This Week In Parasitism

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Guest: Michael Libman Michael returns to help the TWiP trio solve the case of the Delusional African Expatriate, and discuss the association of natural and induced antibodies in mice with differential susceptibility to secondary cystic echinococcosis. Links for this episode: T. brucei life cycle (pdf) Natural and induced antibodies in echinococcosis (Immunobiol) The collaborative cross Letters read on TWiP 104  Case study for TWiP 104 This week's case involves a young man in his thirties, admitted in hospital in Anchorage AK in early June. Chief complaint, severe muscle pain and tenderness. Usually healthy guy, 1 week ago had bad case of diarrhea with belly pain and vomiting, lasted a full week. Now has fever. Concerned because wife now is having diarrhea. Unremarkable history, unknown family history. HIV negative. All childhood vaccinations. Does not eat raw meat. No meds, does seasonal work, social drinker. Came back from successful hunt, g

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Guest: Michael Libman The TWiP-scholars solve the case of the Housewife from Kolkata, discuss mutations in the IL17 gene associated with cerebral malaria, and hear a case presentation from guest Michael Libman.   Links for this episode: IL-17 mutations and risk of cerebral malaria (Inf and Imm) Echinococcosis (CDC) Echinococcus life cycle (pdf) Letters read on TWiP 103  Case study for TWiP 103 This week's case concerns a 42 yo male, refugee in Canada, from DRC, former Zaire, where there is unending civil war. Upper middle class, professor of French at university. Had been imprisoned, tortured, lived in jungle for a few years, reached refugee camp in Tanzania, moved to Canada. Came to health care system 15 months after arrived. Was sent to psych, unstable emotionally, delusions, hallucinations, depression, post traumatic issues. Was under psych care for ~1 yr, did not improve, became worse. Sent to hospital. History: talked about having minor

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiPyzoites solve the case of the Uncommon Parasite, and discuss the role of eosinophils in promoting the growth of Trichinella in skeletal muscle.   Links for this episode: Eosinophils and IL-4 support nematode growth (PLoS Path) Balantidiasis (CDC) Letters read on TWiP 102  Case study for TWiP 102 This week's case involves a 24 yo housewife, from a village outside of Calcutta. Comes into a tertiary care hosp, 6 months coughing up blood, fever, no weight loss. Drinks rainwater, milks her cow. Dogs everywhere, no livestock except cows. Eats meat, well cooked. No extramarital encounters. Husband well. 4 children. Cistern for drinking water is covered.  No health issues. Reports salty, clear mucus. No blood in stool, no changes in stool. Exam: looks healthy, lungs clear. Lab tests: White count of 9000, 12% eosinophils (elevated). So she has eosinophilia. Chest X-ray and CT: lesion on left side in xray. CT: shows 4 cm cavity, with air pocket

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The doctors TWiP solve the case of the Woman with White Worms, and explain the role of a secreted growth factor from a carcinogenic parasite in wound healing and angiogenesis.   Links for this episode: Wound healing growth factor from carcinogenic parasite (PLoS Path) Opisthorchis (CDC) Opisthorchis life cycle (CDC) Image credit Letters read on TWiP 101 Listener Pick Ramon - Ancient Rome was infested with parasites Case study for TWiP 101 This week's case involves an uncommon parasite. Young girl,

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The TWiP trifecta solves the case of the Woman from Bolivia with Belly Pain, and discuss a method for population modification of malaria mosquitoes using a Cas9-mediated driver gene. Links for this episode: Cas9-mediated drive for population modification of malaria mosquito (PNAS) FAQ: Gene drives (pdf) Image credit Letters read on TWiP 100 Case study for TWiP 100 This week's case is a 27 yo female, native NY, referred to outpatient at CU after seeing OBGYN, told had seen worms in stool and underwear. Inch or two in length, pale white, round, moving, 2-3 weeks of constant abdominal bloating. Sexually active. No particular diet. Travel: works for NGO, refugee camp in Ethiopian-Sudan border, southern Sudan. Last visit month ago. Noticed worms when she got back from last trip. Eats what local people eat. Raw food popular there: kitfo, raw steak tartare, with melted butter. Made from local beef. Did not take malaria prophylaxis, did not avoid loc

