This Week In Parasitism

Dickson, Daniel and Vincent solve the case of the Female with Itchy Anus, and reveal the structure of a roundworm membrane protein involved in digestion of nutrients. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode Structure of roundworm digestive complex (PLoS Path) Hero: Dr. Anthony Fauci Fauci Pharmacy (TWiV 219) Letters read on TWiP 183 Become a patron of TWiP. Case Study for TWiP 183 70 yo male. Returns with wife from safari in S. Africa. Reports suffering from 2 weeks watery diarrhea. Severe water shortage in S. Africa, limited washing water, hand sanitizers to clean hands so problem with hand hygiene.  5 days after arrival he and wife have water diarrhea, 12 per day, nauseated, abdominal cramping. Ab no effect. Stool culture, ONP, negative. Healthy, no past med/surg, no allergies, nothing runs in family. Stool sent off for ONP acid fast stain, also GI PCR panel. Prompts treatment for 7 days

Dickson, Daniel and Vincent solve the case of the Ugandan Volunteer With Morning Bites and discuss integration of HIV-1 into the Schistosome genome, with a sprinkling of COVID-19 throughout. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode PWB social media: Facebook, Instagram, Twitter Daniel on TWiV HIV-1 integration into Schistosome genome (PLoS Path) Image from John Southall's Treatise of Buggs, 1730. Letters read on TWiP 182 Become a patron of TWiP. Case Study for TWiP 182 60 yo female comes in with husband, grew up in Lima Peru. Having issue had when child, would get itchiness around anus, mother would have her eat pumpkin seeds. Every 2-3 weeks wakes up with severe itching. Put in q-tip and extracted something, has video of it. ONP stool cultures negative. Referred to Daniel. Negative medical history, no allergies, no surgeries, no medications. Does travel, mainly to Uganda. HIV negative, no toxic habits. Hus

Dickson, Daniel and Vincent solve the case of the Two Volunteers With Watery Diarrhea, discuss diagnosis of SARS-CoV-2 in the New York area, and reveal an approach to preventing honeybee colony collapse by imbuing their gut bacteria with the ability to produce antiviral and antiparasite double-stranded RNAs. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode PWB social media: Facebook, Instagram, Twitter Daniel on TWiV Special Engineered symbionts limit honeybee pathogens (Science) Letters read on TWiP 181 Become a patron of TWiP. Case Study for TWiP 181 Risks of being helpful. Volunteer from previous case. Diarrhea is gone, now has second issue. Since coming to Uganda noticing on waking in AM often has series of 1 cm red raised lesions in a line, 3-4, on torso. Swollen and itchy. New ones in the AM. Manager says welcome to Uganda. They move out of room, leave bedding behind. Lesions stop. What is going on and when c

The TWiP professors solve the case of the Ugandan Child with Splenomegaly, and reveal that mutations in the P. falciparum genome that confer artemisinin resistance interfere with endocytic uptake of hemoglobin. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode PWB social media: Facebook, Instagram, Twitter Endocytosis pathway mediates artemisinin resistance in malaria parasites (Science) Letters read on TWiP 180 Become a patron of TWiP. Case Study for TWiP 180 Uganda with a twist. Meets two people with watery diarrhea, 12 episodes/day, loss of appetite. No fever, no blood in stool. Living for months at staff guest house. One week prior to onset went on weekend trip to area with waterfalls. Were served outdoor meal: meat, salad, fruit. Recommends empiric treatment trimethoprim/sulfamethoxzole for 7 days. Prompt resolution of diarrhea. A few days later, upon drinking coffee with milk gets severe cramps. 20s, long term

