Acute Babesiosis Management Mild/Moderate Disease Severity • Symptoms: Fevers, fatigue, malaise. Headache, nausea. Chills, dyspnea, neck stiffness • Parasite Burden: <4% • Treatment: Azithro 500 mg PO daily+ Atovaquone 750 mg PO BID • Duration: 7-10 days Severe Disease Severity • Symptoms: Same as above. Also ARDS, ARE DIC, shock, splenic rupture/infarcts • Parasite Burden: <4% • Treatment: Azithro 500 mg IV daily + atovaquone 750 mg po BID. Transition to PO azithro after parasitemia diminishes • Duration: Usually 2 weeks, >6 weeks if the patient is immunocompromised - Dr. Kevin Braghirol @KBrag_MD #Babesiosis #Management #treatment #Babesia #microti

Babesia Microti - Clinical Features, Exam, Labs and Major Differential Diagnosis Treatment: 1) Atovaquone and azithromycin 2) exchange transfusion for severe disease (parasitemia >10%, acute encephalopthy, acute liver failure) #Diagnosis #Babesia #Microti #Workup

Babesiosis on Peripheral Smear 85 M from SE USA, hx splenectomy, IgG4 plasmacytic syndrome: F, chills, profound weakness, R flank pain, hematuria, H/A. diagnosis? Transfusion related babesiosis. babesia microti Ab IFA 1:256, PCR+ Treated with clindamycin & quinine, rbc exchange, post exchange: blood smear neg for intra erythrocytic inclusions, improved clinically and dc on azithro &atovaquone Peripheral smear shown: no shistocytes, +innumerable intra & extra erythrocytic inclusions >10%RBC, +maltese cross +burr cells and spur cells, +rouleoux formation Splenectomized pt with fever: think encapsulated organism: strep pneumonia, H influenza, N meningitis, capnocytophaga canis, bordetella holmesii, babesia microti, malaria Babesiosis ixodes tick(parallel distribution/coinfection w/lyme), more common in NY, NJ, CT, RI, MA, MN, WI Asymptomatic or flu like illness, red cell invasion & lysis: fever, anemia, jaundice, hematuria, renal insufficiency. complications: ARDS and DIC, case fatality: 5% Transfusion transmitted babesia TTB can survive indefinitely in cyroperserved w/ glycerol cryopreservation but in abscess of cryopreservation, killed quickly by freezing. - Indiana University Infectious Diseases Fellowship @IUIDfellowship #Babesiosis #Peripheral #Smear #babesia #microti #clinical

Urinary Tract Infection (UTI) Specific Antibiotics - Class Overview 1. Nitrofurantoin (Macrobid) (PO) 2. Fosfomycin (PO) 3. Methenamine (PO) #Pharmacology #Antibiotics #Review #Overview #UTI #UrinaryTract #Infection #Nitrofurantoin #Macrobid #Fosfomycin #Methenamine

Nitrofurantoin Toxicology Serious Adverse Effects: Hemolysis in patients with G6PD-deficiency Peripheral neuropathy Hepatitis Pulmonary toxicity Nephritis By Dr. Kathryn Watson @Kat_Watson #Nitrofurantoin #Macrobid #Toxicity #Toxicology #Pharmacology #Diagnosis

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febrilepodcast] #ID ... #Microbiology #Micro

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