#idboardreview 60 M has pet cats & dogs, Diabetic neuropathy open ulcer on foot for several months, recent drainage, MRI +OM, micro Non motile facultative anaerobic gram negative cocobacilli, Dx? #idsky #idmeded #meded

#idboardreview 20 M from Ethiopia raised on a sheep farm, ingests fresh & raw vegetables, presents w/ RUQ pain. Normal AST, ALT & bili. CT: subcapsular enhancement of the liver & dilated common bile duct. ERCP: brown leaf-shaped worm. Dx? Tx? #medEd #idmedEd #IDsky

#idboardreview recently slaughtered sheep 🐑 for Eid & now presents with this lesion. Diagnosis? #MedEd #IDMedEd #idsky

#idboardreview 40 M diffuse nodular skin lesions x 3+yrs, hemoptysis 1 yr ago: +lung cavity & now w/ gait abnormality, blurred vision. +brain lesions. Diagnosis? #medEd #idmedEd #idsky

#idboardreview 35 M living with HIV not on ART, CD4 10 dull abd pain x1wk, Hb 5, hem occult+, EGD nodules duodenum/jejunum. Dx? #medEd #idMedEd #idsky

#idboardreview 28 F recent rodent control in her NYC apartment building presents w/4-day high fever, chills, generalized rash. +non-tender eschar on back that appeared 1wk prior to systemic symptoms. +tender posterior cervical lymphadenopathy. normal wbc, mild inc LFTs, normal plt. Vector? #idsky

#idboadreview 55 M AML w/ R chest port s/p induction, neutropenia x12 days, now w/ 102F & is on cefepime. New tender, erythematous subcutaneous nodules on his trunk & extremities. Blood cultures Gram positive bacilli identified as corynebacterium, which species is likely? #idsky #idmeded #meded

#idboardreview 80 M hx of cochlear implant, recent vacation in Wisconsin, multiple hikes in forested area 3 days ago, now with symmetic muscle weakness, initial gait instability and now cant move legs, no improvement w/doxy. Engorged tick found on his chest. Next step? #idsky #idmeded #meded

#idboardreview 40 F Mysthania Gravis, recent UTI s/p tmp-smx x 1wk, finished a day before & had dysuria, fever recurrence so s/p gentamicinx1 in ED, sx improved but now w/worsening double vision, difficulty chewing, +arm weakness, symmetric ptosis, DTR ok. Cause? #idsky #idmeded

#idboardreview 50 M from Australia works at wastewater treatment facility, potted plants at home, not best hand hygiene, presents w/ fever, cough, dyspnea, N, V, abd pain, wbc10k, Na130, Tbili7, Alk270, AST75,ALT110 , LLL consolidation. gram negative growth on BCYE #meded #idmedEd #idsky

#idboardreivew 70 M from N Carolina with alcohol use disorder presents in summer with fever, hypotension requiring pressors, rash on leg. Recent trip to Currituck sound, did swimming, fishing and consumed raw oysters. BC GNR #idSky #idmeded #meded

#IDBoardReview 25 M living with HIV (CD4: 20, VL 100k) with painful dysphagia, EGD w/ volcano ulcers. most likely Diagnosis? #medEd #idsky #idmeded

#idboardreview 40 M from California, no travel, PLWH #hiv CD4 5 w/respiratory distress, Cxr b/l diffuse nodules, Blood cultures budding yeast. #idsky #idmeded #meded

#idboardreview 40 M aplastic anemia admitted w/ fever, abd pain, Ecoli bacteremia, injection drug use w/ tap water: developed b/l LE necrotizing fascitis. Blood cultures and surgical cultures gram negative rod. Dx? #meded #idmeded #IDsky

#idboardreview 60 M has 🐈 🐕 visits India & Arizona yearly now w/pneumonia, then headache, diplopia, csf lymphocytic, ⬇️glucose ⬆️protein, coccidio IgG neg, crypto neg. Enlarged ventricles requiring VP shunt. Dx? #medEd #idmedEd #IDsky csf stain 👇

