Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS sexo I-PRESENT_ILLNESS femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 10 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS oriunda B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY provincia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY Misiones, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS consultó I-PRESENT_ILLNESS al I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS Dermatología I-PRESENT_ILLNESS por I-PRESENT_ILLNESS presentar I-PRESENT_ILLNESS múltiples I-PRESENT_ILLNESS placas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS aspecto I-PRESENT_ILLNESS verrugoso I-PRESENT_ILLNESS con I-PRESENT_ILLNESS numerosas I-PRESENT_ILLNESS pápulas I-PRESENT_ILLNESS negruzcas I-PRESENT_ILLNESS sobre I-PRESENT_ILLNESS su I-PRESENT_ILLNESS superficie, I-PRESENT_ILLNESS localizadas I-PRESENT_ILLNESS en I-PRESENT_ILLNESS los I-PRESENT_ILLNESS sitios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS apoyo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS ambos I-PRESENT_ILLNESS pies I-PRESENT_ILLNESS (punta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS dedos, I-PRESENT_ILLNESS metatarso I-PRESENT_ILLNESS y I-PRESENT_ILLNESS talones), I-PRESENT_ILLNESS de I-PRESENT_ILLNESS reciente I-PRESENT_ILLNESS aparición. I-PRESENT_ILLNESS I-PRESENT_ILLNESS Las I-PRESENT_ILLNESS lesiones I-PRESENT_ILLNESS le I-PRESENT_ILLNESS ocasionaban I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS y I-PRESENT_ILLNESS dificultaban I-PRESENT_ILLNESS su I-PRESENT_ILLNESS deambulación. I-PRESENT_ILLNESS Realizada B-TREATMENT la I-TREATMENT extracción I-TREATMENT quirúrgica, I-TREATMENT se B-EXPLORATION obtuvieron I-EXPLORATION alrededor I-EXPLORATION de I-EXPLORATION 20 I-EXPLORATION tungas I-EXPLORATION y I-EXPLORATION las I-EXPLORATION muestras I-EXPLORATION extraídas I-EXPLORATION se I-EXPLORATION enviaron I-EXPLORATION al I-EXPLORATION servicio I-EXPLORATION de I-EXPLORATION anatomopatología, I-EXPLORATION que I-EXPLORATION confirmó I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION tungiasis. I-EXPLORATION La B-TREATMENT paciente I-TREATMENT fue I-TREATMENT tratada I-TREATMENT con I-TREATMENT ivermecti-na I-TREATMENT vía I-TREATMENT oral I-TREATMENT 200 I-TREATMENT µg/kg I-TREATMENT como I-TREATMENT terapia I-TREATMENT coadyuvante, I-TREATMENT debido I-TREATMENT al I-TREATMENT gran I-TREATMENT compromiso I-TREATMENT cutáneo I-TREATMENT y I-TREATMENT la I-TREATMENT multiplicidad I-TREATMENT de I-TREATMENT lesiones. I-TREATMENT Las B-EVOLUTION lesiones I-EVOLUTION evolucionaron I-EVOLUTION favorablemente I-EVOLUTION con I-EVOLUTION resolución I-EVOLUTION completa. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS sexo I-PRESENT_ILLNESS femenino I-PRESENT_ILLNESS internada I-PRESENT_ILLNESS a I-PRESENT_ILLNESS los I-PRESENT_ILLNESS cuatro I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS vida I-PRESENT_ILLNESS por I-PRESENT_ILLNESS fiebre I-PRESENT_ILLNESS y I-PRESENT_ILLNESS depresión I-PRESENT_ILLNESS de I-PRESENT_ILLNESS sensorio. I-PRESENT_ILLNESS Antecedentes: B-PAST_MEDICAL_HISTORY recién I-PAST_MEDICAL_HISTORY nacida I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY término, I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY peso I-PAST_MEDICAL_HISTORY adecuado I-PAST_MEDICAL_HISTORY para I-PAST_MEDICAL_HISTORY su I-PAST_MEDICAL_HISTORY edad I-PAST_MEDICAL_HISTORY gestacional, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY diagnóstico I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY ictericia I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY incompatibilidad I-PAST_MEDICAL_HISTORY ABO, I-PAST_MEDICAL_HISTORY tratada I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY luminoterapia I-PAST_MEDICAL_HISTORY dentro I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY primeras I-PAST_MEDICAL_HISTORY 24 I-PAST_MEDICAL_HISTORY h I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY vida. I-PAST_MEDICAL_HISTORY Al I-PAST_MEDICAL_HISTORY momento I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY egreso I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY valores I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY bilirrubina I-PAST_MEDICAL_HISTORY total I-PAST_MEDICAL_HISTORY eran I-PAST_MEDICAL_HISTORY 9, I-PAST_MEDICAL_HISTORY 9 I-PAST_MEDICAL_HISTORY mg/dl I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY directa I-PAST_MEDICAL_HISTORY 0, I-PAST_MEDICAL_HISTORY 5 I-PAST_MEDICAL_HISTORY mg/dl. I-PAST_MEDICAL_HISTORY Reingresó I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY Neonatología I-PAST_MEDICAL_HISTORY al I-PAST_MEDICAL_HISTORY mes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY vida I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY ictericia I-PAST_MEDICAL_HISTORY prolongada. I-PAST_MEDICAL_HISTORY Durante I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY internación I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY realizó I-PAST_MEDICAL_HISTORY ecografía I-PAST_MEDICAL_HISTORY abdominal I-PAST_MEDICAL_HISTORY cuyo I-PAST_MEDICAL_HISTORY informe I-PAST_MEDICAL_HISTORY mencionaba I-PAST_MEDICAL_HISTORY presencia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY vías I-PAST_MEDICAL_HISTORY biliares I-PAST_MEDICAL_HISTORY intrahepática I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY extrahepáticas, I-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY dilatación. I-PAST_MEDICAL_HISTORY Laboratorio: I-PAST_MEDICAL_HISTORY bilirrubinemia I-PAST_MEDICAL_HISTORY total I-PAST_MEDICAL_HISTORY 11, I-PAST_MEDICAL_HISTORY 3 I-PAST_MEDICAL_HISTORY mg/dl I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY directa I-PAST_MEDICAL_HISTORY 1, I-PAST_MEDICAL_HISTORY 7 I-PAST_MEDICAL_HISTORY mg/dl, I-PAST_MEDICAL_HISTORY FAL I-PAST_MEDICAL_HISTORY 257 I-PAST_MEDICAL_HISTORY UI/L, I-PAST_MEDICAL_HISTORY TGP I-PAST_MEDICAL_HISTORY 55 I-PAST_MEDICAL_HISTORY UI/L, I-PAST_MEDICAL_HISTORY TGO I-PAST_MEDICAL_HISTORY 69 I-PAST_MEDICAL_HISTORY UI/L. I-PAST_MEDICAL_HISTORY Fue I-PAST_MEDICAL_HISTORY dada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY alta I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY continuó I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY seguimiento I-PAST_MEDICAL_HISTORY ambulatorio I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY gastroenterólogo I-PAST_MEDICAL_HISTORY pediatra, I-PAST_MEDICAL_HISTORY hasta I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY internación I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY hemorragia I-PAST_MEDICAL_HISTORY intracraneal. I-PAST_MEDICAL_HISTORY Evolución: B-EXPLORATION al I-EXPLORATION ingreso I-EXPLORATION se I-EXPLORATION encontró I-EXPLORATION ictericia I-EXPLORATION generalizada, I-EXPLORATION hepatomegalia I-EXPLORATION y I-EXPLORATION sopor. I-EXPLORATION Dentro B-EVOLUTION de I-EVOLUTION las I-EVOLUTION primeras I-EVOLUTION 24 I-EVOLUTION h I-EVOLUTION de I-EVOLUTION internación I-EVOLUTION presentó I-EVOLUTION episodio I-EVOLUTION convulsivo I-EVOLUTION focal I-EVOLUTION en I-EVOLUTION hemicuerpo I-EVOLUTION derecho; I-EVOLUTION en B-TREATMENT la I-TREATMENT tomografía I-TREATMENT computada I-TREATMENT cerebral I-TREATMENT (TC) I-TREATMENT se I-TREATMENT constató I-TREATMENT hematoma I-TREATMENT subdural I-TREATMENT que I-TREATMENT requirió I-TREATMENT drenaje I-TREATMENT quirúrgico I-TREATMENT y I-TREATMENT asistencia I-TREATMENT respiratoria I-TREATMENT mecánica I-TREATMENT hasta I-TREATMENT 48 I-TREATMENT h I-TREATMENT del I-TREATMENT postoperatorio. I-TREATMENT Laboratorio B-EXPLORATION de I-EXPLORATION ingreso: I-EXPLORATION GOT I-EXPLORATION 120 I-EXPLORATION UI/L, I-EXPLORATION GPT I-EXPLORATION 180 I-EXPLORATION UI/L, I-EXPLORATION FAL I-EXPLORATION 1053 I-EXPLORATION UI/L, I-EXPLORATION gammaglutamiltranspeptidasa I-EXPLORATION 1119 I-EXPLORATION UI/L, I-EXPLORATION LDH I-EXPLORATION 1262 I-EXPLORATION UI/L, I-EXPLORATION bilirrubinemia I-EXPLORATION total I-EXPLORATION 6 I-EXPLORATION mg/dl I-EXPLORATION y I-EXPLORATION directa I-EXPLORATION 3, I-EXPLORATION 9 I-EXPLORATION mg/ I-EXPLORATION dl, I-EXPLORATION amonio I-EXPLORATION 51, I-EXPLORATION 8 I-EXPLORATION mcg/dl, I-EXPLORATION lactacidemia I-EXPLORATION 7 I-EXPLORATION mmol/L, I-EXPLORATION tiempo I-EXPLORATION de I-EXPLORATION protrombina I-EXPLORATION 59%, I-EXPLORATION KPTT I-EXPLORATION 100 I-EXPLORATION segundos I-EXPLORATION (no I-EXPLORATION se I-EXPLORATION le I-EXPLORATION administró I-EXPLORATION vitamina I-EXPLORATION K I-EXPLORATION ni I-EXPLORATION plasma I-EXPLORATION frasco I-EXPLORATION congelado I-EXPLORATION previo I-EXPLORATION a I-EXPLORATION la I-EXPLORATION toma I-EXPLORATION de I-EXPLORATION muestra). I-EXPLORATION Serologías I-EXPLORATION para I-EXPLORATION VIH, I-EXPLORATION sífilis, I-EXPLORATION toxoplasmosis, I-EXPLORATION hepatitis I-EXPLORATION B, I-EXPLORATION hepatitis I-EXPLORATION A I-EXPLORATION y I-EXPLORATION citomegalovirus I-EXPLORATION negativas. I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION centellograma I-EXPLORATION con I-EXPLORATION HIDA I-EXPLORATION que I-EXPLORATION mostró I-EXPLORATION falta I-EXPLORATION de I-EXPLORATION captación I-EXPLORATION de I-EXPLORATION contraste I-EXPLORATION intrahepático I-EXPLORATION y I-EXPLORATION extrahepático, I-EXPLORATION sin I-EXPLORATION pasaje I-EXPLORATION de I-EXPLORATION contraste I-EXPLORATION al I-EXPLORATION intestino. I-EXPLORATION Se B-TREATMENT decidió I-TREATMENT realizar I-TREATMENT portoenteroanastomosis I-TREATMENT por I-TREATMENT laparoscopia, I-TREATMENT después I-TREATMENT de I-TREATMENT confirmar I-TREATMENT el I-TREATMENT diagnóstico I-TREATMENT de I-TREATMENT atresia I-TREATMENT de I-TREATMENT vías I-TREATMENT biliares I-TREATMENT durante I-TREATMENT la I-TREATMENT cirugía. I-TREATMENT A B-EVOLUTION los I-EVOLUTION 6 I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION vida I-EVOLUTION presentaba I-EVOLUTION maduración I-EVOLUTION neurológica I-EVOLUTION adecuada I-EVOLUTION a I-EVOLUTION la I-EVOLUTION edad. I-EVOLUTION Requirió B-TREATMENT trasplante I-TREATMENT hepático I-TREATMENT cerca I-TREATMENT del I-TREATMENT año I-TREATMENT de I-TREATMENT edad. I-TREATMENT I-TREATMENT Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 30 I-PRESENT_ILLNESS meses, I-PRESENT_ILLNESS nacido B-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY término, I-PAST_MEDICAL_HISTORY cesárea I-PAST_MEDICAL_HISTORY programada, I-PAST_MEDICAL_HISTORY embarazo I-PAST_MEDICAL_HISTORY controlado, I-PAST_MEDICAL_HISTORY peso I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY talla I-PAST_MEDICAL_HISTORY acordes I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY edad I-PAST_MEDICAL_HISTORY gestacional. I-PAST_MEDICAL_HISTORY Antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY dos I-PAST_MEDICAL_HISTORY episodios I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY otitis I-PAST_MEDICAL_HISTORY media, I-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY cirugías, I-PAST_MEDICAL_HISTORY internaciones I-PAST_MEDICAL_HISTORY previas I-PAST_MEDICAL_HISTORY ni I-PAST_MEDICAL_HISTORY alergias. I-PAST_MEDICAL_HISTORY Inmunizaciones I-PAST_MEDICAL_HISTORY completas I-PAST_MEDICAL_HISTORY según I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY calendario I-PAST_MEDICAL_HISTORY oficial. I-PAST_MEDICAL_HISTORY Crecimiento I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY desarrollo I-PAST_MEDICAL_HISTORY normales. I-PAST_MEDICAL_HISTORY Historia B-FAMILY_HISTORY familiar I-FAMILY_HISTORY con I-FAMILY_HISTORY ambos I-FAMILY_HISTORY padres I-FAMILY_HISTORY obesos I-FAMILY_HISTORY con I-FAMILY_HISTORY cirugía I-FAMILY_HISTORY bariátrica I-FAMILY_HISTORY realizada, I-FAMILY_HISTORY y I-FAMILY_HISTORY dos I-FAMILY_HISTORY hermanas I-FAMILY_HISTORY mayores I-FAMILY_HISTORY con I-FAMILY_HISTORY antecedentes I-FAMILY_HISTORY de I-FAMILY_HISTORY asma I-FAMILY_HISTORY e I-FAMILY_HISTORY hipotiroidismo, I-FAMILY_HISTORY respectivamente. I-FAMILY_HISTORY I-FAMILY_HISTORY Es B-DERIVED_FROM/TO derivado I-DERIVED_FROM/TO a I-DERIVED_FROM/TO nuestro I-DERIVED_FROM/TO hospital I-DERIVED_FROM/TO con I-DERIVED_FROM/TO diagnóstico I-DERIVED_FROM/TO de I-DERIVED_FROM/TO síndrome I-DERIVED_FROM/TO ascítico I-DERIVED_FROM/TO edematoso. I-DERIVED_FROM/TO Comenzó B-PRESENT_ILLNESS una I-PRESENT_ILLNESS semana I-PRESENT_ILLNESS antes I-PRESENT_ILLNESS con I-PRESENT_ILLNESS un I-PRESENT_ILLNESS edema I-PRESENT_ILLNESS palpebral I-PRESENT_ILLNESS bilateral I-PRESENT_ILLNESS leve. I-PRESENT_ILLNESS Dos I-PRESENT_ILLNESS días I-PRESENT_ILLNESS después, I-PRESENT_ILLNESS presentó I-PRESENT_ILLNESS un I-PRESENT_ILLNESS exantema I-PRESENT_ILLNESS urticariante I-PRESENT_ILLNESS generalizado I-PRESENT_ILLNESS en I-PRESENT_ILLNESS todo I-PRESENT_ILLNESS el I-PRESENT_ILLNESS cuerpo, I-PRESENT_ILLNESS no I-PRESENT_ILLNESS pruriginoso, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS revirtió I-PRESENT_ILLNESS espontáneamente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS menos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 24 I-PRESENT_ILLNESS horas. I-PRESENT_ILLNESS A I-PRESENT_ILLNESS las I-PRESENT_ILLNESS 48 I-PRESENT_ILLNESS horas, I-PRESENT_ILLNESS apareció I-PRESENT_ILLNESS un I-PRESENT_ILLNESS edema I-PRESENT_ILLNESS bipalpebral I-PRESENT_ILLNESS más I-PRESENT_ILLNESS pronunciado, I-PRESENT_ILLNESS distensión I-PRESENT_ILLNESS abdominal I-PRESENT_ILLNESS e I-PRESENT_ILLNESS irritabilidad. I-PRESENT_ILLNESS Se I-PRESENT_ILLNESS consultó I-PRESENT_ILLNESS al I-PRESENT_ILLNESS pediatra, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS constató I-PRESENT_ILLNESS un I-PRESENT_ILLNESS aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 2 I-PRESENT_ILLNESS kg I-PRESENT_ILLNESS con I-PRESENT_ILLNESS respecto I-PRESENT_ILLNESS a I-PRESENT_ILLNESS peso I-PRESENT_ILLNESS previo I-PRESENT_ILLNESS (2 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS antes). I-PRESENT_ILLNESS No B-PAST_MEDICAL_HISTORY tenía I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY infecciones. I-PAST_MEDICAL_HISTORY Fue B-DERIVED_FROM/TO derivado I-DERIVED_FROM/TO a I-DERIVED_FROM/TO un I-DERIVED_FROM/TO médico I-DERIVED_FROM/TO nefrólogo, I-DERIVED_FROM/TO quien I-DERIVED_FROM/TO solicitó I-DERIVED_FROM/TO estudios I-DERIVED_FROM/TO de I-DERIVED_FROM/TO laboratorio I-DERIVED_FROM/TO cuyos I-DERIVED_FROM/TO resultados I-DERIVED_FROM/TO mostraron I-DERIVED_FROM/TO marcada I-DERIVED_FROM/TO hipoproteinemia I-DERIVED_FROM/TO e I-DERIVED_FROM/TO hipoalbuminemia, I-DERIVED_FROM/TO hipertrigliceridemia, I-DERIVED_FROM/TO hipocalcemia I-DERIVED_FROM/TO leve I-DERIVED_FROM/TO y I-DERIVED_FROM/TO orina I-DERIVED_FROM/TO normal. I-DERIVED_FROM/TO Se I-DERIVED_FROM/TO trasladó I-DERIVED_FROM/TO al I-DERIVED_FROM/TO niño I-DERIVED_FROM/TO a I-DERIVED_FROM/TO nuestro I-DERIVED_FROM/TO hospital I-DERIVED_FROM/TO para I-DERIVED_FROM/TO su I-DERIVED_FROM/TO diagnóstico I-DERIVED_FROM/TO y I-DERIVED_FROM/TO tratamiento. I-DERIVED_FROM/TO I-DERIVED_FROM/TO Examen B-EXPLORATION físico: I-EXPLORATION niño I-EXPLORATION lúcido, I-EXPLORATION vigil, I-EXPLORATION orientado, I-EXPLORATION irritable. I-EXPLORATION TA I-EXPLORATION 109/78 I-EXPLORATION mm I-EXPLORATION Hg, I-EXPLORATION TAM I-EXPLORATION 92 I-EXPLORATION mm I-EXPLORATION Hg, I-EXPLORATION FC I-EXPLORATION 130 I-EXPLORATION lpm, I-EXPLORATION FR I-EXPLORATION 32 I-EXPLORATION rpm, I-EXPLORATION temperatura I-EXPLORATION 36, I-EXPLORATION 7°C, I-EXPLORATION saturación I-EXPLORATION de I-EXPLORATION O2 I-EXPLORATION 96% I-EXPLORATION respirando I-EXPLORATION aire I-EXPLORATION ambiente. I-EXPLORATION Peso I-EXPLORATION 14, I-EXPLORATION 600 I-EXPLORATION kg, I-EXPLORATION palidez I-EXPLORATION generalizada, I-EXPLORATION facies I-EXPLORATION abotagada. I-EXPLORATION Edema I-EXPLORATION palpebral I-EXPLORATION bilateral. I-EXPLORATION Algunos I-EXPLORATION crepitantes I-EXPLORATION basales I-EXPLORATION en I-EXPLORATION ambos I-EXPLORATION campos I-EXPLORATION pulmonares. I-EXPLORATION Edema I-EXPLORATION pretibial I-EXPLORATION bilateral. I-EXPLORATION Abdomen I-EXPLORATION globuloso, I-EXPLORATION distendido, I-EXPLORATION onda I-EXPLORATION ascítica I-EXPLORATION positiva, I-EXPLORATION sin I-EXPLORATION hepatoesplenomegalia. I-EXPLORATION Edema I-EXPLORATION escrotal I-EXPLORATION y I-EXPLORATION suprapúbico. I-EXPLORATION El I-EXPLORATION resto I-EXPLORATION del I-EXPLORATION examen I-EXPLORATION no I-EXPLORATION presentó I-EXPLORATION particularidades. I-EXPLORATION I-EXPLORATION Laboratorio I-EXPLORATION inicial: I-EXPLORATION leucocitos: I-EXPLORATION 17 I-EXPLORATION 700/mm3, I-EXPLORATION fórmula: I-EXPLORATION 27% I-EXPLORATION neutrófilos, I-EXPLORATION 14% I-EXPLORATION eosinófilos, I-EXPLORATION 49% I-EXPLORATION linfocitos, I-EXPLORATION 6% I-EXPLORATION