Imaging and laboratory tests indicated severe left ventricular dysfunction and lead damage. After discussions with the family, comfort care was chosen, and the patient expired shortly afterwards. Discussion: NTM infections are often slow-growing and challenging to treat, and co-infection with Nocardia further complicates the therapeutic regimen, particularly given the limited evidence on optimal antibiotic protocols. Furthermore, high-risk device extraction may be impractical
in cases of extensive calcification, underscoring the need for an individualized, multidisciplinary approach. Dual infections of Mycobacterium margeritense and Nocardia in CRT-D pockets are exceedingly rare and associated with high morbidity and mortality. Early recognition, accurate pathogen identification, and tailored antimicrobial therapy are essential for management. This case underscores the need for further research to guide treatment protocols for such complex infections.
ENHANCING SYPHILIS SCREENING IN ASYMPTOMATIC INDIVIDUALS WITHIN THE PRIMARY CARE SETTING. Joshua Quintana, Hashani Samarasena; Louisiana State University, Lafayette, LA.
Introduction: Syphilis is a sexually transmitted infection that can progress through different stages (primary, secondary, and tertiary) if left untreated. Untreated or delays in treatment of syphilis significantly increases morbidity in affected individuals. Method: Because screening is the primary component in the control of communicable diseases and the high prevalence of syphilis in Louisiana, we propose 1) identification of high-risk patients within our primary care clinic who have not been screened for syphilis within the past year, 2) screening high-risk patients at their next appointment, and 3) comparing data before this screening initiative and after to display an improvement in screening rate and identification of asymptomatic individuals. Increasing syphilis screening rates and earlier detection of infection will improve the morbidity of our affected patients as serve as a guideline for further screening initiatives in the future.
Discussion: Syphilis is a growing public health concern nationally and especially in the state of Louisiana. The number of syphilis cases recorded in Louisiana increased by 36% from 2020 to 2021. Additionally, Louisiana ranked 11th nationally for the rate of primary and secondary syphilis rates. In 2021 Louisiana ranked 3rd in the rate of congenital syphilis with 110 cases reported representing a 75% increase from the year prior. While there are no current guidelines for syphilis screening in asymptomatic individuals, the USPSTF recommends screening for syphilis in individuals at increased risk of infection (Grade A recommendation). Individuals at increased risk for infection include men, men who have sex with men, persons with HIV infection, young adults, persons with history of incarceration, sex workers, or previous military personnel. The USPSTF also recommends that healthcare providers consider the prevalence of syphilis in the community that they serve when determining if syphilis screening is appropriate.
FAVISM AND PERNICIOUS ANEMIA CONVERGING IN A CASE OF SEVERE HEMOLYTIC CRISIS. Gurtaj Mahil, Victoria Lulich, Mitch Capella, Catherine Fontenot, Matthew Bratton, Seth Vignes; Louisiana State University, New Orleans, LA.
Introduction: Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency limits red blood cells’ ability to protect against oxidative damage due to reduced NADPH production in the pentose phosphate pathway. As a result, individuals with G6PD deficiency
are prone to hemolysis when exposed to oxidative stressors. Favism is a syndrome in G6PD-deficient individuals, where hemolytic anemia occurs after consuming fava beans. In contrast, pernicious anemia (PA) is an autoimmune disorder that destroys 31
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