This Week in Parasitism (science)
TWiP is a podcast about the tiny creatures that live in and on us.

The TWiP professors solve the case of the Baby With Pericardial Effusion, and discuss whether the flagellate without a flagella, Dientamoeba fragilis, causes human illness.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 162

A fresh case. Woman in late 30s born in Palestine, moved to NY. Presented for care with sore throat, swollen lymph nodes. Married Lebanese man, he’s still there, travel back in forth. Had been in Lebanon for 3 weeks before illness. Ate special raw meat dish while in Lebanon. No other animal exposure. Small children at home, works in office. No medical/surgical history, no meds. On exam, has posterior cervical lymphadenopathy. Otherwise normal exam. HIV negative. Low grade fever.

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

Music by Ronald Jenkees

Direct download: TWiP162.mp3
Category:Science -- posted at: 9:01am PST

The TWiPsters solve the case of the Brazilian Immigrant With Heart Problems, and describe how genome organization controls trypanosome antigenic variation.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 161

Daniel was asked to see 30 yo female from Bolivia, had to travel back during 3rd trimester. Was there for most of 3rd trimester. Child born in US, pericardial effusion, ascites, moderate PDA. Heart function is ok. Woman was healthy, no issues during pregnancy. Baby’s  white count elevated, diagnostic evaluation. It is a parasite.

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

Music by Ronald Jenkees

Direct download: TWiP161.mp3
Category:Science -- posted at: 8:12am PST

The TWiPlets solve the case of the Electrician from Tamil Nadu with a Liver Mass, and reveal that dogs and humans share a common Chadian Guinea worm.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 160

Referred to Daniel for consult, 40 yo immigrant from Brazil, a farmer had worked there, family in US. While here 1 y ago sees physician for increased heart rate, arrythmia, premature ventricular contractions, A-fib and flutter, treated by cardiologist then gets implantable defibrillator. Diagnostics: EKG, right bundle branch block; Echo shows heart is dilated with apical aneurysm; thrombosis.

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

Music by Ronald Jenkees

Direct download: TWiP160.mp3
Category:Science -- posted at: 8:42am PST

The TWiP triptych solve the case of the 9/11 Survivor infested with parasites, and discuss the effect of community ivermectin treatment for onchocerciasis on Loa loa infections.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 159

Going back to India, gentleman in 20s seen during rainy season in south. Week of feely achy, fever, severe pain in right upper part of belly. Vomiting, no diarrhea. Married, no children, works indoors in trades - electrician. Drinks large amount of palm date liquor. Previously healthy, no allergies, no medical issues. No travel. On exam: right lung base decreased breath sounds; upper right area of belly can feel liver coming down. Area of intercostal tenderness. Elevated white count; left shift, eosinopenic, alk phos up. Chest xray: shows effusion in right base. Ultrasound of liver: fluid filled single lesion. Lesion aspirated.

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

Music by Ronald Jenkees

Direct download: TWiP159.mp3
Category:Science -- posted at: 12:34pm PST

The TWiP hosts solve the case of the Thai Woman With Red Bumps, and reveal that a master manipulator contacts ant brain tissue to control its behavior.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 158

Male in 50s comes to see Daniel, concerned that is infested with parasites. Retired firefighter, 9/11 survivor. Several years of skin issues not resolved. 2009 dating Haitian girl, goes to Haiti to assist with disaster relief efforts, there notices itchy rash, worse at night, elevated eosinophils.  Prior biopsy showed arthropods with compound eyes. Treated with oral ivermectin, topical permethrin. Ulcers form, preceded by small white objects that pop off skin and these can swim in water. Repeat cystoscopies triggered by hematuria. Multiple biopsies and skin scrapings, all unrevealing. Had episode with forked headed worms came out while on toilet. Became temporarily blind. Another physician suggested were drug related. Brings Daniel video of swimming, skin scrapings. Spent time in Egypt where he swam in fresh water. Has issues with substance abuse. Family history unremarkable. One exam, has ulcerated areas widely. CBC eosinophil 700. Calcification at bladder periphery. Many negative tests returned. Review of many biopsies, stool ONP, all unremarkable.

