Mike Russo
@mikerusso.bsky.social
1.4K followers 750 following 33 posts
Peds ID in Philly. Full time clinician. Transplant, NTM, tick-borne infections, and antibiotic allergies. Pro oral antibiotics and short durations Anti cefdinir (He/him) #IDSky
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mikerusso.bsky.social
1/8 Our report of the first confirmed cases of transplant derived Bartonella quintana infection and the public health investigation surrounding them has been published!
#medsky
#idsky
#publichealthsky
#txid

wwwnc.cdc.gov/eid/article/...
<em>Bartonella quintana</em> Infection in Kidney Transplant Recipients from Donor Experiencing Homelessness, United States, 2022
<em>B. quintana</em> Infection from Kidney Donor
wwwnc.cdc.gov
mikerusso.bsky.social
*correlate of protection
mikerusso.bsky.social
Also there’s no serologic correlate of mumps. IgG is more or less useless for telling whether someone is protected
mikerusso.bsky.social
Documented two doses of MMR (or VZV) trump any serologic testing for measles or varicella IgG. Commerically available tests are not sensitive enough and will be false negative in about 1/3 of vaccinated individuals.
mikerusso.bsky.social
Learn some new shitty thing everyday
teenvogue.com
These teenagers and young men — 95% of whom are Black, Latinx, or Filipino — earn between $2.20 and $4 per hour, plus an additional $1 an hour when they’re actively fighting fires, according to the DJJ. ⤵️
In California, Incarcerated Teenagers Help Fight Wildfires
"You’re put in danger every time you’re on the fire line.”
www.teenvogue.com
mikerusso.bsky.social
Been a long time reader of SBM but I missed this! Bookmarking to share with our learners. @andrewhaynes.bsky.social had a good discussion of this at IDWeek the other year too
mikerusso.bsky.social
I will not abide by this feline slander
Kitten
Reposted by Mike Russo
boghuma.bsky.social
This is why clinical trials are important. Unfortunately tecovirimat did not improve resolution of clade IIb mpox compared to placebo.
There are currently no effective antivirals for the treatment of mpox and this is an urgent need. Disappointing result but at least we know.
lizhighleyman.bsky.social
Turns out the antiviral TPOXX (tecovirimat) doesn't work for mild/moderate Clade II #mpox ( #monkeypox) either, as previously shown for Clade I. Many treated people reported improvement, but symptoms typically resolve anyway -- that's why we need controlled trials.

www.niaid.nih.gov/news-events/...
NIH Study Finds Tecovirimat Was Safe but Did Not Improve Mpox Resolution or Pain
Tecovirimat was safe but did not reduce the time to lesion resolution or reduce pain among adults with mild to moderate clade II mpox and a low risk of severe disease in an international study.
www.niaid.nih.gov
mikerusso.bsky.social
Just because it has a name, doesn’t mean we have to try to kill it.
mikerusso.bsky.social
What’s your azithromycin resistance rate these days? Pretty high up here
mikerusso.bsky.social
8/8 None of this would have been possible without strong public health agencies and the people who work there. This is another example of what we stand to lose by appointing individuals that would gut and destroy the very agencies they’d lead.
mikerusso.bsky.social
6/8 This led to rapidly identifying subclinical Bartonella quintana (probable) endocarditis in another organ recipient. Additional testing of banked donor specimens confirmed infection with B. Quintana, cinching the link.
mikerusso.bsky.social
5/8 After a report to OPTN and an email on the Emerging Infections Network, CDC and local DOH’s rapidly responded and initiated an investigation involving content experts, local OPOs, and laboratory partners as well. This was an incredible team effort and public health at its best!
mikerusso.bsky.social
4/8 An eventual excisional liver biopsy revealed vascular-proliferative lesions. The pathologist astutely was concerned for peliosis hepatis and performed a Warthin Starry stain which was teeming with bacilli and a Bartonella PCR was positive.
Liver biopsy of a kidney transplant recipient with a Bartonella quintana infection linked to a donor who experienced homelessness, United States, 2022. A) Fibrovascular proliferation accompanied by few inflammatory cells. Magnification ×200. B) Myxoid stroma that contains clumps of granular material (arrows). Magnification ×400. C) Warthin-Starry stain highlights clumps of bacilli (arrows). Magnification ×400.
mikerusso.bsky.social
3/8 Our index kidney transplant patient presented with fevers and abdominal pain and was found to have lesions in his liver, spleen, and vertebral bodies.
A) Multiple enhancing T2 hyperintense lesions throughout the hepatic parenchyma. B) Numerous enhancing T2 hyperintense lesions affecting cervical, thoracic, and lumbar vertebrae.
mikerusso.bsky.social
2/8 This is a story of transplant ID, but more so a story of public health agencies and what we stand to lose. It was one of the proudest moments of my career to be involved with so many folks who came together to decipher these cases.
mikerusso.bsky.social
1/8 Our report of the first confirmed cases of transplant derived Bartonella quintana infection and the public health investigation surrounding them has been published!
#medsky
#idsky
#publichealthsky
#txid

wwwnc.cdc.gov/eid/article/...
<em>Bartonella quintana</em> Infection in Kidney Transplant Recipients from Donor Experiencing Homelessness, United States, 2022
<em>B. quintana</em> Infection from Kidney Donor
wwwnc.cdc.gov
mikerusso.bsky.social
What the hell?! Who’s next, Dr. Pepper?
mikerusso.bsky.social
“Measles, stand back and stand by,” sums all of *this* up pretty well…
mikerusso.bsky.social
But don’t the data argue that there aren’t local (or accessible) ID specialists for many patients?