Cosmina Gingaras, MD, MPH
@cosepiid.bsky.social
Infectious Diseases MD. I enjoy complex, multidisciplinary cases & rare diseases. When the world gets overwhelming, I find refuge in the arts and in nature. Also formerly trained as an epidemiologist at UTSPH and did some basic science in virology at BCM
For a Nocardia cerebellar abscess, presumably completely removed via surgery, would you continue oral antibiotics? How long? Therapeutic dose or prophylactic?
October 4, 2025 at 1:23 PM
For a Nocardia cerebellar abscess, presumably completely removed via surgery, would you continue oral antibiotics? How long? Therapeutic dose or prophylactic?
Ground zero for field epidemiologists
September 11, 2025 at 3:46 PM
Ground zero for field epidemiologists
Any idea if severe repeated episodes of hypoglycemia in a diabetic patient with ulcerative colitis could be a side effect of Vedolizumab? #ulcerativecolitis #vedolizumab #Entyvio #diabetes
August 16, 2025 at 2:07 PM
Any idea if severe repeated episodes of hypoglycemia in a diabetic patient with ulcerative colitis could be a side effect of Vedolizumab? #ulcerativecolitis #vedolizumab #Entyvio #diabetes
I'm wondering about the mechanism(s) that could explain increasing fibrin monomers, but decreasing D dimers in an upper respiratory-type post-infectious syndrome. No radiological sign of thrombosis, CRP decreasing #IDSky #haematology #SARS-CoV-2 #COVID
April 18, 2025 at 2:31 PM
I'm wondering about the mechanism(s) that could explain increasing fibrin monomers, but decreasing D dimers in an upper respiratory-type post-infectious syndrome. No radiological sign of thrombosis, CRP decreasing #IDSky #haematology #SARS-CoV-2 #COVID
I've been seeing a couple of (likely bacterial) pneumonias with very high D dimers. No identifiable major thrombus, no response to antiX anticoagulants, but responsive to corticosteroids. Mechanism? #haematology #IDSky
April 18, 2025 at 10:44 AM
I've been seeing a couple of (likely bacterial) pneumonias with very high D dimers. No identifiable major thrombus, no response to antiX anticoagulants, but responsive to corticosteroids. Mechanism? #haematology #IDSky
#IDSky intestinal decontamination for treatment and prevention of MDR infections in immunosuppressed, heavily pretreated patients. I feel like that is the last resort. What is your experience with this? What protocols do you use for CRE, ESBL and VRE? @bjegorovic.bsky.social @idvilchez.bsky.social
April 9, 2025 at 12:54 PM
#IDSky intestinal decontamination for treatment and prevention of MDR infections in immunosuppressed, heavily pretreated patients. I feel like that is the last resort. What is your experience with this? What protocols do you use for CRE, ESBL and VRE? @bjegorovic.bsky.social @idvilchez.bsky.social
Reposted by Cosmina Gingaras, MD, MPH
Back in 1975 I was taught to first check a urine Na and K. If the urine K was greater than Na - start spironalactone at 100 and recheck. Until the urine Na was greater than the urine K, increase the spironalactone. Once urine Na > K, then start 40 mg furosemide each day. I still use this model.
March 3, 2025 at 11:42 AM
Back in 1975 I was taught to first check a urine Na and K. If the urine K was greater than Na - start spironalactone at 100 and recheck. Until the urine Na was greater than the urine K, increase the spironalactone. Once urine Na > K, then start 40 mg furosemide each day. I still use this model.
Reposted by Cosmina Gingaras, MD, MPH
Please give it a go advance mode . Here the 🔗 and it’s still working in safari & google chrome 🇬🇧
pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
PubMed
PubMed® comprises more than 37 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central a...
pubmed.ncbi.nlm.nih.gov
March 2, 2025 at 11:48 AM
Please give it a go advance mode . Here the 🔗 and it’s still working in safari & google chrome 🇬🇧
pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
Reposted by Cosmina Gingaras, MD, MPH
EuropePMC relies on a feed (feeds ?) from PubMed.