The TWiP trifecta solves the case of the Professor Who Went to Brazil, and discuss an amazing case of a tapeworm that turned into a tumor in an AIDS patient. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin   Links for this episode: Do young doctors need more sleep? (Slate) H. nana tumor in AIDS patient (NEJM) Hymenolepiasis (CDC) H. nana lifecycle (CDC/Wikipedia) Image credit Letters read on TWiP 99 Case study for TWiP 99 This week's case is a 53 yo woman visiting family in US, comes in with intense belly pain, right upper part of belly. Has become strict vegetarian after having breast cancer, on raw vegetable diet (carrots, collect plants in local markets). From Bolivia. Lives in agricultural area, avoids sheep, fearful of dogs. Housekeeper. Married, lives with husband. Noticed pain when came to US. Breast cancer: localized, removed lesion, no therapy, months ago. No allergies, family healthy. No insect bites, lives in concrete house. Physical exam: not febrile, right upper quadrant is ve

The TWiP-lets reveal Balamuthia infection in the Children from Peru, and discuss resistance to pyrethroids revealed by RNA sequencing of Anopheles mosquitoes. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Balamuthia (CDC) Pyrethroid resistance in Anopheles (Parasit Vectors) Voltage-gated sodium channels Pyrethroid (Wikipedia) Image credit Letters read on TWiP 98 Case study for TWiP 98 This week's case is a Professor clinician, teacher, researcher.  In his 50s, he presents with lesion on big toe, anterior portion, tip, nodular. No surrounding redness, area is itchy. Has a small central black area the size of pencil tip, concerned because feels is getting larger over last week. Spooky. Travels, last in Brasil, had been for a few weeks, noticed toe issue a week after returned. Spent time on beach, but wore flip flops. Different types of beaches, crowded and not crowded. Went with wife. Healthy man, no prior medical problems. Send your diagnosis to twip@twiv.tv Contac

The paratenic hosts reveal a case of scabies in the Traveling Salesman, and discuss a role for natural antibody in protection from infection with Plasmodium. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin   Links for this episode: Parasite Nobel Prizes 2015 Ivermectin story (Nat Rev Micro) Ivermectin target (Brain Res) Gut microbiota and Plasmodium protection (Cell) Natural antibody (virology blog) Image credit Letters read on TWiP 97 Case study for TWiP 97 Daniel has two cases this week. Two people with similar presentations. A 12 yo girl in Peru presented for care with painless dark brown area on right knee. Has brothers and sisters, often play together. No trauma, but area is expanding. Months later develops cognitive changes. Second case is a 5 yo boy from the coastal region of Peru brought in by Mother, has red swollen area on face. Mom says while playing scratched nose, swelling right cheek, eye, nasal obstruction, no response to antibiotics. MRI of both show infiltrating process. G

The TWiPanosomes solve the case about the Young Woman who Went to Belize, and relate how sandfly saliva skews the immune response and increases risk of cutaneous leishmaniasis. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin   Links for this episode: Sandfly exposure and risk of cutaneous leishmaniasis (J Inf Dis) TWiP 14: Leishmania Image is L. longipalpis (credit) Letters read on TWiP 96 Case study for TWiP 96 Daniel's patient for this week is male patient referred for consultation by OB-GYN: his wife is pregnant, has been admitted and is about the give birth. It is her first pregnancy. There are concerns about the husband's skin problem and whether it is a threat to his pregnant wife. No lesions on woman, husband recently developed itchy skin problem on his hands. Bilateral. Small papules on webs of fingers, brown lines, blood clots at ends, has clearly scratched the lesions. Skin between fingers is involved. Travels, often stays in cheap hotels. Beds not clean. Last trip 1 month before

Vincent, Dickson, and Daniel solve the case about the 33 year old Chinese male with watery diarrhea, and discuss whether arsenic in drinking water might lead to treatment failures for Leishmania infections. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: TWiP 17: Entamoeba histolytica Arsenic exposure and Leishmania treatment outcomes (PLoS NTD) TWiP 14: Leishmania Letters read on TWiP 95 This episode is sponsored by ASMGAP. Case study for TWiP 95 Daniel's patient for this week is a 28 yo single female, returns from beach vacation with new boyfriend. Two weeks in Central America (Belize). Often found secluded beaches. Good health, noticed upon her return had small nodules/papules on front of thighs. Thought were insect bites, became very itchy. Noticed serpiginous red lines forming, radiating out from bumps. Felt things moving in her skin. Benadryl did not help. Daniel say something similar occurs in Lima. Healthy, no allergies, surgeries, no relevant family history

Vincent, Dickson, and Daniel solve the case about the man from El Salvador, discuss the use of tyrosine kinase inhibitors to treat onchocerciasis and filariasis. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Targeting filarial tyrosine kinases (J Inf Dis) Onchocerciasis on TWiP 24 Filariasis on TWiP TWiP 25 Image shows c-abl kinase bound to imatinib (red) Image credit What good are ticks? Letters read on TWiP 94 Case study for TWiP 94 Daniel's patient was seen in the clinic. He is a 33 yo chinese male, from Chinatown NYC, for several months on and off has had watery diarrhea, headaches. Tried reflexology, chiropractic therapy, with no results. Has traveled quite a bit, been in Chile (was there a few months before). Came to US when young. Grew up in the US. In Chile, has had many sexual partners, >50, of both sexes, also has done many drugs. Two years ago was diagnosed with chronic HIV, CD4 count 685, on ARVs triple therapy, virus loads are well controlled. Has had

