Factors involved in tuberculosis recurrence in a low-incidence setting. Reactivation predominates over reinfection in a 30-year surveillance study ✅ Just Accepted 🔗 https://bit.ly/40A9k2g

Great #tuberculosis regional meeting today. Talks on prison outbreaks / screening, finding undiagnosed latent cases, abdo TB pathways, strategic TB regional plans, paradoxical reaction management, complex TB-HIV-histoplasmosis infection. All great & good to catch up with colleagues, CPD at its best!

Fancy working with a great set of colleagues, lots of interesting pathology, opportunities for research? Look no further! It’s a great dept, come and see join.humberhealthpartnership.nhs.uk/vacancies/#!...

#IDSky - recurrent transaminitis due to albendazole for hydatid. What do people do? Stop / start, reduce dose, reduce frequency, use praziquantel mono therapy?

#IDSky #TBSky - why is it that when you have a morning TB clinic and you’ve sent someone away on latent treatment their 4 week old sputum flags positive that afternoon!?! Aghhhh

I hate writing grant applications - trying to fit in the effort for it while on call, on the ward, full clinics and Christmas to sort out is driving me bonkers.

First paper in a while, very happy to be involved in this - COVID mortality in haematological malignancy. onlinelibrary.wiley.com/doi/10.1111/...

We are looking for candidates for a new fully-funded joint PhD position at the Universities of Toronto and Melbourne, working on RCTs in bloodstream infection (BALANCE+, SNAP, STRAP). More info here: forms.gle/H9TXEMkwM1cb... Please spread far and wide! @steventong.bsky.social #IDSky

Excellent choice UKHSA! Well done Susan and good luck in the new role www.gov.uk/government/n...

Final wainwrights completed yesterday evening, 214 fells and 13 yrs in the walking. Need to find another “challenge” to keep me sane(ish)

Fells 208-211 done, brilliant weather and hopefully get the final 3 in tomorrow before storm Floris arrives

#IDSky - pulmonary Nocardia (can’t speciate fully, do have MICs) with cavitation and nodules. Pretty well and certainly outpatient. Opat can’t do imipenem. Will have co-trim, would anyone try ertapenem instead of imipenem? Amik and ceftriax MICs high, Moxi is option with lowish MIC

JOB OPPORTUNITY: Come and work with us in the @nihr.bsky.social Health Protection Research Unit in Emerging and Zoonotic Infections @hpruezi.bsky.social. We have a post for a clinician to do a PhD in emerging infections and/or vector borne disease, working on national clinical studies.

#TBsky #IDsky - what do people do when there are unexpected interruptions in TB drug supplies? Have spent clinic changing from rifinah 300 to either separate drugs, rifinah 150 + extra rif or rifabutin as maybe getting low on rifampicin as well. Digging back into DTM&H memories to try and plan it

ARCP time of year for our resident doctors -the ammount of forms they (and me!) need to do is quite bonkers, with lots of duplication. Does anyone think it makes them better medics? Glad I got through before this level of box ticking, sorry for them it’s like this

How do you balance public health risk with individual rights? Here’s how we tried to do it in a complex XDR-TB case, great collaborative effort! academic.oup.com/jpubhealth/a...

when you’ve been on call at the weekend but forgot that you’re on again tomorrow

All day big solo TB clinic and every time I try and request a cxr the system crashes - fml

When yet again the lymph node biopsies only go to histology when requested for ? TB

Academic Clinical Lecturer Posts in Infection now out: for people training in ID in UK & hold/imminently completing PhD. 2 posts @lshtm.bsky.social shorturl.at/EIUIz 1 at St Georges & 1 at Kings shorturl.at/8kDY3 If interested in @lshtm.bsky.social posts get in touch. UK ID people please share!!

Final day on this trip, 2 more fells done - 207 in total now, and finished off the central and northern fells. 4 southern, 2 far eastern, 1 eastern to go…

Another day of great walking, going from frosty and cold in the morning to sunny and probably burning a bit in the afternoon. 3 more fells done, couple more tomorrow hopefully then off home and back to work ☹️

First fell walk of the year (and first time posting here). Chilly breeze but great to get out. 199 Wainwrights done, 15 to go (a few more this trip all being well)

When does the USA become the 47th Oblast of Russia? Trump and Vance are arrogant bullies and despises them intensely

5 years ago tonight we had a leaving dinner for a colleague here. Part way through 2 of us had to go back to the ward to see some ? Wuhan n-CoV referrals. The first 2 UK cases meant I never got pudding that night, and had my steak on the ward at 1am - here’s hoping lightning doesn’t strike twice!

#IDSky #TxIDSky - biliary stent infections in patients with hepatobilliary malignancy. Seeing a few of these where it recurs and getting stent out is nearly impossible. Do people do long term suppression or standby treatment or just wait till next episode?

Great talks and cases - a short thread on what I got from it coming up! #TBSky #IDSky

#TBSky #IDSky - pulmonary TB fully sens, on treatment and improving well, then develops small joint damage thought to be gout, progressed despite steroids / colchicine. Biopsy shows AFB and PCR +ve for TB. Odd to get small joint well into effective treatment - ? Paradox reaction ? Ongoing infection

Join us this month for the BIA/BTS Dilemma Day on 23 January 2025 in Birmingham. Register now 👉 https://fitwise.eventsair.com/2025biadilemmasday/registration-and-fees #Infection #MycobacterialInfections #Mycobacterialdilemmas2025

A stellar cast of mycobacterial speakers (and me!) - will try and post some of the content on the day but try and come along az659834.vo.msecnd.net/eventsairwes...

#IDSky - first paper from us on bluesky. What are the longer term quality of life issues after bloodstream infection in people who inject drugs? Here are some data! www.journalofinfection.com/article/S016...

#IDSky #TBSky Small numbers but impressive response - it would be great to use bedaquiline in NTM cases easier than we can now as it seems to be kryptonite for mycobacteria almost across the board www.nejm.org/doi/full/10....

This will be one of several great talks / cases that day (as well as mine!). Come along for mycobacterial enlightenment

www.bbc.com/news/article... Alarmed by it but then in the article admit they don’t know the size of the “problem” and also say in the report that many home schooled children get a good education - ffs no wonder people think OFSTED are useless, at least know how worried you should be

#IDSky #tuberculosis - pre biological therapy positive IGRA. On interacting meds for rifamycin, tried INH mono and severe rash. Anyone using FQ for non MDR latent treatment in this situation? Asking parent team if any other non biological options / other non interacting meds an option

#FISHIS24 - tropical grand round to finish off. HLH driven by typhus

#FISHIS24 - rising rates of GNBSI and targets to reduce them from UKHSA

#FISHIS24 - Barnett Christie lecture drugs for tropical infections / the infection physician

#FISHIS24 - sequencing and outbreaks, starting with measles

#FIS24 - arrived just in time for the first lecture fungal diagnostics / stewardship

#IDsky is there any procedure more satisfying than aspirating a TB lymph node in the neck? Diagnostic and therapeutic, crack on with TB therapy straight after. Always makes me a little happier after I’ve done it

Being able to ping ideas around with @phillipaburns.bsky.social +/- a couple of other colleagues really does help, certainly makes me more productive, not sure about my effect on them!

First impressions are good on here, mostly here for the educational / research bits but happy to discuss whatever….