Week 7

In the clinic this week, I sat in on rounds with ID fellows and also got the chance to see some in-patients in addition to the out-patients from the general ID clinic.  The most interesting case my clinician and I discussed was that of a patient who contracted malaria during a trip abroad.  After returning to the US, the patient started to develop febrile symptoms and was prescribed two courses of the same broad spectrum antibiotic, on separate occasions, since a definitive diagnosis was never made until the patient decided to seek out an ID specialist at the NY Presbyterian.  Since antibiotics are generally not effective for treating malaria, the patient’s symptoms would return after each course was finished.  Interestingly enough, the particular broad spectrum antibiotic (not named due to potential publication) that was prescribed neutralized almost all erythrocytic stages of plasmodium falciparum but left the exoerythrocytic gametocytes viable.  This essentially means that patients infected with p. falciparum who take this particular antibiotic will be able to temporarily suppress the symptoms of malaria but remain infectious, since the uptake of gametocytes by Anopheles mosquitoes is responsible for the transmission of malaria.  This is the first time this phenomenon has been observed clinically so the clinicians from the ID department are looking to publish a paper in the New England Journal of Medicine, which is pretty exciting.  I had the opportunity to look at the blood smears from the patient and sure enough, banana-shaped gametocytes (see below) could be found easily but the other stages, not so much. 

For my research project, I’ve finally been able to amplify all seven beta subunits of the falciparum proteasome and will send out the last two subunits for sequencing next week.  I will also be starting a mini-exploratory project my last week which will involve mimicking the mechanical filtration of the spleen in vitro using a matrix of metallic microspheres.  I will provide more details regarding this mini-project in my next post.  If successful, this biomimetic filtration technique will be a useful research tool for studying diseases where the mechanical properties of red blood cells are altered.