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Necrotizing soft tissue infection

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https://www.readbyqxmd.com/read/29231774/modern-management-of-diabetic-foot-osteomyelitis-the-when-how-and-why-of-conservative-approaches
#1
Javier Aragón-Sánchez, Benjamin A Lipsky
Introduction Diabetic foot osteomyelitis (DFO) has long been considered a complex infection that is both difficult to diagnose and treat, and is associated with a high rate of relapse and limb loss. Areas covered DFO can usually be diagnosed by a combination of clinical evaluation, serum inflammatory markers and plain X-ray. When the results of these procedures are negative or contradictory, advanced imaging tests or bone biopsy may be necessary. Staphylococcus aureus remains the most frequent microorganism isolated from bone specimens, but infection is often polymicrobial...
December 12, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29211672/necrotizing-soft-tissue-infections
#2
Dennis L Stevens, Amy E Bryant
New England Journal of Medicine, Volume 377, Issue 23, Page 2253-2265, December 2017.
December 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29211657/open-to-air-is-a-viable-option-for-initial-wound-care-in-necrotizing-soft-tissue-infection-that-allows-early-detection-of-recurrence-without-need-for-painful-dressing-changes-or-return-to-operating-room
#3
Derek Yang, April Davies, Bailey Burge, Phillip Watkins, Sharmila Dissanaike
BACKGROUND: The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint...
December 6, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29208199/-amputation-of-an-arm-due-to-infection-with-vibrio-vulnificus-after-beach-holiday
#4
Esra Arici, Allan Evald, Dennis Back Holmgaard, Lars Quist, Susanne Dam Poulsen, Signe W Worm
Infection with Vibrio vulnificus is a rare condition with approximately 11 cases reported in the Danish literature. It is characterized by soft tissue infection/wound, necrotizing fasciitis and septicaemia. In this case report we present a patient admitted with a rapid progression and sepsis consistent with V. vulnificus infection but with no informa-tion of water exposure. The initial treatment was surgery and sepsis management including broad-spectrum antibiotics. On day eight the patient's right arm was amputated...
November 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29205142/necrotizing-fasciitis-associated-with-primary-cutaneous-b-cell-lymphoma-a-case-report
#5
K G Spiridakis, D S Intzepogazoglou, M E Flamourakis, E E Sfakianakis, A V Daskalaki, E K Vakonaki, E Rahmanis, G E Kostakis, M S Christodoulakis
Necrotizing fasciitis is a rapidly progressive and life-threatening infection of the deeper skin layers and subcutaneous tissues that moves along the facial planes. OBJECTIVES: We present the rare case of a patient with necrotizing fasciitis associated with high malignancy b-cell lymphoma. Our purpose is to investigate the probable connection between the two pathologies and evaluate the importance of early surgical intervention. CASE REPORT: 51-year old Caucasian woman presented at the E...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29190840/a-woman-with-a-necrotizing-soft-tissue-infection
#6
William Binder, Paul Cohen, Nicholas Musisca, Francis Sullivan
[Full article available at http://rimed.org/rimedicaljournal-2017-12.asp].
December 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/29184978/chronic-infection-and-infected-non-union-of-the-long-bones-in-paediatric-patients-preliminary-results-of-bone-versus-beta-tricalcium-phosphate-grafting-after-induced-membrane-formation
#7
Marie Rousset, Marjolaine Walle, Ludivine Cambou, Mounira Mansour, Antoine Samba, Bruno Pereira, Ismat Ghanem, Federico Canavese
PURPOSE: Chronic infection (CO) and infected non-union of the long bones are relatively rare conditions in paediatric patients. Large bone defects secondary to these conditions can be managed with the induced membrane technique. The technique requires grafting of the bone void, although it is not yet established what bone substitute is the best option. The aim of this work was to evaluate the outcome and efficacy of treatment in children with CO and infected non-union of the long bones using the induced membrane technique and bone (BG) versus beta-tricalcium phosphate (BTP) grafting...
