Updates in Coccidioidomycosis

By Fariba Donovan, MD, PhD

Dr. Fariba Donovan, Assistant Professor of Medicine at the University of Arizona, and Faculty Member of the Valley Fever Center for Excellence in Tucson, presents her thoughts and perspectives on Coccidioidomycosis, a soil fungus that produces a variety of different pulmonary and non-pulmonary human infections in both immunocompetent and immunocompromised hosts. Dr. Donovan begins her presentation by discussing the epidemiology of Cocci, including the regional areas of high endimicity and typical environmental exposure risks. She then further defines the typical signs of mild self-limited “Valley Fever” and differentiates this from disseminated forms of the infection. The diagnostic work up of Cocci is then reviewed, and she then describes patient treatment, outcomes, and prognosis. Lastly, Dr. Donovan comments on the risks of endemic mycoses on patients on the newer immunomodulatory agents.

Pancytopenia and Profound Neutropeia as a Sequela of Severe SARS-CoV-2 infection with a Concern for Bone Marrow Involvement

By Jarelys Hernandez-Jimenez, MD

Dr. Hernandez reviews a case of Coronavirus disease in a 44 year old B cell ALL patient with chronic Hepatitis B infection status post chemo. He was diagnosed with COVID-19 infection and developed severe pancytopenia during his disease course. She details the evaluation of the patient’s bone marrow deficiency, including the differential diagnosis, appropriate work up tools, and how the treating providers determined the cause to be SARS CoV 2 related pancytopenia and neutropenia, a recently recognized sequela of the disease. Other published cases are also presented and some of the pitfalls of G-CSF use are mentioned.

Pandemics That Changed History

By Michele Davis, MD

Dr Michele Davis, Infectious Diseases fellow at the University of South Florida, discusses historical pandemics of the past in this intriguing podcast. Dr. Davis begins her presentation by defining what constitutes a “pandemic.” She then describes ancient pandemics such as the Plague of Athens, Antonine, Cyprian plague, the Antonine plague, and the Justinian plague. Communicable plagues of the middle ages are also covered, such as leprosy, the black death, the first cholera pandemic, and the Spanish Flu. Finally, pandemics of the last few decades are also explored, including HIV/AIDS, SARS, and COVID-19. Lastly, Dr Davis discusses the lessons learned from previous outbreaks and how pandemics demonstrate why equitable access to health care resources is so critical.

Adverse Effects Associated with Cancer Immunotherapies

By Hareesh Singam, MD

Dr. Hareesh Singam, infectious diseases senior fellow at the University of South Florida College of Medicine, discusses some of the side effects associated with newer cancer therapies in this informative podcast. Dr. Singam broadly divides his remarks into two categories: Syndromes related to Immune Checkpoint Inhibitors, and Syndromes related to CAR-T Cell Therapy. He begins by briefly introducing the Immune Checkpoint Inhibitors (ICIs) and their mechanisms of action. He then discusses mechanisms of ICI toxicity and their clinical features. Dr. Singam goes on to discuss the associated infectious risks and how they are managed. Next, Dr Singham moves on to CAR-T Cell therapy, including its mechanisms of action, what occurs with cytokine release syndrome (CRS), and describes CAR-T Related Encephalopathy (CRES), CAR-T related hematophagic lyphohistiocytosis/macrophage activation syndrome (HLH/MAS), and the factors behind infectious risk after CAR-T therapy. Lastly, Dr. Singam discusses the use of Tocilizumab in CAR-T therapy.

Neglected Gram Positive Bacilli

By Christian Lopez-Padilla, MD

Dr. Lopez discusses the gram positive rods/bacilli which are perhaps lesser well known to the clinician but have important clinical relevance nonetheless. He first discusses the classification system for these bacteria. He then descibes coryneform bacteria other than C. diphtheriae, such as C. jeikeium, which can cause both community-acquired and nosocomial infections. Next, Dr. Lopez discusses Bacilli other than B. anthacis. Erysipelothrix rhusiopathae is an example of this category. Next mentioned are anaerobic non-spore-forming gram-positive rods. Cutibacterium is an example of a pathogen producing infections associated with pustular skin eruptions and infections of implanted hardware. Anerobic spore-forming rods such as Clostridium are a major cause of human infections, including gas gangrene, C difficile, and others. In the end, the listener can easily be convinced that the spectrum of gram positive organisms are equally as diverse as the better known group of gram negative bacteria.

Great Mimics of Infectious diseases: A False Tale of Rashes and Fevers

By Zola Nlandu, MD

Dr. Nlandu, Infectious Diseases Fellow at the University of South Florida, discusses noninfectious conditions that can mimic everyday infectious diseases diagnoses. He begins by discussing hemophagocytic lymphohistiocytosis (HLH), a life threatening clinical syndrome characterized by extreme immune system activation. Next, he covers Behcet’s disease, a form of vasculitis commonly manifesting as mucocutaneous disease. Familial Mediterranean Fever (FMF) is a rarely diagnosed syndrome seen in persons of Mediterranean descent that can mimic many infectious diseases conditions. Lastly, Adult Onset Still’s disease is a syndrome producing a triad of fever, arthrlagias, and a salmon-covered rash. The diagnosis and management options for each syndrome is characterized.

Covid-19 Updates: Viral Variants, Vaccines, and More

By Vivian Vega Rodriguez, MD

Dr. Vivian Vega, Assistant Chief of Epidemiology at the James A Haley Veterans Hospital, presents an update on COVID 19 recorded on March 17, 2021. She begins by defining and discussing the topic of herd immunity, and recaps the progress that the US is making in vaccinations during the Spring. Next, she discusses global vaccine inequality, and how wealthier nations are preferentially vaccinating their populations at the expense of poorer nations, who cannot access vaccine supplies that are being gobbled up by resource rich countries. Next, Dr. Vega discusses viral variants, including the virus strains that are most likely to continue to emerge in the U.S. Lastly, Dr. Vega discusses vaccine strategies and future next generation COVID vaccines.

Mycobacterium abscessus in Florida: Epidemiology, Pathophysiology, and Research Implications

By Anthony Cannella, MD

Dr. Anthony Cannella, Assistant Professor of Medicine at the USF Division of Infectious Diseases and International Medicine, reviews Non-tuberculosis Mycobacteria, with a focus on Mycobacterium abscessus spp. Dr. Cannella begins his presentation by reviewing the microbiology and epidemiology of M. abscessus and their spectrum of disease. He then transitions to discussing the pathophysiology of how these infections occur as well as the pharmacologic options available for treating them. He closes by presenting the research implications of M. abscessus infections from the perspective of the immunological response and pharmacotherapeutic options.