Discover and read the best of Twitter Threads about #microbiology

Most recents (24)

A 44-yo♂️, HIV +, CD4 cell count of 86/mL, viral load of 35,900 copies/mL: a 1-month history of fevers and pruritic blackish-brown lamellated plaques on the limbs and scalp.
¼
👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology Ming J. Liu, M.D., and Wei ...
A RPR titer of 1:32.
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.

MALIGNANT SYPHILIS
2/4

#microbiology #dermpath #RareInfection
Malignant #syphilis:
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4

#primarycare #MedTwitter #Awareness
Read 4 tweets
Human #intestinal #spirochetosis:
✔️#sexual #transmitted infections
✔️of the large intestine by anaerobic spirochetes of the genus Brachyspira spp.
1/10

🖊️A De Gea, @alfredomaldo ,@clarapath, @MarianaDazAlmi1, @alirri, Raquel Escudero, et al.
👇
sciencedirect.com/science/articl… Colonoscopic biopsy. In rou...
@alfredomaldo @clarapath @MarianaDazAlmi1 @alirri Gastrointestinal symptoms such as abdominal pain, proctitis, or chronic diarrhea are the most common manifestations.

Most cases with accompanying symptoms show improvement with metronidazole antibiotic therapy.
2/10

#IntestinalSpirochetosis
Routine staining methods (haematoxylin & eosin & Warthin-Starry) can identify spirochetes on the surface of enterocytes.
Histologically, characteristic findings include a decrease in microvilli &a predominantly eosinophilic inflammatory infiltrate.
3/10

#Pathologists #pathology Colonoscopic biopsy compare...
Read 12 tweets
A 31-YO♂️, #sexually active with 2♂️partners in the previous month: 8 days before redness of the R eye, an itchy perianal rash & rectal pain; scattered, tender, shallow ulcers & pustules on chest (A), abdomen (B), back (C) & perianal (D)
1/9

nej.md/44ILgLy
#proctology Image
PCR from the perianal vesicel:➕for nonvariola orthopoxvirus DNA.
Species-specific PCR: ➕for #mpox virus, clade II.

The patient reported a new rash with numerous ulcer on his chest, abdomen, and back

MPOX (formerly known as #monkeypox)
2/9

#MolBiol #virology
During the next 2 days, the patient took tecovirimat & reported redness & discomfort of the right eye and become painful

He had learned that mpox had been diagnosed in one of his #sexual partners from the previous month.

Likely MPOX CONJUNTIVITIS
3/9

#ophthalmology #IDtwitter On examination of the right...
Read 9 tweets
An 85-YO in rural Mississippi: months of tender, erythematous plaques & edema on bilateral hands extending to the elbows & on feet extending below the knees with significant pain

🔬skin granulomatous inflammation & numerous AFB
Mycobacterial🧫:➖
1/19

#IDtwitter #dermatology ImageImage
A repeat skin extensive granulomatous inflammation (A), with Ziehl-Neelsen stain clusters of acid-fast bacilli throughout the dermis (B).
Kinyoun stain >9 AFB/high-power field (C & D).
2/19

DOI: doi.org/10.1128/jcm.00…
#dermpath #microbiology (A) Skin biopsy specimen, h...
Molecular identification: 100% identity to multiple Mycobacterium leprae

BORDERLINE LEPROMATOUS LEPROSY WITH REVERSAL REACTION
3/19

#MedTwitter #MolBiol
Read 19 tweets
A 44-YO♂️, stayed in a rural cottage of France 2 weeks previously: cramping upper abdominal pain with watery diarrhea.
He had passed what he thought were worms in his feces
Eosinophilia
1/6

doi.org/10.1093/cid/ci…
#GITwitter #IDtwitter #microbiology “Worm” specimen brought to clinic by patient (petri dish
The specimens: identified as the larvae of the drone fly, Eristalis tenax
These larvae are 2.5–3 cm in length; the posterior tube gives them the name of “rat-tailed maggots”

INTESTINAL MYASIS CAUSED BY ERISTALIS TENAX LARVA
2/6

doi.org/10.1093/cid/ci…
#parasites #GIPath #Doctor “Worm” specimen brought to clinic by patient (petri dish
Myiasis caused by E. tenax:
✔️rare but have been
✔️reported from various countries including Europe
✔️most often intestinal myiasis, but cases of infestation of the nasal cavity, urinary tract, and vagina have been described.
3/6

#Doctor #MedStudentTwitter
Read 6 tweets
A 26-YO♂️ no #sexual contacts other than with his male partner: 6-day of fever, malaise, a swollen parotid gland, & ulcerative lesion on the ipsilateral lower lip.

