logo
episode-header-image
Mar 2023
46m 59s

S3Ep9-Sometimes It’s a Zebra: Unusual Ca...

AMERICAN SOCIETY FOR CLINICAL PATHOLOGY
About this episode

The medical laboratory is often seen as a black box that generates definitive results with little effort. But it’s not always that simple.

What if you work up a culture and find an unusual bacteria or fungus? What do the technologists in the microbiology laboratory do to investigate these uncommon cases and provide their patients with a proper diagnosis? 

On this episode of Inside the Lab, our hosts, Ms. Kelly Swails, MT(ASCP), and Dr. Ali Brown, MD, FASCP, are joined by , Medical Director of Infectious Diseases Serology and Molecular Microbiology at Parkland Health in Dallas, Texas, and Assistant Professor in the Department of Pathology at the University of Texas Southwestern Medical Center, Dr. Andrew Clark, PhD, D(ABMM), Medical Directory of the Microbiology Laboratory at Clements University Hospital and Assistant Professor at the University of Texas Southwestern Medical Center, and Dr. Laura Filkins, PhD, D(ABMM), Clinical Microbiology Laboratory Director at Children’s Health System of Texas in Dallas, Texas, and Assistant Professor of Pathology at the University of Texas Southwestern Medical Center, to share their most interesting microbiology cases. 

Dr. Clark discusses an immunosuppressed 73-year-old man with persistent diarrhea who was diagnosed with invasive GI mucormycosis, and Dr. McCormick-Baw describes the case of the healthy 51-year-old woman whose abdominal fullness was caused by coccidioidomycosis, not cancer.  Listen in for Dr. Filkins’ insight on getting the CDC involved when a four-year-old patient contracted Burkholderia pseudomallei and learn how committed clinical laboratory scientists kept digging until they found answers for these three unique patients!

Topics Covered
· Dr. Clark’s case of an immunosuppressed 73-year-old man with persistent diarrhea
· How Dr. Clark’s team found Mucor mold in their patient’s stool culture and diagnosed him with invasive GI mucormycosis
· How rare GI mucormycosis is and why it’s nearly always terminal
· Dr. McCormick-Baw’s case of a healthy 51-year-old woman who presented with abdominal fullness
· How Dr. McCormick-Baw’s team determined that their patient did not have cancer but did have coccidioidomycosis
· Why it took two years after Dr. McCormick-Baw’s patient contracted Coccidioides on a hike for symptoms to present
· Dr. Filkins’ case of a previously healthy four-year-old female (with a colorful animal history) who presented with nausea, vomiting, lethargy and decreased appetite
· How Dr. Filkins’ team cultured their young patient’s tracheal aspirate specimen and found the high-risk pathogen Burkholderia pseudomallei
· How the local health lab, local epidemiologist and CDC’s joint investigation uncovered four cases of Burkholderia pseudomallei in the U.S. and traced them to aromatherapy bottles manufactured in India
· How the CDC, EPA and Texas public health agencies discovered that Dr. Filkins’ patient’s pet raccoon died of Burkholderia pseudomallei and decontaminated its burial site

Connect with ASCP
ASCP on Twitter
Connect with Dr. McCormick-Baw
Dr. McCormick-Baw at UT Southwestern
Connect with Dr. Clark
Dr. Clark at UT Southwestern
Connect with Dr. Filkins
Dr. Filkins at UT Southwestern
Resources
Burkholderia Pseudomalliei Detected in a Raccoon Carcass Linked to a Multistate Aromatherapy-Associated Melioidosis Outbreak’ in Morbidity and Mortality Weekly Report

