This Week in Parasitism
TWiP is a podcast about the tiny creatures that live in and on us.

The TWiPtomaniacs solve the case of the Boy With Visual Disturbances and Itching, and discuss identifying secreted and excreted proteins of Trichinella parasites.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 144

Individual in 30s, male, presented to physician with stomach upset, uncomfortable feeling in legs. Has motile objects in stools. From Vancouver BC, was eating salmon, reports was either dried/smoked or marinated. Not sure if this is relevant. Brought motile objects to physician.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP144.mp3
Category:Science -- posted at: 8:31am PST

The TWiPians solve the case of the Woman With Anemia, Eosinophila, and a Worm in Her Intestine, and discuss a study on the function and druggability of two malarial aspartate proteases.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 143

From 1990s seen by a colleague, boy late teens, initially presented to ER in US chief complaint, visual disturbances and itching preventing sleep. Immigrated from Oaxaca, searching for work. Lived in modest dwelling with dirt floors, no running water, got from local river. Reports dogs, farm animals, many insects. On exam: tender nodules on head, skin irritated from scratching, small punctate lesions on right cornea. Is referred to specialists. Ophthalmologist called in, referred for further diagnostics.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP143.mp3
Category:general -- posted at: 9:49am PST

The TWiPsids solve the case of the Guatemalan Positive for Rhinovirus, and reveal how to kill all African trypanosomes with a primate apolipoprotein.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 142

Woman in 50s, immigrant from rural area with limited resources. Admitted to hospital with iron deficient anemia and eosinophilia. In US. Sent for colonoscopy. Note long slender serpiginous motile object, recovered, 4.5 cm long, one end slender, other large and curled but not blunt. Send worm to parasitology lab for identification. What might fit description? Is this usually associated with eosinophilia? What about anemia, is severe or mild? Would this person have come from outside the US to acquire this, or could they have acquired the infection in the US.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP142.mp3
Category:Science -- posted at: 9:13am PST

The TWiP Wataalamu solve the case of the One Year Old From Kenya With Moving Skin Lesions, and describe how to make mosquitoes refractory to Plasmodium with engineered symbiotic bacteria.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Case Study for TWiP 141

A 59 yo Spanish speaking female on Long Island originally from Guatemala. Goes to ER after returning from 10 day trip to visit friends and relatives in Guatemala and El Salvador with fever, cough, diffuse muscle aches, fatigue, chills. Respiratory pathogen panel done, positive for rhinovirus. Told that it's just a virus, go home. 5 days later returns with fever and chills, pain in upper belly, feels constipated. Admitted. No past med/surg, no allergies, no significant family history, no meds. Works cleaning houses. Travel: spends most time in and around big cities, lots of exposure to animals, ate all local fare; conch ceviche, fresh eggs, flattened chicken dish. Elevated white count left shifted, neutrophils increased, eosinophils cleared; cultured Salmonella from blood. IV antibiotics given, gets better, about to go out the hospital door, when results of stool O&P comes back from initial admission. Observed: Entamoeba coli; Endolimax nana; Blastocystis hominis. Released to home, 2 weeks later feels fine.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP141.mp3
Category:Medicine -- posted at: 5:20am PST

The triple TWiP solve the case of the Peace Corp Veteran with Eosinophilia, and discuss the genome sequence of the hyper-prevalent parasitic eukaryote Blastocystis.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. Get $30 off your first delivery and FREE SHIPPING by going to blueapron.com/twip.

