iiinova — where your digital self keeps evolving

Reposted by Alan Koff

Edward Nirenberg @enirenberg.bsky.social · 25/10/2025

Okay so as promised... let's go through this paper and why it matters 🧵 #medsky #immunosky #idsky

Reposted by Alan Koff

Michael G. Ison, MD MS @michaelisonmd.bsky.social · 21/10/2025

Due to the US Government Shutdown, I will not be able to atted @IDWeek.bsky.social #IDWeek2025. I had worked on my 2 invited talks and so will share them. My first talk was going to be about the epidemiology and clinical course of respiratory viral infections in the immunocompromised.

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Alan Koff @alankoff.bsky.social · 18/10/2025

Hoping to see this reach its funding goal soon! Had a chance to test it out. Tons of learning for ID trainees, or those interested in global health, public health, emerging infections and one health.

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Reposted by Alan Koff

Pharmageddon @pharmageddon.bsky.social · 16/10/2025

🗳️Raffle time! Epipocalypse: Bug Detectives is halfway thru its Kickstarter.📢 Will give away 1 copy to the school, hospital, or club of choice to 2 raffle winners. Raffle ends Sunday AM. Every RT is an entry. Spread the good news! #IDSky #MedSky #EpiSky www.kickstarter.com/projects/pha...

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Pearlie Chong, MD, MSCR, FIDSA @pearliechong.bsky.social · 10/10/2025

💥Transplant ID colleagues attending #IDWeek2025, please mark your calendars 💥 👉 10/20/25: 8-8:25am Dr. Jeremy Walker (UAB) is our invited speaker on “Bridging the Gap between General and TID Practice”, moderated by Drs. Andrea Zimmer and Emily Eichenberger

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Pearlie Chong, MD, MSCR, FIDSA @pearliechong.bsky.social · 10/10/2025

👉 10/20/25: 5-5:25pm TID fellows, Drs. Gabriel Motoa Cardona (Columbia Presbyterian-Cornell) and Stella Radosta (UT Southwestern) will each present a case, with discussions led by Drs. Alan Koff (UC Davis) and Alpana Waghmare (University of Washington/Fred Hutch)

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Alan Koff @alankoff.bsky.social · 01/10/2025

Excited for this new ID game to get funded. Already over $3000 towards funding goal in less than 24 hours! 💸

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Reposted by Alan Koff

Edward Nirenberg @enirenberg.bsky.social · 24/09/2025

Endorsed and co-signed (with the caveat that strictly speaking variola is eradicated, not extinct, and measles is still considered eliminated for now in the US because we haven’t had a year of sustained transmission yet) www.nejm.org/doi/full/10....

nejm.org

Risk and Benefit | NEJM

Editor-in-Chief Eric Rubin asks why, under an administration that says it is focused on making America healthy again, we are denigrating and discarding our single most cost-effective public health ...

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Alan Koff @alankoff.bsky.social · 21/09/2025

News is all about H1B in the tech sector, but doesn’t mention how important that pathway is for IMG physicians. Imagine getting a residency program to sponsor an H1B for $100,000. This pathway will all but disappear except for high-paying specialty hires. Glad you made it back ok.

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Reposted by Alan Koff

Pharmageddon @pharmageddon.bsky.social · 01/09/2025

The Epipocalypse: Bug Detectives Kickstarter goes live in 30 days. Going to update the launch page with a sneak preview of some of the art. Anyone want to vote on which they like best? Vote in the comments "1-4" for images clockwise or vote "5" for no preference. Thanks. #IDSky #MedSky #EpiSky

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FungalDoc AKA Andrej Spec @fungaldoc.bsky.social · 19/08/2025

We are recruiting for a new faculty member in the Transplant ID section at @WashUMedID. Highly dynamic section, with immense growth potential. We want to help people build a career in patient care, education or research. facultyopportunities.wustl.edu/Posting/Deta...

facultyopportunities.wustl.edu

Opportunity Details - Faculty Opportunities

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Reposted by Alan Koff

Joanna Schaenman, MD, PhD @jschaenmanmd.bsky.social · 15/08/2025

Reposting this fellowship opportunity for 1 year study of #TxID at @ucla-id-fellowship.bsky.social #IDfellow #IDSky - and we also have a #TxID faculty position available as well !

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Alan Koff @alankoff.bsky.social · 27/05/2025

Sharing our paper on bacterial hepatic infections and all the unique manifestations of the different bugs. If you're short on time just check out Table 1. Free view/download link active until July 11. authors.elsevier.com/a/1l8Hj3tho0...

authors.elsevier.com

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Alan Koff @alankoff.bsky.social · 21/03/2025

Difference between ABC and TAF is less impressive than both of them compared to TDF. I've tended to get patients on two drug regimens without tenofovir where possible because of some of these metabolic syndrome concerns.

