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Severe skin and soft tissue infections

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https://www.readbyqxmd.com/read/28057476/operative-treatment-of-early-infection-after-internal-fixation-of-limb-fractures-exclusive-of-severe-open-fractures
#1
REVIEW
P Bonnevialle
Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique...
January 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28052529/successful-salvage-and-reconstruction-of-a-finger-threatened-by-vibrio-vulnificus-necrotising-fasciitis-using-fenestrated-type-artificial-dermis-and-three-steps-of-topical-negative-pressure-wound-therapy
#2
Chi-Yu Wang, Hao-Yu Chiao, Chang-Yi Chou, Chien-Ju Wu, Chun-Kai Chang, Tzi-Shiang Chu, Niann-Tzyy Dai
Vibrio vulnificus can cause severe skin and soft tissue infection (SSTI). The pathogen is an opportunistic marine bacterium that is likely to infect patients with chronic liver disease, patients in an immunocompromised state, and those in end-stage renal disease. V. vulnificus gains entry through soft tissues by direct penetration of a wound by infected marine organisms, such as raw oysters, shellfish and other seafood, or by exposing a wound to contaminated water. Despite its ease of entry, V. vulnificus necrotising fasciitis with compartment syndrome has rarely been described...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28049509/hyperbaric-oxygen-therapy-for-a-refractory-skin-ulcer-after-radical-mastectomy-and-radiation-therapy-a-case-report
#3
Mitsuhiro Enomoto, Kazuyoshi Yagishita, Kae Okuma, Takuya Oyaizu, Yasushi Kojima, Atsushi Okubo, Takuma Maeda, Satoko Miyamoto, Atsushi Okawa
BACKGROUND: Radiation therapy is performed as an adjuvant therapy when indicated following surgical resection of malignant tumors. However, radiation exposure induces acute or chronic dermatitis, depending on the radiation dose, interval, tissue volume, or irradiated area of the body. Radiation-induced skin ulcers and osteomyelitis of the underlying bone are intractable late-stage complications of radiation therapy, and often require reconstructive surgery to cover exposed tissue. Hyperbaric oxygen therapy has been suggested as a treatment for delayed radiation injury with soft tissue and bony necrosis...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28041752/burns-and-long-term-infectious-disease-morbidity-a-population-based-study
#4
Janine M Duke, Sean M Randall, Fiona M Wood, James H Boyd, Mark W Fear
BACKGROUND: There is a growing volume of data that indicates that serious injury suppresses immune function, predisposing individuals to infectious complications. With recent evidence showing long-term immune dysfunction after less severe burn, this study aimed to investigate post-burn infectious disease morbidity and assess if burn patients have increased long-term hospital use for infectious diseases. METHODS: A population-based longitudinal study using linked hospital morbidity and death data from Western Australia for all persons hospitalised for a first burn (n=30,997) in 1980-2012...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#5
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/28034602/contribution-of-secreted-nadase-and-streptolysin-o-to-the-pathogenesis-of-epidemic-serotype-m1-streptococcus-pyogenes-infections
#6
Luchang Zhu, Randall J Olsen, Jessica D Lee, Adeline R Porter, Frank R DeLeo, James M Musser
Streptococcus pyogenes secretes many toxins that facilitate human colonization, invasion, and dissemination. NADase (SPN) and streptolysin O (SLO) are two toxins that play important roles in pathogenesis. We previously showed that increased production of SPN and SLO in epidemic serotype M1 and M89 S. pyogenes strains is associated with rapid intercontinental spread and enhanced virulence. The biological functions of SPN and SLO have been extensively studied using eukaryotic cell lines, but the relative contribution of each of these two toxins to pathogenesis of epidemic M1 or M89 strains remains unexplored...
December 27, 2016: American Journal of Pathology
https://www.readbyqxmd.com/read/28019110/severe-kaposi-sarcoma-in-an-urban-public-hospital
#7
Shirin Kasturia, Clifford Gunthel, Cheng Zheng, Minh Ly Nguyen
INTRODUCTION: The national incidence of epidemic Kaposi Sarcoma (KS) has decreased dramatically since the availability of combined antiretroviral therapy (cART). Despite national trends, we continue to see admissions for KS. Methods: Electronic medical records were queried to identify patients with HIV who were admitted with active KS between 2010 and 2013 and records were reviewed to determine patient characteristics and factors affecting survival. Data were collected from all hospital admissions until death or May 1, 2015...
