This Week in Parasitism

TWiP reviews a study showing that the gut microbiota is essential for suppression of colitis by Trichinella spiralis. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Gut bacteria and Trichinella suppression of colitis (PLoS NTD) Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

1/3/25 • 51:46

TWiP solves the case of the middle-aged man with eosinophilia and a history of sexual activity with paid sex workers in Okinawa, and presents a new case for you to solve. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Letters read on TWiP 249 New Case Woman in 30s or 40s goes to Belize and after returning notices a lesion on her face. She goes to see several physicians and despite a number of topical creams the ulcer on her face does not heal. She is then referred to our office where a certain parasitic infection is considered and we involve our friends at Columbia to help us with the diagnosis.. Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

12/20/24 • 55:48

TWiP reviews the observation that infection of Azlheimer’s disease mice with Toxoplasma gondii reduces brain amyloid density globally and regionally. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Toxoplasma reduces amyloid in brain (J Inf Dis) Hero: Theodor Hiepe (Parasitol Res) Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

12/6/24 • 66:59

TWiP solves the case of the Manhattan man with pain on urination or ejaculation, and presents a new case for you to solve. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Hero: Charles Louis Alphonse Laveran Letters read on TWiP 247 New Case A middle-aged male is referred to evaluation because of eosinophilia. This man is married, living here in the NY tristate area, and this was picked up on ‘routine blood work’ by his primary care doctor. This man had been in the military, serving as a marine, with time spent in Okinawa, Japan. This individual does report sexual activity with paid sex workers while in Okinawa  but has been monogamous with his current wife for many years. A number of investigations are done with a test coming back showing serological evidence of a prior parasitic infection and he was treated with an antiparasitic medicine with resolution of the eosinophilia. The eosinophilia returned and he was referred to us. Blood work is now down showing evidence of a viral infection that might explain why the eosinophilia returned after treatment. Pt is HIV negative. This was prior to the COVID-19 pandemic. He is on no medications and in general feels fine. Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

11/18/24 • 58:29

TWiP taps into Dickson’s knowledge of Trichinella to discuss an outbreak in humans who consumed rare bear meat, and the impact of globalization and climate change on the epidemiology of the species. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Outbreak of human trichinellosis (CCDR) Impact of climate change on Trichinella (Food Waterborne Parasit) Letters read on TWiP 246 Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

11/1/24 • 83:52

Founder of Floating Doctors Ben LaBrot joins TWiP to solve the case of the 1 year old in northeastern Panama with a fatal leg infection, followed by a discussion of the history and mission of Floating Doctors. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Guest: Ben LaBrot Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Floating Doctors Letters read on TWiP 245 New Case A man in his early 20s comes in reporting pain when he urinates or ejaculates. He reports that he is sexually active. He does confide that he has been in a relationship with a woman but he had a sexual encounter outside this relationship about 2 weeks ago when they were on a break and he did not wear protection. He feels like he needs to urinate more often and describes thin white discharge from the penis. He reports that he has no history of any sexually transmitted infections and had no medical issues prior to this. Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

10/18/24 • 76:22

Lilach Sheiner joins TWiP to talk about her career and her work on engineering Toxoplasma gondii secretion systems for intracellular delivery of multiple large therapeutic proteins to neurons. Hosts: Vincent Racaniello, Dickson Despommier, and Christina Naula Guest: Lilach Sheiner Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Engineering T. gondii for protein secretion (Nat Micro) Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

10/5/24 • 49:41

TWiP solves the case of the Woman with White Worms, and submits a new case involving a 1 year old in northeastern Panama with a fatal leg infection. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Enterobius, the pinworm (TWiP 19) Hero: Mary Pritchard New Case This case comes from Panama mid summer 2024. A provider for Floating Doctors working in the coastal region in northeastern Panama. This case involves a one year old, so the history is a bit difficult, but there may have initially been a scratch or some sort of break in the skin. Otherwise healthy but over a period of time this area expands and becomes a deep necrotic wound on the leg. Several other nearby wounds develop and become deep and infected. By the time this one year old is seen by the provider much of the leg appears eaten away. This is just the tip of the iceberg as a number of others develop similar wounds in the area. No prior medical history. Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

