Pénfigo Foliáceo con Complicación Oftalmológica en la edad Pediátrica

Abstract

This case corresponds to a male patient 7 years old, Shuar, born and resident in the community of Pastaza Province Montalvo. It is the product of the third gestation, born at 40 weeks by vaginal delivery, received exclusive womb to 5 months, adequate psychomotor development, negative personal medical history. Patient who enters the service of Pediatrics transferred Health Center to present pustular type skin lesions on the face and lower limbs more increase heat unquantified, he went to Health Center Montalvo (Pastaza) where treated empirically with intramuscular penicillin 2 occasions at doses unspecified box does not yield, so the grandmother takes shaman, who performs healing bath (colony and field herbs), no improvement, the picture itching and severe pain out secretions accompanied by thermal skin lesions more boost persistent. Patient remains in General Hospital Puyo for 18 days with a presumptive diagnosis of contagious impetigo, pemphigus foliaceus, seborrheic pemphigus, treated for Pediatrics and Dermatology that starting treatment with oxacillin, unanswered so antibiotic (vancomycin, ceftriaxone, clindamycin) is broken. Patients with poor clinical outcome left corneal ulcer is observed despite broad-spectrum antibiotic, skin lesions persist, febrile stable in response biopsy result sent hemodynamically, for lack of central venous access and require urgent assessment of ophthalmology you choose to transfer a tertiary level hospital Baca Ortiz remained hospitalized for two months in various services, receiving treatment in Infectious Diseases with several schemes antibiotic (benzathine penicillin, ampicillin + sulbatam, clindamycin, piperacillin + tazobactam, vancomycin, amikacin, meropenem) and Clinic General being Pemphigus foliaceus and diagnosed with primary immunodeficiency for which prescribe intravenous immunoglobulin and oral corticosteroid, channel central line for administration of fluids antibioticoterapiay with oral tolerance and progressive improvement of the table is contrarefiere to General Hospital for follow Puyo