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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
#1
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
#2
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/28188947/retroperitoneal-necrotizing-soft-tissue-infection-in-a-healthy-adult-masquerading-as-acute-pancreatitis
#3
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
#4
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
#5
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 (ICD-9 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 the mortality...
December 21, 2016: 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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27821087/comparing-culture-and-molecular-methods-for-the-identification-of-microorganisms-involved-in-necrotizing-soft-tissue-infections
#9
Vibeke Børsholt Rudkjøbing, Trine Rolighed Thomsen, Yijuan Xu, Rachael Melton-Kreft, Azad Ahmed, Steffen Eickhardt, Thomas Bjarnsholt, Steen Seier Poulsen, Per Halkjær Nielsen, Joshua P Earl, Garth D Ehrlich, Claus Moser
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are a group of infections affecting all soft tissues. NSTI involves necrosis of the afflicted tissue and is potentially life threatening due to major and rapid destruction of tissue, which often leads to septic shock and organ failure. The gold standard for identification of pathogens is culture; however molecular methods for identification of microorganisms may provide a more rapid result and may be able to identify additional microorganisms that are not detected by culture...
November 8, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27756512/can-progression-of-odontogenic-infections-to-cervical-necrotizing-soft-tissue-infections-be-predicted
#10
K Zemplenyi, B Lopez, M Sardesai, J K Dillon
The progression of odontogenic infections to necrotizing soft tissue infections (NSTIs) is unknown. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is used to predict risk of NSTI. This study aimed to (1) estimate the frequency at which odontogenic infections progress to NSTIs, (2) measure the value of LRINEC in predicting progression to NSTI, and (3) estimate the charges associated with managing NSTIs. This retrospective cohort study enrolled all subjects admitted for the management of odontogenic infections from 2001 to 2013...
February 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27699220/biofilm-in-group-a-streptococcal-necrotizing-soft-tissue-infections
#11
Nikolai Siemens, Bhavya Chakrakodi, Srikanth Mairpady Shambat, Marina Morgan, Helena Bergsten, Ole Hyldegaard, Steinar Skrede, Per Arnell, Martin B Madsen, Linda Johansson, Julius Juarez, Lidija Bosnjak, Matthias Mörgelin, Mattias Svensson, Anna Norrby-Teglund
Necrotizing fasciitis caused by group A streptococcus (GAS) is a life-threatening, rapidly progressing infection. At present, biofilm is not recognized as a potential problem in GAS necrotizing soft tissue infections (NSTI), as it is typically linked to chronic infections or associated with foreign devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a "thick layer biofilm" in the fascia...
July 7, 2016: JCI Insight
https://www.readbyqxmd.com/read/27602893/the-role-of-radiologic-evaluation-in-necrotizing-soft-tissue-infections
#12
Stefan Walter Leichtle, Lily Tung, Moazzam Khan, Kenji Inaba, Demetrios Demetriades
BACKGROUND: The role of diagnostic imaging in suspected necrotizing soft tissue infections (NSTIs) is not clear owing to concerns about its value and possible delays in definitive surgical care. METHODS: Plain radiograph (XR) and computed tomography (CT) results of all patients who underwent operative debridement for a presumed NSTI from 2007 through 2014 at LAC + USC Medical Center were reviewed. Preoperative imaging was classified as being negative, suspicious (inflammatory changes), or diagnostic (soft tissue gas) for NSTI...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27399982/immunoglobulin-for-necrotising-soft-tissue-infections-instinct-protocol-for-a-randomised-trial
#13
Martin Bruun Madsen, Theis Lange, Peter Buhl Hjortrup, Anders Perner
INTRODUCTION: Necrotising soft tissue infections (NSTI) are aggressive infections that can result in severe disability or death. Intravenous polyspecific immunoglobulin G (IVIG) is used as supplementary treatment for patients with NSTIs. The level of evidence is very low, but suggests that IVIG may have beneficial effects. However, IVIG may also have adverse effects. With this trial we will estimate the effects of IVIG on a patient-reported outcome and other patient-centred outcomes in patients with NSTI...
July 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27399650/genetic-architecture-of-group-a-streptococcal-necrotizing-soft-tissue-infections-in-the-mouse
#14
Karthickeyan Chella Krishnan, Santhosh Mukundan, Jeyashree Alagarsamy, Junguk Hur, Suba Nookala, Nikolai Siemens, Mattias Svensson, Ole Hyldegaard, Anna Norrby-Teglund, Malak Kotb
Host genetic variations play an important role in several pathogenic diseases, and we have previously provided strong evidences that these genetic variations contribute significantly to differences in susceptibility and clinical outcomes of invasive Group A Streptococcus (GAS) infections, including sepsis and necrotizing soft tissue infections (NSTIs). Our initial studies with conventional mouse strains revealed that host genetic variations and sex differences play an important role in orchestrating the severity, susceptibility and outcomes of NSTIs...