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Alan Koff @alankoff.bsky.social · 18/03/2025

Study looks underpowered, numerically the rates of VRE infection were lower with VRE prophylaxis at all time points. Outcomes with tigecycline here may not translate to daptomycin either, given very different drug properties. Need larger datasets/multicenter retrospectives.

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Reposted by Alan Koff

Jonathan Ryder, MD @jonathanrydermd.bsky.social · 02/03/2025

New from @ofidjournal.bsky.social Outcomes of 56 kidney transplant recipients whose donors had positive BCx. Most pathogenic organisms were treated, while most commensals were not. No infections developed in recipients related to bacteremia #IDSky #TxID academic.oup.com/ofid/article...

academic.oup.com

Analyzing the Donor Dilemma: Outcomes of Kidney Transplant Recipients From Donors With Positive Blood Cultures Obtained at Organ Procurement

Abstract. Based on expert consensus, the American Society of Transplantation recommends 7–14 days of preventive antibiotic therapy for solid organ transpla

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Alan Koff @alankoff.bsky.social · 01/03/2025

Are any HCWs at your site just wearing N95s all the time now? ER docs?

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Alan Koff @alankoff.bsky.social · 01/03/2025

Ideally HSCT recipients should be able to rely on the general population for herd immunity from measles. It's unfortunate that this needs to be considered due to waning vaccination rates. Interesting paper though, thanks for sharing.

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Reposted by Alan Koff

IDSA @idsainfo.bsky.social · 27/02/2025

This decision — & other federal efforts to undermine well-established science about vaccine safety — puts everyone at risk, especially when we are currently experiencing the worst U.S. flu season in more than a decade, says IDSA President Tina Tan, MD, FIDSA, FPIDS, FAAP. Statement: bit.ly/41mfTFE

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Reposted by Alan Koff

Ruth Ann Crystal @drruth.bsky.social · 21/02/2025

Measles are contagious. Measles cause 1 in 4 people to be hospitalized. Measles can be deadly especially in children. Measles can cause blindness & deafness. Measles can cause brain damage yrs later. Measles can cause "immune amnesia". Measles are preventable with MMR vaccine. #medsky #IDsky 🛟 😷🧪

Infographic on Measles in Red, light blue and yellow. It contains the timeline for measles, facts and the R0 that each person can infect 12 to 18 people in an unvaccinated population. Be Wise, Immunize with the MMR vaccine. Getting the vaccine is much safer than getting the disease.

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Alan Koff @alankoff.bsky.social · 12/02/2025

Enjoyed reading this paper, especially their list outstanding questions related to utility of SBP prophylaxis. Would also add whether SBP ppx adds anything in patients who are already on rifaximin.

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Alan Koff @alankoff.bsky.social · 21/01/2025

Identify what the trainee wants from the project. Research skills? Networking? Experience for residency / fellowship applications? Publication? The project scope and timeline will vary depending on their goal.

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Alan Koff @alankoff.bsky.social · 16/01/2025

I do feel bad when they have to listen to all the history taking when all they want is to get a quick consent signed. But then they would never know the patient has a rescue dog named "Baxter" or that they worked in the traveling circus, so 🤷‍♂️

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Alan Koff @alankoff.bsky.social · 10/01/2025

Got a sneak peak at this great med ed game, highly recommend. Lots of educational value for GME and CME.

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Alan Koff @alankoff.bsky.social · 09/01/2025

The immune system is amazing isn't it? Sometimes you can find a half dozen infectious / malignant diagnoses in one patient with a very low CD4 count. ART is great but not everyone knows their HIV status or gets linked to care. Glad they have you in their corner!

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Alan Koff @alankoff.bsky.social · 09/01/2025

I tend not to but understand if people do it. Once patients get fungal peritonitis the nephrologists tend to remove the catheter and put them on HD which can have a big impact on QoL.

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Alan Koff @alankoff.bsky.social · 09/01/2025

We saw this once where a colony of mecA+ coag negative Staph was buried underneath all the MSSA. When micro looked closely after asking they found it.

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Reposted by Alan Koff

Dan McQuillen @mcqhoya81.bsky.social · 01/01/2025

Starting 2025 right using new ID E/M add-on code G0545 on my hospital visits thanks to @idsainfo.bsky.social member advocacy #ValueOfID #WeAreID

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Alan Koff @alankoff.bsky.social · 31/12/2024

You might have seen there was a whole issue on tularemia just published in CID (vol 78 Feb 2024). Pulmonic was the primary presentation in 13% in one review by Nelson et al.

