Podcasts about infectious diseases society

Drs. Sumanth Cherukumilli, Milagritos Tapia, and Adama Mamby Keita join Febrile to describe an approach to a gray membranous pharyngitis!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Dr. Adam Ratner joins to discuss a case of facial swelling which leads to a conversation about vaccine hesitancy and current outbreaks.Check out Booster Shots: The Urgent Lessons of Measles and the Uncertain Future of Children's Health !Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Diarrhea is one of the more common concerns in emergency medicine worldwide and in the United States, yet we often do not spend enough time understanding the breadth of causes and considerations for this syndrome. Do you know which patients benefit from Zinc? Would you like to review HUS? Can you mixup Oral Rehydration Solution if you needed to? We cover all of this and more in this “code brown” of a chapter! So come, get dirty with Alex and Venk in this truly crappy chapter of Always on EM!   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Shane AL, Mody RK, Crump JA, Tarr PI, Steiner TS, Kotloff K, Langley JM, Wanke C, Warren CA, Cheng AC, Cantey J, Pickering LK. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80. doi: 10.1093/cid/cix669. PMID: 29053792; PMCID: PMC5850553. Gore JI, Surawicz C. Severe acute diarrhea. Gastroenterol Clin North Am. 2003 Dec;32(4):1249-67. doi: 10.1016/s0889-8553(03)00100-6. PMID: 14696306; PMCID: PMC7127018. Freedman SB, van de Kar NCAJ, Tarr PI. Shiga Toxin–Producing Escherichia coli and the Hemolytic–Uremic Syndrome. The New England Journal of Medicine. 2023;389(15):1402-1414. doi:10.1056/NEJMra2108739. Logan C, Beadsworth MB, Beeching NJ. HIV and diarrhoea: what is new? Curr Opin Infect Dis. 2016 Oct;29(5):486-94. doi: 10.1097/QCO.0000000000000305. PMID: 27472290. Chassany O, Michaux A, Bergmann JF. Drug-induced diarrhoea. Drug Saf. 2000 Jan;22(1):53-72. doi: 10.2165/00002018-200022010-00005. PMID: 10647976. Schiller LR. Secretory diarrhea. Curr Gastroenterol Rep. 1999 Oct;1(5):389-97. doi: 10.1007/s11894-999-0020-8. PMID: 10980977. Gong Z, Wang Y. Immune Checkpoint Inhibitor-Mediated Diarrhea and Colitis: A Clinical Review. JCO Oncol Pract. 2020 Aug;16(8):453-461. doi: 10.1200/OP.20.00002. Epub 2020 Jun 25. PMID: 32584703. Do C, Evans GJ, DeAguero J, Escobar GP, Lin HC, Wagner B. Dysnatremia in Gastrointestinal Disorders. Front Med (Lausanne). 2022 May 13;9:892265. doi: 10.3389/fmed.2022.892265. PMID: 35646996; PMCID: PMC9136014. Expert Panel on Gastrointestinal Imaging; Chang KJ, Marin D, Kim DH, Fowler KJ, Camacho MA, Cash BD, Garcia EM, Hatten BW, Kambadakone AR, Levy AD, Liu PS, Moreno C, Peterson CM, Pietryga JA, Siegel A, Weinstein S, Carucci LR. ACR Appropriateness Criteria® Suspected Small-Bowel Obstruction. J Am Coll Radiol. 2020 May;17(5S):S305-S314. doi: 10.1016/j.jacr.2020.01.025. PMID: 32370974. Rami Reddy SR, Cappell MS. A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction. Curr Gastroenterol Rep. 2017 Jun;19(6):28. doi: 10.1007/s11894-017-0566-9. PMID: 28439845. Modahl L, Digumarthy SR, Rhea JT, Conn AK, Saini S, Lee SI. Emergency department abdominal computed tomography for nontraumatic abdominal pain: optimizing utilization. J Am Coll Radiol. 2006 Nov;3(11):860-6. doi: 10.1016/j.jacr.2006.05.011. PMID: 17412185. Scheirey CD, Fowler KJ, Therrien JA, et al. ACR Appropriateness Criteria Acute Nonlocalized Abdominal Pain. Journal of the American College of Radiology : JACR. 2018;15(11S):S217-S231. doi:10.1016/j.jacr.2018.09.010. Atia AN, Buchman AL. Oral rehydration solutions in non-cholera diarrhea: a review. Am J Gastroenterol. 2009 Oct;104(10):2596-604; quiz 2605. doi: 10.1038/ajg.2009.329. Epub 2009 Jun 23. PMID: 19550407. Musekiwa A, Volmink J. Oral rehydration salt solution for treating cholera: ≤ 270 mOsm/L solutions vs ≥ 310 mOsm/L solutions. Cochrane Database Syst Rev. 2011 Dec 7;2011(12):CD003754. doi: 10.1002/14651858.CD003754.pub3. PMID: 22161381; PMCID: PMC6532622. Centers for Disease Control and Prevention (CDC). Scombroid fish poisoning associated with tuna steaks--Louisiana and Tennessee, 2006. MMWR Morb Mortal Wkly Rep. 2007 Aug 17;56(32):817-9. PMID: 17703171. Résière D, Florentin J, Mehdaoui H, Mahi Z, Gueye P, Hommel D, Pujo J, NKontcho F, Portecop P, Nevière R, Kallel H, Mégarbane B. Clinical Characteristics of Ciguatera Poisoning in Martinique, French West Indies-A Case Series. Toxins (Basel). 2022 Aug 3;14(8):535. doi: 10.3390/toxins14080535. PMID: 36006197; PMCID: PMC9415704. Centers for Disease Control and Prevention (CDC). Ciguatera fish poisoning--Texas, 1998, and South Carolina, 2004. MMWR Morb Mortal Wkly Rep. 2006 Sep 1;55(34):935-7. PMID: 16943762. Thyroid Inferno EM Blog: https://emblog.mayo.edu/2014/11/01/thyroid-inferno/  Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016 Dec 20;12(12):CD005436. doi: 10.1002/14651858.CD005436.pub5. PMID: 27996088; PMCID: PMC5450879. Dhingra U, Kisenge R, Sudfeld CR, Dhingra P, Somji S, Dutta A, Bakari M, Deb S, Devi P, Liu E, Chauhan A, Kumar J, Semwal OP, Aboud S, Bahl R, Ashorn P, Simon J, Duggan CP, Sazawal S, Manji K. Lower-Dose Zinc for Childhood Diarrhea - A Randomized, Multicenter Trial. N Engl J Med. 2020 Sep 24;383(13):1231-1241. doi: 10.1056/NEJMoa1915905. PMID: 32966722; PMCID: PMC7466932. Dalfa RA, El Aish KIA, El Raai M, El Gazaly N, Shatat A. Oral zinc supplementation for children with acute diarrhoea: a quasi-experimental study. Lancet. 2018 Feb 21;391 Suppl 2:S36. doi: 10.1016/S0140-6736(18)30402-1. Epub 2018 Feb 21. PMID: 29553435.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

Drs. Morgan Hui, Jonathan Darby, Max Olenski, and Catriona Halliday join Febrile from Australia to share a unique case of a transplant recipient with a painless lump.Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Estás escuchando #JUNTOSRadio: SARAMPIÓN: Lo que tienes que saber hoy.     ¿Qué se debe de hacer si sospechamos que alguien tiene sarampión?, ¿Existe algún tratamiento o cura para el sarampión?; En este episodio tendremos como invitado al Dr. Fernando Merino, quien responde a estas y otras preguntas.    Sobre nuestro invitado:   El Dr. Fernando Merino es Profesor Adjunto de Medicina en la División de Enfermedades Infecciosas del Departamento de Medicina del Sistema de Salud de la Universidad de Kansas.   El Dr. Merino tiene una amplia experiencia clínica, tanto en el tratamiento de infecciones que requieren ingreso hospitalario como en aquellas enfermedades que pueden tratarse de forma ambulatoria. Sus principales intereses son las infecciones del sistema nervioso central, la enfermedad por VIH, la hepatitis vírica, las infecciones en pacientes inmunodeprimidos, las infecciones óseas y articulares y las enfermedades prevenibles mediante vacunación. El Dr. Merino es especialista acreditado en enfermedades infecciosas. Es miembro de la Infectious Diseases Society of America y del American College of Physicians.     Recursos informativos en español:    CDC  https://www.cdc.gov/measles/data-research/index.html  CNN Español  https://cnnespanol.cnn.com/2025/02/27/salud/casos-sarampion-estados-unidos-trax      Facebook: @juntosKS        Instagram: juntos_ks        YouTube: Juntos KS   Twitter: @juntosKS        Página web: http://juntosks.org        Suscríbete en cualquiera de nuestras plataformas de Podcast: Podbean, Spotify, Amazon Music y Apple Podcast - Juntos Radio        Centro JUNTOS Para Mejorar La Salud Latina        4125 Rainbow Blvd. M.S. 1076,        Kansas City, KS 66160          Este programa está realizado para fines educativos, para diagnósticos y tratamientos consulte su médico.    La información proporcionada por el invitado es responsabilidad de este.      No tenemos los derechos de autor de la música que aparece en este video. Todos los derechos de la música pertenecen a sus respectivos creadores   

Drs. Chelsea Gorsline, Courtney Harris, and Rebecca Kumar join to tell us more about the Transplant ID Early Career Network and how to approach donor call!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on Ocular Infections.Our guest stars this episode are:Miriam Barshak (Massachusetts General Hospital; Mass Eye and Ear)Akash Gupta (University of Pittsburgh Medical Center)Journal article link: Barshak MB, Durand ML, Gupta A, Mohareb AM, Dohlman TH, Papaliodis GN. State-of-the-Art Review: Ocular Infections. Clin Infect Dis. 2024;79(5):e48-e64. doi:10.1093/cid/ciae433Journal companion article - Executive summary link: https://academic.oup.com/cid/article-abstract/79/5/1125/7906419From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Drs. Tom Schmidt, George R Thompson, and Nate Bahr solve a pneumonia not responding to antimicrobials and discuss endemic fungal disease!To learn more about the Mycoses Study Group Research and Education Consortium, check out the MSGERC pageEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