9/20/24 • 66:23

TWiP reviews a study showing that intestinal helminth infection impairs vaccine-induced T cell responses through an IL-10 pathway, which compromised protection against antigenically drifted SARS-CoV-2 variants. Hosts: Vincent Racaniello, Daniel Griffin and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Worms impair COVID vaccines (Sci Trans Med) Heligmosomoides image (Wiki Commons) Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

9/6/24 • 47:39

The show producer has not yet provided a description for this episode.

8/19/24 • 74:57

Sean Murphy joins TWiP to discuss his career and the work of his laboratory to assess the daily natural history of asymptomatic Plasmodium infections in adults and older children in Katakwi, Uganda. Hosts: Vincent Racaniello, Dickson Despommier and Christina Naula Guest: Sean Murphy Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Daily natural history of Plasmodium infections (Lancet Microbe) Become a patron of TWiP  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

8/2/24 • 57:17

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Cryptosporidium (TWiP 18) Letters read on TWiP 239 Become a patron of TWiP  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 twip@microbe.tv with TWiP 239 in the subject line Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

7/19/24 • 30:49

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Elimination of human African trypanosomiasis (PLoS NTD) Hero: David Livingstone Become a patron of TWiP  Send your guesses to twip@microbe.tv with TWiP 237 in the subject line Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

7/5/24 • 96:53

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Toxoplasma gondii (TWiP 12) Parasitic Diseases Lectures #15: Toxoplasmosis Letters read on TWiP 237 Become a patron of TWiP  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 twip@microbe.tv with TWiP 237 in the subject line Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

6/21/24 • 57:01

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute repRNA-based CSP malaria vaccine (NPJ vaccines) Hero: Mwelecele Ntuli Malecela Become a patron of TWiP  Send your guesses to twip@microbe.tv with TWiP 235 in the subject line Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

6/1/24 • 72:40

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute 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 Become a patron of TWiP  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 twip@microbe.tv with TWiP 235 in the subject line Send your questions and comments to twip@microbe.tv

5/17/24 • 75:38

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute 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 Become a patron of TWiP   Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

5/4/24 • 82:35

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute Hero: Keith Vickerman Letters read on TWiP 233 Become a patron of TWiP 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.   Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

4/19/24 • 80:43

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute Cellular lives of Wolbachia (Nat Rev Micro) Hero: Patricia F. Walker Become a patron of TWiP Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

4/5/24 • 53:50

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Please support our work at microbe.tv/contribute Hero: Ann Bishop Become a patron of TWiP 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.  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

3/31/24 • 55:59

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 Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode CIDEIM Healing in cutaneous leishmaniasis (J Immunol) Become a patron of TWiP Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

3/1/24 • 60:47

Eyal joins TWiP to solve the case of the Female Traveler with Intermittent Fever and Ring Enhancements in the Liver. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Guest: Eyal Leshem Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Become a patron of TWiP Case Study for TWiP 229 Woman in her 40s is referred to me to be seen in the office from one of my colleagues. She reports that she has been having recurrent issues with worms exiting her anus and vagina since 2018. She reports that she lives with her husband and 4 children and they have never reported any issues. She reports that initially she took something over the counter and things resolved. She then a couple years later has this problem again and this time discussed the problem with her housekeeper from El Salvador who gave her an antiparasitic tablet from her home country. This problem has now recurred and she was referred to a GI doctor who she explains laughed at her and suggested she see a psychiatrist. She come in now very upset and tearful. She relates that she has this itching that wakes her up at night and was able to take pictures of something she found on the anus. She has photos as well as a video of a thin white 1 cm motile thing with on end coming to a point.  She reports a normal nonrestrictive diet. She reports no travel outside the US or even outside the local area. No PMH, no PSH, family history of different cancers. She does not work outside the home. She reports no pets. She has an unremarkable exam and labs only notable for low vitamin D.  Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

