{"id":387,"date":"2007-05-04T15:43:55","date_gmt":"2007-05-04T19:43:55","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=387"},"modified":"2007-05-04T15:44:03","modified_gmt":"2007-05-04T19:44:03","slug":"lesiones-purpuricas-con-cefalea-fiebre-dolor-retro-esternal-mal-estado-general-en-un-paciente-proceente-del-estado-portuguesa","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/387","title":{"rendered":"Lesiones p\u00farpuricas con cefalea, fiebre, dolor retro-esternal, mal estado general, en un paciente proceente del Estado Portuguesa"},"content":{"rendered":"<p><strong>Reto Diagnostico\/Reto terap\u00e9utico<br \/> Presentado por<br \/> Rolando Hern\u00e1ndez P\u00e9rez (Dermat\u00f3logo)<br \/> Rafael D\u00e1vila (Internista)<br \/> Edgar Hurtado Quintero (Epidemi\u00f3logo)<br \/> Hospital General &ldquo;Dr. Luis Razetti. Barinas&rdquo;<\/strong><br \/> &nbsp;<\/p>\n<p> Paciente de 31 a\u00f1os de edad, agricultor, procedente del Estado Portuguesa, quien es referido del ambulatorio rural por fiebre alta, cefalea, mialgias generalizadas, v\u00f3mito, diarreas liquidas abundante, deshidrataci\u00f3n moderada, dolor retro-esternal de fuerte intensidad no irradiado, tos intensa, lesiones purp\u00faricas (petequias y equimosis en piel y mucosas) con 6 d\u00edas de evoluci\u00f3n. (<font color=\"#009933\">Favor ver foto cl\u00ednica: DSCOO584.jpg &ndash; DSCOO585.jpg &ndash; DSCOO586.jpg &ndash; DSCOO587.jpg &ndash; DSCOO588.jpg<\/font>)&nbsp;&nbsp;<\/p>\n<p><!--more--><a href=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00584.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00584p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00585.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00585p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00586.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00586p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00587.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00587p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00588.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/05\/153\/DSC00588p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a> <\/p>\n<p>A las 24 horas de su ingreso empeor\u00f3 con hemorragia profusa de las enc\u00edas, ampollas hemorr\u00e1gicas en boca, melena y generalizaci\u00f3n del cuadro purp\u00farico con zonas amplias de equ\u00edmosis en tronco y extremidades inferiores, peque\u00f1as \u00e1reas de necrosis, edema facial moderado.&nbsp; Petequias no palpable. Desorientaci\u00f3n y alucinaciones.<\/p>\n<p> RX: infiltrado fino en ambos campos pulmonares.<\/p>\n<p> Laboratorio convencional: leucopenia\/linfocitosis&nbsp; (3.400 blancos)&nbsp; y trombocitopenia 36.000 plaquetas) Hb: 11 g%- Hto: 32% VSG: 38 mm (1&deg; hora) Resto dentro de la normalidad<\/p>\n<p> Ingresa como&nbsp; 1) fiebre hemorr\u00e1gica viral.<\/p>\n<p> &iexcl;Cual es su comentario?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Reto Diagnostico\/Reto terap\u00e9utico Presentado por Rolando Hern\u00e1ndez P\u00e9rez (Dermat\u00f3logo) Rafael D\u00e1vila (Internista) Edgar Hurtado Quintero (Epidemi\u00f3logo) Hospital General &ldquo;Dr. Luis Razetti. Barinas&rdquo; &nbsp; Paciente de 31 a\u00f1os de edad, agricultor, procedente del Estado Portuguesa, quien es referido del ambulatorio rural por fiebre alta, cefalea, mialgias generalizadas, v\u00f3mito, diarreas liquidas abundante, deshidrataci\u00f3n moderada, dolor retro-esternal de &hellip;<\/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-387","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\/387","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=387"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/387\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=387"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=387"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=387"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}