Boris Jegorović, MD, PhD
@BJegorovic
Followers
1,384
Following
282
Media
279
Statuses
6,796
Infectious Diseases Specialist 🦠 with love for #TropicalMedicine 🦟 and #Nephrology 💧Physical examination fanatic 🩺 Whisperer of Ancient Egyptian language.
Belgrade, Serbia
Joined July 2020
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Pinned Tweet
#medtwitter
#nephtwitter
#nephrology
#pocus
#askrenal
What are the best beginner resources to learn nephrology point-of-care ultrasound?
@NephroP
@NephroNicki
@YelenaDrexlerMD
@DrRonWald
@kidney_boy
@RenalFellowNtwk
@Neph_SIM
@jrseltzer
@captainchloride
@nephrothaniel
2
7
17
@ABStewardess
I see this almost every day. We have big problems with antibiotic overuse and multiresistant bacteria, and nobody does nothing to solve the problem, or just to mitigate it.
11
30
452
#IDtwitter
#MedEd
This is my "checklist" for the approach to ID consultations, mainly oriented to in-hospital and ICU-acquired fever. I want your opinion and suggestions for additions and corrections.
#IDtwitter
My dear ID friends, one question. Do you have "checklist" with "staffs" you should ask and see when you are called for consult? Especially for new onset fever in ICU?
@BradSpellberg
@IdVilchez
@ABStewardess
@dralicehan
@CosEpiID
@FReichert667
@DrJimNoble
4
0
14
3
26
124
#IDTwitter
#MedTwitter
Today, I successfully defended my
#PhD
thesis. It was a hard, but great journey. And when one journey ends, another begins. 🛩️
30
0
88
#MedTwitter
#ICU
@IM_Crit_
@PulmCrit
@emcrit
@ogi_gajic
Patient with ARDS. Saturation 68%, pH 7.0, pCO2 ≈100 mmHg. On noradrenaline. What options I have?
24
21
85
#IDTwitter
My colleagues from Clinic for Infectious and Tropical Diseases
#Belgrade
and I were honored to listen to an amazing online lecture about oral antibiotic therapy presented by the great
@BradSpellberg
. Thank you Brad for that opportunity.
#oral_is_new_IV
4
8
70
#IDTwitter
When you think you saw monstrous XDR bacteria, see this abomination. How would you treat it?
@BradSpellberg
@wfwrighID
@IdVilchez
@AntibioticDoc
@ABsteward
@ABStewardess
@dralicehan
18
14
71
It seems that I am an ID Schrödinger's cat — I didn't go to
#IDWeek2022
, but I did. 🐈 🐱
#idwitter
2
2
59
I am sharing my expanded differential diagnosis mnemonic. "Share, retweet, let no fear of missing something throw our hearts in the pit."
@CPSolvers
@DxRxEdu
@rabihmgeha
#MedTwitter
#DifferentialDiagnosis
#DDx
#Dx
#mnemonic
0
12
58
#MedTwitter
#IDTwitter
#CriticalCare
Does anyone use corrected doses of antibiotics in the patient with hypoalbuminemia?
@BradSpellberg
@IdVilchez
@IDstewardship
@tmhohl71
@GermHunterMD
@DrToddLee
@AntibioticDoc
@IDstewardship
16
17
57
#IDTwitter
Patient in ICU on mechanical ventilation. New deterioration. Tracheal aspirate grew this monstrosity. 👇 VAP suspected. No further antibiotic susceptibility testing is available. How would you treat it?
17
8
50
I created new version of the table with all-in-one table for
#ShorterIsBetter
approach based on
@BradSpellberg
original work. All references of mentioned studies in the table are available on
Amazing that after years of searching and collating, people (usually
@absteward
!) still find Shorter Is Better studies we didn't know about! 2 more Lyme disease studies added to table thanks to Dr. Ghanem. One from 1983! Who knew!?
References at
2
59
159
1
8
46
@BrownJHM
@OGdukeneurosurg
I am not surgeon, but I know that this stitches so close to one another will cause tissue ischemia and dehiscence of the wound.
0
1
41
@BrownHospMed
Anthrax is surely in differential diagnosis, but it is not typical that cutaneous anthrax kills at all (5-15% mortality if untreated) and also to lead this quick to death. Plague is more likely considering patient died so fast.
2
1
40
#IDTwitter
In approach to new-onset fever in ICU patient, do you considering urine culture and when? What do you think about text below (screenshot from EMCrit website)? Do you have similar experiences and practices?
