[Necrotising soft tissue infection of orbital area and hand: an unusual combination]. / Necrotiserende wekedeleninfectie van hand en oog.

BACKGROUND: Necrotising soft tissue infection (NSTI) is an infection of the subcutaneous tissues and often follows a fulminant course if not recognised in time. CASE DESCRIPTION: A 78-year-old man was brought to our emergency department in septic shock. Physical examination revealed an erythematous and painful swelling of the right eyelids and to a lesser extent of the right hand. The infection progressed at both sites, and suspicion of NSTI arose. An emergency surgical debridement was performed. Pathological examination of the excised tissue confirmed the presence of a necrotising infection of the fascia consistent with NSTI at both sites. CONCLUSION: This case history describes a, not previously described, 'double' presentation of NSTI. In a patient with misunderstood sepsis in combination with a soft tissue infection, it is important to consult a surgeon immediately. This case report emphasises the need for a multidisciplinary approach when treating patients with these clinical pictures. CONFLICT OF INTEREST AND FINANCIAL SUPPORT: NONE DECLARED.

Results from craniocaudal carotid body tumor resection: should it be the standard surgical approach?

OBJECTIVES: To evaluate results after carotid body tumor (CBT) surgery using a novel dissection technique. METHODS: A retrospective analysis of all operated CBT in the last 6 years was carried out and results were compared with the current literature and our previous series, which reported another 111 cases operated on until 2005. RESULTS: Forty-five CBTs were removed in 41 (56% hereditary cases) patients (seven Shamblin I, 22 II, and 16 III). There were no cases of permanent cranial nerve injury or stroke. These pre- and postoperative results compare favorably with our previous series and are superior to, generally smaller, studies reported in the contemporary literature. CONCLUSIONS: This large series of surgically-treated CBTs supports craniocaudal dissection as the surgical technique of choice as it limits blood loss and facilitates safe CBT resection.