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

TWiP 123: What we know is confusing

TWiP

Ceratitis capitata larvaHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPanorama solve the case of the Dutch Woman with Wormy Objects in Her Stool, dissect a study on cytoadhesion of malaria infected red blood cells, and introduce Parasitology Superheroes.


Click arrow to play
Download TWiP #123 (74 MB .mp3, 122 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world’s best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

Case Study for TWiP 123

Nurse in early 20s, recent grad, decides to spend year in global health internship in western DR/Haitian border. On her foot has skin issue: told is fungal infection, using antifungal cream, is getting worse. Several days, only on one foot. Healthy, no past med/surg/allergies, no meds, no HIV, lives with local family. Daughter, wife, husband, cat. No toxic habits. Originally from US, swims, walks barefoot to and from, shoes off in house. Eats local food, exposure to dogs, cats, sister. Very itchy, but not open; rash area is raised. Blistery in certain areas, involves different areas in different days, snakelike.

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

TWiP 122: If the thunder don’t get you, the lightning will

TWiP

Anisakis simplexHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPniks docs solve the case of the Female from Peru with Epistaxis, and discuss the effect of community deworming on immunosuppression.


Click arrow to play
Download TWiP #122 (68 MB .mp3, 113 minutes)
Subscribe (free): iTunes, RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world’s best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This show is sponsored by Drobo, a family of safe, expandable , yet simple to use storage arrays. Drobos are designed to protect your important data forever. This Holiday season give someone a Drobo to keep all their files and memories safe forever. TWiV listeners can save 20% or more off of their purchase of a Drobo 5D, Drobo 5Dt, Drobo 5N, or any 8-drive or 12-drive system at www.drobostore.com by December 31, 2016 using discount code MICROBE20.

Case Study for TWiP 122

First of a series of cases with a theme, a 23 yo female international aid worker, chief complaint of diarrhea. Dutch descent, born in US, been in rural area of western DR, close to Haitian border. It’s been raining, houses have tin roofs, other flat concrete, rainwater pours off. Child comes by with mangoes, she buys one, washes it in rain water from the roof. Bites open mango, peels it, eats mango. The same night she is not feeling well, loose stools, abdominal discomfort. Next day, goes with group to border town; then has full fledged diarrhea. Looks into toilet, sees white objects 1 cm in length on stool, and they are moving. Uniform width, thinner than long, wormy looking. Has been participating in other activities in this area, swims in local river, walks barefoot, eating lot of local foods. Lunch: rice, beans, cooked meat, avocado. Dinner, yucca, fried salami, etc. Healthy before, no family history, not on meds, living with one of local families, no toxic habits. Dogs, cats, pigs, chickens around. One month earlier, cat in family home had kittens, she played with them. Very excited about that. Local physician contacted, he treats her.

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

TWiP 121: A parasite without borders

TWiP

Chagas Texas-MexicoHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPanosome docs solve the case of the Mali Man with Profuse Diarrhea, and review the presence of Trypanosoma cruzi in vectors, canids, and humans along the Texas-Mexico border.


Click arrow to play
Download TWiP #121 (55 MB .mp3, 91 minutes)
Subscribe (free): iTunes,  RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world’s best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

Case Study for TWiP 121

Back to Peru. 55 yo female from highland central valley area near Cuzco. Works in farming, no prior skin lesions but has multiple hypopigmented scars on exposed extremities (trauma during working), now reports many years of bloody nasal discharge. Seen in Lima by Daniel in outpatient clinic. No other medical problems, no surgeries, no allergies, everyone in family fine, husband and kids. Still working. No travel except to see doctor. Exam in right nare: ulcerated lesion inside nose, muco-cutaneous lesion. Simple test will decide. No anemia, no fever. Not eosinophilic, labs normal, HIV negative.

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

TWiP 120: When they die they calcify

TWiP

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

The TWiP triumvirate solve the case of the Thai Woman with Facial Swelling, and explain how Th17 T cells protect against the intracellular parasite Trypanosoma cruzi.


