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https://www.readbyqxmd.com/read/28101794/diabetic-foot-infections-an-update-in-diagnosis-and-management
#1
REVIEW
Pinelopi Grigoropoulou, Ioanna Eleftheriadou, Edward B Jude, Nikolaos Tentolouris
Foot infections are a common problem in patients with diabetes and a risk factor for limb amputation. They occur as a result of skin ulceration, which facilitates penetration of pathogens to deeper tissues. The diagnosis of infection is clinical. Aerobic gram-positive cocci are the most common pathogens. Ulcers which are chronic, preceded by administration of antibiotics and hospitalization or complicated by severe infection are polymicrobial. Antibiotic therapy is initially empiric based on the severity of the infection...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28096323/pyoderma-gangrenosum-following-complex-reconstruction-of-a-large-scale-lower-limb-defect-by-combined-parascapular-and-latissimus-dorsi-flap
#2
Tomke Cordts, Amir K Bigdeli, Leila Harhaus, Christoph Hirche, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
A female patient with a critical soft tissue defect after elective knee replacement surgery was transferred to our department for reconstruction. As wounds were rapidly progressing, necrotizing fasciitis was initially suspected but eventually ruled out by histopathological analysis. A 50 × 15 cm defect was then reconstructed by means of a combined Parascapular and latissimus dorsi flap before, a couple days later, the patient developed tender pustules and ulcers involving the flap as well as the donor site...
January 17, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28090519/a-rare-case-of-a-blood-clot-masquerading-as-a-retained-surgical-drain
#3
Sean Wl Ho, Ivan Th Chua
Surgical drains are commonly used in surgery to reduce post-operative fluid collections. Whilst rare, a retained surgical drain may result in clinical complications and distress to the patient. A retained surgical drain is a potentially avoidable event and surgeons should be aware on how to confirm the presence of a retained surgical drain. We report a rare case of a blood clot masquerading as a retained surgical drain in a patient. The patient is a 55-year-old Malay male who presented with left gluteal necrotizing fasciitis...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28065641/mdct-of-hand-and-wrist-infections-emphasis-on-compartmental-anatomy
#4
REVIEW
S Ahlawat, F M Corl, D M LaPorte, E K Fishman, L M Fayad
Hand and wrist infections can present with a spectrum of manifestations ranging from cellulitis to deep-space collections. The various infectious processes can be categorised as superficial or deep infections based on their respective locations relative to the tendons. Superficial hand infections are located superficial to the tendons and are comprised of cellulitis, lymphangitis, paronychia, pulp-space infections, herpetic whitlow, and include volar as well as dorsal subcutaneous abscesses. Deep hand infections are located deep to the tendon sheaths and include synovial space infections, such as infectious tenosynovitis, deep fascial space infections, septic arthritis, necrotising fasciitis, and osteomyelitis...
January 5, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28065541/nodular-fasciitis-sonographic-pathologic-correlation
#5
Ho-Hsian Yen, Hong-Jen Chiou, Yi-Hong Chou, Chih-Hsueh Chen, Wan-Yuo Guo
We evaluated nodular fasciitis (NF) in 19 patients, focusing on the correlation between its sonographic and histopathologic features. Sonograms were retrospectively reviewed, and the location, shape, margin, echogenicity, echogenic rim, peripheral hyper-echoic nodules, posterior enhancement and vascularity of the lesions were recorded. In the histopathologic analysis, three patterns-infiltrating, pushing border and well circumscribed-were identified, and culture-like tissue centers were classified according to the distribution of focal keloid-like collagen bundles: uneven or even...
January 5, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28062962/necrotizing-fasciitis-in-aesthetic-surgery-a-review-of-the-literature
#6
REVIEW
Andrea Marchesi, Stefano Marcelli, Pier C Parodi, Rosario E Perrotta, Michele Riccio, Luca Vaienti
INTRODUCTION: Necrotizing fasciitis (NF) is a rare, potentially fatal, infective complication that can occur after surgery. Diagnosis is still difficult and mainly based on clinical data. Only a prompt pharmacological and surgical therapy can avoid dramatic consequences. There are few reports regarding NF as a complication after aesthetic surgical procedures, and a systematic review still lacks. MATERIALS AND METHODS: We have performed a systematic review of English literature on PubMed, covering a period of 30 years...
