This Week in Parasitism
TWiP is a monthly netcast about eukaryotic parasites. Vincent Racaniello, Dickson Despommier, and Daniel Griffin, science Professors from Columbia University, deconstruct parasites, how they cause illness, and present a case study each episode for your solution.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Paul Calle

The TWiP trio visit the Bronx Zoo where Paul solves the case of the Four Year Old with Pulmonary Edema, and talks about his career as the Chief Veterinarian and Director of the Zoological Health program for the Wildlife Conservation Society.

 

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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 110

This week's case involves humans. Young woman, 40s, concerned about bug bites. Several weeks ago her 13 year old daughter woke up in morning, reported bug bites. Several small, red, raised itchy areas, 3-4 in a line, just above belt line. They go on vacation in Europe, no problems. Upon return, several weeks later the Mother woke up with a similar pattern. Then second daughter has the same problem. Family lives in NY metropolitan area, which is an epicenter for this problem. Always on trunk, not on arms or legs. No travel before the first daughter's bug bites. Husband does not report any problems. Family spends a lot of time outdoors, live in suburban wooden area.

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Direct download: TWiP110.mp3
Category:Science -- posted at: 2:11pm PDT

Hosts: Vincent Racaniello and Daniel Griffin

Guest: Paul

Daniel and Vincent solve the case of the Truck Driver from India, discuss why parasites resistant to an antimalarial drug are not transmitted by mosquitoes, and introduce Paul who presents a new case study.

 

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This episode is sponsored by CuriosityStreama 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/m​icrobe ​and use the promo code MICROBE​.

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

Direct download: TWiP109.mp3
Category:Science -- posted at: 5:40pm PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The case of the Man from Assam is solved, and phagocytosis of Leishmania by B-1 cells is brought to you by the Three Twipeteers on this episode of TWiP.

 

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This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016

Case study for TWiP 108

Todays case is a 26 yo male longhaul truck driver from northern tiger country of India. Comes into hospital at end of rainy season with 6 days of fever, chills, muscle aches, small loose stools, vomiting, trouble breathing, cough, decreased urine output. Lives in mud hut with coconut leaf roof. No one else in family  is sick (wife, two children). Significant animal and insect exposure (dogs, cows, monkeys). Got sick after coming home from a trip up north. No significant medical probs, no surgery. Really sick. Pain everywhere. Occasionally drinks palm wine. Some yellowing of eyes. Has lost a little weight. Ketonic breath. Exam: 39 fever, bp 100/71, 126 heart rate, 24 resp rate. Looks distressed, not fully sharp. Nothing focal on lung exam. Belly tender, esp upper right, spleen enlarged. Liver is tender but not enlarged. Some labs: bun elevated 102, creatinine elevated, Hg decreased 11, platelets 9000 (down), white count 10.3 no eosinophils. LDH 8000 AST/ALT normal, bilirubin 21. Never been this sick.

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Direct download: TWiP108.mp3
Category:Science -- posted at: 6:49am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPtastic trio solves the case of the Surfer from Switzerland, and reveal how taste-chemosensory tuft cells in the gut regulate immune responses to parasites.

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This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016

 Case study for TWiP 107

Todays case is a fun case about a 45 year old gentleman from Assam India, with sixteen years of fever, abdominal pain, darkening of skin, yellowing of eyes. Farmer, does not have much energy. Works barefoot in fields. Fever occurs every other day. Prior medical problems, nothing out of the ordinary. No surgeries, no meds, has never seen physician. Married, kids, no extramarital affairs, HIV negative, eats mostly cooked vegetables. Lives in concrete house, no screens, mosquito netting. Other people in area have similar problems. Water comes from pump, fill plastic jugs. Been in Assam sick his whole life, finally came to regional med center for evaluation. Underweight. No pets. Dogs around, avoids dogs. Cows, monkeys are around. Fair appetite. Exam: febrile, in face can see darkening which is increasing, also extremities. Whites of eyes are yellow (jaundiced). Striking is has a very large liver, spleen. Elevated bilirubin. Some increased liver enzymes. No physical scarring or lesions.

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Direct download: TWiP107.mp3
Category:Science -- posted at: 8:45am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP triumvirate solves the case of the Missionary in Kenya, and review the finding of a soldier caste in flatworms that parasitize snails.

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This episode is sponsored by ASM Agar Art Contest

 Case study for TWiP 106

This week's case comes from an ophthalmologist colleague Florian in Switzerland. Swiss female, early 20s, returns after surfing vacation in northern Africa. Accommodations were rustic, lots of animal and insect exposure, right on the beach. No screens. Had loose stools there, now left eye is bothering her, eyelid swollen, eye red. This happened after return. Thinks she has seen things moving around in her eye. Opthalmologist gave eyedrops, now looking for second opinion. Healthy, no med/surg/allergies, no meds, student lives alone, occasional alcohol. No AIDS. Surfing in Morocco. Lots of insect bites. Little tiny things moving around in eye, on surface when she looks in mirror. All blood work was negative. Florian inspects her eye, surprised to see several tiny mobile objects, headed towards lacrymal ducts. Is able to grab one, about 1 mm long, plucks three off.

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Direct download: TWiP106.mp3
Category:Science -- posted at: 10:07am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPanosomes solve the case of the Young Man from Anchorage, and discuss how cestode parasites increase the resistance of brine shrimp to arsenic toxicity.

