Tweet

More from @guerreroespejo

Antonio Guerrero

@guerreroespejo

Nov 8

An 85-YO👨‍🦳, chronic kidney disease, gouty arthritis: fever, neck pain & stiffness.

WBC & CRP:⬆️
MRI suggested cervical meningitis (A): enhancement along the epidural space (arrows), & thin enhancement in a portion of the meninges (arrowheads).

1/5
#neurology #radiology

CSF: not meningitis, & CSF🧫& molecular tests ➖ for bacteria & mycobacteria

CT: calcifications of the transverse ligament of the atlas (B).

Diagnosed with crowned dens syndrome: 20 mg prednisolone, & his symptoms dramatically improved.
2/5

#rheumatology #radres #emergency

However, CSF examination under polarising microscopy revealed monosodium urate crystals (C).
Dual-energy CT confirmed the calcifications to be monosodium urate crystals (D).
Uric acid:⬆️
MONOSODIUM URATE CRYSTALS IN CSF THAT CAUSED MENINGITIS-LIKE SYMPTOMS
3/5
#neurology #MedEd

Read 5 tweets

Antonio Guerrero

@guerreroespejo

Oct 20

A 29-YO👨‍⚕️#physician, a needlestick injury with a needle used to collect a fluid sample from a man who had a pustular rash (later confirmed to be #monkeypox), the gloves appeared intact to him
Four days later, a vesicle appeared on the pricked finger (A)
1/7

#MedTwitter #Doctor

#Monkeypox virus was identified in its fluid by PCR

MONKEYPOX AFTER OCCUPATIONAL NEDDLESTICK INJURY FROM PUSTULE
2/7

doi.org/10.3201/eid281…
#IDtwitter #MedStudentTwitter

Progress of #monkeypox index lesion:
A) on the 4th day of illness
B) on the 6th day of illness
C) on the 18th day of illness
D) Necrotic scab underneath the devitalized tissue of the index lesion on the 24th day of illness
3/7

#resident #medicine

Read 8 tweets

Antonio Guerrero

@guerreroespejo

Oct 19

A👨, HIV + (CD4 = 25 cells/mm3): rash on arms, hands, chest, & buttocks compatible with #monkeypox
Ocular: redness, pain, itching, swelling, discharge, photosensitivity, & vision changes

Unilateral conjunctivitis, ulcer, & keratitis (fig.)
1/8

#ophthalmology #IDtwitter

A PCR swab of the conjunctival lesion:➕for Orthopoxvirus

OCULAR #MONKEYPOX
2/8

DOI: dx.doi.org/10.15585/mmwr.…
#eye #ojo #oftalmologia

Patients with #monkeypox can experience serious ocular complications:
5 consecutive patients with ocular monkeypox, have experienced delays in treatment, prolonged illness, hospitalization, & vision impairment.
3/8

DOI: dx.doi.org/10.15585/mmwr.… #MedEd #MedTwitter

Read 8 tweets

Antonio Guerrero

@guerreroespejo

Oct 18

Mujer 55 años, cáncer de mama, quimioterapia: fiebre, bulla purpúrica dolorosa rodeada de eritema en el cuero cabelludo.

El recuento de glóbulos blancos y absoluto de neutrófilos: ⬇️(neutropenia)
1/4

doi.org/10.1503/cmaj.2…
#dermatology #IDtwitter #MedTwitter

Hemocultivos: Pseudomonas aeruginosa

ECTIMA GRANGRENOSO en sepsis neutropénica por PSEUDOMONAS AERUGINOSA
2/4

#microbiology #dermatologia #emergency

Al principio, las lesiones de ectima gangrenoso toman la forma de máculas rodeadas de eritema que rápidamente se transforman en ampollas y escaras ulcerativas necróticas.
3/4

#criticalcare #MedStudentTwitter #resident

Read 4 tweets

Antonio Guerrero

@guerreroespejo

Sep 21

A 19-YO👩‍🦰, taken care of an 11-YO👦with bronchitis: cough, fever, dyspnea & pneumonia (XR)
Levofloxacin➡️hypoxia resolved, but:
- Orolabial blisters & rash, day 8
- Conjunctivitis, day 9
- Hemorrhagic denuded labial lesions, day 17
1/7

doi.org/10.1093/cid/ci…… #IDtwitter #MedEd

🔬skin lesion: interface dermatitis, consistent with erythema multiforme/Stevens-Johnson syndrome–type histological changes
ELISA for M. pneumoniae IgM, initially➖, &➕at day 10

MYCOPLASMA PNEUMONIAE-INDUCED RASH AND MUCOSITIS (MIRM)
2/7

doi.org/10.1093/cid/ci…
#dermatology

Extrapulmonary manifestations of M. pneumoniae infection:
✔️in 10% of patients
✔️mucocutaneous eruptions, central nervous system disease, carditis, hemolytic anemia, and Raynaud disease associated with cold agglutinins, renal disease, or arthritis.

3/7

#MedTwitter #Doctor

Read 7 tweets

Antonio Guerrero

@guerreroespejo

Sep 19

A 25-yo woman, cirrhosis due to autoimmune hepatitis, not pneumococcal vaccination: rapidly progressive sepsis with purpura fulminans.

16 h after admission, violaceous non-blanching ecchymoses from proximal thighs to the calves, & flaccid bullae.
1/9

#dermatology #MedEd

36 hours after admission, the skin was dusky & violaceous with sharply demarcated borders, bullae filled with red to black-colored fluid

Blood🧫: pan-susceptible Streptococcus pneumoniae.

PNEUMOCOCCAL PURPURA FULMINANS
2/9

doi.org/10.1016/j.idcr…
#IDtwitter #MedTwitter

She had progressive hypoxia & shock despite maximal ventilator & vasopressor support, & the patient passed away within 48 h of admission.

Autopsy: a cirrhotic liver, diffuse alveolar damage, & five liters of serous fluid in the abdominal compartment.
3/9

#Doctor #resident

Read 9 tweets

Share this page!

Antonio Guerrero

People who liked this thread also liked...

Try unrolling a thread yourself!

More from @guerreroespejo

Antonio Guerrero

Antonio Guerrero

Antonio Guerrero

Antonio Guerrero

Antonio Guerrero

Antonio Guerrero

Did Thread Reader help you today?

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

Send Email!