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Sample records for cellulitis

  1. Cellulitis

    MedlinePlus

    ... to prevent it. You probably know that your skin has layers — three, to be exact. Well, cellulitis is an ... infection develops, it may affect just the top layers of skin. But if it goes deeper and becomes cellulitis, ...

  2. Orbital cellulitis

    MedlinePlus

    ... Haemophilus influenzae B) vaccine. The bacteria Staphylococcus aureus , Streptococcus pneumoniae , and beta-hemolytic streptococci may also cause orbital cellulitis. Orbital cellulitis infections in children may get worse very quickly and can lead ...

  3. Bilateral cellulitis.

    PubMed

    Batra, Vivek; Baras, Alexander

    2015-01-01

    We present a case of bilateral lesions in a 50-year-old man, which were on first impression mistaken for and initially treated as bilateral cellulitis. We propose that bilateral cellulitis, as opposed to unilateral, is rare and that other aetiologies should be considered in evaluating a patient with bilateral lesions. The differential diagnosis includes stasis-dermatitis, lipodermatosclerosis, lymphoedema and vascular lesions such as Kaposi sarcoma, as was identified in this case. Early consultation with dermatology and biopsy in unclear cases mitigates the unnecessary use of prolonged antibiotics, antibiotic resistance and Clostridium difficile infections. HIV testing is an essential screening test in all adults who present with non-specific viral symptoms and rash. PMID:26392449

  4. Orbital cellulitis.

    PubMed Central

    Martin-Hirsch, D P; Habashi, S; Hinton, A H; Kotecha, B

    1992-01-01

    Orbital cellulitis is an emergency. It may cause blindness and progress to life-threatening sequelae such as brain abscess, meningitis and cavernous sinus thrombosis. Successful management is dependent upon urgent referral and immediate treatment. Although isolated eyelid erythema and swelling usually indicate primary infection anterior to the orbital septum, they may also be the first signs of an underlying frontal or ethmoidal sinusitis. The condition always requires emergency referral to both an ophthalmologist and otorhinolaryngologist. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:1388488

  5. Cellulitis: diagnosis and management.

    PubMed

    Bailey, Elizabeth; Kroshinsky, Daniela

    2011-01-01

    Cellulitis is an acute infection of the dermal and subcutaneous layers of the skin, often occurring after a local skin trauma. It is a common diagnosis in both inpatient and outpatient dermatology, as well as in the primary care setting. Cellulitis classically presents with erythema, swelling, warmth, and tenderness over the affected area. There are many other dermatologic diseases, which can present with similar findings, highlighting the need to consider a broad differential diagnosis. Some of the most common mimics of cellulitis include venous stasis dermatitis, contact dermatitis, deep vein thrombosis, and panniculitis. History, local characteristics of the affected area, systemic signs, laboratory tests, and, in some cases, skin biopsy can be helpful in confirming the correct diagnosis. Most patients can be treated as an outpatient with oral antibiotics, with dicloxacillin or cephalexin being the oral therapy of choice when methicillin-resistant Staphylococcus aureus is not a concern. PMID:21410612

  6. [Eosinophilic cellulitis (Wells' syndrome)].

    PubMed

    Cerri, D; Carabelli, A; Bertani, E; Portaluppi, F; Novi, C; Gianotti, R; Gelmetti, C

    1990-09-01

    The Authors report a case of eosinophilic cellulitis (Wells' syndrome). The patient was a 61 year old woman, diabetic, with a cardio-respiratory insufficiency and a maniaco-depressive psycosis. She presented, on the upper arms and trunk, a cutaneous eruption of erythematous-urticarial plaques, that histopathologically were characterized by a dermic leukocyte population, with a prevalence of eosinophils, distributed in the perivascular site. Laboratory tests revealed eosinophilia and circulating immune complexes. The etiopathogenesis of the disease is discussed as is the possible role of immune complexes in eosinophilic cellulitis. PMID:2079351

  7. Eosinophilic cellulitis and dermographism.

    PubMed

    Nguyen, Nathalie Q; Ma, Linglei

    2005-01-01

    A 26-year-old man presented with a history of intermittent erythematous plaques on his hands and legs. A peripheral blood eosinophilia was noted. Histopathologic examination showed numerous eosinophils and characteristic flame figures. The clinical presentation and histopathologic alterations are consistent with the diagnosis of Wells' syndrome, which is also known as eosinophilic cellulitis. Wells' syndrome is a rare condition of unclear etiology. We discuss its diagnosis and possible association with other conditions that manifest peripheral eosinophilia. PMID:16403379

  8. Tinea capitis mimicking dissecting cellulitis.

    PubMed

    Torok, Rachel D; Bellet, Jane S

    2013-01-01

    Tinea capitis is a common disease of childhood that typically follows one of several clinical patterns. Our patient and several previously reported cases demonstrate the existence of a dissecting cellulitis-like presentation of tinea capitis. This variant should be recognized to prevent misdiagnosis of dissecting cellulitis and allow proper treatment to prevent scarring alopecia. PMID:24134312

  9. Breast cellulitis after conservative surgery and radiotherapy

    SciTech Connect

    Rescigno, J.; McCormick, B.; Brown, A.E.; Myskowski, P.L. )

    1994-04-30

    Cellulitis is a previously unreported complication of conservative surgery and radiation therapy for early stage breast cancer. Patients who presented with breast cellulitis after conservative therapy are described. Eleven patients that developed cellulitis of the breast over a 38-month period of observation are the subject of this report. Clinical characteristics of patients with cellulitis and their treatment and outcome are reported. Potential patient and treatment-related correlates for the development of cellulitis are analyzed. The risk of cellulitis persists years after initial breast cancer therapy. The clinical course of the patients was variable: some patients required aggressive, long-duration antibiotic therapy, while others had rapid resolution with antibiotics. Three patients suffered from multiple episodes of cellulitis. Patients with breast cancer treated with conservative surgery and radiotherapy are at risk for breast cellulitis. Systematic characterization of cases of cellulitis may provide insight into diagnosis, prevention, and more effective therapy for this uncommon complication. 15 refs., 1 fig., 2 tabs.

  10. Assessment and management of orbital cellulitis.

    PubMed

    Amin, Nikul; Syed, Irfan; Osborne, Sarah

    2016-04-01

    Orbital cellulitis is a medical emergency requiring multidisciplinary team involvement. Early diagnosis and intervention is imperative to avoid serious complications. This article provides an evidence-based approach to the assessment and management of patients with orbital cellulitis. PMID:27071427

  11. Dissecting cellulitis of the scalp.

    PubMed

    Mundi, Jyoti P; Marmon, Shoshana; Fischer, Max; Kamino, Hideko; Patel, Rishi; Shapiro, Jerry

    2012-12-01

    Dissecting cellulitis of the scalp is a chronic, relapsing, inflammatory disease of the scalp that results in scarring alopecia. We present a case of a 32-year-old man with recalcitrant disease who is now responding to treatment with isotretinoin. The pathogenesis, clinical presentation, disease associations, and histopathological findings are reviewed. Treatment can be challenging. The literature on medical and surgical therapeutic options is reviewed. PMID:23286798

  12. Cellulitis

    MedlinePlus

    ... Conditions Most Common Searches Adult Strabismus Amblyopia Cataract Conjunctivitis Corneal Abrasions Dilating Eye Drops Lazy eye (defined) ... Loading... Most Common Searches Adult Strabismus Amblyopia Cataract Conjunctivitis Corneal Abrasions Dilating Eye Drops Lazy eye (defined) ...

  13. Cellulitis

    MedlinePlus

    ... feel ill and develop a fever and sometimes chills and sweats. Swollen lymph nodes (commonly called swollen ... warm, and painful — with or without fever and chills. This is especially important if the area of ...

  14. Cellulitis

    MedlinePlus

    ... mark the edges of the redness with a pen, to see if the redness goes past the ... infection is getting worse (spreading beyond the original pen marking) Your immune system is not working well ( ...

  15. Cellulitis

    MedlinePlus

    ... or do a blood test to identify the bacteria causing infection. Treatment is with antibiotics. They may be oral in mild cases, or intravenous (by IV) for more severe cases. NIH: National Institute of Allergy and Infectious Diseases

  16. Cellulitis

    MedlinePlus

    ... has not improved after 2–3 days of antibiotics, return to your doctor. You may need treatment with different medications, or the infection may have spread deeper into your skin. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of " ...

  17. Cellulitis

    MedlinePlus

    ... there is generally full recovery. Updated 3/2015 Eye Terms & Conditions Most Common Searches Adult Strabismus Amblyopia Cataract Conjunctivitis Corneal Abrasions Dilating Eye Drops Lazy eye (defined) Pink eye (defined) Retinopathy ...

  18. Cellulitis in Japanese quail (Coturnix coturnix japonica).

    PubMed

    Burns, Karen E; Otalora, Raul; Glisson, John R; Hofacre, Charles L

    2003-01-01

    A case of cellulitis was observed in Japanese quail (Coturnix coturnix japonica) reared for commercial meat production. This condition in Japanese quail has not been reported in the literature. This incident was the first, and to date only, occurrence of cellulitis in this processing plant. The cellulitis lesions were localized to the subcutis overlying the breast and inner thigh. Carcasses of processed birds and live birds from the affected farm were presented to the Poultry Diagnostic and Research Center, University of Georgia. Escherichia coli was cultured from the lesion. The affected live birds displayed lameness and had osteomyelitis. Pasteurella multocida serotype 3,4 was cultured from the liver and bone marrow of affected birds. Approximately 4.61% of the processed carcasses from the flock were condemned because of cellulitis. This represented a 10fold increase from the typical condemnation rate. Further investigation revealed birds were placed in higher than normal density; therefore, we theorize that the concurrent pasteurellosis and increased placement density resulted in the cellulitis condition. PMID:12713180

  19. Successful treatment of eosinophilic cellulitis with dapsone.

    PubMed

    Coelho de Sousa, Virgínia; Laureano Oliveira, André; Cardoso, Jorge

    2016-01-01

    A 55-year-old woman presented with a 3-year history of recurrent episodes of pruritic cellulitis-like erythematous plaques, mostly located on the limbs. Simultaneously, fever, malaise and peripheral eosinophilia were noted. The clinical diagnosis of eosinophilic cellulitis (also known as Well's syndrome) was supported by the histopathological finding of typical "flame figures". Treatment with dapsone was initiated at a dose of 50 mg per day. After one year of follow-up the patient was relapse-free. Eosinophilic cellulitis is an uncommon, recurrent inflammatory skin disease. The management is often a challenge, due to the frequent need for long-term therapy. Dapsone is an effective and safe treatment option. PMID:27617724

  20. Bullous leukemia cutis mimicking facial cellulitis*

    PubMed Central

    Caldato, Luciana de Sales; Britto, Juliana de Sousa; Niero-Melo, Ligia; Miot, Hélio Amante

    2016-01-01

    Bullous leukemia cutis is an uncommon clinical manifestation of cutaneous infiltration by leukemic cells, from B-cell chronic lymphocytic leukemia. We present the case of a 67-year-old, female, chronic lymphocytic leukemia patient. She was taking chlorambucil and developed facial edema with erythema and warmth, misjudged as facial cellulitis. Two days later, she developed bullous lesions in the arms, legs, neck and face. The histopathology of facial and bullous lesions confirmed leukemia cutis. All lesions disappeared following the administration of rituximab combined with cycles of fludarabine and cyclophosphamide. Although soft tissue infections are common complications in patients undergoing chemotherapy, leukemia cutis can also resemble cellulitis. PMID:27192532

  1. Wells' Syndrome Mimicking Facial Cellulitis: A Report of Two Cases.

    PubMed

    Cormerais, Maxence; Poizeau, Florence; Darrieux, Laure; Tisseau, Laurent; Safa, Gilles

    2015-01-01

    Wells' syndrome (WS), or eosinophilic cellulitis, is an uncommon inflammatory dermatosis of unknown etiology that typically presents with pruritic cellulitis-like plaques on the extremities. Therefore, WS is often misdiagnosed as bacterial cellulitis due to its similarity in presentation. Here, we report two cases of WS that masqueraded as bacterial facial cellulitis. Under treatment with oral prednisone and/or a combination therapy with levocetirizine and hydroxyzine, both patients showed a dramatic improvement of the skin lesions. These cases highlight the need for clinicians to consider WS in the differential diagnosis when evaluating a patient with facial cellulitis that does not respond to an initial antimicrobial regimen. In addition, our cases suggest that combination therapy with levocetirizine and hydroxyzine may be successfully used as corticosteroid-sparing treatment or to prevent relapse after the discontinuation of corticosteroid treatment. PMID:26120307

  2. Periorbital mass with cellulitis caused by dirofilaria.

    PubMed

    Joseph, K; Vinayakumar, A R; Criton, S; Vishnu, M S; Pariyaram, S E

    2011-01-01

    Dirofilariasis is a zoonotic disease caused by Dirofilaria, a parasite of domestic and wild animals. The disease is transmitted by inoculation of mosquitoes infected with the microfilariae during their blood meal. Accidental infection of man results in lung nodule, subcutaneous mass anywhere in the body or ocular lesion that may be subconjunctival or periorbital. The incidence of ocular dirofilariasis is on the rise in several parts of India particularly in Kerala. Here we report a case of ocular dirofilariasis with cellulitis presenting as a periorbital mass. PMID:22120811

  3. Cellules solaires photovoltaïques plastiques enjeux et perspectives

    NASA Astrophysics Data System (ADS)

    Sicot, L.; Dumarcher, V.; Raimond, P.; Rosilio, C.; Sentein, C.; Fiorini, C.

    2002-04-01

    Après avoir détaillé le fonctionnement d'une cellule photovoltaïque plastique et les paramètres photovoltaïques permettant de caractéiser son efficacité, un état de l'art des technologies de fabrication des cellules est présenté. Des moyens d'amélioration des performances des cellules photovoltaïques organiques sont ensuite illustrés par l'étude de dispositifs développés au Laboratoire Composants Organiques (LCO) du CEA Saclay.

  4. Cold cellulitis. An unusual presentation of cutaneous leishmaniasis.

    PubMed

    Shelleh, Hamdi H; Khan, Sarosh A; Al-Shayeb, Abdul M; Al-Hateeti, Hussni; Khan, Latif A; Kasabah, Mohammad N

    2002-08-01

    We describe a case of cutaneous leishmaniasis, which presented as what we call "cold cellulitis". This may be differentiated from classical cellulitis/erysipelas by 1. Lesser local reaction like pain and tenderness 2. No systemic symptoms 3. No leucocytosis 4. Negative bacteriological and serological assay for bacterial cellulitis/erysipelas, 5. Longer course of illness and 6. Failure to respond to antibiotics. However, awareness of this type and frequent skin smears or skin biopsy will settle the right diagnosis. A review of different leishmanial presentations is given for comparison. PMID:12235479

  5. Anthrax as the cause of preseptal cellulitis.

    PubMed

    Celebi, S; Celebi, H; Celiker, U O; Kandemir, B; Alagöz, G; Esmerligil, S

    1997-08-01

    Anthrax is an infectious disease caused by Bacillus anthracis. It is primarily a disease of domestic animals such as cattle, goats, and sheep; but humans can rarely be infected by contact with infected animals or contaminated animal products. Our case is a 4-year-old boy who was initially diagnosed as preseptal cellulitis, but later he showed the characteristic anthrax lesions with a black necrotic eschar. Scrapings from the necrotic tissue showed gram positive rods and culture grew Bacillus anthracis. The patient responded to intravenous administration of penicillin G, and the lesions resolved, leaving a scar on the right upper eyelid. Eyelid involvement of anthrax is rarely seen in clinical practice, but should be considered in differential diagnosis. PMID:9374261

  6. Anaerobic orbital cellulitis: a clinical and experimental study.

    PubMed Central

    Jedrzynski, M S; Bullock, J D; McGuire, T W; Elder, B L; Bullock, J D

    1991-01-01

    In this article we have reviewed the clinical and bacteriologic aspects of anaerobic orbital cellulitis and have presented six patients to illustrate these points. Physicians who treat patients with orbital cellulitis should have a high index of suspicion for possible instances involving anaerobes, so that appropriate management can be started early. To investigate this problem further, we created an animal model of anaerobic orbital cellulitis. This model may be useful in future studies of the pathogenesis and treatment of this serious and often devastating disease. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18 FIGURE 19 PMID:1808813

  7. Two cases of cellulitis in the course of African tick bite fever: a fortuitous association?

    PubMed

    Bouvresse, Sophie; Del Giudice, Pascal; Franck, Nathalie; Buffet, Marc; Avril, Marie-Françoise; Mondain, Véronique; Rolain, Jean-Marc; Raoult, Didier; Dupin, Nicolas

    2008-01-01

    In African tick bite fever (ATBF), inoculation eschar - resulting from disruption of the cutaneous barrier - may be a risk factor for cellulitis. We report 2 cases of ATBF associated with cellulitis. A 77-year-old woman was referred for severe leg cellulitis upon returning from sub-Saharan Africa. She developed erythematous macules. Rickettsia africae was detected by PCR assay from a skin biopsy specimen, and ATBF diagnosis was confirmed. A 75-year-old man was hospitalized after his return from Zimbabwe for a maculopapular exanthema and erysipelas-like rash of the leg. The diagnosis of cellulitis associated with ATBF was confirmed by PCR and serological methods. Both patients were treated for ATBF and cellulitis by a combination of doxycycline and beta-lactam antibiotics, and both had a good recovery. Inoculation eschar may be a risk factor for cellulitis; thus, we hypothesize a non-fortuitous association between ATBF and cellulitis. PMID:18503259

  8. Genetic Susceptibility to Non-Necrotizing Erysipelas/Cellulitis

    PubMed Central

    Hannula-Jouppi, Katariina; Massinen, Satu; Siljander, Tuula; Mäkelä, Siru; Kivinen, Katja; Leinonen, Rasko; Jiao, Hong; Aitos, Päivi; Karppelin, Matti; Vuopio, Jaana; Syrjänen, Jaana; Kere, Juha

    2013-01-01

    Background Bacterial non-necrotizing erysipelas and cellulitis are often recurring, diffusely spreading infections of the skin and subcutaneous tissues caused most commonly by streptococci. Host genetic factors influence infection susceptibility but no extensive studies on the genetic determinants of human erysipelas exist. Methods We performed genome-wide linkage with the 10,000 variant Human Mapping Array (HMA10K) array on 52 Finnish families with multiple erysipelas cases followed by microsatellite fine mapping of suggestive linkage peaks. A scan with the HMA250K array was subsequently performed with a subset of cases and controls. Results Significant linkage was found at 9q34 (nonparametric multipoint linkage score (NPLall) 3.84, p = 0.026), which is syntenic to a quantitative trait locus for susceptibility to group A streptococci infections on chromosome 2 in mouse. Sequencing of candidate genes in the 9q34 region did not conclusively associate any to erysipelas/cellulitis susceptibility. Suggestive linkage (NPLall>3.0) was found at three loci: 3q22-24, 21q22, and 22q13. A subsequent denser genome scan with the HMA250K array supported the 3q22 locus, in which several SNPs in the promoter of AGTR1 (Angiotensin II receptor type I) suggestively associated with erysipelas/cellulitis susceptibility. Conclusions Specific host genetic factors may cause erysipelas/cellulitis susceptibility in humans. PMID:23437094

  9. Dissecting cellulitis of the scalp: response to isotretinoin.

    PubMed

    Scerri, L; Williams, H C; Allen, B R

    1996-06-01

    We report three patients with dissecting cellulitis of the scalp. Prolonged treatment with oral isotretinoin was highly effective in all three patients. Furthermore, long-term post-treatment follow-up in two of the patients has shown a sustained therapeutic benefit. PMID:8763434

  10. Refractory dissecting Cellulitis of the Scalp Successfully controlled with Adalimumab.

    PubMed

    Martin-García, Rafael F; Rullán, Jennifer M

    2015-06-01

    Dissecting cellulitis of the scalp (DCS) is an uncommon inflammatory disease that often results in scarring alopecia. Numerous therapies have either proved ineffective or only temporarily effective in the management of this condition. Recent reports show adequate responses to tumor necrosis factor (TNF) inhibitors in cases of DCS. We report a case of severe recalcitrant DCS successfully treated with adalimumab. PMID:26061062

  11. Dissecting cellulitis of the scalp in 2 girls.

    PubMed

    Ramesh, V

    1990-01-01

    Two girls with dissecting cellulitis of the scalp are described. In one Pseudomonas aeruginosa was isolated from the sinus discharge. Both patients were controlled with prolonged antibiotic therapy and periodic aspiration of the fluctuant lesions. Role of infection in perpetuating the condition is highlighted. PMID:2106459

  12. All that is red is not cellulitis. Pyoderma gangrenosum.

    PubMed

    Sharma, Prashant; Dhungel, Sourab

    2014-02-01

    A 60-year-old patient presented with progressive worsening, non-healing ulcer on her shin with surrounding erythema following a minor trauma and was treated with several antibiotics for presumed cellulitis with no improvement. A skin biopsy eventually suggested pyoderma gangrenosum and a colonic biopsy showed an underlying ulcerative colitis. PMID:24393443

  13. Corynebacterium minutissimum bacteremia in an immunocompetent host with cellulitis.

    PubMed

    Granok, Alexander B; Benjamin, Patti; Garrett, Lee S

    2002-08-15

    Since its original description in 1961, Corynebacterium minutissimum, the causative agent of erythrasma, has rarely been associated with extracutaneous disease. We report a case of cellulitis and bacteremia due to C. minutissimum. We discuss the treatment of C. minutissimum infection and describe the clinical settings in which isolation of Corynebacterium species from blood cultures should be considered significant. PMID:12145741

  14. Outcome assessment in cellulitis clinical trials: is telephone follow up sufficient?

    PubMed

    Nambudiri, V E; Dwyer, R C; Camargo, C A; Kupper, T S; Pallin, D J

    2015-07-01

    The US Food and Drug Administration has scrutinized clinical trial methodology in cellulitis, partly because the definition and timing of cure are debatable. We analysed the validity of telephone self-report as a proxy for in-person follow up in a cellulitis treatment trial comparing cephalexin alone with cephalexin-plus-trimethoprim/sulfamethoxazole. Our results demonstrate poor agreement between these two methods of outcome determination and have implications for future cellulitis clinical trial design and clinical management. PMID:25882364

  15. Tick-related facial cellulitis caused by Francisella tularensis.

    PubMed

    Arslan, Ferhat; Karagöz, Ergenekon; Zemheri, Ebru; Vahaboglu, Haluk; Mert, Ali

    2016-06-01

    Tick-borne illnesses have diverse biological and clinical features that make recognition and appropriate treatment challenging. Arthropod-transmitted (ticks, fleas and deer flies) tularaemia remains a concern worldwide. Generally, two kinds of tularaemia manifestations, namely ulceroglandular and glandular infections, can arise from the bite of an infected arthropod vector. If the ulceroglandular or glandular form is not treated, suppuration can arise from the gland. In addition, cellulitis is rarely observed around the ulcers. In our case, with the knowledge of tick exposure to the scalp, tularaemia was not initially considered for facial cellulitis without regional lymphadenopathy and also due to apparent failure to respond to doxycycline and gentamicin therapy. Serological confirmation in the late stages of the disease suggests the importance of clinical suspicion in such rare conditions. PMID:27367325

  16. [Crepitant abdominal cellulitis: a rare clinical presentation of sigmoid tumor].

    PubMed

    Chaib, E; Leal, M C; Onofrio, P L; Nahas, P; de Mello, J B

    1990-01-01

    Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to presence of malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. The authors present one case of spontaneous crepitant cellulitis in the lower abdominal wall, associated with sigmoid tumor. The patient had abdominal pain in the left iliaca fossa, fever and skin necrosis of the lower abdominal wall in the last 4 hours. At surgery they performed debridement and excision of necrotic tissue (lower abdominal wall) and partial sigmoidectomy with sigmoid colostomy. The patient died 9 months after initial surgery. A study of tumor mass revealed an adenocarcinoma. The presence of crepitant cellulitis in a lower abdominal wall should result in a search for bowel perforation. PMID:2151244

  17. Refractory dissecting cellulitis of the scalp treated with adalimumab.

    PubMed

    Sukhatme, Smita V; Lenzy, Yolanda M; Gottlieb, Alice B

    2008-10-01

    Dissecting cellulitis of the scalp (DCS) is a suppurative, neutrophillic dermatosis. Therapies typically provide short-term improvement and include antibiotics, prednisone, and isotretinoin, as well as radiation, surgical excision, and laser ablation. The authors report the use of the tumor necrosis factor (TNF) blocker, adalimumab, to successfully treat a 39-year-old male with a long-standing history of DCS. PMID:19112766

  18. Diagnosis, management and treatment of orbital and periorbital cellulitis in children.

    PubMed

    Rashed, Fatima; Cannon, Anna; Heaton, Paul Anthony; Paul, Siba Prosad

    2016-04-01

    Children with red swollen eyes frequently present to emergency departments. Some patients will have orbital cellulitis, a condition that requires immediate diagnosis and treatment. Orbital cellulitis can be confused with the less severe, but more frequently encountered, periorbital cellulitis, which requires less aggressive management. Delayed recognition of the signs and symptoms of orbital cellulitis can lead to serious complications such as blindness, meningitis and cerebral abscess. This article describes the clinical features, epidemiology and outcomes of the condition, and discusses management and treatment. It also includes a case study. PMID:27056016

  19. Orbital cellulitis following silicone-sponge scleral buckles

    PubMed Central

    Nemet, Arie Y; Ferencz, Joseph R; Segal, Ori; Meshi, Amit

    2013-01-01

    Background Acute or chronic infection of the scleral explant is rare. We report seven cases of scleral explant infections that caused orbital cellulitis. Materials and methods This was a retrospective chart review of oculoplastics at oculoplastics and vitreo-retinal units in a secondary referral hospital. All subjects had orbital cellulitis secondary to scleral buckle in the range of January 1990 to March 2010. Demographics, imaging studies, and pathology specimens were reviewed. Results A total of 841 silicone-sponge scleral buckle implants for rhegmatogenous retinal detachment were performed. Forty were extracted (4.75%; annual rate of 1.9 cases). Seven (0.83%) had orbital cellulitis. The mean time from implantation to presentation was 5.7 years. There was bacterial growth in all specimens, with Staphylococcus aureus in four. Conclusions Patients who are operated on with silicone-sponge scleral buckling for rhegmatogenous retinal detachment sometimes require removal of the implant because of infection. However, the infection rate is low. Patients should be followed in the long term for possible complications. PMID:24204118

  20. Periorbital cellulitis in children: Analysis of outcome of intravenous antibiotic therapy.

    PubMed

    Gonçalves, Rita; Menezes, Carlos; Machado, Rute; Ribeiro, Isabel; Lemos, José A

    2016-08-01

    Periorbital cellulitis is a relatively common ocular disease in the pediatric population. Early diagnosis of this disease with a prompt intervention is critical to avoid vision and life-threatening complications. In the last years, medical therapy has been expanding for the treatment of orbital cellulitis, instead of the standard surgical approach. The purpose of this study was to describe the outcome of treatment with intravenous antibiotic of periorbital cellulitis in children. A retrospective review of all children admitted with periorbital cellulitis in our hospital between January 2002 and July 2013 was conducted. Cases were divided in two subgroups, pre-septal and post-septal infection. The demographics, clinical findings, treatment and outcomes were analyzed. In total 110 children were included, 93 with pre-septal and 17 with post-septal cellulitis. The mean age was 3.5 years in children with pre-septal cellulitis and 5.5 years in those with post-septal cellulitis (p = 0.149). For both subgroups the most common predisposing factor was sinusitis. Intravenous antibiotic therapy was successful in all except one patient with an orbital abscess who required surgical intervention. In our study complete recovery was achieve in all (except for one) children with periorbital cellulitis treated with intravenous antibiotics only. PMID:27192038

  1. Clinical and microbiologic features of dacryocystitis-related orbital cellulitis.

    PubMed

    Wladis, Edward J; Shinder, Roman; LeFebvre, Daniel R; Sokol, Jason A; Boyce, Michelle

    2016-10-01

    Dacryocystitis-related orbital cellulitis is a relatively rare condition, and large case series of this clinical entity have been reported. This study was undertaken to identify a larger cohort of patients with this ailment, with the intent of defining its clinical and microbiologic features. Case logs from four institutions were reviewed to identify patients that suffered from dacryocystitis-related orbital cellulitis. A retrospective chart review was then performed to identify clinical features, management strategies, microbiologic features, and outcomes. A dedicated statistical software package was utilized to identify correlations between these variables. 13 patients (7 females, 6 males; mean age = 57.2 years, range = 7-89 years) were identified. One patient carried a diagnosis of immunosuppressive disease. All patients underwent emergent surgical drainage and received intravenous antibiotics. Primary acquired nasolacrimal duct obstruction was found to be the underlying etiology in nine cases (69.2%), whereas four patients suffered from specific causes of their obstructions. An average of 1.07 organisms/patient (standard deviation = 0.49 organisms/patient) were recovered from microbiologic cultures, and Gram-positive bacteria represented the majority of cultured organisms. All patients experienced either stable or improved vision upon discharge. The relationships between a specific etiology and the possibility of vision loss or the number of organisms cultured, between the number of organisms cultured and vision loss, and immunosuppression and vision loss or the number of organisms cultured were all not statistically significant (p > 0.05). Dacryocystitis-related orbital cellulitis most commonly occurs in adult patients who do not carry immunosuppressive diagnoses and suffer from primary obstructions. Multiple microbiologic species may cause this problem, although Gram-positive organisms are most common. With appropriate management, stable or improved vision

  2. Prevalence and Epidemiological Factors Involved in Cellulitis in Korean Patients With Lymphedema

    PubMed Central

    Park, Sae In; Yang, Eun Joo; Kim, Dong Kyu; Jeong, Ho Joong; Kim, Ghi Chan

    2016-01-01

    Objective To evaluate the prevalence and associated factors involved in cellulitis with lymphangitis among a group of Korean patients who were being treated for lymphedema. We present our epidemiologic research and we also report a systematic review of these types of cases. Methods This was a retrospective medical record study among 1,246 patients diagnosed with lymphedema. The study was carried out between January 2006 and December 2012 at the Kosin University Gospel Hospital and Seoul National University Bundang Hospital. Cases were examined for onset time, affected site, seasonal trend, and recurrence pattern of lymphedema, lymphangitis, and cellulitis. We also evaluated the history of blood-cell culture and antibiotic use. Results Ninety-nine lymphedema patients experienced complications such as cellulitis with accompanying lymphangitis. Forty-nine patients had more than two recurrences of cellulitis with lymphangitis. The incidence and recurrence of cellulitis with lymphangitis were significantly higher in the patients with lower-extremity lymphedema. There was a significant trend toward higher cellulitis prevalence in the lower-extremity lymphedema group according to the time of lymphedema onset. Among the cellulitis with lymphangitis cases, 62 cases were diagnosed through blood-cell culture; 8 of these 62 cultures were positive for β-hemolytic streptococci. Conclusion The prevalence rate of cellulitis with lymphangitis in patients with lymphedema was 7.95%, and the prevalence of recurrent episodes was 3.93%. Especially, there was high risk of cellulitis with lymphangitis after occurrence of lower-extremity lymphedema with passage of time. Lymphedema patients should be fully briefed about the associated risks of cellulitis before treatment, and physicians should be prepared to provide appropriate preventive education. PMID:27152284

  3. Cryptococcal cellulitis on the shin of an immunosuppressed patient.

    PubMed

    Zhu, Tian Hao; Rodriguez, Paola G; Behan, James W; Declerck, Brittney; Kim, Gene H

    2016-01-01

    Cryptococcus neoformans is a common fungus found throughout the environment that causes opportunistic disease in immunocompromised individuals. Infection of humans with C neoformans usually manifests as lung disease through inhalation of spores or meningoencephalitis by involvement of the central nervous system. Rarely, dissemination in the form of cutaneous lesions can occur in individuals with long term immunosuppression. We present a patient with C. neoformans manifesting as cellulitis with focal segmental glomerulosclerosis treated with corticosteroids. Because of the mortality associated with disseminated cryptococcosis, early identification, especially of atypical cutaneous presentations is critical from a dermatological perspective. PMID:27617599

  4. Erosive pustular dermatosis of the leg mimicking lower limb cellulitis.

    PubMed

    Zhou, Z; Zhang, Z K; Liu, T H

    2015-12-01

    Erosive pustular dermatosis (EPD) of the leg is an unusual form of amicrobial pustulosis, which typically affects elderly patients with chronic venous insufficiency. We report a patient who presented with painful erythema, crusted erosions and pustules on her right lower leg. Histology showed a dermal infiltration made up predominantly of neutrophils. Bacteria were isolated from the lesions. The condition was initially diagnosed as cellulitis, but antibiotic treatment was unsuccessful. After the correct diagnosis was made, complete resolution was obtained with betamethasone 0.05%. PMID:25476720

  5. Management and morbidity of cellulitis of the leg.

    PubMed Central

    Cox, N H; Colver, G B; Paterson, W D

    1998-01-01

    Ascending cellulitis of the leg is a common emergency. An audit was conducted in two district general hospitals to determine how it is managed and the long-term morbidity, and to formulate a treatment strategy. Case notes were reviewed for 92 patients admitted to hospital under adult specialties. Mean duration of inpatient therapy was 10 days. A likely portal of entry was identified in 51/92 cases, of which the commonest were minor injuries and tinea pedis. Pathogens were rarely identified, group G streptococci being the single most frequent organism. Benzylpenicillin was administered in only 43 cases. Long-term morbidity, identified in 8 of 70 patients with over six months' follow-up, included persistent oedema (6) and leg ulceration (2); an additional 19 patients had either suffered previous episodes or experienced a further episode subsequently. Ascending cellulitis of the leg has substantial short-term and long-term morbidity. Important but often neglected therapeutic suggestions are the inclusion of benzylpenicillin in all cases without a contraindication, assessment and treatment of tinea pedis, use of support hosiery, and serological testing for streptococci to confirm the diagnosis in retrospect. The high frequency of recurrent episodes suggests that longer courses of penicillin, or penicillin prophylaxis, might be useful. PMID:10730111

  6. Acute neck cellulitis and mediastinitis complicating a continuous interscalene block.

    PubMed

    Capdevila, Xavier; Jaber, Samir; Pesonen, Pertti; Borgeat, Alain; Eledjam, Jean-Jacques

    2008-10-01

    We report a case of acute neck cellulitis and mediastinitis complicating a continuous interscalene brachial plexus block. A 61-yr-old man was scheduled for an elective arthroscopic right shoulder rotator cuff repair. A continuous interscalene block was done preoperatively and 20 mL of 0.5% bupivacaine and 20 mL of 2% mepivacaine were injected through the catheter. Postoperative analgesia was provided by a continuous infusion of bupivacaine, 0.25% at 5 mL/h for 39 h using a 240-mL elastomeric disposable pump. The day after surgery, the patient complained of neck pain. The analgesic block was not fully effective. He was discharged home. Three days later, the patient was readmitted with neck edema and erythema, fever and fatigue. Neck ultrasonography and computed tomographic scan revealed an abscess of the interscalene and sternocleidomastiod muscles and cellulitis, as well as acute mediastinitis. Two blood cultures and surgical samples were positive for Staphylococcus aureus. The infection was treated with surgery, the site was surgically debrided, and a 2-mo course of vancomycin, imipenem, and oxacilline. The technique of drawing local anesthetic from the bottle and filling the elastomeric pump was the most likely cause of infection. This case emphasizes the importance of strict aseptic conditions during puncture, catheter insertion, and management of the local anesthetic infusate. PMID:18806062

  7. Orbital Cellulitis: A Rare Presentation of Metastatic Bronchial Carcinoma

    PubMed Central

    Kumar, Rohit; Issing, Wolfgang

    2011-01-01

    Objective. We report a rare and unusual case of bronchial carcinoma presenting with symptoms of complications of sinonasal disease. Case Report. A 66-year-old lady was referred with a 1-week history of progressive ocular pain, chemosis, and visual disturbance. Computed tomography of the paranasal sinuses revealed frontal and ethmoidal sinus opacification with orbital involvement consistent with a diagnosis of orbital cellulitis secondary to sinusitis. Surgical exploration revealed that the sinuses and right orbit were filled with soft tissue and subsequent histopathological examination of the biopsies indicating metastases from an adenosquamous bronchial carcinoma. Further imaging revealed a large, asymptomatic, bronchial primary with deposits in the brain and liver. The advanced presentation of the disease limited treatment to best supportive care. Conclusion. Orbital cellulitis and sinonasal malignancies have a similar pattern of clinical presentation, posing a potential diagnostic pitfall. There are only two previously reported cases of metastatic lung carcinoma in the frontal sinus with 15 cases of sinonasal tract involvement reported overall. There are no reported cases of adenosquamous carcinoma in the sinonasal tract. PMID:22937366

  8. A Case of Cellulitis Associated with Coral Injury

    PubMed Central

    Na, So Young; Lee, Hye Young; Baek, Jin Ok

    2008-01-01

    Corals are the marine organism that belongs to the phylum Cnidaria, and are one of the common causes of superficial injury in the marine environment. In addition to acute reactions such as burning or stinging pain and erythema, coral injuries may present with complications such as foreign body reactions, bacterial infections, and/or localized eczematous reactions. A 23-year-old male presented with an erythematous edematous tender patch with centrally grouped vesicles on the left ankle; the injury had occurred during skin-scuba diving 2 days before. A biopsy of the lesion treated with hematoxylin-eosin stain showed epidermal necrosis with subepidermal blisters and neutrophilic panniculitis. Herein we report a case of cellulitis caused by the nematocyst stings of corals. PMID:27303195

  9. Recurrent cellulitis with benzathine penicillin prophylaxis is associated with diabetes and psoriasis.

    PubMed

    Karppelin, M; Siljander, T; Huhtala, H; Aromaa, A; Vuopio, J; Hannula-Jouppi, K; Kere, J; Syrjänen, J

    2013-03-01

    Risk factors for recurrent cellulitis were assessed in a case-control study including 398 patients receiving prophylactic treatment with benzathine penicillin and 8,005 controls derived from a national population-based health survey. In the multivariate analysis, psoriasis [odds ratio (OR) 3.69], other chronic dermatoses (OR 4.14), diabetes (OR 1.65), increasing body mass index (OR 1.17), increasing age (OR 1.06) and history of previous tonsillectomy (OR 6.82) were independently associated with recurrent cellulitis. Forty percent of the patients reported a cellulitis recurrence, despite ongoing benzathine penicillin prophylaxis. The role of previous tonsillectomy in recurrent cellulitis needs further evaluation. PMID:23007460

  10. A rare case of facial Candida albicans cellulitis in an uncontrolled diabetic patient.

    PubMed

    Kwak, Om-Sub; Kang, Mi-Il; Kim, Jeong-Bae; Kim, Min-Wook; Kim, Young Keun

    2009-07-01

    Facial cellulitis is defined as infections or inflammation of the skin or connective tissue in orbital, periorbital area and cheeks, and is known to be caused mainly by bacterial infections, for which treatment with proper antibiotics and incision and drainage are necessary. Candidal cellulitis is a rare disease and only two cases have been reported in the world to our knowledge. Candidal facial cellulitis is a non-haematogenous, deep-seated infection and we should figure out for known risk factors of candidal colonisation or overgrowth and possible routes of infection for candidiasis. We report one case of facial cellulitis caused by Candida albicans in an uncontrolled diabetic woman aged 50. PMID:18983432

  11. Dissecting cellulitis in a white male: a case report and review of the literature.

    PubMed

    Stites, P C; Boyd, A S

    2001-01-01

    Dissecting cellulitis is an uncommon, chronic, progressive suppurative disease of unknown etiology. It is characterized by painful papules and nodules, interconnecting sinus tracts, purulent drainage, and scarring alopecia. This disease predominately affects young black men, but is rarely reported in white males. The refractory nature of this process makes treatment difficult. We report a case of dissecting cellulitis in a white male, which responded to oral isotretinoin. PMID:11204602

  12. OPAT for cellulitis: its benefits and the factors that predispose to longer treatment.

    PubMed

    Zhang, J; Moore, E; Bousfield, R

    2016-06-01

    This retrospective study investigated the demographics and treatment outcomes of patients with cellulitis receiving outpatient parenteral antibiotic therapy (OPAT) between 2010 and 2014 in Cambridge University Hospitals. The rate of treatment failure (as indicated by the readmission to hospital) was low, at 5.5%. Risk factors associated with a longer duration of OPAT treatment included: immunosuppression, peripheral vascular disease, obesity, lymphoedema, previous cellulitis and diabetes. PMID:27084095

  13. Treatment of eosinophilic cellulitis (Wells syndrome) - a systematic review.

    PubMed

    Räßler, F; Lukács, J; Elsner, P

    2016-09-01

    Eosinophilic cellulitis (Wells syndrome) is a rare inflammatory skin disease defined by erythematous, tender, sometimes urticarial plaques, possibly with vesicles and bullae, and granulomatous eosinophilic infiltrates in the dermis. Usually the disease has a benign course with spontaneous remission within a few weeks. Nevertheless, recurrences are quite frequent and may occur for several years. The objective of this study was to review the so far reported treatment options for Wells syndrome in a systematic manner. This systematic review is based on a search on Medline, Embase and Cochrane Central Register for English and German articles from 1970 to 2015. Advices on the treatment of Wells syndrome are limited predominately to case reports or to small case series. There are no randomized controlled trials, and control groups are missing. A variety of treatment options for Wells syndrome were reported including topical and systemic corticosteroids, antihistamines, cyclosporine, dapsone, azathioprine, griseofulvin, doxycycline, minocycline, antimalarial medications, oral tacrolimus/topical tacrolimus, sulfasalazine, interferon alpha and gamma, TNF alpha inhibitors, colchicine and PUVA therapy. As well-designed, randomized controlled trials are missing, no guidelines for the treatment of this disease can be given. Due to the small number of patients and the frequent misdiagnosis of this clinical entity, the aim of this systematic overview is to call attention to this rare condition and to help clinicians to diagnose and treat Wells syndrome effectively. Due to the good prognosis and tendency to resolve, systemic treatment should be limited to cases resistant to local therapy or with widespread lesions. PMID:27357601

  14. Evidence of streptococcal origin of acute non-necrotising cellulitis: a serological study.

    PubMed

    Karppelin, M; Siljander, T; Haapala, A-M; Aittoniemi, J; Huttunen, R; Kere, J; Vuopio, J; Syrjänen, J

    2015-04-01

    Bacteriological diagnosis is rarely achieved in acute cellulitis. Beta-haemolytic streptococci and Staphylococcus aureus are considered the main pathogens. The role of the latter is, however, unclear in cases of non-suppurative cellulitis. We conducted a serological study to investigate the bacterial aetiology of acute non-necrotising cellulitis. Anti-streptolysin O (ASO), anti-deoxyribonuclease B (ADN) and anti-staphylolysin (ASTA) titres were measured from acute and convalescent phase sera of 77 patients hospitalised because of acute bacterial non-necrotising cellulitis and from the serum samples of 89 control subjects matched for age and sex. Antibiotic treatment decisions were also reviewed. Streptococcal serology was positive in 53 (69%) of the 77 cases. Furthermore, ten cases without serological evidence of streptococcal infection were successfully treated with penicillin. Positive ASO and ADN titres were detected in ten (11%) and three (3%) of the 89 controls, respectively, and ASTA was elevated in three patients and 11 controls. Our findings suggest that acute non-necrotising cellulitis without pus formation is mostly of streptococcal origin and that penicillin can be used as the first-line therapy for most patients. PMID:25403372

  15. Concurrent hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum in a 16-year-old boy.

    PubMed

    Koshelev, Misha V; Garrison, Paige A; Wright, Teresa S

    2014-01-01

    We report the case of a 16-year-old boy who presented to our clinic with concomitant hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum. Recent reports describe the co-occurrence of pyoderma gangrenosum, acne, and hidradenitis suppurativa. This case further expands the spectrum of concomitant pyoderma gangrenosum and dissecting cellulitis of the scalp. PMID:24118007

  16. Klebsiella pneumoniae orbital cellulitis with extensive vascular occlusions in a patient with type 2 diabetes.

    PubMed

    Yang, Sae Jeong; Park, Soo Yeon; Lee, Yun Jeong; Kim, Hee Young; Seo, Ji A; Kim, Sin Gon; Choi, Dong Seop

    2010-03-01

    A 39-year-old woman visited the emergency room complaining of right eye pain and swelling over the preceding three days. The ophthalmologist's examination revealed orbital cellulitis and diabetic retinopathy in the right eye, although the patient had no prior diagnosis of diabetes. It was therefore suspected that she had diabetes and orbital cellulitis, and she was started on multiple antibiotic therapies initially. She then underwent computed tomography scans of the orbit and neck and magnetic resonance imaging of the brain. These studies showed an aggravated orbital cellulitis with abscess formation, associated with venous thrombophlebitis, thrombosis of the internal carotid artery, and mucosal thickening of maxillary sinus with multiple paranasal abscesses. Three days later, initial blood culture grew Klebsiella pneumoniae. She recovered after incision and drainage and antibiotic therapy for 37 days. PMID:20195414

  17. Delayed breast cellulitis: An evolving complication of breast conservation

    SciTech Connect

    Indelicato, Daniel J.; Grobmyer, Stephen R.; Newlin, Heather; Morris, Christopher G.; Haigh, Linda S.; Copeland, Edward M.; Mendenhall, Nancy Price . E-mail: mendenan@shands.ufl.edu

    2006-12-01

    Purpose: Delayed breast cellulitis (DBC) is characterized by the late onset of breast erythema, edema, tenderness, and warmth. This retrospective study analyzes the risk factors and clinical course of DBC. Methods and Materials: From 1985 through 2004, 580 sequential women with 601 stage T0-2N0-1 breast cancers underwent breast conserving therapy. Cases of DBC were identified according to accepted clinical criteria: diffuse breast erythema, edema, tenderness, and warmth occurring >3 months after definitive surgery and >3 weeks after radiotherapy. Potential risk factors analyzed included patient comorbidity, operative technique, acute complications, and details of adjunctive therapy. Response to treatment and long-term outcome were analyzed to characterize the natural course of this syndrome. Results: Of the 601 cases, 16%, 52%, and 32% were Stage 0, I, and II, respectively. The overall incidence of DBC was 8% (50/601). Obesity, ecchymoses, T stage, the presence and aspiration of a breast hematoma/seroma, removal of >5 axillary lymph nodes, and arm lymphedema were significantly associated with DBC. The median time to onset of DBC from the date of definitive surgery was 226 days. Ninety-two percent of DBC patients were empirically treated with antibiotics. Fourteen percent required more invasive intervention. Twenty-two percent had recurrent episodes of DBC. Ultimately, 2 patients (4%) underwent mastectomy for intractable breast pain related to DBC. Conclusion: Although multifactorial, we believe DBC is primarily related to a bacterial infection in the setting of impaired lymphatic drainage and may appear months after completion of radiotherapy. Invasive testing before a trial of antibiotics is generally not recommended.