Click arrow to play
Download TWiP #120 (61 MB .mp3, 100 minutes)
Subscribe (free): iTunes,  RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world’s best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

Case Study for TWiP 120

A 48 yo man from Mali comes to hospital ER in Washington Heights in NY with profuse watery diarrhea. Born in Mali, came to US at 18, working in US as long haul truck driver for 30 y, frequently visits Mali, recently to attend his father’s funeral. Got symptoms one week after return (was there for 3 weeks). 3 liters diarrhea/day. No past med/surg history, not seen doctor in long time. No allergies. Unknown what father died of, Mother in Mali is ok. No medications. Some alcohol, marijuana use. Does report that has exposure to professional female sex workers, no condoms. Temp of 39 C, bp down 80/40, heart over 110, rapid breathing high 20s, cachectic. Wasted. Fungating lesion perianally. Undergoes HIV testing, clade B. T cells <100.

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

TWiP 119: A kinder and gentler case

TWiP

Schistosoma mansoniHosts: Vincent Racaniello and Daniel Griffin

Vincent and Daniel solve the case of the Family with Eosinophilia, and discuss HIV-1 infection and genome integration in the blood fluke Schistosoma mansoni.


Click arrow to play
Download TWiP #119 (53 MB .mp3, 88 minutes)
Subscribe (free): iTunes,  RSS, email

Become a patron of TWiP.

Links for this episode:

This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world’s best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

Case Study for TWiP 119

This one will be kinder and gentler case. Back in Thailand but could be in several places. 25 yo Thai woman from Bangkok, to hospital, chief complaint facial swelling. Eats typical Thai diet (see previous episodes!) Som tum, etc fish that is not cooked. Migratory – moves around face. Not tender, but mild itchiness. For about a week, no pain. Healthy, no past med/surg history, family all fine. HIV negative, no drugs, no travel. On examination, has swelling on right side, 3-4 cm raised, little redness, firm, does not feel like fluid filled. No fever, no GI problems, no bloods. WBC up, eosinophils up.

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

TWiP 118: Crispr capers with Toxoplasma

TWiP

apicomplexanHosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

The TWiPinella solve the case of the Woman from Guinea, and describe the use of CRISPR/Cas9 to identify essential apicomplexan genes.


Click arrow to play
Download TWiP #118 (58 MB .mp3, 95 minutes)
Subscribe (free): iTunes,  RSS, email

Links for this episode:

This episode is sponsored by CuriosityStream, a subscription streaming service that offers over 1,400 documentaries and non­fiction series from the world’s best filmmakers. Get unlimited access starting at just $2.99 a month, and for our audience, the first two months are completely free if you sign up at curiositystream.com/microbe and use the promo code MICROBE.

This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more.

Become a patron of TWiP.

Case Study for TWiP 118

Little bit of a twist – a human family with eosinophilia. Conveyed by good friend/colleague ID physician. Australia, NSW, 45 yo Dad, having problem with mild abdominal distention. Seen by doc in Sydney, CBC shows eosinophil count of 10,500. Wife of same age reports feeling fine, but gets CBC and also shows eosinophils of 5,200. Two daughters, 17 and 19, no symptoms, bloods: 900 and normal eosinophils. One week prior to dads symptoms, sister in law came (also in NSW) and stayed, developed severe diarrhea, discomfort, bloating, weight loss, eosinohils 4,700. Eat raw fish (not known if fresh or salt) purchased at local markets. No overseas travel or out of urban environment. No pets, no home grown foods. Went back to previous labs and found normal eosinophil levels. Full workup for strongyloides, all negative. No HIV. No toxic habits, no remarkable medical history.

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

Contribute

Support our work at Patreon, PayPal, and more

Christina Naula, Ph.D.


Daniel Griffin, M.D.,

Vincent Racaniello, Ph.D.


CLICK FOR MORE INFO

Please note that content in MicrobeTV podcasts should not be construed as medical advice.