Biomedical-TeMU/CodiEsp_corpus · Datasets at Hugging Face

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An 18-month-old girl who consulted for a tick bite on her head detected 24 hours before.
The mother believes that it could happen 3-4 days before, because they made an exit to the country (April months).
Domestic animals (dogs or other pets) did not live with them.
The tick was removed manually and was about 5 mm in diameter.
On the day of the consultation, fever began and you noticed lumps in your head.
On examination, the patient was in good general condition, although irritable and somewhat declining.
In the left parietoccipital region, there was a rare anomaly of approximately 7 mm in diameter mild erythema.
The skull had multiple mastoid and cervical posterior diseases of small size between 1 and 1.5 cm in diameter, slightly painful to adenopation.
The rest of the examination was normal and there were no rashes.
Initially, an analytical test was requested to study tick bite and treatment with amoxicillin-clavulanic acid was recommended, thought about a possible overinfection of the sting.
Controlled afterwards, protein binding persisted, lymphadenopathy and fever persisted. Laboratory results showed leukocytosis with increased erythrocyte sedimentation rate (SV) up to 20 mm/h
The bad evolution of the clinical picture and due to suspicion of rickettsiosis, the case was consulted with the specialists in infectious diseases of our reference hospital and it was decided to treat with oral ciprofloxacin, requesting a new analytical with
The patient is followed up a week later, with persistent fever and good evolution of lymphadenopathies, which return slowly, only a small area of alopecia of about 2 cm in diameter persists.
The control laboratory showed a decrease in leukocytosis and SV.
The second serological test ten days later showed a titer of R. connori: IgG ≤ 1:40 and IgM 1:320.
No sample could be sent for R. slovaca study.
At two months the child was asymptomatic and serology showed lower titers against R. connori IgG 1:40 and IgM ≤ 1:40.
Male Emergency Department, one month old, with no personal history of interest, who came for the third time to the last week with partially consolable crying.
She had been diagnosed with infantile colic and standard measures were recommended.
Take exclusive breastfeeding.
In the last 48 hours she takes the shots worse, the crying, which was initially evening, she stays all day and the mother can't calm him in her arms since yesterday.
The patient remains afflicted and has an excellent general condition. He presents adequate gain, currently enjoys a weight of 4 kg. The physical examination reveals an evident abdominal distension towards a flaccid mass at a perium level
Refuses breastfeeding in the emergency department frankly and presents vomiting food.
With suspected intestinal obstruction, an abdominal X-ray is performed in which there is a marked abdominal silence (absence of gas) in the right hemiabdomen and mass effect with displacement of the left intestinal loops towards the hemiabdomen.
Ultrasound shows an image of approximately 9 x 8.7 x 7.9 cm at the centroabdominal level, which behaves as a large focal lesion occupying a space of cystic characteristics without vascular flow at color Doppler and multiloculated and multita.
1.
It was decided to transfer to a reference center for pediatric surgery.
An abdominal magnetic resonance imaging (MRI) study was completed, in which an intra-abdominal cystic mass of about 90 x 60 x 65 mm appears, located mainly in the right flank and the centroabdominal region.
It extends from the lower hepatic border, in front of the right kidney displacing intestinal structures to the left.
It is a multilocular mass with well-defined borders and walls, with multiple cystic components of different sizes.
The first diagnostic suspicion in a cystic lymphangioma of the mesentery.
1.
The patient underwent a midline laparotomy and a multicystic mass with white fluid content depends on the mesentery of a loop in the middle ileum.
The loop was resected and end-to-end anastomosis was performed.
The postoperative period, the first 24 hours in the Pediatric Intensive Care Unit (PICU) and the rest in the ward, has evolved without incidents and in eight days is sent home with adequate enteral tolerance and without complications.
Histopathological examination confirmed the diagnosis of cystic lymphangioma when a multiseptated cystic mass of approximately 5 cm in diameter with a white mesenchymal wall of 0.1 cm was observed.
An eight-year-old girl of bosian origin presented to our health center with intermittent vaginal bleeding and mucopurulent and malodorant vaginal discharge two months ago.
Physical examination revealed severe congestion and edema of the hymen and vulvar introitus.
The girl with her parents and a father-in-law uncle with her partner in the same house, and not in sexual abuse.
The patient was referred to the emergency department for differential diagnosis of vaginal foreign body and ruling out sexual abuse.
Gynecologic examination revealed a vaginal foreign body and vaginal exudate.
In turn, it was valued by the forensic physician of the daycare center, who issued a court ruling that ruled out signs of sexual abuse.
Vaginal exudate culture was positive for Shigella sonnei resistant according to the antibiogram to amoxicillin/clavulanic acid, penicillin and combination of gentamicin and amoxicillin/clavulanic acid susceptible trimpetoprim and cefoxime.
Coprocultive culture of perianal exudate and urine culture were also requested, which were negative.
It was decided to prescribe antibiotic treatment with cefuroxime axetil for ten days, with clinical manifestations and great clinical improvement, but without complete resolution, so the same treatment regimen was repeated, disappearing.
