daniel@microbe.tv [...] Read more...
TWiP 210: Is there a doctor on board? with Aisha Khatib
TWiP 210: Is there a doctor on board? with Aisha KhatibNovember 3, 2022From ASTMH2022 in Seattle, Aisha joins the TWiP team to talk about her training and her career, including delivering a baby on an airplane, and they solve the Case of the Heartsick Guatemalan Septuagenarian. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Guest: Aisha Khatib Click arrow to playDownload TWiP #210 (57 MB .mp3, 95 minutes) Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Aisha delivers baby on airplane (The Varsity)Helminth infections during pregnancy (J Travel Med)SARS-CoV-2 transmission during air travel (Curr Op Inf Dis)Letters read on TWiP 210 Become a patron of TWiP Case Study for TWiP 210 We are consulted about a rash.  A male in his mid 60s originally from Hong Kong with PMH of T2DM, Hypertension, BPH, Hepatitis B infection, COPD (not on home o2), current smoker, ESRD  with right chest cath on dialysis (MWF) presented to the ED  c/o progressive SOB and DOE for 1 week. 2 weeks prior the patient missed 1 session of hemodialysis. Progressively worsening SOB, DOE, orthopnea began to develop starting one week ago with an associated productive cough with white sputum. Last dialysis was session was 3 days PTA. Pt also began developing nausea and vomiting for 3 days x12 times last week. Pt also started developing diarrhea. Pt has states to have a notable generalized pruritic rash for 3 months that has been worsening. He reports he has been seen by dermatology and was told that the rash is due to certain allergies from food and has been using an unknown cream for 1 month that does not relieve his symptoms. Pt recently admitted for management of bleeding permacath and acute hypoxic respiratory failure likely 2/2 COPD requiring intubation and vent support. Denies recent travel, recent antibiotic use, or sick contacts…but his nephrologist reaches out and is concerned about a certain diagnosis as he says three other patients that come for dialysis have recently been diagnosed with a certain diagnosis. On exam ee has a diffuse symmetrical rash and is scratching the while time. On careful examination there are small linear scabbed areas between his fingers.          9.3   8.97  )———–( 210                28.4  Absolute eosinophil count is >1000 134<L>  |  97  |  51<H> —————————-<  184<H> 3.8   |  25  |  5.10<H> Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees [...] Read more...