A 53-y-o intensive care ##nurse receiving monotherapy with efalizumab for psoriasis involving her arms, legs, & nails: progressive green discoloration of both thumbnails, which were affected by psoriasis-induced onycholysis (A). 1/2 DOI: 10.1056/NEJMicm0706497 #dermatology #MedEd #IDMedEd

The #Bundibugyo #virus disease #outbreak in the Democratic Republic of the Congo: ⬆️case numbers & geographic spread. As of 10 June, a cumulative of 676 confirmed cases, including 136 deaths, from the D. R. of the Congo. Uganda, 19 confirmed cases including 2 deaths. www.who.int/emergencies/...

🦠📍 The ongoing #Ebola #outbreak in the Democratic Republic of the #Congo has spread into new areas, increasing the challenges for surveillance and containment efforts. #Health #Infections #Virology #Microsky via @aljazeera.com

A 12-y-o♂️ patient presented with lesions on the left arm, back, & chest (Figures 1, 2, and 3) of 5 days' duration. The patient experienced pain in the affected area for the two days prior, which began after the lesions appeared. ½ continuum.aeped.es/screens/play... #ClinicalCase #pediatrics #MedEd

#Mortality of enteric #infectious diseases declined substantially between 1990 and 2023. This is consistent with the expansion of public health measures and broader socioeconomic development. The the highest mortality concentrated in sub-Saharan Africa & south Asia DOI: 10.1016/S1473-3099(26)00194-5

A 22-YO♂️, a new sexual partner 1 week before the onset of symptoms: a 1-month history of severe pubic itch that was worst at night. Numerous X? were visible to the naked eye, near the base of the hair shaft (A, with close-up in B). ½ DOI: 10.1056/NEJMicm0707428 #dermatology #ITS #MedEd

The Bundibugyo #Ébola virus disease #outbreak in the Democratic Republic of the #Congo continues to evolve rapidly, with increasing case numbers, geographic spread, and cross-border transmission to Uganda. hq_publichealthintelligenceunit.cmail20.com/t/d-l-wljllj...

31-YO ♂️, #HIV+, CD4 T-cell 10/mm3: fever, cachectic & had umbilicated papules on his face (A), body, arms, & legs. A blood smear: yeastlike organisms intracellular (B) & extracellular. Gram’s staining of blood : septate hyphae fungus (C) ½ DOI: 10.1056/NEJMicm2032478 #MedEd #microbiology

A 5-year-old girl, 6 weeks before a tick buried in her umbilicus and had removed it with tweezers: fever, redness around the umbilicus (A) and inguinal lymphadenopathy on both sides (B). ½ DOI: 10.1056/NEJMicm2032478 #dermatology #MedEd #IDMedEd #microbiology

#Gene clock predicts time to #death in humans — and assesses ‘biological’ age A gene-activity clock could be more sensitive than those based on molecular changes to DNA, which are slower to respond and might not capture the impacts of environmental changes. doi.org/10.1038/s415...

45-YO man, 3 weeks earlier direct contact with sheep & handling meat: a targetoid papule 2 weeks earlier on thumb (A) & progressively enlarged (B). Examination: an edematous and dusky nodule (C). ½ DOI: 10.1056/NEJMicm2029641 #dermatology #MedEd #IDMedEd #medicine

Staphylococcus aureus are common bacteria that spread in healthcare facilities and the community. Methicillin-resistant, Staphylococcus aureus can cause difficult-to-treat staph infections because of #resistance to some #antibiotics. #infectious #Health #Microbiology #Medicine

Streptococcus pneumoniae causes pneumococcal disease, which can range from ear and sinus infections to pneumonia and bloodstream infections. In more than 30% of infections, the bacteria are #resistant to one or more clinically relevant #antibiotics. #MedEd #Clinical #infectious #infectious #Health

Tuberculosis is caused by the bacteria Mycobacterium tuberculosis, and is a frequent cause of death worldwide. Tuberculosis usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. #InfectiousDiseases #microbiology #Medicine

Enterococci, - a type of bacteria, - can cause serious infections for patients in healthcare settings, including ✔️bloodstream, ✔️surgical site, and ✔️urinary tract infections. #InfectiousDiseases #ClinicalMicrobiology #Medicine #Health

Anthrax is a zoonosis caused by Bacillus anthracis, a Gram-positive, spore-forming bacterium. Cutaneous anthrax (suggested particularly by ulceration, eschar and/or oedema) 👇 iris.who.int/server/api/c... #FOAMed #InfectiousDiseases #ClinicalMicrobiology #Medicine

