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Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Mar 26, 2012.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    what is your diagnosis ?
     

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  2. dupuytren

    dupuytren Bronze Member

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    well:
    1st photo: the Oroya fever or Carriòn disease, a bartonellosis (by bartonella bacilliformis)
    2nd photo: circinate balanitis--> Reiter's disease
    3rd photo: keratoderma blenorrhagica --> Reiter's disease
    4th photo: It seems like a stevens Johnson syndrome

    So, if I'm not wrong:
    the patient is taken ill with the Oroya Fever, that has, among its complications, the possible overwhelming by some bacteria, including Salmonella. So the patient develops a salmonellosis, but unfortunately he is predisposed to develop also a Reactive Arthritis (caused by salmonella enteritidis and other bacteria), the so called Reiter's syndrome,that, besides the classic triad arthritis-urethritis-uveitis, can show itself also with balanitis circinata and keratoderma blenorrhagicum (showed in the photos). At last, the patient undergoes also a Stevens Johnson Syndrome, maybe due to the drugs he took: in fact, both antibiotics for salmonellosis, for instance trimethoprim+sulfamethoxazole or a quinolone (and ciprofloxacin is used also for the bartonellosis!) and anti-inflammatory drugs for Reiter's arthritis could lead to a SJS.

    bad luck: sometimes it's worse than you can imagine.
     

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  3. Rocket Queen

    Rocket Queen Super Moderator

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  4. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Answer : Reiter's disease
     

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