Gastric syphilis - Case report.

Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described.

Gastric syphilis - Case report

Abstract: Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described.

Kerion: a importância da sua diferenciação com infecção bacteriana do couro cabeludo: relato de caso / Kerion: the importance of differentiating it from scalp's bacterial infection: case report

JUSTIFICATIVA E OBJETIVOS: Kerion é uma infecção fúngica inflamatória dos folículos do couro cabeludo e pele ao redor, com aumento de linfonodos regionais. É causada frequentemente por fungos geofílicos e zoofílicos, porém há casos descritos por dermatófitos antropofílicos. Caracteriza-se por placa dolorosa, provocada por intensa reação inflamatória com aparecimento de supuração. Há queda de cabelos, podendo evoluir para alopécia cicatricial definitiva. O objetivo deste estudo foi alertar os médicos quanto ao diagnóstico de kerion em crianças que apresentam placa supurativa em couro cabeludo, diferenciando de infecções bacterianas, já que o tratamento é diferente e o diagnóstico tardio da infecção fúngica pode acarretar alopécia cicatricial.RELATO DO CASO: Paciente do sexo masculino, 5 anos,foi referenciado ao serviço de Dermatologia para avaliação de lesão em placa supurativa no couro cabeludo com evolução de aproximadamente 14 dias. Não apresentava doenças imunossupressoras e não havia história de trauma nem de contato com animais. Referia apenas que brincava frequentemente em contato com terra. Ao exame físico: lesão em placa na região occipitoparietal esquerda eritematosa, dolorosa, com intensa supuração e queda de cabelos localizada, medindo aproximadamente 4 cm de diâmetro. Ausência de drenagem e flutuação. Também apresentava linfonodomegaliacervical posterior esquerda, móvel, indolor, sem drenagem ou hiperemia.CONCLUSÃO: Kerion é uma tinea capitis inflamatória que pode ser confundida com diferentes infecções bacterianas. O diagnóstico é realizado através do exame micológico direto e cultura, podendo ser auxiliado pelo uso da luz de Wood.

BACKGROUND AND OBJECTIVES: Kerion is an inflammatory fungal infection of the scalp and surrounding skin follicles,with an increase in regional lymph nodes. It is often caused by zoophilic and geophilic fungi, however, there are cases described by anthropophilic dermatophytes. It is characterizedby a painful plaque, caused by intense inflammatory reaction with development of suppuration. There is hair loss, which can develop permanent cicatricial alopecia. The objective of this study was to warn doctors regarding Kerion diagnosis in children who present suppurative scalp plaque, differentiating it from bacterial infections, since it requests different treatment, and the late diagnosis of fungal infection may cause permanent cicatricial alopecia.CASE REPORT: Male patient, 5 years-old, was sent to the Dermatology service for evaluation of a suppurative plaque lesion on the scalp with approximately 14 days of development. He had no immunosuppressive diseases and no history of trauma or animal contact. He simply states that often plays in contact with soil. On physical examination: erythematous, painful, with intense suppuration and localized hair loss plaque lesion on the left occipitoparietal region,measuring approximately 4 cm in diameter. There is no drainage or fluctuation. He did also presented painless and movable left posterior cervical lymphadenomegaly without drainage or hyperemia.CONCLUSION: Kerion is an inflammatory tinea capitis that can be confused with various different bacterial infections. The diagnosis is made through direct mycological exam and culture, and it can be aided by the utilization of Wood's lamp.