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Related Concept Videos

Giardiasis01:12

Giardiasis

Giardiasis is a globally prevalent intestinal infection caused by the protozoan parasite Giardia duodenalis (also known as G. lamblia or G. intestinalis). This flagellated protozoan is the most frequently identified intestinal parasite in the United States and worldwide. Transmission primarily occurs via the fecal-oral route, with infection arising from ingestion of water or food contaminated with cysts. Individuals in low-resource settings, international travelers, outdoor enthusiasts, daycare...
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American Trypanosomiasis

Chagas disease, or American trypanosomiasis, is a vector-borne parasitic infection caused by Trypanosoma cruzi, a flagellated protozoan (kinetoplastid) of the family Trypanosomatidae. The disease is endemic in Latin America, although cases are increasingly reported worldwide due to human migration. Transmission most commonly occurs when feces of infected triatomine bugs contaminate bite wounds or mucosal surfaces; additional routes include congenital, transfusional, transplant-related, and oral...
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Toxoplasmosis

Toxoplasmosis, a zoonotic disease caused by the protozoan Toxoplasma gondii, poses significant public health challenges globally due to its high seroprevalence and varied clinical manifestations. As an obligate intracellular parasite, T. gondii can infect all warm-blooded vertebrates, but felids are its only definitive hosts, shedding unsporulated oocysts into the environment. Humans typically acquire the infection through ingestion of tissue cysts in undercooked meat or oocysts from...
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Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
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Retrovirus Life Cycles

Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...

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Rare presentation of an old bug.

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Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Immunology

Background:

  • Giant cell arteritis (GCA) is an autoimmune vasculitis often treated with corticosteroids.
  • Corticosteroid therapy, particularly prednisone, can increase susceptibility to opportunistic infections.
  • Legionella pneumonia is a severe bacterial pneumonia typically acquired through inhalation of contaminated water aerosols.

Observation:

  • A 77-year-old woman with a history of GCA treated with prednisone presented with progressive dyspnea.
  • Initial investigations for Pneumocystis pneumonia and other opportunistic infections were negative.
  • Exposure history included a recent hotel stay in Florida.

Findings:

  • Hyponatremia was noted on initial laboratory workup.
  • Bronchoalveolar lavage (BAL) was positive for Legionella pneumophila by PCR.
  • Urinary Legionella antigen test confirmed the diagnosis.

Implications:

  • This case highlights a rare presentation of Legionella infection mimicking other respiratory illnesses in an immunocompromised patient.
  • Early and accurate diagnosis of Legionella is crucial for appropriate treatment and improved patient outcomes.
  • Physicians should consider Legionella in the differential diagnosis of pneumonia, especially in patients on immunosuppressive therapy with relevant exposure history.