Bundibugyo ebolavirus outbreak in the Democratic Republic of the Congo and Uganda: rapid assessment from the ESCMID Emerging Infections Subcommittee 👇 www.clinicalmicrobiologyandinfection.org/article/S119... #InfectiousDiseases #ClinicalMicrobiology #IDSky #EpiSky #IDBlueSky #infectious #Health

48-YO♂️: fever, shortness of breath, blistering skin lesions, retiform purpura & coalescent ulceronecrotic areas over the trunk, arms, & legs, loss of eyebrows, swelling of the earlobes, no wrinkles on the face, & diffuse alopecia 1/3 DOI: 10.1056/NEJMicm2025081 #dermatology #IDMedEd #Medicina

The Bundibugyo #Ebola virus disease outbreak in the Democratic Republic of the Congo & Uganda continues to evolve rapidly, with increasing case numbers, geographic spread, and ongoing cross-border transmission: a total of 906 suspected cases and 223 deaths 👇 www.who.int/emergencies/...

51-YO♀️, acute lymphoblastic leukemia, bone marrow #transplantation 3 months previously, graft-versus-host disease, high doses of #glucocorticoids: pleuritic pain. HbA1c level of 9.6% CT: the reversed halo sign 🧫BAL: ¿? 1/2 DOI: 10.1056/NEJMicm2030205 #microbiology #Pneumology #IDSky

Multi-country #outbreak of #cholera, epidemiological update, WHO The African Region registered the highest number of cases, followed by the Eastern Mediterranean Region, the Region of the Americas and the South-East Asia Region. 👇 www.who.int/publications...

A 36-year-old woman, farmer by occupation: a rare case of cutaneous nocardiosis with involvement of the trachea, anterior mediastinum and sternum. 1/3 doi: 10.1159/000321635 #dermatology #IDSky #FOAMed

A 77-y-o♂️with #Mycobacterium avium complex strain infection of presumed veterinary origin. (A) XR: cavity (black➡️) & a segmented consolidation (white⬇️). CT: (B) cavity in the RUL (black↖️); (C): consolidations in both lungs (flechas). DOI:https://doi.org/10.1128/JCM.00462-13 #MedED #IDSky

The story behind coccidiodomycosis from teh Argentinian chaco to the central valley! #infectiousdiseases #idboardreview #MedEd #IDMeded #MedTwitter #IDsky #History infectiousdiseasehub.com/historid/the...

A 4-month-old baby girl with gangrene in her hands and lower extremities due to meningococcemia. Fulminant meningococcal sepsis can rapidly progress to shock and multiple organ failure. Source: Photo by PHIL, ID# #vaccination

An 81-year-old man underwent a laparoscopic cholecystectomy, and during surgery, characteristic "violin string" adhesions were found between the diaphragm and the liver. 1/2 DOI: 10.24875/CIRU.18000263 #Digestive #surgery #infectiousdiseases #FOAMed #ClinicalCase

A 28-YO woman, 2 weeks before her pet cat had developed lesions on the paws (C) and head: periocular swelling, conjunctival injection and necrosis, purulent discharge, and ophthalmoplegia developed. ½ DOI: 10.1056/NEJMicm2033620 #ophthalmology #medicine #emergency

“Ebola outbreak in DRC is 'spreading rapidly' with almost 750 suspected cases: WHO chief” abcnews.com/Health/ebola... - ABC News #Congo #DemocraticRepublicoftheCongo #DRC #Ebola #Health

The head of the World Health Organization said Friday that the Ebola outbreak in Congo is “spreading rapidly” and now poses a “very high” risk at the national level.

A 65-YO♂️, end-stage renal disease & #hepatitis C virus infection: a 6-month of crusted erosions & atrophic scars on hands & forearms, scattered tense vesicles on the fingers & forearms, onychodystrophy & subungual hyperkeratosis 1/3 DOI: 10.1056/NEJMicm2035140 #dermatology #IDSky

A 53-YO♂️, gardener, #bioprosthetic aortic-valve replacement 6 months before: sudden paralysis in the lower legs, fevers & nonpalpable femoral pulses CT angiography: ascending aortic pseudoaneurysm (↗️), multiple arterial emboli (mesenteric, renal, aorta, & iliofemoral). ½ #MedEd #cardiology

A 67-y-o♀️3 years earlier, aortic-valve replacement: fatigue, shock and ventricular tachycardia Blood 🧫: Streptococcus mutans An ABSCESS was detected in the PERIVALVULAR AORTIC ROOT that was CAUSING CORONARY-ARTERY COMPRESSION DOI: 10.1056/NEJMicm2029179 #IDSky #cardiology #radiology

46-YO♀️: an erythematous lesion on thum treated with clindamycin. By day 7 of treatment, lesion increased in size, & multiple painful, circular, raised lesions with central erosion & crusting on her face, feet, hands, & arms. 1/3 DOI: 10.1056/NEJMicm2033219 #dermatology #MedEd