Up next
Jun 26
The Pathology of Rare Diseases
Host Kelly Swails interviews Dr. Brad Brimhall and genetic counselor Megan Maxwell from the University of Texas Health Science Center San Antonio to discuss challenges with and strategies for the diagnosis of rare diseases. Their discussion covers topics like the advantages of pr ... Show More
56m 36s
May 30
AI and Pathology: A short history and what comes next
In this special episode of Inside the Lab, producer and host David Ritter does a dive into the history of efforts to integrate AI into the practice of healthcare. He’s joined by MD/PhD candidate Rahim Hirani, who discusses the history of efforts to automate diagnostic decision ma ... Show More
1h 1m
Apr 16
Emerging Respiratory Viruses
Inside the Lab is joined by experts Drs. Hannah Wang from the Cleveland Clinic and Rodney Rohde from Texas State University to discuss emerging respiratory viruses. Their discussion begins with lessons learned from the COVID-19 pandemic and an overview of what technologies have e ... Show More
1h 1m
Recommended Episodes
Dec 2023
Special series: Assoc. Prof. Şener and Dr. Pietropaolo talk about networking and building professional relationships in urology
In 'Episode 4' of the series "What do young urologists need to know," 'Segment 1' covers the topic of "Navigating the transition from residency to professional urology practice." Assoc. Prof. Emre Şener (TR) discusses networking and building professional relat ... Show More
11m 47s
Aug 2020
Covid-19 update: Self-isolation, non-Covid-19 hospital admissions, planned care, and weight
Kieran Walsh, clinical director at BMJ, asks editors from BMJ Learning and BMJ Best Practice to summarise the latest clinical guidance related to covid-19. Matt Castleden updates us on self-isolation and shielding, and resources for people recovering from Covid-19. Abigail Davis ... Show More
12m 20s
Feb 2025
How to bring health and happiness to your lab
A relentless pursuit of perfection in science can mean that researchers are in perpetual and self-critical ‘survival mode,’ forever questioning their behaviours and actions in the workplace, says clinical psychologist Desiree Dickerson.“We are not very good at taking the spotligh ... Show More
26m 52s
Nov 2024
Insights for Building a Rockstar MSL Team with Cathy Andorfer, PhD
In this episode of Medical Affairs Unscripted, Peg Crowley-Nowick, PhD, MBA, President of Medical Affairs Consulting at Lumanity, welcomes Cathy Andorfer, PhD, the national Director of Field Medical for Tourmaline Bio, and author of "The Art of Excellence: Build a Rockstar Career ... Show More
47m 1s
Aug 2021
Episode 3: How to Develop an Acute Dialysis Care Quality Program - Quality Metrics and Continuous Improvement
Dr. Ravi Mehta and Theresa Mottes discuss which key components are needed when starting a quality improvement program (QI) for acute dialysis and why those components are needed. They also discuss how to get leverage to implement a QI program and the keys to a successful CRRT qua ... Show More
12m 54s
Mar 2025
Episode 304: Continuous Vital Sign Monitoring with Drs. Meyhoff and Breteler
In this 304th episode I welcome Drs. Meyhoff and Breteler to the show to discuss continuous vital sign monitoring for patients on the floor and at home after surgery. We talk about the pros and cons of this kind of monitoring, what the future holds, and how Anesthesiologist and I ... Show More
51m 35s
May 20
PTJ Author Interview: Metabolic Health Screening in Private Practice
In this episode of the PTJ Podcast, Editor-in-Chief Steven George, PT, PhD, FAPTA, talks with Sally Mastwyk, PT, MPhysio, and Casey Peiris, PT, PhD, about their recently published study, in which 230 participants received a 30-minute health screen in physical therapy private prac ... Show More
25m 59s
Jun 3
Academy Focus: Get to Know APTA Pediatrics
A brief introduction from the president of the academy.Britton Farnum, PT, DPT, interviews Mary Jane Rapport, PT, DPT, PhD, FAPTA, president of APTA Pediatrics. Learn what Rapport says about the skills, settings, and steps to thrive in this specialty.Visit the APTA Pediatrics web ... Show More
14m 13s
Oct 2024
Episode 282: Deeper Dive Into Healthy or Not – Our Experience with Function Health Tests and Results
Both Dr. Nedd and his brother, Ron, completed an extensive series of blood and urine tests.  Getting over 100 biomarkers measured to find any possible areas of weakness they can improve.  This is a program recommended in the book, Good Energy, by Casey and Callie Means that we’ll ... Show More
39m 48s
Aug 2024
S6 Ep119: Epstein Barr Virus - A MONO-lithic Overview
Join us and expert guest Dr. IJ Anosike (The Children’s Hospital at Montefiore) to dissect the complexities of diagnosing and managing Epstein-Barr virus!  From sneaky symptoms to tricky tests, Dr. Anosike provides insight on identifying and tackling this troublesome virus. Don't ... Show More
1h 2m