  18. A case of community-acquired Acinetobacter junii-johnsonii cellulitis.

    PubMed

    Henao-Martínez, Andrés F; González-Fontal, Guido R; Johnson, Steven

    2012-06-01

    Acinetobacter skin and soft tissue infection outside of the traumatic wound setting are rare occurrences. The majority of cases occur in the presence of significant comorbilities and by Acinetobacter baumanii. Herein a case is reported of community-onset, health-care-associated, non-traumatic cellulitis caused by Acinetobacter, species junii-johnsonii with bacteremia. This is the first reported case of Acinetobacter junii-johnsonii skin and soft tissue infection. Hemorrhagic bullae might be one of the clinical features of Acinetobacter cellulitis. PMID:23242290

  19. Dissecting cellulitis of the scalp treated with rifampicin and isotretinoin: case reports.

    PubMed

    Georgala, Sofia; Korfitis, Chrysovalantis; Ioannidou, Dikaia; Alestas, Theodosis; Kylafis, Georgios; Georgala, Caterina

    2008-09-01

    Dissecting cellulitis of the scalp, or perifolliculitis capitis abscedens et suffodiens, is an uncommon chronic suppurative disease of the scalp manifested by follicular and perifollicular inflammatory nodules that suppurate and undermine, forming intercommunicating sinuses, and leading to scarring alopecia. Treatment generally fails to obtain a permanently successful result; thus, many therapeutic options have been proposed. We report 4 cases of dissecting cellulitis of the scalp successfully treated with oral rifampicin and oral isotretinoin. To our knowledge, this is the first report of oral rifampicin used concomitantly with oral isotretinoin in this disease entity. We also present a brief review of the literature on the topic. PMID:18856159

  20. Cellulitis of the Knee in a 16-Month-Old Boy: A Case Report

    PubMed Central

    Joubert, Sonia V.; Duarte, Manuel A.

    2016-01-01

    Objective The purpose of this case report is to describe the presentation of cellulitis in a 16-month-old boy to a chiropractic clinic. Clinical Features The patient presented with nontraumatic, sudden onset of nonpurulent erythema on the right knee. A plain film radiograph of the knee showed a 40-mm thickening of the anterior knee. A diagnosis of cellulitis was rendered based on the presentation of the rapidly spreading erythema and radiographically confirmed findings. Intervention and Outcome The patient was immediately referred to the local emergency room. The patient was hospitalized, treated with clindamycin and amoxicillin for 3 days, and then discharged. The patient’s pediatrician discontinued clindamycin treatment at the posthospitalization follow-up. Two weeks after treatment was discontinued, the patient was diagnosed with recurrent cellulitis. Conclusion This case demonstrated that for this young patient with cellulitis of the knee, timely recognition and referral, together with patient or parent education and immediate treatment, were essential to a successful outcome. PMID:27069433

  1. Chemical Facial Cellulitis Due to Inadvertent Injection of Formalin into Oral Tissue Space

    PubMed Central

    Virk, Pawandeep Sandhu; Arakeri, Gururaj

    2015-01-01

    This paper reports the accidental injection of formalin into oral tissue space, in an 8-year old child resulting in chemical facial necrotizing cellulitis and its management. The common practice of keeping formalin in local anesthesia vials should be avoided by dental clinics, to prevent such unfortunate incidents. PMID:26918101

  2. Concurrent Infections of Conidiobolus Coronatus with Disseminated Tuberculosis Presenting as Bilateral Orbital Cellulitis

    PubMed Central

    Irodi, Aparna; Michael, Joy Sarojini

    2016-01-01

    Zygomycetes species contains two orders of organisms that infect humans, namely Mucorales and Entomophthorales. Entomophthorales cause chronic infection in immunocompetent patients, invading subcutaneous tissues but are non-angioinvasive. This includes Basidiobolus ranarum, Conidiobolus incongruus and Conidiobolus coronatus. We report a case of disseminated tuberculosis with Conidiobolus coronatus infection presenting as orbital cellulitis in an adolescent. PMID:27190852

  3. Dissecting cellulitis of the scalp with associated spondylarthropathy: case report and review.

    PubMed

    Salim, A; David, J; Holder, J

    2003-11-01

    Arthritis is a well-recognized but uncommon accompaniment to several chronic cutaneous inflammatory conditions in which severe acne is one component. We report the case of a man with dissecting cellulitis of the scalp who developed severe peripheral and axial arthritis. PMID:14761139

  4. Musculoskeletal features of acne, hidradenitis suppurativa, and dissecting cellulitis of the scalp.

    PubMed

    Olafsson, S; Khan, M A

    1992-02-01

    This article describes the various forms of acne and the clinical and radiographic features of the associated musculoskeletal manifestations. Occasionally, acne may occur together with hidradenitis suppurativa and dissecting cellulitis of the scalp, the so called "follicular occlusion triad." The current understanding of the etiology of these conditions and their treatment are also reviewed. PMID:1532858

  5. Relapsing cellulitis associated with Campylobacter coli bacteremia in an agammaglobulinemic patient.

    PubMed

    Tokuda, Koichi; Nishi, Junichiro; Miyanohara, Hiroaki; Sarantuya, Jav; Iwashita, Mayumi; Kamenosono, Akira; Hizukuri, Kazuko; Wakimoto, Naoko; Yoshinaga, Masao

    2004-06-01

    Campylobacter coli rarely causes bacteremia or extraintestinal infection. We report herein a case of agammaglobulinemia in which cellulitis associated with C. coli bacteremia relapsed after a disease-free interval of >5 years. Pulsed field gel electrophoresis revealed that the organisms in this patient were genetically identical, suggesting a latent C. coli infection. PMID:15194845

  6. Orbital cellulitis and corneal ulcer due to Cedecea: First reported case and review of the literature.

    PubMed

    Clark, Jeremy D; Fernandez de Castro, Juan P; Compton, Chris; Lee, Harold; Nunery, William

    2016-06-01

    Cedecea is a gram-negative bacterium from the family Enterobacteriaceae, rarely associated with human infection. We report the first case of an orbital cellulitis and corneal ulcer due to Cedecea in a patient who sustained a motor vehicle accident and was then found to have a retained wooden orbital foreign body. PMID:27070554

  7. Bilateral cavernous sinus and superior ophthalmic vein thrombosis in the setting of facial cellulitis

    PubMed Central

    Bell, Bruce; Hise, Joseph; Philip, Joseph; Spak, Cedric; Opatowsky, Michael J.

    2016-01-01

    Cavernous sinus thrombosis is a rare, potentially fatal cause of cerebral venous thrombosis. Infectious causes typically arise from the mid face, orbit, or sinonasal region. We present a case of bilateral cavernous sinus and superior ophthalmic thrombosis secondary to an extreme case of facial cellulitis. PMID:26722163

  8. Factors predisposing to acute and recurrent bacterial non-necrotizing cellulitis in hospitalized patients: a prospective case-control study.

    PubMed

    Karppelin, M; Siljander, T; Vuopio-Varkila, J; Kere, J; Huhtala, H; Vuento, R; Jussila, T; Syrjänen, J

    2010-06-01

    Acute non-necrotizing cellulitis is a skin infection with a tendency to recur. Both general and local risk factors for erysipelas or cellulitis have been recognized in previous studies using hospitalized controls. The aim of this study was to identify risk factors for cellulitis using controls recruited from the general population. We also compared patients with a history of previous cellulitis with those suffering a single episode, with regard to the risk factors: length of stay in hospital, duration of fever, and inflammatory response as measured by C-reactive protein (CRP) level and leukocyte count. Ninety hospitalized cellulitis patients and 90 population controls matched for age and sex were interviewed and clinically examined during the period April 2004 to March 2005. In multivariate analysis, chronic oedema of the extremity, disruption of the cutaneous barrier and obesity were independently associated with acute cellulitis. Forty-four (49%) patients had a positive history (PH) of at least one cellulitis episode before entering the study. Obesity and previous ipsilateral surgical procedure were statistically significantly more common in PH patients, whereas a recent (<1 month) traumatic wound was more common in patients with a negative history (NH) of cellulitis. PH patients had longer duration of fever and hospital stay, and their CRP and leukocyte values more often peaked at a high level than those of NH patients. Oedema, broken skin and obesity are risk factors for acute cellulitis. The inflammatory response as indicated by CRP level and leukocyte count is statistically significantly more severe in PH than NH patients. PMID:19694769

  9. Unilateral proptosis and orbital cellulitis in eight African hedgehogs (Atelerix albiventris).

    PubMed

    Wheler, C L; Grahn, B H; Pocknell, A M

    2001-06-01

    Eight African hedgehogs (Atelerix albiventris) were presented with unilateral proptosis. Six animals presented specifically for an ocular problem, whereas two had concurrent neurologic disease. Enucleation and light microscopic examination of tissues was performed in five animals, and euthanasia followed by complete postmortem examination was performed in three animals. Histopathologic findings in all hedgehogs included orbital cellulitis, panophthalmitis, and corneal ulceration, with perforation in seven of eight eyes. The etiology of the orbital cellulitis was not determined, but it appeared to precede proptosis. Orbits in hedgehogs are shallow and the palpebral fissures are large, which may predispose them to proptosis, similar to brachycephalic dogs. This clinical presentation was seen in 15% (8/54) of African hedgehogs presented to the Western College of Veterinary Medicine over a 2-yr period from January 1995 to December 1996 and warrants further investigation. PMID:12790427

  10. Choroidal malignant melanoma with no extraocular extension presenting as orbital cellulitis.

    PubMed

    Nalcaci, Serhad; Palamar, Melis; Yaman, Banu; Akalin, Taner; Mentes, Jale

    2016-10-01

    This report describes a patient with choroidal malignant melanoma presenting as orbital cellulitis without extraocular tumor extension. It is an interventional case report with histopathologic correlation. A 68-year-old male presented with a 3-day history of painful hyperemia and swelling in the right eye. The examination showed edematous eyelids, mechanical ptosis and chemosis with conjunctival injection. B-scan ultrasonography showed a mass with medium level echogenicity that filled the vitreous cavity. Magnetic resonance imaging showed a solid choroidal mass with hemorrhagic and inflammatory changes with no obvious extraocular extension. Due to these suggestive findings of choroidal melanoma the right eye was enucleated. A spindle cell choroidal melanoma including intense pigmentation and necrosis was confirmed by histopathological examination. Although rare; choroidal melanoma may present as orbital cellulitis, particularly when the tumor is necrotic. PMID:27463451

  11. Facing the danger zone: the use of ultrasound to distinguish cellulitis from abscess in facial infections.

    PubMed

    Lewis, Dywanda L; Butts, Christine J; Moreno-Walton, Lisa

    2014-01-01

    Physical exam alone is often insufficient to determine whether or not cellulitis is accompanied by an abscess. Bedside ultrasound can be a valuable tool in ruling out suspected abscess by allowing direct visualization of a fluid collection. The proximity of the infection to adjacent structures can also be determined, thus aiding clinical decision making. Patients with cellulitis near the eye and nose are of particular concern due to the adjacent facial structures and the anatomy of the venous drainage. Accurately determining the presence or absence of an associated abscess in these patients is a crucial step in treatment planning. The purpose of this report is to (1) emphasize the benefits of bedside ultrasound when used in conjunction with the physical exam to rule out abscess; (2) demonstrate the utility of bedside ultrasound in planning a treatment strategy for soft tissue infection; (3) depict an instance where ultrasound detected an abscess when computed tomography (CT) scan did not. PMID:24851189

  12. The air forces on a systematic series of biplane and triplane cellule models

    NASA Technical Reports Server (NTRS)

    Munk, Max M

    1927-01-01

    The air forces on a systematic series of biplane and triplane cellule models are the subject of this report. The test consist in the determination of the lift, drag, and moment of each individual airfoil in each cellule, mostly with the same wing section. The magnitude of the gap and of the stagger is systematically varied; not, however, the decalage, which is zero throughout the tests. Certain check tests with a second wing section make the tests more complete and conclusions more convincing. The results give evidence that the present army and navy specifications for the relative lifts of biplanes are good. They furnish material for improving such specifications for the relative lifts of triplanes. A larger number of factors can now be prescribed to take care of different cases.

  13. A case of dissecting cellulitis and a review of the literature.

    PubMed

    Scheinfeld, Noah S

    2003-02-01

    Dissecting cellulitis (also called perifolliculitis capitis abscedens et suffodiens) manifests with perifollicular pustules, nodules, abscesses and sinuses that evolve into scarring alopecia. It predominantly occurs in African American men between 20-40 years of age, but can occasionally affect other races and women too. Associated musculoskeletal findings are sometimes reported. When it occurs with acne conglobata, hidradenitis suppurativa, and pilonidal cysts, the syndrome is referred to as the follicular occlusion triad or tetrad. Its course is chronic and relapsing, and treatment is often difficult. Medical therapies include isotretinoin, antibiotics, and prednisone. Destructive therapies include X-ray therapy, surgical excision, and skin grafting. Laser epilation of hair follicles is a promising new therapy for dissecting cellulitis. PMID:12639466

  14. Phalangeal fractures and metacarpophalangeal luxations subsequent to post-traumatic osteomyelitis and cellulitis in a dog.

    PubMed

    Langley-Hobbs, S J; Lascelles, B D X

    2004-07-01

    A working Border collie suffered a puncture wound to the metacarpal pad. No fractures or luxations were identified at initial presentation. Treatment was instigated with various antibacterials for a period of months. At subsequent visits, the dog's condition progressed with development of metacarpophalangeal joint luxation and phalangeal fractures secondary to cellulitis and chronic osteomyelitis. Amputation was curative. Prompt treatment of the acute condition with debridement and drainage may have prevented osteomyelitis becoming established in the first instance. PMID:15266860

  15. Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis

    SciTech Connect

    Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. )

    1991-07-01

    We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

  16. Cellules photovoltaïques à base de semi-conducteurs organiques

    NASA Astrophysics Data System (ADS)

    Videlot, C.; Fichou, D.; Garnier, F.

    1998-06-01

    We describe here the elaboration and performances of photovoltaic cells using organic p type (pentacene) and n type (perylene) semiconductors in a pn heterojunction configuration. Nous décrivons ici l'élaboration et les performances de cellules photovoltaïques à base de semi-conducteurs organiques de type p (pentacène) et de type n (pérylène) dans une hétérojonction pn.

  17. A Woman with Unilateral Rash and Fever: Cellulitis in the Setting of Lymphedema

    PubMed Central

    Joseph, Melissa; Camilon, Marissa; Kang, Tarina

    2015-01-01

    Cellulitis in the setting of lymphedema is an uncommon but clinically important presentation to the emergency department. Stagnant lymph is an ideal medium for bacterial growth and progression can be rapid due to decreased ability to fight infection in the affected area. Infections are commonly caused by gram-positive cocci, though blood cultures are often negative. Treatment should be aimed at rapid initiation of antibiotics targeting these species. There may be a role for antibiotic prophylaxis in recurrent cases. PMID:26171259

  18. Bilateral orbital preseptal cellulitis after combined adenotonsillectomy and strabismus surgery--case report and pathogenetic hypothesis.

    PubMed

    Muzzi, E; Parentin, F; Pelos, G; Grasso, D L; Lora, L; Trabalzini, F; Pensiero, S; Orzan, E

    2013-07-01

    The first case of bilateral orbital preseptal cellulitis complicating combined adenotonsillectomy and strabismus surgery is reported. The issues of antimicrobial prophylaxis are discussed. The authors speculate about the possible routes of surgical site infection. Transient bacteraemia secondary to adenotonsillectomy may be theoretically a source of distant surgical site infection to the orbit, raising the issue of distant surgical site contamination during multidisciplinary surgery. Combined adenotonsillectomy and eye surgery might benefit from prophylactic systemic antibiotic administration. PMID:23664368

  19. Development and Validation of ARKAS cellule: An Advanced Core-Bowing Analysis Code for Fast Reactors

    SciTech Connect

    Ohta, Hirokazu; Yokoo, Takeshi; Nakagawa, Masatoshi; Matsuyama, Shinichiro

    2004-05-15

    An advanced analysis code, ARKAS cellule, has been developed to determine the core distortion and the mechanical behavior of fast reactors. In this code, each hexagonal subassembly duct is represented by a folded thin plate structure divided into a user-specified number of shell elements so that the interduct contact forms and the cross-sectional distortion effect of each duct are properly taken into account. In this paper, the numerical model of the ARKAS cellule code is introduced, and the analytical results for two validation problems are presented. From a single duct compaction analysis, the first validation problem, it is clarified that the new analytical model is applicable to simulating the change of duct compaction stiffness that depends on the loading conditions such as the loading pad forms and the number of contact faces. The second validation analysis has been conducted by comparison with the experimental values obtained by the National Nuclear Corporation Limited in the United Kingdom using the core restraint uniplanar experimental rig (CRUPER), an ex-reactor rig in which a cluster of 91 short ducts is compressed by 30 movable peripheral rams toward the center of the cluster in seven stages. The analysis clarified that the predictions obtained using ARKAS cellule agree well with the measured ram loads and interwrapper gap widths during the compaction sequence. One may conclude that ARKAS cellule is valid for quantitative analysis of the core mechanical behavior and will be particularly useful for the evaluation of transient deformation of core assemblies during accidents in which the distortion of loading pads have important effects on obtaining favorable reactivity feedback.

  20. Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study

    PubMed Central

    Bruun, Trond; Oppegaard, Oddvar; Kittang, Bård R.; Mylvaganam, Haima; Langeland, Nina; Skrede, Steinar

    2016-01-01

    Background. The importance of bacteria other than group A streptococci (GAS) in different clinical presentations of cellulitis is unclear, commonly leading to treatment with broad-spectrum antibiotics. The aim of this study was to describe the etiological and clinical spectrum of cellulitis and identify clinical features predicting streptococcal etiology. Methods. We prospectively enrolled 216 patients hospitalized with cellulitis. Clinical details were registered. Bacterial culture was performed from blood, cutaneous or subcutaneous tissue, and/or swabs from skin lesions. Paired serum samples were analyzed for anti-streptolysin O and anti-deoxyribonuclease B antibodies. Results. Serology or blood or tissue culture confirmed β-hemolytic streptococcal (BHS) etiology in 72% (146 of 203) of cases. An additional 13% (27 of 203) of cases had probable BHS infection, indicated by penicillin response or BHS cultured from skin swabs. β-hemolytic streptococcal etiology was predominant in all clinical subgroups, including patients without sharply demarcated erythema. β-hemolytic group C or G streptococci (GCS/GGS) were more commonly isolated than GAS (36 vs 22 cases). This predominance was found in the lower extremity infections. Group C or G streptococci in swabs were associated with seropositivity just as often as GAS. Staphylococcus aureus was cultured from swabs as a single pathogen in 24 cases, 14 (64%) of which had confirmed BHS etiology. Individual BHS-associated clinical characteristics increased the likelihood of confirmed BHS disease only slightly; positive likelihood ratios did not exceed 2.1. Conclusions. β-hemolytic streptococci were the dominating cause of cellulitis in all clinical subgroups and among cases with S aureus in cutaneous swabs. Group C or G streptococci were more frequently detected than GAS. No single clinical feature substantially increased the probability of confirmed BHS etiology. PMID:26734653

  1. A Woman with Unilateral Rash and Fever: Cellulitis in the Setting of Lymphedema.

    PubMed

    Joseph, Melissa; Camilon, Marissa; Kang, Tarina

    2015-01-01

    Cellulitis in the setting of lymphedema is an uncommon but clinically important presentation to the emergency department. Stagnant lymph is an ideal medium for bacterial growth and progression can be rapid due to decreased ability to fight infection in the affected area. Infections are commonly caused by gram-positive cocci, though blood cultures are often negative. Treatment should be aimed at rapid initiation of antibiotics targeting these species. There may be a role for antibiotic prophylaxis in recurrent cases. PMID:26171259

  2. Hypertrophic osteodystrophy preceding canine juvenile cellulitis in an Australian shepherd puppy

    PubMed Central

    Wentzell, Meaghan L.

    2011-01-01

    A 10-week-old intact female Australian shepherd dog was presented sternally recumbent, mildly pyrexic, and painful on long bone palpation of both forelimbs. Based on radiographs she was diagnosed with hypertrophic osteodystrophy. Analgesia was provided with intravenous, oral, and topical medications. Approximately 2 wk later she was presented for facial swelling, regional dermatitis, and lymphadenopathy. Canine juvenile cellulitis was diagnosed and successfully treated. PMID:21731101

  3. Infratemporal fossa cellulitis caused by a remnant iatrogenic foreign body after a bimaxillary operation.

    PubMed

    Park, Do Yang; Choo, Oak-Sung; Hong, Sang Young; Kim, Hyun Jun

    2015-05-01

    Infratemporal fossa cellulitis is rare and mostly occurs because of sinusitis and dental procedures. Furthermore, cellulitis caused by iatrogenic foreign bodies is very rare. A 28-year-old woman who had previously undergone cosmetic bimaxillary operation visited our hospital complaining of left facial swelling, oppressive pain, and nasal obstruction since 2 years. She had been attending another clinic, but despite having additional procedures and taking medications, her symptoms persisted. A subsequent operation was performed, during which we found a remnant surgical gauze from the previous operation, which was decomposed and trapped around the necrotic soft tissue and had eroded the bony structure around the pterygoid fossa. The material was successfully removed by endoscopic surgery, and the necrotic tissue was debrided. After the operation, all symptoms disappeared, and the patient was discharged without sequelae. During any procedure, surgeons must meticulously check for remnant material. Additionally, physicians must carefully note patient history and perform a physical examination, even in patients without serious symptoms. We report a case of advanced infratemporal fossa cellulitis due to remnant gauze material during a previous operation that was undetected. PMID:25950522

  4. Folliculotropic mycosis fungoides with large-cell transformation presenting as dissecting cellulitis of the scalp.

    PubMed

    Gilliam, A C; Lessin, S R; Wilson, D M; Salhany, K E

    1997-03-01

    Follicular mycosis fungoides (MF) is a rare variant of cutaneous T-cell lymphoma (CTCL) in which malignant lymphocytes preferentially infiltrate hair follicles. This report describes a patient with follicular mycosis fungoides presenting in a manner similar to dissecting cellulitis of the scalp with nonhealing, draining nodular lesions. Follicular mucinosis associated with folliculotropic mycosis fungoides resulted in follicular disruption and deep dissecting cellulitis. Large-cell transformation of CTCL was present in the initial diagnostic scalp and axillary lymph node specimens. The patient died from progressive CTCL 9 months following initial diagnosis despite electron beam radiation, topical mechlorethamine, interferon-alpha, and systemic chemotherapy. This case indicates that large-cell transformation of folliculotropic mycosis fungoides is an aggressive form of CTCL, and that folliculotropic mycosis fungoides can give rise to lesions which resemble dissecting cellulitis of the scalp. Upregulation of intercellular adhesion molecule-1 (ICAM-1) on follicular epithelium adjacent to lymphocyte function-associated antigen-1 (LFA-1)-positive folliculotropic lymphoma cells in this report provides insight into lymphocyte homing mechanisms in folliculotropic MF. PMID:9085153

  5. [Cervico-facial cellulitis during pregnancy: about a series of 10 cases in Mali].

    PubMed

    Doumbia-Singare, K; Timbo, S K; Keita, M; Ag Mohamed, A; Guindo, B; Soumaoro, S

    2014-12-01

    The objective of this work was to analyze the predisposing factors, diagnostic and therapeutic aspects of cervico-facial cellulitis on pregnancies and to determine maternal-fetal prognosis. We conducted a longitudinal observational descriptive study from January 2011 to March 2013 including records from pregnant women with cervicofacial cellulitis treated at the Oto-Rhino-Laryngology (ORL) and cervico-facial surgery department at Gabriel Touré Hospital in Bamako. Ten women met our inclusion criteria. The median age was 23 years. The entry way was dental in all cases. Three women had taken antibiotics and 3 others antibiotics associated with non steroidal anti-inflammatory. The medico-surgical treatment had permitted to cure 8 cases. Two cases of death were recorded and 4 cases of stillbirths. The cervico-facial cellulitis during pregnancy is a serious pathology that can be life-threatening to the mother and or child. Prevention is based on the control of dental status and informing women about the importance of dental hygiene. PMID:25304000

  6. Inflammatory tinea capitis mimicking dissecting cellulitis in a postpubertal male: a case report and review of the literature.

    PubMed

    Stein, Loretta L; Adams, Erin G; Holcomb, Katherine Z

    2013-09-01

    Tinea capitis in postpubertal patients is unusual and may be misdiagnosed as dissecting cellulitis. We report a case of a healthy 19-year-old Hispanic male presenting with a 2-month history of a large, painful subcutaneous boggy plaque on the scalp with patchy alopecia, erythematous papules, cysts and pustules. Although initially diagnosed as dissecting cellulitis, potassium hydroxide evaluation (KOH preparation) of the hair from the affected region was positive. A punch biopsy of the scalp demonstrated endothrix consistent with tinea capitis, but with a brisk, deep mixed inflammatory infiltrate as can be seen with chronic dissecting cellulitis. Fungal culture revealed Trichophyton tonsurans, and a diagnosis of inflammatory tinea capitis was made. The patient was treated over the course of 17 months with multiple systemic and topical antifungal medications, with slow, but demonstrable clinical and histopathological improvement. A rare diagnosis in adults, clinicians should have a high index of suspicion for this condition in an adult with an inflammatory scalp disorder not classic for dissecting cellulitis or with a recalcitrant dissecting cellulitis. Prompt, appropriate diagnosis and treatment is necessary to prevent the long-term complications of scarring alopecia. PMID:23582018

  7. Acute pulpal-alveolar cellulitis syndrome. IV. Clinical parameters, demographics, and affirmation of a traditional etiologic theory. Part 2.

    PubMed

    Matusow, R J

    1986-01-01

    The Part 1 report revealed the microbiologic etiology and introduced the oxidation-reduction potential (Eh) as a major factor in acute cellulitis exacerbations during endodontic therapy. Facultative streptococci were the predominant group of microbes specifically isolated. This Part 2 study revealed a 9.5% incidence of cellulitis exacerbations in patients during endodontic treatment of 168 primarily intact nonvital teeth. These teeth were usually asymptomatic, manifesting radiographic periapical lesions without fistulous tracts and necrotic canals. This category of pulpal periapical inflammation is virtually the only type of tooth that is predisposed to cellulitis exacerbations. A frequency distribution of the 34 permanent teeth studied revealed a spectrum of mandibular and maxillary molars, premolars, and anterior teeth involved with the exacerbations. Sex and age did not appear to be factors. Further clinical evidence is cited, which support the concept of altering the tissue oxidation-reduction potential as the prime etiologic factor in favoring the growth of aerobic microbial pathogens. PMID:3456147

  8. Management of fulminant dissecting cellulitis of the scalp in the pediatric population: Case report and literature review.

    PubMed

    Arneja, Jugpal S; Vashi, Christopher N; Gursel, Eti; Lelli, Joseph L

    2007-01-01

    A case of fulminant dissecting cellulitis of the scalp in a fifteen-year-old African American male is reported. The presentation was refractory to standard medical treatment such that treatment required radical subgaleal excision of the entire hair-bearing scalp. Reconstruction was in the form of split-thickness skin grafting at the level of the pericranium following several days of vacuum-assisted closure dressing to promote an acceptable wound bed for skin grafting and to ensure appropriate clearance of infection. Numerous nonsurgical modalities have been described for the treatment of dissecting cellulitis of the scalp, with surgical intervention reserved for patients refractory to medical treatment. The present paper reports a fulminant form of the disease in an atypical age of presentation, adolescence. The pathophysiology, etiology, natural history, complications and treatment options for dissecting cellulitis of the scalp are reviewed, and the authors suggest this method of treatment to be efficacious for severe presentations refractory to medical therapy. PMID:19554179

  9. Dissecting Cellulitis of the Scalp Responding to Intravenous Tumor Necrosis Factor-alpha Antagonist.

    PubMed

    Wollina, Uwe; Gemmeke, Astrid; Koch, André

    2012-04-01

    The authors present the case of a 30-year-old male patient with a severe and long-standing dissecting cellulitis of the scalp. The disease did not respond to conventional treatment, including oral antibiotics, isotretinoin, and prednisolone. Quality of life was significantly impaired. After introduction of anti-tumor necrosis factor-alpha treatment (infliximab), the malodorous discharge stopped, inflammation was reduced significantly, nodules became flat, and pain decreased. The treatment was well tolerated although he developed a temporary psoriasiform rash after the second intravenous infusion. In conclusion, anti-tumor necrosis factor-alpha treatment is a new therapeutic option in this severe and recalcitrant disorder. PMID:22708007

  10. Surgical Management and Reconstruction of Hoffman's Disease (Dissecting Cellulitis of the Scalp).

    PubMed

    Hintze, Justin M; Howard, Brittany E; Donald, Carrlene B; Hayden, Richard E

    2016-01-01

    Dissecting cellulitis of the scalp, or Hoffman's disease, is a rare dermatologic condition characterized by recurrent pustules and sinus tract formation leading to scarring and alopecia. Medical management includes the use of corticosteroids, antibiotics, isotretinoin, and adalimumab. In cases where the disease is severe, refractory, and intractable, surgery is an option. We report two cases of Hoffman's disease, where medical management failed to achieve remission. Surgical treatment was undertaken with complete resection of the affected scalp in staged procedures with subsequent split-thickness skin grafting for reconstruction. Surgery achieved both disease remission and excellent aesthetic outcomes in both patients. PMID:26966606

  11. Surgical Management and Reconstruction of Hoffman's Disease (Dissecting Cellulitis of the Scalp)

    PubMed Central

    Hintze, Justin M.; Howard, Brittany E.; Donald, Carrlene B.; Hayden, Richard E.

    2016-01-01

    Dissecting cellulitis of the scalp, or Hoffman's disease, is a rare dermatologic condition characterized by recurrent pustules and sinus tract formation leading to scarring and alopecia. Medical management includes the use of corticosteroids, antibiotics, isotretinoin, and adalimumab. In cases where the disease is severe, refractory, and intractable, surgery is an option. We report two cases of Hoffman's disease, where medical management failed to achieve remission. Surgical treatment was undertaken with complete resection of the affected scalp in staged procedures with subsequent split-thickness skin grafting for reconstruction. Surgery achieved both disease remission and excellent aesthetic outcomes in both patients. PMID:26966606

  12. Helicobacter cinaedi bacteremia with cellulitis after ABO-incompatible living-donor liver transplantation: Case report

    PubMed Central

    Mishima, Kohei; Obara, Hideaki; Sugita, Kayoko; Shinoda, Masahiro; Kitago, Minoru; Abe, Yuta; Hibi, Taizo; Yagi, Hiroshi; Matsubara, Kentaro; Mori, Takehiko; Takano, Yaoko; Fujiwara, Hiroshi; Itano, Osamu; Hasegawa, Naoki; Iwata, Satoshi; Kitagawa, Yuko

    2015-01-01

    Helicobacter cinaedi (H. cinaedi), a Gram-negative spiral-shaped bacterium, is an enterohepatic non-Helicobacter pylori Helicobacter species. We report the first case of H. cinaedi bacteremia with cellulitis after liver transplantation. A 48-year-old male, who had been a dog breeder for 15 years, underwent ABO-incompatible living-donor liver transplantation for hepatitis C virus-induced decompensated cirrhosis using an anti-hepatitis B core antibody-positive graft. The patient was preoperatively administered rituximab and underwent plasma exchange twice to overcome blood type incompatibility. After discharge, he had been doing well with immunosuppression therapy comprising cyclosporine, mycophenolate mofetil, and steroid according to the ABO-incompatible protocol of our institution. However, 7 mo after transplantation, he was admitted to our hospital with a diagnosis of recurrent cellulitis on the left lower extremity, and H. cinaedi was detected by both blood culture and polymerase chain reaction analysis. Antibiotics improved his symptoms, and he was discharged at day 30 after admission. Clinicians should be more aware of H. cinaedi in immunocompromised patients, such as ABO-incompatible transplant recipients. PMID:26167092

  13. Step-by-step iconographic description of a prolonged but still favourable course of orbital cellulitis in a child with acute rhinosinusitis: an iconographic case study.

    PubMed

    Torretta, Sara; Marchisio, Paola; Gaffuri, Michele; Capaccio, Pasquale; Esposito, Susanna; Pignataro, Lorenzo

    2014-01-01

    Orbital cellulitis is an infrequent complication of acute ethmoiditis possibly leading to life- or visual-threatening complications. Despite its natural history is well known, its clinical evolution may widely vary among patients, and even in the most favourable cases long-term sequelae may persist. We here provide a step-by-step iconographic description of a periorbital and orbital cellulitis occurring in a child with ipsilateral acute rhinosinusitis. Our report shows that an unusual long-term evolution of periorbital and orbital cellulitis is possible also in apparently favourable cases. PMID:24594215

  14. Facial and Periorbital Cellulitis due to Skin Peeling with Jet Stream by an Unauthorized Person.

    PubMed

    Kaptanoglu, Asli Feride; Mullaaziz, Didem; Suer, Kaya

    2014-01-01

    Technologies and devices for cosmetic procedures are developing with each passing day. However, increased and unauthorized use of such emerging technologies may also lead to increases in unexpected results and complications as well. Here, we report a case of facial cellulitis after a "beauty parlor" session of skin cleaning with jet stream peeling device in 19-year old female patient for the first time. Complications due to improper and unauthorized use of jet stream peeling devices may also cause doubts about the safety and impair the reputation of the technology as well. In order to avoid irreversible complications, local authorities should follow the technology and update the regulations where the dermatologists should take an active role. PMID:24822131

  15. Facial and Periorbital Cellulitis due to Skin Peeling with Jet Stream by an Unauthorized Person

    PubMed Central

    Kaptanoglu, Asli Feride; Mullaaziz, Didem; Suer, Kaya

    2014-01-01

    Technologies and devices for cosmetic procedures are developing with each passing day. However, increased and unauthorized use of such emerging technologies may also lead to increases in unexpected results and complications as well. Here, we report a case of facial cellulitis after a “beauty parlor” session of skin cleaning with jet stream peeling device in 19-year old female patient for the first time. Complications due to improper and unauthorized use of jet stream peeling devices may also cause doubts about the safety and impair the reputation of the technology as well. In order to avoid irreversible complications, local authorities should follow the technology and update the regulations where the dermatologists should take an active role. PMID:24822131

  16. Streptococcus pneumoniae-associated cellulitis in a two-month-old Domestic Shorthair kitten.

    PubMed

    Zhang, Shuping; Wilson, Floyd; Pace, Lanny

    2006-03-01

    An approximately 2-month-old, reproductively intact female Domestic Shorthair kitten was presented to the Mississippi Veterinary Research and Diagnostic Laboratory with a history of possible trauma to the left shoulder region while playing with children, and was found dead the following day. Marked swelling, with subcutaneous edema and hemorrhages, was observed in the left forelimb. Severe pleocellular, but largely suppurative cellulitis, fasciitis, and interstitial myositis with edema were observed microscopically in sections from the affected limb. Massive numbers of gram-positive diplococci also were observed. Other pathologic changes included moderate interstitial pneumonia, mild cholangitis, lymph node hemorrhage, gastrointestinal nematodiasis, mild enteritis, and mild interstitial nephritis. Bacteriologic culture identified Streptococcus pneumoniae as the causative agent, which was confirmed by polymerase chain reaction amplification of the pneumolysin gene from chromosomal DNA of the isolate. PMID:16617709

  17. Suppurative Meckel Diiverticulum in a 3-Year-Old Girl Presenting with Periumbilical Cellulitis

    PubMed Central

    Park, Ji Sook; Lim, Chun Woo; Park, Taejin; Cho, Jae-Min; Youn, Hee-Shang

    2015-01-01

    Meckel diverticulum (MD) is one of the most common congenital gastrointestinal anomalies and occurs in 1.2-2% of the general population. MD usually presents with massive painless rectal bleeding, intestinal obstruction or inflammation in children and adults. Suppurative Meckel diverticulitis is uncommon in children. An experience is described of a 3-year-old girl with suppurative inflammation in a tip of MD. She complained of acute colicky abdominal pain, vomiting and periumbilical erythema. Laparoscopic surgery found a relatively long MD with necrotic and fluid-filled cystic end, which was attatched to abdominal wall caused by inflammation. Herein, we report an interesting and unusual case of a suppurative Meckel diverticulitis presenting as periumbilical cellulitis in a child. Because of its varied presentations, MD might always be considered as one of the differential diagonosis. PMID:25866736

  18. Streptococcal cellulitis of the scrotum and penis with secondary skin gangrene.

    PubMed

    Haury, B; Rodeheaver, G; Stevenson, T; Bacchetta, C; Edgerton, M T; Edlich, R F

    1975-07-01

    Cellulitis of the scrotum and penis is caused, in the majority of instances, by a beta hemolytic streptococci without a discernible portal of entry. Clostridium, occasionally, will result in this disease as a manifestation of a perirectal abscess. In either instance, fluid accumulates rapidly in the closed space between Colles' and Buck's fascia, producing intense swelling of the scrotum. If this compartment is not immediately decompressed by linear incisions, devascularization of the scrotal and penile skin will often occur, resulting in gangrene. Immediate treatment of the bacterial infection with penicillin also is essential. If gangrene does develop, radical debridement of the necrotic tissue as well as a wide margin of adjacent inflamed skin must be undertaken. Continual monitoring of the microflora of the debrided would is essential for the selection of the appropriate antibiotic against any secondary intruders. Coverage of the granulating would is accomplished when the would bacterial count is below 10-5 per gram of tissue. PMID:1098183

  19. Extranodal natural killer/T-cell lymphoma, nasal type, of the orbit mimicking recurrent orbital cellulitis.

    PubMed

    Kim, Ji Wan; An, Jae Hwan

    2014-03-01

    Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare type of lymphoma that is endemic to East Asia and parts of Central and South America. Most patients present with nasal obstruction, sinusitis, ulcer, and epistaxis due to a destructive mass involving the midline facial tissues. The patient visited our clinic approximately 1 year ago; she had right-sided orbital swelling and pain. The patient was sent to the department of ear, nose, and throat (ENT), and computed tomographic scan was performed. Computed tomographic imaging showed a soft tissue density in the right frontal, maxillary, and ethmoidal sinus and demonstrated fungal sinusitis in the right maxillary sinus. Then, she underwent the operation at ENT; her symptoms seemed to have disappeared. After 6 months, however, she had visited our clinic again because of a left-sided orbital cellulitis that seemed to be similar to the previous right-sided symptoms 1 year ago. She received treatments immediately and the operation again at ENT. In addition, a biopsy of left ethmoid sinus tissue was performed. The biopsy result revealed "chronic inflammation." However, unfortunately, the patient had a relapse of almost the same symptoms in a month. An excisional biopsy was performed for histopathologic diagnosis again. The left ethmoid sinus biopsy results were consistent with extranodal NK/T-cell lymphoma, nasal type. The patient then transferred her care to the department of internal medicine for chemotherapy. The authors demonstrate how the progressive-staging extranodal NK/T-cell lymphoma can present in a similar fashion as a recurrent orbital cellulitis. PMID:24621697

  20. Carcinome rénal à cellules chromophobes: à propos de quatre cas et revue de la literature

    PubMed Central

    Othmane, Yddoussalah; Mounir, Lahyani; Tarik, Karmouni; Khalid, Elkhader; Abdellatif, Koutani; Ahmed, Ibn Attya Andaloussi

    2015-01-01

    Nous rapportons dans cet article trois cas de carcinome rénal à cellules chromophobes. Le carcinome chromophobe se voit essentiellement à la cinquième décennie et représente 5% des tumeurs rénales. Il existe deux sous types de cancer à cellules chromophobes: le type clair (70%) et le type éosinophile. La variante à cellules éosinophiles doit être distinguée de l'oncocytome. Ce dernier se caractérise par une cicatrice fibreuse centrale d'aspect stellaire. Le carcinome chromophobe et l'oncocytome peuvent même coexister dans le cadre du syndrome de Birt-Hogg-Dubé. Certaines tumeurs appelées hybrides partagent des caractéristiques architecturales et cytologiques de ces deux tumeurs. Le pronostic du carcinome chromophobe est favorable. Il est le plus souvent limité au rein et de bas grade nucléaire. Il semblerait donc licite dans les cas ou un examen extemporané mettrait en évidence une tumeur chromophobe, de limiter l'intervention à une néphrectomie partielle si elle est techniquement réalisable. PMID:26889304

  1. Étude des perturbations conduites et rayonnées dans une cellule de commutation

    NASA Astrophysics Data System (ADS)

    Costa, F.; Forest, F.; Puzo, A.; Rojat, G.

