Alice Han
@dralicehan.bsky.social
ID physician at MIDC - transforming private practice ID with an academic and lifestyle focus. Opinions my own👩🏻⚕️🧫🩺 #Medsky #IDsky
I would start empiric cefepime for neutropenic fever pending workup and then try to figure out if the neutropenia is drug related or a newly diagnosed heme malignancy
October 31, 2025 at 11:53 AM
I would start empiric cefepime for neutropenic fever pending workup and then try to figure out if the neutropenia is drug related or a newly diagnosed heme malignancy
I appreciate that the bluejay puts wing hygiene first
October 24, 2025 at 1:26 PM
I appreciate that the bluejay puts wing hygiene first
I am still catching up but I really enjoyed this one. Very helpful to go through cases and the decision making involved. The cmv case provided more clarity for me as those cases are very challenging
October 24, 2025 at 12:57 AM
I am still catching up but I really enjoyed this one. Very helpful to go through cases and the decision making involved. The cmv case provided more clarity for me as those cases are very challenging
I don’t think I will be able to do it unless micro makes me learn all these new names
October 24, 2025 at 12:51 AM
I don’t think I will be able to do it unless micro makes me learn all these new names
Agree. It was a far different year, but it was great to see everyone who came. Honestly, I felt optimistic about the future after talking to fellows excited about ID & their upcoming careers. I hope next year will be better!
October 24, 2025 at 12:50 AM
Agree. It was a far different year, but it was great to see everyone who came. Honestly, I felt optimistic about the future after talking to fellows excited about ID & their upcoming careers. I hope next year will be better!
It’s crazy. Sometimes the interpretation of the reference is completely incorrect too. It is really scary
October 23, 2025 at 5:57 PM
It’s crazy. Sometimes the interpretation of the reference is completely incorrect too. It is really scary
Where are the references? They usually reference something and it’s shocking what references get pulled
October 23, 2025 at 5:50 PM
Where are the references? They usually reference something and it’s shocking what references get pulled
Omg. That’s terrible. I am so sorry. I didn’t realize the system was like that in Canada
October 23, 2025 at 1:08 PM
Omg. That’s terrible. I am so sorry. I didn’t realize the system was like that in Canada
Reposted by Alice Han
Really proud to be a part of this community and always inspired by my colleagues around the country who continue to show up even when it's hard.
October 22, 2025 at 11:59 PM
Really proud to be a part of this community and always inspired by my colleagues around the country who continue to show up even when it's hard.
#IDsky
Do granulocyte infusions help with IFI?
Dr Girmenia says that they do not do it.
Dr Papanicalou says they only do it as a bridge to anticipated neutrophil recovery if neutrophil recovery is actually anticipated to occur. But it is logistically difficult
Do granulocyte infusions help with IFI?
Dr Girmenia says that they do not do it.
Dr Papanicalou says they only do it as a bridge to anticipated neutrophil recovery if neutrophil recovery is actually anticipated to occur. But it is logistically difficult
October 22, 2025 at 11:34 PM
#IDsky
Do granulocyte infusions help with IFI?
Dr Girmenia says that they do not do it.
Dr Papanicalou says they only do it as a bridge to anticipated neutrophil recovery if neutrophil recovery is actually anticipated to occur. But it is logistically difficult
Do granulocyte infusions help with IFI?
Dr Girmenia says that they do not do it.
Dr Papanicalou says they only do it as a bridge to anticipated neutrophil recovery if neutrophil recovery is actually anticipated to occur. But it is logistically difficult
#IDsky
Someone asked what do you do when you find an incidental finding concerning for IFI on pretransplant CT?
Dr Girmenia rec bronch & possibly Lamb
Also review old CT scans
If diagnostic bronch nonrevealing, consider repeat ct to make sure it is not advancing. Dr Papanicalou uses isavu.
Someone asked what do you do when you find an incidental finding concerning for IFI on pretransplant CT?
Dr Girmenia rec bronch & possibly Lamb
Also review old CT scans
If diagnostic bronch nonrevealing, consider repeat ct to make sure it is not advancing. Dr Papanicalou uses isavu.
