Eritema Infeccioso

Descripción General

• Eritema infeccioso: enfermedad causada por el parvovirus B19 Parvovirus B19 Primate erythroparvovirus 1 (generally referred to as parvovirus B19, B19 virus, or sometimes erythrovirus B19) ranks among the smallest DNA viruses. Parvovirus B19 is of the family Parvoviridae and genus Erythrovirus. In immunocompetent humans, parvovirus B19 classically results in erythema infectiosum (5th disease) or “slapped cheek syndrome.” Parvovirus B19, asociada con fiebre y un exantema característico
• Epidemiología:
  • La infección afecta a personas de todas las edades, pero es más frecuente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños de entre 3 y 15 años.
  • Los LOS Neisseria brotes ocurren comúnmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum escuelas y guarderías.
  • Las ocurrencias de infección son más frecuentes a fines del invierno y principios del verano.
• Si una persona es inmunocompetente, por lo general se le confiere inmunidad después de la infección.

Fisiopatología

Modo de transmisión

• Secreciones respiratorias a través de:
  • Saliva Saliva The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptyalin. Salivary Glands: Anatomy
  • Moco
  • Fómites
• Contacto con sangre o productos sanguíneos infectados
• Transmisión vertical/transplacentaria en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres no inmunes (puede provocar una infección congénita)

Incubación

El período de incubación es de 4–21 días.

Patogénesis

• Infección viral B19 inicial:
  • Entrada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tracto respiratorio superior → viremia Viremia The presence of viruses in the blood. Erythema Infectiosum (síntomas prodrómicos) 5–10 días desde la exposición
  • El virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology se propaga y es citotóxico para las células precursoras eritroides que se dividen rápidamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la médula ósea → ↓ transitoria de reticulocitos y anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types
  • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum individuos sanos: El efecto sobre la médula ósea no es clínicamente significativo.
  • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum individuos con condiciones hematológicas: ocurre anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types severa/crisis aplásica.
  • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes inmunocomprometidos, el estado virémico puede prolongarse.
• Erupción:
  • 2–5 días después, aparece una erupción malar eritematosa con palidez peribucal (“mejilla abofeteada”).
  • Seguida de erupción eritematosa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de encaje en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tronco y las extremidades
  • La aparición de erupción representa la resolución de la viremia Viremia The presence of viruses in the blood. Erythema Infectiosum (aparición de inmunoglobulina M ( IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions)) → no más síntomas constitucionales
  • Puede reaparecer semanas después, provocado por la luz solar, el estrés o el ejercicio.

Presentación Clínica

Síntomas prodrómicos iniciales ( viremia Viremia The presence of viruses in the blood. Erythema Infectiosum)

• Fiebre de bajo grado
• Cefalea
• Náuseas
• Diarrea
• Síntomas parecidos al AL Amyloidosis resfriado
• Prurito

Síntomas tardíos ( viremia Viremia The presence of viruses in the blood. Erythema Infectiosum resuelta)

• Días 2–5
• Erupción de color rojo rosado, principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las mejillas
  • Apariencia clásica de mejilla abofeteada
  • La erupción se extiende sobre el borde de la nariz o la boca.
• Erupción morbiliforme → reticulada (de encaje):
  • Parte superior de los LOS Neisseria brazos
  • Torso
  • Piernas
• Erupción más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños

Complicaciones

• Artritis:
  • Dolor Dolor Inflammation articular simétrico agudo (manos, rodillas, tobillos)
  • Más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adolescentes y adultos (mujeres > hombres)
  • Hasta el 10% de los LOS Neisseria niños pueden tener articulaciones rígidas.
  • Puede durar 3 semanas o más
  • Sin cambios articulares degenerativos
• Crisis aplásica transitoria:
  • Disminución rápida de eritrocitos
  • Visto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con enfermedad de células falciformes, esferocitosis y otras enfermedades hematológicas
  • Los LOS Neisseria pacientes presentan debilidad/letargo y palidez.
• Infección materna y efectos fetales:
  • Infección rara, pero grave (que conduce a la destrucción de eritrocitos fetales), especialmente cuando comienza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las 1as 20 semanas de embarazo
  • Hidropesía fetal: acumulación de líquido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria tejidos blandos y las cavidades serosas del feto asociada a un riesgo elevado de muerte fetal.
• Infección crónica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes inmunocomprometidos:
  • Estos pacientes no pueden desarrollar una respuesta inmune a la viremia Viremia The presence of viruses in the blood. Erythema Infectiosum, lo que aumenta el riesgo de infección crónica.
  • Produce aplasia Aplasia Cranial Nerve Palsies pura de eritrocitos (pronormoblastos gigantes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la médula ósea) y anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types grave (reticulocitos reducidos)

Diagnóstico y Tratamiento

Enfoque diagnóstico

• Diagnóstico basado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las características clínicas
• Pruebas adicionales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con signos y síntomas de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types:
  • Hemograma completo (la hemoglobina desciende 2 g/dl desde el valor inicial)
  • Recuento de reticulocitos disminuido
• Pruebas de anticuerpos IgG IgG The major immunoglobulin isotype class in normal human serum. There are several isotype subclasses of igg, for example, igg1, igg2a, and igg2b. Hypersensitivity Pneumonitis e IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions:
  • Para mujeres embarazadas
  • Pacientes con hemoglobinopatías/condiciones hemolíticas
  • Artropatía severa o persistente
  • No se utiliza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes inmunocomprometidos, ya que no pueden producir niveles detectables de anticuerpos
• En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes inmunocomprometidos con anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types pura de eritrocitos: la reacción en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cadena de la polimerasa ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)) para parvovirus B19 Parvovirus B19 Primate erythroparvovirus 1 (generally referred to as parvovirus B19, B19 virus, or sometimes erythrovirus B19) ranks among the smallest DNA viruses. Parvovirus B19 is of the family Parvoviridae and genus Erythrovirus. In immunocompetent humans, parvovirus B19 classically results in erythema infectiosum (5th disease) or “slapped cheek syndrome.” Parvovirus B19 detecta la infección.

Tratamiento

• Por lo general, es una enfermedad autolimitada y el tratamiento es, por lo tanto, de soporte.
• Crisis aplásica transitoria grave: puede ser necesaria una transfusión.
• Los LOS Neisseria pacientes inmunocomprometidos con infección crónica y anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types pueden necesitar:
  • Dosis reducida de agentes inmunosupresores
  • Tratamiento con inmunoglobulina intravenosa
  • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos graves, el trasplante de médula ósea

Prevención

• Prácticas generales de control de infecciones
• Se debe informar a las personas de alto riesgo sobre las medidas para evitar la exposición y cuándo buscar atención médica.

Diagnóstico Diferencial

• Hidropesía fetal: afección fetal grave que implica una acumulación de líquido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2 o más compartimentos fetales, que incluye ascitis, derrame pleural, derrame pericárdico y edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema de la piel. La condición conlleva un mal pronóstico para la supervivencia perinatal.
• Crisis aplásica: ocurre con una producción significativamente reducida de eritrocitos que da como resultado una rápida disminución en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el nivel de hemoglobina con reticulocitopenia. Con la infección por parvovirus B19 Parvovirus B19 Primate erythroparvovirus 1 (generally referred to as parvovirus B19, B19 virus, or sometimes erythrovirus B19) ranks among the smallest DNA viruses. Parvovirus B19 is of the family Parvoviridae and genus Erythrovirus. In immunocompetent humans, parvovirus B19 classically results in erythema infectiosum (5th disease) or “slapped cheek syndrome.” Parvovirus B19, la función de la médula generalmente regresa espontáneamente dentro de 1 semana.
• Artritis: trastorno articular caracterizado por dolor Dolor Inflammation y rigidez articular acompañado de otras manifestaciones como enrojecimiento, calor Calor Inflammation, edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema y disminución del rango de movimiento de las articulaciones.