This Week in Parasitism

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TWiP 198: Cyclospora in the dining room with the salad bar Sep 14, 2021

Show notes

The TWiP quadfecta solves the case of the Traveler With Watery Diarrhea, and reveals that a heat-shock response regulated by a transcription factor protects human malaria parasites from the high temperatures of fever.

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

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Malaria parasite resists fever due to heat shock response (Nat Micro)
Malaria beats the heat (Nat Micro)
Letters read on TWiP 198

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Case Study for TWiP 198

31 yo woman, previously healthy, traveled to Tanzania, went on 11 day long safari. One week later, at home, developed fever and severe headache, went into hospital. Thick blood smears negative, physical exam normal, small purple lesion near buttocks. Started on treatment for African tick bite fever. Did not get better, lesion grew in size. Biopsy of lesion, nothing remarkable on microscopy. Improved, sent home, 10 days another bout of fever that went down in 2 days. Lesion healed. PCR for plasmodium, Borrelia negative, but seroconverted for Rickettsia. Went home, a week later another 3 day bout of fever.

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

Music by Ronald Jenkees

TWiP 197: An adventurous eater Aug 16, 2021

Show notes

TWiP solves the case of the Adventurous Eater with Areas of Swelling, and discusses an experimental Trypanosoma vivax vaccine comprising an invariant flagellum antigen.

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

Download TWiP #197 (39 MB .mp3, 64 minutes)

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Experimental T. vivax vaccine (Nature)
Letters read on TWiP 197

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Case Study for TWiP 197

Gentleman in late 20s, has for weeks had watery diarrhea that is not getting better. Recently took trip to Oaxaca, Mexico. Stayed at nice hotel, all fruits, vegetables, salads well cleaned. Always ate at hotel. Developed diarrhea there. Went with three others, stayed at same place. No prior surgeries, no family history, no medications, no toxic habits. Daniel recommends one test and that gives diagnosis and therapy and he resolves.

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

Music by Ronald Jenkees

TWiP 196: Naked eye entomologist Jul 12, 2021

Show notes

TWiP solves the case of the Homeless Man With Skin Issues, and discusses an experimental mRNA based malaria vaccine.

Hosts: Vincent Racaniello and Daniel Griffin

Download TWiP #196 (49 MB .mp3, 81 minutes)

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Entomophagy (TWiP 131)
Malaria mRNA vaccine (NPJ vaccines)
Letters read on TWiP 196

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Case Study for TWiP 196

30 yo woman having areas of swelling in different parts of body, blood work shows elevated eosinophils. History: prior had been travelling around SE Asia. Had some loose stools on return, some tingling in fingers, otherwise fine. Adventurous eater, fish, pickled fish, salads. Previously in good health, no surgeries, all in family healthy. No meds. Lives alone. Went to Indonesia and Thailand. Toxic habits: no smoking, drinks periodically, HIV negative. On exam: swollen area on arm, biopsy is done. Pathologist report: cross section has what appears to be larval nematode.

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

Music by Ronald Jenkees

TWiP 195: Shocking diseases in attractive NY accents May 31, 2021

Show notes

Christina returns to the TWiP trifecta to solve the case of the Beachgoer with Red Lines on Her foot, and an experimental malaria vaccine based on the junctional region of the circumsporozoite protein displayed on a virus-like particle.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Christina Naula

Download TWiP #195 (46 MB .mp3, 76 minutes)

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VLP-based malaria vaccine (Cell)
Promise of a malaria vaccine (Ann Rev Micro)
Hero: Maria Mota
Letters read on TWiP 195

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Case Study for TWiP 195

Gentleman in 60s, does not have permanent home, comes in with skin issues. Pruritis all over. Wearing heavy coat, unwashed polyester shirt. 1 cm diameter patches, erythematous, areas where open from scratching. Cover much of torso. Solve case by examining his clothes.

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

Music by Ronald Jenkees

TWiP 194: Eye had a corneal scraping Apr 24, 2021

Show notes

TWiP solves the case of the Long Island Man with Unilateral Eye Pain, followed by a discussion of how enteric helminth coinfection enhances host susceptibility to West Nile virus by a tuft cell-IL-4 receptor signaling axis.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Christina Naula

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Helminth infection enhances West Nile viruses pathogenesis (Cell)
Hero: Franz Von Lichtenberg
Letters read on TWiP 194

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Case Study for TWiP 194

Woman in 40s, on return from Puerto Rico where she often went. Went to local beaches, brought their dogs. Noticed problem on foot, raised red serpiginous lines, slowly moving all over the foot. Bloodwork showed elevated eosinophils.

