Dr. John Toney, Professor of Medicine at the USF Morsani College of Medicine, looks at the current landscape of Clostridioides difficile infection in the post-COVID environment. A great deal has changed in the years COVID-19 was a major health treat…including taxonomy, epidemiology, and disease prevalence and distribution, as well as treatment practices. Dr. Toney looks at the role of bile acids in C. difficile, as well as virulence mechanisms. Next, he describes the growing recognition for the need for two step testing to screen for true c. diff associated diarrhea. He then describes antimicrobial management, divided into first episode and subsequent recurrences. Also discussed are emerging biotherapeutic options for treatment and whether a C. difficile vaccine will ever be possible.
Archives
Histoplasmosis
Dr. Cilia Nazef, Infectious Diseases Fellow at the USF Morsani College Medicine, presents a talk on Histoplasmosis, an endemic fungal mycosis, in a case based format. Leading off with an in detail discussion of a fascinating patient, Dr. Nazef continues to discuss the clinical manifestations, diagnostic testing, and treatment of this fungal syndrome. She closes the presentation with information on late/long term complications and histoplasmosis in stem cell transplant patients.
Steroids for Various Infectious Diseases
Dr. Patimavirujh, A PGY-2 resident at the USF Morsani College of Medicine, reviews the use of steroid medication in the management of infectious diseases syndromes. Following an introduction on the history of steroids in medicine, the speaker compares and contrasts steroid agents with mineralcorticoid and glucocorticoid activity. Next, the pharmacokinetics of steroids are discussed, as well as dose equivalencies for the different steroid molecules. Next, the use of steroids for various infectious diseases are discussed, including for pneumonia (including Pneumocystis infection), bacterial meningitis, TB meningitis, and cryptococcal meningitis.
Sepsis
Dr. John Toney, Professor of Medicine at the USF Morsani College of Medicine, presents an update on the management of Sepsis. Dr. Toney begins by discussing the pathophysiology regarding sepsis and septic shock. He then shares the most recent sepsis guidelines. Next, he presents the stages of sepsis and covers the qSofa score. Next, Dr. Toney covers the management of sepsis, including resuscitation, antibiotics, and therapies that were once recommended which have either gone by the wayside or have been modified in the modern era.
Emerging Infections in the Current Century
Dr. Somboonwit, Professor of Medicine with the USF Morsani Division of Infectious Diseases, looks at important infectious diseases that have emerged over the last 20+ years, and the factors that have promoted their emergence. These include climate change, urbanization, international travel, and other factors. Syndromes examined include coronaviruses (SARS CoV1 and SARS CoV2), hemorrhagic fevers (Ebola), and vector-borne diseases (Zikavirus, Chikungunya, and Dengue). Future directions for managing emerging infectious diseases are also explored.
Gram Positive Cocci and Gram Positive Rods of Clinical Significance
Dr. Jackie Sherbuk, Assistant Professor of Medicine at the USF Morsani College of Medicine, Division of Infectious Diseases, presents a case-based discussion of gram positive organisms producing disease in humans. Infections discussed include Staphylococcus aureus, Coagulase negative Staphylococcus, Pneumococcus, Streptococcus spp., Enterococcus, Corynebacterium, Bacillus, and Erysipelothrix. Associated clinical syndromes are also discussed.
Managing Infectious Complications in Immunocompromised Cancer Patients
Dr. Rod Quilitz, infectious diseases pharmacotherapist at the Moffitt Cancer Center and Research Institute, presents his talk regarding the infectious diseases syndromes likely to be encountered when managing ID complications in an immunocompromised population. Dr. Quilitz begins by discussing risk factors for infection. He then goes on to discuss neutropenic fever management. The contrast between low grade and high grade neutropenia is also differentiated. Next, Dr. Quilitz discusses strategies for prophylaxis of patients who have prolonged neutropenia, including the use of gram positive antimicrobial agents and antifungals. Other subjects covered include the spectrum of CART toxicities, immune reconstitution, prophylaxis for Pneumocystis, CMV disease/prophylaxis, and other viral infections in the immunocompromised population.
Board Review: HIV Resistance
Dr. Vivian Vega, MD, Assistant Professor of Medicine at the USF Morsani College of Medicine, presents a board review series on HIV drug resistance. Among the topics discussed include what constitutes a drug mutation, the specifics of having a high resistance barrier, when to obtain a genotype, and when to add an integrate inhibitor genotype. Lastly, specific classic mutations to memorize are discussed.
Managing Antibiotic Allergies
Dr. Arun Sunny, infectious diseases attending for ID Associates of Tampa Bay, discusses antibiotic related drug intolerances. Dr. Sunny begins by reviewing the mechanisms behind types 1 through 4 immune-mediated hypersensitivity. Next, he differentiates DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms, TEN (Toxic Epidemial Necrolysis)/Stevens-Johnson Syndrome, and AGEP (Acute Generalized Exanthematous Pustulosis). Dr, Sunny then further characterizes Beta-lactam and Penicillin drug allergies. He then closes by describing antibiotic-related toxicities and provides several examples.
Zoonoses, Antimicrobial Resistance, and YOU: The One Health Game Plan
Dr. John Sia, Infectious Diseases Fellow at the Morsani College of Medicine, shares a grand rounds presentation on the national One Health Framework for addressing zoonotic diseases in the U.S. Dr. Sia introduces a clinical case involving a patient exposed to a zoonotic infection. Next, he covers different zoonotic pathogens and their vectors and focuses on Bartonella, Bacillus anthracis, and Brucella. Next, he describes how the One Health initiative helps teams of medical clinicians, scientists, and veterinarians to address disease threats in a collaborative fashion. After brief descriptions of two more cases, Dr. Sia closes with further examples of how the One Health Initiative is beneficial in combating antimicrobial resistance and connecting human, animal, and environmental health.