{"id":1591,"date":"2007-12-15T07:58:00","date_gmt":"2007-12-15T11:58:00","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=1591"},"modified":"2007-12-15T11:22:22","modified_gmt":"2007-12-15T15:22:22","slug":"dress-sindrome-de-hipersensibilidad-a-la-dapsona","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/1591","title":{"rendered":"DRESS: Sindrome de hipersensibilidad a la Dapsona"},"content":{"rendered":"<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2007\/10\/180\/sem1.jpg\" title=\"sem1.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2007\/10\/180\/sem1.miniatura.jpg\" alt=\"sem1.jpg\" width=\"128\" height=\"102\" align=\"left\" \/><\/a><strong>Presentado por:<\/strong><strong><br \/> Qui\u00f1onez-Chah\u00edn J, Graterol F, Dur\u00e1n Y, Rodr\u00edguez Z, Ortega J, Oliver M, Vielma H. P\u00e9rez-Alfonzo R.<\/strong>&nbsp; <\/p>\n<ul>\n<li>\n<p>R.O. \tFemenino, \t46 a\u00f1os, Natural y procedente: Caracas,<\/p>\n<\/li>\n<li>\n<p>Enfermedad actual comienza en \tEnero 2007: <strong>Fiebre, <\/strong><strong>Erupci\u00f3n \tmaculo popular, <\/strong><strong>Placas eritematosas, <\/strong><strong>Edema \tfacial, Disuria y flujo vaginal f\u00e9tido<\/strong><\/p>\n<\/li>\n<\/ul>\n<p> &nbsp;   <!--more--> <\/p>\n<ul>\n<li>\n<p><strong>ANTECEDENTES PERSONALES:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>Hospitalizaci\u00f3n \tanterior por P\u00e9nfigo Vulgar  (30\/10 al 24\/11\/06)<\/strong><\/p>\n<\/li>\n<li>\n<p><span><strong>En \ttratamiento con: Prednisona: 20 mg\/d\u00eda., Dapsona: 50 mg\/d\u00eda \t(Dic. 2006).<\/strong><\/span><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>IMPRESION DIAGNOSTICA:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>S\u00edndrome de \tStevens- Johnson.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>P\u00e9nfigo \tvulgar CONTROLADO.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Deshidrataci\u00f3n \tleve. <\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Candidiasis oral.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Infecci\u00f3n \tgenitourinaria a descartar.<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>PLAN DE TRABAJO:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>Hospitalizar.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Hidrataci\u00f3n \tEV.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>OMITIR DAPSONA.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Ranitidina: 50 mg \tVEV cada 8 horas.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Clorfeniramina: 10 \tmg VEV cada 8 horas.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Prednisona: 40 mg VO diario.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Esteroides \tt\u00f3picos.<\/strong><\/p>\n<\/li>\n<li>\n<p><span><strong>Soluci\u00f3n \t<\/strong><\/span><span><em><strong>Wonder <\/strong><\/em><\/span><span><strong>(nistatina, \tdifenhidramina, hidrox. Alum, lidocaina viscosa)<\/strong><\/span><\/p>\n<\/li>\n<li>\n<p><strong>Acetaminofen: 500 mg VO cada 6 \thoras SOS fiebre.<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>PLAN DE TRABAJO:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>I\/C Medicina \tInterna<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>I\/C Infectolog\u00eda\t \t     E.I.P Clindamicina  VEV<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>I\/C Ginecolog\u00eda\t<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>EX\u00c1MENES \tCOMPLEMENTARIOS:<\/strong><\/p>\n<\/li>\n<\/ul>\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"447\">\n<tr valign=\"top\">\n<td width=\"110\" height=\"24\">&nbsp;<\/td>\n<td width=\"112\">\n<p><strong>11\/01\/07<\/strong><\/p>\n<\/td>\n<td width=\"112\">\n<p><strong>12\/01\/07<\/strong><\/p>\n<\/td>\n<td width=\"112\">\n<p><strong>15\/01\/07<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n<p><span><strong>*<\/strong><\/span><span><strong>Se evidencian linfocitos at\u00edpicos<\/strong><\/span><\/p>\n<ul>\n<li> <\/li>\n<li>\n<p><strong>EX\u00c1MENES \tCOMPLEMENTARIOS:<\/strong><\/p>\n<\/li>\n<\/ul>\n<table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"394\">\n<tr valign=\"top\">\n<td width=\"76\" height=\"20\">&nbsp;<\/td>\n<td width=\"79\">\n<p><strong>11\/01\/07<\/strong><\/p>\n<\/td>\n<td width=\"79\">\n<p><strong>12\/01\/07<\/strong><\/p>\n<\/td>\n<td width=\"79\">\n<p><strong>15\/01\/07<\/strong><\/p>\n<\/td>\n<td width=\"79\">\n<p><strong>16\/01\/07<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n<p><strong>VIH: negativo<\/strong><\/p>\n<p><strong>VDRL: no reac.<\/strong><\/p>\n<p><strong>PT: 0,94<\/strong><\/p>\n<p><strong>PTT: +0,3<\/strong><\/p>\n<ul>\n<li>\n<p><strong>UROANALISIS: \tDentro de l\u00edmites normales.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>UROCULTIVO:Negativo \ta las 48 horas.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>RX DE T\u00d3RAX:Dentro \tde l\u00edmites normales.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>ECOSONOGRAMA ABDOMINOP\u00c9LVICO: \t<\/strong><span><strong>Normal<\/strong><\/span><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>DIAGNOSTICOS DE EGRESO:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>Reacci\u00f3n \tmedicamentosa:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>Sindrome de \thipersensibilidad a la Dapsona (SHD-DRESS)<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>Penfigo Vulgar  \tCONTROLADO<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>TRATAMIENTO:<\/strong><\/p>\n<\/li>\n<\/ul>\n<ul>\n<li>\n<p><strong>Azatioprina: 50 \tmg\/d\u00eda.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Disminucion \tgradual de Prednisona.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Omeprazol.<\/strong><\/p>\n<\/li>\n<li>\n<p><strong>Lubricaci\u00f3n.<\/strong><\/p>\n<\/li>\n<\/ul>\n<p>&nbsp;Descargue la presentaci\u00f3n fotogr\u00e1fica en formato PowerPoint en el siguiente v\u00ednculo:<\/p>\n<table cellspacing=\"0\" cellpadding=\"0\">\n<tr>\n<td><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/mail.google.com\/mail\/images\/ppt.gif\" width=\"16\" height=\"16\" \/><\/td>\n<td width=\"7\">&nbsp;<\/td>\n<td><strong>caso de dres fotos.ppt<\/strong><br \/> 464K <a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2007\/10\/180\/caso-de-dres-fotos.ppt\" target=\"_blank\">Ver Presentaci\u00f3n<\/a> <\/td>\n<\/tr>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por: Qui\u00f1onez-Chah\u00edn J, Graterol F, Dur\u00e1n Y, Rodr\u00edguez Z, Ortega J, Oliver M, Vielma H. P\u00e9rez-Alfonzo R.&nbsp; R.O. Femenino, 46 a\u00f1os, Natural y procedente: Caracas, Enfermedad actual comienza en Enero 2007: Fiebre, Erupci\u00f3n maculo popular, Placas eritematosas, Edema facial, Disuria y flujo vaginal f\u00e9tido &nbsp;<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[],"class_list":["post-1591","post","type-post","status-publish","format-standard","","category-caso-de-la-semana"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/1591","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=1591"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/1591\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=1591"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=1591"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=1591"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}