This Week in Parasitism
TWiP is a podcast about the tiny creatures that live in and on us.
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TWiP 247: Manhattan mystery malady
11/18/2024
TWiP 247: Manhattan mystery malady
TWiP solves the case of the Manhattan man with pain on urination or ejaculation, and presents a new case for you to solve. Hosts: , , , and Christina Naula Subscribe (free): , , , Links for this episode Join the MicrobeTV Hero: on TWiP 247 New Case A middle-aged male is referred to evaluation because of eosinophilia. This man is married, living here in the NY tristate area, and this was picked up on ‘routine blood work’ by his primary care doctor. This man had been in the military, serving as a marine, with time spent in Okinawa, Japan. This individual does report sexual activity with paid sex workers while in Okinawa but has been monogamous with his current wife for many years. A number of investigations are done with a test coming back showing serological evidence of a prior parasitic infection and he was treated with an antiparasitic medicine with resolution of the eosinophilia. The eosinophilia returned and he was referred to us. Blood work is now down showing evidence of a viral infection that might explain why the eosinophilia returned after treatment. Pt is HIV negative. This was prior to the COVID-19 pandemic. He is on no medications and in general feels fine. Become a of TWiP Send your questions and comments to Music by
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TWiP 246: Everything spiral: a worm in a hurry
11/01/2024
TWiP 246: Everything spiral: a worm in a hurry
TWiP taps into Dickson’s knowledge of Trichinella to discuss an outbreak in humans who consumed rare bear meat, and the impact of globalization and climate change on the epidemiology of the species. Hosts: , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Outbreak of (CCDR) Impact of on Trichinella (Food Waterborne Parasit) on TWiP 246 Become a of TWiP Send your questions and comments to Music by
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TWiP 245: Flying purple people eater with Ben LaBrot
10/18/2024
TWiP 245: Flying purple people eater with Ben LaBrot
Founder of Floating Doctors Ben LaBrot joins TWiP to solve the case of the 1 year old in northeastern Panama with a fatal leg infection, followed by a discussion of the history and mission of Floating Doctors. Hosts: , , and Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV on TWiP 245 New Case A man in his early 20s comes in reporting pain when he urinates or ejaculates. He reports that he is sexually active. He does confide that he has been in a relationship with a woman but he had a sexual encounter outside this relationship about 2 weeks ago when they were on a break and he did not wear protection. He feels like he needs to urinate more often and describes thin white discharge from the penis. He reports that he has no history of any sexually transmitted infections and had no medical issues prior to this. Become a of TWiP Send your questions and comments to Music by
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TWiP 244: Engineering Toxoplasma
10/05/2024
TWiP 244: Engineering Toxoplasma
Lilach Sheiner joins TWiP to talk about her career and her work on engineering Toxoplasma gondii secretion systems for intracellular delivery of multiple large therapeutic proteins to neurons. Hosts: , , and Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV Engineering T. gondii for (Nat Micro) Become a of TWiP Send your questions and comments to Music by
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TWiP 243: Don't blame it on Mexico
09/20/2024
TWiP 243: Don't blame it on Mexico
TWiP solves the case of the Woman with White Worms, and submits a new case involving a 1 year old in northeastern Panama with a fatal leg infection. Hosts: , , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Enterobius, the pinworm () Hero: New Case This case comes from Panama mid summer 2024. A provider for Floating Doctors working in the coastal region in northeastern Panama. This case involves a one year old, so the history is a bit difficult, but there may have initially been a scratch or some sort of break in the skin. Otherwise healthy but over a period of time this area expands and becomes a deep necrotic wound on the leg. Several other nearby wounds develop and become deep and infected. By the time this one year old is seen by the provider much of the leg appears eaten away. This is just the tip of the iceberg as a number of others develop similar wounds in the area. No prior medical history. Become a of TWiP Send your questions and comments to Music by
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TWiP 242: Worms impair COVID vaccines
09/06/2024
TWiP 242: Worms impair COVID vaccines
TWiP reviews a study showing that intestinal helminth infection impairs vaccine-induced T cell responses through an IL-10 pathway, which compromised protection against antigenically drifted SARS-CoV-2 variants. Hosts: , and Subscribe (free): , , , Links for this episode Join the MicrobeTV impair COVID vaccines (Sci Trans Med) Heligmosomoides (Wiki Commons) Become a of TWiP Send your questions and comments to Music by
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TWiP 241: There once was a patient from China
08/19/2024
TWiP 241: There once was a patient from China
