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1.
Artigo em Inglês | MEDLINE | ID: mdl-21393942

RESUMO

BACKGROUND: There is paucity of data regarding the clinical and bacteriological profile of sepsis in dermatology in-patients. AIMS: To study the frequency, etiology, and outcome of sepsis dermatology in-patients. METHODS: The study was conducted in a 30-bedded dermatology ward of a tertiary care center. Sepsis was defined by presence of ≥2 SIRS (systemic inflammatory response syndrome) criteria along with evidence of infection (clinically obvious/culture proven infection of skin or internal organs). Patients were also assessed for known (common) risk factors of sepsis. In suspected sepsis patients, at least two samples of blood cultures by venepuncture were taken. Pus, skin swab, urine, and sputum samples were also collected for culture as needed with avoidance of contamination. RESULTS: Among 860 admitted patients studied from November 2004 to July 2006, 103 (12%) fulfilled SIRS criteria. Of these, 63 had nonsepsis causes of SIRS positivity, while 40 (4.65%) had sepsis. Majority of the sepsis patient had vesicobullous diseases (42.5%), erythroderma (25%), toxic epidermal necrolysis (TEN) (22.5%). Severe sepsis developed in 17 (42.5%) patients, while 15 (37.5%) died. Methicillin-resistant Staphylococcus aureus (MRSA) was the commonest organism isolated (99; 25.9%) in all culture specimens followed by Acinetobacter spp. (52; 13.6%), Pseudomonas spp. (40; 10.5%), Methicillin-sensitive S. aureus (MSSA: 33; 8.7%), and Klebsiella spp. (22; 5.8%). Various risk factors affecting mortality and sensitivity patterns for various isolates were also analyzed. CONCLUSION: Sepsis occurred in 40 (4.65%) inpatients in dermatology ward. The frequency of sepsis was highest in TEN (90%), followed by drug-induced maculopapular rash (20.0%), erythroderma (17.5%), and vesicobullous diseases (8.5%). MRSA, acinetobacter, pseudomonas, MSSA, and Klebsiella were important etiological agents involved in sepsis in dermatology in-patients.


Assuntos
Departamentos Hospitalares , Hospitalização , Sepse/microbiologia , Sepse/terapia , Síndrome de Resposta Inflamatória Sistêmica/microbiologia , Síndrome de Resposta Inflamatória Sistêmica/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas Bacteriológicas , Criança , Pré-Escolar , Dermatologia/métodos , Feminino , Departamentos Hospitalares/métodos , Humanos , Índia , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sepse/patologia , Síndrome de Resposta Inflamatória Sistêmica/patologia , Resultado do Tratamento , Adulto Jovem
2.
Indian J Lepr ; 81(1): 1-4, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-20329361

RESUMO

Lagophthalmos is a well known complication in leprosy due to the involvement of seventh cranial nerve resulting in incomplete closure of the eyelids. The real magnitude of ocular morbidity as a consequence of lagophthalmos is unknown, as several ocular complications can occur independently due to involvement of the fifth (trigeminal) nerve or due to secondary infection. Therefore, a study was designed to carefully examine the eyes of 100 consecutive leprosy patients with lagophthalmos seeking treatment at a leprosy referral centre in Delhi. Among the eyes examined, 145 had lagophthalmos. The symptomatology and anterior-posterior chamber morbidity in eyes with lagophthalmos were significantly higher as compared to unaffected eyes. Significantly, higher morbidity was seen regardless of sex or type of leprosy or deformity. Capacity building of the health professionals regarding ocular morbidity and increased emphasis on the importance of self care among patients can significantly reduce ocular morbidity.


Assuntos
Doenças Palpebrais/microbiologia , Hanseníase Multibacilar/complicações , Hanseníase Paucibacilar/complicações , Estudos Transversais , Doenças Palpebrais/patologia , Feminino , Humanos , Índia , Hanseníase Multibacilar/microbiologia , Hanseníase Multibacilar/patologia , Hanseníase Paucibacilar/microbiologia , Hanseníase Paucibacilar/patologia , Masculino , Morbidade , Mycobacterium leprae , Acuidade Visual
4.
Indian J Lepr ; 77(3): 267-71, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16353525

RESUMO

A leprosy patient with no prior history of respiratory complaints, developed symptoms of dry cough, fever and dyspnea after six weeks of therapy. Peripheral eosinophilia and radiological evidence of pulmonary interstitial infiltrates pointed towards the possibility of drug-induced eosinophilic pneumonitis. The results of relevant tests for other possible pathologies were normal. The resolution of symptoms without any intervention other than withdrawal of the drug and subsequent re-challenge proved dapsone to be the cause.


Assuntos
Dapsona/efeitos adversos , Hansenostáticos/efeitos adversos , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Eosinofilia Pulmonar/induzido quimicamente , Eosinofilia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pessoa de Meia-Idade , Eosinofilia Pulmonar/diagnóstico por imagem , Eosinofilia Pulmonar/patologia , Tomografia Computadorizada por Raios X
5.
J Assoc Physicians India ; 52: 1001-3, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15884465

RESUMO

A case of Neurofibromatosis I (NFI) occurring in association with symmetrical peripheral nerve enlargement and multiple hypopigmented macules strikingly limited to the neurofibromas, with normal to minimally reduced sensations, evoking a strong clinical suspicion of co-existent lepromatous leprosy, is being reported. Leprosy was ruled out by microbiological, histopathological and electrophysiological studies. The case is interesting in view of the hypopigmented macules overlying the neurofibromas, which is an unreported feature of NFI.


Assuntos
Hipopigmentação/etiologia , Hanseníase Virchowiana/diagnóstico , Neurofibromatose 1/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Neurofibromatose 1/complicações , Neoplasias Cutâneas/complicações
7.
Artigo em Inglês | MEDLINE | ID: mdl-20877020

RESUMO

A 45-year-old man with acral lentiginous melanoma (AJCC Stage IV) of the left sole and lymph node metastasis is described. Three cycles of palliative combination chemotherapy administered to him resulted in the decrease of inguinal lump, however, the lesion over sole showed no variation.

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