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Topics:
Internal Medicine
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Rheumatology
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Spondyloarthritis
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Infectious Disease
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Pulmonology
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Critical Care
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Pulmonary Infections
How would you treat a patient with psoriatic arthritis who developed disseminated histoplasmosis while on adalimumab and previously failed all non-biologic DMARDs?
Would you feel comfortable using a non-TNF biologic DMARD?
Related Questions
Does your institution have formal policies or work flows to reduce unnecessary IGRAs ordered for patients on biologics?
What is your approach to counseling patients regarding re-initiation of anti-TNF therapy after completion of treatment for non-disseminated pulmonary histoplasmosis?
Which biomarkers or diagnostic tools do you prioritize to support the decision to start antifungal treatment in septic patients with no clear source of infection but at high risk for fungal infections?
Would you use the pneumococcal conjugate-21 vaccine (Capvaxive) instead of the conjugate-20 (Prevnar-20) for routine vaccinations in immunosuppressed patients?
Do you administer prophylactic antibiotics to prevent VAP following intubation in patients with acute brain injury?
How would you treat an asymptomatic patient with a positive Blastomyces antibody, evidence of prior granulomatous lung disease on imaging, and who may require immunosuppression in the future?
Have you incorporated the use of linezolid in lieu of vancomycin plus clindamycin for empiric treatment of necrotizing fasciitis?
Is there any utility to trending Histoplasma serology titers to guide duration of therapy or treatment response for pulmonary histoplasmosis with negative urine antigen?
What further evaluation do you pursue for patients who present with vague symptoms such as subjective fevers or intermittent night sweats, who have no pulmonary symptoms but have a positive IGRA?
Do you consider use of convalescent plasma early in disease course in COVID-19 induced ARDS in mechanically ventilated patients?