Hospitalist @BIDMC_IM Teaching/Learning Dx @HarvardMed❓, Co-host @Dx_Atypia 🦓 🐎, @CPSolvers Academy🕵🏽♂️, @YaleIMed @ColumbiaPS @UF 👨🏽🎓
Boston, MA
Joined May 2009
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📌 See below for my collection of:
- Tweetorials for Diagnosis❓
- Case Challenges❗️
- @CPSolvers Presentations ♥️
docs.google.com/spreadsheets…
Andrew Sanchez retweeted
🫁 Imaging patterns of community-acquired pneumonia (CAP) in #JTI!
In this review, Franquet et al examine the clinical and imaging spectrum of CAP, highlighting pathogen-specific patterns, diagnostic challenges, and complications.
🔗 Article in reply!
Andrew Sanchez retweeted
nightmare fuel for anyone who places patients on long-term steroid therapy 🫣
this is present in parts of the southern USA & Appalacia. However, its most common in the context of travel & immigration.
#JClinMicro photo quiz! A 13-year-old boy with a history of frequently relapsing nephrotic syndrome, presented with persistent and progressive eosinophilia, alongside pruritic skin lesions. A parasitological workup was undertaken. What's your diagnosis? asm.social/38z
ALT Routine saline wet-mount microscopy of the stool specimen (image at 10× magnification).
Andrew Sanchez retweeted
🧵 KRATOM: What Every Clinician Should Know 🌿
1/10
Kratom is increasingly popular in the US, often marketed as a “natural” alternative for pain, anxiety, and opioid withdrawal.
But is it safe?
New evidence raises important concerns, especially about concentrated 7-OH products.
A clinical thread 👇
Αlpha agonsim mediated vasoconstriction can also lead to severe rhabdo! Have seen 3-limb compartment syndrome from this 💪
It’s happening!!
In 4,398 pts w/out diagnostic ST elevation, the OMI/NOMI approach selected more pts for early invasive management vs conventional very-high-risk #NSTEMI criteria (45.4% vs 13.6%) and identified acute coronary occlusion sooner (35.1% vs 16.7%).
#JACCINT
bit.ly/3VTiqbl
Andrew Sanchez retweeted
In sepsis the endothelium isn't just leaky. It's a moving target that goes from leak to lost tone to clots to inflammation. It bothers me when there’s a bad sepsis outcome and the question is “did they get enough fluids?” 🎩 tip to the authors
eddyjoemd.com/foamed
Andrew Sanchez retweeted
🫀 CardioNugget™:
Not all polymorphic VT is Torsades!
See polymorphic VT (PMVT)? Don’t automatically call it Torsades.
The key question: Is the QT prolonged?
⏳ Long QT + PMVT → Torsades de Pointes
→ think EADs
→ drugs: sotalol, dofetilide
→ electrolytes: ↓K⁺, ↓Mg²⁺
→ treatment: IV magnesium
⚡ Normal QT + PMVT → NOT Torsades
Think:
→ Acute ischemia
→ Brugada syndrome
→ Catecholaminergic polymorphic VT (CPVT)
💡 Brugada pearl:
Brugada can cause PMVT/VF with a normal QT. Its ECG pattern may be intermittent and can be unmasked by Na⁺ channel blockers such as flecainide, procainamide.
🧠 PMVT ≠ Torsades
Torsades = PMVT + prolonged QT.
#CardioNugget #Cardiology #EPeeps #ECG #MedEd
Andrew Sanchez retweeted
【Call for Action: Invasive Fungal Infections Associated With Ibrutinib and Other Small Molecule Kinase Inhibitors】Clin Infect Dis, 2018 Jan @CIDJournal
👉 Useful Viewpoint/case review
@UTMDAnderson
pubmed.ncbi.nlm.nih.gov/2902…
#IDMedEd #IDFellow
【Invasive fungal infections after Bruton tyrosine kinase inhibitor treatment】Blood Adv 2026
@UTMDAnderson ID Journal Club
✍️Great discussion on invasive fungal infections after BTK inhibitor!
Thanks Eduardo! @eduardo_yepezg 🎉
pubmed.ncbi.nlm.nih.gov/4195…
#IDMedEd #IDFellow #OncoID #HCTID
Andrew Sanchez retweeted
BMJ: Bat-borne zoonoses: transmission, impact, prevention, and management
Outstanding and comprehensive review
Jessica Stanhope et al @bmj_latest
bit.ly/47REcPs open
Andrew Sanchez retweeted
A recent case report detailed a patient with fever of unknown origin (FUO) who was diagnosed with L dumoffii bioprosthetic aortic valve endocarditis using metagenomic next-generation sequencing. A new clinical reflection discusses how molecular diagnostics, including microbial cell-free DNA sequencing and 16S rRNA gene sequencing, can identify fastidious organisms when traditional cultures fall silent. Read the full text for free: bit.ly/4hH2npC @AHAScience #AHAJournals
Andrew Sanchez retweeted
Thanks @ASanchez_PS !
Dyspnea is the perfect problem space to explore value of entropy in clinical reasoning. I learned a lot from this case and appreciate your masterful discussion of a complex topic.
The best PRs indeed reflect the size of the diagnostic space as new information emerges. If updated PR is inappropriately narrow, opportunities to reduce uncertainty may get overlooked. If updated PR is inappropriately broad, reflex testing leads to cascades of low value care.
TL;DR Entropy helps us think about value of testing across the ddx.
The concept has sparked ongoing dialogue, so wanted to share our latest response to a letter to the editor:
Finally, shout out to @CoryRohlfsen for his ongoing work on entropy & advocacy for its use -- only took a few tweets to break through my math-naive 🧠
Andrew Sanchez retweeted
If you had told me 5 years ago that this would be the front page of JACC CI, I'm not sure I would have believed you. My thanks to these colleagues for their work.
Pleased to share my first CPS publication!
"Reading Between the Lines" 🕵️♀️
As pulm-crit master clinician Anna Fretz takes us through a case of rapidly-progressive hypoxemia unresponsive to therapies, we integrate "entropy" to showcase uncertainty mgmt. during mgmt. reasoning
Finally, shout out to @CoryRohlfsen for his ongoing work on entropy & advocacy for its use -- only took a few tweets to break through my math-naive 🧠
