So, the NYC dept of Health is investigating some cases of botulism apparently from eating tofu.   Botulism is a very dangerous disease caused by the bacteria, Clostridium botulinum, and is typically associated with contamination of canned foods.  These days it is not as common but cases such as this occasionally pop up. The problem is that no one seems to recognize it or consider it in the differential for a patient with weakness.  It gets mistaken for Guillian – Barre, Myesthenia, Bell’s Palsy, and other things.  Unfortunately, if you miss the boat on this one it can lead to paralysis of the respiratory muscles and respiratory arrest.

Now, I would never have thought that tofu would be a likely source for it but apparently came from unrefrigerated bulk tofu that was bought in the same store in Queens, NY.  So, first of all – don’t eat tofu that is not refrigerated (which to me goes without saying but what do I know) and second, if you are a clinician and see someone with facial or upper body weakness, consider botulism before you discharge them with steroids and Valtrex for Bell’s Palsy.

Ok, this is a new one for me. Everyone knows a cold can easily be spread among family members but although it’s gross no one would think about thrush!
Oral candidiasis or thrush is a common, fairly benign yeast infection in the mouth that newborns can get. (AIDS pts can also get it but I’m not talking about them!). It’s treated with swabbing Nystatin liquid in the baby’s mouth.
Anyway, recently we were perplexed by a woman with a severe bilateral breast rash that we had never seen before. After some questioning we figured out that her newborn had thrush and had spread the yeast to her Mom! Still treatable with Nystatin cream but wow, weird! I guess always check the mouth of what’s going to go on your nipple! Baby as well as adult!

Me: “Sir, you have a really nasty case of ballanitis – your penis is infected with yeast.”

Mr Candida:”Oh. Well does that mean I shouldn’t ask chicks to suck it?”