INFECTIOUS DISEASES of PERU Infectious Diseases of Peru - 2012 Edition
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Smelly Foot Rash
CLINICAL Smelly foot rash Paulo Morais Ligia Peralta Keywords: skin diseases, infectious Case study A previously healthy Caucasian girl, 6 years of age, presented with pruritic rash on both heels of 6 months duration. The lesions appeared as multiple depressions 1–2 mm in diameter that progressively increased in size. There was no history of trauma or insect bite. She reported local pain when walking, worse with moisture and wearing sneakers. On examination, multiple small crater- like depressions were present, some Figure 1. Heel of patient coalescing into a larger lesion on both heels (Figure 1). There was an unpleasant ‘cheesy’ protective/occluded footwear for prolonged odour and a moist appearance. Wood lamp periods.1–4 examination and potassium hydroxide testing for fungal hyphae were negative. Answer 2 Question 1 Pitted keratolysis is frequently seen during What is the diagnosis? summer and rainy seasons, particularly in tropical regions, although it occurs Question 2 worldwide.1,3,4 It is caused by Kytococcus What causes this condition? sedentarius, Dermatophilus congolensis, or species of Corynebacterium, Actinomyces or Question 3 Streptomyces.1–4 Under favourable conditions How would you confirm the diagnosis? (ie. hyperhidrosis, prolonged occlusion and increased skin surface pH), these bacteria Question 4 proliferate and produce proteinases that destroy What are the differential diagnoses? the stratum corneum, creating pits. Sulphur containing compounds produced by the bacteria Question 5 cause the characteristic malodor. What is your management strategy? Answer 3 Answer 1 Pitted keratolysis is usually a clinical Based on the typical clinical picture and the negative diagnosis with typical hyperhidrosis, malodor ancillary tests, the diagnosis of pitted keratolysis (PK) (bromhidrosis) and occasionally, tenderness, is likely. -
Chapter 3 Bacterial and Viral Infections
GBB03 10/4/06 12:20 PM Page 19 Chapter 3 Bacterial and viral infections A mighty creature is the germ gain entry into the skin via minor abrasions, or fis- Though smaller than the pachyderm sures between the toes associated with tinea pedis, His customary dwelling place and leg ulcers provide a portal of entry in many Is deep within the human race cases. A frequent predisposing factor is oedema of His childish pride he often pleases the legs, and cellulitis is a common condition in By giving people strange diseases elderly people, who often suffer from leg oedema Do you, my poppet, feel infirm? of cardiac, venous or lymphatic origin. You probably contain a germ The affected area becomes red, hot and swollen (Ogden Nash, The Germ) (Fig. 3.1), and blister formation and areas of skin necrosis may occur. The patient is pyrexial and feels unwell. Rigors may occur and, in elderly Bacterial infections people, a toxic confusional state. In presumed streptococcal cellulitis, penicillin is Streptococcal infection the treatment of choice, initially given as ben- zylpenicillin intravenously. If the leg is affected, Cellulitis bed rest is an important aspect of treatment. Where Cellulitis is a bacterial infection of subcutaneous there is extensive tissue necrosis, surgical debride- tissues that, in immunologically normal individu- ment may be necessary. als, is usually caused by Streptococcus pyogenes. A particularly severe, deep form of cellulitis, in- ‘Erysipelas’ is a term applied to superficial volving fascia and muscles, is known as ‘necrotiz- streptococcal cellulitis that has a well-demarcated ing fasciitis’. This disorder achieved notoriety a few edge. -
Kellie ID Emergencies.Pptx