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TWiP 240: A daily history of malaria with Sean Murphy
08/02/2024
TWiP 240: A daily history of malaria with Sean Murphy
Sean Murphy joins TWiP to discuss his career and the work of his laboratory to assess the daily natural history of asymptomatic Plasmodium infections in adults and older children in Katakwi, Uganda. Hosts: , and Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV of Plasmodium infections (Lancet Microbe) Become a of TWiP Send your questions and comments to Music by
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TWiP 239: Cryptosporidiosis from NYC tap water in an AIDS patient
07/19/2024
TWiP 239: Cryptosporidiosis from NYC tap water in an AIDS patient
TWiP solves the case of the AIDS patient who developed fever and watery diarrhea after drinking NYC tap water, and present a new case for your sleuthing. Hosts: and Subscribe (free): , , , Links for this episode Join the MicrobeTV Cryptosporidium () on TWiP 239 Become a of TWiP New Case Man in his 70s originally from Mainland China, then Hong Kong who has been living in the US for decades is admitted to the hospital with fever for 6 days. He reports that he saw his primary care physician in Queens and was referred to the hospital after blood work revealed a sodium level of 123 and an increased monocyte count. Pt reports drenching sweats, lots of outdoor activity walking in local parks in Queens. He reports he does not feel particularly sick. PMH-HTN, BPH PSH-neg Social-retired, no wife, has one son, no pets, no exotic exposures or recent travel VS febrile to 39.5, tachycardia, meets sepsis criteria PE -unremarkable Labs, nl wbc, eos-0, elevated neutrophils and monocytes, Na-123, elevated AST, elevated ALT, low platelets, low Hct, CT Chest A/P unremarkable Send your guesses to with TWiP 239 in the subject line Send your questions and comments to Music by
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TWiP 238: Eliminating sleeping sickness
07/05/2024
TWiP 238: Eliminating sleeping sickness
Michael Barrett joins TWiP to discuss progress in the elimination of human African trypanosomiasis caused by Trypanosoma brucei gambiense. Hosts: , and Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV Elimination of human (PLoS NTD) Hero: Become a of TWiP Send your guesses to with TWiP 237 in the subject line Send your questions and comments to Music by
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TWiP 237: Pass the venison, deer with Marilyn Fabbri
06/21/2024
TWiP 237: Pass the venison, deer with Marilyn Fabbri
Marilyn Fabbri joins TWiP to reveal the case of a patient who became very ill after he and a number of friends attended a large dinner where venison and boar were served. Hosts: , and Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV Toxoplasma gondii () Parasitic Diseases Lectures #15: on TWiP 237 Become a of TWiP New Case Man in his 60s with HIV/AIDS CD4 count less than 50, CD4% less than 5% and elevated viral load (VL) with report of prior CNS toxoplasmosis requiring a craniotomy, disseminated Mycobacterium avium complex (MAC), comes in with fever and very watery diarrhea x 4 days. He reports that he lives in Georgia but comes up to NY for his HIV care and stays in NYC. Send your guesses to with TWiP 237 in the subject line Send your questions and comments to Music by
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TWiP 236: Prime-and-trap vaccine for malaria
06/01/2024
TWiP 236: Prime-and-trap vaccine for malaria
Marion Avril of MalarVx, Inc. joins TWiP to discuss an accelerated prime-and-trap regimen using repRNA-based circumsporozoite vaccine. Hosts: and Guest: Subscribe (free): , , , Links for this episode Join the MicrobeTV Please support our work at repRNA-based (NPJ vaccines) Hero: Become a of TWiP Send your guesses to with TWiP 235 in the subject line Send your questions and comments to Music by
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TWiP 235: The case of the regurgitated wriggler
05/17/2024
TWiP 235: The case of the regurgitated wriggler
TWiP solves the case of a man in his 50s reporting months of abdominal discomfort, who takes mebendazole and some time afterwards vomits a worm into the sink. Hosts: , , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Please support our work at The giant intestinal worm, Ascaris lumbricoides () Parasitic Diseases Lectures #24: (YouTube) on TWiP 235 Hero: Become a of TWiP New Case: I first learned about this case from a colleague at work who tells me that their friend has just gotten really sick. The friend is described as having had multiple illnesses over time but that he has never been as sick as he recently got. He reports that the illness began as a diffuse myalgia with fever, there was some sore throat, noted swelling in the neck, and overwhelming fatigue. He tells some of his friends that he is feeling really terrible and it turns out that some of his friends also feel poorly. It turns out that about a week prior to the onset of his symptoms he and a number of friends attended a large dinner where venison and boar was served. This individual is then seen in our office. Some testing is done. He feels really terrible and despite being reassured that he should get better without treatment he is given therapy. Send your guesses to with TWiP 235 in the subject line Send your questions and comments to
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TWiP 234: Hookworms and a leech - parasites suck!
