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This is a 20-year-old male patient, resident in the urban area of Medellín, student, who consulted for a spot on the right palm, asymptomatic, of two months of evolution, without previous treatment, with a single hyperpigmented macule, dark grey, without desquamation, measuring 2 cm x 1 cm, on physical examination. At ... | [
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We present the case of an 11-year-old boy from Gambia who consulted for macroscopic haematuria predominantly at the end of micturition and dysuria of one year's duration; with no history of fever. On taking the medical history, the patient reported a recent trip to his country of origin and several baths in lakes in th... | [
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A 59-year-old woman from China. No relevant medical history. She presented with fever and emesis of 10 days evolution. Last trip to China 1 year ago. No other epidemiological or exposure data of interest.
Laboratory alteration of the liver profile (Bilirubin 2.6 mg/dL and hypertransaminasemia). Isolation of Klebsiella ... | [
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47-year-old male, resident of Cariari in Pococí de Limón. Carrier of type 2 diabetes mellitus, hypertension and chronic liver disease with Child Pugh B clinical stage, secondary to hepatitis B virus infection, with portal hypertension, oesophageal varices and hypersplenism.
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This is a male newborn with a perinatal history of euthecological delivery, gestational age 40 weeks, Apgar 9/9 stitches, Apgar 9/9 stitches. 2 weeks, Apgar 9/9 points and a weight of 3640 grams, who was discharged from the puerperium service at 72 hours of life and at 12 days of age is received in the Neonatology serv... | [
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Anamnesis
No family history of note.
Personal history: no known drug allergies. No toxic habits.
Dyslipidaemia. Stage V chronic kidney disease secondary to juvenile polycystic kidney disease. He started renal replacement therapy in 1991. First kidney transplant from a related living donor (mother) on 16/4/1991, and st... | [
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A 67-year-old man was admitted with fever, cough, nasal congestion, sore throat and diarrhoea, 20 months after an uncomplicated heart transplant. He was not hypoxic.
A chest CT scan showed peripheral, multifocal, bilateral ground-glass opacities. The white blood cell count was 4720/ml, with a lymphocyte count of 1040/... | [
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A 42 year old male traveller from Catalonia who made a 6 month trip (first half of 2001) to South America. He started his trip in the south of Argentina, then in Chile and Bolivia, ending with a month and a half in the Peruvian Amazon, specifically in Iquitos. He came to the clinic with a three-week history of symptoms... | [
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Child aged 6 weeks (March 2014).
Reason for consultation: presence of nasal mucus and cough since 3 weeks of life. During the last week there were more intense coughing spells at night, accompanied by peribuccal cyanosis on some occasions. Afebrile. No other symptoms reported.
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45-YEAR-OLD FEMALE PATIENT who comes to the clinic referred by her general dentist to evaluate the periodontal status of her mouth. The main reason for the patient's consultation is: I have noticed bad breath, bleeding and inflammation for the last 4 years despite having been undergoing periodontal treatment for 3 year... | [
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We present the case of a 45-year-old man who presented to the emergency department with progressive dyspnoea for approximately two weeks accompanied by palpitations. He worked in a florist's shop and reported no past history of interest. He denied recent travel or exposure to environmental toxic agents. Physical examin... | [
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BACKGROUND:
77-year-old woman, allergic to metamizole, and with medical history of arterial hypertension, type 2 diabetes mellitus (insulin-dependent), permanent atrial fibrillation and asmabronchial. Under follow-up by cardiology for rheumatic mitral valve disease with severe mitral stenosis operated by surgical commi... | [
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HISTORY, CURRENT DISEASE AND PHYSICAL EXAMINATION
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History
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Stage III chronic renal failure secondary to vesicoureteral reflux Current illness The patient reported fever and vomiting for 3 days, general malaise, generalised aches and pains, dystrophic sensation, chills, sweating and vomiting.
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A 43-year-old man with no previous history, referred from Ophthalmology for bilateral vitritis of probable infectious aetiology. He reported weight loss for a year without asthenia or anorexia and self-limited catarrhal symptoms a week earlier. She reported risky sexual relations 6 months earlier.
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We present the case of a 16-year-old male patient presenting for consultation due to pubertal and growth retardation.
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Father and brother with normal height and puberty. Maternal grandfather died of glioblastoma.