A 14-year-old male with a history of thrombopenia, who was referred to Neurologic Consultation/90 UI due to an increase in transaminases (up to 1864 IU/L), lactate dehydrogenase (LDH) 4
The patient reported being previously asymptomatic, except for mild asthenia when performing moderate exercise, such as running or climbing stairs, occasionally associated with cramps and myalgia.
Deepening the history, she reported having also presented an isolated episode of macroscopic hematuria after performing previous exercise.
The examination was normal.
An electroencephalogram, an electromyography and a muscular magnetic resonance of the lower extremities were performed, without showing alterations in any of these complementary tests.
A muscle biopsy showed myophosphorylase deficiency with no other added alterations.
The molecular study showed the presence of p.R50X (c.148C>T) and p.R490W (c.1468C>T) mutations in the compound heterozygosis diagnosis.
The patient was referred to nutrition and dietetics, prior to the dietary coupling two episodes of rhabdolysis that required admission to the pediatric intensive care unit.
Currently the patient is asymptomatic, with normal CPK values, following nutritional support guidelines and outpatient controls in Pediatric Neurology and Nutrition.
We report the case of a five-month-old infant who presented with progressive irritation for ten days.
Separate vomiting, no fever, or urine or stool changes
In recent days, the patient complained of abdominal discomfort and, on the same day as the consultation, presented with an exudative purulent discharge from the primary care clinic.
This was a full-term newborn with an adequate weight for gestational age.
She had a controlled pregnancy, without risk factors for infection.
The neonatal period was uneventful.
Omphalorrhexis stands out at 14 days of life, with a small residual granuloma that required cauterization with nitrate dexamethasone on two occasions.
There was no history of moist wound infection.
Upon arrival at the Emergency Department, physical examination revealed a red tumour with spontaneous voiding of pus in the obscure.
The adjacent area was erythematous and distended, without other inflammatory signs.
The rest of the examination was normal.
Vital signs were: temperature 36.1 °C, heart rate 139 bpm, blood pressure 98/51 mmHg and oxygen saturation 100% in room air.
1.
An analytical control with blood count showed leukocytosis with normal and biochemical formula with C-reactive protein (CRP) of 44 mg/l.
Antibiotic treatment with cloxacillin and umbilical exudate was initiated.
An abdominal ultrasound was performed 24 hours after admission, showing adjacent to the upper bladder area towards the infected urachus heterogeneous collection 5.5 × 2.5 × 2.4 cm, with a diagnosis of probable cyst.
Subsequently, Staphylococcus aureus was isolated in culture, maintaining treatment with cloxacillin with good evolution, disappearance of inflammatory signs and purulent secretion.
She was discharged six days after admission, with follow-up by Pediatric Surgery.
A ten-year-old boy presented to the emergency department with testicular pain of four hours duration.
He reported that, being previously well, he progressively complained of discomfort in the left testicle.
He did not report fever, previous trauma or voiding syndrome.
She had no personal or family history of interest.
The clinical examination was normal, except for the left testicle, which showed a slight increase in size, erythematous and discomfort with relief of pain with testicular ascent.
Located cream.
Two tests were performed: normal appearanceand normal appearance, without skin lesions.
Epididymitis and testicular torsion were ruled out by Doppler ultrasound to complete the testicular image compatible with left epididymitis.
As a casual finding, a 1.5 mm image of right intratesticular calcification was observed.
1.
Analgesia measures and recommendations were prescribed to minimize discomfort (elevation and retention), explaining the alarm signs before those who consult again.
And favorable.
Given the image of intratesticular calcification, pediatric consultations were scheduled for follow-up.
In the first two years of follow-up the asymptomatic patient has suffered no changes in the number or distribution of testicular microcalcifications, and no changes in testicular parenchyma echogenicity have been reported.
We will continue performing periodic clinical and laboratory controls to assess its evolution.
We report the case of a three-year-old girl who came to the Primary Care clinic for three days suffering from toothache and mild dental phlegmon, without fever.
1.
The examination revealed caries in the second molar of right lower milk, with mild inflammation and jaw pain.
It was decided to start antibiotic treatment with amoxicillin at high doses, and the dentist was indicated.
It is reviewed in consultation after four days.
Phlegmon and regional lymphadenopathy persist, but there is no pain.
It was decided to continue with the treatment and control.
After one week of treatment the phlegmon is more delimited and with pain, so it is derived to maxillofacial surgery.
That same afternoon she has fever, so she is referred to the emergency department, where they decide to treat amoxicillin plus clavulanic acid and go to the dentist.
At 20 days in primary care presents abscess in right submandibular edge, red, painful and suppurative.
She is referred back to the Emergency Department for drainage.
It drains and samples are taken for culture and pathology of the ulcerated cervical lesion.
Antibiotics were administered with ciprofloxacin.

