Ilan Schwartz
LightNews LightNews
banner
germhuntermd.bsky.social
Ilan Schwartz
@germhuntermd.bsky.social
14K followers 3.8K following 2.3K posts
ID doctor and fungal enthusiast. #IDSky community builder. #TxID, global health, MedEd. @idjclub.bsky.social

Posts don't represent my employer (obviously)
Posts Replies Media Videos
germhuntermd.bsky.social
CDC website changes suggesting that vaccines cause autism were made by a senior communications official without scientific leadership sign off when lower comms ppl balked

"CDC cannot currently be trusted as a scientific voice" @drdemetre.bsky.social

Gift Link to story by Lena Sun wapo.st/3X9Mr43
The current CDC page says that studies supporting a link between vaccines and autism “have been ignored by health authorities.” It states: “The claim ‘vaccines do not cause autism’ is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism.” CDC communications staff who were first asked to post the revisions to the website were reluctant to do so without sign-off from scientific leadership, so a higher-level communications official did so, according to an agency employee and a former federal health official with direct knowledge of the matter, who spoke on the condition of anonymity for fear of retribution. The revisions show that the “CDC cannot currently be trusted as a scientific voice,” said Demetre Daskalakis, who formerly led the agency’s center responsible for respiratory viruses and immunizations. He was one of three senior leaders who resigned in August because of what they said was the politicization of science at the agency. “The weaponization of the CDC voice by validating false claims on official websites confirms what we have been saying,” he said.
November 21, 2025 at 2:40 PM
germhuntermd.bsky.social
@cidjournal.bsky.social State-of-the-Art Review: Antibiotic Allergy—A Multidisciplinary Approach to Delabeling

academic.oup.com/cid/article/...
Graphical abstract
November 20, 2025 at 2:17 PM
germhuntermd.bsky.social
With All Good Intentions: How CDC Decisions Harmed Science and People

An account by Dr John Weiser, a clinician researcher at CDC, on CDC leadership decisions to stand up to RFK/Trump vs going along with intentions of mitigating harms

academic.oup.com/jid/advance-...
Could CDC leaders have saved HIV prevention and research work by standing up to the administration? Given that CDC Director Susan Monarez was fired for not rubber-stamping Kennedy’s positions on vaccinations, the answer is likely no. But her principled stand reverberated widely as a model for defending science and people. In contrast, decisions by some CDC leaders to go along, with the hope of saving what could be saved, have harmed scientific integrity and the people we made a commitment to serve, without achieving the desired salutary effect.
November 17, 2025 at 8:32 PM
germhuntermd.bsky.social
Gender differences in audience participation at infectious disease & microbiology conferences: a prospective observational study

@sarah-delliere.bsky.social #IDSky

Men overrepresented among audience participants during ID /micro meetings

www.clinicalmicrobiologyandinfection.org/article/S119...
Proportion of participations made by men (yellow) and women (purple) according to various session and conference characteristics, including conference type, gender of the first intervenor, moderators' gender, speakers' gender, type of participation (comment vs. question), and conference gender attendance (>50% women). Percentages represent the share of each gender among total participations within each category. Dotted lign represents the global proportion of women attendees at conference. Men over represented in questions/comments across the board
November 14, 2025 at 1:31 PM
germhuntermd.bsky.social
Performance of Diagnostic Tests for Histoplasmosis Across Clinical Syndromes and Immune Statuses

Nico Barros et al @ MiraVista

academic.oup.com/ofid/advance...
Antigen concentration by disease severity and immune status
November 13, 2025 at 10:43 PM
germhuntermd.bsky.social
Hope things get better.
White dog in front of magenta leaves
November 11, 2025 at 2:35 PM
germhuntermd.bsky.social
Ricotta came straight from the spa
White dog in a pink bathrobe and orange shower cap with ears poking through. A blue coffee mug is in front of her.
October 31, 2025 at 11:56 PM
germhuntermd.bsky.social
Happy Halloween!
A white dog in a shower cap and pink bathrobe with a mug in front of her
October 31, 2025 at 11:52 PM
germhuntermd.bsky.social
Invasive candidiasis in intensive care medicine: shaping the future of diagnosis and therapy