4/24/11 ID Alert! recognizing rapidly fatal infections Susan M. Kellie, MD, MPH Professor of Medicine Division of Infectious Diseases, UNMSOM Hospital Epidemiologist UNMHSC and NMVAHCS Fever and…. Rash and altered mental status Rash Muscle pain Lymphadenopathy Hypotension Shortness of breath Recent travel Abdominal pain and diarrhea Case 1. The cross-country trucker A 30 year-old trucker driving from Oklahoma to California is hospitalized in Deming with fever and headache He is treated with broad-spectrum antibiotics, but deteriorates with obtundation, low platelet count, and a centrifugal petechial rash and is transferred to UNMH 1 4/24/11 What is your diagnosis? What is the differential diagnosis of fever and headache with petechial rash? (in the US) Tickborne rickettsioses ◦ RMSF Bacteria ◦ Neisseria meningitidis Key diagnosis in this case: “doxycycline deficiency” Key vector-borne rickettsioses treated with doxycycline: RMSF-case-fatality 5-10% ◦ Fever, nausea, vomiting, myalgia, anorexia and headache ◦ Maculopapular rash progresses to petechial after 2-4 days of fever ◦ Occasionally without rash Human granulocytotropic anaplasmosis (HGA): case-fatality<1% Human monocytotropic ehrlichiosis (HME): case fatality 2-3% 2 4/24/11 Lab clues in rickettsioses The total white blood cell (WBC) count is typicallynormal in patients with RMSF, but increased numbers of immature bands are generally observed. Thrombocytopenia, mild elevations in hepatic transaminases, and hyponatremia might be observed with RMSF whereas leukopenia -
Granuloma De Las Piscinas Carcinoma Basocelular Localmente Avanzado
Penfigoide gestacional pustuloso Granuloma facial de localización atípica Programa de Educación Médica Continua Variantes de Archivos Argentinos de Dermatología clínicas inusuales de Año 2019, volumen 5, número 4 sarcoidosis Octubre, Noviembre y Diciembre 2019. cutánea Precio: $200 Carcinoma basocelular localmente avanzado tratado con Vismodegib Granuloma de las piscinas www.archivosdermato.org.ar [email protected] Educando Nos Programa de Educación Médica Continua de Archivos Argentinos de Dermatología Año 2019, volumen 5, número 4 Sumario Octubre, Noviembre y Diciembre 2019 Editorial Acrodermatitis enteropática 3 Glorio Roberto 36 Ruiz Díaz María, Kuen Bernardita, Caggia Antonella, Díaz Ysabel, Lozinsky Liliana 4 Reglamento de publicaciones Jornadas de Educación 40 Médica Continua Granuloma facial de 6 localización atípica Carcinoma basocelular Digilio Marianela, Manzano Roxana, Bendjuia Gabriela, 42 localmente avanzado tratado Schroh Roberto, Feinsilber Daniel con Vismodegib Van Caester Leandro Rodolfo, Alfaro María Florencia, Consigli Javier, De La Colina Marcelo, Manrique Valeria, Variantes clínicas inusuales de Pereyra Susana Beatriz 10 sarcoidosis cutánea Espósito Daniela, Márquez, Juan Manuel, López Di Noto Ada Laura, Marcucci Carolina, Sánchez Graciela, Merola Gladys Seguimiento en pacientes 46 sensibilizados a Queratosis folicular invertida de metilisotiazolinona 18 localización infrecuente Russo Juan Pedro, Palazzolo Juan Francisco, Adorni Romina, Consigli Carlos Landau Débora, Caruso Territoriale Antonella, Valente -
Lepromatous Leprosy with Erythema Nodosum Leprosum Presenting As
Lepromatous Leprosy with Erythema Nodosum Leprosum Presenting as Chronic Ulcers with Vasculitis: A Case Report and Discussion Anny Xiao, DO,* Erin Lowe, DO,** Richard Miller, DO, FAOCD*** *Traditional Rotating Intern, PGY-1, Largo Medical Center, Largo, FL **Dermatology Resident, PGY-2, Largo Medical Center, Largo, FL ***Program Director, Dermatology Residency, Largo Medical Center, Largo, FL Disclosures: None Correspondence: Anny Xiao, DO; Largo Medical Center, Graduate Medical Education, 201 14th St. SW, Largo, FL 33770; 510-684-4190; [email protected] Abstract Leprosy is a rare, chronic, granulomatous infectious disease with cutaneous and neurologic sequelae. It can be a challenging differential diagnosis in dermatology practice