Mild lymphopenia
⬆️GGT & CRP

1/6
doi.org/10.1016/S0140-…
#IDtwitter #dermatology #EarNoseThroat Swelling of left parotid gland (A)  The ulcerative lesion on
PCRs on the throat & ulcer swabs:➕for human #monkeypox (hMPX)
Genomic sequencing: clade IIb variant clustering within the current international mpox virus outbreak

PAROTIDITIS CAUSED BY hMPX virus

2/6
#sexually #maxillofacial #microbiology
7 days after initial presentation, his clinical condition had improved together with a decrease in the parotid swelling and the size of the ulcer.
3/6

#MedTwitter #Doctor #MedStudentTwitter
Read 6 tweets
A 58-YO♂️, DM, fever & L lower quadrant abdominal pain 2 months prior: acute R-sided back pain, & 3/6 diastolic murmur at R upper sternal border.

CT: a R renal infarction & splenic embolism

MR: multiple infarctions
1/7

doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia Enhanced abdominal computed tomography showing right renal i
Transesophageal echocardiography: a vegetation and severe aortic regurgitation.

Blood 🧫: Cardiobacterium hominis

CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7

#IDtwitter #microbiology Transesophageal echocardiogram revealing a large vegetation
The patient received antibiotic therapy and surgical aortic valve replacement, and he was doing well without major complications.
3/7

#infecciosas #MedTwitter #Doctor
Read 7 tweets
A 71-YO therapy for multiple mieloma, voriconazole for Aspergillus fumigatus sinusitis, prophylaxis with TMP-SMX: febrile neutropenia, nodular lesion on abdominal wall
CT: pulmonary nodule unchanged in last a month
🔬biopsy of pulmonary nodule?
1/8

#Pathologists #haematology Histopathology of the fine-...Image
🔬: Histiocytic process with granular basophilic cytoplasm and Michaelis-Gutmann bodies (arrows), positive for calcium with von Kossa special stain (arrowhead); findings pathognomonic for malakoplakia.

PULMONARY MALAKOPLAQUIA
2/8

doi.org/10.1093/cid/ci…
#pathTwitter
🧫of the pulmonary nodule:➖
🧫biopsy of the abdominal wall lesion: Rhodococcus equi resistant to TMP-SMX, but susceptible to rifampicin, vancomycin, azithromycin, ciprofloxacin, & imipenem.
RHODOCOCCUS EQUI SUBCUTANEOUS ABSCESS
3/8

doi.org/10.1093/cid/ci…
#microbiology
Read 8 tweets
A 57-YO Mexican♀️, works on a farm has several pets, including dogs, at home: epigastric fullness, and a 15-pound weight loss.

CT: complex cystic left liver mass.
1/5

doi.org/10.1093/cid/ci…
#gastroenterology #radiology #medicine
Resection: Cyst wall (red➡️), daughter cysts (*) normal liver tissue (yellow⬅️)
🔬acellular laminated wall (*), inner germinal layer (black⬅️), & protoscoleces surrounded by a broad capsule (green⬅️). Refractile hooklets (blue⬅️) & calcareous bodies (red⬅️)
2/5
#GIPath #IDtwitter
ECHINOCOCCAL CYST

The patient underwent total excision of the cyst followed by albendazole therapy for 4 weeks.
3/5

doi.org/10.1093/cid/ci…

#microbiology #GITwitter #MedStudentTwitter
Read 5 tweets
A 50-YO ♀️ bitten by her pet rat: fever, myalgia, sore throat, headaches a nonpruritic rash on extremities including palms & soles, arthralgias, knees arthritis.

A punctate wound with central necrosis on L palm, & her R thumb.
1/9

#rheumatology #internalmedicine #dermatology
Leukocytosis with neutrophilia
ESR & PCR:⬆️

Purulent R knee synovial fluid:
✔️46 000 cells/mL (88% neutrophils).
✔️Gram stain: scant pleomorphic gram-negative bacilli in chains with lateral bulbar swellings
2/9

doi.org/10.1093/cid/ci…
#microbiology #rheumatologist
Synovial fluid 🧫culture: Streptobacillus moniliformis identified by biochemical testing & confirmed by MALDI-TOF.