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Reason for consultation
A 45 year old man came for consultation, referred by his neurologist who was studying him for insomnia. The patient reports that for a couple of years he has barely been able to fall asleep "no more than two hours a day". He reports marked insomnia of conciliation and maintenance, to such an ext... | [
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58-year-old male, no known drug allergies with a history of hypertension. Smoker and active drinker. Cocaine user and presumably other intoxicants. He had liver cirrhosis of mixed aetiology (HCV genotype 3A infection, never treated, and enolism) with a Child Pugh 12-C and multiple hydropic decompensations, the first in... | [
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JANF, 15 years old, male, from a community located at KM-17 of the AM-010 highway, municipality of Manaus (AM). In August 2007, he presented with fever, palpitations, dyspnoea and chest pain. The patient reported ingestion of açaí juice from the municipality of Coari in the same locality as the infection pathway descri... | [
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Reason for consultation
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Individual approach (anamnesis, examination, complementary tests).
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No RAMS. Cardiac rhabdomyoma in infancy which was not found. Mixed headache. No usual treatment.
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A 52-year-old man presented to our emergency department reporting fever, cough, asthenia, headache, myalgia and photophobia for a week. He stated that he had not travelled in recent months, but reported contacts with several Chinese (none of them with a history of nCoV-19 infection) and Italian persons from the city of... | [
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A 62-year-old male patient, farmer, previously healthy, resident of the province of Santiago del Estero, was admitted to the emergency room with mild trauma and a fracture of the right femur as a result of a road accident (motorbike).
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A 59-year-old man with no drug allergies. Ex-smoker with a pack-year index (PPI) of 15 and active ethylism. Morbid obesity and arterial hypertension. History of liver transplant in 2014 for alcoholic cirrhosis, currently on immunosuppressive treatment with everolimus.
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Alba Vargas first consulted our mental health team at the age of 28. She had had previous sporadic contact with mental health professionals, at the ages of 15 and 17, for parasuicidal behaviour through the use of medication. She was the third of seven siblings. She had lived for years in... | [
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Cough.
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Tyrosine kinase inhibitors (TKIs) have been a revolution in the treatment of patients with EGFR-mutated non-small cell lung cancer. However, their use is not without risks, some of them life-threatening.
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A 32-year-old man, with no pathological history of interest and no previous treatment, operated on for tearing of the splenic hilum, mesentery of the jejunal root and superior mesenteric artery (SMA) due to trauma. Resection of the right colon, ileum and 2/3 of the jejunum with jejunostomy and splenectomy was performed... | [
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A 15-year-old male patient, with no toxic habits or known drug allergies, with a history of allergic rhinitis (grasses and olive trees). He was a student from a rural area. Twelve days prior to admission he presented a fever with odynophagia, being diagnosed by his family doctor as acute pharyngotonsillitis and receivi... | [
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We describe the case of a 91-year-old woman, type 2 diabetic treated with oral hypoglycaemic agents, hypertensive, and previously dependent on physical activities of daily living after an ischaemic stroke. The family reports that the patient has presented with vomiting, hypogastric pain and haematuria in the last 15 da... | [
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Reason for consultation
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We present the case of a patient who developed Cotard's syndrome in the early puerperium, having had a pregnancy marked by severe anxiety and ended early by caesarean section.
IDENTIFICATION OF THE PATIENT
- Pregnant woman, 26 years old, married, one child of 3 years, one previous miscarriage.
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A 36-year-old woman with restrictive-purgative anorexia nervosa and unfavourable evolution; DM1 with poor metabolic control, without complications; primary hypothyroidism; focal epilepsy with complex partial seizures and autolytic attempt with caustic ingestion with oesophageal stenosis requiring right oesophagoplasty ... | [
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A 5-month-old boy was seen in the emergency department on 2 occasions for vomiting, poor general condition, decreased level of consciousness, hypotonia and skin pallor lasting 30 minutes, which started 2 hours after eating gluten-free cereal porridge. During the first episode, blood tests, cranial CT scan and lumbar pu... | [
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A 4-month-old male infant attended the emergency department for an episode of cutaneous pallor, abundant vomiting and intense weakness that started 2 hours after eating gluten-free cereal porridge. Complete resolution of the symptoms with supportive measures and discharge 4 hours later.
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Clinical history. Anamnesis
Male, 73 years old, included in the complex chronic programme for meeting categories C; COPD; D, chronic liver disease, and G; chronic anaemia.
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Anamnesis
A 57 year old patient with no drug allergies, ex-smoker for 20 years, whose personal history included: spontaneous pneumothorax in 1992, lumbosciatica at L4-L5 level with some transitory episodes of sensory alteration. A traffic accident a year and a half ago with no sequelae, and varicocele surgery in childh... | [
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A 73-year-old man with the only relevant history of cirrhosis due to hepatitis C virus under follow-up by the Digestive Department, with good liver function (Child-Turcotte-Pugh class A). HCC was diagnosed at one of the check-ups in May 2008. He was initially managed by the Digestive Department with radiofreq... | [
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A 25-year-old female patient diagnosed with inflammatory bowel disease and under treatment with infliximab attended the Emergency Department for right rib pain, fever and dyspnoea. It was decided to admit her for ceftriaxone and levofloxacin, considering that this was severe pneumonia in an immunocompromised patient.
