Working on therapies for prevention and treatment of coronavirus. Transplant Infectious Diseases physician at Johns Hopkins. @ShohamTxID@med-mastodon.com
At our best infectious diseases experts can act as the synapses that connect surgeons, internists, pharmacists, microbiologists, epidemiologists and the patients to make good decisions.
"Crude 30-day mortality following a positive COVID-19 test was 2.2% in 2020, then decreased before stabilizing to 0.8%–1.0% from 2023 onward." Some people forget just how bad COVID was back then. academic.oup.com/ofid/articl…~
Triazole-resistant Aspergillus fumigatus in the Netherlands between 1994 and 2022: a genomic and phenotypic study - The Lancet Microbe thelancet.com/journals/lanmi…
Aspergillus tanneri fast facts: Tends to be resistant to multiple antifungal agents, described in people with chronic granulomatous disease (CGD) Western parts of US, living in Western parts of the US. Disseminated and contiguous disease patterns
Clinical situation: should you use vancomycin as part of empiric therapy in patient with AML and pneumonia.
Answer from clinical trial: Not typically, if MRSA screen is negative - Talagtag - 2021 - Transplant Infectious Disease - Wiley Online Library onlinelibrary.wiley.com/doi/…
Candida auris: a) adheres to skin and inanimate objects, b) colonization often clinically significant (compared to C. albicans), c) associated with outbreaks, d) often resistant to fluconazole, and sometimes echinocandins too. A good review article by Lionakis in NEJM in 2024
Teaching case: middle aged man with ulcerative colitis. Disease has been stable, but now seemingly flares. CMV viral load ~100K. Endoscopy: CMV colitis. CMV IgG had been negative previously. Now CMV IgM . This is probably primary CMV infection with tissue invasive disease
For a patient in whom there is a high pre-test probability for Clostridium difficile infection: a positive C difficile PCR with a negative EIA for toxin, does not rule out C difficile. False negative tests for the EIA toxin do occur.
Aspergillus calidoustus. I have seen it have a tendency for cutaneous involvement. Tends to be resistant to azoles. Here is another one from the literature. rdcu.be/eg2Fr.
more about this organism and the skin
Seroy J, Antiporta P, Grim SA, Proia LA, Singh K, Clark NM. Aspergillus calidoustus case series and review of the literature. Transpl Infect Dis. 2017 Oct;19(5). doi: 10.1111/tid.12755. Epub 2017 Sep 19. PMID: 28741738.
Thank you to today’s panel of MMI Thursday Seminar presenters — David Sullivan, MD, & our guests from @HopkinsMedicine moderator Dan Hanley, MD, @ShohamTxID, Nicole McBee & Karen Lane! Great interactive discussion about their multi-center #COVID-19 clinical trial
many reasons why life expectancy in US is falling. I have to imagine the painfully system for getting medications covered by insurance companies is one of them. Without A LOT of work on the part of patients there are a million ways that things don't work out.