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Necrotizing soft tissue infection

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https://www.readbyqxmd.com/read/28410938/preservation-of-devitalized-bone-in-necrotic-digits-following-crush-injury-with-free-tissue-transfer
#1
Fei Song, Yongwei Pan, Zhe Zhao, Jiuzheng Deng, Changjiao Sun
Traditional management of necrotic digits has been to allow demarcation between viable and nonviable tissues to occur, and thus to indicate the level of amputation required. In this case report, the phalangeal length of the necrotic thumb was maintained in 2 patients who had sustained crush injury. After nonviable soft tissues were debrided, the devitalized bones were covered with soft tissue flaps. All wounds healed without infection. Both cosmetic and functional results of the reconstructed thumbs were satisfactory...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28398176/septic-shock-due-to-nsti-caused-by-actinomyces-turicensis-the-role-of-clinical-pharmacology-case-report-and-review-of-the-literature
#2
Milo Gatti, Laura Elisa Gasparini, Chiara Maria Grimaldi, Daniela Abbati, Stefano Clemente, Paolo Riccardo Brioschi, Roberto Fumagalli, Francesco Scaglione
Critical septic patients affected by necrotizing soft tissue infections (NSTI) require an early, aggressive and multidisciplinary treatment. Pharmacokinetic alterations in antibiotic therapy are peculiar in these infections. Clinical pharmacology represents a first step in this setting. We report a case of septic shock due to NSTI in which clinical pharmacology is taken into account.
April 11, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28395682/wound-infection-secondary-to-snakebite
#3
M Wagener, M Naidoo, C Aldous
BACKGROUND: Snakebites can produce severe local and systemic septic complications as well as being associated with significant overall morbidity and even mortality. OBJECTIVE: A prospective audit was undertaken to determine the bacterial causation of wound infection secondary to snakebite, and attempt to quantify the burden of disease. METHODS: The audit was undertaken at Ngwelezane Hospital, which provides both regional and tertiary services for north-eastern KwaZulu-Natal Province, South Africa, over a 4-month period...
March 29, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28378613/diagnosis-and-management-of-skin-and-soft-tissue-infections-ssti-a-literature-review-and-consensus-statement-an-update
#4
S Esposito, M Bassetti, E Concia, G De Simone, F G De Rosa, P Grossi, A Novelli, F Menichetti, N Petrosillo, M Tinelli, M Tumbarello, M Sanguinetti, P Viale, M Venditti, C Viscoli
Skin and soft-tissue infections (SSTIs) are among the most common bacterial infections, posing considerable diagnostic and therapeutic challenges. Fourteen members of the Italian Society of Infectious Diseases, after a careful review of the most recent literature using Medline database and their own clinical experience, updated a previous paper published in 2011 by preparing a draught manuscript of the statements. The manuscript was successively reviewed by all members and ultimately re-formulated the present manuscript during a full day consensus meeting...
April 5, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28375805/management-and-novel-adjuncts-of-necrotizing-soft-tissue-infections
#5
REVIEW
Christine S Cocanour, Phillip Chang, Jared M Huston, Charles A Adams, Jose J Diaz, Charles B Wessel, Bonnie A Falcione, Graciela M Bauza, Raquel A Forsythe, Matthew R Rosengart
Necrotizing soft tissue infections (NSTI) have been recognized for millennia and continue to impose considerable burden on both patient and society in terms of morbidity, death, and the allocation of resources. With improvements in the delivery of critical care, outcomes have improved, although disease-specific therapies are lacking. The basic principles of early diagnosis, of prompt and broad antimicrobial therapy, and of aggressive debridement have remained unchanged. Clearly novel and new therapeutics are needed to combat this persistently lethal disease...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28363377/chronic-infections-of-the-chest-wall
#6
REVIEW
Edward J Bergeron, Robert A Meguid, John D Mitchell
Chronic chest wall infections may occur in soft tissue, cartilage, and bone. They may present as localized chest wall pain, a discrete mass initially mistaken for neoplasm, a superficial infection, or a draining sinus. Chronic chest wall infections are typically non-necrotizing and associated with lower morbidity than their more acute and necrotizing counterparts. Effective management of chest wall infections ranges from antimicrobial administration to wide surgical resection and subsequent reconstruction.
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28363376/acute-chest-wall-infections-surgical-site-infections-necrotizing-soft-tissue-infections-and-sternoclavicular-joint-infection
#7
REVIEW
Paul Schipper, Brandon H Tieu
Acute chest wall infections are uncommon and share similar risk factors for infection at other surgical sites. Smoking cessation has been shown to decrease the risk of surgical site infection. Depending on the depth of infection and/or involvement of the organ space, adequate therapy involves antibiotics and drainage. Early diagnosis and debridement of necrotizing soft tissue infections is essential to reduce mortality. Sternoclavicular joint infections require surgical debridement, en bloc resection, and antibiotic therapy...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#8
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28352482/haemophilus-influenzae-pyomyositis-in-a-patient-with-diabetic-ketoacidosis-a-unique-case-and-review-of-literature
#9
Kamolyut Lapumnuaypol, Sanna Fatima, Pradhum Ram, Gemlyn George, Antoinette Climaco
Haemophilus influenzae is a Gram-negative bacillus commonly known to cause upper respiratory tract infections. Skin and soft tissue infections are very uncommon. Of these, the majority were associated with necrotizing fasciitis requiring emergent debridement. We report a case of pyomyositis caused by Haemophilus influenzae in an adult with diabetes.
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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