4-YO girl: fever, cough, & lethargy after a respiratory tract infection O2 saturation of 92%. ⬆️leukocyte count with 88% neutrophils. CXR & CT: right lung collapse due to massive effusion and leftward mediastinal shift (B). ½ DOI: 10.1056/NEJMicm2035551 #MedEd #Pneumology #pediatrics

A 62-y-o ♀️ traveled to #Colombia and receiving mosquito bites: pruritic worsened at nighttime, draining nodules on the back and buttocks; 6 erythematous nodules with clear drainage & a central punctum (A), within which larval movement was observed. 1/2 DOI: 10.1056/NEJMicm2101473 #IDSky #travel

WHO declares Ebola outbreak in DRC and Uganda an international public health emergency… www.who.int/news/item/17... #IDSky

A 30-YO man, unprotected #sexual intercourse 2 months earlier, HIV+, CD4+ 374/ mm3: rash 1 month earlier with circinate, concentric lesions on the palms (A) soles (B) and face, with areas of erosion at the oral commissures (C). 1/2 DOI: 10.1056/NEJMicm2035514 #stds #dermatology #MedEd

26-yo👨sexual contact with #sex workers: a 3-month history of a gradually enlarging, fungating ulcerated mass on his neck & an additional lesion (white asterisk) ¿Pseudoneoplastic #syphilis chancre? 1/2 🖊️@BretKenny et al. doi.org/10.1016/j.jd... #MedEd #IDSky #Medicine

14-year-old male, celiac disease: skin lesions on the chest, scapular region, and posterior aspect of the right arm, present for 2 days. 1/2 🖋️Andreu E, Barrios MM. continuum.aeped.es #dermatology #MedEd #IDMedEd

8-year-old female: painful, macerated, and ulcerated lesion on the third toe of the right foot, present for one week. Initially, three weeks prior, the lesion was pruritic with yellowish exudate. ½ 🖋️@mpraena continuum.aeped.es #pediatrics #dermatology #MedEd

A 45-YO♂️, type 2 diabetes mellitus: pain & decreased vision in his left eye, 39.2°C, diffuse conjunctival injection, a dense cataract, and no light perception (A) CT: abscesses in the lungs, liver (B), kidneys, & prostate 1/2 DOI: 10.1056/NEJMicm2101602 #ophtalmology #MedEd #IDMedEd #microbiology

13-month-old♀️, mother with chickenpox during pregnancy: fever and vesicular lesions on an erythematous base with some crusting, with a dermatomal distribution (C5 and C6) on the arm and some vesicles on the trunk and scalp. 1/2 🖋️Sánchez Suárez A et al. continuum.aeped.es #pediatrics #MedEd #IDMedEd

There is no #vaccine for deadly #hantavirus: what that means for future outbreaks Virologist Jay Hooper is developing a vaccine for the rare rodent virus behind an outbreak on a cruise ship. 👇 www.nature.com/articles/d41...

54-YO♀️: fevers, abdominal pain, difficulty walking & a mass of the abdomen CT: IUD (A,↗️) surrounded by abscesses (*) of abdomen, pelvis, L iliopsoas muscle & L hip joint Drainage of abscesses & removal of IUD coated in sulfur-colored granules (B) 1/2 DOI: 10.1056/NEJMicm2102632 #Gynecology #MedEd

8-year-old male: 3 days of fever, left cervical lymphadenitis, and erythematous, target-like lesions on the palms, lower extremities, and trunk, with non-pruritic palmar and plantar involvement. ½ 🖋️Castellano A, et al. continuum.aeped.es #pediatrics #dermatology #MedEd

I've spent yesterday and today talking to researchers across the globe trying to understand the hantavirus outbreak aboard the cruise ship MV Hondius. My story in @science.org is here (and some threaded thoughts coming): www.science.org/content/arti... 🧪 #IDsky

The possibility of human to human transmission of hantavirus seems less than ideal

Only one strand of the hantavirus—the Andes subtype—is known to spread from person to person, and it has a 40% mortality rate.

A 36-y-o♀️, traveled to the Central African Republic: a moving wormlike structure in the left eyelid. Eosinophil count: ⬆️ 🔬of a fresh-blood wet smear: fast-moving worms ½ DOI: 10.1056/NEJMicm2101227 #microbiology #Medicina #Parasitology

8-year-old male, with pyelonephritis treated with amoxicillin-clavulanic acid: Two weeks into therapy, recent yellowish dental staining. 1/2 🖋️P Morales, et al. continuum.aeped.es/screens/play... #pediatrics #MedEd #Medicine