As I understand, it can run on its own, but I do not know how it will get updated and synchronised with PubMed. Though it does collect some data separately.
I hope EuropePMC had prepared as much as they could for this predictable event.
As I understand, it can run on its own, but I do not know how it will get updated and synchronised with PubMed. Though it does collect some data separately.
I hope EuropePMC had prepared as much as they could for this predictable event.
March 2, 2025 at 9:55 AM
EuropePMC relies on a feed (feeds ?) from PubMed.
As I understand, it can run on its own, but I do not know how it will get updated and synchronised with PubMed. Though it does collect some data separately.
I hope EuropePMC had prepared as much as they could for this predictable event.
As I understand, it can run on its own, but I do not know how it will get updated and synchronised with PubMed. Though it does collect some data separately.
I hope EuropePMC had prepared as much as they could for this predictable event.
Reposted by Cosmina Gingaras, MD, MPH
Francis Collins, the NIH Director for 12 years, led the Human Genome Project and other NIH efforts for 32 years, resigned today. Key words from his resignation letter
www.nytimes.com/2025/03/01/u...
www.nytimes.com/2025/03/01/u...
March 1, 2025 at 6:07 PM
Francis Collins, the NIH Director for 12 years, led the Human Genome Project and other NIH efforts for 32 years, resigned today. Key words from his resignation letter
www.nytimes.com/2025/03/01/u...
www.nytimes.com/2025/03/01/u...
#IDSky Would you use rectal swab results to guide empiric tx in an acute leukemia pt whose CRP is increasing without any signs or symptoms of active infection? Procalcitonin normal/slightly elevated. Any guidance and clinical experience is appreciated. This is a recurrent and frustrating consult rq
March 1, 2025 at 8:57 AM
#IDSky Would you use rectal swab results to guide empiric tx in an acute leukemia pt whose CRP is increasing without any signs or symptoms of active infection? Procalcitonin normal/slightly elevated. Any guidance and clinical experience is appreciated. This is a recurrent and frustrating consult rq
Reposted by Cosmina Gingaras, MD, MPH
How a WHO Staff Member Turned the US Withdrawal into an Act of Solidarity
who.foundation/blogs-post/h...
who.foundation/blogs-post/h...
How a WHO Staff Member Turned the US Withdrawal into an Act of Solidarity
who.foundation
January 25, 2025 at 7:21 AM
How a WHO Staff Member Turned the US Withdrawal into an Act of Solidarity
who.foundation/blogs-post/h...
who.foundation/blogs-post/h...
What if we proved @WHO still matters?
WHO isn't perfect, but it's essential when it comes to global health.
Join me in showing that health truly is for all by donating 👉 whofoundation.donorsupport.co/page/FUNEKRB...
#1dollar1world
#HealthForAll whofoundation.donorsupport.co/page/FUNEKRB...
WHO isn't perfect, but it's essential when it comes to global health.
Join me in showing that health truly is for all by donating 👉 whofoundation.donorsupport.co/page/FUNEKRB...
#1dollar1world
#HealthForAll whofoundation.donorsupport.co/page/FUNEKRB...
1 Dollar, 1 World
I have been at WHO for over 10 years. Like my colleagues, I have worked my butt off day and night to fight Covid and work towards universal access to health care. This place frustrates me every day.
whofoundation.donorsupport.co
January 25, 2025 at 1:53 PM
What if we proved @WHO still matters?
WHO isn't perfect, but it's essential when it comes to global health.
Join me in showing that health truly is for all by donating 👉 whofoundation.donorsupport.co/page/FUNEKRB...
#1dollar1world
#HealthForAll whofoundation.donorsupport.co/page/FUNEKRB...
WHO isn't perfect, but it's essential when it comes to global health.
Join me in showing that health truly is for all by donating 👉 whofoundation.donorsupport.co/page/FUNEKRB...
#1dollar1world
#HealthForAll whofoundation.donorsupport.co/page/FUNEKRB...
