Episodes

  • TWiP 136: Daniel throws a softball

    · This Week in Parasitism

    The TWiP Titans solve the case of the Man from Queens with a Blister Burster, and explain the role of inflammatory monocytes during Leishmania infection of the skin. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Become a patron of TWiP. Links for this episode: Inflammatory monocytes and skin Leishmania (PLoS Path) Dracunculiasis (TWiP 37) Photo: Daniel using a LifeStraw Letters read on TWiP 136 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 your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip. Case Study for TWiP 136 Patient seen by Daniel in India, 18 yo Islamic college student, left home, living in dorms in south, Hindu couple prepare meals, called dorm parents. He is being seen because developed lump in left side of neck, 1-2 cm mass. Previously completely healthy, no med/surg, no allergies. Prays multiple times a day, observes dietary restrictions. Afebrile, normal, but has 2 cm firm nontender lump inside interior portion of sternocleido mastoid muscle. Not tender. End of November, rainy season. No screens on dorm windows. No animal contact. Ultrasound done, and was helpful. Noticed in his neck over several weeks. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 135: Embryonated eggs of wisdom

    · This Week in Parasitism

    Dickson returns to the TWiP hosts to solve the case of the Woman from Colorado With Loose Stools, and explain how single-sex infection with female Schistosoma mansoni reduces hepatic fibrosis. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Become a patron of TWiP. Links for this episode: ASM Grant Writing Online Course Single-sex Schistosoma infection (PLoS NTD) Asterix the Gaul Letters read on TWiP 135 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 your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip. Case Study for TWiP 135 Patient seen in clinic by Daniel's colleague, living in Queens, needs home care. Man with wound on foot, needed daily care. Living 9 months, recently developed painful blister, he put his foot in water, got great relief, blister opened up. Open lesion did not look normal, there was something in blister. Went to see parasitologist, saw something there, wrapped it around piece of wood. Not previously seen a physician, no surgeries, knew little family history. New to our country, where could he have possibly come from? Rural part of some country. Resource limited region. How many days of treatment will he need? Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 134: Does toxoplasma make you sexy?

    · This Week in Parasitism

    Daniel and Vincent solve the case of the Haitian Girl Who Failed To Thrive, and visit two studies that address the question of whether infection with Toxoplasma gondii alters human behavior. Hosts: Vincent Racaniello and Daniel Griffin   Links for this episode: ASM Grant Writing Online Course Is Toxoplasma infection related to brain and behavior impairments? (PLoS One) Toxoplasma infection and sexual attraction (Evol Psychol) TWiP 21 - The giant intestinal worm, Ascaris lumbricoides Candiru (Wikipedia) Image credit Letters read on TWiP 134 Case Study for TWiP 134 Woman in 30s, coming in Colorado to be seen, reports foul smelling loose stools multiple times each day, cramping and nausea. Started a few weeks ago. No fever, summer, no unusual travel, skiing up in mountains, hiking, backpacking. Originally from NE, moved to Colorado one year before. Often drinks from streams. Treats water with iodine. On overnight trips pack food and cook on stoves. Sticky stools, trouble wiping clean. Yes, my stools do float. Color, not as dark. Well formed. No medical problems, no surgeries, no allergies. Takes no medications. Lives alone in private home. Drinks beer, no other toxic habits. None of her friends report similar problems. Sexually active, does not always use protection. Physical exam: unremarkable. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 133: Tape test

    · This Week in Parasitism

    Daniel and Vincent solve the case of the Woman With Anal Area Discomfort, and discuss the multiple functions of a clathrin adapter protein in formation of rhoptry and microneme secretory organelles of Toxoplasma gondii. Hosts: Vincent Racaniello and Daniel Griffin Become a patron of TWiP. Links for this episode: Journal of Microbiology and Biology Education SciComm Issue (link) TWiP 19: Enterobius vermicularis, the pinworm Multiple roles of Toxoplasma gondii clathrin adaptor AP1 protein (PLoS Path) Image credit Letters read on TWiP 133 Case Study for TWiP 133 Seen while working in remote mountain makeshift mobile clinic in Dominican Republic, on Haitian border. Traveled 3 h by pickup truck, remote mountain town, womens centers. Set up makeshift mobile clinic in this center. Mother concerned about 6 yo girl, failure to thrive compared with sister, protuberant belly, frequent abdominal discomfort, going on over 1 year. No surgeries, no meds, first time ever seeing medical person. Mother and sister are family. Three children in family. Father does timber work. Very impoverished region, living in dirt floor home, drinking untreated water from local stream, go to bathroom outside, could be contamination. Diet: carbohydrate, plantains, rice, beans. On exam: lungs clear, heart fine, belly protuberant, liver and spleen not enlarged, some edema. Mother said noticed long motile worm in girls feces. Firm belly, not painful to her. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 132: Salted crab som tum

