Marcos Rust, MD @Mav_Rust Twitter profile

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Marcos Rust, MD

@Mav_Rust

7 months

@TheTennisLetter Leave the guy alone! He’s a 21 yrs old kid amazed by everything that is going on. He’s having fun! I don’t think that’s a bad behavior. Djokovic also smashes rackets on the court. How about that behavior??

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Marcos Rust, MD

@Mav_Rust

3 months

I still get surprised by how mean people are. This afternoon at #ECCMID2024 2 guys from Portugal were laughing at the presenter from Brazil struggling with her English. And these are medical doctors attending to an international conference! 🤬

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Marcos Rust, MD

@Mav_Rust

6 months

@thanh_neville These are fideos and NOT cut spaghetti. What is wrong with @BarillaUS ? Fideos is a type of Spanish pasta! It is a sacrilege for the Spanish cuisine to see that “translated” this way on a Barilla box. 🇪🇸

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Marcos Rust, MD

@Mav_Rust

10 months

Great discussion this morning! Great point targeting the definition of complicated and uncomplicated, as well as the PKs and PDs of the regimen used! #IDWeek2023 #IDTwitter

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Marcos Rust, MD

@Mav_Rust

2 months

Hey, #IDTwitter I just wanted to put it out there. I am shocked by the decision of a renowned hospital here in Berlin to discourage a patient of mine to start his residency program in General Surgery bc of his HIV status. This should not be the case in 2024.

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Marcos Rust, MD

@Mav_Rust

4 months

#IDTWitter , any differential? German 26y M. No recent travel history. 2021-2023 lived in Japan. Since Sep 2023 back. The following wound has been noticed 1 mo ago. No changes yet despite numerous topic therapies.

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Marcos Rust, MD

@Mav_Rust

3 months

I will not use vancomycin if I can. Period! You can start throwing the stones! I am used to it. I have been doing that for a while and I’m used to be criticized for that 🤕 #ECCMID2024 #SAB #IDTwitter

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Marcos Rust, MD

@Mav_Rust

10 months

Great to see some changes in the treatment of HIV during pregnancy. Thank you for the nice talk @PaulSaxMD . @IDWeekmtg #IDWeek2023 #IDTwitter

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Marcos Rust, MD

@Mav_Rust

10 months

Excellent!!! 👏🏻 #IDTwitter #IDWeek2023

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Marcos Rust, MD

@Mav_Rust

3 months

@JamesLucasIT My hometown!! 😍

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Marcos Rust, MD

@Mav_Rust

1 year

It was a great 1st day! #ECCMID2023

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Marcos Rust, MD

@Mav_Rust

3 months

#IDTwitter 54M, PLWHIV, fever, night sweats. VL undetectable. CD4 > 400. ART: EVG/c/FTC/TAF. Dry coughing. O2Sa in room air: 91%. CTscan below. How would you treat it empirically? 😉

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Marcos Rust, MD

@Mav_Rust

1 month

A resident called me today to ask if it was ok to treat a pat with a combination of: CRO, Metronidazole and Meropenem. Once asked why, she went: Diverticulitis + a diabetic ulcer from which we’ve isolated a Pseudomonas pip/taz I. Like..😩 S.O.S. #IDTwitter

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Marcos Rust, MD

@Mav_Rust

3 months

@TBrnaughtTB Right?! That is so disturbing…Specially bc I work speaking a different language from the one I grew up speaking and that is DAMN hard! I have all the respect for everyone who has the courage to do so!

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Marcos Rust, MD

@Mav_Rust

1 year

@silentID3 @ABStewardess @BJegorovic @ABsteward @guerreroespejo @AntibioticDoc @dralicehan @OncIDPharmd @maudi_ahmed @InYourFAECIUM @BradSpellberg @TomBoylesID @IDstewardship @CosEpiID @Cortes_Penfield @DrToddLee @drtimothyli @michael_david1 @FReichert667 @DrNeilStone @DrEmilyMcD @IdVilchez We no longer prescribe Gentamicin for IE. I hope the future guidelines realized it is no longer needed. 🙏🏻

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Marcos Rust, MD

@Mav_Rust

2 months

#IDTwitter . Male patient: I came in bc I have scabies. Me: Is that so? Why do you think you’ve got it? P: My skin itches since last time I’ve had sex. I have been using permethrin wo success. I need ivermectin. And please 2 boxes bc I need 5 pills, I weight 85Kg. Me: 😳

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Marcos Rust, MD

@Mav_Rust

2 months

@ABStewardess Krass!! Wie kann man ins Ausland OHNE KV reisen?!?! Das kann ich wirklich nicht verstehen!