Reposted by Cosmina Gingaras, MD, MPH
#MedSky🧪 #IDSky #Neurosky Besides #Neurocovid related sequelas , patients who recovered from #COVID19 also often developed cardiovascular implications . The most prevalent abnormalities observed included myocardial inflammation, arrhythmia, tachycardia, bradycardia, and atrioventricular block …
January 22, 2025 at 5:41 AM
#MedSky🧪 #IDSky #Neurosky Besides #Neurocovid related sequelas , patients who recovered from #COVID19 also often developed cardiovascular implications . The most prevalent abnormalities observed included myocardial inflammation, arrhythmia, tachycardia, bradycardia, and atrioventricular block …
#ImmunoSky #immunology Could a seemingly healthy person taking short-term dexamethasone experience a significant drop in CD4 (221/mmc), CD8 (108) and NK cells (79)? (Dexa 16 mg x 7 days, then 8 mg x 5 days, then lymphocyte subpop were measured)
January 17, 2025 at 4:06 PM
#ImmunoSky #immunology Could a seemingly healthy person taking short-term dexamethasone experience a significant drop in CD4 (221/mmc), CD8 (108) and NK cells (79)? (Dexa 16 mg x 7 days, then 8 mg x 5 days, then lymphocyte subpop were measured)
Ciprofloxacin for S.aureus osteoarticular infections (in combination with another agent). Yes or preferably use Levo or Moxi? The Sanford guide does not have MSSA or MRSA in the spectrum of Cipro. @cortes-penfield.bsky.social @tai-md.com
January 17, 2025 at 9:27 AM
Ciprofloxacin for S.aureus osteoarticular infections (in combination with another agent). Yes or preferably use Levo or Moxi? The Sanford guide does not have MSSA or MRSA in the spectrum of Cipro. @cortes-penfield.bsky.social @tai-md.com
Reposted by Cosmina Gingaras, MD, MPH
#IDSky #MedSky #PharmSky @idsainfo.bsky.social @cidjournal.bsky.social @ofidjournal.bsky.social @sidpharm.bsky.social
🚨 In this #BMJ article we update the clinical practice approach to adult fever of unknown origin #FUO!
bmj.com/cgi/content/...
🚨 In this #BMJ article we update the clinical practice approach to adult fever of unknown origin #FUO!
bmj.com/cgi/content/...
Fever of unknown origin
### What you need to know
Fever of unknown origin (also known as fever of undetermined origin or pyrexia of unknown origin) is often a debilitating clinical syndrome. Patients with this syndrome pres...
bmj.com
January 6, 2025 at 1:29 PM
#IDSky #MedSky #PharmSky @idsainfo.bsky.social @cidjournal.bsky.social @ofidjournal.bsky.social @sidpharm.bsky.social
🚨 In this #BMJ article we update the clinical practice approach to adult fever of unknown origin #FUO!
bmj.com/cgi/content/...
🚨 In this #BMJ article we update the clinical practice approach to adult fever of unknown origin #FUO!
bmj.com/cgi/content/...
#IDSky Do you think a S.epidermidis isolate resistant to Doxy (MIC>1) and sensitive to Tige (MIC 0.5) will be susceptible to Mino? Isolate is from a knee sonicated prosthesis @wwrighid.bsky.social @cortes-penfield.bsky.social @idvilchez.bsky.social
December 11, 2024 at 3:41 PM
#IDSky Do you think a S.epidermidis isolate resistant to Doxy (MIC>1) and sensitive to Tige (MIC 0.5) will be susceptible to Mino? Isolate is from a knee sonicated prosthesis @wwrighid.bsky.social @cortes-penfield.bsky.social @idvilchez.bsky.social
#IDSky 4 ring-enhancing lesions in a lenticular ganglion in an immunocompetent host. No apparent primary tumour somewhere else, albeit on native CT. 2 dogs. Recent dental work, but not major. No foreign travel. Sudden onset of focal neurological deficit, no fever, no weight loss. Etiology?
December 9, 2024 at 12:29 PM
#IDSky 4 ring-enhancing lesions in a lenticular ganglion in an immunocompetent host. No apparent primary tumour somewhere else, albeit on native CT. 2 dogs. Recent dental work, but not major. No foreign travel. Sudden onset of focal neurological deficit, no fever, no weight loss. Etiology?