Case Study for TWiP 140

From Dr. Arthur Mumelo, northern Kenya. One-year-old girl. Brought by mother with skin lesions that developed a week prior. The lesions are five in total – on the forehead, neck, back, chest and right arm. The lesions look like boils/furuncles but keep changing size and appearance – like something is moving under the skin. They are painful and itchy. Child is breastfeeding well. No other complaints. Child was born at Nyahururu County Referral Hospital. Gets vaccinations at Melwa Health Centre (Rural), vaccinations are up to date. They live in a wooden house with a dirt floor, roofed with corrugated iron sheets. The house has two rooms. They sleep on raised beds. There is a big community dam in the neighborhood, with stagnant water throughout the year. They don’t use mosquito nets. They have reliable clean water supply from the government. They have one dog but the neighbors’ dogs also visit their compound and living area. They hang their clothes on the clothesline after washing; never dry their clothes on the grass. Clothes not hot-ironed. On Examination; Child is breastfeeding well, afebrile, no pallor, no jaundice, not in distress. Occipital lymphadenopathy; tender, mobile. Furuncles on the forehead, chest neck, back and right arm. They are 1-3cm in diameter and 0.5 cm high, tender, have a central punctum from which serosanguineous fluid is discharging.  This is a rural health centre – the only labs done are a peripheral blood film – which showed increased eosinophils and neutrophils. HIV test – negative.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP140.mp3
Category:general -- posted at: 1:11pm PST

The TWiPwalas solve the case of the Woman with a Worm in Her Eye, and discuss the role of nitric oxide in the resistance of rats to Schistosoma japonicum.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 139

Seen at Columbia Medical Center, a crossover. Woman in 30s returns to US after 2 years in Peace Corp, Cameroon and Gabon. On medical exam 2 years earlier: eosiniphilia noted, no diagnosis reached. Now comes to NYC 2 years later to attend grad school, again eosinophilia noted. Asymptomatic.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP139.mp3
Category:Medicine -- posted at: 5:29am PST

The TWiPsters solve the case of the Child from DR with Poppy Seed Sized Things On His Head Hair Shafts, and reveal how the skin parasite landscape determines the infectiousness of Leishmania.

Hosts: Vincent Racaniello and Daniel Griffin

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 138

New Yorker, female teenager from an outer boroughs, visual loss in right eye noted during routine eye exam. Not sure when started. Left is 20-20, otherwise feels fine. No surgeries, no noted medical history, no medications, in school, living with family, no toxic habits. Travel: had been upstate NY in past year. No pets. Defect in right eye pupillary reflex, pallor to optic nerve. Serologies: toxocara, HCV, syphilis, all negative. Dilated fundal exam: sees 1850 microns motile worm in the eye. Not on surface, not Loa Loa.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP138.mp3
Category:Science -- posted at: 8:14am PST

The TWiPtoids solve the case of the Man from India with a Neck Lump, and explore the role of a transmissible dysbiotic skin microbiome in inflammation during cutaneous leishmaniasis.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 137

Little town in DR, fall of 2016, have already mentioned this patient; little boy 2-3 years old, not behaving well, warned if doesn’t behave, los gusanos will eat you! Mother asks Daniel to help son: lately is more irritable, troublesome, not well behaved; notices things in his hair. Has small poppy seed sized things on side of hair shafts. She picks them off in fingers and smashes them. What are they, what do I do? Simple dwelling, dirt floor, walls and tin roof, animals everywhere. No money for medicines, what can she do?

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP137.mp3
Category:Science -- posted at: 9:11am PST

The TWiP Titans solve the case of the Man from Queens with a Blister Burster, and explain the role of inflammatory monocytes during Leishmania infection of the skin.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 136

Patient seen by Daniel in India, 18 yo Islamic college student, left home, living in dorms in south, Hindu couple prepare meals, called dorm parents. He is being seen because developed lump in left side of neck, 1-2 cm mass. Previously completely healthy, no med/surg, no allergies. Prays multiple times a day, observes dietary restrictions. Afebrile, normal, but has 2 cm firm nontender lump inside interior portion of sternocleido mastoid muscle. Not tender. End of November, rainy season. No screens on dorm windows. No animal contact. Ultrasound done, and was helpful. Noticed in his neck over several weeks.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP136.mp3
Category:Science -- posted at: 2:12pm PST

Dickson returns to the TWiP hosts to solve the case of the Woman from Colorado With Loose Stools, and explain how single-sex infection with female Schistosoma mansoni reduces hepatic fibrosis.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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Links for this episode:

This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase – WITH FREE SHIPPING – by going to blueapron.com/twip.