In his weekly clinical update, Dr. Griffin and Vincent Racaniello bemoan the continued outbreak of Sudan virus and growing number of paralytic polio cases before discussing growing measles outbreak in the US and Europe, the vaccine, an interview with a parent whose child died of measles infection, adverse effects of vaccination and how parents do not think they have accurate information about “bird flu” before Dr. Griffin reviews recent statistics on RSV, influenza and SARS-CoV-2 infections, the WasterwaterScan dashboard, where to find PEMGARDA, what happens when antiviral therapy is delayed, provides information for Columbia University Irving Medical Center's long COVID treatment center, where to go for answers to your long COVID questions, long COVID interventions and the benefits of antiviral therapies on post acute SARS-Cov-2 infection sequelae. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Sudan virus disease(WHO) New cases of poliomyelitis  (GPEI) Measles 159 in Texas…. (Texas Health and Human Services) 2025 Measles outbreak guidance (New Mexico Health) First cases of measles in Oklahoma (Oklahoma) Measles case on Long Island (CBS News) Public health confirms measles case in Los Angeles County (County of Los Angeles Public Health) Measles exposure (Department of public health: City of Philadelphia) Where US measles outbreaks are spreading (New York Times) Statement from the chief public health officer of Canada on the increase in measles cases and the risk to people in Canada(Health Canada) Measles and rubella monthly report (ecdc) Measles on the rise again in Europe (EurekAlert) Measles: symptoms, spread & SSPE | Doctors Talk | Children's Hospital of Philadelphia (YouTube) Measles (CDC Measles (Rubeola)) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM: NCBI) Measles vaccination: know the facts? (Infectious Diseases Society of America) Deaths following vaccination: What does the evidence show? (Vaccine) Facts and myths about measles (LANCET: Infectious Diseases) His daughter was America's first measles death in a decade (The Atlantic) Less than half of parents think they have accurate information about bird flu (EurekAlert) Many US parents feeluninformed about avian flu risks (CIDRAP) Trends in respiratory pathogen testing at us children's hospital(JAMA Network) Changes in respiratory viral testing before and after the covid-19 pandemic(JAMA Network) Free COVID-19 test program stops taking orders (Health day) Human cases of highly pathogenic avian influenza a(h5n1) — California, September–December 2024 (CDC MMWR) Letters read on TWiV 1198 37:56 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

Tuberculosis remains a pressing public health challenge, with recent outbreaks highlighting its persistent threat. In this episode infectious disease expert Dr. Matt Shoemaker dives into the TB outbreak in Kansas. He unpacks the complexities of its transmission, the symptoms to watch for, and the obstacles faced in controlling its spread. Explore how public health officials are tackling this crisis, the crucial role of identifying latent TB cases, and the broader influence of policy on prevention. Join us for an eye-opening discussion on combating this enduring health concern. Hosted by: Kelly Holmes, MS, CIC, FAPIC and Lerenza L. Howard, MHA, CIC, LSSGB About our Guest: Dr. Matt Shoemaker, DO, FIDSA Dr. Matt Shoemaker, DO, FIDSA, Infectious Disease and Internal Medicine, graduated from the University of Health Sciences-College of Osteopathic Medicine in Kansas City, MO in 2000. He subsequently completed a traditional rotating osteopathic internship at Capital Regional Medical Center in Jefferson City, MO. After completion of his internship, he completed a residency in Internal Medicine and a fellowship in Infectious Disease, both at the University of Missouri – Columbia School of Medicine in Columbia, MO. He also maintains a medical practice specializing in Infectious Disease. Dr. Shoemaker is certified by the American Board of Internal Medicine in Infectious Diseases and Internal Medicine. He was in private practice in southeast Missouri from 2006 until 2019. He also served as vice president and chief medical officer at SoutheastHEALTH in Cape Girardeau, MO from 2014 until 2019. In 2018 he was advanced to a Fellow of the Infectious Diseases Society of America. In July of 2019 he joined the University of Kansas Medical Center Division of Infectious Diseases as assistant professor of clinical medicine. He is currently an associate professor of clinic medicine and serves as the Director of the Division of Infectious Disease at the University of Kansas Medical Center.

This StAR episode features the CID State-of-the-Art Review on delusional infestation.Our guest stars this episode are: Alexandra Mendelsohn (Dell Medical School, University of Texas Austin)Alysse Wurcel (Boston Medical Center)Journal article link: https://academic.oup.com/cid/article-abstract/79/2/e1/7718272Journal companion article - Executive summary link: https://academic.oup.com/cid/article-abstract/79/2/287/7718273From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Dean's Chat hosts,  Dr. Jeffrey Jensen  and Dr. Johanna Richey, are  joined by Dr. Wayne Bakotic and Dr. Warren Joseph on today's show discussing their careers and their specialties that overlap in dematopathology and infectious disease.   Discussions range from PCR testing for both fungus and bacteria, to their careers, their influence in the podiatric community, the advancement of AI in medicine, and relationship among specialists. A wonderful discussion, you'll wonder where 45 minutes went! Dr. Wayne L. Bakotic began his medical training with early acceptance into Barry University School of Podiatric Medicine where he completed his biomedical sciences degree through his podiatric medical studies. Prior to graduation, Dr. Bakotic left his podiatry training to initiate studies in Osteopathic medicine at Nova Southeastern University College of Osteopathic Medicine. It was, however, his time at Barry University which set the stage for his interest in podiatric pathology. After graduating with honors and completing his Doctor of Osteopathy in 1998, Dr. Bakotic continued his journey at Emory University School of Medicine where he gained training in anatomic and clinical pathology. He remained at Emory University to complete fellowship training in surgical pathology, Cytopathology and Dermatopathology, gaining board certification in anatomic pathology, clinical pathology, and Dermatopathology. In 2008 Dr. Bakotic co-founded Bako Diagnostics in Alpharetta, GA with the goal of serving the podiatric medical community and where he continues in the role of Chief Medical Officer.  Dr. Joseph a leader in our profession and a member of the Podiatric Hall of Fame. Dr. Joseph is a specialist in the treatment of lower extremity infectious diseases. He received his podiatric degree from the Wm. Scholl College of Podiatric Medicine in Chicago. Dr Joseph completed his postgraduate training in podiatric medicine/surgery at St. Joseph's Hospital, and a fellowship in infectious diseases at Hahnemann University School of Medicine, both in Philadelphia. He is currently an Adjunct Clinical Professor at the Arizona College of Podiatric Medicine at Midwestern University in Glendale, AZ. Dr. Joseph is a fellow of the Infectious Diseases Society of America and is an author of the IDSA Diabetic Foot Infection Guidelines. He is also certified by the American Board of Podiatric Medicine and currently serves as Editor of the Journal of the American Podiatric Medical Association. Dr Joseph lectures extensively and his presentations have focused on the treatment of bacterial and fungal infections of the lower extremity. He has authored close to 100 publications in the field of lower extremity infections. A fun discussion not only on Dr. Joseph's career but a look into his eclectic interests as well! Enjoy! https://bakodx.com/ https://bmef.org/ www.explorepodmed.org www.apma.org https://podiatrist2be.com/ https://higherlearninghub.com/    

In this episode of Going anti-Viral, Dr Michael Saag speaks with Dr Melanie Thompson who is a clinical researcher and provider of HIV clinical care in Atlanta, Georgia. As Principal Investigator and Executive Director of the AIDS Research Consortium of Atlanta (ARCA), she has led over 400 studies of HIV treatment and prevention and is recognized as an expert in the treatment of patients with HIV. In the episode, Dr Thompson and Dr Saag discuss the recently released 2024 update of primary care guidance for providers who care for persons with HIV by the HIV Medicine Association of the Infectious Diseases Society of America (see links in resources below). They address topics such as telemedicine, outreach to underserved populations, and how to create a welcoming clinic to improve retention in care. They discuss how HIV providers have been leaders in primary care in areas like hepatitis and address how to bring future generations of providers into HIV medicine. Finally, they address the importance of providers being advocates to their elected representatives about HIV medicine and that providing care to individuals, no matter who they are and where they come from, improves overall public health.0:00 – Introduction1:30 – A discussion of Dr Thompson's background in HIV medicine and transition from primary care to focus on HIV4:54 – What's new in the recently released primary care guidelines for persons with HIV 8:40 – Discussion of new recommendations in how providers can manage outreach, including providing mobile care to individuals with substance use disorder and unstable housing15:15 – Treatment of hepatitis as an example of how HIV medicine has led the way in providing primary care 17:04 – Review of guidance on substance use disorder including the use of Narcan and Buprenorphine19:14 – Reflections on the importance of providers being advocates to their elected representatives  24:10 – A discussion of how to create a future generation of HIV providers whether from internal medicine or infectious diseases, or both28:05 – Closing remarks  ResourcesHIV Medicine Association - https://www.hivma.org/HIVMA/IDSA HIV Primary Care Guidance - https://academic.oup.com/cid/advance-arti__________________________________________________Produced by IAS-USA, Going anti–Viral is a podcast for clinicians involved in research and care in HIV, its complications, and other viral infections. This podcast is intended as a technical source of information for specialists in this field, but anyone listening will enjoy learning more about the state of modern medicine around viral infections. Going anti-Viral's host is Dr Michael Saag, a physician, prominent HIV researcher at the University of Alabama at Birmingham, and volunteer IAS–USA board member. In most episodes, Dr Saag interviews an expert in infectious diseases or emerging pandemics about their area of specialty and current developments in the field. Other episodes are drawn from the IAS–USA vast catalogue of panel discussions, Dialogues, and other audio from various meetings and conferences. Email podcast@iasusa.org to send feedback, show suggestions, or questions to be answered on a later episode.Follow Going anti-Viral on: Apple Podcasts YouTubeXFacebookInstagram...