    · This Week in Parasitism

    The TWiP-tastic peeps solve the case of the Thai Man Coughing Up Blood, and reveal potential therapies for trypanosomiasis that are inhibitors of protein import into glycosomes. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Become a patron of TWiP. Links for this episode: Inhibitors of protein import into trypanosome glycosomes (Science) Hookworm (TWiP #22) Photo by Nita Letters read on TWiP 132 Case Study for TWiP 132 Young NYC woman with son (10), chief complaint of discomfort and itchiness in anal area. Has tried to look but nothing abnormal. Married, no complaints from husband or child. Two older kids have no complaints. But son has also been scratching in anal area. Everything fine 3 months ago, sister came to visit with 3 young pre-school children, may have caught something from them. No past med or surg history, no allergies. No meds, work out of home, no toxic habits, no recent travel. Have dog. Do lots of volunteering with children. History of sushi consumption. She does not like raw fish but son does. Worse itching at night. Going on for a number of weeks. Reports being under a lot of stress recently due to family. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 131: Entomophagy

    · This Week in Parasitism

    Jonathan from the podcast Arthro-Pod joins the TWiPerati to solve the case of the Peruvian Woman With Inguinal Insect Bite, and discuss warm autoimmune hemolytic anemic that develops after babesiosis. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Guest:  Jonathan Larson Become a patron of TWiP. Links for this episode: Jonathan Larson (Twitter, Google Plus) Arthro-Pod podcast Warm hemolytic anemia after babesiosis (NEJM) Tickborne diseases of the US (CDC) Image credit Letters read on TWiP 131 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 your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 131 Thailand. 39 yo man reports 7 months of coughing up bright red blood, several times with mucus. Otherwise feels well. Big fan of salted crab som tum. Fisherman, lives with family. Healthy, no past med/surg problems. No meds. On seeing him: afebrile, chest xray abnormal: area of increased opacification. Not a smoker. No toxic habits. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 130: Paige Turner

    · This Week in Parasitism

    Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPniks solve the case of the Man With AIDS, and explore how secretion of extracellular vesicles influences the social motility of Trypanosoma brucei. Become a patron of TWiP. Links for this episode: T. brucei exosomes and social motility (PLoS Path) Image credit Parasites Without Borders Letters read on TWiP 130 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 your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 130 Back in Peru. 24 yo female seen in ER, lives in rural area outside of big city, adobe house in highlands, thatched roof, dirt floor, 3000 meters. Quite ill with skin lesion for 48 h. 2 days before was pulling on pjs, felt sharp sudden pain in right upper leg. Next day found small living creature in pajamas, inguinal region. Developed red lesion, enlarged, developed black central dot. Then begins vomiting, comes to hospital. No fever, breathing fast 20, hr 70, bp 160/10, on exam see in right inguinal region an enlarging, necrotic area 1-2 cm, starting to look sick. Whites at 26000, left shift, 200 platelets, eosinophils 4%, bilirubin 3.5, creatinine 4.9 (going into renal failure, not making much urine). Hematocrit 14, BUN 59.7, CPK 227, RBCs and leukocytes in urine. No health problems, no surgeries, first interaction with health system. No toxic habit. Brings in the small creature! Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 129: Human kindness, river blindness

    · This Week in Parasitism

    Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiP Masters solve the case of the Australian Wildlife Carer, and review evidence that nodding syndrome may be caused by an autoimmune reaction to the parasitic worm that causes river blindness. Become a patron of TWiP. Links for this episode: Nodding syndrome an autoimmune disease? (Sci Transl Med) Nodding syndrome: Preventable and treatable (Sci Transl Med) River Blindness lyrics (Google Play) Image credit Letters read on TWiP 129 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 your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 129 Young male in 30s, presents to ER with male partner, NY area, chief complaint over 1 month significant diarrhea, watery, non bloody. Abdominal cramping. Feels poorly, low energy, fever. Some vomiting, lost noticeable amount of weight, can’t stay hydrated. Past: AIDS positive, not on meds, last CD4

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  • TWiP 128: It's over 9000!

    · This Week in Parasitism

    Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPerati solve the case of the Man Who Sat in Feces, and discuss a study on how Dickson's favorite parasite induces the formation of a collagen capsule. Become a patron of TWiP. Links for this episode: Induction of collagen synthesis by Trichinella (Vet Parasitol) Letters read on TWiP 128 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 your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 128 Daniel doesn’t expect anyone to get this. From Australia, 80 yo retired teacher from Atherton, northheast Australia, presents to clinic with generalized weakness, concern of chronic lyme or Q fever. Seen by neurologist, concern about motor neuron disease. 18 months of illness, insidious onset of limb (arms and legs) weakness. No issues with speaking, swallowing or breathing; no weight loss; no fever, sweat, chill. History of osteoarthritis, joint replacements; myocarditis; vertigo; allergic to pen and dox. Father, rhematoid arthritis, brother colon cancer. On a number of medications. Does extensive travel, when not traveling, is a volunteer carer in Australia (abandoned wildlife), over the past three years. Lives with husband. Marsupials, hand feeds puggles and juvenile spiny anteaters, has pet cockatoo. No history of polio, HIV negative. Neuro exam: diffuse non tender muscle with no rash. Normal upper and lower limb tone, strength is symmetrically reduced proximally. Reflexes good at knees, normal sensation to all modalities. Normal cranial nerve exam. Test results: has eosinophilia, elevated muscle enzymes, EMG shows myopathic changes, nerve conduction normal. Stop statin therapy, no change. This is a rare parasite. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

