Infectious Diseases Fellowship at Indiana University
@iuidfellowship.bsky.social
#idboardreview #idfellows #idfellowship #IDsky #HIVsky #idmeded
#idboardreview Person living w/HIV CD4 60, chronic sinusitis presents w/1wk of nasal discharge, fever, facial pain, uses squirt bottle tap water to rinse sinuses. +Perforation of septum, taken for sinus surgery: necrotic debri & cysts H&E stain #idmeded #meded #idsky
December 2, 2025 at 11:15 PM
#idboardreview Person living w/HIV CD4 60, chronic sinusitis presents w/1wk of nasal discharge, fever, facial pain, uses squirt bottle tap water to rinse sinuses. +Perforation of septum, taken for sinus surgery: necrotic debri & cysts H&E stain #idmeded #meded #idsky
#idboardreview 30 M living with HIV, unstable housing, not on ART CD4 9, VL 600k presents w/ fever, progressive dyspnea, non productive cough, hypoxia. Histology frothy eosinophilic honeycomb material filling alveolar space. Dx? #medEd #idmedEd #IDsky
December 2, 2025 at 2:13 AM
#idboardreview 30 M living with HIV, unstable housing, not on ART CD4 9, VL 600k presents w/ fever, progressive dyspnea, non productive cough, hypoxia. Histology frothy eosinophilic honeycomb material filling alveolar space. Dx? #medEd #idmedEd #IDsky
#idboardreview Pt living in Texas x15yrs originally from Mexico had thyroid ca s/p neck dissection: histopath 275-µm encapsulated cyst w/larva 27 µm w/bacillary bands. He ate raw pork 10yr ago in Texas. Wbc 6k, absolute eosinophil count 360 & CK 150 #IDsky #idmeded #meded
November 26, 2025 at 1:20 AM
#idboardreview Pt living in Texas x15yrs originally from Mexico had thyroid ca s/p neck dissection: histopath 275-µm encapsulated cyst w/larva 27 µm w/bacillary bands. He ate raw pork 10yr ago in Texas. Wbc 6k, absolute eosinophil count 360 & CK 150 #IDsky #idmeded #meded
#idboardreview A sheep farmer from rural Pakistan w/ complex liver cyst going under workup. He has an episode of dyspnea, tachy, hypotensive, swollen lips/tongue, wheezing, diffuse hives. Afebrile, normal LFTs. #idsky #idmeded #meded
November 25, 2025 at 1:26 AM
#idboardreview A sheep farmer from rural Pakistan w/ complex liver cyst going under workup. He has an episode of dyspnea, tachy, hypotensive, swollen lips/tongue, wheezing, diffuse hives. Afebrile, normal LFTs. #idsky #idmeded #meded
#idboardreview Pt w/ R knee & b/l ankle joint pain x1wk: dx aseptic arthritis. 2 wks later, extensive erythema nodosum on legs & non-tender supraclavicular lymph node: biopsy caseating granuloma. Afb+ #IDsky #idmeded #meded
November 21, 2025 at 12:13 AM
#idboardreview Pt w/ R knee & b/l ankle joint pain x1wk: dx aseptic arthritis. 2 wks later, extensive erythema nodosum on legs & non-tender supraclavicular lymph node: biopsy caseating granuloma. Afb+ #IDsky #idmeded #meded
#idboardreview A Pt w/travel to Mexico a few months prior (drank tap water, ate raw vegetables) noticed a small worm-like object on inner surface of her lower lip. She removed the object with a needle. Dx? #medEd #idmeded #IDsky #parasitology
November 19, 2025 at 11:17 PM
#idboardreview A Pt w/travel to Mexico a few months prior (drank tap water, ate raw vegetables) noticed a small worm-like object on inner surface of her lower lip. She removed the object with a needle. Dx? #medEd #idmeded #IDsky #parasitology
November 19, 2025 at 12:59 AM
#idboardreview 45 farmer from Uganda 🇺🇬 presents acutely w/fever, fatigue, headache, black tarry stools, nose bleed, blurry vision. Recent contact w/ sick 🐄 during birth. ⬆️Cr, LFTs, CK, LDH, ⬇️Hb, wbc. Retinitis w/ hemorrhage. Dx? #medEd #idmedEd #idsky #virologySky