    1993-12-01

    The principles used in static conversion and the rise of the performances of the new switching devices contribue to increase the level of electromagnetic noises emitted by electronic converters. We have studied the way how these perturbations are created and coupled through their environment in conducted and radiated mode by a switching cell. This one can work in hard switching, zero current or voltage switching modes. We first outline the general problems of electromagnetic pollution and their metrology in converters. Then we describe the experimental environment. We analyse the mechanisms of generation of parasitic signals in a switching cell related to the electrical constraints and its switching mode. The simulated results, issued of the analytical models obtained, are confronted with the experimental ones. Then we show a method to calculate analytically the E and H near fields. It has been confirmed by experimental results. At last, we present, in a synthetic manner, the main results obtained, relative to the switching mode and the electrical constraints, using a new characterizing method. Theses results will allow the designer to incorporate the electromagnetic considerations in the conception of a converter. Les principes de commutation employés en conversion statique, l'évolution des performances statiques et dynamiques des composants, contribuent à faire des dispositifs de conversion statique de puissants générateurs de perturbations conduites et rayonnées. Nous nous sommes attachés à étudier les mécanismes de génération et de couplage des perturbations, tant en mode conduit que rayonné dans des structures à une seule cellule de commutation et fonctionnant selon les trois principaux modes de commutation : commutation forcée, à zéro de courant (ZCS), et à zéro de tension (ZVS). Après la mise en évidence de la problématique de pollution électromagnétique dans les structures et leur métrologie, nous décrivons l'environnement exp

  2. A rare case of orbital cellulitis followed by therapeutic(orthodontic) extraction.

    PubMed

    Srinivasa Prasad, B; Govardhan, T

    2011-09-01

    We report a rare case of orbital cellulitis occurring secondary to a dental infection followed by therapeutic (orthodontic) extraction. A 16 year old female patient presented to the dental office with a left orbital proptosis for the past 4 days. PNS view, CT scan revealed an abscess in relation to medial, lateral superior inferior walls of the orbit associated with naso ethmoidal and left maxillary sinus. Through nasal endoscopy, middle meatus antrostomy and ethmoidectomy was performed for the drainage of pus from the orbit, ethmoid and maxillary sinus under general anesthesia. Immediately regression of orbital swelling was noticed. Eyeball movements improved. Epiphora reduced and proptosis declined. With the advent of higher antibiotics, orbital infection rarely occurs secondary to dental causes except in a very few cases. Complete elimination of pus from orbital cavity, para nasal air sinuses and appropriate antibiotic coverage at the earliest forms the mainstay of treatment. The nasal endoscopic approach with orbital decompression is the most acceptable atrumatic, cosmetic and functional procedure. PMID:22942598

  3. Necrotizing cellulitis with multiple abscesses on the leg caused by Serratia marcescens.

    PubMed

    Hau, Estelle; Bouaziz, Jean-David; Lafaurie, Matthieu; Saussine, Anne; Masson, Vincent; Rausky, Jonathan; Bagot, Martine; Guibal, Fabien

    2016-03-01

    Serratia marcescens is an unusual cause of severe skin infection initially described in immunocompromised patients. We report a case of necrotizing cellulitis of the leg caused by S marcescens in a 68-year-old woman with diabetes mellitus and a history of chronic lymphoedema of the leg. We reviewed the literature and found 49 cases of severe skin infections from S marcescens that included 20 cases of necrotizing fasciitis (NF) as well as 29 cases of severe skin infections without NF (non-NF cases). Patients were immunocompromised in 59% to 70% of cases. The mortality rate was high in NF cases (60%) versus non-NF cases (3%). Surgery was required in 95% of NF cases and in 24% of non-NF cases. The other clinical manifestations of S marcescens skin infection reported in the literature included disseminated papular eruptions in patients infected with human immunodeficiency virus with folliculitis on the trunk. Serratia marcescens is naturally resistant to amoxicillin alone and amoxicillin associated with clavulanic acid. Broad-spectrum antibiotics are indicated to treat S marcescens skin infections, and surgery should be promptly considered in cases of severe skin infections if appropriate antibiotic therapy does not lead to rapid improvement. PMID:27023094

  4. Hypertrophic osteoarthropathy presenting as unilateral cellulitis with successful treatment using pamidronate disodium.

    PubMed

    Bernardo, Sebastian G; Emer, Jason J; Burnett, Mark E; Gordon, Marsha

    2012-09-01

    Hypertrophic pulmonary osteoarthropathy is a paraneoplastic syndrome seen in patients with lung cancer. This condition is characterized by the presence of digital clubbing, periosteal thickening, synovial thickening, and severe pain of the affected joints. Other syndromes exhibiting clubbing may or may not have underlying diseases causing their manifestation. An example is primary hypertrophic osteoarthropathy, or pachydermoperiostosis. While clubbing makes up part of the clinical picture in both hypertrophic pulmonary osteoarthropathy and hypertrophic osteoarthropathy, the latter has no underlying disease associations. Rather, primary hypertrophic osteoarthropathy is familial, idiopathic, and has a chronic course often beginning during puberty in males. Secondary hypertrophic osteoarthropathy is an acquired form of clubbing that is classically associated with lung disease. However, it has also been associated with diseases of the heart, liver, and intestines. In the setting of pulmonary malignancy, secondary hypertrophic osteoarthropathy is known as hypertrophic pulmonary osteoarthropathy. Hypertrophic pulmonary osteoarthropathy has a distinct constellation of clinical findings that includes intractable pain often refractory to treatments other than resolution of the underlying disease process. The authors herein report a case of hypertrophic pulmonary osteoarthropathy masquerading as recurrent lower extremity cellulitis with chronic hand and foot pain in the setting of pulmonary malignancy that responded dramatically to intravenous pamidronate disodium (a bisphosphonate). Given the rarity of hypertrophic osteoarthropathy associated with lung cancer and the difficulty with pain management in such circumstances, the authors present the following case in which pain was mitigated by treatment with bisphosphonate therapy. PMID:23050033

  5. Risk factors for erysipelas of the leg (cellulitis): case-control study

    PubMed Central

    Dupuy, Alain; Benchikhi, Hakima; Roujeau, Jean-Claude; Bernard, Philippe; Vaillant, Loïc; Chosidow, Olivier; Sassolas, Bruno; Guillaume, Jean-Claude; Grob, Jean-Jacques; Bastuji-Garin, Sylvie

    1999-01-01

    Objective To assess risk factors for erysipelas of the leg (cellulitis). Design Case-control study. Setting 7 hospital centres in France. Subjects 167 patients admitted to hospital for erysipelas of the leg and 294 controls. Results In multivariate analysis, a disruption of the cutaneous barrier (leg ulcer, wound, fissurated toe-web intertrigo, pressure ulcer, or leg dermatosis) (odds ratio 23.8, 95% confidence interval 10.7 to 52.5), lymphoedema (71.2, 5.6 to 908), venous insufficiency (2.9, 1.0 to 8.7), leg oedema (2.5, 1.2 to 5.1) and being overweight (2.0, 1.1 to 3.7) were independently associated with erysipelas of the leg. No association was observed with diabetes, alcohol, or smoking. Population attributable risk for toe-web intertrigo was 61%. Conclusion This first case-control study highlights the major role of local risk factors (mainly lymphoedema and site of entry) in erysipelas of the leg. From a public health perspective, detecting and treating toe-web intertrigo should be evaluated in the secondary prevention of erysipelas of the leg. Key messagesLocal factors are potential risks for erysipelas of the legLymphoedema and disruption of the cutaneous barrier exhibit the highest relative riskToe-web intertrigo has a high population attributable risk, and its detection and treatment may prevent up to 60% of cases of erysipelas of the leg PMID:10364117

  6. Prophylactic antibiotics for the prevention of cellulitis (erysipelas) of the leg: results of the U.K. Dermatology Clinical Trials Network’s PATCH II trial

    PubMed Central

    2012-01-01

    Summary Background Cellulitis (erysipelas) of the leg is a common, painful infection of the skin and underlying tissue. Repeat episodes are frequent, cause significant morbidity and result in high health service costs. Objectives To assess whether prophylactic antibiotics prescribed after an episode of cellulitis of the leg can prevent further episodes. Methods Double-blind, randomized controlled trial including patients recently treated for an episode of leg cellulitis. Recruitment took place in 20 hospitals. Randomization was by computer-generated code, and treatments allocated by post from a central pharmacy. Participants were enrolled for a maximum of 3 years and received their randomized treatment for the first 6 months of this period. Results Participants (n = 123) were randomized (31% of target due to slow recruitment). The majority (79%) had suffered one episode of cellulitis on entry into the study. The primary outcome of time to recurrence of cellulitis included all randomized participants and was blinded to treatment allocation. The hazard ratio (HR) showed that treatment with penicillin reduced the risk of recurrence by 47% [HR 0·53, 95% confidence interval (CI) 0·26–1·07, P = 0·08]. In the penicillin V group 12/60 (20%) had a repeat episode compared with 21/63 (33%) in the placebo group. This equates to a number needed to treat (NNT) of eight participants in order to prevent one repeat episode of cellulitis [95% CI NNT(harm) 48 to ∞ to NNT(benefit) 3]. We found no difference between the two groups in the number of participants with oedema, ulceration or related adverse events. Conclusions Although this trial was limited by slow recruitment, and the result failed to achieve statistical significance, it provides the best evidence available to date for the prevention of recurrence of this debilitating condition. PMID:21910701

  7. Erysipelas and cellulitis: clinical and microbiological spectrum in an Italian tertiary care hospital.

    PubMed

    Lazzarini, Luca; Conti, Emma; Tositti, Giulia; de Lalla, Fausto

    2005-12-01

    Patients hospitalized in the authors' institution for erysipelas or cellulitis between January 1995 and December 2002 were included in this retrospective review. Two hundred cases of soft tissue infections were hospitalized during the study period. The mean age of the patients was 58 years. The most commonly involved site was the leg (66%), followed by the arm (24%) and face (6%). Most patients (71%) had a recognized risk factor for soft tissue infection. Fever was present in 71% of cases, with a mean duration of 3 days. Blood cultures were positive in 3 out of 141 (2%) cases, whereas cutaneous swabs were positive in 73 out of 92 (79%) cases. On admission, white blood cells counts (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were elevated above normal levels in 100 out of 191 (50%) cases, 151 out of 176 (85%) cases, and 150 out of 154 (97%) cases, respectively. Patients with a hospital stay of more than 10 days had significantly higher CRP and ESR values than patients hospitalized for 10 days or less (P<0.01). A single antibiotic was used as treatment in 115 cases, whereas in the remaining 85 cases a combination of two antibiotics was administered. The most commonly used antibiotics were amoxicillin-clavulanic acid as single agent and penicillin with clindamycin as combination therapy. The mean duration of hospitalization was 7 days for patients treated with a single antibiotic and 11 days for patients treated with an antibiotic combination. A recurrence of infection occurred in 34 (17%) patients. Soft tissue infections are common and have a high degree of morbidity and require prolonged hospitalization and antibiotic treatment. Microbiological diagnosis is difficult and treatment is based on empiric evidence. ESR and CPR levels on admission may predict the severity of the disease and duration of hospitalization. PMID:16321649

  8. The importance of histopathologic aspects in the diagnosis of dissecting cellulitis of the scalp.

    PubMed

    Brănişteanu, Daciana Elena; Molodoi, Andreea; Ciobanu, Delia; Bădescu, Aida; Stoica, Loredana Elena; Brănişteanu, D; Tolea, I

    2009-01-01

    Dissecting cellulitis of the scalp or dissecting folliculitis also known as "perifoliculitis capitis abscedens et suffodiens" (PCAS), is a rare, severe and distinct dermatological disease. It most probably occurs because of follicular occlusion via hyperkeratosis, having the same mechanism of acnea conglobata and hidradenitis suppurativa. These dermatoses may be associated or may have an isolated evolution. PCAS is one of the primitive cicatricial alopecia of neutrophilic type (with pustules). What is characteristic for the histopathologic picture of the disease is the deep inflammatory infiltrate, placed at the reticular derm or hypoderm level. The initial perifolliculitis evolves towards forming profound abscesses and the destruction of polysebaceous follicles because of granuloma, usually lymphoplasmocitary and with gigantic cells. Here is the case of a 24-year-old male with records of acne conglobata and cicatricial alopecia of the scalp, with relapsed inflammatory nodular lesions on the surface of the alopecic plaques and follicular pustules on their margin. The patient had followed before hospitalizing a systemic treatment with antibiotics (azithromycin, tetracycline, ciprofloxacin, in therapeutic schemes that the patient cannot mention, but anyway of short time) and after that a treatment with retinoids (isotretinoin, 20-30 mg/day, in two successive therapies of one month each). The evolution of the disease under these treatments was with outbreaks and short times of remission of the acne lesions and nodular lesions of the scalp. The clinical diagnosis of PCAS is difficult, especially in the initial stage of the disease, as it was the case of the patient presented here. We underline the importance of a correct history of the disease, of the complete clinical exams and the need of paraclinical investigations (histopathologic exam from the lesional biopsy - microscopy and immunohistochemistry) in order to come with a positive diagnosis of PCAS and a

  9. Cellulitis: Home Or Inpatient in Children from the Emergency Department (CHOICE): protocol for a randomised controlled trial

    PubMed Central

    Ibrahim, Laila F; Babl, Franz E; Orsini, Francesca; Hopper, Sandy M; Bryant, Penelope A

    2016-01-01

    Introduction Children needing intravenous antibiotics for cellulitis are usually admitted to hospital, whereas adults commonly receive intravenous treatment at home. This is a randomised controlled trial (RCT) of intravenous antibiotic treatment of cellulitis in children comparing administration of ceftriaxone at home with standard care of flucloxacillin in hospital. The study aims to compare (1) the rate of treatment failure at home versus hospital (2) the safety of treatment at home versus hospital; and (3) the effect of exposure to short course ceftriaxone versus flucloxacillin on nasal and gut micro-organism resistance patterns and the clinical implications. Methods and analysis Inclusion criteria: children aged 6 months to <18 years with uncomplicated moderate/severe cellulitis, requiring intravenous antibiotics. Exclusions: complicated cellulitis (eg, orbital, foreign body) and immunosuppressed or toxic patients. The study is a single-centre, open-label, non-inferiority RCT. It is set in the emergency department (ED) at the Royal Children's Hospital (RCH) in Melbourne, Australia and the Hospital-in-the-Home (HITH) programme; a home-care programme, which provides outreach from RCH. Recruitment will occur in ED from January 2015 to December 2016. Participants will be randomised to either treatment in hospital, or transfer home under the HITH programme. The calculated sample size is 188 patients (94 per group) and data will be analysed by intention-to-treat. Primary outcome: treatment failure defined as a change in treatment due to lack of clinical improvement according to the treating physician or adverse events, within 48 h Secondary outcomes: readmission to hospital, representation, adverse events, length of stay, microbiological results, development of resistance, cost-effectiveness, patient/parent satisfaction. This study has started recruitment. Ethics and dissemination This study has been approved by the Human Research Ethics Committee of the RCH

  10. Successful treatment of recalcitrant dissecting cellulitis of the scalp with ALA-PDT: case report and literature review.

    PubMed

    Liu, Ye; Ma, Ying; Xiang, Lei-Hong

    2013-12-01

    A case of refractory dissecting cellulitis of the scalp (DCS) in a forty-one-year-old Chinese female patient was treated with a total of 6 sessions of topical ALA-PDT at one week intervals. The patient tolerated and responded well to this new approach without any adverse events. This suggested that topical ALA-PDT could be an effective and safe alternative for DCS patients who were refractory to other conventional therapies. We also reviewed etiology, pathophysiology, natural history and treatment options for DCS. PMID:24284093

  11. Revetements antireflet-passivation a base de nitrure de silicium PECVD pour cellules solaires triple-jonction III-V/ Ge

    NASA Astrophysics Data System (ADS)

    Homier, Ram

    Dans le contexte environnemental actuel, le photovoltaïque bénéficie de l'augmentation des efforts de recherche dans le domaine des énergies renouvelables. Pour réduire le coût de la production d'électricité par conversion directe de l'énergie lumineuse en électricité, le photovoltaïque concentré est intéressant. Le principe est de concentrer une grande quantité d'énergie lumineuse sur des petites surfaces de cellules solaires multi-jonction à haute efficacité. Lors de la fabrication d'une cellule solaire, il est essentiel d'inclure une méthode pour réduire la réflexion de la lumière à la surface du dispositif. Le design d'un revêtement antireflet (ARC) pour cellules solaires multi-jonction présente des défis à cause de la large bande d'absorption et du besoin d'égaliser le courant produit par chaque sous-cellule. Le nitrure de silicium déposé par PECVD en utilisant des conditions standards est largement utilisé dans l'industrie des cellules solaires à base de silicium. Cependant, ce diélectrique présente de l'absorption dans la plage des courtes longueurs d'onde. Nous proposons l'utilisation du nitrure de silicium déposé par PECVD basse fréquence (LFSiN) optimisé pour avoir un haut indice de réfraction et une faible absorption optique pour l'ARC pour cellules solaires triple-jonction III-V/Ge. Ce matériau peut aussi servir de couche de passivation/encapsulation. Les simulations montrent que l'ARC double couche SiO2/LFSiN peut être très efficace pour réduire les pertes par réflexion dans la plage de longueurs d'onde de la sous-cellule limitante autant pour des cellules solaires triple-jonction limitées par la sous-cellule du haut que pour celles limitées par la sous-cellule du milieu. Nous démontrons aussi que la performance de la structure est robuste par rapport aux fluctuations des paramètres des couches PECVD (épaisseurs, indice de réfraction). Mots-clés : Photovoltaïque concentré (CPV), cellules

  12. Cutaneous Richter Syndrome mimicking a lower limb cellulitis infection - a case report and review of the literature.

    PubMed

    César, Artur; Calistru, Ana; Pardal, Joana; Magina, Sofia; Mota, Alberto; Azevedo, Filomena

    2016-01-01

    Richter syndrome (RS) is characterized by the development of a high-grade lymphoma in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Herein, we present the case of an 85-year-old woman with a 3-year history of stable asymptomatic CLL that developed a cutaneous RS. The patient presented with painless inflammation in the left leg and foot that was initially diagnosed as a cellulitis infection. She was treated accordingly with ceftriaxone and clindamycin. However, after completing the antibiotic regimen, not only did the inflammation persist, but also superimposed painless nodules gradually appeared on the left leg and foot over the course of four months. The histopathological examination of the nodules revealed a large B-cell cutaneous lymphoma. The patient underwent chemotherapy with CVP, followed by R-CHOP, resulting in a reduction of size of the nodules and remission of the inflammation. The patient died five months after the diagnosis owing to a bacterial pneumonia. We identified in previous reports a total of fifteen cases of cutaneous RS. Most cases presented with rapidly growing tumors or multiple erythematous nodules, similar to our case. This case of a cutaneous RS mimicking a cellulitis infection underlines the importance of a low threshold for performing biopsies of suspicious skin lesions in patients with CLL/SLL. PMID:27617524

  13. Ultrahigh-rate supercapacitors with large capacitance based on edge oriented graphene coated carbonized cellulous paper as flexible freestanding electrodes

    NASA Astrophysics Data System (ADS)

    Ren, Guofeng; Li, Shiqi; Fan, Zhao-Xia; Hoque, Md Nadim Ferdous; Fan, Zhaoyang

    2016-09-01

    Large-capacitance and ultrahigh-rate electrochemical supercapacitors (UECs) with frequency response up to kilohertz (kHz) range are reported using light, thin, and flexible freestanding electrodes. The electrode is formed by perpendicularly edge oriented multilayer graphene/thin-graphite (EOG) sheets grown radially around individual fibers in carbonized cellulous paper (CCP), with cellulous carbonization and EOG deposition implemented in one step. The resulted ∼10 μm thick EOG/CCP electrode is light and flexible. The oriented porous structure of EOG with large surface area, in conjunction with high conductivity of the electrode, ensures ultrahigh-rate performance of the fabricated cells, with large areal capacitance of 0.59 mF cm-2 and 0.53 mF cm-2 and large phase angle of -83° and -80° at 120 Hz and 1 kHz, respectively. Particularly, the hierarchical EOG/CCP sheet structure allows multiple sheets stacked together for thick electrodes with almost linearly increased areal capacitance while maintaining the volumetric capacitance nearly no degradation, a critical merit for developing practical faraday-scale UECs. 3-layers of EOG/CCP electrode achieved an areal capacitance of 1.5 mF cm-2 and 1.4 mF cm-2 at 120 Hz and 1 kHz, respectively. This demonstration moves a step closer to the goal of bridging the frequency/capacitance gap between supercapacitors and electrolytic capacitors.

  14. Primary cellulitis and cutaneous abscess caused by Yersinia enterocolitica in an immunocompetent host

    PubMed Central

    Kato, Hirofumi; Sasaki, Shugo; Sekiya, Noritaka

    2016-01-01

    Abstract Primary extraintestinal complications caused by Yersinia enterocolitica are extremely rare, especially in the form of skin and soft-tissue manifestations, and little is known about their clinical characteristics and treatments. We presented our case and reviewed past cases of primary skin and soft-tissue infections caused by Y enterocolitica. We report a case of primary cellulitis and cutaneous abscess caused by Y enterocolitica in an immunocompetent 70-year-old woman with keratodermia tylodes palmaris progressiva. She presented to an outpatient clinic with redness, swelling, and pain of the left ring finger and left upper arm without fever or gastrointestinal symptoms 3 days before admission. One day later, ulceration of the skin with exposed bone of the proximal interphalangeal joint of the left ring finger developed, and cefditoren pivoxil was described. However, she was admitted to our hospital due to deterioration of symptoms involving the left finger and upper arm. Cefazolin was initiated on admission, then changed to sulbactam/ampicillin and vancomycin with debridement of the left ring finger and drainage of the left upper arm abscess. Wound culture grew Y enterocolitica serotype O:8 and methicillin-sensitive Staphylococcus aureus. Blood cultures were negative and osteomyelitis was ruled out. Vancomycin was switched to ciprofloxacin, then skin and soft-tissue manifestations showed clear improvement within a few days. The patient received 14 days of ciprofloxacin and oral amoxicillin/clavulanate and has since shown no recurrence. We reviewed 12 cases of primary skin and soft-tissue infections caused by Y enterocolitica from the literature. In several past cases, portal entry involved failure of the skin barrier on distal body parts. Thereafter, infection might have spread to the regional lymph nodes from the ruptured skin. Y enterocolitica is typically resistant to aminopenicillins and narrow-spectrum cephalosporins. In most cases, these inefficient

  15. Tests of Nacelle-Propeller Combinations in Various Positions with Reference to Wings V : Clark Y Biplane Cellule - NACA Cowled Nacelle - Tractor Propeller

    NASA Technical Reports Server (NTRS)

    Valentine, E Floyd

    1935-01-01

    This report is the fifth of a series giving the results obtained from wind tunnel tests on the interference drag and propulsive efficiency of nacelle-propeller-wing combinations. This report gives results of tests of an NACA cowled air-cooled engine nacelle with tractor propeller located in 12 positions with reference to a Clark Y biplane cellule.

  16. Cellulitis-like symptoms manifested by bone metastasis of lung cancer in a patient living with human immunodeficiency virus.

    PubMed

    Kashima, Jumpei; Okuma, Yusuke; Watanabe, Kageaki; Ajisawa, Atushi; Hishima, Tsunekazu

    2016-09-01

    Human immunodeficiency virus (HIV)-infected patients are at a high risk of cancer compared with the general population. As the use of antiretroviral therapy (ART) has increased, non-AIDS-defining cancers have also increased in the past decade. A 61-year-old man with HIV infection on ART developed a painful, erythematous and oedematous lower left leg and an associated fever. He was initially treated with antibiotics for cellulitis but there was no improvement, which warranted further investigation. A translucent lesion was found by X-ray imaging and bone scintigraphy showed bone metastasis from a primary adenocarcinoma of the lung, documented by chest computed tomography and an axillary lymph node biopsy. The patient died three months after the diagnosis despite undergoing chemotherapy. This case demonstrates that physicians should consider metastatic malignancies as a differential diagnoses for diverse skin changes in HIV-infected patients. PMID:26404113

  17. Sarcome à cellules claires du rein : À propos d’un cas chez un jeune de 17 ans

    PubMed Central

    Mazdar, Adil; Sakel, Adil Ait; Essatara, Younes; Beddouche, Ali; Elsayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

    2014-01-01

    Résumé Le sarcome à cellules claires du rein (SCCR) se voit très rarement chez les jeunes. Il est caractérisé par une évolution agressive marquée par un taux élevé de récidive et de mortalité. Nous rapportons le cas d’un SCCR chez un patient de 17 ans et nous discutons de son apport et de son intérêt médical en vue d’une bonne prise en charge thérapeutique. L’agressivité du SCCR et la prolifération de métastases surtout osseuses impliquent qu’il ne faut pas méconnaître ce diagnostic afin de mettre en place un traitement adapté. PMID:24940474

  18. Spondyloarthritis associated with acne conglobata, hidradenitis suppurativa and dissecting cellulitis of the scalp: a review with illustrative cases.

    PubMed

    Lim, Debbie T; James, Neena M; Hassan, Sobia; Khan, Muhammad A

    2013-08-01

    To review and highlight the association of acne conglobata, hidradenitis suppurativa, and dissecting cellulitis of the scalp with inflammatory arthritic conditions, we report five illustrative patients with this association, and a review of the literature. All our patients were African-American males, and their skin disease present before the onset of arthritis. Both asymmetric peripheral arthritis and axial disease can occur. The arthritis is usually insidious and lacks association with rheumatoid factor and HLA-B27. Imaging of peripheral joints can reveal erosions, periosteal bone reaction and new bone formation. When the axial skeleton is involved, imaging can reveal sacroiliitis, syndesmophyte formation. NSAIDs, oral and intra-articular steroids, DMARDs and TNF alpha antagonists have all been used with success. Controlled trials with larger numbers of patients are needed to assess which treatment options are the most effective for this group of patients. PMID:23771559

  19. Early Differential Diagnosis of Rhino-Orbito-Cerebral Mucormycosis and Bacterial Orbital Cellulitis: Based on Computed Tomography Findings

    PubMed Central

    Son, Jun Hyuk; Lim, Hyung Bin; Lee, Soo Hyun; Yang, Jae Wook; Lee, Sung Bok

    2016-01-01

    Purpose To identify significant clinical and radiological findings that distinguish rhino-orbito-cerebral mucormycosis (ROCM) from bacterial orbital cellulitis (BOC). Methods This study was retrospective, multicenter, case-control study that enrolled 34 cases; 14 cases were diagnosed with ROCM and 20 cases were diagnosed with BOC at three different tertiary hospitals between 2005 and 2013. The medical records of all 34 cases were reviewed. The initial clinical manifestations (eyelid swelling, ptosis, extraocular muscle [EOM] limitation, conjunctival injection, and chemosis) and computed tomography (CT) findings (sinus mucosal thickening, full opacification, and air-fluid level) of both diseases were compared. Results Patients with diabetes mellitus (DM) and hypertension (HTN) showed higher incidence rates of ROCM than BOC (DM: p < 0.001, HTN: p = 0.036). ROCM cases exhibited more frequent EOM limitation than cases with BOC (100.0% vs. 66.7%, p = 0.024) but less frequent eyelid swelling (35.7% vs. 90.0%, p = 0.002). However, the incidence rates of ptosis, conjunctival injection, and chemosis exhibited no differences between the diseases. Abnormal CT findings were observed in the sinuses of all patients with ROCM, whereas 12 patients with BOC had sinus abnormalities (100.0% vs. 60.0%, p = 0.011). Thickening of the sinus mucosa was more frequent in patients with ROCM than in those with BOC (92.9% vs. 45.0%, p = 0.009). No significant differences in full opacification or air-fluid level were detected between the groups. Conclusions The differential diagnosis of ROCM and BOC is difficult. Nevertheless, physicians should consider ROCM when a patient with suspected orbital cellulitis presents with EOM limitation without swollen eyelids or thickening of the sinus mucosa on a CT scan. PMID:27501044

  20. A Homeopathic Arnica Patch for the Relief of Cellulitis-derived Pain and Numbness in the Hand

    PubMed Central

    Kaszkin-Bettag, Marietta

    2012-01-01

    Objectives: Arnica montana, belonging to the Compositae family, is a plant with a longstanding tradition of relieving pain and/or inflammation in muscles and joints and may thus represent an alternative to nonsteroidal antiinflammatory drugs, which are often ineffective or lead to a number of adverse effects. A homeopathic arnica patch (3X dilution according to the Homeopathic Pharmacopoeia of the United States) was developed to alleviate pain symptoms in the back and neck muscles and joints. Case Presentation: The present case report describes the treatment outcome after administration of the arnica patch in a 55-year-old female patient with pain in the right hand and numbness in the fourth finger after cellulitis in the palmar area. The cellulitis was treated with antibiotics, but pain symptoms remained at 7 points on a 0-to-10–point visual analog scale (VAS) for pain despite intake of oral ibuprofen and oral and topical application of an arnica-containing complex homeopathic ointment. Ten arnica patches were dispensed to the patient. She cut the patch into strips to cover all painful areas of the hand and applied them at night. After 3 days, she reported a substantial decrease in pain symptoms (VAS = 1) and a marked decrease in numbness and in the size of a tender nodule on the third metacarpal area. Moreover, the patient was able to sleep through the night without being awakened by the pain. The symptoms declined further during the next 2 days. Conclusion: This case demonstrates that after a relatively short period of time, the administration of the arnica patch on the hand provided a marked reduction of pain and recovery of functionality of the hand. PMID:24278813

  1. Carcinome à cellule vitreuse du col de l'utérus: à propos d'un cas et revue de littérature

    PubMed Central

    Hakimi, Ihssane; Zazi, Abdelghani; Chahdi, Hafsa; Guelzim, Khalid; Kouach, Jaouad; Babahabib, Myabdellah; Elhassani, Myehdi; Rahali, Driss Moussaoui; Dehayni, Mohammed

    2015-01-01

    Le carcinome à cellule vitreuse du col de l'utérus est un type de histologique rare de cancer du col de l'utérus qui survient à un âge plus jeune, et s'associe au risque élevé d’échec thérapeutique et le pronostic est plus mauvais en comparaison au type cellulaire squameux. La radiothérapie est associée au risque diminué de récidive. Le but de cette étude est de récapituler à travers d'une observation et une revue de littérature les données sur l'incidence, le comportement clinique et la survie globale de patients avec le carcinome à cellule vitreuse du col de l'utérus. PMID:26664556

  2. Mixed Mycobacterium Avium-Intracellulare and Serratia Marcescens Cellulitis of the Breast in an HIV-Negative Patient with Breast Cancer: A Case Report

    PubMed Central

    Kyvernitakis, Andreas; Kontoyiannis, Dimitrios P

    2016-01-01

    Mycobacterium avium-intracellulare (MAI) causes pulmonary infection in patients with chronic lung diseases or severe T-cell deficiency. Cutaneous manifestations caused by MAI are rare and the few cases reported describe mostly patients with hematologic malignancies who were treated with highly immunosuppressive agents. Herein, we report a case of a breast cancer survivor who developed chronic breast cellulitis due to MAI, following localized breast cancer treatment.

  3. Cancer bronchique à petites cellules et grossesse: à propos d'un cas avec revue de la literature

    PubMed Central

    Safini, Fatima; Jjouhadi, Hassan; Chehal, Asmaa; Mernissi, Farida; Wilfried, Akpoo; Bouchbika, Zineb; Taleb, Amina; Benchakroun, Nadia; Tawfiq, Nezha; Sahraoui, Souha; Benider, Abdellatif

    2016-01-01

    Le cancer broncho-pulmonaire (CBP) de la femme enceinte est une entité rare, d’évolution péjorative. Cette situation devient de plus en plus fréquente, du fait de l'augmentation du tabagisme chez la femme. La transmission tumorale trans-placentaire avec atteinte fœtale est décrite surtout chez les femmes non traitées. Le traitement est multidisciplinaire et n'est pas bien codifié. Nous rapportons le cas d'une patiente de 23 ans chez qui le diagnostic d'un carcinome bronchique à petites cellules a été fait au cours de sa grossesse. Elle avait bénéficié d'une chimiothérapie pendant la grossesse, bien tolérée. L’évaluation radiologique a objectivé une stabilisation du processus pulmonaire. Le traitement a été complété par une association radio-chimiothérapie concomitante après l'accouchement. PMID:27279957

  4. Hypothesis of Lithocoding: Origin of the Genetic Code as a "Double Jigsaw Puzzle" of Nucleobase-Containing Molecules and Amino Acids Assembled by Sequential Filling of Apatite Mineral Cellules.

    PubMed

    Skoblikow, Nikolai E; Zimin, Andrei A

    2016-05-01

    The hypothesis of direct coding, assuming the direct contact of pairs of coding molecules with amino acid side chains in hollow unit cells (cellules) of a regular crystal-structure mineral is proposed. The coding nucleobase-containing molecules in each cellule (named "lithocodon") partially shield each other; the remaining free space determines the stereochemical character of the filling side chain. Apatite-group minerals are considered as the most preferable for this type of coding (named "lithocoding"). A scheme of the cellule with certain stereometric parameters, providing for the isomeric selection of contacting molecules is proposed. We modelled the filling of cellules with molecules involved in direct coding, with the possibility of coding by their single combination for a group of stereochemically similar amino acids. The regular ordered arrangement of cellules enables the polymerization of amino acids and nucleobase-containing molecules in the same direction (named "lithotranslation") preventing the shift of coding. A table of the presumed "LithoCode" (possible and optimal lithocodon assignments for abiogenically synthesized α-amino acids involved in lithocoding and lithotranslation) is proposed. The magmatic nature of the mineral, abiogenic synthesis of organic molecules and polymerization events are considered within the framework of the proposed "volcanic scenario". PMID:27048216

  5. Radiosensibilité comparative des cellules épithéliales de trachée de rats après irradiation alpha in vitro

    NASA Astrophysics Data System (ADS)

    Kugel, C.; Bailly-Despiney, I.; Lagroye, I.; Poncy, J. L.

    1998-04-01

    The main risk in nuclear industry is the internal contamination after inhalation of high LET alpha emitters radionuclides. Main targets of pulmonary carcinogenesis are epithelial respiratory tract cells. An in vitro study was performed in order to determine if a difference in the radiosensitivity occured in epithelial cells from the trachea of two rat strains: Sprague Dawley and Wistar Furth-Fischer F344 after alpha exposure. The cells were irradiated after sedimentation in a specific well. The irradiation was performed using 241Am electrodeposited sources. The irradiation dosecloning efficiency relation was evaluated. A kinetic study of the proliferation and the clonal growth has also been investigated. La contamination interne par inhalation de radionucléides émetteurs alpha de haut TEL est le risque majeur de l'industrie nucléaire. Les cibles principales de la cancérogenèse pulmonaire sont les cellules épithéliales de l'appareil respiratoire. Une étude in vitro a été menée pour déterminer s'il existe une différence de radiosensibilité aux rayonnement alpha, des cellules épithéliales trachéales de deux souches de rats : Sprague Dawley et Wistar Furth-Fischer F344. Les cellules sont irradiées sédimentées au fond d'un puit spécifique à l'aide de sources électrodéposées de 241Am. L'évaluation de la survie cellulaire en fonction de la dose d'irradiation est complétée par un suivi cinétique de la formation et de la prolifération des colonies.

  6. Dissecting cellulitis (Perifolliculitis Capitis Abscedens et Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitis suppurativa.

    PubMed

    Scheinfeld, Noah

    2014-05-01

    Dissecting cellulitis (DC) also referred to as to as perifolliculitis capitis abscedens et suffodiens (Hoffman) manifests with perifollicular pustules, nodules, abscesses and sinuses that evolve into scarring alopecia. In the U.S., it predominantly occurs in African American men between 20-40 years of age. DC also occurs in other races and women more rarely. DC has been reported worldwide. Older therapies reported effective include: low dose oral zinc, isotretinoin, minocycline, sulfa drugs, tetracycline, prednisone, intralesional triamcinolone, incision and drainage, dapsone, antiandrogens (in women), topical clindamycin, topical isotretinoin, X-ray epilation and ablation, ablative C02 lasers, hair removal lasers (800nm and 694nm), and surgical excision. Newer treatments reported include tumor necrosis factor blockers (TNFB), quinolones, macrolide antibiotics, rifampin, alitretinoin, metronidazole, and high dose zinc sulphate (135-220 mg TID). Isotretinoin seems to provide the best chance at remission, but the number of reports is small, dosing schedules variable, and the long term follow up beyond a year is negligible; treatment failures have been reported. TNFB can succeed when isotretinoin fails, either as monotherapy, or as a bridge to aggressive surgical treatment, but long term data is lacking. Non-medical therapies noted in the last decade include: the 1064 nm laser, ALA-PDT, and modern external beam radiation therapy. Studies that span more than 1 year are lacking. Newer pathologic hair findings include: pigmented casts, black dots, and "3D" yellow dots. Newer associations include: keratitis-ichthyosis-deafness syndrome, Crohn disease and pyoderma gangrenosum. Older associations include arthritis and keratitis. DC is likely a reaction pattern, as is shown by its varied therapeutic successes and failures. The etiology of DC remains enigmatic and DC is distinct from hidradenitis suppurativa, which is shown by their varied responses to therapies and their

  7. Spinning characteristics of wings II : rectangular Clark Y biplane cellule: 25 percent stagger; 0 degree decalage; gap/chord 1.0

    NASA Technical Reports Server (NTRS)

    Bamber, M J

    1935-01-01

    General methods of theoretical analysis of airplane spinning characteristics have been available for some time. Some of these methods of analysis might be used by designers to predict the spinning characteristics of proposed airplane designs if the necessary aerodynamic data were known. The present investigation, to determine the spinning characteristics of wings, is planned to include variations in airfoil sections, plan forms, and tip shapes of monoplane wings and variations in stagger, gap, and decalage for biplane cellules. The first series of tests, made on a rectangular Clark Y monoplane wing, are reported in reference 1. That report also gives an analysis of the data for predicting the probable effects of various important parameters on the spin for normal airplanes using such a wing. The present report is the second of the series. It gives the aerodynamic characteristics of a rectangular Clark Y biplane cellule in spinning attitudes and includes a discussion of the data, using the method of analysis given in reference 1.