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  • TWiP 127: Kava not Cava

    · This Week in Parasitism

    Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPsters solve the case of the Peace Corps Volunteer with a Liver Lesion, and discuss the dependence of Leishmania survival on the gut microbiome of the sandfly. Become a patron of TWiP. Links for this episode: Leishmania depends on sandfly gut microbiome (mBio) Kava (Wikipedia) Letters read on TWiP 127 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 your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip. Case Study for TWiP 127 The last of our trio for the Peace Corp, an eosinophilia case. 29 yo pc volunteer in Rwanda, male, 3 weeks of feeling poorly. Starts with rash on lower back and upper legs, maculopapular rash. Fatigue later, cough, then diarrhea, 51% eosinophils (9000). No significant exposure to fresh water. Stool sent for oandp. Said sat down and got something on behind, realized later was feces, this was where rash developed. OandP seeing larva in stool. HIV neg, no med issue, no surgeries, no Kava.  Send your case diagnosis, questions and comments to twip@microbe.tv

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  • TWiP 126: A virus walks into a parasite

    · This Week in Parasitism

    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: Viral vaccine prevents exacerbated leishmaniasis (PLoS NTD) For whom the trich tolls (TWiP 47) A virus in a parasite in a human (virology blog) Virologists in the mist (TWiV 128) Letters read on TWiP 126 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 126 Another 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

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  • TWiP 125: Third time's a charm

    · This Week in Parasitism

    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: Genetically engineered P. falciparum sporozoite vaccine (Sci Transl Med) Parasitology Superhero: Francesco Redi Image credit: Betsy Weissbrod Letters read on TWiP 125 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 125 Thanks 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

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  • TWiP 124: RPAing with the tryps

    · This Week in Parasitism

    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: RPA protein and differentiation of T. cruzi (PLoS NTD) Image credit Letters read on TWiP 124 Case Study for TWiP 124 28 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

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  • TWiP 123: What we know is confusing

    · This Week in Parasitism

    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: Myiasis (Wikipedia) Cytoadhesion of Plasmodium in severe malaria (PLoS Path) Image credit Letters read on TWiP 123 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 123 Nurse 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

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  • TWiP 122: If the thunder don't get you, the lightning will

    · This Week in Parasitism

    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: Community deworming and immune hyporesponsiveness (PNAS) Paul C. Beaver (one, two) Photo by Oscar Adam Oscarson Letters read on TWiP 122 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 First of a series of cases with a theme, a 23 yo female international aid worker, chief complaint of diarrhea. Dutch descent, born in US, been in rural area of western DR, close to Haitian border. It’s been raining, houses have tin roofs, other flat concrete, rainwater pours off. Child comes by with mangoes, she buys one, washes it in rain water from the roof. Bites open mango, peels it, eats mango. The same night she is not feeling well, loose stools, abdominal discomfort. Next day, goes with group to border town; then has full fledged diarrhea. Looks into toilet, sees white objects 1 cm in length on stool, and they are moving. Uniform width, thinner than long, wormy looking. Has been participating in other activities in this area, swims in local river, walks barefoot, eating lot of local foods. Lunch: rice, beans, cooked meat, avocado. Dinner, yucca, fried salami, etc. Healthy before, no family history, not on meds, living with one of local families, no toxic habits. Dogs, cats, pigs, chickens around. One month earlier, cat in family home had kittens, she played with them. Very excited about that. Local physician contacted, he treats her.  Send your case diagnosis, questions and comments to twip@microbe.tv

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  • TWiP 121: A parasite without borders

    · This Week in Parasitism

    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: T. cruzi in vectors, canids, humans at Mexican border (PLoS NTD) Tetracapsuloides bryosalmonae (Wikipedia) T. cruzi in US (Clin Micro Rev) Image credit Letters read on TWiP 121 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 121 Back 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

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  • TWiP 120: When they die they calcify

    · This Week in Parasitism

    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: Th17 cells protect against Trypanosoma cruzi (PLoS Path) Plasticity of helper CD4+ cells (Science) Image credit Letters read on TWiP 120 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 120 A 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

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  • TWiP 119: A kinder and gentler case

    · This Week in Parasitism

    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: Family cluster of eosinophilia (Clin Inf Dis) Dientamoeba fragilis (Wikipedia) Parasites without borders HIV integrates into Schistosoma genome (PLoS Path) Image credit Letters read on TWiP 119 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 119 This 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

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  • TWiP 118: Crispr capers with Toxoplasma

    · This Week in Parasitism

    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: Malarias in Guinea (CDC) Genome-wide CRISPR screen in Toxoplasma (Cell) Plasmodium parasitemia associated with increased Ebola survival (Clin Inf Dis) Image credit Letters read on TWiP 118 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 118 Little 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

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  • TWiP 117: Parasitic puzzles

    · This Week in Parasitism

    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: TWiP 27: Trematodes Leishmaniavirus and IL-17A dependent leishmaniasis (PLoS Path) Image credit Letters read on TWiP 117 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 117 Woman 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

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