Posts filed under ‘Images in Clinical Medicine’

Disseminated Gonococcal Infection

N Engl J of Medic April 18, 2019 V.380 P.1565

IMAGES IN CLINICAL MEDICINE

Florez-Pollack and M.M. Mauskar

A 20-year-old woman presented to the emergency department with a rash involving the arms, legs, trunk, and scalp, which had erupted that morning. She also reported generalized muscle aches, fever, and pain in both ankles. Two weeks earlier …

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMicm1811120?query=TOC

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMicm1811120?articleTools

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April 21, 2019 at 11:37 am

TUNGIASIS

NEJM april 2019

Tunga penetrans

Una niña (10) sana, se presentó en la clínica de atención primaria con un historial de 10 días de múltiples pápulas con picazón en las plantas de los pies y en los dedos de los pies. Las lesiones tenían puntos negros en el centro y eran dolorosas.

Dos semanas antes, ella y su familia habían viajado a zonas rurales de Brasil. Durante este tiempo, el niña había jugado descalza sobre terrenos sucios.

Se extrajeron pulgas de arena de múltiples lesiones y se diagnosticó tungiasis.

La tungiasis es una infestación de la piel causada por la pulga de arena Tunga penetrans, un ectoparásito que se encuentra en todas las partes tropicales y subtropicales del mundo.

La niña había recibido previamente todas las vacunas recomendadas incluyendo la antitetánica. El tratamiento incluyó la extirpación del parásito y el cuidado local de heridas.

Después del tratamiento, hubo una remisión completa de las lesiones, sin complicaciones en el seguimiento.

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMicm1810588

April 5, 2019 at 3:53 pm

Parvovirus B19 Infection

N Engl J of Medicine December 13, 2018

IMAGES IN CLINICAL MEDICINE

Mende and K. Sockel

A 67-year-old woman presented to the emergency department with a 6-week history of progressive exertional dyspnea. Her medical history was notable for lung transplantation that had been performed 8 years earlier. Immunosuppressive medications included mycophenolate mofetil and tacrolimus……

LINK

https://www.nejm.org/doi/full/10.1056/NEJMicm1807156?query=TOC

December 14, 2018 at 8:52 am

IMAGES IN CLINICAL MEDICINE – Spinal Brucellosis

N Engl J of Med October 25, 2018 V.379 P.e28

Christine Cho, M.D., and Michihiko Goto, M.D.

A 62-year-old man presented to the emergency department with a 6-month history of worsening low back pain, fevers, chills, night sweats, and weight loss. He regularly traveled to Mexico and had occasionally consumed unprocessed dairy products. He had no history of tuberculosis infection or known exposure. Laboratory studies revealed a white-cell count of 10,600 per cubic millimeter (reference range, 3700 to 10,500) and an erythrocyte sedimentation rate of 65 mm per hour (reference range, 0 to 15)…..

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMicm1803513?query=infectious-disease

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMicm1803513

November 6, 2018 at 8:19 am

Vibrio vulnificus Infection

New England Journal of Medicine July 2018

Images in Clinical Medicine

Jin Park, M.D., Ph.D., and Chang-Seop Lee, M.D., Ph.D.

A 71-year-old man presented to the emergency department with a 2-day history of fever and excruciating pain in his left hand that had developed 12 hours after eating raw seafood. He had a history of type 2 diabetes mellitus and hypertension and was undergoing hemodialysis for end-stage renal disease. At the time of presentation …

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMicm1716464?query=TOC

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMicm1716464

July 26, 2018 at 8:35 am

Pyoderma Gangrenosum in Ulcerative Colitis

New England Journal of Medicine July 2018

Images in Clinical Medicine

Perricone and M. Vangeli

A 71-year-old man with a 5-year history of glucocorticoid-dependent ulcerative colitis presented to the gastroenterology clinic with painful, rapidly progressive ulcerative lesions involving the left chest (Panel A) and leg (Panel B). The physical examination revealed skin ulcerations with a purulent base and an irregular purple edge. The histopathological examination of …

FULL TEXT

https://www.nejm.org/doi/full/10.1056/NEJMicm1802201?query=TOC

PDF

https://www.nejm.org/doi/pdf/10.1056/NEJMicm1802201

July 26, 2018 at 8:31 am

Gas Gangrene of a Prosthetic Hip

N Engl J of Med Nov. 2014

IMAGES IN CLINICAL MEDICINE

John C. Kurylo, M.D., and Andrew H. Schmidt, M.D.

Hennepin County Medical Center, Minneapolis, MN

john.kurylo.md@gmail.com

An 82-year-old man with diabetes mellitus who had undergone a total hip replacement 10 years earlier presented to the emergency department with the acute onset of pain in the left hip and groin and a fever (temperature, 39.2°C).

On presentation, the blood pressure was 96/57 mm Hg, and the white-cell count was 12,400 per cubic milliliter.

A radiograph and subsequent computed tomographic scan of the hip (Panels A and B, respectively) showed free air extending lateral to the greater trochanter and superior to the acetabular component.

Broad-spectrum antibiotic therapy was initiated, and the patient underwent emergency surgical débridement with removal of the acetabular component; intra-articular cultures grew Clostridium septicum….

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMicm1400498

 

November 13, 2014 at 8:53 am

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