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

Music by Ronald Jenkees

TWiP 193: A serpiginous trail Mar 29, 2021

Show notes

Audun returns to help solve the case of the Ecuadorean Gentleman Treated for COVID-19, followed by a discussion of the interaction of Blastocystis with the intestinal microbiota and the immune system, and of course a new clinical case from Daniel.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Audun Lier

Download TWiP #192 (46 MB .mp3, 76 minutes)

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Blastocystis interactions with gut microbiota and immune system (PLoS Path)
Hero: Lucy Engel Graves Taliaferro
Letters read on TWiP 193

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Case Study for TWiP 193

Male, 50s, seen by physician for unilateral eye pain, blurred vision, watery drainage. Soft contact lens wearer. Given eye drops, oral medication, sent for another opinion when does not resolve. Has hypertension, hyperlipidemia, no surgeries, no allergies, is on hypertension/statin med. Works in store. No toxic substance use. HIV negative. Lives on large piece of land with his own well, away from city, own septic tank. Left eye is very red. Ophthalmologist report: decreased visual acuity in left eye, injection of conjunctiva, edema, erosions, send corneal scrapings for culture. Swims in Long Island Sound. No travel history. No pets.

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

Music by Ronald Jenkees

TWiP 192: Towel off vigorously Feb 15, 2021

Show notes

The TWiPers solve the case of the Teenager in Malawi with Red Urine, then Audun joins to present our clinical case for this episode.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Audun Lier

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Case Study for TWiP 192

Older gentlemen with chills, muscle aches, headaches, shortness of breath, family members same symptoms. Hypertension, diabetes. From rural Ecuador, worked in timber industry, worked on farm. No pets. COVID positive. Treated with steroids, ab. Got worse over next two weeks. Developed bloodstream infection and pneumonia. Saw serpiginous trail on diagnostic agar plate of sputum sample. Started on treatment and recovered. No eosinophils on admission, later developed eosinophilia.

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

Music by Ronald Jenkees

TWiP 191: Dickson's ocular anomaly Jan 11, 2021

Show notes

The TWiPers solve the case of the Rural Man from North Carolina with Blurred Vision, and discuss the results of single-cell RNA sequencing of Schistosoma mansoni.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

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RNAseq atlas of S. mansoni (Science)
Hero: Kathleen Hussey
Letters read on TWiP 191

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Case Study for TWiP 191

Visit in Malawi, capital, teenage son of USAID worker urine has started to turn red. New to Malawi. On weekends go 2.5 hr east to lake and place to swim, Lake Malawi. Given pills, taken morning and night, clears up. Rest of family has been swimming in Lake Malawi. All in family are healthy.

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

Music by Ronald Jenkees

TWiP 190: But Doc, what could it be? Dec 08, 2020

Show notes

Christina from Glasgow returns to help the TWiPlets solve the case of the Ghanian Woman with Abdominal Mass, followed by discussion of the impact of COVID-19 on malaria morbidity and mortality in Africa.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Christina Naula

Download TWiP #190 (57 MB .mp3, 94 minutes)

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COVID-19 effects on malaria in Africa (Lancet)
Hero: Clark Read
Letters read on TWiP 190

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Case Study for TWiP 190

Male, 50 yo, rural NC, suddenly notices blurred vision right eye. Went away 1 hr later, normal vision. Returned next night, same eye, then corrected. Went to local doctor, sent to larger med center, went to Presbyterian Hospital NYC. Had exposure to various animals, normal diet. Dickson and Dr. Brown went to see this gentleman. Examined by head of ophthalmology dept. Dickson looked through ophthalmoscope and saw cause of his blurred vision in anterior chamber of eye. Next morning when were going to remove it, had penetrated optic nerve and disappeared. Sent home and never heard from again. Made living by selling hunting dogs, ran a kennel.

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

Music by Ronald Jenkees

TWiP 189: Toe jammin' Nov 07, 2020

Show notes

Christina from Glasgow joins the TWiPlets to solve the case of the Elderly Gentlemen with Full Body Rash, and to present a new clinical case for listeners to solve.

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin

Guest: Christina Naula

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Hero: Tony Fauci
Tony Fauci on TWiV 219 and 641
Letters read on TWiP 189

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Case Study for TWiP 189

At a clinic in Ghana, woman seen for hernia, large swelling in right upper abdomen that grew steadily in previous year. Exam found to have mass, too high for inguinal hernia. Thought to be in liver. Mother, subsistence farmer, 50s, not unwell, no jaundice, mobile, overweight. Lump was firm, did not appear to be fluid filled, did not reduce under pressure, smooth, over 20 cm. Concern was liver cancer. Due to remoteness of clinic not possible to order tests. One test was done which could deliver the diagnosis.

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

Music by Ronald Jenkees

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