Erythema nodosum (EN) is a delayed hypersensitivity response that may be triggered by a range of conditions, including infections and vaccines. Rare cases of EN caused by COVID-19 were recently reported but none due t...Erythema nodosum (EN) is a delayed hypersensitivity response that may be triggered by a range of conditions, including infections and vaccines. Rare cases of EN caused by COVID-19 were recently reported but none due to COVID-19 vaccines were documented. We report here a case of EN occurring after COVID-19 vaccination. Patient presented with painful nodular lesions of all 4 limbs, evolving for one month. These lesions appeared 48 h after the second dose of COVID-19 vaccination. The patient reported no recent infectious episodes. The physical examination found numerous, erythematous dermohypodermatitis knots with no palpable adenopathy. Some were regressive according to biligenesis shades. Biology and radiology findings eliminated other common causes of this dermatosis. The skin biopsy was done and suggested EN. The final diagnosis was post COVID-19 vaccine EN. Patient received a symptomatic treatment and had a slight improvement of the lesions 10 days after diagnosis. Physicians should be aware of the side effects of the vaccine including skin manifestations, especially since more people are bound to be vaccinated.展开更多
Background:Leishmaniases are vector-borne diseases caused by the protozoa of the Leishmania genus.The clinical spectrum of these diseases extends from benign dermal lesions to visceral forms.In the Mediterranean regio...Background:Leishmaniases are vector-borne diseases caused by the protozoa of the Leishmania genus.The clinical spectrum of these diseases extends from benign dermal lesions to visceral forms.In the Mediterranean region,zoonotic visceral leishmaniasis(ZVL)is caused by L.infantum.If untreated within two years,the disease usually leads to death.In Morocco,ZVL is endemic in the north,with a hundred cases notified each year,mostly in children aged below five years.Here,we report on two clinical observations in infants presenting unusual concomitant VL and cutaneous leishmaniasis(CL)in Morocco.Case presentation:In this case study,we report on two infants aged nine and 12 months old.They both have a history of febrile splenomegaly,anemia,and pallor of mucous membranes.Visceral leishmaniasis was confirmed by parasitological diagnosis(positive bone marrow smear and screening of anti-L.infantum antibodies).However,the clinical examination also showed cutaneous lesions that suggested the presence of CL.This was reinforced by the patients having a history of living or traveling to endemic foci.Thus,direct examination,culture,and PCR-RFLP(ITS1-Hae 3)were carried out on the patients’dermal exudates.In one of the infants,CL was associated with L.infantum,while in the other it was associated with L.tropica.The infants were treated as according to the recommendations of the Ministry of Health.Both patients were cured in two months;defervescence,reduction of splenomegaly,and healing of cutaneous lesions were all observed.Conclusions:These singular patients illustrate the clinical polymorphism of CL and the necessity of updating the differential diagnosis of leukemia-like syndromes,including VL,in children living in or travelling to known endemic areas.These observations suggest a change in the Mediterranean VL phenotype that may be associated with CL.展开更多
文摘Erythema nodosum (EN) is a delayed hypersensitivity response that may be triggered by a range of conditions, including infections and vaccines. Rare cases of EN caused by COVID-19 were recently reported but none due to COVID-19 vaccines were documented. We report here a case of EN occurring after COVID-19 vaccination. Patient presented with painful nodular lesions of all 4 limbs, evolving for one month. These lesions appeared 48 h after the second dose of COVID-19 vaccination. The patient reported no recent infectious episodes. The physical examination found numerous, erythematous dermohypodermatitis knots with no palpable adenopathy. Some were regressive according to biligenesis shades. Biology and radiology findings eliminated other common causes of this dermatosis. The skin biopsy was done and suggested EN. The final diagnosis was post COVID-19 vaccine EN. Patient received a symptomatic treatment and had a slight improvement of the lesions 10 days after diagnosis. Physicians should be aware of the side effects of the vaccine including skin manifestations, especially since more people are bound to be vaccinated.
文摘Background:Leishmaniases are vector-borne diseases caused by the protozoa of the Leishmania genus.The clinical spectrum of these diseases extends from benign dermal lesions to visceral forms.In the Mediterranean region,zoonotic visceral leishmaniasis(ZVL)is caused by L.infantum.If untreated within two years,the disease usually leads to death.In Morocco,ZVL is endemic in the north,with a hundred cases notified each year,mostly in children aged below five years.Here,we report on two clinical observations in infants presenting unusual concomitant VL and cutaneous leishmaniasis(CL)in Morocco.Case presentation:In this case study,we report on two infants aged nine and 12 months old.They both have a history of febrile splenomegaly,anemia,and pallor of mucous membranes.Visceral leishmaniasis was confirmed by parasitological diagnosis(positive bone marrow smear and screening of anti-L.infantum antibodies).However,the clinical examination also showed cutaneous lesions that suggested the presence of CL.This was reinforced by the patients having a history of living or traveling to endemic foci.Thus,direct examination,culture,and PCR-RFLP(ITS1-Hae 3)were carried out on the patients’dermal exudates.In one of the infants,CL was associated with L.infantum,while in the other it was associated with L.tropica.The infants were treated as according to the recommendations of the Ministry of Health.Both patients were cured in two months;defervescence,reduction of splenomegaly,and healing of cutaneous lesions were all observed.Conclusions:These singular patients illustrate the clinical polymorphism of CL and the necessity of updating the differential diagnosis of leukemia-like syndromes,including VL,in children living in or travelling to known endemic areas.These observations suggest a change in the Mediterranean VL phenotype that may be associated with CL.
