Púrpura trombocitopénica idiopática (pti): su diagnóstico a través de lesiones en cavidad oral / Purple Idiopathic Thrombocytopenic (Itp): diagnosis through lesions in the oral cavity

La PTI es una alteración hemorrágica de instalación súbdita, adquirida, que se manifiesta inicialmente con petequias, equimosis o hematomas en piel y mucosas, sangrado nasal y gingival, sin causa aparente. La mucosa bucal puede ser el sitio donde las lesiones se observen con frecuencia y por primera vez. Se reporta el caso de un paciente masculino de 28 años de edad, con manifestaciones clínicas de un cuadro purpúrico, se describen signos, síntomas, terapéutica y manejo estomatológico (AU)

PTI is a hemorrhagic alteration of sudden installation, acquired, which manifests initially with petechiae, esquimosis or bruises on skin and mucosae, nasal and gingival bleeding without apparent cause. Bucal mucosae can be the site where lesions are observed with frequency, and for the first time. The case of a male patient with 28 years of age with clinical manifestationsofpurpuric syndrome is reported, signs, symptoms, therapeutic and stomatological handling are described (AU)

Escorbuto en el siglo XXI / Scurvy in XXI century

El escorbuto es una enfermedad causada por la deficiencia de vitamina C o ácido ascórbico. Sus manifestaciones clínicas son variadas debido a que esa vitamina es un cofactor de enzimas que intervienen en numerosos procesos, como la síntesis de colágeno y la absorción de diferentes nutrientes. La expresión cutánea característica son las petequias foliculares con pelos en cuello de cisne y en tirabuzón. El compromiso mucoso se manifiesta como hipertrofia y hemorragia gingival, gingivitis y pérdida de piezas dentarias. El diagnóstico es clínico y puede confirmarse mediante la determinación de la vitamina C plasmática o leucocitaria. El tratamiento se basa en el aporte suplementario de esa vitamina. Se presenta el caso de un paciente de 32 años con escorbuto debido a una dieta casi exclusivamente a base de harinas y carente de frutas y verduras. (AU)

Scurvy is a disease caused by vitamin C deficiency (also called ascorbic acid). Its clinical manifestations are varied because this vitamin is a cofactor of enzymes that take part in numerous processes, such as the synthesis of collagen and the absorption of different nutrients. Cutaneous expression of scurvy is follicular petechiae with corkscrew hairs. Mucous involvement manifests as gingival hypertrophy and bleeding, gingivitis and loss of teeth. The diagnosis of this entity is clinical and can be confirmed by plasma or leukocyte vitamin C dosing. The treatment consists of vitamin C supplementation. We present a 32-year-old male patient with scurvy secondary to a diet based almost exclusively on flour and lacking in fruits and vegetables. (AU)

A Study of Febrile Thrombocytopenia

Introduction: Febrile thrombocytopenia is thethrombocytopenia associated with febrile illness. Thecommon causes are dengue, rickettsiae, malaria, typhoid,septicemia and in some cases undifferentiated fever. Thepresent study was intended to know the underlying etiology offebrile thrombocytopenia cases admitted to our hospital, thevarious presentations and relationship between platelet countand bleeding manifestation and prognosis.Material and methods: The study was conducted on 855patients aged 18 years and above who presented with feverand thrombocytopenia and were admitted in MVJ MedicalCollege and Research Hospital, Hoskote, Bengaluru ruraldistrict from January 2016 to December 2018.Results: A total of 855 patients of febrile thrombocytopeniawere admitted to our hospital during study period. Majority ofpatients were in the age group of 18 to 40 years with male tofemale ratio of 1.15: 1. Most of the cases presented during themonths of July to September. Commonest clinical presentationwere fever (100%), myalgia (86.5%) and headache (84.7%).In the majority of patients, thrombocytopenia was transient,present for 2 – 3 days, but bleeding manifestations were seenin 24.3% of patients. Petechiae (14%) was the commonestbleeding manifestation. 691 (80.81%) patients had plateletcount between 50000 to 1.5 lakh/mm3 and 164 (19.18%)cases had platelet count less than 50000/mm3 Only 5.6%had need for platelet transfusion. Dengue (51.9%) was thecommonest cause of thrombocytopenia followed by rickettsialfever (27.7%). In 15.6% of patients the etiology could not beascertained.Conclusion: Febrile thrombocytopenia is the most commoncause for admission to the hospital which requires extensiveevaluation and prompt management.

Dengue hemorrhagic fever in a Japanese traveler who had preexisting Japanese encephalitis virus antibody

A patient, an adultJapanese traveler who had just returned from Thailand, had developed denguehemorrhagic fever (DHF). A primary infection of dengue virus (DENV) wasconfirmed, in particular, DENV serotype 2 (DENV-2) via the detection of the virusgenome, a significant increase in its specific neutralizing antibody and the isolationof DENV-2. DHF is often observed following a secondary infection from another serotypeof dengue virus, particularly in children, but this case was a primaryinfection of DENV. Japan is a non-endemic country of dengue disease. Instead,only Japanese encephalitis (JE) is known to be an endemic flavivirus family. Inthis study, IgG antibody against Japanese encephalitis virus (JEV) was detected.JEV belongs to the family of dengue virus and prevails in Japan, particularly inKyushu. Among many risk factors for the occurrence of DHF, a plausiblecandidate could be a cross-reactive antibody-dependent enhancement (ADE)mechanism by JEV antibody. This indicates that most Japanese travelers, wholive in non-endemic areas of dengue, particularly in Kyushu, should payattention to the occurrence of DHF.