@IdVilchez
@BradSpellberg
@ABsteward
@IDstewardship
@DrToddLee
4
17
40
#IDTwitter
#IDXposts
Patient with sepsis in ICU, probably of intraabdominal origin. Blood culture (only one), aerobic bottle, no anaerobic, grew this rarity. 👇 How would you approach it and how would you treat if you need to? Susceptibility with * were done by disk-diffusion.
16
5
40
@IM_Crit_
In my country, we have much bigger problem. In our institution microbiology lab is open only on weekdays, and morning hours on Saturday. So, if I admit patient in Saturday afternoon, the blood cultures will wait Monday to be proceeded. Other cultures also.
2
0
39
@drtimothyli
Froin syndrome is characteristic of intraspinal tumors in majority of cases (tumor causing spinal block and hyperproteinorachia which leads to hypercoagulation of CSF).
1
4
36
@BrownJHM
He had hell of vacation. He was swimming in dirty water and had contact with rats... Where he was, in sewer?
8
0
35
@SyedAAhmad5
The real problem today is the fact that most of modern doctors does not have enough skill in physical examination. Sixty years ago, the only thing you had is your senses, and old physicians were masters of physical examination and diagnosis. 👇
5
4
34
#idtwitter
#medtwitter
A 17-year old female pregnant patient in 32nd week of pregnancy is discovered to have:
1) TPHA ➕ 1:640
2) VDRL ➖
3) IgG ELISA ➕
There were no signs or symptoms of 1° or 2° syphilis. What would be your next diagnostic and therapeutic steps?
11
6
34
#IDtwitter
I can proudly say that for the last two months I tremendously changed my practice by incorporating IV-to-PO antibiotic switch for many infections which I previously treated with only IV therapy. I want to thank
@BradSpellberg
for his teaching and the inspiration.
1
2
32
#IDTwitter
After long wait, I finally get my copy of new 24th edition of Manson's Tropical Diseases! I am so excited to dive in. Thank you
@PeterHotez
@JeremyFarrar
for your work!
0
3
29
#IDTwitter
#IDXposts
CASE UPDATE: Patient died next day in septic shock and MODS. His therapy on the day of death was cefepime, levofloxacin and linezolid. Post-portem blood culture result came up 👇 He didn't stood a chance...
#IDTwitter
#IDXposts
A 80-years old gentleman was admitted for AKI requiring hemodialysis. On admission ceftriaxone was started because of elevated WBC (24) and lung crackles on the left. There was no fever and CRP was normal. On 2nd day of hospitalization his CRP rose to 150 👇
8
2
20
8
9
31
My first case presentation on VMR
@CPSolvers
. I was very nervous, but at the end everything went quite good. I am honored that
@DxRxEdu
and
@rabihmgeha
were case discussants. I hope we will have more VMR sessions like this.
3
2
30
#IDTwitter
A 30-year-old man with endocarditis, septic shock, and septic emboli to the brain, spleen, and kidney. He was started on ampicillin, vancomycin, and ceftriaxone. One day later, blood cultures grew Staphylococcus aureus with shown antibiotic susceptibility. 👇
20
5
28
Staphylococcus aureus isolated from bronchial aspirate - true VA pneumonia patogen or just colonizer considering staphylococcal pneumonia is really destructive, fast, cavitating pneumonia, but in reality VAP rarely presenting that way?
#IDTwitter
#MedTwitter
@wfwrighID
8
6
26
@AlanPlotzker
@AdamRodmanMD
Beautifully stated. Modern diagnostics does not tell us one crucial thing — how sick is the patient.
1
2
27
#IDtwitter
Young patient with severe Streptococcus pyogenes sepsis with meningoencephalitis, severe brain edema with DIC on vassopressors. Currently on meropenem and clindamycin. No obvious primary source. Would you give immunoglobulins (Ig) and how much?
Yes (how much?)
377
No.
242
Other (please comment).
62
17
3
28
How often do you use 2nd generation cephalosporins, for what indications and which one?
#IDtwitter
@BradSpellberg
@IdVilchez
@wfwrighID
@ABsteward
@AntibioticDoc
@IDstewardship
@FungalDoc
@GermHunterMD
17
7
27
#IDtwitter
#MedTwitter
📋A 26-year-old male with 6 days of cough, sore throat, and fatigue, and last 3 days of 🌡️ 39,5°C. Two days before the current presentation the amoxicillin-clavulanate was prescribed, but without effect - the patient get worse, with more throat pain, his 👇
9
3
26
Terminal malignancy patient with sepsis. This is the result of the hemoculture. What would be your antibiotic choice and why?
