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Necrotizing soft tissue infection

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https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#1
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28296993/clinical-characteristics-and-outcomes-of-patients-with-cellulitis-requiring-intensive-care
#2
Duncan R Cranendonk, Lonneke A van Vught, Maryse A Wiewel, Olaf L Cremer, Janneke Horn, Marc J Bonten, Marcus J Schultz, Tom van der Poll, W Joost Wiersinga
Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis is often confused for cellulitis at initial presentation and is considered to be more severe and thus has previously been described in more detail. Objective: To describe the clinical presentation and outcomes of patients with ICU-necessitating cellulitis and to compare them with patients with necrotizing fasciitis...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28296037/laboratory-risk-indicator-for-necrotizing-fasciitis-score-for-early-diagnosis-of-necrotizing-fasciitis-in-darwin
#3
Vignesh Narasimhan, Geraldine Ooi, Stephanie Weidlich, Phillip Carson
BACKGROUND: Soft tissue infections are a major health burden in the Top End of the Northern Territory of Australia. Necrotizing fasciitis (NF) is associated with mortality rates from 8 to 40%. Early recognition and aggressive surgical debridement are the cornerstones of successful treatment. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, developed by Wong et al., uses six routine biochemical variables to aid early diagnosis. We aim to assess the diagnostic efficacy of the LRINEC score in our population...
March 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28294674/-necrotizing-fasciitis-in-head-and-neck-area
#4
Beáta Sántha, Katalin Sári, Zoltán Fülep, Márta Patyi, Ferenc Oberna
Necrotizing fasciitis is a fulminant infection of the deeper layers of skin and subcutaneous tissues characterized by progressive soft tissue necrosis and high mortality. It rarely occurs in the head and neck area. The clinical picture includes non-specific but typical local and systemic symptoms. The treatment is a complex, multidisciplinary task which includes radical surgical exploration, debridement and drainage, empirically started and then targeted intravenous antibiotics and supportive therapy. Authors report a case of necrotizing fasciitis localized on the right side of the face which caused multi-organ failure and phlegmone of the neck...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28293522/a-case-report-of-the-first-nonburn-related-military-trauma-victim-treated-with-spray-skin-regenerative-therapy-in-combination-with-a-dermal-regenerate-template
#5
Ian L Valerio, Daniel A Hammer, Juan L Rendon, Kerry P Latham, Mark E Fleming
Massive soft tissue and skin loss secondary to war-related traumas are among the most frequently encountered challenges in the care of wounded warriors. This case report outlines the first military nonburn-related trauma patient treated by a combination of regenerative modalities. Our case employs spray skin technology to an established dermal regenerate matrix. Our patient, a 29-year-old active duty male, suffered a combat blast trauma in 2010 while deployed. The patient's treatment course was complicated by a severe necrotizing fasciitis infection requiring over 100 surgical procedures for disease control and reconstruction...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28289755/-necrotizing-fasciitis-of-the-upper-and-lower-extremities
#6
M Kückelhaus, T Hirsch, M Lehnhardt, A Daigeler
Necrotizing fasciitis is a potentially fatal soft tissue infection that may affect the upper and lower extremities, scrotum, perineum and abdominal wall. Typically, the infection demonstrates rapid spreading along the fascial planes leading to sepsis with mortality rates of 15-46%. Without adequate treatment, the mortality rate increases to close to 100%. There are four groups of pathogens that can lead to necrotizing fasciitis, namely beta-hemolytic group A streptococci, mixed infections with obligate and facultative anaerobes, clostridium species and fungal infections...
March 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28270166/the-laboratory-risk-indicator-for-necrotizing-fasciitis-lrinec-scoring-the-diagnostic-and-potential-prognostic-role
#7
Ayman El-Menyar, Mohammad Asim, Insolvisagan N Mudali, Ahammed Mekkodathil, Rifat Latifi, Hassan Al-Thani
BACKGROUND: Necrotizing fasciitis (NF) is a devastating soft tissue infection associated with potentially poor outcomes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been introduced as a diagnostic tool for NF. We aimed to evaluate the prognostic value of LRINEC scoring in NF patients. METHODS: A retrospective analysis was conducted for patients who were admitted with NF between 2000 and 2013. Based on LRINEC points, patients were classified into (Group 1: LRINEC < 6 and Group 2: LRINEC ≥ 6)...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28266045/outcomes-in-necrotizing-soft-tissue-infections-treated-with-therapeutic-plasma-exchange
#8
Nabiha Huq Saifee, Heather L Evans, Amalia S Magaret, John R Hess, Meghan Delaney, Grant E O'Keefe, Tam N Pham, Hugh Foy, Eileen Bulger, Monica B Pagano
BACKGROUND: Treatment of necrotizing soft tissue infections (NSTIs) includes prompt surgical debridement and antibiotics, but despite standard care, the morbidity and mortality remain high. Since therapeutic plasma exchange (TPE) has been considered for treatment of severe sepsis, this study evaluates the efficacy of TPE for patients with NSTI. STUDY DESIGN AND METHODS: This is a retrospective study of patients with diagnosis of NSTI who received treatment with and without TPE over an 11-year period...