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

Music by Ronald Jenkees

Direct download: TWiP158.mp3
Category:Science -- posted at: 6:58pm PST

The Podfessors solve the case of the Itchy Child from Panama, and discuss competition for blood in human malaria-helminth co-infections.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 151

Woman in 30s, mother of last two boys we saw, same locale. Concerned about abdominal pain for 3 years. Fullness, bloating of lower abdomen. No blood in stool, but occasionally loose stools, difficult to clean, stick/pasty/greasy stool. Had visited hospital, underwent test, told it is an ovarian cyst and needs surgery. Took omeprazole, allbendazole, azithromycin, none helped. On exam, diffuse abdominal tenderness. Portable ultrasound: small ovarian cyst 1.5 cm, not tender.

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

Music by Ronald Jenkees

Direct download: TWiP151.mp3
Category:Science -- posted at: 8:33am PST

Shivang joins the TWiP triumvirate to solve the case of the New Yorker With Rash and Pins and Needles, and reveal how agrochemicals increase risk of human schistosomiasis by causing high snail density.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Shivang Shah

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Case Study for TWiP 149

31 yo man ulcer on let, 4 cm diameter. Raised borders, reddish and hard. Feels well, concerned not resolving. Started as bump, slowly enlarged, ulcerated, 1 month now. Healthy, no prior med, diabetes in mom. Works in field with machete, lives with family, social drinking, smoking. Lives in isolated villages on Northern Panama archepelago, many animals and insects. Homes are raised, slats on floor. No fever, normal bp hr, breathing low teens. Healthy athletic young man, otherwise good health except for ulcer on left leg. Non tender, no pain, base of ulcer red; no purulent material, borders raised but not undermined. Feels hard around edge, no scab. Did dermoscopic exam: erythema, small yellowish teardrops, small white starbursts.

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

Music by Ronald Jenkees

Direct download: TWiP149.mp3
Category:Science -- posted at: 3:00am PST

The TWIPniks solve the case of the Man With Diarrhea and 100 Micron Objects In Stool, and discuss the reticulocyte receptor for Plasmodium vivax.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 146

27 yo male lawyer comes NY area to be seen, has 4 cm ulcer on right foot. Painless, has raised borders, minimal surrounding erythema. Going on for quite a while. Initially was papule, enlarged, ulcerated, this enlarged and has been more than 4 weeks. No past med probs, allergic to penicillin but just upset his stomach. No meds. Social habits: drinking. Own apt in NYC. Travel: 1 month before papule was whitewater rafting in Costa Rica, noticed when he got back. Wore sandals, got lots of insect bites. Afebrile, normal BP, fit athletic young man. Non tender lesion, base is red, white fibrous coating. Border raised but not undermined. No surrounding swelling, no eschar over wound, open non healing.

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

Music by Ronald Jenkees

Direct download: TWiP146.mp3
Category:Science -- posted at: 8:36am PST

The Estimados Profesores of TWIP solve the case of the Man With Motile Objects, and reveal the secreted and excreted proteins of Giardia parasites.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 145

Male 40s, visiting NYC on business. Lives in Thailand, seeks medical attention for diarrhea and abdominal pain. Diarrhea is continuous, even at night. Feels swollen. Stool cultures come back negative. CBC reveals eosinophilia. Clinician orders stool O&P. See something in stool: large elliptical objects, over 100 microns.

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

Music by Ronald Jenkees

Direct download: TWiP145.mp3
Category:Science -- posted at: 7:00am PST

The TWiPtomaniacs solve the case of the Boy With Visual Disturbances and Itching, and discuss identifying secreted and excreted proteins of Trichinella parasites.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 144

Individual in 30s, male, presented to physician with stomach upset, uncomfortable feeling in legs. Has motile objects in stools. From Vancouver BC, was eating salmon, reports was either dried/smoked or marinated. Not sure if this is relevant. Brought motile objects to physician.

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

Music by Ronald Jenkees

Direct download: TWiP144.mp3
Category:Science -- posted at: 8:31am PST