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necrotizing fasciitis

Sanjay Mhalasakant Khaladkar, Kunaal Mahesh Jain, Rajesh Kuber, Sidappa Gandage
Emphysematous pyelonephritis is a life-threatening severe form of pyelonephritis usually occurring in patients with diabetes mellitus with or without obstructive uropathies in whom there is necrotizing infection leading to the gas production of an unclear mechanism involving the renal parenchyma and the collecting system. Necrotizing fasciitis is characterized by progressive necrosis of fat and fascia due to deep-seated infection of subcutaneous tissue. It has a fulminant course with considerable mortality...
2018: Journal of Clinical Imaging Science
David K Tso, Ajay K Singh
OBJECTIVE: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease. CONCLUSION: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, US, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis...
March 14, 2018: British Journal of Radiology
Kristine M Thompson, Brian T Kruse, Mary Ann S Hedges
BACKGROUND: Necrotizing fasciitis is usually associated with a surgical or traumatic wound. Clostridial myonecrosis is an uncommon but deadly infection that can develop in the absence of a wound and is often associated with occult gastrointestinal cancer or immunocompromise, or both. CASE REPORT: We report a case of catastrophic atraumatic Clostridium septicum infection in an immunocompromised host. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians most commonly associate necrotizing fasciitis with superinfection of an open wound...
March 10, 2018: Journal of Emergency Medicine
J P Gawaziuk, R Strazar, N Cristall, S Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a debilitating soft tissue infection that results in disfiguring scars and often amputations. While mortality rates have improved, long-term outcomes in survivors of NF are poorly understood. OBJECTIVES: The objective of this study is to analyze the impact of NF on survivors' health-related quality of life (HRQoL) influenced by age, sex, comorbidities, %TBSA, and confidence with appearance. METHODS: We surveyed 56 adult patients with NF treated at either of two regional referral centers in Manitoba, Canada, between January 1, 2004, and December 31, 2014...
February 14, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Gregory M Taylor, David V Hess
Fournier's gangrene, a rare polymicrobial infection that affects the genitals and perineum, can present as an insidious onset to a rapid and fulminant course. Early recognition, diagnosis, initiation of broad-spectrum antibiotics and prompt surgical treatment remain the foundation of management. If treatment is not initiated aggressively, the patient will likely rapidly deteriorate, leading to organ failure and death. We present the case of a 58-year-old diabetic female presenting febrile, hypoxic, with severe respiratory distress and evidence of septic shock, found to have necrotizing fasciitis of the entire right hemi-pelvis...
February 2018: Oxford Medical Case Reports
Lynn De Roeck, Lauranne Van Assche, Veronique Verhoeven, Ina Vrints, Jana Van Thielen, Thierry Tondu, Filip Thiessen
OBJECTIVE: Subcutaneous emphysema can be an alarming sign of a necrotizing soft tissue infection. However, non-infectious etiologies exist that can be treated conservatively. This case report describes a subcutaneous emphysema of unknown origin and highlights the importance of distinguishing these clinical entities. METHODS: We present a 17-year old female with pain and subcutaneous emphysema of the left arm. There were no systemic symptoms. Inflammatory parameters were slightly elevated...
February 23, 2018: Acta Chirurgica Belgica
Daniel Francisco Mello, Americo Helene Júnior
OBJECTIVE: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier's gangrene). METHODS: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. RESULTS: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48...
2018: Revista do Colégio Brasileiro de Cirurgiões
Monika Wojtera, Horace Cheng, Kyle Fiorini, Kevin Coughlin, Michelle Barton, Julie Strychowsky
BACKGROUND: There is no consensus regarding approaches to infantile group B streptococcal (GBS) head and neck cellulitis and necrotizing fasciitis. We present a case of GBS necrotizing cellulitis and summarizes the literature regarding the presentation and management of infantile head and neck GBS cellulitis and necrotizing fasciitis. METHODS: The literature was searched using PubMed, Web of Science, EMBASE, and Medline (inception to April 2017) by two independent review authors...
February 7, 2018: Pediatric Infectious Disease Journal
Ahmed Hassan El-Sabbagh
Background: Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Tomoko Sumitomo, Yasushi Mori, Yuumi Nakamura, Mariko Honda-Ogawa, Seitaro Nakagawa, Masaya Yamaguchi, Hiroyuki Matsue, Yutaka Terao, Masanobu Nakata, Shigetada Kawabata
Streptococcus pyogenes is responsible for a wide variety of cutaneous infections ranging from superficial impetigo to fulminant invasive necrotizing fasciitis. Dysfunction of desmosomes is associated with the pathogenesis of cutaneous diseases. We identified streptococcal pyrogenic exotoxin B (SpeB) as a proteolytic factor that cleaves the extracellular domains of desmoglein 1 and 3. In an epicutaneous infection model, lesional skin infected with an speB deletion mutant were significantly smaller as compared to those caused by the wild-type strain...
2018: Frontiers in Cellular and Infection Microbiology
Vipul D Yagnik
No abstract text is available yet for this article.