January 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28062435/flaccid-paralysis-in-an-infant-associated-with-a-dirty-wound-and-application-of-honey
#7
Charlotte Jane Joseph, Teik Beng Khoo, Keng Yee Lee
An infant, who was born preterm at 36 weeks, presented with fever and ulcer at umbilical region which progressed to necrotising fasciitis of anterior abdominal wall. He was treated with intravenous penicillin, intravenous cloxacillin and local application of medicated honey. Subsequently, he required wound debridement. Postoperatively, he required prolonged invasive ventilation due to poor respiratory effort which was associated with hypotonia and areflexia. Nerve conduction study revealed absent responses...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28054929/rare-complication-of-stomas-peristomal-necrotizing-fasciitis
#8
Kivanc Derya Peker, Burak M Ilhan
INTRODUCTION: A stoma formation is a frequently performed procedure in patients undergoing colorectal surgery. Although stoma formation is a simple process, it should be performed with caution. The aim of this study was to attract physicians' attention to this rare disease and also to identify the surgical and medical treatment options for peristomal necrotizing fasciitis as a rare complication. MATERIALS AND METHODS: Risk factors including age, sex, additional diseases, previous surgical procedures, source of infection, physical findings, and vital signs of 14 patients with peristomal necrotizing fasciitis over a period of 10 years from 2005 to 2015 were retrospectively evaluated...
December 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28054280/successful-bypass-operation-for-esophageal-obstruction-after-acute-esophageal-necrosis-a-case-report
#9
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Masato Nagino
BACKGROUND: Acute esophageal necrosis (AEN) is a rare clinical disorder. Esophageal stenosis or obstruction is one of severe complications, but there are a few reports about surgical treatments. In such a situation, it still remains controversial which to choose, esophagectomy or bypass operation. CASE PRESENTATION: A 61-year-old woman was admitted to the local hospital for septic shock with diabetic ketoacidosis due to necrotizing fasciitis of the right thigh. Three days later, she had hematemesis, and gastrointestinal endoscopy revealed black mucosal coloration throughout the entire esophagus...
December 2017: Surgical Case Reports
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
#10
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/28042407/nodular-fasciitis-of-the-neck-causing-emergency-a-case-report
#11
Serkan Yaşar Çelik, Yelda Dere, Özgür İlhan Çelik, Serhan Derin, Murat Şahan, Özcan Dere
Nodular fasciitis is a benign, reactive, tumor-like lesion composed of fibroblasts and myofibroblasts. It typically occurs in the extremities and the trunk. Head and neck localization is 13-20%. As it grows rapidly, clinicians frequently misdiagnose it as an aggressive or a malignant lesion. Some lesions show moderate cellularity, mild cellular atypia, and mitosis histologically causing pathologists to over-diagnose the lesion as a malignant tumor. It is important to diagnose nodular fasciitis correctly to avoid unnecessary additional surgery and treatment...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28041910/necrotizing-fasciitis-in-a-patient-receiving-tocilizumab-for-rheumatoid-arthritis-case-report
#12
Diana Rosa-Gonçalves, Miguel Bernardes, Lúcia Costa
We present a case of necrotizing fasciitis in a 66-year-old Caucasian woman with rheumatoid arthritis receiving tocilizumab, and provide a review of published cases. The patient exhibited no systemic symptoms and discreet cutaneous inflammatory signals at presentation. She was successfully treated with broad-spectrum empiric antibiotic therapy and surgical debridement.
December 29, 2016: Reumatología Clinica
https://www.readbyqxmd.com/read/28035291/pediatric-necrotizing-fasciitis-restitutio-ad-integrum-after-early-diagnosis-and-aggressive-surgical-treatment
#13
Angela Lemaréchal, Sabine Zundel, Philipp Szavay
Necrotizing fasciitis (NF) is a severe, life-threatening infectious condition. Diagnosis is difficult due to unspecific symptoms yet crucial for favorable outcomes. We report a case of a 1 year old, previously healthy boy, where early suspicion of NF led to prompt aggressive therapy and consecutive restitutio ad integrum.
December 2016: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28034881/impact-of-intravenous-immunoglobulin-on-survival-in-necrotizing-fasciitis-with-vasopressor-dependent-shock-a-propensity-score-matched-analysis-from-130-us-hospitals
#14
Sameer S Kadri, Bruce J Swihart, Stephanie L Bonne, Samuel F Hohmann, Laura V Hennessy, Peter Louras, Heather L Evans, Chanu Rhee, Anthony F Suffredini, David C Hooper, Dean A Follmann, Eileen Bulger, Robert L Danner
BACKGROUND: Shock frequently complicates necrotizing fasciitis (NF) caused by group A streptococcus (GAS) or Staphylococcus aureus (SA). Intravenous immunoglobulin (IVIG) is sometimes administered for presumptive toxic shock syndrome (TSS), but its frequency of use and efficacy are unclear. METHODS: Adult patients with NF and vasopressor-dependent shock undergoing surgical debridement from 2010 to 2014 were identified at 130 U.S. hospitals. IVIG cases were propensity-matched and risk-adjusted...