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Marcos Rust, MD

@Mav_Rust

1 year

@NEJM Neonatal herpes

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Marcos Rust, MD

@Mav_Rust

8 months

I had the pleasure to be invited to write an article about the difficulties of being recognized as an official ID specialist in Europe.

Javier Membrillo

@javimembrillo

8 months

Los infectólogos 🇪🇦 discriminados sin libertar de circulación por 🇪🇺 #SIEspecialidadEI #SpainhasnoIDSpeciality @SEIMC_ @sanidadgob @Monica_Garcia_G @Mav_Rust

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Marcos Rust, MD

@Mav_Rust

10 months

What’s up, Boston? #IDTwitter @IDWeekmtg #IDWeek2023

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Marcos Rust, MD

@Mav_Rust

1 month

Hey, #IDTwitter 3rd case this week. Skin lesions „Impetigo like”. All young and healthy in their 30s. Lesions start like a small blister. It bursts originating the lesion seen on the pics. Ideas?! They all heal spontaneously. Always seen in dif stages at the same time.

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Marcos Rust, MD

@Mav_Rust

3 months

The horrible natural disaster hitting the southern state of Rio Grande do Sul in Brazil comes with the risk of various infections, one of those is the leptospirosis. When and how is the quimioprophylaxis indicated ? 😉 #Brazil #ID

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Marcos Rust, MD

@Mav_Rust

5 months

Hey #IDTwitter up for some case solving? 🧵33M MSM complains about low grade fever (38,5C) for the last 3 weeks. Night sweats. No other complains. Lab: L:12,1, Hb:12,2, T: 180. CRP: 162. Spent 2 w in 🇮🇱 before the symptoms started. Next step? Empirical AB?

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Marcos Rust, MD

@Mav_Rust

1 year

And people still think Kaposi Sarcoma no longer exists. 36M, CD4: 44, VL: 230k. TAF/FTC/BIC. Non-adherent.

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Marcos Rust, MD

@Mav_Rust

3 months

Great to see a full house discussing PJP. #ECCMID2024

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Marcos Rust, MD

@Mav_Rust

4 months

@lamebaron That’s exactly what I’m planning

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Marcos Rust, MD

@Mav_Rust

10 months

Hey, #IDTwitter how are you treating MDR Mycoplasma genitalium (Azi and Moxi resistent)? #STI

Pristinamycin

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Minocycline

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Doxi 7d following Azi 3d

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Marcos Rust, MD

@Mav_Rust

3 months

Bad part of these huge conferences is bumping into people you don’t like 😎 #ECCMID2024

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Marcos Rust, MD

@Mav_Rust

3 months

Stubborn Marcos part II: I will keep vaccinating MSMs between 25-45y against HPV! Even the ones who have been treated for AIN! Period! #ECCMID2024 #IDTWitter

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Marcos Rust, MD

@Mav_Rust

10 months

I’m so excited

IDWeek

@IDWeekmtg

10 months

Coming soon! 🏗️ #IDWeek2023

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Marcos Rust, MD

@Mav_Rust

5 months

@ABStewardess In BERLIN Essen für PLWH wird noch am Tür gestellt!!! PLWH unter der Nachweisgrenze sind noch auf der Akte rot markiert (Achtung; HIV)! Nach 40J Pandemie haben die Menschen in dem Gesundheitswesen NICHTS gelernt! 😤

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Marcos Rust, MD

@Mav_Rust

29 days

@BJegorovic @dralicehan @ABStewardess I wouldn’t decide only based on that. Culture of bone / periosteal biopsie. Wound swabs not always reliable.

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Marcos Rust, MD

@Mav_Rust

3 months

I keep saying: know your epidemiology! So important to pick you empirical treatment. #ECCMID2024 #ABS

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Marcos Rust, MD

@Mav_Rust

7 months

@guerreroespejo Aqui en Brasil la llamamos “bicho de pé”. Pero un caso así tan extenso aún no había visto.

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Marcos Rust, MD

@Mav_Rust

3 months

Benefits of waking up early on a Sat morning! Experiencing BCN’s emptiness! 😍 #ECCMID2024

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Marcos Rust, MD

@Mav_Rust

10 months

Loved the Chlamydia, @id_cure !! #IDWeek2023

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Marcos Rust, MD

@Mav_Rust

4 months

@ABStewardess Right? ! Such a weird kind of wound. No previous health conditions. Athletic, healthy. Skin bx planned.

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Marcos Rust, MD

@Mav_Rust

2 years

@MayoClinicINFD Mycobacterium marinum

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Marcos Rust, MD

@Mav_Rust

2 months

The patient is extremely psychologically stressed considering to give up Medicine and even terminates his life. He is right now under psychological treatment with support with his parents who moved in concerning his current mental status.

