Lellis nejm photo ucsdh dermatology ear hzv vesicles differential hematology rakari cold

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Rickettsialpox Eschar

40 homeless male from NY admitted with fever, chills, headache, myalgias. Diagnosis?
Rickettsialpox R akari classic

triad of fever, vesiclar ... Primary papule➡️vesicle ... not endothelial cells ... #clinical #photo ... #skinrash #dermatology

Cold Agglutinin Disease

3 Types of Cold Sensitive Antibodies:
1. Cold Agglutinins (CAD)
2. Donath-Landsteiner

Agglutination in the nose, ears ... Mycoplasma, EBV, HIV ... younger pts) Differential ... sensitize red blood cells ... hemolytic #anemia #hematology

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