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A 73-year-old male patient with a history of brucellosis, hyperuricaemia and hypercholesterolaemia was admitted to our department for scheduled surgery for benign prostatic hyperplasia. In the diagnostic study, a rectal examination revealed a prostate with adenomatous characteristics, very enlarged (G III/IV). A retrop... | [
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Medical history.
Anamnesis
We present the case of a 34-year-old man from Huelva, a crane operator by profession, with no family history of interest, no known cardiovascular risk factors or toxic habits, whose only relevant medical history was a fracture of the tibia and fibula at the age of 24 years.
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A 35-year-old port worker consulted for fever of up to 40oC for six days with general weakness, vomiting, diffuse abdominal pain, some diarrhoeal discharge, oliguria and jaundice. Personal history of tobacco and cannabis use and drinking (76 gr alcohol/day). He has not travelled abroad and has no contact with animals.
... | [
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68-year-old woman. She came to the emergency department with dyspnoea and fever of three days' evolution. Previously a week of general malaise with vomiting. Laboratory tests showed sepsis. An abdominopelvic CT scan after contrast shows reticulation adjacent to the head and uncinate process of the pancreas, suggestive ... | [
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A 10-year-old girl with a history of idiopathic hypercalcaemia, renal lithiasis and hypertension, who has been attended by the nephrology service since the age of 6 years and treated with hydrochlorothiazide, potassium citrate and vitamin D. She was referred for evaluation of the rash. She was referred for evaluation o... | [
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A 63-year-old patient with a history of permanent non-valvular atrial fibrillation, benign prostatic hypertrophy and high-grade intraurothelial bladder neoplasia. He had no known drug allergies or toxic habits and was receiving regular treatment with atenolol 50mg/24h, digoxin 0.25mg/24h, ASA 300mg/24h, omeprazole 40mg... | [
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Personal history
Male, 56 years old. No known drug allergies. No known cardiological history. Behçet's disease (pulmonary aneurysms in the right lung, surgery in 1995). Chronic hepatitis B. Home treatment: ASA 300 mg, peginterferon alfa 2a, entecavir.
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An 11-year-old girl presented with asthenia, weight loss and fever of 13 days' duration, with fever peaks every day, with no fixed time pattern. Examination revealed an asthenic habitus (weight P3-10) and thick, whitish mucus in the cavum, with the rest of the examination being normal.
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The patient was a 19 year old male who came for consultation brought by his relatives because of strange behaviour at home. All this had started after a high consumption of cannabis and alcohol, which provoked the sudden appearance of a psychotic episode. He was treated at his mental health centre for 4 months with neu... | [
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Male, 57 years old, smoker of 20 cigarettes a day for more than 40 years, moderate drinker and with a history of repeated dental infections without other medical-surgical diseases of interest. He presented with a rapidly progressive, non-brusque picture of approximately 72 hours of evolution, consisting of in... | [
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The patient is a 66-year-old woman, with no known drug allergies and an active smoker of 7-8 cigarettes a day, with a cumulative rate of 19 pack-years. Independent for basic activities of daily living. Family history of cancer: mother died of pancreatic neoplasia at the age of 89 and father died of prostate n... | [
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Female, 41 years old. Smoker. Conversive disorder being treated by psychiatry. She came to the emergency department for the fifth time in 12 days due to intense and continuous holocranial headache that did not go away with the usual analgesia together with numerous vomiting. No fever. No other symptoms.
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Fever and impaired level of consciousness.
Individual approach
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Allergic to diclofenac.
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Patient: HIV/AIDS admitted to the Hospital del Instituto de Medicina Tropical ̈Pedro Kourí ̈ for presenting with lower respiratory symptoms with fluid interposition.
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An eight-year-old boy born and living in Sierra Leone consulted the Saint John of God Hospital in Sierra Leone because of a tumour on the lower eyelid of the left eye that had been present for about a month. The father reported a history of contact with papaya leaves.
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A 51 year old woman, allergic to penicillin and derivatives, with no other history of interest, who came to the emergency department due to the appearance of an erythematous, pruritic and slightly scaly plaque on the dorsum of the left hand. The patient was referred to the dermatology department. Physical examination r... | [
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A 21-year-old woman presented to the emergency department with left facial and neck swelling. She had presented eight days previously to another ED with fever, cough and dyspnoea and was diagnosed with COVID-19. Despite improvement of his respiratory symptoms, he presented with progressive unilateral swelling of the f... | [
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Anamnesis
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