December 26, 2016: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28017792/vislisi-trial-a-prospective-clinical-study-allowing-identification-of-a-new-metalloprotease-and-putative-virulence-factor-from-staphylococcus-lugdunensis
#8
Xavier Argemi, Gilles Prévost, Philippe Riegel, Daniel Keller, Nicolas Meyer, Marion Baldeyrou, Nawal Douiri, Nicolas Lefebvre, Kilifa Meghit, Cécile Ronde Oustau, Daniel Christmann, Cianférani Sarah, Jean Marc Strub, Yves Hansmann
OBJECTIVE: Staphylococcus lugdunensis is coagulase-negative Staphylococcus that displays an unusually highvirulence rate close to that of S. aureus. It also shares phenotypic properties with S. aureus and several studies found putative virulence factors. Objective of the study was to describe the clinical manifestations of S. lugdunensis infections and investigate putative virulence factors. METHOD: We conducted a prospective study from November 2013 to March 2016 at the University Hospital of Strasbourg...
December 22, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28005689/epidemiology-and-outcomes-of-hospitalized-children-with-necrotizing-soft-tissue-infections
#9
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/27917738/incidence-and-factors-associated-with-emergency-department-visits-for-recurrent-skin-and-soft-tissue-infections-in-patients-in-california-2005-2011
#10
L May, E Y Klein, E M Martinez, N Mojica, L G Miller
More than 2 million visits for skin and soft tissue infections (SSTIs) are seen in US emergency departments (EDs) yearly. Up to 50% of patients with SSTIs, suffer from recurrences, but associated factors remain poorly understood. We performed a retrospective study of patients with primary diagnosis of SSTI between 2005 and 2011 using California ED discharge data from the State Emergency Department Databases and State Inpatient Databases. Using a multivariable logistic regression, we examined factors associated with a repeat SSTI ED visits up to 6 months after the initial SSTI...
December 5, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27917329/minimally-invasive-treatment-of-tibial-pilon-fractures-through-arthroscopy-and-external-fixator-assisted-reduction
#11
Huasong Luo, Liaobin Chen, Kebin Liu, Songming Peng, Jien Zhang, Yang Yi
OBJECTIVE: The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. METHODS: Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27907197/clinical-experience-of-patients-receiving-doripenem-containing-regimens-for-the-treatment-of-healthcare-associated-infections
#12
Chien-Ming Chao, Chi-Chung Chen, Hui-Ling Huang, Yin-Ching Chuang, Chih-Cheng Lai, Hung-Jen Tang
In this study, we retrospectively reviewed the clinical experience of patients receiving doripenem-containing regimens for the treatment of healthcare-associated infections (HCAIs) in a tertiary care center and assessed the clinical usefulness of doripenem therapy in this clinical setting. In this retrospective study, the medical records of all adult patients who had ever received doripenem-containing therapy for the treatment of HCAIs were reviewed between September 1, 2012 and August 31, 2014, and the following data were extracted: age, gender, type of infection, disease severity, underlying comorbidities or conditions, and laboratory results...
2016: PloS One
https://www.readbyqxmd.com/read/27897966/behavioral-characteristics-and-injection-practices-associated-with-skin-and-soft-tissue-infections-among-people-who-inject-drugs-a-community-based-observational-study
#13
Disa Dahlman, Anders Håkansson, Alex H Kral, Lynn Wenger, Elizabeth L Ball, Scott P Novak
BACKGROUND: People who inject drugs (PWID) are at increased risk for bacterial skin and soft tissue infections (SSTIs). Although SSTIs pose significant health risks, little is known about their prevalence and characteristics in the population of PWID in the United States. This study investigates whether behavioral factors related to skin and equipment hygiene and tissue-damaging injection practices are associated with recent SSTIs among PWID. METHODS: Active PWID were recruited using targeted sampling in San Francisco in 2011-2013...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27894236/virulence-factor-targeting-of-the-bacterial-pathogen-staphylococcus-aureus-for-vaccine-and-therapeutics
#14
Trevor Kane, Katelyn Carothers, Shaun Lee
Staphylococcus aureus is a major bacterial pathogen capable of causing a range of infections in humans from gastrointestinal disease, skin and soft tissue infections, to severe outcomes such as sepsis. Staphylococcal infections in humans can be frequent and recurring, with treatments becoming less effective due to the growing persistence of antibiotic resistant S. aureus strains. Significant research into virulence factors produced by S. aureus have yielded many important findings regarding specific mechanisms that contribute to its overall pathogenesis...