2/27/24 • 62:53

TWiP discusses a tapeworm that causes extreme lifespan extension in infected ant workers, and a candidate antibody drug for prevention of malaria. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Extreme lifespan extension in tapeworm-infected ant workers (Roy Soc Open Sci) Candidate antibody drug for prevention of malaria Ceilidh goes viral (YouTube) Become a patron of TWiP Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

2/6/24 • 68:48

Jim Small joins TWiP to solve the case of the 41 year old Man with sudden GI distress and itchy hives, followed by a discussion of parasites and childhood stunting. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Guest: Jim Small Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Parasites and childhood stunting (Trends Parasitol) Letters read on TWiP 227 Become a patron of TWiP Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

1/20/24 • 98:53

TWiP reviews some parasite stories of 2023, including progress in the control of malaria and polio, and review a connection between parasites and childhood stunting. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Second malaria vaccine (Nature) Malaria report 2023 (WHO) Malaria and climate change (WHO) Parasites and childhood stunting (Trends Parasitol) Sea creature spotted off Japan identified (Science) Become a patron of TWiP Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees

1/3/24 • 83:18

Lee Gottesdiener joins TWiP to help solve the case of the 46 Year Old Man with Ongoing Upper Extremity Swelling, and review plant‑based production of a protective vaccine antigen against the bovine parasitic nematode Ostertagia ostertagi. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Vaccine against cow parasite (Vert Farm Daily) Protective vaccine against bovine parasitic nematode Ostertagia ostertagi Hero: Dr. Katy Ewer Letters read on TWiP 225 Become a patron of TWiP Case Study for TWiP 225 41-year-old male mechanical engineer, former Army Ranger trainee, moved from Denver, CO to Chattanooga, TN. He was in his usual state of vigorous health, hiking, doing Spartan races, working on his semi-rural property,  and commuting to his place of work daily when about three months previous to his diagnosis, he began having episodes of sudden GI distress with diarrhea, followed by itchy hives in axilla and groin. He treated these episodes with Benadryl and got relief. At 10 PM one evening, he had another such episode, again took Benadryl, but began to experience gradual onset but relentlessly increasing shortness of breath and wheezing. He was taken at high speed to the Emergency Room by his wife. He reported that relaxation with a repetitive, meditative prayer seemed to control the symptoms but said it was like his throat was closing. Past history includes variable exercise and cold-induced asthma treated with an inhaler as a child, with only rare episodes in adulthood related to high exposure to allergens like cat dander. Family history is not contributory. Diet was omnivorous. They had one dog, a labradoodle named Raphael, which they chose because he was “hypoallergenic.” In the Emergency Department, he was treated with bronchodilators, intramuscular epinephrine, and antihistamines, and the symptoms abated. The experienced ED physician ordered a diagnostic test, having seen other similar cases in the region. A lifestyle intervention was successful.

12/20/23 • 84:53

Chuck Knirsch returns to TWiP to discuss the Neglected Tropical Diseases Roadmap published by WHO, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups. Chuck Knirsch returns to TWiP to discuss the Neglected Tropical Diseases Roadmap published by WHO, which sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups. Hosts: Vincent Racaniello, Dickson Despommier, and Chuck Knirsch Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Neglected Tropical Diseases Roadmap (WHO) World malaria report 2023 (WHO) Become a patron of TWiP Send your questions and comments to twip@microbe.tv