November 28, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29180205/effect-of-transfer-status-on-outcomes-for-necrotizing-soft-tissue-infections
#8
Angela M Ingraham, Hee Soo Jung, Amy E Liepert, Charles Warner-Hillard, Caprice C Greenberg, John E Scarborough
BACKGROUND: Whether patients with necrotizing soft tissue infections (NSTI) who presented to under-resourced hospitals are best served by immediate debridement or expedited transfer is unknown. We examined whether interhospital transfer status impacts outcomes of patients requiring emergency debridement for NSTI. METHODS AND MATERIALS: We conducted a retrospective review studying patients with an operative diagnosis of necrotizing fasciitis, Fournier's gangrene, or gas gangrene in the 2010-2015 American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29166257/raoultella-planticola-a-rare-cause-of-wound-infection
#9
Shana S Kalaria, Kristina Elliott, Neal Combs, Linda G Phillips
Raoultella planticola is a gram-negative, aerobic, rod bacterium commonly found in the environment, particularly in water, soil, and fish. This organism has been found to cause a variety of infections, such as necrotizing fasciitis, cystitis, cholecystitis, pancreatitis, hepatic disease, and soft tissue infections. The authors report the case of a 73-year-old-woman who presented with a R planticola wound infection of her left lower extremity after a dog scratch. She was treated successfully with local wound care using dehydrated human amnion/chorion and oral levofloxacin...
November 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29146218/presentation-and-diagnosis-of-fournier-s-gangrene
#10
REVIEW
Bryan B Voelzke, Judith C Hagedorn
Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier's gangrene, a type of necrotizing fasciitis, affects the genitalia and/or perineum. While a rare health condition, Fournier's gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition...
November 13, 2017: Urology
https://www.readbyqxmd.com/read/29124012/necrotizing-soft-tissue-infection-of-the-thigh-associated-with-retroperitoneal-abscess-in-a-patient-with-locally-advanced-ascending-colon-cancer-a-case-report
#11
Shotaro Harada, Takaharu Kato, Shinichiro Okada, Kensuke Nakatani, Risa Matsumoto, Kazuhiro Nishida, Hiroyasu Komuro, Ai Yokoyama, Chikara Takase, Toshiyuki Suganuma
Necrotizing soft tissue infection (NSTI) is a rare but rapidly progressing soft-tissue infection. Few reports of NSTI caused by colon cancer have been published. We present a rare case of NSTI of the thigh associated the retroperitoneal spread of ascending colon cancer. A 64-year-old man had noticed right hip pain since 3 months before admission, he felt pain in the right thigh which was reddening, and he had difficulty in walking. He was referred to Yokosuka general hospital Uwamachi. Anterolateral aspect of his right thigh was reddening and swelling...
2017: IDCases
https://www.readbyqxmd.com/read/29109842/submental-perforator-flap-for-soft-tissue-reconstruction-in-bisphosphonate-related-osteonecrosis-of-the-jaws
#12
Jose-Antonio García-de Marcos, Juan Rey-Biel
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has emerged as an important and increasingly common comorbidity, especially in patients undergoing long-term treatment with high doses of bisphosphonates. The management of BRONJ remains controversial. Surgical treatment is necessary in severe cases. Treatment of the bone requires sequestrectomy or resection. Given the lack of sufficient mucosa to perform the operation and fragility of margins in many patients, local flaps are crucial. We report two cases of stage-3 BRONJ presenting secondary infection with Actinomyces , receiving treatment consisting of marginal resection of the necrotic bone, reinforcement with a reconstruction plate, and reconstruction of soft tissues using a submental perforator artery flap ipsilateral to the lesion...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29090420/soft-tissue-infection-secondary-to-cellulitis-killed-st-john-of-the-cross-1542-1591
#13
Raffaella Bianucci, Otto Appenzeller, Peter Evans, Philippe Charlier, Antonio Perciaccante
PURPOSE: St. John of the Cross (1542-1591) died aged 49 years after 3 months of excruciating pain following a trivial lesion in his right foot. Erysipelas, a superficial bacterial infection of the skin, and subsequent sepsis were previously suggested as the cause of his death. Here, an alternative diagnosis is proposed. METHODS: An accurate perusal of his biography allowed the symptomatology, the clinical evolution, the depth of the infection and the associated systemic manifestations displayed by Fray John to be reconstructed...
October 31, 2017: Infection
https://www.readbyqxmd.com/read/29082520/necrotizing-soft-tissue-infections-a-multicentre-prospective-observational-study-infect-protocol-and-statistical-analysis-plan
#14
M B Madsen, S Skrede, T Bruun, P Arnell, A Rosén, M Nekludov, Y Karlsson, F Bergey, E Saccenti, V A P Martins Dos Santos, A Perner, A Norrby-Teglund, O Hyldegaard
BACKGROUND: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating these to patient-important outcomes. With this protocol and statistical analysis plan we describe the methods used to obtain data and the details of the planned analyses. METHODS: The INFECT study is a multicentre, prospective observational cohort study...
