Factors involved in tuberculosis recurrence in a low-incidence setting. Reactivation predominates over reinfection in a 30-year surveillance study
✅ Just Accepted
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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/#!...
The end of the decade one will be relevant given how bad the 2020s have been so far…
Yes, been through the mdt. Has the TDM been helpful in dose reduction with hepatotoxicity?
#IDSky - recurrent transaminitis due to albendazole for hydatid. What do people do? Stop / start, reduce dose, reduce frequency, use praziquantel mono therapy?
It turned out to be an NTM so all is well but agree it’s an old fashioned false dichotomy and the spectrum is much more fluid than I realised as a trainee
#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.
Interesting effects on pre malignant conditions from shielding / vaccination in a variety of different conditions. CLL isn’t great for vaccine responses….
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
Place Fell overlooking Ullswater - it is a great scene
Agree - being able to tailor regimens to the individual case in front of you from shorter through to longer is key, either with biomarkers / response to treatment
Quite, there’s a reason many of us extend treatment in severe disease…
True, but I suppose most of us tend to over treat MDR / XDR TB so unlikely (esp in xdr cases) to not use it if littke eise. And it’s still in the leprosy guidelines
Only use it when few other options but there is some evidence
www.medrxiv.org/content/10.1...
www.nejm.org/doi/full/10....
But apart from that, what has doxycycline ever done for us?
Because you’re not allowed to say cockwomble on TV?
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)
Selfie on Dow Crag
View from summit
Looking towards Scaffell massif
Looking towards the coast from Dow Crag
Fells 208-211 done, brilliant weather and hopefully get the final 3 in tomorrow before storm Floris arrives
Certainly worth trying, worked in some people quite nicely
LP then crack on with induction treatment, then probably long term suppression given the lymphoma isn’t going away
Blood cultures done? Has their lymphoma been treated (and if so with what?) Titre of the crypto antigen? Given their immune status and findings I’d probably get an LP then treat with Ambisome +\- flucytosine (not been able to get it for ages here). Interested to see what people do…
Reasonably extensive disease and previous NTM treatment so will prob do co-trim + Moxi for 4-6 weeks then drop to co-trim if improving. Imipenem mentioned in lots of guidance but it’s awkward to use hence asking about erta / other options
Thanks, as not had any treatment yet and extensive disease on CT I’m prob going to do co-trim and Moxi initially then drop to co-trim mono when improving
I tend to be cautious with using co-trim and linezolid together over marrow suppression but certainly happy to use linezolid if probs with co-trim