05/04/2024
TWiP 234: Hookworms and a leech - parasites suck!
TWiP discusses hookworm infection and the phase 1 clinical trial for a hookworm vaccine that could one day protect children from the hookworm anaemia, and reduce transmission of this infection. Hosts: , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Please support our work at in school-aged children in Gabon (Lancet Inf Dis) Step forward towards (Lancet Inf Dis) Hookworm vaccine (FASEB J) Hero: Become a of TWiP Send your questions and comments to Music by
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TWiP 233: Cryptosporidium not cryptocurrency
04/19/2024
TWiP 233: Cryptosporidium not cryptocurrency
TWiP solves the case of the physician with no significant previous medical history who is currently doing their fellowship training develops diarrhea, and presents a new clinical case for our astute listeners to solve. Hosts: , , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Please support our work at Hero: on TWiP 233 Become a of TWiP New Case study: I was recently asked about this case while I was off visiting Denmark. A man in his 50s has been reporting months of abdominal discomfort and decides to go discuss this situation with a local pharmacist. He describes this discomfort, some nausea, and some bloating of the abdomen. The pharmacist recommends that he take mebendazole. He takes the mebendazole and some time afterwards he vomits a worm into the sink. The worm does not have any obvious segmentation and appears completely nonsegmented and is moving around. One end is very pointy and the other little less so. Send your questions and comments to Music by
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TWiP 232: Lives of Wolbachia
04/05/2024
TWiP 232: Lives of Wolbachia
TWiP reviews the cellular lives of Wolbachia, a gram-negative bacteria that infects many arthropods and filarial nematodes with very different outcomes – parasitism or mutualism. Hosts: , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Please support our work at Cellular lives of (Nat Rev Micro) Hero: Become a of TWiP Send your questions and comments to Music by
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TWiP 231: Scotch in drink and tape
03/31/2024
TWiP 231: Scotch in drink and tape
TWiP solves the case of the Woman With White Worms, and presents a new clinical case to decipher. Hosts: , , , and Subscribe (free): , , , Links for this episode Join the MicrobeTV Please support our work at Hero: Become a of TWiP New Case study: A physician with no significant PMH who is currently doing their fellowship training develops diarrhea. The diarrhea is significant enough that they are beginning to feel weak, lightheaded, and end up going to the local ER. The physician lives in NYC, works most of the time but did just get back from a week-long vacation in Florida with their long-term partner where they got a chance to swim in the pool and get some sun. They returned feeling well and then noted the onset of the diarrhea. The diarrhea was watery, with some abdominal cramping but no noted blood or actual fever. The stool did not have a strong smell and no floating stools were reported. The physician was given IVF and returned home feeling better but now gets a call that there is a parasite on the stool testing and is recommended to take a medicine they have never heard of 3x per day for 3 days. Send your questions and comments to Music by
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TWiP 230: Healing cutaneous leishmaniasis with Maria Adelaida Gomez
03/01/2024
TWiP 230: Healing cutaneous leishmaniasis with Maria Adelaida Gomez
Maria Adelaida Gomez joins TWiP to discuss her career and the work of her laboratory on understanding the healing process during cutaneous leishmaniasis. Hosts: , , , and Guest: Maria Adelaida Gomez Subscribe (free): , , , Links for this episode Healing in (J Immunol) Become a of TWiP Send your questions and comments to Music by
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TWiP 229: The very hungry flatworm
02/27/2024
TWiP 229: The very hungry flatworm