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Marcos Rust, MD

@Mav_Rust

10 months

@Stanford_ID Same thing here in Barcelona! Hospitall with 760 beds. But here we’ve still got the Ortho-team and the Endocarditis team! Each team with one attending or two and residents. Besides that, we’ve got a ward with 20 beds, 2 attendings and 4 residents! The ID team is huge! Loving it!

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Marcos Rust, MD

@Mav_Rust

7 months

The restrict supply of PrEP in Germany has reached a critical point. In Berlin it is no longer available and the situation will last at least 2 months. #IDTwitter #prep

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Marcos Rust, MD

@Mav_Rust

10 months

Checkin‘ in, #IDWeek2023 #IDTwitter

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Marcos Rust, MD

@Mav_Rust

10 months

The eternal discussion between IDs and hematologists! How long?? 🤔 #IDWeek2023 #IDTwitter

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Marcos Rust, MD

@Mav_Rust

11 months

@drtimothyli I’d reduce the dose only if the patient shows signs of thrombocytopenia. Otherwise I would go for 600 daily as recommended.

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Marcos Rust, MD

@Mav_Rust

11 months

@BJegorovic Holly sh#*!! Well, first I’ll try to be sure about the VAP. We see a lot of colonization without radiological signs. Clinical deterioration due to other causes excluded? As @ABStewardess said, Aztreonam + Avibactam maybe? 🤔

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Marcos Rust, MD

@Mav_Rust

1 year

My beautiful hometown! #RiodeJaneiro #brazil #home

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Marcos Rust, MD

@Mav_Rust

3 months

@JamesWilsonDO1 @IdVilchez @DrToddLee @BradSpellberg @ABsteward @ABStewardess @IDiots_pod @raj_karnatak @PulmCrit First question: is it really a VAP or ist Steno only a contaminant? If Steno pneumonia is confirmed I would address the BSA separately and with cafezolin. Don’t really trust TMP/SMX for BSI. I mean I have no experience myself.

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Marcos Rust, MD

@Mav_Rust

1 year

Thank you, Leipzig! #kit2023 was a great opportunity to meet friends and get updated on the ID hotspots!

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Marcos Rust, MD

@Mav_Rust

2 months

#IDTwitter : Today at the out-patients clinic: 250 patients. 3 doctor. Can you handle it? 😵

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Marcos Rust, MD

@Mav_Rust

5 months

@SCMIMC1 Émbolo séptico cerebral. Foco principal: endocarditis de válvula mitral por Streptococcus 🤔

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Marcos Rust, MD

@Mav_Rust

1 month

The next case from this same skin affection, #IDTwitter

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Marcos Rust, MD

@Mav_Rust

10 months

@SCMIMC1 Bartonella henselae. Amox/ac clav.

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Marcos Rust, MD

@Mav_Rust

5 months

#IDTwitter , a 36 F came to see me today bc her throat swab was pos for Haemophilus parainfluenza. urged to be treated bc she works in a daycare. No symptoms. The swab was done bc she hat a soared throat and went to see her GP, who ordered the swab. What would’ve done??

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Marcos Rust, MD

@Mav_Rust

4 months

@BJegorovic @laocarinadetapi @IdVilchez @wwrighID @BradSpellberg @Cortes_Penfield @dralicehan @ABsteward @DrToddLee @DrEmilyMcD @ParasiteGal @PaulSaxMD It is a shame Tinodazol and Secnidazol are not approved everywhere in Europe. In Brazil we treat Giardia sp with a single dose (2g) secnidazol and I have never seen a failure. I always bring some with me. You never know… 😉

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Marcos Rust, MD

@Mav_Rust

4 months

@PeterItebimien @IUIDfellowship @DrAkhilRaghavan @nihardesai7 @NicoGagelmann @AaronGoodman33 @imedverse @BrownJHM @ManualOMedicine @WilliamAird4 @MorphologyAmigo @drkeithsiau Relapsing fever. Borrelia sp.

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Marcos Rust, MD

@Mav_Rust

7 months

32 M. Painful not healing wound on his left foot after a trip to the Philippines in November last year. No other symptoms. Differentials? #IDTwitter

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Marcos Rust, MD

@Mav_Rust

8 months

@Beingmediccoo @DrAkhilRaghavan @TSM_Humanist TB might be an good call, but I wouldn’t exclude cancer, lymphatic metastasis? Any particular reason for the lymphopenia ?