Today's show is sponsored by Americans for Free Choice in Medicine -- https://www.afcm.orgDr. Adalja is an expert on infectious disease, emergency preparedness, pandemics, and the intersections of public health and national security. is a board-certified physician in internal medicine, emergency medicine, infectious diseases, and critical care medicine. Dr. Adalja's expertise is frequently sought by international and national media.He has also published in such journals as the New England Journal of Medicine, JAMA, Journal of Infectious Diseases, Clinical Infectious Diseases, Emerging Infectious Diseases, Annals of Emergency Medicine, and Health Security.Dr. Adalja is a Fellow of the Infectious Diseases Society of America, the American College of Physicians, and the American College of Emergency Physicians. He is a member of various medical societies, including the American Medical Association, the HIV Medicine Association, and the Society of Critical Care Medicine.Dr. Adalja is a native of Butler, Pennsylvania, and actively practices infectious disease, critical care, and emergency medicine in the Pittsburgh metropolitan area.Dr. Adalja is the Chairman of the board of Americans for Free Choice in Medicine.Reinier Schuur is the Executive Director of AFCM. He holds a PhD in Philosophy from the University of Birmingham in the United Kingdom, where he specialized in the philosophy of medicine, and a Masters of Science in Philosophy of Psychiatry from King's College London. A native of the Netherlands, Reinier was a visiting Fulbright scholar at New York University and at the University of Pittsburgh. Reinier develops AFCM's educational offerings and collaborates with other organizations to educate the American public about how to advocate for their individual rights in healthcare.Show is Sponsored by The Ayn Rand Institute https://www.aynrand.org/starthereEnergy Talking Points, featuring AlexAI, by Alex Epstein https://alexepstein.substack.com/Express VPN https://www.expressvpn.com/yaronJoin this channel to get access to perks: / @yaronbrook Like what you hear? Like, share, and subscribe to stay updated on new videos and help promote the Yaron Brook Show: https://bit.ly/3ztPxTxSupport the Show and become a sponsor: / yaronbrookshow or https://yaronbrookshow.com/Or make a one-time donation: https://bit.ly/2RZOyJJContinue the discussion by following Yaron on Twitter (https://bit.ly/3iMGl6z) and Facebook (https://bit.ly/3vvWDDC )Want to learn more about Ayn Rand and Objectivism? Visit the Ayn Rand Institute: https://bit.ly/35qoEC3#freemarket #healthcare #Rights #individualism #AynRand #science #philosophyofscience #ethics #selfishness #egoism #capitalism #philosophy #Morality ​ ​#Objectivism​ #politicsBecome a supporter of this podcast: https://www.spreaker.com/podcast/yaron-brook-show--3276901/support.

Estás escuchando #JUNTOSRadio: Gripe Aviar: Bajo la Lupa    ¿Qué es la gripe aviar?, ¿Cómo se transmiten enfermedades entre animales y personas?, ¿Cómo puedo saber si yo tengo gripe aviar?; En este episodio tendremos como invitado al Dr. Fernando Merino, quien responde a estas y otras preguntas.      Sobre nuestro invitado:   El Dr. Fernando Merino es Profesor Adjunto de Medicina en la División de Enfermedades Infecciosas del Departamento de Medicina del Sistema de Salud de la Universidad de Kansas.   El Dr. Merino tiene una amplia experiencia clínica, tanto en el tratamiento de infecciones que requieren ingreso hospitalario como en aquellas enfermedades que pueden tratarse de forma ambulatoria. Sus principales intereses son las infecciones del sistema nervioso central, la enfermedad por VIH, la hepatitis vírica, las infecciones en pacientes inmunodeprimidos, las infecciones óseas y articulares y las enfermedades prevenibles mediante vacunación. El Dr. Merino es especialista acreditado en enfermedades infecciosas. Es miembro de la Infectious Diseases Society of America y del American College of Physicians.     Recursos informativos en español:    National Center for Farmworker Health H5N1 Bird Flu Resources       https://www.ncfh.org/uploads/3/8/6/8/38685499/ncfh_h5n1_resources_10.24.24.pdf       National Center for Farmworker Health (NCFH)   https://www.ncfh.org/uploads/3/8/6/8/38685499/8.23.24_spanish_ncfh_avianflu_flyer.pdf    Facebook: @juntosKS        Instagram: juntos_ks        YouTube: Juntos KS   Twitter: @juntosKS        Página web: http://juntosks.org        Suscríbete en cualquiera de nuestras plataformas de Podcast: Podbean, Spotify, Amazon Music y Apple Podcast - Juntos Radio        Centro JUNTOS Para Mejorar La Salud Latina        4125 Rainbow Blvd. M.S. 1076,        Kansas City, KS 66160          Este programa está realizado para fines educativos, para diagnósticos y tratamientos consulte su médico.    La información proporcionada por el invitado es responsabilidad de este.      No tenemos los derechos de autor de la música que aparece en este video. Todos los derechos de la música pertenecen a sus respectivos creadores 

Listen in as Stephen Cantrill, MD, FACEP; Rajesh T. Gandhi, MD; and Payal K. Patel, MD, MPH, FIDSA, discuss best practices in treating patients hospitalized with mild to moderate COVID-19, including: Current guidelines from the Infectious Diseases Society of America and National Institutes of Health How to optimize therapy selection based on patient risk factors, including key data supporting best practicesA detailed patient case to illustrate key takeawaysPresenters:Stephen Cantrill, MD, FACEP​Associate Director and Medical Director (Retired) ​Department of Emergency Medicine​Denver Health Medical Center​Associate Professor ​Department of Emergency Medicine​University of Colorado Health Sciences Center​Denver, ColoradoRajesh T. Gandhi, MD​Massachusetts General Hospital​Professor of Medicine​Harvard Medical School​Boston, MassachusettsPayal K. Patel, MD, MPH, FIDSA​Systemwide Director of Antimicrobial Stewardship​Associate Professor, Division of Infectious Diseases​Intermountain Health​Salt Lake City, UtahLink to full program: https://bit.ly/4fs7HcbGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In our Season 4 finale wrapping up 2024, Febrile is excited to host our biggest guest list yet to discuss the importance of International Medical Graduates (IMGs) in infectious diseases! Our guests:Ana Del Valle (Pediatric ID faculty at Arkansas Children's Hospital)Cristina Tomatis (Pediatric ID faculty at Nationwide Children's Hospital)Diego Cruz (Current pediatric resident and recent graduate of pediatric ID fellowship program at Nationwide Children's Hospital)Radhika Sheth (Adult ID faculty at Henry Ford Health System)Shweta Anjan (Adult ID faculty at University of Miami and Jackson Memorial Hospital)Zheyi Teoh (Pediatric ID faculty at Seattle Children's Hospital)Cesar Berto (Adult ID faculty at University of Alabama Birmingham)Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

On episode #66 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 10/8 – 10/23/24. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Prevalence of Human Papillomavirus (HPV) and HPV Type Distribution in Penile Samples in Young Men in Denmark: Results 10 Years After Implementation of a Girls-Only HPV Vaccination Program (JID) Primary Care Guidance for Providers of Care for Persons With Human Immunodeficiency Virus: 2024 Update by the HIV Medicine Association of the Infectious Diseases Society of America (CID) Bacterial Adjunctive linezolid versus clindamycin for toxin inhibition in β-lactam-treated patients with invasive group A streptococcal infections in 195 US hospitals from 2016 to 2021: a retrospective cohort study with target trial emulation (LANCET: Infectious Diseases) Time to turn off the toxins: adjuvant suppression of group A streptococcus (LANCET: Infectious Diseases) Comparing rates of recurrent infection for first occurrence of Clostridioides difficile between tapered oral vancomycin and standard vancomycin: a retrospective, propensity matched cohort study(Infection Control and Hospital Epidemiology) Evaluation of primary oral vancomycin prophylaxis against C. difficile infection during autologous stem cell transplantation (OFID) Oral Vancomycin to Prevent C. difficile in Stem Cell Transplant Recipients: The last frontier in antimicrobial prophylaxis (OFID) First Report of a Fatal Septicemia Case Caused by Vibrio metoecus: A Comprehensive Functional and Genomic Study (JID) Fungal The Last of US Season 2 (YouTube) A global chromoblastomycosis strategy and development of the global chromoblastomycosis working group(PLoS Neglected Tropical Diseases) Epidemiological and clinical features of a large blastomycosis outbreak at a paper mill in Michigan (CID) Do morphogenetic switching and intraspecies variation enhance virulence of Candida auris? (PLoS Pathogens) Parasitic Beyond Human Babesiosis: Prevalence and Association of Babesia Coinfection with Mortality in the United States, 2015–2022: A Retrospective Cohort Study (OFID) New WHO guidelines for treating rhodesiense human African trypanosomiasis: expanded indications for fexinidazole and pentamidine (LANCET: Infectious Diseases) Miscellaneous Social and Environmental Benefitsof Pediatric Infectious Disease Telemedicine (Journal of the Pediatric Infectious Diseases Society) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

Estás escuchando #JUNTOSRadio: COVID19: La nueva vacuna   ¿Si ya recibí varias dosis, realmente necesito esta nueva vacuna?, ¿Esta nueva dosis es un refuerzo o una vacuna completamente nueva?, ¿Esta nueva dosis es un refuerzo o una vacuna completamente nueva?; En este episodio tendremos como invitado al Dr. Fernando Merino, quien responde a estas y otras preguntas.    Sobre nuestro invitado:  El Dr. Fernando Merino es Profesor Adjunto de Medicina en la División de Enfermedades Infecciosas del Departamento de Medicina del Sistema de Salud de la Universidad de Kansas.  El Dr. Merino tiene una amplia experiencia clínica, tanto en el tratamiento de infecciones que requieren ingreso hospitalario como en aquellas enfermedades que pueden tratarse de forma ambulatoria. Sus principales intereses son las infecciones del sistema nervioso central, la enfermedad por VIH, la hepatitis vírica, las infecciones en pacientes inmunodeprimidos, las infecciones óseas y articulares y las enfermedades prevenibles mediante vacunación. El Dr. Merino es especialista acreditado en enfermedades infecciosas. Es miembro de la Infectious Diseases Society of America y del American College of Physicians.  Recursos informativos en español:   YAKIMA Health District  https://www.yakimacounty.us/2510/VACUNA-CONTRA-COVID-19    Haz clic aquí para obtener una lista de lugares que ofrecen la vacuna contra COVID-19.    Centro para el Control y Prevención de Enfermedades (CDC)   CENTROS PARA EL CONTROL Y LAPREVENCIÓN DE ENFERMEDAD  https://espanol.cdc.gov/covid/vaccines/stay-up-to-date.html?s_cid=SEM.GA:PAI:RG_AO_GA_HM_A18_C-CVD-StayUpToDate-Brd:nueva%20vacuna%20contra%20el%20covid:SEM00190&utm_id=SEM.GA:PAI:RG_AO_GA_HM_A18_C-CVD-StayUpToDate-Brd:nueva%20vacuna%20contra%20el%20covid:SEM00190&gad_source=1         Facebook: @juntosKS       Instagram: juntos_ks       YouTube: Juntos KS   Twitter: @juntosKS       Página web: http://juntosks.org       Suscríbete en cualquiera de nuestras plataformas de Podcast: Podbean, Spotify, Amazon Music y Apple Podcast - Juntos Radio       Centro JUNTOS Para Mejorar La Salud Latina       4125 Rainbow Blvd. M.S. 1076,       Kansas City, KS 66160        Este programa está realizado para fines educativos, para diagnósticos y tratamientos consulte su médico.     No tenemos los derechos de autor de la música que aparece en este video. Todos los derechos de la música pertenecen a sus respectivos creadores.                

