Common Skin Conditions in Children and Adolescents: Bacterial Infections.

Bacterial skin infections represent a significant health care burden. Cellulitis and erysipelas are rapidly spreading, painful, superficial skin infections, usually caused by streptococci or Staphylococcus aureus. Folliculitis is an infection of hair follicles mostly caused by S aureus. Simple folliculitis typically is self-limited. Topical benzoyl peroxide is a first-line nonantibiotic treatment. Mupirocin and clindamycin are topical antibiotic options. For treatment-resistant cases, oral cephalexin or dicloxacillin is an appropriate option. Impetigo is a common, self-limited infection in children. Bullous impetigo is caused by S aureus, and nonbullous impetigo is caused by beta-hemolytic streptococci, S aureus, or both. In most cases, topical mupirocin or retapamulin (Altabax) is effective. Oral antibiotics should be considered for household outbreaks or patients with multiple lesions. Abscesses are red, painful collections of purulence in the dermis and deeper tissues caused by S aureus or polymicrobial infections. Furuncles are abscesses of a hair follicle, whereas carbuncles involve several hair follicles. In recurrent cases of these lesions, culture of the exudate is recommended. Abscess, furuncle, and carbuncle management consists of incision and drainage. Oral antibiotics are not necessary in most cases but should be prescribed for patients with severe immunocompromise or systemic signs of infection. In bacterial skin infections, methicillin-resistant S aureus coverage should be considered for patients with infections that have not improved with treatment.

Furuncular myiasis: unusual case of African Dermatobia hominis.

Human cutaneous myiasis is a common disease in endemic tropical zones. Increased international travel has produced increases in imported cases. We present an unusual patient with myiasis infestation of the leg caused by Dermatobia hominis, which manifested after returning from the Democratic Republic of Congo. This particular infestation has not been reported in Morocco prior to this case. Furuncular cutaneous miyasis must be considered when travellers exhibit draining nodules. Medical treatment consists of occlusion of the furuncular punctum with vaseline to stimulate extrusion of the larva or surgical debridement under local anesthesia.

[Probiotics use in local comprehensive treatment of patients with suppurative-inflammatory diseases of maxillofacial region].

In spite of many studies in the field of suppurative-inflammatory diseases of maxilla-facial region diagnostics and treatment (in particular furuncle and carbuncle) the quantitative measures of the pathology does not have tendency to reduce. Patient contingent is predominantly young able-bodied age. The existing diagnostic methods are not always meeting the modern requirements all along the time and quality. On the background of conducted comprehensive antibacterial treatment unwanted consequences are seen, terms of such treatment are long stationary stage includes. Probiotics use in the comprehensive local and general treatment of such patient category let to shorten terms of treatment and rehabilitation, to avoid negative effects of antibacterial treatment and laser fluorescence diagnostic method use considerably speeds up the process of pathogenic flora diagnosis.

Laboratory-acquired skin infections in a clinical microbiologist: Is wearing only gloves really safe?

Laboratory-acquired infection is one of the leading occupational health hazards. On a laboratory worker's hands, carbuncles occurred. Staphylococcus aureus was isolated from pus samples of the carbuncles, with the same pulsed field gel electrophoresis band pattern with one of the recently studied strains in the laboratory. Incorrect or inadequate application of infection control measures may result in pathogen acquisition from the clinical samples, and wearing only gloves is not sufficient for the biosafety of laboratory workers in clinical diagnostic laboratories.

Primary cutaneous nocardiosis in an immune-competent patient.

We present a patient who was hospitalized due to a purulent skin lesion with a surrounding erythematous area in the region of the right paranasal crease accompanied by a swelling of the right eyelid. Initially the diagnosis of a carbuncle caused by an infection with Staphylococcus aureus was supposed. A surgical debridement was performed and an antibiotic therapy was started. Only special microbial investigations requested by the clinician led to the diagnosis of a cutaneous infection with Nocardia brasiliensis. The presented case is remarkable because the nocardia infection was in an immune-competent patient and the patient showed a primary cutaneous nocardiosis without dissemination.

