Exantema en neonato irritable / Irritable newborn rash

La escabiosis es la infestación cutánea por el parásito Sarcoptes scabiei var. hominis. A diferencia de la forma clásica que afecta a niños y adultos, la escabiosis neonatal presenta una serie de características distintivas que dificultan su diagnóstico. Presentamos un caso de escabiosis neonatal cuyo diagnóstico supuso un reto ante la ausencia de antecedentes epidémicos familiares (AU)

Scabies is the cutaneous infestation by the parasite Sarcoptes scabiei var. hominis. There are some clinical variants, among which the neonatal one stands out, which typically affect the face and scalp, unlike classic variant. We present a case of neonatal scabies that supposed a challenge in the absence of a family epidemic history. (AU)

Eczema-like Eruption Limited to the Right Sole: Localised Scabies.

Scabies is a cutaneous infectious disease caused by the ectoparasite Sarcoptes scabiei. The disease has gained attention due to its increasing incidence in recent years. Rare and atypical forms of scabies can imitate many other cutaneous conditions. Such unfamiliar presentations may lead to misdiagnosis and mistreatment. Localised scabies is extremely rare and only few cases have been reported in the relevant literature. Herein, we report the case of a 4-month-old girl presenting with localised scabies limited to the right plantar surface. To the best of our knowledge, scabies restricted to the plantar region has never been reported in the paediatric population. Furthermore, scabies restricted to a single foot has never been reported in any age group. Awareness about the atypical and extraordinary manifestations of scabies can lead to early diagnosis and treatment and, thus, decrease disease-related morbidity and risk of transmission.

The Retrospective Analysis of Demodex spp. Results in Aydin Adnan Menderes University Faculty of Medicine Hospital Parasitology Laboratory.

OBJECTIVE: Demodex spp. is one of the most common ectoparasites in humans. The aim of the present study is to evaluate the positivity of Demodex spp. in our Parasitology Laboratory, retrospectively. METHODS: The study included Demodex spp. suspected cases from different departments between 2008 and 2017. The link between Demodex spp. and demographics and symptoms was investigated. In addition, Demodex spp. was evaluated regarding symptoms and distribution pattern (U, T and diffuse region). RESULTS: Demodex spp. was detected in 576 (78%) of 738 cases. There was no relationship between sex and parasite positivity, but frequency was lower in cases below 19 years. There was a relationship between presence of parasite and redness, itching, burning and rash. The parasite density was higher in U region (n=335, 58.2%). When clinical findings and parasite number were statistically compared; itching, burning and rash were significantly higher in patients with parasite density ≥5 parasites/cm2, while a similar result was not observed in patients with redness. CONCLUSION: Given its prevalence and its relationship with the clinical findings; we believe that Demodex is an important parasitic disease for our province and should be evaluated in cases with various dermatological complaints in the face.

Traumatic rupture of a hydatid cyst of the liver presenting with skin lesions.

The hydatid cyst is the evolution of a parasitic infection caused by Echinococcus granulosus and is an endemic disease in Turkey. The hydatid cysts of the liver can give origin to several complications and the rupture is one of them. Rupture can occur spontaneously or as a result of external trauma. The presentation with skin lesions is very rare. We present a 20-year-old male patient who presented himself after a car accident, and was diagnosed with a rupture of traumatic hydatid cysts due to hives rash. In the operation, a scolicidal gent was administered to the cyst, the cyst wall was partially excised and the germinative membranes were removed. Medical treatment with albendazole was started. The postoperative period was quiet. The intraperitoneal traumatic rupture of a hydatid cyst is rare, but it can cause severe anaphylactic reactions and biliary peritonitis. Although a rare and broken hydatid cyst due to trauma may present with skin lesions in a patient in an endemic region, it should be considered in the differential diagnosis. KEY WORDS: Primary hydatid cyst, Trauma, Urticaria.

Space Occupying Lesion in the Liver Caused by Hepatic Visceral Larva Migrans: A Case Report.

Visceral larva migrans (VLM) is one of the clinical syndromes of human toxocariasis. We report a case of hepatic VLM presenting preprandial malaise and epigastric discomfort in a 58-year-old woman drinking raw roe deer blood. The imaging studies of the abdomen showed a 74-mm hepatic mass featuring hepatic VLM. Anti-Toxocara canis immunoglobulin G (IgG) was observed in enzyme-linked immunosorbent assay (ELISA) and western blot. Despite anthelmintic treatment, the patient complained of newly developed cough and skin rash with severe eosinophilia. Hepatic lesion increased in size. The patient underwent an open left lobectomy of the liver. After the surgery, the patient was free of symptoms such as preprandial malaise, epigastric discomfort, cough, and skin rash. Laboratory test showed a normal eosinophilic count at postoperative 1 month, 6 months, 1 year, and 4 years. The initial optical density value of 2.55 of anti-T. canis IgG in ELISA was found to be negative (0.684) at postoperative 21 months. Our case report highlights that a high degree of clinical suspicion for hepatic VLM should be considered in a patient with a history of ingestion of raw food in the past, presenting severe eosinophilia and a variety of symptoms which reflect high worm burdens. Symptom remission, eosinophilia remission, and complete radiological resolution of lesions can be complete with surgery.