RAT BITE FEVER (RBF) WITH SEPTIC ARTHRITIS DUE STREPTOBACILLUS MONILIFORMIS
3/9

#bacteriology #IDtwitter #microbiología
Read 9 tweets
A 17-YO♀️, unprotected #sexual intercourse with multiple male partners: a 1-month history of pruritic genital lesions, multiple smooth, grayish-white papules & plaques were noted on the vulva & upper inner thighs.
1/5

DOI: 10.1056/NEJMicm2207538
#gynecology #womenshealth Image
A Treponema pallidum particle agglutination assay:➕
Rapid plasma reagin titer: ➕1:16.

CONDYLOMA LATA OF SECONDARY SYPHILIS
2/5

#microbiology #gynecologist #primarycare
✔️Testing for other sexually transmitted infections, including HIV infection: ➖

✔️Counseling on the importance of condom use

✔️IM penicillin G benzathine
At the 1-month follow-up visit, the lesions had resolved, and the RPR was 1:8.
3/5

#dermtwitter #IDtwitter #MedTwitter
Read 5 tweets
A 29-YO♂️, 6 months before, HIV + & non–drug-resistant pulmonary tuberculosis, antiretroviral & 4-drug antituberculous therapy initiated but soon reduced to rifampin & isoniazid only: abdominal pain on the L side
CT: ?
1/5

DOI: 10.1056/NEJMicm2206174
#radiologist #GITwitter
CT: an enlarged spleen with numerous hypodense lesions (A).
CD4 cell count: 119/mm3
VIH viral load: 1778 copies/mm3

A splenectomy was performed to evaluate for cancer:
numerous necrotic nodules with purulent discharge (B).
2/5

#microbiology #gastroenterology #IDtwitter
🔬granulomatous inflammation with caseous necrosis (C) and acid-fast bacilli (D, arrowheads).
A tissue🧫: ➖

PCR: ➕for Mycobacterium tuberculosis

SPLENIC TUBERCULOSIS
3/5

#bacteriology #MedTwitter #GIPath
Read 5 tweets
A 17-YO: a 3-week of dizziness, headache, & weakness of the R leg

MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)
1/6

DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
IgG ab for Echinococcus multilocularis & E. granulosus: ➖

Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)

RT-PCR: ➕for E. multilocularis
2/6

#parasitology #Pathologists #pathology
CT imaging of the chest and abdomen did not show any other sites of disease.

CEREBRAL ALVEOLAR ECHINOCOCCOSIS
3/6

DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
Read 6 tweets
A 14-yo ♂️ lived on a farm: a 1-month history of episodic headaches, vomiting, & papilledema
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow)
1/5

DOI: 10.1056/NEJMicm2208104
#neurology #radiology #pediatric Image
Findings suggestive of CYSTIC ECHINOCOCCOSIS.

CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture.
2/5

DOI: 10.1056/NEJMicm2208104
#IDtwitter #parasitology Image
🔬: an echinococcal laminated membrane lined by a germinal layer with daughter cysts (Panel D, arrows) and protoscolices (inset, arrows) with hooklets (arrowhead).

PRIMARY CEREBRAL CYSTIC ECHINOCOCCOSIS FROM ECHINOCOCCUS GRANULOSUS
3/5

#microbiology #Pathologists #pathology Image
Read 5 tweets
A 50-YO♂️of North India, visited bat caves & a bird sanctuary in Thailand: multiple plaques & nodules on his face, neck, arms & trunk with hoarseness, fever, weight loss for months
Laryngoscopy: nodules over the tonsils & posterior pharyngeal wall
1/4

#medicine #dermatology
Skin & laryngeal 🔬: histiocytes with intracellular & extracellular PAS+ yeast cells
Skin biopsy🧫: tuberculate macroconidia confirmed as H. capsulatum var. capsulatum
Ab against Histoplasma by ID:➕

DISSEMINATED HISTOPLASMOSIS
2/4

doi.org/10.3109/136937…
#mycology #IDtwitter
Disseminated histoplasmosis involving skin & larynx in an apparently immunocompetent individual

The infection appeared to be imported from Thailand.