Martin-Loeches et al, Intensive Care Medicine

link.springer.com/article/10.1... #IDSky #TxID #MedMycoSky
Algorithm for the management of suspected IC with septic shock. *For patients with IC who do not present with septic shock, empiric antifungal therapy should be withheld. In these cases, investigations should focus on obtaining blood cultures and, where relevant, site-directed samples. Biomarkers such as serum BDG may support discontinuation when suspicion decreases but should not be used as a trigger to initiate antifungal therapy. BDG (1 → 3)-β-D-glucan; IC Invasive candidiasis; R Resistance Table 5: Key actions in management of persistent candidemia Table 6 Combination strategies for difficult deep-seated refractory infections. Combination therapy is not routine. Reserve it for the specific scenarios above (endocarditis, CNS involvement, ocular disease, renal candidiasis with obstruction, persistent candidemia or very high fungal burden despite source control, suspected/proven resistance, major PK uncertainty or delayed TDM), begin with a pre-defined 48–72 h reassessment, obtain early susceptibility testing, perform TDM for azoles and consider it for echinocandins in complex PK settings, and de-escalate to the narrowest effective monotherapy as soon as feasible. In summary, avoid routine concurrent Amphotericin B–azole combinations for Candida spp. unless there is a compelling salvage reason; prefer alternative pairs (e.g., echinocandin + azole) if combination therapy is needed. If stepping from an azole to Amphotericin B, be aware of potential carry-over effects; if stepping from Amphotericin B to an azole, keep the overlap brief
October 27, 2025 at 7:21 PM
germhuntermd.bsky.social
Nasal iodophor to reduce Candidozyma auris nasal carriage in nursing home residents

Intriguing pilot study (n=27) that treated C auris-colonized NH residents with intranasal iodophor bid x 5d. Intervention assoc w decreased C auris burden, some were decolonized

academic.oup.com/ofid/advance...
Figure Panel A shows the iodophor treatment timeline and nasal sampling timepoints. Panel B displays a dot plot of C. auris nasal bioburden at each timepoint and Panel C displays a dot plot of changes in C. auris bioburden for culture-based sampling which occurred on Days 1, 5, and 9. Each dot represents a participant. A box is drawn around the median bioburden or change in bioburden. Nasal bioburden was assessed as follows: 0 = no growth; 1 = few (1-2 isolated colonies); 2 = 1+ (growth in first quadrant only); 3 = 2+ (growth into second quadrant); 4 = 3+ (growth into third quadrant); and 5 = 4+ (growth in all quadrants, high burden).
October 27, 2025 at 7:05 PM
germhuntermd.bsky.social
This is Ricotta, our 6 month old rescue, enjoying a beautiful autumn day in NC.
A large white dog sits on a gravel trail in front of trees
October 24, 2025 at 1:45 AM
germhuntermd.bsky.social
#NoKings 2.0, Durham NC
A woman in an inflatable cow suit in front of colorfully dressed people marching holds a sign that says “EAT MOR FASCISTS”
October 18, 2025 at 10:17 PM
germhuntermd.bsky.social
Invasive Fungal Infections after CD19 CAR T-cell Therapy for B-Cell Lymphoma: a LYSA study from the DESCAR-T Registry

IFI occurred in 3% of patients receiving CD19 CAR-T for refractory/relapsed B cell lymphoma

www.clinicalmicrobiologyandinfection.org/article/S119... #OpenAccess #MedMycoSky
Visual abstract, featuring pie graph showing IFIs affecting 3.1% of the 1012 patients in the DESCART registry who had refractory/relapsed B cell lymphoma treated with CD19 CAR T cell therapy. The IFI related mortality among these 3.1% was 22%. Mostly candidemia and pulmonary aspergillosis, followed by Aspergillus/mucormycosis co-infection, PCP, and other.
October 16, 2025 at 1:33 PM
germhuntermd.bsky.social
I'm so sorry, Paul. This is a beautiful tribute. I truly hope this is a false alarm - or at the most, something manageable. I'm thinking of you and your family.

