Alice Han

I think this is a very difficult organism to treat and high chance of relapsed infection with prosthesis, likely biofilm

Omg. 😱

I would ask how in the world does this ever happen, but I do remember ordering takeout once years ago and finding a huge cooked roach in the food.

It was horrifying. These are the kinds of cases that give you delusional parasitosis.

#idboardreview A Pt w/travel to Mexico a few months prior (drank tap water, ate raw vegetables) noticed a small worm-like object on inner surface of her lower lip. She removed the object with a needle. Dx? #medEd #idmeded #IDsky #parasitology

Pt relapsed twice. Has a deep seated infection until proven otherwise and now has a prosthetic valve so would suppress indefinitely

🤣

I got a different antibiotic this time! I am now moxifloxacin! I don’t know what that means about me. I feel like I was penicillin before

I would repeat TEE to make sure there isn’t a perivalvular abscess and consider imaging of spine as well. Would consider linezolid, tedizolid (not sure if it’s available anymore) or dalvance suppression after repeat treatment course

I blame p traps

The hospital is handing out taffy apples 🍎today, and I am just here to say they are delicious!

I am ashamed to admit I grew up in the midwest, and this is the first time I have ever had a taffy apple.

Don’t make my mistake, go try one now! They are so good! 😋

I would start empiric cefepime for neutropenic fever pending workup and then try to figure out if the neutropenia is drug related or a newly diagnosed heme malignancy

I appreciate that the bluejay puts wing hygiene first

I am still catching up but I really enjoyed this one. Very helpful to go through cases and the decision making involved. The cmv case provided more clarity for me as those cases are very challenging

Cefdinir Versus Cephalexin for the Treatment of Uncomplicated Urinary Tract Infections Due to its poor bioavailability and urinary excretion, cefdinir may be a suboptimal agent for UTI treatment. Our findings demonstrate that patients treated

‼️Just shared at #IDWeek2025 & now published in @ofidjournal.bsky.social cephalexin vs. cefdinir for tx of uUTI in females. Spoiler: Cefdinir was independently associated with/failure & cefdinir pts were twice as likely to fail. Let’s stop Rx’ing cefdinir for UTI! 🛑💊 academic.oup.com/ofid/article...

I don’t think I will be able to do it unless micro makes me learn all these new names

Agree. It was a far different year, but it was great to see everyone who came. Honestly, I felt optimistic about the future after talking to fellows excited about ID & their upcoming careers. I hope next year will be better!

#IDsky
Wow!!! This is a really exciting prospect. To think that the COVID19 mRNA primes the immune system to make immunotherapy more effective against cancer is a BIG deal. This is fascinating science 🤩

It’s crazy. Sometimes the interpretation of the reference is completely incorrect too. It is really scary

Where are the references? They usually reference something and it’s shocking what references get pulled

Omg. That’s terrible. I am so sorry. I didn’t realize the system was like that in Canada

Really proud to be a part of this community and always inspired by my colleagues around the country who continue to show up even when it's hard.

This year's #IDweek is now over. Our community has taken so many hits since the pandemic and now the assaults on public health, science, vaccines etc.
Yet the infectious disease community has some of the most dedicated, resilient and thoughtful people I know.
Here's to hope & staying with the fight.

#IDsky
Do granulocyte infusions help with IFI?
Dr Girmenia says that they do not do it.
Dr Papanicalou says they only do it as a bridge to anticipated neutrophil recovery if neutrophil recovery is actually anticipated to occur. But it is logistically difficult

#IDsky
Someone asked what do you do when you find an incidental finding concerning for IFI on pretransplant CT?
Dr Girmenia rec bronch & possibly Lamb
Also review old CT scans
If diagnostic bronch nonrevealing, consider repeat ct to make sure it is not advancing. Dr Papanicalou uses isavu.

#IDsky
Someone asked what do you do with IFI if the lobe is able to be resected? Do you recommend?
Recommended if possible with mucor, not typically with IA
Hard to know what to do with other rare IFI

#IDsky
Sometimes the best part of the conferences are the Q&A sessions afterwards
-Someone asked what do you do with pts colonized with MDRO’s prior to transplant
-Dr Papanicolau creates a detailed abx plan for when pt has a neutropenic fever
-Someone said that they decolonize w/ oral gentamicin 🤯

#IDsky
This was a great presentation by Dr Girmenia
Highly recommend!

Posa vs itra/flu during induction showed clear benefit in development of IFI

So what do we do?
Continue antifungal drug for at least 4 weeks and until PMN recovery and objective s/sx of improvement and then switch to secondary antifungal ppx with anti- mold activity
Consider reduced intensity conditioning regimen

Despite this, keep in mind that more than 2/3 remain alive with pre SCT IA, and the allo SCT is potentially curative.
We have to weigh the risk of relapsed AML, losing out transplant window, having underlying disease undermine our efforts to control the infection.

Major prognostic determinants of IFD relapse post HSCT
How to make a risk calculation in your 🧠