An 18-month-old girl who consulted for a tick bite on her head detected 24 hours before.

The mother believes that it could happen 3-4 days before, because they made an exit to the country (April months).

Domestic animals (dogs or other pets) did not live with them.

The tick was removed manually and was about 5 mm in diameter.

On the day of the consultation, fever began and you noticed lumps in your head.

On examination, the patient was in good general condition, although irritable and somewhat declining.

In the left parietoccipital region, there was a rare anomaly of approximately 7 mm in diameter mild erythema.

The skull had multiple mastoid and cervical posterior diseases of small size between 1 and 1.5 cm in diameter, slightly painful to adenopation.

The rest of the examination was normal and there were no rashes.

Initially, an analytical test was requested to study tick bite and treatment with amoxicillin-clavulanic acid was recommended, thought about a possible overinfection of the sting.

Controlled afterwards, protein binding persisted, lymphadenopathy and fever persisted. Laboratory results showed leukocytosis with increased erythrocyte sedimentation rate (SV) up to 20 mm/h

The bad evolution of the clinical picture and due to suspicion of rickettsiosis, the case was consulted with the specialists in infectious diseases of our reference hospital and it was decided to treat with oral ciprofloxacin, requesting a new analytical with

The patient is followed up a week later, with persistent fever and good evolution of lymphadenopathies, which return slowly, only a small area of alopecia of about 2 cm in diameter persists.

The control laboratory showed a decrease in leukocytosis and SV.

The second serological test ten days later showed a titer of R. connori: IgG ≤ 1:40 and IgM 1:320.

No sample could be sent for R. slovaca study.

At two months the child was asymptomatic and serology showed lower titers against R. connori IgG 1:40 and IgM ≤ 1:40.

Male Emergency Department, one month old, with no personal history of interest, who came for the third time to the last week with partially consolable crying.

She had been diagnosed with infantile colic and standard measures were recommended.

Take exclusive breastfeeding.

