TWiP 133: Tape test

TWiP

rhoptryDaniel and Vincent solve the case of the Woman With Anal Area Discomfort, and discuss the multiple functions of a clathrin adapter protein in formation of rhoptry and microneme secretory organelles of Toxoplasma gondii.

Hosts: Vincent Racaniello and Daniel Griffin


Click arrow to play
Download TWiP #133 (59 MB .mp3, 97 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

Case Study for TWiP 133

Seen while working in remote mountain makeshift mobile clinic in Dominican Republic, on Haitian border. Traveled 3 h by pickup truck, remote mountain town, womens centers. Set up makeshift mobile clinic in this center. Mother concerned about 6 yo girl, failure to thrive compared with sister, protuberant belly, frequent abdominal discomfort, going on over 1 year. No surgeries, no meds, first time ever seeing medical person. Mother and sister are family. Three children in family. Father does timber work. Very impoverished region, living in dirt floor home, drinking untreated water from local stream, go to bathroom outside, could be contamination. Diet: carbohydrate, plantains, rice, beans. On exam: lungs clear, heart fine, belly protuberant, liver and spleen not enlarged, some edema. Mother said noticed long motile worm in girls feces. Firm belly, not painful to her.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 132: Salted crab som tum

TWiP

MeguroHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiP-tastic peeps solve the case of the Thai Man Coughing Up Blood, and reveal potential therapies for trypanosomiasis that are inhibitors of protein import into glycosomes.


Click arrow to play
Download TWiP #132 (56 MB .mp3, 92 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

Case Study for TWiP 132

Young NYC woman with son (10), chief complaint of discomfort and itchiness in anal area. Has tried to look but nothing abnormal. Married, no complaints from husband or child. Two older kids have no complaints. But son has also been scratching in anal area. Everything fine 3 months ago, sister came to visit with 3 young pre-school children, may have caught something from them. No past med or surg history, no allergies. No meds, work out of home, no toxic habits, no recent travel. Have dog. Do lots of volunteering with children. History of sushi consumption. She does not like raw fish but son does. Worse itching at night. Going on for a number of weeks. Reports being under a lot of stress recently due to family.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 131: Entomophagy

TWiP

Babesia vogeliHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest:  Jonathan Larson

Jonathan from the podcast Arthro-Pod joins the TWiPerati to solve the case of the Peruvian Woman With Inguinal Insect Bite, and discuss warm autoimmune hemolytic anemic that develops after babesiosis.


Click arrow to play
Download TWiP #131 (64 MB .mp3, 106 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 131

Thailand. 39 yo man reports 7 months of coughing up bright red blood, several times with mucus. Otherwise feels well. Big fan of salted crab som tum. Fisherman, lives with family. Healthy, no past med/surg problems. No meds. On seeing him: afebrile, chest xray abnormal: area of increased opacification. Not a smoker. No toxic habits.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 130: Paige Turner

TWiP

T. brucei motilityHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPniks solve the case of the Man With AIDS, and explore how secretion of extracellular vesicles influences the social motility of Trypanosoma brucei.


Click arrow to play
Download TWiP #130 (64 MB .mp3, 106 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 130

Back in Peru. 24 yo female seen in ER, lives in rural area outside of big city, adobe house in highlands, thatched roof, dirt floor, 3000 meters. Quite ill with skin lesion for 48 h. 2 days before was pulling on pjs, felt sharp sudden pain in right upper leg. Next day found small living creature in pajamas, inguinal region. Developed red lesion, enlarged, developed black central dot. Then begins vomiting, comes to hospital. No fever, breathing fast 20, hr 70, bp 160/10, on exam see in right inguinal region an enlarging, necrotic area 1-2 cm, starting to look sick. Whites at 26000, left shift, 200 platelets, eosinophils 4%, bilirubin 3.5, creatinine 4.9 (going into renal failure, not making much urine). Hematocrit 14, BUN 59.7, CPK 227, RBCs and leukocytes in urine. No health problems, no surgeries, first interaction with health system. No toxic habit. Brings in the small creature!

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 129: Human kindness, river blindness

TWiP

Onchocerca volvulus emerging from black flyHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiP Masters solve the case of the Australian Wildlife Carer, and review evidence that nodding syndrome may be caused by an autoimmune reaction to the parasitic worm that causes river blindness.


Click arrow to play
Download TWiP #129 (64 MB .mp3, 105 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 129

Young male in 30s, presents to ER with male partner, NY area, chief complaint over 1 month significant diarrhea, watery, non bloody. Abdominal cramping. Feels poorly, low energy, fever. Some vomiting, lost noticeable amount of weight, can’t stay hydrated. Past: AIDS positive, not on meds, last CD4 <50, viral load elevated and uncontrolled. Non contributory family history, no meds. Social history: had worked in office, can no longer; lives with male partner; occasional alcohol, no pets, no other significant exposures. Partner also AIDS, also not on therapy. Physical: febrile, 38.5C, 115 bp, 95/65, 18 resp, thin male, clearly uncomfortable. Oral thrush in buccal mucosa. No subungual saliva. Lungs clear, abdomen diffusely tender, increased bowel sounds. Labs: elevated creatinine, BUN, decreased sodium, elevated WBC count with significant eosinophilia. No pets or houseplants.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 128: It’s over 9000!

TWiP

It's Over 9000!Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPerati solve the case of the Man Who Sat in Feces, and discuss a study on how Dickson’s favorite parasite induces the formation of a collagen capsule.


