Methylprednisolone enhances the growth of Exserohilum rostratum in vitro, attenuates spontaneous apoptosis, and increases mortality rates in immunocompetent Drosophila flies.

High concentrations of methylprednisolone (0.32 mg/mL) accelerated growth and attenuated spontaneous apoptosis of Exserohilum rostratum in vitro. Injection of E. rostratum conidia preexposed to 0.32 mg/mL of methylprednisolone for 7 days in immunocompetent flies led to increased mortality and a higher fungal burden. Exposure to methylprednisolone could enhance the virulence of E. rostratum.

Unusual presentation of pulmonary blastomycosis complicated by amphotericin-induced refractory electrolyte abnormalities.

Blastomyces dermatitidis is an endemic mold infection commonly seen in the midwestern of the USA and rarely affects pregnant women. The most common presentation is a pulmonary infection with variable degrees of severity. Of note, the clinical and radiographic findings of pulmonary blastomycosis can be mistaken for other pulmonary pathologies, thus earning the title of 'the great pretender'. The treatment of choice of infected pregnant patients is amphotericin B, which is known to produce electrolyte imbalances. However, it infrequently causes severe, prolonged and profound hypokalemia and hypomagnesemia. We present the case of a 27-year-old pregnant patient with pulmonary blastomycosis presenting with a lung mass suspicious of malignancy and treated with amphotericin B with subsequent prolonged refractory hypokalemia and hypomagnesemia. Keywords pulmonary blastomycosis pregnancy biopsy computed tomography angiography liposomal amphotericin B.

Oseltamivir and baloxavir: Dual treatment for rapidly developing ARDS on a patient with renal disease.

Influenza is an annual epidemic disease that in severe cases can lead to the development of ARDS. Current practice recommends the routine use of neuraminidase inhibitors with emerging evidence for the use of endonuclease inhibitors. We present the case of a 22-year-old female with diabetes and IgG4 tubulo-interstitial nephritis that developed rapidly progressive ARDS from influenza infection requiring ventilatory support and extra corporeal oxygenation in which oseltamivir and baloxavir were used in combination. Patient oxygen requirements and imaging improved significantly after treatment initiation, leading to an overall short period of therapy. We present the first case of a patient treated with this combination in the context of chronic kidney disease.

Not your Typical Rash: A Case of IgA Nephropathy in the Setting of HIV.

Human immunodeficiency virus (HIV) infection presents with a variety of conditions. We describe the case of a 33-year-old Hispanic male with IgA nephropathy and Henoch-Schonlein Purpura in the setting of HIV. The incidence of vasculitis associated with HIV infection is less than 1%. There are few cases reported of IgA nephropathy in the context of HIV. Henoch-Schonlein Purpura usually presents in children. We encountered a patient with rare illnesses while in the setting of immunodeficiency.