Share
array:24 [ "pii" => "S2387020617303868" "issn" => "23870206" "doi" => "10.1016/j.medcle.2017.06.002" "estado" => "S300" "fechaPublicacion" => "2017-07-07" "aid" => "3757" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2017;149:e3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775316303955" "issn" => "00257753" "doi" => "10.1016/j.medcli.2016.09.005" "estado" => "S300" "fechaPublicacion" => "2017-07-07" "aid" => "3757" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2017;149:e3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 51 "formatos" => array:2 [ "HTML" => 37 "PDF" => 14 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Mononucleosis infecciosa con manifestaciones clínicas inusuales" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e3" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infectious mononucleosis with unusual clinical manifestations" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 750 "Ancho" => 1000 "Tamanyo" => 134406 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ilduara Pintos Pascual" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Ilduara" "apellidos" => "Pintos Pascual" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020617303868" "doi" => "10.1016/j.medcle.2017.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617303868?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775316303955?idApp=UINPBA00004N" "url" => "/00257753/0000014900000001/v1_201706170053/S0025775316303955/v1_201706170053/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020617304011" "issn" => "23870206" "doi" => "10.1016/j.medcle.2017.06.012" "estado" => "S300" "fechaPublicacion" => "2017-07-07" "aid" => "3792" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2017;149:e5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "A lumpy jaw" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e5" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mandíbula abultada" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 923 "Ancho" => 975 "Tamanyo" => 236525 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Satvinder Singh Bakshi" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Satvinder" "apellidos" => "Singh Bakshi" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S002577531630495X" "doi" => "10.1016/j.medcli.2016.09.035" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531630495X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617304011?idApp=UINPBA00004N" "url" => "/23870206/0000014900000001/v1_201707230028/S2387020617304011/v1_201707230028/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020617303856" "issn" => "23870206" "doi" => "10.1016/j.medcle.2017.06.001" "estado" => "S300" "fechaPublicacion" => "2017-07-07" "aid" => "3755" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2017;149:e1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Localized cutaneous leishmaniasis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e1" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Leishmaniasis cutánea localizada" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1204 "Ancho" => 2667 "Tamanyo" => 607460 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Miguel Ángel Flores-Terry, Manuela López-Nieto, Rafael Cruz-Conde de Boom, Jose Antonio Garrido-Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Miguel Ángel" "apellidos" => "Flores-Terry" ] 1 => array:2 [ "nombre" => "Manuela" "apellidos" => "López-Nieto" ] 2 => array:2 [ "nombre" => "Rafael" "apellidos" => "Cruz-Conde de Boom" ] 3 => array:2 [ "nombre" => "Jose Antonio" "apellidos" => "Garrido-Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775316303931" "doi" => "10.1016/j.medcli.2016.08.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775316303931?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617303856?idApp=UINPBA00004N" "url" => "/23870206/0000014900000001/v1_201707230028/S2387020617303856/v1_201707230028/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Infectious mononucleosis with unusual clinical manifestations" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e3" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Ilduara Pintos Pascual" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Ilduara" "apellidos" => "Pintos Pascual" "email" => array:1 [ 0 => "ilduarapintos@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mononucleosis infecciosa con manifestaciones clínicas inusuales" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 750 "Ancho" => 563 "Tamanyo" => 75609 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">36-year-old male was presented with no history of interest. The subject came to the emergency department due to a 2-day history of bluish colored auricles. The patient had had a fever of up to 39<span class="elsevierStyleHsp" style=""></span>°<span class="elsevierStyleSmallCaps">C</span> for a week, accompanied by cough and odynophagia. After taking amoxicillin-clavulanic acid, a rash appeared on the trunk, without involvement of palms or soles. He also started with conjunctival jaundice and choluria without acholia or abdominal pain. Physical examination revealed rash, amygdala hyperemia, mild conjunctival jaundice and acrocyanosis in the auricles (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). CBC results: hemoglobin 11<span class="elsevierStyleHsp" style=""></span>g/dl, MCV 101<span class="elsevierStyleHsp" style=""></span>fl, reticulocytes 3%. Smear test: frequent activated lymphocytes. Biochemistry: normal renal function and ions, bilirubin 3.6<span class="elsevierStyleHsp" style=""></span>mg/dl, LDH 3.020<span class="elsevierStyleHsp" style=""></span>U/l, ALT 235<span class="elsevierStyleHsp" style=""></span>U/l, AST 156<span class="elsevierStyleHsp" style=""></span>U/l, GGT 486<span class="elsevierStyleHsp" style=""></span>U/l, alkaline phosphatase 217<span class="elsevierStyleHsp" style=""></span>U/l. Coagulation, urinalysis, chest X-ray and abdominal ultrasound without findings. Serologies were requested, being positive for EBV VCA IgM. Red cell aggregates were detected at room temperature by the presence of cold agglutinins. The patient responded favorably, without any new episodes (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cold agglutinin autoimmune hemolytic anemia only occurs in 3% of EBV mononucleosis, with clinical manifestations, such as acrocyanosis, being rare.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pintos Pascual I. Mononucleosis infecciosa con manifestaciones clínicas inusuales. Med Clin (Barc). 2017;149:e3.</p>" ] ] "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 563 "Tamanyo" => 83148 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 750 "Ancho" => 1000 "Tamanyo" => 134406 ] ] ] 2 => array:6 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 750 "Ancho" => 563 "Tamanyo" => 75609 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014900000001/v1_201707230028/S2387020617303868/v1_201707230028/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014900000001/v1_201707230028/S2387020617303868/v1_201707230028/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617303868?idApp=UINPBA00004N" ]