March 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28253941/arthrodesis-of-the-ankle
#9
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28246361/new-mouse-model-for-chronic-infections-by-gram-negative-bacteria-enabling-the-study-of-anti-infective-efficacy-and-host-microbe-interactions
#10
Daniel Pletzer, Sarah C Mansour, Kelli Wuerth, Negin Rahanjam, Robert E W Hancock
Only a few, relatively cumbersome animal models enable long-term Gram-negative bacterial infections that mimic human situations, where untreated infections can last for weeks. Here, we describe a simple murine cutaneous abscess model that enables chronic or progressive infections, depending on the subcutaneously injected bacterial strain. In this model, Pseudomonas aeruginosa cystic fibrosis epidemic isolate LESB58 caused localized high-density skin and soft tissue infections and necrotic skin lesions for up to 10 days but did not disseminate in either CD-1 or C57BL/6 mice...
February 28, 2017: MBio
https://www.readbyqxmd.com/read/28237623/effect-of-underlying-immune-compromise-on-the-manifestations-and-outcomes-of-group-a-streptococcal-bacteremia
#11
Kathleen A Linder, Leen Alkhouli, Mayur Ramesh, George A Alangaden, Carol A Kauffman, Marisa H Miceli
BACKGROUND: Group A streptococcal bloodstream infection is the most common presentation of invasive group A streptococcal disease. We sought to determine the impact of immunosuppression on severity of disease and clinical outcomes. METHODS: This retrospective review of 148 patients with at least one positive blood culture for Streptococcus pyogenes from 1/2003 to 3/2013 compared immunocompromised patients with those with no immunocompromise in regards to development of severe complications and mortality...
February 22, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28201995/zoonotic-necrotizing-myositis-caused-by-streptococcus-equi-subsp-zooepidemicus-in-a-farmer
#12
Bård Reiakvam Kittang, Veronika Kuchařová Pettersen, Oddvar Oppegaard, Dag Harald Skutlaberg, Håvard Dale, Harald G Wiker, Steinar Skrede
BACKGROUND: Streptococcus equi subsp. zooepidemicus is a beta-hemolytic group C streptococcus mainly causing infections in domesticated animals. Here we describe the first case of zoonotic necrotizing myositis caused by this bacterium. CASE PRESENTATION: The patient was a 73-year-old, previously healthy farmer with two asymptomatic Shetland ponies in his stable. After close contact with the ponies while feeding them, he rapidly developed erythema of his left thigh and sepsis with multiple organ failure...
February 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28197297/reconstruction-of-an-anterior-cervical-necrotizing-fasciitis-defect-using-a-biodegradable-polyurethane-dermal-substitute
#13
Marcus Jd Wagstaff, Yugesh Caplash, John E Greenwood
Introduction: Although we have previously described the use of a novel polyurethane biodegradable dermal substitute in the reconstruction of 20 free flap donor sites, and extensive cutaneous defects, including a large area of exposed calvarium secondary to burn injury, our experience with this material now extends to 35 free flap donor site reconstructions and 13 major or complex burns. Methods: The polyurethane material (NovoSorb BTM; PolyNovo Biomaterials Pty Ltd, Port Melbourne, Victoria, Australia) was recently employed in another complex wound scenario, implanted into a large anterior cervical cutaneous and soft-tissue defect remaining after serial radical debridement for necrotizing fasciitis...
2017: Eplasty
https://www.readbyqxmd.com/read/28195896/contributing-factors-for-complications-and-outcomes-in-patients-with-snakebite-experience-in-a-medical-center-in-southern-taiwan
#14
Yu-Hsuan Hsieh, Jung-Hua Hsueh, Wen-Chung Liu, Kuo-Chung Yang, Kuei-Chang Hsu, Cheng-Ta Lin, Yen-Yi Ho, Lee-Wei Chen
OBJECTIVES: Snakebite usually results in various complications, such as significant soft tissue damage, infection, hematological, and neurological deficit. Surgical intervention, usually, is indicated in patients with tissue necrosis, infection, and compartment syndrome. To identify the contributing factors for complications and outcomes in different patients with snakebite so that outcomes can be evaluated and treatment of such patients can be initiated at the earliest. METHODS: Information was collected regarding age, sex, underlying disease, species of snake, and the course of treatment of the victims of snakebite who visited the emergency department of a medical center in southern Taiwan between 2004 and 2014...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28194352/application-of-a-silicone-sheet-in-negative-pressure-wound-therapy-to-treat-an-abdominal-wall-defect-after-necrotizing-fasciitis
#15
Jin Su Shin, Hwan Jun Choi
Necrotizing fasciitis (NF) is an aggressive soft-tissue infection involving the deep fascia and is characterized by extensive deterioration of the surrounding tissue. Immediate diagnosis and intensive treatment, including debridement and systemic antibiotics, represent the most important factors influencing the survival of NF patients. In this report, we present a case of NF in the abdomen due to an infection caused by a perforated small bowel after abdominal liposuction. It was successfully treated using negative-pressure wound therapy, in which a silicone sheet functioned as a barrier between the sponge and internal organs to protect the small bowel...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28188947/retroperitoneal-necrotizing-soft-tissue-infection-in-a-healthy-adult-masquerading-as-acute-pancreatitis
#16
Nitin Agarwal, Mohammad Shazib Faridi, Pradeep Saini, Navneet Kaur, Arun Gupta
Necrotizing soft tissue infections (NSTIs) are polymicrobial infections with high morbidity and mortality. We report a case of retroperitoneal NSTI in an immunocompetent young male, with clinical symptoms and signs mimicking acute pancreatitis (pseudo-Cullen's and pseudo-Grey-Turner's signs. The initiating lesion was a pustule which progressed and mimics acute pancreatitis. CT scan showed features of retroperitoneal NSTI. After extensive debridement and antibiotics, the patient improved. NSTI of the retroperitoneum is rare...
January 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28187489/-dentogene-focus-as-a-rare-cause-of-necrotizing-fasciitis
#17
Christopher Kloth, Sebastian Hoefert, Till Fischborn, Christina Schraml
History and clinical findings We elaborate the case of a 72-year-old patient who presented with a painful swelling of the lower jaw in the emergency unit. Investigations and diagnosis In the clinical examination and the CT scan, a widespread cervical emphysema was found which raised suspicion for the presence of a necrotizing fasciitis of the head and neck due to aerogenic infection. Close spatial vicinity to the teeth of the left upper and lower jaw was present, so that the necrotizing fasciitis was assumed to be odontogenic...
February 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28177973/monomicrobial-klebsiella-pneumoniae-necrotizing-fasciitis-with-liver-abscess-a-case-report-and-literature-review
#18
Ching-En Chen, Yu-Chung Shih
BACKGROUND: Necrotizing fasciitis is one of the most life-threatening soft tissue infections and usually follows a major or minor trauma. Published reports regarding single microorganism liver abscess caused by Klebsiella pneumoniae in Taiwan indicate a septic metastasis rate about 12%. Although a hematogenous origin of necrotizing fasciitis from a liver abscess is rare in Taiwan, it remains possible in our clinical practice. CASE PRESENTATION: A 75-year-old man with a history of diabetes and liver abscess had a status of postdrainage 5 years earlier...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28151765/necrotizing-soft-tissue-infection-or-sweet-syndrome-surgery-versus-no-surgery-a-case-report
#19
Tiffany M N Otero, Samuel R Barber, D Dante Yeh, Sadeq A Quraishi
The authors report a case of necrotizing Sweet syndrome in a 24-year-old transsexual male who presented with recurrent myonecrosis of the neck/upper chest. On index admission, computer tomography revealed gas and fat stranding of the sternocleidomastoid and pectoralis major muscle-findings suggestive of a necrotizing soft tissue infection. Despite debridement procedures and intravenous antibiotic therapy, myonecrosis of the affected areas persisted. Evaluation of tissue samples by dermatopathology revealed neutrophilic infiltration extending into the dermis and muscle necrosis, findings consistent with necrotizing Sweet syndrome...
February 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28134677/are-there-any-reasons-to-change-our-behavior-in-necrotizing-fasciitis-with-the-advent-of-new-antibiotics
#20
Francesco Menichetti, Simone Giuliano, Simona Fortunato
PURPOSE OF REVIEW: The treatment of necrotizing fasciitis requires a multifaceted approach, consisting of surgical source control with immediate surgical debridement along with life support, clinical monitoring, and antimicrobial therapy. Many drugs are now available for the treatment of this life-threatening infectious disease, and the purpose of this review is to provide the reader with an updated overview of the newest therapeutic options. RECENT FINDINGS: Because most necrotizing soft tissue infections are polymicrobial, broad-spectrum coverage is advisable...
April 2017: Current Opinion in Infectious Diseases
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