This Week in Parasitism

The TriTWiPomonads solve the case of the Child Who Passed a Worm, and reveal recombination between bovine and human schistosome species.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• S. bovis and S. haematobiumhybrids (PLoS Path)
• Hero: Ann Bishop
• Letters read on TWiP 169

9 yo boy brought into mobile clinic set up in small village Bocas del Toro archipelago. Initially had red painful eye a few months ago, lasted 1-2 weeks. Eye no longer red but has issues with vision in the eye. On eye exam, some peripheral vision, but no sharp clear vision. Notes retinal retraction, seems quiet granuloma over macula of affected eye.

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Music by Ronald Jenkees

The Giardians of the Galaxy solve the case of the Woman With a Colonic Stowaway from Hispaniola, and discuss activation of intestinal tuft cells by Trichinella spiralis.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• T. spiralisand intestinal tuft cells (PNAS)
• Hero: Carl Theodore Ernst Van Siebold
• Letters read on TWiP 168

18 month old child, on medical mission for previous year with older sibling and 2 parents. Back in US for 2-3 months, just as leaving remote location were given dose of allbendazole. Call comes to Mom, child is at child care and has passed something. It is serpiginous, 5-6 inches in length, moving a bit. Not flat, but round. Child otherwise fine.

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Music by Ronald Jenkees

The Tremendous Trio solve the case of the Woman With Foul Steatorrhea, and reveal breakdown of the glycocalyx associated with severe and fatal malaria.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• Glycocalyx and severe malaria (Clin Inf Dis)
• Hero: Bridget Ogilvie
• Letters read on TWiP 167

Woman 30 yo, traveled to DR, went to tourist part. On return for yearly physical, asked about her chronic constipation. She said does not have it any more, has normal bowel habits. A few weeks after her return this occurred. Primary care doc was intrigued, sent off some tests. Found Entamoeba hartmanni. What might the doc have done? What were the consequences of infection?

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Music by Ronald Jenkees

The Podfessors solve the case of the Teenager With Swollen Scrotum, and continue the story arc of Daniel's favorite cells, B-1 cells, and their association with protective immune responses in human Chagas disease.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• B1 cells and Chagas disease (Front Immunol)
• Daniel discovers B1 cells (J Exp Med)
• Hero: Bridget Ogilvie
• Image credit
• Letters read on TWiP 166

Recent consult from gastroenterologist. 61 yo woman on trip to Thailand, Cambodia for a few weeks. Developed diarrhea, took azithromycin, 3 days. Diarrhea continued, back in states now ongoing a few weeks. Left lower abdominal pain, bloated, gassy, loose stools, stick and foul smelling. Not sexually active, but is relevant. Not restrictive in what she ate. Drank bottled water. Did not eat raw items.

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Music by Ronald Jenkees

The TWiP team solves the case of the Four Year Old with Fever, Headache, and Cough, and discuss the release of extracellular vesicles from Leishmania amazonensis that manipulate the host immune response.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• Crackles (Wikipedia)
• Extracellular vesicles released by L. amazonensis (Front Microbiol)
• Hero: Marietta Voge
• Image credit
• Letters read on TWiP 165

Still in Uganda. Young boy came from a distance to see Daniel, teenager with large swelling in scrotum, left side, 4-6 cm diameter, superior to testicle. Not only young man in area with similar problem. Daniel asked, are there people with large swollen legs? He said yes, my brothers wife, left leg is large, swollen, irregularity. Nontender. Can be transilluminated, and it glows.

Send your case diagnosis, questions and comments to [email protected]

Music by Ronald Jenkees

The TWiP legends solve the case of Surfer Sans Septum, and discuss how two symbiotic bacteria in the tsetse fly allow colonization with Trypanosoma brucei.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• A Tale of Three Species (mBio)
• V.B. Wigglesworth (Wikipedia)
• VB Nimble, VB Quick
• Hero: James Paget
• Letters read on TWiP 164

Welcome to Uganda. Mother brings in 4 yo female child, end of rainy season, concerned that has one day of fever, headache, cough. On exam looks ill, unremarkable except rapid heart rate, localized crackles in right lower lung. Several children in family. Spends day swimming in local stream. Take care of animals. Help gather drinking water in morning. Live in dirt floor home, thatch roof, with animals around. Saw many others with same problem. What tests do you want to do?

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Music by Ronald Jenkees

The doctors of awesome solve the case of the Woman Who Visited Lebanon, and reveal that immunoglobulins protect the olfactory organ of trout against infection with the Ich parasite.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• Mucosal Ig protect trout from Ich (PLoS Path)
• Hero: Sir Patrick Manson
• Letters read on TWiP 163

From here in US before leaving for Uganda: male has lesion affecting nose. Has been having problem with nose for 2 yr, in 40s, surfer, hit nose with board. Southern eastern Costa Rica. After that had blood and scabs from nose. Inside of nares, scab formed. Did not improve with time. Saw ENT doc on LI, said he hit nose and needs reconstructive surgery. Entire septum destroyed. 20+ years ago had non healing ulcer on left hand, saw physician in CR, was treated for 20 days.

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Music by Ronald Jenkees

The TWiP professors solve the case of the Baby With Pericardial Effusion, and discuss whether the flagellate without a flagella, Dientamoeba fragilis, causes human illness.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• Patients with Dientamoeba fragilis infection (Am J Trop Med Hyg)
• Hero: Dr. Eloise B. Cram
• Image credit
• Letters read on TWiP 162

A fresh case. Woman in late 30s born in Palestine, moved to NY. Presented for care with sore throat, swollen lymph nodes. Married Lebanese man, he's still there, travel back in forth. Had been in Lebanon for 3 weeks before illness. Ate special raw meat dish while in Lebanon. No other animal exposure. Small children at home, works in office. No medical/surgical history, no meds. On exam, has posterior cervical lymphadenopathy. Otherwise normal exam. HIV negative. Low grade fever.

Send your case diagnosis, questions and comments to [email protected]

Music by Ronald Jenkees

The TWiPsters solve the case of the Brazilian Immigrant With Heart Problems, and describe how genome organization controls trypanosome antigenic variation.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• Trypanosome genome organization and antigenic variation (Nature)
• Hero: Arthur Looss
• Letters read on TWiP 161

Daniel was asked to see 30 yo female from Bolivia, had to travel back during 3rd trimester. Was there for most of 3rd trimester. Child born in US, pericardial effusion, ascites, moderate PDA. Heart function is ok. Woman was healthy, no issues during pregnancy. Baby's white count elevated, diagnostic evaluation. It is a parasite.

Send your case diagnosis, questions and comments to [email protected]

Music by Ronald Jenkees

The TWiPlets solve the case of the Electrician from Tamil Nadu with a Liver Mass, and reveal that dogs and humans share a common Chadian Guinea worm.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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• Chadian Guinea worms in humans and dogs (PLoS NTD)
• Hero: Karl George Friedrich Rudolf Leuckart
• Image credit
• Letters read on TWiP 160

Referred to Daniel for consult, 40 yo immigrant from Brazil, a farmer had worked there, family in US. While here 1 y ago sees physician for increased heart rate, arrythmia, premature ventricular contractions, A-fib and flutter, treated by cardiologist then gets implantable defibrillator. Diagnostics: EKG, right bundle branch block; Echo shows heart is dilated with apical aneurysm; thrombosis.

Send your case diagnosis, questions and comments to [email protected]

Music by Ronald Jenkees