The TWiP DVD solve the case of the Child Who Passed Worms, and discuss a non-human primate model for severe malarial anemia. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode PWB social media: Facebook, Instagram, Twitter Primate model of severe malarial anemia (Sci Rep) Ascaris skirt (and more!) Hero: Harold W. Brown Letters read on TWiP 179 Become a patron of TWiP. Case Study for TWiP 179 From Uganda, eastern up in mountains, rainy season. 6 yo girl brought in by mother on Monday, reporting several days of feeling poorly, headache, fever, muscle aches. Negative malaria smear on Monday. Wednesday returns, feeling worse, fever higher, headache worse. Lungs clear, belly (pain on left side) has large spleen. Living in good conditions, well dressed, dirt floor house, concrete walls. Toilet is hole in back. Same dietary habits, high in carbs. No mosquito netting. Water from stream. No siblings. HIV negative. Send your

The Knights of the TWiP solve the case of the Man Who Lost Weight, and discuss a Plasmodium protein kinase that is a malarial drug target. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode PWB social media: Facebook, Instagram, Twitter Protein kinase as malaria drug target (Science) Hero: Myron Schultz Letters read on TWiP 178 Become a patron of TWiP. Case Study for TWiP 178 Eastern border of Uganda with Kenya, in mountains. Drinking water from nearby stream. Two young boys come to clinic, without parents. Sent in by grandmother because 1 yo brother has been passing worms. Long, white, flat. Shown photos in PD7, pinkish worm, 8 inches long, round. He points to those, what he has been seeing in brother’s stool. 1 year old seems small, protuberant abdomen; brother small for stated age, bit of protuberant belly. Diet: high carbohydrate, flour deep fried; yams; cabbage; some rice; soybeans; pumpkin; bananas. Send your

The TWiPsters solve the case of the Rashy Schoolteacher, and reveal a drug from rotifers that live on the snail intermediate host which paralyzes schistosome cercariae and prevents infection of mice. Hosts: Vincent Racaniello, Dand Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode Progress towards global eradication of dracunculiasis (MMWR) Rotifer compound that paralyzes schistosome cercariae (PLoS Biol) Image credit Letters read on TWiP 177 Become a patron of TWiP. Case Study for TWiP 177 49 yo man sent to Daniel for ID consultation. Reports in August visited Hawaii with family, then flies to CA. Family event there. Take him to Pakistani restaurant. One day later has gastrointestinal issues, nausea, diarrhea. Goes to urgent care, send stool for O&P. Look at stool, shows chilomastix mesnili. No medicines, will be ok. Over this period of 1 week he loses 15 pounds. Gains 5 back. End of October feels fine, no bloating or diarrhea. No symptoms but goes to gastro

The TWiPpers of the bite fantastic solve the case of the Indian Man Who Hiked, and discuss the effects of schistosome soluble egg antigen on infection of lymphocytes with HIV-1. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode Effect of schistosome soluble egg antigen on HIV-1 infection (PLoS P) Hero: Lawson Soulsby Letters read on TWiP 176 Become a patron of TWiP. Case Study for TWiP 176 Recent case, woman in late 20s, schoolteacher. Outer boroughs of NYC. Wakes up on Saturday, completely rash-y, head to toe. Goes to urgent care center, say is allergic, give anti histamines and steroids. Persists after a few days, goes to allergist. Only allergen positive, dust mites. Few days later goes to GP, still itchy and rash-y. He does more thorough exam, notices she has small red lesions on fingers and between fingers. Several children in classes she is teaching has similar malady. Given therapeutic, rash goes away. Othe

The TWiP'ers solve the case of the Sudanese Boy With Fever, and reveal antibodies against that slow invasion of red blood cells potentiate other malaria-blocking antibodies. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode Antibodies that slow malaria invasion (Cell) Hero: Sir Leonard Rogers (pdf) Letters read on TWiP 175 Become a patron of TWiP. Case Study for TWiP 175 70 yo man born in India, came to US 1985. Has not gone back for 2-3 years. Admitted with acute onset of fever, cough, not eating well. Was fine until a week ago, had lost consciousness, fever 102F. Negative cultures for urine and blood. Some kidney stones, type II diabetes, elevated cholesterol, no surgeries. No family medical issues. Started on vancomycin on zosyn. Works in post office, lives with house in private home. No toxic habits. Has history of hiking trip 1-2 months prior, in Rhode Island, in June. No pets, animals. Exam unimpressive. Labs:

