TWiP 108: B1 cells and Leishmania, insider traitors

Hosts: Vincent Racaniello, Dickson Despommier, and Daniel Griffin The case of the Man from Assam is solved, and phagocytosis of Leishmania by B-1 cells is brought to you by the Three Twipeteers on this episode of TWiP.   Subscribe to TWiP (free) in iTunes, Google Play Music, by the RSS feed or by email Links for this episode: Kalazar detect (pdf) Phagocytosis of Leishmania promastigotes by B-1 cells (Parasite Immunol) Image credit Letters read on TWiP 108 This episode is sponsored by ASM Agar Art Contest and ASM Microbe 2016 Case study for TWiP 108 Todays case is a 26 yo male longhaul truck driver from northern tiger country of India. Comes into hospital at end of rainy season with 6 days of fever, chills, muscle aches, small loose stools, vomiting, trouble breathing, cough, decreased urine output. Lives in mud hut with coconut leaf roof. No one else in family  is sick (wife, two children). Significant animal and insect exposure (dogs, cows, monkeys). Got sick after coming home from a trip up north. No significant medical probs, no surgery. Really sick. Pain everywhere. Occasionally drinks palm wine. Some yellowing of eyes. Has lost a little weight. Ketonic breath. Exam: 39 fever, bp 100/71, 126 heart rate, 24 resp rate. Looks distressed, not fully sharp. Nothing focal on lung exam. Belly tender, esp upper right, spleen enlarged. Liver is tender but not enlarged. Some labs: bun elevated 102, creatinine elevated, Hg decreased 11, platelets 9000 (down), white count 10.3 no eosinophils. LDH 8000 AST/ALT normal, bilirubin 21. Never been this sick. Send your diagnosis to [email protected] Send your questions and comments to [email protected]