Episode 369: WDx #33: Clinical Unknown Discussion with Dr Laila Woc-Colburn
Dec 11, 2024
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In this conversation with Dr. Laila Woc-Colburn, an associate professor specializing in infectious diseases at Emory University, listeners dive into a compelling case of a young pregnant woman with severe headaches. Dr. Woc shares her passion for tackling complex diagnoses, particularly in immunosuppressed patients. The discussion also touches on the challenges of treating conditions like tuberculosis during pregnancy and highlights the importance of mentorship for women in medicine. Her insights on navigating uncertainty in the medical field add an engaging layer to the conversation.
Dr. Laila Woc-Colburn's expertise in infectious diseases emphasizes the critical importance of thorough prenatal care and screenings for maternal health.
The presented clinical case highlights the complexities in diagnosing infections related to geographic backgrounds and patient history, especially in pregnant women.
The case concluded with the successful identification of Mycobacterium tuberculosis, demonstrating challenges and decision-making in treating infectious diseases during pregnancy.
Deep dives
Thanksgiving Reflections
The hosts express their excitement for the upcoming Thanksgiving, elaborating on their tradition of hosting a Friendsgiving gathering. One host acknowledges the culinary skills of the other, particularly her exceptional turkey and gravy, despite her not being a fan of turkey herself. The conversation highlights their appreciation for holiday traditions and the importance of gathering with family and friends. They reflect on the joy that comes from shared meals and the spirit of togetherness that embodies the season.
Guest Introduction and Expertise
Dr. Lila Wilk-Colburn, an associate professor in Infectious Diseases at Emory University, is introduced as a guest interloper whose medical expertise focuses on tropical diseases and HIV. The hosts express admiration for Dr. Wilk-Colburn's commitment to medical education and her passion for empowering women and BIPOC individuals in medicine. They set the stage for a clinical discussion that will delve into a complex case, emphasizing the collaborative nature of sharing knowledge among colleagues in the medical field. The conversation establishes a foundation for in-depth learning and exchange of insights surrounding infectious diseases.
Emerging Clinical Case
A clinical case is presented involving a 24-year-old pregnant woman experiencing severe headaches and dizziness, raising concerns about elevated intracranial pressure. The medical team discusses the importance of thorough prenatal care and screenings for infectious diseases, such as HIV and syphilis, during pregnancy. Factors related to the patient's background, including living in Northern Mexico, further complicate her situation, necessitating a careful consideration of potential infections endemic to the region. The presentation underlines the need for a comprehensive approach to diagnosis, considering both medical history and geographical influences on health.
Diagnostic Considerations
The discussion shifts towards potential causes of the patient’s symptoms, including the possibility of space-occupying lesions attributed to infections like neurosyphilis or congenital issues. Elevated intracranial pressure is suspected, and imaging studies, particularly a CT scan, are deemed necessary to investigate further. The hosts weigh various differential diagnoses based on anatomical knowledge and the patient’s history, including reactivation of dormant infections due to physiological changes during pregnancy. This part of the conversation emphasizes the ongoing challenge of diagnosing complex cases in a collaborative team environment.
Treatment Decisions and Outcomes
Following imaging, a right temporal craniotomy is performed on the patient to address the suspected brain tumor, which reveals a granuloma with caseating necrosis on histological examination. The team debates the implications of initiating tuberculosis treatment as a precaution due to the presence of the granuloma and the patient's elevated risk factors for TB infection. A combination regimen of antitubercular therapy is started, monitored for safety, especially given the patient's pregnancy. The case concludes with the identification of Mycobacterium tuberculosis, demonstrating the clinical complexities and decision-making processes inherent in infectious disease management.
In this episode of WDx, Sharmin, Yaz, and Kaylin are joined by Dr. Laila Woc-Colburn. Tune in to hear Dr. Woc expertly discuss a case of a young woman with a worsening headache, followed by a roundtable discussion about what drew her to infectious diseases and her passions in medicine and life.
Bio:
**Laila Woc-Colburn, MD** is an associate professor in the Division of Infectious Diseases at Emory University School of Medicine. A graduate of Universidad Francisco Marroquín in Guatemala, she completed her internal medicine residency at Advocate Illinois Masonic Medical Center in Chicago and her fellowship in infectious diseases and HIV medicine at Case Western University in Cleveland. Dr. Woc-Colburn also holds a Diploma in Tropical Medicine and Hygiene.
Her clinical interests encompass tropical diseases in immunosuppressed individuals, including those with HIV, as well as mycotic diseases, orthopedic infections, and medical education. She is passionate about teaching the next generation of healthcare professionals about infectious diseases and is dedicated to empowering women and BIPOC individuals in medicine.
