51-YO🧔‍♂️alcoholic homeless living with dog in southern France: fever, confusión, a maculopapular rash on the trunk (A), hypotension, disorientation, an eschar on his right shoulder (B), & several tiny black spots
Platelet:⬇️
AST, ALT, GGT, LDH:⬆️
1/

doi.org/10.1086/420747
#MedEd
Careful examination: these spots were actually #ticks (a total of 22) attached on the skin; they were removed

During 25 h, he was examined by diferente doctors. Dermatologic examination was woefully incomplete, as often occurs when unhygienic, homeless, &/or drunken patients
2/
All ticks were identified as #Rhipicephalus sanguineus, the brown dog tick, including 1 female (A) and nymphs (B).

MEDITERRANEAN SPOTTED FEVER IN ITS MALIGNANT FORM
3/

doi.org/10.1086/420751
#IDtwitter #dermatolgy
Empirical treatment with doxycycline and ciprofloxacin was started.
The patient's condition deteriorated, and he died 10 h later.
4/
Blood & biopsy escare culture:➕positive for Rickettsia conorii, the agent of MEDITERRANEAN SPOTTED FEVER
R. conorii DNA from a specimen of the spleen: ➕
1 of the 22 ticks: ➕for R. conorii by molecular methods and shell-vial cell culture

5/
#dermatology #microbiology

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Antonio Guerrero

Antonio Guerrero Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @guerreroespejo

Jul 28
Se sugiere que el enigma de la #hepatitis aguda grave de etiología desconocida en #niños lo explica la coinfección con #adenovirus y virus adenoasociado de tipo 2 (AAV2), y con menos frecuencia el virus del herpes 6 (HHV6)
1/
👇
espanol.medscape.com/verarticulo/59…
Dos estudios independientes: Un estudio fue dirigido por la University of Glasgow, en Glasgow, y el otro por el Great Ormond Street Hospital de Londres, ambos en Reino Unido.
2/
Los investigadores del estudio de Glasgow usando secuenciación y PCR, confirmaron la presencia de virus adenoasociado de tipo 2 en el plasma de los 9 casos de hepatitis de inicio agudo y en el hígado de los 4 pacientes analizados.
3/
Read 6 tweets
Jul 28
Mystery #hepatitis cases in #kids linked to unexpected viral suspect

Two preliminary studies finding #adeno-associated viruses in pediatric hepatitis cases suggest a child's genetic background and other virusesall act in concert
1/
👇
science.org/content/articl…
Researchers found high adeno-associated virus 2 (AAV2) levels in the blood or liver cells in 24 of 25 children with unexplained hepatitis.

In a group of kids without this condition, almost none had AAV2, even those with #adenovirus.
2/
The young #hepatitis patients were also much likelier to have a #genetic variant that may make their immune systems overreact to viruses.
3/
Read 7 tweets
Jul 27
#Monkeypox Virus Infection in Humans across 16 Countries, NEJM

Authors report 528 infections diagnosed in 16 countries.
75% were White.
41% had human immunodeficiency virus infection
The median age was 38 years.
1/
👇
DOI: 10.1056/NEJMoa2207323 Image
Transmission was suspected to have occurred through sexual activity in 95% of the persons with infection.

Overall, 98% of the persons with infection were gay or bisexual men.
2/

#monkeypox
In this case series, 95% of the persons presented with a rash (with 64% having <10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion).

3/
#MonkeypoxVirus Image
Read 9 tweets
Jul 27
A 28-YO👨‍🦰traveling through Africa & Asia: a pruritic, erythematous rash on his back, trunk, buttocks, genitals, & lower limbs; dry cough & wheeze

X-ray: bilateral reticulonodular infiltrates
Eosinophilia
1/

doi.org/10.1093/cid/ci…
#IDtwitter #MedTwitter #dermatology ImageImageImage
CUTANEOUS LARVA MIGRANS (CLM) & LOEFFLER SYNDROME

The “creeping” skin lesions are diagnostic of CLM

The pustular rash across the patient’s buttocks & back is likely secondary to CLM folliculitis—a rarer, but well-described skin manifestation of CLM
2/

#Doctor #MedEd ImageImage
The patient’s cough and chest radiograph findings are characteristic of Loeffler syndrome, a recognized but rare complication of CLM.

CLM is caused by the infective stage larvae of animal hookworms from the family Ancylostomidae.
3/

#MedStudentTwitter #resident Image
Read 7 tweets
Jul 26
42-YO African American man, AIDS, CD4 57 cells/ mm3: 18-mth of progressively multiple papules coalescing into large exophytic nodules & plaques on face, scalp, & neck (A & B); & several lesions in in the groin, penis, & RUE
🔬:?
1/

doi.org/10.1093/cid/ci…
#dermatology #idtwitter ImageImage
GIANT MOLLUSCUM CONTAGIOSUM

Molluscum contagiosum is a benign skin tumor caused by molluscum contagiosum virus.

Lesions >1 cm diameter are known as giant molluscum
2/

#Virology #MedEd #MedTwitter
Well-circumscribed intraepidermal lobules containing molluscum bodies (arrow)
These structures, which are composed of viral particles & cellular debris, are pathognomonic for this condition
Molluscum bodies enlarge and rise to the surface as cells age
3/

#Doctor #dermatologia Image
Read 8 tweets
Jul 16
3 cause of eosinophilic #meningitis:
1⃣Angiostrongylus,
2⃣Baylisascaris, and
3⃣Gnathostomiasis.

#MedEd #IDTwitter
1) Angiostrongylus cantonensis: a common cause of human eosinophilic meningitis (neural angiostrongyliasis) and occasionally ocular disease.

#neurology #IDtwitter #MedTwitter
2) Baylisascaris procyonis, the raccoon roundworm, is a rare but serious cause of neurologic and ocular disease in humans.

#neurology #IDtwitter #MedTwitter
Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(