TWiP 290: What's Biting You at Night?

TWiP solves the case of the patient who developed an intensely itchy, red papular rash after close contact with chickens and their bedding, where small mites were found. Hosts: Vincent Racaniello, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Hero of the Month: Ogobara Doumbo (Lancet, AJTMH, Lancet) Letters read on TWiP 290 New Case Man in 30s with well controlled diabetes, elevated AST ALT liver tests, asymptomatic. Ultrasound of liver, multiple cysts. Born in rural Yemen, grew up on farm with cattle, sheep, donkeys, 3-4 indoor/outdoor dogs, bathroom inside house, frequently swam in fresh water, as adult worked in construction, 2010 moved to capital, in 2017 Moved to US works in Brooklyn. March 2023 get abnormal lab results. Decide to follow, 1 year later, repeat ultrasound, 3 new lesions 1-2 cm range, triggers abdominal MRI, has enlarged liver 21 cm, hepatic steatosis, cysts. June 2024 has acute right side lower back pain, goes to ED, they say its musculoskeletal. A year later May 2025 goes back to Yemen, develops abdominal discomfort, then resolves. Oct 2025 develops day of severe diffuse abdominal pain, fever, admitted with wbc elevated, eosinophil 100, liver enzymes normal. CT shows multiple cysts 6.5 x 5 cm, with small internal cysts, few have internal enhancing curvilinear serpiginous material. Become a patron of TWiP Send your questions and comments to [email protected] Music by Ronald Jenkees