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TWiP is a monthly netcast about eukaryotic parasites. Vincent Racaniello and Dickson Despommier, science Professors from Columbia University, deconstruct parasites, how they cause illness, and how you can prevent infections.
TWiP is a monthly netcast about eukaryotic parasites. Vincent Racaniello and Dickson Despommier, science Professors from Columbia University, deconstruct parasites, how they cause illness, and how you can prevent infections.
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Here's a quick summary of the last 5 episodes on This Week in Parasitism.
Hosts
Vincent Racaniello
Daniel Griffin
Christina Naula
Previous Guests
Michelle Labrunda
Michelle Labrunda is a medical professional with expertise in infectious diseases and parasitology. She has contributed to various research projects and case studies related to parasitic infections and their impact on human health. Her work often involves diagnosing and managing complex cases of infectious diseases, making her a valuable guest on the TWiP podcast.
Michelle Labrunda is a medical professional with expertise in infectious diseases and parasitology. She has contributed to various research projects and case studies related to parasitic infections and their impact on human health. Her work often involves diagnosing and managing complex cases of infectious diseases, making her a valuable guest on the TWiP podcast.
Topics Discussed
Malaya
Malaysia
Kuching
parasites
fever
anemia
jungle exposure
Orangutans
Plasmodium falciparum
drug resistance
paleoparasitology
5th-16th century latrine
Naegleria fowleri
Katayama fever
Georgian in Guinea
dry cough
eculizumab
complement protein C5
Borneo
Infectious Disease
parasitic disease
antigen testing
Trypanosoma brucei
antigenic diversity
tissue spaces
parasitism
somnolence
erythrocytic
malaria
Guinea
cough
abdominal pain
diarrhea
diagnosis
management
I'm Vincent Racaniello, Earth's virology Professor and I believe that education should be free. It's my goal to teach virology and other life sciences to the world. Here you'll find my lectures at Columbia University, our science shows This Week in Virology, This Week in Parasitism, This Week in Microbiology, This Week in Evolution, Immune, This Week in Neuroscience, Infectious Disease Puscast, Beyond the Noise, interviews that I've done with microbiologists, livestreams and more. Subscribe and stay tuned for future awesome science content.
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We are still in Kuching, Malaysia in the northern part of the Island of Borneo. This is the Sarawak portion of Malaysia. A man in his late 30s is admitted to the hospital in December with daily fevers that last for several hours and shaking chills. He had previously been healthy with no medical problems. He lives in the city and works in an office, however, in the few weeks prior to getting admitted he was visiting the jungle. Apparently not too far outside of Kuching, one can go up into the jungle and see Orangutans. He had gone into the jungle but this was 2 weeks prior to the onset of symptoms. Since then he reports no unusual exposures. He lives with his wife and children and they are all healthy. A few days prior to admission he noted fever, chills, and a headache. He is a little nauseated but no vomiting.
On exam he has a fast heart rate and appears ill. His respiratory rate is increased and he is not febrile on admission but later does have fever. No enlargement of the liver or spleen on exam. Otherwise unremarkable.
His labs are notable for low white blood cells, anemia, and a platelet count of less than 50k per microL. His coagulation studies are abnormal, serum creatinine is elevated, and there is elevation of his serum aminotransferases.
We are still in Kuching, Malaysia in the northern part of the Island of Borneo. This is the Sarawak portion of Malaysia. A man in his late 30s is admitted to the hospital in December with daily fevers that last for several hours and shaking chills. He had previously been healthy with no medical problems. He lives in the city and works in an office, however, in the few weeks prior to getting admitted he was visiting the jungle. Apparently not too far outside of Kuching, one can go up into the jungle and see Orangutans. He had gone into the jungle but this was 2 weeks prior to the onset of symptoms. Since then he reports no unusual exposures. He lives with his wife and children and they are all healthy. A few days prior to admission he noted fever, chills, and a headache. He is a little nauseated but no vomiting.
On exam he has a fast heart rate and appears ill. His respiratory rate is increased and he is not febrile on admission but later does have fever. No enlargement of the liver or spleen on exam. Otherwise unremarkable.
His labs are notable for low white blood cells, anemia, and a platelet count of less than 50k per microL. His coagulation studies are abnormal, serum creatinine is elevated, and there is elevation of his serum aminotransferases.
Plasmodium falciparumdrug resistancepaleoparasitology5th-16th century latrineNaegleria fowleri
TWiP explains a study that carries out selection of Plasmodium falciparum in the presence of inhibitors to identify determinants of drug resistance, and a paleoparasitological analysis of a 5th–16th c. CE latrine.
TWiP explains a study that carries out selection of Plasmodium falciparum in the presence of inhibitors to identify determinants of drug resistance, and a paleoparasitological analysis of a 5th–16th c. CE latrine.
A man who is on eculizumab, a recombinant humanized monoclonal antibody that targets complement protein C5 which serves as a terminal complement inhibitor, comes in with left arm swelling. He lives in a city in the north part of the island of Borneo. He is being managed by a doctor in the Malaysian City of Kuching. Now the doctor caring for this man is married to an Infectious Disease expert and she raises concerns that this might be due to a parasitic disease. She is told by the husband that the disease of which she is thinking is not present in the region. She is not swayed and admits him for nightly blood smears which are negative. She then does a rapid immunochromatographic dipstick test that is positive. He lives in a community outside the city and they go to that village and find others with limb swelling issues who are also positive on antigen testing. He is treated with an antibiotic, not antiparasitic for 4 weeks and the arm improves. Hint: this is not Wuchereria Bancrofti.