Drs. Jonathan Ryder and Sarah Turbett discuss blood culture stewardship!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

In this episode of HIV unmuted, host Juan Michael Porter II sits down with Jeanne Marrazzo, the Director of the National Institute of Allergy and Infectious Diseases (NIAID), in a conversation that goes beyond the headlines and deep into the heart of HIV research and advocacy. Dr Marrazzo, a leader with decades of experience in infectious disease research, shares her inspiring journey from her roots in Scranton, Pennsylvania, to her groundbreaking work in HIV prevention and care. Through this intimate conversation, listeners will discover what drives Dr. Marrazzo's commitment to equity, diversity and community-centered research, and how her personal and professional experiences shape her vision for the future of HIV science. From the challenges of addressing global health inequities to the optimism surrounding new HIV prevention methods, Dr Marrazzo offers valuable insights into the importance of inclusive messaging, the power of collaboration, and why putting people first remains at the core of her mission. Tune in to hear how Jeanne Marrazzo plans to navigate the evolving landscape of global health as she leads NIAID into a new era, and why she believes that hope, innovation, and community are key to overcoming the ongoing challenges in the HIV response. Meet our guest: Jeanne Marrazzo   Jeanne Marrazzo, MD, MPH, FACP, FIDSA, is the Director of NIAID at the U.S. National Institutes of Health (NIH), where she oversees a USD 6.3 billion budget that supports research to advance understanding, diagnosis and treatment of infectious, immunologic and allergic diseases. She was previously the C. Glenn Cobbs Endowed Chair and Director of Infectious Diseases at the University of Alabama at Birmingham Heersink School of Medicine. She is a Fellow of the American College of Physicians and the Infectious Diseases Society of America (IDSA), and was Treasurer of the IDSA from 2021 to 2023, having served on the board since 2018. She researches the vaginal microbiome, sexually transmitted infections and HIV pre-exposure prophylaxis. She has had leadership roles in the NIH HIV Prevention Trials Network and the Infectious Diseases Clinical Research Consortium. She was a leading voice in communicating science during the COVID-19 pandemic.   Meet our host: Juan Michael Porter II  Juan Michael Porter II is a health journalist, HIV advocate, culture critic, educator and the host of HIV unmuted, the IAS podcast. He is the Senior Editor of TheBody.com and TheBodyPro – and the first person openly living with HIV to hold the position. Juan Michael's reportage combines data dives, personal narratives and policy analyses to address the real-world consequences of ever-shifting legislation on people's health outcomes. He has written for the Public Broadcasting Service, SF Chronicle, Philadelphia Inquirer, Christian Science Monitor, NY Observer, TDF Stages, Playbill, American Theatre, Time Out NY, Queerty, Anti-Racism Daily, Positively Aware, Documentary Magazine, SYFY Wire, Scholastic and Dance Magazine. 

This StAR episode features the CID State-of-the-Art Review on use of antimicrobials at the end of life.Our guest stars this episode are:Daniel Karlin (University of California Los Angeles, UCLA)Christine Pham (UCLA)Daisuke Furukawa (Stanford)Journal article link: Karlin D, Pham C, Furukawa D, et al. State-of-the-Art Review: Use of Antimicrobials at the End of Life. Clin Infect Dis. 2024;78(3):e27-e36. doi:10.1093/cid/ciad735Journal companion article - Executive summary link: https://academic.oup.com/cid/article/78/3/493/7596075From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on a comprehensive approach to vascular graft infection.Our guest stars this episode are:Hussam TabajaSupavit “Mac” ChesdachaiDaniel DeSimone(from Mayo Clinic, Rochester, Minnesota)Journal article link: Tabaja H, Chesdachai S, Shah AS, et al. Fostering Collaborative Teamwork-A Comprehensive Approach to Vascular Graft Infection Following Arterial Reconstructive Surgery. Clin Infect Dis. 2024;78(6):e69-e80. doi:10.1093/cid/ciae150Journal companion article - Executive summary link: https://academic.oup.com/cid/article/78/6/1391/7651000From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on Unintended Consequences: Risk of Opportunistic Infections Associated with Long-term Glucocorticoid Therapies in Adults.Our guest stars this episode are:Daniel Chastain (University of Georgia College of Pharmacy)Megan Spradlin (University of Colorado)Hiba Ahmad (University of Colorado)Andrés F Henao-Martínez (University of Colorado)Journal article link: Chastain DB, Spradlin M, Ahmad H, Henao-Martínez AF. Unintended Consequences: Risk of Opportunistic Infections Associated With Long-term Glucocorticoid Therapies in Adults. Clin Infect Dis. 2024;78(4):e37-e56. doi:10.1093/cid/ciad474Journal companion article - Executive summary link: https://academic.oup.com/cid/article/78/4/811/7643625From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on ##.Our guest stars this episode are:Arsheena Yassin (Robert Wood Johnson University Hospital)Mariya Huralska (Robert Wood Johnson University Hospital)Journal article link: Yassin A, Huralska M, Pogue JM, Dixit D, Sawyer RG, Kaye KS. State of the Management of Infections Caused by Multidrug-Resistant Gram-Negative Organisms. Clin Infect Dis. 2023;77(9):e46-e56. doi:10.1093/cid/ciad499Journal companion article - Executive summary link: https://academic.oup.com/cid/article/77/9/1223/7408674From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Drs. Maxime Billick and Isaac Bogoch from the University of Toronto discuss the buffet of options available for HIV biomedical prevention!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This is episode 33 of the Love, Hope, Lyme podcast. Fred Diamond's popular book, "Love, Hope, Lyme: What Family Members, Partners, and Friends Who Love a Chronic Lyme Survivor Need to Know" offers those who love someone with persistent or chronic Lyme ideas and tips to support this beloved person. It also helps Lyme survivors know how to ask for support. On today's episode, Fred interviews patient-centered healthcare advocate Bruce Alan Fries. It's incredible that Lyme and other tick-borne diseases have political implications. For scores, entities such as the CDC and the Infectious Diseases Society of America (IDSA) refused to acknowledge that chronic Lyme disease even existed and recommended minimal treatment protocols that, in many cases, did not even come close to treating the diseases. Bruce discussed some of the political initiatives he created or participated in to bring more government awareness of these troubling diseases. If someone you love has been afflicted with Lyme disease, watch this podcast now. If you have Lyme disease, listen for ways to get the support you need. The e-version of Fred's book is always free for Lyme survivors. Just reach out to Fred on Facebook or LinkedIn. The print copy can be ordered at https://a.co/d/ifi9Wne.

This StAR episode features the CID State-of-the-Art Review on Staphylococcus aureus bacteremia - controversies in clinical practice.Our guest stars this episode are: Daniel Minter (UCSF)Sarah Doernberg (UCSF)Journal article link: Minter DJ, Appa A, Chambers HF, Doernberg SB. Contemporary Management of Staphylococcus aureus Bacteremia-Controversies in Clinical Practice. Clin Infect Dis. 2023 Nov 30;77(11):e57-e68. doi: 10.1093/cid/ciad500. PMID: 37950887.Journal companion article - Executive summary link: https://academic.oup.com/cid/article/77/11/1489/7453594From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Drs. Maria Gabriela Segura, Misti Ellsworth, and Michael Chang from UTHealth Houston McGovern Medical School and Children's Memorial Hermann Hospital chat about an unusual pediatric case of fever of unknown origin.Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on neurosyphilis.Our guest star this episode is Dr. Matthew Hamill (Johns Hopkins University)Journal article link: Hamill MM, Ghanem KG, Tuddenham S. State-of-the-Art Review: Neurosyphilis. Clin Infect Dis. 2024 May 15;78(5):e57-e68. doi: 10.1093/cid/ciad437. PMID: 37593890.Journal companion article - Executive summary link: https://academic.oup.com/cid/article/78/5/1085/7672813From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Dean's Chat host, Dr. Jeffrey Jensen, is joined by Dr. Warren S. Joseph, fresh off a cruise to Greece and Malta with his better half, Judy.  This is Warren's second appearance on the podcast.  Today our discussion focuses on the Journal of the American Podiatric Medical Association (JAPMA).    Dr. Joseph is a leader in our profession and a member of the Podiatric Hall of Fame. Dr. Joseph is a specialist in the treatment of lower extremity infectious diseases. He received his podiatric degree from the Wm. Scholl College of Podiatric Medicine in Chicago. Dr Joseph completed his postgraduate training in podiatric medicine/surgery at St. Joseph's Hospital, and a fellowship in infectious diseases at Hahnemann University School of Medicine, both in Philadelphia. He is currently an Adjunct Clinical Professor at the Arizona College of Podiatric Medicine at Midwestern University in Glendale, AZ.  Dr. Joseph is a fellow of the Infectious Diseases Society of America and is an author of the IDSA Diabetic Foot Infection Guidelines. He is also certified by the American Board of Podiatric Medicine and currently serves as Editor of the Journal of the American Podiatric Medical Association. Dr Joseph lectures extensively and his presentations have focused on the treatment of bacterial and fungal infections of the lower extremity. He has authored close to 100 publications in the field of lower extremity infections. A fun discussion not only on Dr. Joseph's career but a look into his eclectic interests as well!  Throughout his professional journey, Dr. Joseph has been deeply committed to education, actively engaging in student and resident mentorship. Dr. Joseph firmly believes that education is a noble pursuit and considers it one of the most important aspects of professional development. He was honored to officially join the faculty at the Arizona College of Podiatric Medicine as an adjunct clinical professor, further contributing to the field. Additionally, he has successfully initiated and managed residency programs in the past. Dr. Joseph can be contacted at wsjoseph@APMA.org for questions regarding research or publications in JAPMA.  In this episode, Dr. Joseph discusses his love of theater!  Check out the links below with Sutton Foster on her roles from Tony Award winning Anything Goes and as Mrs. Lovett from Sweeney Todd. Enjoy!  https://youtu.be/j3b5XRd15KM?si=3aM7OL4bTzyxBwu8 https://youtu.be/JsBCezjnoQk?si=JnPLSW894oyHktxI https://youtu.be/BKgWfWQs8ws?si=N2sXBEGqbVSHHTwc https://www.youtube.com/watch?v=wslzJW02e0w&t=395s&pp=ygUac3V0dG9uIGZvc3RlciBzd2VlbmV5IHRvZGQ%3D   https://explorepodmed.org   https://deanschat.com/  

