RESUMO
This case report explores the clinical journey of a patient initially diagnosed with botryomycosis, only to later reveal the underlying and rare condition of actinomycosis. The report highlights the challenges in getting to an accurate diagnosis, emphasizing the importance of considering uncommon pathologies, the utility of multi-disciplinary teams and clinico-pathologic correlation in clinical practice.
RESUMO
We report on a rare case of perforating folliculitis with a paradoxical presentation. An 18-year-old patient with end-stage kidney failure was undergoing continuous ambulatory peritoneal dialysis following 1 year of hemodialysis treatment. While being treated with continuous ambulatory peritoneal dialysis, he developed an itchy papular eruption on an erythematous base over his face and chest, which was diagnosed as chicken pox and treatedwith acyclovir.He also underwent successful deceased donor kidney transplant 1 year later. On day 10 posttransplant, he presented with a papular eruption over the chest, face, and forearms. A skin biopsy revealed a perforating folliculitis lesion. He was treated with prednisone and tacrolimus, as part of the kidney transplant treatment. The skin lesions resolved progressively. His urea, creatinine, and electrolyte levels remained normal and on an ever-improving trend at each visit. By 4 months posttransplant, the skin lesions had resolved almost completely.
Assuntos
Foliculite , Transplante de Rim , Foliculite/diagnóstico , Foliculite/tratamento farmacológico , Foliculite/etiologia , Humanos , Rim/patologia , Transplante de Rim/efeitos adversos , Masculino , Tacrolimo/efeitos adversos , Resultado do TratamentoAssuntos
Úlcera de Buruli/diagnóstico , Úlcera de Buruli/tratamento farmacológico , Adolescente , Idoso , Antibióticos Antituberculose/uso terapêutico , Claritromicina/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium ulcerans , Rifampina/uso terapêutico , VitóriaAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Pigmentação da Pele/fisiologia , Vitiligo/diagnóstico , Vitiligo/tratamento farmacológico , Colorimetria/métodos , Humanos , Injeções Subcutâneas , Masculino , Remissão Espontânea , Pigmentação da Pele/efeitos dos fármacosRESUMO
A 31-year-old HIV-seropositive woman from Durban, KwaZulu-Natal, South Africa, presented with a 3-month history of widespread umbilicated and ulcerated skin papules, plaques, and nodules. The skin lesions were biopsied and sent for histology and fungal culture; the cultured isolate was referred for molecular identification. Histology, fungal culture, and molecular testing confirmed that the dimorphic fungal pathogen Emergomyces africanus had caused a disseminated mycosis.