  8. Primary cellulitis and cutaneous abscess caused by Yersinia enterocolitica in an immunocompetent host: A case report and literature review.

    PubMed

    Kato, Hirofumi; Sasaki, Shugo; Sekiya, Noritaka

    2016-06-01

    Primary extraintestinal complications caused by Yersinia enterocolitica are extremely rare, especially in the form of skin and soft-tissue manifestations, and little is known about their clinical characteristics and treatments. We presented our case and reviewed past cases of primary skin and soft-tissue infections caused by Y enterocolitica. We report a case of primary cellulitis and cutaneous abscess caused by Y enterocolitica in an immunocompetent 70-year-old woman with keratodermia tylodes palmaris progressiva. She presented to an outpatient clinic with redness, swelling, and pain of the left ring finger and left upper arm without fever or gastrointestinal symptoms 3 days before admission. One day later, ulceration of the skin with exposed bone of the proximal interphalangeal joint of the left ring finger developed, and cefditoren pivoxil was described. However, she was admitted to our hospital due to deterioration of symptoms involving the left finger and upper arm. Cefazolin was initiated on admission, then changed to sulbactam/ampicillin and vancomycin with debridement of the left ring finger and drainage of the left upper arm abscess. Wound culture grew Y enterocolitica serotype O:8 and methicillin-sensitive Staphylococcus aureus. Blood cultures were negative and osteomyelitis was ruled out. Vancomycin was switched to ciprofloxacin, then skin and soft-tissue manifestations showed clear improvement within a few days. The patient received 14 days of ciprofloxacin and oral amoxicillin/clavulanate and has since shown no recurrence. We reviewed 12 cases of primary skin and soft-tissue infections caused by Y enterocolitica from the literature. In several past cases, portal entry involved failure of the skin barrier on distal body parts. Thereafter, infection might have spread to the regional lymph nodes from the ruptured skin. Y enterocolitica is typically resistant to aminopenicillins and narrow-spectrum cephalosporins. In most cases, these inefficient

  9. Cellulitis and Erysipelas

    MedlinePlus

    ... the NIAID Institute of Allergy and Infectious Diseases web site to work incorrectly. Please visit your browser settings and ... is inflammation of the skin and deep underlying tissues. Erysipelas is an inflammatory disease of ...

  10. What Is Cellulitis?

    MedlinePlus

    ... Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy ...

  11. Perianal streptococcal cellulitis

    MedlinePlus

    ... inflammation of the anus and rectum caused by Streptococcus bacteria. ... Gerber MA. Group A streptococcus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; ...

  12. Localisation humérale d'une tumeur à cellules géantes récidivantes (à propos d'un cas)

    PubMed Central

    Nader, Youssef; Serghini, Issam; Koulali, Idrissi Khalid; Salahi, Hicham; Galwia, Farid

    2015-01-01

    Les auteurs rapportent un cas de localisation rare d'une tumeur à cellules géantes au niveau de la palette humérale du coude droit chez un militaire de 36 ans de sexe masculin, la radio standard montrait une image kystique ne soufflant pas la corticale. L'examen anatomo-pathologique a permis d’ établir le diagnostic et le traitement a fait appel: au début a une Exérèse chirurgicale totale et une greffe osseuse par un greffon iliaque de la totalité de la palette huméral qui s'est compliquée à 6 mois de recule d une récidive locale. PMID:25995809

  13. Etude des phenomenes chimiques au contact entre le bloc cathodique et la barre collectrice d'une cellule d'electrolyse d'aluminium

    NASA Astrophysics Data System (ADS)

    Lebeuf, Martin

    La production d'aluminium est une industrie importante au Québec. Les propriétés de ce métal le vouent à de multiples usages présents et futurs dans le cadre d'une économie moderne durable. Toutefois, le procédé Hall-Héroult est très énergivore et des progrès demeurent donc nécessaires pour en diminuer les coûts financiers et environnementaux. Parmi les améliorations envisageables de la cellule d'électrolyse se trouve le contact entre la cathode et la barre collectrice, qui doit offrir une faible résistivité au passage du courant électrique. En cours d'opération de la cellule, ce contact a tendance à se dégrader, générant des pertes énergétiques significatives. Les causes de cette dégradation, pouvant provenir de phénomènes chimiques, thermiques, mécaniques et/ou électriques, demeurent mal comprises. Le but du présent projet était donc d'étudier les phénomènes chimiques se produisant au contact bloc-barre de la cellule d'électrolyse Hall-Héroult. En premier lieu, un aspect crucial à considérer est la pénétration du bain électrolytique dans la cathode, car des composés de bain atteignent éventuellement la barre collectrice et peuvent y réagir. A cet effet, une méthode novatrice a été développée afin d'étudier les cathodes et la pénétration du bain dans celles-ci à l'aide de la microtomographie à rayons X. Cette méthode rapide et efficace s'est avérée fort utile dans le projet et a un potentiel important pour l'étude future des cathodes et des phénomènes qui s'y produisent. Ensuite, une cellule d'électrolyse rectangulaire à petite échelle a été développée. Plusieurs phénomènes observés 'en industrie sur des autopsies de cellules post-opération et rapportés dans la littérature ont été reproduis avec succès à l'aide de cette cellule expérimentale. Puis, des tests sans électrolyse, ciblant l'effet du bain électrolytique sur l'acier, ont aussi été conçus et complétés afin de s

  14. Precautions for breast cancer-related lymphoedema: risk from air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and cellulitis.

    PubMed

    Asdourian, Maria S; Skolny, Melissa N; Brunelle, Cheryl; Seward, Cara E; Salama, Laura; Taghian, Alphonse G

    2016-09-01

    Precautionary recommendations conveyed to survivors of cancer by health-care practitioners to reduce the risk of breast cancer-related lymphoedema are indispensable aspects of clinical care, yet remain unsubstantiated by high-level scientific evidence. By reviewing the literature, we identified 31 original research articles that examined whether lifestyle-associated risk factors (air travel, ipsilateral arm blood pressure measurements, skin puncture, extreme temperatures, and skin infections-eg, cellulitis) increase the risk of breast cancer-related lymphoedema. Among the few studies that lend support to precautionary guidelines, most provide low-level (levels 3-5) or inconclusive evidence of an association between lymphoedema and these risk factors, and only four level 2 studies show a significant association. Skin infections and previous infection or inflammation on the ipsilateral arm were among the most clearly defined and well established risk factors for lymphoedema. The paucity of high-level evidence and the conflicting nature of the existing literature make it difficult to establish definitive predictive factors for breast cancer-related lymphoedema, which could be a considerable source of patient distress and anxiety. Along with further research into these risk factors, continued discussion regarding modification of the guidelines and adoption of a risk-adjusted approach is needed. PMID:27599144

  15. Particles cellulation composite (PCC): Dispersion morphology of SiC particles in Si{sub 3}N{sub 4}/SiC composites

    SciTech Connect

    Yamada, K.; Kamiya, N.

    1995-10-01

    Dispersion morphology of fine SiC particles in Si{sub 3}N{sub 4}/xSiC (x = 0, 10, 20, 30wt%, average size: 0.03 {micro} m) composites was statistically analyzed, and typical properties of the composites such as creep, electric and thermal conductivity were investigated. The dispersion morphology of SiC particles was analyzed by observing the ECR-plasma etched surface of the sintered composites using scanning electron microscopy. SiC particles in Si{sub 3}N{sub 4}/SiC composites were distributed both within Si{sub 3}N{sub 4} grains and on Si{sub 4}N{sub 4} grain boundary, but 90% or more of them was located on the grain boundary. For the composites with 20--30 wt%SiC, the SiC particles on the grain boundary clearly formed a three-dimensional network structure surrounding a few or more Si{sub 3}N{sub 4} crystalline grains. A Si{sub 3}N{sub 4}/SiC composite with a three-dimensional network structure of SiC particles, named particles cellulation composite (PCC), was artificially made by pressing the granulated Si{sub 3}N{sub 4} powder (less than 500 {micro} m diameter) discontinuously coated with SiC particles (average size: 0.4 {micro}m). The creep deformation of PCC was reduced to about 60% of that of the composites with SiC particles randomly dispersed. Electrical and thermal properties were also improved. These results suggest that the formation of three-dimensional network structure by the second phase particles in a composite would considerably improve its mechanical property as well as electrical and thermal properties.

  16. Cassures double-brin de l'ADN, cassures chrosomiques et létalité des cellules humaines irradiées

    NASA Astrophysics Data System (ADS)

    Foray, N.; Arlett, C. F.; Malaise, E. P.

    1998-04-01

    DNA double-strand breaks (DSB) are the likely event which may explain the radiation-induced killing effect in mammalian cells. An overview of the litterature shows that, to the exception of a small group of human tumours, the repair defect rather than the induction rate of DSB plays the major role. However, the arguments supporting the relationship between DSB and intrinsic radiosensitivity are most often indirect. Our results dealing with intrinsic radiosensitivity, residual DNA DSB and chromosome breaks have been achieved with untransformed human fibroblasts (5 control and 18 hypersensitive cell lines). We describe a quantitative relationship between the intrinsic radiosensitivity and the residual breaks. The death of a human fibroblast is linked to 1.3 unrepaired chromosome break and 6.6 unrepaired DSB. Les cassures double-brin (CDB) de l'ADN constituent l'événement-clé susceptible d'expliquer l'effet létal des radiations ionisantes. Une revue générale de la littérature montre que, à l'exception d'un groupe minoritaire de tumeurs humaines, c'est surtout une déficience de réparation plutôt que l'incidence des dégâts qui est associée à la mort des cellules de mammifères irradiées. Toutefois, les arguments en faveur d'un lien entre radiosensibilité et CDB sont généralement indirects. À partir de 23lignées fibroblastiques humaines (5témoins et 18hypersensibles), nous décrivons une relation quantifiée entre la radiosensibilité intrinsèque et les cassures résiduelles de l'ADN et des chromosomes. La mort d'un fibroblaste humain irradié est associée à 6,6 CDB et 1,3 cassure chromosomique non réparées.

  17. Réactivation d'hépatite virale B chez un patient traité pour lymphome non hodgkinien B diffus à grandes cellules par rituximab: à propos d'un cas

    PubMed Central

    Houssou, Bienvenu; Massi, Romaric Mahutondji; Camara, Marième; Mifdal, Hassan; Nourichafi, Nadia; Zafad, Saadia; Oukkache, Bouchra

    2015-01-01

    La réactivation du virus de l'hépatite B est secondaire à une diminution de l'immunité de l'hôte et peut être suivie d'une poussée d'hépatite aigue potentiellement mortelle. Nous rapportons le cas d'un patient D.H, 47 ans, sexe masculin, AgHBs négatif, jamais transfusé, jamais vacciné contre l'hépatite B qui avait présenté en mars 2013 un LNH B diffus à grandes cellules stade IV par moelle. Traité par 8 cures R-CHOP, il était en rémission complète clinique et paraclinique. Neuf mois après, il fait une rechute de son lymphome classé stade III, associée à une hépatite virale B en réplication virale (18.000 copies/mL): réactivation virale B chez porteur occulte traité avec entécavir 0.5mg par jour pendant 6 mois, l'ADN du VHB était indétectable en fin de traitement. Il avait reçu deux cures de DHAP puis deux cures R-DHAP avec une rémission complète. Lors du recueil des cellules souches en vue de l'autogreffe, l'AgHBs est à nouveau positif. Il a été greffé le 12/01/2015 et continue son traitement antiviral pour 6 mois encore. PMID:26664523

  18. Fragmentation radioinduite de l'ADN et réparation étudiée par immunomarquage anti poly(ADP-ribose)polymérase (PARP) dans les cellules de hamster chinois (CHO)

    NASA Astrophysics Data System (ADS)

    Bidon, N.; Varlet, P.; Noël, G.; Demurcia, G.; Salamero, J.; Averbeck, D.

    1998-04-01

    The poly(ADP-ribose)polymerase is a nuclear ubiquitous enzyme capable of binding to DNA breaks. Chinese hamster ovary cells were (CHO-K1) cultured on slides and γ-irradiated (137Cs) at a high (12.8 Gy/min) or medium dose rate (5 Gy/min), and immunolabelling against (ADP-ribose) polymers immediatly or three hours after irradiation. Quantification and localisation of γ-ray induced breaks was performed by confocal microscopy. The results show a dose effect relationship, a dose-rate effect and the signal disappearence after 3 hours at 37 °C. The presence of PARP activity appears to reflect γ-rays induced DNA fragmentation. Le poly(ADP-ribose)polymérase est une enzyme nucléaire ubiquitaire capable de se fixer sur les cassures de l'ADN. Sur une lignée sauvage de cellules d'ovaire de hamster chinois (CHO-K1) cultivée sur lame et irradiée aux rayons γ à haut débit de dose (HD) 12,8 Gy/min ou à moyen débit de dose (MD) 5 Gy/min, nous avons réalisé un immunomarquage anti-polymères d'ADP-ribose immédiatement après l'irradiation γ ou après trois heures d'incubation à 37 °C. La quantification et la localisation des lésions radioinduites ont été réalisées par microscopie confocale. Les résultats montrent une relation dose-effet et un effet de débit de dose, ainsi qu'une disparition du signal après 3 heures à 37 °C. La présence de la PARP semble donc bien refléter la fragmentation radioinduite de l'ADN.

  19. Periorbital cellulitis due to cutaneous anthrax.

    PubMed

    Gilliland, Grant; Starks, Victoria; Vrcek, Ivan; Gilliland, Connor

    2015-12-01

    Virgil's plague of the ancient world, Bacillus anthracis, is rare in developed nations. Unfortunately rural communities across the globe continue to be exposed to this potentially lethal bacterium. Herein we report a case of periorbital cutaneous anthrax infection in a 3-year-old girl from the rural area surrounding Harare, Zimbabwe with a brief review of the literature. PMID:25763844

  20. Orbital Cysticercosis - masquerading as preseptal cellulitis with ptosis.

    PubMed

    Raj, Amit; Arya, Sudesh Kumar; Topiwala, Pratik; Gupta, Panchmi; Sood, Sunandan

    2015-07-01

    We are sharing a case of orbital cysticercosis,which presented to us initially with simple ptosis and later on with upper lid inflammation and restricted ocular motility in upgaze. Human cysticercosis, a parasitic infection caused by Cysticercus cellulosae, the larval form of the cestode, Taenia solium, is a benign infection of the subcutaneous tissues, inter-muscular fascia, muscles and other organs. Though it exists worldwide, it is more prevalent in the developing countries of Latin America, Asia and Africa, especially in areas where under-cooked pork is consumed regularly (Pushker et al, 2001). However, 5 year study of 33 cases of Ocular/Adnexal cysticercosis showed seventy percent of patients were of low socioeconomic group and 70% were strictly vegetarians (Atul et al, 1995). The clinical manifestation of orbital cysticercosis is entirely different from neuro-cysticercosis or cysticercosis of other parts of body. Diagnosis of cysticercosis is mainly based on highly specific radiological signs and history of exposure in endemic areas. PMID:27363971

  1. Skin and Soft Tissue Infection (Cellulitis) (Beyond the Basics)

    MedlinePlus

    ... skin infections are discussed separately. (See "Patient education: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics)" and "Patient ... be caused by a skin infection known as methicillin-resistant Staphylococcus aureus (MRSA). This is discussed separately. (See " ...

  2. Biopuces pour le traitement de cellules vivantes : micromanipulation des cellules par voie électrique ou microfluidique

    NASA Astrophysics Data System (ADS)

    Le Pioufle, Bruno; Frénéa, Marie; Tixier, Agnès

    2004-06-01

    After a brief overview of the state of the art in the domain of cell biochips, and more particularly, the usual methods for cell placement and characterization on a chip, our research on highly parallelized cell placement on a chip is presented. Single cell arraying methods, using dielectrophoresis effects, or microfluidic effects produced by bulk micromachined sub-micrometric capillaries are compared. Target applications of such cell biochips cover the domain of gene transfer on a large population of cells, parallelized cell sorting, or drug high-throughput screening on living cells. To cite this article: B. Le Pioufle et al., C. R. Physique 5 (2004).

  3. Detection de produits de fission a l'aide de cellules photovoltaiques

    NASA Astrophysics Data System (ADS)

    Liatard, E.; Akrouf, S.; Bruandet, J. F.; Fontenille, A.; Glasser, F.; Stassi, P.; Chan, Tsan Ung

    1988-04-01

    The response of photovoltaic cells to heavy ions and fission products have been tested in-beam. Their main advantages are their extremely low price, their low sensitivity to energetic light ions with respect to fission products, and the possibility to cut and fit them together to any shape without dead zone. The time output signals of a charge sensitive preamplifier connected to these cells allows fast coincidences. A resolution of 12 ns (FWHM) has been measured between two cells.

  4. Orbital wall infarction mimicking periorbital cellulitis in a patient with sickle cell disease.

    PubMed

    Ozkavukcu, Esra; Fitoz, Suat; Yagmurlu, Banu; Ciftci, Ergin; Erden, Ilhan; Ertem, Mehmet

    2007-04-01

    Orbital wall infarction and subperiosteal haematomas are unusual manifestations of sickling disorders. Here we report an 11-year-old girl with sickle cell anaemia having multiple skull infarctions including the orbital bony structures associated with subperiosteal haematomas. The diagnosis was made by MRI, which showed bone marrow changes and associated haemorrhagic collections. The patient was successfully managed without surgical intervention. PMID:17297619

  5. Draft Genome Sequence of Nocardia jinanensis, an Opportunistic Bacterial Pathogen That Causes Cellulitis

    PubMed Central

    Chakrabortti, Alolika; Li, Jinming

    2016-01-01

    The draft genome sequence of Nocardia jinanensis, an opportunistic pathogen that can cause skin infections, reveals genes that may contribute to the lifestyle and pathogenicity of N. jinanensis. The genome also reveals the biosynthetic capacity of N. jinanensis in producing mycolic acids, siderophores, and other polyketide and nonribosomal peptide-derived secondary metabolites. PMID:27445366

  6. Pressure Distribution Tests on a Series of Clark Y Biplane Cellules with Special Reference to Stability

    NASA Technical Reports Server (NTRS)

    Noyes, Richard W

    1933-01-01

    The pressure distribution data discussed in this report represents the results of part of an investigation conducted on the factors affecting the aerodynamic safety of airplanes. The present tests were made on semispan, circular-tipped Clark Y airfoil models mounted in the conventional manner on a separation plane. Pressure readings were made simultaneously at all test orifices at each of 20 angles of attack between -8 degrees and +90 degrees. The results of the tests on each wing arrangement are compared on the bases of maximum normal force coefficient, lateral stability at a low rate of roll, and relative longitudinal stability. Tabular data are also presented giving the center of pressure location of each wing.

  7. Une Technique D' Analyse D' Image Par Cellule Sur Ecran Video

    NASA Astrophysics Data System (ADS)

    Lefebvre, G.; Thorax, L.; Ducom, J.

    1985-02-01

    In packaging,vision of making process is difficult due to high speed of machines. The setting of box erecting is tedious. The origin of filling hazards tedious is often unknown. Some performances on line are not reproducible. To visualisate, decompose and analyse the fast moving phenomenons which are causing packaging troubles, the French Paper and Board Research Institute has obtained video NAC eouinment (200 pictures/sec.). An articulate stand able to move on a carriage is designed to facilitate shooting on machine. An elaborate image analysis is undertaken to find the characteristics of the hoards which are necessary to optimize making the folding box erection on the packaging lines. Actual image analysis with computer systems are large, expensive and necessitate a specific program for each problem. Important equipment are actually used exclusively for special fields. For packaging field where machines and products are diversified we have developed an easy electronical technique for picture analysis. This technique is suitable for all kinds of processes or defects, visualised by high speed video from video shooting on machine. The processes and the manufacture incidents are analysed, controled with a cell on video screen. The light intensity variations are detected and writed on self-recording apparatus. Materials move, their forming modifications and the moves of machine elements are expressed like "signature". All changes on "signature" show hazardous or reproducible variations according to defects of manufacture processes. A short time event, visible on few images only is located with normal or slower speed of the magnetic tape according to the importance of variation. This technique is used to measure in real time the packaging deformations on line. Ease for use, speed of setting and quantity of data are operating qualities of efficient image analysis.

  8. Nouveautes Dans la Reconstruction Cutanee: Cultures de Cellules et Substituts Dermiques et Revue de la Litterature

    PubMed Central

    Koch, N.; Erba, P.; Benathan, M.; Raffoul, W.

    2010-01-01

    Summary La prise en charge de patients souffrant de brûlures profondes et étendues reste un défi important pour les chirurgiens reconstructeurs. Ceci est d'autant plus vrai que les grands progrès réalisés dans la réanimation assurent actuellement la survie de patients brûlés sur plus de 90% de leur surface corporelle. De ce fait la reconstruction moderne a dû innover et est devenue une chirurgie complexe nécessitant un plan stratégique impliquant des matériaux et des méthodes chirurgicales multiples adaptées à chaque situation clinique. Ce type de prise en charge nécessite aussi la collaboration étroite et coordonnée de plusieurs équipes hautement spécialisées. Le taux de survie ainsi que de la qualité de vie de ces patients sont alors nettement améliorés. De même nous observons clairement que le nombre de complications secondaires telles que les rétractions et les instabilités cicatricielles ont également diminué de façon significative. Mots-clés: brûlure, greffe, culture, substitut dermique, reconstruction PMID:21991212

  9. Inflammatory tinea capitis (kerion) mimicking dissecting cellulitis. Occurrence in two adolescents.

    PubMed

    Sperling, L C

    1991-03-01

    Tinea capitis is unusual in postpubertal individuals and is frequently misdiagnosed. In cases of inflammatory disease, prompt initiation of therapy is essential to prevent scarring and permanent hair loss. Two examples are presented to illustrate principles of evaluation and treatment. PMID:2037403

  10. Influence de revetements bioactifs sur les cellules endotheliales: Vers des protheses vasculaires non thrombotiques

    NASA Astrophysics Data System (ADS)

    Fadlallah, Hicham

    Developing vascular prostheses of small diameter to replace vessels closed by atherosclerosis remains a challenge because of the risk of thrombosis. Seeding of endothelial cells, which have antithrombogenic properties, is a promising solution, but we must create surfaces which promote their adhesion and retention to resist shear stresses created by the blood flow on the surface. This master's project aimed at investigating the effect of a plasma polymerized coating rich in primary amines (called LP), with or without elements of the extracellular matrix (Fibronectin (FN) or chondroitin sulphate (CS)) on the endothelial cells and hemocompatibility of polyethylene terephthalate (PET). The adhesion, growth and retention of human umbilical vein endothelial cells (HUVECs) on PET and LP, in the presence and absence of FN or CS, have been studied. In addition, platelet adhesion on different surfaces was evaluated by a perfusion test with whole blood, platelets being previously labeled with rhodamine. Finally a double fluorescent labeling (using Cellview Maroon to mark the HUVECs and CD61 antibody for platelets) was developed to study the retention of endothelial cells, under blood flow and verify their non thrombogenic character. The results obtained show that both the LP coating and the adsorbed FN, strongly increase both the cellular adhesion and growth on PET; however they have no additional effect when the two are combined. They also augment cellular retention to surface, but this remains incomplete. Moreover we observed that the plasma coating (LP) greatly increases the thrombogenicity of the surface, with strong platelet adhesion and activation. This thrombogenicity is extremely reduced when endothelial cells cover the surface, but cell loss under the effect of shear produced by the perfusion creates significant areas of platelet adhesion. The grafting of CS on LP also permits good HUVECs adhesion, growth and retention under shear stress on HUVEC, with no difference from the LP alone. In addition, the CS sharply decreases the platelet adhesion, which is found below the value observed for PET. The double cell labeling also showed that cells adhered on LP+CS has an anti-thrombotic phenotype and can resist blood flow. These studies suggest that a coating of CS is a promising strategy for vascular prosthesis given the combination of the good adhesion of endothelial cells and the low thrombogenicity of the underlying surface. Keywords: vascular prostheses, polymers, bioactive coating, thrombogenicity, HUVECs.

  11. Orbital roof fracture and orbital cellulitis secondary to halo pin penetration: case report.

    PubMed

    Menon, K Venugopal; Al Rawi, Asif Esam; Taif, Sawsan; Al Ghafri, Khalifa; Mollahalli, Kishore Kumar

    2015-02-01

    Study Design Case report. Objective To report and discuss a rare complication after a patient was treated conservatively with a halo vest. Methods A 51-year-old man sustained a hangman's injury of the C2 vertebra following a motor vehicle collision. He was treated conservatively in a halo vest appliance and following mobilization was discharged from the hospital. Two weeks after discharge, the patient presented to the emergency department complaining of proptosis, ptosis, diplopia, and pin loosening. He was readmitted to the hospital, the halo vest was removed, and urgent imaging studies including computed tomography scan and magnetic resonance imaging were performed. They revealed that one of the halo pins had penetrated the orbital roof with active infection of the extraocular soft tissues. In consultation with the ophthalmologist, he was treated conservatively with antibiotics for 10 days. Results His ophthalmologic complaints resolved gradually and his eye returned to normal appearance and function. In the meantime, he was immobilized in a sterno-occipital mandibular immobilizer brace. Conclusion Though rare, penetrating injuries after cranial pin insertion can occur. Halo devices must be applied by, or under close supervision of, experienced personnel to avoid such complications, and halo vests should be reviewed frequently to detect such incidents early. PMID:25648519

  12. Adult-onset Invasive Haemophilus influenzae Type f Caused by Acute Lower Leg Cellulitis.

    PubMed

    Usui, Yuko; Kakuta, Risako; Araki, Makoto; Sato, Taigo; Gu, Yoshiaki; Yano, Hisakazu; Taniuchi, Norihide

    2016-01-01

    In Japan, routine Haemophilus influenzae type b (Hib) vaccination began in 2013. Thus, similar to other countries, a strain shift is expected in the near future. We experienced a case of H. influenzae type f (Hif) bacteremia in a 66-year-old man. The primary focus of the infection was the soft tissue of the left lower leg, which is an extremely rare origin in adults. Subsequently, we conducted multilocus sequence typing and identified the strain as sequence type 124, which is the most common invasive strain of Hif worldwide. This case may mark the beginning of an Hif strain shift in Japan. PMID:27374690

  13. Juvenile cellulitis in a 7-week-old golden retriever dog

    PubMed Central

    Martens, Sabrina M.

    2016-01-01

    A 7-week-old golden retriever puppy was presented with acute onset of marked facial inflammation and pustular dermatitis, markedly enlarged submandibular lymph nodes, and pyrexia. Treatment included high-dose corticosteroids and antibiotics. One week after presentation the puppy showed a significant decrease in inflammation and healing pustules. PMID:26834274

  14. First Report of Wohlfahrtiimonas chitiniclastica Isolation from a Patient with Cellulitis in the United States

    PubMed Central

    de Dios, Angel; Jacob, Seby; Tayal, Amit; Fisher, Mark A.; Dingle, Tanis C.

    2015-01-01

    We report the first documented isolation of Wohlfahrtiimonas chitiniclastica from a human in the United States. Initially misidentified as Acinetobacter lwoffii by Vitek-2, the isolate was subsequently identified as W. chitiniclastica by matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. While the clinical significance of the isolate in this case is unclear, it highlights the superior performance of MALDI-TOF MS for bacterial identification. PMID:26378273

  15. Métastases musculaires squelettique asymptomatique d'un cancer bronchique non à petites cellules

    PubMed Central

    Raoufi, Mohammed; Oukabli, Mohamed; Biyi, Abdelhamid; Elouazzani, Hanane; Rhorfi, Ismail Abderrahman; Abid, Ahmed

    2015-01-01

    Le cancer bronchique reste parmi les cancers les plus agressifs malgré les avancées diagnostiques et thérapeutiques, les métastases à distance constituent l’élément majeur d'un mauvais pronostic. Nous rapportons une observation de métastases musculaires chez un patient porteur d'un cancer du poumon inopérable. La détection de cette métastase était grâce au TEP scan au 18 FDG. Ce bilan a conduit à un traitement par chimiothérapie systémique après biopsie exérèse de la localisation fessière. Les métastases musculaires squelettiques du cancer bronchique sont rares mais bien qu'indiquant un mauvais pronostic, elles sont accessibles à un traitement local efficace. PMID:26918076

  16. Combined enzyme mediated fermentation of cellulous and xylose to ethanol by Schizosaccharoyces pombe, cellulase, .beta.-glucosidase, and xylose isomerase

    DOEpatents

    Lastick, Stanley M.; Mohagheghi, Ali; Tucker, Melvin P.; Grohmann, Karel

    1994-01-01

    A process for producing ethanol from mixed sugar streams from pretreated biomass comprising xylose and cellulose using enzymes to convert these substrates to fermentable sugars; selecting and isolating a yeast Schizosaccharomyces pombe ATCC No. 2476, having the ability to ferment these sugars as they are being formed to produce ethanol; loading the substrates with the fermentation mix composed of yeast, enzymes and substrates; fermenting the loaded substrates and enzymes under anaerobic conditions at a pH range of between about 5.0 to about 6.0 and at a temperature range of between about 35.degree. C. to about 40.degree. C. until the fermentation is completed, the xylose being isomerized to xylulose, the cellulose being converted to glucose, and these sugars being concurrently converted to ethanol by yeast through means of the anaerobic fermentation; and recovering the ethanol.

  17. Effects of yeast extract and vitamin D on turkey mortality and cellulitis incidence in a transport stress model.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We evaluated yeast extract (YE) and vitamin D (VD) in turkeys treated with dexamethasone (Dex) at intervals designed to simulate transport stress during a 3 stage growout. YE but not VD decreased early mortality (P = 0.001) and mortality at wk 7 (P= 0.02) and wk 12 (P = 0.002) but not wk 16. Celluli...

  18. Pathology Image Of the Month: Rapidly Progressive Hemorrhagic Cellulitis of Bilateral Lower Extremities with Subsequent Septic Shock and Death.

    PubMed

    Connor, Ellen E; Jackson, Nicole R; McGoey, Robin R

    2016-01-01

    A 51-year-old man presented to a community based emergency department with bilateral lower extremity swelling that began four days prior and that had evolved into recent blister formation on the left lower extremity. Medical history was significant only for hypertension and a recent self-described episode of "food poisoning" five days earlier characterized by diarrhea, nausea, and vomiting that quickly resolved. Physical exam revealed marked bilateral lower extremity edema and an ecchymotic rash below the knee. In addition to the rash, there were large flaccid bullae on the left leg, mostly intact but some notable for draining of scanty serosanguinous fluid. The patient was tachycardic with a rate of 114 bpm and initial labs showed thrombocytopenia (platelets 56 x 103/uL [140-440 x 103/uL]), hypoglycemia (15mg/dl [70-105mg/dl]), an elevated creatinine (2.7mg/dL [0.7- 1.25mg/dL]), and aspartate aminotransferase (AST 156U/L [5- 34U/L]). Two sets of blood cultures were drawn, broad spectrum antibiotics including doxycycline were empirically initiated and then he was subsequently transported to a tertiary care hospital for escalation of care. Within hours of presentation to the tertiary care facility, the rash appeared progressively hemorrhagic and bullous, lactic acidosis and coagulopathy developed and hemodynamic instability and septic shock necessitated endotracheal intubation and vasopressors. He was taken to the operating room for skin debridement but was emergently converted to bilateral above the knee lower extremity amputations due to the extent of the soft tissue necrosis. The patient remained intubated and in critical condition following surgery and the ecchymotic rash reappeared at the amputation sites. A newly developed ecchymotic rash with bullae formation was noted on the right upper extremity forearm. At that time, the clinicians were notified that four out of four blood culture bottles from admission were rapidly growing a microorganism. The family elected for withdrawal of care, and the patient died approximately 72 hours following presentation. A full and unrestricted autopsy was authorized by the Coroner's Office. PMID:27389382

  19. Une métastase intra-thyroïdienne révélant un cancer bronchique non à petites cellules

    PubMed Central

    Boukir, Anwar; El Kabous, Mustapha; Azghari, Ilham; Boutayeb, Saber; El Ghissassi, Ibrahim; Mrabti, Hind; Errrihani, Hassan

    2015-01-01

    Les métastases thyroïdiennes sont très peu fréquentes. Elles peuvent de façon exceptionnelle révéler le cancer primitif. Nous rapportons le cas d'une patiente qui a présenté une dysphonie secondaire à un gros nodule thyroïdien lobaire droit. L'examen anatomopathologique de la pièce de l'hémi thyroïdectomie a révélé la présence d'un adénocarcinome d'origine pulmonaire. Le bilan d'extension a confirmé la présence d'une masse au niveau du Fowler droit ainsi qu'une métastase du trochanter fémoral droit et une récidive au niveau de la loge thyroïdienne. Une chimiothérapie à base de Paclitaxel, Carboplatine et Bevacizumab a été débuté. L’évaluation après 4 cures est en faveur d'une stabilité radiologique avec amélioration des symptômes. PMID:26918084

  20. Etude ab initio des proprietes electroniques et optiques d'un systeme donneur-accepteur organique utilise dans les cellules photovoltaiques

    NASA Astrophysics Data System (ADS)

    Maillard, Arnaud

    The search for new sources of clean and renewable energy has recently been encouraged by the growing energy demand caused by the industrialization of developing countries and by population growth. In this context, the generation of electricity through the exploitation of solar energy with photovoltaic cells is particularly interesting, since this energy source is largely unused compared to its full potential. Nevertheless, large scale electricity generation with the current design of photovoltaic cells based on silicon is hindered by the large manufacturing cost of these devices. A new generation of photovoltaic cells, which includes organic photovoltaic cells that use semiconducting polymers, is under intense development in order to significantly reduce the manufacturing costs. The replacement of conventional materials with conjugated polymers in photovoltaic cells opens the possibility of using large scale manufacturing processes to produce large-area devices at low cost. However, the power conversion efficiency and the lifetime of organic photovoltaic cells are currently too low for these devices to be cost effective. A better understanding of the organic photovoltaic process is therefore necessary to improve the power conversion efficiency of these devices. The operating principle of photovoltaic cells requires the charge transfer between a polymer acting as an electron donor and a molecule acting as an electron acceptor to enable the dissociation of photogenerated excitons into free charge carriers. Furthermore, to ensure that the majority of the photogenerated excitons dissociates, the active region of an organic photovoltaic cell is typically formed by a bulk heterojunction between the donor and the acceptor. Many experimental studies have shown that the power conversion efficiency of these devices, which is proportional to the product of their short-circuit current Isc with their open circuit potential Voc, is strongly governed by the microstructure of the bulk heterojunction defined as the local order of the two phases and the organization of the donor-acceptor interfaces. Even though these studies have helped to increase the efficiency of organic photovoltaic cells, the relations linking the microstructure of the bulk heterojunction to their electronic and optical properties are still to be established. The objective of the research project is to computationally study the electronic and optical properties of organic bulk heterojunctions composed of regioregular poly(3-hexylthiophene) (rrP3HT) and C60, two materials typically used in organic photovoltaic cells. In this study, the microstructure of the donor-acceptor systems can be directly controlled, which facilitates the systematic study of the influence of this parameter on the electronic and optical properties of the organic bulk heterojunctions. The density functional theory (DFT) is used to study the ground state geometric and electronic properties of multiple bulk heterojunction systems, while the time dependent density functional theory (TDDFT) is used to study the optical properties of these systems. The SIESTA software package is used to study periodic systems representing perfectly crystalline materials. The results obtained in this research project show that the power conversion efficiency of organic photovoltaic cells is strongly modulated by the microstructure of the bulk heterojunctions. Indeed, the size of the rrP3HT crystalline domains must be optimized to maximize the efficiency of the photovoltaic devices, since Voc and Isc have opposite behaviors with respect to π-stacking of the rrP3HT chains. In addition, the efficiency of organic photovoltaic cells could be improved by imposing geometrical constraints in the bulk heterojunctions through manufacturing methods in order to increase the value of Voc without altering the value of Isc. (Abstract shortened by UMI.).

  1. MODIFICATIONS ULTRASTRUCTURALES DES CELLULES SÉCRÉTRICES DE LA GLANDE PROTHORACIQUE DE VERS À SOIE AU COURS DES DEUX DERNIERS ÂGES LARVAIRES

    PubMed Central

    Beaulaton, J. A.

    1968-01-01

    Ultrastructural study of the prothoracic glands of silkworms (Antheraea pernyi and Bombyx mori) at the last two larval stages has shown that the essential modifications which take place during each intermolt affect the chondriome of secretory cells. A description is given of the differentiation of macromitochondria from typical mitochondria by a general swelling, a clearing of the matrix, and the formation of a complex tubular network. The hypothesis of fixation or anaesthesia artifacts has been dismissed because of the persistence of these transformations after different fixations and because of the existence of numerous intermediary stages between these two types of chondriosomes which imply the progressiveness of differentiation. The cytochemical demonstration of mitochondrial DNA fibers suggests that the genetic information, probably present in this type of nucleic acid, controls the differentiation and the specific metabolic activity of these organelles. The frequent relationships observed in Antheraea between the tubules of agranular reticulum and the macromitochondria which are reminiscent of the vacuoles-mitochondria associations of the adrenal cortex, may be related to the transfer of cholesterol and other precursors of steroidogenesis. In the last stages, the macromitochondria become transformed into vacuoles by a disappearance of the tubular network. The correlation revealed between mitochondrial transformations and the cyclical release of ecdysone (65) leads to the conclusion that a prominent fraction of chondriosomes is involved, in relation to the agranular reticulum, in the elaboration of steroid hormones such as ecdysone. PMID:5699930

  2. Tumeur à cellules géantes du fémur proximal traitée par arthroplastie totale de hanche

    PubMed Central

    Mhammdi, Younes; Kharmaz, Mohamed

    2016-01-01

    The authors report the case of a giant cell tumor grade 1 of the proximal femur, diagnosed in a young patient of 18 years. The diagnosis was suspected on a standard x-ray complemented by MRI, it was confirmed on histological examination after biopsy. The tumor was a metaphyseal-epiphyseal location above the level of the femoral cut on preoperative planning. The management had combined two surgical techniques, with a marginal resection of the femoral head and neck, and femoral curettage-filling of the metaphyseal region with implantation of a total cemented hip prosthesis. After 2 years of follow up, the result is very satisfactory with good functional recovery and no signs of recurrence. PMID:27279937

  3. Peritonsillar abscess

    MedlinePlus

    ... obstruction Cellulitis of the jaw, neck, or chest Endocarditis (rare) Fluid around the lungs ( pleural effusion ) Inflammation ... chap 196. Read More Abscess Breathing difficulty Cellulitis Endocarditis Pericarditis Pleural effusion Pneumonia - adults (community acquired) Retropharyngeal ...

  4. Optimising Diagnosis and Antibiotic Prescribing for Acutely Ill Children in Primary Care

    ClinicalTrials.gov

    2015-02-16

    Sepsis; Bacteraemia; Meningitis; Abscess; Pneumonia; Osteomyelitis; Cellulitis; Gastro-enteritis With Dehydration; Complicated Urinary Tract Infection; Viral Respiratory Infection Complicated With Hypoxia

  5. Facial swelling

    MedlinePlus

    ... Allergic reaction ( allergic rhinitis , hay fever, or a bee sting ) Angioedema Blood transfusion reaction Cellulitis Conjunctivitis (inflammation ... Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of ...

  6. Lymphadenitis

    MedlinePlus

    Lymph node infection; Lymph gland infection; Localized lymphadenopathy ... Untreated lymphadenitis may lead to: Abscess formation Cellulitis (a skin infection) Fistulas (seen in lymphadenitis that is due to tuberculosis) Sepsis (bloodstream infection)

  7. Skin Infections

    MedlinePlus

    ... nearby What to Do Teach kids not to pop, pick at, or scratch pimples, pus-filled infections, ... Your Skin Abscess Impetigo Ringworm Cellulitis Should I Pop My Pimple? Tips for Taking Care of Your ...

  8. Fibrinopeptide A blood test

    MedlinePlus

    ... problems with blood clotting such as disseminated intravascular coagulation ( DIC ). Certain types of leukemia are associated with ... be a sign of: Cellulitis DIC (disseminated intravascular coagulation) Leukemia at the time of diagnosis, during early ...

  9. ARRAYS FOR BIOMONITORING ENVIRONMENTAL AND REPRODUCTIVE TOXICOLOGY

    EPA Science Inventory

    DNA arrays are receiving increasing interest as a tool for monitoring the developmental and reproductive impact of xenobiotics and other hazardous materials on human and wildlife populations. The primary tenet of toxicogenomics is that effects of environmental exposure on cellul...

  10. SHEWANELLA AND PHOTOBACTERIUM IN OYSTERS AND SEAWATER FROM THE DELAWARE BAY

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Shewanella algae, S. putrefaciens, and Photobacterium damselae subsp. damselae are indigenous marine bacteria and human pathogens causing cellulitis, necrotizing fasciitis, abscesses, septicemia, and death. Infections are rare and are most often associated with the immunocompromized host. A study ...

  11. Stasis Dermatitis

    MedlinePlus

    ... as lanolin) Cellulitis (a serious infection that extends deep into the skin) Image #1 used with permission ... especially a blood clot in a leg like deep vein thrombosis Previous injury to the area Many ...

  12. Toxic Shock Syndrome (For Parents)

    MedlinePlus

    ... Problems Talking to Your Child About Menstruation Cellulitis MRSA Staph Infections What Are Germs? Why Is Hand ... in? Feeling Fresh All About Menstruation Staph Infections MRSA Toxic Shock Syndrome Contact Us Print Resources Send ...

