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necrotizing fasciitis

Falco Hietbrink, Lonneke G Bode, Louis Riddez, Luke P H Leenen, Marijke R van Dijk
BACKGROUND: Necrotizing fasciitis is an uncommon, rapidly progressive and potential lethal condition. Over the last decade time to surgery decreased and outcome improved, most likely due to increased awareness and more timely referral. Early recognition is key to improve mortality and morbidity. However, early referral frequently makes it a challenge to recognize this heterogeneous disease in its initial stages. Signs and symptoms might be misleading or absent, while the most prominent skin marks might be in discrepancy with the position of the fascial necrosis...
2016: World Journal of Emergency Surgery: WJES
Joseph Tseng, Peter Poullos
Fournier's gangrene is a severe polymicrobial necrotizing fasciitis of the perineal, genital, or perianal regions. The classic presentation is severe pain and swelling with systemic signs. Crepitus and cutaneous necrosis are often seen. Characteristic CT findings include subcutaneous gas and inflammatory stranding. Unless treated aggressively, patients can rapidly become septic and die. Factitious Disorder is the falsification of one's own of medical or psychological signs and symptoms. Many deceptive methods have been described, from falsely reporting physical or psychological symptoms, to manipulating lab tests, or even injecting or ingesting foreign substances in order to induce illness...
September 2016: Journal of Radiology Case Reports
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...
October 15, 2016: International Journal of Oral and Maxillofacial Surgery
Christopher Thom, Mary Warlaumont
BACKGROUND: Point-of-care ultrasound has an increasing role in characterizing soft-tissue infections and has been described previously in the evaluation of necrotizing fasciitis (NF). The identification of air within the soft tissues can be very suggestive of NF in the correct clinical context. CASE REPORT: A 78-year-old male presented to the emergency department with extensive lower-extremity redness and edema. A point-of-care ultrasound revealed hyperechoic areas within the soft tissues consistent with air, and the patient was taken to surgery and found to have NF...
October 12, 2016: Journal of Emergency Medicine
Henrik Galust, Matthew H Oliverio, Daniel J Giorgio, Alexis M Espinal, Rami Ahmed
Necrotizing fasciitis (NF) is a rare and rapidly progressing life-threatening infectious process. By progressing through a simulation involving a patient with NF and participating in a post-scenario debriefing, learners will gain the necessary skills and knowledge to properly diagnose and manage patients with NF. Learners are taught to initiate appropriate and timely treatment and to advocate on behalf of their patient after inappropriate pushback from consultants to improve outcomes.
August 31, 2016: Curēus
Sreekanth Raveendran, Dukhabandhu Naik, Samuel C Raj Pallapati, John Jude Prakash, Binu Prathap Thomas, Nihal Thomas
BACKGROUND: Pyogenic Infections of the hand in diabetes are largely a tropical entity and published material in the area are rather meagre. PATIENTS AND METHODS: This is a retrospective study on the pattern of hand infections and involves the microbiological profile of 39 cases of diabetes hand-related infections admitted to the hospital between the years 2004 and 2010. RESULTS: This study included 39 patients, among whom 23 (59%) had necrotizing fasciitis (NF), and 16 (9-abscess and 7-tenosynovitis) had nonnecrotizing infection...
September 2016: Indian Journal of Endocrinology and Metabolism
Mohammad Reza Hayeri, Pouya Ziai, Monda L Shehata, Oleg M Teytelboym, Brady K Huang
Infection of the musculoskeletal system can be associated with high mortality and morbidity if not promptly and accurately diagnosed. These infections are generally diagnosed and managed clinically; however, clinical and laboratory findings sometimes lack sensitivity and specificity, and a definite diagnosis may not be possible. In uncertain situations, imaging is frequently performed to confirm the diagnosis, evaluate the extent of the disease, and aid in treatment planning. In particular, cross-sectional imaging, including computed tomography and magnetic resonance imaging, provides detailed anatomic information in the evaluation of soft tissues due to their inherent high spatial and contrast resolution...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Gerardo Bosco, Giacomo Garetto, Alessandro Rubini, Antonio Paoli, Prachiti Dalvi, Devanand Mangar, Enrico M Camporesi
INTRODUCTION: Some patients admitted to the intensive care unit (ICU) might require repetitive hyperbaric oxygen treatment (HBOT) while receiving critical care. In such cases, the presence of a hyperbaric chamber located inside or near an ICU is preferable; however, this set-up is not always possible. In Padua, the "Associazione Tecnici IPerbarici" hyperbaric centre is a stand-alone facility outside of a hospital. Despite this, selected ICU patients receive HBOT at this facility. METHODS: We retrospectively reviewed the medical records from 2003 to 2013 of 75 consecutive, critically-ill patients, 28 of whom were initially intubated and mechanically ventilated whilst undergoing HBOT...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Kegan Jessamy, Fidelis O Ojevwe, Ezinnaya Ubagharaji, Anuj Sharma, Obiajulu Anozie, Christy Ann Gilman, Sekou Rawlins
Clostridium septicum is a highly virulent pathogen which is associated with colorectal malignancy, hematological malignancy, immunosuppression, diabetes mellitus and cyclical neutropenia. Presentation may include disseminated clostridial infection in the form of septicemia, gas gangrene, and mycotic aortic aneurysms. We report the case of a 62-year-old female presenting with necrotizing fasciitis of her left thigh and subsequently developing rectal bleeding. While she was being treated with empiric antibiotics, her blood culture was found to be positive for C...
