Herpes Zoster (Shingles)

The following illustration presents a very quick review of VZV infection causing Herpes Zoster, also known as “shingles”. Quick reminder about pain management: Do not forget that the most effective strategy to prevent pain complications is early treatment of infection with antiviral drugs. If pain is already established, the recommendation is treating the acute phase…

Novel coronavirus 2019-nCoV associated pneumonia

A new strain of Betacoronavirus, similar to the one from bats causing an ourbreak of SARS in 2003, has been identified in Wuhan, Hubei – China. The following illustration is a summary of data from a very small study made of 41 patients only, initially infected with the new Coronavirus in Wuhan. This data was…

Meralgia paresthetica

Check the following illustrations out. A patient comes for your help due to thigh pain. It hurts in a clearly demarcate area on the anterior and lateral region of her thigh. Pain is of a burning quality. Numbness is also felt. No motor abnormalities. Patient is overweight and has been wearing a very tight belt…

Causes of upper gastrointestinal bleeding, part II: vascular abnormalities.

Upper GI also happens due to vascular abnormalities in the gastric and duodenal mucosa. Let’s review three: 1. Angiodysplasia (most common), 2. Dieulafoy’s lesion (associated with cardiovascular disease and NSAID use) and 3. GAVE -gastric antral vascular ectasia, associated with congestive gastropathy (due to portal hypertension, for example). Hope you enjoy learning and reviewing from…

Causes of upper gastrointestinal bleeding, part I

The following illustrations are a summary of some of the causes of upper GI in adults. Ulcer related, erosive and variceal (portal hypertensive related and non portal HT related) are included: The second part will include vascular causes, such as Deulafoy lesion and GAVE (gastric antral vascular ectasia). See ya next time! Augusto Saldaña M.D.

Pulmonary embolism / Tromboembolismo pulmonar

Think about it whenever you have a patient who presents with abrupt unexplained shortness of breath, tachypnea and tachycardia, specially in the setting of deep venous thrombosis, recent surgery, having to wear a cast on the leg, prolonged immobilization (like after a long trip), or active cancer. After a careful examination, you may find out…

Community acquired pneumonia / Neumonía adquirida en la comunidad.

Diagnosis will be based on the clinical presentation and the results from a plain chest x-ray. There are very sensitive and specific symptoms and signs that will form a “constellation” most associated with pneumonia. X-ray will then confirm the suspicion. Although, it must be said that older patients my have different signs and symptoms like…

Infective endocarditis diagnostic criteria / Endocarditis infecciosa, criterios diagnósticos.

Criteria can be quickly summarized in: Major clinical criteria (or pathological criteria) – Evidence of either valve damage or evidence of microorganisms within the bloodstream: Positive ecocardiography for infective endocarditis: vegetation, abscess, dehiscence of prosthetic valve. 2 separated positive blood cultures for typical IE microorganisms, or a single one for Cox. Burnetti. Minor clinical criteria…

Acute calculous cholecystitis / Colecistitis aguda calculosa.

Acute cholecystitis (inflammation of the gallbladder) results from injury from a gallstone, like impactation or cystic duct obstruction. Sometimes inflammation occurs without gallstone disease due to infection of bile (acalculous cholecystitis). The main difference between a patient who complains from abdominal pain and suffers from uncomplicated gallstone disease and acute cholecystitis is the evidence of…