The patient responded very well to intravenous amphotericin B followed by itraconazole.
3/4

#microbiology #MedTwitter #Doctor
Read 4 tweets
A 46-YO ♂️: oropharyngeal lesions, cervical lymphadenopathy, intermittent fever, hepatosplenomegaly, and deteriorating general health.

Needle aspiration from submandibular lymph node: intra- and extracellular yeasts
1/4

DOI:
doi.org/10.4269/ajtmh.…
#dermpath #mycology Mucocutaneous examination showed multiple well defined, disc
The histopathology of oral lesion showed features of HISTOPLASMOSIS confirmed later from culture of Histoplasma capsulatum on culture
2/4

#IDtwitter #microbiology #MedTwitter Fine needle aspiration cytology from submandibular lymph nod
In immunocompetent hosts, when chronic disseminated histoplasmosis occurs from pulmonary infection, oral ulcers, nodules, and vegetative plaques are common and dissemination to liver, spleen, bone marrow, and other organs is frequent.
3/4

#Doctor #MedStudentTwitter #resident
Read 4 tweets
A 37-YO, farmer in India, #HIV+ immunecompromised ♂️, treatment for suspected pulmonary tuberculosis: papulonodular lesions of 3-month duration over the face, neck, trunk, limbs, palms & soles, & oropharynx; fever & generalized lymphadenopathy
🔬: ?
1/7

#IDTwitter #microbiology Wide spread papules and nodules over face. Similar lesions w
🔬: Blastoconidias within the macrophages.
🧫: Histoplama capsulatum: characteristic colony, conversion to yeast form, characteristic🔬appearance.

PROGRESSIVE DISSEMINATED HISTOPLASMOSIS
2/7

doi: 10.4269/ajtmh.17-0432
#dermpath #mycology #internalmedicine 1.- Histologic section of skin lesion showing sheets of macr
Diagnosis is usually suspected on visualization of characteristic intracellular yeast (blastoconidias), the pathogenic or tisular form, with a clear rim and garnulomatous cellular infiltrate in tissue specimen or lymph node aspirate
3/7

#MedTwitter #Doctor
Read 7 tweets
A 31-YO ♂️, sex with men, HIV treatment, HCV: in 2022, fever, cervical lymph nodes & erythemato-squamous papules, with umbilications & ulcerations, vesicles & pustules, & honey-colored crusts on the face, trunk & limbs including his palms & soles
1/7

#IDtwitter #primarycare ImageImageImage
PCR: ➕for MPXVirus.
#HIV viral load of < 40 copies/mL and a CD4 + count of 167 cells/mm3

#MPOX (MONKEYPOX)
2/7

#healthcare #internalmedicine #microbiology
doi.org/10.1016/j.idcr…
Supportive care of Mpox was provided, namely,
✔️beta-lactams due to bacterial superinfection of the lesions,
✔️in addition to analgesia, which was initially administered with NSAIDs and then escalated to opioids.
3/7

#MedTwitter #MedStudentTwitter #dermtwitter
Read 7 tweets
A 32-YO ♂️ sex worker, sex with men unprotected, HIV under treatment: 20 lesions scattered throughout the body of umbilicated, erythematous, violaceous papules with central ulcerations & pustules, fevers, cervical & axillary lymph nodes
1/5

#IDtwitter #primarycare #healthcare
HIV viral load of 1577 copies/mL and a CD4 + count of 932 cells/mm3

PCR: ➕ for Mpox virus

MPOX (MONKEYPOX)
2/5

#internalmedicine #microbiology doi.org/10.1016/j.idcr…
Mpox had been a neglected disease until May, 2022, and since then, there has been a notorious increase in the number of human monkeypox cases in non-endemic areas
3/5

#MedTwitter #MedStudentTwitter #dermtwitter
Read 5 tweets
A 24-YO♀️: a 10-year of episodes of redness & photophobia in eyes, &⬇️visual acuity
SLE: conjunctival hyperemia & peripheral corneal opacification, inflammation & crystalline deposits on the corneal
⬇️
INTERSTITIAL KERATITIS
1/5