January 2018: Saudi Journal of Anaesthesia
Kiyoko Fukui, Masaki Fujioka, Satoko Ishiyama
INTRODUCTION: Fournier's gangrene (FG) is a type of necrotizing fasciitis of the perineum and scrotum that is characterized by very rapid progression. Sacral pressure ulcers are one of the causes of FG. CASE REPORT: An 85-year-old man was referred to the National Hospital Organization Nagasaki Medical Center (Ohmura City, Japan) with a diagnosis of FG extending to the retroperitoneum caused by a sacral pressure ulcer. Immediate debridement was performed; however, it was not possible to remove all necrotic tissue from the pelvis...
January 2018: Wounds: a Compendium of Clinical Research and Practice
Rachel Bystritsky, Henry Chambers
Cellulitis and soft tissue infections are a diverse group of diseases that range from uncomplicated cellulitis to necrotizing fasciitis. Management of predisposing conditions is the primary means of prevention. Cellulitis is a clinical diagnosis and thus is made on the basis of history and physical examination. Imaging may be helpful for characterizing purulent soft tissue infections and associated osteomyelitis. Treatment varies according to the type of infection. The foundations of treatment are drainage of purulence and antibiotics, the latter targeted at the infection's most likely cause...
February 6, 2018: Annals of Internal Medicine
Jumpei Hamashige, Hiroshi Umemura, Kenji Asagoe
No abstract text is available yet for this article.
February 1, 2018: European Journal of Dermatology: EJD
Zheng-Hao Huang, Yu-Chen Chiu, Li-Lu Ho, Hsiu-Lung Fan, Chun-Chi Lu
RATIONALE: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, spiking fever, arthralgia/ arthritis, and lymphadenopathy. AOSD sometimes was fatal when it is complicated by macrophage activation syndrome (MAS) or hemophagocytic lymphohistiocytosis (HLH). Nonetheless, the literature provides no recommendations for treatment of AOSD patients with severe sepsis. PATIENT CONCERNS: A previously healthy 65-year-old man with history of AOSD was referred to our hospital for persistent right lower quadrant abdominal pain for 2 days...
February 2018: Medicine (Baltimore)
Orville V Baez-Pravia, Miriam Díaz-Cámara, Oscar De La Sen, Carlos Pey, Mercedes Ontañón Martín, Luis Jimenez Hiscock, Begoña Morató Bellido, Ángel Luis Córdoba Sánchez
RATIONALE: Cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) are rare forms of complication of Ludwig angina. These potentially lethal infections are difficult to recognize in early stages and are often associated with predisposing factors like diabetes and immunocompromised states. Moreover, IgG hypogammaglobulinemia (hypo-IgG) is considered to be a risk factor of mortality in patients with septic shock; however, it is not routinely quantified in patients with extremely serious infections, particularly in cases with no history or evidence of immunocompromising disorders...
November 2017: Medicine (Baltimore)
Shigefumi Okamoto, Satoshi Nagase
Group A Streptococcus (GAS) are pathogenic bacteria of the genus Streptococcus, and cause severe invasive GAS infections that comprise a wide range of diverse diseases, including acute respiratory distress syndrome, renal failure, toxic shock-like syndrome (TSLS), sepsis, cellulitis, and necrotizing fasciitis. The essential virulence, infected host, and external environmental factors required for invasive GAS infections still have not known. We demonstrated that superinfection with influenza virus and GAS induced invasive GAS infections in a mouse model, and then several investigators reported clinical cases of invasive GAS infections secondary to influenza virus infection in Japan, the United States, Canada, the United Kingdom, China, and others...
January 27, 2018: Microbiology and Immunology
Bolesław Kuzaka, Marta M Wróblewska, Tomasz Borkowski, Dariusz Kawecki, Piotr Kuzaka, Grażyna Młynarczyk, Piotr Radziszewski
BACKGROUND Fournier's gangrene (FG) is a fulminant form of infective, polymicrobial, necrotizing fasciitis of the perineal, genital, and perianal regions. It commonly affects men, but women and children may also develop this type of tissue necrosis. MATERIAL AND METHODS This study is a retrospective analysis of the management of 13 cases of Fournier's gangrene, diagnosed from among about 45 000 patients (men, women, and children) treated in the Department of General, Oncological, and Functional Urology (Medical University of Warsaw) from 1995 to 2013...
January 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Maryann C Gruda, Karl-Gustav Ruggeberg, Pamela O'Sullivan, Tamaz Guliashvili, Andrew R Scheirer, Thomas D Golobish, Vincent J Capponi, Phillip P Chan
OBJECTIVE: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. In sepsis and septic shock, pathogen-associated molecular pattern molecules (PAMPS), such as bacterial exotoxins, cause direct cellular damage and/or trigger an immune response in the host often leading to excessive cytokine production, a maladaptive systemic inflammatory response syndrome response (SIRS), and tissue damage that releases DAMPs, such as activated complement and HMGB-1, into the bloodstream causing further organ injury...
2018: PloS One
Kun-Lin Chuang, Fu-Wen Liang, Shyh-Jou Shieh, Tsung-Hsueh Lu
BACKGROUND: Little is known about the national population-based incidence rates of necrotizing fasciitis (NF) and related epidemiological profiles in Asian countries. We plastic surgeons always face and treat this complicated disease in the first line at the hospital. METHODS: Using Taiwan's National Health Insurance inpatient claims data from 2005 through 2010, we investigated the national annual incidence rate of NF by sex, age, year, month, beneficiary category, and region...
January 25, 2018: Annals of Plastic Surgery
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