Vincent and Daniel solve the case of the Panamanian Farmer with Three Weeks of Diarrhea, and discuss how microbes egested during bites of sand flies exacerbate the severity of leishmaniasis. Hosts: Vincent Racanielloand Daniel Griffin Become a patron of TWiP. Links for this episode: Sand fly microbesand leishmaniasis severity (Cell Host Micr) Letters read on TWiP 153 Case Study for TWiP 153 Man in clinic, in city recently, developed rash in groin area, concerned about this. Lives in open relationship with male partner, had sexual encounter with another male. Few weeks. Rash is in the pubic hair, is very itchy. Mostly around umbilicus, can see blue spots in this area. These are skin changes. Buys magnifying glass to look and describes seeing things which we see as well. No notable medical history. Send your case diagnosis, questions and comments to twip@microbe.tv Music by Ronald Jenkees