Happy World Environment Day (June 5 2024)! Our guests celebrate by discussing sustainability in healthcare and infectious diseases. Join Drs. Shreya Doshi, Preeti Jaggi, Pam Lee, and Shira Abeles as they raise awareness about the ways ID professionals can help reduce the negative environmental impact of the way we provide healthcare to our patients!Here is the JPIDS/OFID Supplement Introduction from Drs. Doshi and Jaggi: Healthcare Environmental Sustainability Through an Infectious Diseases LensThe second article mentioned is: Healthcare Sustainability to Address Climate Change, Call for Action to the Infectious Diseases CommunityThe Sustainabil-ID group mentioned in the podcast can be found on Twitter/X @sustain-ID as well as via email at sustainabilityiddocs@gmail.comEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

In this episode,  hosts Drs. Temara Hajjat and Peter Lu talk to Dr. Maria Oliva-Hemker about diagnosing and managing Clostridioides difficile (C. diff) in children who have inflammatory bowel disease (IBD). Dr. Oliva-Hemker is the Director of the Division of Pediatric Gastroenterology, Hepatology, and Nutrition and the Stermer Family Professor for Pediatric IBD at the Johns Hopkins University School of Medicine. She is also the Vice Dean for Faculty and the Mary Wallace Stanton Professor for Faculty Affairs. Learning Objectives:Learn how to diagnose Clostridioides difficile, particularly when there is concern about a new IBD diagnosis.Learn how to manage C. diff infection in a patient with known IBD.Learn how to manage recurrent and refractory C. diff infection in a patient with IBD.Link: Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)AGA Clinical Practice Guideline on Fecal Microbiota–Based Therapies for Select Gastrointestinal DiseasesACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile InfectionsSupport the Show.This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Step into the role of a hospital epidemiologist managing a measles outbreak response with Drs. Palak Patel, Emily Landon, and David Zhang from the University of Chicago!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on acute encephalitis.Our guest stars this episode are: Karen Bloch (Adult ID physician at Vanderbilt University Medical Center)Carol Glaser (Pediatric ID physician at California Department of Public Health)David Gaston (Adult ID physician and clinical microbiologist at Vanderbilt University Medical Center)Arun Venkatesan (Neurologist at Johns Hopkins University)Journal article link: Bloch KC, Glaser C, Gaston D, Venkatesan A. State of the Art: Acute Encephalitis. Clin Infect Dis. 2023;77(5):e14-e33. doi:10.1093/cid/ciad306Journal companion article - Executive summary link: https://academic.oup.com/cid/article/77/5/669/7269079From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on periprosthetic joint infections.Our guest stars this episode are: Sandra Nelson (ID physician at Massachusetts General Hospital)Jodian Pinkney (ID physician at Massachusetts General Hospital)Antonia Chen (Orthopedic surgeon at Brigham and Women's Hospital)Aaron Tande (ID physician at Mayo Clinic)Journal article link: Nelson SB, Pinkney JA, Chen AF, Tande AJ. Periprosthetic Joint Infection: Current Clinical Challenges. Clin Infect Dis. 2023;77(7):e34-e45. doi:10.1093/cid/ciad360Journal companion article - Executive summary link: https://academic.oup.com/cid/article/77/7/939/7289507From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review: Frame Shift – Focusing on Harm Reduction and Shared Decision Making for People Who Use Drugs Hospitalized with Infections.Our guest stars this episode are: Dr. Kinna Thakarar (ID and Addiction Medicine physician at MaineHealth/Tufts University School of Medicine)Dr. Ayesha Appa (ID and Addiction Medicine physician at University of California San Francisco, UCSF)Chastity Tuell (Harm reductionist and Washington County Program Director for Maine Access Points)Journal article link: Thakarar K, Appa A, Abdul Mutakabbir JC, Goff A, Brown J 3rd, Tuell C, Fairfield K, Wurcel A. Frame Shift: Focusing on Harm Reduction and Shared Decision Making for People Who Use Drugs Hospitalized With Infections. Clin Infect Dis. 2024 Feb 17;78(2):e12-e26. doi: 10.1093/cid/ciad664. PMID: 38018174.Journal companion article - Executive summary link: https://academic.oup.com/cid/article/78/2/233/7453720From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

