Clinical Case Discussions and Video Conference Archive

Originally broadcast live, these archived discussions link health providers from the Johns Hopkins School of Medicine with providers from in-country partner institutions to address a wide range of clinical practice and science issues.

Hosted by Dr. Natasha Chida, Global Grand Rounds in Infectious Diseases (GGRID) assists health providers in caring for persons with infectious diseases (ID), using case-based instruction to provide accessible, evidence-based, and easy to use information. GGRID takes advantage of experts in global health and infectious diseases to present updated information.

All case presentations in this program have been standardized and quality assured in selection, presentation and discussion. Our goal is to publish and build a library of cases within this program to maximize the professional development of our presenters and the infectious disease knowledge of our learners.

Global Grand Rounds in Infectious Diseases (2017-10-25)

Dr. Akshaya Shewale
19 year-old man living in Pune, India, presents with 5 days of high grade fever with chills, nausea, vomiting, headache.

Global Grand Rounds in Infectious Diseases (2017-09-28)

Dr. Madhura Tinaikar and Dr. Shashikala Sangle
A 50 year old male with HIV. not on regular ART admitted with progressive distension of abdomen x 6 months.

Global Grand Rounds in Infectious Diseases (2017-07-20)

Natasha Chida, MD, MSPH
A 45 year old man presents to outpatient clinic with a 6-month history of numbness and weakness in right foot.

Global Grand Rounds in Infectious Diseases (2017-11-29)

Dr. Kapil Sejpal
History of Presenting Illness: Past-no h/o similar illness in the past, no h/o jaundice in the past; personal-Not contributory; Family-no h/o Tuberculosis in the family.

Hosted by Dr. Maunank Shah, this case-based webcast brings together clinicians caring for patients with active tuberculosis to discuss diagnostic and therapeutic challenges. Participants include clinical TB experts from the Johns Hopkins University Division of Infectious Diseases, University of California—Los Angeles and LA County TB program, Harvard University-Beth Israel, and local and regional health departments.

TB Case Conference (2017-09-06)

Drs. Maunank Shah and Ruvandhi Nathavitharana
Case Review: 62 yo, previously healthy male from Cape Verde; presented to PCP in Dec 2015; abscesses on chest, back & axilla.

TB Case Conference (2017-08-02)

Dr. Caitlin Reed
Clinicians face management dilema with 30yo Ugandan male in US x 1yr who presents with dry cough, weakness, weight loss and fever

TB Case Discussion (2017-05-17)

Dr. Maunank Shah
Clinicians faced diagnostic challenges when a 60 year-old man presented with fever and respiratory distress with hypoxia.

TB Case Discussion (2017-03-22)

Dr. Maunank Shah
58 year-old traveler from Philippines arrived 3 weeks prior to presentation; 2-3 weeks of productive cough

TB Case Discussion (2016-09-07)

Dr. Maunank Shah
56 y/o Filipino male presents w/3 day hx of hemoptysis and 10lb wt loss over 1 yr. CT chect shows scarring w/ traction bronchiectasis in Bilat UL, groundglass opacties in RUL, BLL. HIV-negative

TB Case Discussion (2015-11-25)

Maunank Shah, MD PhD
22 year old woman from Zambia: Living in the US since 2011 and going to school, lives with sister and bofriend, all from Zambia, interns 20-30 hours a week at an accounting firm.

TB Case Discussion (2015-06-17)

Dr. Ruvandhi Nathavitharana
58 y/o female from the Philippines with new diagnosis of cervical cancer, referred to ID clinic early April 2015 due to pulmonary nodules discovered on PET CT.

TB Case Discussion (2015-04-15)

Dr. Caitlin Reed
57 yo homeless US born M presented to OSH with weakness, productive cough, dyspnea x 1 wk on 2/17/15. CXR: mod large R pleural effusion with consolidation.