  13. Other Causes of Leg Pain | NIH MedlinePlus the Magazine

    MedlinePlus

    ... the bone (osteomyelitis) or skin and soft tissue (cellulitis) Inflammation of the leg joints by arthritis or gout Nerve damage —common in diabetics, smokers, and alcoholics (symptoms include numbness, tingling, or ...

  14. Isotretinoin induced rhabdomyolysis? A case report.

    PubMed

    Trauner, M A; Ruben, B S

    1999-11-01

    Isotretinoin, an effective therapy for nodulocystic acne and dissecting cellulitis of the scalp, has many known side effects. However, its association with elevated creatine kinase levels and its potential to cause rhabdomyolysis is not well established. We describe a patient with a significant elevation in creatine kinase after beginning therapy with isotretinoin for dissecting cellulitis of the scalp. The implications of isotretinoin causing rhabdomyolysis are discussed. PMID:10673455

  15. Propriétés optiques du silicium mésoporeux et ses applications potentielles

    NASA Astrophysics Data System (ADS)

    Lévy-Clément, C.; Bastide, S.

    2002-04-01

    Une couche de silicium poreux formée électrochimiquement à la surface de l'émetteur d'une jonction p-n+ peut jouer efficacement le rôle d'une couche antireflet pour les cellules solaires au silicium. En ajustant la densité de courant et le temps de formation, des simple et double-couches antireflet aux propriétés optiques optimisées ont pu être réalisées, conduisant à des réflectivités effectives respectives de 7.3 et 2.7 % sur l'ensemble du spectre solaire utile pour les cellules (400-1000 nm). De hauts rendements de conversion de l'énergie solaire, de l'ordre de 13-13.4 %, sont ainsi actuellement obtenus pour des cellules au silicium multicristallin avec une couche antireflet de silicium poreux.

  16. Periorbital cellulits – a mistaken diagnosis!

    PubMed Central

    Fozard, Julia; Pandya, Nikila; Pulikot, Ashok; Fish, David; Malhotra, Raman; Lake, Damian

    2011-01-01

    A 12-year-old girl presented with a 1 week history of orbital swelling associated with granuloma, purulent discharge from the eye and preauricular and submandibular lymphadenopathy. Initial conventional treatment for presumed preseptal cellulitis was unsuccessful. Despite treatment with broad spectrum antibiotics, the preseptal cellulitis progressed to orbital cellulitis with restriction of eye movements in addition to the marked conjunctival chemosis and haemorrhage. A detailed history revealed she had been in close contact with newborn kittens at home and biopsy of the granuloma demonstrated Bartonella species, confirming the diagnosis of cat scratch disease. The child received a course of appropriate oral and topical antibiotics and steroids. Unfortunately eyesight in the right eye remains poor on follow-up. PMID:22688944

  17. Microbiology and management of soft tissue and muscle infections.

    PubMed

    Brook, Itzhak

    2008-08-01

    This review summarizes the microbiological aspects and management of soft tissue and muscle infections. The infections presented are: impetigo, folliculitis, furunculosis and carbuncles, cellulitis, erysipelas, infectious gangrene (includes necrotizing fasciitis or streptococcal gangrene, gas gangrene or clostridium myonecrosis, anaerobic cellulites, progressive bacterial synergistic gangrene, synergistic necrotizing cellulitis or perineal phlegmon, gangrenous balanitis, and gangrenous cellulitis in the immunocompromised patient), secondary bacterial infections complication skin lesions, diabetic and other chronic superficial skin ulcers and subcutaneous abscesses and myositis. These infections often occur in body sites or in those that have been compromised or injured by foreign body, trauma, ischemia, malignancy or surgery. In addition to Group A streptococci and Staphylococcus aureus, the indigenous aerobic and anaerobic cutaneous and mucous membranes local microflora usually is responsible for polymicrobial infections. These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy. PMID:17720643

  18. Injection of household spray insecticide.

    PubMed

    Goldberg, L H; Shupp, D; Weitz, H H; Zeccardi, J A

    1982-11-01

    During a three-week period, two patients who had attempted suicide by injecting themselves with commercially available household spray insecticides were seen in our emergency department. Both presented with cellulitis at and adjacent to the injection sites, and both were admitted for intravenous antibiotics, warm soaks, and elevation. In both patients abscesses subsequently developed in the areas of cellulitis. It is not clear whether the pathologic processes in these two patients were primarily due to inoculation of microorganisms or to the effects of the insecticide per se. PMID:7137672

  19. Periorbital Dirofilariasis: A Rare Case from Western India

    PubMed Central

    Kulkarni, Varsha

    2016-01-01

    Dirofilariasis is a zoonotic disease caused commonly by Dirofilaria repens and Dirofilaria immitus. The definitive hosts are domestic dogs and cats. Human beings are accidental dead end hosts, and acquire infestation through mosquito bites. So far, very few cases have been reported from western India. We report a case of a 27-year-old male who presented with preseptal cellulitis right eye and a firm mass in the lower lid. Histopathological examination after surgical excision of the mass revealed a diagnosis of dirofilariasis. Although rare in Western India a diagnosis of dirofilariasis should be considered in cases of preseptal cellulitis associated with a periorbital mass. PMID:27134918

  20. A serious drug interaction leading to spontaneous total hyphema.

    PubMed

    Trivedi, D; Newton, J D; Mitra, A; Puri, P

    2010-01-01

    A 70 year-old diabetic man receiving anti-coagulant therapy (Warfarin) for pulmonary embolism secondary to factor V Leiden deficiency, presented to the hospital for chest pain. After initial evaluation, he was started on aspirin (300 mg) and clopidogrel (300 mg). Three days after he was discharged, he presented with preseptal cellulitis complicating left upper eyelid chalazion. Initially, he was treated with several anti-microbial agents used sequentially. Although, the cellulitis resolved, he developed total hyphema of the left eye. The complication seems to have resulted from a complex interaction amongst anti-microbial agents, Warfarin and anti-platelet agents. PMID:20393256

  1. Ludwig's Angina in Post Partum Patient.

    PubMed

    Banu, Khurshida; Srikanth, G

    2014-06-01

    Ludwig's Angina is a rapid progressive cellulitis of the submandibular spaces, with potential for significant upper airway obstruction. Most reported cases follow an odontogenic infection. We present a case of 22-year-old female patient in her 2 weeks post partum period developing a life threatening infection. Immediate intubation, surgical decompression and antibiotic therapy successfully resolved the episode. PMID:24822014

  2. Fine-Needle Aspiration as a Method of Diagnosis of Subcutaneous Fat Necrosis of the Newborn.

    PubMed

    Schubert, Pawel Tomasz; Razak, Rubina; Jordaan, Henry Francois

    2016-05-01

    A 5-day-old boy presented with cellulitis-like, fluctuant lesions since birth. Clinically, subcutaneous fat necrosis was suspected, but an infective lesion could not be excluded. By performing a fine-needle aspiration biopsy, a diagnosis was established within minutes. PMID:27125326

  3. Linezolid and Rasagiline - A culprit for serotonin syndrome.

    PubMed

    Hisham, Mohamed; Sivakumar, Mundalipalayam N; Nandakumar, V; Lakshmikanthcharan, S

    2016-01-01

    A 65-year-old female patient was admitted to the hospital for cellulitis. She had a history of diabetes mellitus and parkinsonism on levodopa/carbidopa, rasagiline, ropinirole, trihexyphenidyl, amantadine, metformin, and glipizide. We present here a case of rare incidence of serotonin syndrome associated with linezolid and rasagiline. PMID:26997732

  4. Linezolid and Rasagiline – A culprit for serotonin syndrome

    PubMed Central

    Hisham, Mohamed; Sivakumar, Mundalipalayam N.; Nandakumar, V.; Lakshmikanthcharan, S.

    2016-01-01

    A 65-year-old female patient was admitted to the hospital for cellulitis. She had a history of diabetes mellitus and parkinsonism on levodopa/carbidopa, rasagiline, ropinirole, trihexyphenidyl, amantadine, metformin, and glipizide. We present here a case of rare incidence of serotonin syndrome associated with linezolid and rasagiline. PMID:26997732

  5. Increased Serum Levels of Epidermal Growth Factor in Children with Autism

    ERIC Educational Resources Information Center

    Iseri, Elvan; Guney, Esra; Ceylan, Mehmet F.; Yucel, Aysegul; Aral, Arzu; Bodur, Sahin; Sener, Sahnur

    2011-01-01

    The etiology of autism is unclear, however autism is considered as a multifactorial disorder that is influenced by neurological, environmental, immunological and genetic factors. Growth factors, including epidermal growth factor (EGF), play an important role in the celluler proliferation and the differentiation of the central and peripheral…

  6. Complete Genome Sequence of Mycobacterium chelonae Type Strain CCUG 47445, a Rapidly Growing Species of Nontuberculous Mycobacteria

    PubMed Central

    Jaén-Luchoro, Daniel; Salvà-Serra, Francisco; Aliaga-Lozano, Francisco; Seguí, Carolina; Busquets, Antonio; Ramírez, Antonio; Ruíz, Mikel; Gomila, Margarita; Lalucat, Jorge

    2016-01-01

    Mycobacterium chelonae strains are ubiquitous rapidly growing mycobacteria associated with skin and soft tissue infections, cellulitis, abscesses, osteomyelitis, catheter infections, disseminated diseases, and postsurgical infections after implants with prostheses, transplants, and even hemodialysis procedures. Here, we report the complete genome sequence of M. chelonae type strain CCUG 47445. PMID:27284158

  7. Vertebral Osteomyelitis Caused by Helicobacter cinaedi

    PubMed Central

    Yoshizaki, Aisa; Takegawa, Hiroshi; Doi, Asako; Mizuno, Yasushi

    2015-01-01

    Helicobacter cinaedi causes bacteremia, cellulitis, and gastroenteritis. We report the first case of vertebral osteomyelitis caused by H. cinaedi in an elderly man with low back pain and fever. The pathogen was detected in blood and lumbar disc, and the infection was successfully treated with oral doxycycline for 11 weeks. PMID:26109448

  8. The Virtual Liver: Modeling Chemical-Induced Liver Toxicity

    EPA Science Inventory

    The US EPA Virtual Liver (v-Liver) project is aimed at modeling chemical-induced processes in hepatotoxicity and simulating their dose-dependent perturbations. The v-Liver embodies an emerging field of research in computational tissue modeling that integrates molecular and cellul...

  9. Uncovering common bacterial skin infections.

    PubMed

    Napierkowski, Daria

    2013-03-10

    The four most common bacterial skin infections are impetigo, erysipelas, cellulitis, and folliculitis. This article summarizes current information about the etiology, clinical presentation, diagnosis, prevention, treatment, and implications for primary care practice needed to effectively diagnose and treat common bacterial skin infections. PMID:23361375

  10. Children's Ophthalmologic Problems.

    ERIC Educational Resources Information Center

    Robb, Richard M.

    1977-01-01

    The author points out the need for early screening for ophthalmologic disorders and reviews symptoms of various eye disorders. Among the types of eye pathology considered are retinoblastoma, retrolental fibroplasia, congenital glaucoma, congenital cataracts, congenital strabismus, chlamydia oculogenitalis, orbital cellulitis, and eye injuries.…

  11. Chronic keratoconjunctivitis with dermatitis as a presenting sign of child abuse.

    PubMed

    Moore, Daniel B; Herlihy, Erin P; Weiss, Avery H

    2012-04-01

    A 13-month-old girl presented with chronic keratoconjunctivitis with dermatitis. She was initially diagnosed with corneal abrasion and mild preseptal cellulitis and was treated with topical and oral antibiotics. After failing to respond to standard therapy, she was eventually identified as a victim of abuse. We discuss key findings that could have provoked earlier recognition. PMID:22525179

  12. Streptococcal Infections

    MedlinePlus

    ... Strep throat - a sore, red throat, sometimes with white spots on the tonsils Scarlet fever - an illness that follows strep throat. It causes a red rash on the body. Impetigo - a skin infection Toxic shock syndrome Cellulitis and necrotizing fasciitis (flesh-eating disease) Group ...

  13. Complete Genomic Sequence of an Avian Pathogenic Escherichia coli Strain of Serotype O7:HNT

    PubMed Central

    Maluta, Renato P.; Nicholson, Bryon; Logue, Catherine M.; Nolan, Lisa K.; Rojas, Thaís C. G.

    2016-01-01

    Avian pathogenic Escherichia coli (APEC) is associated with colibacillosis in poultry. Here, we present the first complete sequence of an APEC strain of the O7:HNT serotype and ST73 sequence type, isolated from a broiler with cellulitis. Complete genomes of APEC with distinct genetic backgrounds may be useful for comparative analysis. PMID:26823578

  14. Complete Genome Sequence of Mycobacterium chelonae Type Strain CCUG 47445, a Rapidly Growing Species of Nontuberculous Mycobacteria.

    PubMed

    Jaén-Luchoro, Daniel; Salvà-Serra, Francisco; Aliaga-Lozano, Francisco; Seguí, Carolina; Busquets, Antonio; Ramírez, Antonio; Ruíz, Mikel; Gomila, Margarita; Lalucat, Jorge; Bennasar-Figueras, Antoni

    2016-01-01

    Mycobacterium chelonae strains are ubiquitous rapidly growing mycobacteria associated with skin and soft tissue infections, cellulitis, abscesses, osteomyelitis, catheter infections, disseminated diseases, and postsurgical infections after implants with prostheses, transplants, and even hemodialysis procedures. Here, we report the complete genome sequence of M. chelonae type strain CCUG 47445. PMID:27284158

  15. Bone scintigraphy for neonatal osteomyelitis: simulation by extravasation of intravenous calcium

    SciTech Connect

    Balsam, D.; Goldfarb, C.R.; Stringer, B.; Farruggia, S.

    1980-04-01

    Intravenously administered calcium gluconate has become increasingly popular in the treatment of neonatal tetany. Occasionally, extravasation results in cellulitis, leading to a clinical diagnosis of superimposed osteomyelitis. Osseous scintigraphy, as the accepted modality in the early detection of osteomyelitis, would tend to be used in this circumstance. This case illustrates a false-positive result, probably due to soft-tissue calcification.

  16. Wind Tunnel Pressure Distribution Tests on a Series of Biplane Wing Models

    NASA Technical Reports Server (NTRS)

    Knight, Montgomery; Noyes, Richard

    1929-01-01

    This report is on the changes in forces on each wing of a biplane cellule when either the stagger or the gap is varied. Since each test was carried up to a 90 degree angle of attack, the results may be used in the study of stalled flight and of spinning as well as in the structural design of biplane wings.

  17. Hair and scalp disorders in blacks.

    PubMed

    Halder, R M

    1983-10-01

    Hair and scalp disorders in blacks and the properties of hair in blacks that make it behave differently are described. Hair disorders commonly seen now are the result of permanent and relaxer damage, heat, and traction alopecias. Presently, the most common scalp disorders in blacks are keloidal folliculitis and dissecting cellulitis of the scalp. Treatment modalities for these disorders are reviewed. PMID:6226494

  18. Feedlot therapeutics.

    PubMed

    Apley, M D; Fajt, V R

    1998-07-01

    This article discusses therapeutic approaches to conditions commonly encountered in feedlots. Challenges discussed include bovine respiratory complex, tracheal edema, atypical interstitial pneumonia, footrot, toe abscesses, mycoplasma arthritis, cardiovascular disease, lactic acidosis, bloat, coccidiosis, central nervous system diseases, abscesses and cellulitis, pregnancy management and abortion, and ocular disease. PMID:9704416

  19. Infected Abdominal Aortic Aneurysm with Helicobacter cinaedi

    PubMed Central

    Iwasawa, Takamasa; Tamura, Atsushi; Lefor, Alan T.

    2016-01-01

    Helicobacter cinaedi is a rare human pathogen which has various clinical manifestations such as cellulitis, bacteremia, arthritis, meningitis, and infectious endocarditis. We report an abdominal aortic aneurysm infected with Helicobacter cinaedi, treated successfully with surgical repair and long-term antimicrobial therapy. PMID:26885430

  20. An unusual complication of transradial coronary angiography.

    PubMed

    McEntegart, Margaret B; Dalzell, Jonathan R; Lindsay, M Mitchell

    2009-05-01

    We report the first case of extensive cellulitis and staphylococcal bacteremia with the subsequent development of a remote mycotic pseudoaneurysm in the ipsilateral brachial artery following right transradial coronary angiography in a diabetic patient with previous right axillary node clearance. The potential for serious complication should be borne in mind when deciding on the site of vascular access in such patients. PMID:19411734

  1. Bacteroides isolated from four mammalian hosts lack host specific 16S rRNA gene phylogeny and carbon and nitrogen utilization patterns

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Within the distal gut of mammals are trillions of microbes that utilize nutrients from diet, intestinal mucosa, and other gut microbes. One hundred three (103) isolates of B. ovatus, B. thetaiotaomicron, and B. xylanisolvens were recovered from cow, goat, human, and pig fecal enrichments with cellul...

  2. Caracterisation thermique de modules de refroidissement pour la photovoltaique concentree

    NASA Astrophysics Data System (ADS)

    Collin, Louis-Michel

    Pour rentabiliser la technologie des cellules solaires, une reduction du cout d'exploitation et de fabrication est necessaire. L'utilisation de materiaux photovoltaiques a un impact appreciable sur le prix final par quantite d'energie produite. Une technologie en developpement consiste a concentrer la lumiere sur les cellules solaires afin de reduire cette quantite de materiaux. Or, concentrer la lumiere augmente la temperature de la cellule et diminue ainsi son efficacite. Il faut donc assurer a la cellule un refroidissement efficace. La charge thermique a evacuer de la cellule passe au travers du recepteur, soit la composante soutenant physiquement la cellule. Le recepteur transmet le flux thermique de la cellule a un systeme de refroidissement. L'ensemble recepteur-systeme de refroidissement se nomme module de refroidissement. Habituellement, la surface du recepteur est plus grande que celle de la cellule. La chaleur se propage donc lateralement dans le recepteur au fur et a mesure qu'elle traverse le recepteur. Une telle propagation de la chaleur fournit une plus grande surface effective, reduisant la resistance thermique apparente des interfaces thermiques et du systeme de refroidissement en aval vers le module de refroidissement. Actuellement, aucune installation ni methode ne semble exister afin de caracteriser les performances thermiques des recepteurs. Ce projet traite d'une nouvelle technique de caracterisation pour definir la diffusion thermique du recepteur a l'interieur d'un module de refroidissement. Des indices de performance sont issus de resistances thermiques mesurees experimentalement sur les modules. Une plateforme de caracterisation est realisee afin de mesurer experimentalement les criteres de performance. Cette plateforme injecte un flux thermique controle sur une zone localisee de la surface superieure du recepteur. L'injection de chaleur remplace le flux thermique normalement fourni par la cellule. Un systeme de refroidissement est installe

  3. Superoxide release by confluent endothelial cells, an electron spin resonance (ESR) study

    NASA Astrophysics Data System (ADS)

    Barbacanne, M.-A.; Margeat, E.; Arnal, J.-F.; Nepveu, F.; Souchard, J.-P.

    1999-01-01

    In the present study we used ESR to detect the release of oxygen radicals by endothelial cells stimulated with calcium ionophore A23187. Dimethyl-1-pyrroline-N-oxide (DMPO) was used as a spin trap. Although the observed adduct (DMPO-OH) suggested the presence of the hydroxyl radical, the use of superoxide dismutase and catalase revealed that superoxide anion was released in the medium. Superoxide production was more efficient when the cells were post-confluent for a few days. The release of superoxide was 3-fold greater in growth arrested cells (D6-D9) than in proliferating cells (D0). Although two inhibitors of the mitochondrial respiratory chain carbanyl cyanide m-chlorophenylhydrazone (CCCP), antimycine decreased the ESR signal by 35%, the use of superoxide dismutase (SOD) and tumor necrosis factor (TNF) suggested that the release of O2- occurred in the cell membrane. The physiological significance of this extracellular superoxide release by post-confluent cells deserves further study. Ce travail présente une étude par RSE de la libération des radicaux oxygénés par les cellules endothéliales bovines (BAEC) sous l'effet de l'ionophore calcique A23187. Le diméthyl-1-pyrroline-N-oxyde (DMPO) est utilisé comme piégeur de spin. Bien que l'adduit formé (DMPO-OH) semble traduire la présence du radical hydroxyle .OH, l'utilisation de superoxyde dismutase et de catalase a révélé que les cellules endothéliales libéraient l'anion superoxyde. La production du radical superoxyde est plus abondante lorsque les cellules sont à confluence depuis plusieurs jours. Lorsque les cellules sont entre J6 et J9, la production de superoxyde est trois fois supérieure à celle observée lorsque les cellules sont en prolifération (J0). Bien que deux inhibiteurs de la chaîne mitochondriale 1-carbonyldinitrile-m-chlorophenylhydrazone (CCCP), antimycineinhibent de 35 % le signal RPE, l'utilisation de superoxyde dismutase (SOD) et du tumor necrosis factor (TNF) sugg

  4. Bilateral Orbital Abscesses After Strabismus Surgery.

    PubMed

    Dhrami-Gavazi, Elona; Lee, Winston; Garg, Aakriti; Garibaldi, Daniel C; Leibert, Michelle; Kazim, Michael

    2015-01-01

    Infectious orbital complications after strabismus surgery are rare. Their incidence is estimated to be 1 case per 1,100 surgeries and include preseptal cellulitis, orbital cellulitis, subconjunctival and sub-Tenon's abscesses, myositis, and endophthalmitis. This report describes the case of an otherwise healthy 3-year-old boy who underwent bilateral medial rectus recession and disinsertion of the inferior obliques. A few days after surgery, the patient presented with bilateral periorbital edema and inferotemporal chemosis. A series of CT scans with contrast revealed inferotemporal orbital collections OU. The patient immediately underwent transconjunctival drainage of fibrinous and seropurulent collections in the sub-Tenon's space and experienced rapid improvement a few days later. The patient is reported to be in stable condition in a follow-up examination performed more than a year after the reported events. PMID:24896771

  5. Evaluation of the Painful Eye.

    PubMed

    Pflipsen, Matthew; Massaquoi, Mariama; Wolf, Suzanne

    2016-06-15

    Eye problems constitute 2% to 3% of all primary care and emergency department visits. Common eye conditions that can cause eye pain are conjunctivitis, corneal abrasion, and hordeolum, and some of the most serious eye conditions include acute angle-closure glaucoma, orbital cellulitis, and herpetic keratitis. The history should focus on vision changes, foreign body sensation, photophobia, and associated symptoms, such as headache. The physical examination includes an assessment of visual acuity and systematic evaluation of the conjunctiva, eyelids, sclera, cornea, pupil, anterior chamber, and anterior uvea. Further examination with fluorescein staining and tonometry is often necessary. Because eye pain can be the first sign of an ophthalmologic emergency, the physician should determine if referral is warranted. Specific conditions that require ophthalmology consultation include acute angle-closure glaucoma, optic neuritis, orbital cellulitis, scleritis, anterior uveitis, and infectious keratitis. PMID:27304768

  6. Guidelines for the Diagnosis, Treatment and Prevention of Postoperative Infections

    PubMed Central

    Hager, W. David; Livengood, Charles H.; Hoyme, Udo

    2003-01-01

    Bacterial contamination of the operative site is a common occurrence in obstetrics and gynecology. The widespread use of antibiotic prophylaxis has reduced but not eliminated serious postoperative infections. For most operations, a single dose of a limited-spectrum drug has been as effective as a multidose regimen. In the differential diagnosis it is important to consider cellulitis, abscess, necrotizing fasciitis and septic pelvic thrombophlebitis. Abscess and necrotizing fasciitis are expected to require invasive therapy in addition to antibiotics, while cellulitis and septic pelvic thrombophlebitis should respond to medical management alone. Although a postoperative fever is a warning sign of possible infection, it may also be caused by the antibiotics that are given for treatment. The use of prolonged courses of antibiotics once the patient is clinically well is discouraged. While clinical guidelines are provided for use in the diagnosis and management of postoperative infections, these recommendations are intended for general direction and not as an exclusive management plan. PMID:12839635

  7. A Classic Clinical Case: Neutrophilic Eccrine Hidradenitis

    PubMed Central

    Copaescu, Ana-Maria; Castilloux, Jean-François; Chababi-Atallah, Myrna; Sinave, Christian; Bertrand, Janie

    2013-01-01

    Background Neutrophilic eccrine hidradenitis (NEH) is a rare condition described mostly in adult patients receiving chemotherapy for acute myelogenous leukemia. When it affects the facial region, it can mimic cellulitis and delay the diagnostic, thus proper recognition is essential. Objective This article describes a classic case of NEH. We will review the diagnostic, the differential diagnostic (mostly cellulitis) and the management of this condition. Methods After a literature review, the patient's file was properly studied in order to portray a clear picture of this condition. Medical photographs and appropriate physical examination upon presentation are also included. Results The diagnostic for NEH was suggested by the clinical presentation and confirmed histopathologically (skin biopsy). Conclusion The diagnostic of NEH is essential in order to prevent multiple unnecessary antibiotics. PMID:24474918

  8. Radionuclide imaging in the evaluation of osteomyelitis and septic arthritis

    SciTech Connect

    Kim, E.E.; Haynie, T.P.; Podoloff, D.A.; Lowry, P.A.; Harle, T.S. )

    1989-01-01

    Despite controversy over its exact role, radionuclide imaging plays an important role in the evaluation of patients suspected of having osteomyelitis. The differentiation between osteomyelitis and cellulitis is best accomplished by using a three-phase technique using Tc-99m methylene diphosphonate (MDP). Frequently, it is necessary to obtain multiple projections and magnification views to adequately assess suspected areas. It is recommended that a Ga-67 or In-111 leukocyte scan be performed in those cases where osteomyelitis is strongly suspected clinically and the routine bone scan is equivocal or normal. Repeated bone scan after 48 to 72 h may demonstrate increased radioactivity in the case of early osteomyelitis with the initial photon-deficient lesion. In-111 leukocyte imaging is useful for the evaluation of suspected osteomyelitis complicating recent fracture or operation, but must be used in conjunction with clinical and radiographic correlation. The recognition of certain imaging patterns appears helpful to separate osteomyelitis from septic arthritis or cellulitis. 83 references.

  9. Pressure-Distribution Measurements on O-2H Airplane in Flight

    NASA Technical Reports Server (NTRS)

    Pearson, H A

    1937-01-01

    Results are given of pressure-distribution measurements made over two different horizontal tail surfaces and the right wing cellule, including the slipstream area, of an observation-type biplane. Measurements were also taken of air speed, control-surface positions, control-stick forces, angular velocities, and accelerations during various abrupt maneuvers. These maneuvers consisted of push-downs and pull-ups from level flight, dive pull-outs, and aileron rolls with various thrust conditions. The results from the pressure-distribution measurements over the wing cellule are given on charts showing the variation of individual rib coefficients with wing coefficients; the data from the tail-surface pressure-distribution measurements are given mainly as total loads and moments. These data are supplemented by time histories of the measured quantities and isometric views of the rib pressure distributions occurring in abrupt maneuvers.

  10. Posttonsillectomy pain in children.

    PubMed

    Sutters, Kimberly A; Isaacson, Glenn

    2014-02-01

    Tonsillectomy, used to treat a variety of pediatric disorders, including obstructive sleep apnea, peritonsillar cellulitis or abscesses, and very frequent throat infection, is known to produce nausea, vomiting, and prolonged, moderate-to-severe pain. The authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions in pain management, recommendations for patient and family teaching regarding pain management, and best practices for improving medication adherence. PMID:24445532

  11. [Cheek perforation of dental origin and the effect of anti-inflammatory drug treatment during self-medication. Apropos of a case].

    PubMed

    Kouame, P; Souaga, K; Amantchi, D

    1999-06-01

    Complications of dental caries not treated and mal-treated are frequent in Africa (cellulitis, osteitis, etc...). Patients consult late due to effective automedication with anti-inflammatory agents but the continuing pathological process leading to fistulae, perforation and persistent pain are finally the reasons of consultation. We present a case of a young Ivorian student of 22 years we have received after one year of erratic treatment with a right jaw perforation. PMID:11372091

  12. Acute dental pain, Part II: Diagnosis and emergency treatment.

    PubMed

    Antonelli, J R

    1990-09-01

    Part II of this two-part series differentiates and explores endodontic-related emergencies with reversible and irreversible pulpitis. Indications and contra-indications for vital pulp therapy are explained, and treatment is outlined. The inflammatory process involved in irreversible pulpal disease is summarized, and the clinical signs, symptoms, and treatment of irreversible pulpitis (with and without acute periradicular involvement, with pulp necrosis, and acute periradicular abscess with and without cellulitis) are discussed. PMID:2097056

  13. Ocular sparganosis from Assam

    PubMed Central

    Nath, Reema; Gogoi, Rajendra Nath

    2015-01-01

    Sparganosis is caused by plerocercoid larvae of the Pseudophyllidea tapeworms of the genus Spirometra. Though prevalent in East Asian and south east Asian countries like China, Japan, Korea, Taiwan, Vietnam, Thailand; yet very few cases are reported from India. We report a case of migrating sub-conjunctival ocular sparganosis mimicking scleritis which later on developed into orbital cellulitis from Dibrugarh, Assam, North-eastern part of India. This case is reported for its rarity. PMID:25709957

  14. Clostridial orthopedic infections: case reports and review of the literature.

    PubMed

    Lazzarini, L; Conti, E; Ditri, L; Turi, G; de Lalla, F

    2004-02-01

    Clostridia are anaerobic Gram-positive bacilli that can be isolated from the soil and the intestinal tract of humans. These microorganisms are recognized as the cause of devastating soft tissue infections, such as cellulitis, myositis, and gas gangrene. However, such bacteria may also be involved in various postoperative orthopedic infections, including prosthetic joint infection. We present three clinical cases of clostridial orthopedic infection and review the related medical literature. PMID:15078006

  15. Bacteremia due to Agrobacterium tumefaciens (radiobacter). Report of infection in a pregnant women and her stillborn fetus.

    PubMed

    Southern, P M

    1996-01-01

    Agrobacterium tumefaciens (radiobacter) is usually a plant pathogen, but is isolated occasionally from human clinical specimens, frequently along with other bacteria. Agrobacterium tumefaciens (radiobacter) has been isolated from blood, central intravenous catheters, peritoneal fluid, urine, and cellulitis aspirates, often in immunocompromised individuals. This report details the isolation of A. tumefaciens (radiobacter) from the blood of a pregnant woman, as well as from the blood of her stillborn, premature fetus. It is, to our knowledge, the first report of such an occurrence. PMID:8988763

  16. Recognizing pyoderma: more difficult than it may seem.

    PubMed

    Gortel, Kinga

    2013-01-01

    Although bacterial pyoderma is among the most commonly encountered dermatologic conditions in dogs, some cases present diagnostic challenges even to experienced clinicians. This article presents several unusual manifestations of pyoderma, including bullous impetigo, superficial spreading pyoderma, mucocutaneous pyoderma, and post-grooming furunculosis. Conditions mimicking pyoderma, including juvenile cellulitis, immunomodulatory-responsive lymphocytic-plasmacytic pododermatitis, and pemphigus foliaceus are also described. Diagnostic techniques used for diagnosing and characterizing pyoderma are also discussed. PMID:23182321

  17. How I Manage Ingrown Toenails.

    PubMed

    Subotnick, S I

    1983-12-01

    In brief: An ingrown toenail is one of the most common diseases of the nail. Initial treatment includes trimming away the ingrown area and soaking the foot in Epsom salt, or a combination of Epsom salt and pHisoHex or Betadine. If inflammation, localized cellulitis, and pain do not resolve rapidly, chemocautery with phenol or a surgical partial matricectomy can be carried out. PMID:27409375

  18. [Ultrastructural study of embryonic development in Grantia compressa F. (Porifera, Calcarea)].

    PubMed

    Gallissian, M F

    1983-01-01

    The embryonic development of Grantia compressa is studied by means of the electron microscope from the blastula inside the mesenchyme to the mature amphi-blastula released in the excurrent canals. The study of the different cellular categories of the embryon shows the distribution of the vitellin inclusions and their evolution. The ultrastructure of the "cellules en croix" is not in favour of a photoreceptor part. PMID:6639044

  19. Malignant proliferating pilar tumors arising in KID syndrome: a report of two patients.

    PubMed

    Nyquist, Gurston G; Mumm, Christina; Grau, Renee; Crowson, A Neil; Shurman, Daniel L; Benedetto, Paul; Allen, Pamela; Lovelace, Kelli; Smith, David W; Frieden, Ilona; Hybarger, C Patrick; Richard, Gabriele

    2007-04-01

    We report on two young adults with KID syndrome and follicular hyperkeratosis, hidradenitis suppurativa of the groin, progressive development of proliferative pilar cysts and dissecting cellulitis of the scalp, who developed metastatic malignant pilar tumors. Based on our findings, we believe that cancer surveillance in patients with KID syndrome should include screening for pilar tumors and their early removal to avoid development of malignant proliferating pilar tumors with poor prognosis. PMID:17330861

  20. Hair and scalp disorders in ethnic populations.

    PubMed

    Rodney, Ife J; Onwudiwe, Oge C; Callender, Valerie D; Halder, Rebat M

    2013-04-01

    Human hair has been classified into 3 major groups, as determined by ethnic origin. In these populations, significant structural and biochemical variations of the hair follicle and shaft are seen, as well as unique hair grooming practices. These structural variations of the hair are closely linked to the common disorders of the hair and scalp, such as acquired trichorrhexis nodosa, seborrheic dermatitis, traction alopecia, central centrifugal cicatricial alopecia, dissecting cellulitis, frontal fibrosing alopecia, and pseudofolliculitis barbae. PMID:23652889

  1. Sternocostoclavicular hyperostosis: two cases with differing dermatologic syndromes.

    PubMed

    Ongchi, D R; Fleming, M G; Harris, C A

    1990-10-01

    Sternocostoclavicular hyperostosis is a rare rheumatic condition characterized by ossification and erosion of the clavicle and the first rib, that has been shown to be associated with pustular skin lesions. We present 2 cases, one of which had features of pustulosis palmaris et plantaris and the other dissecting cellulitis of the scalp. Although the dermatologic manifestations differ, both cases have rheumatologic and roentgenographic features diagnostic of sternocostoclavicular hyperostosis. PMID:2254905

  2. Follicular occlusion tetrad.

    PubMed

    Vasanth, Vani; Chandrashekar, Byalakere Shivanna

    2014-10-01

    Follicular occlusion tetrad is a symptom complex consisting of four conditions having a similar pathophysiology. It includes Hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus. The exact pathogenesis of this group of disease is unknown but evidence suggests that they share the same pathological process initiated by follicular occlusion in apocrine gland bearing areas. Though each of these conditions is commonly encountered singly, follicular occlusion tetrad as a symptom complex has been rarely reported in the literature. PMID:25396138

  3. Follicular occlusion tetrad

    PubMed Central

    Vasanth, Vani; Chandrashekar, Byalakere Shivanna

    2014-01-01

    Follicular occlusion tetrad is a symptom complex consisting of four conditions having a similar pathophysiology. It includes Hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus. The exact pathogenesis of this group of disease is unknown but evidence suggests that they share the same pathological process initiated by follicular occlusion in apocrine gland bearing areas. Though each of these conditions is commonly encountered singly, follicular occlusion tetrad as a symptom complex has been rarely reported in the literature. PMID:25396138

  4. Acne keloidalis nuchae and tufted hair folliculitis.

    PubMed

    Luz Ramos, M; Muñoz-Pérez, M A; Pons, A; Ortega, M; Camacho, F

    1997-01-01

    Acne keloidalis nuchae is a chronic, scarring folliculitis that affects mostly black patients and is located on the back of the neck of young adults. The course is progressive and leads to hypertrophic scarring, chronic abscesses and hair loss. We discuss the relationship between acne keloidalis and tufted hair folliculitis, pointing out the possibility that tufted hair folliculitis is not a specific disease but secondary to other progressive folliculitis like folliculitis decalvans, dissecting cellulitis or acne keloidalis. PMID:9031798

  5. Radionucleotide scanning in osteomyelitis

    SciTech Connect

    Sachs, W.; Kanat, I.O.

    1986-07-01

    Radionucleotide bone scanning can be an excellent adjunct to the standard radiograph and clinical findings in the diagnosis of osteomyelitis. Bone scans have the ability to detect osteomyelitis far in advance of the standard radiograph. The sequential use of technetium and gallium has been useful in differentiating cellulitis and osteomyelitis. Serial scanning with technetium and gallium may be used to monitor the response of osteomyelitis to antibiotic therapy.

  6. Wind tunnel pressure distribution tests on a series of biplane wing models Part II : effects of changes in decalage, dihedral, sweepback and overhang

    NASA Technical Reports Server (NTRS)

    Knight, Montgomery; Noyes, Richard W

    1929-01-01

    This preliminary report furnishes information on the changes in the forces on each wing of a biplane cellule when the decalage, dihedral, sweepback and overhang are separately varied. The data were obtained from pressure distribution tests made in the Atmospheric Wind Tunnel of the Langley Memorial Aeronautical Laboratory. Since each test was carried up to 90 degree angle of attack, the results may be used in the study of stalled flight and of spinning and in the structural design of biplane wings.

  7. Hyaluronidase hypersensitivity: A rare complication of peribulbar block

    PubMed Central

    Rajalakshmi, A R; Kumar, M Ashok

    2016-01-01

    Peribulbar block, though safe, can cause serious complications such as globe perforation and peribulbar hemorrhage. Hyaluronidase is an enzyme that is used as an adjuvant in peribulbar anesthesia, and it helps in rapid penetration of the anesthetic agent. Hypersensitivity to hyaluronidase is a rare but potentially sight-threatening complication. We report a case of hyaluronidase hypersensitivity following peribulbar injection for cataract surgery mimicking as peribulbar hematoma in the immediate postinjection phase and as orbital cellulitis 48 h later. PMID:27050356

  8. Group B streptococcus infections of soft tissue and bone in California adults, 1995-2012.

    PubMed

    Smith, E M; Khan, M A; Reingold, A; Watt, J P

    2015-11-01

    Group B streptococcus (GBS) is an increasing cause of disease in adults. We present long-term trends in incidence of overall infections and identify characteristics of patients with GBS cellulitis, bone and joint infections. Active, population-based surveillance was conducted from 1995-2012 in three California counties and the data were analysed retrospectively. All cases had isolation of GBS from a normally sterile site. Cases of cellulitis were classified based on clinical diagnosis. GBS bone or joint infection was defined as isolation of GBS from a bone or joint or a diagnosis of osteomyelitis or septic arthritis. Medical charts were reviewed for demographic and clinical information. There were 3917 cases of GBS; the incidence of disease increased from 5·8 to 8·3 cases/100 000 persons (P < 0·001) from 1995 to 2012. In adults aged ⩾40 years, the overall incidence of GBS increased from 8·5 to 14·2 cases/100 000 (P < 0·001) persons during the study period. The incidence of cellulitis increased from 1·6 to 3·8 cases/100 000 (P < 0·001), bone infection increased from 0·7 to 2·6 cases/100 000 (P < 0·001), and the incidence of joint infection remained approximately constant at an average rate of 1·0 case/100 000. The highest incidence rates were observed in men, persons aged ⩾80 years, non-Hispanic blacks and Hispanics. Diabetes was the most common underlying condition (51·2% cellulitis cases, 76·3% bone infections, 29·8% joint infections). PMID:26418351

  9. Improvement of a Clinical Score for Necrotizing Fasciitis: ‘Pain Out of Proportion’ and High CRP Levels Aid the Diagnosis

    PubMed Central

    Siegel, Ekkehard; Hanke, Eric; von Stebut, Esther

    2015-01-01

    Necrotizing fasciitis (NF) is a rare mono-/polymicrobial skin infection that spreads to underlying tissues. NF is quickly progressing and leads to life threatening situations. Immediate surgical debridement together with i.v. antibiotic administration is required to avoid fatal outcome. Early diagnosis is often delayed due to underestimation or confusion with cellulitis. We now compared the initial clinical and laboratory presentation of NF and cellulitis in detail to assess if a typical pattern can be identified that aids timely diagnosis of NF and avoidance of fatal outcome. 138 different clinical and laboratory features of 29 NF patients were compared to those of 59 age- and gender matched patients with severe erysipelas requiring a subsequent hospitalization time of ≥10 days. Differences in clinical presentation were not obvious; however, NF patients suffered significantly more often from strong pain. NF patients exhibited dramatically elevated CRP levels (5-fold, p>0.001). The overall laboratory risk indicator for necrotizing fasciitis (LRINEC) score was significantly higher in NF patients as compared to cellulitis. However, a modification of the score (alteration of laboratory parameters, addition of clinical parameters) led to a clear improvement of the score with a higher positive predictive value without losing specificity. In summary, clinical differentiation of NF from cellulitis appears to be hard. ‘Pain out of proportion’ may be an early sign for NF. An improvement of the LRINEC score emphasizing only relevant laboratory and clinical findings as suggested may aid the early diagnosis of NF in the future leading to improvement of disease outcome by enabling rapid adequate therapy. PMID:26196941

  10. Bilateral Chest X-Ray Shadowing and Bilateral leg lesions - A case of Pulmonary Kaposi Sarcoma

    PubMed Central

    Khattak, M

    2016-01-01

    We report a case of a 30 year old gentleman seen on the respiratory ward with no significant past medical history presenting with a three week history of worsening dyspnoea, productive cough, fever, bilateral leg swelling and bilateral leg swelling. Initial differential diagnosis included community-acquired pneumonia, cellulitis and deep vein thrombosis. After much investigation a diagnosis of AIDS-related kaposi's sarcoma with visceral manifestations was made. PMID:27239297

  11. Charcot neuroarthropathy: An often overlooked complication of diabetes.

    PubMed

    Botek, Georgeanne; Anderson, Martha A; Taylor, Ryan

    2010-09-01

    In patients with long-standing, poorly controlled diabetes and peripheral neuropathy, a red, hot, swollen foot without open ulceration should raise the suspicion of Charcot neuroarthropathy, an often-overlooked diabetic foot complication. The authors discuss key diagnostic features and how to differentiate this condition from cellulitis, osteomyelitis, and other conditions. They review key elements of the workup and emphasize the importance of early diagnosis and prompt treatment to preserve a functioning foot. PMID:20810870

  12. Tropical diabetic hand syndrome.

    PubMed

    Tiwari, Sangeeta; Chauhan, Ashutosh; Sethi, N T

    2008-10-01

    Tropical diabetic hand syndrome (TDHS) is a terminology used to describe a specific complication affecting patients with diabetes mellitus in the tropics. The syndrome encompasses a localized cellulitis with variable swelling and ulceration of the hands to progressive, fulminant hand sepsis, potentially fatal. Since this syndrome is less recognized it is often under-reported. Authors present two cases of TDHS and emphasize on aggressive glycemic control and surgical therapy to prevent potential crippling or fatal complications. PMID:20165601

  13. Immunodeficiency induced by child abuse.

    PubMed

    Fukunaga, T; Tanegashima, A; Yamamoto, H; Saijoh, K

    1998-12-01

    We report the case of a 9-year-old girl who died from sepsis from cellulitis of the neck caused by a right ear injury. The autopsy findings showed severe involution of the thymus and atrophy of lymphoid tissues. The impairment of T- and B-cell functions was demonstrated both histologically and immunohistologically. Thymic involution caused by child abuse might lead to secondary immunodeficiency. PMID:15335522

  14. Extraintestinal human infection caused by Edwardsiella tarda.

    PubMed Central

    Clarridge, J E; Musher, D M; Fainstein, V; Wallace, R J

    1980-01-01

    Edwardsiella tarda is an uncommon enteric bacterium which has been found generally in animal hosts and occasionally in human feces. Three cases of extraintestinal infection caused by E. tarda which are described herein include a typhoid-like illness, peritonitis with sepsis, and cellulitis from a wound acquired while fishing. The microbiology of E. tarda and the previous reports of infection due to this organism are reviewed. PMID:7381019

  15. Gunshot-like wound caused by sling shot injury – a case report

    PubMed Central

    Vinuthinee, Naidu; Azreen-Redzal, Anuar; Juanarita, Jaafar; Zunaina, Embong

    2015-01-01

    We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT) scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic. PMID:25709507

  16. Orbital cellulits following cataract surgery under peribulbar anaesthesia

    PubMed Central

    Mukherjee, Chandoshi; Mitra, Arijit; Mushtaq, Bushra

    2015-01-01

    Introduction: Orbital cellulits following cataract surgery is extremely rare. We describe a case of orbital and facial cellulitis that occurred after routine cataract operation with peribulbar anaesthesia. There were no preoperative systemic or ocular risk factors for postoperative infection. Case description: An 89-year-old man presented to eye casualty, the day after he underwent an uneventful phacoemulsification and posterior chamber lens implantation in the left eye under peribulabr anaesthesia, with soreness, swelling and reduced visual acuity (6/18) in the operated eye. On initial presentation periorbital swelling was noted, the eye was minimally tender, intraocular pressure was raised at 28 mHg and fundoscopy was limited due to a hazy cornea. The patient was discharged on topical medication with a diagnosis of allergic reaction to postoperative drops. The following day, the patient re-presented with worsening orbital swelling involving the left cheek. Ocular findings remained unchanged. CT scan revealed left orbit soft tissue swelling and a locule of air medial to the medial rectus. There were no signs of sinus infection or periosteal inflammation. A diagnosis of left orbital and facial cellulitis was made and the patient was treated with intravenous antibiotics. Discussion: Our patient did not have any predisposing risk factors, therefore most likely cause of cellulitis is surgical trauma during administration of the peribulbar block. This case illustrates the need for adequate skin preparation before the administration of peribulbar anaesthesia and minimal tissue trauma during the procedure.

