Sat, 4 February 2017
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiP Trinity solve the case of the Peace Corps volunteer with diarrhea, and reveal how immunizing against a virus ameliorates exacerbated leishmaniasis. Become a patron of TWiP. Links for this episode:
This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 126Another Peace Corps volunteer in Fiji. 24 yo male, several days of fever, headache, dry cough, rash. Feels poorly, starts diarrhea. No blood or mucus, no vomiting but abdominal discomfort. Heart rate over 100. At private nearby hospital for evaluation: no prior med probs or surgeries. Social history: MSM, not always protected, drinks every weekend. Home blown away by cyclone. Alcohol: drinks beer, a lot. White rice, split peas, bread diet. Fan of cava, also drank unfiltered water. He is admitted, continues to feel poorly. Continued fevers, localized abdominal pain RUQ. On exam he has tender palpable liver, elevated WBC 17.8, eosinopenia, 0 cells. AST/ALT slightly above normal. Dengue, chick, lepto, blood all negative. Ultrasound of liver: shows 8x8 cm mixed echogenic lesion in right lobe. HIV negative. Send your case diagnosis, questions and comments to twip@microbe.tv |
Sat, 21 January 2017
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPonderers solve the case of the Timber Worker with Severe Shaking Chills, and describe an experimental malaria vaccine comprising attenuated sporozoites produced by genetic engineering. Become a patron of TWiP. Links for this episode:
This episode of TWiP is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 125Thanks to the Peace Corps - 24 yo female serving in Cameroon, teaching English and science at local school. Been in country 5 months, first 3 lived with host family, now in own home in community with electricity, 12 hr from Yaounde, capital. Reports intermittent diarrhea, loose stools, abdominal discomfort. No prior problems, no problems in family. No meds. No drinking or smoking. Lots of animals present, roam into class. Eating all local fare, cooks some, or buy locally. Eats fish, vegetables, no fish. Sleeps in house with mosquito nets. Not sexually active, AIDS negative. Young kids at school 6-12 yo, 20 in room. Does not eat at school. Not clear if water is treated. Not on antimalarials. Going on for a few a few weeks. No fever, no rash. Send your case diagnosis, questions and comments to twip@microbe.tv |
Wed, 4 January 2017
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The prolific podcast-shedding Hosts solve the case of the Global Health Intern with a snakelike lesion on her foot, and reveal the role of a single-stranded DNA binding protein in differentiation of trypanosomes. Become a patron of TWiP. Links for this episode:
Case Study for TWiP 12428 yo male from referral hospital near thai-burma border. Fever and chills 2 days, feels poorly, small amount of dark urine. Severe shaking chills, 1x per day, no rash. No diarrhea, difficulty breathing. Seen by local health care volunteer, went to hospital then tertiary hospital in Bangkok. Exposure history to pigs, dogs, insects, etc. Involved in timber industry and farming, sleeping out at night with no cover, clothes and sandals. No meds. Not married, family lives with him. Family is fine. Sleep in dwelling but no screens. No toxic habits, HIV negative, sexually active but not brothels. High fever, low bp, rapid heart rate, breathing rapidly, scleral icterus, dry mucus membranes, neck supple, lungs clear. 2/6 systolic murmur. Abdomen soft but tender, enlarged liver and spleen. Many cuts, bruises, bug bites. Labs: low platelets, low hematocrit, low glucose. Blood smear: abnormal, 5-10% infected RBCs with multiple band forms. Send your case diagnosis, questions and comments to twip@microbe.tv |
Tue, 20 December 2016
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPanorama solve the case of the Dutch Woman with Wormy Objects in Her Stool, dissect a study on cytoadhesion of malaria infected red blood cells, and introduce Parasitology Superheroes. Become a patron of TWiP. Links for this episode:
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 123Nurse in early 20s, recent grad, decides to spend year in global health internship in western DR/Haitian border. On her foot has skin issue: told is fungal infection, using antifungal cream, is getting worse. Several days, only on one foot. Healthy, no past med/surg/allergies, no meds, no HIV, lives with local family. Daughter, wife, husband, cat. No toxic habits. Originally from US, swims, walks barefoot to and from, shoes off in house. Easts local food, exposure to dogs, cats, sister. Very itchy, but not open; rash area is raised. Blistery in certain areas, involves different areas in different days, snakelike. Send your case diagnosis, questions and comments to twip@microbe.tv |
Tue, 6 December 2016
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPniks docs solve the case of the Female from Peru with Epistaxis, and discuss the effect of community deworming on immunosuppression. Become a patron of TWiP. Links for this episode:
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. This show is sponsored by Drobo, a family of safe, expandable , yet simple to use storage arrays. Drobos are designed to protect your important data forever. This Holiday season give someone a Drobo to keep all their files and memories safe forever. TWiV listeners can save 20% or more off of their purchase of a Drobo 5D, Drobo 5Dt, Drobo 5N, or any 8-drive or 12-drive system at www.drobostore.com by December 31, 2016 using discount code MICROBE20. Case Study for TWiP 122 Send your case diagnosis, questions and comments to twip@microbe.tv |
Wed, 16 November 2016
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPanosome docs solve the case of the Mali Man with Profuse Diarrhea, and review the presence of Trypanosoma cruzi in vectors, canids, and humans along the Texas-Mexico border. Become a patron of TWiP. Links for this episode:
