The case of a preschooler with Ramsay Hunt Syndrome (RHS) is reported, an infrequent pediatric neurological condition caused by the reactivation of the varicella-zoster virus, whose atypical manifestation represented a diagnostic challenge. The patient, a 3-year and 4-month-old male, presented with vesicular lesions on the forehead and periorbital region, without the classic auricular rash, which led to a delayed diagnosis. Once RHS with bacterial superinfection was confirmed, acyclovir, prednisone, and antibiotics were administered, achieving a favorable evolution. The atypical presentation highlights the diagnostic challenges in children and the risk of delayed management. Therefore, it is crucial to maintain a high index of suspicion for RHS in pediatrics, even with unusual presentations, to ensure early treatment and prevent severe long-term complications.
Hand-foot-and-mouth disease, commonly caused by Coxsackievirus A16, can manifest in atypical and severe forms associated with the CVA6 serotype, termed "eczema coxsackium," which may mimic serious pathologies. This report describes the case of a 10-year-old boy with a diffuse maculopapular rash, targetoid and bullous lesions, and systemic compromise, initially diagnosed as erythema multiforme major. The discussion focuses on the differential diagnostic challenge with eczema herpeticum, highlighting that despite the alarming clinical presentation, etiological confirmation via PCR for CVA6 was crucial to rule out other infections, discontinue unnecessary acyclovir, and focus treatment on supportive care, leading to a favorable outcome. In conclusion, eczema coxsackium due to CVA6 should be considered in severe vesiculobullous rashes, with PCR being essential for an accurate diagnosis and proper management, as its prognosis is generally benign.
Este estudio de naturaleza sincrónica entabla un diálogo exegético sobre el texto de Génesis 2:25. Para ello, se emplean dos recursos metodológicos. El primero es un análisis ecdótico que permite definir una perícope sobre la cual discutir, a saber, Génesis 2:4-4:26, en el Códice Leningrandensis B19A. El segundo es un examen narratológico que destaca los conceptos de unión y separación. Finalmente, se concluye que dichas nociones conforman un paradigma retórico que permea todos los grados textuales analizados: desde el texto principal (Gn 2:25), seguido de la perícope narrativa (2:4-3:24), hasta el escrito completo del libro de Génesis.
