#IDTwitter @ID_fellows #SIDPharm @TxID_Fellows #TwitteRx @IdVilchez #AMRrounds: called about this microbiology confirmed clinical bloodstream isolate inquiring about AmpC resistance.

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows #TwitteRx @IdVilchez #IDrounds: fisherman w/ EtOH use disorder seen w/ MAP 40-50, WBC 35 & bilateral lower extremity hemorrhage bullous lesions. Records report history of raw oyster ingestion. Most likely cause:

#IDTwitter @ID_fellows #SIDPharm @TxID_Fellows #TwitteRx @IdVilchez #IDrounds: oncology patient on trimethoprim-sulfamethoxazole (SXT), acyclovir (ACY), & posaconazole (POS) presents w/ worsening HTN, ⬇️K, ⬆️ Na, & ⬇️ extremity edema. Stable Cr & ⬆️ HCO3. Most likely cause:

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows #TwitteRx @IdVilchez #AMRrounds: HIV patient on TAF/FTC/BIC with multiple missed doses and HIV-RNA 5444 copies/mL (3202 copies/mL 3-months prior). Genotype results include M184V and G148H. You would recommend:

#IDTwitter #SIDPharm #TwitteRx @IdVilchez #IDrounds: patient reports history of serious rash days after amoxicillin use for dental infection < 5-years prior; resolved with a short course of oral corticosteroids. Which type of reaction is a contraindication to skin testing?

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows #TwitteRx @IdVilchez #IDrounds: crab fisherman working in Chesapeake Bay waters presents with painful red rash on his right hand for several days after crab spine injury. Wound culture with GP+ rod. Most likely:

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez 1/ #IDrounds: Cerebral Spinal Fluid (CSF) analysis is the most valuable indicator of infectious diseases of the Central Nervous System (CNS). Understanding the three (3) basic CSF types can be useful.

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows #TwitteRx @IdVilchez #IDrounds: immunocompetent patient seen for non-bloody diarrhea. No nausea/vomiting. Temperature 37.9C. Family members with similar diarrhea episodes 3-4 days prior. Which is most likely:

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #IDrounds: Previously healthy male farmer w/ AV mobile echo density. BC prior to ABX remained negative. Records indicate Rx for culture-negative CAP w/ hepatitis 6-months prior. Which is most likely:

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #IDrounds: Non-HIV male smoker admitted to MICU with severe CAP. Vitals: T 42C, RR 28, & O2 70% RA. WBC 19, Na 120, & ALT 62. Employed with cleaning horse stables at a racetrack. Which is most likely?

#IDTwitter #SIDPharm #MedTwitter #TwitteRx @IdVilchez Fever is frequently encountered in ICU. While it augments immune response & ⬇️ viral/bacterial replication, it ⬆️ metabolic rate, O2 consumption, impairs cardiac function. Optimal temperature control remains unclear. You:

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #IDrounds: asymptomatic immunocompetent failed blood donor seen for positive HTLV-1/2 serology with chronic Strongyloides stercoralis coinfection. Recalling treatment failures, you: IVM=ivermectin

1/ #IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #AMRrounds: called about this microbiology confirmed isolate from urine inquiring about mechanisms of resistance for ampicillin and ampicillin-sulbactam but susceptible to amoxicillin-clavulanate.

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #AMRrounds: Mushtaq et al doi.org/10.1128/spectr… recently reported genotypic-phenotypic discordance & prevalence of CTX-M, KPC, OXA-48/23, NDM, IMP, & VIM among GN blood isolates in single-center (NYC).

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #Microbiologyrounds: nondimorphic yeast; small blastocondia (1-4 um) as pathogen; pink-purple colonies; haploid genome; assimilates only glucose/trehalose; and often azole resistant. Who am I?

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #IDrounds: called about IDDM patient with ESRD scheduled for DDKT. Donor T pallidum-AB and RPR positive with no documentation of treatment. Your recommendation(s) for treatment for the recipient is:

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez @jobadd @ShohamTxID @AndrewKaraba Another #CraftBeer night trying the second new release from @stbcbeer , the orange 🍊 twist imperial ale with nice orange notes and delicious orange-vanilla sherbet taste!

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez @jobadd @ShohamTxID @AndrewKaraba #CraftBeer night trying the newest microbial fermentation beverage that is surprisingly smooth for a stout and very creamy flavor.

#IDTwitter @ID_fellows #SIDPharm @ASMicrobiology @TxID_Fellows @IdVilchez #IDrounds: Lung Tx pt (Tac+MMF) w/ pulmonary Aspergillosis on VRC for 6mo w/ joint aches. nml ROM. Plain-film extremities w/periosteal thickening, ⬆️ AP, ⬆️ Fluoride but nml TSH & VitA. Likely dx:

#IDTwitter #SIDPharm @Orioles @MLB @JHMed_ID @HopkinsMedicine @UofMaryland He worked to guarantee a strong Baltimore Orioles organization for the citizens of Maryland and deserves to be thanked by every baseball fan in the region.