TB Case Discussion (2015-01-21) - Case 1

Dr. Ruvandhi Nathavitharana
44 year old Filipino male with a history of 2 renal transplants. Presents with fevers, dry cough and abdominal pain. Reports some blood in sputum and pleuritic pain. Differential Diagnosis? Further work up? Empiric therapy?

TB Case Discussion (2015-01-21) - Case 2

Dr. Michelle Haas
50 year old woman, PMH of diabetes, HbA1c of 12.6 who presented to her PCP with 2 months of cough on 8/12/14. ROS: fatigue. PMH: known prior +TST, seen in TB clinic 14 years prior, LTBI treatment not recommended (age <35 years and in the US >5 years at that time).

TB Case Discussion (2014-12-10) - Case 1

Dr. Caitlin Reed
80 yo F presenting to ED with worsening SOB x few months. Exercise tolerance decreased from 150 to 50 ft in last week. Dry cough. No fevers, chills, NS, wt loss, hemoptysis.

TB Case Discussion (2014-12-10) - Case 2

Dr. Caitlin Reed
60 yo M, Mexican immigrant, with PMHx gout, hypothyroidism, BPH, OA. Presented with easy bruising, petechiae, gingival bleed. No constitutional sx. Meds: Terazosin, Allopurinol, Levothyroxine, Tramadol.

TB Case Discussion (2014-11-12)

Dr. Maunank Shah
37 y/o man from Honduras presented to outside hospital with hemoptysis. Chest Xray showed bilateral infiltrates. AFB smear-positive (3+). GeneXpert Positive (Rif sensitive).

Tuberculosis Case Conference (2014-09-24) - Case 1

Dr. Maunank Shah
69 y/o M from Indonesia in US for 2 years. CC: Fevers and Cough.

TB Case Discussion (2014-09-24) - Case 2

Dr. Maunank Shah
79 y/o presents with Afib with RVR. Echo reveals EF 54% with mod pericardial effusion. Normal BP and converts with amiodarone.

Tuberculosis Case Conference (2014-08-27)

Dr. Teeb Al-Samarrai
34 year-ld Indian woman with history of smear and culture negative TB treatment in India and US 2006-2007. Subsequent progressive respiratory decline secondary to presumed interstitial lung disease. Now s/p lung transpant in June 2014.

Tuberculosis Case Conference (2014-06-25)

Dr. Maunank Shah
If you missed our most recent TB Case Discussion, you can view it on-demand HERE . Click "Read More..." for a complete list of archived cases.

Tuberculosis Case Conference (2014-05-28)

Dr. Caitlin Reed
No PMHx, presents with L draining ear x two wks, not improving with Amoxicillin, 3 days increasing SOB. Hear the discussion and more!

Tuberculosis Case Conference (2014-05-07)

Maunank Shah, MD and Caitlin Reed, MD
43 y/o with SLE on low dose steroids/plaquenil, treated for TB in Peru in 2000, received 'pulmonary M. fortuitum' tx in 2012, presented 1/2014 cough and "pneumonia" on CXR.

Tuberculosis Case Conference (2014-03-05)

38 yo M, Armenian ethnicity, started on Remicade in July 2013 for tx of Ankylosing Spondylitis. received RIF and subsequently INH for tx of LTBI (+TST, CXR with old granulomatous dz) starting July 2013.

Tuberculosis Case Conference (2014-02-05)

Drs. Maunank Shah and Caitlin Reed
62 yo homeless male presents with cough, NS, anorexia, dyspnea, 15lb wt loss x 3 mos, generalized weakness x 1 wk; found to have Hgb 7.5, stool FOBT+.

Tuberculosis Case Conference (2013-12-18)

Drs. Maunank Shah and Caitlin Reed
Twelve year old female from India recently immigrated presents with one week of mild headache and malaise. No fevers, chills, cough, wieght loss, night sweats. Noted to be very irritable with personality changes and went to emergency department.

