Dr. Aliyah Baluch, Chief BMT ID clinician at the Moffitt Cancer Center and Research Institute reviews 3 interesting BMT-related ID cases and offers insights into their management. From a lecture originally recorded in December, 2019.
Dr. Ward begins her presentation by reviewing the impact of beta-lactam allergies on the healthcare system. She then discusses the classification system for the different types of hypersensitivity reactions. The significance of beta-lactam allergy cross reactivity is then mentioned. She goes on to explain how beta-lactam allergy testing is performed. Lastly, she identifies strategies to improve the documentation of beta-lactam allergy reporting.
Dr. Kami Kim, Chief of Infectious Diseases at the University of South Florida College of Medicine, discusses an important subset of emerging infections: sexually transmitted diseases (STIs). She initially reviews the current epidemiology of STIs in the U.S. She differentiates the more common and less common STIs. She goes on to discuss risk factors for sexually transmitted infections. She focuses on Neisseria gonorrhea infections, and discusses epidemiology, drug resistance, and treatment changes. She closes by sharing information on the diverse syndromes associated with Chlamydia trachomatis, including genital ulcer disease, urethritis, and cervicitis, extragenital infections, and pelvic inflammatory disease, and shares general treatment strategies and pitfalls.
Dr. Olga Klinkova, Infectious Diseases Clinician at the Moffitt Cancer Center and Research Institute, discusses the recent updates to the diagnosis and management of community acquired pneumonia. Dr. Klinkova begins her talk by referring to the recently introduced IDSA-ATS guidelines, released in August, 2019. She then discusses updates in the microbiology of CAP, including the most likely organisms, the role of MRSA, atypicals and the significance of viral pathogens. She then mentions diagnostic modalities and the relevance of clinical prediction algorithms such as CURB-65 and the Pneumonia Severity Index (PSI). Treament considerations including outpatient versus inpatient, and inpatient non-severe versus inpatient severe management are also differentiated. Specific treatment agents and therapy durations are also mentioned. Lastly, she discusses options for the management of MRSA pneumonia and aspiration syndromes.
Dr. Ju Hee Katzman begins her lecture by discussing some basic epidemiology of Tuberculosis, a major killer worldwide and still a significant infectious cause of mobility in the U.S. Dr. Katzman reviews the traditional diagnostic modalities for diagnosing TB (including expectorated sputum samples for smear and culture). She then goes on to discuss specific molecular techniques for diagnosing TB that will play an increasingly larger role in the future. Lastly, she touches upon the ways in which AI (Artificial Intelligence) can be utilized to detect and treat active tuberculosis in settings where health provider availability is greatly challenged.
Dr. Bachmeier presents an up-to-date review of newer-generation antimicrobials designed to be effective against infections with multiple drug-resistant pathogens. He first reviews the different types of extended-spectrum beta-lactamase (ESBL) resistance. He then discusses the significance of Carbapenemase-producing enterobacteriaceae and ESBL producing E coli, Klebsiella pneumonia, and Pseudomonas aeruginosa strains. Such organisms have become increased threats to our patients over the last two decades while new drug approvals have dwindled. Dr. Bachmeier reviews Ceftolozane-tazobactam, Ceftazidime-avibactam and their current indications. He then reviews Meropenem-vaborbactam and its utility in the treatment of Klebsiella pneumonia carbabenemase (KPC) infections. He then discusses imipenem-relebactam and its advantages in the treatment of MDR gram-negative infections. Lastly, he reviews plazomycin, eravacycline, and Cefiderocol.
Dr. Sinnott’s grand rounds presentation reflects upon the history of infectious diseases, from the late 1960’s, when the battle with infectious agents was felt to have been won, to the present age of widespread antimicrobial resistance, emerging pathogens, and the newer therapies of the “post-antibiotic era.” He focuses on genetic susceptibility, and how this has played a major role in infectious diseases outbreaks of the past. He also touches upon commercial “boutique” genetics services which offer to sequence an individual’s genome for ancestry and hereditary purposes. Lastly, he comments on the importance of the human microbiome to disease susceptibility and wellness.
Dr. Nguyen examines the complex problem of the addiction crisis, a major cause of morbidity and death in much of the US, and especially in the state of Florida. He first discusses the epidemiology of addictive disorders and the US states where these patients are more likely to be found. He then discusses specific addiction-related medical syndromes, including acute eosinophilic pneumonia, crack cocaine lung, complications of body packing, fungal sinusitis, endocarditis, skin and soft tissue infections, fungal pneumonia, and other septic complications of injection drug use
Dr. Oehler discusses three fascinating patients from his archives involving cases that were good enough to publish in medical journals. He first discusses a 59 year old patient with a fever, headache, and a lytic bone infection. He next reviews a 49 year old homeless man with an aquatic cellulitis and an unusual bacteremia. Lastly, he shares the history on a 50 year old patient with acute graft thrombosis after eating at a mexican restaurant. In the process of discussing these cases, Dr. Oehler discusses the differential diagnosis of these presentations and the unusual syndromes that form the ultimate diagnoses.
Dr. Lopez-Perez examines the infectious diseases syndromes that via bioterrorism and natural outbreaks could be responsible for “end of the world” scenarios. He initially focuses on agents of bioterrorism, including Anthrax, Smallpox, Plague, Tularemia and Botulism. He then goes on to discuss the threat posed by pandemic influenza. He also touches upon the possibility of genetically engineered pandemics, in which techniques such as “CRISPR” could be used to create “designer organisms” or to replicate or modify already fearsome pathogens (such as influenza or smallpox) with devastating results.