Staphylococcal scalded skin syndrome: A pediatric dermatology case report

Staphylococcal scalded skin syndrome is a condition which predominantly affects children and causes a spectrum of skin lesions. We present a case of a 2-month-old infant with complaints of fever and fragile blisters over the body. The mucosal areas were spared. The diagnosis of staphylococcal scalded skin syndrome was reached on clinical grounds and culture report. The patient responded well to the treatment, which included an antibiotic (cloxacillin), an analgesic (paracetamol), and hydration with intravenous fluids. He was discharged after 8 days, with almost complete resolution of his skin lesions. Having a high clinical suspicion for staphylococcal scalded skin syndrome, early diagnosis/treatment, and following robust hygiene measures are imperative for the effective management of staphylococcal scalded skin syndrome. More efforts are needed to develop novel therapies for staphylococcal scalded skin syndrome.

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Norwegian or Crusted Sarcoptic Mange in Two Leishmanial Dogs

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-6445 ◽

2017 ◽

Vol 53 (6) ◽

pp. 326-330

Author(s):

Flora Kaltsogianni ◽

Rania Farmaki ◽

Alexander F. Koutinas

Keyword(s):

Complete Resolution ◽

Nutritional Support ◽

Antibody Test ◽

Skin Lesions ◽

The Body ◽

End Stage Kidney Disease ◽

Rare Type ◽

End Stage ◽

Crusted Scabies ◽

Immunofluorescent Antibody Test

ABSTRACT Norwegian or crusted scabies (N/CS) is a rare skin disease with very few cases reported in the dog or the cat. Two adult, stray dogs were admitted in our clinic with a generalized, multifocal to diffuse and nonpruritic dermatitis that was characterized by severe crusting, scaling, and ulceration. In both instances, leishmaniosis and N/CS were diagnosed by immunofluorescent antibody test serology, lymph node cytology, and skin scrapings in which high numbers of Sarcoptes mites were found. The combination of miticidal and antileishmanial treatment, supported by topical treatment and nutritional support, resulted in the complete resolution of the skin lesions and spectacular improvement of the body condition in both cases. Dog 1 eventually died from end-stage kidney disease attributed to leishmaniosis-associated glomerulonephritis, whereas the also proteinuric dog 2 remains clinically healthy. The manifestation of the rare type of N/CS in these dogs could be attributed to cell-mediated immunosuppression, which was most likely induced by leishmaniosis and malnutrition. The necessity of searching for leishmaniosis in those scabietic cases, especially in the endemic areas of leishmaniosis, is strongly recommended.

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Cutaneous Manifestations of Toxoplasmosis: a Case Report

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2014-0010 ◽

2014 ◽

Vol 6 (3) ◽

pp. 113-119 ◽

Cited By ~ 2

Author(s):

Sonya Marina ◽

Valja Broshtilova ◽

Ivo Botev ◽

Dimitrina Guleva ◽

Maria Hadzhiivancheva ◽

...

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Toxoplasma Gondii ◽

Complete Resolution ◽

Skin Lesions ◽

The Body ◽

Chemiluminescence Immunoassay ◽

Cutaneous Manifestations ◽

Blood Eosinophilia ◽

The World

Abstract Although toxoplasmosis is one of the most widely spread infections in the world, types that involve the skin are extremely rare. However, skin lesions are not specific; moreover, they are quite diverse, which makes the diagnosis of cutaneous toxoplasmosis rather difficult. Thus, differential diagnosis should include a number of other diseases. We present a case of a 43-year-old immunocompetent man with multiple livid erythematous papules and nodules with yellowish discharge that involved the skin of the body and the extremities. By using electro-chemiluminescence immunoassay, immunoglobulin G antibodies to Toxoplasma gondii were detected in the serum, confirming the diagnosis of toxoplasmosis. The treatment with pyrimethamine and trimethoprim-sulfamethoxazole led to complete resolution of skin lesions. In conclusion, although rare in the dermatological practice, cutaneous toxoplasmosis should be considered in all patients presenting with lymphadenopathy, non-specific skin eruptions, especially nodular and colliquative, blood eosinophilia and histological findigs revealing abundant eosinophilic inflitrations.

