Louisiana Research Day Program Book 2025

Case Studies: Section 1

Case Studies: Section 1

Hillary Vo, OMS-IV; Moneeb Musfata, MD VCOM-Louisiana; Department of Internal Medicine, Rapides Regional Medical Center, Alexandria, LA 71 ANTIPHOSPHOLIPID SYNDROME AND CEREBRAL VASCULAR MANIFESTATION IN A YOUNG PREVIOUSLY HEALTHY FEMALE

Hassan Khanani, OMS-III 1 ; Kareem Abdelhamid, OMS-III 2 ; Wasifuddin Syed, OMS-III 2 ; Abir Islam, OMS-III 2 ; Gowrish Vaka, OMS-III 2 ; Roopin Singh, OMS-III 2 1 Willis-Knighton Medical Center; 2 Department of Internal Medicine, Shreveport, Louisiana 70 ECZEMA GONE VIRAL: A CASE OF ECZEMA HERPETICUM

Context/Impact: Eczema herpeticum is a rare but severe complication of atopic dermatitis characterized by widespread herpes simplex virus (HSV) infection. This case demonstrates the risk of systemic involvement in patients on immunomodulatory agents such as Dupilumab and underscores the importance of early intervention to prevent serious morbidity. Report of Case: A 23-year-old male with longstanding atopic dermatitis presented with a two-day history of pruritic, ulcerative lesions on his face, arms, and genitals, accompanied by fever (102.1°F) and tachycardia. Initially crusted, the lesions progressed to open, draining wounds. The patient had recently tested positive for HSV-2. Examination revealed shallow ulcerative lesions with erythematous borders on the face, nostrils, and scrotum, while laboratory findings indicated systemic inflammation. Differential diagnoses included impetigo, staphylococcal scalded skin syndrome, and disseminated herpes zoster. Management was initiated with intravenous (IV) acyclovir and vancomycin (for potential methicillin-resistant Staphylococcus aureus, MRSA). Vancomycin was discontinued when cultures were negative

for MRSA. The patient demonstrated significant improvement in both lesions and systemic symptoms with acyclovir therapy and was later switched to oral antiviral medication. A methicillin-sensitive Staphylococcus aureus (MSSA) infection developed at the IV site and was successfully treated with Cefazolin. The patient was discharged in stable condition with healed lesions and continued on oral antiviral therapy. Comments/Conclusions: This case underscores the importance of promptly recognizing and treating eczema herpeticum, especially in immunocompromised individuals with atopic dermatitis. Literature supports that timely antiviral intervention reduces systemic complications, consistent with the patient’s favorable outcome. Clinicians should maintain a high index of suspicion for herpetic superinfection in patients receiving biologics like Dupilumab. Methods: A focused literature review was conducted using the terms eczema herpeticum, Dupilumab, and disseminated HSV infection in databases such as PubMed and Google

Scholar. Sources reviewed included Clinical Reviews in Allergy & Immunology, the British Journal of Dermatology, and the Journal of the American Academy of Dermatology. The findings highlighted the increased risk of severe HSV infection in individuals with atopic dermatitis and emphasized the critical nature of early therapeutic intervention.

Background: Cerebral ischemic stroke (CIS) is an uncommon but serious disease in young adults. One of the leading causes of this disease in female young adults is antiphospholipid syndrome (APS). We report a 23-year-old previously healthy female who presented to the Emergency Department (ED) with evidence of a new acute onset of CIS. She was managed with a treatment regimen of double anticoagulant therapy and statin based on the standard treatment of ischemic stroke. The patient returned to the ED seven days later with evidence of another acute onset of CIS. She was diagnosed with primary APS and was managed with low-dose aspirin and warfarin with INR therapy of 2-3. The case highlights the early onset of APS in otherwise healthy young females and the crucial role of early detection and appropriate treatment in preventing recurrent stroke events in patients.

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2025 Research Recognition Day