Solved on Sermo: November 2019 edition

We’re back to bring you two interesting patient cases recently solved by our physicians. Keep reading to see how the power of the crowd can help patients’ across the world.

Case 1: High fever in a 4 year old

Pre-school female of 4 years who presented two weeks ago a very high fever of 39 and 40 ºC that repeated every 6 hours and sometimes with chills, accompanied by myalgias, abdominal pain and nasal congestion… she had a cough with phlegm and 6 days after her illness she had erythematous lesions, whole body skin rash with coryza and strawberry tongue, so a diagnosis of scarlet fever was made. It was indicated to take amoxicillin of 500 mgs, 5 cc every 12 hours. Treatment was completed after 8 days and a few days ago the fever returned but for a single day. The mother contacted a Venezuelan infectologist based in Chile who indicated serology for Eistein Barr which was negative. Sermo friends is it justified that the acute phase reactants were not made during the first days of the disease even though the patient had a high fever and had no precise diagnosis? Do you agree that it is a scarlet fever?

Total time until solved: 2 days
Total Comments: 45
Diagnosis: Scarlet fever

Member Comment:

Sermo Physical Medicine & Rehabilitation Physician: Scarlet fever is a bacterial disease typical of people who have strep throat. It is characterized by a bright red rash that affects most of the body, almost always accompanied by a sore throat and high fever. It is important to perform basic paraclinics in the acute stage, to confirm the diagnosis. Good case Dr. excellent images, I congratulate you.

Case 2: Injuries to both arms

23-year-old female patient, with a history of asthma who refers to the onset of current disease for 1 week when she presents papule-like lesions on the arms, erythematoses and prurigonoses, self-medicates with desloratadine and reports slight improvement of pruritus. Physical Exam: TA: 120/80 mmHg FC: 67 lpm FR: 16 rpm Skin: coin-shaped lesions are evident in both arms, itching, with meliceric scabs. Sermo colleagues, what do you think of this case? What would be the indicated treatment for this patient?

Total time till solved: 1 day
Total Comments: 12
Diagnosis: Numular eczema

Member Comment:

Sermo Anonymous User: It is numular eczema, with some impetiginized lesions. The treatment with diprogenta 2 times a day for 5 days will solve them completely.

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