Eyal joins TWiP to solve the case of the Female Traveler with Intermittent Fever and Ring Enhancements in the Liver. Hosts: , , , and Guest: Subscribe (free): , , , Links for this episode Become a of TWiP Case Study for TWiP 229 Woman in her 40s is referred to me to be seen in the office from one of my colleagues. She reports that she has been having recurrent issues with worms exiting her anus and vagina since 2018. She reports that she lives with her husband and 4 children and they have never reported any issues. She reports that initially she took something over the counter and things resolved. She then a couple years later has this problem again and this time discussed the problem with her housekeeper from El Salvador who gave her an antiparasitic tablet from her home country. This problem has now recurred and she was referred to a GI doctor who she explains laughed at her and suggested she see a psychiatrist. She come in now very upset and tearful. She relates that she has this itching that wakes her up at night and was able to take pictures of something she found on the anus. She has photos as well as a video of a thin white 1 cm motile thing with on end coming to a point. She reports a normal nonrestrictive diet. She reports no travel outside the US or even outside the local area. No PMH, no PSH, family history of different cancers. She does not work outside the home. She reports no pets. She has an unremarkable exam and labs only notable for low vitamin D. Send your questions and comments to Music by
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TWiP 228: Parasitic fountain of youth
02/06/2024
TWiP 228: Parasitic fountain of youth
TWiP discusses a tapeworm that causes extreme lifespan extension in infected ant workers, and a candidate antibody drug for prevention of malaria. Hosts: , , , and Subscribe (free): , , , Links for this episode in tapeworm-infected ant workers (Roy Soc Open Sci) for prevention of malaria goes viral (YouTube) Become a of TWiP Send your questions and comments to Music by
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TWiP 227: Alpha-gal syndrome
01/20/2024
TWiP 227: Alpha-gal syndrome
Jim Small joins TWiP to solve the case of the 41 year old Man with sudden GI distress and itchy hives, followed by a discussion of parasites and childhood stunting. Hosts: , , , and Christina Naula Guest: Jim Small Subscribe (free): , , , Links for this episode Parasites and (Trends Parasitol) on TWiP 227 Become a of TWiP Send your questions and comments to Music by
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TWiP 226: Successful systems attract parasites
01/03/2024
TWiP 226: Successful systems attract parasites
TWiP reviews some parasite stories of 2023, including progress in the control of malaria and polio, and review a connection between parasites and childhood stunting. Hosts: , , , and Christina Naula Subscribe (free): , , , Links for this episode Second (Nature) 2023 (WHO) Malaria and (WHO) Parasites and (Trends Parasitol) spotted off Japan identified (Science) Become a of TWiP Send your questions and comments to Music by
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TWiP 225: Wandering worm with Lee Gottesdiener
12/20/2023
TWiP 225: Wandering worm with Lee Gottesdiener
Lee Gottesdiener joins TWiP to help solve the case of the 46 Year Old Man with Ongoing Upper Extremity Swelling, and review plant‑based production of a protective vaccine antigen against the bovine parasitic nematode Ostertagia ostertagi. Hosts: , , , and Christina Naula Subscribe (free): , , , Links for this episode Vaccine against (Vert Farm Daily) Protective vaccine against bovine parasitic nematode Ostertagia ostertagi Hero: on TWiP 225 Become a of TWiP Case Study for TWiP 225 41-year-old male mechanical engineer, former Army Ranger trainee, moved from Denver, CO to Chattanooga, TN. He was in his usual state of vigorous health, hiking, doing Spartan races, working on his semi-rural property, and commuting to his place of work daily when about three months previous to his diagnosis, he began having episodes of sudden GI distress with diarrhea, followed by itchy hives in axilla and groin. He treated these episodes with Benadryl and got relief. At 10 PM one evening, he had another such episode, again took Benadryl, but began to experience gradual onset but relentlessly increasing shortness of breath and wheezing. He was taken at high speed to the Emergency Room by his wife. He reported that relaxation with a repetitive, meditative prayer seemed to control the symptoms but said it was like his throat was closing. Past history includes variable exercise and cold-induced asthma treated with an inhaler as a child, with only rare episodes in adulthood related to high exposure to allergens like cat dander. Family history is not contributory. Diet was omnivorous. They had one dog, a labradoodle named Raphael, which they chose because he was “hypoallergenic.” In the Emergency Department, he was treated with bronchodilators, intramuscular epinephrine, and antihistamines, and the symptoms abated. The experienced ED physician ordered a diagnostic test, having seen other similar cases in the region. A lifestyle intervention was successful.
