Candida auris (C. auris) has become a significant challenge in critical care across the country. It spreads across surfaces, equipment, and even skin, allowing outbreaks to take hold long before they are detected. These infections tend to appear in patients with comorbidities like advanced age, diabetes, kidney disease, malignancy, dialysis…
The Karius test is a liquid biopsy that leverages next-generation sequencing to identify and quantify microbial cell-free DNA (cfDNA) from over 1,500 pathogens, including bacteria, DNA viruses, fungi, and parasites. Traditional infectious disease diagnostic methods, including blood cultures, serologies, and polymerase chain reaction (PCR) assays, face limitations in sensitivity, specificity, and the time…
Isavuconazonium (Cresemba) is an oral and intravenous antifungal agent used to treat invasive aspergillosis and mucormycosis in adult patients by disrupting fungal cell membrane formation. After it is converted to isavuconazole in the plasma, it inhibits lanosterol 14-α-demethylase which prevents lanosterol from getting converted to ergosterol. Isavuconazonium is also used…
Fungal endocarditis (inflammation of the heart’s inner lining) is most commonly caused by Candida species and is associated with a high mortality rate. Risk factors include long-term antibiotic therapy (especially with indwelling central lines), immunosuppression, prosthetic heart material (valves, implantable devices, etc.), and IV drug use. Like bacterial endocarditis, patients can present…
I’m thankful I was in group 1A for my hospital system’s vaccine roll-out. I received my first dose of the Pfizer-BioNTech COVID-19 vaccine on December 18, 2020 followed by my second dose exactly three weeks later on January 8, 2021. In this post, I’ll discuss the ingredients and my symptoms…
Conventional vaccines typically involve growing a virus in various cell lines, injecting a part of the virus into the host, and relying on the host to mount an immunologic response (ie, create antibodies and “memory”) for the next time the virus is encountered. This process can be time-consuming, expensive, and…
N95 masks have become one of the most coveted pieces of personal protective equipment (PPE) during the COVID-19 pandemic; however, the mechanism by which these masks capture particles has very little to do with the gaps between mask fibers (ie, the N95 doesn’t work like a strainer).
This observational Lancet study compared ~96,000 patients across 671 international hospitals with a positive COVID-19 diagnosis who received hydroxychloroquine (HCQ) +/- a macrolide (ie, azithro) or chloroquine +/- a macrolide (four total treatment arms) to a control arm that received none of the aforementioned therapies. The primary outcome was In-hospital…
Fluconazole (Diflucan) is an intravenous and oral antifungal medication that inhibits ergosterol synthesis (an important component of fungal cell membranes). As an intensivist, I most often use this medication to cover Candida albicans infections (especially symptomatic cystitis given fluconazole’s excellent urine penetration); however, it doesn’t cover C. krusei and has…
The seasonal influenza (“flu”) vaccine is recommended for all people ≥ 6 months old who don’t have a contraindication (including pregnant women regardless of trimester) and is typically administered from late October through April in the United States.