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPloid organisms solve the case of the Doctor with Chronic Epigastric Pain, and reveal how levels of linoleic acid in the intestine enable the sexual cycle of Toxoplasma gondii in cats. Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode: Determinant of T. gondii sexual cycle(bioRxiv) A Year's Worth of TWiP by Kevin Carney Hero: William Trager Letters read on TWiP 174 Become a patron of TWiP. Case Study for TWiP 174 12 yo male living in refugee camp after fleeing Sudan. Presents to doctor with history of fever for many months, every other day; chronic abdominal pain. Tried antimalarials, no effect. Broad spectrum antibiotics, no effect. Exam: fast heart, clear lung, enlarged liver, enlarged palpable spleen. Camp has limited resources, no more diagnostic tests. Tried intravenous amphotericin. Child improves.   Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The podcastellani hosts solve the case of the Sailor With Dysentery, and reveal the first virus discovered in Plasmodium species. Subscribe (free): iTunes, Google Podcasts, RSS, email Links for this episode: Matryoshka RNA virus of Plasmodium (bioRxiv) Hero: Rose Gana Fomban Leke Letters read on TWiP 173 Become a patron of TWiP. Case Study for TWiP 173 Successful individual in NY area with 9 months of epigastric pain. Did upper endoscopy, saw in stomach several small mobile white serpiginous moving objects. 2.8 mm. Seem to be trying to burrow into gastric mucosa. One grabbed and sent to lab. History: curious habit of curing his own protein sources.  Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The metacyclic TWiPomastigotes solve the case of the Child With a Painless Leg Lesion, and reveal how to kill mosquitoes with a genetically modified fungus. Subscribe (free): iTunes, Google Podcasts, RSS, email Transgenic Metarhizium kills mosquitoes (Science) Hero: Veena Tandon Letters read on TWiP 172 Links for this episode: Become a patron of TWiP. Case Study for TWiP 172 Retired US Navy physician, lives aboard his sailboat, just finished doing remote medical volunteer work in C. America. In DR when has sudden onset of dull prog worsening epigastric lower abdominal pain. Over next 12 hr intensifies, near tears, went to local medical center. Admitted, given IV, probiotics. Febrile, elevated WBC 20,000, platelets low, white counts left shift. Initially some constipation, then diarrhea with some blood. Discharged without diagnosis; still fever and chills; rash rose colored spots on torso. Daniel gets involved; 3 day course of azithromycin, sy

The Leishmaniacs solve the case of the Child With Band Keratopathy, and reveal a eukaryotic parasite with functional mitochondria but without mitochondrial genomes. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: Elmer Pfefferkorn, 87 Eukaryotic parasite without mitochondrial genomes (Sci Adv) Hero: Charles Wardell Stiles Letters read on TWiP 171 Case Study for TWiP 171 By boat to remote village, young boy (

The TWiPlicates solve the case of the Child With Retinal Granuloma, and discuss an association of the complement protein collectin-11 with the pathophysiology of Chagas disease. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: Chagas disease pathophysiology and collectin-11 (PLoS NTD) Hero: Theobald Smith Image credit: Toxocara canis by Ben Liffner Letters read on TWiP 170 Case Study for TWiP 170 3 yo girl, same context: mobile clinic in Bocas del Toro archipelago. Small village on remote island. Initially had red eye, rubbing a lot, mother noticed she seemed to have vision loss. On exam ophthalmologist did fundoscopic exam, sees band keratopathy, calcium on the cornea, and outer retinal punctate lesions. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

The TriTWiPomonads solve the case of the Child Who Passed a Worm, and reveal recombination between bovine and human schistosome species. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: S. bovis and S. haematobiumhybrids (PLoS Path) Hero: Ann Bishop Letters read on TWiP 169 Case Study for TWiP 169 9 yo boy brought into mobile clinic set up in small village Bocas del Toro archipelago. Initially had red painful eye a few months ago, lasted 1-2 weeks. Eye no longer red but has issues with vision in the eye. On eye exam, some peripheral vision, but no sharp clear vision. Notes retinal retraction, seems quiet granuloma over macula of affected eye. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

