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Mike Russo

@mikerusso.bsky.social
1.5K followers 773 following 33 posts

Peds ID in Philly. Full time clinician. Transplant, NTM, tick-borne infections, and antibiotic allergies. Pro oral antibiotics and short durations Anti cefdinir (He/him) #IDSky

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Mike Russo @mikerusso.bsky.social · 03/04/2025
*correlate of protection
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Mike Russo @mikerusso.bsky.social · 03/04/2025
Also there’s no serologic correlate of mumps. IgG is more or less useless for telling whether someone is protected
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Mike Russo @mikerusso.bsky.social · 03/04/2025
Documented two doses of MMR (or VZV) trump any serologic testing for measles or varicella IgG. Commerically available tests are not sensitive enough and will be false negative in about 1/3 of vaccinated individuals.
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Mike Russo @mikerusso.bsky.social · 10/01/2025
Thursday?
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Mike Russo @mikerusso.bsky.social · 09/01/2025
Learn some new shitty thing everyday
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Reposted by Mike Russo
Alexandra Petri @petridishes.bsky.social · 03/01/2025
some thoughts on the rush to compromise wapo.st/40h75BM
wapo.st
Opinion | Let’s try something different in how we deal with polio
Finding middle ground is hard. Why not just give ground instead!
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Mike Russo @mikerusso.bsky.social · 17/12/2024
Been a long time reader of SBM but I missed this! Bookmarking to share with our learners. @andrewhaynes.bsky.social had a good discussion of this at IDWeek the other year too
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Mike Russo @mikerusso.bsky.social · 13/12/2024
I will not abide by this feline slander
Kitten
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Reposted by Mike Russo
BK. Titanji @boghuma.bsky.social · 10/12/2024
This is why clinical trials are important. Unfortunately tecovirimat did not improve resolution of clade IIb mpox compared to placebo. There are currently no effective antivirals for the treatment of mpox and this is an urgent need. Disappointing result but at least we know.
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Mike Russo @mikerusso.bsky.social · 06/12/2024
The dramatic changes this has brought have been humbling to witness. Hope for improved access worldwide and modulators for those with rarer mutations next.
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Mike Russo @mikerusso.bsky.social · 27/11/2024
Just because it has a name, doesn’t mean we have to try to kill it.
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Mike Russo @mikerusso.bsky.social · 27/11/2024
What’s your azithromycin resistance rate these days? Pretty high up here
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Mike Russo @mikerusso.bsky.social · 20/11/2024
8/8 None of this would have been possible without strong public health agencies and the people who work there. This is another example of what we stand to lose by appointing individuals that would gut and destroy the very agencies they’d lead.
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Mike Russo @mikerusso.bsky.social · 20/11/2024
7/8 Subsequently, another cluster was identified in Alberta, Canada. This has all lead to wider knowledge of this issue and discussion on ways to move forward academic.oup.com/ofid/article...
academic.oup.com
Donor-Derived Bartonella quintana Infection in Solid Organ Transplantation: An Emerging Public Health Issue With Diagnostic Challenges
In 2023, multiple cases of donor-derived Bartonella quintana, a louse-borne bacterium, were acquired in Canada and the United States from deceased donors w
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Mike Russo @mikerusso.bsky.social · 20/11/2024
6/8 This led to rapidly identifying subclinical Bartonella quintana (probable) endocarditis in another organ recipient. Additional testing of banked donor specimens confirmed infection with B. Quintana, cinching the link.
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Mike Russo @mikerusso.bsky.social · 20/11/2024
5/8 After a report to OPTN and an email on the Emerging Infections Network, CDC and local DOH’s rapidly responded and initiated an investigation involving content experts, local OPOs, and laboratory partners as well. This was an incredible team effort and public health at its best!
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Mike Russo @mikerusso.bsky.social · 20/11/2024
4/8 An eventual excisional liver biopsy revealed vascular-proliferative lesions. The pathologist astutely was concerned for peliosis hepatis and performed a Warthin Starry stain which was teeming with bacilli and a Bartonella PCR was positive.
Liver biopsy of a kidney transplant recipient with a Bartonella quintana infection linked to a donor who experienced homelessness, United States, 2022. A) Fibrovascular proliferation accompanied by few inflammatory cells. Magnification ×200. B) Myxoid stroma that contains clumps of granular material (arrows). Magnification ×400. C) Warthin-Starry stain highlights clumps of bacilli (arrows). Magnification ×400.
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Mike Russo @mikerusso.bsky.social · 20/11/2024
