TWiP 155: Miss Dickson

July 23, 2018

Lutra canadensisJustin joins the TWiP team to solve the case of the Gentleman with B cell Lymphoma, and consider the finding of Dracunculus species in river otters from Arkansas.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Justin Aaron

Click arrow to play
Download TWiP #155 (56 MB .mp3, 92 minutes)
Subscribe (free): iTunes, Google PodcastsRSSemail

Become a patron of TWiP.

Links for this episode:

Case Study for TWiP 155

Another challenging one. 60 yo man with poorly defined immunodeficiency: low Ig, low T cells, on chronic Ig therapy. Admitted with 1 yr chronic diarrhea. Had upper endoscopy, inflammation of duodenum, crypt hyperplasia, diffuse ulceration. Lower colonoscopy: granular appearance to cecal mucosa. Loss of haustral folds. Biopsies done and sent for culture. PMH: poorly understood interstitial lung disease. Unable to work, no toxic habits. Born Ecuador, moved to US in early 40s, living in Staten Island. No fever, bp low, hr >100, resp high teens. Remarkable: looks frail but not terribly ill. Labs: normal WBC, shifted to left with increase in neutrophils and eosinophils. Albumin low; respiratory pathogen positive for rhinovirus. Serum CMV: >4000 (virus measurement). Started on ivermectin, WBC rises, broad spectrum Ab.

Send your case diagnosis, questions and comments to

Music by Ronald Jenkees

Leave a Reply

Your email address will not be published. Required fields are marked *