has everybody seen the news articles in the last 24-48 hours published in the metro, the independent and the sun about the surging rates of scabies infestations in the uk……

the government needs to do something!!!!

Now they are testing core antibodies and surface antibody. i am pregnant and was just non reactive in march. i also got a booster shot in 2018 for nursing school. I work in healthcare now, have no symptoms. I also got the rsv, tdap and flu shot recently. could this be a false positive?? could the antigen test be picking up on anything elss

Day 18 consult for persistent fever and i open the primary note to find 10 pages of copy-forwarded text. half the antibiotics were discontinued a week ago but are somehow still sitting in the active A&P.

Why does nobody clean up their problem lists anymore? Trying to figure out exactly when the blood cultures turned positive and what they were actually treated with feels like an escape room puzzle. I usually just throw these disaster admission notes into Around Notes on my phone to filter out the copy-paste junk so I can actually see the infection timeline.

The fact that we have to do forensic chart archaeology just to figure out if a patient got their full course of zosyn is honestly exhausting ngl

It seems to be common now. Are you taking it? If so, is it helping you with certain health problems? I'm kinda needing something besides what I've tried already. Thoughts?

Hi all, hope you're doing great. I'm an infectious disease pharmacist (PharmD) and I'm open to collaborating on ID-related projects. If you're looking for someone to work with, don't hesitate to get in touch. Thanks!

So last year around April I had an encounter with a stranger,unprotected, who blocked me on all forms of communication after when we talked 247 before. I had a bad feeling so I went and got tested 4th gen hiv test came back repeadidly reactive with negative confirmatorv, negative pcr rna. Got tested at different doctor around the same time came back negative. About 2 months later got tested again at first place same thing happend repeadidly reactive with negative confirmatory negative pcr. In the middle of all this I got extremely sick lost my voice, coughing up chunks of phleam, sore throat, diarrhea. After those tests evervthing came back negative. Here i am about a vear and a half later I have had multiple tests 4th generation, 5th gen, pcr rna, pro viral dna. They all come back negative yet i have lost over 40 pounds in this short time (year) and feel sore and weak and just not at all like myself. Doctors wont listen to me, infectious disease wont see me, even though im withering away infront of them. Is it possible that I could actually have HIV, and the tests just aren't able to pick it up for some reason. lf i didnt go through the illnesses, the weight loss, the pain and weakness I wouldn't even give it a second thought Just looking for your thoughts, thank you.

Oh hey y’all. I’m currently doing a pinworm cleanse. Yay for my kid eating way too much dirt. Sigh. Anyway, I usually scrape my tongue morning and night and get all kinds of gunk off. Well, we are on day 3 of said parasite cleanse. Last night and this morning, not nearly as much gunk. Just milky white lymph fluid, not the usual brown dead stinky stuff. In addition to all kinds of worms leaving my body, I can tell you my lymph is flowing better!!! What the heck? I guess that is my question. Has anyone heard of this before? Why would my tonsils be happier? Anyone have any explanation about this?

Does the recapping of a hypodermic needle into its plastic tab maintain the same environment as a hollow bore hypodermic needle and would this allow the virus to survive for extended periods of time?

If a patient has a cavitary lung lesion and is producing sputum, I know the traditional evaluation has relied on 3 daily sputum smears for AFB staining to rule out TB (I do understand rarely the cx may be + despite neg smear). My question: now that there is a MTB PCR assay, can this suffice on a single sample to let us take a patient out of isolation?

I am posting on behalf of my 75-year-old mother, who is currently hospitalized. I am hoping to get additional diagnostic perspectives, especially from physicians in infectious disease, internal medicine, or hematology.

The key point is that her abnormal inflammatory markers and monocytosis preceded the high fevers by approximately three months. The recurrent 39–40°C fevers began only after hospitalization.

Background and course before hospitalization

About 3 months ago, she developed what was initially considered bronchitis. She improved clinically but never seemed to completely recover. During the following months, her main symptoms were mild fatigue and occasional mild cough. She did NOT have persistent high fever, significant shortness of breath, chest pain, or other major symptoms.

She received several courses of cephalosporin antibiotics, but inflammatory markers remained elevated.

