Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.798
Filtrar
1.
J Assoc Physicians India ; 68(11): 77-78, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33187046

RESUMO

Rash associated with a febrile illness often poses challenges in diagnosis. The clinical knowledge of pathogenesis, onset and characteristics of rash is therefore essential to make an early diagnosis and for successful management of the disease. We present herewith a case of a young man with acute febrile illness and rash which raised doubts with regards to the possible etiological diagnosis and necessitated detailed work up which revealed a diagnosis of COVID-19. The case is being highlighted as often the history and clinical presentation may seem to be obvious but an atypical uncommon presentation which in this case was a maculopapular rash may not fit the picture of a single etiological diagnosis according to the known medical literature.


Assuntos
Infecções por Coronavirus , Exantema , Pandemias , Pneumonia Viral , Betacoronavirus , Exantema/etiologia , Febre/etiologia , Humanos , Masculino
4.
BMC Infect Dis ; 20(1): 753, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054715

RESUMO

BACKGROUND: Safety of live vaccines in patients treated with immunosuppressive therapies is not well known, resulting in contradictory vaccination recommendations. We describe here the first case of vaccine-associated measles in a patient on natalizumab treatment. CASE PRESENTATION: A young female patient with relapsing-remitting multiple sclerosis on natalizumab treatment received the live attenuated measles, mumps, and rubella vaccine in preparation for a change in her treatment in favour of fingolimod, with established immunosuppressive qualities. Seven days after receiving the vaccine, our patient experienced diffuse muscle pain, fatigue, and thereafter developed a fever and then an erythematous maculopapular rash, compatible with vaccine associated measles. This was later confirmed by a positive measles RT-PCR throat swab. The patient's symptoms resolved without any sequelae. CONCLUSION: In this case report we review the immunosuppressive qualities of natalizumab and the evidence in favour and against live vaccines in patients on this treatment. Our findings reveal the insufficient understanding of the immunosuppressive effects of new immunomodulators, and thus of the safety of live vaccines in patients on such medications. While this case triggers precaution, there is insufficient evidence to conclude that natalizumab treatment could favor the onset of vaccine-associated measles.


Assuntos
Vacina contra Sarampo/efeitos adversos , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Sarampo/etiologia , Natalizumab/uso terapêutico , Adulto , Exantema/induzido quimicamente , Feminino , Febre/etiologia , Humanos , Fatores Imunológicos/uso terapêutico , Imunossupressão/efeitos adversos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Sarampo/diagnóstico , Vacina contra Sarampo/uso terapêutico , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Natalizumab/imunologia , Vacinas Atenuadas/efeitos adversos , Vacinas Atenuadas/imunologia , Vacinas Atenuadas/uso terapêutico
5.
BMJ Case Rep ; 13(10)2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122237

RESUMO

A 50-year-old man presented to our dermatology clinic with itchy skin rash. The rash began 5 days after systemic symptoms appeared such as mild fever and mild dyspnoea. The rashes were a characteristic of follicular eruption, which started on his stomach and spread all over his body. After a thorough evaluation, he was diagnosed with COVID-19 and was started on COVID-19 regimens. Skin lesions disappeared on the ninth day of treatment. Our findings contribute to the growing awareness of dermatological manifestations in patients with COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Exantema/diagnóstico , Pneumonia Viral/diagnóstico , Dermatopatias Virais/diagnóstico , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Diagnóstico Diferencial , Quimioterapia Combinada , Dispneia/diagnóstico , Dispneia/etiologia , Exantema/tratamento farmacológico , Febre/diagnóstico , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/tratamento farmacológico , Dermatopatias Virais/tratamento farmacológico , Resultado do Tratamento
6.
Medicine (Baltimore) ; 99(44): e23025, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126388

RESUMO

RATIONALE: Pulmonary hemorrhage is a rare but fatal complication of Henoch-Schönlein purpura (HSP), and more easily ignored in children than in adults due to the absence of clinically evident hemoptysis. Moreover, despite being sporadically reported, given that pulmonary hemorrhage may develop after regression and even disappearance of skin rash, the asynchronous progression of skin and lung lesions poses escalating challenges in the timely diagnosis. We herein presented a delayed diagnosis of late-onset pulmonary hemorrhage in a child with HSP after regression of purpuric rash. PATIENT CONCERNS: A 6-year and 3-month child with a history of self-resolved purpuric rash three weeks ago, presented acutely with cough and dyspnea but without fever. DIAGNOSES: The decreased hemoglobin and diffuse ground-glass opacities of both lungs on CT scan weren't comprehensively evaluated. The child was initially misdiagnosed as pneumonia. INTERVENTIONS: Antibiotic treatment was initiated. However, no improvement of respiratory status was found following aggressive combination therapy. Bronchoscopy was subsequently performed. OUTCOMES: An diffuse alveolar hemorrhage with low inflammatory profile was noted after a bronchoscopy. Considering the history of HSP, the diagnosis of HSP-associated pulmonary hemorrhage was ultimately confirmed and the patient received corticosteroids with satisfactory results. LESSONS: Pulmonary hemorrhage could occur in children with HSP at late onset of disease after regression of skin rash. New-onset respiratory symptoms in patients with a history of HSP should heighten suspicion for pulmonary hemorrhage, particularly if presenting with lack of fever, sudden drop of hemoglobin, new pulmonary infiltrates and unresponsiveness to antibiotics therapy. Bronchoscopy should be performed early to confirm the diagnosis, specifically for children.


