Category: Opportunistic Infections

Straight from the Horse’s Lung: Rhodococcus Equi

Originally described as a pathogen in 1923, Corynebacterium equi was isolated from the lungs of ten foals (aka a young horse) who had pneumonia (1). Its name was later changed to rhodococcus (aka red coccus), and can be mistaken for mycobacterium spp due to its sometimes acid-fast appearance (2). It is known to infect horses,

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Basics of Pulmonary Valley Fever

Coccidioides (from now on, called Cocci) is an endemic fungi that exists in two forms, yeast and mold, that is endemic to the southeastern United States (1). It is related to both Histoplasma and Blastomyces with two species known to infect humans. C. immitis and C. posadasii. Arthroconidia can be transported in soil or fomites,

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Cryptococcus Meningitis – Making Amphotericin Float Like a Crashing Seagull and Sting Like a Scorpion

Am I going there? Am I going to look into a topic that one of my attendings literally wrote the guidelines for? I guess I am. Cryptococcus is a yeast that is typically found everywhere there is bat/pigeon droppings or contaminated soil, as well as in certain tree species throughout the world. The most common

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Crash and Burn: CMV Pneumonitis in Hematological Malignancies

What is this? I am writing about a topic related to transplant infectious diseases? Something has to be going on! I had originally intended to write about CMV serostatus and risk of organ rejection in SOT patients, but that was a more difficult topic to tackle (just like that HTLV-1 post; yeah that one is

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Emergence of the New Menace! Candida Auris and the Rise of MDR Yeasts.

Ear yeast! That is the translation of Candida auris. It was discovered by isolation from an ear infection in an elderly patient in Japan in 2009 and since then it has been isolated in places such as India, southeast Asia and several parts of south America (1-4):  One of the defining characteristics is its resistance

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Candidal Endocarditis – Looking for Sasquash

Infective endocarditis is a rare enough disease in and of itself that many folks won’t see much of in their lifetimes, though the rise in IV drug abuse means this may not be the case in the future. Staphylococcus aureus and streptococci, as well as enterococci, tend to be the most common organisms associated with

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Tracking Disseminated Histoplasmosis Treatment

When I say bat poop, caves, and Indiana, the answer is Histoplasmosis. In general, most people will not get disease even when inhaling any conidia, however those who have decreased cellular immunity (i.e. solid organ transplant and HIV) are at risk of pulmonary or disseminated disease. One of the difficult issues in those patients is

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Bad Bug, Bad Bug – Or Mould? Meet Your Demise

Last week I talked about invasive pulmonary aspergillosis in influenza and COVID patients. This is not the first time I have talked about this topic. I have mentioned how the halo sign is not terribly specific for IPA, especially in hematological patients and the testing characteristics of galactomannan. I have also spoken about the other

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Types of Amphotericin B – What I Didn’t Know

I’ve been reading quite a bit about antifungals lately and one of the things I realized is the many formulations of amphotericin. Actually, the realization I had was I didn’t know the differences between them. It is a polyene antifungal that has broad spectrum antifungal activity (including Leshmania spp) but it is limited by its

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Microbiological Diagnosis of PJP – PCR and Beta D glucan

This post will not cover the clinical course or risk factors. We’ll be going over the direct fluorescence antibody, PCR, as well as the elusive beta-D glucan as well as taking a brief look at the original ways we used to diagnose PJP (or in some places, how they still diagnose it. In the days

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