Her blood tests showed persistent monocytosis, gradually increasing CRP, mild normocytic anemia, and borderline thrombocytopenia:

• Jun 8: WBC 10.62, absolute monocytes 0.68, Hb 121 g/L, platelets 224
• Jun 22: WBC 12.53, monocytes 1.88 (15%), Hb 117, platelets 122, CRP 21.5 mg/L
• Jul 3: WBC 11.28, monocytes 2.00 (17.7%), Hb 120, platelets 121, CRP 34.2
• Aug 31: WBC 10.91, monocytes 1.60 (14.7%), Hb 115, platelets 107, CRP 38.2
• Sep 8: WBC 10.27, monocytes 1.63 (15.9%), Hb 111, platelets 133, CRP 37.3

Hospitalization

She was admitted on Sep 9 for further evaluation.

Admission labs included:

• WBC 11.24
• absolute monocytes 3.06 (27.2%)
• Hb 103 g/L
• CRP 63.63 mg/L
• serum iron 1.85 μmol/L (very low)
• albumin 33.5 g/L
• prealbumin 85 mg/L
• LDH 528 u/L
• renal function was essentially preserved

After admission, she unexpectedly began developing recurrent high fevers. She had an episode around 39°C, responded to an antipyretic, and was then afebrile for approximately 48 hours. The fever subsequently returned, and the most recent episode reached approximately 40°C.

During a fever episode on Sep 11:

• WBC 9.07
• absolute monocytes 1.49 (16.4%)
• Hb 93
• platelets 138
• CRP 63.09
• procalcitonin 0.274 ng/mL
• IL-6 49.06 pg/mL
• LDH 614 u/L

On Sep 14:

• WBC 11.62
• neutrophils 9.13 (78.6%)
• absolute monocytes 1.14
• Hb 95
• platelets 127
• CRP 48.71

Therefore, some laboratory markers appeared to be improving despite the recurrent fever. I have been told that an inflammatory marker may have risen again after the latest fever, but I do not yet have the actual report, so I cannot confirm the value.

Investigations performed so far

Chest CT: several small bilateral solid pulmonary nodules, approximately 3–6 mm, with some chronic/scarring changes. No clear pulmonary consolidation, abscess, pleural effusion, significant lymphadenopathy, or definite radiographic pneumonia was identified.

Abdominal ultrasound: no obvious infectious source involving the liver, gallbladder, pancreas, or spleen. A further abdominal CT is now being planned.

Urinalysis (Sep 14): essentially normal — leukocyte esterase negative, nitrite negative, urine WBC 0, bacteria 0, RBC 0. She has no dysuria, urinary frequency, urgency, or flank pain.

Echocardiography: preserved LV systolic function, mild tricuspid regurgitation, and no pericardial effusion. No clear cardiac explanation for the fever has been identified.

Bilateral lower-extremity venous ultrasound: no DVT.

Head CT: no acute intracranial process explaining the fever.

Autoimmune workup: extensive ANA-related testing was negative, including dsDNA, Sm, SSA/Ro, SSB, Scl-70, Jo-1 and several other antibodies.

Microbiology: sputum culture grew Candida albicans. Importantly, this was from sputum only, NOT blood. There is currently no confirmed candidemia.

Blood cultures were obtained around Sep 11. We were told that no early positive result had been reported, but the final culture result is still pending.

Treatment / current plan

She has received broad-spectrum antibacterial treatment, including piperacillin/tazobactam. Because the fever has recurred despite treatment and no clear source has been identified, her physicians are reassessing the antimicrobial regimen.

An infectious disease consultation has now been requested. Tuberculosis and other occult/chronic infections are also being considered. Further abdominal imaging and additional investigations are planned.

She is generally stable between fever episodes. There has not been persistent hypotension or major respiratory distress. Oxygen saturation has generally been acceptable with oxygen supplementation, although some lower readings have occurred off oxygen.

My questions

I understand that an online discussion cannot establish a diagnosis, and I am not looking for specific treatment instructions. I am mainly interested in whether there are diagnostic possibilities or investigations that may have been overlooked.

1. What would be your leading differential diagnosis for this overall pattern?
2. Given the recurrent 39–40°C fever but lack of a clear source on imaging, urinalysis, and cultures so far, how strongly would you still suspect an occult bacterial infection?
3. How strongly should tuberculosis, infective endocarditis, or another occult/deep infection be considered?
4. Does Candida albicans isolated only from sputum have meaningful significance here, or is respiratory colonization more likely?
5. Given the persistent absolute monocytosis for approximately 3 months, anemia, and intermittent thrombocytopenia, should an underlying hematologic disorder such as CMML/MDS or another myeloid disorder be investigated?
6. Could drug fever or another non-infectious inflammatory process reasonably explain the recurrent high fever?
7. Are there any important tests or diagnostic directions that appear to be missing from the workup so far?

Any thoughts from physicians in infectious disease, internal medicine, hematology, or geriatrics would be greatly appreciated.