Cody Cunningham
@cunninghamresus.bsky.social
MD, PhD. Current ID fellow. Former scientist. #IDSky.
7 years of training down, 3(?) to go
June 1, 2025 at 5:44 AM
7 years of training down, 3(?) to go
Medicine resident wins award
May 13, 2025 at 2:40 AM
Medicine resident wins award
We (Arizona) peaked at 131% above 5 year average a few weeks ago, thankfully we have continued to downtrend
February 11, 2025 at 4:20 AM
We (Arizona) peaked at 131% above 5 year average a few weeks ago, thankfully we have continued to downtrend
During aerosol transmission, virus appeared to be sourced from the upper airway (nasal turbinates) but not the trachea or lungs
January 30, 2025 at 1:57 AM
During aerosol transmission, virus appeared to be sourced from the upper airway (nasal turbinates) but not the trachea or lungs
The number of unique barcodes transferred depended on route of infection with direct contact > aerosol > fomite
January 30, 2025 at 1:57 AM
The number of unique barcodes transferred depended on route of infection with direct contact > aerosol > fomite
During productive aerosol transmission, between 13 - 42 unique viruses were transferred. Upper and lower airways had unique signatures suggesting independent seeding by different virus particles.
January 30, 2025 at 1:57 AM
During productive aerosol transmission, between 13 - 42 unique viruses were transferred. Upper and lower airways had unique signatures suggesting independent seeding by different virus particles.
The authors generated >200 unique (barcoded) viruses that were fitness neutral in vitro and in vivo
January 30, 2025 at 1:57 AM
The authors generated >200 unique (barcoded) viruses that were fitness neutral in vitro and in vivo
Legionella by both PCR and culture! The patient recovers well after a course of effective
therapy.
therapy.
January 5, 2025 at 1:17 AM
Legionella by both PCR and culture! The patient recovers well after a course of effective
therapy.
therapy.
When using the Legionella urine antigen test, it is also critical to know the relative
abundance of L. pneumophila serogroups. For my local area, serogroup 1 (detected by the urine test) makes up less than half of all confirmed Legionella cases.
pubmed.ncbi.nlm.nih.gov/30814318/
abundance of L. pneumophila serogroups. For my local area, serogroup 1 (detected by the urine test) makes up less than half of all confirmed Legionella cases.
pubmed.ncbi.nlm.nih.gov/30814318/
January 5, 2025 at 1:17 AM
When using the Legionella urine antigen test, it is also critical to know the relative
abundance of L. pneumophila serogroups. For my local area, serogroup 1 (detected by the urine test) makes up less than half of all confirmed Legionella cases.
pubmed.ncbi.nlm.nih.gov/30814318/
abundance of L. pneumophila serogroups. For my local area, serogroup 1 (detected by the urine test) makes up less than half of all confirmed Legionella cases.
pubmed.ncbi.nlm.nih.gov/30814318/
A second consideration is the duration of symptoms. One study found that the peak of urine antigen positivity (black bars) occurred 5 – 10 days into illness.
pubmed.ncbi.nlm.nih.gov/14970242/
pubmed.ncbi.nlm.nih.gov/14970242/
January 5, 2025 at 1:17 AM
A second consideration is the duration of symptoms. One study found that the peak of urine antigen positivity (black bars) occurred 5 – 10 days into illness.
pubmed.ncbi.nlm.nih.gov/14970242/
pubmed.ncbi.nlm.nih.gov/14970242/
What's important to remember when interpreting these tests is that they detect only
Legionella pneumophilia serogroup 1. When restricting to this serogroup only, the pooled sensitivity was somewhat improved at 0.86 (95% CI 0.78-0.91)
Legionella pneumophilia serogroup 1. When restricting to this serogroup only, the pooled sensitivity was somewhat improved at 0.86 (95% CI 0.78-0.91)
January 5, 2025 at 1:17 AM
What's important to remember when interpreting these tests is that they detect only
Legionella pneumophilia serogroup 1. When restricting to this serogroup only, the pooled sensitivity was somewhat improved at 0.86 (95% CI 0.78-0.91)
Legionella pneumophilia serogroup 1. When restricting to this serogroup only, the pooled sensitivity was somewhat improved at 0.86 (95% CI 0.78-0.91)
Negative. Does this test sufficiently rule out Legionella?
January 5, 2025 at 1:17 AM
Negative. Does this test sufficiently rule out Legionella?
How good (or bad) is the Legionella urine antigen test?
A middle-aged SOT patient presents to the ED with fever, cough, and diarrhea of 2 days duration. T = 39.4 C, rest of vitals stable. Labs show neutrophilic leukocytosis and mild hyponatremia. CT of the chest shows a LLL consolidation. #IDSky
A middle-aged SOT patient presents to the ED with fever, cough, and diarrhea of 2 days duration. T = 39.4 C, rest of vitals stable. Labs show neutrophilic leukocytosis and mild hyponatremia. CT of the chest shows a LLL consolidation. #IDSky
January 5, 2025 at 1:17 AM
How good (or bad) is the Legionella urine antigen test?
A middle-aged SOT patient presents to the ED with fever, cough, and diarrhea of 2 days duration. T = 39.4 C, rest of vitals stable. Labs show neutrophilic leukocytosis and mild hyponatremia. CT of the chest shows a LLL consolidation. #IDSky
A middle-aged SOT patient presents to the ED with fever, cough, and diarrhea of 2 days duration. T = 39.4 C, rest of vitals stable. Labs show neutrophilic leukocytosis and mild hyponatremia. CT of the chest shows a LLL consolidation. #IDSky
Im not sure how much baloxavir marboxil added to this case (if we can extrapolate from endemic IAV), but it certainly has the coolest MOA in ID
January 2, 2025 at 9:06 PM
Im not sure how much baloxavir marboxil added to this case (if we can extrapolate from endemic IAV), but it certainly has the coolest MOA in ID
Quick synthesis of the recent trials on ppx antibiotics to prevent VAP
November 17, 2024 at 12:05 AM
Quick synthesis of the recent trials on ppx antibiotics to prevent VAP