monocitos I-EXPLORATION y I-EXPLORATION 4% I-EXPLORATION linfocitos I-EXPLORATION atípicos. I-EXPLORATION Calcio I-EXPLORATION total I-EXPLORATION 7, I-EXPLORATION 4 I-EXPLORATION mmol/L I-EXPLORATION (VN I-EXPLORATION 8, I-EXPLORATION 5-10), I-EXPLORATION proteínas I-EXPLORATION totales I-EXPLORATION 3 I-EXPLORATION g/dl I-EXPLORATION (VN I-EXPLORATION 6, I-EXPLORATION 6-8, I-EXPLORATION 7), I-EXPLORATION albúmina I-EXPLORATION 1, I-EXPLORATION 6 I-EXPLORATION g/dl I-EXPLORATION (VN I-EXPLORATION 3, I-EXPLORATION 5-3), I-EXPLORATION IgG I-EXPLORATION 136 I-EXPLORATION mg/dl I-EXPLORATION (VN I-EXPLORATION 490-1450), I-EXPLORATION IgE I-EXPLORATION 140 I-EXPLORATION UI/ I-EXPLORATION ml I-EXPLORATION (VN I-EXPLORATION hasta I-EXPLORATION 75), I-EXPLORATION triglicéridos I-EXPLORATION 196 I-EXPLORATION mg/dl I-EXPLORATION (N I-EXPLORATION < I-EXPLORATION 150), I-EXPLORATION TGO I-EXPLORATION 62 I-EXPLORATION U/L I-EXPLORATION (VN I-EXPLORATION < I-EXPLORATION 37), I-EXPLORATION TGP I-EXPLORATION 43 I-EXPLORATION U/L I-EXPLORATION (VN I-EXPLORATION < I-EXPLORATION 41), I-EXPLORATION I-EXPLORATION colesterol I-EXPLORATION total I-EXPLORATION 129 I-EXPLORATION mg/dl I-EXPLORATION (VN I-EXPLORATION < I-EXPLORATION 200), I-EXPLORATION HDL I-EXPLORATION 25 I-EXPLORATION mg/ I-EXPLORATION dl I-EXPLORATION (VN I-EXPLORATION > I-EXPLORATION 35). I-EXPLORATION PCR I-EXPLORATION 1, I-EXPLORATION 3mg/dl I-EXPLORATION (VN I-EXPLORATION < I-EXPLORATION 0, I-EXPLORATION 06). I-EXPLORATION Orina I-EXPLORATION normal I-EXPLORATION sin I-EXPLORATION proteinuria. I-EXPLORATION Relación I-EXPLORATION Prot/Cr I-EXPLORATION 0, I-EXPLORATION 26. I-EXPLORATION Hormonas I-EXPLORATION tiroideas I-EXPLORATION normales I-EXPLORATION y I-EXPLORATION anticuerpos I-EXPLORATION para I-EXPLORATION enfermedad I-EXPLORATION celíaca I-EXPLORATION negativos. I-EXPLORATION Prueba I-EXPLORATION de I-EXPLORATION la I-EXPLORATION tuberculina I-EXPLORATION negativa. I-EXPLORATION I-EXPLORATION Al B-EVOLUTION segundo I-EVOLUTION día I-EVOLUTION de I-EVOLUTION internación, I-EVOLUTION el I-EVOLUTION niño I-EVOLUTION presentó I-EVOLUTION dos I-EVOLUTION picos I-EVOLUTION febriles, I-EVOLUTION fauces I-EVOLUTION congestivas, I-EVOLUTION subcrepitantes I-EVOLUTION pulmonares I-EVOLUTION bibasales I-EVOLUTION leves. I-EVOLUTION Radiografía B-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION y I-EXPLORATION ecografía I-EXPLORATION renal I-EXPLORATION sin I-EXPLORATION particularidades. I-EXPLORATION Ecografía I-EXPLORATION abdominal I-EXPLORATION sin I-EXPLORATION visceromegalia, I-EXPLORATION con I-EXPLORATION líquido I-EXPLORATION ascítico I-EXPLORATION moderado, I-EXPLORATION mucosa I-EXPLORATION gástrica I-EXPLORATION sin I-EXPLORATION agrandamiento I-EXPLORATION ni I-EXPLORATION hipertrofia I-EXPLORATION de I-EXPLORATION pliegues. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION descartó I-EXPLORATION la I-EXPLORATION etiología I-EXPLORATION cardiovascular, I-EXPLORATION renal I-EXPLORATION o I-EXPLORATION hepática I-EXPLORATION por I-EXPLORATION la I-EXPLORATION clínica I-EXPLORATION y I-EXPLORATION los I-EXPLORATION estudios I-EXPLORATION realizados. I-EXPLORATION I-EXPLORATION Ante I-EXPLORATION la I-EXPLORATION sospecha I-EXPLORATION de I-EXPLORATION gastroenteropatía I-EXPLORATION perdedora I-EXPLORATION de I-EXPLORATION proteínas, I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION endoscopia I-EXPLORATION esofagogastroduodenal I-EXPLORATION con I-EXPLORATION biopsia, I-EXPLORATION cuyo I-EXPLORATION informe I-EXPLORATION reveló: I-EXPLORATION esófago I-EXPLORATION con I-EXPLORATION cambio I-EXPLORATION mucoso I-EXPLORATION a I-EXPLORATION 23 I-EXPLORATION cm, I-EXPLORATION mucosa I-EXPLORATION pálida I-EXPLORATION y I-EXPLORATION muy I-EXPLORATION edematosa; I-EXPLORATION estómago I-EXPLORATION con I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION pliegues I-EXPLORATION engrosados, I-EXPLORATION seudopólipos I-EXPLORATION y I-EXPLORATION erosiones I-EXPLORATION de I-EXPLORATION la I-EXPLORATION mucosa. I-EXPLORATION Duodeno I-EXPLORATION con I-EXPLORATION pliegues I-EXPLORATION engrosados I-EXPLORATION y I-EXPLORATION mucosa I-EXPLORATION edematosa. I-EXPLORATION El I-EXPLORATION informe I-EXPLORATION de I-EXPLORATION la I-EXPLORATION biopsia I-EXPLORATION correspondió I-EXPLORATION a I-EXPLORATION esofagitis, I-EXPLORATION gastritis I-EXPLORATION y I-EXPLORATION duodenitis I-EXPLORATION crónica I-EXPLORATION leve I-EXPLORATION a I-EXPLORATION moderada I-EXPLORATION con I-EXPLORATION frecuentes I-EXPLORATION eosinófilos. I-EXPLORATION No I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION depuración I-EXPLORATION de I-EXPLORATION α1-antitripsina I-EXPLORATION por I-EXPLORATION la I-EXPLORATION falta I-EXPLORATION de I-EXPLORATION accesibilidad I-EXPLORATION al I-EXPLORATION método. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION solicitó I-EXPLORATION en I-EXPLORATION sangre, I-EXPLORATION IgM-IgG I-EXPLORATION para I-EXPLORATION CMV: I-EXPLORATION positivo; I-EXPLORATION antígeno I-EXPLORATION temprano: I-EXPLORATION reactivo; I-EXPLORATION PCR: I-EXPLORATION 2075 I-EXPLORATION copias I-EXPLORATION (no I-EXPLORATION reactivo I-EXPLORATION < I-EXPLORATION 750 I-EXPLORATION copias). I-EXPLORATION No I-EXPLORATION se I-EXPLORATION analizó I-EXPLORATION material I-EXPLORATION de I-EXPLORATION biopsia I-EXPLORATION para I-EXPLORATION la I-EXPLORATION detección I-EXPLORATION del I-EXPLORATION virus. I-EXPLORATION I-EXPLORATION El B-TREATMENT paciente I-TREATMENT fue I-TREATMENT sometido I-TREATMENT a I-TREATMENT una I-TREATMENT dieta I-TREATMENT hiperproteica I-TREATMENT y I-TREATMENT gastroprotectora. I-TREATMENT Recibió I-TREATMENT una I-TREATMENT infusión I-TREATMENT intravenosa I-TREATMENT de I-TREATMENT albúmina I-TREATMENT (25% I-TREATMENT 1 I-TREATMENT g/ I-TREATMENT kg, I-TREATMENT una I-TREATMENT dosis), I-TREATMENT omeprazol I-TREATMENT 20 I-TREATMENT mg/día I-TREATMENT por I-TREATMENT vía I-TREATMENT intravenosa I-TREATMENT y I-TREATMENT espironolactona I-TREATMENT 3 I-TREATMENT mg/kg/día I-TREATMENT por I-TREATMENT vía I-TREATMENT oral. I-TREATMENT Al I-TREATMENT no I-TREATMENT mejorar I-TREATMENT clínicamente, I-TREATMENT a I-TREATMENT los I-TREATMENT 6 I-TREATMENT días I-TREATMENT se I-TREATMENT comenzó I-TREATMENT la I-TREATMENT administración I-TREATMENT de I-TREATMENT ganciclovir I-TREATMENT por I-TREATMENT vía I-TREATMENT intravenosa I-TREATMENT (5 I-TREATMENT mg/kg I-TREATMENT cada I-TREATMENT 12 I-TREATMENT horas). I-TREATMENT A I-TREATMENT las I-TREATMENT 48 I-TREATMENT horas I-TREATMENT se I-TREATMENT rotó I-TREATMENT a I-TREATMENT valganciclovir I-TREATMENT oral I-TREATMENT (400 I-TREATMENT mg/día) I-TREATMENT por I-TREATMENT la I-TREATMENT imposibilidad I-TREATMENT de I-TREATMENT mantener I-TREATMENT la I-TREATMENT venoclisis. I-TREATMENT I-TREATMENT A B-EVOLUTION los I-EVOLUTION 10 I-EVOLUTION días I-EVOLUTION de I-EVOLUTION internación, I-EVOLUTION dada I-EVOLUTION la I-EVOLUTION buena I-EVOLUTION evolución, I-EVOLUTION se I-EVOLUTION le I-EVOLUTION otorgó I-EVOLUTION el I-EVOLUTION alta I-EVOLUTION hospitalaria. I-EVOLUTION Laboratorio B-EXPLORATION al I-EXPLORATION alta: I-EXPLORATION proteínas I-EXPLORATION totales I-EXPLORATION 4, I-EXPLORATION 6 I-EXPLORATION g/ I-EXPLORATION dl I-EXPLORATION (VN I-EXPLORATION 6, I-EXPLORATION 6-8, I-EXPLORATION 7), I-EXPLORATION albúmina I-EXPLORATION 2, I-EXPLORATION 6 I-EXPLORATION g/dl I-EXPLORATION (VN I-EXPLORATION 3, I-EXPLORATION 5-5), I-EXPLORATION triglicéridos I-EXPLORATION 254 I-EXPLORATION mg/dl I-EXPLORATION (VN I-EXPLORATION < I-EXPLORATION 150). I-EXPLORATION Carga I-EXPLORATION viral I-EXPLORATION para I-EXPLORATION CMV I-EXPLORATION < I-EXPLORATION 750 I-EXPLORATION copias. I-EXPLORATION Se B-TREATMENT indicó I-TREATMENT continuar I-TREATMENT con I-TREATMENT dieta I-TREATMENT hiperproteica, I-TREATMENT protectores I-TREATMENT gástricos I-TREATMENT y I-TREATMENT valganciclovir I-TREATMENT por I-TREATMENT vía I-TREATMENT oral I-TREATMENT hasta I-TREATMENT completar I-TREATMENT 6 I-TREATMENT semanas I-TREATMENT de I-TREATMENT tratamiento. I-TREATMENT Cuatro B-EXPLORATION meses I-EXPLORATION después, I-EXPLORATION se I-EXPLORATION repitió I-EXPLORATION la I-EXPLORATION endoscopia I-EXPLORATION esofagogastroduodenal, I-EXPLORATION cuyo I-EXPLORATION resultado I-EXPLORATION fue I-EXPLORATION normal. I-EXPLORATION I-EXPLORATION Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 3 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS con I-PRESENT_ILLNESS lesión I-PRESENT_ILLNESS eritematosa I-PRESENT_ILLNESS en I-PRESENT_ILLNESS antifaz, I-PRESENT_ILLNESS pequeñas I-PRESENT_ILLNESS placas I-PRESENT_ILLNESS redondeadas, I-PRESENT_ILLNESS ligeramente I-PRESENT_ILLNESS atróficas I-PRESENT_ILLNESS en I-PRESENT_ILLNESS región I-PRESENT_ILLNESS temporooccipital I-PRESENT_ILLNESS bilateral I-PRESENT_ILLNESS y I-PRESENT_ILLNESS cuello I-PRESENT_ILLNESS y I-PRESENT_ILLNESS finas I-PRESENT_ILLNESS telangiectasias I-PRESENT_ILLNESS en I-PRESENT_ILLNESS su I-PRESENT_ILLNESS superficie. I-PRESENT_ILLNESS En I-PRESENT_ILLNESS región I-PRESENT_ILLNESS genital, I-PRESENT_ILLNESS lesión I-PRESENT_ILLNESS eritematosa, I-PRESENT_ILLNESS atrófica, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS bordes I-PRESENT_ILLNESS definidos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 2 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución. I-PRESENT_ILLNESS I-PRESENT_ILLNESS Madre B-FAMILY_HISTORY con I-FAMILY_HISTORY alopecia I-FAMILY_HISTORY cicatrizal, I-FAMILY_HISTORY ojo I-FAMILY_HISTORY seco, I-FAMILY_HISTORY boca I-FAMILY_HISTORY seca I-FAMILY_HISTORY y I-FAMILY_HISTORY anemia, I-FAMILY_HISTORY sin I-FAMILY_HISTORY diagnóstico I-FAMILY_HISTORY de I-FAMILY_HISTORY su I-FAMILY_HISTORY enfermedad I-FAMILY_HISTORY al I-FAMILY_HISTORY momento I-FAMILY_HISTORY de I-FAMILY_HISTORY la I-FAMILY_HISTORY consulta. I-FAMILY_HISTORY I-FAMILY_HISTORY Exámenes B-EXPLORATION complementarios: I-EXPLORATION Hb I-EXPLORATION 11, I-EXPLORATION 2g/dl, I-EXPLORATION Hto I-EXPLORATION 33%, I-EXPLORATION TGO I-EXPLORATION 265 I-EXPLORATION UI/L, I-EXPLORATION TGP I-EXPLORATION 212 I-EXPLORATION UI/L, I-EXPLORATION FAL I-EXPLORATION 927 I-EXPLORATION UI/L, I-EXPLORATION C3 I-EXPLORATION 54 I-EXPLORATION mg/dl, I-EXPLORATION C4 I-EXPLORATION 2 I-EXPLORATION mg/dl, I-EXPLORATION FAN I-EXPLORATION + I-EXPLORATION 1/1000 I-EXPLORATION patrón I-EXPLORATION moteado I-EXPLORATION grueso I-EXPLORATION y I-EXPLORATION anti I-EXPLORATION La I-EXPLORATION positivo I-EXPLORATION (paciente), I-EXPLORATION FAN I-EXPLORATION + I-EXPLORATION 1/2000 I-EXPLORATION patrón I-EXPLORATION homogéneo I-EXPLORATION y I-EXPLORATION anti I-EXPLORATION La I-EXPLORATION y I-EXPLORATION anti I-EXPLORATION Ro I-EXPLORATION positivos I-EXPLORATION (madre) I-EXPLORATION I-EXPLORATION Estudio I-EXPLORATION histopatológico: I-EXPLORATION capa I-EXPLORATION córnea I-EXPLORATION engrosada, I-EXPLORATION epidermis I-EXPLORATION adelgazada, I-EXPLORATION intensa I-EXPLORATION vacuolización I-EXPLORATION de I-EXPLORATION queratinocitos I-EXPLORATION basales, I-EXPLORATION en I-EXPLORATION dermis I-EXPLORATION infiltrado I-EXPLORATION mononuclear I-EXPLORATION difuso. I-EXPLORATION Membrana I-EXPLORATION basal I-EXPLORATION engrosada. I-EXPLORATION IFD I-EXPLORATION negativa. I-EXPLORATION I-EXPLORATION Valoración I-EXPLORATION cardiológica I-EXPLORATION normal. I-EXPLORATION I-EXPLORATION Tratamiento: B-TREATMENT Hidrocortisona I-TREATMENT 1% I-TREATMENT tópico, I-TREATMENT Pimecrolimus I-TREATMENT 1%. I-TREATMENT Desaparición B-EVOLUTION de I-EVOLUTION las I-EVOLUTION lesiones I-EVOLUTION eritematosas I-EVOLUTION a I-EVOLUTION los I-EVOLUTION 15 I-EVOLUTION días I-EVOLUTION y I-EVOLUTION persistencia I-EVOLUTION de I-EVOLUTION lesiones I-EVOLUTION atróficas I-EVOLUTION con I-EVOLUTION puntillado I-EVOLUTION petequial I-EVOLUTION en I-EVOLUTION cuero I-EVOLUTION cabelludo, I-EVOLUTION normalizando I-EVOLUTION las I-EVOLUTION enzimas I-EVOLUTION hepáticas I-EVOLUTION a I-EVOLUTION los I-EVOLUTION 10 I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION vida. I-EVOLUTION I-EVOLUTION Luego, I-EVOLUTION a I-EVOLUTION la I-EVOLUTION madre I-EVOLUTION de I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION se I-EVOLUTION le I-EVOLUTION realizó I-EVOLUTION diagnóstico I-EVOLUTION de I-EVOLUTION Síndrome I-EVOLUTION (Sme.) I-EVOLUTION de I-EVOLUTION Sjögren. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 77 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS acude I-PRESENT_ILLNESS al I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS en I-PRESENT_ILLNESS ambos I-PRESENT_ILLNESS ojos I-PRESENT_ILLNESS (AO), I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS agudeza I-PRESENT_ILLNESS visual I-PRESENT_ILLNESS (AV). I-PRESENT_ILLNESS Asimismo, I-PRESENT_ILLNESS comenta I-PRESENT_ILLNESS que I-PRESENT_ILLNESS lleva I-PRESENT_ILLNESS unos I-PRESENT_ILLNESS días I-PRESENT_ILLNESS notando I-PRESENT_ILLNESS molestias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS manera I-PRESENT_ILLNESS alterna I-PRESENT_ILLNESS en I-PRESENT_ILLNESS uno I-PRESENT_ILLNESS y I-PRESENT_ILLNESS otro I-PRESENT_ILLNESS ojo. I-PRESENT_ILLNESS B-FAMILY_HISTORY No I-FAMILY_HISTORY presenta I-FAMILY_HISTORY antecedentes I-FAMILY_HISTORY familiares I-FAMILY_HISTORY de I-FAMILY_HISTORY interés I-FAMILY_HISTORY y B-PAST_MEDICAL_HISTORY entre I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY personales I-PAST_MEDICAL_HISTORY destaca I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY cardiopatía I-PAST_MEDICAL_HISTORY isquémica I-PAST_MEDICAL_HISTORY hace I-PAST_MEDICAL_HISTORY 3 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY con: I-PAST_MEDICAL_HISTORY Pravastatina I-PAST_MEDICAL_HISTORY 10 I-PAST_MEDICAL_HISTORY mg/24 I-PAST_MEDICAL_HISTORY horas, I-PAST_MEDICAL_HISTORY Atenolol I-PAST_MEDICAL_HISTORY 50 I-PAST_MEDICAL_HISTORY mg/12 I-PAST_MEDICAL_HISTORY horas, I-PAST_MEDICAL_HISTORY Ranipril I-PAST_MEDICAL_HISTORY 2, I-PAST_MEDICAL_HISTORY 5 I-PAST_MEDICAL_HISTORY mg/12 I-PAST_MEDICAL_HISTORY horas, I-PAST_MEDICAL_HISTORY Acido I-PAST_MEDICAL_HISTORY acetilsalicílico I-PAST_MEDICAL_HISTORY 100 I-PAST_MEDICAL_HISTORY mg/24 I-PAST_MEDICAL_HISTORY horas I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY Lorazepam I-PAST_MEDICAL_HISTORY 1 I-PAST_MEDICAL_HISTORY mg/24 I-PAST_MEDICAL_HISTORY horas. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY Como B-PRESENT_ILLNESS antecedente I-PRESENT_ILLNESS personal I-PRESENT_ILLNESS más I-PRESENT_ILLNESS próximo, I-PRESENT_ILLNESS señalar I-PRESENT_ILLNESS que I-PRESENT_ILLNESS dos I-PRESENT_ILLNESS semanas I-PRESENT_ILLNESS antes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS empezar I-PRESENT_ILLNESS con I-PRESENT_ILLNESS los I-PRESENT_ILLNESS problemas I-PRESENT_ILLNESS oculares I-PRESENT_ILLNESS había I-PRESENT_ILLNESS sido I-PRESENT_ILLNESS ingresada I-PRESENT_ILLNESS en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS medicina I-PRESENT_ILLNESS interna I-PRESENT_ILLNESS con I-PRESENT_ILLNESS el I-PRESENT_ILLNESS diagnóstico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS Neumonía I-PRESENT_ILLNESS neumocócica I-PRESENT_ILLNESS en I-PRESENT_ILLNESS lóbulo I-PRESENT_ILLNESS superior I-PRESENT_ILLNESS derecho I-PRESENT_ILLNESS tratada I-PRESENT_ILLNESS con I-PRESENT_ILLNESS Moxifloxacino I-PRESENT_ILLNESS a I-PRESENT_ILLNESS dosis I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 400 I-PRESENT_ILLNESS mg/24 I-PRESENT_ILLNESS horas I-PRESENT_ILLNESS durante I-PRESENT_ILLNESS 10 I-PRESENT_ILLNESS días, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS buena I-PRESENT_ILLNESS respuesta. I-PRESENT_ILLNESS Tras I-PRESENT_ILLNESS el I-PRESENT_ILLNESS alta I-PRESENT_ILLNESS hospitalaria, I-PRESENT_ILLNESS ya I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS tratamiento I-PRESENT_ILLNESS antibiótico, I-PRESENT_ILLNESS la I-PRESENT_ILLNESS paciente I-PRESENT_ILLNESS comienza I-PRESENT_ILLNESS a I-PRESENT_ILLNESS referir I-PRESENT_ILLNESS molestias I-PRESENT_ILLNESS oculares I-PRESENT_ILLNESS de I-PRESENT_ILLNESS manera I-PRESENT_ILLNESS alterna I-PRESENT_ILLNESS en I-PRESENT_ILLNESS AO. I-PRESENT_ILLNESS I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION oftalmológica I-EXPLORATION se I-EXPLORATION objetiva I-EXPLORATION una I-EXPLORATION AV I-EXPLORATION en I-EXPLORATION ojo I-EXPLORATION derecho I-EXPLORATION (OD) I-EXPLORATION de I-EXPLORATION 0, I-EXPLORATION 6 I-EXPLORATION que I-EXPLORATION mejora I-EXPLORATION a I-EXPLORATION 0, I-EXPLORATION 8 I-EXPLORATION con I-EXPLORATION corrección I-EXPLORATION y I-EXPLORATION en I-EXPLORATION el I-EXPLORATION ojo I-EXPLORATION izquierdo I-EXPLORATION (OI) I-EXPLORATION de I-EXPLORATION 0, I-EXPLORATION 3 I-EXPLORATION que I-EXPLORATION mejora I-EXPLORATION a I-EXPLORATION 0, I-EXPLORATION 6 I-EXPLORATION con I-EXPLORATION corrección. I-EXPLORATION I-EXPLORATION En I-EXPLORATION el I-EXPLORATION segmento I-EXPLORATION anterior I-EXPLORATION destaca I-EXPLORATION una I-EXPLORATION reacción I-EXPLORATION inflamatoria I-EXPLORATION en I-EXPLORATION cámara I-EXPLORATION anterior I-EXPLORATION de I-EXPLORATION AO I-EXPLORATION (Fenómeno I-EXPLORATION de I-EXPLORATION tyndall I-EXPLORATION de I-EXPLORATION células I-EXPLORATION +1 I-EXPLORATION y I-EXPLORATION proteínas I-EXPLORATION +1), I-EXPLORATION y I-EXPLORATION una I-EXPLORATION fuerte I-EXPLORATION dispersión I-EXPLORATION de I-EXPLORATION pigmento I-EXPLORATION (+/++) I-EXPLORATION que I-EXPLORATION se I-EXPLORATION deposita I-EXPLORATION en I-EXPLORATION todas I-EXPLORATION las I-EXPLORATION estructuras: I-EXPLORATION en I-EXPLORATION el I-EXPLORATION endotelio I-EXPLORATION corneal I-EXPLORATION de I-EXPLORATION forma I-EXPLORATION difusa, I-EXPLORATION sobre I-EXPLORATION el I-EXPLORATION iris, I-EXPLORATION sinequias I-EXPLORATION posteriores I-EXPLORATION y I-EXPLORATION malla I-EXPLORATION trabecular. I-EXPLORATION I-EXPLORATION La I-EXPLORATION tensión I-EXPLORATION ocular I-EXPLORATION era I-EXPLORATION de I-EXPLORATION 9 I-EXPLORATION mm I-EXPLORATION Hg I-EXPLORATION en I-EXPLORATION OD I-EXPLORATION y I-EXPLORATION 8 I-EXPLORATION mmHg I-EXPLORATION en I-EXPLORATION OI. I-EXPLORATION El I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo, I-EXPLORATION bajo I-EXPLORATION midriasis I-EXPLORATION farmacológica, I-EXPLORATION era I-EXPLORATION normal, I-EXPLORATION y I-EXPLORATION no I-EXPLORATION se I-EXPLORATION apreció I-EXPLORATION reacción I-EXPLORATION inflamatoria I-EXPLORATION en I-EXPLORATION la I-EXPLORATION cámara I-EXPLORATION vítrea. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION historia I-EXPLORATION clínica, I-EXPLORATION dentro I-EXPLORATION del I-EXPLORATION protocolo I-EXPLORATION de I-EXPLORATION uveítis I-EXPLORATION seguido I-EXPLORATION en I-EXPLORATION nuestro I-EXPLORATION departamento, I-EXPLORATION que I-EXPLORATION incluyó I-EXPLORATION una I-EXPLORATION anamnesis I-EXPLORATION por I-EXPLORATION aparatos I-EXPLORATION y I-EXPLORATION la I-EXPLORATION solicitud I-EXPLORATION de I-EXPLORATION las I-EXPLORATION exploraciones I-EXPLORATION complementarias I-EXPLORATION dirigidas, I-EXPLORATION sistemático I-EXPLORATION de I-EXPLORATION sangre, I-EXPLORATION bioquímica, I-EXPLORATION VDRL, I-EXPLORATION FTA-abs I-EXPLORATION y I-EXPLORATION placa I-EXPLORATION de I-EXPLORATION tórax. I-EXPLORATION I-EXPLORATION Se B-TREATMENT inició I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT midriáticos I-TREATMENT y I-TREATMENT corticoides I-TREATMENT tópicos I-TREATMENT cediendo B-EXPLORATION el I-EXPLORATION cuadro I-EXPLORATION en I-EXPLORATION pocos I-EXPLORATION días, I-EXPLORATION manteniéndose, I-EXPLORATION en I-EXPLORATION las I-EXPLORATION sucesivas I-EXPLORATION revisiones, I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION pigmento I-EXPLORATION en I-EXPLORATION numerosas I-EXPLORATION estructuras I-EXPLORATION del I-EXPLORATION segmento I-EXPLORATION anterior I-EXPLORATION y I-EXPLORATION manteniendo I-EXPLORATION una I-EXPLORATION presión I-EXPLORATION intraocular I-EXPLORATION de I-EXPLORATION 14 I-EXPLORATION mmHg I-EXPLORATION en I-EXPLORATION AO. I-EXPLORATION I-EXPLORATION Las I-EXPLORATION exploraciones I-EXPLORATION complementarias I-EXPLORATION realizadas I-EXPLORATION no I-EXPLORATION detectaron I-EXPLORATION ninguna I-EXPLORATION alteración I-EXPLORATION significativa. I-EXPLORATION I-EXPLORATION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 18 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY interés, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS acudió I-PRESENT_ILLNESS a I-PRESENT_ILLNESS urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS cefalea I-PRESENT_ILLNESS holocraneal I-PRESENT_ILLNESS con I-PRESENT_ILLNESS fiebre I-PRESENT_ILLNESS y I-PRESENT_ILLNESS vómitos. I-PRESENT_ILLNESS I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION neurológica I-EXPLORATION presentaba I-EXPLORATION hipoestesia I-EXPLORATION de I-EXPLORATION miembro I-EXPLORATION superior I-EXPLORATION derecho I-EXPLORATION y I-EXPLORATION dudosa I-EXPLORATION rigidez I-EXPLORATION de I-EXPLORATION nuca, I-EXPLORATION sin I-EXPLORATION otros I-EXPLORATION signos I-EXPLORATION meníngeos. I-EXPLORATION I-EXPLORATION La I-EXPLORATION tomografía I-EXPLORATION axial I-EXPLORATION computarizada I-EXPLORATION (TAC) I-EXPLORATION cerebral I-EXPLORATION era I-EXPLORATION normal, I-EXPLORATION el I-EXPLORATION análisis I-EXPLORATION del I-EXPLORATION líquido I-EXPLORATION cefalorraquídeo I-EXPLORATION (LCR) I-EXPLORATION mostró I-EXPLORATION hiperproteinorraquia, I-EXPLORATION hipoglucorraquia I-EXPLORATION y I-EXPLORATION pleocitosis I-EXPLORATION (98% I-EXPLORATION linfocitos). I-EXPLORATION Ante B-TREATMENT la I-TREATMENT sospecha I-TREATMENT de I-TREATMENT meningitis I-TREATMENT vírica I-TREATMENT o I-TREATMENT bacteriana I-TREATMENT decapitada, I-TREATMENT se I-TREATMENT instauró I-TREATMENT tratamiento I-TREATMENT intravenoso I-TREATMENT con I-TREATMENT aciclovir, I-TREATMENT ceftriaxona I-TREATMENT y I-TREATMENT ampicilina. I-TREATMENT I-TREATMENT A B-EVOLUTION los I-EVOLUTION 3 I-EVOLUTION días I-EVOLUTION presentó I-EVOLUTION disminución I-EVOLUTION de I-EVOLUTION conciencia, I-EVOLUTION midriasis I-EVOLUTION arreactiva I-EVOLUTION bilateral I-EVOLUTION y I-EVOLUTION parálisis I-EVOLUTION bilateral I-EVOLUTION de I-EVOLUTION los I-EVOLUTION pares I-EVOLUTION craneales I-EVOLUTION III, I-EVOLUTION IV, I-EVOLUTION VI, I-EVOLUTION VII, I-EVOLUTION IX I-EVOLUTION y I-EVOLUTION X. I-EVOLUTION La B-EXPLORATION resonancia I-EXPLORATION magnética I-EXPLORATION nuclear I-EXPLORATION (RMN) I-EXPLORATION mostró I-EXPLORATION realce I-EXPLORATION lepto I-EXPLORATION y I-EXPLORATION paquimeníngeo I-EXPLORATION e I-EXPLORATION hidrocefalia I-EXPLORATION tetraventricular. I-EXPLORATION A B-TREATMENT pesar I-TREATMENT de I-TREATMENT los I-TREATMENT resultados I-TREATMENT microbiológicos I-TREATMENT no I-TREATMENT concluyentes I-TREATMENT (hemocultivos, I-TREATMENT Mantoux, I-TREATMENT Tinción I-TREATMENT tinta I-TREATMENT china I-TREATMENT y I-TREATMENT Ziehl I-TREATMENT de I-TREATMENT LCR: I-TREATMENT todos I-TREATMENT negativos), I-TREATMENT y I-TREATMENT ante I-TREATMENT la I-TREATMENT sospecha I-TREATMENT de I-TREATMENT leptomeningitis I-TREATMENT tuberculosa I-TREATMENT se I-TREATMENT modificó I-TREATMENT el I-TREATMENT tratamiento, I-TREATMENT pautándose I-TREATMENT inicialmente I-TREATMENT isoniacida I-TREATMENT 600 I-TREATMENT mg/día I-TREATMENT (más I-TREATMENT vitamina I-TREATMENT B6), I-TREATMENT etambutol I-TREATMENT 22 I-TREATMENT mg/kg/día I-TREATMENT y I-TREATMENT rifampicina I-TREATMENT 600 I-TREATMENT mg/día; I-TREATMENT a I-TREATMENT las I-TREATMENT 48 I-TREATMENT horas I-TREATMENT se I-TREATMENT suspendió I-TREATMENT el I-TREATMENT etambutol I-TREATMENT y I-TREATMENT se I-TREATMENT añadió I-TREATMENT pirazinamida I-TREATMENT 1, I-TREATMENT 5 I-TREATMENT g/día, I-TREATMENT estreptomicina I-TREATMENT 1g/día I-TREATMENT y I-TREATMENT dexametasona I-TREATMENT 24 I-TREATMENT mg/día I-TREATMENT sustituyendo I-TREATMENT la I-TREATMENT ampicilina I-TREATMENT por I-TREATMENT cotrimoxazol. I-TREATMENT I-TREATMENT A B-EVOLUTION los I-EVOLUTION 12 I-EVOLUTION días I-EVOLUTION la I-EVOLUTION agudeza I-EVOLUTION visual I-EVOLUTION (AV) I-EVOLUTION bajó I-EVOLUTION a I-EVOLUTION amaurosis I-EVOLUTION bilateral I-EVOLUTION con I-EVOLUTION alucinaciones I-EVOLUTION visuales. I-EVOLUTION La B-EXPLORATION funduscopia I-EXPLORATION era I-EXPLORATION normal. I-EXPLORATION Los I-EXPLORATION potenciales I-EXPLORATION visuales I-EXPLORATION evocados I-EXPLORATION (PEV) I-EXPLORATION mostraron I-EXPLORATION una I-EXPLORATION onda I-EXPLORATION P100 I-EXPLORATION muy I-EXPLORATION degradada I-EXPLORATION con I-EXPLORATION latencia I-EXPLORATION muy I-EXPLORATION aumentada, I-EXPLORATION en I-EXPLORATION la I-EXPLORATION estimulación I-EXPLORATION mono I-EXPLORATION y I-EXPLORATION binocular. I-EXPLORATION I-EXPLORATION El I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION meningitis I-EXPLORATION tuberculosa I-EXPLORATION se I-EXPLORATION confirmó I-EXPLORATION mediante I-EXPLORATION cultivo I-EXPLORATION del I-EXPLORATION LCR I-EXPLORATION en I-EXPLORATION medio I-EXPLORATION Lowestein. I-EXPLORATION I-EXPLORATION Durante B-TREATMENT 6 I-TREATMENT meses I-TREATMENT se I-TREATMENT mantuvo I-TREATMENT el I-TREATMENT tratamiento I-TREATMENT tuberculostático I-TREATMENT (rifampicina I-TREATMENT y I-TREATMENT piridoxina) I-TREATMENT y I-TREATMENT dexametasona. I-TREATMENT I-TREATMENT La B-EVOLUTION AV I-EVOLUTION mejoró I-EVOLUTION lentamente I-EVOLUTION y B-EXPLORATION al I-EXPLORATION año I-EXPLORATION presenta I-EXPLORATION la I-EXPLORATION siguiente I-EXPLORATION exploración: I-EXPLORATION AV I-EXPLORATION bilateral: I-EXPLORATION 1/1, I-EXPLORATION leve I-EXPLORATION midriasis I-EXPLORATION reactiva, I-EXPLORATION sin I-EXPLORATION restricciones I-EXPLORATION en I-EXPLORATION la I-EXPLORATION motilidad I-EXPLORATION ocular I-EXPLORATION extrínseca I-EXPLORATION y I-EXPLORATION el I-EXPLORATION nervio I-EXPLORATION óptico I-EXPLORATION presenta I-EXPLORATION una I-EXPLORATION leve I-EXPLORATION palidez I-EXPLORATION papilar I-EXPLORATION sin I-EXPLORATION aumento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION excavación. I-EXPLORATION I-EXPLORATION La I-EXPLORATION perimetría I-EXPLORATION computarizada I-EXPLORATION en I-EXPLORATION ojo I-EXPLORATION derecho I-EXPLORATION muestra I-EXPLORATION una I-EXPLORATION reducción I-EXPLORATION concéntrica I-EXPLORATION con I-EXPLORATION respeto I-EXPLORATION de I-EXPLORATION los I-EXPLORATION 10º I-EXPLORATION centrales, I-EXPLORATION y I-EXPLORATION en I-EXPLORATION ojo I-EXPLORATION izquierdo I-EXPLORATION una I-EXPLORATION reducción I-EXPLORATION concéntrica I-EXPLORATION en I-EXPLORATION hemicampo I-EXPLORATION temporal I-EXPLORATION y I-EXPLORATION parte I-EXPLORATION del I-EXPLORATION nasal. I-EXPLORATION Los I-EXPLORATION PVE I-EXPLORATION demuestran I-EXPLORATION una I-EXPLORATION notable I-EXPLORATION mejoría I-EXPLORATION de I-EXPLORATION la I-EXPLORATION onda I-EXPLORATION P100 I-EXPLORATION en I-EXPLORATION voltaje, I-EXPLORATION latencia I-EXPLORATION y I-EXPLORATION morfología. I-EXPLORATION I-EXPLORATION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 78 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS afáquica B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY ambos I-PAST_MEDICAL_HISTORY ojos I-PAST_MEDICAL_HISTORY tras I-PAST_MEDICAL_HISTORY haber I-PAST_MEDICAL_HISTORY sido I-PAST_MEDICAL_HISTORY intervenida I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY cataratas I-PAST_MEDICAL_HISTORY veinte I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY antes, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS desarrolló I-PRESENT_ILLNESS un I-PRESENT_ILLNESS glaucoma I-PRESENT_ILLNESS secundario I-PRESENT_ILLNESS en I-PRESENT_ILLNESS ojo I-PRESENT_ILLNESS derecho I-PRESENT_ILLNESS (OD). I-PRESENT_ILLNESS Ante B-TREATMENT la I-TREATMENT falta I-TREATMENT de I-TREATMENT control I-TREATMENT de I-TREATMENT su I-TREATMENT presión I-TREATMENT intraocular I-TREATMENT con I-TREATMENT el I-TREATMENT tratamiento I-TREATMENT médico, I-TREATMENT se I-TREATMENT decidió I-TREATMENT la I-TREATMENT implantación I-TREATMENT de I-TREATMENT un I-TREATMENT dispositivo I-TREATMENT de I-TREATMENT drenaje I-TREATMENT valvulado I-TREATMENT de I-TREATMENT Ahmed, I-TREATMENT con I-TREATMENT parche I-TREATMENT de I-TREATMENT esclera I-TREATMENT recubriendo I-TREATMENT el I-TREATMENT trayecto I-TREATMENT extraocular I-TREATMENT del I-TREATMENT tubo I-TREATMENT y I-TREATMENT el I-TREATMENT extremo I-TREATMENT del I-TREATMENT mismo I-TREATMENT localizado I-TREATMENT en I-TREATMENT cámara I-TREATMENT anterior. I-TREATMENT El B-EVOLUTION postoperatorio I-EVOLUTION evolucionó I-EVOLUTION favorablemente. I-EVOLUTION La I-EVOLUTION agudeza I-EVOLUTION visual I-EVOLUTION (AV) I-EVOLUTION postoperatoria I-EVOLUTION era I-EVOLUTION de I-EVOLUTION 0, I-EVOLUTION 5 I-EVOLUTION en I-EVOLUTION OD I-EVOLUTION y I-EVOLUTION 0, I-EVOLUTION 2 I-EVOLUTION en I-EVOLUTION ojo I-EVOLUTION izquierdo I-EVOLUTION (OI). I-EVOLUTION La B-TREATMENT presión I-TREATMENT intraocular I-TREATMENT en I-TREATMENT OD I-TREATMENT era I-TREATMENT de I-TREATMENT 12 I-TREATMENT mmHg I-TREATMENT en I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT tartrato I-TREATMENT de I-TREATMENT brimonidina I-TREATMENT 0, I-TREATMENT 2%. I-TREATMENT El I-TREATMENT cuerpo I-TREATMENT valvular I-TREATMENT estaba I-TREATMENT situado I-TREATMENT en I-TREATMENT el I-TREATMENT cuadrante I-TREATMENT temporal I-TREATMENT superior I-TREATMENT y I-TREATMENT la I-TREATMENT ampolla I-TREATMENT era I-TREATMENT amplia I-TREATMENT y I-TREATMENT de I-TREATMENT paredes I-TREATMENT finas. I-TREATMENT El I-TREATMENT tubo I-TREATMENT quedaba I-TREATMENT situado I-TREATMENT en I-TREATMENT cámara I-TREATMENT anterior I-TREATMENT y I-TREATMENT libre I-TREATMENT de I-TREATMENT vítreo. I-TREATMENT Acudió B-EVOLUTION a I-EVOLUTION urgencias I-EVOLUTION nueve I-EVOLUTION meses I-EVOLUTION tras I-EVOLUTION la I-EVOLUTION cirugía I-EVOLUTION siendo I-EVOLUTION diagnosticada I-EVOLUTION de I-EVOLUTION conjuntivitis I-EVOLUTION aguda I-EVOLUTION en I-EVOLUTION el I-EVOLUTION OD, I-EVOLUTION se B-TREATMENT instauró I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT medidas I-TREATMENT higiénicas I-TREATMENT y I-TREATMENT colirio I-TREATMENT de I-TREATMENT tobramicina I-TREATMENT 1 I-TREATMENT gota/8 I-TREATMENT horas I-TREATMENT (Tobrex I-TREATMENT solución I-TREATMENT Gotas I-TREATMENT oft. I-TREATMENT 0, I-TREATMENT 3%; I-TREATMENT Alcon I-TREATMENT Cusi; I-TREATMENT Barcelona; I-TREATMENT España) I-TREATMENT y I-TREATMENT lágrimas I-TREATMENT artificiales I-TREATMENT a I-TREATMENT demanda. I-TREATMENT Cuatro B-EVOLUTION días I-EVOLUTION más I-EVOLUTION tarde I-EVOLUTION acudió I-EVOLUTION a I-EVOLUTION revisión I-EVOLUTION presentando I-EVOLUTION una I-EVOLUTION AV I-EVOLUTION de I-EVOLUTION movimiento I-EVOLUTION de I-EVOLUTION manos. I-EVOLUTION En B-EXPLORATION la I-EXPLORATION biomicroscopía I-EXPLORATION presentaba I-EXPLORATION hiperemia I-EXPLORATION 3-4 I-EXPLORATION +, I-EXPLORATION blebitis, I-EXPLORATION no I-EXPLORATION seidel, I-EXPLORATION edema I-EXPLORATION corneal I-EXPLORATION difuso I-EXPLORATION de I-EXPLORATION 3+, I-EXPLORATION tyndall I-EXPLORATION 4+, I-EXPLORATION plastrón I-EXPLORATION de I-EXPLORATION fibrina I-EXPLORATION en I-EXPLORATION cámara I-EXPLORATION anterior, I-EXPLORATION no I-EXPLORATION hipopion I-EXPLORATION y I-EXPLORATION PIO I-EXPLORATION de I-EXPLORATION 35 I-EXPLORATION mm I-EXPLORATION Hg. I-EXPLORATION La I-EXPLORATION conjuntiva I-EXPLORATION que I-EXPLORATION recubría I-EXPLORATION el I-EXPLORATION tubo I-EXPLORATION y I-EXPLORATION la I-EXPLORATION cápsula I-EXPLORATION filtrante I-EXPLORATION parecía I-EXPLORATION íntegra. I-EXPLORATION El I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION no I-EXPLORATION se I-EXPLORATION visualizaba I-EXPLORATION por I-EXPLORATION opacidad I-EXPLORATION de I-EXPLORATION medios. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION ecografía I-EXPLORATION aparecían I-EXPLORATION ecos I-EXPLORATION de I-EXPLORATION baja I-EXPLORATION densidad, I-EXPLORATION sin I-EXPLORATION signos I-EXPLORATION de I-EXPLORATION desprendimiento I-EXPLORATION de I-EXPLORATION retina. I-EXPLORATION Ante B-TREATMENT el I-TREATMENT diagnóstico I-TREATMENT de I-TREATMENT una I-TREATMENT endoftalmitis I-TREATMENT aguda I-TREATMENT tardía, I-TREATMENT se I-TREATMENT decidió I-TREATMENT iniciar I-TREATMENT el I-TREATMENT protocolo I-TREATMENT existente I-TREATMENT en I-TREATMENT el I-TREATMENT hospital, I-TREATMENT con I-TREATMENT la I-TREATMENT obtención I-TREATMENT de I-TREATMENT muestras I-TREATMENT de I-TREATMENT humor I-TREATMENT acuoso I-TREATMENT y I-TREATMENT vítreo, I-TREATMENT y I-TREATMENT tratamiento I-TREATMENT intravenoso I-TREATMENT a I-TREATMENT base I-TREATMENT de I-TREATMENT ceftazidima I-TREATMENT 1 I-TREATMENT gramo/8 I-TREATMENT horas I-TREATMENT y I-TREATMENT vancomicina I-TREATMENT 1 I-TREATMENT gramo/12 I-TREATMENT horas, I-TREATMENT inyección I-TREATMENT intravítrea I-TREATMENT de I-TREATMENT ceftazidima I-TREATMENT 2, I-TREATMENT 25 I-TREATMENT mg/0, I-TREATMENT 1 I-TREATMENT ml I-TREATMENT y I-TREATMENT vancomicina I-TREATMENT 1 I-TREATMENT mg/0, I-TREATMENT 1 I-TREATMENT ml I-TREATMENT y I-TREATMENT colirio I-TREATMENT tópico I-TREATMENT reforzado I-TREATMENT 50 I-TREATMENT mg/ml I-TREATMENT de I-TREATMENT vancomicina I-TREATMENT y I-TREATMENT ceftazidima I-TREATMENT cada I-TREATMENT hora. I-TREATMENT A B-EXPLORATION las I-EXPLORATION 48 I-EXPLORATION horas I-EXPLORATION el I-EXPLORATION resultado I-EXPLORATION del I-EXPLORATION cultivo I-EXPLORATION fue I-EXPLORATION Haemophilus I-EXPLORATION influenzae I-EXPLORATION resistente I-EXPLORATION a I-EXPLORATION vancomicina I-EXPLORATION y I-EXPLORATION sensible I-EXPLORATION a I-EXPLORATION betalactámicos, I-EXPLORATION quinolonas, I-EXPLORATION rifamicina, I-EXPLORATION aminoglicósidos I-EXPLORATION y I-EXPLORATION tetraciclinas I-EXPLORATION por B-TREATMENT lo I-TREATMENT que I-TREATMENT se I-TREATMENT suspendió I-TREATMENT el I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT vancomicina I-TREATMENT y I-TREATMENT se I-TREATMENT añadió I-TREATMENT una I-TREATMENT quinolona I-TREATMENT intravenosa I-TREATMENT y I-TREATMENT tópica, I-TREATMENT además I-TREATMENT de I-TREATMENT una I-TREATMENT nueva I-TREATMENT inyección I-TREATMENT intravítrea I-TREATMENT de I-TREATMENT ceftazidima I-TREATMENT y I-TREATMENT decadrán. I-TREATMENT A I-TREATMENT las I-TREATMENT 72 I-TREATMENT horas, I-TREATMENT y I-TREATMENT ante I-TREATMENT la I-TREATMENT mala I-TREATMENT evolución, I-TREATMENT se I-TREATMENT decidió I-TREATMENT la I-TREATMENT retirada I-TREATMENT del I-TREATMENT dispositivo I-TREATMENT de I-TREATMENT drenaje, I-TREATMENT lavado I-TREATMENT de I-TREATMENT la I-TREATMENT cámara I-TREATMENT anterior, I-TREATMENT e I-TREATMENT inyección I-TREATMENT de I-TREATMENT ceftazidima I-TREATMENT subconjuntival I-TREATMENT e I-TREATMENT intravítrea. I-TREATMENT La I-TREATMENT mala I-TREATMENT visualización I-TREATMENT desestimó I-TREATMENT la I-TREATMENT práctica I-TREATMENT de I-TREATMENT vitrectomía. I-TREATMENT A I-TREATMENT los I-TREATMENT cuatro I-TREATMENT días, I-TREATMENT la I-TREATMENT AV I-TREATMENT era I-TREATMENT de I-TREATMENT no I-TREATMENT percepción I-TREATMENT de I-TREATMENT luz I-TREATMENT por I-TREATMENT lo I-TREATMENT que I-TREATMENT se I-TREATMENT decidió I-TREATMENT eviscerar. I-TREATMENT I-TREATMENT Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 36 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY ser I-PAST_MEDICAL_HISTORY bebedor I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY 350 I-PAST_MEDICAL_HISTORY gr/alcohol/día, I-PAST_MEDICAL_HISTORY fumador I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY 1 I-PAST_MEDICAL_HISTORY cajetilla/día, I-PAST_MEDICAL_HISTORY ExUDVP I-PAST_MEDICAL_HISTORY (heroína I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY cocaína), I-PAST_MEDICAL_HISTORY VHB I-PAST_MEDICAL_HISTORY +, I-PAST_MEDICAL_HISTORY VHC I-PAST_MEDICAL_HISTORY +, I-PAST_MEDICAL_HISTORY VIH I-PAST_MEDICAL_HISTORY -, I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY hepatitis I-PAST_MEDICAL_HISTORY crónica I-PAST_MEDICAL_HISTORY multifactorial I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY estadio I-PAST_MEDICAL_HISTORY A I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY Child I-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY datos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY hipertensión I-PAST_MEDICAL_HISTORY portal. I-PAST_MEDICAL_HISTORY Acude B-PRESENT_ILLNESS al I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS urgencias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS nuestro I-PRESENT_ILLNESS hospital I-PRESENT_ILLNESS por I-PRESENT_ILLNESS una I-PRESENT_ILLNESS pérdida I-PRESENT_ILLNESS brusca I-PRESENT_ILLNESS e I-PRESENT_ILLNESS importante I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS AV I-PRESENT_ILLNESS de I-PRESENT_ILLNESS varias I-PRESENT_ILLNESS horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución. I-PRESENT_ILLNESS I-PRESENT_ILLNESS El B-EXPLORATION estudio I-EXPLORATION oftalmológico I-EXPLORATION mostraba I-EXPLORATION una I-EXPLORATION AV I-EXPLORATION de I-EXPLORATION movimiento I-EXPLORATION de I-EXPLORATION manos I-EXPLORATION en I-EXPLORATION ambos I-EXPLORATION ojos I-EXPLORATION (AO), I-EXPLORATION con I-EXPLORATION un I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION con I-EXPLORATION infiltrados I-EXPLORATION en I-EXPLORATION polo I-EXPLORATION posterior I-EXPLORATION y I-EXPLORATION desprendimiento I-EXPLORATION seroso I-EXPLORATION macular. I-EXPLORATION El I-EXPLORATION resto I-EXPLORATION de I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION oftalmológica I-EXPLORATION era I-EXPLORATION normal. I-EXPLORATION Además I-EXPLORATION presentaba I-EXPLORATION fiebre I-EXPLORATION de I-EXPLORATION 38, I-EXPLORATION 4ºC I-EXPLORATION y I-EXPLORATION discreto I-EXPLORATION dolor I-EXPLORATION abdominal I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación I-EXPLORATION con I-EXPLORATION hepatomegalia I-EXPLORATION de I-EXPLORATION dos I-EXPLORATION traveses I-EXPLORATION de I-EXPLORATION dedo. I-EXPLORATION I-EXPLORATION Ante B-DERIVED_FROM/TO la I-DERIVED_FROM/TO sospecha I-DERIVED_FROM/TO de I-DERIVED_FROM/TO una I-DERIVED_FROM/TO pancreatitis I-DERIVED_FROM/TO aguda I-DERIVED_FROM/TO es I-DERIVED_FROM/TO derivado I-DERIVED_FROM/TO al I-DERIVED_FROM/TO Servicio I-DERIVED_FROM/TO de I-DERIVED_FROM/TO Medicina I-DERIVED_FROM/TO Interna, I-DERIVED_FROM/TO que B-EXPLORATION confirmada I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION tras I-EXPLORATION los I-EXPLORATION estudios I-EXPLORATION de I-EXPLORATION laboratorio: I-EXPLORATION Leucocitos I-EXPLORATION 12, I-EXPLORATION 4 I-EXPLORATION (4, I-EXPLORATION 8-10, I-EXPLORATION 8 I-EXPLORATION x103 I-EXPLORATION ul); I-EXPLORATION Neutrófilos I-EXPLORATION 88% I-EXPLORATION (42,2-75,2); I-EXPLORATION Volumen I-EXPLORATION Corpuscular I-EXPLORATION Medio I-EXPLORATION 111 I-EXPLORATION fl I-EXPLORATION (85,9-95,9); I-EXPLORATION Bilirrubina I-EXPLORATION total I-EXPLORATION 8, I-EXPLORATION 23 I-EXPLORATION mg/dl I-EXPLORATION (0,2-1,0); I-EXPLORATION Amilasa I-EXPLORATION 1.523 I-EXPLORATION u/l I-EXPLORATION (55-201); I-EXPLORATION GOT I-EXPLORATION 200 I-EXPLORATION u/l I-EXPLORATION (5-45); I-EXPLORATION GPT I-EXPLORATION 227 I-EXPLORATION u/l I-EXPLORATION (5-45); I-EXPLORATION GGT I-EXPLORATION 1.346 I-EXPLORATION u/l I-EXPLORATION (3-52); I-EXPLORATION Fosfatasa I-EXPLORATION Alcalina I-EXPLORATION 1.159 I-EXPLORATION u/l I-EXPLORATION (98-295); I-EXPLORATION Fibrinógeno I-EXPLORATION 157 I-EXPLORATION mg/dl I-EXPLORATION (200-400) I-EXPLORATION y I-EXPLORATION de I-EXPLORATION imagen I-EXPLORATION [tomografía I-EXPLORATION axial I-EXPLORATION computerizada I-EXPLORATION (TAC) I-EXPLORATION y I-EXPLORATION ecografía I-EXPLORATION abdominales I-EXPLORATION que I-EXPLORATION muestran I-EXPLORATION hepatopatía I-EXPLORATION grasa I-EXPLORATION y I-EXPLORATION infiltración I-EXPLORATION del I-EXPLORATION tejido I-EXPLORATION peripancreático, I-EXPLORATION especialmente I-EXPLORATION a I-EXPLORATION la I-EXPLORATION altura I-EXPLORATION de I-EXPLORATION la I-EXPLORATION cola I-EXPLORATION del I-EXPLORATION páncreas, I-EXPLORATION donde I-EXPLORATION la I-EXPLORATION infiltración I-EXPLORATION continúa I-EXPLORATION por I-EXPLORATION el I-EXPLORATION espacio I-EXPLORATION pararrenal I-EXPLORATION anterior I-EXPLORATION izquierdo]. I-EXPLORATION La I-EXPLORATION angiografía I-EXPLORATION fluoresceínica I-EXPLORATION mostraba I-EXPLORATION inicialmente I-EXPLORATION áreas I-EXPLORATION de I-EXPLORATION no I-EXPLORATION perfusión I-EXPLORATION capilar, I-EXPLORATION que I-EXPLORATION se I-EXPLORATION correspondían I-EXPLORATION con I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION los I-EXPLORATION exudados, I-EXPLORATION seguidas I-EXPLORATION de I-EXPLORATION difusión I-EXPLORATION en I-EXPLORATION tiempos I-EXPLORATION tardíos I-EXPLORATION y I-EXPLORATION efectos I-EXPLORATION pantalla I-EXPLORATION provocados I-EXPLORATION por I-EXPLORATION las I-EXPLORATION hemorragias I-EXPLORATION retinianas. I-EXPLORATION La B-TREATMENT resolución I-TREATMENT del I-TREATMENT cuadro I-TREATMENT digestivo I-TREATMENT fue I-TREATMENT favorable I-TREATMENT con I-TREATMENT tratamiento I-TREATMENT médico I-TREATMENT mediante I-TREATMENT sueroterapia, I-TREATMENT dieta I-TREATMENT absoluta I-TREATMENT y I-TREATMENT antibioticoterapia, I-TREATMENT con B-EVOLUTION rápida I-EVOLUTION mejoría I-EVOLUTION de I-EVOLUTION la I-EVOLUTION sintomatología I-EVOLUTION clínica I-EVOLUTION e I-EVOLUTION importante I-EVOLUTION mejoría I-EVOLUTION de I-EVOLUTION la I-EVOLUTION analítica I-EVOLUTION a I-EVOLUTION los I-EVOLUTION dos I-EVOLUTION semanas, I-EVOLUTION aunque B-EXPLORATION un I-EXPLORATION mes I-EXPLORATION después I-EXPLORATION presenta I-EXPLORATION una I-EXPLORATION encefalopatía I-EXPLORATION de I-EXPLORATION Wernicke I-EXPLORATION con I-EXPLORATION una I-EXPLORATION TAC I-EXPLORATION craneal I-EXPLORATION normal. I-EXPLORATION I-EXPLORATION A B-EVOLUTION los I-EVOLUTION dos I-EVOLUTION meses I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION había I-EVOLUTION recuperado I-EVOLUTION una I-EVOLUTION AV I-EVOLUTION de I-EVOLUTION 1 I-EVOLUTION en I-EVOLUTION AO I-EVOLUTION y I-EVOLUTION el I-EVOLUTION estudio I-EVOLUTION de I-EVOLUTION fondo I-EVOLUTION de I-EVOLUTION ojo I-EVOLUTION solo I-EVOLUTION mostraba I-EVOLUTION algún I-EVOLUTION pigmento I-EVOLUTION residual. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 58 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS acude I-PRESENT_ILLNESS de I-PRESENT_ILLNESS urgencia I-PRESENT_ILLNESS a I-PRESENT_ILLNESS nuestras I-PRESENT_ILLNESS consultas I-PRESENT_ILLNESS por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS ocular I-PRESENT_ILLNESS unilateral I-PRESENT_ILLNESS de I-PRESENT_ILLNESS unas I-PRESENT_ILLNESS horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS acompañado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS cierto I-PRESENT_ILLNESS grado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS disminución I-PRESENT_ILLNESS de I-PRESENT_ILLNESS agudeza I-PRESENT_ILLNESS visual. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION presenta I-EXPLORATION inyección I-EXPLORATION ciliar, I-EXPLORATION midriasis I-EXPLORATION media I-EXPLORATION arreactiva I-EXPLORATION y I-EXPLORATION una I-EXPLORATION presión I-EXPLORATION intraocular I-EXPLORATION de I-EXPLORATION 53 I-EXPLORATION mm I-EXPLORATION Hg. I-EXPLORATION Ante B-EVOLUTION este I-EVOLUTION cuadro I-EVOLUTION se I-EVOLUTION establece I-EVOLUTION el I-EVOLUTION diagnóstico I-EVOLUTION presuntivo I-EVOLUTION de I-EVOLUTION ataque I-EVOLUTION agudo I-EVOLUTION de I-EVOLUTION glaucoma I-EVOLUTION de I-EVOLUTION ángulo I-EVOLUTION estrecho I-EVOLUTION y I-EVOLUTION se I-EVOLUTION procede I-EVOLUTION a I-EVOLUTION la I-EVOLUTION toma I-EVOLUTION de I-EVOLUTION imágenes I-EVOLUTION mediante I-EVOLUTION BMU I-EVOLUTION y I-EVOLUTION OCT. I-EVOLUTION El B-EXPLORATION OCT I-EXPLORATION muestra I-EXPLORATION un I-EXPLORATION cierre I-EXPLORATION angular I-EXPLORATION con I-EXPLORATION contacto I-EXPLORATION entre I-EXPLORATION la I-EXPLORATION malla I-EXPLORATION trabecular I-EXPLORATION y I-EXPLORATION la I-EXPLORATION zona I-EXPLORATION más I-EXPLORATION periférica I-EXPLORATION del I-EXPLORATION iris I-EXPLORATION en I-EXPLORATION los I-EXPLORATION cuatro I-EXPLORATION cuadrantes. I-EXPLORATION De I-EXPLORATION igual I-EXPLORATION forma I-EXPLORATION la I-EXPLORATION BMU I-EXPLORATION muestra I-EXPLORATION una I-EXPLORATION disposición I-EXPLORATION similar I-EXPLORATION del I-EXPLORATION ángulo I-EXPLORATION en I-EXPLORATION los I-EXPLORATION 360º. I-EXPLORATION Se B-TREATMENT instaura I-TREATMENT el I-TREATMENT tratamiento I-TREATMENT médico I-TREATMENT correspondiente I-TREATMENT para I-TREATMENT posteriormente I-TREATMENT realizar I-TREATMENT unas I-TREATMENT iridotomías I-TREATMENT bilaterales I-TREATMENT con I-TREATMENT láser I-TREATMENT YAG. I-TREATMENT Tras B-EXPLORATION las I-EXPLORATION iridotomías I-EXPLORATION se I-EXPLORATION realiza I-EXPLORATION un I-EXPLORATION OCT I-EXPLORATION de I-EXPLORATION cámara I-EXPLORATION anterior I-EXPLORATION que I-EXPLORATION nos I-EXPLORATION muestra I-EXPLORATION como I-EXPLORATION la I-EXPLORATION iridotomía I-EXPLORATION en I-EXPLORATION el I-EXPLORATION ojo I-EXPLORATION del I-EXPLORATION ataque I-EXPLORATION agudo I-EXPLORATION de I-EXPLORATION glaucoma I-EXPLORATION no I-EXPLORATION es I-EXPLORATION permeable, I-EXPLORATION siendo B-TREATMENT necesario I-TREATMENT retratar I-TREATMENT la I-TREATMENT zona I-TREATMENT con I-TREATMENT nuevos I-TREATMENT impactos. I-TREATMENT Tras B-EVOLUTION este I-EVOLUTION segundo I-EVOLUTION tratamiento I-EVOLUTION se I-EVOLUTION realiza I-EVOLUTION un I-EVOLUTION nuevo I-EVOLUTION OCT I-EVOLUTION que, I-EVOLUTION esta I-EVOLUTION vez I-EVOLUTION sí, I-EVOLUTION muestra I-EVOLUTION permeabilidad I-EVOLUTION de I-EVOLUTION la I-EVOLUTION iridotomía, I-EVOLUTION apertura I-EVOLUTION del I-EVOLUTION ángulo I-EVOLUTION y I-EVOLUTION profundización I-EVOLUTION de I-EVOLUTION la I-EVOLUTION cámara I-EVOLUTION anterior. I-EVOLUTION I-EVOLUTION Una B-PRESENT_ILLNESS mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 25 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS fue B-DERIVED_FROM/TO remitida I-DERIVED_FROM/TO a I-DERIVED_FROM/TO nuestro I-DERIVED_FROM/TO servicio I-DERIVED_FROM/TO para I-DERIVED_FROM/TO confirmar I-DERIVED_FROM/TO la I-DERIVED_FROM/TO presencia I-DERIVED_FROM/TO de I-DERIVED_FROM/TO un I-DERIVED_FROM/TO síndrome I-DERIVED_FROM/TO de I-DERIVED_FROM/TO Susac, I-DERIVED_FROM/TO debido I-DERIVED_FROM/TO a I-DERIVED_FROM/TO una I-DERIVED_FROM/TO pérdida I-DERIVED_FROM/TO visual I-DERIVED_FROM/TO bilateral. I-DERIVED_FROM/TO La B-PAST_MEDICAL_HISTORY paciente I-PAST_MEDICAL_HISTORY tenía I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY historia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY alteraciones I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY equilibrio, I-PAST_MEDICAL_HISTORY ataxia, I-PAST_MEDICAL_HISTORY incontinencia I-PAST_MEDICAL_HISTORY fecal I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY urinaria, I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY pérdida I-PAST_MEDICAL_HISTORY auditiva I-PAST_MEDICAL_HISTORY izquierda I-PAST_MEDICAL_HISTORY desde I-PAST_MEDICAL_HISTORY hacía I-PAST_MEDICAL_HISTORY cuatro I-PAST_MEDICAL_HISTORY años, I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY estaba I-PAST_MEDICAL_HISTORY recibiendo I-PAST_MEDICAL_HISTORY corticoides, I-PAST_MEDICAL_HISTORY nimodipino I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY anticoagulantes. I-PAST_MEDICAL_HISTORY En B-EXPLORATION el I-EXPLORATION examen I-EXPLORATION neurológico I-EXPLORATION se I-EXPLORATION apreciaba I-EXPLORATION una I-EXPLORATION paraparesia I-EXPLORATION espástica, I-EXPLORATION hiperreflexia I-EXPLORATION tendinosa I-EXPLORATION y I-EXPLORATION disfunción I-EXPLORATION genitourinaria. I-EXPLORATION La I-EXPLORATION analítica I-EXPLORATION sanguínea I-EXPLORATION que I-EXPLORATION incluía I-EXPLORATION hemograma, I-EXPLORATION bioquímica I-EXPLORATION general, I-EXPLORATION velocidad I-EXPLORATION de I-EXPLORATION sedimentación I-EXPLORATION globular, I-EXPLORATION enzima I-EXPLORATION conversor I-EXPLORATION de I-EXPLORATION la I-EXPLORATION angiotensina I-EXPLORATION y I-EXPLORATION coagulación I-EXPLORATION resultaba I-EXPLORATION sin I-EXPLORATION alteraciones. I-EXPLORATION La I-EXPLORATION serología I-EXPLORATION de I-EXPLORATION lúes, I-EXPLORATION virus I-EXPLORATION de I-EXPLORATION la I-EXPLORATION inmunodeficiencia I-EXPLORATION humana, I-EXPLORATION herpes I-EXPLORATION simple, I-EXPLORATION hepatitis I-EXPLORATION B I-EXPLORATION y I-EXPLORATION C, I-EXPLORATION proteína I-EXPLORATION C I-EXPLORATION reactiva, I-EXPLORATION factor I-EXPLORATION reumatoide, I-EXPLORATION anticoagulante I-EXPLORATION lúpico, I-EXPLORATION anticuerpos I-EXPLORATION antinucleares, I-EXPLORATION anticardiolipina, I-EXPLORATION y I-EXPLORATION antifosfolípido I-EXPLORATION fue I-EXPLORATION negativa. I-EXPLORATION La I-EXPLORATION radiografía I-EXPLORATION de I-EXPLORATION tórax, I-EXPLORATION electrocardiograma, I-EXPLORATION ecocardiografía I-EXPLORATION y I-EXPLORATION tomografía I-EXPLORATION axial I-EXPLORATION computerizada I-EXPLORATION craneal I-EXPLORATION no I-EXPLORATION presentaban I-EXPLORATION alteraciones. I-EXPLORATION El I-EXPLORATION líquido I-EXPLORATION cefalorraquídeo I-EXPLORATION (LCR) I-EXPLORATION era I-EXPLORATION de I-EXPLORATION aspecto I-EXPLORATION claro I-EXPLORATION y I-EXPLORATION con I-EXPLORATION presión I-EXPLORATION de I-EXPLORATION apertura I-EXPLORATION normal, I-EXPLORATION con I-EXPLORATION ligero I-EXPLORATION aumento I-EXPLORATION de I-EXPLORATION proteínas, I-EXPLORATION y I-EXPLORATION resto I-EXPLORATION de I-EXPLORATION fórmula I-EXPLORATION normal. I-EXPLORATION La I-EXPLORATION serología I-EXPLORATION en I-EXPLORATION LCR I-EXPLORATION para I-EXPLORATION borrelia, I-EXPLORATION virus I-EXPLORATION de I-EXPLORATION Epstein-Barr, I-EXPLORATION citomegalovirus I-EXPLORATION y I-EXPLORATION lúes, I-EXPLORATION además I-EXPLORATION de I-EXPLORATION los I-EXPLORATION cultivos I-EXPLORATION habituales I-EXPLORATION resultaron I-EXPLORATION negativos. I-EXPLORATION La I-EXPLORATION detección I-EXPLORATION de I-EXPLORATION bandas I-EXPLORATION oligoclonales I-EXPLORATION en I-EXPLORATION el I-EXPLORATION mismo I-EXPLORATION también I-EXPLORATION resultó I-EXPLORATION negativa. I-EXPLORATION La I-EXPLORATION Resonancia I-EXPLORATION Magnética I-EXPLORATION Nuclear I-EXPLORATION (RMN) I-EXPLORATION cerebral I-EXPLORATION mostraba I-EXPLORATION múltiples I-EXPLORATION áreas I-EXPLORATION focales I-EXPLORATION de I-EXPLORATION hiperintensidad I-EXPLORATION en I-EXPLORATION la I-EXPLORATION sustancia I-EXPLORATION blanca I-EXPLORATION periventricular I-EXPLORATION y I-EXPLORATION pericallosa, I-EXPLORATION y I-EXPLORATION en I-EXPLORATION las I-EXPLORATION regiones I-EXPLORATION del I-EXPLORATION centro I-EXPLORATION semioval. I-EXPLORATION Los I-EXPLORATION tests I-EXPLORATION audiométricos I-EXPLORATION estándares I-EXPLORATION revelaron I-EXPLORATION pérdida I-EXPLORATION auditiva I-EXPLORATION neurosensorial, I-EXPLORATION asimétrica, I-EXPLORATION de I-EXPLORATION predominio I-EXPLORATION izquierdo, I-EXPLORATION para I-EXPLORATION las I-EXPLORATION bajas I-EXPLORATION frecuencias. I-EXPLORATION A I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION oftalmológica, I-EXPLORATION su I-EXPLORATION agudeza I-EXPLORATION visual I-EXPLORATION era I-EXPLORATION de I-EXPLORATION 20/25 I-EXPLORATION en I-EXPLORATION ambos I-EXPLORATION ojos. I-EXPLORATION La I-EXPLORATION campimetría I-EXPLORATION de I-EXPLORATION Goldmann I-EXPLORATION (Haag-Streit, I-EXPLORATION Berna, I-EXPLORATION Suiza) I-EXPLORATION mostró I-EXPLORATION una I-EXPLORATION cuadrantanopsia I-EXPLORATION inferior I-EXPLORATION bitemporal. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION biomicroscopía I-EXPLORATION del I-EXPLORATION segmento I-EXPLORATION anterior I-EXPLORATION no I-EXPLORATION se I-EXPLORATION apreciaban I-EXPLORATION hallazgos I-EXPLORATION destacables. I-EXPLORATION El I-EXPLORATION examen I-EXPLORATION funduscópico I-EXPLORATION reveló I-EXPLORATION una I-EXPLORATION microangiopatía I-EXPLORATION retiniana I-EXPLORATION periférica, I-EXPLORATION apreciándose I-EXPLORATION amputación I-EXPLORATION de I-EXPLORATION vasos I-EXPLORATION con I-EXPLORATION cúmulos I-EXPLORATION de I-EXPLORATION microaneurismas I-EXPLORATION en I-EXPLORATION ambos I-EXPLORATION ojos. I-EXPLORATION No I-EXPLORATION se I-EXPLORATION observaron I-EXPLORATION signos I-EXPLORATION de I-EXPLORATION inflamación I-EXPLORATION o I-EXPLORATION células I-EXPLORATION en I-EXPLORATION el I-EXPLORATION vítreo, I-EXPLORATION ni I-EXPLORATION envainamiento I-EXPLORATION de I-EXPLORATION los I-EXPLORATION vasos I-EXPLORATION retinianos. I-EXPLORATION La I-EXPLORATION angiografía I-EXPLORATION fluoresceínica I-EXPLORATION (AGF) I-EXPLORATION demostró I-EXPLORATION signos I-EXPLORATION de I-EXPLORATION isquemia I-EXPLORATION en I-EXPLORATION las I-EXPLORATION áreas I-EXPLORATION correspondientes I-EXPLORATION a I-EXPLORATION las I-EXPLORATION oclusiones I-EXPLORATION arteriolares. I-EXPLORATION El I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION síndrome I-EXPLORATION de I-EXPLORATION Susac I-EXPLORATION se I-EXPLORATION basó I-EXPLORATION en I-EXPLORATION la I-EXPLORATION asociación I-EXPLORATION de I-EXPLORATION encefalopatía I-EXPLORATION con I-EXPLORATION hallazgos I-EXPLORATION típicos I-EXPLORATION en I-EXPLORATION la I-EXPLORATION RMN, I-EXPLORATION microangiopatía I-EXPLORATION retiniana I-EXPLORATION y I-EXPLORATION pérdida I-EXPLORATION auditiva I-EXPLORATION neurosensorial. I-EXPLORATION I-EXPLORATION Debido B-TREATMENT a I-TREATMENT la I-TREATMENT evidente I-TREATMENT isquemia I-TREATMENT retiniana I-TREATMENT periférica I-TREATMENT apreciada I-TREATMENT en I-TREATMENT la I-TREATMENT AGF, I-TREATMENT se I-TREATMENT le I-TREATMENT realizó I-TREATMENT fotocoagulación I-TREATMENT retiniana I-TREATMENT con I-TREATMENT láser I-TREATMENT en I-TREATMENT las I-TREATMENT áreas I-TREATMENT isquémicas I-TREATMENT de I-TREATMENT forma I-TREATMENT profiláctica, I-TREATMENT manteniéndose I-TREATMENT estable I-TREATMENT el I-TREATMENT cuadro I-TREATMENT visual I-TREATMENT desde I-TREATMENT entonces. I-TREATMENT Al B-EVOLUTION cabo I-EVOLUTION de I-EVOLUTION dos I-EVOLUTION años I-EVOLUTION no I-EVOLUTION ha I-EVOLUTION habido I-EVOLUTION variaciones I-EVOLUTION significativas I-EVOLUTION tanto I-EVOLUTION en I-EVOLUTION el I-EVOLUTION estado I-EVOLUTION neurológico I-EVOLUTION como I-EVOLUTION auditivo. I-EVOLUTION I-EVOLUTION Varón, B-PRESENT_ILLNESS hijo B-PAST_MEDICAL_HISTORY único, I-PAST_MEDICAL_HISTORY nacido I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY cuarenta I-PAST_MEDICAL_HISTORY semanas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY gestación I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY cesárea. I-PAST_MEDICAL_HISTORY Como B-FAMILY_HISTORY antecedentes I-FAMILY_HISTORY familiares I-FAMILY_HISTORY destacar I-FAMILY_HISTORY que I-FAMILY_HISTORY su I-FAMILY_HISTORY madre I-FAMILY_HISTORY presentaba I-FAMILY_HISTORY diabetes I-FAMILY_HISTORY mellitus I-FAMILY_HISTORY no I-FAMILY_HISTORY insulinodependiente I-FAMILY_HISTORY desde I-FAMILY_HISTORY los I-FAMILY_HISTORY 17 I-FAMILY_HISTORY años I-FAMILY_HISTORY y I-FAMILY_HISTORY no I-FAMILY_HISTORY existir I-FAMILY_HISTORY consaguinidad I-FAMILY_HISTORY entre I-FAMILY_HISTORY los I-FAMILY_HISTORY padres. I-FAMILY_HISTORY I-FAMILY_HISTORY A B-PRESENT_ILLNESS los I-PRESENT_ILLNESS cuatro I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS vida, I-PRESENT_ILLNESS sufre I-PRESENT_ILLNESS una I-PRESENT_ILLNESS parada I-PRESENT_ILLNESS cardiorrespiratoria, I-PRESENT_ILLNESS (diagnosticado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS cardiomiopatía I-PRESENT_ILLNESS dilatada) I-PRESENT_ILLNESS (1). I-PRESENT_ILLNESS Durante B-EVOLUTION su I-EVOLUTION ingreso I-EVOLUTION hospitalario I-EVOLUTION comienza I-EVOLUTION con I-EVOLUTION fotofobia I-EVOLUTION y I-EVOLUTION nistagmus I-EVOLUTION intermitente, I-EVOLUTION y B-EXPLORATION se I-EXPLORATION recomienda I-EXPLORATION revisión I-EXPLORATION oftalmológica I-EXPLORATION en I-EXPLORATION su I-EXPLORATION lugar I-EXPLORATION de I-EXPLORATION origen. I-EXPLORATION I-EXPLORATION El I-EXPLORATION niño I-EXPLORATION presenta I-EXPLORATION un I-EXPLORATION retraso I-EXPLORATION psicomotor I-EXPLORATION por I-EXPLORATION lo I-EXPLORATION que I-EXPLORATION se I-EXPLORATION solicita I-EXPLORATION una I-EXPLORATION Resonancia I-EXPLORATION Magnética I-EXPLORATION Nuclear I-EXPLORATION (RMN) I-EXPLORATION y B-TREATMENT comienza I-TREATMENT desde I-TREATMENT el I-TREATMENT año I-TREATMENT de I-TREATMENT vida I-TREATMENT con I-TREATMENT tratamiento I-TREATMENT de I-TREATMENT estimulación I-TREATMENT precoz, I-TREATMENT consiguiendo I-TREATMENT en I-TREATMENT ocho I-TREATMENT meses I-TREATMENT los I-TREATMENT objetivos I-TREATMENT propuestos. I-TREATMENT En B-EXPLORATION la I-EXPLORATION RMN I-EXPLORATION se I-EXPLORATION observan I-EXPLORATION pequeñas I-EXPLORATION áreas I-EXPLORATION de I-EXPLORATION aumento I-EXPLORATION de I-EXPLORATION señal I-EXPLORATION en I-EXPLORATION T2 I-EXPLORATION y I-EXPLORATION FLAIR I-EXPLORATION en I-EXPLORATION las I-EXPLORATION regiones I-EXPLORATION periatriales I-EXPLORATION y I-EXPLORATION sustancia I-EXPLORATION blanca I-EXPLORATION temporal. I-EXPLORATION I-EXPLORATION A B-DERIVED_FROM/TO los I-DERIVED_FROM/TO dos I-DERIVED_FROM/TO años I-DERIVED_FROM/TO es I-DERIVED_FROM/TO remitido I-DERIVED_FROM/TO a I-DERIVED_FROM/TO nuestro I-DERIVED_FROM/TO Hospital I-DERIVED_FROM/TO para I-DERIVED_FROM/TO estudio I-DERIVED_FROM/TO ecográfico I-DERIVED_FROM/TO y I-DERIVED_FROM/TO oftalmológico. I-DERIVED_FROM/TO Se B-EXPLORATION solicita I-EXPLORATION un I-EXPLORATION ERG I-EXPLORATION que I-EXPLORATION muestra I-EXPLORATION ausencia I-EXPLORATION de I-EXPLORATION respuestas, I-EXPLORATION y I-EXPLORATION Potenciales I-EXPLORATION Evocados I-EXPLORATION Visuales I-EXPLORATION (PEV) I-EXPLORATION normales. I-EXPLORATION Oftalmoscópicamente I-EXPLORATION muestra I-EXPLORATION nistagmus I-EXPLORATION con I-EXPLORATION fotofobia I-EXPLORATION intensa. I-EXPLORATION El I-EXPLORATION segmento I-EXPLORATION anterior I-EXPLORATION y I-EXPLORATION el I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION son I-EXPLORATION normales. I-EXPLORATION I-EXPLORATION Como I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION clínico I-EXPLORATION es I-EXPLORATION sugestivo I-EXPLORATION de I-EXPLORATION Síndrome I-EXPLORATION de I-EXPLORATION Alström, I-EXPLORATION se I-EXPLORATION solicita I-EXPLORATION un I-EXPLORATION estudio I-EXPLORATION genético I-EXPLORATION en I-EXPLORATION el I-EXPLORATION que I-EXPLORATION tras I-EXPLORATION analizar I-EXPLORATION los I-EXPLORATION exones I-EXPLORATION 10, I-EXPLORATION 16 I-EXPLORATION y I-EXPLORATION un I-EXPLORATION segmento I-EXPLORATION del I-EXPLORATION exón I-EXPLORATION 8 I-EXPLORATION del I-EXPLORATION gen I-EXPLORATION ALMS-1 I-EXPLORATION (3) I-EXPLORATION donde I-EXPLORATION se I-EXPLORATION encuentran I-EXPLORATION las I-EXPLORATION mutaciones I-EXPLORATION descritas I-EXPLORATION hasta I-EXPLORATION el I-EXPLORATION momento, I-EXPLORATION amplificado I-EXPLORATION por I-EXPLORATION PCR I-EXPLORATION y I-EXPLORATION secuenciación I-EXPLORATION automatizada, I-EXPLORATION no I-EXPLORATION se I-EXPLORATION detectan I-EXPLORATION mutaciones, I-EXPLORATION sin I-EXPLORATION embargo, I-EXPLORATION estos I-EXPLORATION resultados I-EXPLORATION no I-EXPLORATION excluyen I-EXPLORATION el I-EXPLORATION diagnóstico. I-EXPLORATION I-EXPLORATION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 28 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY «Síndrome I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY múltiples I-PAST_MEDICAL_HISTORY puntos I-PAST_MEDICAL_HISTORY blancos I-PAST_MEDICAL_HISTORY evanescentes» I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY ambos I-PAST_MEDICAL_HISTORY ojos I-PAST_MEDICAL_HISTORY hace I-PAST_MEDICAL_HISTORY 7 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY buena I-PAST_MEDICAL_HISTORY respuesta I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY corticoterapia I-PAST_MEDICAL_HISTORY oral. I-PAST_MEDICAL_HISTORY Acude B-PRESENT_ILLNESS a I-PRESENT_ILLNESS urgencias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS nuestro I-PRESENT_ILLNESS hospital I-PRESENT_ILLNESS por I-PRESENT_ILLNESS disminución I-PRESENT_ILLNESS de I-PRESENT_ILLNESS agudeza I-PRESENT_ILLNESS visual I-PRESENT_ILLNESS bilateral I-PRESENT_ILLNESS y I-PRESENT_ILLNESS cefalea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 15 I-PRESENT_ILLNESS días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION oftalmológica I-EXPLORATION presenta I-EXPLORATION una I-EXPLORATION agudeza I-EXPLORATION visual I-EXPLORATION de I-EXPLORATION 3/10 I-EXPLORATION con I-EXPLORATION reacción I-EXPLORATION inflamatoria I-EXPLORATION en I-EXPLORATION cámara I-EXPLORATION anterior I-EXPLORATION y I-EXPLORATION desprendimiento I-EXPLORATION de I-EXPLORATION retina I-EXPLORATION exudativo I-EXPLORATION bilateral. I-EXPLORATION Se B-TREATMENT inicia I-TREATMENT tratamiento I-TREATMENT corticoideo I-TREATMENT oral I-TREATMENT a I-TREATMENT altas I-TREATMENT dosis I-TREATMENT (80 I-TREATMENT mg I-TREATMENT de I-TREATMENT prednisona), I-TREATMENT constatándose I-TREATMENT una I-TREATMENT buena I-TREATMENT respuesta I-TREATMENT inicial. I-TREATMENT Al B-EVOLUTION mes I-EVOLUTION del I-EVOLUTION tratamiento I-EVOLUTION se I-EVOLUTION observa I-EVOLUTION una I-EVOLUTION recidiva I-EVOLUTION del I-EVOLUTION desprendimiento I-EVOLUTION de I-EVOLUTION retina I-EVOLUTION foveal I-EVOLUTION en I-EVOLUTION el I-EVOLUTION ojo I-EVOLUTION izquierdo, I-EVOLUTION por I-EVOLUTION lo I-EVOLUTION que I-EVOLUTION se I-EVOLUTION asocia I-EVOLUTION a I-EVOLUTION su I-EVOLUTION tratamiento I-EVOLUTION CyA I-EVOLUTION (dosis I-EVOLUTION inicial I-EVOLUTION de I-EVOLUTION 4 I-EVOLUTION mg/kg/día). I-EVOLUTION Tras I-EVOLUTION nueve I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION seguimiento, I-EVOLUTION presenta I-EVOLUTION una I-EVOLUTION agudeza I-EVOLUTION visual I-EVOLUTION de I-EVOLUTION unidad I-EVOLUTION en I-EVOLUTION el I-EVOLUTION ojo I-EVOLUTION derecho I-EVOLUTION y I-EVOLUTION de I-EVOLUTION 8/10 I-EVOLUTION en I-EVOLUTION el I-EVOLUTION ojo I-EVOLUTION izquierdo I-EVOLUTION con I-EVOLUTION movilización I-EVOLUTION pigmentaria I-EVOLUTION en I-EVOLUTION cuatro I-EVOLUTION cuadrantes I-EVOLUTION y I-EVOLUTION fibrosis I-EVOLUTION subretiniana. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 67 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS remitida B-DERIVED_FROM/TO de I-DERIVED_FROM/TO otro I-DERIVED_FROM/TO centro I-DERIVED_FROM/TO para I-DERIVED_FROM/TO tratamiento I-DERIVED_FROM/TO de I-DERIVED_FROM/TO carcinoma I-DERIVED_FROM/TO de I-DERIVED_FROM/TO células I-DERIVED_FROM/TO sebáceas I-DERIVED_FROM/TO de I-DERIVED_FROM/TO ojo I-DERIVED_FROM/TO derecho I-DERIVED_FROM/TO intervenido I-DERIVED_FROM/TO en I-DERIVED_FROM/TO seis I-DERIVED_FROM/TO ocasiones. I-DERIVED_FROM/TO Debutó B-PRESENT_ILLNESS como I-PRESENT_ILLNESS una I-PRESENT_ILLNESS lesión I-PRESENT_ILLNESS pediculada I-PRESENT_ILLNESS en I-PRESENT_ILLNESS conjuntiva I-PRESENT_ILLNESS tarsal I-PRESENT_ILLNESS superior. I-PRESENT_ILLNESS La B-EXPLORATION biopsia I-EXPLORATION realizada I-EXPLORATION se I-EXPLORATION informó I-EXPLORATION como I-EXPLORATION carcinoma I-EXPLORATION sebáceo. I-EXPLORATION Se B-TREATMENT hicieron I-TREATMENT varias I-TREATMENT ampliaciones I-TREATMENT de I-TREATMENT márgenes I-TREATMENT quirúrgicos I-TREATMENT de I-TREATMENT lamela I-TREATMENT posterior I-TREATMENT de I-TREATMENT párpado I-TREATMENT superior I-TREATMENT derecho, I-TREATMENT hasta I-TREATMENT encontrar I-TREATMENT límites I-TREATMENT libre I-TREATMENT de I-TREATMENT tumor. I-TREATMENT Las B-EXPLORATION piezas I-EXPLORATION se I-EXPLORATION informaron I-EXPLORATION como I-EXPLORATION carcinoma I-EXPLORATION sebáceo I-EXPLORATION con I-EXPLORATION diseminación I-EXPLORATION pagetoide. I-EXPLORATION I-EXPLORATION La B-EVOLUTION paciente I-EVOLUTION refería I-EVOLUTION inflamación I-EVOLUTION crónica I-EVOLUTION palpebral I-EVOLUTION y I-EVOLUTION conjuntival. I-EVOLUTION A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION destacaba I-EXPLORATION leve I-EXPLORATION engrosamiento I-EXPLORATION de I-EXPLORATION tercio I-EXPLORATION externo I-EXPLORATION del I-EXPLORATION borde I-EXPLORATION libre I-EXPLORATION de I-EXPLORATION párpado I-EXPLORATION superior I-EXPLORATION derecho. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION biomicroscopía I-EXPLORATION presentaba: I-EXPLORATION conjuntiva I-EXPLORATION bulbar I-EXPLORATION superior I-EXPLORATION irregular I-EXPLORATION y I-EXPLORATION muy I-EXPLORATION eritematosa, I-EXPLORATION área I-EXPLORATION de I-EXPLORATION 6 I-EXPLORATION mm I-EXPLORATION de I-EXPLORATION amplitud I-EXPLORATION en I-EXPLORATION la I-EXPLORATION que I-EXPLORATION se I-EXPLORATION observaba I-EXPLORATION una I-EXPLORATION desestructuración I-EXPLORATION de I-EXPLORATION la I-EXPLORATION arquitectura I-EXPLORATION limbar, I-EXPLORATION con I-EXPLORATION infiltración I-EXPLORATION de I-EXPLORATION las I-EXPLORATION empalizadas I-EXPLORATION de I-EXPLORATION Vogt I-EXPLORATION por I-EXPLORATION cordones I-EXPLORATION amarillentos I-EXPLORATION de I-EXPLORATION aspecto I-EXPLORATION sebáceo I-EXPLORATION y I-EXPLORATION conjuntivalización I-EXPLORATION del I-EXPLORATION epitelio I-EXPLORATION corneal I-EXPLORATION superior, I-EXPLORATION acortamiento I-EXPLORATION de I-EXPLORATION fórnix I-EXPLORATION superior I-EXPLORATION y I-EXPLORATION simbléfaron I-EXPLORATION en I-EXPLORATION zona I-EXPLORATION del I-EXPLORATION canto I-EXPLORATION externo. I-EXPLORATION No I-EXPLORATION se I-EXPLORATION observó I-EXPLORATION afectación I-EXPLORATION ganglionar I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación. I-EXPLORATION La I-EXPLORATION TC I-EXPLORATION de I-EXPLORATION cráneo, I-EXPLORATION abdomen I-EXPLORATION y I-EXPLORATION tórax I-EXPLORATION era I-EXPLORATION normal. I-EXPLORATION La I-EXPLORATION gammagrafía I-EXPLORATION ósea I-EXPLORATION era I-EXPLORATION normal. I-EXPLORATION I-EXPLORATION Se B-TREATMENT realizó I-TREATMENT blefarectomía I-TREATMENT en I-TREATMENT cuña I-TREATMENT de I-TREATMENT la I-TREATMENT zona I-TREATMENT engrosada I-TREATMENT del I-TREATMENT párpado I-TREATMENT superior I-TREATMENT derecho I-TREATMENT y I-TREATMENT mapeo I-TREATMENT de I-TREATMENT biopsias I-TREATMENT conjuntivales. I-TREATMENT La B-EXPLORATION pieza I-EXPLORATION principal I-EXPLORATION se I-EXPLORATION informó I-EXPLORATION como I-EXPLORATION carcinoma I-EXPLORATION sebáceo. I-EXPLORATION Las I-EXPLORATION muestras I-EXPLORATION conjuntivales I-EXPLORATION estaban I-EXPLORATION libres I-EXPLORATION de I-EXPLORATION tumor. I-EXPLORATION I-EXPLORATION Ampliamos B-TREATMENT la I-TREATMENT blefarectomía I-TREATMENT y I-TREATMENT esperamos I-TREATMENT a I-TREATMENT poder I-TREATMENT instaurar I-TREATMENT tratamiento I-TREATMENT de I-TREATMENT la I-TREATMENT superficie I-TREATMENT ocular I-TREATMENT con I-TREATMENT colirio I-TREATMENT de I-TREATMENT mitomicina I-TREATMENT C. I-TREATMENT No B-EVOLUTION se I-EVOLUTION pudo I-EVOLUTION seguir I-EVOLUTION la I-EVOLUTION evolución I-EVOLUTION del I-EVOLUTION caso I-EVOLUTION ya I-EVOLUTION que I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION decidió I-EVOLUTION seguir I-EVOLUTION con I-EVOLUTION el I-EVOLUTION tratamiento I-EVOLUTION en I-EVOLUTION su I-EVOLUTION ciudad I-EVOLUTION de I-EVOLUTION residencia. I-EVOLUTION I-EVOLUTION Un B-PRESENT_ILLNESS varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 58 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS acudió I-PRESENT_ILLNESS a I-PRESENT_ILLNESS Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS una I-PRESENT_ILLNESS diplopía I-PRESENT_ILLNESS binocular I-PRESENT_ILLNESS de I-PRESENT_ILLNESS instauración I-PRESENT_ILLNESS subaguda I-PRESENT_ILLNESS de I-PRESENT_ILLNESS al I-PRESENT_ILLNESS menos I-PRESENT_ILLNESS 3 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS atribuida I-PRESENT_ILLNESS inicialmente I-PRESENT_ILLNESS a I-PRESENT_ILLNESS los I-PRESENT_ILLNESS efectos I-PRESENT_ILLNESS secundarios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS quimioterapia. I-PRESENT_ILLNESS El B-PAST_MEDICAL_HISTORY paciente I-PAST_MEDICAL_HISTORY había I-PAST_MEDICAL_HISTORY sido I-PAST_MEDICAL_HISTORY tratado I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY ciclos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY carboxiplatino/taxol I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY radioterapia I-PAST_MEDICAL_HISTORY concomitante I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY carcinoma I-PAST_MEDICAL_HISTORY pulmonar I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY células I-PAST_MEDICAL_HISTORY grandes I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY estadio I-PAST_MEDICAL_HISTORY T2N3M0 I-PAST_MEDICAL_HISTORY diagnosticado I-PAST_MEDICAL_HISTORY hacía I-PAST_MEDICAL_HISTORY 7 I-PAST_MEDICAL_HISTORY meses. I-PAST_MEDICAL_HISTORY En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION oftalmológica, I-EXPLORATION la I-EXPLORATION AV I-EXPLORATION mejor I-EXPLORATION corregida I-EXPLORATION era I-EXPLORATION de I-EXPLORATION 0, I-EXPLORATION 9 I-EXPLORATION en I-EXPLORATION ojo I-EXPLORATION derecho I-EXPLORATION (OD) I-EXPLORATION y I-EXPLORATION de I-EXPLORATION 0, I-EXPLORATION 8 I-EXPLORATION en I-EXPLORATION ojo I-EXPLORATION izquierdo I-EXPLORATION (OI). I-EXPLORATION Ambas I-EXPLORATION pupilas I-EXPLORATION estaban I-EXPLORATION en I-EXPLORATION midriasis I-EXPLORATION media I-EXPLORATION con I-EXPLORATION escasa I-EXPLORATION reactividad I-EXPLORATION a I-EXPLORATION la I-EXPLORATION luz I-EXPLORATION y I-EXPLORATION convergencia. I-EXPLORATION Respecto I-EXPLORATION a I-EXPLORATION la I-EXPLORATION motilidad I-EXPLORATION ocular I-EXPLORATION extrínseca, I-EXPLORATION se I-EXPLORATION objetivaba I-EXPLORATION una I-EXPLORATION exotropía I-EXPLORATION de I-EXPLORATION -50 I-EXPLORATION dp I-EXPLORATION (dioptrías I-EXPLORATION prismátricas) I-EXPLORATION con I-EXPLORATION dominancia I-EXPLORATION OD I-EXPLORATION pero I-EXPLORATION con I-EXPLORATION capacidad I-EXPLORATION de I-EXPLORATION fijación I-EXPLORATION alternante. I-EXPLORATION En I-EXPLORATION el I-EXPLORATION OD I-EXPLORATION se I-EXPLORATION observaba I-EXPLORATION una I-EXPLORATION limitación I-EXPLORATION de I-EXPLORATION las I-EXPLORATION supraducciones I-EXPLORATION (+++) I-EXPLORATION y I-EXPLORATION de I-EXPLORATION la I-EXPLORATION aducción I-EXPLORATION (++) I-EXPLORATION pero I-EXPLORATION con I-EXPLORATION conservación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION abducción. I-EXPLORATION El I-EXPLORATION OI I-EXPLORATION presentaba I-EXPLORATION un I-EXPLORATION ptosis I-EXPLORATION palpebral I-EXPLORATION casi I-EXPLORATION total I-EXPLORATION y I-EXPLORATION una I-EXPLORATION severa I-EXPLORATION limitación I-EXPLORATION de I-EXPLORATION las I-EXPLORATION supraducciones I-EXPLORATION (+++), I-EXPLORATION de I-EXPLORATION la I-EXPLORATION aducción I-EXPLORATION (++) I-EXPLORATION y I-EXPLORATION de I-EXPLORATION las I-EXPLORATION infraducciones I-EXPLORATION (+++) I-EXPLORATION con I-EXPLORATION conservación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION abducción. I-EXPLORATION La I-EXPLORATION biomicroscopía I-EXPLORATION del I-EXPLORATION segmento I-EXPLORATION anterior I-EXPLORATION era I-EXPLORATION normal I-EXPLORATION así I-EXPLORATION como I-EXPLORATION la I-EXPLORATION tensión I-EXPLORATION ocular I-EXPLORATION de I-EXPLORATION ambos I-EXPLORATION ojos I-EXPLORATION (AO). I-EXPLORATION En I-EXPLORATION el I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION tampoco I-EXPLORATION se I-EXPLORATION hallaron I-EXPLORATION alteraciones I-EXPLORATION patológicas. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION neurológica I-EXPLORATION el I-EXPLORATION paciente I-EXPLORATION no I-EXPLORATION mostraba I-EXPLORATION ninguna I-EXPLORATION alteración I-EXPLORATION clínica. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION le I-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION resonancia I-EXPLORATION magnética I-EXPLORATION (RM) I-EXPLORATION cerebral I-EXPLORATION que I-EXPLORATION evidenció I-EXPLORATION la I-EXPLORATION existencia I-EXPLORATION una I-EXPLORATION lesión I-EXPLORATION solitaria I-EXPLORATION en I-EXPLORATION la I-EXPLORATION región I-EXPLORATION posterior I-EXPLORATION del I-EXPLORATION suelo I-EXPLORATION del I-EXPLORATION III I-EXPLORATION ventrículo. I-EXPLORATION Dicha I-EXPLORATION lesión I-EXPLORATION tenía I-EXPLORATION un I-EXPLORATION aspecto I-EXPLORATION anular I-EXPLORATION hiperintenso, I-EXPLORATION con I-EXPLORATION una I-EXPLORATION porción I-EXPLORATION central I-EXPLORATION hipointensa I-EXPLORATION sugestiva I-EXPLORATION de I-EXPLORATION necrosis, I-EXPLORATION y I-EXPLORATION afectaba I-EXPLORATION bilateralmente I-EXPLORATION a I-EXPLORATION los I-EXPLORATION núcleos I-EXPLORATION y I-EXPLORATION fascículos I-EXPLORATION del I-EXPLORATION III I-EXPLORATION nervio I-EXPLORATION craneal I-EXPLORATION en I-EXPLORATION el I-EXPLORATION mesencéfalo I-EXPLORATION central. I-EXPLORATION I-EXPLORATION Mujer B-PRESENT_ILLNESS hispana I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 33 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY interés, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS queja I-PRESENT_ILLNESS una I-PRESENT_ILLNESS disminución I-PRESENT_ILLNESS progresiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS visión I-PRESENT_ILLNESS en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS ojo I-PRESENT_ILLNESS izquierdo I-PRESENT_ILLNESS (OI). I-PRESENT_ILLNESS I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION destaca I-EXPLORATION una I-EXPLORATION agudeza I-EXPLORATION visual I-EXPLORATION (AV) I-EXPLORATION de I-EXPLORATION 0, I-EXPLORATION 05 I-EXPLORATION en I-EXPLORATION OI. I-EXPLORATION En I-EXPLORATION el I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION (FO) I-EXPLORATION del I-EXPLORATION OI I-EXPLORATION se I-EXPLORATION observa I-EXPLORATION una I-EXPLORATION masa I-EXPLORATION papilar I-EXPLORATION elevada, I-EXPLORATION polipoidea, I-EXPLORATION intensamente I-EXPLORATION pigmentada I-EXPLORATION así I-EXPLORATION como I-EXPLORATION ristras I-EXPLORATION de I-EXPLORATION pigmento I-EXPLORATION móvil I-EXPLORATION en I-EXPLORATION la I-EXPLORATION cavidad I-EXPLORATION vítrea. I-EXPLORATION El I-EXPLORATION resto I-EXPLORATION de I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION oftalmológica I-EXPLORATION es I-EXPLORATION normal. I-EXPLORATION I-EXPLORATION En I-EXPLORATION la I-EXPLORATION angiofluoresceingrafía I-EXPLORATION (AFG) I-EXPLORATION se I-EXPLORATION apreció I-EXPLORATION un I-EXPLORATION efecto I-EXPLORATION pantalla. I-EXPLORATION I-EXPLORATION La I-EXPLORATION ecografía I-EXPLORATION mostró I-EXPLORATION una I-EXPLORATION lesión I-EXPLORATION sólida. I-EXPLORATION En I-EXPLORATION modo I-EXPLORATION A I-EXPLORATION se I-EXPLORATION observó I-EXPLORATION una I-EXPLORATION reflectividad I-EXPLORATION interna I-EXPLORATION muy I-EXPLORATION elevada I-EXPLORATION sin I-EXPLORATION movimiento I-EXPLORATION vascular I-EXPLORATION espontáneo. I-EXPLORATION I-EXPLORATION En I-EXPLORATION aquel I-EXPLORATION momento I-EXPLORATION fueron I-EXPLORATION consultados I-EXPLORATION varios I-EXPLORATION expertos. I-EXPLORATION Unos I-EXPLORATION se I-EXPLORATION inclinaron I-EXPLORATION por I-EXPLORATION un I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION melanoma I-EXPLORATION maligno I-EXPLORATION y I-EXPLORATION otros I-EXPLORATION por I-EXPLORATION melanocitoma. I-EXPLORATION I-EXPLORATION La B-TREATMENT decisión I-TREATMENT adoptada I-TREATMENT fue I-TREATMENT seguir I-TREATMENT observando I-TREATMENT a I-TREATMENT la I-TREATMENT paciente. I-TREATMENT A B-EVOLUTION lo I-EVOLUTION largo I-EVOLUTION de I-EVOLUTION diecinueve I-EVOLUTION años I-EVOLUTION la I-EVOLUTION lesión I-EVOLUTION aumentó I-EVOLUTION paulatinamente I-EVOLUTION de I-EVOLUTION tamaño I-EVOLUTION sin I-EVOLUTION cambios I-EVOLUTION rápidos I-EVOLUTION en I-EVOLUTION su I-EVOLUTION configuración I-EVOLUTION por I-EVOLUTION lo I-EVOLUTION que I-EVOLUTION el I-EVOLUTION diagnóstico I-EVOLUTION de I-EVOLUTION melanocitoma I-EVOLUTION seguía I-EVOLUTION siendo I-EVOLUTION el I-EVOLUTION más I-EVOLUTION apropiado. I-EVOLUTION La I-EVOLUTION paciente I-EVOLUTION acabó I-EVOLUTION por I-EVOLUTION perder I-EVOLUTION completamente I-EVOLUTION la I-EVOLUTION visión I-EVOLUTION del I-EVOLUTION OI I-EVOLUTION y I-EVOLUTION la I-EVOLUTION funduscopia I-EVOLUTION llegó I-EVOLUTION a I-EVOLUTION ser I-EVOLUTION impracticable, I-EVOLUTION al I-EVOLUTION principio I-EVOLUTION a I-EVOLUTION causa I-EVOLUTION del I-EVOLUTION pigmento I-EVOLUTION vítreo I-EVOLUTION y I-EVOLUTION posteriormente I-EVOLUTION por I-EVOLUTION una I-EVOLUTION catarata. I-EVOLUTION I-EVOLUTION A I-EVOLUTION los I-EVOLUTION 19 I-EVOLUTION años I-EVOLUTION de I-EVOLUTION la I-EVOLUTION primera I-EVOLUTION visita I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION empezó I-EVOLUTION a I-EVOLUTION aquejar I-EVOLUTION intenso I-EVOLUTION dolor I-EVOLUTION debido I-EVOLUTION a I-EVOLUTION un I-EVOLUTION glaucoma I-EVOLUTION agudo I-EVOLUTION con I-EVOLUTION inflamación I-EVOLUTION en I-EVOLUTION cámara I-EVOLUTION anterior I-EVOLUTION y I-EVOLUTION seclusión I-EVOLUTION pupilar I-EVOLUTION sin I-EVOLUTION rubeosis I-EVOLUTION por B-TREATMENT lo I-TREATMENT que I-TREATMENT se I-TREATMENT decidió I-TREATMENT la I-TREATMENT enucleación. I-TREATMENT I-TREATMENT En B-EXPLORATION el I-EXPLORATION examen I-EXPLORATION anatomopatológico I-EXPLORATION del I-EXPLORATION globo I-EXPLORATION ocular I-EXPLORATION : I-EXPLORATION el I-EXPLORATION ángulo I-EXPLORATION camerular I-EXPLORATION está I-EXPLORATION abierto, I-EXPLORATION contiene I-EXPLORATION abundantes I-EXPLORATION macrófagos I-EXPLORATION llenos I-EXPLORATION de I-EXPLORATION pigmento I-EXPLORATION que I-EXPLORATION infiltran I-EXPLORATION la I-EXPLORATION malla I-EXPLORATION trabecular, I-EXPLORATION rodean I-EXPLORATION el I-EXPLORATION canal I-EXPLORATION de I-EXPLORATION Schlemm, I-EXPLORATION tapizan I-EXPLORATION la I-EXPLORATION superficie I-EXPLORATION anterior I-EXPLORATION del I-EXPLORATION iris, I-EXPLORATION y I-EXPLORATION aparecen I-EXPLORATION sobre I-EXPLORATION la I-EXPLORATION cápsula I-EXPLORATION posterior I-EXPLORATION del I-EXPLORATION cristalino, I-EXPLORATION entre I-EXPLORATION los I-EXPLORATION procesos I-EXPLORATION ciliares I-EXPLORATION y I-EXPLORATION en I-EXPLORATION el I-EXPLORATION vítreo I-EXPLORATION anterior. I-EXPLORATION El I-EXPLORATION cristalino I-EXPLORATION es I-EXPLORATION cataratoso. I-EXPLORATION Emergiendo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION cabeza I-EXPLORATION del I-EXPLORATION nervio I-EXPLORATION óptico I-EXPLORATION y I-EXPLORATION extendiéndose I-EXPLORATION por I-EXPLORATION la I-EXPLORATION retina I-EXPLORATION yuxtapapilar I-EXPLORATION se I-EXPLORATION aprecia I-EXPLORATION un I-EXPLORATION tumor I-EXPLORATION densamente I-EXPLORATION pigmentado I-EXPLORATION compuesto I-EXPLORATION por I-EXPLORATION células I-EXPLORATION grandes I-EXPLORATION poliédricas I-EXPLORATION con I-EXPLORATION citoplasma I-EXPLORATION abundante I-EXPLORATION y I-EXPLORATION núcleos I-EXPLORATION picnóticos I-EXPLORATION pequeños. I-EXPLORATION La I-EXPLORATION mayoría I-EXPLORATION de I-EXPLORATION las I-EXPLORATION células I-EXPLORATION son I-EXPLORATION anucleoladas I-EXPLORATION pero I-EXPLORATION unas I-EXPLORATION pocas I-EXPLORATION tienen I-EXPLORATION nucléolos I-EXPLORATION pequeños. I-EXPLORATION El I-EXPLORATION tumor I-EXPLORATION muestra I-EXPLORATION focos I-EXPLORATION de I-EXPLORATION necrosis I-EXPLORATION en I-EXPLORATION su I-EXPLORATION superficie, I-EXPLORATION con I-EXPLORATION siembra I-EXPLORATION de I-EXPLORATION macrófagos I-EXPLORATION llenos I-EXPLORATION de I-EXPLORATION pigmento I-EXPLORATION sobre I-EXPLORATION la I-EXPLORATION membrana I-EXPLORATION limitante I-EXPLORATION interna I-EXPLORATION y I-EXPLORATION en I-EXPLORATION el I-EXPLORATION vítreo. I-EXPLORATION En I-EXPLORATION algunas I-EXPLORATION áreas I-EXPLORATION se I-EXPLORATION observan I-EXPLORATION células I-EXPLORATION fusiformes I-EXPLORATION intensamente I-EXPLORATION pigmentadas. I-EXPLORATION Las I-EXPLORATION células I-EXPLORATION pigmentadas I-EXPLORATION en I-EXPLORATION muchas I-EXPLORATION áreas I-EXPLORATION se I-EXPLORATION extienden I-EXPLORATION a I-EXPLORATION lo I-EXPLORATION largo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION membrana I-EXPLORATION limitante I-EXPLORATION interna I-EXPLORATION de I-EXPLORATION la I-EXPLORATION retina I-EXPLORATION llegando I-EXPLORATION hasta I-EXPLORATION la I-EXPLORATION ora I-EXPLORATION serrata. I-EXPLORATION Las I-EXPLORATION preparaciones I-EXPLORATION decoloradas I-EXPLORATION del I-EXPLORATION tumor I-EXPLORATION muestran I-EXPLORATION características I-EXPLORATION citológicas I-EXPLORATION benignas I-EXPLORATION propias I-EXPLORATION de I-EXPLORATION las I-EXPLORATION células I-EXPLORATION del I-EXPLORATION melanocitoma. I-EXPLORATION El I-EXPLORATION tumor I-EXPLORATION no I-EXPLORATION revela I-EXPLORATION actividad I-EXPLORATION mitótica, I-EXPLORATION no I-EXPLORATION se I-EXPLORATION observa I-EXPLORATION evidencia I-EXPLORATION de I-EXPLORATION melanoma I-EXPLORATION maligno I-EXPLORATION ni I-EXPLORATION de I-EXPLORATION extensión I-EXPLORATION extraocular. I-EXPLORATION I-EXPLORATION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 70 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS remitido I-PRESENT_ILLNESS por I-PRESENT_ILLNESS disminución I-PRESENT_ILLNESS progresiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS visión I-PRESENT_ILLNESS en I-PRESENT_ILLNESS ojo I-PRESENT_ILLNESS derecho I-PRESENT_ILLNESS (OD) I-PRESENT_ILLNESS y I-PRESENT_ILLNESS escotoma I-PRESENT_ILLNESS central I-PRESENT_ILLNESS relativo, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 6 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución. I-PRESENT_ILLNESS Sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY oftalmológicos I-PAST_MEDICAL_HISTORY personales I-PAST_MEDICAL_HISTORY ni I-PAST_MEDICAL_HISTORY familiares I-PAST_MEDICAL_HISTORY conocidos. I-PAST_MEDICAL_HISTORY Diabetes I-PAST_MEDICAL_HISTORY mellitus I-PAST_MEDICAL_HISTORY tipo I-PAST_MEDICAL_HISTORY 2, I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY tres I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY evolución, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY buen I-PAST_MEDICAL_HISTORY control I-PAST_MEDICAL_HISTORY metabólico, I-PAST_MEDICAL_HISTORY e I-PAST_MEDICAL_HISTORY hipertensión I-PAST_MEDICAL_HISTORY arterial I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY La B-EXPLORATION mejor I-EXPLORATION agudeza I-EXPLORATION visual I-EXPLORATION con I-EXPLORATION corrección I-EXPLORATION en I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION inicial I-EXPLORATION era I-EXPLORATION de I-EXPLORATION 4/10 I-EXPLORATION en I-EXPLORATION OD I-EXPLORATION (+1, I-EXPLORATION 75; I-EXPLORATION -1.00×95o) I-EXPLORATION y I-EXPLORATION 8/10 I-EXPLORATION en I-EXPLORATION ojo I-EXPLORATION izquierdo I-EXPLORATION (OI) I-EXPLORATION (+1, I-EXPLORATION 75; I-EXPLORATION -1, I-EXPLORATION 50×85o). I-EXPLORATION La I-EXPLORATION biomicroscopia I-EXPLORATION del I-EXPLORATION polo I-EXPLORATION anterior I-EXPLORATION era I-EXPLORATION normal. I-EXPLORATION En I-EXPLORATION el I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION se I-EXPLORATION observaba I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION una I-EXPLORATION lesión I-EXPLORATION amarillenta, I-EXPLORATION sobreelevada I-EXPLORATION en I-EXPLORATION el I-EXPLORATION área I-EXPLORATION macular I-EXPLORATION del I-EXPLORATION OD I-EXPLORATION y I-EXPLORATION alteración I-EXPLORATION pigmentaria I-EXPLORATION macular I-EXPLORATION en I-EXPLORATION el I-EXPLORATION OI. I-EXPLORATION No I-EXPLORATION se I-EXPLORATION encontraron I-EXPLORATION signos I-EXPLORATION de I-EXPLORATION retinopatía I-EXPLORATION diabética I-EXPLORATION en I-EXPLORATION ninguno I-EXPLORATION de I-EXPLORATION los I-EXPLORATION ojos. I-EXPLORATION La I-EXPLORATION tomografía I-EXPLORATION de I-EXPLORATION coherencia I-EXPLORATION óptica I-EXPLORATION (OCT) I-EXPLORATION mostraba, I-EXPLORATION en I-EXPLORATION el I-EXPLORATION área I-EXPLORATION macular I-EXPLORATION del I-EXPLORATION OD, I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION una I-EXPLORATION masa I-EXPLORATION de I-EXPLORATION reflectividad I-EXPLORATION media, I-EXPLORATION por I-EXPLORATION encima I-EXPLORATION de I-EXPLORATION la I-EXPLORATION banda I-EXPLORATION del I-EXPLORATION epitelio I-EXPLORATION pigmentario, I-EXPLORATION con I-EXPLORATION levantamiento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION retina I-EXPLORATION neurosensorial, I-EXPLORATION sin I-EXPLORATION evidencia I-EXPLORATION de I-EXPLORATION fluido I-EXPLORATION intrarretiniano I-EXPLORATION ni I-EXPLORATION subretiniano. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION angiografía I-EXPLORATION fluoresceínica I-EXPLORATION (AGF) I-EXPLORATION podía I-EXPLORATION comprobarse I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION una I-EXPLORATION lesión I-EXPLORATION hiperfluorescente I-EXPLORATION con I-EXPLORATION centro I-EXPLORATION de I-EXPLORATION hipofluorescencia, I-EXPLORATION que I-EXPLORATION aumentaba I-EXPLORATION de I-EXPLORATION intensidad I-EXPLORATION en I-EXPLORATION fases I-EXPLORATION tardías I-EXPLORATION pero I-EXPLORATION sin I-EXPLORATION difusión I-EXPLORATION del I-EXPLORATION contraste, I-EXPLORATION que I-EXPLORATION confirmaría I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION DFVA. I-EXPLORATION Las I-EXPLORATION pruebas I-EXPLORATION electrofisiológicas, I-EXPLORATION tanto I-EXPLORATION el I-EXPLORATION electrorretinograma I-EXPLORATION como I-EXPLORATION el I-EXPLORATION electrooculograma, I-EXPLORATION fueron I-EXPLORATION normales. I-EXPLORATION I-EXPLORATION A I-EXPLORATION partir I-EXPLORATION de I-EXPLORATION ese I-EXPLORATION momento I-EXPLORATION se I-EXPLORATION establecieron I-EXPLORATION controles I-EXPLORATION oftalmológicos I-EXPLORATION periódicos, I-EXPLORATION en I-EXPLORATION los I-EXPLORATION que I-EXPLORATION se I-EXPLORATION evidenció I-EXPLORATION la I-EXPLORATION regresión I-EXPLORATION progresiva I-EXPLORATION de I-EXPLORATION la I-EXPLORATION lesión I-EXPLORATION viteliforme I-EXPLORATION y I-EXPLORATION la I-EXPLORATION evolución I-EXPLORATION hacia I-EXPLORATION la I-EXPLORATION atrofia I-EXPLORATION del I-EXPLORATION epitelio I-EXPLORATION pigmentario I-EXPLORATION macular I-EXPLORATION en I-EXPLORATION el I-EXPLORATION OD. I-EXPLORATION La I-EXPLORATION visión I-EXPLORATION en I-EXPLORATION el I-EXPLORATION OI I-EXPLORATION se I-EXPLORATION mantuvo I-EXPLORATION estable I-EXPLORATION (7/10), I-EXPLORATION a I-EXPLORATION pesar I-EXPLORATION de I-EXPLORATION que I-EXPLORATION las I-EXPLORATION alteraciones I-EXPLORATION pigmentarias I-EXPLORATION maculares I-EXPLORATION eran I-EXPLORATION cada I-EXPLORATION vez I-EXPLORATION más I-EXPLORATION evidentes. I-EXPLORATION I-EXPLORATION Dos B-EVOLUTION años I-EVOLUTION y I-EVOLUTION medio I-EVOLUTION después I-EVOLUTION de I-EVOLUTION la I-EVOLUTION primera I-EVOLUTION visita, I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION consulta I-EVOLUTION por I-EVOLUTION disminución I-EVOLUTION brusca I-EVOLUTION de I-EVOLUTION visión I-EVOLUTION en I-EVOLUTION el I-EVOLUTION OI I-EVOLUTION (2/10), I-EVOLUTION coincidiendo I-EVOLUTION con I-EVOLUTION la I-EVOLUTION aparición I-EVOLUTION de I-EVOLUTION un I-EVOLUTION desprendimiento I-EVOLUTION macular I-EVOLUTION serohemorrágico I-EVOLUTION en I-EVOLUTION dicho I-EVOLUTION ojo. I-EVOLUTION La B-EXPLORATION OCT I-EXPLORATION mostraba I-EXPLORATION un I-EXPLORATION importante I-EXPLORATION levantamiento I-EXPLORATION macular I-EXPLORATION con I-EXPLORATION desprendimiento I-EXPLORATION del I-EXPLORATION epitelio I-EXPLORATION pigmentario, I-EXPLORATION quistes I-EXPLORATION intrarretinianos I-EXPLORATION y I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION líquido I-EXPLORATION subretiniano I-EXPLORATION (LSR) I-EXPLORATION en I-EXPLORATION los I-EXPLORATION bordes I-EXPLORATION de I-EXPLORATION la I-EXPLORATION lesión. I-EXPLORATION Mediante I-EXPLORATION AGF I-EXPLORATION se I-EXPLORATION comprobó I-EXPLORATION la I-EXPLORATION existencia I-EXPLORATION de I-EXPLORATION una I-EXPLORATION membrana I-EXPLORATION neovascular I-EXPLORATION oculta I-EXPLORATION con I-EXPLORATION difusión I-EXPLORATION tardía I-EXPLORATION del I-EXPLORATION colorante. I-EXPLORATION En B-TREATMENT este I-TREATMENT momento I-TREATMENT se I-TREATMENT decidió I-TREATMENT realizar I-TREATMENT tratamiento I-TREATMENT en I-TREATMENT el I-TREATMENT OI I-TREATMENT con I-TREATMENT ranibizumab I-TREATMENT intravítreo, I-TREATMENT a I-TREATMENT la I-TREATMENT dosis I-TREATMENT habitualmente I-TREATMENT utilizada I-TREATMENT para I-TREATMENT el I-TREATMENT tratamiento I-TREATMENT de I-TREATMENT la I-TREATMENT degeneración I-TREATMENT macular I-TREATMENT exudativa I-TREATMENT (0,5mg/0,05ml). I-TREATMENT I-TREATMENT A B-EVOLUTION las I-EVOLUTION 4 I-EVOLUTION semanas I-EVOLUTION de I-EVOLUTION la I-EVOLUTION inyección I-EVOLUTION la I-EVOLUTION agudeza I-EVOLUTION visual I-EVOLUTION había I-EVOLUTION mejorado I-EVOLUTION a I-EVOLUTION 3/10 I-EVOLUTION en I-EVOLUTION el I-EVOLUTION OI, I-EVOLUTION con I-EVOLUTION reabsorción I-EVOLUTION prácticamente I-EVOLUTION completa I-EVOLUTION de I-EVOLUTION la I-EVOLUTION hemorragia I-EVOLUTION macular, I-EVOLUTION apreciándose I-EVOLUTION una I-EVOLUTION mínima I-EVOLUTION cantidad I-EVOLUTION de I-EVOLUTION LSR I-EVOLUTION en I-EVOLUTION la I-EVOLUTION tomografía. I-EVOLUTION Tras I-EVOLUTION 8 I-EVOLUTION semanas, I-EVOLUTION la I-EVOLUTION AV I-EVOLUTION era I-EVOLUTION de I-EVOLUTION 4/10, I-EVOLUTION comprobándose I-EVOLUTION en I-EVOLUTION la I-EVOLUTION OCT I-EVOLUTION una I-EVOLUTION disminución I-EVOLUTION importante I-EVOLUTION del I-EVOLUTION grosor I-EVOLUTION macular I-EVOLUTION central I-EVOLUTION con I-EVOLUTION mínima I-EVOLUTION fibrosis I-EVOLUTION subretiniana. I-EVOLUTION En I-EVOLUTION el I-EVOLUTION control I-EVOLUTION de I-EVOLUTION los I-EVOLUTION 3 I-EVOLUTION meses, I-EVOLUTION la I-EVOLUTION visión I-EVOLUTION en I-EVOLUTION el I-EVOLUTION OI I-EVOLUTION había I-EVOLUTION descendido I-EVOLUTION (2/10), I-EVOLUTION evidenciándose I-EVOLUTION en I-EVOLUTION la I-EVOLUTION OCT I-EVOLUTION un I-EVOLUTION aumento I-EVOLUTION del I-EVOLUTION espesor I-EVOLUTION macular I-EVOLUTION superior I-EVOLUTION a I-EVOLUTION 100micras, I-EVOLUTION con I-EVOLUTION presencia I-EVOLUTION de I-EVOLUTION líquido I-EVOLUTION subretiniano, I-EVOLUTION por B-TREATMENT lo I-TREATMENT que I-TREATMENT se I-TREATMENT decide I-TREATMENT realizar I-TREATMENT segunda I-TREATMENT inyección I-TREATMENT de I-TREATMENT ranibizumab. I-TREATMENT La B-EVOLUTION respuesta I-EVOLUTION a I-EVOLUTION esta I-EVOLUTION segunda I-EVOLUTION inyección I-EVOLUTION fue I-EVOLUTION favorable, I-EVOLUTION y I-EVOLUTION a I-EVOLUTION las I-EVOLUTION 12 I-EVOLUTION semanas I-EVOLUTION se I-EVOLUTION pudo I-EVOLUTION comprobar I-EVOLUTION la I-EVOLUTION reabsorción I-EVOLUTION completa I-EVOLUTION del I-EVOLUTION fluido I-EVOLUTION subretiniano, I-EVOLUTION quedando I-EVOLUTION una I-EVOLUTION mínima I-EVOLUTION fibrosis I-EVOLUTION subretiniana I-EVOLUTION como I-EVOLUTION resultado I-EVOLUTION del I-EVOLUTION cierre I-EVOLUTION de I-EVOLUTION la I-EVOLUTION membrana I-EVOLUTION neovascular. I-EVOLUTION I-EVOLUTION Doce I-EVOLUTION meses I-EVOLUTION después I-EVOLUTION de I-EVOLUTION la I-EVOLUTION última I-EVOLUTION inyección I-EVOLUTION la I-EVOLUTION agudeza I-EVOLUTION visual I-EVOLUTION se I-EVOLUTION mantiene I-EVOLUTION estable I-EVOLUTION en I-EVOLUTION el I-EVOLUTION OI I-EVOLUTION (6/10), I-EVOLUTION sin I-EVOLUTION signos I-EVOLUTION de I-EVOLUTION reactivación I-EVOLUTION de I-EVOLUTION la I-EVOLUTION membrana I-EVOLUTION y I-EVOLUTION sin I-EVOLUTION complicaciones I-EVOLUTION derivadas I-EVOLUTION del I-EVOLUTION tratamiento I-EVOLUTION intravítreo. I-EVOLUTION I-EVOLUTION Embarazada B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 40 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS multípara B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY tres, I-PAST_MEDICAL_HISTORY serología I-PAST_MEDICAL_HISTORY VIH I-PAST_MEDICAL_HISTORY negativo, I-PAST_MEDICAL_HISTORY cursó I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY sífilis I-PAST_MEDICAL_HISTORY latente I-PAST_MEDICAL_HISTORY precoz I-PAST_MEDICAL_HISTORY diagnosticada I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY semana I-PAST_MEDICAL_HISTORY 28 I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY embarazo I-PAST_MEDICAL_HISTORY (VDRL I-PAST_MEDICAL_HISTORY no I-PAST_MEDICAL_HISTORY reactivo I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY 12 I-PAST_MEDICAL_HISTORY semanas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY gestación, I-PAST_MEDICAL_HISTORY VDRL I-PAST_MEDICAL_HISTORY 1: I-PAST_MEDICAL_HISTORY 128 I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY 28 I-PAST_MEDICAL_HISTORY semanas I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY VDRL I-PAST_MEDICAL_HISTORY 1: I-PAST_MEDICAL_HISTORY 32 I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY 31 I-PAST_MEDICAL_HISTORY semanas, I-PAST_MEDICAL_HISTORY MHA-TP I-PAST_MEDICAL_HISTORY (microhemagglutination-Treponema I-PAST_MEDICAL_HISTORY pallidum I-PAST_MEDICAL_HISTORY test) I-PAST_MEDICAL_HISTORY positivo. I-PAST_MEDICAL_HISTORY Tratada I-PAST_MEDICAL_HISTORY junto I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY su I-PAST_MEDICAL_HISTORY pareja I-PAST_MEDICAL_HISTORY 3 I-PAST_MEDICAL_HISTORY semanas I-PAST_MEDICAL_HISTORY antes I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY inicio I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY trabajo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY parto. I-PAST_MEDICAL_HISTORY Sin I-PAST_MEDICAL_HISTORY historia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY sífilis I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY embarazos I-PAST_MEDICAL_HISTORY previos I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY pareja I-PAST_MEDICAL_HISTORY estable I-PAST_MEDICAL_HISTORY hace I-PAST_MEDICAL_HISTORY más I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY 2 I-PAST_MEDICAL_HISTORY años. I-PAST_MEDICAL_HISTORY Ingresó B-PRESENT_ILLNESS al I-PRESENT_ILLNESS Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS Urgencia I-PRESENT_ILLNESS por I-PRESENT_ILLNESS rotura I-PRESENT_ILLNESS prematura I-PRESENT_ILLNESS ovular I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 30 I-PRESENT_ILLNESS h I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS administrándose B-TREATMENT corticoides I-TREATMENT y I-TREATMENT 6 I-TREATMENT dosis I-TREATMENT de I-TREATMENT ampicilina. I-TREATMENT Se B-EXPLORATION realizó I-EXPLORATION RPR I-EXPLORATION en I-EXPLORATION parto I-EXPLORATION que I-EXPLORATION resultó I-EXPLORATION no I-EXPLORATION reactivo I-EXPLORATION (no I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION VDRL). I-EXPLORATION I-EXPLORATION Nació B-EVOLUTION RN I-EVOLUTION por I-EVOLUTION parto I-EVOLUTION vaginal I-EVOLUTION de I-EVOLUTION 34 I-EVOLUTION semanas, I-EVOLUTION pequeño I-EVOLUTION para I-EVOLUTION la I-EVOLUTION edad I-EVOLUTION gestacional I-EVOLUTION (PEG) I-EVOLUTION peso I-EVOLUTION de I-EVOLUTION 1.920 I-EVOLUTION g, I-EVOLUTION con I-EVOLUTION cianosis I-EVOLUTION generalizada, I-EVOLUTION sin I-EVOLUTION esfuerzo I-EVOLUTION respiratorio, I-EVOLUTION APGAR I-EVOLUTION 6-8, I-EVOLUTION requiriendo B-TREATMENT ventilación I-TREATMENT a I-TREATMENT presión I-TREATMENT positiva. I-TREATMENT Cursó I-TREATMENT con I-TREATMENT enfermedad I-TREATMENT de I-TREATMENT membrana I-TREATMENT hialina I-TREATMENT (EMH) I-TREATMENT administrándose I-TREATMENT surfactante, I-TREATMENT sin I-TREATMENT embargo, I-TREATMENT por I-TREATMENT compromiso I-TREATMENT respiratorio I-TREATMENT progresivo I-TREATMENT debió I-TREATMENT conectarse I-TREATMENT a I-TREATMENT ventilación I-TREATMENT mecánica. I-TREATMENT Evolucionó B-EVOLUTION grave I-EVOLUTION con I-EVOLUTION altos I-EVOLUTION requerimientos I-EVOLUTION de I-EVOLUTION oxígeno, I-EVOLUTION con I-EVOLUTION deterioro I-EVOLUTION del I-EVOLUTION estado I-EVOLUTION general, I-EVOLUTION se I-EVOLUTION agregó I-EVOLUTION ictericia I-EVOLUTION generalizada, I-EVOLUTION petequias I-EVOLUTION múltiples, I-EVOLUTION sangrado I-EVOLUTION en I-EVOLUTION sitios I-EVOLUTION de I-EVOLUTION punción I-EVOLUTION e I-EVOLUTION hipertensión I-EVOLUTION pulmonar I-EVOLUTION por B-TREATMENT lo I-TREATMENT que I-TREATMENT debió I-TREATMENT iniciarse I-TREATMENT drogas I-TREATMENT vasoactivas. I-TREATMENT Al B-EXPLORATION examen I-EXPLORATION físico I-EXPLORATION destacaba: I-EXPLORATION abdomen I-EXPLORATION globuloso, I-EXPLORATION hepato-esplenomegalia I-EXPLORATION (ambos I-EXPLORATION en I-EXPLORATION 3 I-EXPLORATION cm I-EXPLORATION bajo I-EXPLORATION reborde I-EXPLORATION costal), I-EXPLORATION petequias, I-EXPLORATION edema I-EXPLORATION de I-EXPLORATION pared I-EXPLORATION abdominal I-EXPLORATION y I-EXPLORATION extremidades, I-EXPLORATION y I-EXPLORATION descamación I-EXPLORATION palmo-plantar. I-EXPLORATION Inició B-TREATMENT tratamiento I-TREATMENT con I-TREATMENT penicilina I-TREATMENT sódica I-TREATMENT y I-TREATMENT gentamicina I-TREATMENT i.v. I-TREATMENT por I-TREATMENT sospecha I-TREATMENT de I-TREATMENT sepsis I-TREATMENT precoz. I-TREATMENT I-TREATMENT Se B-EXPLORATION recibió I-EXPLORATION resultado I-EXPLORATION del I-EXPLORATION VDRL I-EXPLORATION en I-EXPLORATION sangre I-EXPLORATION del I-EXPLORATION RN I-EXPLORATION 1: I-EXPLORATION 64, I-EXPLORATION no I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION punción I-EXPLORATION lumbar I-EXPLORATION (PL) I-EXPLORATION en I-EXPLORATION ese I-EXPLORATION momento I-EXPLORATION por I-EXPLORATION gravedad I-EXPLORATION y I-EXPLORATION trombocitopenia I-EXPLORATION marcada. I-EXPLORATION Los I-EXPLORATION exámenes I-EXPLORATION de I-EXPLORATION laboratorio I-EXPLORATION iniciales I-EXPLORATION se I-EXPLORATION muestran I-EXPLORATION en I-EXPLORATION la I-EXPLORATION tabla I-EXPLORATION 1. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION asumió I-EXPLORATION diagnóstico I-EXPLORATION probable I-EXPLORATION de I-EXPLORATION sífilis I-EXPLORATION congénita I-EXPLORATION y I-EXPLORATION sepsis I-EXPLORATION precoz, I-EXPLORATION se I-EXPLORATION decidió I-EXPLORATION completar I-EXPLORATION estudio I-EXPLORATION para I-EXPLORATION pesquisa I-EXPLORATION de I-EXPLORATION daño I-EXPLORATION multisistémico. I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION ecocardiografía, I-EXPLORATION ecografía I-EXPLORATION abdominal I-EXPLORATION y I-EXPLORATION ecografía I-EXPLORATION cerebral I-EXPLORATION que I-EXPLORATION resultaron I-EXPLORATION normales. I-EXPLORATION Los I-EXPLORATION hemocultivos I-EXPLORATION fueron I-EXPLORATION negativos. I-EXPLORATION Completó B-EVOLUTION tratamiento I-EVOLUTION antibiótico I-EVOLUTION con I-EVOLUTION 7 I-EVOLUTION días I-EVOLUTION de I-EVOLUTION gentamicina I-EVOLUTION iv I-EVOLUTION y I-EVOLUTION 14 I-EVOLUTION de I-EVOLUTION penicilina I-EVOLUTION sódica I-EVOLUTION iv., I-EVOLUTION lográndose I-EVOLUTION disminuir I-EVOLUTION progresivamente I-EVOLUTION las I-EVOLUTION drogas I-EVOLUTION vasoactivas I-EVOLUTION hasta I-EVOLUTION su I-EVOLUTION suspensión. I-EVOLUTION I-EVOLUTION En B-EXPLORATION contexto I-EXPLORATION de I-EXPLORATION transaminasas I-EXPLORATION elevadas I-EXPLORATION y I-EXPLORATION hepatomegalia I-EXPLORATION se I-EXPLORATION completó I-EXPLORATION estudio I-EXPLORATION con I-EXPLORATION serología I-EXPLORATION para I-EXPLORATION Hepatitis I-EXPLORATION B I-EXPLORATION y I-EXPLORATION C I-EXPLORATION que I-EXPLORATION resultaron I-EXPLORATION negativas. I-EXPLORATION No I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION estudio I-EXPLORATION de I-EXPLORATION citomegalovirus I-EXPLORATION (CMV). I-EXPLORATION Se I-EXPLORATION logró I-EXPLORATION realizar I-EXPLORATION PL I-EXPLORATION a I-EXPLORATION los I-EXPLORATION 28 I-EXPLORATION días I-EXPLORATION de I-EXPLORATION vida, I-EXPLORATION resultando I-EXPLORATION citoquímico I-EXPLORATION de I-EXPLORATION líquido I-EXPLORATION cefalorraquídeo I-EXPLORATION (LCR) I-EXPLORATION normal I-EXPLORATION y I-EXPLORATION VDRL I-EXPLORATION no I-EXPLORATION reactivo, I-EXPLORATION con I-EXPLORATION VDRL I-EXPLORATION en I-EXPLORATION sangre I-EXPLORATION de I-EXPLORATION 1: I-EXPLORATION 32. I-EXPLORATION Radiografía I-EXPLORATION de I-EXPLORATION huesos I-EXPLORATION largos I-EXPLORATION y I-EXPLORATION fondo I-EXPLORATION de I-EXPLORATION ojo I-EXPLORATION no I-EXPLORATION mostraron I-EXPLORATION alteraciones. I-EXPLORATION Durante B-EVOLUTION el I-EVOLUTION primer I-EVOLUTION mes I-EVOLUTION de I-EVOLUTION hospitalización I-EVOLUTION evolucionó I-EVOLUTION favorablemente I-EVOLUTION del I-EVOLUTION punto I-EVOLUTION de I-EVOLUTION vista I-EVOLUTION clínico, I-EVOLUTION con I-EVOLUTION mejoría I-EVOLUTION de I-EVOLUTION pruebas I-EVOLUTION hepáticas I-EVOLUTION pero I-EVOLUTION con I-EVOLUTION mal I-EVOLUTION incremento I-EVOLUTION ponderal. I-EVOLUTION I-EVOLUTION Adolescente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 16 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS procedente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY zona I-PAST_MEDICAL_HISTORY rural I-PAST_MEDICAL_HISTORY lejana, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY altura I-PAST_MEDICAL_HISTORY superior I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY 2.500 I-PAST_MEDICAL_HISTORY m I-PAST_MEDICAL_HISTORY sobre I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY nivel I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY mar, I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY Departamento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY Nariño-Colombia, I-PAST_MEDICAL_HISTORY con B-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 3 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS consistente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS aparición I-PRESENT_ILLNESS de I-PRESENT_ILLNESS masa I-PRESENT_ILLNESS abdominal I-PRESENT_ILLNESS en I-PRESENT_ILLNESS hipocondrio I-PRESENT_ILLNESS izquierdo. I-PRESENT_ILLNESS El B-EXPLORATION paciente I-EXPLORATION nunca I-EXPLORATION antes I-EXPLORATION había I-EXPLORATION tenido I-EXPLORATION contacto I-EXPLORATION con I-EXPLORATION un I-EXPLORATION servicio I-EXPLORATION de I-EXPLORATION salud. I-EXPLORATION I-EXPLORATION Ingresó I-EXPLORATION al I-EXPLORATION Hospital I-EXPLORATION con I-EXPLORATION disnea I-EXPLORATION de I-EXPLORATION pequeños I-EXPLORATION esfuerzos, I-EXPLORATION cianosis I-EXPLORATION peribucal, I-EXPLORATION conjuntivas I-EXPLORATION hipercrómicas I-EXPLORATION y I-EXPLORATION soplo I-EXPLORATION holosistólico I-EXPLORATION en I-EXPLORATION todos I-EXPLORATION los I-EXPLORATION focos I-EXPLORATION grado I-EXPLORATION IV/VI, I-EXPLORATION de I-EXPLORATION predominio I-EXPLORATION tricuspídeo, I-EXPLORATION con I-EXPLORATION reforzamiento I-EXPLORATION de I-EXPLORATION segundo I-EXPLORATION ruido. I-EXPLORATION En I-EXPLORATION abdomen, I-EXPLORATION masa I-EXPLORATION no I-EXPLORATION móvil, I-EXPLORATION con I-EXPLORATION bordes I-EXPLORATION definidos, I-EXPLORATION con I-EXPLORATION diámetro I-EXPLORATION de I-EXPLORATION 14 I-EXPLORATION x I-EXPLORATION 15 I-EXPLORATION cm, I-EXPLORATION indolora, I-EXPLORATION localizada I-EXPLORATION en I-EXPLORATION dorso I-EXPLORATION izquierdo I-EXPLORATION llegando I-EXPLORATION hasta I-EXPLORATION hipogastrio. I-EXPLORATION Dedos I-EXPLORATION en I-EXPLORATION palillo I-EXPLORATION de I-EXPLORATION tambor I-EXPLORATION y I-EXPLORATION extremidades I-EXPLORATION inferiores I-EXPLORATION con I-EXPLORATION edema I-EXPLORATION grado I-EXPLORATION I. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION decidió I-EXPLORATION hospitalizar I-EXPLORATION para I-EXPLORATION estudio I-EXPLORATION de I-EXPLORATION la I-EXPLORATION masa I-EXPLORATION abdominal, I-EXPLORATION diagnóstico I-EXPLORATION y I-EXPLORATION compensación I-EXPLORATION de I-EXPLORATION patología I-EXPLORATION cardiovascular. I-EXPLORATION I-EXPLORATION El I-EXPLORATION hemograma I-EXPLORATION de I-EXPLORATION ingreso I-EXPLORATION mostró I-EXPLORATION marcado I-EXPLORATION aumento I-EXPLORATION de I-EXPLORATION glóbulos I-EXPLORATION rojos I-EXPLORATION (9.320.000/mm3), I-EXPLORATION hemoglobina I-EXPLORATION de I-EXPLORATION 19, I-EXPLORATION 9 I-EXPLORATION g/dL, I-EXPLORATION hematocrito I-EXPLORATION de I-EXPLORATION 66%, I-EXPLORATION glóbulos I-EXPLORATION blancos I-EXPLORATION 3.500/mm3, I-EXPLORATION plaquetas I-EXPLORATION 48.000/mm3, I-EXPLORATION ácido I-EXPLORATION úrico I-EXPLORATION 10, I-EXPLORATION 5 I-EXPLORATION mg/dL. I-EXPLORATION I-EXPLORATION El I-EXPLORATION ecocardiograma I-EXPLORATION reportó I-EXPLORATION dilatación I-EXPLORATION severa I-EXPLORATION de I-EXPLORATION cavidades I-EXPLORATION derechas, I-EXPLORATION insuficiencia I-EXPLORATION tricuspídea I-EXPLORATION e I-EXPLORATION hipertensión I-EXPLORATION pulmonar I-EXPLORATION (HTP) I-EXPLORATION severa I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION suprasistémico, I-EXPLORATION (presión I-EXPLORATION sistólica I-EXPLORATION arterial I-EXPLORATION pulmonar- I-EXPLORATION PSAP: I-EXPLORATION 115 I-EXPLORATION mmHg). I-EXPLORATION I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION tomografía I-EXPLORATION computarizada I-EXPLORATION (TC) I-EXPLORATION de I-EXPLORATION abdomen I-EXPLORATION con I-EXPLORATION medio I-EXPLORATION de I-EXPLORATION contraste I-EXPLORATION endovenoso, I-EXPLORATION que I-EXPLORATION mostró I-EXPLORATION grandes I-EXPLORATION masa I-EXPLORATION tumoral I-EXPLORATION intrarrenales I-EXPLORATION bilaterales, I-EXPLORATION de I-EXPLORATION mayor I-EXPLORATION tamaño I-EXPLORATION gran I-EXPLORATION tamaño I-EXPLORATION y I-EXPLORATION de I-EXPLORATION crecimiento I-EXPLORATION exofítico I-EXPLORATION a I-EXPLORATION izquierda I-EXPLORATION y I-EXPLORATION con I-EXPLORATION marcado I-EXPLORATION adelgazamiento I-EXPLORATION del I-EXPLORATION parénquima I-EXPLORATION en I-EXPLORATION ambos I-EXPLORATION riñones. I-EXPLORATION El I-EXPLORATION examen I-EXPLORATION mostró I-EXPLORATION además I-EXPLORATION adenopatías I-EXPLORATION retroperitoneales I-EXPLORATION múltiples I-EXPLORATION y I-EXPLORATION lesiones I-EXPLORATION osteolíticas I-EXPLORATION vertebrales. I-EXPLORATION La I-EXPLORATION TC I-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION no I-EXPLORATION mostró I-EXPLORATION alteraciones I-EXPLORATION en I-EXPLORATION el I-EXPLORATION parénquima I-EXPLORATION pulmonar. I-EXPLORATION I-EXPLORATION Por B-TREATMENT sospecha I-TREATMENT de I-TREATMENT HTP I-TREATMENT severa I-TREATMENT con I-TREATMENT signos I-TREATMENT clínicos I-TREATMENT de I-TREATMENT hipoxia I-TREATMENT crónica, I-TREATMENT se I-TREATMENT le I-TREATMENT administró I-TREATMENT sildenafil I-TREATMENT y I-TREATMENT oxígeno I-TREATMENT como I-TREATMENT vasodilatadores I-TREATMENT pulmonares, I-TREATMENT furosemida I-TREATMENT para I-TREATMENT manejo I-TREATMENT de I-TREATMENT su I-TREATMENT sobrecarga I-TREATMENT hídrica I-TREATMENT y I-TREATMENT alopurinol I-TREATMENT como I-TREATMENT tratamiento I-TREATMENT de I-TREATMENT hiperuricemia I-TREATMENT para I-TREATMENT prevenir I-TREATMENT lesión I-TREATMENT renal. I-TREATMENT I-TREATMENT La B-EXPLORATION biopsia I-EXPLORATION de I-EXPLORATION médula I-EXPLORATION ósea I-EXPLORATION reportó I-EXPLORATION hiperplasia I-EXPLORATION eritroide I-EXPLORATION sin I-EXPLORATION evidencia I-EXPLORATION de I-EXPLORATION infiltración, I-EXPLORATION por I-EXPLORATION lo I-EXPLORATION que I-EXPLORATION se I-EXPLORATION descartó I-EXPLORATION linfoma. I-EXPLORATION Por I-EXPLORATION riesgo I-EXPLORATION anestésico, I-EXPLORATION secundario I-EXPLORATION a I-EXPLORATION HTP, I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION biopsia I-EXPLORATION renal I-EXPLORATION con I-EXPLORATION Trucut I-EXPLORATION guiada I-EXPLORATION por I-EXPLORATION Ecografía, I-EXPLORATION cuyo I-EXPLORATION reporte I-EXPLORATION de I-EXPLORATION patología I-EXPLORATION confirmó I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION HEM. I-EXPLORATION I-EXPLORATION Se B-EVOLUTION ha I-EVOLUTION realizado I-EVOLUTION seguimiento I-EVOLUTION durante I-EVOLUTION 8 I-EVOLUTION meses, I-EVOLUTION sin I-EVOLUTION cambios I-EVOLUTION significativos I-EVOLUTION en I-EVOLUTION su I-EVOLUTION evolución. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 6 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY epilepsia I-PAST_MEDICAL_HISTORY secundaria I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY extensa I-PAST_MEDICAL_HISTORY alteración I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY desarrollo I-PAST_MEDICAL_HISTORY cortical I-PAST_MEDICAL_HISTORY hemisférico I-PAST_MEDICAL_HISTORY derecho. I-PAST_MEDICAL_HISTORY Presentó B-PRESENT_ILLNESS estatus I-PRESENT_ILLNESS epiléptico I-PRESENT_ILLNESS refractario I-PRESENT_ILLNESS que B-TREATMENT re I-TREATMENT quirió I-TREATMENT ingreso I-TREATMENT a I-TREATMENT Unidad I-TREATMENT de I-TREATMENT Cuidados I-TREATMENT Intensivos I-TREATMENT para I-TREATMENT soporte I-TREATMENT vital I-TREATMENT y I-TREATMENT tratamiento, I-TREATMENT el I-TREATMENT que I-TREATMENT incluyó I-TREATMENT como I-TREATMENT terapia I-TREATMENT de I-TREATMENT tercera I-TREATMENT línea I-TREATMENT infusión I-TREATMENT intravenosa I-TREATMENT continua I-TREATMENT de I-TREATMENT propofol I-TREATMENT en I-TREATMENT dosis I-TREATMENT progresivas I-TREATMENT hasta I-TREATMENT alcanzar I-TREATMENT una I-TREATMENT tasa I-TREATMENT 10 I-TREATMENT mg/kg/h. I-TREATMENT Cursó B-EVOLUTION con I-EVOLUTION compromiso I-EVOLUTION hemodinámico I-EVOLUTION y I-EVOLUTION a I-EVOLUTION las I-EVOLUTION 24 I-EVOLUTION h I-EVOLUTION de I-EVOLUTION iniciado I-EVOLUTION el I-EVOLUTION tratamiento I-EVOLUTION se I-EVOLUTION observó I-EVOLUTION alza I-EVOLUTION de I-EVOLUTION la I-EVOLUTION creatinifosfokinasa I-EVOLUTION (CK), I-EVOLUTION acidosis I-EVOLUTION metabólica I-EVOLUTION y I-EVOLUTION lactacidemia I-EVOLUTION elevada, I-EVOLUTION y B-TREATMENT luego I-TREATMENT de I-TREATMENT descartar I-TREATMENT otras I-TREATMENT causas I-TREATMENT se I-TREATMENT planteó I-TREATMENT el I-TREATMENT dianóstico I-TREATMENT de I-TREATMENT SIP I-TREATMENT por I-TREATMENT lo I-TREATMENT que I-TREATMENT se I-TREATMENT suspendió I-TREATMENT la I-TREATMENT droga, I-TREATMENT logrando B-EVOLUTION esta I-EVOLUTION bilización I-EVOLUTION hemodinámica I-EVOLUTION a I-EVOLUTION las I-EVOLUTION 24 I-EVOLUTION h. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 58 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que B-PAST_MEDICAL_HISTORY presentaba I-PAST_MEDICAL_HISTORY como I-PAST_MEDICAL_HISTORY enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY base I-PAST_MEDICAL_HISTORY leucemia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY 4 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY evolución, I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY precisaba I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY transfusiones I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY derivados I-PAST_MEDICAL_HISTORY hemáticos I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY cierta I-PAST_MEDICAL_HISTORY frecuencia. I-PAST_MEDICAL_HISTORY Tras B-PRESENT_ILLNESS presentar I-PRESENT_ILLNESS una I-PRESENT_ILLNESS síndrome I-PRESENT_ILLNESS constitucional I-PRESENT_ILLNESS en I-PRESENT_ILLNESS los I-PRESENT_ILLNESS últimos I-PRESENT_ILLNESS meses, I-PRESENT_ILLNESS se I-PRESENT_ILLNESS le I-PRESENT_ILLNESS había I-PRESENT_ILLNESS detectado I-PRESENT_ILLNESS una I-PRESENT_ILLNESS masa I-PRESENT_ILLNESS en I-PRESENT_ILLNESS pared I-PRESENT_ILLNESS costal I-PRESENT_ILLNESS derecha I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 4 I-PRESENT_ILLNESS cm I-PRESENT_ILLNESS de I-PRESENT_ILLNESS diámetro, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS fue I-PRESENT_ILLNESS diagnosticada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS múcor. I-PRESENT_ILLNESS I-PRESENT_ILLNESS Planteamos B-TREATMENT intervención I-TREATMENT quirúrgica I-TREATMENT para I-TREATMENT resecar I-TREATMENT la I-TREATMENT lesión I-TREATMENT con I-TREATMENT 3 I-TREATMENT cm I-TREATMENT de I-TREATMENT margen. I-TREATMENT Al I-TREATMENT estar I-TREATMENT situada I-TREATMENT en I-TREATMENT la I-TREATMENT proximidad I-TREATMENT de I-TREATMENT la I-TREATMENT línea I-TREATMENT axilar I-TREATMENT anterior, I-TREATMENT llevamos I-TREATMENT a I-TREATMENT cabo I-TREATMENT la I-TREATMENT reconstrucción I-TREATMENT con I-TREATMENT un I-TREATMENT colgajo I-TREATMENT de I-TREATMENT músculo I-TREATMENT dorsal I-TREATMENT ancho I-TREATMENT con I-TREATMENT isla I-TREATMENT de I-TREATMENT piel I-TREATMENT desepidermizada I-TREATMENT de I-TREATMENT 8 I-TREATMENT por I-TREATMENT 12 I-TREATMENT cm I-TREATMENT ; I-TREATMENT se I-TREATMENT anclaron I-TREATMENT puntos I-TREATMENT de I-TREATMENT sutura I-TREATMENT desde I-TREATMENT los I-TREATMENT bordes I-TREATMENT costales I-TREATMENT hasta I-TREATMENT la I-TREATMENT dermis I-TREATMENT del I-TREATMENT colgajo, I-TREATMENT para I-TREATMENT así I-TREATMENT dar I-TREATMENT continuidad I-TREATMENT a I-TREATMENT la I-TREATMENT propia I-TREATMENT pared I-TREATMENT costal. I-TREATMENT La B-EVOLUTION paciente I-EVOLUTION recibió I-EVOLUTION el I-EVOLUTION alta I-EVOLUTION hospitalaria I-EVOLUTION una I-EVOLUTION semana I-EVOLUTION más I-EVOLUTION tarde, I-EVOLUTION sin I-EVOLUTION problemas I-EVOLUTION ventilatorios I-EVOLUTION ni I-EVOLUTION respiración I-EVOLUTION paradójica. I-EVOLUTION No I-EVOLUTION han I-EVOLUTION aparecido I-EVOLUTION recidivas I-EVOLUTION ni I-EVOLUTION complicaciones I-EVOLUTION tras I-EVOLUTION 24 I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION seguimiento I-EVOLUTION postoperatorio. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS 25 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS diagnosticada B-PAST_MEDICAL_HISTORY clínicamente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY miocardiopatía I-PAST_MEDICAL_HISTORY hipertrófica I-PAST_MEDICAL_HISTORY obstructiva I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY farmacológico I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY antiarrítmicos I-PAST_MEDICAL_HISTORY (Amiodarona) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY betabloqueantes I-PAST_MEDICAL_HISTORY (Propanolol). I-PAST_MEDICAL_HISTORY La B-FAMILY_HISTORY madre I-FAMILY_HISTORY había I-FAMILY_HISTORY fallecido I-FAMILY_HISTORY súbitamente I-FAMILY_HISTORY a I-FAMILY_HISTORY los I-FAMILY_HISTORY 48 I-FAMILY_HISTORY años I-FAMILY_HISTORY por I-FAMILY_HISTORY la I-FAMILY_HISTORY misma I-FAMILY_HISTORY enfermedad. I-FAMILY_HISTORY Una B-PRESENT_ILLNESS noche I-PRESENT_ILLNESS salió I-PRESENT_ILLNESS a I-PRESENT_ILLNESS cenar I-PRESENT_ILLNESS con I-PRESENT_ILLNESS los I-PRESENT_ILLNESS compañeros I-PRESENT_ILLNESS de I-PRESENT_ILLNESS trabajo I-PRESENT_ILLNESS regresando I-PRESENT_ILLNESS al I-PRESENT_ILLNESS domicilio I-PRESENT_ILLNESS sobre I-PRESENT_ILLNESS las I-PRESENT_ILLNESS 4 I-PRESENT_ILLNESS horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS madrugada. I-PRESENT_ILLNESS No I-PRESENT_ILLNESS manifestó I-PRESENT_ILLNESS ninguna I-PRESENT_ILLNESS sintomatología I-PRESENT_ILLNESS y I-PRESENT_ILLNESS se I-PRESENT_ILLNESS acostó I-PRESENT_ILLNESS en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS sofá I-PRESENT_ILLNESS del I-PRESENT_ILLNESS salón. I-PRESENT_ILLNESS Poco I-PRESENT_ILLNESS después I-PRESENT_ILLNESS el I-PRESENT_ILLNESS perro I-PRESENT_ILLNESS comenzó I-PRESENT_ILLNESS a I-PRESENT_ILLNESS ladrar I-PRESENT_ILLNESS por I-PRESENT_ILLNESS lo I-PRESENT_ILLNESS que I-PRESENT_ILLNESS el I-PRESENT_ILLNESS padre I-PRESENT_ILLNESS se I-PRESENT_ILLNESS levantó I-PRESENT_ILLNESS encontrándola I-PRESENT_ILLNESS inconsciente. I-PRESENT_ILLNESS Se B-EVOLUTION avisó I-EVOLUTION a I-EVOLUTION los I-EVOLUTION servicios I-EVOLUTION de I-EVOLUTION emergencia I-EVOLUTION 061 I-EVOLUTION que I-EVOLUTION se I-EVOLUTION limitaron I-EVOLUTION a I-EVOLUTION constatar I-EVOLUTION el I-EVOLUTION fallecimiento. I-EVOLUTION I-EVOLUTION