Case Study for TWiP 135

Patient seen in clinic by Daniel's colleague, living in Queens, needs home care. Man with wound on foot, needed daily care. Living 9 months, recently developed painful blister, he put his foot in water, got great relief, blister opened up. Open lesion did not look normal, there was something in blister. Went to see parasitologist, saw something there, wrapped it around piece of wood. Not previously seen a physician, no surgeries, knew little family history. New to our country, where could he have possibly come from? Rural part of some country. Resource limited region. How many days of treatment will he need?

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP135.mp3
Category:Science -- posted at: 7:08pm PST

Daniel and Vincent solve the case of the Haitian Girl Who Failed To Thrive, and visit two studies that address the question of whether infection with Toxoplasma gondii alters human behavior.

Hosts: Vincent Racaniello and Daniel Griffin

 

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Case Study for TWiP 134

Woman in 30s, coming in Colorado to be seen, reports foul smelling loose stools multiple times each day, cramping and nausea. Started a few weeks ago. No fever, summer, no unusual travel, skiing up in mountains, hiking, backpacking. Originally from NE, moved to Colorado one year before. Often drinks from streams. Treats water with iodine. On overnight trips pack food and cook on stoves. Sticky stools, trouble wiping clean. Yes, my stools do float. Color, not as dark. Well formed. No medical problems, no surgeries, no allergies. Takes no medications. Lives alone in private home. Drinks beer, no other toxic habits. None of her friends report similar problems. Sexually active, does not always use protection. Physical exam: unremarkable.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP134.mp3
Category:Science -- posted at: 7:31am PST

Daniel and Vincent solve the case of the Woman With Anal Area Discomfort, and discuss the multiple functions of a clathrin adapter protein in formation of rhoptry and microneme secretory organelles of Toxoplasma gondii.

Hosts: Vincent Racaniello and Daniel Griffin

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Case Study for TWiP 133

Seen while working in remote mountain makeshift mobile clinic in Dominican Republic, on Haitian border. Traveled 3 h by pickup truck, remote mountain town, womens centers. Set up makeshift mobile clinic in this center. Mother concerned about 6 yo girl, failure to thrive compared with sister, protuberant belly, frequent abdominal discomfort, going on over 1 year. No surgeries, no meds, first time ever seeing medical person. Mother and sister are family. Three children in family. Father does timber work. Very impoverished region, living in dirt floor home, drinking untreated water from local stream, go to bathroom outside, could be contamination. Diet: carbohydrate, plantains, rice, beans. On exam: lungs clear, heart fine, belly protuberant, liver and spleen not enlarged, some edema. Mother said noticed long motile worm in girls feces. Firm belly, not painful to her.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP133.mp3
Category:Science -- posted at: 8:41am PST

The TWiP-tastic peeps solve the case of the Thai Man Coughing Up Blood, and reveal potential therapies for trypanosomiasis that are inhibitors of protein import into glycosomes.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

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Case Study for TWiP 132

Young NYC woman with son (10), chief complaint of discomfort and itchiness in anal area. Has tried to look but nothing abnormal. Married, no complaints from husband or child. Two older kids have no complaints. But son has also been scratching in anal area. Everything fine 3 months ago, sister came to visit with 3 young pre-school children, may have caught something from them. No past med or surg history, no allergies. No meds, work out of home, no toxic habits, no recent travel. Have dog. Do lots of volunteering with children. History of sushi consumption. She does not like raw fish but son does. Worse itching at night. Going on for a number of weeks. Reports being under a lot of stress recently due to family.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP132.mp3
Category:Science -- posted at: 9:57am PST

Jonathan from the podcast Arthro-Pod joins the TWiPerati to solve the case of the Peruvian Woman With Inguinal Insect Bite, and discuss warm autoimmune hemolytic anemic that develops after babesiosis.