#idboardreview 25 military returned from Iraq 3wks ago: Fever, myalgia/arthralgia, headache, cough x1wk, mild abd pain, exposure to goat herders & bought a wool rug +sick contacts w/flu like sx. wbc3k, plt110 Cr1.2, mild⬆️AST/ALT+interstitial pneumonia #medEd #idmedEd #idsky

#idboardreview 40 M teacher returned from Kenya where he stayed w/ local family, laundry dried on clothesline, now w/ pruritic painful lesion w/ wriggling sensation. Dx? #medEd #idmedEd #IDsky

#idboardreview 22 M admitted w/fever, headache, petechial rash. BC+Neisseria meningitidis serogroup Y. This is 2nd episode of meningococcal meningitis (at age 16). In addition to ensuring up-to-date vaccinations, which diagnostic workup to evaluate for an underlying immunodeficiency? #idsky #idmeded

#idsky current #hantavirus timeline by Dr Ian Mackay from Australia, shared on X

#idboardreview 65 M s/p brain biopsy for rapidly progressive dementia, ataxia, myoclonus concern for sporadic Creutzfeldt-Jakob Disease. Neurosurgical instruments used are heat-resistant but cannot be immediately incinerated. Best approach to decontaminate these tools? choices below #idsky

#idboardreview 60 M enlarging ulcerated plaques of forearm not responding to antibiotics. Biopsy: endospores scattered throughout dermis with tightly packed, morula-like sporangium. Dx? #medSky #idmedEd #IDsky

#idboardreview 18 M diabetic, student from Florida presents w/ acne which is not responding to usual topical meds, extremely itchy pruritic papule on face and chest. diagnosis? #medEd #idmedEd #idsky

#idboardreview 70 poultry farm worker, trauma pt with prolonged hospitalization, vent associated pneumonian. BC+/BAL+ fastidious aerobic oxidase+, gram-negative bacillus, id on vitek and confirmed with 16sRNA. R to cephalosporins, improved on meropenem. dx? #medEd #idmeded #idsky

#idboardreview 70 M infliximab for RA, shingles 7wk ago while on mediterranean cruise improved w/famciclovir now w/ confusion & HA. LP 90wbc 90% mononuclear, gluc50,protein60. MRI SAH, small/med vessels narrowing int carotid artery. dx? #medEd #idmedEd #idsky

#idboardreview A patient living with HIV has these lesions on his forehead. What is the most likely body site where the virus can spread to? #idmeded #meded #idsky

🆕💥Exciting news U.S. FDA Grants Priority Review of New Drug Application for Gilead’s once-daily single-tablet combination(Bictegravir Plus Lenacapavir) regimen for the treatment of HIV in adults who are virologically suppressed PDUFA: August 27, 2026 #idsky www.gilead.com/news/news-de...

#idboardreview 51 M farmer exposure to cattle, horse, recent contact w/ mice carcasses due to recent regional mouse plague w/1 mo arthralgia of back,hip, knee now w/headache, neck stiffness, photophobia, lower abdominal rash. CSF ME panel neg. pic for ref #idsky #idmeded #meded

#idboardreview Refugee from Eritrea presents with fever, abd pain, petechial rash, jaundice, leukopenia, anemia, thrombocytopenia, giemsa thick film shown #idsky#idmeded #MedEd

#idboardreview 65 Japanese M PMH cirrhosis who has raw fish diet admitted with RUQ and diarrhea, imaging +cholecysitis and later +BC GNR oxidase-positive, glucose-fermenting, motile resistant to ampicillin, beta hemolysis w/green pigment on agar #idsky #idmeded #meded

#IDBoardReview 30 MSM, abd pain, diarrhea, 40 lb wt loss, inguinal lymphadenopathy, rash, Hb 6, EGD/colonoscopy results shown. Duodenal biopsy: pindle cells, slit like vascular channels, extravasated rbc, +CD34 immunestain. rectosigmoid: mucin granuloma #medEd #IDMedEd #idsky