due to several overlapping features with rheumatologic disorders. Patients with leprosy can develop reactive states as a result of immune complex-mediated inflammatory processes, leading to the appearance of additional cutaneous lesions that may further complicate the clinical picture. We describe a case of a woman presenting with a long history of a recurrent bullous rash with chronic ulcers, with an evolution of vasculitic diagnoses, who was later determined to have lepromatous leprosy with reactive erythema nodosum leprosum (ENL). Introduction accompanied by an intense bullous purpuric rash on management of sepsis secondary to bacteremia, Leprosy is a slowly progressive disease caused by bilateral arms and face. For these complaints she was with lower-extremity cellulitis as the suspected infection with Mycobacterium leprae (M. leprae). seen in a Complex Medical Dermatology Clinic and source. A skin biopsy was taken from the left thigh, Spread continues at a steady rate in several endemic clinically diagnosed with cutaneous polyarteritis and histopathology showed epidermal ulceration countries, with more than 200,000 new cases nodosa. -
WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA). -
Leprosy' Revi"Ew
LEPROSY' REVI"EW lbe QD8rterIy Publication of THE BRITISH LEPROSY RELIEF ASSOCIAll0N VOL. XXVIII. No 3. JULY 1957 Principal Contents EditoriaIs Secondary Infections and Neoplasms in Leprosy Patients. Leprosy of the Eye. Thiosemicarbazone in the Treatment of the Reactional and Bordeline Forms of Leprosy. Some Data on the Influence of B.C.G. Vaccination in Leprosy Patients. Abstracts 8 PORTMAN STREET, LONDON, W.l Price: Three Shillings and Sixpence, plus posfage Annual Subscripfion: Fiffeen Shillings, including posfage LEPROSY REVIEW VOL. XXVIII, No. 3. JULY, 1957 CONTENTS PAGE Editorials: Corticosteroids in Leprosy 91 Is there a place for hypnotherapy in leprosy treatment? 92 Secondary Infections and Neoplasms in Leprosy Patients FELIX CONTRERAS 95 Leprosy of the Eye .. W. ]. HOLMES 108 Thiosemicarbazone in the Treatment of the Reactional and Borderline Forms of Leprosy H. W. WHEATE 124 Some Data on the Influence of BCG Vaccination in Leprosy Patients ]. VAN DE HEYNING 130 Abstracts 131 Edited by DR. J. Ross INNES, Medical Secretary of the British Leprosy Relief Association, 8 Portman Street, London, W.l, to whom all communications should be sent. The Association does not accept responsibilty for views expressed by writers. Contributors of original articles will receive 25 loose reprints free, but more formal bound reprints must be ordered at time of submitting the article, and the cost reimbursed later. THE ONE DOSE REMEDY , ANTEPAR ' is such a simple and practical ascarifuge, it enables you to tackle tbe roundworm problem on a large scale. You simply givc each adult or child onc dosc of 'A TEPAR' }!'Iixir. 0 purging, fasting or dieling is necessary. -
A Clinical Case of Fournier's Gangrene: Imaging Ultrasound
J Ultrasound (2014) 17:303–306 DOI 10.1007/s40477-014-0106-5 CASE REPORT A clinical case of Fournier’s gangrene: imaging ultrasound Marco Di Serafino • Chiara Gullotto • Chiara Gregorini • Claudia Nocentini Received: 24 February 2014 / Accepted: 17 March 2014 / Published online: 1 July 2014 Ó Societa` Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2014 Abstract Fournier’s gangrene is a rapidly progressing Introduction necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency Fournier’s gangrene is an acute, rapidly progressive, and with a potentially high mortality rate. Although the diagnosis potentially fatal, infective necrotizing fasciitis affecting the of Fournier’s gangrene is often made clinically, emergency external genitalia, perineal or perianal regions, which ultrasonography and computed tomography lead to an early commonly affects men, but can also occur