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https://www.readbyqxmd.com/read/28892969/fistulating-richter-s-hernia-of-groin-with-necrotizing-soft-tissue-infection-a-lethal-combination
#1
Shibojit Talukder, Ashish Gupta, Basant Narayan Singh, Lileswar Kaman, P Abhinaya Reddy
Strangulation of groin hernia can result in significant morbidity and mortality. Spontaneous external fistulation following strangulation is rare and typically occurs with Richter's hernia. Spreading Necrotizing Soft Tissue Infection (NSTI) secondary to Enterocutaneous Fistula (ECF) is an ominous sign, further worsening its prognosis. Early diagnosis and prompt surgical treatment is crucial to improve outcome. Herewith the authors are presenting a case of neglected inguinal hernia. It was complicated with ECF formation and rapidly spreading NSTI of flank...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28863028/associations-of-plasma-nitrite-l-arginine-and-asymmetric-dimethylarginine-with-morbidity-and-mortality-in-patients-with-necrotizing-soft-tissue-infections
#2
Marco Bo Hansen, Lars Simon Rasmussen, Peter Garred, Katrine Pilely, Anna Mygind Wahl, Anders Perner, Martin Bruun Madsen, Elise Røge Hedegaard, Ulf Simonsen, Ole Hyldegaard
BACKGROUND: The nitric oxide system could play an important role in the pathophysiology related to necrotizing soft tissue infection (NSTI). Accordingly, we investigated the association between plasma nitrite level at admission and the presence of septic shock in patients with NSTI. We also evaluated the association between nitrite, asymmetric dimethylarginine (ADMA), L-arginine, L-arginine/ADMA-ratio and outcome. METHODS: We analyzed plasma from 141 NSTI patients taken upon hospital admission...
August 31, 2017: Shock
https://www.readbyqxmd.com/read/28814893/presentation-and-outcomes-of-necrotizing-soft-tissue-infections
#3
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/28762168/the-role-of-computed-tomography-in-the-diagnosis-of-necrotizing-soft-tissue-infections
#4
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/28673381/biomarkers-of-necrotising-soft-tissue-infections-aspects-of-the-innate-immune-response
#5
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
#6
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/28628390/influence-of-screw-surface-treatment-on-retention-of-implant-supported-fixed-partial-dentures
#7
Marcos Boaventura de Moura, Renata Borges Rodrigues, Leandro Moreira Pinto, Cleudmar Amaral de Araújo, Veridiana Resende Novais, Paulo César Simamoto Júnior
The aim of this study was to assess the effect of DLC (Diamond-like carbon) coating on the removal torque of prefabricated implant screws after cyclic loading. Four groups with two crowns supported by two implants (n=5) were obtained according to splinted and non-splinted prosthesis, using titanium or DLC screw (STi, SC, NSTi and NSC). The prosthetic screws were tightened at 32Ncm, retightened, and the specimens were submitted to 106 mechanical cycles (4Hz/98N). After cyclic loading, loosening torque was evaluated and the final measurements were performed...
June 19, 2017: Journal of Oral Implantology
https://www.readbyqxmd.com/read/28538644/validation-of-a-clinical-trial-composite-endpoint-for-patients-with-necrotizing-soft-tissue-infections
#8
Eileen M Bulger, Addison May, Wayne Dankner, Greg Maislin, Bryce Robinson, Anat Shirvan
OBJECTIVE: Our objective was to develop and validate a composite endpoint for patients with necrotizing soft tissue infections (NSTI) that incorporates: local tissue injury, systemic organ dysfunction, and mortality. METHODS: The Necrotizing Infection Clinical Composite Endpoint (NICCE) was defined as follows:(i) Alive at day 28 (ii) ≤3 debridements prior to day 14 (iii) No amputation beyond first debridement (iv) Modified SOFA score (mSOFA) at day 14 ≤1. To be considered a success, all individual criteria must be met...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452064/mortality-of-necrotising-fasciitis-relative-influence-of-individual-and-hospital-level-factors-a-nationwide-multi-level-study-france-2007-2012
#9
E Audureau, C Hua, N de Prost Nicolas, F Hemery, J W Decousser, R Bosc, R Lepeule, O Chosidow, E Sbidian
BACKGROUND: Necrotising soft-tissue infections (NSTI) are rare, life-threatening conditions. OBJECTIVES: We aimed to assess whether admitting hospital characteristics were associated with NSTI mortality. METHODS: We studied the French nationwide hospital discharge database (retrospective national cohort). All patients admitted in 2007-2012 with an ICD-10 code of necrotising fasciitis were eligible. We extracted data on the patients (age, sex, ICU admission, co-morbidities) and hospitals (public vs private proprietary; for public hospitals, teaching, yes/no; and number of NSTI admissions, ≥3 NSTI cases/year, yes/no)...
April 27, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28421246/immunoglobulin-g-for-patients-with-necrotising-soft-tissue-infection-instinct-a-randomised-blinded-placebo-controlled-trial
#10
Martin B Madsen, Peter B Hjortrup, Marco B Hansen, Theis Lange, Anna Norrby-Teglund, Ole Hyldegaard, Anders Perner
PURPOSE: The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI). METHODS: We randomised 100 patients with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission. The primary outcome was the physical component summary (PCS) score of the 36-item short form health survey (SF-36) 6 months after randomisation; patients who had died were given the lowest possible score (zero)...