The Giardians of the Galaxy solve the case of the Woman With a Colonic Stowaway from Hispaniola, and discuss activation of intestinal tuft cells by Trichinella spiralis. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: T. spiralisand intestinal tuft cells (PNAS) Hero: Carl Theodore Ernst Van Siebold Letters read on TWiP 168 Case Study for TWiP 168 18 month old child, on medical mission for previous year with older sibling and 2 parents. Back in US for 2-3 months, just as leaving remote location were given dose of allbendazole. Call comes to Mom, child is at child care and has passed something. It is serpiginous, 5-6 inches in length, moving a bit. Not flat, but round. Child otherwise fine. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

The Tremendous Trio solve the case of the Woman With Foul Steatorrhea, and reveal breakdown of the glycocalyx associated with severe and fatal malaria. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: Glycocalyx and severe malaria (Clin Inf Dis) Hero: Bridget Ogilvie Letters read on TWiP 167 Case Study for TWiP 167 Woman 30 yo, traveled to DR, went to tourist part. On return for yearly physical, asked about her chronic constipation. She said does not have it any more, has normal bowel habits. A few weeks after her return this occurred. Primary care doc was intrigued, sent off some tests. Found Entamoeba hartmanni. What might the doc have done? What were the consequences of infection? Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

The Podfessors solve the case of the Teenager With Swollen Scrotum, and continue the story arc of Daniel's favorite cells, B-1 cells, and their association with protective immune responses in human Chagas disease. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: B1 cells and Chagas disease (Front Immunol) Daniel discovers B1 cells (J Exp Med) Hero: Bridget Ogilvie Image credit Letters read on TWiP 166 Case Study for TWiP 166 Recent consult from gastroenterologist. 61 yo woman on trip to Thailand, Cambodia for a few weeks. Developed diarrhea, took azithromycin, 3 days. Diarrhea continued, back in states now ongoing a few weeks. Left lower abdominal pain, bloated, gassy, loose stools, stick and foul smelling. Not sexually active, but is relevant. Not restrictive in what she ate. Drank bottled water. Did not eat raw items. Send your case diagnosis, questions and comments to twip@microbe.tv Mu

The TWiP team solves the case of the Four Year Old with Fever, Headache, and Cough, and discuss the release of extracellular vesicles from Leishmania amazonensis that manipulate the host immune response. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: Crackles (Wikipedia) Extracellular vesicles released by L. amazonensis (Front Microbiol) Hero: Marietta Voge Image credit Letters read on TWiP 165 Case Study for TWiP 165 Still in Uganda. Young boy came from a distance to see Daniel, teenager with large swelling in scrotum, left side, 4-6 cm diameter, superior to testicle. Not only young man in area with similar problem. Daniel asked, are there people with large swollen legs? He said yes, my brothers wife, left leg is large, swollen, irregularity. Nontender. Can be transilluminated, and it glows. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees

The TWiP legends solve the case of Surfer Sans Septum, and discuss how two symbiotic bacteria in the tsetse fly allow colonization with Trypanosoma brucei. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiP. Links for this episode: A Tale of Three Species (mBio) V.B. Wigglesworth (Wikipedia) VB Nimble, VB Quick Hero: James Paget Letters read on TWiP 164 Case Study for TWiP 164 Welcome to Uganda. Mother brings in 4 yo female child, end of rainy season, concerned that has one day of fever, headache, cough. On exam looks ill, unremarkable except rapid heart rate, localized crackles in right lower lung. Several children in family. Spends day swimming in local stream. Take care of animals. Help gather drinking water in morning. Live in dirt floor home, thatch roof, with animals around. Saw many others with same problem. What tests do you want to do? Send your case diagnosis, questions and comments to twip@microbe.tv Musi