Dengue Hemorrhagic Fever in a Japanese Traveler with Pre-existing Japanese Encephalitis Virus Antibody

An adult Japanese man who had just returned from Thailand developed dengue hemorrhagic fever (DHF). A primary infection of dengue virus (DENV) was confirmed, specifically DENV serotype 2 (DENV-2), on the basis of the detection of the virus genome, a significant increase in the neutralizing antibody and the isolation of DENV-2. DHF is often observed following a secondary infection from another serotype of dengue virus, particularly in children, but this case was a primary infection of DENV. Japan is a non-endemic country for dengue disease. In fact, only Japanese encephalitis (JE) is known to be a member of the endemic flavivirus family. In this study, IgG antibody against Japanese encephalitis virus (JEV) was detected. JEV belongs to the family of dengue virus and prevails in Japan, particularly Kyushu. Among many risk factors for the occurrence of DHF, a plausible candidate could be a cross-reactive antibody-dependent enhancement (ADE) mechanism caused by JEV antibody. This indicates that most Japanese travelers who living in dengue non-endemic areas, particularly Kyushu, should be aware of the occurrence of DHF.

Incidence of Subconjunctival Petechiae by Type of Hanging / 대한법의학회지

Hanging is traditionally classified as complete, incomplete by the completeness of suspension and typical, atypical by the point of suspension and location of knot. It has been well known that the signs of hanging including subconjunctival petechiae are different according to the type of hanging. We evaluated the incidence of subconjunctival petechiae on 260 cases of hanging and classified the point of suspension and location of knot, ligature mark, and position on cases with subconjunctival petechiae. The subconjunctival petechiae was found in 33.6% of all cases, mostly seen in incomplete, atypical hanging. However, about 30% of incomplete, atypical hanging showed no definite subconjunctival petechiae. The patterns of location of ligature mark, type of knot, and position were somewhat different between positive and negative cases of subconjunctival petechiae in incomplete, atypical hanging.

A Case of Calcaneal Petechiae in a Child / 대한피부과학회지

Calcaneal petechiae (black heel) is a traumatic lesion affecting the back or posterolateral aspect of the heel. An asymptomatic, pigmented, macular lesion is found on one or both heels immediately above the hyperkeratotic border of the foot. It is caused by any sport, such as basketball, tennis, or football, that leads to slamming of the foot against the shoe. Calcaneal petechiae is probably more common than is realized. As it is usually symptomless, it may be disregarded or only observed by chance. The importance of the lesion lies in its clinical resemblance to a malignant melanoma. We report a case of calcaneal petechiae which was confused clinically with a melanoma.

A retrospective study of dengue hemorrhagic fever in pediatric patients of the Divine Word University Hospital, Tacloban City

A retrospective study was undertaken in 39 pediatric patients with Dengue Hemorrhagic Fever admitted to the Divine Word University Hospital, Tacloban City between January 1985 and December 1989. Diagnosis was based on the WHO (World Health Organization) case definitions for Dengue Hemorrhagic Fever/Dengue Shock Syndrome (DHF/DSS) Of the 39 patients, females (64%) outnumbered the males and 51% were females above 4 years old. The nutritional status of most of these patients (92%) were within normal. Majority (72%) had their residence with in Tacloban City. The most common hemorrhagic manifestations were a positive tourniquet test (100%), petecchiae (84%), rash (62%) and epistaxis (26%) while the most common non-specific manifestations were fever (100%), vomiting (51%) and abdominal pain (41%). The difference of the duration of the fever between males and females and the different age groups was not significant. The platelet count was 100,000/mm3 or less in 9 patients (23%). One patient had pleural effusion. One of the two patients who had hypotension died within 24 hours from admission.

Clinical Experience of Hydrodistension in Men Diagnosed as Prostatodynia / 대한비뇨기과학회지

PURPOSE: This study was designed to investigate that men with prostatodynia have petechiae in the bladder and improvement of symptoms after hydrodistension. MATERIALS AND METHODS: A total of 14 men with the diagnosis of prostatodynia underwent cystoscopy and hydrodistension under a general or regional anesthetic. Their charts were retrospectively reviewed. RESULTS: Of the 14 men 5(36%) had moderate to severe petechiae similar in appearance to women with interstitial cystitis after hydrodistension. Men with moderate to severe bladder petechiae had fewer leukocytes in expressed prostatic secretions and smaller bladder capacities than men with more normal appearing bladders after hydrodistension. Symptomatic improvement 2 to 6 weeks after hydrodistension was more common in men with moderate to severe petechiae than in those with fewer petechiae. CONCLUSIONS: We suggest that bladder petechiae after hydrodistension may be a diagnostic finding in men with prostatodynia as well as women with interstitial cystitis. Therefore, the diagnosis of interstitial cystitis should be considered in patients with prostatodynia.