Antonio Guerrero MD PhD
@guerreroespejo
Infectious diseases physician and clinical microbiologist | Valencia (Spain)
Ebola Bundibugyo: ➖3rd-largest outbreak ever. ➖>80% of new cases outside contact lists. ➖First vaccine in Phase I. ➖WHO: virus accelerating. #PublicHealth #Medicine www.afro.who.int/media-centre...
A 25-y-o♂️, 6 years earlier, treated for tuberculosis: 1-month of coughing up bloodstained sputum. XR: cavitary lesion (A, arrow) CT: biapical cavities (B &C, arrows) with a radiopaque, gravity-dependent ball (arrowheads) that moved in the supine (B) & prone (C) positions (Monod's sign) ½ #MedEd
West Nile virus infection in Europe: 48 cases reported to the WHO (Greece 21, Italy 21, Spain 2). 20 neuroinvasive cases, 13 hospitalizations. WHO urges mosquito surveillance. www.who.int/europe/news/... #EpidemiologicalSurveillance #Medicine
A 46-YO woman eating raw fish: intermittent colicky abdominal pain and 1 day of excretion of tapelike materials. Colonoscopy: a long, moving tapeworm, located in the terminal ileum and extending to the sigmoid colon ½ DOI: 10.1056/NEJMicm0810335 #Parasitology #MedEd #microbiology #medicine
#Hantavirus outbreak (Andes) on the M/V Hondius cruise ship, closed by the WHO (July 2, 2026). ➖ 13 cases, 3 deaths (23% fatality rate); ➖ Person-to-person transmission on board. Spain provided assistance in Tenerife. www.who.int/emergencies/... #EpidemiologicalSurveillance #Medicine
West Nile virus in Europe: 35 areas across 6 countries (Spain: 2). 2026 season intensifying; more cases expected. 📍Italy, Greece, Spain www.ecdc.europa.eu/en/publicati... #EpidemiologicalSurveillance #Medicine
Airport malaria (Frankfurt): 4 cases of *P. falciparum* in workers with no travel to endemic areas. Mosquito imported by aircraft. 📍Germany www.ecdc.europa.eu/en/publicati... #EpidemiologicalSurveillance #Medicine
Spread of explosive #diarrhea in U.S., caused by #Cyclospora cayetanensis, reveals weaknesses in food safety & distribution system More than 1,600 confirmed cases —compared with just 249 cases at the same point last year—& thousands more suspected 🖊️Escuela de Salud Pública Johns Hopkins Bloomberg
A 50-YO ♂️: a 1-month history of generalized pruritus, yellowish-brown flecks in the hair of the upper arm (A), chest, and axilla on the left side and in the pubic area. Dermoscopy (B,C): !? 1/2 DOI: 10.1056/NEJMicm0810134 #Parasitology #dermatology #MedEd #IDMedEd #microbiology #medicine
A 63-y-o ♂️ with recurrent aseptic #meningitis: fever, headache, scleral injection & nuchal rigidity. CSF: monocytic pleocytosis indicative of aseptic meningitis. Marked bilateral auricular swelling & redness developed (A). 1/2 DOI: 10.1056/NEJMicm0901800 #Neurology #IDX #MedEd #emergency
33-YO ♂️ rheumatic heart disease, replacement of the mitral & aortic valves: an acute onset of chest pain, diaphoresis. Cardiac catheterization: prosthetic aortic valve was significantly displaced with each heartbeat (A & B, arrows). ½ DOI: 10.1056/NEJMicm0805989 #Cardiology #radiology #IDMedEd
A 25-year-old man from Iran: a 1-year history of painless erythematous papules & nodules with overlying scale and crust, some of which had central ulceration on his nose and arm (A & B) 1/2 DOI: 10.1056/NEJMicm0808917 #dermatology #MedSky #IDSky #MedEd #microbiology #medicine
CUTANEOUS LAVA MIGRANS - caused by the migration of hookworm larvae. - transmission, when skin comes in direct contact with contaminated soil or sand. Two weeks after albendazole: signs of healing, with areas of desquamation and hyperpigmentation (B). 2/2 #parasitology #IDSky
A 42-year-old man, barefoot stroll on the beach: raised, sergynous, erythematous, pruritic tracts with bulla formation, on the dorsum of his right foot. ½ DOI: 10.1056/NEJMicm0808714 #Parasitology #dermatology #MedEd #IDMedEd #microbiology #medicine
