This case-based conference begins with a patient with CLL who was found to have persistent Staph epi bacteremia with native aortic valve endocarditis, and ultimately underwent surgical aortic valve replacement. The clinical course then shifts to the development of marked eosinophilia and pruritus after prolonged antimicrobial exposure and valve replacement, prompting discussion of medication reactions, eosinophilic dermatosis of hematologic malignancy, parasitic and fungal mimics, and the question of alpha-gal–related reactions to bioprosthetic valves.
The teaching portion uses a set of “MARS calls” (Medical Access and Referral Service, the 24h phone-line used at WVU for patient transfers, after hours patient questions) to explore how infectious diseases might behave during spaceflight. Topics include functional immune changes in astronauts, shifts in the GI and spacecraft microbiome, biofilm behavior in low-shear microgravity-like conditions, challenges with infection prevention in closed environments, possible changes in pathogen virulence, nematode models of infection in space, and degradation of medications during prolonged storage on the ISS.