Fatal Balamuthia mandrillaris brain infection associated with improper nasal lavage.

We report the case of a 69-year-old female who presented with a chronic nasal skin rash, new onset focal seizure, and a cerebral ring-enhancing lesion after a year of improper nasal irrigation. Despite aggressive and novel anti-amoebic treatment, she died as a result of a Balamuthia mandrillaris brain infection.

Outbreak of Trichinella T9 Infections Associated with Consumption of Bear Meat, Japan.

An outbreak of trichinellosis occurred in Japan in December 2016. All case-patients had eaten undercooked bear meat, from which Trichinella larvae were subsequently isolated. DNA sequencing analysis of the mitochondrial genes cytochrome c-oxidase subunit 1 and internal transcribed spacer 2 confirmed that Trichinella T9 had caused the outbreak.

Metabolic differentiation of early Lyme disease from southern tick-associated rash illness (STARI).

Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early Lyme disease and STARI. Specifically, a metabolic biosignature consisting of 261 molecular features (MFs) revealed that altered N-acyl ethanolamine and primary fatty acid amide metabolism discriminated early Lyme disease from STARI. Development of classification models with the 261-MF biosignature and testing against validation samples differentiated early Lyme disease from STARI with an accuracy of 85 to 98%. These findings revealed metabolic dissimilarity between early Lyme disease and STARI, and provide a powerful and new approach to inform patient management by objectively distinguishing early Lyme disease from an illness with nearly identical symptoms.

Contemporary infectious exanthems: an update.

An exanthem is a skin rash that may be associated with mucous membrane eruption, fever or other symptoms. It may develop as manifestation of an infectious disease or as adverse reaction to drugs. Beside the 'classical exanthems' commonly occurring in childhood, other exanthems, defined as 'atypical' for the different morphology and causal agents, may occur. Among the atypical exanthems with infectious etiology, viral, bacterial, parasitic and helminth infections are implicated. We describe herein etiology and epidemiology of the atypical exanthems caused by infectious agents. In case of exanthem, to make a correct etiological diagnosis is crucial for both the patient and community concerning issues such as time off school, immunizations and risk in pregnancy and immunocompromised individuals.

Acute strongyloidiasis in a traveller returning from South East Asia.

We report a case of acute strongyloidiasis, presenting with fever, pronounced eosinophilia and a disseminated skin rash, in a traveller returning from South East Asia.

Bullous scabies: a case report and review of the literature.

BACKGROUND: Scabies is a common parasitic infection caused by the mite Sarcoptes Scabiei. About 300 million cases of scabies are reported annually. Scabies usually presents clinically with an erythematous excoriated papulovesicular rash, burrows, nodules and hyperkeratotic lesions in specific body areas. A rare presentation of scabies is the bullous pemphigoid-like bullous scabies. So far, to the best of our knowledge, only 32 cases of bullous scabies have been reported in medical literature, of which only 11 were under 60 years of age at the time of initial presentation. This is the first case of bullous scabies being reported from Pakistan. CASE PRESENTATION: Herein we discuss, with reference to the existing literature, the case of a 23-year-old Punjabi male who presented with a 3 day history of a tense, non-erythematous, non-tender bulla measuring approximately 0.5 cm x 0.8 cm on the right foot near the interdigital cleft. He was diagnosed to have bullous scabies. CONCLUSION: The diagnosis of scabies should be considered in all patients who present with tense bullous lesions accompanied by pruritus and a maculopapular rash. This is particularly relevant if these lesions do not resolve with steroid treatment. In such patients, in order to prevent a misdiagnosis of bullous pemphigoid, scrapings for Sarcoptes Scabiei mites and eggs should be taken.

A papulopustular, vesicular, crusted rash in a 4-week-old neonate.

Scabies is commonly seen worldwide, in its usual classic form when afflicting older children and adults. However, neonatal scabies is described as its own entity in the literature. We present a case of a 4-week-old infant with a generalized papulopustular, vesicular, and crusted rash who was diagnosed with scabies. We contrast the differing clinical features of neonatal and classic scabies, describe possible mimickers of this diagnostic dilemma, and review current treatment options available for scabies in this very young age group.