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

TWiP 235: The case of the regurgitated wriggler

TWiP solves the case of a man in his 50s reporting months of abdominal discomfort, who takes mebendazole and some time afterwards vomits a worm into the sink.

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

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New Case:

I first learned about this case from a colleague at work who tells me that their friend has just gotten really sick. The friend is described as having had multiple illnesses over time but that he has never been as sick as he recently got. He reports that the illness began as a diffuse myalgia with fever, there was some sore throat, noted swelling in the neck, and overwhelming fatigue. He tells some of his friends that he is feeling really terrible and it turns out that some of his friends also feel poorly. It turns out that about a week prior to the onset of his symptoms he and a number of friends attended a large dinner where venison and boar was served. 

This individual is then seen in our office. Some testing is done. He feels really terrible and despite being reassured that he should get better without treatment he is given therapy.

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Music by Ronald Jenkees

TWiP 234: Hookworms and a leech – parasites suck!

TWiP discusses hookworm infection and the phase 1 clinical trial for a hookworm vaccine that could one day protect children from the hookworm anaemia, and reduce transmission of this infection.

Hosts: Dickson Despommier, Daniel Griffin, and Christina Naula

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Music by Ronald Jenkees

TWiP 233: Cryptosporidium not cryptocurrency

TWiP solves the case of the physician with no significant previous medical history who is currently doing their fellowship training develops diarrhea, and presents a new clinical case for our astute listeners to solve.

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

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New Case study:

I was recently asked about this case while I was off visiting Denmark. A man in his 50s has been reporting months of abdominal discomfort and decides to go discuss this situation with a local pharmacist. He describes this discomfort, some nausea, and some bloating of the abdomen. The pharmacist recommends that he take mebendazole. He takes the mebendazole and some time afterwards he vomits a worm into the sink. The worm does not have any obvious segmentation and appears completely nonsegmented and is moving around. One end is very pointy and the other little less so. 

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Music by Ronald Jenkees

TWiP 232: Lives of Wolbachia

TWiP reviews the cellular lives of Wolbachia, a gram-negative bacteria that infects many arthropods and filarial nematodes with very different outcomes – parasitism or mutualism.

Hosts: Dickson Despommier, Daniel Griffin, and Christina Naula

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Music by Ronald Jenkees

TWiP 231: Scotch in drink and tape

TWiP solves the case of the Woman With White Worms, and presents a new clinical case to decipher.

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

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New Case study:

A physician with no significant PMH who is currently doing their fellowship training develops diarrhea. The diarrhea is significant enough that they are beginning to feel weak, lightheaded, and end up going to the local ER. The physician lives in NYC, works most of the time but did just get back from a week-long vacation in Florida with their long-term partner where they got a chance to swim in the pool and get some sun. They returned feeling well and then noted the onset of the diarrhea. The diarrhea was watery, with some abdominal cramping but no noted blood or actual fever. The stool did not have a strong smell and no floating stools were reported. The physician was given IVF and returned home feeling better but now gets a call that there is a parasite on the stool testing and is recommended to take a medicine they have never heard of 3x per day for 3 days. 

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Music by Ronald Jenkees

TWiP 230: Healing cutaneous leishmaniasis with Maria Adelaida Gomez

Maria Adelaida Gomez joins TWiP to discuss her career and the work of her laboratory on understanding the healing process during cutaneous leishmaniasis.

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

Guest: Maria Adelaida Gomez

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Music by Ronald Jenkees

TWiP 229: The very hungry flatworm

Eyal joins TWiP to solve the case of the Female Traveler with Intermittent Fever and Ring Enhancements in the Liver.

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

Guest: Eyal Leshem

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Case Study for TWiP 229

Woman in her 40s is referred to me to be seen in the office from one of my colleagues. She reports that she has been having recurrent issues with worms exiting her anus and vagina since 2018. She reports that she lives with her husband and 4 children and they have never reported any issues. She reports that initially she took something over the counter and things resolved. She then a couple years later has this problem again and this time discussed the problem with her housekeeper from El Salvador who gave her an antiparasitic tablet from her home country. This problem has now recurred and she was referred to a GI doctor who she explains laughed at her and suggested she see a psychiatrist. She come in now very upset and tearful. She relates that she has this itching that wakes her up at night and was able to take pictures of something she found on the anus. She has photos as well as a video of a thin white 1 cm motile thing with on end coming to a point. 

She reports a normal nonrestrictive diet. She reports no travel outside the US or even outside the local area. No PMH, no PSH, family history of different cancers. She does not work outside the home. She reports no pets. She has an unremarkable exam and labs only notable for low vitamin D. 

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Music by Ronald Jenkees

TWiP 228: Parasitic fountain of youth

TWiP discusses a tapeworm that causes extreme lifespan extension in infected ant workers, and a candidate antibody drug for prevention of malaria.

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

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Music by Ronald Jenkees

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Christina Naula, Ph.D.


Daniel Griffin, M.D.,

Vincent Racaniello, Ph.D.


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