This StAR episode features the CID State-of-the-Art Review on evaluation and management of diabetes-related foot infections.Our guest stars this episode are:Dr. Meghan Brennan (ID physician at University of Wisconsin)Dr. Marcos Schechter (ID physician at Emory University)Dr. Tze-Woei Tan (Vascular surgeon at University of Southern California)Dr. David Armstrong (Podiatric surgeon at University of Southern California)Journal article link: Nicolas W Cortes-Penfield, David G Armstrong, Meghan B Brennan, Maya Fayfman, Jonathan H Ryder, Tze-Woei Tan, Marcos C Schechter, Evaluation and Management of Diabetes-related Foot Infections, Clinical Infectious Diseases, Volume 77, Issue 3, 1 August 2023, Pages e1–e13, https://doi.org/10.1093/cid/ciad255Journal companion article - Executive summary link: https://academic.oup.com/cid/article/77/3/335/7242512From Clinical Infectious DiseasesEpisodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Drs. Paul Sax, Tara Vijayan, and Allan Tunkel join Febrile to chat about the debut of a new series called “StAR”!! These upcoming episodes will highlight the outstanding Clinical Infectious Diseases (CID) journal State-of-the-Art Reviews (StAR), which cover common clinical topics that ID clinicians encounter. Learn more about the creation of these articles from these CID editors before we kick off 4 back-to-back episodes!!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Drs. Jack Flores and Madan Kumar chat about the nuances of Kawasaki disease (and provide a mystery riddle!! solution in the Consult Notes!)Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Episode 164: More Than Just A HeadacheDr. Song presents a case of a subacute headache that required an extensive workup and multiple visits to the hospital and clinic to get a diagnosis. Dr. Arreaza added comments about common causes of subacute headaches.    Written by Zheng (David) Song, MD. Editing and comments by Hector Arreaza, MD.  You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction to the episode: We are happy to announce the class of 2027 of the Rio Bravo / Clinica Sierra Vista Family Medicine Residency Program. Our new group will be (in alphabetical order): Ahamed El Azzih Mohamad, Basiru Omisore, Kenechukwu Nweke, Mariano Rubio, Nariman Almnini, Patrick De Luna, Sheila Toro, and Syed Hasan. We welcome all of you. We hope you can enjoy 3 enriching and fulfilling years. During this episode, you will hear a conversation between Dr. Arreaza and Dr. Song. Some elements of the case have been modified or omitted to protect the patient's confidentiality. 1. Introduction to the case: Headache. A 40-year-old male with no significant PMH presents to the ED in a local hospital due to over a month history of headaches. Per the patient, headaches usually start from the bilateral temporal side as a tingling sensation, and it goes to the frontal part of the head and then moves up to the top of the head. 8 out of 10 severities were the worst. Pt reports sometimes hypersensitivity to outdoor sunlight but not indoor light. OTC ibuprofen was helpful for the headache, but the headache always came back after a few hours. The patient states that if he gets up too quickly, he feels slightly dizzy sometimes, but it is only for a short period of time. There was only one episode of double vision lasting a few seconds about 2 weeks ago but otherwise, the patient denies any other neurological symptom. He does not know the cause of the headache and denies any similar history of headaches in the past. The patient denies any vomiting, chest pain, shortness of breath, cough, abdominal pain, or joint pain. The patient further denies any recent traveling or sick contact. He does not take any chronic medication. The patient denies any previous surgical history. He does not smoke, drink, or use illicit drugs. What are your differential diagnoses at this moment? Primary care: Tension headache, migraines, chronic sinusitis, and more.2. Continuation of the case: Fever and immigrant.Upon further inquiries, the patient endorses frequent “low-grade fever” but he did not check his temperature. He denies any significant fatigue, night sweats, or weight loss. He migrated from Bolivia to the U.S. 12 years ago and has been working as a farm worker in California for the past 10 years. He is married. His wife and daughter are at home in Bolivia. He is currently living with friends. He is not sexually active at this moment and denies having any sexual partners. Differential diagnoses at this moment?  Tension headache, migraine, infections, autoimmune disease, neurocysticercosis. 3. Continuation of the case: Antibiotics and eosinophilia. As we kept asking for more information, the patient remembered he visited a clinic about four months ago for a dry cough and was told he had bronchitis and was given antibiotics and the cough got better after that. He went to another local hospital ED one month after that because the cough came back, now with occasional phlegm and at that time he also noticed two “bumps” on his face but nothing significant. After a CXR at the ED, the patient was diagnosed with community-acquired pneumonia and sent home with cough medication and another course of antibiotics. His cough improved after the second round of antibiotics. We later found on the medical record that the CXR showed “mild coarse perihilar interstitial infiltrates of unknown acuity”. His blood works at the ED showed WBC 15.2, with lymphocyte 21.2%, monocyte 10.1%, neutrophil 61.7%, eosinophil 5.9% (normally 1-4%), normal kidney, liver functions, and electrolytes, and prescribed with benzonatate 100mg TID and doxycycline 100mg bid for 10 days. He went to the same ED one month before he saw us for headache and fever (we reviewed his EMR, and temp was 99.8F at the ED). After normal CBC, CMP and chest x-ray. The patient was diagnosed with a viral illness and discharged home with ibuprofen 400mg q8h.Due to the ongoing symptoms of headache and fever, the patient went back to the same clinic he went to four months ago for a dry cough and requested a complete physical and blood work. The patient was told he had a viral condition and was sent home with oseltamivir (Tamiflu®) for five days. However, the provider did order some blood work for him. Differential diagnoses at this moment?  Patients with subacute meningitis typically have an unrelenting headache, stiff neck, low-grade fever, and lethargy for days to several weeks before they present for evaluation. Cranial nerve abnormalities and night sweats may be present. Common causative organisms include M. tuberculosis, C. neoformans, H. capsulatum, C. immitis, and T. pallidum. At his physical exam visit, the patient actually asked the provider specifically to check him for coccidiomycosis because of his job as a farm worker and he heard from his friends that the infection rate is pretty high in the Central Valley of California. His serum cocci serology panel showed positive IGG and IGM with CF titer of 1:128. His HIV, syphilis, HCV, HBV are all negative. The patient was told by that clinic to come to ED due to his history of headache, fever, and very high serum coccidiomycosis titer.  The senior and resident intern were on the night shift that night and we were contacted by the ED provider at around 9:30 pm for this patient. When reviewing his ED record, his vitals were totally normal at the ED, the preliminary ED non-contrast head CT showed no acute intracranial abnormality. A lumbar puncture was performed by the ED provider, which showed WBCs (505 - 71%N, 20%L, 7%M), RBC (1), glucose (19), and protein (200). CSF: High Leukocytes, low glucose, and high protein.On the physical exam, the patient was pleasant and cooperative, he was A&O x 4, he had a normal examination except for two brown healing small nodules on his forehead and left cheek and slight neck stiffness. At that point, we knew the patient most likely had fungal meningitis by cocci except for the predominant WBC in his CSF fluid was neutrophil not the more typical picture of lymphocyte dominant. And because of his very benign presentation and subacute history, we were not 100% sure if we had a strong reason to admit this patient. We thought this patient could be managed as an outpatient with oral fluconazole and referred to infectious disease and neurology. 4. Continuation of case: Admission to the hospital.Looking back, one thing that was overlooked while checking this patient in the ED was the LP opening pressure. Later, the open pressure was reported as 340mm H2O (very high). The good thing was, after speaking to the ED attending and our attending, the patient was admitted to the hospital and started on oral fluconazole.  Three hours after the admission, a rapid response was called on him. While the floor nurses were doing their check-in physical examination, the patient had a 5-minute episode of seizure-like activity which included bilateral tonic arm/hand movements, eye deviation to the left, LOC unresponsive to sternal rub, and the patient desaturated to 77%. He eventually regained consciousness after the seizure and pulse oximetry increased to 100% on room air. The patient was started on Keppra and seen by a neurologist the following day. His 12-hour EEG was normal, but his head MRI showed “diffuse thickening and nodularity of the basal meninges are seen demonstrating enhancement, suggesting chronic meningitis, possibly related to cocci. Other etiologies including sarcoidosis and TB meningitis and/or infiltration by metastatic process/lymphoma are not excluded. The ventricles are slightly prominent in size”. MRI of the cervical, thoracic, and lumbar spines also showed extensive diffuse leptomeningeal thickening, extensive meningitis, and nodular dural thickening. Also, his chest x-ray showed “some heterogeneity and remodeling of the distal half of the left clavicle. Metabolic bone disease, infectious etiology and/old trauma considered”. This could also be due to disseminated cocci infection. The infectious disease doctor saw this patient and recommended continuing with fluconazole, serial LPs until opening pressure is less than 250 mmH2O and neurosurgery consultation for possible VP shunt placement. The neurologist recommended the patient continue with Keppra indefinitely in the context of structural brain damage secondary to cocci meningitis.Take home points: Suspect cocci meningitis in patients with subacute headache associated with respiratory symptoms, new skin lesions, photophobia, neck stiffness, nausea, vomiting, eosinophilia, erythema nodosum (painful nodules on the anterior aspect of legs). Other symptoms to look for include arthralgias, particularly of the ankles, knees, and wrists.