A man who is on eculizumab, a recombinant humanized monoclonal antibody that targets complement protein C5 which serves as a terminal complement inhibitor, comes in with left arm swelling. He lives in a city in the north part of the island of Borneo. He is being managed by a doctor in the Malaysian City of Kuching. Now the doctor caring for this man is married to an Infectious Disease expert and she raises concerns that this might be due to a parasitic disease. She is told by the husband that the disease of which she is thinking is not present in the region. She is not swayed and admits him for nightly blood smears which are negative. She then does a rapid immunochromatographic dipstick test that is positive. He lives in a community outside the city and they go to that village and find others with limb swelling issues who are also positive on antigen testing. He is treated with an antibiotic, not antiparasitic for 4 weeks and the arm improves. Hint: this is not Wuchereria Bancrofti.
TWiP explains a study which finds that tissue spaces are reservoirs of antigenic diversity for Trypanosoma brucei, then remembers our departed colleague Dickson Despommier.
TWiP explains a study which finds that tissue spaces are reservoirs of antigenic diversity for Trypanosoma brucei, then remembers our departed colleague Dickson Despommier.
TWiP explains a study which finds that tissue spaces are reservoirs of antigenic diversity for Trypanosoma brucei, then remembers our departed colleague Dickson Despommier.
TWiP explains a study which finds that tissue spaces are reservoirs of antigenic diversity for Trypanosoma brucei, then remembers our departed colleague Dickson Despommier.
26-year-old female with no past medical history. Patient is from Georgia in the US and is volunteering in Hérico, Guinea (town in the Lélouma Prefecture in the Labé Region of northern-central Guinea). She arrived in Guinea in December 2023. She was taking doxycycline for malaria prophylaxis and says that she has not missed any doses
On October 2024 she presented with fever and dry cough. Lab work was done and follow up planned for the following day. The patient slept poorly, was febrile to 104 and had ongoing cough. The next day she went to the hospital and was evaluated in the ER for acute febrile illness of unclear etiology.
In the hospital, VS were 97.9F, BP 105/70, P 94 Oxy sat 98%, normal physical exam.
She was started on Augmentin and Coartem.
Pause here to think about the differential at this point and maybe some more history and what testing you might want
Stool parasite screen + for some sort of eggs, malaria smear negative, CXR with b/l infiltrates
She was given a medication (vomited 30 min after dose received). She then received a second dose of medication 5 hours after the first) and was discharged. The following day the patient returned to the ER, stating that she felt worse. Her temperature had climbed to 104 overnight, and she developed watery diarrhea and nausea. There were no additional episodes of vomiting. She was given an additional dose of a medication, ibuprofen, and started on ceftriaxone 1 gm IV Q12 hrs. During the day she continued to have low grade fevers and developed abdominal pain. That night she was again febrile to 104 F.
She remained admitted for 5 days with ongoing symptoms of diarrhea, nighttime fevers and diffuse abdominal discomfort. Three more malaria tests were negative (rapid test and slide review)
Blood cultures collected – no growth
She continued to have mild elevation of WBC and slight elevation of AST and ALT.
The patient was transferred to a different hospital. They give her a different medication, and within 24 hours symptoms resolve.
What is the diagnosis and what happened here with management?
26-year-old female with no past medical history. Patient is from Georgia in the US and is volunteering in Hérico, Guinea (town in the Lélouma Prefecture in the Labé Region of northern-central Guinea). She arrived in Guinea in December 2023. She was taking doxycycline for malaria prophylaxis and says that she has not missed any doses
On October 2024 she presented with fever and dry cough. Lab work was done and follow up planned for the following day. The patient slept poorly, was febrile to 104 and had ongoing cough. The next day she went to the hospital and was evaluated in the ER for acute febrile illness of unclear etiology.
In the hospital, VS were 97.9F, BP 105/70, P 94 Oxy sat 98%, normal physical exam.
She was started on Augmentin and Coartem.
Pause here to think about the differential at this point and maybe some more history and what testing you might want
Stool parasite screen + for some sort of eggs, malaria smear negative, CXR with b/l infiltrates
She was given a medication (vomited 30 min after dose received). She then received a second dose of medication 5 hours after the first) and was discharged. The following day the patient returned to the ER, stating that she felt worse. Her temperature had climbed to 104 overnight, and she developed watery diarrhea and nausea. There were no additional episodes of vomiting. She was given an additional dose of a medication, ibuprofen, and started on ceftriaxone 1 gm IV Q12 hrs. During the day she continued to have low grade fevers and developed abdominal pain. That night she was again febrile to 104 F.
She remained admitted for 5 days with ongoing symptoms of diarrhea, nighttime fevers and diffuse abdominal discomfort. Three more malaria tests were negative (rapid test and slide review)
Blood cultures collected – no growth
She continued to have mild elevation of WBC and slight elevation of AST and ALT.
The patient was transferred to a different hospital. They give her a different medication, and within 24 hours symptoms resolve.
What is the diagnosis and what happened here with management?