October 29, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29082050/a-case-of-rituximab-induced-necrotizing-fasciitis-and-a-review-of-the-literature
#15
Abdullateef Abdulkareem, Ryan S D'Souza, Oluwaseun Shogbesan, Anthony Donato
Necrotizing fasciitis is a fulminant soft tissue infection characterized by rapid progression and high mortality. Rituximab is a generally well-tolerated immunosuppresive medication used for B-cell malignancies and some rheumatological disorders. We report a case of a 69-year-old male with chronic lymphocytic leukemia who suffered necrotizing fasciitis of his left lower extremity secondary to Clostridium septicum 7 weeks after treatment with rituximab. Despite immediate intravenous antimicrobial therapy and emergent fasciotomy with extensive debridement, his hospital course was complicated by septic shock and he required an above-the-knee amputation...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29079067/clinical-mimics-an-emergency-medicine-focused-review-of-cellulitis-mimics
#16
Garrett Blumberg, Brit Long, Alex Koyfman
BACKGROUND: Cellulitis is a common clinical condition with low rates of morbidity and mortality if treated appropriately. Mimics of cellulitis presenting with erythema, edema, warmth, and pain can be associated with grave morbidity and mortality if misdiagnosed. OBJECTIVE: This review investigates the signs and symptoms of cellulitis, mimics of cellulitis, and an approach to the management of both cellulitis and its mimics. DISCUSSION: The current emergency medicine definition of cellulitis includes erythema, induration, warmth, and swelling...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29068632/calculated-decisions-lrinec-score-for-necrotizing-soft-tissue-infection
#17
Calvin Hwang
No abstract text is available yet for this article.
October 25, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29066701/-a-case-of-fournier-s-gangrene-due-to-perforation-of-lower-rectal-cancer-during-chemotherapy
#18
Haruhi Fukuhisa, Kenji Baba, Yoshiaki Kita, Hiroshi Tanabe, Tetsuya Ijichi, Shinichiro Mori, Shoji Natsugoe
Fournier's gangrene is a rapidly progressing bacterial infection, involving the subcutaneous and deep fascia. Although intestinal perforation after treatment with bevacizumab is well known, Fournier's gangrene rarely occurs during chemotherapy. A 73-year-old man with unresectable rectal cancer during chemotherapy involving the mFOLFOX6 plus bevacizumab regimen had a consciousness disorder and was admitted to our hospital on emergency. Computed tomography scans indicated a necrotizing soft tissue infection with large amounts of pneumoderma throughout the perineum...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29051525/virulence-characteristics-of-carbapenem-resistant-klebsiella-pneumoniae-strains-from-patients-with-necrotizing-skin-and-soft-tissue-infections
#19
Fiorella Krapp, Andrew R Morris, Egon A Ozer, Alan R Hauser
Two types of Klebsiella pneumoniae (KP) strains are currently emerging: hypervirulent (hvKP) strains and carbapenem-resistant (CR-KP) strains. To date, these two strain types rarely overlap. Recent reports, however, suggest that CR-KP strains are increasing in virulence. hvKP strains frequently present as highly invasive infections, such as necrotizing skin and soft tissue infections (NSSTI). To examine whether CR-KP strains with features of hvKP were present in our U.S. hospital, we retrospectively identified four cases of CR-KP NSSTI diagnosed between January 2012 and January 2016...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29049258/autologous-platelet-rich-plasma-thrombin-gel-combined-with-split-thickness-skin-graft-to-manage-postinfectious-skin-defects-a-randomized-controlled-study
#20
Barbara Hersant, Mounia SidAhmed-Mezi, Romain Bosc, Jean-Paul Meningaud
BACKGROUND: Managing cutaneous substance loss after debridement is challenging, especially if it is secondary to necrotizing soft tissue infection, such as necrotizing fasciitis and Fournier gangrene. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. OBJECTIVE: The aim of this study was to investigate whether autologous platelet-rich plasma (A-PRP) could accelerate and improve wound healing after cutaneous reconstruction for tissue loss secondary to soft tissue infection...
November 2017: Advances in Skin & Wound Care
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