[The value of sonography in the diagnosis of renal space-occupying lesions]. / Der Wert der Sonographie in der Diagnostik renaler raumfordernder Prozesse

1. Sonography achieves an accuracy of 93% (n = 55/59) in the localisation of space-occupying lesions in the kidney. Since the method is somewhat laborious, ultra sound, in the form of a slow B-scan, cannot be regarded as an alternative to radiology with an accuracy of 97% (n = 57/59). 2. For a pathological diagnosis, particularly in the distinction between tumours and cysts, sonography, with an accuracy of 98% (n = 54/55) is markedly better than radiology with an accuracy of 50% (n = 21/42). Sonography is approximately equal to angiography, which has an accuracy of 97% (n = 69/71). 3. Sonography is useful and is indicated for: a) the investigation of non-functioning kidneys, b) patients in whom radiographic contrast media are contra-indicated, and c) for puncture of renal cysts. (F. St.).

[Accuracy in the diagnosis of renal masses. Computed tomography, sonography, urography, angiography]. / Treffsicherheit in der Diagnostik renaler Raumforderungen.

One hundred and twelve renal masses, whose histology was confirmed at operation, as well as renal vein thrombosis and renal infiltration, were examined by urography, sonography, CT and angiography. In general the results showed good agreement. For the diagnosis of the type of tumour, its size, infiltration into the renal capsule, demonstration of regional lymph node metastases and infiltration into neighbouring organs and for the diagnosis of liver metastases, CT was superior to the other methods.

[Kidney carbuncle in a 9-year-old boy]. / Nierenkarbunkel bei einem 9-jährigen Jungen.

Report on a 9-year-old boy with right-sided renal carbuncle. The symptoms, diagnosis and treatment of the renal carbuncle are described. The possibility of maintaining the function and reconstructing the kidney through fibrin adhesive is discussed.

Common bacterial skin infections.

Skin infections account for a significant portion of dermatologic disease, often resulting in or as a consequence of a disruption in the skin's integrity. This article covers the presentation, diagnosis, and treatment of the more common bacterial infections. The infections presented herein include impetigo, ecthyma, folliculitis, carbuncles/furuncles, cellulitis, toxic shock syndrome, and ecthyma gangrenosum. Once a diagnosis is made, treatment is based on the culture and antibiotic sensitivities of the offending organisms.

[Diagnostic image (185). A man with a pimple on the upper lip. Carbuncle of the upper lip]. / Diagnose in beeld (185). Een man met een puistje op de bovenlip. Karbonkel van de bovenlip.

A 24-year-old man presented with a carbuncle of the upper lip. Surgical drainage was installed and flucloxacillin was administered. Full recovery ensued. In culture Staphylococcus aureus was abundant.

[Septic metastatic complications in facial furuncles and carbuncles]. / Septico-metastaticheskie oslozhneniia pri furunkulakh i karbunkulakh litsa.

According the information of Maxillo-Facial Surgery Clinic of Moscow Medical Academy the percentage of the patients with face furuncles and carbuncles from all the hospitalised is the following: 1994--4.5%, 1995--7.9%, 1996--11.4%, 1997--17.0%. That gives about 3.7 times during the last 2 years. The rate of dangerous for life septic metastatic complications in the course of such diseases considerably exceeds those at phlegmons. This figure has increased 2 to 2.5 times during the last 2 years. Two clinical cases which demonstrate possibility of bacterial thromboemboli spreading in face furuncles and carbuncles not only through small, but also through large blood circulation with formation of septic centres in organs are described. The treatment tactics for such patients requires a strictly individual approach. At slightest suspicion of the complication urgent hospitalisation of the patients for active conservative therapy is necessary. In case of purulent process extension surgery is indicated.

[Renal carbuncle and perirenal abscess in children and adolescents]. / Nierenkarbunkel und perinephritischer Abszess im Kindes- und Jugendalter.

Renal abscesses are rare in childhood. The diagnosis is often complicated by non-specific symptoms and the typical signs of urinary tract infections are frequently absent. The currently available imaging methods are necessary and helpful for a differentiated therapeutic approach; nevertheless, cases are continuously being found in which a renal abscess is only diagnosed intraoperatively. In most patients a combined intravenous therapy including an antibiotic which is effective against staphylococci is sufficient. The therapy is supported if necessary by percutaneous abscess drainage. Open revision or even nephrectomy is rarely required.