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 Case study for TWiP 105

This week's case involves a 32 yo male with several concerns. Spent 6 weeks doing religious missionary work in Kenya, performed baptisms in Lake Victoria.Waist deep in water, no shoes. Took malaria drugs, ate lots of interesting foods: cichlids, ugali, corn based food, flavored with greens; stew with some sort of meat, beef and goat. Five weeks after return developed rash with fever, shortness of breath. Three of four friends who were with him in Kenya reported similar symptoms. The fourth who did not get sick did not go in water, nor did he eat very much. No medical/surgical history, no drugs. Had some sexual activity while there. Elevated white count, 70% eosinophils. Chest CT shows nodules in lungs. Doc told him, allergy, you will be fine. The water he went into is near a village, there are rodents nearby, and a runoff.

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Direct download: TWiP105.mp3
Category:Science -- posted at: 7:45am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

Guest: Michael Libman

Michael returns to help the TWiP trio solve the case of the Delusional African Expatriate, and discuss the association of natural and induced antibodies in mice with differential susceptibility to secondary cystic echinococcosis.

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 Case study for TWiP 104

This week's case involves a young man in his thirties, admitted in hospital in Anchorage AK in early June. Chief complaint, severe muscle pain and tenderness. Usually healthy guy, 1 week ago had bad case of diarrhea with belly pain and vomiting, lasted a full week. Now has fever. Concerned because wife now is having diarrhea. Unremarkable history, unknown family history. HIV negative. All childhood vaccinations. Does not eat raw meat. No meds, does seasonal work, social drinker. Came back from successful hunt, got a black bear. Dressed in field, cooked at home really well. Wife also ate bear meat. Bear meat is in freezer. No vegetables. Also eats salmon which he caught the previous season, then frozen. Drinks water from the stream when he hunts. Physical exam: hot, 38.5, bp 115/75, pulse 105, breathing comfortably. Anxious, swelling around both eyes. Sclera not noted. Labs: WBC elevated 14,000, 30% eosinophils; chemistries fine; muscle enzymes LDH, CK elevated.

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Direct download: TWiP104.mp3
Category:Science -- posted at: 6:05am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

Guest: Michael Libman

The TWiP-scholars solve the case of the Housewife from Kolkata, discuss mutations in the IL17 gene associated with cerebral malaria, and hear a case presentation from guest Michael Libman.

 

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 Case study for TWiP 103

This week's case concerns a 42 yo male, refugee in Canada, from DRC, former Zaire, where there is unending civil war. Upper middle class, professor of French at university. Had been imprisoned, tortured, lived in jungle for a few years, reached refugee camp in Tanzania, moved to Canada. Came to health care system 15 months after arrived. Was sent to psych, unstable emotionally, delusions, hallucinations, depression, post traumatic issues. Was under psych care for ~1 yr, did not improve, became worse. Sent to hospital. History: talked about having minor injury, hurt lower back, pain there bothering him. Some anemia (normochromic), basic hem/chem/urine/liver nothing remarkable. Physical exam, nothing remarkable. HIV negative. Some evidence for chronic inflammatory condition: sed rate 60 (elevated), had diffuse increase in IgG, IgM. Developed some low level autoantibodies; anti-nuclear, p-anka, anti-neutrophil cytoplasmic antibodies. Slightly elevated fever for a few days, then few days or week with no fever. No eosinophilia. Radiology: on CT did have some mediastinal, aortic, axillae, lymphadenopathy. Prob screened in Africa for malaria and treated; prob also got ivermectin. Also got head MRI: not completely normal, classic nonspecific midbrain abnormality. Diffuse mild edema. Weight loss remarkable. No visual problems.

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Direct download: TWiP103.mp3
Category:Science -- posted at: 7:42am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPyzoites solve the case of the Uncommon Parasite, and discuss the role of eosinophils in promoting the growth of Trichinella in skeletal muscle.

 

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 Case study for TWiP 102

This week's case involves a 24 yo housewife, from a village outside of Calcutta. Comes into a tertiary care hosp, 6 months coughing up blood, fever, no weight loss. Drinks rainwater, milks her cow. Dogs everywhere, no livestock except cows. Eats meat, well cooked. No extramarital encounters. Husband well. 4 children. Cistern for drinking water is covered.  No health issues. Reports salty, clear mucus. No blood in stool, no changes in stool. Exam: looks healthy, lungs clear. Lab tests: White count of 9000, 12% eosinophils (elevated). So she has eosinophilia. Chest X-ray and CT: lesion on left side in xray. CT: shows 4 cm cavity, with air pocket on left side, mid-lung. HIV negative. Dusty soil, birds.

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Direct download: TWiP102.mp3
Category:Science -- posted at: 9:36am PDT

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The doctors TWiP solve the case of the Woman with White Worms, and explain the role of a secreted growth factor from a carcinogenic parasite in wound healing and angiogenesis.

 

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Listener Pick

Ramon - Ancient Rome was infested with parasites

Case study for TWiP 101

This week's case involves an uncommon parasite. Young girl, <10 y, brought in by parents from rural area to regional hospital with fever, diarrhea for 2 weeks. No blood in stool. Parents: few weeks prior to problems, young girls went with family on wild pig hunting trip. With guns. Girl did consume pig on trip, all meat was very well cooked. Was involved with preparation of meat with Mother only. No one else got sick. No surgery, no allergies. Both parents have diabetes. Has four brothers. Some weight loss. This is outside the US. Physical exam: low grade fever, diffuse mild abdominal discomfort, slight microcytic anemia, size of cells is slightly smaller than normal. WBC: normal, except no eosinophils. Blood cultures negative. Stool examination is where we get our answer.

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Direct download: TWiP101.mp3
Category:Science -- posted at: 5:42am PDT