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 121Back to Peru. 55 yo female from highland central valley area near Cuzco. Works in farming, no prior skin lesions but has multiple hypopigmented scars on exposed extremities (trauma during working), now reports many years of bloody nasal discharge. Seen in Lima by Daniel in outpatient clinic. No other medical problems, no surgeries, no allergies, everyone in family fine, husband and kids. Still working. No travel except to see doctor. Exam in right nare: ulcerated lesion inside nose, muco-cutaneous lesion. Simple test will decide. No anemia, no fever. Not eosinophilic, labs normal, HIV negative. Send your case diagnosis, questions and comments to twip@microbe.tv |
Wed, 9 November 2016
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiP triumvirate solve the case of the Thai Woman with Facial Swelling, and explain how Th17 T cells protect against the intracellular parasite Trypanosoma cruzi. Become a patron of TWiP. Links for this episode:
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 120A 48 yo man from Mali comes to hospital ER in Washington Heights in NY with profuse watery diarrhea. Born in Mali, came to US at 18, working in US as long haul truck driver for 30 y, frequently visits Mali, recently to attend his father’s funeral. Got symptoms one week after return (was there for 3 weeks). 3 liters diarrhea/day. No past med/surg history, not seen doctor in long time. No allergies. Unknown what father died of, Mother in Mali is ok. No medications. Some alcohol, marijuana use. Does report that has exposure to professional female sex workers, no condoms. Temp of 39 C, bp down 80/40, heart over 110, rapid breathing high 20s, cachectic. Wasted. Fungating lesion perianally. Undergoes HIV testing, clade B. T cells <100. Send your case diagnosis, questions and comments to twip@microbe.tv |
Tue, 25 October 2016
Hosts: Vincent Racaniello and Daniel Griffin Vincent and Daniel solve the case of the Family with Eosinophilia, and discuss HIV-1 infection and genome integration in the blood fluke Schistosoma mansoni. Become a patron of TWiP. Links for this episode:
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. This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more. Case Study for TWiP 119This one will be kinder and gentler case. Back in Thailand but could be in several places. 25 yo Thai woman from Bangkok, to hospital, chief complaint facial swelling. Eats typical Thai diet (see previous episodes!) Som tum, etc fish that is not cooked. Migratory - moves around face. Not tender, but mild itchiness. For about a week, no pain. Healthy, no past med/surg history, family all fine. HIV negative, no drugs, no travel. On examination, has swelling on right side, 3-4 cm raised, little redness, firm, does not feel like fluid filled. No fever, no GI problems, no bloods. WBC up, eosinophils up. Send your case diagnosis, questions and comments to twip@microbe.tv |
Thu, 6 October 2016
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPinella solve the case of the Woman from Guinea, and describe the use of CRISPR/Cas9 to identify essential apicomplexan genes. Links for this episode:
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. This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more. Become a patron of TWiP. Case Study for TWiP 118Little bit of a twist - a human family with eosinophilia. Conveyed by good friend/colleague ID physician. Australia, NSW, 45 yo Dad, having problem with mild abdominal distention. Seen by doc in Sydney, CBC shows eosinophil count of 10,500. Wife of same age reports feeling fine, but gets CBC and also shows eosinophils of 5,200. Two daughters, 17 and 19, no symptoms, bloods: 900 and normal eosinophils. One week prior to dads symptoms, sister in law came (also in NSW) and stayed, developed severe diarrhea, discomfort, bloating, weight loss, eosinohils 4,700. Eat raw fish (not known if fresh or salt) purchased at local markets. No overseas travel or out of urban environment. No pets, no home grown foods. Went back to previous labs and found normal eosinophil levels. Full workup for strongyloides, all negative. No HIV. No toxic habits, no remarkable medical history. Send your case diagnosis, questions and comments to twip@microbe.tv |
Mon, 26 September 2016
Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The parasite prophets solve the case of the Thai Man with Abdominal Distention, and discuss the finding that metastatic leishmaniasis dependent on a virus can be prevented by blocking IL-17A. Links for this episode:
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. This episode is also sponsored by Drobo, a family of safe, expandable, yet simple to use storage arrays. Drobos are designed to protect your important data forever. Visit www.drobo.com to learn more. Become a patron of TWiP. Case Study for TWiP 117Woman 66 yo born in Guinea, grew up the moved to US past 10 years, just retired. Lives in Washington Heights. Mother having issues in Guinea, so went back for 3 months in 2016. Just came back a week ago, reporting headache, fever, feeling poorly. Staying in big city, with Mom (80s). Has own private toilet in nice home. No screens or bednets. Married for 40 years, recently divorces. Has had 10 children. Not sexually active. Starts with high fever, breaks, then 2 days later another for several hours, goes to ER. Given Ebola screening questions, negative, do some blood work, send her back out. 2-3 days later high fever, double vision, headache, comes to Columbia ER. No diarrhea, no urination discomfort. Has backache, feels that mouth is dry. Was admitted. Past med history: high bp, cholesterol, diabetes; not overweight; appendix out; has unknown reaction to novocaine. No smoking, drinking. Physical: 39.4 temp, 14-16 breath rate, heart rate over 100, rapid heartbeat, 2/6 systolic murmur with radiation to left carotid (flow murmur). No jugular venous distention. Abdomen right upper quadrant: slight enlargement of liver, not tender, can palpate spleen tip in left upper quadrant, slightly enlarged spleen. Normal bowel sounds, no rash. Blood: elevated white count, bands 9%. 0.1 eosinophils, platelets 79, hemoglobin 11. Bilirubin 1.5, bicarb 20, chest xray clear. Red cells: small, 79.4 mcv. Animals: don’t like animals! In middle of rainy season. Likes to walk outside in rain during day. No cats to keep out rodents. Food: all food is prepared in home. Eats all favorite foods: rice. No sick contacts, no exposure to health care setting, no bug bites. Send your case diagnosis, questions and comments to twip@microbe.tv |