The reason for driving a patient who is 41 years old to the Emergency Room of Hospital Auxilio Mutuo is the poorest of the poor. Without embarrassment the specialists are surprised by this unusual case and new diagnosis.
Belinda Z. Burgos
Agencia Latina de Noticias Medicina y Salud Pública
In an interview with Medicina y Salud Pública, la Dra. Sherli Marie Martínez Rodríguez, an internal medicine physician, narrated the conomed rheumatology procedure as dermatomyositis was presented in an atypical form in a patient with puberty.
In the case of Covid-19, the extra condition was left to the specialists to evaluate in the patient who was presented in the emergency room with poverty, pain, inflammation and marks in his skin during the years of manhood, then the first thought The medical team was treated by a new virus because of the new virus and infiltrations in the pulmonary feces.
Dermatomyositis is a common autoimmune disease that causes inflammation of the muscles that cause muscle fibers and skin. You can provoke cutaneous eruptions of redheads in the nudillos, around the eyes or in other parts of the body and you can be associated with other diseases such as lupus and rheumatoid arthritis.
“The patient suffers from generalized edema, which he has experienced recently. Sondeverbod, the law because it has been used to treat respiratory problems, or dysnea. And we are told that since April, the habit has caused some outbreaks in the body, there are problems in the articles and it is edible for him to visit different doctors who have not been able to do what he says in detail.
“As we are in the cohabitation pandemic, we think that ten cohabitation will be the only thing that will happen to the cohabitation. Realize the test and not covid, negative salió ”added.
A list of other analyzes reveals that the patient had Gottron’s papules, which were endorsed by the men. This manifestation is a characteristic of dermatomyositis. The patient has edema in the lungs, between the ovaries, the cuticle around the ounces is inflamed and the production is very painful.
“As these characteristics are the properties of dermatomyositis, we intend to look for the other characteristic that is classified in dermatomyositis, which is that the person has impairment in the proximal muscles.” tell the doctor. Sondeverbod, the patient does not reflect this condition as debilitespierd. Thus, the specialist concentrates on whether the patient reflects symptoms of a subclassification of the disease called amyotrophic dermatomyositis.
“Amiothrophytic dermatomyositis is due to having the characteristics of the skin and the pain per se with debilitation. It is 10 to 30% of all cases of dermatomyositis. The rarity is that the person does not have the disability geschierde ”profounded the Dra. Martínez Rodríguez.
In Puerto Rico there is no information, especially not the details of the person he sufrido esta enfermedad. Without embargo, in the United States, the pueden can present 1 to 6 people per one hundred thousand adults. The special of this case was that in addition to representing a subclass of the patient, the patient presented the characteristics that are very rare in both scenarios.
“It presents thrombocytopenia which is due to the plaques, it presents a condition in the hiccup, and it is presented with intensity in the pulmonary. It’s the most beautiful thing that can happen quickly, ”said Dra. Martínez.
There are dates that reflect atypical cases. However, due to the form in which it is presented in the patient, the Dra. Martínez indicates that due to the pulmonary lesion, the doctors also believe that the patient presents with a numbness or that the pulmonary is enveloped in the same dermatomyositis.
The test of evidence for determining the presence of bacteria in the patient and distinguishing them from laboratory tests that result in negative results, except for dates confirming that the patient suffers from a pulmonary disease, the doctors read the conclusion that the affection in the pulses is deba to a dermatomiositis attacking the pulmon.
This disease manifests itself in the patient, and affects other organs of its body, specifically the hygiene with the enzymes of the hygienic altar.
In summary and the most embarrassing for the specialists is that the muscular condition of this rheumatology nurse started causing deaths in other organs of the patient’s body.
“Empezamos a tratar y los pulmones empezaron a sanar. The regression regimen when the emphysema is treated with high-level asteroids, if it is bombarded with asteroids, is the anti-nuclear drug that attacks the immunological system to kill a smallpox. And so soon hicimos so the pulmon empezo to recover. “So, bottom line is that we’re really looking forward to it,” said Dra. Martínez.
When the patient is in this ward, he receives the assistance of an integrated multidisciplinary team of 7 doctors: a rheumatologist, an infectologist, a neurologist, an internist, a hematologist oncologist, a gastroenterologist and a doctor of physics and rehabilitation.
The clinical lesson for specialists is based on the importance of having an atypical case. In particular, it was noted that it is possible that dermatomyositis attacks the pulmonary, and the lethality is high and increases by 60%. “Enthusiasts that are important can quickly identify the type of dermatomyositis by this very thing, because we do not have any common understanding that it can be discarded and the consequence of this being the death of a patient. And again, these would mean that you have to spend for these processes. ” Martínez.
The patient will be able to recover from hospitalization during a month and a half. Inklusief, debido the complications the specialists llegaron to think that tendrian to entubar to the patient. But, not necessarily, and the patient sobrevivió in a panoramic complex, rare and unusual.
“Important is that these cases are also related to malignancy. She does not have a signal that she will have any cancer. ”Insisted the doctor.
La Dra. Martínez indicates that the problem is that rheumatologists generally treat their inflammation, which the patient expresses when the pain is one of them and the pain disappears, and the people are late in determining what causes it, diagnoses. Demonstration can complicate matters even more for the person who has some associated disease in this camp of health, especially if the patient suffers from unspecified illnesses.
Therefore, the internal medicine insisting that it is important that the persons assisted in their routine citations with the generalist, because they are the ones who are most familiar with the patient, can detect these manifestations and can refer the patient to the necessary specialist.
“There are many times more prevention than waiting for the consequences. The medicine works when we are pregnant and the general practitioner, our family medicine is what we have to treat them and give them to the specialist. Concluded the Dra. Martínez.