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Profil penyakit infeksi kulit karena virus pada anak di Divisi Dermatologi Anak Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP Prof. Dr. R. D. Kandou Manado periode tahun 2013 - 2015

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.9.1.2017.15319 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Anthony S. Wibawa ◽

Ellen Gunawan ◽

Herry E. J. Pandaleke

Keyword(s):

Herpes Zoster ◽

Viral Replication ◽

Pediatric Patients ◽

Skin Diseases ◽

Skin Lesions ◽

Mouth Disease ◽

The Body ◽

Skin Infections ◽

Pediatric Dermatology ◽

Hand Foot Mouth Disease

Abstract: Viral skin infection can occur in all ages, especially in children. These viruses can cause skin lesions due to the viral replication in the epidermis or as a secondary effect of viral replication in other part of the body. This study was aimed to obtain the profile of viral skin infections in Pediatric Dermatology Division of Dermatovenereology Clinic, Prof. Dr. R. D. Kandou Hospital Manado from 2013 to 2015. This was a retrospective study using medical records of new pediatric patients with viral skin diseases, aged 0-14 years from 2013 to 2015. The results showed that there were 113 pediatric patients (12.71%) with viral skin infections. The majority of cases were 5-14 years old (73.45%), followed by 1-4 years old (25.66%) and 0-1 years old (0.88%); females (52,21%) were more commonly found. The viral skin diseases in this study were moluscum kontagiosum (47.79%), verucca vulgaris (29.20%), varicella (8.85%), herpes zoster (7.97%), and hand foot mouth disease (6.19%). Conclusion: Skin viral diseases in children were found in 12.71% of new patients, most common in females and aged 5-14 years. Moluscum contagiosum was the most common skin viral disease in all ages.Kata kunci: penyakit kulit, infeksi virus, anakAbstrak: Penyakit infeksi kulit karena virus dapat terjadi pada semua usia, tetapi lebih banyak pada anak-anak. Virus dapat menyebabkan timbulnya lesi kulit sebagai hasil dari replikasi virus di epidermis atau sebagai efek sekunder replikasi virus di tempat lain pada tubuh. Penelitian ini bertujuan untuk mengetahui profil penyakit infeksi kulit karena virus pada anak di Divisi Dermatologi Anak Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP Prof. Dr. R. D. Kandou Manado selama periode tahun 2013-2015. Jenis penelitian ialah retrospektif menggunakan rekam medik pasien anak baru dengan infeksi kulit karena virus, berusia 0-14 tahun periode tahun 2013-2015. Hasil penelitian mendapatkan 113 pasien anak (12,71%) dengan penyakit infeksi kulit karena virus, paling sering pada kelompok usia 5-14 tahun (73,45%), diikuti dengan usia 1-4 tahun (25,66%) dan usia 0-1 tahun (0,88%); lebih banyak pada anak perempuan (52,21%). Penyakit infeksi kulit karena virus terdiri dari moluskum kontagiosum (47,79%), veruka vulgaris (29,20%), varisela (8,85%), herpes zoster (7,97%), dan hand foot mouth disease (6,19%). Simpulan: Penyakit infeksi kulit karena virus pada anak didapatkan sebanyak 12,71% dari pasien baru, terbanyak pada kelompok usia 5-14 tahun dan jenis kelamin perempuan. Moluskum kontagiosum ditemukan terbanyak pada semua kelompok usia.Kata kunci: penyakit kulit, infeksi virus, anak

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Fulminant hepatitis in a patient with secondary syphilis

International Journal of STD & AIDS ◽

10.1177/0956462418785257 ◽

2018 ◽

Vol 29 (13) ◽

pp. 1348-1350

Author(s):

Ana Beatriz Affonso da Costa ◽

Bruna Fornazari ◽

Fernanda Perin Maia da Silva ◽

Gibran A Frandoloso ◽

Giovanni L Breda

Keyword(s):

Acute Hepatitis ◽

Fulminant Hepatitis ◽

Unusual Case ◽

Clinical Manifestations ◽

Skin Lesions ◽

Secondary Syphilis ◽

Clinical Suspicion ◽

Diagnosis And Treatment ◽

Atypical Presentation ◽

High Clinical Suspicion

Despite the increasing incidence of syphilis and due to its wide variety of clinical manifestations, syphilis remains an under-diagnosed condition. We report an unusual case of secondary syphilis presenting with acute hepatitis and skin lesions, confirmed based on positive treponemal and non-treponemal assays. Despite adequate diagnosis and treatment, the patient developed fulminant hepatitis and brain death. This atypical presentation emphasizes the importance of high clinical suspicion in recognizing syphilis as an etiology for unexplained acute hepatitis, allowing early diagnosis and treatment and possibly avoiding severe complications such as fulminant hepatic failure.

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Fracture of the Body of the Hamate With Dorsal Dislocation of the 4th and 5th Metacarpals: A Case Report

The Open Orthopaedics Journal ◽

10.2174/1874325001711010447 ◽

2017 ◽

Vol 11 (1) ◽

pp. 447-451 ◽

Cited By ~ 2

Author(s):

Vasilis Athanasiou ◽

Ilias D. Iliopoulos ◽

Konstantinos Pantazis ◽

Andreas Panagopoulos

Keyword(s):

Case Report ◽

Full Range ◽

Clinical Suspicion ◽

The Body ◽

Dominant Hand ◽

Intraarticular Fracture ◽

Patient Morbidity ◽

High Clinical Suspicion ◽

With Screws

Background: Solitary fractures of the body of the hamate are rare. Their diagnosis is difficult and requires a high clinical suspicion and a proper radiological examination. Case report: We present a case of a 36-year-old male patient who sustained an intraarticular fracture of the body of the hamate along with dorsal dislocation of the 4th and 5th metacarpals on his right dominant hand. Through a dorsal surgical approach, he underwent ORIF of the hamate with screws and stabilization of the dislocated 4th and 5th metacarpals with KW. At his last follow-up appointment, 18 months postoperatively, he had no pain, almost full range of motion on his fingers and a Mayo Wrist score of 90 points. Conclusions: Hamate fractures are rare entities that can cause significant patient morbidity if not recognized and treated appropriately.

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A Rare Case of Tuberculous Prostatitis

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v2i1.5863 ◽

2016 ◽

Vol 1 (2) ◽

pp. 33

Author(s):

Nurul Yaqeen Mohd Esa ◽

Mohammad Hanafiah ◽

Marymol Koshy ◽

Hilmi Abdullah ◽

Ahmad Izuanuddin Ismail ◽

...

Keyword(s):

Rare Case ◽

Correct Diagnosis ◽

Immunocompetent Patient ◽

Clinical Suspicion ◽

Tuberculosis Infection ◽

Advanced Age ◽

Immunocompromised Patients ◽

Prostatic Biopsy ◽

High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

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Haemolytic Anaemia: A Diagnostic Dilemma

Haematology Journal of Bangladesh ◽

10.37545/haematoljbd201815 ◽

2018 ◽

Vol 2 (01) ◽

pp. 29-31

Author(s):

Md. Rezaul Karim Chowdhury ◽

Mohammad Quamrul Hasan ◽

Md. Haroon Ur Rashid

Keyword(s):

Haemolytic Anaemia ◽

Clinical Suspicion ◽

Diagnostic Dilemma ◽

High Clinical Suspicion ◽

Immune Haemolytic Anaemia

It is sometime difficult to find out the cause of haemolysis in haemolytic anaemia due to inconclusive results of investigation. Diagnosis of immune haemolytic anaemia is often difficult when Coomb’s test is negative. Here we present such a case of fourteen years old girl who presented with haemolytic anaemia with negative Coomb’s test. Due to high clinical suspicion we labelled her as a case of Coomb’s negative immune haemolytic anaemia and she responded well to steroid.

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Advantages of 18F-FDG PET/CT Imaging over Modified Duke Criteria and Clinical Presumption in Patients with Challenging Suspicion of Infective Endocarditis

Diagnostics ◽

10.3390/diagnostics11040720 ◽

2021 ◽

Vol 11 (4) ◽

pp. 720

Author(s):

Valentin Pretet ◽

Cyrille Blondet ◽

Yvon Ruch ◽

Matias Martinez ◽

Soraya El Ghannudi ◽

...

Keyword(s):

Infective Endocarditis ◽

Predictive Value ◽

Fdg Pet ◽

Clinical Suspicion ◽

Duke Criteria ◽

High Clinical Suspicion ◽

Pet Ct ◽

18F Fdg ◽

Sensitivity Specificity ◽

Fdg Pet Ct

According to European Society of Cardiology guidelines (ESC2015) for infective endocarditis (IE) management, modified Duke criteria (mDC) are implemented with a degree of clinical suspicion degree, leading to grades such as “possible” or “rejected” IE despite a persisting high level of clinical suspicion. Herein, we evaluate the 18F-FDG PET/CT diagnostic and therapeutic impact in IE suspicion, with emphasis on possible/rejected IE with a high clinical suspicion. Excluding cases of definite IE diagnosis, 53 patients who underwent 18F-FDG PET/CT for IE suspicion were selected and afterwards classified according to both mDC (possible IE/Duke 1, rejected IE/Duke 0) and clinical suspicion degree (high and low IE suspicion). The final status regarding IE diagnosis (gold standard) was based on the multidisciplinary decision of the Endocarditis Team, including the ‘imaging specialist’. PET/CT images of the cardiac area were qualitatively interpreted and the intensity of each focus of extra-physiologic 18F-FDG uptake was evaluated by a maximum standardized uptake value (SUVmax) measurement. Extra-cardiac 18F-FDG PET/CT pathological findings were considered to be a possible embolic event, a possible source of IE, or even a concomitant infection. Based on the Endocarditis Team consensus, final diagnosis of IE was retained in 19 (36%) patients and excluded in 34 (64%). With a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and global accuracy of 79%, 100%, 100%, 89%, and 92%, respectively, PET/CT performed significantly better than mDC (p = 0.003), clinical suspicion degree (p = 0.001), and a combination of both (p = 0.001) for IE diagnosis. In 41 patients with possible/rejected IE but high clinical suspicion, sensitivity, specificity, PPV, NPV, and global accuracies were 78%, 100%, 100%, 85%, and 90%, respectively. Moreover, PET/CT contributed to patient management in 24 out of 53 (45%) cases. 18F-FDG PET/CT represents a valuable diagnostic tool that could be proposed for challenging IE cases with significant differences between mDC and clinical suspicion degree. 18F-FDG PET/CT allows a binary diagnosis (definite or rejected IE) by removing uncertain diagnostic situations, thus improving patient therapeutic management.

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Ovarian Torsion in a 5-Year Old: A Case Report and Review

Case Reports in Emergency Medicine ◽

10.1155/2012/679121 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Matthew F. Ryan ◽

Bobby K. Desai

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Case Report ◽

Urinary Tract ◽

Clinical Suspicion ◽

Ovarian Torsion ◽

Surgical Emergencies ◽

High Clinical Suspicion ◽

Tract Infections ◽

Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

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Symptomatic Patent Foramen Ovale with Hemidiaphragm Paralysis

Case Reports in Pulmonology ◽

10.1155/2017/9848696 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Hussain Ibrahim ◽

Adnan Khan ◽

Shawn P. Nishi ◽

Ken Fujise ◽

Syed Gilani

Keyword(s):

Right Atrium ◽

Chronic Conditions ◽

Patent Foramen Ovale ◽

Hospital Admissions ◽

Clinical Suspicion ◽

Chronic Obstructive ◽

Foramen Ovale ◽

Obstructive Pulmonary Disease ◽

Benign Condition ◽

High Clinical Suspicion

Dyspnea accounts for more than one-fourth of the hospital admissions from Emergency Department. Chronic conditions such as Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and Asthma are being common etiologies. Less common etiologies include conditions such as valvular heart disease, pulmonary embolism, and right-to-left shunt (RLS) from patent foramen ovale (PFO). PFO is present in estimated 20–30% of the population, mostly a benign condition. RLS via PFO usually occurs when right atrium pressure exceeds left atrium pressure. RLS can also occur in absence of higher right atrium pressure. We report one such case that highlights the importance of high clinical suspicion, thorough evaluation, and percutaneous closure of the PFO leading to significant improvement in the symptoms.

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