#idtwitter
@IdVilchez
@BradSpellberg
@wfwrighID
@IDstewardship
11
5
26
@nihardesai7
@Sthanu5
Cyclosporin is highly metabolized in humans and animals after ingestion. The metabolites, which include cyclosporin B, C, D, E, H, and L, have less than 10% of cyclosporin's immunosuppressant activity and are associated with higher kidney toxicity.
0
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@PulmCrit
This is the best book on electrocardoography. 👇🏻 Enough but not to much details, with grat differential diagnosis at the end and 16-steps how to interpret ECG. Highly recomended!
1
3
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#IDTwitter
A 57-year old woman with history of suspected Cushing syndrome was found to have MRSA bacteriemia and extensive spinal epidural abscess without obvious neurologic abnormalities except slight weakness of the legs. There are no signs of sepsis. How would you treat?
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2
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#IDTwitter
Male patient with history of prostate hyperplasia, developed UTI, without sepsis. Urine culture result attached. How would you treat and for how long?
@dralicehan
@ABStewardess
@BradSpellberg
@IdVilchez
@CosEpiID
@mykkymcg
@DrToddLee
@wwrighID
@he
11
4
25
#NephTwitter
I just did my first IVC ultrasound for congestion assessment. Small steps, but I am happy.
@NephroP
1
1
24
Did anyone have experience with oral
#fosfomycin
(IV form not available) for serious
#MDR
/PDR bacterial infections? Today I was consulted for a patient with AML, WBC 0 and pan-resistant Klebsiella in blood.
#Idtwitter
#txid
@IdVilchez
@BradSpellberg
@DrToddLee
@wfwrighID
👇
15
5
26
#IDTwitter
#IDXposts
Patient planned for surgery for tumor of the kidney. Urine culture grow Enterococcus (see below). Would you: not treat, treat or give prophylactic antibiotic before surgery only? Which antibiotic and for how long if patient needs treatment?
@dralicehan
12
5
26
#idtwitter
Maybe weird question, but why there is so much discussion about ceftaroline and daptomycin for MRSA bacteriemia? Is this therapy is better than vanco and linezolid, or there is something else. In my country we do not have any of those two drugs, just vanco 👇
11
4
25
#IDTwitter
I do not know if I was faster than
@ABsteward
, but here is a game-changing study if the quality of the study is supportive enough for practice-changing. Adjunctive dexamethasone for Listeria meningitis actually improves survival:
🔓
7
7
24
#IDTwitter
#AMRounds
@wwrighID
@IdVilchez
@dralicehan
@ABStewardess
What would be the resistance mechanism in this clinical blood isolate (2 blood culture sets)? The patient is clinically stable, only febrile. How would you treat it?
@BradSpellberg
@DrToddLee
12
3
24
#idtwitter
Patient with proven subacute endocarditis, vegetations surgically removed and valve repaired, responded very well to meropenem + vancomycin (afebrile). No organism cultured. Team wants to release the patient on PO antibiotics. What ABx would you suggest? 👇
12
1
23
#IDtwitter
#AntibioticResistance
Hospitalized patient with slight intermittent suprapubic pain and pyuria. No fever. Urine culture grew this abomination. Can we treat it and why not?
@ABStewardess
@dralicehan
@AntibioticDoc
@IdVilchez
@BradSpellberg
@TorontoIDDoc
@wfwrighID
15
1
23
#IDtwitter
#AMRrounds
Clinical isolates from the patient in ICU from tracheal aspirate
1. Pseudomonas aeruginosa
2. Providencia spp.
I am interested in the mechanism of resistance in both these isolates and hypothetical therapy.
6
1
23
#idweek2022
#IDtwitter
By the kindness of
@GermHunterMD
I just recieved my
@IDJClub
badge. The IDTweet bird landed my doorstep after long fly over the ocean 🤓
2
0
23
@serotavirus
It seems not just ertapenem:
#MedTwitter
#IDTwitter
#CriticalCare
Does anyone use corrected doses of antibiotics in the patient with hypoalbuminemia?
@BradSpellberg
@IdVilchez
@IDstewardship
@tmhohl71
@GermHunterMD
@DrToddLee
@AntibioticDoc
@IDstewardship
16
17
57
0
3
23
#IDTwitter
What do you think about initial therapy with piperacillin-tazobactam + linezolid for community-acquired sepsis of unknown source?