#IDSky Do you use antibiotics to prophylax in case of variceal bleeding? The Sanford Guide says yes, Cochrane metaanalyses say yes, some large retrospective studies published recently say no(so people are trying to change the paradigm). I just realized I've never done it. What is your practice?
December 4, 2024 at 2:14 PM
#IDSky Do you use antibiotics to prophylax in case of variceal bleeding? The Sanford Guide says yes, Cochrane metaanalyses say yes, some large retrospective studies published recently say no(so people are trying to change the paradigm). I just realized I've never done it. What is your practice?
The genetic architecture of infectious diseases, by Dr Jean-Laurent Casanova. Fascinating historical references to a few ID titans, building up to modern genetics underlying predisposition and resistance to infections
pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov/articles/PMC...
The Genetic Theory of Infectious Diseases: A Brief History and Selected Illustrations
Until the mid-nineteenth century, life expectancy at birth averaged 20 years worldwide, owing mostly to childhood fevers. The germ theory of diseases then gradually overcame the belief that diseases w...
pmc.ncbi.nlm.nih.gov
November 16, 2024 at 3:01 PM
The genetic architecture of infectious diseases, by Dr Jean-Laurent Casanova. Fascinating historical references to a few ID titans, building up to modern genetics underlying predisposition and resistance to infections
pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov/articles/PMC...
#IDSky Would you do an LP on an HIV+ person who presents with secondary syphilis rash, positive VDRL and really high TPPA (over 1/40000)? No neurological symptoms.
November 16, 2024 at 10:38 AM
#IDSky Would you do an LP on an HIV+ person who presents with secondary syphilis rash, positive VDRL and really high TPPA (over 1/40000)? No neurological symptoms.
Reposted by Cosmina Gingaras, MD, MPH
Derangements in hemostasis can affect any organ system.
But no other organ system has more effects on hemostasis than the liver.
Liver dysfunction (LD) can result in deranged hemostasis with wide ranging implications.
A #skeetorial. #liversky #hemesky
1/n
But no other organ system has more effects on hemostasis than the liver.
Liver dysfunction (LD) can result in deranged hemostasis with wide ranging implications.
A #skeetorial. #liversky #hemesky
1/n
kermit the frog is covering his face with his hand and says your liver be like
Alt: kermit the frog is covering his face with his hand and says your liver be like
media.tenor.com
November 13, 2024 at 8:11 PM
Derangements in hemostasis can affect any organ system.
But no other organ system has more effects on hemostasis than the liver.
Liver dysfunction (LD) can result in deranged hemostasis with wide ranging implications.
A #skeetorial. #liversky #hemesky
1/n
But no other organ system has more effects on hemostasis than the liver.
Liver dysfunction (LD) can result in deranged hemostasis with wide ranging implications.
A #skeetorial. #liversky #hemesky
1/n
Reposted by Cosmina Gingaras, MD, MPH
Adult skull bone marrow is an expanding and resilient haematopoietic reservoir
www.nature.com/articles/s41...
www.nature.com/articles/s41...
Adult skull bone marrow is an expanding and resilient haematopoietic reservoir - Nature
Skull bone marrow expands during adult life, exhibits lifelong vascular growth and increases its haematopoietic potential during ageing.
www.nature.com
November 13, 2024 at 10:45 PM
Reposted by Cosmina Gingaras, MD, MPH
Hey #IDsky #MedSky 👋
Do you know your
Evans-based Medicine Rules ?
You can now learn them with @skepticaliddoc.bsky.social on 🦋! Welcome 🤗
Do you know your
Evans-based Medicine Rules ?
You can now learn them with @skepticaliddoc.bsky.social on 🦋! Welcome 🤗
November 12, 2024 at 10:28 PM
Hey #IDsky #MedSky 👋
Do you know your
Evans-based Medicine Rules ?
You can now learn them with @skepticaliddoc.bsky.social on 🦋! Welcome 🤗
Do you know your
Evans-based Medicine Rules ?
You can now learn them with @skepticaliddoc.bsky.social on 🦋! Welcome 🤗