in women and diagnosis with accurate assessment of disease extent. The children [1]. Although originally thought to be an idio- Authors report their experience in ultrasound diagnosis of pathic process, Fournier’s gangrene has been shown to one case of Fournier’s gangrene of testis illustrating the main have a predilection for patients with state diabetes mellitus sonographic signs and imaging diagnostic protocol. as well as long-term alcohol misuse. However, it can also affect patients with non-obvious immune compromise. Keywords Fournier’s gangrene Á Sonography Comorbid systemic disorders are being identified more and more in patients with Fournier’s gangrene. Diabetes mel- Riassunto La gangrena di Fournier e` una fascite necro- litus is reported to be present in 20–70 % of patients with tizzante a rapida progressione che coinvolge il perineo, le Fournier’s Gangrene [2] and chronic alcoholism in regioni perianale e genitali e costituisce una vera emer- 25–50 % patients [3]. -
Bacterial Skin Infections
BACTERIAL SKIN INFECTIONS SPEAKER: DR LUIZ ALBERTO BOMJARDIM PÔRTO DERMATOLOGIST BRAZIL MRSA INFECTIONS • Concept: Methicillin- resistant Staphylococcus aureus • Epidemiology: Gradual increase of resistance. • Nosocomial MRSA risk factors: Hospitalization, ICU, invasive procedures, previous antibiotic therapy, health professionals, diabetes mellitus, EV drugs, immunosuppression and chronic diseases. MRSA INFECTIONS • Community MARSA risk factors: Children, EV drugs, indigenous, homosexual men, military, prisoners and athletes. • Microorganisms more virulent by genetic characteristics. MRSA INFECTIONS • Clinic caracteristics: -Abscess, cellulitis, folliculitis, impetigo, infected wounds, external otitis, paronychia and colonization of the skin in cases of atopic dermatitis. - Increased morbidity. • Propedeutics: Culture blood, tissue or secretion. MRSA INFECTIONS • Treatment: - Pathology-specific treatment. - Prefer non-beta-lactam antibiotics, such as: clindamycin, sulfamethoxazole- trimethoprim and tetracyclines. - On suspicion of MARSA infection, start empirical antibiotics and stagger specific antibiotics by culture with antibiograma. MRSA INFECTIONS • Treatment: - Decolonization: systemic antibiotic therapy, topical 2% mupirocin, personal hygiene with antiseptic or antimicrobial solutions (iodine-povidine, chlorhexidine or triclosan). MRSA INFECTIONS • Prevention: - Avoid skin-to-skin contact and share personal belongings / clothing. - Hand washing. - Use of alcohol gels. - Cover wounds. - Isolation contact of MARSA carriers. - Early -
The Care of a Patient with Fournier's Gangrene
CASE REPORT The care of a patient with Fournier’s gangrene Esma Özşaker, Asst. Prof.,1 Meryem Yavuz, Prof.,1 Yasemin Altınbaş, MSc.,1 Burçak Şahin Köze, MSc.,1 Birgül Nurülke, MSc.2 1Department of Surgical Nursing, Ege University Faculty of Nursing, Izmir; 2Department of Urology, Ege University Faculty of Medicine Hospital, Izmir ABSTRACT Fournier’s gangrene is a rare, necrotizing fasciitis of the genitals and perineum caused by a mixture of aerobic and anaerobic microor- ganisms. This infection leads to complications including multiple organ failure and death. Due to the aggressive nature of this condition, early diagnosis is crucial. Treatment involves extensive soft tissue debridement and broad-spectrum antibiotics. Despite appropriate therapy, mortality is high. This case report aimed to present nursing approaches towards an elderly male patient referred to the urology service with a diagnosis of Fournier’s gangrene. Key words: Case report; Fournier’s gangrene; nursing diagnosis; patient care. INTRODUCTION Rarely observed in the peritoneum, genital and perianal re- perineal and genital regions, it is observed in a majority of gions, necrotizing fasciitis is named as Fournier’s gangrene.[1-5] cases with general symptoms, such as fever related infection It is an important disease, following an extremely insidious and weakness, and without symptoms in the perineal region, beginning and causing necrosis of the scrotum and penis by negatively influencing the prognosis by causing a delay in diag- advancing rapidly within one-two days.[1] The rate of mortal- nosis and treatment.[2,3] Consequently, anamnesis and physical ity in the literature is between 4 and 75%[6] and it has been examination are extremely important. -