____________________Brief summary of coccidiomycosis. Etiology Coccidioidomycosis, commonly known as Valley fever, is caused by dimorphic soil-dwelling fungi of the genus Coccidioides (C. immitis and C. posadasii). They are indistinguishable in clinical presentation and routine laboratory test results.1, 2, 3, 5Epidemiology In the United States, endemic areas include the southern portion of the San Joaquin Valley of California and the south-central region of Arizona. However, infection may be acquired in other areas of the southwestern United States, including the southern coastal counties in California, southern Nevada, southwestern Utah, southern New Mexico, and western Texas (including the Rio Grande Valley). There are also cases in eastern Washington state and in northeastern Utah. Outside the United States, coccidioidomycosis is endemic to northern Mexico as well as to localized regions of Central and South America.1, 2Overall, the incidence within the United States increased substantially over the 1998-2019, most of that increase occurred in south-central Arizona and in the southern San Joaquin Valley of California. From 1998 to2019, reported cases in California increased from 719 to 9004.1, 6The risk of infection is increased by direct exposure to soil harboring Coccidioides. Past outbreaks have occurred in military trainees, archaeologists, construction or agricultural workers, people exposed to earthquakes or dust storms. However, in endemic areas, many cases of Coccidioides infection occur without obvious soil or dust exposure and are not associated with outbreaks. Change in population, climate change, urbanization and construction activities, and increased awareness and reporting, are possible contributing factors.1, 2, 5 Pathology In the soil, Coccidioides organisms exist as filamentous molds. Small structures called arthroconidia from the hyphae may become airborne for extended periods. Arthroconidia are usually 3-5 μm—small enough to evade bronchial tree mucosal mechanical defenses and reach deep into the lungs.1, 3Once inhaled by a susceptible host into the lung, the arthroconidia develop into spherules (theparasitic existence in a host), which are unique to Coccidioides. Endospores from ruptured spherules can themselves develop into spherules, thus propagating infection locally.1, 3, 5Although rare cases of solid organ donor-derived or fomite transmitted infections have been reported, coccidioidomycosis does not occur in person-to-person or zoonotic contagion, and transplacental infection in humans has never been documented.2, 5Cellular immunity plays a crucial role in the host's control of coccidioidomycosis. Among individuals with decreased cellular immunity, Coccidioides may spread locally or hematogenously after an initial symptomatic or asymptomatic pulmonary infection to extrathoracic organs.1, 3, 7Clinical manifestationThe majority of infected individuals (about 60%) are completely asymptomatic. Symptomatic persons (40% of cases) have symptoms that are related principally to pulmonary infection, including cough, dyspnea, and pleuritic chest pain. Some patients may also experience fever, headache (common finding in early-stage infection and does not represent meningitis), fatigue, night sweats, rash, myalgia.1, 2, 3, 5In most patients, primary pulmonary coccidioidomycosis usually resolves in weeks without sequelae and lifelong immunity to reinfection. However, some patients may develop chronic pulmonary complications, such as nodules or pulmonary cavities, or chronic fibrocavitary pneumonia. Some individuals with intense environmental exposure or profoundly suppressed cellular immunity (e.g., in patients with AIDS) may develop a primary pneumonia with diffuse reticulonodular pulmonary process in association with dyspnea and fever.1, 3, 5Fewer than 1% of infected individuals develop extrathoracic disseminated coccidioidal infection. Common sites for dissemination include joints and bones, skin and soft tissues, and meninges. One site or multiple anatomic foci may be affected. 1, 2, 3, 7It is estimated that coccidioidal meningitis, the most lethal complication of coccidioidomycosis, affects only 0.1% of all exposed individuals. Patients with coccidioidal meningitis usually present with a persistent headache (rather than a self-limited headache in some patients with primary pulmonary infection), with nausea and vomiting, and sometimes vision change. Some may also develop altered mental status and confusion. Meningismus such as nuchal rigidity, if present, is not severe.Hydrocephalus and cerebral infarction may develop in some cases. Papilledema is more commonly observed in pediatric patients.1, 3, 4, 5, 7When meningitis develops, most patients may not have any respiratory symptoms nor radiographic manifestation of pulmonary infection. However, a large number of these individuals also present with other extrathoracic lesions.7DiagnosisAlthough early diagnosis carries obvious benefits for patients and the health care systems as a whole (e.g., decreases patient anxiety, reduces the cost of expensive and invasive tests, removes the temptation for empirical antibacterial or antiviral treatments, and allows for early detection of complications), considerable diagnostic delays up to several weeks to months are common in both endemic areas and non-endemic areas.3, 7 Most symptomatic persons with coccidioidal infection present with primarily pulmonary symptoms and are often misdiagnosed as community-acquired bacterial pneumonia and treated with antibiotics. In endemic areas like south-central Arizona, previous studies found up to 29% of community-acquired pneumonia is caused by coccidioidomycosis. Healthcare providers thus should maintain a high clinical suspicion for coccidioidomycosis when evaluating persons with pneumonia who live in or have traveled to endemic areas recently. Elevated peripheral-blood eosinophilia of over 5%, hilar or mediastinal adenopathy on chest radiography, marked fatigue, and failure to improve with antibiotic therapy should prompt suspicion and testing for infection with coccidioidomycosis in endemic areas.1, 3, 5Serological testing plays an important role in establishing a diagnosis of coccidioidomycosis. Enzyme immunoassay (EIA) to detect IgM and IgG antibodies is highly sensitive and therefore commonly used as the screening tool. Immunodiffusion is more specific but less sensitive than enzyme immunoassay. It is used to confirm the diagnosis of positive EIA test results. Complement fixing (CF) test, which indirectly detects the presence of coccidioidal antibodies by testing the consumption of serum complement, are expressed as titers. Serial measurements of titers are of not only diagnostic but also prognostic value.1, 2, 3, 5Other methods, including culture, microscopic, or polymerase chain reaction (PCR) exam on tissue or respiratory specimens, are limited by their availability, sample obtaining and handling, or lack of sufficient evaluation.1, 2, 3, 5Cerebrospinal fluid (CSF) examination in coccidioidal meningitis usually demonstrates lymphocyte dominated elevation of leukocytes, although polymorphonuclear leukocyte dominance can also be seen in the early stage of the infection. Profound hypoglycorrhachia and elevated protein levels in CSF examination are also very common in coccidioidal meningitis.1, 7Although isolating Coccidioides from CSF or other CNS specimens are diagnostic for coccidioidal meningitis, in practice, diagnoses are often made based on the combination of clinical presentation, CSF examination that suggesting fungal infection, and positive Coccidioides antibodies found in CSF.7Imaging, especially enhanced magnetic resonance imaging (MRI), can help in diagnosing coccidioidal meningitis. Basilar leptomeningeal enhancement is a more common finding even though hydrocephalus, cerebral infarction, and vertebral artery aneurysm can also be seen.7TreatmentMost patients with focal primary pulmonary coccidioidomycosis do not require antifungal therapy. According to 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline, antifungal therapy should be considered in patients with concurrent immunosuppression that adversely affect cellular immunity (e.g., organ transplant patients, AIDS in HIV-infected patients, and patients receiving anti–tumor necrosis factor therapy) and those with significantly debilitating illness, extensive pulmonary involvement, with concurrent diabetes, pregnant women, or who are otherwise frail because of age or comorbidities. Some experts would also include African or Filipino ancestry as indications for treatment. Conversely, humoral immunity comprise splenectomy, hypocomplementemia, or neutrophil dysfunction syndromes are not major risk factors for this disease.1, 2, 3, 4, 5Triazole antifungals (fluconazole or itraconazole) are currently considered as the first-line medications used to treat most cases of coccidioidomycosis. Amphotericin B is reserved for only the most severe cases of dissemination and patients with coccidioidal meningitis in whom triazole antifungal therapy has failed. It is also the choice of therapy for coccidioidomycosis in pregnant women during the first trimester because of the possible teratogenic effect of high-dose triazole therapy during this period of time.1, 3, 4, 5Treating coccidioidal meningitis (CM) poses a special challenge because untreated meningitis is nearly always fatal. Lifelong therapy is recommended for CM because the majority 80% patients with CM experience relapse when therapy is stopped despite initial response to antifungal treatment. Shunting of CSF is required in cases of meningitis complicated by hydrocephalus.1, 3, 4, 5, 7Prevention Avoidance of direct contact with contaminated soil in endemic areas (e.g., respirator use by construction workers) may reduce disease risk, although clear evidence of its benefit is lacking.1, 5Some special population groups may benefit from prophylactic use of antifungals, such as those about to undergo allogeneic solid-organ transplantation or patients with a history of active coccidioidomycosis or a positive coccidioidal serology in whom therapy with tumor necrosis factor α antagonists is being initiated. The administration of prophylactic antifungals is not recommended for HIV-1-infected patients even if they live in an endemic region.1, 5Conclusion: Now we conclude episode number 164, “More than just a headache.” Dr. Song explained that a headache with an indolent course, accompanied by subacute respiratory symptoms, nausea, vomiting, photophobia, neck stiffness, and skin lesions can be secondary to Valley Fever. The Central Valley of California, as well as other areas with dry climate, are endemic and we need to keep this disease in our differential diagnosis.This week we thank Hector Arreaza and Zheng (David) Song. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Roos KL, Tyler KL. Acute Meningitis. McGraw Hill Medical. Published 2023. Accessed August 18, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192020493Information for Healthcare Professionals. Published 2023. Accessed August 18, 2023. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/health-professionals.html#printValley Fever (Coccidioidomycosis) a Training Manual for Primary Care Professionals. Accessed August 18, 2023. https://vfce.arizona.edu/sites/default/files/valleyfever_training_manual_2019_mar_final-references_different_colors.pdfAmpel NM. Coccidioidomycosis. Idsociety.org. Published July 27, 2016. Accessed August 18, 2023. https://www.idsociety.org/practice-guideline/coccidioidomycosis/Herrick KR, Trondle ME, Febles TT. Coccidioidomycosis (Valley Fever) in Primary Care. American Family Physician. 2020;101(4):221-228. Accessed August 18, 2023. https://www.aafp.org/pubs/afp/issues/2020/0215/p221.htmlValley Fever Statistics. Published 2023. Accessed August 18, 2023. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/statistics.htmlUpToDate. Uptodate.com. Published 2023. Accessed August 18, 2023. https://www.uptodate.com/contents/coccidioidal-meningitis?search=7%20Coccidioidal%20meningitis&source=search_result&selectedTitle=1~10&usage_type=default&display_rank=1Royalty-free music used for this episode: Tropicality by Gushito, downloaded on July 20, 2023, from  https://www.videvo.net/