  17. Angiomyolipomes épithélioïdes rénal bénin: à propos de deux cas

    PubMed Central

    Bagayogo, Tidiani; Othmane, Yddoussalah; Tarik, Karmouni; Khalid, Elkhader; Abdellatif, Koutani; Ahmed, Ibn Attya Andaloussi

    2015-01-01

    Les angiomyolipomes épithélioïdes rénaux (AMLeR) sont des tumeurs rares (identifiées chez moins de 0,1 patients pour 1000 habitants) et représentent 8% des angiomyolipomes (AML) opérés. Il a longtemps été considérécomme un hamartome mais plusieurs articles récents font penser qu'il s'agir d'une tumeur dérivant de cellules épithélioïdespérivasculaires. L'angiomyolipome épithélioïde est une forme rare d'angiomyolipome à potentiel malin, composé decellules épithélioïdes posant des problèmes de diagnostic différentiel avec les carcinomes à cellules rénales. L'immunohistochimie,en révélant la positivité des cellules épithélioïdes au marqueur HMB45 est essentielle au diagnostic. Les auteursrapportent l'aspect tomodensitométrique et histologique d'angiomyolipomes épithélioïdes chez deux patientes. PMID:26953738

  18. Studying a disease with no home - lessons in trial recruitment from the PATCH II study

    PubMed Central

    2010-01-01

    Background Cellulitis is a very common condition that often recurs. The PATCH II study was designed to explore the possibility of preventing future episodes of cellulitis, with resultant cost savings for the NHS. This was the first trial to be undertaken by the UK Dermatology Clinical Trials Network. As such, it was the first to test a recruitment model that involved many busy clinicians each contributing just a few patients. Methods A double-blind randomised controlled trial comparing prophylactic antibiotics (penicillin V) with placebo tablets, for the prevention of repeat episodes of cellulitis of the leg. Primary outcome was time to subsequent recurrence of cellulitis. Results The PATCH II study was closed to recruitment having enrolled 123 participants from a target of 400. Whilst the recruitment period was extended by 12 months, it was not possible to continue beyond this point without additional funds. Many factors contributed to poor recruitment: (i) changes in hospital policy and the introduction of community-based intravenous teams resulted in fewer cellulitis patients being admitted to hospital; ii) those who were admitted were seen by many different specialties, making it difficult for a network of dermatology clinicians to identify suitable participants; and iii) funding for research staff was limited to a trial manager and a trial administrator at the co-ordinating centre. With no dedicated research nurses at the recruiting centres, it was extremely difficult to maintain momentum and interest in the study. Attempts to boost recruitment by providing some financial support for principal investigators to employ local research staff was of limited success. Discussion The model of a network of busy NHS clinicians all recruiting a few patients into large clinical studies requires further testing. It did not work very well for PATCH II, but this was probably because patients were not routinely seen by dermatologists, and recruitment took place prior to

  19. Three phase bone scan interpretation based upon vascular endothelial response

    PubMed Central

    Kumar, Kush

    2015-01-01

    Objectives: A new method of interpretation of Three Phase Bone Scan (TPBS) scan based upon the normal physiological vascular endothelial related response. Materials and Methods: Fifty cases of TPBS were evaluated. Thirteen were normal. In remaining 37 positive studies, 20 showed localized hyperemic response. All localized hyperemic responses except one with vascular endothelial dysfunction were without infection (95.0%). Infection could be ruled out in absence of generalized massive flow and pool response. All 17 cases with generalized massive hyperemic response had infection, consistent with infection or CRPS/RSD. Micro-bacterial or histological confirmation of infection was obtained in 11 cases. All 11 cases with confirmed infection showed generalized massive hyperemic response (100.0%). Two were CRPS/RSD and 2 cases were of cellulitis (100.0%). Among remaining 2, one refused surgery and other was lost to follow-up. Additionally, 20 published cases in the literature of osteomyelitis were also analyzed. Nineteen cases of bone and joint infection, (osteomyelitis/arthritis/cellulitis) except one with endothelial dysfunction showed generalized massive increased flow and pool response (95.0%). All published cases of osteomyelitis in the literature showed generalized massive hyperemic response (100.0%). Results: The data clearly indicated that 100% of the cases of bone infection (osteomyelitis/arthritis/cellulitis) and cases of CRPS/RSD showed generalized massive flow and pool pattern. Infection could be ruled out in absence of generalized massive flow and pool response. All 100% published cases of osteomyelitis in the literature showed positive vascular endothelial response. Conclusion: By incorporating the concept of vascular endothelial related response causing massive vasodilatation in infection, the interpretation of the TPBS can be more précised as it is based upon the normal physiology. Larger studies are recommended. PMID:25829726

  20. Extensive cervical lymphadenitis mimicking bacterial adenitis as the first presentation of Kawasaki disease

    PubMed Central

    Rossi, Felipe de Souza; da Silva, Marco Felipe Castro; Kozu, Kátia Tomie; Camargo, Luís Fernando Aranha; Rossi, Flávia Feijó Panico; Silva, Clovis Artur; Campos, Lúcia Maria de Arruda

    2015-01-01

    Cervical adenitis >1.5cm in diameter is the less frequently observed criteria in patients with Kawasaki disease and it is usually found in association with other symptoms during the acute phase. Moreover, the finding of fever and lymphadenitis with intense local signs of inflammation and phlegmon is rarely seen as the initial manifestation of Kawasaki disease. We report the case of a 7-year-old boy who had cervical lymphadenitis with adjacent cellulitis and phlegmon mimicking bacterial adenitis as the first presentation of Kawasaki disease. The patient had fever, cervical lymphadenitis with adjacent cellulitis, and severe headache. Cefadroxil was prescribed based on the clinical diagnosis of bacterial adenitis. Because he remained febrile and phlogistic signs worsened, after 1 day of hospitalization, antibiotics were administrated intravenously (ceftriaxone and oxacillin). The computed tomography of the neck showed primary infectious/inflammatory process. On the fourth day, the patient had dry and scaly lips, and treatment with oxacillin was replaced by clindamycin because the patient was still febrile. On the ninth day, he presented non-exudative bilateral conjunctival injection. On the tenth day of febrile disease, a rash appeared on his trunk, hands and feet. Patient’s symptoms resolved after intravenous administration of immunoglobulin (2g/kg/dose), and he was discharged 2 days later. On the 14th day, the patient had lamellar desquamation of fingers. Kawasaki disease should be considered as a differential diagnosis in children with febrile cervical lymphadenitis unresponsive to empiric antibiotics even if they have adjacent cellulitis and phlegmon. PMID:26132362

  1. [Intraorbital wood foreign body: a case study].

    PubMed

    Karim, A; Taha, I; Tachfouti, S; Benzakour, H; Bencherif, Z; Cherkaoui, O; Mohcine, Z; Daoudi, R

    2006-12-01

    A 12-year-old child had left orbital trauma by wood. He consulted 4 months after for orbital cellulitis with cutaneous fistula. The CT scan showed the presence of a left orbital wood foreign body extended to the homolateral cavernous sinus and intracranial. Extraction of the wood fragment associated with an adapted antibiotic treatment led to clinical improvement without visual recovery. A situation of orbital trauma and secondary orbital inflammatory syndrome must raise the suspicion of a foreign body of the orbit and motivate emergency imaging for optimal management of the disorder. PMID:17211317

  2. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation

    PubMed Central

    Rubinstein, Tal J.; Clemett, John; Birnbach, Charles D.; LauKaitis, Steven J.; Sires, Bryan S.

    2016-01-01

    A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material. PMID:27413562

  3. Tropical diabetes hand syndrome with autoamputation of the digits: case report and review of literature

    PubMed Central

    Raimi, Taiwo Hussean; Alese, Oluwole Ojo

    2014-01-01

    The tropical diabetes hand syndrome is a complication affecting patients with diabetes mellitus in the tropics, and consists of localized cellulitis, swelling and ulceration of the hands which may progress to fulminant sepsis and gangrene of the whole limb. It is associated with a poor outcome. We report a 32 year old woman with tropical diabetes hand infection with autoamputation of the digits, review the relevant literature, and highlight the need for prevention and early hospital presentation in diabetics with hand infection, in order to prevent potentially crippling or fatal complications. PMID:25419326

  4. Vulvar Abscess Caused by Methicillin-resistant Staphylococcus Aureus (MRSA) in a Postmenopausal Woman

    PubMed Central

    Kim, Tae-Hee; Kim, Soo Ah; Heo, Gyeong-Eun

    2016-01-01

    Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to lifethreatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Employing a multidisciplinary team approach to care for vulvar cellulitis and abscess can guide treatment from antibiotic therapies to more aggressive surgical debridement. In this report, we describe a case of vulvar abscess caused by Methicillin-resistant staphylococcus aureus (MRSA) in a postmenopausal woman with underlying diseases of bronchiectasis and atelectasis. PMID:27617247

  5. Glabellar dermoid cyst: A case presentation.

    PubMed

    Celik, Tuba

    2016-09-01

    Dermoid cysts are one of the most common non-inflammatory space-occupying orbital lesions in the pediatric population. They are ectodermal cysts which may contain squamous epithelium with dermal contents such as skin, hair follicles, sebaceous glands, or sweat glands. Dermoid cyts are often innocent, however complications such as inflammation of the fistula or preseptal cellulitis are occasionally seen. We present a case of a 6-year-old girl with a glabellar dermoid cyst and describe the appropriate investigations and definitive treatment. PMID:26885559

  6. Gas gangrene infection of the eyes and orbits.

    PubMed Central

    Crock, G W; Heriot, W J; Janakiraman, P; Weiner, J M

    1985-01-01

    The literature on Clostridium perfringens infections is reviewed up to 1983. An additional case is reported with bilateral clostridial infections of the eye and orbit. One eye followed the classical course of relentless panophthalmitis, amaurosis, and orbital cellulitis ending in enucleation. The second eye contained intracameral mud and gas bubbles that were removed by vitrectomy instrumentation. Subsequent removal of the toxic cataract resulted in a final aided visual acuity of 6/18, N8. This is the third report of a retained globe, and we believe the only known case where the patient was left with useful vision. Images PMID:3967002

  7. Refractory Toxic Shock-Like Syndrome from Streptococcus dysgalactiae ssp. equisimilis and Intravenous Immunoglobulin as Salvage Therapy: A Case Series.

    PubMed

    Islam, Marjan; Karter, Dennis; Altshuler, Jerry; Altshuler, Diana; Schwartz, David; Torregrossa, Gianluca

    2016-01-01

    Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS. PMID:27597908

  8. Ruptured Popliteal Cyst Diagnosed by Ultrasound Before Evaluation for Deep Vein Thrombosis

    PubMed Central

    Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

    2014-01-01

    Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis. PMID:25566485

  9. Radionuclide evaluation of nonmalignant bone disorders

    SciTech Connect

    Winzelberg, G.G.

    1983-02-01

    Recent advances in nuclear imaging have improved the noninvasive evaluation of patients with nonmalignant bone disorders. When bone scanning agents are combined with bone marrow scanning agents and gallium-67 scintigraphy, a more accurate diagnosis can be obtained. By selecting the appropriate imaging sequence, it is often possible to distinguish cellulitis from underlying osteomyelitis. In patients with total hip replacements, it may be possible to separate postsurgical changes from prosthetic loosening or infection. Stress fractures in joggers may be detected by radionuclide bone scintigraphy before radiographs become abnormal. These nuclear imaging procedures can be done in most hospitals.

  10. Histopathologic features in a case of hyperimmunoglobulinemia D syndrome.

    PubMed

    Pace, Sarah; Bingham, Jonathan; Royer, Michael

    2015-12-01

    We describe a case of Mevalonate Kinase Deficiency (MKD) also known as Hyperimmunoglobulinemia D Syndrome (HIDS) presenting as a Sweet-like syndrome in a 5-week-old with multiple erythematous plaques, fever, aseptic meningitis, and bronchiolitis. The locations of the predominant plaques were periumbilical and periocular, which originally prompted concern for omphalitis and preseptal cellulitis. Histopathology demonstrated a neutrophilic and histiocytic dermatitis with prominent squamous syringometaplasia and leukocytoclasis in the absence of a vasculitis. This case is reported here due to the unique findings of a prominent histiocytic component in addition to the typically described neutrophilic infiltrate. PMID:26904447

  11. L'atteinte osseuse dans le sarcome de Kaposi classique et agressif: à propos d'un cas

    PubMed Central

    Sbiyaa, Mouhcine; El Alaoui, Adil; El Bardai, Mohammed; Mezzani, Amine; Lahrach, Kamal; Marzouki, Amine; Boutayeb, Fawzi

    2016-01-01

    Le sarcome de Kaposi classique est une tumeur rare multifocale d'origine des cellules endothéliales vasculaires à caractère évolutif progressif et peu maligne. L'atteinte viscérale dans le sarcome de kaposi est parfois observée chez les patients VIH positif par contre la dissémination tumorale dans les ganglions lymphatiques viscérales dans le SK classique reste très rare. On rapporte un cas rare de sarcome de kaposi classique agressif de la main avec une évolution rapide et destructive. PMID:27347285

  12. Magnetic resonance imaging (MRI) in the diagnosis of head and neck disease.

    PubMed

    Supsupin, Emilio P; Demian, Nagi M

    2014-05-01

    Magnetic resonance imaging (MRI) is the modality of choice to identify intracranial or perineural spread from a head and neck primary tumor. Perineural spread is a form of metastatic disease in which primary tumors spread along neural pathways. Orbital cellulitis is a sight-threatening, and potentially life-threatening condition. Urgent imaging is performed to assess the anatomic extent of disease, including postseptal, cavernous sinus, and intracranial involvement, and identify orbital abscesses that require exploration and drainage. MRI is useful in the evaluation of the brachial plexus. PMID:24794270

  13. Annual progress report, July 1, 1983-June 30, 1984

    SciTech Connect

    Not Available

    1984-01-01

    Research in the Laboratory of Biomolecular and Celluler Sciences deals with proliferation, gene expression and differentiation in normal cells and in cells exposed to pollutants, carcinogens or tumor promoters. The research program of the Laboratory of Environmental Biology presents an integrated approach to studies of the functional interactions of the physical and biotic components of arid land ecosystems. Nuclear Medicine research has focussed on development of positron emission tomography, preparation of short-lived isotopes of oxygen, nitrogen, carbon and fluorine, use of these isotopes to label physiological substrates, tracer studies of cerebral biochemistry and physiology, measurement of regional myocardial fatty acid metabolism and blood flow. (AER)

  14. Bladder cancer arising in a spina bifida patient.

    PubMed

    Game, X; Villers, A; Malavaud, B; Sarramon, J

    1999-11-01

    We report the case of a 52-year-old patient with spina bifida, neurologic bladder, and a history of recurrent urinary tract infections (UTIs) in whom a bladder cancer was incidentally discovered. Cytology, cystoscopy, and cystography showed nonspecific, extensive inflammatory lesions. Cystography demonstrated a complex of diverticulae and cellules. Pathologic examination of a diverticulectomy specimen revealed a grade III pT3b transitional and squamous cell carcinoma. Because of the similar disease causation (recurrent UTIs, stones, and indwelling catheterization), we suggest extension of the guidelines proposed for patients with spinal cord injuries (ie, annual serial bladder biopsies) to patients with nontraumatic neurogenic bladder. PMID:10754152

  15. Brown recluse spider bite to the upper lip.

    PubMed

    Dare, Ryan K; Conner, Kelly B; Tan, Poliana C; Hopkins, Robert H

    2012-03-01

    Brown recluse spiders are predominantly found in south central United States. Their bites usually cause mild self-limiting reactions, although localized tissue necrosis and rare systemic, potentially fatal, envenomations are known to occur. Herein, we report an atypical presentation of a brown recluse bite in a 20 year old female who was admitted to the intensive care unit due to angioedema and cellulitis. We photographically document the bite site for twenty-four hours following envenomation. She received glucocorticoids, antihistamines, antibiotics and dapsone while hospitalized and was subsequently discharged with complete resolution of symptoms without the development of tissue necrosis or scarring. PMID:22479977

  16. Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.

    PubMed

    Yang, Rong-Hsin; Shen, Shu-Huei; Li, Wing-Yin; Chu, Yum-Kung

    2015-01-01

    Ludwig's angina is a life-threatening cellulitis that involves the submandibular and sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We present here a cancer patient exhibiting the sequential features of bisphosphonate related osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights the need for medical practitioners to be alert to these rare combinations in the compromised patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina secondary to osteonecrosis of the jaw has been reported. PMID:25074798

  17. Necrotizing Fasciitis - Report of ten cases and review of recent literature

    PubMed Central

    Al Shukry, S; Ommen, J

    2013-01-01

    Necrotizing fasciitis is an uncommon disease that results in gross morbidity and mortality if not diagnosed and treated in its early stages. At onset, however, it is difficult to differentiate from other superficial skin conditions such as cellulitis. Family physicians must have a high level of suspicion and low threshold for surgical referral when confronted with cases of pain, fever, and erythema. We present ten cases of necrotizing fasciitis managed in a provincial secondary hospital in Oman over 3 years ago. A review of recent literature is also presented. PMID:23904882

  18. Vibrio vulnificus infection and liver cirrhosis: a potentially lethal combination.

    PubMed

    Nazir, Salik; Brown, Krysta; Shin, Ann Kyungwohn; Donato, Anthony A

    2016-01-01

    We present a case of a 40-year-old man with decompensated alcoholic liver cirrhosis presenting with atraumatic cellulitis of one extremity and severe sepsis that rapidly progressed to compartment syndrome despite broad-spectrum antibiotics. Local cultures following debridement revealed Vibrio vulnificus, and subsequent history revealed consumption of raw oysters 48 h before presentation. Our case points out the unique susceptibility of those with cirrhosis and elevated iron saturation to Vibrio septicaemia, as well as the rapidity and severity of the disease progression. PMID:27151052

  19. A rare glimpse into the morbid world of necrotising fasciitis: Flesh-eating bacteria Vibrio vulnificus.

    PubMed

    Madiyal, M; Eshwara, V K; Halim, I; Stanley, W; Prabhu, M; Mukhopadhyay, C

    2016-01-01

    Necrotising fasciitis is one of the fatal skin and soft tissue infections. Vibrio vulnificus is a rare cause of necrotising fasciitis; however, the disease is one of the major manifestations of the bacteria. Here, we report one such case in a middle-aged male patient. He presented with the signs of bilateral lower limb cellulitis and altered sensorium. V. vulnificus was isolated from blood culture and also from debrided tissue. Though the organism is well characterised, it is a rare causative agent of necrotising fasciitis. This case is a re-emphasis on active look out for this bacterium in patients presenting with necrotizsing fasciitis. PMID:27514968

  20. “The Clock Is Ticking”: The Timely Management of a Painful Skin Rash in a Seventy-Year-Old Woman

    PubMed Central

    Patel, Vijaykumar G.; Nichols, Michelle L.

    2014-01-01

    Necrotizing fasciitis is an uncommon but a potentially fatal condition and can affect any part of the body. Most patients have pre-existing conditions that render them susceptible to infection, although etiology is unclear. Diagnosis is primarily clinical and is often delayed because of the unfamiliarity of the condition among clinicians. Management consists of immediate resuscitation, early surgical debridement, and administration of broad spectrum intravenous antibiotics. We report a case of a 70 year old woman who presented with a painful erythematous rash, was admitted as a case of cellulitis, later developed worsening of symptoms and septic shock, and was diagnosed as necrotizing fasciitis. PMID:24715917

  1. Intraperitoneal insulin therapy for a patient with type 1 diabetes with insulin injection site inflammation.

    PubMed

    Lee, Siang Ing; Narendran, Parth

    2014-01-01

    A 36-year-old man with type 1 diabetes developed skin inflammation at the site of subcutaneous insulin injection after 10 years of basal bolus subcutaneous insulin therapy. This inflammation led to poor insulin absorption, poorly controlled blood glucose and subsequently to ketoacidosis. The problem persisted despite a trial of continuous subcutaneous insulin infusion. The patient went on to be treated with continuous intraperitoneal insulin infusion. Three months after the procedure, he was achieving good glucose control and was able to resume his normal life, with the only complication being an episode of cellulitis surrounding the port site. PMID:25188930

  2. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation.

    PubMed

    Rubinstein, Tal J; Clemett, John; Birnbach, Charles D; LauKaitis, Steven J; Sires, Bryan S

    2016-01-01

    A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material. PMID:27413562

  3. Management of Large Erupting Complex Odontoma in Maxilla

    PubMed Central

    Murphy, Colm; O'Connell, John Edward; Cotter, Edward; Kearns, Gerard

    2014-01-01

    We present the unusual case of a large complex odontoma erupting in the maxilla. Odontomas are benign developmental tumours of odontogenic origin. They are characterized by slow growth and nonaggressive behaviour. Complex odontomas, which erupt, are rare. They are usually asymptomatic and are identified on routine radiograph but may present with erosion into the oral cavity with subsequent cellulitis and facial asymmetry. This present paper describes the presentation and management of an erupting complex odontoma, occupying the maxillary sinus with extension to the infraorbital rim. We also discuss various surgical approaches used to access this anatomic area. PMID:25580339

  4. Multiple nontuberculous scrofulodermas showing dramatic response to clarithromycin.

    PubMed

    Parimalam, Kumar; Senthil, G; Vinnarasan, M; Arumugakani, V; Amutha, B M; Lalitha, S; Swarna, S

    2015-01-01

    Atypical mycobacteria are distinct from the Mycobacterium tuberculosis. Mycobacterium chelonae, a non-pigment producing rapid grower, can be found in many cutaneous sites; infection occurs most commonly after skin trauma from surgery, injections, or minor injuries. In immune competent patients, the infection is more frequently localized as a cellulitis or a nodule, whereas, in the immunocompromised patient, dissemination (more than five lesions) can occur. Because the organism is resistant to antituberculous therapy, abscess can develop and follow a chronic, indolent course. We report a case of multiple scrofuloderma due to nontuberculous infection caused by M. chelonae showing dramatic response to clarithromycin. PMID:25657914

  5. Hereditary angioedema type 2 presented as an orbital complication of acute rhinosinusitis.

    PubMed

    Somuk, Battal Tahsin; Göktas, Göksel; Özer, Samet; Sapmaz, Emrah; Bas, Yalcın

    2016-03-01

    Hereditary angioedema is an autosomal dominant and life-threatening disorder characterized by recurrent episodes of non-pitting edema affecting the skin, respiratory system and digestive tracts and caused by a congenital deficiency or function defect of the C1 esterase inhibitor. Preseptal cellulitis is defined as an infection of the tissues of the anterior orbital septum. It is generally caused by complications from an upper respiratory tract infection, dacryocystitis, dermal infection, and, rarely, sinusitis. The disease presents with orbital pain, edema on the eyelids, erythema, and fever. In this case, a child with hereditary angioedema type 2 who presented as mimicking a complication of acute sinusitis is discussed. PMID:26857308

  6. Vulvar Abscess Caused by Methicillin-resistant Staphylococcus Aureus (MRSA) in a Postmenopausal Woman.

    PubMed

    Kim, Tae-Hee; Seap, Bel; Kim, Soo Ah; Heo, Gyeong-Eun

    2016-08-01

    Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to lifethreatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Employing a multidisciplinary team approach to care for vulvar cellulitis and abscess can guide treatment from antibiotic therapies to more aggressive surgical debridement. In this report, we describe a case of vulvar abscess caused by Methicillin-resistant staphylococcus aureus (MRSA) in a postmenopausal woman with underlying diseases of bronchiectasis and atelectasis. PMID:27617247

  7. Wolf in sheep's clothing: a case of carcinoma erysipeloides

    PubMed Central

    Bhattacharyya, Ambarish; Gangopadhyay, Mitali; Ghosh, Kaushik; Ray, Pranamita

    2016-01-01

    Cutaneous metastases of the breast carcinomas can present clinically as nodules, plaques and tumors (most commonly as nodules) as well as ‘erysipelas-like’ lesions are known as ‘carcinoma erysipeloides’. We want to share our experience in diagnosing a middle-aged lady with carcinoma erysipeloides secondary to breast carcinoma and her management as this is commonly misdiagnosed as cellulitis or scleroderma in general practice. Unfortunately, the patient had presented to us at a late stage with wide-spread metastasis, and as such, chemotherapy was the only available option. She expired after her third cycle of chemotherapy. PMID:27127640

  8. Intraperitoneal insulin therapy for a patient with type 1 diabetes with insulin injection site inflammation

    PubMed Central

    Lee, Siang Ing; Narendran, Parth

    2014-01-01

    A 36-year-old man with type 1 diabetes developed skin inflammation at the site of subcutaneous insulin injection after 10 years of basal bolus subcutaneous insulin therapy. This inflammation led to poor insulin absorption, poorly controlled blood glucose and subsequently to ketoacidosis. The problem persisted despite a trial of continuous subcutaneous insulin infusion. The patient went on to be treated with continuous intraperitoneal insulin infusion. Three months after the procedure, he was achieving good glucose control and was able to resume his normal life, with the only complication being an episode of cellulitis surrounding the port site. PMID:25188930

  9. Infection of human keratinocytes by Streptococcus dysgalactiae subspecies dysgalactiae isolated from milk of the bovine udder.

    PubMed

    Roma-Rodrigues, Catarina; Alves-Barroco, Cynthia; Raposo, Luís R; Costa, Mafalda N; Fortunato, Elvira; Baptista, Pedro Viana; Fernandes, Alexandra R; Santos-Sanches, Ilda

    2016-04-01

    Streptococcus dysgalactiae subsp. dysgalactiae (SDSD) are considered exclusive animal pathogens; however, a putative zoonotic upper limb cellulitis, a prosthetic joint infection and an infective endocarditis were described in humans. To unravel if bovine SDSD isolates are able to infect human cells, the adherence and internalization to human primary keratinocytes of two bovine SDSD strains isolated from milk collected from udder were analyzed. Bacterial adhesion assays and confocal microscopy indicate a high adherence and internalization of SDSD isolates to human cells, suggesting for the first time the ability of bovine isolates to infect human cells. PMID:26655883

  10. Ultrasonography of the extremities and pelvic girdle and correlation with computed tomography

    SciTech Connect

    Yeh, H.C.; Rabinowitz, J.G.

    1982-05-01

    Ultrasonography was performed on 54 patients with lesions of the extremities and pelvic girdle. Computed tomography (CT) was employed in 8 patients. Focal space-occupying lesions such as tumors, abscesses, hematomas, aneurysms, and popliteal cysts (dissecting or otherwise) were delineated by ultrasound and their extent defined. Differentiation from diffuse changes such as lymphedema, cellulitis, or phlebitis and diagnosis of aneurysms were possible. Popliteal cysts were ususally quite characteristic, while correlation with the clinical features suggested the correct diagnosis in the case of the other lesions. CT correlated well with ultrasound, except for one tumor of the forearm which was not shown by CT.

  11. Indigenous human cutaneous anthrax in Texas.

    PubMed

    Taylor, J P; Dimmitt, D C; Ezzell, J W; Whitford, H

    1993-01-01

    In December 1988 an indigenous case of cutaneous anthrax was identified in Texas. The patient, a 63-year-old male Hispanic from southwest Texas, was a sheep shearer and had a recent history of dissecting sheep that had died suddenly. He experienced an illness characterized by left arm pain and edema. A necrotic lesion developed on his left forearm, with cellulitis and lymphadenopathy. After treatment with oral and intravenous penicillins, the patient fully recovered. Western blot testing revealed a fourfold or greater rise in antibody titer to Bacillus anthracis protective antigen and lethal factor. This represents the first case of indigenous anthrax in Texas in more than 20 years. PMID:8420007

  12. Acquired scalp alopecia. Part II: A review.

    PubMed

    Sullivan, J R; Kossard, S

    1999-05-01

    The neutrophil-associated and infiltrative scarring alopecias are reviewed including folliculitis decalvans, tufted folliculitis, dissecting cellulitis of the scalp, acne keloidalis and follicular degeneration syndrome. The management of acquired scalp alopecia is also reviewed including newer, promising therapies. More specific agents targeting components of the androgen system will make the treatment of androgenetic alopecia more rewarding. Similarly new immunomodulatory therapies show great promise for the lymphocyte-associated alopecias and include a new generation of macrolide immunosuppressives (tacrolimus, SDZ ASM 981, and SDZ 281-240), some of which appear to have good transcutaneous absorption. PMID:10333615

  13. Use of ultrasound in osteomyelitis.

    PubMed

    Nath, A K; Sethu, A U

    1992-08-01

    The use of ultrasound in osteomyelitis has been studied in 25 patients clinically suspected of osteomyelitis. A sonographic diagnosis of osteomyelitis was made if fluid was present in direct contact with the bone, without intervening soft tissues. This was thought to represent an inflammatory exudate dissecting in a subperiosteal and/or extraperiosteal location. Ultrasonographically 15 patients were found to have osteomyelitis, proved either by surgical drainage or needle aspiration. Seven patients had soft-tissue abscesses, one had cellulitis and two patients had no abnormality. PMID:1393388

  14. The groin hit: complications of intravenous drug abuse.

    PubMed

    Roszler, M H; McCarroll, K A; Donovan, K R; Rashid, T; Kling, G A

    1989-05-01

    We are seeing an increased number of complications in intravenous drug abusers who resort to injecting the groin for vascular access (the "groin hit"). Vascular complications include venous thrombosis, arteriovenous fistula, mycotic aneurysm, ruptured pseudoaneurysm, and dissecting hematoma. Soft tissue complications include cellulitis and abscess. The latter may dissect into the extraperitoneal space. Skeletal complications include osteomyelitis and septic arthritis. This paper illustrates the radiographic spectrum of these complications. An algorithm will illustrate the radiographic evaluation of a groin mass in a drug addict. PMID:2727357

  15. Improved early diagnosis of acute inflammatory skeletal-articular diseases in children: A two-radiopharmaceutical approach

    SciTech Connect

    Handmaker, H.; Giammona, S.T.

    1984-05-01

    The febrile child with a painful bone or joint still presents a difficult pediatric diagnostic problem. Acute hematogenous osteomyelitis, septic arthritis, and cellulitis are the most common causes of this symptom. Thirty-seven patients with these disorders were studied. Because findings from technetium-99m phosphate bone scans and roentgenograms are often normal in patients in the early stages of acute hematogenous osteomyelitis, children suspected of having this disorder were tested using gallium-67 citrate scans in addition to the other diagnostic procedures. The increased diagnostic accuracy of this approach over that of bone scan and roentgenogram studies alone was observed in the children with fever and bone or joint pain.

  16. Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections

    SciTech Connect

    Carter, B.L.; Bankoff, M.S.; Fisk, J.D.

    1983-06-01

    Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination of patients with orbital and intracranial infection.

  17. Ultrasonography and computed tomography of inflammatory abdominal wall lesions

    SciTech Connect

    Yeh, H.C.; Rabinowitz, J.G.

    1982-09-01

    Twenty-four patients with inflammatory lesions of the abdominal wall were examined by ultrasonography. Nine of these patients underwent computed tomographic (CT) scanning as well. Both ultrasonography and CT clearly delineated the exact location and extent of abdominal wall abscesses. Abscesses were easily differentiated from cellulitis or phlegmon with ultrasound. The peritoneal line was more clearly delineated on ultrasonograms than on CT scans; abscesses were also more distinct on the ultrasonograms because of their low echogenicity compared with the surrounding structures. Gas bubbles, fat density with specific low attenuation values, and underlying inflamed bowel loops in obese patients with Crohn's disease were better delineated by CT.

  18. Garenoxacin in Skin and Skin Structure Infections Sustained due to Road Traffic Accident

    PubMed Central

    Krishnaprasad, K; Bhargava, Amit Indra

    2014-01-01

    Skin and soft tissue infections represent a continuum of symptoms that range from uncomplicated cellulitis to the potentially lethal entity necrotizing fasciitis that is often considered to be microbial invasions of the epidermis, dermis and subcutaneous tissues. Garenoxacin, a newer oral des-fluoroquinolone having potent antimicrobial activity against wide variety of common pathogens involved in skin and skin structure infections (SSTIs), including the resistant strains offer the advantage of broad spectrum of coverage including gram positive, gram negative and anaerobic organisms. This case study indicates the utility of garenoxacin in treating skin and soft tissue infections caused by road traffic accidents. PMID:25121004

  19. Refractory Toxic Shock-Like Syndrome from Streptococcus dysgalactiae ssp. equisimilis and Intravenous Immunoglobulin as Salvage Therapy: A Case Series

    PubMed Central

    Karter, Dennis; Altshuler, Jerry; Altshuler, Diana; Schwartz, David; Torregrossa, Gianluca

    2016-01-01

    Infections from Streptococcus dysgalactiae ssp. equisimilis (SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS. PMID:27597908

  20. Nonketotic hyperglycinemia: novel mutation in the aminomethyl transferase gene. Case report.

    PubMed

    Gencpinar, Pinar; Çavuşoğlu, Dilek; Özbeyler, Ömer; Kaya, Özge Ö; Baydan, Figen; Olgac Dundar, Nihal

    2016-06-01

    Panton-Valentine leukocidin (PVL) is an exotoxin that is produced by many strains of Staphylococcus aureus, and an important virulence factor. A PVL-positive S. aureus infection leads to rapid and severe infections of soft tissue and necrotizing pneumonia in healthy adolescents, and has a high mortality. This case report included a 12-year-old male patient who admitted for fever, respiratory distress and hip pain and was identified with necrotizing pneumonia with septic pulmonary embolism, psoas abscess, cellulitis and osteomyelitis. The PVL positive methicillin-sensitive S. aureus (MSSA) was isolated in the patient blood culture. PMID:27164344

  1. Métastase anale d'un adénocarcinome du sigmoïde: la partie visible de l'iceberg

    PubMed Central

    El Barni, Rachid; Lahkim, Mohamed; Fihri, Jawad Fassi; Mejdane, Abdelhadi; Bouchama, Rachid; Achour, Abdessamad

    2014-01-01

    Les auteurs rapportent l'observation d'une métastase anale d'un adénocarcinome sigmoïdien dont le traitement a consisté en une amputation abdominopérinéale du rectum, étendue au côlon sigmoïde avec colostomie iliaque gauche définitive. Les différents mécanismes d'extension tumorale sont discutés et la greffe de cellules tumorales viables exfoliées dans la lumière colique est le mécanisme le plus souvent retenu. PMID:25419304

  2. Skin disorders at sea.

    PubMed

    Lucas, Ray; Boniface, Keith; Hite, Michael

    2010-01-01

    The purpose of this study is to characterize the types of skin disorders occurring at sea requiring acute treatment. The case logs of a tele-medicine service for US flagged ships at sea were reviewed from March 1, 2006 until March 1, 2009. Of 1844 total cases, 10% (n = 183) were for skin disorders. Sixty-eight percent (n = 125) were infections, 14% (n = 25) were inflammatory, 7% (n = 13) were environmental, and 11% (n = 20) were non-specific rashes. Cutaneous abscesses and cellulitis (n = 84) were the most common acute skin disorders encountered. In some cases (n = 81), still digital photographs aided in the diagnosis. PMID:20496321

  3. Frequent bacterial skin and soft tissue infections: diagnostic signs and treatment.

    PubMed

    Sunderkötter, Cord; Becker, Karsten

    2015-06-01

    Skin and soft tissue infections rank among the most frequent infections worldwide. Classic erysipelas is defined as a non-purulent infection by beta-hemolytic streptococci. The typical signs are tender, warm, bright erythema with tongue-like extensions and early systemic symptoms such as fever or at least chills. Erysipelas always and best responds to penicillin. Limited soft tissue infection or limited cellulitis are the terms we have introduced for infections frequently caused by S. aureus and often originating from chronic wounds or acute trauma. Clinically, they are marked by tender, erythematous swelling which, unlike erysipelas, exhibit a darker red hue and is not always accompanied by fever or chills at onset. Severe cellulitis is a purulent, partially necrotic infection extending to the fascia, with general symptoms of infection, requiring surgical management in addition to antibiotics. It often fulfils criteria of so-called complicated soft tissue infections according to the definition of the FDA, due to their frequent association with e.g. severe diabetes mellitus, peripheral arterial occlusive disease or severe immunosuppression. In contrast, the rare necrotizing skin and soft tissue infections represent a distinct entity, characterized by rapid progression to ischemic necroses and shock due to special bacterial toxins. Limited cellulitis should be treated with cephalosporins group 1 or 2, or, when S.aureus is the isolated or highly likely causative agent, isoxazolyl-penicillins (exploiting their minimal selection pressure on other bacteria). For severe cellulitis, initial antibiotic treatment (mostly iv) includes - depending on the location - agents also active against gram-negative and/or anaerobic bacteria. (e.g. clindamycine, aminopeniclilline with inhibitors of betalaktamase, fluochinolons, cephalosporines group 4). For cutaneous abscesses, drainage presents the therapy of choice. Only under certain conditions additional antibiotic therapy is

  4. Idiopathic Hypereosinophilic Syndrome With Cutaneous Manifestations and Flame Figures: A Spectrum of Eosinophilic Dermatoses Whose Features Overlap With Wells' Syndrome

    PubMed Central

    Kiracofe, Elizabeth A.; Clark, Lindsey N.; Gru, Alejandro A.