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

Guest:  Jonathan Larson

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 131

Thailand. 39 yo man reports 7 months of coughing up bright red blood, several times with mucus. Otherwise feels well. Big fan of salted crab som tum. Fisherman, lives with family. Healthy, no past med/surg problems. No meds. On seeing him: afebrile, chest xray abnormal: area of increased opacification. Not a smoker. No toxic habits.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP131.mp3
Category:Science -- posted at: 6:06am PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPniks solve the case of the Man With AIDS, and explore how secretion of extracellular vesicles influences the social motility of Trypanosoma brucei.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 130

Back in Peru. 24 yo female seen in ER, lives in rural area outside of big city, adobe house in highlands, thatched roof, dirt floor, 3000 meters. Quite ill with skin lesion for 48 h. 2 days before was pulling on pjs, felt sharp sudden pain in right upper leg. Next day found small living creature in pajamas, inguinal region. Developed red lesion, enlarged, developed black central dot. Then begins vomiting, comes to hospital. No fever, breathing fast 20, hr 70, bp 160/10, on exam see in right inguinal region an enlarging, necrotic area 1-2 cm, starting to look sick. Whites at 26000, left shift, 200 platelets, eosinophils 4%, bilirubin 3.5, creatinine 4.9 (going into renal failure, not making much urine). Hematocrit 14, BUN 59.7, CPK 227, RBCs and leukocytes in urine. No health problems, no surgeries, first interaction with health system. No toxic habit. Brings in the small creature!

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP130.mp3
Category:Science -- posted at: 11:04am PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP Masters solve the case of the Australian Wildlife Carer, and review evidence that nodding syndrome may be caused by an autoimmune reaction to the parasitic worm that causes river blindness.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 129

Young male in 30s, presents to ER with male partner, NY area, chief complaint over 1 month significant diarrhea, watery, non bloody. Abdominal cramping. Feels poorly, low energy, fever. Some vomiting, lost noticeable amount of weight, can’t stay hydrated. Past: AIDS positive, not on meds, last CD4 <50, viral load elevated and uncontrolled. Non contributory family history, no meds. Social history: had worked in office, can no longer; lives with male partner; occasional alcohol, no pets, no other significant exposures. Partner also AIDS, also not on therapy. Physical: febrile, 38.5C, 115 bp, 95/65, 18 resp, thin male, clearly uncomfortable. Oral thrush in buccal mucosa. No subungual saliva. Lungs clear, abdomen diffusely tender, increased bowel sounds. Labs: elevated creatinine, BUN, decreased sodium, elevated WBC count with significant eosinophilia. No pets or houseplants. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP129.mp3
Category:Science -- posted at: 2:00pm PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPerati solve the case of the Man Who Sat in Feces, and discuss a study on how Dickson's favorite parasite induces the formation of a collagen capsule.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 128

Daniel doesn’t expect anyone to get this. From Australia, 80 yo retired teacher from Atherton, northheast Australia, presents to clinic with generalized weakness, concern of chronic lyme or Q fever. Seen by neurologist, concern about motor neuron disease. 18 months of illness, insidious onset of limb (arms and legs) weakness. No issues with speaking, swallowing or breathing; no weight loss; no fever, sweat, chill. History of osteoarthritis, joint replacements; myocarditis; vertigo; allergic to pen and dox. Father, rhematoid arthritis, brother colon cancer. On a number of medications. Does extensive travel, when not traveling, is a volunteer carer in Australia (abandoned wildlife), over the past three years. Lives with husband. Marsupials, hand feeds puggles and juvenile spiny anteaters, has pet cockatoo. No history of polio, HIV negative. Neuro exam: diffuse non tender muscle with no rash. Normal upper and lower limb tone, strength is symmetrically reduced proximally. Reflexes good at knees, normal sensation to all modalities. Normal cranial nerve exam. Test results: has eosinophilia, elevated muscle enzymes, EMG shows myopathic changes, nerve conduction normal. Stop statin therapy, no change. This is a rare parasite.

Send your case diagnosis, questions and comments to twip@microbe.tv

Music by Ronald Jenkees

Direct download: TWiP128.mp3
Category:Science -- posted at: 7:56am PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPsters solve the case of the Peace Corps Volunteer with a Liver Lesion, and discuss the dependence of Leishmania survival on the gut microbiome of the sandfly.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free with your first purchase - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 127

The last of our trio for the Peace Corp, an eosinophilia case. 29 yo pc volunteer in Rwanda, male, 3 weeks of feeling poorly. Starts with rash on lower back and upper legs, maculopapular rash. Fatigue later, cough, then diarrhea, 51% eosinophils (9000). No significant exposure to fresh water. Stool sent for oandp. Said sat down and got something on behind, realized later was feces, this was where rash developed. OandP seeing larva in stool. HIV neg, no med issue, no surgeries, no Kava. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP127.mp3
Category:Science -- posted at: 4:47am PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiP Trinity solve the case of the Peace Corps volunteer with diarrhea, and reveal how immunizing against a virus ameliorates exacerbated leishmaniasis.

