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Necrotizing soft tissue infection

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https://www.readbyqxmd.com/read/28814893/presentation-and-outcomes-of-necrotizing-soft-tissue-infections
#1
Kuan-Chin Jean Chen, Michelle Klingel, Shelley McLeod, Sean Mindra, Victor K Ng
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are aggressive infections associated with significant morbidity, including amputation and organ failure, and high mortality. The rapid progression and significant risk of morbidity and mortality associated with NSTIs makes quick diagnosis and treatment critical. The objective of this study was to determine the presentation of patients diagnosed with NSTIs and their in-hospital outcomes. METHODS: This was a retrospective review of adult (>17 years) patients with a discharge diagnosis of necrotizing fasciitis at London Health Sciences Centre (annual census 125,000) over a 5-year period (April 2008-March 2013)...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28808517/the-mythos-of-laudable-pus-along-with-an-explanation-for-its-origin
#2
Jeffrey A Freiberg
The presence of pus is one of the most easily recognizable signs of an infection. However, for several centuries suppuration, known as 'laudable pus,' was believed to be a sign of a healthy, healing wound. This historical misconception can be explained by the difference in the presentation of a necrotizing soft tissue infection versus other more common skin and soft tissue infections. Chronic wound infections, due to pyogenic bacteria, typically produce large amounts of thick, whitish-yellow pus. On the other hand, necrotizing soft tissue infections, despite their severe mortality and morbidity, are devoid of pus in the traditional sense...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28807000/necrotizing-streptococcal-myositis-of-the-upper-extremity-a-case-report
#3
Johannes C Reichert, Götz Habild, Paul Simon, Ulrich Nöth, Jan B Krümpelmann
BACKGROUND: Necrotizing myositis is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the affected tissue. The myositis is often caused by toxin-producing, virulent bacteria such as group A β-hemolytic streptococcus and associated with severe systemic toxicity. It is rapidly fatal unless diagnosed promptly and treated aggressively. However, necrotizing myositis is often initially misdiagnosed as a more benign soft-tissue infection as such fulminant, invasive muscle infections are rare with no more than 30 cases reported over the last century...
August 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28803865/ureaplasma-urealyticum-necrotizing-soft-tissue-infection
#4
Ian Gassiep, Letitia Gore, Joanne L Dale, E Geoffrey Playford
Ureaplasma urealyticum is a urogenital commensal and often associated with localised infection. With the advent of monoclonal immunosuppressive therapy and improved diagnostic methods, reports of non-urogenital infections are accumulating. We report a rare case of U. urealyticum necrotizing soft tissue infection and left hip septic arthritis in a hypogammaglobulinaemic patient. Consideration of this organism as an etiological agent, and potential early use of nucleic-acid diagnostic investigation with empiric therapy including activity against Ureaplasma in this patient population may be warranted...
August 10, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28792191/comparison-of-vacuum-assisted-closure-therapy-and-debridement-with-primer-surgical-closure-for-fournier-s-gangrene-treatment-10-years-experience-of-a-single-centre
#5
Mustafa Ozan Horsanali, Utku Eser, Burcu O Horsanali, Omer Altas, Huseyin Eren
OBJECTIVE: Fournier's gangrene is a type of necrotizing soft tissue infection of the perineal, genital and perianal region that has a rapidly progressive and potentially fatal course. In the present study, our goal was to compare the patients submitted to surgical debridement for Fournier Gangrene with Vacuum-asisted Closure (VAC) and without VAC therapy after debridement. MATERIALS AND METHODS: We retrospectively analyzed 313 patients underwent surgical debridement for FG in our hospital...
