A 38-YO♂️, #HIV➕: asthenia, fever, & generalized & confluent maculopapular rash predominantly on the back, cervical & inguinal lymphadenopathies, & stippled petechial hemorrhages in the soft palate (Forchheimer’s spots)
Subsequently, pustules appeared

1/5
#emergency #IDtwitter
Classic Mpox pustules appeared
PCR:
✔️for measles & rubella➖
✔️for Mpox➕

HUMAN Mpox, although confluent maculopapular rash & Forchheimer’s spots have been reported as classic signs of rubella or measles infections
2/5

DOI: doi.org/10.4269/ajtmh.…
#microbiology #MedTwitter
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

#dermatology #internalmedicine #primarycare
Classic features of mpox (formerly monkeypox) include macules, papules, umbilicated vesicles with a necrotic center, as well as pustular & crusting lesions.

Since May 2022, cases have been reported in countries where the disease was not endemic
4/5

#healthcare #virology
Although confluent maculopapular rash & Forchheimer's spots have been reported as classic signs of rubella or measles infections, this sexually transmitted disease in previously non-endemic areas could be a "great imitator" like syphilis.
5/5

DOI: doi.org/10.4269/ajtmh.… #MedEd

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Antonio Guerrero

Antonio Guerrero Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @guerreroespejo

Jan 13
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.
¼

DOI: doi.org/10.1503/cmaj.2…
#dermtwitter #IDtwitter #MedTwitter
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

#dermatology #Doctor
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/

#virology
Read 4 tweets
Jan 11
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

doi.org/10.1016/j.idcr…
#haematology #radiology #IDtwitter
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

3/7
#lungdisease #parasitology #Pathologists
Read 7 tweets
Jan 9
A 4-YO♂️ treated for tuberculosis for 3 years with chronic cough, kyphosis, recurrent pneumonia, rib osteomyelitis: lung consolidation, mediastinal lymphadenopathy, cervical kyphosis; R-sided paravertebral soft tissue swelling (T3 to T6)
1/7

#IDtwitter #radiology #Orthopedics
Serology: ➕for Aspergillus flavus & Aspergillus fumigatus.
Aspiration of the paravertebral soft tissue:
🔬granulomatous inflammation
🧫Acinetobacter spp.

VERTEBRAL OSTEOMYELITIS & ACINETOBACTER SPP PARAVERTEBRAL SOFT TISSUE INFECTION
2/7

#microbiology #MedTwitter
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)

CHRONIC GRANULOMATOUS DISEASE
3/7

DOI: 10.1097/INF.0000000000001221
#medicine
Read 6 tweets
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
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
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 7
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
Read 5 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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

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

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(