Tuberculosis Case Conference (2013-10-23)

Drs. Caitlin Reed and Maunank Shah
What is your experience with hypercalcemia during TB treatment? Is this a component of IRIS in HIV-infected patients with disseminated TB after initiating ART? Does Vitamin D deficiency put a patient at increased risk for active TB? Is Vitamin D supplementation safe in TB Patients?

Tuberculosis Case Conference (2013-09-25)

Drs. Maunank Shah and Caitlin Reed
Issues raised in this session included the usage of flouroquinolone based regimens and management of TB in patients with underlying liver disease and the diagnosis and management of TB relapse.

Tuberculosis Case Conference (2013-06-26)

Dr. Maunank Shah
Symptoms/radiography resolved 3 weeks later and no systemic symptoms. Would anyone have started empiric MDR-TB therapy for ‘pleural TB’? LTBI therapy? Regimen? Can we rule out early active TB? Risk of further drug-resistance acquisition if given monotherapy? 'Watchful waiting’?

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Hosted by Dr. Natasha Chida, this is a case-based discussion series among and for clinicians caring for patients with HIV/AIDS. Participants in this series include the Byramjee Jeejeebhoy Government Medical College; National AIDS Research Institute; DY Patil Medical College, Hospital, and Research Center; and and Krishna Medical College.

India HIV Case Discussion (2016-10-20) Case 1

Dr. Mitty George
A 32yr old female, resident of Shirur, Pune. k/c/o PLHIV since 2 year on ART. Presented with c/o. Nausea, vomiting, fatigue, malaise, decrease in appetite for 1 month.

India HIV Case Discussion (2016-10-20) Case 2

Dr. Nitish Singh
37yr/female. K/c/o HIV-1 reactive since 4 months (Dec 2015). Came to SGH in April 2016 with c/o 1) diminished vision in both the eyes since 1 month 2) involuntary movements of right hand since 1 month.

India HIV Case Discussion (2016-08-18) Case 2

Dr. Saurabh Gandhi
19 year old lady presented to our OPD with the history of - - weakness of B/L lower limbs i.e. she had difficulty in getting up from squatting position and climbing upstairs associated with muscle cramps since last 6 months

India HIV Case Discussion (2016-08-18) Case 1

Dr. Aken Desai
35 y/o female, recently diagnosed with HIV, presented with: Fever—intermittent, fluctuating between 101-103 o F, associated with chills for 2 weeks; dry cough for 2 weeks

India HIV Case Discussion (2016-07-21) Case 1

Dr. Piyush Prajapati, Krishna Institute of Medical Sciences
A 35 y/o female presents with headache and giddiness for 13-15 days; vomiting, decreased appetite and generalized weakness for 10 days; detected HIV positive 10 days prior. A case of CNS Toxoplasmosis.

India HIV Case Discussion (2016-05-19)

Dr. Shraddha Bapat
This month's case discussion features a 42 year old female who presented March 3, 2016, with complaints of a dry cough persisting for 3-4 weeks

India HIV Case Discussion (2016-03-17) - Case 1

Dr. Amit Kothari
51 year old female, housewife by occupation came with c/o: - Difficulty in walking with swaying to either side which increased during night since 2 months - History of slipping of footwear without knowledge since 2 months - Pain in Abdomen, diffuse but more in epigastrium since 1 month associated...

India HIV Case Discussion (2016-03-17) - Case 2

Dr. Jagdale Nilesh
A 65 year female, admitted with the complaints of: - Reduced appetite since 1 month - Pain in abdomen since 15 days - Vomiting 3-4 episodes since 15 days - Giddiness since 15 days N/H/O - Haematemesis, Faver, Headache, Diplopia, Ear discharge

India HIV Clinical Case Discussion (2015-12-17) - Case 1

Dr. Jagdale Nilesh
A 39-year-old man with a past medical history of HIV on ART (last CD4 count of 230) and pulmonary TB/TB meningitis diagnosed 2 months prior...

