11 años ♀️, enrojecimiento del ojo D e inyección conjuntival (fig. 1), tobramicina en colirio: A los 9 días presenta un orzuelo palpebral inferior del mismo ojo (fig. 2)
1/2

✍️B Rodríguez y @mpraena
continuum.aeped.es/courses/info/6…
@ContinuumAEP @aepediatria
#pediatria #oftalmologia
La conjuntivitis o QUERATOCONJUNTIVITIS FLICTENULAR representa una reacción de hipersensibilidad frente a antígenos.

Se caracteriza por la formación de pequeñas lesiones circunscritas, nódulos (flicténulas), en el limbo corneal dentro de la conjuntiva y/o la córnea
2/5

#MedEd
Puede producir lagrimeo intenso, fotofobia, visión borrosa, molestias y sensación de cuerpo extraño.

La asociación de un orzuelo en este paciente sugiere que Staphylococcus aureus fuera la etiología más probable.
3/5

#microbiology #MedTwitter
Además de los antígenos estafilocócicos sensibilizantes se han implicado, a la tuberculoproteína, infestación por gusanos, hongos, virus, parásitos u otras causas.
4/5

#Doctor #MedStudentTwitter
La enfermedad ocurre típicamente en forma aguda, autolimitada y la lesión inicial puede parecerse a una ampolla, pero el pequeño nódulo rojo de tejido linfoide característicamente se convierte en un microabsceso que se ulcera y sana en 10-14 días
5/5

#AtencionPrimaria #urgencias

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More from @guerreroespejo

Jan 8
A 24-YO ♂️ 2 years prior bitten by an insect on his left mid-arm in Nicaraguan: within a week, developed a lesion at the site of the bite; over time increased in number and spread in multiple hyperkeratotic, wart-like papules.
1/8

doi.org/10.1093/cid/ci…
#IDtwitter #dermatology Image
Wet mount slide from cultures of biopsy using rabbit blood agar slant: aggregates of Leishmania promastigotes (arrow), which can be identified based on their elongated shape and flagella.

CUTANEOUS LEISHMANIASIS
2/8

doi.org/10.1093/cid/ci…
#parasitology #MedTwitter Image
Biopsy cultures in “triple N” media, PCR and DNA sequencing: Leishmania panamensis.

He received a 10-day course of intravenous liposomal amphotericin B. His lesions slowly regressed over 3 months.
3/8

doi.org/10.1093/cid/ci…
#Doctor #microbiology
Read 8 tweets
Jan 4
A 27-YO ♂️ with #HIV & #syphilis, condomless receptive & insertive vaginal, anal, & oral intercourse with male & female partners: a diffuse, erythematous, macular rash (involved the palms) & umbilicated, pustular lesions on face, arms (A), legs, trunk (B, flank) & neck (C)
1/7
PCR swabbed lesions:➕for #monkeypox

MONKEYPOX in a sexually-active man with HIV and SYPHILIS

He was started on antiretroviral therapy for his recent diagnosis of HIV, & administered IM benzathine penicillin G for syphilis.
2/7

doi.org/10.1016/j.visj…
#IDtwitter #dermatology
As direct contact is the primary mode of transmission, sexual intimacy has been identified as a risk factor for #Mpox, and a high proportion of the current multinational outbreak has been in men who have sex with men.
3/7

#MedTwitter #Doctor
Read 7 tweets
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
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
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
Read 8 tweets
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
Jan 1
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
Read 5 tweets
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

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