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Dec 28 • 6 tweets • 6 min read
Lactante ♀️ de 5 meses: fiebre, síntomas catarrales, buen estado general y lesiones redondeadas, algunas anulares con centro violáceo y otras en diana, algo sobreelevadas, desaparecen parcialmente a la vitropresión y de aspecto indurado
1/6
#pediatría #urgencias #MedEd
El EDEMA HEMORRÁGICO AGUDO DEL LACTANTE afecta a niños entre los 3 meses y los 2 años.
2/6
✍️B Cabezas y col
continuum.aeped.es/screens/play/1… @ContinuumAEP @aepediatria
#AtencionPrimaria #Pediatrics
@ContinuumAEP @aepediatria No tiene afectación sistémica, aunque es frecuente la aparición de fiebre.

Es una entidad benigna y el tratamiento es conservador con resolución entre 1 y 3 semanas
3/6
#IDtwitter #MedTwitter
@ContinuumAEP @aepediatria El edema hemorrágico agudo del lactante es una vasculitis leucocitoclástica caracterizada por edema, fiebre y lesiones cutáneas de tipo purpúrico.
4/6
#Doctor #MedStudentTwitter
Existe un claro predominio invernal en relación con cuadros respiratorios de vías altas.

También se ha relacionado con la administración de medicamentos así como de vacunas
5/6
#medicine #MedicalStudents
El edema hemorrágico agudo del lactante, de aparición súbita:
✔️Pápulas y placas purpúricoedematosas de aspecto equimótico y con tendencia a formar lesiones en escarapela o diana
✔️Edema distal inflamatorio
✔️Febrícula o fiebre
6/6
#MIR #EducaciónMédica #Medicina

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More from @guerreroespejo

Antonio Guerrero Profile picture
Dec 29
A 49-YO♀️: fever, myalgia, headache, blanching papular rash on her trunk & limbs, & conjunctivitis (1)
Neutropenia & mild hepatitis
The patient's husband accompanied the patient to the Cook Islands: a highly similar rash (2)
1/6
doi.org/10.1093/cid/ci…
#IDtwitter #microbiology ImageImage
Arboviral infection was suspected.
Pan-flavivirus PCR: ➕
PCR was sequenced, & a BLAST search: ➕ for Zika virus.

ZIKA VIRUS INFECTION

The wife (and her husband): recovery over 5 days with no specific treatment.
2/ 6

doi.org/10.1093/cid/ci…
#virology #MedTwitter #MolBiol
Zika virus, endemic to Southeast Asia & Africa, is transmitted by Aedes species mosquitoes.

Clinical manifestations (fever, maculopapular rash, myalgias, and headache) are similar to other arboviral infections, such as dengue and chikungunya,
3/6
#dermatology #Doctor
Read 6 tweets
Antonio Guerrero Profile picture
Dec 27
82 años♂️, DM, dislipemia, y enfermedad arterial periférica: dolor torácico anginoso con semiología de insuficiencia cardiaca.
ECG:⬆️segmento ST en V2-V3 y DI-AVL.
PCR SARS-CoV-2:➕
Coronariografía: arterias coronarias sin lesiones
1/6
#cardiologia #urgencias #MedicinaInterna
Ventriculografía: fracción de eyección del ventrículo izquierdo muy reducida a expensas de acinesia apical extensa.

SÍNDROME DE TAKO-TSUBO ASOCIADO A LA INFECCIÓN POR #SARSCoV2
2/6

DOI: 10.1016/j.recesp.2020.06.022
#IDtwitter #Cardiology
El ecocardiograma confirmó los hallazgos de la ventriculografía

Rx de tórax: signos de insuficiencia cardiaca leve, sin evidencia de neumonía.

Buena evolución, con mejoría del cuadro de insuficiencia cardiaca.
3/6
#MedTwitter #Doctor
Read 7 tweets
Antonio Guerrero Profile picture
Dec 26
A 77-YO ♂️, 2 weeks before herpes zoster on the right T3 and T4 dermatomes, celecoxib to treat new-onset back pain: a coalescing, erythematous eruption that spared the skin surrounding crusted herpes zoster lesions
¼

DOI: 10.1056/NEJMicm2205584
#IDtwitter #dermatology
Skin-biopsy: consistent with a drug rash
Patch testing identified celecoxib as the trigger.

REVERSE ISOTOPIC RESPONSE in a drug rash sparing a healed herpes zoster infection.
2/4
#MedTwitter #dermtwitter #Doctor
A reverse isotopic response or an isotopic nonresponse occurs when:
✔️a new skin disorder by an unrelated disease
✔️spares the area of skin previously affected, healed dermatosis.

The mechanism of this phenomenon is unclear.
3/4
#MedStudentTwitter #resident
Read 4 tweets
Antonio Guerrero Profile picture
Dec 15
Lactante♀️, 20 meses: fiebre, sialorrea, lesión costrosa hemática con contenido purulento y restos de costras melicéricas, eritema, edema y lesiones vesiculosas en 2º dedo de la mano, adenopatías epitrocleares, vesículas en paladar y aftas en encías
1/5
#pediatria #infecciosas
El PANADIZO HERPÉTICO es una lesión cutánea producida, especialmente en pediatría, por el virus herpes simple tipo 1.
2/5
pap.es/articulo/13681…
#AtencionPrimaria #microbiología
La presentación clínica habitual es una lesión con vesículas arracimadas, cuya localización típica es en primer o segundo dedo.

En los pacientes pediátricos es frecuente que se produzca tras autoinoculación desde una gingivoestomatitis herpética.
3/5
#MIR #EducaciónMédica
Read 5 tweets
Antonio Guerrero Profile picture
Dec 14
A 12-MO♀️ girl, immunization for hepatitis B, 2 weeks prior: a rapidly spreading, nonblanching, nonpalpable, purpuric rash over legs & cheeks surrounded by edema, 37.6°C, nontoxic in appearance

Leukocytosis,⬆️CRP
1/9
#dermatology #Emergency #Pediatrics doi.org/10.1093/cid/ci…
The next day, the hemorrhagic rash became palpable
Pharyngeal PCR:➕for enterovirus
🔬 of purpuric lesions: leukocytoclastic vasculitis, & DI studies showed vascular wall fibrinogen deposition, consistent with ACUTE HEMORRHAGIC EDEMA OF INFANCY (AHEI)
2/9
#pediatric #IDtwitter
Typical patient of ACUTE HEMORRHAGIC EDEMA OF INFANCY:
✔️6–24 months of age,
✔️during winter,
✔️nontoxic presentation,
✔️low-grade fever,
✔️abrupt onset of large purpuric skin lesions,
✔️and edema in face and extremities
3/9
doi.org/10.1093/cid/ci…
#MedTwitter #pediatria
Read 9 tweets
Antonio Guerrero Profile picture
Dec 12
A 65-YO man, from North African: asymptomatic dorsolumbar mass for 30 years with normal skin appearance.

MRI: ?
1/6
doi.org/10.1093/cid/ci…
#radiology #MedTwitter #parasitology
MRI: a multivesicular cyst in the latissimus dorsi muscle (arrow)

🧪for Echinococcus granulosus: ELISA, & Western blot➕
Surgery: multiple daughter vesicles of E. granulosus, with the presence of multiple scolices

INTRAMUSCULAR HYDATID CYST
2/6
#parasites #medicine #radres
No puncture should be performed, to avoid dissemination of the cysts that can cause an anaphylactic shock.

The patient received 3 other courses of albendazole: serologic control became negative after 1 year.
3/6
#IDtwitter #surgery
Read 6 tweets

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