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TWiP 224: Neglected tropical diseases roadmap with Chuck Knirsch
12/12/2023
TWiP 224: Neglected tropical diseases roadmap with Chuck Knirsch
Chuck Knirsch returns to TWiP to discuss the Neglected Tropical Diseases Roadmap published by WHO, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups. Chuck Knirsch returns to TWiP to discuss the Neglected Tropical Diseases Roadmap published by WHO, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups. Hosts: , , and Chuck Knirsch Subscribe (free): , , , Links for this episode Neglected Tropical Diseases (WHO) World report 2023 (WHO) Become a of TWiP Send your questions and comments to
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TWiP 223: Voluminous diarrhea
11/28/2023
TWiP 223: Voluminous diarrhea
TWiP solves the case of the Haitian female with AIDS and voluminous diarrhea, and review the pathogenesis, epidemiology, prevention and treatment of malaria and Chagas disease. Hosts: , , , and Christina Naula Click arrow to play Download (63 MB .mp3, 88 minutes) Subscribe (free): , , , Links for this episode (Lancet) (AJTMH) Hero: on TWiP 223 Become a of TWiP Case Study for TWiP 223 46 yo man with minimal pmh, elevated cholesterol, ongoing right upper extremity swelling, 5-10 years intermittently. Goose egg swelling on hand, foot. Lasts for hours, every few months. Go to ER, right upper extremity. Lives in NYS suburbs, Is vet and epidemiologist. Has done extensive travel, Liberia, Ghana, DRC, Uganda, Rwanda, 2 week duration. Doing work, fair amount of animal contact with bats, rodents, birds. PE unremarkable except for swelling of right arm. Blood work unremarkable. 2.5 yr later notice prickling irritation under right eyelid, think they see undulation under skin. Send your case diagnosis, questions and comments to Music by
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TWiP 222: Balamuthia in the brain with Natasha Spottiswoode
10/31/2023
TWiP 222: Balamuthia in the brain with Natasha Spottiswoode
At the meeting of the American Society for Tropical Medicine and Hygeine in Chicago, Natasha joins TWiP to solve the case of the Man with a Generalized Seizure and Infectious Forms in the Brain. Hosts: , , , and Christina Naula Guest: Subscribe (free): , , , Links for this episode Treatment of Balamuthia encephalitis with (Emerg Inf Dis) on TWiP 222 Become a of TWiP Case Study for TWiP 222 Haitian creole speaking, cachetic female in her 50s w/ hx HIV (noncompliant on medication), migrating from Haiti brought in by her daughter for dysphagia, cough x days, associated with NBNB vomiting, oral thrush extending to soft palate, concerning for oropharyngeal candidiasis. Weeks of nonresolving diarrhea. Admitted for failure to thrive and deconditioning, found to be Parainfluenza 3 positive), undergoing TB rule out. Diarrhea is voluminous, pt is dehydrated, there has been significant weight loss and lethargy over the last few weeks. MHx: HIV Shx: Lives in haiti Remarried, Last sexual encounter 2 years ago. Denies illicit drug use. Drinks alcohol Allergies: No Active Allergies Labs return with CD4 count in the 50s, elevated viral load. CD4 55/3% Send your case diagnosis, questions and comments to Music by
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TWiP 221: Delusional parasitosis
10/01/2023
TWiP 221: Delusional parasitosis
Michelle and Alexander join TWiP to solve their case of the 36 Year Old Male with shortness of breath, stinging pain in the extremities, fatigue, abdominal cramps, and bowel irregularities, and discuss host cell invasion by Trypanosoma cruzi. Hosts: , , , and Christina Naula Guests: Michelle Naegeli and Alexander Grieb Subscribe (free): , , , Links for this episode by Trypanosoma cruzi (PLoS NTDS) on TWiP 220 Become a of TWiP Case Study for TWiP 221 This is the case of a man in his 50s, with no remarkable prior medical history, who received care at a hospital in northern California, USA, after experiencing a generalized seizure. Magnetic resonance imaging (MRI) demonstrated a solitary left temporal lobe T2 hyperintensity with gadolinium rim enhancement and surrounding edema. After receiving treatment with dexamethasone and levetiracetam, he was transferred to an academic medical center. Examination by neurology consultants noted disorientation, inattention, moderate aphasia (difficulty communicating), and mild right hemiparesis. Cerebrospinal fluid (CSF) testing revealed increased nucleated cells up to 80/UL (60% lymphocytes, 17% neutrophils, 23% monocytes), protein concentration 38 mg/dL, and glucose concentration 100 mg/dL. They proceed to do a brain biopsy from the left temporal lobe lesion with cultures from the brain biopsy sample that did not grow bacteria, fungi, or mycobacteria. They performed metagenomic next-generation sequencing (mNGS) on a CSF sample and sent brain biopsy samples for universal broad-range PCR amplicon sequencing (uPCR) for bacteria, fungi, Mycobacterium tuberculosis, and nontuberculous mycobacteria. which is preliminarily reported as showing well-formed granulomata with acute inflammation. Rereview of neuropathology raised concern for certain round infectious forms that are about 50um in size with some surrounding clearing and a dark area within these forms. Send your case diagnosis, questions and comments to Music by