In the last 48 hours she takes the shots worse, the crying, which was initially evening, she stays all day and the mother can't calm him in her arms since yesterday.

The patient remains afflicted and has an excellent general condition. He presents adequate gain, currently enjoys a weight of 4 kg. The physical examination reveals an evident abdominal distension towards a flaccid mass at a perium level

Refuses breastfeeding in the emergency department frankly and presents vomiting food.

With suspected intestinal obstruction, an abdominal X-ray is performed in which there is a marked abdominal silence (absence of gas) in the right hemiabdomen and mass effect with displacement of the left intestinal loops towards the hemiabdomen.

Ultrasound shows an image of approximately 9 x 8.7 x 7.9 cm at the centroabdominal level, which behaves as a large focal lesion occupying a space of cystic characteristics without vascular flow at color Doppler and multiloculated and multita.

1.

It was decided to transfer to a reference center for pediatric surgery.

An abdominal magnetic resonance imaging (MRI) study was completed, in which an intra-abdominal cystic mass of about 90 x 60 x 65 mm appears, located mainly in the right flank and the centroabdominal region.

It extends from the lower hepatic border, in front of the right kidney displacing intestinal structures to the left.

It is a multilocular mass with well-defined borders and walls, with multiple cystic components of different sizes.

The first diagnostic suspicion in a cystic lymphangioma of the mesentery.

1.

The patient underwent a midline laparotomy and a multicystic mass with white fluid content depends on the mesentery of a loop in the middle ileum.

The loop was resected and end-to-end anastomosis was performed.

The postoperative period, the first 24 hours in the Pediatric Intensive Care Unit (PICU) and the rest in the ward, has evolved without incidents and in eight days is sent home with adequate enteral tolerance and without complications.

Histopathological examination confirmed the diagnosis of cystic lymphangioma when a multiseptated cystic mass of approximately 5 cm in diameter with a white mesenchymal wall of 0.1 cm was observed.

An eight-year-old girl of bosian origin presented to our health center with intermittent vaginal bleeding and mucopurulent and malodorant vaginal discharge two months ago.

Physical examination revealed severe congestion and edema of the hymen and vulvar introitus.

The girl with her parents and a father-in-law uncle with her partner in the same house, and not in sexual abuse.

The patient was referred to the emergency department for differential diagnosis of vaginal foreign body and ruling out sexual abuse.

Gynecologic examination revealed a vaginal foreign body and vaginal exudate.

In turn, it was valued by the forensic physician of the daycare center, who issued a court ruling that ruled out signs of sexual abuse.

Vaginal exudate culture was positive for Shigella sonnei resistant according to the antibiogram to amoxicillin/clavulanic acid, penicillin and combination of gentamicin and amoxicillin/clavulanic acid susceptible trimpetoprim and cefoxime.

Coprocultive culture of perianal exudate and urine culture were also requested, which were negative.

It was decided to prescribe antibiotic treatment with cefuroxime axetil for ten days, with clinical manifestations and great clinical improvement, but without complete resolution, so the same treatment regimen was repeated, disappearing.

A 14-year-old male with a history of thrombopenia, who was referred to Neurologic Consultation/90 UI due to an increase in transaminases (up to 1864 IU/L), lactate dehydrogenase (LDH) 4

The patient reported being previously asymptomatic, except for mild asthenia when performing moderate exercise, such as running or climbing stairs, occasionally associated with cramps and myalgia.

Deepening the history, she reported having also presented an isolated episode of macroscopic hematuria after performing previous exercise.

The examination was normal.

An electroencephalogram, an electromyography and a muscular magnetic resonance of the lower extremities were performed, without showing alterations in any of these complementary tests.

A muscle biopsy showed myophosphorylase deficiency with no other added alterations.

The molecular study showed the presence of p.R50X (c.148C>T) and p.R490W (c.1468C>T) mutations in the compound heterozygosis diagnosis.

