Infectious Disease

Podcast #377: Endocarditis

Author:  Nick Tsipis, MD Educational Pearls: Persistent fever or positive blood cultures should raise suspicion for endocarditis Patients with recent dental procedures, recent cardiac surgeries are at risk, or who inject drugs are at higher risk Physical exam findings may include fever with a new murmur, Janeway lesions, Osler nodes, and/or splinter hemorrhages   References:…

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Podcast # 373: Legionnaires Disease

Author:  Gretchen Hinson, MD Educational Pearls: Legionnaires disease refers to a severe pneumonia caused by Legionella pneumophilia and occurs typically at the extremes of age Associated gastrointestinal symptoms (nausea/vomiting/diarrhea) may be present Hyponatremia is a common laboratory finding Legionella urinary antigen can be a convenient test to identify the infection Treatment is with fluoroquinolones, macrolides…

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Podcast # 360: Epidural Abscess Screening

Author: Dylan Luyten, MD. Educational Pearls: Dangerous causes of back pain: AAA, cauda equina syndrome, epidural abscess. Young person with back pain needs to be evaluated for injection drug use (major risk factor). Patient with focal neurologic deficits (FND) require an MRI.  Patients without FND can be screened with ESR and CRP. An ESR <…

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Podcast #355: Syphilis

Author: Aaron Lessen, MD Educational Pearls: Re-emerging STI. Progresses through distinct phases if untreated: Primary syphilis: frequently overlooked because initial chancre is painless. Secondary syphilis: viral syndrome, rash on trunk, palms, and soles. Latent syphilis: asymptomatic period, lasting 5-20 years. Tertiary syphilis: includes neurosyphilis (dementia, encephalitis, etc.) and cardiovascular syphilis (aortitis, etc). Treatment penicillin G…

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Podcast # 353: Xofluza

Author: Sam Killian, MD Educational Pearls: Japan recently approved baloxavir marboxil (Xofluza), which may potentially “kill” Flu A/B within 24 hours Recent RCT trial showed superiority over oseltamavir (Tamiflu) in cessation of viral shedding (24 vs 72 hours) Compared to placebo, superior in time to symptom resolution (53.7 vs 80.7  hours) Administered as single dose…

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Podcast # 345: Epidural Abscess

Author: Sue Chilton, MD Educational Pearls: IV drug use and spinal procedures are major risk factors. Classic triad of back pain, focal neurological deficit and fever. However, presence of fever is highly variable. Neurologic deficits may not present until later, but then they can have a rapid progression of neurological decline. MRSA is most common…

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Podcast # 326: Valley Fever

Author: Michael Hunt, MD Educational Pearls: Valley fever is a fungal infection known as Coccidiomycosis that can present with vague symptoms like cough, fever, myalgias. A thorough history is critical to the diagnosis. Disease is localized to  the Southwestern US (California, New Mexico, Arizona, Nevada, Utah) and parts of Central/South America. Disease is caused by…

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Podcast #313: Flu Screening

Author: Peter Bakes, M.D. Educational Pearls: High risk patients: underlying lung disease, immunocompromised, extremes of age (<2 or >65), underlying cardiac/renal/neurologic disease, and pregnant women. Testing: RT-PCR (RNA based test that is both sensitive and specific) Workup: comorbidities dictate whether or not they are screened; CXR indicated in high risk patients with respiratory symptoms. Morbidity…

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Podcast #307: Guillain-Barre Syndrome

Author: Peter Bakes, M.D. Educational Pearls: Rare disease with 1-2 patients out of 100,000. About 60% of patients report a preceding diarrheal illness and classically presents with an ascending motor weakness. Pathophysiology is likely due to molecular mimicry where the immune system creates antibodies against a pathogen (C. jejuni ) which appears similar to the…

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Podcast #302: Flu

Author: Jared Scott, M.D. Educational Pearls Flu is widespread throughout the US (through Jan 20th 2018). All age groups have seen surge in hospitalizations, but 65 + age group has seen the largest surge in hospitalizations due to flu. New recommendations for treating with Tamiflu! Treat the following high-risk groups at any stage of illness:…

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