Here's a photo of my pup, Ricotta, trying on her halloween costume (if it still fits in a month) to make you smile
A white dog in a pink robe and a orange hairnet lays in front of a coffee mug
September 26, 2025 at 7:01 PM
germhuntermd.bsky.social
Very inspiring to hear @petebuttigieg.bsky.social tonight at Duke’s Sanford School of Public Policy. I feel wiser though not any less concerned about the state of politics
Promotional image for Pete Buttigieg lecture Pete Buttigieg at a lectern A man and a woman sitting on stage in discussion
September 26, 2025 at 12:23 AM
germhuntermd.bsky.social
My kid’s recreational youth soccer program is promoting DNA testing of children to optimize performance through “personalized health, nutrition, and performance insights“.

Cool, cool. I see nothing concerning about this whatsoever 🫠
A promotional email for a DNA testing company offering “personalized health, nutrition, and performance insights” brought to you by North Carolina FC Obsequious quote by director of soccer at NCFC above promotional text about supposed benefits of dna testing your child
September 25, 2025 at 1:40 PM
germhuntermd.bsky.social
Lobomycosis

-caused by the noncultivable fungus, Paracoccidioides lobogeorgii (formerly Lacazia loboi)
-Found in Amazon basin
-causes keloid-like lesions
-Dx: histopath (round yeasts like pearls)

Here, a child developed it after a tick bite 1 yr earlier

wwwnc.cdc.gov/eid/article/... #MedMycoSky
Nodule and histopathology in a case of Jorge Lobo’s disease in child with tick exposure, Brazil. A) Single granulomatous lesion on the right ear, which was surgically excised and histologically examined in 2018. B, C) Hematoxylin and eosin stain of nodule showing cells of the mononuclear phagocyte system, including monocytes, macrophages, epithelioid cells, and multinucleated giant cells, revealing granulomatous inflammation with spherical, double-walled yeast cells in branching chains (B) and prominent histiocytes and multinucleated giant cells (C), which are predominantly dense with areas of mild neovascularization, stromal hyalinization, and a slight infiltrate of lymphocytes and neutrophils. D) Grocott–Gomori methenamine silver stain of recurrent nodule from 2024 in which yeast-like fungal structures are diffusely distributed throughout the stroma and in the cytoplasm of phagocytic cells.
September 25, 2025 at 1:12 PM
germhuntermd.bsky.social
Half of Americans, eyeing France and Brazil
Man in suit with furrowed brow, praying. Text says "Jesus, I see what you've done for other people, and I want that for me"
September 25, 2025 at 12:56 PM
germhuntermd.bsky.social
Donor-derived infections with Rickettsia typhi (agent of murine typhus) in 2 kidney transplant recipients (1 fatal)

Teaching points
- 🐭 typhus transmitted by fleas (& transplant)
- Cases 📈 in Texas
- Death of diffuse 🫁 , 🧠 edema w/o dx=👎 tx
- cfDNA MGS (Karius) can dx