November 19, 2025 at 12:56 AM
#idboardreview 45 farmer from Uganda 🇺🇬 presents acutely w/fever, fatigue, headache, black tarry stools, nose bleed, blurry vision. Recent contact w/ sick 🐄 during birth. ⬆️Cr, LFTs, CK, LDH, ⬇️Hb, wbc. Retinitis w/ hemorrhage. Dx? #medEd #idmedEd #idsky #virologySky
Ref IDBR for the slide
November 18, 2025 at 12:46 AM
Ref IDBR for the slide
November 18, 2025 at 12:43 AM
#idboardreview forest worker from New Mexico fever 104F, fatigue, fingertips cyanosis, painful inguinal adenopathy. Peripheral smear shown. Develops dyspnea, CXR pneumonia. What isolation precautions? #medEd #IDMedEd #idsky #IPky
November 18, 2025 at 12:42 AM
#idboardreview forest worker from New Mexico fever 104F, fatigue, fingertips cyanosis, painful inguinal adenopathy. Peripheral smear shown. Develops dyspnea, CXR pneumonia. What isolation precautions? #medEd #IDMedEd #idsky #IPky
#idboardreview 50 M s/p liver transplant cmv D+/R- 28d ago now w/ dyspnea, fever, sore throat, myalgias, cough, yellow sputum x2d➡️hypoxia, ALT3k AST1k TBili2.3. Liver Biopsy: intranuclear eosinophilic inclusions. Dx? #medEd #idmedEd #IDsky #idfellows #idfellowship
November 14, 2025 at 12:39 AM
#idboardreview 50 M s/p liver transplant cmv D+/R- 28d ago now w/ dyspnea, fever, sore throat, myalgias, cough, yellow sputum x2d➡️hypoxia, ALT3k AST1k TBili2.3. Liver Biopsy: intranuclear eosinophilic inclusions. Dx? #medEd #idmedEd #IDsky #idfellows #idfellowship
#IDboardreview 25 yo M w/ recent tattoo (2 wks ago) now presents with this non-pruritic non-tender rash? Diagnosis? #medEd #IDMedEd #idsky
November 12, 2025 at 11:27 PM
#IDboardreview 25 yo M w/ recent tattoo (2 wks ago) now presents with this non-pruritic non-tender rash? Diagnosis? #medEd #IDMedEd #idsky
#idboardreview A renal transplant Pt initial immunosuppressants prednisone, MMF, tacrolimus x several yrs then ⬆️Cr changed to sirolimus, reduced tacrolimus. 1 yr later, Pt presents w/dyspnea, interstitial infiltrates, BAL micro neg #IDsky #idmeded #MedEd
November 11, 2025 at 10:45 PM
#idboardreview A renal transplant Pt initial immunosuppressants prednisone, MMF, tacrolimus x several yrs then ⬆️Cr changed to sirolimus, reduced tacrolimus. 1 yr later, Pt presents w/dyspnea, interstitial infiltrates, BAL micro neg #IDsky #idmeded #MedEd
#idboardreview 16 M history of nail biting presents w/ swollen/tender left fourth finger s/p I&D +purulence. Anaerobic gram neg bacillus. Diagnosis? #medEd #idmedEd #idsky
November 11, 2025 at 1:23 AM
#idboardreview 16 M history of nail biting presents w/ swollen/tender left fourth finger s/p I&D +purulence. Anaerobic gram neg bacillus. Diagnosis? #medEd #idmedEd #idsky
#idboardreview A physician working for Doctors Without Borders in Afghanistan reported being hit in the eye 👁 by a fly & had instant burning discomfort in 👁& sensation of a moving foreign body. Few others reported similar sx. Dx? #medEd #idmedEd #IDsky
November 7, 2025 at 1:19 AM
#idboardreview A physician working for Doctors Without Borders in Afghanistan reported being hit in the eye 👁 by a fly & had instant burning discomfort in 👁& sensation of a moving foreign body. Few others reported similar sx. Dx? #medEd #idmedEd #IDsky
#idboardreview 40 M presents w/ N, V, severe epigastric pain. SH:smoker, drinks 18 beers/day, monogamous with wife, bit by his dog 3d ago, dental cleaning 7d ago, recently installed air conditioning system. Bandemia, AKI. Diffuse blanching rash & mottling. Dx? #medEd #idmeded #idsky
