Images of Infectious Diseases
70F. IL —> AZ.
UC on Infliximab / prednisone.
CC: confusion x 3 mo. No F/C. PE: left sided neglect, facial droop, anisocoria
CT (photo). Surgery: cavity with pus and swelling. Path (photo). Culture: growth in 24h
Your DDx?
#MayoIDQ MCQ next
70F. IL —> AZ.
UC on Infliximab / prednisone.
CC: confusion x 3 mo. No F/C. PE: left sided neglect, facial droop, anisocoria
CT (photo). Surgery: cavity with pus and swelling. Path (photo). Culture: growth in 24h
Your DDx?
#MayoIDQ MCQ next
2/
Excellent DDx #IDTwitter
70F IL —> AZ. UC on infliximab/ prednisone. Progressive confusion for 3 months. Head CT, biopsy, culture (prior tweet). Serum GM - / BDG +. What is the most likely diagnosis?
Excellent DDx #IDTwitter
70F IL —> AZ. UC on infliximab/ prednisone. Progressive confusion for 3 months. Head CT, biopsy, culture (prior tweet). Serum GM - / BDG +. What is the most likely diagnosis?
3/
Case diagnosis:
#Scedosporiosis
Culture: #Lomentospora prolificans
BDG+/GM- makes Mucor/Aspergillus less likely
Path: hyphae makes Coccidiodes less likely
Case diagnosis:
#Scedosporiosis
Culture: #Lomentospora prolificans
BDG+/GM- makes Mucor/Aspergillus less likely
Path: hyphae makes Coccidiodes less likely
4/
#Infliximab #TNFalphaInhibitors increase the risk of infections!
Bacterial: pneumonia, TB (screen / Rx prior to use), NTM, S aureus, Listeria
Viral: zoster (vaccinate!); screen for HBV HCV
Opportunistic: fungal infections (endemics and others)
cghjournal.org
#Infliximab #TNFalphaInhibitors increase the risk of infections!
Bacterial: pneumonia, TB (screen / Rx prior to use), NTM, S aureus, Listeria
Viral: zoster (vaccinate!); screen for HBV HCV
Opportunistic: fungal infections (endemics and others)
cghjournal.org
5/
#Infliximab #TNFalphaInhibitors #Fungus
Histoplasma
Coccidiodes
Blastomyces
Cryptococcus
Aspergillus
Pneumocystis (consider prophylaxis if also on high dose steroids)
Other IFI
doi.org
#Infliximab #TNFalphaInhibitors #Fungus
Histoplasma
Coccidiodes
Blastomyces
Cryptococcus
Aspergillus
Pneumocystis (consider prophylaxis if also on high dose steroids)
Other IFI
doi.org
6/
#Scedosporiosis
1. S. apiospermum, Lomentospora prolificans
2. Environment; inhalation or inoculation
3. Localized (trauma, keratitis) vs. invasive, disseminated (ICH)
4. Dx: culture, path, BDG+/GM-
5. Rx: voriconazole (check MDR profile); combo Rx
doi.org
#Scedosporiosis
1. S. apiospermum, Lomentospora prolificans
2. Environment; inhalation or inoculation
3. Localized (trauma, keratitis) vs. invasive, disseminated (ICH)
4. Dx: culture, path, BDG+/GM-
5. Rx: voriconazole (check MDR profile); combo Rx
doi.org
/7
#Scedosporiosis brain abscess has been reported in #neardrowning episodes, potentially through the sinuses or hematogenous spread from underlying pneumonia
#IDBR You Need to Know!
Thanks for participating.
doi.org
#Scedosporiosis brain abscess has been reported in #neardrowning episodes, potentially through the sinuses or hematogenous spread from underlying pneumonia
#IDBR You Need to Know!
Thanks for participating.
doi.org
Loading suggestions...