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1.
Unfallchirurg ; 123(1): 68-75, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31392345

RESUMO

This article presents the case of a rapidly progressing pyoderma gangrenosum (PG) following a minor trauma and surgical intervention. A 46-year-old patient was admitted to hospital after a minor trauma of the right lower leg with a suspected diagnosis of erysipelas bullosum. A magnetic resonance imaging (MRI) scan showed the suspicion of necrotizing fasciitis (NF) with indications for immediate incision and fascia resection. According to the results of the histopathological analysis and microbiological assessment without signs for a bacterial infection, high-dose steroid treatment and immunosuppressive treatment with cyclosporin A were initiated under the assumption of PG. Additionally, the patient was treated with hyperbaric oxygenation (HBO). The 2­year follow-up showed a gradual restitution of the soft tissues.


Assuntos
Fasciite Necrosante , Pioderma Gangrenoso , Desbridamento , Diagnóstico Diferencial , Fasciite Necrosante/etiologia , Fasciite Necrosante/terapia , Humanos , Imunossupressores , Pessoa de Meia-Idade , Pioderma Gangrenoso/etiologia , Pioderma Gangrenoso/terapia , Ferimentos e Lesões/complicações
2.
Zhonghua Shao Shang Za Zhi ; 35(8): 619-621, 2019 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-31474046

RESUMO

On January 1st 2018, a male 44 years old diabetic patient with subcutaneous soft tissue infection in right thigh was admitted to our hospital. The patient repeatedly used the same needle to inject insulin subcutaneously in the unsterilized right thigh, and his blood glucose was badly controlled in the long term. Severe subcutaneous soft tissue infection of the right thigh occurred after his fatigue, accompanied with ketoacidosis. Then he received conservative treatment in the local hospital for one month, but the infection persisted. After being transferred to our hospital, we highly suspected the diagnosis of necrotizing fasciitis according to previous test indicators and local B-ultrasound results, but suggestion of aggressive surgery was refused. So we treated him with conservative therapies using sensitive antibiotics and supportive remedies. The patient was basically healed after treatment of 1 month and he was recovered well during the follow-up 2 months after discharged from our hospital. This case emphasizes the importance of standard injection of insulin and early diagnosis of severe subcutaneous soft tissue infection.


Assuntos
Contaminação de Equipamentos , Fasciite Necrosante/etiologia , Agulhas/efeitos adversos , Infecções dos Tecidos Moles/etiologia , Adulto , Glicemia , Humanos , Injeções/efeitos adversos , Insulina , Masculino , Coxa da Perna
4.
Forensic Sci Med Pathol ; 15(4): 616-621, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31359306

RESUMO

Even if there are well-known consequences of anabolic androgenic steroid (AAS) abuse, their full pathway of action is still being investigated. In this context, the presented case report aims to discuss and provide evidence of unusual adverse effects linked to immunodeficiency in an AAS abuser. In fact, this kind of chronic complication, even if not usually considered, may lead sudden death. In this case a 31-year-old aesthetic weightlifter, who presented to the emergency department due to an accidental fall that resulted in left thigh trauma. This subsequently developed into left thigh necrotizing myofasciitis in the following few days. Although surgery and hyperbaric therapy were carried out, the man died. An autopsy with complete biological sampling for toxicological studies was performed. This case highlights the close relationship between AAS abuse and immunodeficiency and highlights it's importance for further studies. However, it should be considered that of all the dangerous effects produced by AAS use, necrotizing fasciitis is not such an unusual consequence.


Assuntos
Anabolizantes/efeitos adversos , Fasciite Necrosante/etiologia , Hospedeiro Imunocomprometido , Miosite/etiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Acidentes por Quedas , Adulto , Anabolizantes/administração & dosagem , Fasciite Necrosante/patologia , Evolução Fatal , Humanos , Injeções Intramusculares , Masculino , Miosite/patologia , Coxa da Perna , Levantamento de Peso
5.
Eur J Clin Microbiol Infect Dis ; 38(11): 1999-2004, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31325061

RESUMO

Vibrio vulnificus is a Gram-negative bacterium that belongs to the Vibrionaceae family. It represents a deadly opportunistic human pathogen which grows in water with the proper temperature and salinity, and is mostly acquired from seafood eating or direct contact. In susceptible individuals, a traumatic infection could be fatal, causing severe wound infection and even septic shock, and may require amputation. Global warming plays an important role in the geographical area expanding of Vibrio disease. The pathogenesis of Vibrio vulnificus-associated sepsis is very complex, including iron intake, cell injury, and adhesion-related protein and virulence regulation. Vibrio vulnificus infection mainly manifests clinical subtypes such as primary sepsis, traumatic infection, and gastroenteritis, with rapid symptom progression and signs of multiple organ dysfunction syndrome (MODS). It is important to assess these pathogenetic mechanisms in order to select more appropriate measures to prevent and treat Vibrio vulnificus infections, including antibiotic usage and surgical intervention. In this work, we report a typical case of successful treatment of necrotizing fasciitis caused by Vibrio vulnificus, and review the epidemiology, pathogenetic mechanism, clinical characteristics, and treatment of Vibrio vulnificus infection.


Assuntos
Vibrioses , Vibrio vulnificus/patogenicidade , Idoso , Amputação , Antibacterianos/uso terapêutico , Mordeduras e Picadas/complicações , Mordeduras e Picadas/microbiologia , Fasciite Necrosante/epidemiologia , Fasciite Necrosante/etiologia , Fasciite Necrosante/patologia , Fasciite Necrosante/terapia , Feminino , Humanos , Insuficiência de Múltiplos Órgãos/epidemiologia , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/patologia , Insuficiência de Múltiplos Órgãos/terapia , Resultado do Tratamento , Vibrioses/complicações , Vibrioses/epidemiologia , Vibrioses/patologia , Vibrioses/terapia
6.
BMC Infect Dis ; 19(1): 524, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200657

RESUMO

BACKGROUND: The occurrence of adverse events following immunization (AEFI) in national immunization programmes is very rare; however, if they occur causality assessment is conducted to identify the associated cause. In the report, we describe a case of severe necrotizing fasciitis in the left arm of a 9-month old boy following administration of the measles vaccine. CASE PRESENTATION: A 9-month old boy presented with swelling on the left upper arm and adjoining the chest area, low-grade continuous fever, frequent passage of loose watery stool and persistent cries 24 h after measles vaccine was administered on the left upper arm. On examination, he was mildly pale, febrile, anicteric. Extensive erythema of the left upper arm occurred thereafter with extensive scalded skin lesions involving the deltoid area, the upper chest wall and arm. This was followed by desquamation of the affected areas and severe necrosis. A diagnosis of severe necrotizing fasciitis was made. A causality assessment was conducted by the state AEFI committee using the detailed AEFI investigation forms to identify the cause of the incidence. CONCLUSION: Here we present a rare case of necrotizing fasciitis which could have been caused by incorrect use of reconstituted measles vaccine. Hence we recommend training of routine immunization service providers on proper vaccine management as well as intensified supervision of immunization sessions.


Assuntos
Fasciite Necrosante/etiologia , Vacina contra Sarampo/efeitos adversos , Vacinação/efeitos adversos , Causalidade , Fasciite Necrosante/patologia , Fasciite Necrosante/terapia , Humanos , Lactente , Masculino , Vacina contra Sarampo/administração & dosagem , Nigéria , Vacinação/normas
7.
World J Surg ; 43(10): 2393-2400, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31214830

RESUMO

BACKGROUND: The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scoring system was developed to aid the diagnosis of necrotizing fasciitis and guide management [1]. AIM: To validate the LRINEC score and identify clinical predictors to develop a refined diagnostic scoring tool for the diagnosis of necrotizing fasciitis at Middlemore Hospital, New Zealand. METHODS: This was a retrospective case-control study of patients admitted to Middlemore Hospital with necrotizing fasciitis and severe cellulitis between January 2000 and December 2010. The LRINEC scores at admission were evaluated for performance in discriminating between cases of necrotizing fasciitis and severe cellulitis. Cases and controls were randomized into developmental and validation cohorts. Univariate and multivariate logistic regression analysis of demographic, clinical, and laboratory variables for the diagnosis of necrotizing fasciitis was performed. The identified independent predictors were used to develop a new diagnostic scoring tool. RESULTS: The area under the receiver operating characteristic curve (C-statistic) of a LRINEC score ≥6 for the diagnosis of necrotizing fasciitis was 0.679. The newly developed SIARI score [Site other than the lower limb, Immunosuppression, Age < 60 years, Renal impairment (creatinine > 141), and Inflammatory markers (CRP ≥ 150, WCC > 25] demonstrated superior diagnostic ability compared with the LRINEC score in both the developmental (C-statistic: 0.832 vs. 0.691, p < 0.001) and validation cohorts (C-statistic: 0.847 vs. 0.667, p < 0.001). CONCLUSION: The LRINEC score exhibited only modest discriminative performance in this cohort, while the SIARI score is a simplified tool that demonstrates superior diagnostic ability for detecting necrotizing fasciitis. Future external validation studies are required to confirm the trends observed in this study.


Assuntos
Técnicas de Apoio para a Decisão , Fasciite Necrosante/diagnóstico , Adulto , Idoso , Fasciite Necrosante/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
8.
PLoS One ; 14(6): e0218668, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31220158

RESUMO

BACKGROUND: Necrotizing fasciitis (NF) is a serious skin and soft tissue infection causing high mortality. Investigating region specific epidemiologic factors associated with NF is important for establishing appropriate treatment strategies. This multicenter study was done to provide an update of the microbial etiology, clinical characteristics, and outcomes of NF in Korea. MATERIALS AND METHODS: A retrospective cohort of adult patients with NF was established using patient data from 13 general hospitals between January 2012 and December 2015 in Korea. We evaluated microbial etiology and clinical characteristics to identify risk factors associated with in-hospital mortality; analyses were performed using binary logistic regression models. RESULTS: A total of 161 patients with NF were included. The most common underlying disease was diabetes mellitus (66 cases, 41.0%). A total of 148 organisms were isolated from 119 (73.9%) patients. Enteric Gram-negative organisms (36 patients) were the most common pathogen, followed by Staphylococcus aureus (30 patients) and streptococci (28 patients). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 6.2% (10/161) of patients. Of 37 enteric Gram-negative isolates tested, 26 (70.3%) isolates were susceptible to ceftriaxone. The in-hospital mortality rate was 22.4%. Intensive care unit admission, septic shock, and Gram-negative organism infections were significantly associated with in-hospital mortality, and surgery was not a favorable prognostic factor. CONCLUSIONS: As initial empirical antibiotics, glycopeptides against MRSA and broad-spectrum antibiotics against third-generation cephalosporin-resistant organisms should be considered for patients with community-onset NF in Korea.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/etiologia , Fasciite Necrosante/epidemiologia , Fasciite Necrosante/etiologia , Adulto , Idoso , Estudos de Coortes , Infecções Comunitárias Adquiridas/diagnóstico , Fasciite Necrosante/diagnóstico , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prognóstico , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/epidemiologia
9.
Pan Afr Med J ; 32: 71, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223362

RESUMO

Introduction: Odontogenic infections are fairly common in healthcare settings. However, late presentations such as Ludwig's angina, facial cellulitis, necrotizing cervical fasciitis (NCF), among others could lead to mortality. In view of suggestions that the occurrence of severe, near-fatal odontogenic infections is declining, this study set out to determine the incidence of such severe odontogenic infections over the past 5 years at the Korle-Bu Teaching Hospital, a major referral centre in Ghana. Methods: A retrospective review was done, involving all patients with severe odontogenic infection, thereby requiring admission, per stated criteria at the Department of Oral and Maxillofacial Surgery (Dental clinic), Korle-Bu Teaching Hospital, in the period between July 2012 and July 2017. The cumulative incidence for the respective years were then computed for the years of review. Results: A total of 243 patients were included in the study. This consisted of 121 males and 122 females, with an average age of 42.9 years (SD = 16.6), ranging from 18 months to 91 years. Incidence proportions for the years of the review were 8.2, 8.9, 17.7, 17.9 and 27.7 people per 1000 cases of tooth-related infections for the respective years. With a fatality rate of 5.8%, the incidence of odontogenic infections among patients attending the outpatient Dental clinic of the hospital is 40.3%, while that of dentoalveolar abscess is 6.2%. Ludwig's angina was the commonest (52%) form of presentation of spreading odontogenic infection. Conclusion: This study highlights the importance of persisting severe, near-fatal odontogenic infections in Ghana. Not only is there a need to assess the public, professional and institutional strategies to management, but for more evidence-based studies in our local setting to aid in management.


Assuntos
Angina de Ludwig/epidemiologia , Abscesso Periapical/epidemiologia , Doenças Dentárias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Celulite (Flegmão)/epidemiologia , Celulite (Flegmão)/etiologia , Criança , Pré-Escolar , Fasciite Necrosante/epidemiologia , Fasciite Necrosante/etiologia , Feminino , Gana/epidemiologia , Hospitais de Ensino , Humanos , Incidência , Lactente , Angina de Ludwig/etiologia , Masculino , Pessoa de Meia-Idade , Abscesso Periapical/etiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Doenças Dentárias/complicações , Doenças Dentárias/microbiologia , Adulto Jovem
10.
J Wound Care ; 28(Sup5): S21-S27, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31067168

RESUMO

Necrotising fasciitis can result in extensive loss of soft tissue and limb function. Therefore, surgical intervention requires a balance between extensive tissue removal and saving the limb. A 56-year-old male presented with necrotising fasciitis of the upper extremity. Debridement resulted in a full-thickness wound of the forearm and upper arm, an exposed olecranon and two proximally-based skin flaps. Reconstruction required multiple debridements to optimise the wound for skin grafting and to obtain flap adherence to underlying tissues of the upper arm. Conventional dressings over the flaps proved unsuccessful. Therefore, a customised versatile dressing to address each area of the wound was developed. Negative pressure wound therapy (NPWT) was applied over the exposed muscle (no exposed bone or tendon) of the lower arm and anterior upper arm; a hydropolymer foam dressing covered the elbow region. Closed incision negative pressure wound therapy (ciNPT) was applied over the incision on the posterior upper arm. Ultimately, complete wound closure was achieved, with normal/near-normal range of motion for all joints of the affected limb. There was complete take of skin grafts on the wrist, lower arm and anterior upper arm. ciNPT was effective in holding the incision together and promoting healing of the posterior upper arm, and the hydropolymer foam dressing aided with healing and coverage of the elbow region. In this case, healing of a large, complex upper extremity wound and restored limb function were achieved following use of a combination of surgical techniques and customisation of wound therapy modalities.


Assuntos
Traumatismos do Braço/complicações , Fasciite Necrosante/terapia , Bandagens , Desbridamento , Fasciite Necrosante/etiologia , Fasciite Necrosante/microbiologia , Fasciite Necrosante/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Pele , Retalhos Cirúrgicos , Cicatrização
11.
Ann Ital Chir ; 82019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-31112521

RESUMO

Necrotizing fasciitis (NF) is a rare, life-threatening soft tissue infection that affects the skin, subcutaneous tissue, fascia, and muscle, and is characterized by rapid spread and invasion of pathogens. Treatment is possible with early diagnosis, appropriate antibiotic therapy, and quick surgical intervention. Nevertheless, despite all interventions, it is sometimes difficult to manage NF. The Authors present the case of a patient with extensive NF caused by multidrug-resistant Acinetobacter baumannii (A. baumannii) that developed following an intramuscular injection of diclofenac sodium administered at home by someone who was not a healthcare professional. Wound sample culture revealed multidrug-resistant A. baumannii. The patient was treated using negative-pressure wound therapy along with antibiotic treatment and extensive surgical debridement. KEY WORDS: Multidrug-resistant acinetobacter baumannii, Necrotizing fasciitis, Negative-pressurelf-injection, Wound therapy.


Assuntos
Infecções por Acinetobacter/etiologia , Acinetobacter baumannii , Fasciite Necrosante/etiologia , Injeções Intramusculares/efeitos adversos , Fasciite Necrosante/microbiologia , Humanos
12.
Arch. Soc. Esp. Oftalmol ; 94(5): 242-247, mayo 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-180830

RESUMO

Mujer de 80 años sin antecedentes médicos que consulta por empeoramiento de picor y dolor palpebral derecho tras la picadura de un insecto. Presenta zonas de laceración por rascado en los párpados, que evolucionan a placas de necrosis fibrinoide durante las primeras 24 horas. Se cultivan las lesiones, demostrando Streptococcus pyogenes y Staphylococcus aureus. Se ingresa a la paciente con diagnóstico de fascitis necrosante periorbitaria para tratamiento intravenoso con ceftriaxona, linezolid y desbridamiento quirúrgico urgente. Permanece ingresada durante 17 días; se le realizan curas diarias consistentes en desbridamiento de restos necróticos, limpieza con clorhexidina y curas con pomadas de mupirocina, sulfadiazina y miconazol. Sufre síndrome de shock tóxico estreptocócico, del que se recupera durante la primera semana de ingreso. A las 2 semanas se le realiza reconstrucción plapebral con autoinjerto de piel de espesor total preauricular en el párpado superior y avance malar lateral en el párpado inferior, con adecuado resultado cosmético y funcional


An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral itching and pain after an insect bite. Her eyelids had areas of laceration due to scratching, which rapidly progressed to fibrinoid necrosis over the first 24 hours. Lesions were cultivated, revealing Streptococcus pyogenes and Staphylococcus aureus. The patient was admitted to hospital with the diagnosis of periorbital necrotising fasciitis, in order to receive treatment with intravenous ceftriaxone, linezolid, and immediate surgical debridement. She remained in hospital for 17 days. Daily wound management consisted of debridement of necrotic remains, disinfection with chlorhexidine, and wound dressing with mupirocin, sulfadiazine, and miconazole ointments. The patient suffered streptococcal toxic shock syndrome, but she recovered over the first week. Palpebral reconstruction was performed on day 15, consisting of a preauricular total thickness skin graft for the superior eyelid, and lateral malar advancement to cover the lower eyelid. Adequate cosmetic and functional results were obtained


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Fasciite Necrosante/etiologia , Fasciite Necrosante/cirurgia , Doenças Orbitárias/etiologia , Doenças Orbitárias/cirurgia , Infecções Estafilocócicas/complicações , Infecções Estreptocócicas/complicações , Mordeduras e Picadas de Insetos/complicações
13.
BMJ Case Rep ; 12(4)2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30948409

RESUMO

Varicella gangrenosum is a gangrenous ulceration of varicella lesions involving the skin and soft tissues of the body. The term was coined more than 100 years ago. This occurs due to superimposed bacterial infection. The presentation of primary varicella in adults is more severe with catastrophic systemic complications as compared with children. These complications include necrotising fasciitis, disseminated intravascular coagulation, wet/dry gangrene and death, as was seen in our case. Survival is dependent on early diagnosis and treatment. Adequate antibiotic treatment and particularly early radical surgical debridement should be the cornerstone of management. Less than 10 such cases are reported in the literature.


Assuntos
Varicela/complicações , Fasciite Necrosante/etiologia , Gangrena/etiologia , Infecções Estafilocócicas/complicações , Fasciite Necrosante/diagnóstico , Evolução Fatal , Gangrena/diagnóstico , Doenças dos Genitais Masculinos/etiologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Extremidade Inferior/patologia , Masculino , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Adulto Jovem
14.
BMJ Case Rep ; 12(4)2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31015232

RESUMO

We report the case of a 56-year-old man, previously well, who presented with a spontaneous right-sided periorbital necrotising soft tissue infection and subsequently found to have undiagnosed hepatitis C and liver cirrhosis. The patient presented with rapid onset right eye pain, periorbital swelling and septic shock. CT scan revealed diffuse inflammatory changes to the soft tissue anterior to the right eye. The initial treatment included intravenous antibiotics, emergency debridement of necrotic tissue and admission to intensive care. Group A streptococcus was cultured from the debrided tissue. The patient developed decompensated liver failure and life-threatening haematemesis. Liver screening detected hepatitis C positive serology, the only risk factor for which was an old tattoo. The patient was effectively managed by early involvement of multiple clinical teams. We review the literature surrounding periorbital necrotising fasciitis, discuss the evidence for hepatic disorders as a potential cause and make recommendations for managing these patients.


Assuntos
Fasciite Necrosante/etiologia , Hepatite C/diagnóstico , Cirrose Hepática/diagnóstico , Doenças Orbitárias/patologia , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Desbridamento/métodos , Diagnóstico Diferencial , Fasciite Necrosante/tratamento farmacológico , Fasciite Necrosante/microbiologia , Fasciite Necrosante/cirurgia , Hepatite C/complicações , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus/isolamento & purificação , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
15.
BMJ Case Rep ; 12(3)2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30872346

RESUMO

Necrotising fasciitis (NF) resulting from sigmoid perforation is rare, but none the less remains life threatening. Early surgical intervention and empiric broad-spectrum antibiotic remains the standard of care. A 65-year-old man with history of stage 4 rectal cancer presented with bilateral hip pain. An X-ray of the hip and pelvis to rule out fracture revealed abnormal gas pattern overlying the right hip. CT imaging revealed distal sigmoid perforation with air extending from the pelvis to posterior aspect of the right hip and thigh. Aggressive surgical intervention and antibiotic initiation was associated with successful outcomes in our patient. Although less common, sigmoid perforation leading to NF in posterior thigh is a reminder of a potentially lethal complication.


Assuntos
Artralgia/etiologia , Colo Sigmoide/patologia , Fasciite Necrosante/etiologia , Perfuração Intestinal/complicações , Idoso , Artralgia/diagnóstico , Bacteroides fragilis , Colostomia/métodos , Desbridamento/métodos , Diagnóstico Diferencial , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/microbiologia , Quadril/patologia , Humanos , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/tratamento farmacológico , Perfuração Intestinal/cirurgia , Masculino , Infecção da Ferida Cirúrgica/complicações , Infecção da Ferida Cirúrgica/microbiologia , Resultado do Tratamento
16.
J Craniofac Surg ; 30(6): e487-e489, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30865123

RESUMO

Internal jugular vein thrombosis (IJVT) is a rare complication of cervical necrotizing fasciitis (CNF) which may lead to life threat. This article reports a patient with severe CNF complicated with IJVT, and combined with the literature to analyze the diagnosis and treatment of CNF and IJVT.


Assuntos
Fasciite Necrosante/diagnóstico por imagem , Veias Jugulares/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Fasciite Necrosante/etiologia , Feminino , Humanos , Veias Jugulares/cirurgia , Pessoa de Meia-Idade , Pescoço , Trombose Venosa/complicações , Trombose Venosa/cirurgia
18.
Arch Soc Esp Oftalmol ; 94(5): 242-247, 2019 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30733068

RESUMO

An 80 year-old woman with no relevant medical history, consulted for worsening of right palpebral itching and pain after an insect bite. Her eyelids had areas of laceration due to scratching, which rapidly progressed to fibrinoid necrosis over the first 24hours. Lesions were cultivated, revealing Streptococcus pyogenes and Staphylococcus aureus. The patient was admitted to hospital with the diagnosis of periorbital necrotising fasciitis, in order to receive treatment with intravenous ceftriaxone, linezolid, and immediate surgical debridement. She remained in hospital for 17 days. Daily wound management consisted of debridement of necrotic remains, disinfection with chlorhexidine, and wound dressing with mupirocin, sulfadiazine, and miconazole ointments. The patient suffered streptococcal toxic shock syndrome, but she recovered over the first week. Palpebral reconstruction was performed on day 15, consisting of a preauricular total thickness skin graft for the superior eyelid, and lateral malar advancement to cover the lower eyelid. Adequate cosmetic and functional results were obtained.


Assuntos
Fasciite Necrosante/etiologia , Mordeduras e Picadas de Insetos/complicações , Lacerações/etiologia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Desbridamento , Fasciite Necrosante/terapia , Feminino , Humanos , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/diagnóstico , Streptococcus pyogenes/isolamento & purificação
19.
Rev. clín. med. fam ; 12(1): 24-27, feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182885

RESUMO

La fascitis necrotizante es una infección agresiva y altamente destructiva de la fascia y el músculo con una alta morbimortalidad. Se suele presentar en pacientes inmunocomprometidos tales como VIH, diabéticos, oncológicos o trasplantados, siendo sus localizaciones más habituales las extremidades, pared abdominal y periné; en esta última localización recibe el nombre de gangrena de Fournier. Su asociación con úlceras de decúbito es infrecuente, relacionándose en la mayoría de las ocasiones con procesos osteomielíticos, traumatismos con heridas cutáneas o presencia de cuerpos extraños. Presentamos un caso clínico de un paciente con fascitis necrotizante secundaria a úlcera de decúbito. Nos parece interesante presentar las características clínicas, así como exponer los hallazgos radiológicos de esta entidad y, por otra parte, acentuar la importancia de un adecuado cuidado de las úlceras por presión, ya que pueden ser el origen de la fascitis necrotizante


Necrotizing fasciitis is an aggressive and highly destructive infection of the fasciae and muscles with high morbidity and mortality. It usually occurs in immunocompromised patients such as HIV, diabetic, oncology or transplant patients. Its most common locations are the extremities, abdominal wall and perineum; in this latter location it is called Fournier's gangrene. Its association with pressure ulcers is infrequent, being connected in most cases with osteomyelitic processes, traumas with skin wounds or presence of foreign bodies. We present the clinical case of a patient with necrotizing fasciitis secondary to pressure ulcer. We find it interesting to present the clinical characteristics as well as the radiological findings of this entity and, on the other hand, to emphasize the importance of an adequate care of pressure ulcers, since they can be the origin of necrotizing fasciitis


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Fasciite Necrosante/etiologia , Lesão por Pressão/complicações , Cicatrização , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de Risco , Doença de Alzheimer/complicações , Fragilidade/complicações
20.
Blood Purif ; 47(1-3): 259-264, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30517912

RESUMO

Renal failure patients have an increased risk of infection, including skin and soft tissue infections. This increased susceptibility is multifactorial, due to the conditions causing the renal failure as well as complications of treatment and renal failure's innate effects on patient health. These infections have a significant impact on patient morbidity, increased hospital and procedural demands, and the cost of health care. Many renal failure patients are seen regularly by their nephrology clinic caregivers due to the need for frequent dialysis and transplant monitoring. Familiarity with common skin and soft tissue infections by these caregivers allowing enhanced patient education, optimal infection prevention, and early recognition could significantly reduce the morbidity and cost of these disorders, such as diabetic foot syndrome, necrotizing fasciitis, and herpetic infections.


Assuntos
Pé Diabético , Fasciite Necrosante , Herpes Simples , Educação de Pacientes como Assunto , Insuficiência Renal , Custos e Análise de Custo , Pé Diabético/complicações , Pé Diabético/economia , Pé Diabético/epidemiologia , Fasciite Necrosante/economia , Fasciite Necrosante/epidemiologia , Fasciite Necrosante/etiologia , Herpes Simples/economia , Herpes Simples/epidemiologia , Herpes Simples/etiologia , Humanos , Insuficiência Renal/complicações , Insuficiência Renal/economia , Insuficiência Renal/epidemiologia , Fatores de Risco
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