November 6, 2025 at 12:13 AM
#idboardreview 40 M presents w/ N, V, severe epigastric pain. SH:smoker, drinks 18 beers/day, monogamous with wife, bit by his dog 3d ago, dental cleaning 7d ago, recently installed air conditioning system. Bandemia, AKI. Diffuse blanching rash & mottling. Dx? #medEd #idmeded #idsky
November 4, 2025 at 10:39 PM
#idboardreview 50 F recent dental infection presents 4d of fever, R headache, L weakness. MRI ring enhancing lesion & aspirate w/ GPC ‘balls of yarn’ 🧶 diagnosis? #medEd #idmedEd #IDsky
November 4, 2025 at 10:35 PM
#idboardreview 50 F recent dental infection presents 4d of fever, R headache, L weakness. MRI ring enhancing lesion & aspirate w/ GPC ‘balls of yarn’ 🧶 diagnosis? #medEd #idmedEd #IDsky
patient's teeth after extensive dental cleaning
November 3, 2025 at 11:14 PM
patient's teeth after extensive dental cleaning
#IDBoardReview 20 F MTB empiric RIPE. NAAT: RIF resistance: RIF dc, moxi and amikacin added. 3 wk later: molecular testing for +resistance RIF, ETA, INH: INH & ETA dc & linezolid & cycloserine added. 11 wks post initial presentation: discoloration of teeth. cause? #idsky #idmeded #meded
November 3, 2025 at 11:12 PM
#IDBoardReview 20 F MTB empiric RIPE. NAAT: RIF resistance: RIF dc, moxi and amikacin added. 3 wk later: molecular testing for +resistance RIF, ETA, INH: INH & ETA dc & linezolid & cycloserine added. 11 wks post initial presentation: discoloration of teeth. cause? #idsky #idmeded #meded
#IdBoardReview 25 F recent Caribbean vacation, walked barefoot on sand and now with creepy rash. diagnosis? #idmedEd #MedEd #idsky
October 31, 2025 at 1:23 AM
#IdBoardReview 25 F recent Caribbean vacation, walked barefoot on sand and now with creepy rash. diagnosis? #idmedEd #MedEd #idsky
#idboardreview 30 MSM PLWH Cd4 800 VL<20 on ART presents w/ 2wk abd cramps & watery diarrhea. gram-neg, non-lactose fermenter (susceptibilites shown); Blood agar: translucent, flat bacterial colony that appeared to spread across plate. Dx? #medEd #idmedEd #IDsky
October 30, 2025 at 12:05 AM
#idboardreview 30 MSM PLWH Cd4 800 VL<20 on ART presents w/ 2wk abd cramps & watery diarrhea. gram-neg, non-lactose fermenter (susceptibilites shown); Blood agar: translucent, flat bacterial colony that appeared to spread across plate. Dx? #medEd #idmedEd #IDsky
#idboardreview 40 M living w/HIV CD4 40 VL 100k w/ low back pain & ascending weakness of b/l LE x 1 mo, loss of deep tendon reflexes & now bowel/bladder incontinence/flaccid paralysis. Inclusions in Schwann cells in cauda equina. Dx? #medEd #idmedEd #IDsky
October 28, 2025 at 9:47 PM
#idboardreview 40 M living w/HIV CD4 40 VL 100k w/ low back pain & ascending weakness of b/l LE x 1 mo, loss of deep tendon reflexes & now bowel/bladder incontinence/flaccid paralysis. Inclusions in Schwann cells in cauda equina. Dx? #medEd #idmedEd #IDsky
#idboardreview Pt w/ hypogammaglobulinemia presents w/ fever, pain, swelling, warmth of knee. Synovial fluid 60k wbc 55% neutrophils, culture negative. Progressive swelling/pain on vancomycin & cefepime. Dx made by 16SRNA. Diagnosis? pic for ref/A7 agar #medEd #idmedEd #IDsky #idfellows
October 28, 2025 at 12:03 AM
#idboardreview Pt w/ hypogammaglobulinemia presents w/ fever, pain, swelling, warmth of knee. Synovial fluid 60k wbc 55% neutrophils, culture negative. Progressive swelling/pain on vancomycin & cefepime. Dx made by 16SRNA. Diagnosis? pic for ref/A7 agar #medEd #idmedEd #IDsky #idfellows