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necrotizing fasciitis

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https://www.readbyqxmd.com/read/29784062/multidrug-resistant-proteus-mirabilis-and-escherichia-coli-causing-fulminant-necrotising-fasciitis-a-case-report
#1
Eugene Vernyuy Yeika, Joyce Bei Foryoung, Derrick Tembi Efie, Eugene Adze Nkwetateba, Paul Nkemtendong Tolefac, Marcelin Ngowe Ngowe
BACKGROUND: Necrotizing fasciitis is a rare soft tissue infection characterized by rapid progressive necrosis with relative sparing of underlying muscles. This case is reported to highlight the emergence of multidrug resistant microbes in recent days which limits the use of empiric antibiotic therapy and necessitates early cultures and sensitivity enabling targeted antibiotic therapy. Factors that lead to antimicrobial resistance especially in sub-Saharan Africa have also been discussed...
May 21, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29775787/genomic-insights-of-reduced-teicoplanin-susceptible-community-acquired-methicillin-resistant-staphylococcus-aureus-mrsa-case-of-necrotizing-fasciitis
#2
Yamuna Devi Bakthavatchalam, Boopalan Ramaswamy, Rajinikanth Janakiraman, Runal John Steve, Balaji Veeraraghavan
OBJECTIVE: Glycopeptides are being increasingly used to multi-resistant MRSA infections. We report MRSA with low level teicoplanin resistance recovered from a patient treated with teicoplanin for fatal necrotizing fasciitis. PATIENT AND METHODS: MRSA recovered from a patient with necrotizing fasciitis was treated with teicoplanin. The minimum inhibitory concentration (MIC) for vancomycin and teicoplanin was determined using E-test. Reduced glycopeptide susceptibility was screened using GRD E-test and population analysis profile (PAP) method...
May 15, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29775588/neurons-are-the-inflammatory-problem
#3
Kevin J Tracey
The discovery that reflex neuronal circuits control immunity provided a new mechanistic understanding of infection and injury. Pinho-Ribeiro et al. (2018) report that lethal tissue destruction from streptococcal necrotizing fasciitis ("flesh-eating disease") occurs because sensory neurons reflexively inhibit frontline immune responses.
May 17, 2018: Cell
https://www.readbyqxmd.com/read/29766139/necrotizing-fasciitis-following-abdominal-gunshot-wound
#4
Eliza Moskowitz, Thomas Schroeppel
No abstract text is available yet for this article.
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765591/a-case-of-periorbital-necrotizing-fasciitis-rapidly-progressing-to-severe-multiorgan-failure
#5
Paola Eiben, Sancho Rodriguez-Villar
Periorbital necrotizing fasciitis (PNF) is a severe suppurative infection of the subcutaneous tissue and underlying fascia of the periorbital region. Typically, the course of PNF is milder and has a better prognosis than that of necrotizing fasciitis in other parts of the body. As such, this disease is thought to be associated with a significantly smaller risk of morbidity and mortality. Nevertheless, it is a rare and devastating condition that can lead to disfigurement, blindness and death. Early recognition is critical to improved patient outcomes...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29757663/bicipital-tendinopathy-and-carpal-valgus-following-a-distant-direct-thoracoabdominal-skin-flap-in-a-german-shepherd-with-necrotizing-fasciitis
#6
Benjamin Mielke, Nicola Kulendra, Zoe Halfacree, Elvin Kulendra
A 4 mo old German shepherd dog was presented following an acute onset lameness and swelling of the thoracic limb. Clinical signs, surgical findings, and culture results were consistent with a diagnosis of necrotizing fasciitis. Initial management consisted of extensive surgical debridement, wound lavage, and bandaging. Surgical closure was achieved with an axillary fold flap and distant direct single-pedicle thoracoabdominal flap. Three mo later, following deterioration of the lameness that was associated with carpal valgus, carpal subluxation, and tendinopathy of the distal radial insertion of the biceps brachii tendon, a closing wedge pancarpal arthrodesis and tenotomy of the biceps brachii tendon was performed...
May 14, 2018: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/29754819/blocking-neuronal-signaling-to-immune-cells-treats-streptococcal-invasive-infection
#7
Felipe A Pinho-Ribeiro, Buket Baddal, Rianne Haarsma, Maghnus O'Seaghdha, Nicole J Yang, Kimbria J Blake, Makayla Portley, Waldiceu A Verri, James B Dale, Michael R Wessels, Isaac M Chiu
The nervous system, the immune system, and microbial pathogens interact closely at barrier tissues. Here, we find that a bacterial pathogen, Streptococcus pyogenes, hijacks pain and neuronal regulation of the immune response to promote bacterial survival. Necrotizing fasciitis is a life-threatening soft tissue infection in which "pain is out of proportion" to early physical manifestations. We find that S. pyogenes, the leading cause of necrotizing fasciitis, secretes streptolysin S (SLS) to directly activate nociceptor neurons and produce pain during infection...