3/8 Our index kidney transplant patient presented with fevers and abdominal pain and was found to have lesions in his liver, spleen, and vertebral bodies.
A) Multiple enhancing T2 hyperintense lesions throughout the hepatic parenchyma. B) Numerous enhancing T2 hyperintense lesions affecting cervical, thoracic, and lumbar vertebrae.
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Mike Russo @mikerusso.bsky.social · 20/11/2024
2/8 This is a story of transplant ID, but more so a story of public health agencies and what we stand to lose. It was one of the proudest moments of my career to be involved with so many folks who came together to decipher these cases.
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Mike Russo @mikerusso.bsky.social · 20/11/2024
1/8 Our report of the first confirmed cases of transplant derived Bartonella quintana infection and the public health investigation surrounding them has been published! #medsky #idsky #publichealthsky #txid wwwnc.cdc.gov/eid/article/...
wwwnc.cdc.gov
<em>Bartonella quintana</em> Infection in Kidney Transplant Recipients from Donor Experiencing Homelessness, United States, 2022
<em>B. quintana</em> Infection from Kidney Donor
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Mike Russo @mikerusso.bsky.social · 19/11/2024
What the hell?! Who’s next, Dr. Pepper?
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Mike Russo @mikerusso.bsky.social · 15/11/2024
“Measles, stand back and stand by,” sums all of *this* up pretty well…
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Reposted by Mike Russo
Jonathan Howard @joho.bsky.social · 15/11/2024
We can pray he won’t get confirmed. But if he does, doctors who’s normalized RFK Jr. own the next 4 years. So do the doctors who normalized these cranks and charlatans. My latest for SBM. sciencebasedmedicine.org/ownit/
sciencebasedmedicine.org
If You Sanewashed RFK Jr., Or If You Sanewashed Doctors Who Did, You Own the Next 4 Years | Science-Based Medicine
When RFK Jr. does to the U.S. what he did to Samoa, doctors will say they are horrified, that they love vaccines, blah blah blah. But it will be too late.
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Mike Russo @mikerusso.bsky.social · 14/11/2024
Too late
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Mike Russo @mikerusso.bsky.social · 13/11/2024
But don’t the data argue that there aren’t local (or accessible) ID specialists for many patients?
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Mike Russo @mikerusso.bsky.social · 12/11/2024
Lol
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Mike Russo @mikerusso.bsky.social · 12/11/2024
It worked!!
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Mike Russo @mikerusso.bsky.social · 12/11/2024
6. Causes brick red stools and may cause young interns to freak out overnight (my villain origin story)!
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Mike Russo @mikerusso.bsky.social · 12/11/2024
5. More expensive than say cephalexin or amoxicillin
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Mike Russo @mikerusso.bsky.social · 12/11/2024
4. Less really excreted than other beta lactams, particularly in children! Better options for UTI!
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Mike Russo @mikerusso.bsky.social · 12/11/2024
3. Even with aggressive dosing, a middling likelihood of target attainment for Strep pneumo (most important pathogen for URTI and LRTI). Decreased cure in some studies but poor performance hidden by many of these conditions resolving without antibiotics in children.
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Mike Russo @mikerusso.bsky.social · 12/11/2024
2. Highly protein bound. Very little in the bloodstream is able to diffuse into the site of infection.
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Mike Russo @mikerusso.bsky.social · 12/11/2024
Great question! 1. Poor bioavailability. Very little is getting into the bloodstream 15-25% absorbed compared to 90% for Amoxicillin and Cephalexin!
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Mike Russo @mikerusso.bsky.social · 12/11/2024
Truly, a magical land!
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Mike Russo @mikerusso.bsky.social · 11/11/2024
Summoning the rest of PedsID to Bluesky: Cefdinir, cefdinir, cefdinir! #idsky #medsky #cefdiniristrash
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Mike Russo @mikerusso.bsky.social · 11/11/2024
We’ve been doing TID cephalexin for osteoarticular infections for a number of years now! Possibly cefadroxil BID to come! journals.asm.org/doi/10.1128/...
journals.asm.org
Cefadroxil and cephalexin pharmacokinetics and pharmacodynamics in children with musculoskeletal infections | Antimicrobial Agents and Chemotherapy
Musculoskeletal infections in children, including acute hematogenous osteomyelitis and septic arthritis, are among the most common severe infections affecting children. Staphylococcus aureus is the most common bacterial etiology, with most isolates remaining methicillin-susceptible S. aureus (MSSA) throughout the United States (1). The current standard of care for treating pediatric musculoskeletal infections includes a short course of intravenous (IV) therapy, followed by prolonged oral treatment, to complete 3–6 total weeks (1–5).
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