October 22, 2025 at 11:34 PM
#IDsky
Someone asked what do you do when you find an incidental finding concerning for IFI on pretransplant CT?
Dr Girmenia rec bronch & possibly Lamb
Also review old CT scans
If diagnostic bronch nonrevealing, consider repeat ct to make sure it is not advancing. Dr Papanicalou uses isavu.
Someone asked what do you do when you find an incidental finding concerning for IFI on pretransplant CT?
Dr Girmenia rec bronch & possibly Lamb
Also review old CT scans
If diagnostic bronch nonrevealing, consider repeat ct to make sure it is not advancing. Dr Papanicalou uses isavu.
#IDsky
Someone asked what do you do with IFI if the lobe is able to be resected? Do you recommend?
Recommended if possible with mucor, not typically with IA
Hard to know what to do with other rare IFI
Someone asked what do you do with IFI if the lobe is able to be resected? Do you recommend?
Recommended if possible with mucor, not typically with IA
Hard to know what to do with other rare IFI
October 22, 2025 at 11:34 PM
#IDsky
Someone asked what do you do with IFI if the lobe is able to be resected? Do you recommend?
Recommended if possible with mucor, not typically with IA
Hard to know what to do with other rare IFI
Someone asked what do you do with IFI if the lobe is able to be resected? Do you recommend?
Recommended if possible with mucor, not typically with IA
Hard to know what to do with other rare IFI
October 22, 2025 at 10:56 PM
Posa vs itra/flu during induction showed clear benefit in development of IFI
October 22, 2025 at 10:55 PM
Posa vs itra/flu during induction showed clear benefit in development of IFI
So what do we do?
Continue antifungal drug for at least 4 weeks and until PMN recovery and objective s/sx of improvement and then switch to secondary antifungal ppx with anti- mold activity
Consider reduced intensity conditioning regimen
Continue antifungal drug for at least 4 weeks and until PMN recovery and objective s/sx of improvement and then switch to secondary antifungal ppx with anti- mold activity
Consider reduced intensity conditioning regimen
October 22, 2025 at 10:54 PM
So what do we do?
Continue antifungal drug for at least 4 weeks and until PMN recovery and objective s/sx of improvement and then switch to secondary antifungal ppx with anti- mold activity
Consider reduced intensity conditioning regimen
Continue antifungal drug for at least 4 weeks and until PMN recovery and objective s/sx of improvement and then switch to secondary antifungal ppx with anti- mold activity
Consider reduced intensity conditioning regimen
Despite this, keep in mind that more than 2/3 remain alive with pre SCT IA, and the allo SCT is potentially curative.
We have to weigh the risk of relapsed AML, losing out transplant window, having underlying disease undermine our efforts to control the infection.
We have to weigh the risk of relapsed AML, losing out transplant window, having underlying disease undermine our efforts to control the infection.
October 22, 2025 at 10:54 PM
Despite this, keep in mind that more than 2/3 remain alive with pre SCT IA, and the allo SCT is potentially curative.
We have to weigh the risk of relapsed AML, losing out transplant window, having underlying disease undermine our efforts to control the infection.
We have to weigh the risk of relapsed AML, losing out transplant window, having underlying disease undermine our efforts to control the infection.
Major prognostic determinants of IFD relapse post HSCT
How to make a risk calculation in your 🧠
How to make a risk calculation in your 🧠
October 22, 2025 at 10:54 PM
Major prognostic determinants of IFD relapse post HSCT
How to make a risk calculation in your 🧠
How to make a risk calculation in your 🧠
Risk factors associated with invasive fungal infection include duration of neutropenia, time from IFI and HSCT, type of antifungal used, and presence of GVHD. And recurrent IFI was associated with higher mortality
October 22, 2025 at 10:42 PM
Risk factors associated with invasive fungal infection include duration of neutropenia, time from IFI and HSCT, type of antifungal used, and presence of GVHD. And recurrent IFI was associated with higher mortality