May 7, 2018: Cell
https://www.readbyqxmd.com/read/29734459/-application-of-vacuum-wound-therapy-with-split-thickness-skin-grafts-in-the-head-and-neck-area
#8
Julia Thierauf, Paul Severin Wiggenhauser, Thomas Karl Hoffmann, Jens Greve, Marc Scheithauer, Johannes Adrian Veit
OBJECTIVE: In vacuum wound therapy (VAC) a negative pressure can continuously clean effusions and enhance the formation of granulation tissue significantly. In visceral, trauma and burns surgery this technique is used frequently in critical wounds. In the head and neck area there is limited experience and publications. Especially in the combined use of split-thickness-skin grafts (STSG) and VAC there is no published evidence. MATERIAL AND METHODS: A retrospective database analysis was done and resulted in 36 single VAC therapies in 13 patients...
May 7, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29684366/human-streptococcal-necrotizing-fasciitis-histopathology-mirrored-in-a-murine-model
#9
Nadia Keller, Federica Andreoni, Claudine Reiber, Helga Luethi-Schaller, Reto Andreas Schuepbach, Holger Moch, Ewerton Marques Maggio, Annelies Sophie Zinkernagel
Streptococcal necrotizing fasciitis (NF) causes high morbidity and mortality despite state-of-the-art therapy. Low incidence and rapid disease progression, necessitating immediate initiation of therapy, have proven challenging aspects for setting up prospective randomized trials. This has resulted in little therapeutic progress over the last decade. The validation of reliable murine NF models to study both pathogenesis and optimized therapeutic regimens of streptococcal NF are thus essential. In this study, we characterized a murine NF model and compared the pathology to an in-depth tissue analysis of streptococcal NF in patients...
April 20, 2018: American Journal of Pathology
https://www.readbyqxmd.com/read/29676331/cervicofacial-emphysema-following-unilateral-external-dacryocystorhinostomies-a-case-report
#10
Ziya Akingol, Safak Karslioglu, Didem Serin
Cervicofacial emphysema (CFE), mostly seen after trauma or dental procedures, is an unexpected, extremely rare condition after uncomplicated dacryocystorhinostomy (DCR). It may be misdiagnosed as angioedema or necrotizing fasciitis. In this article, we present the case of a 40-year-old female with CFE twice after uncomplicated unilateral DCR for left and right sides on different operative days. CFE was confirmed by computed tomography, demonstrating extensive air within subcutaneous tissues of the face, neck, and orbital cavity...
May 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29672405/necrotizing-soft-tissue-infection-diagnostic-accuracy-of-physical-examination-imaging-and-lrinec-score-a-systematic-review-and-meta-analysis
#11
Shannon M Fernando, Alexandre Tran, Wei Cheng, Bram Rochwerg, Kwadwo Kyeremanteng, Andrew J E Seely, Kenji Inaba, Jeffrey J Perry
OBJECTIVE: We sought to summarize accuracy of physical examination, imaging, and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score in diagnosis of necrotizing soft tissue infection (NSTI) in adults with a soft tissue infection clinically concerning for NSTI. SUMMARY OF BACKGROUND DATA: NSTI is a life-threatening diagnosis. Delay to diagnosis and surgical management is associated with increased mortality. METHODS: We searched 6 databases from inception through November 2017...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29652296/validation-of-the-aast-egs-grade-for-skin-and-soft-tissue-infection
#12
Mohamed D Ray-Zack, Matthew C Hernandez, Moustafa Younis, Wyatt B Hoch, Dylan S Soukup, Nadeem Haddad, Martin D Zielinski
INTRODUCTION: Skin and soft tissue infections (SSTI) present with variable severity. The American Association for the Surgery of Trauma (AAST) developed an emergency general surgery (EGS) grading system for several diseases. We aimed to determine whether the AAST EGS grade corresponds with key clinical outcomes. METHODS: Single institution retrospective review of patients (≥18 years) admitted with SSTI during 2012-2016 was performed. Patients with surgical site infections or <18 years were excluded...
February 27, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29629889/necrotizing-fasciitis-possible-profiles-of-professional-liability-with-reference-to-two-cases
#13
Gian Luca Marella, Enrico De Dominicis, Giovanni Battista Paliani, Giuseppe Santeusanio, Luigi Tonino Marsella, Saverio Potenza
Necrotizing fasciitis is one of the most dangerous complication of an abscess and it is still a disease with a high mortality. In this work, we decided to consider two cases: the first one concerns a male subject, aged 66, deceased because of a fatal necrotizing fasciitis associated to a cervical descending mediastinitis, which evolved from a primary peritonsillar abscess; the second is about a 50-year-old woman with a perineal abscess, then evolved into necrotizing fasciitis associated to a fatal septis shock...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29628671/scrotal-reconstruction-with-integra-following-necrotizing-fasciitis
#14
Briar L Dent, Anant Dinesh, Khuram Khan, Ryan Engdahl
Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. IntegraTM bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. We report the successful use of Integra and a subsequent split-thickness skin graft for reconstruction of the anterior scrotum and coverage of the exposed testes in a 43-year-old man who developed Group A Streptococcus necrotizing fasciitis of his right lower extremity, groin, and scrotum requiring serial operative debridements...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29627916/necrotizing-fasciitis-case-series-and-review-of-the-literature-on-clinical-and-medico-legal-diagnostic-challenges
#15
Paolo Fais, Alessia Viero, Guido Viel, Renzo Giordano, Dario Raniero, Stefano Kusstatscher, Chiara Giraudo, Giovanni Cecchetto, Massimo Montisci
Necrotizing fasciitis (NF) is a life-threatening infection of soft tissues spreading along the fasciae to the surrounding musculature, subcutaneous fat and overlying skin areas that can rapidly lead to septic shock and death. Due to the pandemic increase of medical malpractice lawsuits, above all in Western countries, the forensic pathologist is frequently asked to investigate post-mortem cases of NF in order to determine the cause of death and to identify any related negligence and/or medical error. Herein, we review the medical literature dealing with cases of NF in a post-mortem setting, present a case series of seven NF fatalities and discuss the main ante-mortem and post-mortem diagnostic challenges of both clinical and forensic interests...
April 7, 2018: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29626087/human-igg-increases-virulence-of-streptococcus-pyogenes-through-complement-evasion
#16
David Ermert, Antonin Weckel, Michal Magda, Matthias Mörgelin, Jutamas Shaughnessy, Peter A Rice, Lars Björck, Sanjay Ram, Anna M Blom
Streptococcus pyogenes is an exclusively human pathogen that can provoke mild skin and throat infections but can also cause fatal septicemia. This gram-positive bacterium has developed several strategies to evade the human immune system, enabling S. pyogenes to survive in the host. These strategies include recruiting several human plasma proteins, such as the complement inhibitor, C4b-binding protein (C4BP), and human (hu)-IgG through its Fc region to the bacterial surface to evade immune recognition. We identified a novel virulence mechanism whereby IgG-enhanced binding of C4BP to five of 12 tested S...
April 6, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29621529/severe-snakebite-envenomation-in-french-guiana-when-antivenom-is-not-available
#17
Hatem Kallel, Claire Mayence, Stéphanie Houcke, Cyrille Mathien, Hossein Mehdaoui, José María Gutiérrez, Bruno Megarbane, Didier Hommel, Dabor Resiere
In French Guiana, Bothrops atrox, Bothrops brazili, Bothrops bilineatus, Lachesis muta and Micrurus sp are responsible for most cases of snakebite envenomation. The clinical features in patients suffering from envenomations by viperid snakes involve local tissue damage and systemic manifestations, such as hemorrhage, coagulopathies and hemodynamic instability. We report a severe case of envenomation in a patient bitten by a large unidentified pit viper in French Guiana. Due to lack of antivenom, the patient only received symptomatic management...
April 2, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29619495/fournier-s-gangrene-in-an-obese-female-in-third-trimester-of-pregnancy
#18
Saqer Althunayyan, Evangelos Karamitosos
Fournier gangrene is a rapidly progressive necrotizing fasciitis of the perianal and genitourinary area. Although typically affects men, we present here a rare disease founding in a pregnant woman. An obese 36-year-old female patient in her third trimester of pregnancy presented with a history of perianal pain and swelling. She was subsequently diagnosed with Fournier gangrene and underwent emergency cesarean section with a surgical debridement. The key to successful outcomes in such a complicated presentation of Fournier gangrene includes a high index of suspicion, fluid resuscitation, rapid administration of broad-spectrum antibiotics, and an early interdisciplinary approach by multiple teams...
April 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29595103/application-of-medicinal-plants-as-a-source-for-therapeutic-agents-against-streptococcus-pyogenes-infections
#19
Adil Mohd, H P Vasantha Rupasinghe
Streptococcus pyogenes, a major human pathogen, causes a wide variety of invasive systemic infections such as acute pharyngitis, skin and soft-tissue infections, especially necrotizing fasciitis. This Gram-positive bacterium has an ability to form mature biofilm and this sessile lifestyle plays an important role in S. pyogenes pathogenicity. The virulence of these bacteria is further strengthened by its ability to communicate within the micro-colonies through quorum sensing. Most treatments are now aimed at either elimination of this bacterium or suppression of its virulence...
March 29, 2018: Current Drug Metabolism
https://www.readbyqxmd.com/read/29589220/ocular-involvement-in-melioidosis-a-23-year-retrospective-review
#20
Sasi Yaisawang, Somkiat Asawaphureekorn, Ploenchan Chetchotisakd, Surasakdi Wongratanacheewin, Peerapat Pakdee
BACKGROUND: Ocular involvement in melioidosis is rare and has devastating outcomes. Although there have been few reports on the condition, Khon Kaen, a city in northeast Thailand, has been called the "capital of melioidosis" due to the high prevalence of the condition in the region. We retrospectively reviewed all admitted cases of melioidosis with ocular involvement from the two largest hospitals in Khon Kaen. We reviewed cases from Srinagarind Hospital (a university hospital) of patients admitted between 1993 and 2016 and from Khon Kaen Hospital (a provincial hospital) of patients who presented from 2012 to 2016...
March 27, 2018: Journal of Ophthalmic Inflammation and Infection
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