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28791216/toxic-shock-syndrome-caused-by-suture-abscess-with-methicillin-resistant-staphylococcus-aureus-mrsa-with-late-onset-after-caesarean-section
#6
Hiroyasu Komuro, Takaharu Kato, Shinichiro Okada, Kensuke Nakatani, Risa Matsumoto, Kazuhiro Nishida, Hiroyuki Iida, Maki Iida, Shiro Tsujimoto, Toshiyuki Suganuma
Toxic shock syndrome (TSS) is a rare but life-threatening multisystem disease known to develop in the early postoperative period after various surgery. We report a rare case in which a patient who underwent Caesarean section developed TSS caused by methicillin-resistant Staphylococcus aureus (MRSA) on the 39th postoperative day. She was treated with debridement because of the possible diagnosis of necrotizing soft tissue infections. Culture test from the resected specimen was positive for MRSA. She was diagnosed with TSS caused by suture abscess and was treated with intensive care including antimicrobials...
2017: IDCases
https://www.readbyqxmd.com/read/28790435/emergence-of-a-streptococcus-dysgalactiae-subspecies-equisimilis-stg62647-lineage-associated-with-severe-clinical-manifestations
#7
Oddvar Oppegaard, Haima Mylvaganam, Steinar Skrede, Paul Christoffer Lindemann, Bård Reiakvam Kittang
Increasing incidence rates of invasive Streptococcus dysgalactiae subspecies equisimilis (SDSE) infections have been reported worldwide, but the evolutionary mechanisms underlying this development remain elusive. Through prospective surveillance of invasive SDSE infections in western Norway, we observed the emergence of a novel and virulent SDSE genotype, stG62647. This emm-type, rarely encountered as a cause of invasive disease during 1999-2012, emerged in 2013 as the predominant SDSE-genotype. The stG62647-infections were associated with an aggressive clinical course, including the occurrence of streptococcal toxic shock syndrome, necrotizing soft-tissue infections and endocarditis...
August 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28783418/diagnosis-and-management-of-panton-valentine-leukocidin-toxin-associated-staphylococcus-aureus-infection-an-update
#8
Yamuna Devi Bakthavatchalam, Laura E B Nabarro, Ravikar Ralph, Balaji Veeraraghavan
The incidence of invasive Staphylococcus aureus (SA) infection has increased in the past decade and is associated with poor outcomes and high mortality rates. Of all the virulence factors, Panton-Valentine Leukocidin (PVL) has received the greatest attention. PVL producing SA strains are more likely to produce severe skin and soft tissue infections (SSTIs) and necrotizing pneumonia. This review focuses on the current evidence on PVL-SA virulence, epidemiology, clinical disease and treatment with relevance to healthcare in India...
August 7, 2017: Virulence
https://www.readbyqxmd.com/read/28779832/evaluation-and-management-of-necrotizing-soft-tissue-infections
#9
REVIEW
Stephanie L Bonne, Sameer S Kadri
Despite advances in antibiotic and surgical management and supportive care for necrotizing soft tissue infections, morbidity and mortality remain substantial. Although there are clinical practice guidelines in place, there still remains much variability in choice and duration of antibiotic therapy, time to initial surgical debridement, and use of adjuvant medical therapies. This article offers an overview of necrotizing soft tissue infections with a focus on current diagnostic and treatment modalities.
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28762168/the-role-of-computed-tomography-in-the-diagnosis-of-necrotizing-soft-tissue-infections
#10
Myriam Martinez, Thomas Peponis, Aglaia Hage, Daniel D Yeh, Haytham M A Kaafarani, Peter J Fagenholz, David R King, Marc A de Moya, George C Velmahos
BACKGROUND: The exact role of IV contrast-enhanced computed tomography (CT) in the diagnosis of necrotizing soft tissue infections (NSTIs) has not yet been established. We aimed to explore the role of CT in patients with clinical suspicion of NSTI and assess its sensitivity and specificity for NSTI. METHODS: The medical records of patients admitted between 2009 and 2016, who received IV contrast-enhanced CT to rule out NSTI, were reviewed. CT was considered positive in case of: (a) gas in soft tissues, (b) multiple fluid collections, (c) absence or heterogeneity of tissue enhancement by the IV contrast, and (d) significant inflammatory changes under the fascia...