Vincent, Dickson, and Daniel solve their fishy tale, and present a new case study for your consumption. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Freezing and the quality of sushi (Clin Inf Dis) Anisakis biology (CDC) Image credit Letters read on TWiP 93 Case study for TWiP 92   April 2015 a 177 lb 5ft10in 39 yo man seen as outpatient in ID clinic, reports 2 y ago had issues with constipation on and off; throat hurts; feels closing when lies down. For several years has had skin irritation on upper chest and arms. Tried to donate blood, was rejected, told to see doctor. Emigrated to US from El Salvador 2002, married, reports no extramarital sex, smokes 2-3 cigs/day, now quit; had drinking issue in past, no more; was agricultural worker in rural part of El Salvador; has history of asthma, on a number of medicines, including steriod nasal spray, inhaler, no visual problems, healthy appearing, not allergic to medicines. Family history: mother heart attack and diab

Vincent, Dickson, and Daniel discuss how fluctuation in the price of guinea pig food could help transmission of the agent of Chagas disease, and present a new case study for your consumption. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Ascaris on TWiP 21 Ascaris lumbricoides life cycle (jpg) Child with distended abdomen due to Ascaris (jpg) Bottlenecks and Chagas disease (Proc Biol Soc) Letters read on TWiP 92 Case study for TWiP 92 A 20 yo Japanese female student went to the emergency room with severe abdominal pain. nausea, had vomited. Had just enjoyed homemade sushi an hour or two previuosly. She prepared the sushi: rice, salmon, tuna rolls. Salmon was local, caught by boyfriend. Tuna from store, sushi grade. No past medical history, mother with anemia. Takes oral contraceptives. No toxic habits. No travel. Monogamous. Temp 100.2, bp 140/90, hr high 90s, breathing upper teens. Physical exam normal except appears distressed in pain, belly extended, tender in

Vincent, Dickson, and Daniel review how Viagra might be used to block transmission of Plasmodium falciparum, and introduce a new case study. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Malaria life cycle (jpg) cAMP regulates gametocyte infected erythrocyte deformability (PLoS Path) P. falciparum in bone marrow (Blood) Image credit Letters read on TWiP 91 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email

Vincent, Dickson, and Daniel discuss identification of an erythrocyte protein essential for invasion of Plasmodium falciparum, and introduce a new case study. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Dermatobia hominis (Wikipedia) Plasmodium falciparum erythrocyte invasion (Science) Plasmodium life cycle (TWiP #10) Letters read on TWiP 90 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email

Vincent, Dickson, and Daniel reveal last week's case study and introduce a new one concerning a patient who traveled to Belize. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Neurocysticercosis (TWiP 6) Cysticercosis (CDC) Sarah Lane's neurocysticercosis Letters read on TWiP 89 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email

Vincent, Dickson, and Daniel discuss how a secreted protein from the protozoan parasite Theileria transforms its host cells via a cellular proto-oncogene. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Leishmania (TWiP #14) Transformation by a prolyl isomerase (Nature) Theileria.org Prolyl isomerase (Wikipedia) Image from Transformation & Oncogenesis Letters read on TWiP 88 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email

Vincent, Dickson, and Daniel review new insight into antigenic variation in trypanosomes, reveal the difficult solution to the last case study, and present another mystery for your solving. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Pinworm (CDC) Pinworm on TWiP #19 Dynamics of antigenic variation in T. brucei (Science) Image credit Letters read on TWiP 87 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email

Vincent, Dickson, and Daniel discuss how filarial infection modulates the immune response to mycobacterial infection, and reveal a new case study. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Filarial infection modulate immune response (J Immunol) Memory T cells (Wikipedia) Image: Loa loa microfilaria Letters read on TWiP 86 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email

Vincent, Dickson, and Daniel explain how trypanolytic factor forms membrane channels to lyse trypanosomes, and present a new case study. Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin Links for this episode: Human trypanolytic factor forms channels (PNAS) Human paragonimiasis (MMWR) Don't eat raw crawfish Daniel and Dickson in studio (jpg) Image credit Letters read on TWiP 85 Contact Send your questions and comments (email or mp3 file) to twip@twiv.tv Subscribe Subscribe to TWiP (free) in iTunes, by the RSS feed or by email