A rare case of eczema herpeticum associated with HIV: A case report.

Eczema herpeticum (EH), also known as Kaposi's varicelliform eruption, is a disseminated herpes simplex virus infection seen in patients with underlying skin conditions, most commonly atopic dermatitis. Monomorphic vesicles and "punched-out" erosions with hemorrhagic crusts over eczematous regions are the hallmarks of EH's presentation. Here, we discuss a first reported case of eczema herpeticum in a patient living with well controlled HIV with prior steroid use. A 30-year-old male patient living with HIV presented to the hospital with a generalized rash involving the face, neck, arms, hands, low back region, and both feet. Herpes simplex 1 and 2 by PCR DNA were detected from external auditory ear canal drainage. The patient was treated with intravenous acyclovir and responded well. He had long term history of eczema and required acyclovir prophylaxis later.

Monkeypox - An emerging pandemic.

Monkeypox-a zoonotic disease caused by the monkeypox virus, an orthopoxviruses family member. Recently monkeypox cases are increasing at an alarming rate in the US and worldwide. Health care professionals should keep a high index of suspicion for the disease in anyone with new onset fever, a vesicular or pustular rash with central umbilication, and lymphadenopathy. Such patients should be isolated at home or the hospital to prevent secondary transmission. The cases are typically self-limited, and most people only need home supportive care. However, as recommended by CDC, immunocompromised patients, pregnant patients, and children younger than eight years should be offered pre- or post-exposure prophylaxis with vaccines. The current outbreak explicitly targets a cohort of homosexual and gay patients. The role of sexual transmission of the virus needs to be explored further. Patients with severe symptoms or respiratory complications can also be treated with antivirals such as tecovirimat (TPOXX) and brincidofovir or with intravenous vaccinia immune globulin (VIGIV).

Fatal Case of Rhabdomyolysis Post-COVID-19 Vaccine.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 pandemic has taken away the lives of many people (>4 million per WHO) around the world as of July 2021. With the advancement of the vaccine against COVID-19, in less than a year since the start of the pandemic, the infection rate has come under control in certain regions but is still rising in many more. However, with time, we are also learning a lot more about the adverse events related to the vaccine. This report documents the first fatal case of rhabdomyolysis potentially associated with the COVID-19 vaccine and supports the possibility that autoimmunity is a major risk factor for covid vaccine-related rhabdomyolysis.

Initial response to chemotherapy, not delay in diagnosis, predicts overall survival in inflammatory breast cancer cases.

OBJECTIVES: To determine whether chemotherapy response and diagnostic delay affect overall survival (OS) of classic inflammatory breast cancer (IBC) cases receiving chemotherapy as initial treatment and to determine whether OS differs between classic and "atypical" IBC cases. METHODS: This is a prospective cohort study of 155 patients enrolled in the IBC Registry. "Classic" IBC cases met AJCC or SEER case definitions. "Atypical" IBC cases exhibited classic features but involved <1/2 breast without documented dermal lymphatic invasion. Variables included OS (years from initial chemotherapy treatment until death or last contact), chemotherapy response (complete, partial, or none), diagnostic delay (days from first medical contact for signs/symptoms of abnormal breast to definitive pathologic IBC diagnosis), age at diagnosis (y), and triple-negative status (yes or no). OS curves stratified by individual predictors were estimated and compared using Kaplan-Meier methods and log-rank tests. Associations between OS and predictors were examined collectively using Cox proportional hazards regression. RESULTS: Classic IBC cases with complete, partial, or no response had respective median (95% confidence interval [CI]) OS times of 10.30 (6.78, +), 6.27 (4.42, +), and 2.86 (1.11, 11.42) years (P=0.0072). Chemotherapy response was significantly associated with OS after controlling for covariates (P=0.003). Women not responding to chemotherapy had a significantly higher hazard of death compared with women with complete (hazard ratio [HR]=5.76; 95% CI, 2.09-15.84) or partial (HR=3.40; 95% CI, 1.27-9.10) response. Diagnostic delay was not significantly associated with OS (HR=1.003; 95% CI, 0.999-1.007). OS did not differ significantly between classic and "atypical" IBC cases (P=0.60). CONCLUSIONS: Response to standard IBC chemotherapy is a dominant prognostic factor in determining patient outcomes. In our study, with limited statistical power, delay in diagnosis defined as >60 days from the time of first physician contact did not seem to affect patient outcomes. Data support similarities between classic and "atypical" IBC.