@IdVilchez
@wfwrighID
@BradSpellberg
@DrToddLee
@ABsteward
@AntibioticDoc
@tmhohl71
@CosEpiID
18
7
22
@nihardesai7
@Sthanu5
Amphotericin A didn’t have useful antifungal activity, so during the original manufacturing process of amphotericin B the goal was solely to reduce the amount of Amp A. Toxicity was not improved with reductions in Amp A so its unlikely to significant contribute to toxicity either
1
0
20
#IDTwitter
In some places I reading that maximum daily dose of TMP(-SMX) is 960 mg of TMP. This means that if patient has PJP/PCP pneumonia, and his BW is 80 kg, and the dose is 20 mg/kg/day, I cannot give him 1600 mg of TMP per day, but only 960 mg? Is this correct? 👇
6
4
21
#IDTwitter
#IDXposts
A 80-years old gentleman was admitted for AKI requiring hemodialysis. On admission ceftriaxone was started because of elevated WBC (24) and lung crackles on the left. There was no fever and CRP was normal. On 2nd day of hospitalization his CRP rose to 150 👇
8
2
20
What is the most beautiful thing in infectious diseases for you?
For me, it is the
#Staphylococcus
aureus isolated in culture, sensitive to
#penicillin
G.
#IDTwitter
#medtwitter
#antibiotics
@ABsteward
@FungalDoc
@BradSpellberg
@IdVilchez
@IDstewardship
14
3
21
#idtwitter
Patient with otogenic purulent meningitis caused by Streptococcus pneumoniae, currently on meropenem and vancomycin, getting better Antibiotic susceptibility results showed S to everything except levofloxacin (I) and tigecycline (IE). How would you treat?
ceftriaxone
699
penicillin G
371
TMP-SMX
25
Other (comment)
14
5
6
21
#IDTwitter
Could "Shorter is better" principle be applied in patients who are immunosuppressed (receiving corticosteroids, biologicals, cyclosporine, have AIDS, etc.), or it duration of antibiotic therapy should be extended?
@BradSpellberg
@ABsteward
@IdVilchez
@dralicehan
2
3
20
@Weavofloxacin
The problem with UTI are not patient who can tell their symptoms, but those other that can't. We need good laboratory criteria for UTI in patients who are altered and who do not have localizing signs.
1
1
20
#IDTwitter
#IDXposts
Why labs reporting aminoglycoside sensitivity of Staphylococcus aureus? What S to gentamicin means? Who will use aminoglycosides to treat S. aureus?
@ABsteward
@dralicehan
@ABStewardess
@maudi_ahmed
@BradSpellberg
@DrToddLee
@IdVilchez
@Cortes_Penfield
11
2
20
If some bacterial species is R to cefazolin, does this automatically means that it is also R to other 1ˢᵗ generation cephalosporins?
#IDTwitter
@wfwrighID
@BradSpellberg
@DrToddLee
@IdVilchez
@ABsteward
@IDstewardship
7
4
19
#IDTwitter
When you switch patients from IV to PO antibiotics during hospitalization, do you observe them for some time in hospital after switch, and if yes, for how long? And after release from hospital, when you plan follow-up visit?
@IdVilchez
@BradSpellberg
@DrToddLee
👇
10
6
19
@transplantID
Differential diagnosis for necrotizing granulomas in lung:
• infections
— TB and non-TB mycobacteria
— Histoplasma spp.
— Coccidioides spp.
— Blasomyces spp.
— Aspergillus spp.
— Sporothrix spp.
— Candida spp.
• autoimmune
— reumatoid nodule
— Wegener's granulomatosis 👇
2
0
19
A middle-age woman with COVID-19 pneumonia, on MV in ICU, with new-onset fever and rise of inflammatory markers with pyuria. Urine culture grow 100 000 CFU/mL of Klebsiella-Enterobacter spp. What would be right antibiotic choice for this patient?
#IDTwitter
#txid
@IdVilchez
14
4
19
I had my second
#VMR
with
@CPSolvers
and its masters
@DxRxEdu
and
@rabihmgeha
as discussants, and this time everything passed much smoother and I was way less nervous. Thank you all for the great discussion.
2
4
19
@dralicehan
@BradSpellberg
@IdVilchez
@IDstewardship
@tmhohl71
@GermHunterMD
@DrToddLee
@AntibioticDoc
Here it is:
Very good reference, if you ask me.
