212 episodes

TWiP is a monthly netcast about eukaryotic parasites. Vincent Racaniello and Dickson Despommier, science Professors from Columbia University, deconstruct parasites, how they cause illness, and how you can prevent infections.

This Week in Parasitism Vincent Racaniello

    • Science
    • 4.9 • 424 Ratings

TWiP is a monthly netcast about eukaryotic parasites. Vincent Racaniello and Dickson Despommier, science Professors from Columbia University, deconstruct parasites, how they cause illness, and how you can prevent infections.

    The Man from Mali with Shauna Gunaratne

    The Man from Mali with Shauna Gunaratne

    Shauna Gunaratne joins TWiP to solve the case of the Man from Mali with Painless Skin Lesions, and discuss her plans for a tropical medicine institute in New York City.
    Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
    Guest: Shauna Gunaratne
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    Download TWiP #212 (51 MB .mp3, 84 minutes)
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    Links for this episode Letters read on TWiP 212 Become a patron of TWiP
    Case Study for TWiP 212
    14 year old boy with a history of slow progressive development of abdominal ascites over years.  Appears wasted and malnourished. Afebrile, no history of weight loss or night sweats, no history of TB exposure, HIV negative. Had an older brother who died the year before of apparently the same disease. Had lived early life by the shores of lake Victoria. Currently has really impressive abdomen.
    Send your case diagnosis, questions and comments to twip@microbe.tv
    Music by Ronald Jenkees

    • 1 hr 27 min
    Monoclonal against malaria in Mali

    Monoclonal against malaria in Mali

    TWiP solves the case of the Man from Hong Kong with Multiple Comorbidities, and discuss safety and efficacy of a monoclonal antibody against malaria in Mali.
    Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
    Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email
    Links for this episode Monoclonal antibody against malaria trial (NEJM) Hero: Stephen Hoffman Letters read on TWiP 211 Become a patron of TWiP
    Case Study for TWiP 211
    Man in his 20s originally from Mali who comes in with a dermatological complaint about 1 mo after he returned from spending time in Bamako, Mali with friends and family. Reports this has been going on for months and he is getting very frustrated as he is not getting any answers. He relates that this started with itching over a “blackhead” resembling a pimple that was itchy and very small. Over the subsequent months it started to get larger with ongoing itchiness but no pain. No erythema or warmth in the area. Other lesions developed in addition to the first one. There was no drainage from the skin lesions. He started putting triple antibiotic ointment on his lesions that he bought from a pharmacy.
    He then went to his primary doctor who prescribed a topical medication and PO antibiotics but this did not help. 
    He reports that when in Mali he stayed in his house with his parents, siblings, grandmother and other extended relatives – more than 40-50 people under one roof. food made by his family, reports consumption of only cooked meat, no uncooked meat. Ate salads and uncooked vegetables. No contact with any animals, no pets in the home. Denies any contact with any pets or farm animals such as pigs, cows, horses, cattle. Denies swimming in any lakes or ponds. No hiking or outdoor activities. No riding horses.
    Was sexually active in Mali with women and is HIV negative. 
    On examination he has a 10 cm lesion over anterior L thigh, with verrucous and vegetative appearance with yellow crusting over central area and heaped up lesion, not undermined. No erythema, warmth or drainage. Has a similar smaller lesion measuring about 3 cm on R flank. Has a 3rd smaller lesion with some mild crusting and about 2cm over R posterior thigh.
    He ends up getting a biopsy that reveals:
    HISTOLOGIC FEATURES That ARE NOT DIAGNOSTIC.  THERE IS NO EVIDENCE OF any specific organisms.  THE EXOGENOUS MATERIAL WHICH COULD REPRESENT SOME TYPE OF FOREIGN BODY IS NOT IDENTIFIABLE AS PART OF A FLY OR ARTHROPOD, NOR IS IT TYPICAL OF A SPLINTER AND ITS PRESENCE IN THE SPECIMEN MAKES IT PROBLEMATIC AS TO ITS SIGNIFICANCE. MICROSCOPIC DESCRIPTION: WITHIN THE DERMIS THERE IS A DENSE DIFFUSE MIXED CELL INFLAMMATORY INFILTRATE INCLUDING MANY PLASMA CELLS AND NEUTROPHILS. THERE IS EXOGENOUS MATERIAL.  PAS, GMS, FITE AND GRAM STAINS ARE NEGATIVE FOR INFECTIOUS ORGANISMS.
    Additional testing is ordered that leads to the diagnosis.
    He is planning on returning to Mali and perhaps sooner than originally planned if he does not get a diagnosis since he thinks the doctors in Mali would know what he has.
    Send your case diagnosis, questions and comments to twip@microbe.tv
    Music by Ronald Jenkees