July 2016: PLoS Pathogens
https://www.readbyqxmd.com/read/27385469/first-report-of-monomicrobial-candida-parapsilosis-necrotizing-fasciitis
#15
I Gassiep, J Douglas, E G Playford
Candida parapsilosis is an emerging pathogen worldwide. It commonly causes soft tissue infection; however, to our knowledge there has been no previous report of monomicrobial necrotizing soft tissue infection (NSTI) secondary to C. parapsilosis. We report the first case of NSTI caused by C. parapsilosis in an immunocompromised renal transplant patient, with the diagnosis proven both histologically and microbiologically. Our patient required aggressive surgical intervention and antifungal therapy, with postoperative survival at 90 days...
October 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27355483/the-lectin-complement-pathway-in-patients-with-necrotizing-soft-tissue-infection
#16
Marco B Hansen, Lars S Rasmussen, Katrine Pilely, Dorthe Hellemann, Estrid Hein, Martin B Madsen, Ole Hyldegaard, Peter Garred
BACKGROUND: Mannose-binding lectin (MBL) and ficolins are pattern recognition molecules (PRMs) that play an important role during infection through activation of the lectin complement pathway. We assessed whether plasma PRM levels were associated with mortality in patients with necrotizing soft tissue infection (NSTI). METHODS: We conducted a prospective, observational study over 25 months involving 135 NSTI patients with a maximum follow-up of 2.7 years. Blood samples were taken upon admission...
2016: Journal of Innate Immunity
https://www.readbyqxmd.com/read/27296812/the-need-to-feed-balancing-protein-need-in-a-critically-ill-patient-with-fournier-s-gangrene
#17
Desiree Gregg, Lynn Hiller, Peter Fabri
Necrotizing soft tissue injury (NSTI) is rare with an impressively difficult and dangerous clinical course. While the importance of nutrition as part of the treatment plan for NSTI is recognized as essential to recovery, specific recommendations have not been elucidated. A review of the evidence-based guidelines and published research to accomplish wound healing is presented. The nutrition considerations in the setting of organ failure are also discussed. This article outlines a complicated case of a septic, malnourished man with Fournier's gangrene and acute kidney injury...
June 13, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27233372/laboratory-evaluation-for-pediatric-patients-with-suspected-necrotizing-soft-tissue-infections-a-case-control-study
#18
Luke R Putnam, Morgan K Richards, Brinkley K Sandvall, Richard A Hopper, John H T Waldhausen, Matthew T Harting
BACKGROUND/PURPOSE: Optimal outcomes for necrotizing soft tissue infections (NSTI) depend on rapid diagnosis and management. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is a validated diagnostic tool for adult NSTI, but its value for children remains unknown. We hypothesized that modification of the LRINEC score may increase its diagnostic accuracy for pediatric NSTI. METHODS: We performed a case-control study of pediatric patients (age <18) with NSTI (cases) and patients with severe soft tissue infections prompting surgical consultation (controls)...
June 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26880104/pentraxin-3-as-a-marker-of-disease-severity-and-risk-of-death-in-patients-with-necrotizing-soft-tissue-infections-a-nationwide-prospective-observational-study
#19
RANDOMIZED CONTROLLED TRIAL
Marco Bo Hansen, Lars Simon Rasmussen, Peter Garred, Daniel Bidstrup, Martin Bruun Madsen, Ole Hyldegaard
BACKGROUND: New biomarkers are needed to assess the severity of necrotizing soft tissue infection (NSTI) at an early stage and to individualize treatment strategies. We assessed pentraxin-3 (PTX3) as a marker of disease severity and risk of death in patients with NSTI. METHODS: We conducted a prospective, observational study in the intensive care unit at Copenhagen University Hospital, where treatment of NSTI is centralized at a national level. We compared PTX3, procalcitonin and C-reactive protein in septic shock versus nonshock patients and in amputated versus nonamputated patients using the Mann-Whitney U test...
February 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26778253/necrotizing-soft-tissue-infection-caused-by-serratia-marcescens-a-case-report-and-literature-review
#20
REVIEW
Hideharu Hagiya, Masahiro Ojima, Takeshi Yoshida, Takahiro Matsui, Eiichi Morii, Kazuaki Sato, Shinichiro Tahara, Hisao Yoshida, Kazunori Tomono
A 64-year-old man with advanced liver cirrhosis was transferred to an emergency center due to septic shock and markedly inflamed left leg. Under a clinical diagnosis of necrotizing soft tissue infection (NSTI), the patient undertook intensive therapy but died 25 h after arrival. The pathogenic organism, Serratia marcescens, was later isolated from blood and soft tissue cultures. NSTI is very rarely associated with S. marcescens. A literature review showed that only 16 such cases, including our case, have been reported to date...
May 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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