ABSTRACT
Se evaluó paciente femenino de 51 años, con antecedentes de diabetes mellitus tipo II e infecciones urinarias a repetición, procedente de la comunidad Mario Briceño Iragorry, quien acude al ambulatorio centro de especialidades "Los Grillitos", de la Corporación de Salud del Estado de Aragua - Venezuela, presentando lesión ulcerada a nivel de hemicadera izquierda, posterior a la colocación vía intramuscular de diclofenac sódico el 28/03/17, el que fue indicado por facultativo para tratar dolor por infección urinaria alta. Posteriormente, a las 24 horas presenta en la zona de la inyección una coloración violácea, induración y mucho dolor, motivo por el que acude nuevamente al facultativo. Se le realizó ecosonograma de partes blandas en región glútea izquierda, reportando imagen heterogénea a predominio hipoecoico con ecos internos de mediana intensidad, que genera reforzamiento posterior de 49x39 mm, con aproximadamente 30 cc de líquido, que correspondería a un proceso inflamatorio e infeccioso (absceso). Posteriormente a la evaluación, se indica antibiótico terapia a base de oxacilina 1 g cada 8 horas vía endovenosa por siete días, además 100 mg cada 12 horas vía oral de nitrofurantoína para el proceso infeccioso urinario, que el urocultivo indica ser sensible a la E. Coli. Al tercer día de la enfermedad actual, se le drena absceso con material purulento aproximadamente 20 cc y cura sucesiva por cinco días, evolucionando satisfactoriamente del proceso infeccioso de partes blandas e infección urinaria.
A 51-year-old female patient with a history of type II diabetes mellitus and recurrent urinary tract infections from the Mario Briceño Iragorry community, attended the outpatient clinic "Los Grillitos" of the health corporation of Aragua Venezuela, with an ulcerated lesion at the left hemi-hip level, following the intramuscular placement of diclofenac sodium on 03/28/17, which was indicated by facultative to treat pain due to high urinary tract infection, afterwards approximately 24 hours presents at the injection site a violet coloration, induration and a lot of pain, which is why she returned to facultative, she performed a soft-tissue echosonogram in the left gluteal region reporting a heterogeneous image to hypoechoic predominance with internal echoes of medium intensity that generates posterior reinforcement which measures 49x39 mm with approximately 30 cc of liquid that could correspond to an inflammatory and infectious process (abscess), post-evaluation is indicated antibiotic therapy based on oxacillin 1 g every 8 hours intravenous route for seven days plus 100 mg every 12 hours oral route of nitrofurantoin for the urinary infectious process that the urine culture indicates to be sensitive E. coli, the third day of illness is drained abscess purulent material approximately 20 cc and successive cure for five days. Satisfactory evolution of the infectious process of soft tissue and urinary tract infection.
ABSTRACT
Comunicamos el caso de una paciente femenina de 23 años de edad, natural y procedente de la localidad, quien consulta el 30 de Noviembre de 2016 al Centro Integral de Especialidades "Los Grillitos", CORPOSALUD, Municipio Mario Briceño Iragorry, por presentar lesiones puntiformes no pruriginosas en tronco, cuya aparición fue posterior al cuadro viral leve, motivo por el que acude al médico quien le indica antihistamínicos orales y glucocorticoides tópicos no fluorados. Con posterioridad a la primera consulta médica, se evidencian lesiones ovales rosadas con relieve no pruriginoso, diseminado en tronco. Se continúa tratamiento y se indica administrar una ampolla de betametasona intramuscular. Acude nuevamente a evaluación médica y se evidencian lesiones ovales menos eritematosas, descamativas en el límite del borde libre; en general se encuentran involucionadas, observándose actualmente mejoría clínica del cuadro.
We communicate a 23-year-old female patient, natural and from the locality, who on November 30, 2016, visits the Integral Center of Specialties "Los Grillitos", CORPOSALUD, Municipality Mario Briceño Iragorry, for presenting non-pruriginous punctate lesions on the trunk, which appeared after a mild viral picture, reason why she goes to the doctor who indicates oral antihistamines and non-fluorinated topical glucocorticoids. Subsequent medical evolution shows pink oval lesions with non-pruriginous relief, disseminated in the trunk. Treatment is continued and an intramuscular betamethasone ampoule is indicated. The patient returns to medical evaluation and there is evidence of oval lesions less erythematous, desquamative at the border of the free border; in general they are involuted, observing at the moment clinical improvement of the picture.
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.