    2015-01-01

    Importance: Wells syndrome (WS) (eosinophilic cellulitis) is an uncommon eosinophilic dermatitis that has been rarely described in association with, but distinct from, hypereosinophilic syndrome (HES). Observations: We report a case of an eosinophilic dermatosis with flame figures in association with idiopathic HES, manifested by inflammatory myocarditis, asthma, and peripheral blood eosinophilia. Conclusions and Relevance: The diagnoses of WS and HES, rather than being distinct findings, may represent 2 entities on a spectrum of hypereosinophilic diseases. The diagnosis of WS should be made with caution and should prompt a thorough investigation that includes a work-up for a systemic eosinophilic disorder. PMID:25839890

  5. Rhino-orbito-cerebral mucormycosis in patients with diabetic ketoacidosis.

    PubMed

    Gen, Ramazan; Horasan, Elif Şahin; Vaysoğlu, Yusuf; Arpaci, Rabia Bozdoğan; Ersöz, Gülden; Özcan, Cengiz

    2013-03-01

    Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. The most common predisposing risk factor for mucormycosis is diabetes mellitus. Rhino-orbito-cerebral mucormycosis is the most common form in diabetic patients and is characterized by paranasal sinusitis, ophthalmoplegia with blindness, and unilateral proptosis with cellulitis, facial pain with swelling, headache, fever, rhinitis, granular or purulent nasal discharge, nasal ulceration, epistaxis, hemiplegia or stroke, and decreased mental function. Diabetic ketoacidosis is the most common and serious acute complication of diabetic patients. We herein report 2 cases of fatal rhino-orbito-cerebral mucormycosis in a patient with diabetic ketoacidosis. PMID:23524816

  6. MR imaging of urgent inflammatory and infectious conditions affecting the soft tissues of the musculoskeletal system.

    PubMed

    Yu, Joseph S; Habib, Paula

    2009-07-01

    Soft tissue infections and inflammatory conditions of the musculoskeletal system are a group of disorders commonly seen by emergency room physicians and radiologists. Many of these entities can either be limb- or life-threatening. Magnetic resonance imaging is currently the best imaging modality to evaluate these conditions. In this review, the characteristic imaging findings of cellulitis, abscess formation, necrotizing fasciitis, pyomyositis, diabetic ischemic infarction, acute and exertional compartment syndromes, and rhabdomyolysis will be emphasized as well as imaging factors that can help to differentiate these disorders. PMID:19132424

  7. Risking Life and Limb: A Case of Spontaneous Diabetic Muscle Infarction (Diabetic Myonecrosis).

    PubMed

    Cumberledge, Jeremy; Kumar, Bharat; Rudy, David

    2016-06-01

    Diabetic muscle infarction, also known as diabetic myonecrosis, is a microvascular complication of poorly controlled diabetes mellitus characterized by unilateral limb pain and swelling. Because these symptoms closely mimic cellulitis and thromboembolism, diagnosis is often delayed or missed altogether, leading to increased morbidity and inappropriate treatment. We describe a case of unilateral limb pain and swelling due to diabetic muscle infarction in a 36-year-old patient with poorly controlled diabetes mellitus. We also review the literature on the diagnosis, prognosis, and management of this under-recognized condition. PMID:26643376

  8. Imaging of the diabetic foot diagnostic dilemmas.

    PubMed

    Loredo, Rebecca; Rahal, Andres; Garcia, Glenn; Metter, Darlene

    2010-10-01

    Multiple diagnostic imaging modalities are available and beneficial for the evaluation of the diabetic foot. There is not yet "one best test" for sorting out the diagnostic dilemmas commonly encountered. The differentiation of cellulitis alone from underlying osteomyelitis and the early detection of abscesses remain important diagnostic goals. Equally important, differentiation of osteomyelitis and neuroarthropathy remains a difficult job. This is often compounded by postoperative diabetic foot states status after reconstruction. Diagnostic evaluation often involves multiple studies that are complementary and that include conventional radiography, computed tomography, nuclear medicine scintigraphy, magnetic resonance imaging, ultrasonography, and positron emission tomography. PMID:20966452

  9. Case series on tropical diabetic hand syndrome.

    PubMed

    Ezeani, I U; Edo, A E

    2014-01-01

    Tropical diabetic hand syndrome is a term used to describe diabetes complication of the hand affecting people in the tropics. It consists of localized cellulitis with variable swelling and ulceration of the hands, progressive, fulminant hand sepsis and gangrene in extreme cases. This syndrome is not well-recognized and is therefore less frequently reported. The authors describe three different female patients who were known diabetics of varying duration presenting with this syndrome at our tertiary health center and who were successfully managed by both the surgical and medical units. The need for early diagnosis and aggressive management is emphasized. PMID:24909485

  10. Bacterial infections of the skin. I: primary and secondary infections.

    PubMed

    Chan, H L

    1983-01-01

    Bacterial skin infections are important to recognize because we have the means to eradicate almost all of them. Primary skin infections are mainly caused by staphylococci or streptococci. Staphylococci infections present as furuncles and carbuncles, superficial folliculitis, impetigo or rarely the Scalded Skin Syndrome. Streptococcal infections present as impetigo, ecthyma, erysipelas or cellulitis. Corynebacteria causes erythrasma, trichomycosis or pitted keratolysis. Gram-negative primary skin infections, although uncommon, may occur; bacterial cultures are generally necessary for diagnosis. Secondary bacterial infections of pre-existing wounds, burns, dermatitic skin, or retention cysts are common events. PMID:6859802

  11. Over-the-scope clip closure of gastrocutaneous fistula.

    PubMed

    Rodrigues-Pinto, Eduardo; Pereira, Pedro; Vilas-Boas, Filipe; Macedo, Guilherme

    2016-09-01

    A 35-year-old female patient, with Batten's disease, submitted to a surgical gastrostomy in 2005, and had it replaced in 2007, 2011 and 2014 with one with a filled balloon as its internal retention mechanism. In 2015, she presented to the emergency room due to stomal enlargement, leakage and chemical dermatitis and cellulitis. A 12 mm over-the-scope clip was placed, after anchoring the fistula edges with the twin grasper and suction of the defect into the applicator cap. Endoscopic resolution of the fistula was achieved. PMID:27615017

  12. Pyoderma gangrenosum induced by episiotomy.

    PubMed

    Alani, Angela; Sadlier, Muriel; Ramsay, Bart; Ahmad, Kashif

    2016-01-01

    We present a patient who developed genital ulceration within hours following episiotomy procedure during a normal vaginal delivery. This was initially treated by the gynaecology and medical team as cellulitis with no improvement. A diagnosis of pyoderma gangrenosum (PG) was made by the dermatology team 12 days later. On further investigation, she was found to be hepatitis C positive. We report this case to highlight the phenomenon of pathergy and frequent misdiagnosis of PG by other medical teams. When a postsurgical wound is not healing despite relevant systemic treatment, the clinician should suspect PG as an early diagnosis and treatment is crucial. PMID:26786531

  13. Histopathologic features in a case of hyperimmunoglobulinemia D syndrome

    PubMed Central

    Pace, Sarah; Bingham, Jonathan; Royer, Michael

    2015-01-01

    We describe a case of Mevalonate Kinase Deficiency (MKD) also known as Hyperimmunoglobulinemia D Syndrome (HIDS) presenting as a Sweet-like syndrome in a 5-week-old with multiple erythematous plaques, fever, aseptic meningitis, and bronchiolitis. The locations of the predominant plaques were periumbilical and periocular, which originally prompted concern for omphalitis and preseptal cellulitis. Histopathology demonstrated a neutrophilic and histiocytic dermatitis with prominent squamous syringometaplasia and leukocytoclasis in the absence of a vasculitis. This case is reported here due to the unique findings of a prominent histiocytic component in addition to the typically described neutrophilic infiltrate. PMID:26904447

  14. [Community associated-methicillin-resistant Staphylococcus aureus (SAMR-AC): comunication of the first four pediatric cases in the Roberto del Rio Children's Hospital].

    PubMed

    Acuña, Mirta; Benadof, Dona; Jadue, Carla; Hormazábal, Juan C; Alarcón, Pedro; Contreras, Julio; Torres, Ramón; Mülchi, Cristóbal; Aguayo, Carolina; Fernández, Jorge; Araya, Pamela

    2015-06-01

    Staphylococcus aureus is a known pathogen in pediatric patients that produces skin infections, cutaneous abscess, cellulitis and osteoarticular infections. Most of these infections are produced by a meticilin susceptible strain. The community associated methicillin resistant Staphylococcus aureus was published for the first time in 1993, ever since then is has been recognized as a cosmopolite pathogen. The first report in Latin America was published in 2003, and in Chile in 2008 from adult patients that have reported traveling to other countries. The following series describes four pediatric cases, all school-aged children, diagnosed since 2012 with clinical followups and molecular studies. Two cases presented as osteomyelitis of the lower extremity; and one presented as arm cellulitis. These three cases had Panton Valentine leukocidine (PV-L) negative strains from the clone complex 8. The last case presented a renal abscess, the strain was PV-L positive from the clone complex 30. This case series constitutes the first pediatric case report in Chile. PMID:26230445

  15. Pressure ulcers: prevention, evaluation, and management.

    PubMed

    Bluestein, Daniel; Javaheri, Ashkan

    2008-11-15

    A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. Predisposing factors are classified as intrinsic (e.g., limited mobility, poor nutrition, comorbidities, aging skin) or extrinsic (e.g., pressure, friction, shear, moisture). Prevention includes identifying at-risk persons and implementing specific prevention measures, such as following a patient repositioning schedule; keeping the head of the bed at the lowest safe elevation to prevent shear; using pressure-reducing surfaces; and assessing nutrition and providing supplementation, if needed. When an ulcer occurs, documentation of each ulcer (i.e., size, location, eschar and granulation tissue, exudate, odor, sinus tracts, undermining, and infection) and appropriate staging (I through IV) are essential to the wound assessment. Treatment involves management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery. Debridement is indicated when necrotic tissue is present. Urgent sharp debridement should be performed if advancing cellulitis or sepsis occurs. Mechanical, enzymatic, and autolytic debridement methods are nonurgent treatments. Wound cleansing, preferably with normal saline and appropriate dressings, is a mainstay of treatment for clean ulcers and after debridement. Bacterial load can be managed with cleansing. Topical antibiotics should be considered if there is no improvement in healing after 14 days. Systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection. PMID:19035067

  16. Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

    PubMed Central

    Wan, Yuzhu; Shi, Guanggang; Wang, Haibo

    2016-01-01

    Background: The orbital complications account for about 80% of all complications secondary to acute rhinosinusitis. If the treatment is not correct and in time, orbital complications could progress rapidly, leading to optic neuritis, cavernous sinus thrombophlebitis or life-threatening intracranial complications. Aims: To evaluate the therapeutic efficacy of conservative therapy for the patients with orbital cellulitis and endoscopic sinus surgery (ESS) performed on patients with subperiosteal abscess (SPA) secondary to acute rhinosinusitis in children. Study Design: Retrospective cross-sectional study. Methods: The retrospective study included 31 pediatric patients with orbital complications secondary to acute rhinosinusitis. In all cases, intensive treatment was initiated with a combination of oral or intravenous antibiotics, glucocorticoid and gelomyrtol forte after admission. ESS was performed if an improvement in the condition of patients did not occur after 48 hours. However, the patients with orbital SPA, motility disorders of eyeball or decreased vision received ESS immediately within 24 hours. Results: Sixteen patients were cured by conservative therapy and 15 patients by ESS. All of the signs and symptoms disappeared after conservative therapy or ESS. There were no recurrences within the follow-up period of 1 to 8 years. Conclusion: Conservative therapy is an effective method for patients with inflammatory edema and most cases of orbital cellulitis in children. SPA can be cured by ESS. PMID:27606135

  17. Efficacy of Slimming Cream Containing 3.5% Water-Soluble Caffeine and Xanthenes for the Treatment of Cellulite: Clinical Study and Literature Review

    PubMed Central

    Byun, Sang-Young; Kwon, Soon-Hyo; Heo, Su-Hak; Shim, Jae-Seong; Du, Mi-Hee

    2015-01-01

    Background Cellulite is a 'cottage cheese-like' cutaneous change caused by subcutaneous fat bulging into the dermis that usually leads to cosmetic problems. Slimming cream containing 3.5% water-soluble caffeine and xanthenes exhibits a lipolytic effect with penetration into the dermis. Objective To evaluate the efficacy and safety of slimming cream for the treatment of cellulite. Methods Fifteen subjects with cellulite applied slimming cream to the thighs and inner side of the upper arms twice daily for 6 weeks. Efficacy was assessed using a standard visual scale, changes in the circumferences of the thighs and upper arms, and patient satisfaction by a questionnaire at baseline, week 3, and week 6. Safety was assessed by inquiring about adverse events through questionnaires. Results The standard visual scale score improved significantly by 0.49 points (19.8%) at week 6. Thigh and upper-arm circumferences decreased by 0.7 cm (1.7%) and 0.8 cm (2.3%), respectively, at week 6. Slight itching and transient flushing were commonly reported, but no serious adverse event occurred. Conclusion The slimming cream tested appears to be effective for the treatment of cellulitis without serious adverse effects. However, additional large clinical trials are required to confirm the efficacy and safety of slimming cream for the treatment of cellulitis. PMID:26082579

  18. Red or uncomfortable eye.

    PubMed Central

    Davey, C.; Hurwitz, B.

    1992-01-01

    1. A red, uncomfortable eye may be accompanied by other symptoms such as blurred, decreased, or double vision, haloes, photophobia, pain or discharge. 2. A careful history and brief systematic examination will sort out most problems. 3. Examine eyelids, the conjunctivae and corneas. Checking visual acuity is often important. 4. The most common underlying causes can usually be managed within general practice, though a few patients will require urgent eye assessment, or routine referral to ophthalmic outpatients. 5. The following are typical eye problems which require urgent referral: History of pain as opposed to discomfort, Trauma including foreign bodies, chemicals and suspected penetrating injury, Unexplained drop in visual acuity of two lines or more in a painful eye. Specific conditions: preseptal cellulitis, herpes simplex ulcer, scleritis, orbital cellulitis, herpes zoster, bacterial corneal ulcer, dacryocystitis. 6. The following are typical problems which may require routine referral: Persistence of the problem not relieved by simple measures, Recurrent disorders of uncertain diagnosis, Eyelid swelling such as chalazion, cysts, basal cell carcinoma, Gradual loss of vision, for example cataract, macular degeneration. PMID:1345157

  19. Sequential use of radiophosphate and radiogallium imaging in the differential diagnosis of bone, joint and soft tissue infection: quantitative analysis.

    PubMed

    Rosenthall, L; Kloiber, R; Damtew, B; Al-Majid, H

    1982-01-01

    A quantitative analysis of the results obtained by sequential 99mTc methylene diphosphonate (MDP) and 67Ga-citrate (Ga) imaging to disclose and distinguish infections in bone, synovium and adjacent soft tissue is reported. There were 129 patients with proved or probable osteomyelitis, septic arthritis and cellulitis, and 94 patients who were eventually shown to be free of sepsis, but not necessarily free of some other nonseptic affliction. Of the 159 patients referred with a presumptive clinical diagnosis of osteomyelitis 94 were eventually shown to be free of infection. The results of this group by sequential imaging were true positive 0.72, true negative 0.86 and accuracy 0.80 when low-grade Ga uptakes, which were similar in distribution to MDP, were excluded. In 26 patients with septic arthritis, the true-positive fraction for combined MDP and Ga was 0.84. The true-positive fraction for Ga in 38 patients with cellulitis was 0.79. PMID:6215237

  20. Periocular cutaneous anthrax in Jimma Zone, Southwest Ethiopia: a case series

    PubMed Central

    2013-01-01

    Background Anthrax is a zoonotic disease caused by Bacillus anthracis. Naturally occurring human infection is rare and is generally the result of contact with anthrax-infected animals or animal products. Case presentation We examined three patients who had contact with presumed anthrax-infected animal and/or its product and presented with preseptal cellulitis with a localized itchy erythematous papule of the eyelid and non-pitting periorbital edema, followed by ulceration and dark eschar formation. All the three patients responded to intravenous antibiotics, and the lesion resolved leaving scars which caused cicatricial ectropion in all cases. Conclusion Anthrax is a rare disease but should be considered in the differential diagnosis of ulcerative (and eschar forming) preseptal cellulitis with a history of contact with anthrax-infected animals or animal products. Furthermore, cicatrization of the eyelids, one of the sequelae of periocular cutaneous anthrax, should be addressed. Urgent case report to the local zoonotic disease and infection control body and other responsible authorities is recommended. PMID:23924443

  1. Early demographic and clinical predictors of developing acute kidney injury in snake bite patients: A retrospective controlled study from an Indian tertiary care hospital in North Eastern Uttar Pradesh India

    PubMed Central

    Singh, R. R.; Uraiya, Dharmendra; Kumar, Anoop; Tripathi, Neeraj

    2016-01-01

    Aims: This study was conducted retrospectively to define early demographic and clinical predictors for acute kidney injury (AKI) among snake bite patients at the time of hospital admission. Materials and Methods: We analyzed 138 cases with a poisonous snake bite. Patients were classified into two groups according to the presence and absence of AKI. The data regarding clinical features and demographic profile of these patients were collected from the hospital records in a prestructured pro forma and statistically compared. Results: Of the 138 patients of venomous snake bite, 62 developed AKI (44.92%). Patients who developed AKI were older in age. Moreover, prolonged bite to anti-snake venom (ASV) time had a significant relationship in developing AKI (P < 0.05). Among the clinical features, there was an independent positive association of AKI with abdomen pain, tenderness and vomiting, cellulitis, bleeding tendencies, myalgia, and black or brown urine (P < 0.05). Neurological features were inversely associated with renal involvement. Conclusion: We found that marked abdominal pain, tenderness and vomiting, myalgia, black or brown urine, bite site cellulitis, bleeding tendencies, and prolonged (>2 h) bite to ASV time were significantly associated with the development of AKI in snake bite patients. PMID:27555694

  2. Poultry abattoir survey of carcass condemnation for standard, vegetarian, and free range chickens.

    PubMed Central

    Herenda, D; Jakel, O

    1994-01-01

    During the period April 1991 to March 1992, data concerning the condemnation rate of standard, vegetarian, and free-range chickens were collected and summarized from one federally inspected abattoir in Ontario. The purpose of this study was to discuss the effects of diet, management, and breed of chickens on pathological lesions, ensuing condemnation rates, and consequent losses to the growers and the poultry industry. The data collected at this abattoir revealed that vegetarian chickens showed a higher condemnation rate (5.23%) for disease and nondisease conditions compared with standard (1.48%) and free-range (0.94%) chickens. Free-range chickens were approximately two weeks older than vegetarian and standard chickens at the time of slaughter. The most common causes of condemnation in vegetarian chickens was cellulitis (1.18%), followed by ascites (0.77%). Ascites and cellulitis (0.26% both) were also the most common causes of condemnation in standard chickens. Cyanosis (0.21%) and mutilation (0.17%) represented the highest rate of condemnation in free-range chickens. The low rate of pathological lesions in free-range chickens is a positive trend in poultry disease management. PMID:8050075

  3. Validation of a disease model in Japanese quail (Coturnix coturnix japonica) with the use of Escherichia coli serogroup O2 isolated from a turkey

    PubMed Central

    Nain, Sukhbir; Smits, Judit E.G.

    2011-01-01

    This study established a disease model and protocol for bacterial challenge with Escherichia coli serogroup O2 strain EC317 in Japanese quail. Five groups of 10 birds each were injected subcutaneously in the breast with 200 μL of a brain–heart infusion (BHI) culture containing 1 × 108, 1 × 107, 1 × 106, 1 × 105, or 1 × 104 colony-forming units/mL of the test organism, which had been isolated from a turkey with cellulitis and septicemia. Birds in a 6th group were controls that received sterile BHI alone. Localized lesions of cellulitis developed in all of the birds that received E. coli. The morbidity and mortality rates were highest (100%) in the birds receiving the highest dose of E. coli and decreased linearly with decreasing dose (P < 0.05). Severity of disease, including lesions of pericarditis and perihepatitis, was also directly proportional to the dose of E. coli. These findings indicate that this disease challenge protocol can be used to study disease resistance and immunologic consequences of contaminant exposure or other stressors in birds. PMID:22210992

  4. Tufted folliculitis of the scalp: a distinctive clinicohistological variant of folliculitis decalvans.

    PubMed

    Annessi, G

    1998-05-01

    Tufted folliculitis is an uncommon folliculitis of the scalp that resolves with patches of scarring alopecia within which multiple hair tufts emerge from dilated follicular orifices. The clinicohistological data from a group of 15 patients with tufted folliculitis were reviewed and compared with those of seven patients with folliculitis decalvans, five with acne keloidalis nuchae, four with dissecting cellulitis of the scalp, three with kerion celsi and 20 with follicular lichen planus. It was found that tufted folliculitis could be differentiated from folliculitis decalvans only by finding several hair tufts scattered within patches of scarring alopecia. Histologically, a single tuft consisted of peculiar clustering of adjacent follicular units opening at the bottom of an epidermal depression. Conversely, the presence of keloidal plaques in acne keloidalis nuchae, coalescing nodules discharging purulent material in dissecting cellulitis of the scalp, erythematous plaques covered by pustules replete with fungal elements in kerion celsi, and the absence of follicular pustules in follicular lichen planus distinguished these diseases from tufted folliculitis. On the basis of these findings, it is suggested that tufted folliculitis should be considered as a distinctive clinicohistological variant of folliculitis decalvans. Tufting of hair is caused by clustering of adjacent follicular units due to a fibrosing process and to retention of telogen hairs within the involved follicular units. PMID:9666825

  5. A case of Ludwig angina: a case report and review of the literature.

    PubMed

    Marcus, Bradley J; Kaplan, Jennifer; Collins, Kim A

    2008-09-01

    Ludwig angina is a rapidly progressing submaxillary, submandibular, and sublingual necrotizing cellulitis of the floor of the mouth that can have lethal consequences due to airway obstruction. Various aerobic and anaerobic microorganisms, and less often fungi, have been implicated to cause Ludwig angina, including oral flora such as streptococci and staphylococci. Early recognition and the use of parenteral antibiotics can prevent mortality and morbidity. We report a case of a 25-year-old white man who was admitted to the hospital by his dentist after being diagnosed with Ludwig angina secondary to periodontal abscesses involving teeth #17 and #32. Although antibiotics were administered, while in the hospital, the decedent had difficulty swallowing and was drooling. He suddenly began to have seizure-like activity thought to be anoxic myoclonus. The decedent was aggressively resuscitated and taken to the operating room for neck exploration and a tracheostomy. Neck exploration revealed severe necrotizing acute inflammation of the deep soft tissues and musculature of the neck. He remained on life support for 7 days until he was declared brain dead. Ludwig angina is a progressive cellulitis that often results in death by asphyxia. Ludwig angina can be complicated by subsequent deep neck infection. The underlying etiologies and common scenarios are examined, and significant autopsy findings and dissecting procedures are discussed. The pathophysiology of Ludwig angina is studied with a review of the current literature. PMID:18725784

  6. Pigmented casts.

    PubMed

    Miteva, Mariya; Romanelli, Paolo; Tosti, Antonella

    2014-01-01

    Pigmented casts have been reported with variable frequency in scalp biopsies from alopecia areata, trichotillomania, chemotherapy-induced alopecia and postoperative (pressure induced) alopecia. Their presence and morphology in other scalp disorders has not been described. The authors assessed for the presence and morphology of pigmented casts in 308 transversely bisected scalp biopsies from nonscarring and scarring alopecia, referred to the Department of Dermatology, University of Miami within a year. The pigmented casts were present in 21 of 29 cases of alopecia areata (72%), 7 of 7 cases of trichotillomania (100%), 1 case of friction alopecia, 4 of 28 cases of central centrifugal cicatricial alopecia (14%), and 4 of 4 cases of dissecting cellulitis (100%). They did not show any distinguishing features except for the morphology in trichotillomania, which included twisted, linear (zip), and "button"-like pigment aggregation. The linear arrangement was found also in friction alopecia and dissecting cellulitis. Pigmented casts in the hair canals of miniaturized/vellus hairs was a clue to alopecia areata. Pigmented casts can be observed in biopsies of different hair disorders, but they are not specific for the diagnosis. Horizontal sections allow to better assess their morphology and the follicular level of presence of pigmented casts, which in the context of the other follicular findings may be a clue to the diagnosis. PMID:23823025

  7. Evaluation of extremity pain in children using technetium-99m MDP bone scan: A general hospital experience

    SciTech Connect

    Park, H.M.; Rothschild, P.A.; Kernek, C.B.

    1984-01-01

    This study was undertaken to evaluate the efficacy of three-phase bone scan in detection of significant pathology i.e., osteomyelitis (OM), septic joint, cellulitis, etc., in children with symptoms of extremity pain. A total of 100 consecutive patients (age 9 days - 16 yrs, 63 boys and 37 girls) were studied. The authors reviewed their scans, x-rays and hospital records. The final diagnoses were based on the findings of needle aspiration, surgical drainage, biopsy, culture, and on the therapeutic response. In 87%, sufficiently long clinical follow-up was available to confirm the final diagnoses. In the remaining 13%, the symptoms resolved quickly and follow-up was not felt necessary. The scan was essential in pinpointing the lesions in pts with referred or nonlocalizing extremity pain. The +ve and -ve predictive values of the scan and OM were 89% and 96% respectively. One spiral fracture was misinterpreted as diffuse OM. One ''Subacute epiphyseal OM'' was not detected. In two cases, cellulitis and septic joint obscured underlying OM. Prior antibotic therapy resulted in one equivocal scan. Although less sensitive (29%) in early OM, radiographs play an important complimentary role. Bone scans detected underlying pathology for extremity pain in 61% of all pts studied.

  8. Evidence for increasing severity of community-onset boils and abscesses in UK General Practice.

    PubMed

    Shallcross, L J; Hayward, A C; Johnson, A M; Petersen, I

    2015-08-01

    In England, hospital admissions for severe staphylococcal boils and abscesses trebled between 1989 and 2004. We investigated this trend using routine data from primary and secondary care. We used The Health Improvement Network (THIN), a large primary-care database and national data on hospital admissions from Hospital Episode Statistics (HES). Time trends in the incidence of primary-care consultations for boils and abscesses were estimated for 1995-2010. HES data were used to calculate age-standardized hospital admission rates for boils, abscesses and cellulitis. The incidence of boil or abscess was 450 [95% confidence interval (CI) 447-452] per 100 000 person-years and increased slightly over the study period (incidence rate ratio 1·005, 95% CI 1·004-1·007). The rate of repeat consultation for a boil or abscess increased from 66 (95% CI 59-73) per 100 000 person-years in 1995 to peak at 97 (95% CI 94-101) per 100 000 person-years in 2006, remaining stable thereafter. Hospital admissions for abscesses, carbuncles, furuncles and cellulitis almost doubled, from 123 admissions per 100 000 in 1998/1999 to 236 admissions per 100 000 in 2010/2011. Rising hospitalization and recurrence rates set against a background of stable community incidence suggests increased disease severity. Patients may be experiencing more severe and recurrent staphylococcal skin disease with limited treatment options. PMID:25530161

  9. Superoxide anions produced by Streptococcus pyogenes group A-stimulated keratinocytes are responsible for cellular necrosis and bacterial growth inhibition.

    PubMed

    Regnier, Elodie; Grange, Philippe A; Ollagnier, Guillaume; Crickx, Etienne; Elie, Laetitia; Chouzenoux, Sandrine; Weill, Bernard; Plainvert, Céline; Poyart, Claire; Batteux, Frédéric; Dupin, Nicolas

    2016-02-01

    Gram-positive Streptococcus pyogenes (group A Streptococcus or GAS) is a major skin pathogen and interacts with keratinocytes in cutaneous tissues. GAS can cause diverse suppurative and inflammatory infections, such as cellulitis, a common acute bacterial dermo-hypodermitis with a high morbidity. Bacterial isolation yields from the lesions are low despite the strong local inflammation observed, raising numerous questions about the pathogenesis of the infection. Using an in vitro model of GAS-infected keratinocytes, we show that the major ROS produced is the superoxide anion ([Formula: see text]), and that its production is time- and dose-dependent. Using specific modulators of ROS production, we show that [Formula: see text] is mainly synthesized by the cytoplasmic NADPH oxidase. Superoxide anion production leads to keratinocyte necrosis but incomplete inhibition of GAS growth, suggesting that GAS may be partially resistant to the oxidative burst. In conclusion, GAS-stimulated keratinocytes are able to develop an innate immune response based on the production of ROS. This local immune response limits GAS development and induces keratinocyte cell death, resulting in the skin lesions observed in patients with cellulitis. PMID:26621818

  10. A Multidisciplinary Approach with Hyperbaric Oxygen Therapy Improve Outcome in Snake Bite Injuries

    PubMed Central

    Korambayil, Pradeoth Mukundan; Ambookan, Prashanth Varkey; Abraham, Siju Varghese; Ambalakat, Ajay

    2015-01-01

    Aim: Snakebite injuries are common in tropical India among those who are involved in outdoor activities. These injuries results in cellulitis, gangrene at the bite area, bleeding manifestations, compartment syndrome, regional lymphadenopathy, septicemia, hypotension, and disseminated intravascular coagulation (DIC) resulting in significant morbidity and mortality. The purpose of this study is to share our experience of multidisciplinary approach in the management of snakebite injuries of the extremities with various treatment modalities including hyperbaric oxygen (HBO) therapy, surgical debridement, and soft tissue reconstruction to provide an effective treatment for snake bite injuries. Methods: The study was conducted in the Department of Plastic Surgery, during the period October 2012–December 2014, wherein all the patients who were admitted with snakebite injuries were enrolled and the patients treated in plastic surgery department were included into the study. Out of total 766 patients, there were 323 patients treated with anti snake venom (ASV) and 29 died among the treated patients; 205 patients belonged to pediatric age group. Results: Out of 112 patients referred to Department of Plastic Surgery, 50 cases presented with cellulitis, 24 patients with compartment syndrome, and 38 patients were referred for the management of soft tissue cover over the extremities. Among 112 patients, 77 involved the lower extremity and 35 the upper extremity. Conclusion: Multidisciplinary approach including hyperbaric oxygen (HBO) therapy improves outcome in the management of snakebite injuries of the extremities. PMID:26862269

  11. Wound emergencies: the importance of assessment, documentation, and early treatment using a wound electronic medical record.

    PubMed

    Golinko, Michael S; Clark, Sunday; Rennert, Robert; Flattau, Anna; Boulton, Andrew J M; Brem, Harold

    2009-05-01

    Chronic wounds such as diabetic foot ulcers, venous ulcers, and pressure ulcers are a major source of morbidity and mortality. To describe wound characteristics associated with a wound emergency, the Wound Electronic Medical Records (WEMR) of 200 consecutive admissions (139 patients, average number of admissions 1.4) to a dedicated inpatient wound healing unit over a period of 5 months were retrospectively reviewed. Patient mean age was 62 +/- 16 years, 59% were men, 27% had a foot ulcer and diabetes mellitus, and 29% had venous ulcers. Presenting signs and symptoms included wound pain, cellulitis, nonpurulent drainage, and undermining, but few presented with classic local clinical signs of infection. Treatment consisted of sharp debridement with deep tissue culture and pathology from the wound base and/or systemic antibiotics. Twenty-percent (20%) of patients had pathology-confirmed and 38% had pathology- or radiology-confirmed osteomyelitis on admission, supporting that new or increasing wound pain, cellulitis, and/or nonpurulent drainage or presence of significant undermining may be indicative of an invasive infection and that patients presenting with these signs and symptoms require an immediate treatment plan and consideration of hospital admission. Use of an objective documentation system such as the WEMR may help alert clinicians to subtle wound changes that require aggressive treatment; thereby, avoiding emergency room visits and hospital admissions. Future research is needed utilizing the WEMR across multiple medical centers to further define criteria for a chronic wound emergency. PMID:19471049

  12. Necrotizing soft-tissue infections in the feet of patients with diabetes: outcome of surgical treatment and factors associated with limb loss and mortality.

    PubMed

    Aragón-Sánchez, Javier; Quintana-Marrero, Yurena; Lázaro-Martínez, Jose L; Hernández-Herrero, Maria J; García-Morales, Esther; Beneit-Montesinos, Juan V; Cabrera-Galván, Juan J

    2009-09-01

    The aim of this study was to analyze the outcomes of treatment of necrotizing soft-tissue infections (NSTIs) in the feet of diabetic patients and to determine factors associated with limb salvage and mortality. A retrospective study of a consecutive series of 145 diabetic patients suffering from NSTIs treated in the Diabetic Foot Unit, La Paloma Hospital was done. NSTIs were classified as necrotizing cellulitis if it involved the subcutaneous tissue and the skin, as necrotizing fasciitis if it involved the deep fascia, and as myonecrosis in those cases where muscular necrosis was present. In the necrotizing cellulitis group (n = 109), 8 (7.3%) major amputations were performed. In the necrotizing fasciitis group (n = 25), 13 (52%) major amputations were undertaken. In the myonecrosis group (n = 11), 6 (54.5%) major amputations were performed. Predictive variables related to limb loss were fasciitis (OR = 20, 95% CI = 3.2-122.1) and myonecrosis (OR = 53.2, 95% CI = 5.1-552.4). Predictive variables of mortality were age >75 years (OR = 10.3, 95% CI = 1.9-53.6) and creatinine values >132.6 micromol/L (OR = 5.8, 95% CI = 1.1-30.2). NSTIs of the foot are an important cause of morbidity and mortality in diabetic patients.When fascia and/or muscle are involved, there are significant risks of major amputation. PMID:19703949

  13. Epidemiology of Orthopaedic Trauma Admissions Over One Year in a District General Hospital in England

    PubMed Central

    Taylor, A; Young, A

    2015-01-01

    Introduction : Admission to district general hospitals in England has undergone change in recent years due to both an aging population and the reconfiguration of the major trauma network throughout the United Kingdom. Methods : We utilised a retrospective cohort study to analyse the epidemiology over a 12-month period at a district general hospital. Data was collected and divided into groups: upper limb, lower limb, vertebral disc disease, vertebral fracture, cellulitis without bone involvement and deep infection including metalwork. Results : 2817 patients were admitted over the 12-month period. There were 893 upper limb fractures, 1511 lower limb fractures, 126 vertebral disc disease, 55 vertebral fractures, 108 cellulitis without bone involvement and 124 deep infections with 19 admissions not specified due to coding. AN average of 242 patients were admitted each month with the majority admitted during the summer months. Conclusion : Although fractures make up the majority of the reason for which a person is admitted, there are also many other injuries/morbidities, which may necessitate admission. There is an increasing incidence of elderly osteoporotic fractures in females, which is balancing out the previously more common fractures seen in younger adults and adolescents. PMID:26069514

  14. Croissance epitaxiale de GaAs sur substrats de Ge par epitaxie par faisceaux chimiques

    NASA Astrophysics Data System (ADS)

    Belanger, Simon

    La situation energetique et les enjeux environnementaux auxquels la societe est confrontee entrainent un interet grandissant pour la production d'electricite a partir de l'energie solaire. Parmi les technologies actuellement disponibles, la filiere du photovoltaique a concentrateur solaire (CPV pour concentrator photovoltaics) possede un rendement superieur et mi potentiel interessant a condition que ses couts de production soient competitifs. La methode d'epitaxie par faisceaux chimiques (CBE pour chemical beam epitaxy) possede plusieurs caracteristiques qui la rendent interessante pour la production a grande echelle de cellules photovoltaiques a jonctions multiples a base de semi-conducteurs III-V. Ce type de cellule possede la meilleure efficacite atteinte a ce jour et est utilise sur les satellites et les systemes photovoltaiques a concentrateur solaire (CPV) les plus efficaces. Une des principales forces de la technique CBE se trouve dans son potentiel d'efficacite d'utilisation des materiaux source qui est superieur a celui de la technique d'epitaxie qui est couramment utilisee pour la production a grande echelle de ces cellules. Ce memoire de maitrise presente les travaux effectues dans le but d'evaluer le potentiel de la technique CBE pour realiser la croissance de couches de GaAs sur des substrats de Ge. Cette croissance constitue la premiere etape de fabrication de nombreux modeles de cellules solaires a haute performance decrites plus haut. La realisation de ce projet a necessite le developpement d'un procede de preparation de surface pour les substrats de germanium, la realisation de nombreuses sceances de croissance epitaxiale et la caracterisation des materiaux obtenus par microscopie optique, microscopie a force atomique (AFM), diffraction des rayons-X a haute resolution (HRXRD), microscopie electronique a transmission (TEM), photoluminescence a basse temperature (LTPL) et spectrometrie de masse des ions secondaires (SIMS). Les experiences ont permis

  15. Children hospitalized with skin and soft tissue infections: a guide to antibacterial selection and treatment.

    PubMed

    Vayalumkal, Joseph V; Jadavji, Tajdin

    2006-01-01

    Skin and soft tissue infections in children are an important cause for hospitalization. A thorough history and physical examination can provide clues to the pathogens involved. Collection of purulent discharge from lesions should be completed prior to initiating antimicrobial therapy, and results of bacteriologic studies (Gram stain and culture) should guide therapeutic decisions. The main pathogens involved in these infections are Staphylococcus aureus and group A beta-hemolytic streptococci, but enteric organisms also play a role especially in nosocomial infections. Increasing antibacterial resistance is becoming a major problem in the treatment of these infections worldwide. Specifically, the rise of methicillin-resistant S. aureus and glycopeptide-resistant S. aureus pose challenges for the future. Infections of the skin and soft tissues can be broadly classified based on the extent of tissue involvement. Superficial infections such as erysipelas, cellulitis, bullous impetigo, bite infections, and periorbital cellulitis may require hospitalization and parenteral antibacterials. Deeper infections such as orbital cellulitis, necrotizing fasciitis, and pyomyositis require surgical intervention as well as parenteral antibacterial therapy. Surgery plays a key role in the treatment of abscesses and for the debridement of necrotic tissue in deep infections. Intravenous immunoglobulin, as an adjunctive therapy, can be helpful in treating necrotizing fasciitis. For most infections an antistaphylococcal beta-lactam antibacterial is first-line therapy. Third-generation cephalosporins and beta-lactam/beta-lactamase inhibitor antibacterials as well as clindamycin or metronidazole are often required to provide broad-spectrum coverage for polymicrobial infections.Special populations, such as immunocompromised children, those with an allergy to penicillins, and those that acquire infections in hospitals, require specific antibacterial strategies. These usually involve broader

  16. A 13C-NMR study of exopolysaccharide synthesis in Rhizobium meliloti Su47 strain

    NASA Astrophysics Data System (ADS)

    Tavernier, P.; Portais, J.-C.; Besson, I.; Courtois, J.; Courtois, B.; Barbotin, J.-N.

    1998-02-01

    Metabolic pathways implied in the synthesis of succinoglycan produced by the Su47 strain of R. meliloti were evaluated by 13C-NMR spectroscopy after incubation with [1{-}13C] or [2{-}13C] glucose. The biosynthesis of this polymer by R. meliloti from glucose occurred by a direct polymerisation of the introduced glucose and by the pentose phosphate pathway. Les voies métaboliques impliquées dans la synthèse du succinoglycane produit par la souche Su47 de R. meliloti ont été évaluées par la spectroscopie de RMN du carbone 13 après incubation des cellules avec du [1{-}13C] ou [2{-}13C] glucose. La biosynthèse de ce polymère à partir du glucose se produit par polymérisation directe du glucose et par la voie des pentoses phosphate.

  17. Pasteurella canis Isolation following Penetrating Eye Injury: A Case Report.

    PubMed

    Rashid, Noor-Khairul; Zam, Zarifah; Mdnoor, Siti-Suraya; Siti-Raihan, Ishak; Azhany, Yaakub

    2012-01-01

    A 3-year-old boy presented with history of trauma to the left eye after he accidentally injured his eye with a broom stick made up from coconut skewers. There was history of cats as their pets but not dogs. Ocular examination revealed left superonasal conjunctival laceration and scleral perforation with prolapsed vitreous. Fundus examination showed minimal vitreous haemorrhage and flat retina. Conjunctiva swab at the wound site was sent for gram staining, culture, and sensitivity. He underwent scleral suturing, vitreous tap, and intravitreal injection of Ceftazidime and Amikacin. Vitreous tap was sent for gram stained, culture and sensitivity. Postoperatively, he was started empirically on IV Ciprofloxacin 160 mg BD, Guttae Ciprofloxacin, and Guttae Ceftazidime. Conjunctiva swab grew Pasteurella canis which was sensitive to all Beta lactams, Ciprofloxacin, Chloramphenicol, and Aminoglycoside. Post-operative was uneventful, absent signs of endophthalmitis or orbital cellulitis. PMID:22606491

  18. Carcinoma erysipeloides as a presenting feature of breast carcinoma: A case report and brief review of literature

    PubMed Central

    Al Ameer, Ali; Imran, Maryam; Kaliyadan, Feroze; Chopra, Rajan

    2015-01-01

    Carcinoma erysipeloides (CE) is an uncommon but distinctive form of cutaneous metastasis that usually manifests clinically as a fixed erythematous patch or plaque resembling cellulitis or erysipelas. The inflamed area may show a distinct raised edge at the periphery and also edema secondary to lymphatic obstruction. Histologically, dense carcinoma cells in the dermal vascular channels and dense perivascular lymphocytic infiltrate may be seen. CE may rarely be the first sign of “silent” tumor of breast. We report a case of a 52-year-old married lady who presented with a three months history of pruritic erythematous patches over the left side of the breast that was resistant to all topical treatments and was diagnosed as erysipeloid breast carcinoma. PMID:26753138

  19. Limited approach to the right flank for placement of a duodenostomy tube.

    PubMed

    Novo, R E; Churchill, J; Faudskar, L; Lipowitz, A J

    2001-01-01

    A new enterostomy tube placement technique is described for provision of nutrients into the duodenum. Placement of the duodenostomy tube (d-tube) is performed through a limited right flank approach under sedation and local anesthesia. Seven client-owned animals (three dogs and four cats) requiring enteral nutritional support were selected for d-tube placement. Patients were fed via the d-tube for two to 28 days. Complications included discomfort when manipulating and exteriorizing the duodenum, discomfort with bolus feedings, local cellulitis, and tube site infection. All complications resolved without further incident. This technique should be considered in patients that are not good candidates for prolonged general anesthesia or esophageal or gastric feeding, or patients being mechanically ventilated. PMID:11300529

  20. Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs.

