~30 yo alcohol use disorder
Northern suburbs of Montreal 🇨🇦

➡️ Any idea why this pneumonia did not improve with PipTazo/Vanco and Meropenem ? (😉💥-to🍄)

#IDXposts #IDTwitter
#MicroRounds

59-años,♂️ : vesículas y lesiones costrosas en las regiones perioral (A), úlceras dolorosas en los paladares duro y blando (B), desarrolladas en el transcurso de una semana, dificultad para tragar y hablar
1/3

DOI: 10.1056/NEJMicm1205661
#IDXposts #dermatología
1/3

✅ Recently approved in Europe, here are some cliff notes on Aztreonam-avibactam which is brand name #Emblaveo

➡️ idstewardship.com/drugs/aztreona…

Coming to the 🇺🇸 soon? 🤔

Anyone know the deets on what the brand name means?

Anything to add to the cliff notes? 🤷‍♂️ #IDtwitter #IDxPosts

65 años vietnamita, glucocorticoides (arteritis de células gigantes), bacteriemias por BGN: duodenitis
🔬bronquial: huevos embrionados (A), larvas rabditoides (B) y filariformes móviles (C)
🔬heces, larvas rabditoides y formas adultas (D)
½

DOI: 10.1056/NEJMicm1204579
#IDXposts

Brucella, Coxiella meet Bartonella, Pasteurella #IDXposts #IDTwitter

Fighting Flesh Eating Bacteria? Check out this week’s KASIC pearl to learn about an Antimicrobial Stewardship Opportunity: Stopping Antibiotics in Necrotizing Fasciitis ➡️ tinyurl.com/ypb62tav

#IDTwitter #IDXPosts #AntimicrobialResistance #antimicrobialstewardship #rxtwitter

Is anaerobic coverage necessary for aspiration pneumonia with metronidazole or Augmentin?
NEJM JWatch reports from a large retro study with N ~ 4000

Findings show no added mortality benefit but an increased risk of CDI

journal.chestnet.org/article/S0012-…

#IDTwitter #IDXposts

Continue Antibiotics until Neutrophil Recovery? Hold up! Check out this week’s KASIC pearl to learn about an Antimicrobial Stewardship Opportunity: Discontinuing Antibiotics in Neutropenic Fever ➡️tinyurl.com/bdbur6we

#IDTwitter #IDXPosts #AntimicrobialResistance

Olgotrelvir is an oral antiviral with dual mechanisms of action targeting severe acute respiratory syndrome coronavirus 2 main protease (i.e., Mpro) and human cathepsin.
Dose 600mgq12h for 5d #idxposts

A very enlightening talk by Angela Hutner on simple vs complicated UTI definitions
Simplicity wins
Anything that is beyond the bladder = complicated UTI (including prostatitis)

This will be updated in 2024 by both the IDSA and ESCMID

#IDTwitter #IDXposts

#idboardreview 50 M RA on etanercept: Fever & purple nodules on arms x2wks. wbc30k 95%lymph, multiple sex partners, +fishing/camping, cleaned alley & scratched by rats, cats. Biopsy lobular endothelial cells w/vascular proliferation. dx? #medEd #idmedEd #idtwitter #idxposts

ESBL E. coli intrabdominal infection
.
Me: hey can you switch the zosyn to a carbapenem
.
Surg: nah we do not care about death
#Twitterx #IDTwitter #IDXposts #bruh 😫😫😫

Interesting!

My gut response was shorter for C diff would not be okay, but look what they found… 🤔…

academic.oup.com/jac/advance-ar… #IDxPosts Brad Spellberg Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟

#IDTwitter #IDXposts Patient with sepsis in ICU, probably of intraabdominal origin. Blood culture (only one), aerobic bottle, no anaerobic, grew this rarity. 👇 How would you approach it and how would you treat if you need to? Susceptibility with * were done by disk-diffusion.

Best practices in prevention of surgical site infxns are combined in care bundles for consistent implementation. Care bundles ⬆️standardization of processes & ⬇️operative variance that both lead to ⬇️SSI #IDTwitter #IDXPosts link.springer.com/article/10.100…

#IDTwitter #IDXposts A 69-years old man with diabetes was diagnosed with liver abscess which was drained 2 weeks ago, still on IV antibiotics (cefotaxime + metro, 5 weeks), afebrile 9d. Isolate is 👇🏻 How would you treat further? Brad Spellberg Todd C. Lee Gabe 🦊 Alice Han

Sepsis is a heterogeneous syndrome!
🆕️⚡️⚡️Large Retrospective study Annals of Int Med
There was a 30-fold variation in crude deaths depending on the primary site of infection , ranging from 1% (tick or vector-borne infec tions) to 33% (bacteremia) #idxposts
acpjournals.org/doi/10.7326/M2…

#IDTwitter #IDXposts Patient with bilateral nephrostoma with renal abscess. Isolate from urine (>100.000 CFU/mL). How would you treat? Dr. Lynora Saxinger MD FRCPC Infectious Diseases Sam Aitken Annette Hennigs Brad Spellberg Todd C. Lee Gabe 🦊 Alice Han Bug Pharmacist 💊🧫 Tim Gauthier 𝐒𝐮𝐦𝐨𝐧 𝐂𝐡𝐚𝐤𝐫𝐚𝐛𝐚𝐫𝐭𝐢 Tobias Hohl MD, PhD Timothy Li

#idboardreview 40 F who has well water in her home and works at daycare presents w/ greasy foul diarrhea w/ abd pain, bloating, flatulence and weight loss & fatigue. diagnosis? #idmeded #medEd #idxposts #idtwitter

#IDTwitter #IDXposts Patient planned for surgery for tumor of the kidney. Urine culture grow Enterococcus (see below). Would you: not treat, treat or give prophylactic antibiotic before surgery only? Which antibiotic and for how long if patient needs treatment? Alice Han