Cosmina Gingaras, MD, MPH

Sepsis Sepsis is defined as a dysregulated host response to infection that leads to life-threatening organ dysfunction. The infectious insult triggers a dysregulated immune response that variably activates a...

Sepsis - The Lancet www.thelancet.com/journals/lan...

Thank you, that's my opinion, too. The surgeon recommended to try a few months of antifungals, which he did (itraconazole) and the lesion is unchanged. Now both the surgeon and the patient would like to try a different antifungal. The cavity is 2.7/3.9/4.6 cm and the fungal ball 3.2 cm

@germhuntermd.bsky.social @fungaldoc.bsky.social

48 yo male, with upper right lobectomy 31 ys ago for abscess, discovers an #aspergilloma on CT in May 2024. Serial imaging q 3-4 months shows no change in size, including after treatment for 5 mo with itraconazole and the pt remains paucisymptomatic. Should we tx with Cresemba/Vorico or just wait?

Microbiology royalty: Elizabeth O. King and the legacy of Elizabethkingia meningoseptica The genus Elizabethkingia comprises Gram-negative, nonmotile, nonspore-forming aerobic rods in the family Weeksellaceae. These nonglucose-fermenting organisms were long included within Flavobacterium ...

📣 Who is behind #Kingella kingae, #Elizabethkingia
meningoseptica, and several other bacteria? Anne-Marie Dolan et al describe the legacy of Elizabeth O. King, #CDC microbiologist & World War II army officer, for our #Personbehindthename series.

#IDSky #clinmicro

www.cmi-comms.org/article/S295...

#IDSky Are antibiotics recommended for prophylaxis of neutropenia most likely induced by Azathioprine in an ANCA+vasculitis patient on hemodialysis?

Right. I thought about that and if she's negative, get the vaccine. However, assuming she's negative and unwilling to vaccinate, how long should they abstain from sex?

#IDSky A male patient with acute hepatitis A asked me how soon after the episode he can try and have a baby with his partner. The partner is presumed uninfected at this point. What would you advise him? @bjegorovic.bsky.social @idvilchez.bsky.social @dralicehan.bsky.social @abstewardess.bsky.social

For a Nocardia cerebellar abscess, presumably completely removed via surgery, would you continue oral antibiotics? How long? Therapeutic dose or prophylactic?

Ground zero for field epidemiologists

Any idea if severe repeated episodes of hypoglycemia in a diabetic patient with ulcerative colitis could be a side effect of Vedolizumab? #ulcerativecolitis #vedolizumab #Entyvio #diabetes

Oxa and linezolid, esp.initially. Once the patient stabilizes and I see clinical, biological and radiologic improvement, usually at least 10 days into treatment, I try to switch to oral, probably two agents, not one (tmp-smx and rifa for example). Total duration is a minimum of one month

Thank you!

Right, I'm interested in the protocols you use.

Do you have any use for rectal swabs?

Interesting. Do you use rectal swabs for anything?

Selective digestive decontamination with oral colistin plus gentamicin for persistent bacteraemia caused by non-carbapenemase-producing carbapenem-resistant Klebsiella pneumoniae in a neutropenic pati... Carbapenem-resistant Klebsiella pneumoniae (CRKp) have become an increasing public health problem worldwide. While most CRKp around the world harbour a carbapenemase enzyme, the clinical relevance of ...

pmc.ncbi.nlm.nih.gov/articles/PMC....

I'm wondering about the mechanism(s) that could explain increasing fibrin monomers, but decreasing D dimers in an upper respiratory-type post-infectious syndrome. No radiological sign of thrombosis, CRP decreasing #IDSky #haematology #SARS-CoV-2 #COVID

I've been seeing a couple of (likely bacterial) pneumonias with very high D dimers. No identifiable major thrombus, no response to antiX anticoagulants, but responsive to corticosteroids. Mechanism? #haematology #IDSky

#IDSky intestinal decontamination for treatment and prevention of MDR infections in immunosuppressed, heavily pretreated patients. I feel like that is the last resort. What is your experience with this? What protocols do you use for CRE, ESBL and VRE? @bjegorovic.bsky.social @idvilchez.bsky.social

Very interesting.

Blood cultures. If CRP and procalcitonin are raised, then start empiric cefazolin plus/minus vancomycin. If not raised, continue monitoring for recurrent fever and repeat above process.

Back in 1975 I was taught to first check a urine Na and K. If the urine K was greater than Na - start spironalactone at 100 and recheck. Until the urine Na was greater than the urine K, increase the spironalactone. Once urine Na > K, then start 40 mg furosemide each day. I still use this model.

PubMed PubMed® comprises more than 37 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central a...

Please give it a go advance mode . Here the 🔗 and it’s still working in safari & google chrome 🇬🇧

pubmed.ncbi.nlm.nih.gov

EuropePMC relies on a feed (feeds ?) from PubMed.

As I understand, it can run on its own, but I do not know how it will get updated and synchronised with PubMed. Though it does collect some data separately.

I hope EuropePMC had prepared as much as they could for this predictable event.

Francis Collins, the NIH Director for 12 years, led the Human Genome Project and other NIH efforts for 32 years, resigned today. Key words from his resignation letter
www.nytimes.com/2025/03/01/u...

Thank you!

Oncology is pretty reserved with antibiotherapy compared to hematology. Possibly because infections tend to be more common and more problematic in hematological patients, given that immune cells are principally and more profoundly affected

Sure, I agree. I'm an ID doctor, so I know our side of the story. I'm trying to see the other side and whether there are some gaps in knowledge or experience that I may fill :) of course, again, culture data depends heavily on lab capabilities (and also sampling procedures)

I think this frequent and compulsive check of inflammatory biomarkers reflects a continuous preparation for the start of chemo and evaluation during chemo. An increase in CRP is a cue to escalate ABs, even if no infection is clinically apparent. A decreasing CRP=continue current broad spectrum ABs:)