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Jan 1 • 5 tweets • 4 min read
7 años ♀️: acceso de tos intensa con un vómito, y dificultad respiratoria grave.

Rx tórax: lesión quística derecha con nivel hidroaéreo e imágenes ondulantes (signo del nenúfar).
1/5
DOI: 10.1016/j.anpedi.2018.03.010
#urgencias #pediatria #Radiología
La membrana del QUISTE HIDATIDICO ROTO flotando en el nivel hidroaéreo origina el signo del nenúfar, en la Rx de tórax.

TAC: Gran lesión quística con nivel hidroaéreo, atelectasia lobar media e inferior y desplazamiento mediastínico contralateral.
2/5
#radres #infecciosas
Tras la exéresis quirúrgica urgente, los estudios microbiológicos y anatomopatológicos confirmaron la etiología hidatídica del quiste.
3/5
#cirugía #parasitología
DOI: 10.1016/j.anpedi.2018.03.010
La hidatidosis:
✔️zoonosis producida por Echinococcus granulosus. ✔️distribución mundial; España es un área endémica.
✔️la pulmonar se asocia a edades más tempranas que la forma hepática pura, a causa de la mayor distensibilidad del parénquima pulmonar.
4/5
#neumología
Hidatidosis pulmonar:
✔️desde asintomática a presentar un cuadro clínico grave al romperse hacia el árbol bronquial o pleura.
✔️tratamiento con albendazol y cirugía
5/5
#infecciosas #microbiologia

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More from @guerreroespejo

Antonio Guerrero Profile picture
Jan 3
A 6-YO Bedouin ♂️: a limp, headache, left facial nerve palsy, & left hemiparesis.

Blood eosinophil count of 890/μL.

MRI: a brain cyst.
1/8
DOI: doi.org/10.4269/ajtmh.…
#neurology #pediatric #MedTwitter Image
Abdominal ultrasound and chest radiography did not reveal additional cysts.
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖

The brain cyst was fully removed surgically.
2/8
DOI: doi.org/10.4269/ajtmh.…
#neuro #Pediatrics #surgery Image
Histopathological examination of the brain cyst fluid showed several echinococcal larvae (C and D), confirming CYSTIC ECHOCOCCOSIS diagnosis.

Over the following 4 months, he was treated with albendazole without complications.
3/8
#parasitology #microbiology #IDtwitter Image
Read 8 tweets
Antonio Guerrero Profile picture
Jan 2
A 39-YO ♂️, same-sex relationships involving condomless anal sex: 38°C, cervical lymphadenopathy, mucosal ulceration on his tongue and a maculopapular rash on his face, neck and anterior chest.
1/5
DOI: doi.org/10.1503/cmaj.2…
#Doctor #emergency #dermatology
RPR: ➖
Immunoassay:➕for HIV antibodies
HIV-1 blood viral load: 4.79 million copies/mL
Blood CD4 T-cell count of 0.1 × 109/L.

ACUTE HIV INFECTION

Started antiretroviral treatment with bictegravir–emtricitabine–tenofovir alafenamide.
2/5
#IDtwitter #microbiology
Features of acute HIV infection occur 2–4 weeks after exposure.
Common presentation includes fever, arthralgia and lymphadenopathy, which may mimic acute mononucleosis.

Seroconversion usually occurs 3–8 weeks after initial infection.
3/5
#virology #MedTwitter
Read 5 tweets
Antonio Guerrero Profile picture
Dec 30, 2022
A 3-month-old ♂️, a dimple at the center of a lumbosacral hemangioma (a): fever & deteriorating condition.

CSF: ⬆️cell count 5717/µL;⬆️protein = 352 mg/dL; ⬇️glucose < 10 mg/dL.

RM (b): ?
1/7
doi.org/10.1016/j.idcr…
#pediatric #IDtwitter #Neurology
RM b): a congenital dermal sinus communicating with the spinal cord.

Enterobacter aerogenes was isolated from CSF and stool cultures

CONGENITAL DERMAL SINUS ASSOCIATED WITH MENINGITIS BY ENTEROBACTER AEROGENES
2/7
#radiology #microbiology #pediatria
Congenital dermal sinus is associated with meningitis caused by atypical pathogens.

Enterobacter aerogenes community-acquired infections associated with congenital dermal sinus are rarely observed.
3/7
#bacteriology #MedTwitter
Read 7 tweets
Antonio Guerrero Profile picture
Dec 29, 2022
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
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 28, 2022
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
Read 6 tweets
Antonio Guerrero Profile picture
Dec 27, 2022
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

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