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The triple TWiP solve the case of the Peace Corp Veteran with Eosinophilia, and discuss the genome sequence of the hyper-prevalent parasitic eukaryote Blastocystis.

Hosts:\xa0Vincent Racaniello, Dickson Despommier, and\xa0Daniel Griffin

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• Genome diversity of Blastocystis (PLoS Biol)
• Photo credit
• Letters read\xa0on TWiP 140

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From Dr. Arthur Mumelo, northern Kenya.\xa0One-year-old girl.\xa0Brought by mother with skin lesions that developed a week prior.\xa0The lesions are five in total \u2013 on the forehead, neck, back, chest and right arm.\xa0The lesions look like boils/furuncles but keep changing size and appearance \u2013 like something is moving under the skin. They are painful and itchy.\xa0Child is breastfeeding well.\xa0No other complaints.\xa0Child was born at Nyahururu County Referral Hospital. Gets vaccinations at Melwa Health Centre (Rural), vaccinations are up to date.\xa0They live in a wooden house with a dirt floor, roofed with corrugated iron sheets. The house has two rooms. They sleep on raised beds.\xa0There is a big community dam in the neighborhood, with stagnant water throughout the year. They don\u2019t use mosquito nets.\xa0They have reliable clean water supply from the government.\xa0They have one dog but the neighbors\u2019 dogs also visit their compound and living area.\xa0They hang their clothes on the clothesline after washing; never dry their clothes on the grass. Clothes not hot-ironed.\xa0On Examination;\xa0Child is breastfeeding well, afebrile, no pallor, no jaundice, not in distress.\xa0Occipital lymphadenopathy; tender, mobile.\xa0Furuncles on the forehead, chest neck, back and right arm.\xa0They are 1-3cm in diameter and 0.5 cm high, tender, have a central punctum from which serosanguineous fluid is discharging. \xa0This is a rural health centre \u2013 the only labs done are a peripheral blood film \u2013 which showed increased eosinophils and neutrophils.\xa0HIV test \u2013 negative.

Send your case diagnosis, questions and comments to\xa0twip@microbe.tv

Music by\xa0Ronald Jenkees