Drs. Sumanth Cherukumilli, Emma Mohr, and Paul Spearman join for a live Febrile recording at the St. Jude / PIDS Pediatric Infectious Diseases Research Conference in Memphis, TN. They cover some learning points about early onset neonatal sepsis and chat about career development. Thank you to the conference organizers for the opportunity!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

Dr. Lisa Law and Dr. Randy Taplitz share the latest evidence-based recommendations from ASCO on vaccines in adults with cancer. They discuss recommended routine preventative vaccinations, additional vaccinations and revaccinations for adults undergoing HSCT, CD19 CAR-T treatment, or B cell-depleting therapy, guidance for adults with cancer traveling outside the U.S., and recommendations for vaccination of household and close contacts of adults with cancer. Dr. Law and Dr. Taplitz also share their insights on the guideline, including the importance of this guideline for adults with cancer and their clinicians, future advances in research, and current unmet needs. Read the full guideline, “Vaccination of Adults with Cancer: ASCO Guideline” at www.asco.org/supportive-care-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/supportive-care-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.24.00032       The ASCO Specialty Societies Advancing Adult Immunization (SSAAI) Project is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the Council of Medical Specialty Societies (CMSS) (with 100 percent funded by CDC/HHS). The contents are those of the authors and do not necessarily represent the official views of nor endorsement, by CDC/HHS or the U.S. Government. Brittany Harvey: Hello, and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts.  My name is Brittany Harvey, and today, I am interviewing Dr. Lisa Law from Kaiser Permanente and Dr. Randy Taplitz from City of Hope Comprehensive Cancer Center, authors on “Vaccination of Adults with Cancer: ASCO Guideline.” Thank you for being here, Dr. Law and Dr. Taplitz. Dr. Lisa Law: Thank you. Dr. Taplitz: Thank you, Brittany. Brittany Harvey: Before we discuss this guideline, I'd like to take note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Taplitz and Dr. Law, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes.  So then, to dive into the content, here first, Dr. Taplitz, can you provide a general overview of both the scope and purpose of this guideline on vaccination of adults with cancer? Dr. Randy Taplitz: Yes, so people with cancer often experience a compromised immune system due to a variety of factors. This includes chronic inflammation, impaired or decreased function of the hematopoietic system, and treatments that compromise their immune function. Because of this, people with cancer are at a higher risk for infection, including with vaccine-preventable diseases. Also, response to vaccines in patients with cancer may well be affected by this underlying immune status, and their anticancer therapy, as well as the severity of the underlying malignancy. The purpose of vaccination in this group of patients is to prevent infection or to attenuate the severity of the disease when infection cannot be fully prevented.   This ASCO review builds on a 2013 guideline by the Infectious Diseases Society of America, or IDSA, and uses what's called a systematic literature review of 102 publications between 2013 and 2023. This includes 24 systematic reviews, 14 randomized clinical trials, and 64 non-randomized studies. The largest body of evidence in these studies, not surprisingly, addresses COVID vaccines on the efficacy and safety of vaccines used by adults with cancer or their household contacts. ASCO convened an expert panel to review this evidence and formulate recommendations for vaccinations in this population. Brittany Harvey: Understood. I appreciate that context, Dr. Taplitz. So then, next, Dr. Law, I'd like to review the key recommendations of this guideline. The guideline addresses four overarching clinical questions. So starting with the first question, what are the recommended routine preventative vaccinations for adults with cancer? Dr. Lisa Law: Thank you, Brittany. Before I start, I just want to wholeheartedly thank the first author of this paper, Dr. Mini Kamboj, Dr. Elise Kohn from the NCI, as well as the ASCO staff in putting this publication and guideline together. It is a very, very important guideline, and I echo everything Dr. Taplitz just said.  So going back to your question, what are the recommended routine preventative vaccines for adults with cancer? As per this guideline, there are about 7 to 8 based on patient age and risk. Namely, they are: seasonal flu, RSV for those aged 60 or above, COVID-19, Tdap, Hepatitis B, Shingrix, Pneumococcal vaccine, and the HPV vaccine. These vaccines should ideally be given two to four weeks before therapy. However, non-live vaccines can be given anytime during or after chemo, immunotherapy, hormonal treatment, radiation, or surgery. Brittany Harvey: Excellent. Thank you for reviewing those vaccinations and the timing of them as well. So then, following those recommendations, Dr. Taplitz, what additional vaccinations and revaccinations are recommended for adults undergoing hematopoietic stem cell transplantation, CD19 CAR-T treatment, or B-cell depleting therapy?  Dr. Randy Taplitz: Many studies have shown that stem cell transplant recipients essentially lose immunity from childhood immunizations, and we know that these individuals are very vulnerable to infection, particularly in the first year after transplant. Revaccination is critical to help restore their immunity. The optimal timing of vaccination is based on our understanding of adequate immune reconstitution with B and T-cell recovery so that the individual can mount a response to the vaccine. We know that a lot of factors influence this immune reconstitution, including the age of the stem cell transplant recipient, the source of the donor, the time from transplant, graft-versus-host disease prophylaxis, the treatment and severity of graft-versus-host disease, and the vaccine type and antigens used.   There are a number of bodies throughout the world, IDSA as I mentioned, CDC, American Society for Transplant and Cellular Therapy, European Society for Blood and Marrow Transplant, and European Conference for Infections and Leukemia. All of these bodies have guidelines that approach vaccination in stem cell transplants. However, variation does exist in the use of a variety of things including whether to use immune predictors to help guide vaccination, and there is really not consensus on whether this immune predictor guided vaccination is more likely to produce a protective immune response versus a standardized schedule. In addition, the duration of protection is incompletely understood.  The bottom line in these guidelines is that they recommend complete revaccination starting for most vaccines at 6 to 12 months after stem cell transplant, in order to restore vaccine-induced immunity. And I just want to go through a few of the particulars. For COVID-19, which is a three-dose series in the primary series, influenza - generally high-dose influenza - and pneumococcal vaccine, PCV20 in general, ultimately four doses, can be administered, starting as early as three months after transplant. Although there is really not much data to guide the use of the recombinant zoster vaccine in allogeneic stem cell transplant, the vaccine can be administered after the end of antiviral prophylaxis, which in general is 12 to 18 months after allogeneic and 3 to 12 months after autologous stem cell transplant. Some of the other vaccines, such as hepatitis B, Tdap, meningococcal vaccines, and HPV revaccination in those less than 45 are also recommended.   I want to also spend the moment talking about the two recently licensed RSV vaccines, which were essentially studied in less compromised hosts and really without any immunogenicity data in stem cell transplant, and thus, there is no recommendation in this guideline for the use of these vaccines after transplant. Live vaccines, such as MMR and varicella – varicella would be in varicella-seronegative patients without a prior history of varicella – should be delayed for at least two years and only given in the absence of active graft-versus-host disease or immunosuppression.  Moving briefly to CAR T, which is an immunotherapy that involves adoptive cell therapy, given the available data and after a review by the group, it was recommended that adults with hematopoietic malignancies receiving CAR T therapy directed against B-cell antigens should receive influenza and COVID-19 vaccines either two weeks before lymphodepletion or no sooner than three months after the completion of therapy. Administration of non-live vaccines preferably should occur before CAR T treatment or at least 6 to 12 months after, following the same timing as what we recommend for stem cell transplant. There is really little data to guide the safety and timing of administration of live vaccines after CAR T therapy.   In terms of adults receiving B-cell depleting therapy, they are generally unable for time to mount an effective humoral response but may have at least partially intact cellular immune responses. They are encouraged to be revaccinated for COVID-19 no sooner than six months after completion of B-cell depleting therapy, and they should receive influenza vaccine approximately four weeks from the most recent treatment dose for patients on chronic therapy. For other non-seasonal immunizations, vaccines ideally should be given two to four weeks before commencing anti-CD20 therapy or delayed until 6 to 12 months after completion, except for the recombinant zoster vaccine, which can be given one month after the most recent dose of B-cell depleting therapy. Brittany Harvey: I appreciate you reviewing each of those vaccinations and when they should be given, and reviewing the available data – albeit, limited data – in these situations.  So beyond these routine preventative vaccinations and revaccinations that you've both just described, Dr. Law, what additional vaccinations does the expert panel recommend for adults with cancer traveling outside the United States? Dr. Lisa Law: Good question. As per these ASCO guidelines, adults with solid or blood cancer traveling outside of the United States should follow the CDC standard recommendations for their destination. For the 2024 CDC Yellow Book, travel vaccines, in general, should be delayed until three months from the last chemotherapy or, and for those with solid tumors, ideally when the disease is in remission. Of note, hepatitis A, typhoid, inactivated polio, Hep B, rabies, meningococcal vaccine, and Japanese encephalitis vaccines are considered to be safe. In all cases of travel, patients should be counseled by their healthcare provider about the travel timing, with the additional attention to the regional seasonality of infections, for instance, influenza is more common in late summer in Australia, and also with attention to any outbreaks that may be occurring globally at the time of travel. Brittany Harvey: Absolutely. Those are key points for clinicians to discuss with their patients as they consider upcoming travel.  So then, the final clinical question that the panel addressed, Dr. Taplitz, what vaccinations does the panel recommend for household and close contacts of adults with cancer?  Dr. Randy Taplitz: Thank you. Yes, it is recommended that all household members and close contacts, when possible, be up to date on their vaccinations. And the only further thing I would say is that there are some special considerations for the use of live vaccines in household contacts, particularly in stem cell transplant recipients. Contacts of people who receive stem cell transplants should preferably receive inactivated influenza vaccines. As was mentioned, MMR and varicella vaccines are both safe to administer to close contacts. Vaccine strain transmission to immunocompromised hosts has not been associated with MMR use in family members.   Eleven cases of the varicella vaccine strain transmission are described in the published literature, but none occurred in compromised hosts. Because the vaccine strain can cause severe and fatal varicella in profoundly immunocompromised people, precautions are advised to avoid close contact with a person with a vaccine-induced rash. For household contact travelers, MMR and yellow fever vaccines are considered safe. Oral cholera should be avoided. For smallpox vaccines, the second-generation ACAM2000 has rarely been associated with vaccinia transmission and should be avoided because of this. But the live replication-deficient MVA-based JYNNEOS vaccine is felt to be safe for household contacts of immunocompromised individuals. Brittany Harvey: I appreciate you reviewing the importance of vaccination for household and close contacts, and some of those precautions that individuals should take. I appreciate you both for reviewing all of these recommendations.  So then in your view, Dr. Law, what is the importance of this guideline, and how will it impact both clinicians and adults with cancer? Dr. Lisa Law: In my opinion, this is a very important guideline that is long overdue in the oncology community and will have a huge impact on both clinicians and adults with cancer. Over the years, I have often been asked by my colleagues and patients, “Can I have the flu vaccine, and if so, when?” So this guideline really is going to be helpful. More importantly, our cancer patients are living much longer. They may have years of quality of life even with third or fourth line of treatment, especially, for instance, like CAR T for myeloma and lymphoma. However, we know that with additional treatment, that carries a substantial risk of infection complication among these immunocompromised patients. So it is of paramount importance to inform our patients and colleagues to be proactive in advocating preventive therapy ahead of time, meaning trying to get the patients appropriately vaccinated as early as possible to generate immunity.  Another case in point is the Shingrix vaccine. I used to see lots of shingles, but ever since we have the recombinant Shingrix, I have fewer encounters. And this is huge because post-herpetic neuralgia robs a patient's quality of life. So, again, it is very important to recommend appropriate vaccines for our cancer patients.  Brittany Harvey: Absolutely. It is key to ensure patients receive these preventative vaccines, and we hope that this guideline puts an emphasis on that for clinicians and patients.  So finally, to wrap us up, Dr. Taplitz, what are the current gaps in knowledge regarding the vaccination of people with cancer? Dr. Randy Taplitz: There are a number of really important gaps in knowledge and really critical unmet needs that require research and other dedicated efforts. Among these are, and I think paramount, are really the participation of people with cancer with varied types of immunocompromise in vaccine trials. Where vaccine trials are only for cancer patients, obviously is ideal, testing vaccines in the appropriate population. But when that's not feasible, pre-existing cancer should not preclude eligibility, and inclusion of cohorts of people receiving anticancer treatment should be incorporated prospectively. So that's really critical because the quality of our guidelines is based upon the data. We use the data for developing guidelines and gathering more data in the particular patient population is really, really critical.  Secondly, work for creating more immunogenic vaccines and research to understand the immune response to vaccines after immuno-depleting therapies, particularly with newer therapies such as CAR T and newer B cell therapies, bispecific antibodies, etc. is really critical. We need to really understand the immune response and have the most potent vaccines available to these people who may have impaired immune responses.  Switching gears a little bit, we really need mechanisms to promote institutional commitment to integrate and sustain immunization best practices for people with cancer. This will largely be through multidisciplinary, team-based approaches, protocol-based vaccination standing orders, and leveraging data sharing so that we can all be on the same page with giving vaccines to these individuals. We also need education and evidence-based decision-making tools, emphasizing preventive care through immunization, the availability of educational resources to clinicians and patients to address commonly asked questions and also misconceptions about vaccination, that's absolutely critical.  And finally, I think we need to develop strategies for addressing unique challenges and factors contributing to vaccine hesitancy during cancer therapy. We need to focus on patient and clinician communication, and very importantly, we need to consider health equity considerations in the development and approach to vaccines in these compromised patients. Brittany Harvey: Definitely, we'll look forward to research and advances in these areas that you've just described to support these guidelines and increase vaccine uptake.  So I want to thank you both so much for your work on this important guideline, and thank you for your time today, Dr. Law and Dr. Taplitz. Dr. Lisa Law: Thank you.  Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

Drs. Genevieve Martin, Catherine Marshall, and Bart Currie from the Royal Darwin Hospital share their approach to Burkholderia pseudomallei aka melioidosis!Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA). Audio editing/mixing provided by Bentley Brown.

Drs. Michael Moran and Swapnil Lanjewar from the University of Wisconsin-Madison walk through a case and their approach to the common ID consult for fever and rash.Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA). Audio editing/mixing by Bentley Brown.

Future physician Sophie Samson, Dr. Kristen Bastug, and Dr. Beth Thielen discuss a case of a 7 year old girl who presented with new onset seizure, headache, and fever in Minnesota.Episodes | Consult Notes | Subscribe | Twitter | Merch | febrilepodcast@gmail.comFebrile is produced with support from the Infectious Diseases Society of America (IDSA)

In this episode, we discuss the evaluation of fever in the adult ICU patient. We discuss updates from the recently published Society of Critical Care Medicine and Infectious Diseases Society of America clinical guidelines. My guest is Dr. Andre Kalil, a critical care and infectious disease physician. Dr. Kalil is a Professor in the Division of Infectious Disease and Director of Transplant Infectious Disease at the University of Nebraska Medical Center (UNMC). A renowned clinician, educator, and researcher, Dr. Kalil has received many distinctions, including the 2021 Scientist Laureate Award at UNMC. Dr. Kalil is an author of the 2023 Society of Critical Care Medicine and The Infectious Disease Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU.

On this episode, we review the 2023 Hepatitis C Guidance that was recently published by the Infectious Diseases Society of America (IDSA) and the American Association for the Study of Liver Diseases (AASLD). We discuss the pre-treatment work-up, various treatment options, and drug-drug interactions/clinical pearls for the most commonly used direct-acting antivirals.  Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! We want to give a big thanks to our sponsor, High-Powered Medicine. HPM is a book/website database of summaries for over 150 landmark clinical trials. You can get a copy of HPM, written by Dr. Alex Poppen, PharmD, at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to give a big thanks to our main sponsor Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. You can find our account at the website below:  www.patreon.com/corconsultrx If you have any questions for Cole or me, reach out to us on any of the following: Text - 415-943-6116 Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx  This podcast reviews current evidence-based medicine and pharmacy treatment options. This podcast is intended to be used for educational purposes only and is intended for healthcare professionals and students. This podcast is not for patients and not intended as advice or treatment.

This is the next episode of our Push Dose Pearls miniseries with ED Pharmacist, Chris Adams. In this ongoing series we'll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode again focuses on common antibiotics we use in the ED. What has changed and what are the latest recommendations? We'll answer these questions and more!  Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis Resources: CDC STI Treatment Guidelines Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437. ACEP EMRA Antibiotic Guide. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Contributor: Jared Scott MD Educational Pearls A recently published study assessed the burden of respiratory viruses in a longitudinal cohort of children from 0 to 2 years of age The children in the study received nasal swab PCR testing weekly to determine infectivity They were also monitored for symptoms via weekly text surveys The study differentiated between infection and illness by defining an acute respiratory illness (ARI) as fever ≥38°C or cough.  The median infectivity rate was 9.4 viral infections per child per year The median illness rate was 3.3 ARIs per child per year The most common etiological viruses isolated from the nasal samples were rhinovirus and enterovirus Most infections were asymptomatic or mild References Teoh, Z., Conrey, S., McNeal, M., Burrell, A., Burke, R. M., Mattison, C., McMorrow, M., Payne, D. C., Morrow, A. L., & Staat, M. A. (2023). Burden of Respiratory Viruses in Children Less Than 2 Years Old in a Community-based Longitudinal US Birth Cohort. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 77(6), 901–909. https://doi.org/10.1093/cid/ciad289 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII