Isquemia mesentérica masiva en paciente puerperal por shock tóxico estreptocócico / Massive mesenteric ischemia in a puerperal woman due to streptococcal toxic shock

El estreptococo B hemolítico del grupo A es una bacteria aerobia Gram +, que puede producir una gran variedad de síndromes infecciosos en el puerperio. Hasta un tercio de las infecciones se complicará con un shock tóxico estafilocócico, caracterizado por shock y disfunción multiorgánica. Cultivos, diagnóstico y tratamiento precoces son vitales para el buen pronóstico. Presentamos el caso de una paciente puerperal con un síndrome de shock tóxico estreptocócico, complicado con una isquemia mesentérica masiva, donde tratamiento antibiótico y cirugía precoz fueron claves para la evolución

B hemolytic group A streptococcus is an aerobic Gram-positive bacteria that can produce a wide variety of infectious syndromes in the puerperium. Up to one-third of infections will be complicated by streptococcal toxic shock, characterized by shock and multiorgan dysfunction. Early cultures, diagnosis and treatment are vital to good prognosis. We present the case of a puerperal patient with streptococcal toxic shock, complicated by massive mesenteric ischemia, in whom antibiotic treatment and early surgery were the key to outcome

[Argon plasma flowing the complex treatment of different forms of erysipelas].

The results of complex treatment of 113 patients with different forms of erysipelas were analyzed. In 73 (64.6%) of them argon plasma using "Argon scalpel SP-CPT" in therapeutic regimen was applied as daily local exposure. In 40 (35,4%) patients with complicated form of erysipelas regimen "coagulation" was applied for additional sanitation of wound surface after surgical treatment of purulent focus. The results of treatment in the study group were better than in the control group. Argon plasma may be regarded as effective method of prophylaxis of necrotic and purulent complications particularly in patients with high risk of these complications.

[Erysipelas. Clinicopathological classification and terminology]. / Classification anatomoclinique, terminologie.

Erysipelas and necrotizing fasciitis are the words used to qualify 2 well-defined aspects of acute microbial dermohypodermal infection. According to the literature a third word, "cellulitis" is used to describe a large variety of inflammatory conditions of soft tissues, either infectious or not. The authors who advocate using this word consider either that an infectious cellulitis is a clinical variant differing from erysipelas or fasciitis, or that it describes the whole spectrum of acute microbial infections of soft tissues, including these 2 entities. This term, whatever its meaning, has no anatomical or histopathological validation. It should be definitively deleted and replaced by "dermohypodermal infection".

[Complex treatment of patients with complicated forms of erysipelas]. / Kompleksnoe lechenie bol'nykh s oslozhnennymi formami rozhi.

The authors made an analysis of variants of treatment strategy and its results in patients with different forms of erysipelas. The use of complex conservative and operative treatment allowed lethality to be reduced from 4 to 1.9%, in patients with severe course of the disease the frequency of complications being reduced to 10%.