Click arrow to play
Download TWiP #128 (65 MB .mp3, 108 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 128

Daniel doesn’t expect anyone to get this. From Australia, 80 yo retired teacher from Atherton, northheast Australia, presents to clinic with generalized weakness, concern of chronic lyme or Q fever. Seen by neurologist, concern about motor neuron disease. 18 months of illness, insidious onset of limb (arms and legs) weakness. No issues with speaking, swallowing or breathing; no weight loss; no fever, sweat, chill. History of osteoarthritis, joint replacements; myocarditis; vertigo; allergic to pen and dox. Father, rhematoid arthritis, brother colon cancer. On a number of medications. Does extensive travel, when not traveling, is a volunteer carer in Australia (abandoned wildlife), over the past three years. Lives with husband. Marsupials, hand feeds puggles and juvenile spiny anteaters, has pet cockatoo. No history of polio, HIV negative. Neuro exam: diffuse non tender muscle with no rash. Normal upper and lower limb tone, strength is symmetrically reduced proximally. Reflexes good at knees, normal sensation to all modalities. Normal cranial nerve exam. Test results: has eosinophilia, elevated muscle enzymes, EMG shows myopathic changes, nerve conduction normal. Stop statin therapy, no change. This is a rare parasite.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 127: Kava not Cava

TWiP

Lutzomyia longipalpis sandflyHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPsters solve the case of the Peace Corps Volunteer with a Liver Lesion, and discuss the dependence of Leishmania survival on the gut microbiome of the sandfly.


Click arrow to play
Download TWiP #127 (49 MB .mp3, 80 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 127

The last of our trio for the Peace Corp, an eosinophilia case. 29 yo pc volunteer in Rwanda, male, 3 weeks of feeling poorly. Starts with rash on lower back and upper legs, maculopapular rash. Fatigue later, cough, then diarrhea, 51% eosinophils (9000). No significant exposure to fresh water. Stool sent for oandp. Said sat down and got something on behind, realized later was feces, this was where rash developed. OandP seeing larva in stool. HIV neg, no med issue, no surgeries, no Kava.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

TWiP 126: A virus walks into a parasite

TWiP

Hofstra SOMHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiP Trinity solve the case of the Peace Corps volunteer with diarrhea, and reveal how immunizing against a virus ameliorates exacerbated leishmaniasis.


Click arrow to play
Download TWiP #126 (46 MB .mp3, 76 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 126

Another Peace Corps volunteer in Fiji. 24 yo male, several days of fever, headache, dry cough, rash. Feels poorly, starts diarrhea. No blood or mucus, no vomiting but abdominal discomfort. Heart rate over 100. At private nearby hospital for evaluation: no prior med probs or surgeries. Social history: MSM, not always protected, drinks every weekend. Home blown away by cyclone. Alcohol: drinks beer, a lot. White rice, split peas, bread diet. Fan of cava, also drank unfiltered water. He is admitted, continues to feel poorly. Continued fevers, localized abdominal pain RUQ. On exam he has tender palpable liver, elevated WBC 17.8, eosinopenia, 0 cells. AST/ALT slightly above normal. Dengue, chick, lepto, blood all negative. Ultrasound of liver: shows 8×8 cm mixed echogenic lesion in right lobe. HIV negative.

Send your case diagnosis, questions and comments to twip@microbe.tv

TWiP 125: Third time’s a charm

TWiP

p. falciparum life cycleHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPonderers solve the case of the Timber Worker with Severe Shaking Chills, and describe an experimental malaria vaccine comprising attenuated sporozoites produced by genetic engineering.


Click arrow to play
Download TWiP #125 (58 MB .mp3, 95 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 125

Thanks to the Peace Corps – 24 yo female serving in Cameroon, teaching English and science at local school. Been in country 5 months, first 3 lived with host family, now in own home in community with electricity, 12 hr from Yaounde, capital. Reports intermittent diarrhea, loose stools, abdominal discomfort. No prior problems, no problems in family. No meds. No drinking or smoking. Lots of animals present, roam into class. Eating all local fare, cooks some, or buy locally. Eats fish, vegetables, no fish. Sleeps in house with mosquito nets. Not sexually active, AIDS negative. Young kids at school 6-12 yo, 20 in room. Does not eat at school. Not clear if water is treated. Not on antimalarials. Going on for a few a few weeks. No fever, no rash.

Send your case diagnosis, questions and comments to twip@microbe.tv

TWiP 124: RPAing with the tryps

TWiP

T. cruziHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The prolific podcast-shedding Hosts solve the case of the Global Health Intern with a snakelike lesion on her foot, and reveal the role of a single-stranded DNA binding protein in differentiation of trypanosomes.


Click arrow to play
Download TWiP #124 (61 MB .mp3, 100 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

Case Study for TWiP 124

28 yo male from referral hospital near thai-burma border. Fever and chills 2 days, feels poorly, small amount of dark urine. Severe shaking chills, 1x per day, no rash. No diarrhea, difficulty breathing. Seen by local health care volunteer, went to hospital then tertiary hospital in Bangkok. Exposure history to pigs, dogs, insects, etc. Involved in timber industry and farming, sleeping out at night with no cover, clothes and sandals. No meds. Not married, family lives with him. Family is fine. Sleep in dwelling but no screens. No toxic habits, HIV negative, sexually active but not brothels. High fever, low bp, rapid heart rate, breathing rapidly, scleral icterus, dry mucus membranes, neck supple, lungs clear. 2/6 systolic murmur. Abdomen soft but tender, enlarged liver and spleen. Many cuts, bruises, bug bites. Labs: low platelets, low hematocrit, low glucose. Blood smear: abnormal, 5-10% infected RBCs with multiple band forms.

Send your case diagnosis, questions and comments to twip@microbe.tv

Contribute

Support our work at Patreon, PayPal, and more