Assuntos
Exantema , Hemorragia/diagnóstico , Pneumopatias/diagnóstico , Púrpura de Schoenlein-Henoch , Criança , Tosse/etiologia , Diagnóstico Tardio , Hemorragia/complicações , Hemorragia/diagnóstico por imagem , Humanos , Pneumopatias/complicações , Pneumopatias/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X
9.
Arch. argent. pediatr ; 118(5): e468-e475, oct 2020. tab, ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1122525

RESUMO

El trasplante de médula ósea es una terapia potencialmente curativa para múltiples enfermedades; el alogénico es el más indicado en leucemias. La enfermedad injerto versus huésped (EIVH) constituye la principal complicación del trasplante de médula ósea alogénico. Tanto en la EIVH aguda como crónica, la piel es el órgano más frecuentemente comprometido. El objetivo fue analizar las manifestaciones cutáneas de esta entidad. Trabajo retrospectivo y descriptivo, que incluyó a 59 pacientes trasplantados de edades entre 0 y 20 años. En 50 casos, se realizó trasplante de médula ósea alogénico. Veinticinco pacientes desarrollaron EIVH (17, la forma aguda, y 8, la forma crónica), y 24 tuvieron compromiso cutáneo. En concordancia con lo comunicado se encontró que las manifestaciones cutáneas fueron la manifestación clínica más común de EIVH. El hallazgo principal en EIVH aguda en nuestra serie fue el rash eritematoso maculopapular y, en EIVH crónica, las lesiones escleróticas símil morf


Bone marrow transplant is a potentially curative therapy for several diseases, and allogeneic bone marrow transplant is the most commonly indicated type for leukemias. Graft versus host disease (GVHD) is the main complication of allogeneic bone marrow transplant. In both acute and chronic GVHD, the skin is the most frequently involved organ. The objective of this study was to analyze cutaneous manifestations of this disease. Retrospective and descriptive study that included 59 transplanted patients aged 0 to 20 years. In 50 cases allogeneic bone marrow transplant was performed. Twenty-five patients developed GVHD (17 acute disease and 8 chronic disease) and 24 of them had cutaneous involvement. According to the literature, skin compromise was the commonest clinical manifestation of GVHD. Main finding in acute GVHD in our series was the erythematous maculopapular rash, while in chronic GVHD they were sclerotic lesions resembling morphe


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Doença Enxerto-Hospedeiro/diagnóstico , Manifestações Cutâneas , Transplante Homólogo , Leucemia , Epidemiologia Descritiva , Estudos Retrospectivos , Transplante de Medula Óssea , Exantema
10.
J Drugs Dermatol ; 19(9): 858-864, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026745

RESUMO

As the coronavirus epidemic continues, a host of new cutaneous complications is seen on the faces of frontline healthcare workers wearing personal protective equipment on a daily basis. To minimize the risk of COVID-19 infection, healthcare workers wear tight-fitting masks that lead to an excessive amount of pressure on the facial skin. Mechanical pressure, mask materials, and perspiration can all lead to various types of cutaneous lesions such as indentations of the face, skin tears, post-inflammatory hyperpigmentation, ulceration, crusting, erythema, and infection. The objective of this article is to provide effective and straightforward recommendations to those health care providers using facial masks in order to prevent skin-related complications. J Drugs Dermatol. 2020;19(9):858-864. doi:10.36849/JDD.2020.5259.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dermatoses Faciais/etiologia , Traumatismos Faciais/etiologia , Máscaras/efeitos adversos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Eritema/etiologia , Eritema/fisiopatologia , Exantema/etiologia , Exantema/fisiopatologia , Dermatoses Faciais/fisiopatologia , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/fisiopatologia , Feminino , Saúde Global , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Medição de Risco
11.
Praxis (Bern 1994) ; 109(14): 1109-1116, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33108997

RESUMO

CME Dermatology 22: Measles - Empidemiology and Clinical Manifestations Abstract. Measles is a highly contagious, acute and febrile illness that results from infection with measles virus. The World Health Organization (WHO) estimates a worldwide prevalence of ten million patients per year, leading to approximately 142 000 deaths (case fatality rate 1.4 %). The illness begins with fever, malaise and typically with at least one of the following signs: cough, coryza and/or conjunctivitis. Three to four days later, the characteristical rash appears. The primary clinical diagnosis needs to be confirmed by detection of specific IgM antibodies in serum or viral RNA by a throat swap. The management mainly consists of supportive therapy, a specific antiviral treatment does not exist. Therefore, prevention by widespread measles vaccination has absolute priority.