2
3
19
#idtwitter
Pansensitive E. coli was isolated in blood culture in older lady with severe urinary tract infection. Before culture result came back, patient was started on IV cefuroxime, and responded in a few days really good. I am planing to switch to PO. What would be the best 👇
11
3
19
#idtwitter
Older patient was admitted for bacterial meningitis. Empirical antibiotic therapy included: ceftriaxone, vancomycin and ampicillin. When culture came back positive for pan-S Streptococcus pneumoniae you do what about antibiotics?
Leave ceftriaxone only.
481
Leave ampicillin only.
79
Give penicillin G.
192
Somthing else (comment)
16
12
4
17
#IDtwitter
A 57-year old woman with history of treated pharyngeal carcinoma admitted because of fever and AMS. Bacterial meningitis was diagnosed based on clinical picture and CSF findings. Empirical therapy with ampicillin, ceftriaxone and vancomycin was started and patient 👇
6
7
18
An 80-yeaf old female with suspected Creutzfeldt-Jakob disease, currently in coma, intubated for almost 3 weeks, developed new pulmonary infiltrates and deterioration of respiratory function. The result of bronchial aspirate culture is shown. How to approach treatment of this?
13
3
18
A young woman with few days of dysuria and low-grade fever. Urine culture result is shown (> 100 000 CFU/mL). What would be the best antibiotic choice and for how long? Can we use fosfomycin or nitrofurantoin?
#IDtwitter
@IdVilchez
@wright
@BradSpellberg
@ABsteward
@IDstewardship
16
3
17
#IDTwitter
#MedTwitter
How do you make the diagnosis of sepsis (not septic shock)? What history do you ask for, what are you looking for in physical exam, and what laboratory analyses and other diagnostic tests do you order before diagnosing sepsis? 👇
7
4
17
#IDTwitter
Can someone share good practical guidelines and a reliable online calculator for vancomycin dosing based on AUC? I need a simple step-by-step approach.
@dralicehan
@ABStewardess
@IDstewardship
@OncIDPharmd
@IdVilchez
@AntibioticDoc
@DrToddLee
@DrEmilyMcD
10
2
18
@DxRxEdu
Hypercalcemia is only relative contraindication considering lower levels of Ca in Ringer's lactate than in blood and also minuscule amount of Ca given. Ringer's lactate can cause alkalosis which by itself causing Ca bonding to albumin, lowering its value in serum.
1
2
18
If I have a patient with acute fever and no localizing symptoms, but urine analysis shows
#leukocyturia
(e.g. 10-20 WBC/mL), protein 1+ and lot of bacteria, should I consider
#UTI
and treat empirically for it?
#IDTwitter
#MedTwitter
@TxID_Edu
@FungalDoc
@medrants
@BradSpellberg
9
3
17
#medtwitter
#idtwitter
For the first time, I will teach students about clinical medicine, particullary ID, from October this year. What I want the most, is to implement clinical reasoning in my lectures. Do you have any tips, resources, personal thoughts, advices, etc. for me 👇
13
3
17
Had a great time yesterday while presenting the case at
@CPSolvers
#VMR
. Great discussants
@Api_chew
and
@sukritibanthiya
. It was a very interesting case for me when I saw that patient in the office, and I learned a lot from it. Great people in the chat also.
1
0
17
@DxRxEdu
@rabihmgeha
I found two terms that make no sense:
- acute myocardial infarction (is there a chronic one?)
- malignant melanoma (is there a benign one?).
2
2
17
#IDTwitter
#IDXposts
Postcystectomy patient developed fever. Before culture results were available, pip/taz and vancomycin are prescribed. Patient is still febrile after 7 d of therapy, but clinically well and CRP is going 🔽. This is result of blood culture 👇 What you do next?
18
2
17
UPDATE: Listeria monocytogenes was isolated in CSF culture. Multiplex PCR was negative, as were blood cultures. The patient responded partially to antibiotics but developed confusion. She is on oxygen therapy over the simple mask. Chest X-ray showed no changes for better. 👇
#IDTwitter
#Tropical
A previously healthy obese (110 kg) 45-year-old female presents with 4 days of fever (39°C), malaise, myalgia, chills, mild rigors, maculopapular rash, and dry cough. Everything started after she returned from 2 weeks vacation in Thailand (Phuket island) 👇
11
2
15
5
2
16
#IDTwitter
#Tropical
A previously healthy obese (110 kg) 45-year-old female presents with 4 days of fever (39°C), malaise, myalgia, chills, mild rigors, maculopapular rash, and dry cough. Everything started after she returned from 2 weeks vacation in Thailand (Phuket island) 👇
11
2
15
What do you think about one dose of aminoglycoside and do you have some experience with this approach?