Histopathological Study of Dermal Granuloma Gunvanti B
https://ijmsweb.com Indian Journal of Medical Sciences Original Article Histopathological study of dermal granuloma Gunvanti B. Rathod1, Pragnesh Parmar2 1Departments of Pathology, 2Forensic Medicine, GMERS Medical College, Vadnagar, Gujarat, India. ABSTRACT Introduction: The objectives of this study were to confirm the diagnosis of clinically suspected dermal granuloma- tous diseases by histopathological examination and by routine and special stains as well as to study the incidence of various types of dermal granulomas. *Corresponding author: Materials And Methods: This study was conducted at the Department of Pathology in collaboration with De- partment of Skin and Venereal disease. A total of 90 cases from outdoor patient department of skin and venereal Dr. Gunvanti Rathod, disease, which were clinically diagnosed as suspected dermal granulomatous diseases, were taken as the study Departments of Pathology, population. GMERS Medical College, Vadnagar, Gujarat, India. Results: In our study, we found that leprosy had the highest incidence (50%), followed by cutaneous tuberculosis (30%) among all dermal granulomatous diseases like syphilis, fungal, granuloma annulare, foreign body, actino- [email protected] mycosis, and sarcoidosis. Dermal granulomas were most common in middle age between 21 and 40 years of age. Received : 18 September 19 Conclusion: Histopathology played an important role in the final diagnosis of dermal granulomatous lesions. Most common dermal granulomatous disease was leprosy, followed by cutaneous tuberculosis. -
Mandrillus Leucophaeus Poensis)
Ecology and Behavior of the Bioko Island Drill (Mandrillus leucophaeus poensis) A Thesis Submitted to the Faculty of Drexel University by Jacob Robert Owens in partial fulfillment of the requirements for the degree of Doctor of Philosophy December 2013 i © Copyright 2013 Jacob Robert Owens. All Rights Reserved ii Dedications To my wife, Jen. iii Acknowledgments The research presented herein was made possible by the financial support provided by Primate Conservation Inc., ExxonMobil Foundation, Mobil Equatorial Guinea, Inc., Margo Marsh Biodiversity Fund, and the Los Angeles Zoo. I would also like to express my gratitude to Dr. Teck-Kah Lim and the Drexel University Office of Graduate Studies for the Dissertation Fellowship and the invaluable time it provided me during the writing process. I thank the Government of Equatorial Guinea, the Ministry of Fisheries and the Environment, Ministry of Information, Press, and Radio, and the Ministry of Culture and Tourism for the opportunity to work and live in one of the most beautiful and unique places in the world. I am grateful to the faculty and staff of the National University of Equatorial Guinea who helped me navigate the geographic and bureaucratic landscape of Bioko Island. I would especially like to thank Jose Manuel Esara Echube, Claudio Posa Bohome, Maximilliano Fero Meñe, Eusebio Ondo Nguema, and Mariano Obama Bibang. The journey to my Ph.D. has been considerably more taxing than I expected, and I would not have been able to complete it without the assistance of an expansive list of people. I would like to thank all of you who have helped me through this process, many of whom I lack the space to do so specifically here.