India HIV Clinical Case Discussion (2015-12-17) - Case 2

Dr. Abhishek Bansal
A 40 year-old-man with a history of untreated HIV and a last known CD4 count of 112 presents to a hospital in India with 10 days of weakness in the upper and lower extremities, ataxia, and a new rash over his left lower extremity and face.

India HIV Clinical Case Discussion (2015-10-15) - Case 1

Dr. Rajkumar Gaikwad
38 year old female patient admitted on 15/9/15 came with fever on-off since 15 days, multiple painful lesions all over body since 15 days, slurring of speech since 2-3 days, 1 episode of convulsion on day of admission.

India HIV Clinical Case Discussion (2015-10-15) - Case 2

Dr. Vivek Singh Rathore
32 year old male, driver by occupation, presented with complaints of: Swallowing difficulty, both for solids & liquids since 2 months, weakness in Rt. Upper & Lower limb with difficulty in lifting & holding objects with right hand - 15 days, difficulty in walking - 15 days.

India HIV Clinical Case Conference (2015-07-15) - Case 1

Dr. Natasha Chida
A 24 year old woman with newly diagnosed HIV and no prior past medical history presents to the emergency department with 2 weeks of a dry cough and 1 week of fevers up to 39 degrees Celsius.

India HIV Clinical Case Discussion (2015-06-17) - Case 2

Dr. Shrikant Hegade
36 y/o HIV seropositive male with pulmonary koch and CNS tuberculomas admits with c/o abdominal pain, swelling of both LL, fever, decreased urine output, scrotal swelling and pain. H/o night sweats and weight loss. Baseline CD4= 175. MRI brain s/o lesion in Lt. occipital region.

India HIV Clinical Case Discussion (2015-06-17) - Case 1

Dr. Hamza Dalal
HIV-infected Indian man with CD4 account 423 and undetectable plasma viral load on HAART, who presents with neurological symptoms and a CNS HIV viral load of >1 million copies/ml.

India HIV Clinical Case Discussion (2015-05-20)

Dr. Yogesh Daware
24 years old married female, contractual manual laborer, migrant from Karnataka state, staying in Pune since 5 years, PLHIV...

India HIV Clinical Case Discussion (2015-04-15)

Dr. Prashant Bhattad
36 yo male is diagnosed w/ pyogenic meningitis and started on treatment after presenting w/fever, chills, disorientation and rt lower limb weakness.

India HIV Clinical Case Discussion (2015-03-18) - Case 1

Dr. Akshay Dhamme
65/F presented for complaints of double vision since 10days, more on looking left. Frontal Headache since 10 days, throbbin type. History of fever, low grade since 10 days.

India HIV Clinical Case Discussion (2015-03-18) - Case 2

Dr. Anurag Aggarwal, J.R. II
A 38 year old housewife, detected HIV+ve, had complaints of 1) Weakness in left side of the body 6 years; 2) Burning sensation in both the palms and soles 6 years

India HIV Clinical Case Discussion (2015-02-18) - Case 1

Dr. Rahul Mahajan, J.R. III
15 yr old female K\C\O PLHIV since 10 yrs on ART since last 2 yrs. C/O 1) Focal continuous convulsions involving face and left UL and left LL since 3 day

India HIV Clinical Case Discussion (2015-02-18) - Case 2

Dr. Rohan Badave JR-III
- 57 yrs Male - Brought by relative with c/o -Loose motions: since 10 days 7-8 episodes/day, watery, non foul smelling, not continining mucus or blood. - Breathlessness: since 15 days, increasing progressively from NYHA Gr. 1- Gr. III

India HIV Clinical Case Discussion (2015-01-21)

44 yr old male HIV reactive - 12 yrs recently started on ART. Regimen - ZLN. Baseline CD4- 211 cells/cumm. Admitted to hospital with c/o- jerky involuntary movements- Lt UL, Rt LL limb, blurring vision in both eyes.