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Marcos Rust, MD

@Mav_Rust

4 months

@andreaskardio It could be. But he hasn’t been to any endemic places. I haven’t heard of an autoctone case in Germany yet.

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Marcos Rust, MD

@Mav_Rust

6 months

Ojalá!!

SEIMC

@SEIMC_

6 months

#SIEspecialidadEI #SpainhasnoIDspeciality La ministra de @sanidadgob , @Monica_Garcia_G , acaba de anunciar en la Comisión de #Sanidad del @Congreso_Es , que esta legislatura se reconocerá la demanda histórica de la creación de la especialidad de enfermedades #infecciosas

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Marcos Rust, MD

@Mav_Rust

7 months

Golbal warming plus the rise in globalization = IDs are even more important now than before. Here a good example: 👇🏻 #IDTwitter

Locally Acquired Melioidosis Linked to Environment — Mississippi, 2020–2023 | NEJM

Melioidosis, caused by Burkholderia pseudomallei, is a rare but potentially fatal bacterial disease endemic to tropical and subtropical regions worldwide. It is typically acquired through contact w...

www.nejm.org

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Marcos Rust, MD

@Mav_Rust

4 months

@FReichert667 Yep I thought about NTM , Fungi. The punch will help I guess. 🙏🏻

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Marcos Rust, MD

@Mav_Rust

1 year

@Paddy_Barrett I almost never proscribe statins! All my patients reach that goal with a plant -based diet.

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Marcos Rust, MD

@Mav_Rust

3 months

It is a real ordeal if you have to fly from Berlin “International” Airport! #ECCMID2024 here I go.

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Marcos Rust, MD

@Mav_Rust

1 year

That’s beyond human

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Marcos Rust, MD

@Mav_Rust

1 year

Since when elderly patients are not allowed to present with an acute viral infection? ER resident on the phone: “79F no evident signs of infection . No complains but 3 days fever up to 38,5C. 14k Leu, 300 CR f*^%ing P. Which antibiotic?” 😒

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Marcos Rust, MD

@Mav_Rust

2 months

@tennisheader This pic looks way better now!

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Marcos Rust, MD

@Mav_Rust

9 months

@BrownJHM @nihardesai7 Epi is so important in those cases. Other viruses can also cause similar presentation. But if you say he was on Holidays in Rio 3 days prior presentation, I would’ve said immediately dengue. 🦟

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Marcos Rust, MD

@Mav_Rust

1 year

@PPIDJournal @dralicehan Infectious due to Arbovirus. Dengue or because of the hip joint pain chikungunya.

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Marcos Rust, MD

@Mav_Rust

1 year

@drtimothyli Fungus (Aspergillus), TB, Neoplsia

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Marcos Rust, MD

@Mav_Rust

3 months

#IDTwitter , I don’t know about your experience, but I need to stop seeing outpatients! This Gen Z /Millennials are killing me! In Berlin there is now a new trend: every guy, whose gf has a pos pap-smear pos for HPV wants to get tested. Meaning urethral swab HPV-PCR! 😳

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Marcos Rust, MD

@Mav_Rust

5 months

@PeterItebimien @BrownJHM @DrAkhilRaghavan @drkeithsiau @Sthanu5 @IhabFathiSulima @radRounds @ManualOMedicine @nihardesai7 Neurosarcoidosis

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Marcos Rust, MD

@Mav_Rust

1 year

@TheAmirImani It doesn’t matter where you practice ID. We’ve got all the same problems 😆

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Marcos Rust, MD

@Mav_Rust

11 months

@ABsteward Europeans say Cefepime is dangerous bc of its potential of triggering seizures. When I first moved here they were like: “cefe…what?”

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Marcos Rust, MD

@Mav_Rust

2 months

@sebpoule Right! And the discouragement came from the INFECTIOUS DISEASES Department!!!! 😤

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Marcos Rust, MD

@Mav_Rust

8 months

#IDTwitter 30y M. Professional dancer. After “popping a pimple” on his thigh, the area became swollen and red as seen. Allergic to penicillin he was started on Bactrim DS tid. No improvement after 4 days. T 39C, vomiting and weakness. Skin rash developed: face and limbs. ⬇️ 1/2

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Marcos Rust, MD

@Mav_Rust

10 months

@MayoClinicINFD Tropheryma whipplei ! Attention for the TMP/SMX resistance. Getting more and more common! 😉

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Marcos Rust, MD

@Mav_Rust

3 months

@atp4me @paulabadosa is def a lucky gal!