DOI: 10.1056/NEJMicm1709103
#eye #internalmedicine
Etiologies:
✔️Bacterial: SYPHILIS, Lyme borreliosis, tuberculosis, etc.
✔️Viral: Herpesviridae (HERPES SIMPLEX, H. zoster, E-B)...
✔️Parasitic: Onchocerciasis, Acanthamoeba...
✔️Immune: Cogan's syndrome, contact lens-associated keratitis, autoimmune disease…
2/5

#microbiology
ESR:⬆️& evaluation for infectious causes: unremarkable.
6 months after the diagnosis of interstitial keratitis: vertigo, tinnitus, & hearing loss.
Audiometry: sensorineural hearing loss in both ears.
Clinical findings consistent with COGAN´S SYNDROME
3/5

#Ophthalmology #MedEd
Read 5 tweets
We’re pleased to announce the 2023 NAS Awards recipients! These 16 individuals are honored for their extraordinary scientific achievements in a wide range of fields spanning the physical, biological, and medical sciences. bit.ly/402ovjs #NASaward #Science #Awards
Join us in congratulating Kirk Bryan Jr. of NOAA Geophysical Fluid Dynamics Laboratory & @Princeton, winner of the 2023 Alexander Agassiz Medal for pioneering and visionary work in oceanography and climate science! Learn about his work: bit.ly/3HoGh91#NASawa… #Climate
We are honoring David J. McComas of @Princeton with the 2023 Arctowski Medal for his pioneering contributions to experimental space plasma physics! You can read more about his achievements here: bit.ly/3kqUFog #NASaward #Space #Physics
Read 17 tweets
A 20-YO ♀️, college wrestling, Mexico: itching in the past 2 months, erythematous & fine-scaling papules with annular plaques having a raised border affecting the face, neck, & torso.
1/6

doi: 10.18502/cmm.6.4.5439
#dermatology #primarycare #MedTwitter
KOH: multiple thin & septate hyphae.
🧫, MALDI-TOF-MS: Trichophyton tonsurans
T. tonsurans was isolated in 4 cases belonging to the school fighting team & from one of the training mats

TINEA GLADIATORUM DUE TO TRICHOPHYTON TONSURANS IN A SCHOLL WRESTLING TEAN
2/6

#mycology
Oral terbinafine for 3 weeks: clinical & mycological cure.
Tinea gladiatorum is a type of dermatophytosis that occurs in combat athletes, such as wrestlers and judo fighters, as a result of Trichophyton species.
3/6

doi: 10.18502/cmm.6.4.5439
#IDtwitter #microbiology #Doctor
Read 6 tweets
A 38-YO♂️, #HIV➕: asthenia, fever, & generalized & confluent maculopapular rash predominantly on the back, cervical & inguinal lymphadenopathies, & stippled petechial hemorrhages in the soft palate (Forchheimer’s spots)
Subsequently, pustules appeared

1/5
#emergency #IDtwitter
Classic Mpox pustules appeared
PCR:
✔️for measles & rubella➖
✔️for Mpox➕

HUMAN Mpox, although confluent maculopapular rash & Forchheimer’s spots have been reported as classic signs of rubella or measles infections
2/5

DOI: doi.org/10.4269/ajtmh.…
#microbiology #MedTwitter
Forchheimer spots, a type of enanthem:
📌sometimes precede the skin rash of rubella.
📌tiny red spots on the soft palate in rubella, measles and scarlet fever.
3/5

#dermatology #internalmedicine #primarycare
Read 5 tweets
A 32-YO♀️ from Guatemala, Ph+ B-ALL post #chemotherapy: #dyspnea
CT: ground-glass opacities (2A yellow box), interstitial pulmonary edema with septal thickening (2B yellow circles), & pericardial effusion (2C yellow arrows), lymph nodes (2D yellow arrows)
Eosinophilia
1/7
Due to normal ejection fraction, the differential diagnosis of dyspnea included non-cardiogenic pulmonary edema, pneumonitis secondary to chemotoxicity, and infection.
2/7

doi.org/10.1016/j.idcr…
#haematology #radiology #IDtwitter
She progressed to acute hypoxic respiratory failure.

🔬bronchoalveolar lavage: numerous larvae (3A,3B) with short buccal grove (arrow head) and prominent genital primordium (arrow) consistent with STRONGYLOIDES HYPERINFECTION

3/7
#lungdisease #parasitology #Pathologists
Read 7 tweets

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