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This episode is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 126

Another Peace Corps volunteer in Fiji. 24 yo male, several days of fever, headache, dry cough, rash. Feels poorly, starts diarrhea. No blood or mucus, no vomiting but abdominal discomfort. Heart rate over 100. At private nearby hospital for evaluation: no prior med probs or surgeries. Social history: MSM, not always protected, drinks every weekend. Home blown away by cyclone. Alcohol: drinks beer, a lot. White rice, split peas, bread diet. Fan of cava, also drank unfiltered water. He is admitted, continues to feel poorly. Continued fevers, localized abdominal pain RUQ. On exam he has tender palpable liver, elevated WBC 17.8, eosinopenia, 0 cells. AST/ALT slightly above normal. Dengue, chick, lepto, blood all negative. Ultrasound of liver: shows 8x8 cm mixed echogenic lesion in right lobe. HIV negative. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP126.mp3
Category:Science -- posted at: 8:22am PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The TWiPonderers solve the case of the Timber Worker with Severe Shaking Chills, and describe an experimental malaria vaccine comprising attenuated sporozoites produced by genetic engineering.

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Links for this episode:

This episode of TWiP is brought to you by Blue Apron. Blue Apron is the #1 fresh ingredient and recipe delivery service in the country. See what’s on the menu this week and get your first 3 meals free - WITH FREE SHIPPING - by going to blueapron.com/twip.

Case Study for TWiP 125

Thanks to the Peace Corps - 24 yo female serving in Cameroon, teaching English and science at local school. Been in country 5 months, first 3 lived with host family, now in own home in community with electricity, 12 hr from Yaounde, capital. Reports intermittent diarrhea, loose stools, abdominal discomfort. No prior problems, no problems in family. No meds. No drinking or smoking. Lots of animals present, roam into class. Eating all local fare, cooks some, or buy locally. Eats fish, vegetables, no fish. Sleeps in house with mosquito nets. Not sexually active, AIDS negative. Young kids at school 6-12 yo, 20 in room. Does not eat at school. Not clear if water is treated. Not on antimalarials. Going on for a few a few weeks. No fever, no rash.

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP125.mp3
Category:Science -- posted at: 11:42am PST

Hosts: Vincent RacanielloDickson Despommier, and Daniel Griffin

The prolific podcast-shedding Hosts solve the case of the Global Health Intern with a snakelike lesion on her foot, and reveal the role of a single-stranded DNA binding protein in differentiation of trypanosomes.

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Case Study for TWiP 124

28 yo male from referral hospital near thai-burma border. Fever and chills 2 days, feels poorly, small amount of dark urine. Severe shaking chills, 1x per day, no rash. No diarrhea, difficulty breathing. Seen by local health care volunteer, went to hospital then tertiary hospital in Bangkok. Exposure history to pigs, dogs, insects, etc. Involved in timber industry and farming, sleeping out at night with no cover, clothes and sandals. No meds. Not married, family lives with him. Family is fine. Sleep in dwelling but no screens. No toxic habits, HIV negative, sexually active but not brothels. High fever, low bp, rapid heart rate, breathing rapidly, scleral icterus, dry mucus membranes, neck supple, lungs clear. 2/6 systolic murmur. Abdomen soft but tender, enlarged liver and spleen. Many cuts, bruises, bug bites. Labs: low platelets, low hematocrit, low glucose. Blood smear: abnormal, 5-10% infected RBCs with multiple band forms. 

Send your case diagnosis, questions and comments to twip@microbe.tv

Direct download: TWiP124.mp3
Category:Science -- posted at: 5:31pm PST

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