July 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28698756/treatment-of-decubitis-ulcer-stage-iv-in-the-patient-with-polytrauma-and-vertical-share-pelvic-fracture-diagnosed-entherocollitis-and-deep-wound-infection-with-clostridium-difficile-with-combined-negative-pressure-wound-therapy-npwt-and-faecal-management-system
#11
Slavcho Stojmenski, Igor Merdzanovski, Andrej Gavrilovski, Sofija Pejkova, Gjorge Dzokic, Smilja Tudzarova
AIM: The aim of this paper was to present a case with the successful treatment of decubitis ulcer stage IV in the patient with polytrauma and vertical share pelvic fracture and diagnosed entherocollitis combined with deep wound infection with Clostridium difficile treated with combined Negative Pressure Wound Therapy (NPWT) and faecal management system. CASE REPORT: Patient D.S.1967 treated on Traumatology Clinic after tentamen suicide on 9.2.2015 with diagnosis: brain contusion; contusion of thoracal space; vertical share pelvic fracture; open fracture type II of the right calcaneus; fracture of the left calcaneus; fracture on the typical place of the left radius; fracture of the right radius with dislocation...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28682290/prolonged-allograft-survival-in-a-patient-with-chronic-immunosuppression-a-case-report-and-systematic-review
#12
Krishna S Vyas, Chase Burns, Dylan T Ryan, Lesley Wong
A 41-year-old man with past medical history of kidney-liver transplantation requiring chronic immunosuppression presented 2 years posttransplant with a necrotizing soft tissue infection of his right thigh. Serial debridement to remove necrotic tissue was performed, and a Matrix HD Allograft Fenestrated (RTI Surgical, Alachua, FL) was applied. At 5-months post grafting, the patient demonstrated fully vascularized and intact skin. Under normal circumstances, a cadaveric allograft sloughs over several weeks and is not usually considered a permanent solution for wound closure...
June 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28675810/use-of-leukocyte-and-platelet-rich-fibrin-in-the-treatment-of-medication-related-osteonecrosis-of-the-jaws
#13
Gustavo Maluf, Rogério Jardim Caldas, Paulo Sérgio Silva Santos
Lesions associated with medication-related osteonecrosis of the jaws (MRONJ) are refractory to different treatment approaches. Hence, auxiliary approaches capable of improving patient outcomes should be explored. Leukocyte- and platelet-rich fibrin (LPRF) is a second-generation platelet concentrate (natural autologous fibrin matrix). It shows anti-infectious activity through immune regulation and accelerates the angiogenesis and multiplication of fibroblasts and osteoblasts; in consequence, it stimulates soft tissue healing and prevents exposure of the alveolar bone in the oral cavity...
June 12, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28673381/biomarkers-of-necrotising-soft-tissue-infections-aspects-of-the-innate-immune-response
#14
Marco Bo Hansen
Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death. However, the lack of pathognomonic signs impedes early diagnosis and treatment. Moreover, the rarity of the disease makes it difficult to conduct large prospective studies, thus prospective research is almost non-existent in this group of patients...
July 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28641951/necrotizing-fasciitis-attended-in-the-emergency-department-in-a-tertiary-hospital-evaluation-of-the-lrinec-scale
#15
J R Ballesteros-Betancourt, R García-Tarriño, J Ríos-Guillermo, J M Rodriguez-Roiz, P Camacho, A Zumbado-Dijeres, A Domingo-Trepat, M Llusá-Pérez, A Combalia-Aleu, S García-Ramiro, A Soriano-Viladomiu
AIM: To describe mortality and complications of patients seen in the emergency room, diagnosed with necrotizing soft tissue infection (NSTI) and the correlation of such complications with the Laboratory Risk Indicator for Necrotizing fasciitis scale (LRINEC). METHODS: Retrospective observational study including patients with a diagnosis of NSTI in the emergency room of a tertiary hospital over 7 years. The results are shown as median, interquartile range and absolute range for quantitative variables...
July 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28614442/skin-and-soft-tissue-infections-in-the-intensive-care-unit-a-retrospective-study-in-a-tertiary-care-center
#16
Luís Filipe Malheiro, Rita Magano, Alcina Ferreira, António Sarmento, Lurdes Santos
Objective: To identify factors that may influence outcomes in patients with severe skin and soft tissue infections in the intensive care unit. Methods: A retrospective observational study was conducted in a cohort of 1,123 critically ill patients admitted to an intensive care unit with a primary or secondary diagnosis of severe skin and soft tissues infection between January 2006 and December 2014. Results: Thirty patients were included, 20 (66...
June 12, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28611889/evaluating-the-laboratory-risk-indicator-to-differentiate-cellulitis-from-necrotizing-fasciitis-in-the-emergency-department
#17
Michael M Neeki, Fanglong Dong, Christine Au, Jake Toy, Nima Khoshab, Carol Lee, Eugene Kwong, Ho Wang Yuen, Jonathan Lee, Arbi Ayvazian, Pamela Lux, Rodney Borger
INTRODUCTION: Necrotizing fasciitis (NF) is an uncommon but rapidly progressive infection that results in gross morbidity and mortality if not treated in its early stages. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is used to distinguish NF from other soft tissue infections such as cellulitis or abscess. This study analyzed the ability of the LRINEC score to accurately rule out NF in patients who were confirmed to have cellulitis, as well as the capability to differentiate cellulitis from NF...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28600919/group-a-streptococci-infection-a-systematic-clinical-review-exemplified-by-cases-from-an-obstetric-department
#18
REVIEW
Line Winther Gustafson, Jan Blaakær, Rikke Bek Helmig
Group A streptococci infection has re-emerged since the 1980s and onward, despite the awareness of the etiology and the use of penicillin. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of group A streptococci disease compared to non-pregnant women. This review focuses on the epidemiology, pathophysiology, clinical presentation, prevention and treatment of group A streptococcal infection in pregnancy. SEARCH STRATEGY: We searched the following electronic databases from 1980-March 2016: PubMed-Medline, Embase, SveMed+, Bibliotek...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28591027/necrotizing-fasciitis-a-catastrophic-complication-following-routine-tibia-fracture-surgery-a-case-report-and-literature-review
#19
REVIEW
Shuai Shang, Ruipeng Zhang, Zhiyong Hou
RATIONALE: Necrotizing fasciitis (NF) is defined as a rare, life-threatening, rapidly spreading soft tissue infection resulting from a polymicrobial origin, with a predominance of anaerobic organisms that presents with necrosis of the muscle, fascia, and surrounding soft tissue. PATIENT CONCERNS AND DIAGNOSES: A 64-year-old male who sustained tibia fracture caused by falling from a height underwent a tibia surgery with minimally invasive plate osteosynthesis technique in another institution...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28586594/risk-factors-for-necrotizing-fasciitis-and-its-outcome-at-a-tertiary-care-centre
#20
Yogendra Gupta, Manisha Chhetry, Kamal Raj Pathak, Ranjib Kumar Jha, Nischal Ghimire, Bibhuti Nath Mishra, Navin Kumar Karn, Ganesh Kumar Singh, Jatindra Nath Bhagabati
BACKGROUND: Necrotizing fasciitis (NF) is a serious and potentially fatal condition where there is rapid progression of inflammation of skin, subcutaneous tissue, and superficial fascia and can be mono-microbial or poly-microbial. The disease is rapidly progressive in nature and if not promptly treated leads to significant morbidity or even mortality. This study was designed to explore the various risk factors commonly present and study the outcome of the disease. METHODS: This was a cross sectional study done in tertiary centre over period of one year from April 2014 to March 2015...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
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