December 29, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28028519/beneficial-effects-of-platelet-rich-plasma-on-improvement-of-pain-severity-and-physical-disability-in-patients-with-plantar-fasciitis-a-randomized-trial
#15
Babak Vahdatpour, Lida Kianimehr, Ahmad Moradi, Shila Haghighat
BACKGROUND: The present study aimed to clinically examine the effects of platelet-rich plasma (PRP) on improvement of plantar fasciitis and its related manifestations. PATIENTS AND METHODS: This single-blind randomized controlled trial was performed on 32 consecutive patients with the final diagnosis of plantar fasciitis that were randomly assigned to the case group (that received PRP, n = 16) and the control group (that received corticosteroid as methylprednisolone 1 ml plus lidocaine 1 ml, n = 16)...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28018683/nodular-fasciitis-complicating-a-staged-surgical-excision-of-dermatofibrosarcoma-protuberans
#16
C Helen Malone, Brandon Goodwin, Richard F Wagner, Vicente Resto, Brent Kelly
Dermatofibrosarcoma protuberans (DFSP) is an unusual spindle cell tumor with a high rate of local recurrence with traditional excision. Fortunately, Mohs micrographic surgery yields excellent cure rates for this neoplasm due to contiguous tumor spread and meticulous tumor mapping and margin analysis. We present the unique case of a patient treated with a modified Mohs technique with an analysis of the final margin with permanent sections, who developed a spindle cell neoplasm in the margins of her second stage excision consistent with nodular fasciitis...
2016: Case Reports in Dermatological Medicine
https://www.readbyqxmd.com/read/28013013/a-canine-model-of-chronic-graft-versus-host-disease
#17
Scott S Graves, Andrew Rezvani, George Sale, Diane Stone, Maura Parker, Steven Rosinski, Michele Spector, Bruce Swearingen, Leslie Kean, Rainer Storb
In long-term survivors of allogeneic hematopoietic cell transplantation (HCT), chronic graft-versus-host disease (GVHD) is the major cause of morbidity and mortality and a major determinant of quality of life. Chronic GVHD responds poorly to current immunosuppressive drugs, and while T cell depletion may be preventive, this gain is offset by increased relapse rates. A significant impediment to progress in treating chronic GVHD has been the limitations of existing animal models. The goal of this study was to develop a reproducible comprehensive model of chronic GVHD in the dog...
December 21, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28009608/fosb-is-a-useful-diagnostic-marker-for-pseudomyogenic-hemangioendothelioma
#18
Yin P Hung, Christopher D M Fletcher, Jason L Hornick
Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a distinctive vascular neoplasm of intermediate biological potential with a predilection for young adults and frequent multifocal presentation. Pseudomyogenic hemangioendothelioma is characterized by loose fascicles of plump spindled and epithelioid cells with abundant eosinophilic cytoplasm and coexpression of keratins and endothelial markers. Recently, a SERPINE1-FOSB fusion has been identified as a consistent genetic alteration in pseudomyogenic hemangioendothelioma...
December 22, 2016: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28007393/fournier-s-gangrene-during-acth-therapy
#19
Shingo Numoto, Hirokazu Kurahashi, Yoshiteru Azuma, Atsushi Numaguchi, Kozaburo Nakahara, Takahisa Tainaka, Michihiko Takasu, Kiyoshi Yamakawa, Nozomi Nago, Taichiro Muto, Yoshiro Kitagawa, Akihisa Okumura
Fournier's gangrene is an infectious necrotizing fasciitis of the perineal, genital, or perianal regions and is uncommon in children. Adrenocorticotropic hormone (ACTH) is effective for the treatment of infantile spasms; however, suppression of immune function is one of the major adverse effects of this approach. We encountered a 2-month-old boy with infantile spasms that had been treated with ACTH and had developed complicating Fournier's gangrene. Strangulation of a right inguinal hernia was observed after ACTH treatment...
December 19, 2016: Brain & Development
https://www.readbyqxmd.com/read/27999021/development-of-operationalized-intravenous-to-oral-antibiotic-switch-criteria
#20
H Akhloufi, M Hulscher, D C Melles, J M Prins, H van der Sijs, A Verbon
OBJECTIVES: Despite huge overlap in suggested criteria for a safe intravenous (iv)-to-oral antibiotic switch, there is considerable variation in their operationalization. The objective of this study was to develop a set of measurable conditions that should be met in adult hospitalized patients for a safe iv-to-oral switch. METHODS: A RAND-modified Delphi procedure was performed to develop a set of operationalized iv-to-oral switch criteria. Switch criteria and their accompanying suggested measurable conditions were extracted from the literature and appraised by a multidisciplinary expert panel during two questionnaire rounds with a face-to-face meeting between these two rounds...
December 20, 2016: Journal of Antimicrobial Chemotherapy
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