May 2016: Case Reports in Gastroenterology
Remigio Pernetti, Fabiano Palmieri, Elisabetta Sagrini, Marco Negri, Claudio Morisi, Andrea Carbone, Paolo Bassi, Salvatore Voce
Fournier's gangrene is a life-threatening acute necrotizing fasciitis of perianal,genitourinary and perineal areas. Nowadays, is well known that Fournier gangrene is almost never an idiopathic disease. In this article we report a case of a 70-year-old patient that initially was not treated properly. The gold standard therapy of the Fournier's gangrene remains today a complete, early and extended surgical debridement.
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Jagdish Chander, Nidhi Singla, Mandeep Kaur, Rajpal Singh Punia, Ashok Attri, Ana Alastruey-Izquierdo, José F Cano-Lira, Alberto Miguel Stchigel, Josep Guarro
BACKGROUND: Saksenaea erythrospora is an emerging and recently described pathogenic fungus mainly causing invasive cutaneous infections. Globally, very few human cases, caused by S. erythrospora, have been reported. In India, among the genus Saksenaea, S. vasiformis was the only reported pathogenic species, until recently when a case of fungal rhinosinusitis was reported to be caused by S. erythrospora. We observed five human cases of necrotizing skin and soft tissue infections caused by S...
October 4, 2016: Infectious Diseases
Jason P Burnham, John P Kirby, Marin H Kollef
PURPOSE: To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis. METHODS: Guidelines, expert opinion, and local institutional policies were reviewed. RESULTS: Severe SSTIs are common and their management complex due to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses...
October 3, 2016: Intensive Care Medicine
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
Mohamed El-Shazly, Mohamed Aziz, Hamdy Aboutaleb, Shady Salem, Eid El-Sherif, Mohamed Selim, Mohamed Sultan, Mohamed Omar, Tarek Abd Elbaky, Fouad Zanaty, Talal Alenezi, Abdelazeem Ghobashi, Adel Allam
BACKGROUND: Fournier's gangrene (FG) is an acute progressive necrotizing fasciitis of the genital area and perineum with possible extension to the abdominal wall. Surgical debridement is the gold standard management modality of established patients. Equivocal (early) FG represents a challenge in diagnosis. The objective of this study was to compare conservative management and early exploration in cases of equivocal (early) FG. METHODS: This was an observational study where data of all patients diagnosed as early FG in our departments over 4 years (2011-2015) were enrolled...
October 2016: Therapeutic Advances in Urology
Mark-Bram Bouman, Wouter B van der Sluis, Marlon E Buncamper, Müjde Özer, Margriet G Mullender, Wilhelmus J H J Meijerink
BACKGROUND: In young transgender women previously treated with puberty-suppressing hormones, penoscrotal hypoplasia can make penoscrotal inversion vaginoplasty unfeasible. The aim of this study was to prospectively assess surgical outcomes and follow-up of total laparoscopic sigmoid vaginoplasty as primary reconstruction in a cohort of transgender women with penoscrotal hypoplasia. METHODS: Baseline demographics, surgical characteristics, and intraoperative and postoperative complications of all performed total laparoscopic sigmoid vaginoplasty procedures were prospectively recorded...
October 2016: Plastic and Reconstructive Surgery
Lisanne C Cruz, Svetlana Abrams, Jeffrey S Fine, Subhadra Nori
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Dmitry Esterov, Kiin Kim, Sara J Cuccurullo, Iqbal H Jafri
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Kevin Tyler, Alicia Patterson, Andre Hebra
No abstract text is available yet for this article.
September 2016: American Surgeon
Vera L Negenborn, Wouter B van der Sluis, Wilhelmus J H J Meijerink, Mark-Bram Bouman
BACKGROUND: The absence of a functional vagina has a negative effect on the (sexual) quality of life of (transgender) women. Multiple surgical procedures have been described for vaginal reconstruction in these patients. CASE: We present a case of an 18-year-old transgender woman, who underwent laparoscopic intestinal vaginoplasty as vaginal reconstruction and subsequently developed septic shock and multiple organ failure based on an extended-spectrum beta-lactamase-producing E...
September 21, 2016: Journal of Pediatric and Adolescent Gynecology
Heather VanderMeulen, Jeffrey M Pernica, Madan Roy, April J Kam
Objective To assess the promptness and appropriateness of management in pediatric cases of necrotizing fasciitis (NF). Methods A retrospective chart review examined cases of pediatric NF treated at a pediatric tertiary care center over a 10-year period. Results Twelve patients were identified over the 10-year period. The median (25th to 75th centile) times to appropriate antibiotic administration, infectious disease consults, surgical consults and debridement surgeries were 2.6 (2.1-3.2), 7.7 (3.4-24.4), 4...
September 23, 2016: Clinical Pediatrics
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