wwwnc.cdc.gov/eid/article/...
Figure 1. Timeline describing the transmission of Rickettsia typhi from an organ donor to 2 kidney transplant recipients, Texas, 2024. Day 1 of donor hospitalization is represented as −5, the day of death as −1, and the day of transplantation as 0, after which posttransplant days are listed, ending with the discharge of recipient 1 from the hospital on posttransplant day 20. Figure 2. Chest radiographs from an organ donor with murine typhus, from a study describing the transmission of Rickettsia typhi from an organ donor to 2 kidney transplant recipients, Texas, 2024. A) Chest radiograph obtained at hospital admission, 5 days after symptom onset, with no specific abnormalities noted. B) Chest radiograph obtained on hospital day 3, revealing extensive alveolar opacities predominantly in the middle and lower lung fields. Figure 3. Histopathological and immunohistochemical features of formalin-fixed, paraffin-embedded biopsy specimens collected from the right and left kidney allografts procured from a donor who died of murine typhus, from a study describing the transmission of Rickettsia typhi from an organ donor to 2 kidney transplant recipients, Texas, 2024. A) When stained with hematoxylin and eosin, both allografts showed multifocal, interstitial, and predominantly mononuclear peritubular infiltrates, associated with focal endarteritis (thin arrows), features of acute tubular injury, including epithelial attenuation with loss of apical cytoplasm (thin arrowheads), and pigmented casts (large arrow). B) Glomeruli displayed moderate mesangial hypercellularity and tuft adhesions to the Bowman’s capsules (arrows) and intracapillary and mesangial phagocytic foam-cells (arrowheads), That finding is compatible with focal segmental glomerulosclerosis. C) Short chains comprising small, rod-shaped bacteria were revealed in glomerular capillaries by the Warthin–Starry silver impregnation staining technique. Immunoreactive R. typhi antigens were noted within intracellular bacteria in endothelial cells of renal arterioles. D–F) An immunohistochemical stain for typhus-group rickettsiae revealed intact bacteria within endothelial cells of inflamed small vessels and vascular spaces of mesangial capillaries (arrows) and phagocytized bacterial antigens in the cytoplasm of glomerular foam-cells (arrows). Original magnifications ×400 (A, B and E) and ×1,000 (C, D, and F). Figure 4. Annual case counts of murine typhus in Texas, USA, during 1920–2024. Cases increased from close to zero to ~ 500 in 1930s before spiking to ~2000 in 1940s, then back down close to zero by 1950s, and remained near zero until started creeping back up in 2000s, steadily increasing, now with ~800 cases/year
September 25, 2025 at 12:50 PM
germhuntermd.bsky.social
College of American Pathologist-accredited labs must maintain *consistent* nomenclature across testing platforms & *consider* contemporary nomenclature.

Integration into healthcare settings requires names be both scientifically accurate & clinically meaningful.

academic.oup.com/cid/article-...
Navigating Nomenclature in Patient Care: Taxonomy Considerations From the College of American Pathologists’ Microbiology Committee Table 1. Impact of Nomenclature on Clinical Interpretation of Disease, Therapy Considerations, and Laboratory Considerations Table 1. Impact of Nomenclature on Clinical Interpretation of Disease, Therapy Considerations, and Laboratory Considerations (cont'd) Table 1. Impact of Nomenclature on Clinical Interpretation of Disease, Therapy Considerations, and Laboratory Considerations (cont'd)
September 23, 2025 at 2:15 PM
germhuntermd.bsky.social
😔/😡 that I had to abandon #TIMM2025 in Bilbao, Spain due to chaos of Trump’s H1b proclamation. Was able to give 1 talk & grateful to @neleshg.bsky.social for stepping in for another. Glad for the fleeting chance to see some friends, albeit much too briefly. Lots of chaos/stress for nothing!
Man in blue jacket in front of a lecture Man (me!) and woman (Minette Rosario) Me and Neil Clancy Memo from Duke University calling H1b holders back to US asap due to Trump proclamation
September 21, 2025 at 12:30 PM
germhuntermd.bsky.social
As close as I got to the Guggenheim in Bilbao before scrambling to find a flight back to US before I turned into a pumpkin at midnight
September 21, 2025 at 11:15 AM
germhuntermd.bsky.social
Empirical antifungal treatment of critically ill patients with influenza-associated acute respiratory distress syndrome: A propensity score weighted observational study

Stefan Hatzl et al in @cidjournal.bsky.social

academic.oup.com/cid/advance-...
Visual abstract for study "Empirical antifungal treatment of critically ill patients with influenza associated acute respiratory distress syndrome: a propensity score weighted observational study"
September 16, 2025 at 12:16 PM
germhuntermd.bsky.social
Moraine Lake in Banff for your SkyLine
Moraine Lake. Brilliant turquoise waters in front of mountains, surrounded by pine trees
September 12, 2025 at 11:40 AM
germhuntermd.bsky.social
Updating the epidemiology of blastomycosis and histoplasmosis in the United States, using national electronic health record data, 2013–2023

Nice study by Jennifer Head and colleagues showing modest increase in incidences of histoplasmosis & blastomycosis in the US

academic.oup.com/jid/advance-...
Graph showing annual adjusted incidence rate ratios of blastomycosis and histoplasmosis for 2013 to 2023 compared to the incidence rate in 2013 for each disease.
September 10, 2025 at 7:55 PM