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Alan Koff @alankoff.bsky.social · 31/12/2024

That's interesting you mostly see pulmonary cases, what are their reported exposures?

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Alan Koff @alankoff.bsky.social · 31/12/2024

The transmission of tularemia has also shifted from rabbit exposure to deer fly and tick bites. With warmer average temperatures I would think vector range would expand and cases would increase.

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Alan Koff @alankoff.bsky.social · 22/12/2024

Consider posting it on EIN and see if other centers have had the same thing. Maybe micro lab can freeze the isolates for sequencing

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Alan Koff @alankoff.bsky.social · 22/12/2024

Have never seen a case, do they have sore throat and enteritis? Asymptomatic PCR colonization of GAS in pharynx would be hard to interpret otherwise.

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Alan Koff @alankoff.bsky.social · 20/12/2024

Screening with cocci EIA gives a bunch of false positive IgM too. We do ID and CF testing for our screening and still get some false positives. To really assess donor for who to screen you'd also need a thorough travel history which is rarely available, case incidence even within CA is so variable.

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Alan Koff @alankoff.bsky.social · 20/12/2024

Yes, certainly not an expert on the topic, but as I understand it there is some concern about pigs transmitting known or novel pathogens to humans. They do mitigate this risk given the way xeno pigs are raised but it is an area of uncertainty and people do monitor for PCMV and other viruses.

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Alan Koff @alankoff.bsky.social · 20/12/2024

We recently started using mold PCRs through Stanford (including Aspergillus PCR), we tend to order these instead of Karius where IFI is suspected. Cost is about 1/3 to 1/2 for individual tests vs the whole panel.

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Alan Koff @alankoff.bsky.social · 20/12/2024

Cost is an issue with these major diagnostics, and we also can't assume they will give us an answer for some of our sickest patients. I think about the respiratory failure HSCT consults where the noninfectious list includes DAH, PERDS, TACO, TRALI, IPS, GVHD... #TxID

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Alan Koff @alankoff.bsky.social · 20/12/2024

We have found the mold PCR panel on serum or BAL at Stanford to be helpful when we suspect IFI. Karius has made some great diagnoses when carefully selected, but many tests end up negative or with normal/uninterpretable flora (looking at you HHV-6). Culture is still the best when feasible.

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Alan Koff @alankoff.bsky.social · 20/12/2024

Protocols are such an important part of transplant-related care to maintain consistency at high volume centers, it can be hard to break from them, yet each patient needs a different plan in some way. I see microbiome in HSCT as being an area where we very much need to bring bench to bedside. #TxID

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Alan Koff @alankoff.bsky.social · 20/12/2024

If I could like this post more than once I would 🙂

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Alan Koff @alankoff.bsky.social · 20/12/2024

2/2... have unacceptably high rates of hyperacute/acute rejection. They overcame this with intensive immunosuppression combinations, only to find excess OIs not seen previously. Use of complement inhibitors, high dose IS, and porcine transmissions would be the biggest ID concerns. #TxID

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Alan Koff @alankoff.bsky.social · 20/12/2024

A3. There are still many unknowns as this is a nascent field. As others have mentioned, there is also the risk of additive immunosuppression to overcome the species barrier and we will see how this affects long-term infection outcomes. In the early days of organ transplantation they used to... 1/2

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Alan Koff @alankoff.bsky.social · 20/12/2024

A2. A number of our learners use ID podcasts to expand on areas of interest in their training. We have covered a number of topics through jeopardy style trivia to give a change of pace from didactic lectures. There are so many great options for learning nowadays. #TxID

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Alan Koff @alankoff.bsky.social · 20/12/2024

Hi everyone, I'm Alan at UC Davis in Sacramento. Looking forward to a great inaugural Bluesky discussion for TxID Early Career Network. 🙂

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Reposted by Alan Koff

TxID Early Career Network @txidfellows.bsky.social · 07/12/2024

🔥Join us for our first #TxIDChat on Bluesky coming Thursday Dec 19th at 7:30pm EST/6:30pm CST. You can follow along on our profile, searching #TxIDChat, or using TxID Feed created by @germhuntermd.bsky.social (Profile -> Feeds -> TxID -> top right select Pin to add to your home screen)! #IDSky

Promotional image for #TxIDChat planned for Thurs 12/19 at 7:30pm EST/6:30pm CST.

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Joseph Sassine @josephsassinemd.bsky.social · 15/12/2024

First post on #IDSky We have an ID fellowship opening at the University of Oklahoma @ou.edu, starting July 2025. Two-year program, with great exposure to HIV, transplant ID and surgical infections, and above all, great people to train with! DM me for details! medicine.ouhsc.edu/academic-dep...

medicine.ouhsc.edu

Fellowship Opportunities

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