The patient was referred to nutrition and dietetics, prior to the dietary coupling two episodes of rhabdolysis that required admission to the pediatric intensive care unit.

Currently the patient is asymptomatic, with normal CPK values, following nutritional support guidelines and outpatient controls in Pediatric Neurology and Nutrition.

We report the case of a five-month-old infant who presented with progressive irritation for ten days.

Separate vomiting, no fever, or urine or stool changes

In recent days, the patient complained of abdominal discomfort and, on the same day as the consultation, presented with an exudative purulent discharge from the primary care clinic.

This was a full-term newborn with an adequate weight for gestational age.

She had a controlled pregnancy, without risk factors for infection.

The neonatal period was uneventful.

Omphalorrhexis stands out at 14 days of life, with a small residual granuloma that required cauterization with nitrate dexamethasone on two occasions.

There was no history of moist wound infection.

Upon arrival at the Emergency Department, physical examination revealed a red tumour with spontaneous voiding of pus in the obscure.

The adjacent area was erythematous and distended, without other inflammatory signs.

The rest of the examination was normal.

Vital signs were: temperature 36.1 °C, heart rate 139 bpm, blood pressure 98/51 mmHg and oxygen saturation 100% in room air.

1.

An analytical control with blood count showed leukocytosis with normal and biochemical formula with C-reactive protein (CRP) of 44 mg/l.

Antibiotic treatment with cloxacillin and umbilical exudate was initiated.

An abdominal ultrasound was performed 24 hours after admission, showing adjacent to the upper bladder area towards the infected urachus heterogeneous collection 5.5 × 2.5 × 2.4 cm, with a diagnosis of probable cyst.

Subsequently, Staphylococcus aureus was isolated in culture, maintaining treatment with cloxacillin with good evolution, disappearance of inflammatory signs and purulent secretion.

She was discharged six days after admission, with follow-up by Pediatric Surgery.

A ten-year-old boy presented to the emergency department with testicular pain of four hours duration.

He reported that, being previously well, he progressively complained of discomfort in the left testicle.

He did not report fever, previous trauma or voiding syndrome.

She had no personal or family history of interest.

The clinical examination was normal, except for the left testicle, which showed a slight increase in size, erythematous and discomfort with relief of pain with testicular ascent.

Located cream.

Two tests were performed: normal appearanceand normal appearance, without skin lesions.

Epididymitis and testicular torsion were ruled out by Doppler ultrasound to complete the testicular image compatible with left epididymitis.

As a casual finding, a 1.5 mm image of right intratesticular calcification was observed.

1.

Analgesia measures and recommendations were prescribed to minimize discomfort (elevation and retention), explaining the alarm signs before those who consult again.

And favorable.

Given the image of intratesticular calcification, pediatric consultations were scheduled for follow-up.

In the first two years of follow-up the asymptomatic patient has suffered no changes in the number or distribution of testicular microcalcifications, and no changes in testicular parenchyma echogenicity have been reported.

We will continue performing periodic clinical and laboratory controls to assess its evolution.

We report the case of a three-year-old girl who came to the Primary Care clinic for three days suffering from toothache and mild dental phlegmon, without fever.

1.

The examination revealed caries in the second molar of right lower milk, with mild inflammation and jaw pain.

It was decided to start antibiotic treatment with amoxicillin at high doses, and the dentist was indicated.

It is reviewed in consultation after four days.

Phlegmon and regional lymphadenopathy persist, but there is no pain.

It was decided to continue with the treatment and control.

After one week of treatment the phlegmon is more delimited and with pain, so it is derived to maxillofacial surgery.

That same afternoon she has fever, so she is referred to the emergency department, where they decide to treat amoxicillin plus clavulanic acid and go to the dentist.

At 20 days in primary care presents abscess in right submandibular edge, red, painful and suppurative.

She is referred back to the Emergency Department for drainage.

It drains and samples are taken for culture and pathology of the ulcerated cervical lesion.

Antibiotics were administered with ciprofloxacin.