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Cases from SFGH HIV/ID Wards: Curves, Coffee and Caves
Slide 1.
Cases from SFGH HIV/ID Wards: Curves, Coffee and Caves
Slide 1.
Case #1 (Curves)
Slide 2.
Case #1 (continued)
Slide 3.
Case #1 (continued)
Slide 4.
Case #1
Slide 5.
ARS: What is the most likely organism in the patient's blood culture?
Slide 6.
Case #1 (continued)
Slide 7.
Case #1 (continued)
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Slide 9
Slide 9.
ARS: What is this curved GNR that causes cellulitis without many systemic symptoms with persistent bacteremia?
Slide 10.
Likely Helicobacter cinaedi
Slide 11.
Helicobacter cinaedi infections and HIV
Slide 12.
Helicobacter cinaedi and cellulitis
Slide 13.
Helicobacter cinaedi and cellulitis
Slide 14.
Susceptibilities
Slide 15.
Case reports, updated findings
Slide 16.
Case #1 (continued)
Slide 17.
Case #2 (Coffee)
Slide 18.
ARS: What is the most likely reason the patient's Cr went from 1.53 to 1.63 on dolutegravir/TDF/FTC?
Slide 19.
Dolutegravir and creatinine
Slide 20.
ARS: What was the mean increase of Cr seen with DTG in the treatment-naïve (and dose-finding) trials?
Slide 21.
What was the mean increase of Cr seen with DTG in the treatment-naïve (and dose-finding) trials?
Slide 22.
DTG inhibits tubular secretion of Cr
Slide 	23.
ARS: Which renal transporter known to regulate creatinine secretion does DTG inhibit
Slide 24.
ARS: For our patient in Case #2, which nuc-sparing regimen would you consider based on recent data?
Slide 25.
NEAT001
Slide 26.
Nuc-sparing regimen had problems in subgroups and with resistance
Slide 27.
GSK744 and TMC278 Nanosuspensions
Slide 28.
LATTE: Study Design
Slide 29.
LATTE Study: Treatment Outcomes-Maintenance Population
Slide 30.
LATTE: Virologic Success During Induction and Maintenance Phases
Slide 31.
Modified LATTE? DRV/r/DTG ± 3TC
Slide 32.
Case #3 (Cave)
Slide 33.
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Slide 36.
ARS: What is this patient's unifying diagnosis?
Slide 36.
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Slide 37.
It's beginning to look a lot like fungus!
Slide 38.

Image courtesy of the J. Craig Venter Institute and Stephanie Mounaud (Harris).

ARS: What are the typical forms of endemic fungi?
Slide 39.
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Slide 42.
What about these hyphal forms?
Slide 43.
Early case reports of hyphal or filamentous structures of histoplasmosis in the body
Slide 44.
More case reports in endocarditis
Slide 45.
Recent case series (Medicine, July 2014)
Slide 46.
But our patient didn't have endocarditis (we looked)
Slide 47.
Slide 48
Slide 48.
Follow-up on Case #3 (Cave fever)
Slide 49.
Thank you!
Slide 50.