    • 1 hr 24 min
    Is there a doctor on board? with Aisha Khatib

    Is there a doctor on board? with Aisha Khatib

    From ASTMH2022 in Seattle, Aisha joins the TWiP team to talk about her training and her career, including delivering a baby on an airplane, and they solve the Case of the Heartsick Guatemalan Septuagenarian.
    Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula
    Guest: Aisha Khatib
    Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email
    Links for this episode Aisha delivers baby on airplane (The Varsity) Helminth infections during pregnancy (J Travel Med) SARS-CoV-2 transmission during air travel (Curr Op Inf Dis) Letters read on TWiP 210 Become a patron of TWiP
    Case Study for TWiP 210
    We are consulted about a rash.  A male in his mid 60s originally from Hong Kong with PMH of T2DM, Hypertension, BPH, Hepatitis B infection, COPD (not on home o2), current smoker, ESRD  with right chest cath on dialysis (MWF) presented to the ED  c/o progressive SOB and DOE for 1 week. 2 weeks prior the patient missed 1 session of hemodialysis. Progressively worsening SOB, DOE, orthopnea began to develop starting one week ago with an associated productive cough with white sputum. Last dialysis was session was 3 days PTA. Pt also began developing nausea and vomiting for 3 days x12 times last week. Pt also started developing diarrhea. Pt has states to have a notable generalized pruritic rash for 3 months that has been worsening. He reports he has been seen by dermatology and was told that the rash is due to certain allergies from food and has been using an unknown cream for 1 month that does not relieve his symptoms. Pt recently admitted for management of bleeding permacath and acute hypoxic respiratory failure likely 2/2 COPD requiring intubation and vent support. Denies recent travel, recent antibiotic use, or sick contacts…but his nephrologist reaches out and is concerned about a certain diagnosis as he says three other patients that come for dialysis have recently been diagnosed with a certain diagnosis.
    On exam ee has a diffuse symmetrical rash and is scratching the while time. On careful examination there are small linear scabbed areas between his fingers.
             9.3  
    8.97  )———–( 210    
               28.4 
    Absolute eosinophil count is >1000
    134  |  97  |  51
    —————————-
    3.8   |  25  |  5.10
    Send your case diagnosis, questions and comments to twip@microbe.tv
    Music by Ronald Jenkees

    • 1 hr 35 min
    A worm in paradise

    A worm in paradise

    The TWiP team solves the case of the Woman From Hawaii With Allodynia and abdominal pain, bilateral hip and leg pain, dizziness, and diffuse hyperesthesia.
    Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
    Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email
    Links for this episode Use coupon code MicrobeTV when purchasing a spike t-shirt from Vaccinated.us Accidental host (TWiP 207) Hero: Dan Colley Letters read on TWiP 209 Become a patron of TWiP
    Case Study for TWiP 209
    Man in his early 70s with PMH sig for HTN, DM-II, HLD, BPH is admitted to the hospital after coming from Guatemala to visit his son. He feels faint with standing and is noted to have a HR in the 40s and does not feel well when he stands. He is also noted to have diarrhea, but this has been going for an unclear period of time. On EKG he is noted to have a RBBB.
    PMH  HTN, DM-II, HLD, BPH PSH neg
    Allergies NKADR
    Social -no toxic habits reported, reports living in Guatemala City but grew up in the rural areas. Enjoys fruit juice
    FH-noncontrib
    Exam: slow heart rate, orthostatic
    A number of blood and stool tests are collected and he is referred to a tertiary care center for implantation of a cardiac pacemaker. At the tertiary care center the patient is seen by an Infectious Disease Specialist and a number of tests are ordered by the Infectious Disease Consultant but they are canceled by Cardiologist who writes in their note “no concern for an infectious process”. Now one of the tests collected at the first hospital returns with an interesting result that is later confirmed by a second test.
    Send your case diagnosis, questions and comments to twip@microbe.tv

