This Week in Parasitism

TWiP solves the case of the AIDS patient who developed fever and watery diarrhea after drinking NYC tap water, and present a new case for your sleuthing.

Hosts: Vincent Racaniello and Daniel Griffin

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• Cryptosporidium (TWiP 18)
• Letters read on TWiP 239

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New Case

Man in his 70s originally from Mainland China, then Hong Kong who has been living in the US for decades is admitted to the hospital with fever for 6 days. He reports that he saw his primary care physician in Queens and was referred to the hospital after blood work revealed a sodium level of 123 and an increased monocyte count. Pt reports drenching sweats, lots of outdoor activity walking in local parks in Queens. He reports he does not feel particularly sick. PMH-HTN, BPH PSH-neg Social-retired, no wife, has one son, no pets, no exotic exposures or recent travel VS febrile to 39.5, tachycardia, meets sepsis criteria PE -unremarkable Labs, nl wbc, eos-0, elevated neutrophils and monocytes, Na-123, elevated AST, elevated ALT, low platelets, low Hct, CT Chest A/P unremarkable

Send your guesses to [email protected] with TWiP 239 in the subject line

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Music by Ronald Jenkees

Michael Barrett joins TWiP to discuss progress in the elimination of human African trypanosomiasis caused by Trypanosoma brucei gambiense.

Hosts: Daniel Griffin, Dickson Despommier and Christina Naula

Guest: Michael Barrett

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• Elimination of human African trypanosomiasis (PLoS NTD)
• Hero: David Livingstone

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Send your guesses to [email protected] with TWiP 237 in the subject line

Send your questions and comments to [email protected]

Music by Ronald Jenkees

Marilyn Fabbri joins TWiP to reveal the case of a patient who became very ill after he and a number of friends attended a large dinner where venison and boar were served.

Hosts: Daniel Griffin, Dickson Despommier and Christina Naula

Guest: Marilyn Fabbri

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• Toxoplasma gondii (TWiP 12)
• Parasitic Diseases Lectures #15: Toxoplasmosis
• Letters read on TWiP 237

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New Case

Man in his 60s with HIV/AIDS CD4 count less than 50, CD4% less than 5% and elevated viral load (VL) with report of prior CNS toxoplasmosis requiring a craniotomy, disseminated Mycobacterium avium complex (MAC), comes in with fever and very watery diarrhea x 4 days. He reports that he lives in Georgia but comes up to NY for his HIV care and stays in NYC.

Send your guesses to [email protected] with TWiP 237 in the subject line

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Music by Ronald Jenkees

Marion Avril of MalarVx, Inc. joins TWiP to discuss an accelerated prime-and-trap regimen using repRNA-based circumsporozoite vaccine.

Hosts: Dickson Despommier and Christina Naula

Guest: Marion Avril

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• repRNA-based CSP malaria vaccine (NPJ vaccines)
• Hero: Mwelecele Ntuli Malecela

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Send your guesses to [email protected] with TWiP 235 in the subject line

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Music by Ronald Jenkees

TWiP solves the case of a man in his 50s reporting months of abdominal discomfort, who takes mebendazole and some time afterwards vomits a worm into the sink.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

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• The giant intestinal worm, Ascaris lumbricoides (TWiP 21)
• Parasitic Diseases Lectures #24: Giant Intestinal Worm (YouTube)
• Letters read on TWiP 235
• Hero: Ernst A. H. Friedheim

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New Case:

I first learned about this case from a colleague at work who tells me that their friend has just gotten really sick. The friend is described as having had multiple illnesses over time but that he has never been as sick as he recently got. He reports that the illness began as a diffuse myalgia with fever, there was some sore throat, noted swelling in the neck, and overwhelming fatigue. He tells some of his friends that he is feeling really terrible and it turns out that some of his friends also feel poorly. It turns out that about a week prior to the onset of his symptoms he and a number of friends attended a large dinner where venison and boar was served.

This individual is then seen in our office. Some testing is done. He feels really terrible and despite being reassured that he should get better without treatment he is given therapy.

Send your guesses to [email protected] with TWiP 235 in the subject line

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TWiP discusses hookworm infection and the phase 1 clinical trial for a hookworm vaccine that could one day protect children from the hookworm anaemia, and reduce transmission of this infection.

Hosts: Dickson Despommier, Daniel Griffin, and Christina Naula

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• Hookworm vaccines in school-aged children in Gabon (Lancet Inf Dis)
• Step forward towards hookworm vaccines (Lancet Inf Dis)
• Hookworm vaccine protects dogs (FASEB J)
• Hero: Muriel Robertson

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Music by Ronald Jenkees

TWiP solves the case of the physician with no significant previous medical history who is currently doing their fellowship training develops diarrhea, and presents a new clinical case for our astute listeners to solve.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

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• Hero: Keith Vickerman
• Letters read on TWiP 233

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New Case study:

I was recently asked about this case while I was off visiting Denmark. A man in his 50s has been reporting months of abdominal discomfort and decides to go discuss this situation with a local pharmacist. He describes this discomfort, some nausea, and some bloating of the abdomen. The pharmacist recommends that he take mebendazole. He takes the mebendazole and some time afterwards he vomits a worm into the sink. The worm does not have any obvious segmentation and appears completely nonsegmented and is moving around. One end is very pointy and the other little less so.

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Music by Ronald Jenkees

TWiP reviews the cellular lives of Wolbachia, a gram-negative bacteria that infects many arthropods and filarial nematodes with very different outcomes – parasitism or mutualism.

Hosts: Dickson Despommier, Daniel Griffin, and Christina Naula

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• Cellular lives of Wolbachia (Nat Rev Micro)
• Hero: Patricia F. Walker

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Music by Ronald Jenkees

TWiP solves the case of the Woman With White Worms, and presents a new clinical case to decipher.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

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• Hero: Ann Bishop

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New Case study:

A physician with no significant PMH who is currently doing their fellowship training develops diarrhea. The diarrhea is significant enough that they are beginning to feel weak, lightheaded, and end up going to the local ER. The physician lives in NYC, works most of the time but did just get back from a week-long vacation in Florida with their long-term partner where they got a chance to swim in the pool and get some sun. They returned feeling well and then noted the onset of the diarrhea. The diarrhea was watery, with some abdominal cramping but no noted blood or actual fever. The stool did not have a strong smell and no floating stools were reported. The physician was given IVF and returned home feeling better but now gets a call that there is a parasite on the stool testing and is recommended to take a medicine they have never heard of 3x per day for 3 days.

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Music by Ronald Jenkees

Maria Adelaida Gomez joins TWiP to discuss her career and the work of her laboratory on understanding the healing process during cutaneous leishmaniasis.

Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula

Guest: Maria Adelaida Gomez

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• CIDEIM
• Healing in cutaneous leishmaniasis (J Immunol)

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Music by Ronald Jenkees