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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

www.cdc.gov/leishmaniasi...

Generally, all clinically manifest cases of visceral leishmaniasis and mucosal leishmaniasis should

www.cdc.gov

Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

Species id is helpful in tx decision. Serology is rarely used due to variable sensitivity & specificity.Tx (topical or systemic) is based on location # & chronicity of lesions, species id & host immune status. high-risk (close to eye), multiple lesions, IC state favor systemic tx

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

Cutaneous #leishmania lesions may spontaneously heal within 6 to 15 months of disease onset. Self-resolution confers lifelong protection from the disease but leaves a scar.

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#leishmaniasis incubation period 2-8 wk: dz begins as erythematous papule at site of sandfly bite on exposed parts of body
papule increases in size➡️nodule➡️ulcerates➡️crusts over. The border is usually raised & ulcer is large but painless unless 2ndry bacterial or fungal infect

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

Cutaneous #leishmaniasis amastigotes in macrophages

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

www.cdc.gov/dpdx/monthly...

CDC - DPDx - Case #481 - December 2018

DPDx, Division of Parasitic Diseases and Malaria (DPDM), DPDx applications, diagnosis of parasitic diseases, diagnostic reference resources, diagnostic quizzes, parasites and parasitic diseases, paras...

www.cdc.gov

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#idboardreview 25 M travel to rainforest in Peru 6mo ago presents w/ painless, ulcerating lesion with crusting & mild swelling on arm. A smear of a scraping from biopsy site stained with Giemsa stain. Dx? #medEd #idmedEd #idsky

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

new genus faucicola according to this www.microbiologyresearch.org/content/jour...

Reclassification of Moraxella boevrei, M. osloensis and M. atlantae, into the genus Faucicola, and proposal of a new genus within the family Moraxellaceae, Lwoffella lincolnii gen. nov., comb. nov., t...

The genus Moraxella (Moraxellaceae, Pseudomonadales) comprises a diverse group of bacteria inhabiting human and animal mucosa, as well as environmental niches such as water, soil and food. While some ...

www.microbiologyresearch.org

Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

pmc.ncbi.nlm.nih.gov/articles/PMC...

Bacteremia due to Moraxella osloensis: a case report and literature review

Herein we report the case of a 10-year-old boy with an autosomal mosaic mutation who developed bacteremia. The causative agent was identified as Moraxella osloensis by matrix-assisted laser desorption...

pmc.ncbi.nlm.nih.gov

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

www.sciencedirect.com/science/arti...

Moraxella osloensis infection among adults and children: A pediatric case and literature review

Moraxella osloensis has been reported in the literature as a human pathogen, particularly among immunocompromised adults. In contrast to the adult pop…

www.sciencedirect.com

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#moraxella osloensis is usually susceptible to penicillin G, cephalosporins, and aminoglycosides. This patient was treated successfully with surgical debridement and intravenous third-generation cephalosporins alone.

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

Proper diagnosis and antimicrobial treatment are prudent. #moraxella oselensis is not a new clinically emerging pathogen, but rather emerging owing to new techniques. In this case identified by 16SRNA

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#moraxella oselensis vast majority of cases in immunocompromised eg solid tumors or hematological malignancies or transplant pt.

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#moraxella oselensis gram- aerobic, oxidase+ coccobacillus isolated from environmental sources in hospital as anesthetic agents & sink traps; capable of spreading to pt from environment. Rare cause of meningitis, endocarditis, bacteremia, pneumonia, peritonitis, catheter inftz

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#Moraxella oselensis Ref www.sciencedirect.com/science/arti...

An unusual osteomyelitis caused by Moraxella osloensis: A case report

Moraxella osloensis is a gram-negative coccobacillus, that is saprophytic on skin and mucosa, and rarely causing human infections. Reported cases of h…

www.sciencedirect.com

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 1d

#idboardreview 30 M w/ 2 mo of thigh pain, swelling & serous drainage, US abscess: gets transiently better w/ I&D, not resolved w/ clinda or cipro. MRI sinus track communicating w/ femur. Culture unexpected organism: gram-negative cocobacilli. Dx? #medEd #idmedEd #IDtsky

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

Acute #retroviral syndrome #hiv
less common: neurological complications: aseptic meningitis, facial palsy, or Guillain-Barré syndrome
Rarely, acute infection substantial drop in CD4 patients may initially present: oral candidiasis or even major AIDS-defining opportunistic infect

Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

Symptoms of primary #HIV typically begin within 28 days of infection, most common: fever, fatigue, myalgia, skin rash, headache, pharyngitis, and cervical adenopathy -skin rash is typically morbilliform or maculopapular & most often involves the trunk

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

www.hiv.uw.edu/pdf/screenin...

www.hiv.uw.edu

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

Set point: relatively stable #HIV RNA level reached about 1-2 months after peak HIV RNA levels associated w/ acute HIV infection.
Without antiretroviral therapy: HIV RNA levels tend to chronically remain near the set point established early in HIV infection

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

Seroconversion Window Period: interval b/w #HIV acquisition & first detection of anti-HIV Ab
-duration of window period depends on sensitivity of Ab assay used, with IgM/IgG-sensitive HIV Ab tests detecting HIV sooner than IgG-sensitive HIV Ab tests

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

#Fiebig Stages of Early #HIV Infection: classification system used to describe various stages of early HIV infection & based on timing & results of diagnostic tests

#Founder Virus: initial virus (or small cluster of viruses) that succeeds in catalyzing HIV mucosal infection

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

Early #HIV Infection: initial 6mo time period following HIV acquisition; 3phases
time from infection until acute HIV
acute HIV infection
recent HIV infection

Eclipse Phase: short interval 10-12d following HIV acquisition in which no diagnostic test is capable of detecting HIV

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

Definitions
Acute #HIV Infection: phase of HIV immediately after HIV acquisition +detectable HIV RNA or HIV p24 in absence of anti-HIV Ab

Acute #Retroviral Syndrome: acute symptomatic illness that develops during the acute HIV infection phase.

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Infectious Diseases Fellowship at Indiana University @iuidfellowship.bsky.social · 5d

primary #HIV or acute retroviral syndrome, is frequently mistaken for an alternate viral infection, such as mononucleosis or influenza
-Early ART arrests explosive burst of viremia associated w/ acute HIV infection: ⬆️long-term health outcomes & ⬇️transmission of HIV to others

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