April 18, 2017: Intensive Care Medicine
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
#11
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/28375805/management-and-novel-adjuncts-of-necrotizing-soft-tissue-infections
#12
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/28292567/images-of-suffering-depicted-in-diaries-of-family-caregivers-in-the-acute-stage-of-necrotising-soft-tissue-infection-a-content-analysis
#13
Ingrid Egerod, Annette E Andersson, Ann-Mari Fagerdahl, Vibeke E Knudsen
OBJECTIVES: Severe necrotising soft tissue infections (NSTI) are rare life threatening rapidly progressing bacterial infections requiring immediate diagnosis and treatment. The aim of the study was to explore the experience of family caregivers of patients with necrotising soft tissue infection during the acute stage of disease. METHODS: Our study had a qualitative descriptive binational design using qualitative content analysis to explore diaries written by close family members (n=15)...
March 11, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28266045/outcomes-in-necrotizing-soft-tissue-infections-treated-with-therapeutic-plasma-exchange
#14
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...
June 2017: Transfusion
https://www.readbyqxmd.com/read/28188947/retroperitoneal-necrotizing-soft-tissue-infection-in-a-healthy-adult-masquerading-as-acute-pancreatitis
#15
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/28176831/association-between-cytokine-response-the-lrinec-score-and-outcome-in-patients-with-necrotising-soft-tissue-infection-a-multicentre-prospective-study
#16
Marco Bo Hansen, Lars Simon Rasmussen, Mattias Svensson, Bhavya Chakrakodi, Trond Bruun, Martin Bruun Madsen, Anders Perner, Peter Garred, Ole Hyldegaard, Anna Norrby-Teglund
Early assessment of necrotising soft tissue infection (NSTI) is challenging. Analysis of inflammatory markers could provide important information about disease severity and guide decision making. For this purpose, we investigated the association between cytokine levels and the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC)-score, disease severity and mortality in NSTI patients. In 159 patients, plasma was analysed for IL-1β, IL-6, IL-10 and TNF-α upon admission. The severity of NSTI was assessed by SAPS, SOFA score, septic shock, microbial aetiology, renal replacement therapy and amputation...
February 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28005689/epidemiology-and-outcomes-of-hospitalized-children-with-necrotizing-soft-tissue-infections
#17
Balagangadhar R Totapally
OBJECTIVE: The purpose of this study was to evaluate the epidemiology and outcome of hospitalized children with a diagnosis of necrotizing soft-tissue infections (NSTIs). METHODS: Demographic and outcome data of children 1 month to 18 years of age with a diagnosis of NSTI (International Classification of Diseases, 9th revision diagnosis codes 728.86 and 729.4) were extracted from the Kids' Inpatient Database 2009 and 2012. Univariate and multivariate analyses were done to determine the factors affecting mortality...
July 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27930570/successful-treatment-of-a-rare-extended-retroperitoneal-necrotizing-soft-tissue-infection-caused-by-extended-spectrum-beta-lactamase-producing-escherichia-coli-a-case-report
#18
Rui He, Xin Qi, Bing Wen, XiangYan Li, Li Guo
RATIONALE: Retroperitoneal necrotizing soft tissue infection (NSTI) is a rare but life-threatening disease. Here, we present a case of extended retroperitoneal NSTI caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E coli). PATIENT CONCERNS: The patient complained of progressive redness, swelling, and right flank pain for 10 days, extending to the scrotum for 1 day. DIAGNOSES: He was admitted with an initial diagnosis of cellulitis...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27848903/-necrotising-soft-tissue-infection-of-orbital-area-and-hand-an-unusual-combination
#19
M P M Paridaans, J A Govaert, E H Scholten, D H de Lange
BACKGROUND: Necrotising soft tissue infection (NSTI) is an infection of the subcutaneous tissues and often follows a fulminant course if not recognised in time. CASE DESCRIPTION: A 78-year-old man was brought to our emergency department in septic shock. Physical examination revealed an erythematous and painful swelling of the right eyelids and to a lesser extent of the right hand. The infection progressed at both sites, and suspicion of NSTI arose. An emergency surgical debridement was performed...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27834617/a-multi-center-review-of-care-patterns-and-outcomes-in-necrotizing-soft-tissue-infections
#20
REVIEW
Iris Faraklas, Derek Yang, Michael Eggerstedt, Yan Zhai, Patrick Liebel, Gareth Graves, Sharmila Dissanaike, Michael Mosier, Amalia Cochran
BACKGROUND: Surgical debridement and broad-spectrum empiric antibiotics are first-line therapy for necrotizing soft tissue infections (NSTI). The objective of this multi-center retrospective review was to evaluate antimicrobial agent initiation and duration and compare outcomes in the treatment of patients with NSTI. PATIENTS AND METHODS: This review included adults with NSTI, as indicated by International Classification of Diseases, 9th Edition, Clinical Modification codes 728...
December 2016: Surgical Infections
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