    • 1 hr 8 min
    A red herring

    A red herring

    The TWiP team solves the case of the Woman Who Vomited Up a Worm, and discuss how malaria transmission intensity can modify the effectiveness of the RTS, S/AS01 vaccine in Africa.
    Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
    Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email
    Links for this episode Malaria intensity modifies vaccine effectiveness (J Inf Dis) Letters read on TWiP 208 Become a patron of TWiP
    Case Study for TWiP 208
    An adult female resident of Hawai’i presented to the emergency department (ED) with several days of fever, abdominal pain, urinary hesitancy, and generalized itchiness. white blood cell [WBC] count 14,000 cells/mL) without eosinophilia. Urinalysis suggested a urinary tract infection and she was treated for acute UTI and discharged home. 
    The following day she returned to the ED because of worsening abdominal pain, bilateral hip and leg pain, dizziness, diffuse hyperesthesia, and allodynia (Pain from stimuli which are not normally painful)  (worse on her feet and legs.) Urine culture from her initial ED visit grew normal urogenital flora. Her leukocytosis increased and she now had eosinophilia (WBC count 15,500 cells/mL; absolute eosinophil count 574). Laboratory evaluation was otherwise unremarkable. CT scans of the brain, abdomen, and pelvis were normal.
    She was hospitalized and her allodynia worsened despite treatment with analgesics. She also developed a sensation of “electric eels swimming through [her] body. Electromyography and nerve conduction studies were normal. The patient underwent a lumbar puncture and CSF examination was notable for eosinophilic meningitis with 138 WBCs and 13% eosinophils (absolute eosinophil count 18).
    Send your case diagnosis, questions and comments to twip@microbe.tv
    Music by Ronald Jenkees

    • 1 hr 4 min
    Accidental host with Claire Panosian, MD

    Accidental host with Claire Panosian, MD

    Claire joins the TWiP team to discuss her training and experience as an infectious disease physician, and her transition to science communication, then we solve the case of the Honduran Male with Seizures.
    Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
    Guest: Claire Panosian
    Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email
    Links for this episode Claire’s website Claire’s videos (Vimeo) Letters read on TWiP 207 Become a patron of TWiP
    Case Study for TWiP 207
    Woman in 20s, spent time in Kenya 6 months prior, vomited up a worm. 0.5 cm in length. Sent to lab. Was moving. Earlier that day she went out with friends to sushi place, ate fish. Developed horrible abdominal pain, then vomited. 
    Send your case diagnosis, questions and comments to twip@microbe.tv
    Music by Ronald Jenkees

    • 1 hr 42 min

Customer Reviews

4.9 out of 5
424 Ratings

424 Ratings

Asciguy ,

Monoclonal Antibodies Against Malaria in Mali

When discussing administration of CIS43LS they forgot to check the math. One dose for me at 40mg per kilogram would be 3.38 grams. That would require an IV infusion.

BulgarianNurse ,

I love it!!

I am a nursing student and i am fascinated by microbiology and infectious diseases. Thank you for having this amazing resource for free!

MadmanDrew ,

Less clinical cases and more research would be nice.

I like the other This Week In series quite a bit, but this one is the odd one out since they spend a large amount of time (sometimes the entire episode) on case studies. They present these with the idea of listeners writing in to guess what parasite it is. What’s lame about these is that most of the time the listeners all say the exact same thing so it’s rather boring. Also it’s not exciting for many folks who are into research since most of us want to hear scientists talk about their latest work and what’s going on in the field.

Perhaps this podcast should be split into TWIP and This Week in Case Studies so that the doctors and medical students can still have their fun while us researchers can have the content we prefer.

Just my two cents. Just feels like a bit of a misleading podcast since it is so different from the other sister podcasts.

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