Assuntos
Exantema , Sarampo , Dermatologia , Humanos , Sarampo/diagnóstico , Sarampo/epidemiologia , Vírus do Sarampo , Vacinação
14.
Pediatr. aten. prim ; 22(87): 295-303, jul.-sept. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-194301

RESUMO

Un nuevo coronavirus llamado coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2), causante de una pandemia global, afecta a la población pediátrica con unas características clínicas diferentes a las de los adultos. Las lesiones dermatológicas acroisquémicas que se pueden asociar, se manifiestan más en pacientes jóvenes sin cuadro respiratorio. Se presentan tres casos clínicos con estudios analíticos, que incluyen determinación de anticuerpos neutralizantes por inmunocromatografía. En ninguno de los casos se ha podido demostrar la participación del SARS-CoV-2 como agente implicado. El término de "acroisquemia aguda en el niño en tiempos de COVID-19" parece ser el término más adecuado hasta tener un mayor conocimiento del cuadro


A new coronavirus called coronavirus 2 of severe acute respiratory syndrome (SARSCoV-2), causing a global pandemic, affects the pediatric population with some characteristics different from those of adults. The acro-ischemic dermatological lesions that can be associated, are manifested more in young patients without respiratory symptoms. Three clinical cases with analytical studies that include neutralizing antibody determinations by immunochromatography are presented. In none of these cases the SARS-CoV-2 appears to be an involved agent. The term "acute acro-ischemia in the child in the times of the Covid-19" seems to be the best term until there is a better understanding of the disease


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Infecções por Coronavirus/diagnóstico , Acrodermatite/virologia , Isquemia/virologia , Dermatopatias Vasculares/virologia , Dermatopatias Virais/diagnóstico , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Cuidado da Criança/métodos , Pandemias/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Exantema/virologia
15.
Medicine (Baltimore) ; 99(35): e21810, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871902

RESUMO

RATIONALE: The clinical manifestations of the SARS-CoV-2 infection are mainly respiratory but the virus can cause a variety of symptoms. Dermatological findings are less well-characterized. Data is scarce on their timing, type and correlation with the immune response. PATIENT CONCERNS: We present the case of SARS-CoV-2 infection in a previously healthy woman who presented with respiratory symptoms and developed anosmia, diarrhea, and an erythematous maculo-papular rash on day 15 from symptom onset. DIAGNOSIS: The nasopharyngeal swab tested by real time PCR for COVID-19 was positive. We interpreted this as a viral exanthema likely caused by an immune response to SARS-CoV-2 nucleotides. INTERVENTIONS: She was treated with Hydroxychloroquine, Azithromycin and Lopinavir/Ritonavir, and the rash with topical corticosteroids. OUTCOMES: All symptoms resolved except for anosmia which persisted for 6 weeks. At the 4- and 6-weeks follow-up the IgG titers for SARS-CoV-2 were high. LESSONS: We must consider that SARS-CoV-2 has a multi-organ tropism. In our case, the SARS-CoV-2 infection had lung, nasopharyngeal, neurological, digestive, and skin manifestations. Identifying the different manifestations is useful for understanding the extent of SARS-CoV-2 infection. We not only present a rare manifestation but also suggest that cutaneous manifestations may correlate with immunity.


Assuntos
Azitromicina/administração & dosagem , Betacoronavirus , Infecções por Coronavirus , Exantema , Glucocorticoides/administração & dosagem , Hidroxicloroquina/administração & dosagem , Lopinavir/administração & dosagem , Pandemias , Pneumonia Viral , Ritonavir/administração & dosagem , Administração Tópica , Adulto , Antivirais/administração & dosagem , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Combinação de Medicamentos , Exantema/diagnóstico , Exantema/tratamento farmacológico , Exantema/etiologia , Exantema/imunologia , Feminino , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Avaliação de Sintomas/métodos , Resultado do Tratamento
16.
Rev Soc Bras Med Trop ; 53: e20200533, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32935788

RESUMO

Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and has spread rapidly and caused a global pandemic. Knowledge about clinical and laboratory manifestations in the pediatric population is necessary to guide and monitor such patients. A 3-year-old female patient diagnosed with COVID-19 presented with high fever. After defervescence, she experienced a maculopapular rash that worsened by the sixth day of the disease with self-limited evolution without relevant laboratory changes. The identification of rashes in children with COVID-19 is an unusual and important condition that must be recognized in view of the high transmissibility shown.


Assuntos
Infecções por Coronavirus/diagnóstico , Exantema/virologia , Pneumonia Viral/diagnóstico , Pré-Escolar , Infecções por Coronavirus/complicações , Feminino , Humanos , Pandemias , Pneumonia Viral/complicações
18.
Hautarzt ; 71(10): 809-826, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32926199

RESUMO

Vesicles, pustules and vesiculopustules are frequent in newborns and infants and mostly self-limiting. In order to differentiate the rare life-threatening diseases and to therefore initiate the treatment in a timely manner, knowledge of vesicular, pustular and vesiculopustular dermatoses in early childhood is necessary.


Assuntos
Vesícula , Exantema , Dermatopatias Vesiculobolhosas , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA