ABSTRACT
Se trata de una adolescente femenina de 16 años de edad, natural de Cuyagua estado Aragua y procedente de la localidad, quien presenta desde hace cuatro meses aproximadamente, prurito intenso a nivel del complejo areola pezón y exudado, amarillento, no fétido, de moderada cantidad en ambas mamas. Refiere haber consultado a facultativo quien indica tratamiento, a base de oxacilina no presentando mejoría. Acude el día 05/04/16 al Centro Integral de Especialidades "Los Grillitos", CORPOSALUD. Municipio Mario Briceño Iragorry a consulta especializada. Al examen físico se evidencia: mamas simétricas, complejo areola pezón eritematoso, con zonas de descamación, exudado amarillento y a nivel de mama izquierda se extiende hasta piel del cuadrante ínfero interno; se indica realizar paraclínicos: ecosonograma mamario, hematología completa, VSG, PCR y se toma muestra para cultivo, de la misma manera se indica tratamiento con corticoides tópicos y antibióticoterapia (ciprofloxacina). Acude a control el 15/04/16 con evolución clínica satisfactoria y resultado de cultivo positivo para S. aureus, sensible a ciprofloxacina.
It is female 16-year-old native of Cuyagua state Aragua and from the town, who presents from four months about intense itching at the level of the nipple areola complex and not fetid yellowish exudate moderate amount of both breasts, which refers consultation with physician who indicates treatment based oxacillin presented no improvement. She goes on 5/4/16 at Integral Center specialty "The Grillitos" CORPOSALUD. Municipio Mario Briceño Iragorry a specialist consultation, physical examination is evident: symmetrical breasts, nipple areola complex erythematosus, with areas of desquamation and yellowish exudate, and level of left breast extends to skin internal bottom quadrant shown performing paraclinical: sonogram breast, complete blood count, ESR, CRP and sample is taken for cultivation, in the same way treatment with topical corticosteroids and antibiotics (ciprofloxacin) is indicated. Control goes to 04/15/16 with satisfactory clinical evolution resulting in positive culture for S. aureus sensitive to ciprofloxacin.
ABSTRACT
Comunicamos una paciente femenina de 24 años de edad, natural y procedente de la localidad, quien consulta en el mes de enero de 2016 al Centro Integral de Especialidades “Los Grillitos”, CORPOSALUD. Municipio Mario Briceño Iragorry por presentar lesión ulcerosa a nivel de hemicadera derecha, cuya aparición fue posterior a la administración de medicamentos vía intramuscular (ampolla de amikacina). El tratamiento aplicado fue debido a una infección vaginal que presentó en el mes de septiembre 2015, cuyo cultivo resultó sensible a este antibiótico; comenzó a presentar un área endurecida color violáceo, hasta convertirse en una úlcera en el mes de diciembre 2015. Por este motivo, acude al médico quien indica ecosonograma de partes blandas (27/1/2016), informando: úlcera de 29 mm asociado a celulitis post infecciosa a administración medicamentosa, en hemicadera derecha y hematoma, organizado en hemicadera izquierda (0,25 cc); se realiza cultivo (27/1/2016) reportando presencia de Acinetobacter baumani complex sensible a la ciprofloxacina, la que se indica, observándose actualmente mejoría clínica de la lesión.
It is 24 years female patient age and naturally from the locality, who consults in January 2016 to Integral Center Specialty "The Grillitos" Corposalud. Municipio Mario Briceño Iragorry to present Injury ulcer type level right hemi hip whose appearance was after drug administration (vial amikacin) treatment applied due to a vaginal infection present in the month of September 2015 whose culture was sensitive to this antibiotic, he began to present purple colored hardened to become ulcerated area in December 2015. Which is why go to the doctor who said soft tissue sonography (01/27/2016) ulcer reporting 29 mm associated with post-infectious cellulitis to drug administration right hemi hip and a left organized hematoma (0.25 cc); culture (01.27.2016) is perform reporting presence of Acinetobacter baumani sensitive Ciprofloxacin treatment indicated Complex currently observed clinical improvement of the injury.
ABSTRACT
Comunicamos un caso de dermatitis por contacto severa debida al Árnica montana, en una paciente con antecedentes de hipertensión arterial tratada regularmente y controlada; se enfatiza la importancia de un control evolutivo, examen físico semiológico completo y los diagnósticos diferenciales, de estas variantes severas e infrecuentes.
The presentation of a case of irritant contact dermatitis in a patient with a history of high blood pressure regularly treated and controlled, who starts on 19.04.13 with fever of 39º5 which ceded with use of current antipyretic; accompanied by myalgia, retro-ocular pain, arthralgias, headache of strong intensity, complete haematology reports thrombocytopenia and leukocytosis at the expense of segmented, picture that remained for 48 hours; later is associated with stabbing pain and right lower limb rigidity. 22.04.13 presents increase in volume and signs of phlogosis of elevated erythematous edges that extends to the sural region, with blister on right twin region of approximately 10x10 cm with functional limitation of that member. The patient is hospitalized under the diagnosis of Bullous erysipelas, receives broad spectrum antibiotics to Gram +, Gram - and anaerobic. 29.04.13 blister hatches draining not foul-smelling yellowish secretion; it is cultivated and Gram, reporting no bacterial growth. Refers to Central Hospital of Maracay entering it with the diagnosis of cellulitis blistering, where it performed second Gram and cultivation reported without bacterial growth; they perform a biopsy which reports epidermal necrotic dermatitis superficial and deep compatible with dermatitis irritant contact. The case is reevaluated, interrogating again to the patient and the dermal symptoms coincide with the use of Árnica montana product (this data was not reported or questioned in the initial history). Update about the product reported that exists extensive reference on cases of dermatitis contact, mainly by the use of Árnica montana and one of its components; methylparaben, these cases have been reported by prolonged use of the product described as excited skin syndrome or angry back. The patient after to the second questioned referred the use of this product frequently for several years topically and even concerned using infusions of the flower of Árnica montana orally. It was decided to deal with steroids intravenously, resulting in evident improvement with egress to the fifth day and outpatient follow-up, which reported complete remission of picture.