November 28, 2016: Current Drug Targets
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#15
Murat Sütçü, Güntulu Duran Şık, Feryal Gün, Ayper Somer, Nuran Salman
Necrotizing fasciitis is a life-threatening soft tissue infection characterized by progressive necrosis of the skin, subcutaneous tissues and fascia. Fournier's gangrene (FG) is a serious and aggressive form of infective necrotizing fasciitis involving perineal region and genitalia. Presently described are 2 pediatric cases of FG with widespread necrosis of surrounding tissue following anorectal surgery, causing severe septic shock. Case 1: Six-month-old female patient with anal stenosis and duplication presented at emergency clinic with fever, somnolence, irritability, and feeding difficulty...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27844159/clinical-and-epidemiological-differences-between-implant-associated-and-implant-free-orthopaedic-infections
#16
Céline Cuérel, Sophie Abrassart, Julien Billières, Diego Andrey, Domizio Suva, Victor Dubois-Ferrière, Ilker Uçkay
PURPOSE: Although there have been many publications regarding the risk factors for implant-associated orthopaedic infections, none have investigated how clinical presentations and epidemiology may differ between infections with and without osteosynthetic material. METHODS: We pooled clinical data from several databases of adult patients with orthopaedic infections hospitalized at Geneva University Hospitals from January 2004 to December 2014. RESULTS: Among 2740 episodes of orthopaedic infections, 76% were implant-free osteoarticular or soft tissue infections...
November 14, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27844118/the-cost-of-infection-in-severe-open-tibial-fractures-treated-with-a-free-flap
#17
Ulrik Kähler Olesen, Nicolas Jones Pedersen, Henrik Eckardt, Line Lykke-Meyer, Christian Thorsten Bonde, Upender Martin Singh, Martin McNally
PURPOSE: Open tibial fractures needing soft tissue cover are challenging injuries. Infection risk is high, making treatment difficult and expensive. Delayed skin closure has been shown to increase the infection rate in several studies. We aimed at calculating the direct and indirect cost of treatment, and to determine the effect of delayed skin closure on this cost. METHODS: We reviewed all records of patients treated with a free flap in our institution for an open tibial fracture from 2002 to 2013...
November 14, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27836315/elderly-patients-are-at-increased-risk-for-treatment-failure-in-outpatient-management-of-purulent-skin-infections
#18
John P Haran, Eric Wilsterman, Tyler Zeoli, Francesca L Beaudoin, Jennifer Tjia, Patricia L Hibberd
OBJECTIVE: Current Infectious Disease Society of America (IDSA) guidelines for the management of purulent skin or soft tissue infections do not account for patient age in treatment recommendations. The study objective was to determine if age was associated with outpatient treatment failure for purulent skin infection after adjusting for IDSA treatment guidelines. METHODS: We conducted a multicenter retrospective study of adult patients treated for a purulent skin infection and discharged home from four emergency departments between April and September 2014...
October 29, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27832748/invasive-mucormycosis-in-children-an-epidemiologic-study-in-european-and-non-european-countries-based-on-two-registries
#19
Zoi Dorothea Pana, Danila Seidel, Anna Skiada, Andreas H Groll, Georgios Petrikkos, Oliver A Cornely, Emmanuel Roilides
BACKGROUND: Mucormycosis has emerged as a rare but frequently fatal invasive fungal disease. Current knowledge on paediatric mucormycosis is based on case reports and small series reported over several decades. Contemporary data on a large cohort of patients is lacking. METHODS: Two large international registries (Zygomyco.net and FungiScope™) were searched for mucormycosis cases in ≤19 year-old patients. Cases enrolled between 2005 and 2014 were extracted, and dual entries in the two databases merged...
November 10, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27814724/severe-open-lisfranc-injuries-one-stage-operation-through-internal-fixation-associated-with-vacuum-sealing-drainage
#20
Wenqing Qu, Shuqin Ni, Zhenhai Wang, Yong Zhao, Shimin Zhang, Yiheng Cheng, Tong Liu, Min Yu, Dan Wang
BACKGROUND: This study aimed to investigate the clinical feasibility of treating severe open Lisfranc injuries by means of one-stage internal fixation with k-wires associated with vacuum sealing drainage (VSD). METHODS: The clinical outcomes of 20 cases of severe open Lisfranc joint fracture-dislocation treated by using one-stage internal fixation with k-wires associated with VSD, after debridement and suturing during emergency treatment, were reviewed. RESULTS: At 6 and 12 months after surgery, the American Orthopaedic Foot and Ankle Society midfoot scores were 69...
November 4, 2016: Journal of Orthopaedic Surgery and Research
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