@IdVilchez
@wfwrighID
@BradSpellberg
@ABsteward
@IDstewardship
1
3
15
#medtwitter
@DrToddLee
@ABsteward
@ABsteward
Any good guidelines for prophylactic use of proton-pump inhibitors and LMWH in hospitalized patients? Based on my observation, it seems that we use a lot of it, totally unnecesary.
6
3
15
#IDTwitter
Case update: Patient was started only on ceftriaxone + metronidazole. Next day he already regained conciousness and his hemiparesis was less pronounced. His Meningitis/Encephalitis PCR Panel showed Streptococcus pneumoniae.
@ABStewardess
@DrToddLee
@brad
#IDTwitter
A 44-years old patient with bacterial meningitis, right facial palsy and hemiparesis as a complication of acute otitis media. There is no diabetes or other obvious risk factors. What would be your empiric therapy of choice?
20
1
11
3
1
14
#idtwitter
Does anybody have experience with acyclovir-resistance of HSV developing during treatment of HSV encephalitis?
@BradSpellberg
@IdVilchez
@DrToddLee
@ABsteward
@AntibioticDoc
@wfwrighID
5
6
15
@IM_Crit_
In my institution, me and my collegues are everything - internists, infectious disease specialists and intensivists.
1
0
14
@IDstewardship
As great
@BradSpellberg
said (paraphrasing): "If you didn't have courage not to give antibiotics, have the courage to discontinue them early when unnecesary".
1
1
15
#IDTwitter
Urine culture. Please comment on resistance mechanism (Pseudomonas predominantly) and possible treatment.
@wfwrighID
@IdVilchez
@ABsteward
@AntibioticDoc
@BradSpellberg
@FungalDoc
@GermHunterMD
#sensishot
5
3
14
@captainchloride
Venous congestion causes ⬆️ in renal vein pressure with subsequent ⬆️ of pressure in postglomerular capillares and renal interstitium which is then transmittes to renal tubules. In one moment, intratubular pressure will be > than glomerular hydrostatic pressure and filtration 🛑.
0
0
15
#IDTwitter
What is the usefulness of PCR in detecting Candida blood-stream infections/invasive candidiasis? If I get postive result in ICU patient with fever, is it enough for diagnosis of candidemia?
@FungalDoc
@GermHunterMD
@DrNeilStone
6
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"Any diagnosis can be one of the two things - either infection or non-infectious." I like this because it is true.
@DxRxEdu
It reminds me what my grandfather said many years ago when I told him I want to practice ID:
"Every disease is infection, besides hereditary ones."
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#idtwitter
How long do you treat uncomplicated herpes zoster in patient with transplanted kidney on corticosteroids and calcineurin-inhibitors? Do you check CD4 in those patients and if yes, do you base duration on therapy on this result?
@IdVilchez
@dralicehan
@BradSpellberg
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@ABsteward
@BradSpellberg
Let's not forget that, for example, beta-lactams are older than the humans. Antibiotics where there long before we discovered them and struggle for survival is old for millions of years.
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#MedTwitter
#nephtwitter
How would you manage an 81-years old patient with hypercalcemia (total Ca 3.5 mmol/L → 14.03 mg/dL; ionized Ca 2.0 mmol/L → 8.02 mg/dL), hypernatremia (171), metabolic alkalosis (HCO3 40 mmol/L), hypokalemia (2.0) and diarrhea and polyuria? What 👇
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#MedTwitter
#MedEd
I just subscribed for annual plan with , and I am very excited about this special learning journey with phenomenal
@rabihmgeha
and
@DxRxEdu
.
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@jmugele
During measles epidemic in my country I worked in 24-hours shift in outpatient infectious diseases clinic alone. I saw 30+ cases of measles, few cases of sepsis, few cases of UTI, few cases of pneumonia, chickenpox, cellulitis, gastroenteritis... total 90-100 patients.
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#IDTwitter
#IDXposts
What is the significance of ➕ EBV PCR in CSF with minimal pleocytosis in middle aged immunosupressed woman with transplanted kidney (mycophenolate, cyclosporin) with progressive subacute neurological dementia-like deterioration in last 3 months, with 👇
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