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TWiP 220: Denies any bug bites
08/20/2023
TWiP 220: Denies any bug bites
TWiP solves the case of the Hiker from Queens who Denies Bug Bites, and reveal two different malaria experimental vaccines that target different parts of the parasite life cycle. Hosts: , , , and Christina Naula Subscribe (free): , , , Links for this episode Malaria vaccine (Lancet Inf Dis) against malaria (Nat Immunol) on TWiP 220 Become a of TWiP Case Study for TWiP 220 Sent by Michelle and Alexander from the First Vienna Parasitology Passion Club A 36 year old male presents to the local ED with shortness of breath. Additional symptoms included a stinging pain in different parts of his extremities, fatigue, abdominal cramps and bowel irregularities. On exam he was resting comfortably and his vitals were normal, but the patient appears very distressed by his symptoms. His left eye showed signs of irritation, including redness and swelling. A detailed history reveals travel to the Caribbean about 4 years ago and several short trips to central and east Africa, all between 5 and 10 years ago. His initial labs were grossly unremarkable and a chest x-ray showed no abnormalities. The patient himself suspected a specific parasitic etiology of his symptoms, so we performed a number of serologies and stool examinations in search of parasitic diseases. None of the tests revealed evidence of an ongoing infection. He is HIV negative and not sexually active at the moment. He has no pets and no other recent travel history. He eats a normal diet and has been out of work for two years. Thank you for the opportunity to participate in this fantastic project! All the best, Michelle and Alexander from the First Vienna Parasitology Passion Club Send your case diagnosis, questions and comments to Music by
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TWIP 219: Sick as a dog
07/24/2023
TWIP 219: Sick as a dog
TWiP solves the case of the 19 month old Female Having Issues, and discusses the finding that selection for insecticide resistance can promote Plasmodium falciparum infection in Anopheles mosquitoes. Hosts: , Dickson Despommier, , and Christina Naula Subscribe (free): , , , Links for this episode Insecticide resistance in mosquitoes (PLoS Path) on TWiP 219 Become a of TWiP Case Study for TWiP 220 73 y/o M w/ no significant PMhs who is referred to ED for fever, lethargy and progressive weakness as for the past 2 weeks. Thursday of the prior week he went to his PCP and blood work was performed. CBC demonstrated RBC inclusions. Labs also demonstrated anemia, thrombocytopenia, mildly elevated total bili and ALT. He was started on PO azithromycin and atovaquone on Saturday, however, he has not noted much improvement. He was seen in our office Monday and reports intermittent fever to 102, continued chills . Additional symptoms include dark urine, chills, occasional diaphoresis. Normally patient rides his bike 15 miles a day and runs 3 miles per day but states now he barely has the energy to walk a few feet and is now in a wheelchair. He report that he regular goes for Runs in parks in Queens. He denies any bug bites, tick bites, rashes, blood transfusions in the past year. Send your case diagnosis, questions and comments to Music by
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TWiP 218: Malaria parasite evades mosquito
06/29/2023
TWiP 218: Malaria parasite evades mosquito
TWiP solves two cases this week, the Man with Issues after COVID-19, and the Man with Left Arm Weakness, then describe how the malaria parasite evades mosquito immunity by glutaminyl cyclase–mediated posttranslational protein modification. Hosts: , , and Christina Naula Subscribe (free): , , , Links for this episode Malaria parasite evades (Proc Natl Acad Sci USA) on TWiP 218 Become a of TWiP Case Study for TWiP 218 A fun twist for today. Did I mention recently I was spending time with Paul Calle at the Central Park and instead of Jeff Bezos showing up for Dinner Chevy Chase was there. Here we have the case of a 19 month old female who seems to be having some issues. Lots of increased respiratory effort even with minimal exertion. Some issue with loose stools and then followed by the onset of facial swelling. No sig PMH or PSH, fairly confident there is not smoking or drinking of alcohol and certainly not HIV+. On exam the increased respiratory effort that is audible. Directed testing reveals canine coccidia and giardia in the stool. So what is going on? Should I be worried about my daughter who has had lots of exposure? Send your case diagnosis, questions and comments to Music by
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