TWiP 269: Peripatetic Martin Grobusch
This Week in Parasitism
TWiP travels to Toronto, CA for the American Society for Tropical Medicine and Hygiene conference where they meet up with Martin Grobusch to discuss his career and his work. Hosts: , , and Christina Naula Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV Primaquine for blocking (Lancet Inf Dis) , Sierra Leone (New Microb New Inf) Become a of TWiP Send your questions and comments to Music by
info_outline
TWiP 268: A loyal parasite
This Week in Parasitism
TWiP discusses a 41-year long human infection with Schistosoma mansoni, and CRISPR screens that reveal genes essential for Cryptosporidium survival in the host intestine. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Schistosoma infection (J Travel Med) Genes essential for Cryptosporidium (Nat Comm) Become a of TWiP Send your questions and comments to Music by
info_outline
TWiP 267: It dropped from her scalp
This Week in Parasitism
TWiP solves the case about the female who traveled to Brazil and upon returning home felt movements under her scalp on the back of her head, and present another case for your solving, a man with abnormal brain MRI. Hosts: , , and Christina Naula Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV Life cycle of Dermatobia hominis on TWiP 267 New Case Man in his 40s, married with 2 children, on Eliquis for a prior DVT, diet-controlled diabetes, who is admitted for evaluation of an abnormal brain MRI. He left AMA...
info_outline
TWiP 266: Wraps and ivermectin for malaria
This Week in Parasitism
TWiP explains research showing that treatment of baby wraps with an insect repellent, and oral dosing with ivermectin, are both effective measures to prevent malaria. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Treated baby wraps (NEJM) prevents malaria (NEJM) Become a of TWiP Send your questions and comments to Music by
info_outline
TWiP 265: Things that jump are cleaner than things that squat
This Week in Parasitism
TWiP solves the case about the parasite check in summer camp, and presents a new case about a woman who traveled to Brazil and developed furuncles on the back of her head. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Hero: Francesco Redi Wikipedia: Linda Hall Library, Kansas: Habermehl, G., (1994). Francesco Redi—Life and work, Toxicon 32 (4) . on TWiP 265 New Case From Eyal Leshem, a returning case “provider” 43 years old female who travelled to Brazil on May 2025 for a...
info_outline
TWiP 264: Toxoplasma changes your brain
This Week in Parasitism
Vincent and Daniel discuss research showing that Toxoplasma gondii infection of the brain alters extracellular vesicle production and the communication between neurons and astrocytes. Hosts: and Subscribe (free): , , , Links for this episode Join the MicrobeTV T. gondii (PLoS Path) Become a of TWiP Send your questions and comments to Music by
info_outline
TWiP 263: Tick-tock
This Week in Parasitism
TWiP solves the case of the world travelers with poppy-seed size dots embedded in their skin, then present a new case about parasite check in summer camp. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Hero: on TWiP 263 New Case It is the first day of summer camp and the children are lined up for a parasite check. Some of the children have certificates that allow them to bypass the screening. Some of the parents are upset about this process commenting that this is not required by the state and...
info_outline
TWiP 262: Do schistosomes affect behavior?
This Week in Parasitism
TWiP reviews research suggesting that schistosome infection affect behavior through the gut-brain axis, and Chuck Knirsch joins to reminisce about Dickson Despommier. Hosts: , , and Christina Naula Guest: Chuck Knirsch Subscribe (free): , , , Links for this episode Join the MicrobeTV Does affect behavior? (PLoS NTD) Hero: (NY Times) Become a of TWiP Send your questions and comments to Music by
info_outline
TWiP 261: A case for Dr. Hickam
This Week in Parasitism
TWiP solves the case of the pregnant woman from Tanzania with dehydration and 3 weeks of bloody stool, a situation that would confuse Ockam but not Dr. Hickam. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Hero: Dame Bridget Ogilvie ( and ) on TWiP 261 New Case I feel like the back section of our book has been a bit neglected. The new PD 8th Edition is posted on our website so please download a copy and extra points to anyone who can tell us what that is on the cover. Three individuals are...
info_outline
TWiP 260: Daily rhythms
This Week in Parasitism
TWiP explains how circadian clocks of parasite and vector circadian mediate efficient malaria transmission. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Clocks mediate (Nat Micro) Hero: () Become a of TWiP Send your questions and comments to Music by
info_outlineTWiP solves the case of the man with somnolence and something extra-erythrocytic, and presents a new puzzle for you to solve.
Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email
Links for this episode
- Join the MicrobeTV Discord server
- Letters read on TWiP 253
New Case
26-year-old female with no past medical history. Patient is from Georgia in the US and is volunteering in Hérico, Guinea (town in the Lélouma Prefecture in the Labé Region of northern-central Guinea). She arrived in Guinea in December 2023. She was taking doxycycline for malaria prophylaxis and says that she has not missed any doses
On October 2024 she presented with fever and dry cough. Lab work was done and follow up planned for the following day. The patient slept poorly, was febrile to 104 and had ongoing cough. The next day she went to the hospital and was evaluated in the ER for acute febrile illness of unclear etiology.
In the hospital, VS were 97.9F, BP 105/70, P 94 Oxy sat 98%, normal physical exam.
She was started on Augmentin and Coartem.
Pause here to think about the differential at this point and maybe some more history and what testing you might want
WBC 14, Hb 13, HCT 40, PLT 285, Neut abs 8, Eos Abso0.80; BUN/creat normal, AST normal; ALT 44, GGT 125
Stool parasite screen + for some sort of eggs, malaria smear negative, CXR with b/l infiltrates
She was given a medication (vomited 30 min after dose received). She then received a second dose of medication 5 hours after the first) and was discharged. The following day the patient returned to the ER, stating that she felt worse. Her temperature had climbed to 104 overnight, and she developed watery diarrhea and nausea. There were no additional episodes of vomiting. She was given an additional dose of a medication, ibuprofen, and started on ceftriaxone 1 gm IV Q12 hrs. During the day she continued to have low grade fevers and developed abdominal pain. That night she was again febrile to 104 F.
She remained admitted for 5 days with ongoing symptoms of diarrhea, nighttime fevers and diffuse abdominal discomfort. Three more malaria tests were negative (rapid test and slide review)
Blood cultures collected – no growth
She continued to have mild elevation of WBC and slight elevation of AST and ALT.
The patient was transferred to a different hospital. They give her a different medication, and within 24 hours symptoms resolve.
What is the diagnosis and what happened here with management?
Become a patron of TWiP
Send your questions and comments to twip@microbe.tv
Music by Ronald Jenkees