12/12/23 • 57:54

TWiP solves the case of the Haitian female with AIDS and voluminous diarrhea, and review the pathogenesis, epidemiology, prevention and treatment of malaria and Chagas disease. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Click arrow to play Download TWiP #223 (63 MB .mp3, 88 minutes) Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Malaria (Lancet) Chagas disease (AJTMH) Hero: Joe Cook Letters read on TWiP 223 Become a patron of TWiP Case Study for TWiP 223 46 yo man with minimal pmh, elevated cholesterol, ongoing right upper extremity swelling, 5-10 years intermittently. Goose egg swelling on hand, foot. Lasts for hours, every few months. Go to ER, right upper extremity. Lives in NYS suburbs, Is vet and epidemiologist. Has done extensive travel, Liberia, Ghana, DRC, Uganda, Rwanda, 2 week duration. Doing work, fair amount of animal contact with bats, rodents, birds. PE unremarkable except for swelling of right arm. Blood work unremarkable. 2.5 yr later notice prickling irritation under right eyelid, think they see undulation under skin.  Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

11/28/23 • 87:47

At the meeting of the American Society for Tropical Medicine and Hygeine in Chicago, Natasha joins TWiP to solve the case of the Man with a Generalized Seizure and Infectious Forms in the Brain. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Guest: Natasha Spottiswoode Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Treatment of Balamuthia encephalitis with nitroxoline (Emerg Inf Dis) Letters read on TWiP 222 Become a patron of TWiP Case Study for TWiP 222 Haitian creole speaking, cachetic female in her 50s w/ hx HIV (noncompliant on medication), migrating from Haiti brought in by her daughter for dysphagia, cough x days, associated with NBNB vomiting, oral thrush extending to soft palate, concerning for oropharyngeal candidiasis. Weeks of nonresolving diarrhea. Admitted for failure to thrive and deconditioning, found to be Parainfluenza 3 positive), undergoing TB rule out. Diarrhea is voluminous, pt is dehydrated, there has been significant weight loss and lethargy over the last few weeks. MHx: HIV  Shx: Lives in haiti Remarried, Last sexual encounter 2 years ago. Denies illicit drug use. Drinks alcohol  Allergies: No Active Allergies Labs return with CD4 count in the 50s, elevated viral load. CD4 55/3% Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

10/31/23 • 68:01

Michelle and Alexander join TWiP to solve their case of the 36 Year Old Male with shortness of breath, stinging pain in the extremities, fatigue, abdominal cramps, and bowel irregularities, and discuss host cell invasion by Trypanosoma cruzi. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Guests: Michelle Naegeli and Alexander Grieb Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode cAMP-dependent invasion by Trypanosoma cruzi (PLoS NTDS) Letters read on TWiP 220 Become a patron of TWiP Case Study for TWiP 221 This is the case of a  man in his 50s, with no remarkable prior medical history, who received care at a hospital in northern California, USA, after experiencing a generalized seizure. Magnetic resonance imaging (MRI) demonstrated a solitary left temporal lobe T2 hyperintensity with gadolinium rim enhancement and surrounding edema. After receiving treatment with dexamethasone and levetiracetam, he was transferred to an academic medical center. Examination by neurology consultants noted disorientation, inattention, moderate aphasia (difficulty communicating), and mild right hemiparesis. Cerebrospinal fluid (CSF) testing revealed increased nucleated cells up to 80/UL (60% lymphocytes, 17% neutrophils, 23% monocytes), protein concentration 38 mg/dL, and glucose concentration 100 mg/dL.  They proceed to do a brain biopsy from the left temporal lobe lesion with cultures from the brain biopsy sample that did not grow bacteria, fungi, or mycobacteria. They performed metagenomic next-generation sequencing (mNGS) on a CSF sample and sent brain biopsy samples for universal broad-range PCR amplicon sequencing (uPCR) for bacteria, fungi, Mycobacterium tuberculosis, and nontuberculous mycobacteria. which is preliminarily reported as showing well-formed granulomata with acute inflammation. Rereview of neuropathology raised concern for certain round infectious forms that are about 50um in size with some surrounding clearing and a dark area within these forms. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

10/1/23 • 83:19