Lymphocutaneous Sporotrichiosis Infection
Landscaper w/ painless nodular rash of arm present for months wax and wane; diagnosis?
Lymphocutaneous sporotrichiosis minor trauma leads to skin inoculation. Papulonodular, erythematous often ulcerates, painless, no systemic signs, labs normal. Culture of tissue biopsy preferred
Differential of papulonodular lesions w/ lymphatic spread: common: nocardia, leishmania, Tb, NTM; less common (leprosy, staph aureus, cow pox, strep pyogenes, tularemia, scedosporium, fusarium)
Indiana University Infectious Diseases Fellowship @IUIDfellowship
#Lymphocutaneous #Sporotrichiosis #Infection #clinical #photo #hand
Vibrio vulnificus Infection- At the time of presentation, hemorrhagic bullae measuring 3.5 by 4.5 cm had developed on the palm of his left hand (Panel A), and erythematous swelling with confluent tense bullae and ecchymoses had developed on the dorsum of the hand and forearm (Panel B). Surgical intervention was performed urgently, and Vibrio vulnificus was isolated from the bullae. Postoperatively, the patient received intravenous ceftazidime and ciprofloxacin. V. vulnificus can cause skin infections after wound exposure to contaminated seawater, as well as primary septicemia through the consumption of contaminated raw or undercooked seafood. Patients with immunocompromising conditions, including chronic liver disease and cancer, are at increased risk for infection and complications. #clinical #photo #NEJM #vibrio #vulnificus #bullae
Tinea Capitis in a Newborn- A 3-week-old male newborn was brought to the pediatrician with three large scalp lesions, which had appeared in the first week of life. The lesions were annular with raised papular and pustular borders and flat, hyperkeratotic central areas (Panel A). The baby’s mother, who was originally from Somalia, had similar skin lesions on her upper trunk. Scalp scrapings and a swab cultured on Sabouraud’s dextrose agar grew yellow-colored colonies with radiating hyphae (Panel B). Polymerase-chain-reaction assays of extracted DNA identified trichophyton species, and DNA sequencing revealed Trichophyton soudanense. Tinea capitis, a fungal infection of the scalp commonly known as ringworm, was diagnosed...The patient was initially treated with intravenous fluconazole and topical clotrimazole and octenidine therapy; after 1 week of treatment, the lesions were resolving, leaving hyperpigmentation (Panel C). He was treated with oral fluconazole for an additional 2 weeks. #clinical #photo #NEJM #tinea #capitis #ringworm #derm
Pseudomonas Toenail Infection
Green nails = infection with a bacteria called “Pseudomonas”. Not all bacterial infections are green, only the ones caused by Pseudomonas. (Dr. Harvey Lui and University of British Columbia)
What: When nails appear green in colour, this could be due to a bacteria called pseudomonas. The bacteria, which creates a green pigment, typically affects people who often submerge their nails in water, such as a dishwasher.
What to do: See a doctor who can treat the condition with diluted bleach.
#Pseudomonas #Toenail #Infection #Clinical #Photo #Podiatry #Dermatology
Mycoplasma pneumoniae–Associated Mucositis- ...severe mucositis developed that involved the lips, buccal mucosa (Panel A), conjunctivae, and urethral meatus...Testing for Mycoplasma pneumoniae by PCR of the nasopharyngeal aspirate and for serum IgM antibody was positive. Mycoplasma is commonly associated with exanthems. In this case, the clinical presentation was consistent with Mycoplasma pneumoniae–induced erythema multiforme, also referred to as mycoplasma-induced rash and mucositis. Given the severity of the mucosal involvement, a nasogastric tube was placed for nutrition and for administration of medications. After approximately 2 weeks of treatment with doxycycline, the patient had complete resolution of his respiratory illness and mucositis (Panel B). #clinical #photo #NEJM #mycoplasma #pneumoniae #mucositis #erythema #multiforme
