A 27-YO ♀️, fever and PCR + for #SARSCoV2: One week later, she developed migratory, pruritic urticarial erythematous plaques (wheals) on her face, limbs, trunk, palms & soles, and angioedema of her lips.
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Treated with cetirizine, 12 weeks later, she was still having episodes of urticaria
The most likely diagnosis was CHRONIC SPONTANEOUS URTICARIA TRIGGERED BY SARS-CoV-2, but other considerations were urticarial vasculitis and chronic inducible urticaria. 2/4
Urticaria is commonly triggered by viral & bacterial infections, including herpes simplex virus, cytomegalovirus, Epstein–Barr virus, HIV & mycoplasma.
It commonly precedes or occurs concurrently with COVID-19, but can rarely occur after symptoms have resolved. 3/
Forchheimer spots, a type of enanthem:
📌sometimes precede the skin rash of rubella.
📌tiny red spots on the soft palate in rubella, measles and scarlet fever. 3/5
A 32-YO♀️ from Guatemala, Ph+ B-ALL post #chemotherapy: #dyspnea
CT: ground-glass opacities (2A yellow box), interstitial pulmonary edema with septal thickening (2B yellow circles), & pericardial effusion (2C yellow arrows), lymph nodes (2D yellow arrows)
Eosinophilia 1/7
Due to normal ejection fraction, the differential diagnosis of dyspnea included non-cardiogenic pulmonary edema, pneumonitis secondary to chemotoxicity, and infection. 2/7
She progressed to acute hypoxic respiratory failure.
🔬bronchoalveolar lavage: numerous larvae (3A,3B) with short buccal grove (arrow head) and prominent genital primordium (arrow) consistent with STRONGYLOIDES HYPERINFECTION
Nitroblue tetrazolium dye reduction test: no reduction of the nitroblue tetrazolium
No right shift noted in the activated neutrophils in flow cytometry-based DHR assay (E, patient; F, control)
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
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.
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
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
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