William Wright @wwrighID
ABIM Infectious Diseases | ABP Clinical Microbiologist (Yale) | MPH Biostatistics Epidemiology | Clinical Researcher | Clinical Director | OPAT Director | Baltimore, MD Joined July 2023-
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#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 @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:
Excellent CSF table Luke! Thanks for sharing! 👇
Excellent CSF table Luke! Thanks for sharing! 👇
#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:
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Is there any other anti infective drug as versatile as tmp-smx? Treats: bacteria gram positive and negative Fungi (e.g. PCP) Parasites (e.g. toxo)
@wwrighID @ID_fellows @TxID_Fellows @IdVilchez The resistance pattern seeing here reflects basal AmpC production
@wwrighID @ID_fellows @TxID_Fellows @IdVilchez Sounds like the pseudo-hypoaldosteronism that can happen with prolonged posaconazole use :) one of my favorite teaching points with this agent
#IDtwitter would you trust on ceftazidime for treatment? I don't have the pip tazo MIC @OncIDPharmd @davidvanduin @PriyaNori @BradSpellberg @wwrighID @JonathanRyderMD @dralicehan @ABsteward @DrToddLee
@Infected_Terran @BennyFdzLpz @IdVilchez @OncIDPharmd @davidvanduin @PriyaNori @BradSpellberg @wwrighID @JonathanRyderMD @dralicehan @ABsteward @DrToddLee Would check out this Breakpoints podcast! Cefepime more affected by MexXY-oprM and MexCD-oprJ mutations compared to ceftazidime. open.spotify.com/episode/6omdSw…
Anyone watching the @Pirates game tonight see me catch that smoked foul ball in bottom of 8th? What an athlete. Glad I’m dressed in uniform. Saved a young lady’s life. Gave her the ball. Like a knight of old. #LetsGoBucs
@wwrighID @ID_fellows @ASMicrobiology @TxID_Fellows @IdVilchez Vibrio vulnificus
What’s a pool-related ID myth you’d like to debunk? #IDTwitter #MedTwitter #idxposts Others post below! @IdVilchez @ABsteward @BradSpellberg @IDiots_pod @raj_karnatak @JonathanRyderMD @IDdocAdi @KMirza @EmpiricGame @DrToddLee @Weavofloxacin @wwrighID @doxy_cycling
@wwrighID @ID_fellows @ASMicrobiology @TxID_Fellows @IdVilchez Erysipeloid.
@wwrighID @ID_fellows @ASMicrobiology @TxID_Fellows @IdVilchez Nice reminder, thank U!
@InYourFAECIUM @wwrighID @ID_fellows @ASMicrobiology @TxID_Fellows @IdVilchez Yes this sounds like classic erysipeloid. Looks like an odd version of cellulitis and can use penicillin or first gen cephalosporins!
@wwrighID @ID_fellows @ASMicrobiology @TxID_Fellows @IdVilchez Since this is an acute onset type of injury, can likely rule out M marinum which leave’s Erysipelothrix as that’s the only other GP bacilli on this list :) teaching point: this isolate is intrinsically R to vanco..
How New Regulation of Laboratory-Developed Antimicrobial Susceptibility Tests Will Affect Infectious Diseases Clinical Practice ✅ Just Accepted ✍️ @romneyintn et al. bit.ly/3xkyIhb
@wwrighID I also always wonder about the difference of using amoxicillin versus ampicillin with in-vitro testing?
This paper is 20 years old, but amazingly every time a hospitalized patient has a fever (sometimes even just 100F), it prompts a “sepsis” work-up, and “pan-cultures!” Maybe we’ll never learn?
@Weavofloxacin Jaimes et al found that fever was not a useful independent predictor of bacteremia and needed to be considered in light of other factors, such as hypotension, white blood cell (WBC) counts, and the presence or absence of shaking chills. #IDTwitter doi.org/10.1086/380967
@wwrighID @ID_fellows @ASMicrobiology @TxID_Fellows @IdVilchez Thanks for your generous engagement.
On ID consults, pulled out this old letter to editor, criticizing guidelines for recommending CT before LP. I been howling at the moon for 20 yrs. Scary. Take a good look @DrToddLee and @DrEmilyMcD and team @Wiki_Guidelines at your old & cranky future... academic.oup.com/cid/article/40…
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