TWiP 245: Flying purple people eater with Ben LaBrot

Founder of Floating Doctors Ben LaBrot joins TWiP to solve the case of the 1 year old in northeastern Panama with a fatal leg infection, followed by a discussion of the history and mission of Floating Doctors.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

Guest: Ben LaBrot

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New Case

A man in his early 20s comes in reporting pain when he urinates or ejaculates. He reports that he is sexually active. He does confide that he has been in a relationship with a woman but he had a sexual encounter outside this relationship about 2 weeks ago when they were on a break and he did not wear protection. He feels like he needs to urinate more often and describes thin white discharge from the penis. He reports that he has no history of any sexually transmitted infections and had no medical issues prior to this.

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Music by Ronald Jenkees

TWiP 244: Engineering Toxoplasma

Lilach Sheiner joins TWiP to talk about her career and her work on engineering Toxoplasma gondii secretion systems for intracellular delivery of multiple large therapeutic proteins to neurons.

Hosts: Vincent Racaniello, Dickson Despommier, and Christina Naula

Guest: Lilach Sheiner

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Music by Ronald Jenkees

TWiP 243: Don’t blame it on Mexico

TWiP solves the case of the Woman with White Worms, and submits a new case involving a 1 year old in northeastern Panama with a fatal leg infection.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

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New Case

This case comes from Panama mid summer 2024. A provider for Floating Doctors working in the coastal region in northeastern Panama. This case involves a one year old, so the history is a bit difficult, but there may have initially been a scratch or some sort of break in the skin. Otherwise healthy but over a period of time this area expands and becomes a deep necrotic wound on the leg. Several other nearby wounds develop and become deep and infected. By the time this one year old is seen by the provider much of the leg appears eaten away. This is just the tip of the iceberg as a number of others develop similar wounds in the area. No prior medical history.

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Music by Ronald Jenkees

TWiP 242: Worms impair COVID vaccines

TWiP reviews a study showing that intestinal helminth infection impairs vaccine-induced T cell responses through an IL-10 pathway, which compromised protection against antigenically drifted SARS-CoV-2 variants.

Hosts: Vincent Racaniello, Daniel Griffin and Christina Naula

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Music by Ronald Jenkees

TWiP 241: There once was a patient from China

TWiP solves the case of the man from China with drenching sweats, discusses ‘worms’ found in Olympic food, and presents a new case for you to solve.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

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New Case

A woman in her 20s who has been previously healthy comes in to an Urgent Care in the NY TriState area reporting and I quote “I’ve seen small white worms in my stool since yesterday.” The small round white worms are about 1 cm in length. She reports that she recently returned from a trip to Mexico where she stayed in a luxury resort. She reports never leaving the resort, only drinking bottled water, but does volunteer that she did eat from the salad bar/buffet at the resort. She reports some lower abdominal cramping but no actual pain. She reports no fever, no chills, no rash, no diarrhea, no rectal pain, and no anal itching. Her exam is unremarkable and she refuses a rectal exam. Blood work is unremarkable and stool O+P is sent that comes back negative. 

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Music by Ronald Jenkees

TWiP 240: A daily history of malaria with Sean Murphy

Sean Murphy joins TWiP to discuss his career and his laboratory’s work to assess the daily natural history of asymptomatic Plasmodium infections in adults and older children in Katakwi, Uganda.

Hosts: Vincent Racaniello, Dickson Despommier and Christina Naula

Guest: Sean Murphy

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Music by Ronald Jenkees

TWiP 239: Cryptosporidiosis from NYC tap water in an AIDS patient

TWiP solves the case of the AIDS patient who developed fever and watery diarrhea after drinking NYC tap water, and present a new case for your sleuthing.

Hosts: Vincent Racaniello and Daniel Griffin

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New Case

Man in his 70s originally from Mainland China, then Hong Kong who has been living in the US for decades is admitted to the hospital with fever for 6 days. He reports that he saw his primary care physician in Queens and was referred to the hospital after blood work revealed a sodium level of 123 and an increased monocyte count. Pt reports drenching sweats, lots of outdoor activity walking in local parks in Queens. He reports he does not feel particularly sick.
PMH-HTN, BPH
PSH-neg
Social-retired, no wife, has one son, no pets, no exotic exposures or recent travel
VS febrile to 39.5, tachycardia, meets sepsis criteria
PE -unremarkable
Labs, nl wbc, eos-0, elevated neutrophils and monocytes, Na-123, elevated AST, elevated ALT, low platelets, low Hct, CT Chest A/P unremarkable

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Music by Ronald Jenkees

TWiP 238: Eliminating sleeping sickness

Michael Barrett joins TWiP to discuss progress in the elimination of human African trypanosomiasis caused by Trypanosoma brucei gambiense.

Hosts: Daniel Griffin, Dickson Despommier and Christina Naula

Guest: Michael Barrett

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Music by Ronald Jenkees

TWiP 237: Pass the venison, deer with Marilyn Fabbri

Marilyn Fabbri joins TWiP to reveal the case of a patient who became very ill after he and a number of friends attended a large dinner where venison and boar were served.

Hosts: Daniel Griffin, Dickson Despommier and Christina Naula

Guest: Marilyn Fabbri

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New Case

Man in his 60s with HIV/AIDS CD4 count less than 50, CD4% less than 5% and elevated viral load (VL) with report of prior CNS toxoplasmosis requiring a craniotomy, disseminated Mycobacterium avium complex (MAC), come in with fever and very watery diarrhea x 4 days. He reports that he lives in Georgia but comes up to NY for his HIV care and stays in NYC.

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Music by Ronald Jenkees

TWiP 236: Prime-and-trap vaccine for malaria

Marion Avril of MalarVx, Inc. joins TWiP to discuss an accelerated prime-and-trap regimen using repRNA-based circumsporozoite vaccine.

Hosts: Dickson Despommier and Christina Naula

Guest: Marion Avril

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Music by Ronald Jenkees

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