CUTANEOUS LAVA MIGRANS - caused by the migration of hookworm larvae. - transmission, when skin comes in direct contact with contaminated soil or sand. Two weeks after albendazole: signs of healing, with areas of desquamation and hyperpigmentation (B). 2/2 #medicine #MedicalStudents #parasitology
74-YO👨🦳: 2-month of fever, cough & gynecomastia (A) CT: L-chest-wall collection with erosion of the ribs, pleural effusion (B & C, arrows), bilateral nodular infiltrates, & enlarged mediastinal lymph nodes ½ DOI: 10.1056/NEJMicm0809026 #MedEd #Pneumology #radres #radiology
42-YO♀️: 5 years after R pneumonectomy because TBC: wheezing, & dyspnea CT: mediastinum rotation, mediastinal shift & left-lower-lobe bronchus (LLLB) compression between the pulmonary artery & aorta (A, arrow) Bronchoscopy: LLLB obstruction (C) ½ DOI: 10.1056/NEJMicm0707911 #Pneumology #radiology
A 53-y-o ♀️: lower abdominal pain and dysuria. XR: air throughout the urinary tract in the kidneys, ureters, and bladder (arrows). Elevated: blood glucose, C-reactive protein, serum creatinine, & white-cell count. 1/2 DOI: 10.1056/NEJMicm0804468 #Nefrology #ClinicalCase #InfectiousDiseases #FOAMed
Cutaneous anthrax symptoms can include: ✔️A group of small blisters or bumps that may itch ✔️Swelling can occur around the sore ✔️A painless skin sore (ulcer) with a black center that appears after the small blisters or bumps #ClinicalCase #InfectiousDiseases #Microbiology #IDSky
A 17-year-old girl from Iranian village exposed to contaminated soil and livestock products: a black necrotic lesion on her left cheek and periorbital edema. ½ DOI: 10.1056/NEJMicm0802093 #dermatology #MedEd #IDMedEd #microbiology #medicine #MedicalStudents #emergency
🧫 from the fluid in the balls (C) & blood: Pseudomonas aeruginosa INFECTION 57 YEARS AFTER PLOMBAGE Late complications associated with the plombage procedure include hemorrhage, infection, and fistula formation. 2/2 DOI: 10.1056/NEJMicm0707466 #IDSky #microbiology #Medicina
An 86-y-o ♂️57 years after plombage with polymethyl methacrylate (acrylic or Lucite) balls, repeated episodes of septic shock due to methicillin-resistant Staphylococcus aureus pneumonia: died of pseudomonal sepsis and pneumonia. 1/2 #pulmonary #radiology #MedEd #IDMedEd #microbiology #Medicina
Surgical evacuation of the empyema cavity: No recurrence on x-ray (C) or on CT 5 months after surgery. NON-TUBERCULOUS LEFT PLEURAL EMPYEMA DUE TO STAPHYLOCOCCUS AUREUS Plombage abandoned after the development of effective antituberculosis drugs. 2/2 #IDMedEd #microbiology #Medicina #Doctor
73-YO ♀️, chemotherapy for cancer, Lucite-ball plombage for tuberculosis 50 years earlier: a nontuberculous empyema, which had not responded to tube thoracostomy (XR, A) & antibiotics for Staph. aureus cultured from pleural fluid (CT, B). ½ DOI: 10.1056/NEJMicm0802723 #pulmonary #radiology #MedEd
52-YO ♀️ from Tunisia: a 2-year history of an asymptomatic, thick, reddish infiltrated plaque on her right ear (A) 🔬: epithelioid granulomas suggestive of leishmaniasis, tuberculosis, or sarcoidosis (B) ½ DOI: 10.1056/NEJMicm0708175 #dermatology #MedEd #IDMedEd
CUTANEOUS LARVA MIGRANS - generally caused by Ancylostoma braziliense or Ancylostoma caninum, which typically infect dogs and cats. - endemic in tropical or subtropical areas After one dose of ivermectin, adequate response. 2/2 #microbiology #medicine #clinicalcase
5-year-old male, recently traveled to Senegal: pruritic, erythematous, raised, tunnel-like, and serpiginous lesion on the thenar eminence and root of the first finger of the right hand, present for 4 days. 1/2 continuum.aeped.es/screens/play... #dermatology #MedEd #pediatrics