PA01 Crusted nodules in returning travellers
نویسندگان
چکیده
Abstract We present the cases of two brothers, aged 10 and 13 years, who, on returning from a 6-week holiday in Sri Lanka, presented to emergency department with painful, pruritic crusted nodules. Both children were usually fit well, up date their childhood immunizations; older brother had background mild eczema. On examination, there multiple widespread 1–2 cm well-defined, superficial excoriated ulcers overhanding edges. These over arms, legs, back feet younger brother, lower legs brother. There was no history prodromal illness, they remained afebrile throughout, evidence lymphadenopathy or systemic illness. Bacterial wound swabs demonstrated Corynebacterium diphtheriae. Real-time polymerase chain reaction confirmed presence TOX, followed by Elek test, which expression diphtheria toxin, confirming diagnosis cutaneous due toxigenic strain. treated empirically intravenous flucloxacillin clindamycin as inpatients. clinically well discharged home oral co-amoxiclav for total further days. Public Health informed this notifiable disease, contact tracing appropriate family screening performed. Our patients isolated appropriately made full recovery, negative swabs. Historically, most have been caused C. diphtheriae (a Gram-positive nonencapsulated, nonsporulating, nonmotile bacillus) an incubation period 2–7 days, although other strains, notably ulcerans, become increasingly prevalent. Despite being classically described respiratory England data found that nearly two-thirds infections presentation. Concurrent infection are rare. Either form can be nontoxigenic strains; former may result toxic complications (such myocarditis, polyneuritis, septic arthritis, osteomyelitis death); however, these rare diphtheria, even if TOX-positive. Systems review our did not highlight any features patients. exemplify classic raise important reminder consider endemic areas, despite vaccination schedules place.
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ژورنال
عنوان ژورنال: British Journal of Dermatology
سال: 2023
ISSN: ['1365-2133', '0007-0963']
DOI: https://doi.org/10.1093/bjd/ljad113.306