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Marcos Rust, MD

@Mav_Rust

10 months

Omadacycline seems like a really good option regarding the treatment of osteomyelitis #IDWeek2023 #IDTwitter

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Marcos Rust, MD

@Mav_Rust

10 months

MIC alone is not all! We need to get to know more about the bugs we’re treating! Great talk this am. #IDWeek2023 #IDTwitter

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Marcos Rust, MD

@Mav_Rust

9 months

@MayoClinicINFD Echinococcus multilocularis

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Marcos Rust, MD

@Mav_Rust

10 months

@ABStewardess @docfettzi Finde es auch eine sehr gute Idee. 👍🏻

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Marcos Rust, MD

@Mav_Rust

8 months

Thankful or my 49th trip around the sun! 🙏🏻

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Marcos Rust, MD

@Mav_Rust

8 months

Loving Dublin 🇮🇪☘️🍺📖

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Marcos Rust, MD

@Mav_Rust

11 months

@ShohamTxID None so far. But I’d love to hear from the colleagues who have had this experience already

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Marcos Rust, MD

@Mav_Rust

7 months

@pascalisID @MayoClinicSOM Sporotrichosis

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Marcos Rust, MD

@Mav_Rust

3 months

Time to relax and forget about RCT for a while. #cinema

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Marcos Rust, MD

@Mav_Rust

3 months

@BJegorovic @ABsteward @dralicehan @ABStewardess @maudi_ahmed @BradSpellberg @DrToddLee @IdVilchez @Cortes_Penfield You don’t. You just don’t

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Marcos Rust, MD

@Mav_Rust

1 year

@ABStewardess @ABsteward @BJegorovic @dralicehan @silentID3 @IDlism We do it depending on the findings on TEE/TTE. If it doesn’t show any signs of vegetation the hardware might be kept. However, if still so the following bc don’t clear we support the removal of the hardware.

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Marcos Rust, MD

@Mav_Rust

2 months

@ABStewardess Yes! I saw only this am (8:30-12:30) 32 patients alone!!! How can that be ok??

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Marcos Rust, MD

@Mav_Rust

4 months

Hey #IDTwitter , is that so that 20 pills of linezolid in Germany cost 997€ ? 😳 We don’t have that notion of price in hospitals until a patient comes back and tell you: “I can’t afford it”. #absstewardship

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Marcos Rust, MD

@Mav_Rust

4 months

Sometimes I really feel like quitting Medicine bc of how we doctors are treated nowadays. That fact you want to practice a good evidence based Medicine is seen as a bad practice. Patients treat you bad bc you haven’t given them an antibiotic how they expected to 🤯

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Marcos Rust, MD

@Mav_Rust

1 year

@ABsteward Good results in treating prolonged S . maltophilia BSI on Bactrim in a patient with metastatic uterus carcinoma. BC cleared after 48h.

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Marcos Rust, MD

@Mav_Rust

1 year

@DrEmilyMcD @Wiki_Guidelines @pod_tina @emilie_trinh @BradSpellberg @DrToddLee @ABsteward Is gentamicin really needed as part of IE treatment? That’s the question.

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Marcos Rust, MD

@Mav_Rust

5 months

@SamuelDM18 E histolytica

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Marcos Rust, MD

@Mav_Rust

1 year

@DrToddLee @BradSpellberg In Germany, EVERY single person who walks into an ER gets CRP!!! It does not matter what their complains are about. Like Oprah says: “You got a CRP! You, you, you and you! Every one gets a CRP!!” 🤬🤬🤬

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Marcos Rust, MD

@Mav_Rust

1 year

@PottJohannes Ich dachte das wäre ein Problem nur in Berlin, aber sehr offensichtlich es ist ein Problem, das Landesweit zu sehen ist. Traurig!!

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Marcos Rust, MD

@Mav_Rust

2 months

@dralicehan @JonathanRyderMD @IdVilchez @DrToddLee @AntibioticDoc @ABStewardess I usually prescribe methenamine or I do TMP/SMX PEP 480mg, bc in Berlin you cannot find urologists / gynecologist who a longing to work together in this particular matter. Quite hard indeed.

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Marcos Rust, MD

@Mav_Rust

2 months

@javimembrillo @JesicaAbbey @octaarce @SEIMC_ Dios mio! La situación es de verdad muy complicada. 😕

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Marcos Rust, MD

@Mav_Rust

3 months

@transplantID 100%

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Marcos Rust, MD

@Mav_Rust

7 months

@ABStewardess @BJegorovic Spot on!! I would’ve done the same. I don’t know the MIC for Pneumococcus in Serbia, but here I would do CRO 2 bid mono. What does the CSF-Gram show? Pseudomonas might be considered too. Does she have a mastoiditis? In that case empirical should contain a anti-pseudomonas.

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