    PubMed

    Falcone, Marco; Concia, Ercole; Giusti, Massimo; Mazzone, Antonino; Santini, Claudio; Stefani, Stefania; Violi, Francesco

    2016-08-01

    Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed. PMID:27084183

  1. Études des propriétés électro-optiques d'une série de diphtalocyanines de terres rares

    NASA Astrophysics Data System (ADS)

    Videlot, C.; Fichou, D.; Garnier, F.

    1998-06-01

    In this work, we describe the study of photovoltaic cells for a series of rare earth diphthalocyanines. This p type organic compounds have been used in Schottky and pn configurations. Current-voltage curves and action spectra show different replies in energy's conversion according to the rare earth of the diphthalocyanine. Dans ce travail, nous décrivons l'étude de cellules photovoltaïques pour une série de diphtalocyanines de terres rares. Ces composés organiques de type p ont été étudiés dans des configurations Schottky et hétérojonction pn. Les courbes de courant-tension et les spectres d'action montrent des réponses différentes dans la conversion de l'énergie suivant la terre rare de la diphtalocyanine.

  2. Trichotillomania and dermatitis artefacta: a rare coexistence.

    PubMed

    Varyani, Neeraj; Garg, Sunny; Gupta, Garima; Singh, Shivendra; Tripathi, Kamlakar

    2012-01-01

    A 24-year-old pregnant female patient presented with complains of bilateral lower limb swelling and fever for 1 month. On examination, blood pressure was 144/94 mmHg along with pitting pedal edema. She had bizarre skin lesions, aligned longitudinally and distributed over the approachable site of the body with tapering ends and in various stages of healing. Lower limbs examination also revealed similar lesions with signs of cellulitis. Her scalp had short and distorted hair suggesting pulling and plucking. These skin lesions and the denial of self-infliction by the patient made us reach the diagnosis of dermatitis artefacta with trichotillomania. Psychotherapy was advocated along with conservative management of skin lesions. The patient improved and is under our follow up. PMID:22934222

  3. Trichotillomania and Dermatitis Artefacta: A Rare Coexistence

    PubMed Central

    Varyani, Neeraj; Garg, Sunny; Gupta, Garima; Singh, Shivendra; Tripathi, Kamlakar

    2012-01-01

    A 24-year-old pregnant female patient presented with complains of bilateral lower limb swelling and fever for 1 month. On examination, blood pressure was 144/94 mmHg along with pitting pedal edema. She had bizarre skin lesions, aligned longitudinally and distributed over the approachable site of the body with tapering ends and in various stages of healing. Lower limbs examination also revealed similar lesions with signs of cellulitis. Her scalp had short and distorted hair suggesting pulling and plucking. These skin lesions and the denial of self-infliction by the patient made us reach the diagnosis of dermatitis artefacta with trichotillomania. Psychotherapy was advocated along with conservative management of skin lesions. The patient improved and is under our follow up. PMID:22934222

  4. A Traumatic Bilateral Anterolateral Compartment Syndrome and Subsequent small Bowel Obstruction in a Patient with Schizophrenia

    PubMed Central

    Kapur, Benjamin Pal; Grant, Michael; Ramakrishnan, Muthukrishnan

    2015-01-01

    Introduction: A traumatic bilateral compartment syndrome is not widely reported. There is usually a precipitating event to cause compartment syndrome for example open and closed fractures, plaster of Paris application, burns and post-ischaemia reperfusion injury. This case confirms the need for a high index of suspicion for compartment syndrome in a patient presenting with bilateral leg pain, swelling and erythema as early diagnosis and urgent decompression by fasciotomy is of vital importance to preserve limb function and avoid complications. Case Report: We wish to report the case of atraumatic bilateral anterolateral compartment syndrome in a 58-year-old Caucasian man with a medical history of schizophrenia. He presented to Accident and Emergency with bilateral leg pain, swelling and erythema with no preceding history of trauma. Initially he was treated for bilateral lower leg cellulitis with a late diagnosis of compartment syndrome. Conclusion: This case illustrates the need for a broad differential diagnosis. PMID:27299031

  5. Ludwig's Angina - An emergency: A case report with literature review.

    PubMed

    Candamourty, Ramesh; Venkatachalam, Suresh; Babu, M R Ramesh; Kumar, G Suresh

    2012-07-01

    Ludwig's angina is a form of severe diffuse cellulitis that presents an acute onset and spreads rapidly, bilaterally affecting the submandibular, sublingual and submental spaces resulting in a state of emergency. Early diagnosis and immediate treatment planning could be a life-saving procedure. Here we report a case of wide spread odontogenic infection extending to the neck with elevation of the floor of the mouth obstructing the airway which resulted in breathlessness and stridor for which the patient was directed to maintain his airway by elective tracheostomy and subsequent drainage of the potentially involved spaces. Late stages of the disease should be addressed immediately and given special importance towards the maintenance of airway followed by surgical decompression under antibiotic coverage. The appropriate use of parenteral antibiotics, airway protection techniques, and formal surgical drainage of the infection remains the standard protocol of treatment in advanced cases of Ludwig's angina. PMID:23225990

  6. Necrotising fasciitis due to an infected sebaceous cyst

    PubMed Central

    Bosman, W M P F; Brekelmans, W; Verduijn, P S; Borger van der Burg, B L S; Ritchie, E D

    2014-01-01

    The current case presents a patient who was admitted to our hospital with the diagnosis of cellulitis of the right groin. In the following days, the patient's condition deteriorated and developed a septic shock. Exploration in the operating room showed a necrotising fasciitis of the adductor muscles, with an infected sebaceous cyst in the inguinal crest as port d'entrée. After extensive surgical debridement, antibiotic therapy, haemodynamic and respiratory support, the patient recovered. Necrotising fasciitis is a rare but very lethal condition, which necessitates aggressive surgical therapy and antibiotic support. The current case report is the first report to show a necrotising fasciitis due to an infected sebaceous cyst. PMID:24789153

  7. Erysipelas: a common potentially dangerous infection.

    PubMed

    Celestin, R; Brown, J; Kihiczak, G; Schwartz, R A

    2007-09-01

    Erysipelas is an acute superficial cutaneous cellulitis that commonly occurs not only in elderly and immunocompromised persons, but also in neonates and small children subsequent to bacterial inoculation through a break in the skin barrier. Group A Beta-hemolytic streptococcus (GABHS, Streptoccocus pyogenes) is the usual etiologic agent. Factors that predispose pediatric patients to the development of erysipelas include very young age, diabetes mellitus, an immunocompromised state, and nephrotic syndrome. Patients typically have a well-demarcated, erythematous, indurated, rapidly spreading patch with a palpable advancing border on the face or extremities. Fever with chills and general malaise may be prominent symptoms. Antibiotics are usually effective. Patients handled in a timely manner tend to recover without problems. However, potential complications include abscess formation, necrotizing fasciitis, septicemia, recurrent infection, and lymphedema. PMID:17994173

  8. [A unique Lemierre syndrome case in an elderly woman with deviation of the tongue].

    PubMed

    Nakamichi, Seiko; Izumikawa, Koichi; Inoue, Keita; Sakamoto, Noriho; Ishimatsu, Yuji; Kohno, Shigeru; Ozono, Yoshiyuki

    2014-09-01

    We report herein on the case of a 71-year-old woman hospitalized for continued postauricular pain of unknown origin with tongue deviation. In view of the severe inflammatory reaction and multiple nodular shadows of the lungs, the existence of infectious disease was indicated. A contrast-enhanced CT scan of the neck revealed a thrombosis of the right internal jugular vein, osteomyelitis of right temporal-occipital bone and upper cervical spine, and cellulitis of the adjacent soft tissue. Multiple nodular shadows of the lungs were suspected to be the result of a metastatic septic embolism. Hence, she was diagnosed with Lemierre syndrome. Following treatment with long course of antimicrobial therapy including beta-lactams and clindamycin, complete recovery in this patient was achieved. PMID:25672142

  9. Tropical Diabetic Hand Syndrome

    PubMed Central

    Okpara, TC; Ezeala-Adikaibe, BA; Omire, O; Nwonye, E; Maluze, J

    2015-01-01

    Any adult with diabetes in the tropics with hand cellulitis, infection and gangrene qualifies for tropical diabetic hand syndrome (TDHS). We reviewed a 39-year-old woman with a 3-week history of swelling of the left index finger following an insect bite. The swelling progressively increased in size, was very painful, and extended to the palm. There was no history or symptoms suggestive of chronic complications of diabetes. Random blood sugar on presentation was above 600 mg/dl using a glucometer. Examination revealed an edematous left palm draining pus from multiple sinuses, necrotic and gangrenous left index finger extending down to just above the thenar eminence. A diagnosis of TDHS in a patient with hyperosmolar state was made. She was managed accordingly and subsequently underwent aggressive debridement and desloughing. Two fingers were amputated and the wound was allowed to heal by secondary intention. PMID:27057390

  10. Plants used to treat skin diseases

    PubMed Central

    Tabassum, Nahida; Hamdani, Mariya

    2014-01-01

    Skin diseases are numerous and a frequently occurring health problem affecting all ages from the neonates to the elderly and cause harm in number of ways. Maintaining healthy skin is important for a healthy body. Many people may develop skin diseases that affect the skin, including cancer, herpes and cellulitis. Some wild plants and their parts are frequently used to treat these diseases. The use of plants is as old as the mankind. Natural treatment is cheap and claimed to be safe. It is also suitable raw material for production of new synthetic agents. A review of some plants for the treatment of skin diseases is provided that summarizes the recent technical advancements that have taken place in this area during the past 17 years. PMID:24600196

  11. Endogenous Panophthalmitis in a case of Multiple Myeloma and Diabetes Mellitus

    PubMed Central

    Nayak, Madhurima K.

    2016-01-01

    Multiple myeloma cripples the human body in many ways, one of them being decreased immunity. Infections occurring spontaneously can increase the morbidity. We report a case of an elderly lady with multiple myeloma on treatment and uncontrolled diabetes, who developed loss of vision, swelling and redness of left eye of 4 days duration. There was no history of injury or entry of a foreign body. She also had left arm cellulitis. Ocular examination revealed visual acuity of 6/36 in right eye and no perception of light in left eye. Anterior segment of the right eye was insignificant while the left eye showed features suggestive of panophthalmitis. B scan revealed choroidal detachment and confirmed panophthalmitis. She underwent evisceration of the left eye. The cause of spontaneous infections is an immunocompromised state due to multiple myeloma and uncontrolled diabetes. This case report highlights the propensity of multiple myeloma to cause infections of the eye debilitating enough to cause severe visual morbidity.

  12. Children with dermatological conditions admitted to paediatric intensive care: analysis of a national clinical audit database.

    PubMed

    George, S M C; Sen, S M; Harrison, D A; McShane, P; Patel, K; Darley, C R

    2016-06-01

    There is little published literature about dermatological conditions in paediatric intensive care units (PICUs). The aim of this study was to describe the range of skin disorders in children admitted to PICUs in the UK and Ireland using data from a national audit. An analysis was conducted using data for 2002 - 2010 from the Paediatric Intensive Care Audit Network (PICANet). In total, 999 admissions of 882 children were identified, representing 0.8% of all PICU admissions. The most frequent dermatological conditions were skin infections, including cellulitis and necrotizing fasciitis, and inflammatory conditions. In 28% of cases, the dermatological diagnosis was considered the reason for PICU admission, in 35% it was a manifestation of systemic disease and in 37% it was considered incidental. Overall mortality was similar to the general PICU population, with 52 deaths (5.2%), but was greater in children with vascular/haematological conditions. PMID:26684929

  13. Orbital Relapsing Polychondritis: A Unique Presentation, Complication, and Treatment.

    PubMed

    Moore, Grant H; Rootman, Daniel B; Roybal, C Nathaniel; Goldberg, Robert A

    2016-01-01

    An 87-year-old man with a history of relapsing polychondritis presented to the emergency department after 4 days of worsening left periorbital swelling and erythema. On examination, he demonstrated clinical features consistent with orbital cellulitis and was treated with a trial of intravenous antibiotics. His condition did not improve over the next 36 hours and intravenous methylprednisolone was initiated. This led to rapid improvement in orbital symptoms and signs, and a diagnosis of specific orbital inflammation secondary to relapsing polychondritis was made. The patient was discharged on a tapering dose of prednisone. As a steroid-sparing measure, adalimumab was initiated; however, the patient developed Sweet Syndrome. Adalimumab was subsequently discontinued, steroid dose was increased, and anakinra treatment was initiated. This therapeutic course led to significant clinical improvement. Since initiating anakinra, the patient has had no recurrences of Sweet Syndrome. Anakinra may be a useful adjunct therapy for ophthalmic manifestations of relapsing polychondritis. PMID:25072220

  14. TRACHEOSTOMAPLASTY: A SURGICAL METHOD FOR IMPROVING RETENTION OF AN INTRALUMINAL STOMA BUTTON FOR HANDS-FREE TRACHEOESOPHAGEAL SPEECH

    PubMed Central

    Moreno, Mauricio A.; Lewin, Jan S.; Hutcheson, Katherine A.; Bishop Leone, Julie K.; Barringer, Denise A.

    2014-01-01

    Background We describe a minimally invasive surgical technique, tracheostomaplasty, to overcome anatomical deformities of the stoma that preclude successful retention of a stoma button for hands free tracheoesophageal (TE) speech. Methods We conducted a retrospective analysis of 21 patients who underwent tracheostomaplasty after laryngectomy to accommodate an intraluminal valve attachment for hands-free TE speech. Results Sixteen men and 5 women (median age, 65 years; median follow-up, 27.7 months) underwent tracheostomaplasty; 6 patients developed a mild cellulitis that required therapy and 5 patients required a minor revision surgery. At last follow-up, 15 (71%) patients successfully achieved hands-free TE speech using an intraluminal stoma button. Three patients only retained the intraluminal device to facilitate digital occlusion. Tracheostomaplasty failed in 3 patients because of granulation tissue formation or stomal stenosis. Conclusions Tracheostomaplasty is a successful technique to improve intraluminal retention of a stoma button for hands-free TE speech in laryngectomy patients. PMID:20848405

  15. Fatal clostridium septicum myonecrosis in a captive canada lynx (Lynx canadensis).

    PubMed

    Izer, Jenelle M; Wilson, Ronald P; Cooper, Timothy K

    2014-09-01

    A 1-yr-old female Canada lynx (Lynx canadensis) presented for sudden onset of rapidly progressive bilateral pelvic limb paralysis. The lynx was chemically immobilized to perform a physical examination but expired shortly thereafter. On postmortem radiographs, there were myriad small irregular, round-to-spherical gas densities within the skeletal muscle of the right thigh and epaxial musculature. At gross necropsy, the muscles of the right thigh, right lateral abdominal wall, and epaxial region were emphysematous and necrohemorrhagic, with subcutaneous and muscular crepitant swelling. Multiple skin puncture wounds, consistent with bites, were present over the affected tissues. Clostridium septicum was isolated in pure anaerobic culture from the musculature of the right hind limb. Histopathologic examination confirmed the diagnosis of acute, severe necrohemorrhagic and gangrenous myositis and cellulitis. Gram stains demonstrated large gram-positive bacilli with subterminal spores. This is the first known documented case of C. septicum myonecrosis in a nondomestic felid. PMID:25314833

  16. Acute allergic angioedema of upper lip.

    PubMed

    Mahendran, Kavitha; Padmini, Govindasway; Murugesan, Ramesh; Srikumar, Arthiseethalakshmi

    2016-01-01

    Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures. PMID:27217646

  17. Acute allergic angioedema of upper lip

    PubMed Central

    Mahendran, Kavitha; Padmini, Govindasway; Murugesan, Ramesh; Srikumar, Arthiseethalakshmi

    2016-01-01

    Mishaps can occur during dental procedures, some owing to inattention to detail and others are totally unpredictable. They usually include anaphylaxis or allergic reactions to materials used for restorative purposes or drugs such as local anesthetics. A patient reported to our department with moderate dental fluorosis, and the treatment was planned with indirect composite veneering. During the procedure while cementation acute allergic reaction occurred, the specific cause could not be identified after allergic testing. During the procedure while cementationacute allergic angioedema of upper lip. Anaphylaxis, urticaria, allergy, hereditary atopic eczema, cellulitis, cheilitis granulomatosa, and cheilitis glandularis. The patient was reassured and given prednisolone 10 mg and cetirizine 10 mg orally, once daily for 3 days after which the symptoms subsided. This paper will discuss the pathogenesis, classification, identification, and management of angioedema during dental procedures. PMID:27217646

  18. Deadly case of Pasteurella multocida aortitis and mycotic aneurysm following a cat bite.

    PubMed

    Cho, Dennis Dane; Berliner, Yaniv; Carr, David

    2016-06-16

    Animal bites are frequently encountered in the emergency department (ED). Aortitis leading to mycotic abdominal aortic aneurysm is a rare and potentially deadly complication of Pasteurella multocida (P. multocida) following an animal bite. We present the case of a 68-year-old male who presented to the ED after falling at home. He complained of weakness and abdominal pain. He was in septic shock and was treated empirically with broad-spectrum antibiotics and intravenous fluids. He reported previous antibiotic treatment of a cellulitis secondary to a cat bite injury to his right thumb four weeks prior. Abdominal ultrasound and subsequent computed tomography scan revealed a leaking mycotic abdominal aneurysm that was surgically repaired. Blood cultures and aortic wall tissue cultures grew P. multocida. Given how common animal bite presentations are in the ED, this case highlights the need to consider aortitis and mycotic abdominal aortic aneurysm in an unwell patient with an animal bite. PMID:27326399

  19. Kawasaki Disease with Retropharyngeal Edema following a Blackfly Bite

    PubMed Central

    Watanabe, Toru

    2014-01-01

    We describe a patient with Kawasaki disease (KD) and retropharyngeal edema following a blackfly bite. An 8-year-old boy was referred to our hospital because of a 3-day-history of fever and left neck swelling and redness after a blackfly bite. Computed tomography of the neck revealed left cervical lymph nodes swelling with edema, increased density of the adjacent subcutaneous tissue layer, and low density of the retropharyngeum. The patient was initially presumed to have cervical cellulitis, lymphadenitis, and retropharyngeal abscess. He was administered antibiotics intravenously, which did not improve his condition. The patient subsequently exhibited other signs of KD and was diagnosed with KD and retropharyngeal edema. Intravenous immunoglobulin therapy and oral flurbiprofen completely resolved the symptoms and signs. A blackfly bite sometimes incites a systemic reaction in humans due to a hypersensitive reaction to salivary secretions, which may have contributed to the development of KD in our patient. PMID:25349761

  20. Radiofrequency thermoneurolysis for the treatment of Morton's neuroma.

    PubMed

    Moore, Joshua L; Rosen, Ritchard; Cohen, Jeffrey; Rosen, Brad

    2012-01-01

    Pedal neuroma is a common disorder. The authors undertook a review of 32 feet in 29 patients with a symptomatic neuroma treated between January 2007 and January 2010 to evaluate the effectiveness of radiofrequency thermoneurolysis therapy in alleviating symptoms. Overall relief of symptoms was rated as complete by 24 (83%) patients, with 5 patients experiencing minimal to no relief. Two patients were lost to follow-up after 1 month, 2 patients opted for no further intervention, and 1 patient went to open resection of the neuroma. Average follow-up was 13 months and total recovery time was 2 days. Complications included 1 foot with cellulitis treated by a course of oral antibiotics. The results of this retrospective study indicate radiofrequency thermoneurolysis therapy is a safe, effective, and minimally invasive alternative treatment for symptomatic neuromas of the foot. PMID:22055491

  1. Acute febrile neutrophilic dermatosis associated with JAK-2 positive myeloproliferative disorder.

    PubMed

    Smyth, Dean; Selwyn, Jey

    2016-01-01

    We present a case of a 77-year-old man with a history of myeloproliferative disorder. He was admitted with a 2-week history of erythaema, swelling and significant pain of the right forearm following a mechanical fall at home, which had caused a skin laceration. During his admission, he developed ongoing intermittent fever and persistently elevated C reactive protein, and total white cell count. Initially, he was treated with antibiotics for suspected cellulitis. However, symptoms continued to progress, making a suitable management plan challenging. Wound swabs, blood cultures and viral PCR did not confirm infection. A punch biopsy of a skin lesion on the forearm was performed. The histology demonstrated a dense infiltrate of neutrophils and neutrophilic debris in keeping with acute febrile neutrophilic dermatosis (Sweet's syndrome). He was treated with oral steroids and after that he had a complete resolution of symptoms. However, he required a period of rehabilitation before returning home. PMID:27118753

  2. Disseminated infection due to Cylindrocarpon (Fusarium) lichenicola in a neutropenic patient with acute leukaemia: report of a case and review of the literature.

    PubMed

    Rodríguez-Villalobos, H; Georgala, A; Beguin, H; Heymans, C; Pye, G; Crokaert, F; Aoun, M

    2003-01-01

    Described here is an unusual case of disseminated Cylindrocarpon lichenicola (Fusarium lichenicola) infection originating from a toenail lesion of a neutropenic woman with cellulitis of the foot and underlying acute leukaemia. A computed tomography scan of the chest showed multiple, ill-defined, nodular infiltrates with alveolar consolidation. The fungus was isolated from both the nail and the skin of the infected toe. Susceptibility testing revealed low minimum inhibitory concentrations for amphotericin B (0.78 micro g/ml) and voriconazole (1.56 micro g/ml) and high minimum inhibitory concentrations (>100 micro g/ml) for fluconazole, ketoconazole and itraconazole. The infection resolved after treatment with a total dose of 1 g of amphotericin B followed by oral itraconazole and bone marrow regeneration. PMID:12582748

  3. [Historical meanings of Santiago Ramón y Cajal's Rétine des vertébrés. Summary of his first scientific].

    PubMed

    Baratas Díaz, L A

    1994-01-01

    The retina was one of the main objects of study in the first stage of the scientific work of Ramón y Cajal. As culmination of his previous works Cajal published in 1893 in the journal La Cellule an article titled "La rétine des Vertébrés". This article on the retina is a perfect example of Cajal's ability for the systematic study of the cellular types of the nervous centers, its morphological description and its intercellular contacts, as well as for the formulation of physiological interpretations and hypothesis on the development of the neuronal prolongations. Finally some comments are made on the influence of the evolutionary thinking of Haeckel and Herbert Spencer on the work of Ramón y Cajal. PMID:11640477

  4. American kestrel (Falco spaverius) fledgling with severe bilateral periorbital swelling and infection with Mycoplasma buteonis, Avibacterium (Pasteurella) gallinarum, and Staphylococcus pasteuri.

    PubMed

    Bezjian, Marisa; Bezjian, Marisa

    2014-06-01

    Abstract: A female American kestrel (Falco spaverius) fledgling was found on the ground with a suspected trauma to the right eye and open-mouth breathing. During the first 2 days of hospitalization, the bird developed severe bilateral periorbital cellulitis, blepharoedema, and sinusitis. The periocular tissues of the right globe were devitalized and communicated with a fistula at the commissure of the right side of the beak. The blepharoedema of the left eye was aspirated and yielded a dark colored malodorous fluid, which was submitted for aerobic bacterial and Mycoplasma cultures. Results showed a mixed infection with Mycoplasma buteonis, Avibacterium gallinarum, and Staphylococcus pasteuri, all of which are not commonly isolated from birds of prey. With antimicrobial therapy, supportive care, and surgical debridement of the right periocular necrotic tissues and adhesed phthisical globe, the kestrel recovered from this severe mixed upper respiratory infection. PMID:25115041

  5. Erythema nodosum migrans successfully treated with indomethacin: A rare entity

    PubMed Central

    Mokhtari, Fatemeh; Abtahi-Naeini, Bahareh; Pourazizi, Mohsen

    2014-01-01

    Erythema nodosum migrans (subacute nodular migratory panniculitis) is a panniculitis characterized by migrating subcutaneous nodules or plaque on the lower extremity. We describe a 75-year-old woman with idiopathic erythema nodosum migrans which was manifest centrifugally spreading, slightly morpheaform erythematous plaque on the lower left leg successfully treated with indomethacin. She was initially diagnosed and treated as a case with cellulitis and with poor clinical response. A biopsy specimen from this lesion showed that the septal was thickening; fibrous tissue was also seen with lymphohistiocytic infiltrate and occasional multinucleated giant cells with some inflammatory cells infiltrated into the periphery of the fat lobules. Erythema nodosum migrans should be kept in mind in the differential diagnosis of any morpheaform centrifugally expended plaque, especially in the lower extremities in cases of unknown etiology. PMID:25625103

  6. Working charts for the determination of the lift distribution between biplane wings

    NASA Technical Reports Server (NTRS)

    Kuhn, Paul

    1934-01-01

    In this report are presented empirical working charts from which the distribution of lift between wings, that is the fraction of the total lift borne by each, can be determined in the positive lift range for any ordinary biplane cellule whose individual wings have the same profile. The variables taken directly into account include airfoil section, stagger, gap/chord ratio, decalage, chord ratio, and overhang. It is shown that the influence of unequal sweepback and unequal dihedral in upper and lower wings may be properly provided for by utilizing the concepts of average stagger and average gap/chord ratio, respectively. The effect of other variables is discussed, but they have not been included in the charts either because their influence was obviously small or because insufficient data existed to make possible a complete determination of their influence. All available pertinent biplane data were analyzed in establishing the charts, and in some cases theoretical relationships were utilized to establish qualitative tendencies.

  7. In vitro activity of tedizolid against gram-positive bacteria in patients with skin and skin structure infections and hospital-acquired pneumonia: a Korean multicenter study.

    PubMed

    Lee, Yangsoon; Hong, Sung Kuk; Choi, Sunghak; Im, Weonbin; Yong, Dongeun; Lee, Kyungwon

    2015-09-01

    We compared the activities of tedizolid to those of linezolid and other commonly used antimicrobial agents against gram-positive cocci recovered from patients with skin and skin structure infections (SSSIs) and hospital-acquired pneumonia (HAP) in Korean hospitals. Gram-positive isolates were collected from 356 patients with SSSIs and 144 patients with HAP at eight hospitals in Korea from 2011 to 2014. SSSIs included impetigo, cellulitis, erysipelas, furuncles, abscesses, and infected burns. Antimicrobial susceptibility was tested by using the CLSI agar dilution method. All of the gram-positive isolates were inhibited by ≤1 μg/mL tedizolid. The minimum inhibitory concentration [MIC]₉₀ of tedizolid was 0.5 μg/mL for methicillin-resistant Staphylococcus aureus, which was 4-fold lower than that of linezolid. Tedizolid may become a useful option for the treatment of SSSIs and HAP caused by gram-positive bacteria. PMID:26206690

  8. Treatment of metastatic cutaneous Crohn disease with certolizumab.

    PubMed

    Kiuru, Maija; Camp, Brendan; Adhami, Katayun; Jacob, Vinita; Magro, Cynthia; Wildman, Horatio

    2015-11-01

    Metastatic Crohn disease is a rare cutaneous manifestation of Crohn disease characterized by granulomatous lesions discontinuous with the diseased areas of the gastrointestinal tract. We report a case of a 32-year-old woman with history of Crohn disease who was admitted for treatment of cellulitis after presenting with a tender erythematous plaque of the left calf. Microbiological tests including tissue cultures were negative. A skin biopsy revealed granulomatous dermatitis consistent with metastatic cutaneous Crohn disease. Owing to concomitant perianal fistulas and abscesses and prior infusion reaction to infliximab, the patient was treated with certolizumab, a pegylated tumor necrosis factor (TNF) inhibitor combined with methotrexate resulting in complete resolution of the skin lesion. This case emphasizes the importance of recognizing this rare skin manifestation of Crohn disease and adds certolizumab as one of TNF inhibitors useful in the treatment of metastatic cutaneous Crohn disease. PMID:26632928

  9. Randomized comparative study of ampicillin/sulbactam vs. ceftriaxone for treatment of soft tissue and skeletal infections in children.

    PubMed

    Kulhanjian, J; Dunphy, M G; Hamstra, S; Levernier, K; Rankin, M; Petru, A; Azimi, P

    1989-09-01

    In a prospective study 105 children hospitalized with soft tissue infection, 11 children with suppurative arthritis and 9 children with osteomyelitis were treated with either parenterally administered ampicillin/sulbactam or ceftriaxone. Treatment was randomized using a computer-generated table in a 2:1 fashion: 84 patients received ampicillin/sulbactam and 41 patients received ceftriaxone. Organisms isolated from wound site or blood cultures included Staphylococcus aureus (33), Streptococcus pyogenes (19), Haemophilus influenzae (9) including 4 beta-lactamase-positive organisms, Streptococcus pneumoniae (5), Neisseria gonorrhoeae (3) and 9 other organisms. Clinical and bacteriologic response was satisfactory in 100% of the ampicillin/sulbactam-treated patients and in 93% of the ceftriaxone-treated patients. Two patients with S. aureus infections treated with ceftriaxone had a delayed response and required change in therapy to parenterally administered oxacillin. Ampicillin/sulbactam represents a potentially useful single agent for the treatment of cellulitis and bone or joint infections in pediatric patients. PMID:2677956

  10. High hard magnetic properties and cellular structure of nanocomposite magnet Nd 4.5Fe 73.8B 18.5Cr 0.5Co 1.5Nb 1Cu 0.2

    NASA Astrophysics Data System (ADS)

    The, N. D.; Chau, N.; Vuong, N. V.; Quyen, N. H.

    2006-08-01

    The formation of special nanostructure, cellular structure, in Nd 4.5Fe 73.8B 18.5Cr 0.5Co 1.5Nb 1Cu 0.2 nanocomposite magnet has been observed by means of SEM for the first time. Ultrafine structure of cellules with thickness of 20-25 nm and length in range of 200-300 nm leads to high shape anisotropy of the materials. Therefore, high hard magnetic properties were obtained with ( BH) max up to 17.3 MG Oe in ribbons with very high remanence of 13.5 kG. The role of Cr and Co in the formation and refinement of cellular structure is proposed. Effect of heat treatment on hard magnetic properties is discussed in detail.

  11. Prevalence of oral lesions in a selected Vietnamese population.

    PubMed

    Nair, R G; Samaranayake, L P; Philipsen, H P; Graham, R G; Itthagarun, A

    1996-02-01

    Clinical examination of the oral and peri-oral regions of a cohort of 550 Vietnamese living in a refugee camp in Hong Kong was conducted. They comprised 216 (39 per cent) males and 334 (61 per cent) females and their age ranged from 2 to 60 years. A positive clinical finding was observed in 14 per cent, 35 males and 43 females. The most common condition observed was periapical infection (36 per cent), either with an abscess or a sinus. Other lesions noted include mucocele (10 per cent), traumatic ulcers (9 per cent), tori, either palatal (6 per cent) or mandibular (3 per cent), lymph node enlargement (7 per cent), pulp polyp (6 per cent), angular cheilitis (4 per cent), papillomas (3 per cent), cellulitis (3 per cent) and herpes lesions (2 per cent), 7 out of 9 (78 per cent) mucoceles were found in females. No malignant lesions were noted. PMID:8744917

  12. Tropical Diabetic Hand Syndrome.

    PubMed

    Okpara, T C; Ezeala-Adikaibe, B A; Omire, O; Nwonye, E; Maluze, J

    2015-01-01

    Any adult with diabetes in the tropics with hand cellulitis, infection and gangrene qualifies for tropical diabetic hand syndrome (TDHS). We reviewed a 39-year-old woman with a 3-week history of swelling of the left index finger following an insect bite. The swelling progressively increased in size, was very painful, and extended to the palm. There was no history or symptoms suggestive of chronic complications of diabetes. Random blood sugar on presentation was above 600 mg/dl using a glucometer. Examination revealed an edematous left palm draining pus from multiple sinuses, necrotic and gangrenous left index finger extending down to just above the thenar eminence. A diagnosis of TDHS in a patient with hyperosmolar state was made. She was managed accordingly and subsequently underwent aggressive debridement and desloughing. Two fingers were amputated and the wound was allowed to heal by secondary intention. PMID:27057390

  13. NOCARDIA BEIJINGENSIS PSOAS ABSCESS AND SUBCUTANEOUS PHAEOHYPHOMYCOSIS CAUSED BY PHAEOACREMONIUM PARASITICUM IN A RENAL TRANSPLANT RECIPIENT: THE FIRST CASE REPORT IN THAILAND.

    PubMed

    Palavutitotai, Nattawan; Chongtrakoo, Piriyaporn; Ngamskulrungroj, Popchai; Chayakulkeeree, Methee

    2015-11-01

    We describe the first case of a psoas muscle abscess caused by Nocardia beijingensis and subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum in a renal transplant recipient. The patient was treated for nocardiosis with percutaneous drainage and intravenous trimethoprim/sulfamethoxazole (TMP/SMX) combined with imipenem for 2 weeks, followed by a 4-week course of intravenous TMP/SMX and then oral TMP/SMX. During hospitalization for the psoas muscle abscess the patient developed cellulitis with subcutaneous nodules of his right leg. Skin biopsy and cultures revealed a dematiaceous mold, subsequently identified as P. parasiticum by DNA sequencing. The subcutaneous phaeohyphomycosis was treated with surgical drainage and liposomal amphotericin B for 4 weeks followed by a combination of itraconazole and terbinafine. The patient gradually improved and was discharged home after 18 weeks of hospitalization. PMID:26867363

  14. Langerhans cell histiocytosis with presentation as orbital disease

    PubMed Central

    Bhanage, Ashok B.; Katkar, Anand D.; Ghate, Prajakta S.

    2015-01-01

    Langerhans cell histiocytosis (LCH) is an uncommon multisystem disease with an abnormal polyclonal proliferation of Langerhans cells that invade various organs. In rare instances, the affection of the orbit is the only and the first symptom. We report an unusual case of an 18-month-old male who presented with orbital disease as the first symptom, in the form of chronic presentation of periorbital swelling (2 months duration) with acute inflammation (1-week duration) giving a suspicion of orbital cellulitis. Histopathology after radical excision confirmed the diagnosis of LCH and was advised initial therapy as per Histiocyte Society Evaluation and Treatment Guidelines (2009) but was lost to follow-up only reappearing with progression (multisystem LCH with risk organ involvement) and developed progressive active disease on treatment after 5 weeks. He was treated with salvage therapy for risk patients achieving complete remission. PMID:26167225

  15. Chronic osteomyelitis of the clavicle

    SciTech Connect

    Granick, M.S.; Ramasastry, S.S.; Goodman, M.A.; Hardesty, R.

    1989-07-01

    Osteomyelitis of the clavicle is an uncommon disease, but it should be considered in patients who present with pain, cellulitis, or drainage in the sternoclavicular area following head and neck surgery, irradiation, subclavian vein catheterization, or immunosuppression. An idiopathic presentation is possible. In contrast to primary osteomyelitis of the clavicle, which is occasionally seen in children, secondary osteomyelitis is quite rare. It is often mistaken for a fracture or a possible neoplasm on plain x-rays. Tomograms and CT scanning are confirmatory, and in early cases, technetium-99m bone scanning can be helpful. Treatment must include early, aggressive surgical debridement of all affected tissues, followed by wound coverage with a well-vascularized flap and perioperative antibiotics.

  16. An aggressive primary orbital natural killer/T-cell lymphoma case: poor response to chemotherapy.

    PubMed

    Marchino, Tizana; Ibáñez, Núria; Prieto, Sebastián; Novelli, Silvana; Szafranska, Justyna; Mozos, Anna; Graell, Xavier; Buil, José A

    2014-01-01

    Natural killer/T-cell lymphoma (NKTCL) and its presentation with extranodal orbital involvement as a single lesion are extremely rare. The aim of this article was to describe the presentation, diagnosis, and systemic treatment of a primary orbital NKTCL. A 67-year-old Caucasian woman presented with left exophthalmos, pain, periorbital swelling, and limited extrinsic ocular motility. Orbital cellulitis was suspected, but finally orbital biopsy was performed due to no response to initial antibiotic and anti-inflammatory standard treatment. The pathologic diagnosis was NKTCL. Systemic evaluations were negative. CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy was initiated, but after 2 cycles of treatment, tumoral progression was observed. SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, etoposide) rescue chemotherapy was then administered. Lymphoma progression was inevitable. She died 10 months later. Although more nasal NKTCL cases have been described, the nonnasal primary orbital NKTCL is an uncommon neoplasm with high mortality rate, despite the recent use of more potent chemotherapy regimens. PMID:24317101

  17. Etudes physiques des mélanges eau-cryoprotecteurs

    NASA Astrophysics Data System (ADS)

    Vassoille, R.; Perez, J.

    The aim of the following review is to present the most important studies concerning the physical properties of water-solutes mixtures used in cryobiology. Cryobiology is a branch of biology which deals with the very low temperature behaviour of cells. This technique is developed today in several directions. The creation of banks of cells and perhaps in a short time of small organs, is the purpose of much research in this domain. Before freezing, living cells are generally put in a solution containing one or more solutes. The role of these solutes is to protect the cells against damage due to crystallization of water (cryoprotectors). The mechanisms of cryoprotection are not well known ; nevertheless the vitreous state formation during cooling is often invoked. So, it is possible to avoid crystallization damage such as mechanical strain (due to an increase of volume of about 10 %) and salt effects (due to osmotic pressure). The conditions in which the vitreous state is obtained, maintained during cooling, storage at low temperature and rewarming can be defined by physical studies presented in the following review. Le présent travail est essentiellement une revue bibliographique des principales études physiques qui ont été réalisées avec des solutions de composés habituellement employés en cryobiologie. La cryobiologie est une branche de la biologie qui s'intéresse au comportement des cellules à basse température. Cette discipline est actuellement en plein développement dans des domaines très divers. Son principal but est la création de banques de cellules de plus en plus complexes avec comme perspective la conservation des organes. Les cellules vivantes sont généralement placées avant congélation dans une solution contenant divers composés dont le rôle est de protéger les cellules contre les effets de la cristallisation de l'eau. L'action protectrice de ces cryoprotecteurs est encore mal connue; cependant, la formation d'un état vitreux lors du

  18. Molecular and pathological characterization of Fusarium solani species complex infection in the head and lateral line system of Sphyrna lewini.

    PubMed

    Pirarat, Nopadon; Sahatrakul, Komsil; Lacharoje, Sitthichok; Lombardini, Eric; Chansue, Nantarika; Techangamsuwan, Somporn

    2016-08-01

    A severe fungal infection affecting the head and lateral line system was diagnosed in 7 captive scalloped hammerhead sharks Sphyrna lewini in an aquarium in Thailand. Extensive and severe necrotizing cellulitis was consistently observed microscopically along the cephalic and lateral line canals in conjunction with positive fungal cultures for Fusarium sp. Molecular phylogenetic analysis was performed from 3 isolates based on the nucleotide sequences containing internally transcribed spacer (ITS) and a portion of 5.8S and 28S rDNA. The fungus was highly homologous (100%) and closely related to F. solani species complex 2 (FSSC 2), which belongs to Clade 3 of the FSSC. Our results illustrate the histopathological findings and expand upon our knowledge of the prevalence of invasive fusariosis in the head and lateral line system of hammerhead sharks. PMID:27503915

  19. Pasteurella canis Isolation following Penetrating Eye Injury: A Case Report

    PubMed Central

    Rashid, Noor-Khairul; Zam, Zarifah; MdNoor, Siti-Suraya; Siti-Raihan, Ishak; Azhany, Yaakub

    2012-01-01

    A 3-year-old boy presented with history of trauma to the left eye after he accidentally injured his eye with a broom stick made up from coconut skewers. There was history of cats as their pets but not dogs. Ocular examination revealed left superonasal conjunctival laceration and scleral perforation with prolapsed vitreous. Fundus examination showed minimal vitreous haemorrhage and flat retina. Conjunctiva swab at the wound site was sent for gram staining, culture, and sensitivity. He underwent scleral suturing, vitreous tap, and intravitreal injection of Ceftazidime and Amikacin. Vitreous tap was sent for gram stained, culture and sensitivity. Postoperatively, he was started empirically on IV Ciprofloxacin 160 mg BD, Guttae Ciprofloxacin, and Guttae Ceftazidime. Conjunctiva swab grew Pasteurella canis which was sensitive to all Beta lactams, Ciprofloxacin, Chloramphenicol, and Aminoglycoside. Post-operative was uneventful, absent signs of endophthalmitis or orbital cellulitis. PMID:22606491

  20. Rhinocerebral mucormycosis in a patient with type 1 diabetes presenting as toothache: a case report from Himalayan region of India

    PubMed Central

    Singh, Vikram; Singh, Mridu; Joshi, Chitra; Sangwan, Jyoti

    2013-01-01

    Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. It is a rapidly progressive fatal infection mostly reported in susceptible individuals, such as those with poorly controlled diabetes or those with defects in phagocytic function. Rhinocerebral mucormycosis is the most common type of mucormycosis in diabetic patients. This case report describes a 17-year-old girl with type 1 diabetes mellitus presenting with rhinocerebral mucormycosis. The patient presented with a history of toothache and facial pain with oedema of left half of face, periorbital oedema and depressed conciousness. She had hyperglycaemia with diabetic ketoacidosis and rapidly developed hemiparesis progressing to quadriparesis and died within 3 days of admission. The current report emphasises the importance of having a high index of suspicion when dealing with patients with diabetes presenting with facial pain or cellulitis and prompt initiation of medical therapy along with surgical debridement for control of rhinocerebral mucormycosis. PMID:24172773

  1. Two cases of orbital infarction syndrome.

    PubMed

    Yang, S W; Kim, S Y; Chung, J; Kim, K B

    2000-12-01

    Orbital infarction syndrome is defined as ischemia of all intraorbital and intraocular structures. It is a rare disease caused by rich anastomotic vascularization of the orbit. It can occur secondary to different conditions, such as, acute perfusion failure, systemic vasculitis, orbital cellulitis and vasculitis. It results in orbital and ocular pain, total ophthalmoplegia, anterior and posterior segment ischemia, and acute blindness. We report here upon two cases of orbital infarction with similar presentations but with different causes, namely, mucormycosis and as a postoperative complication of intracranial aneurysm, discuss the possible mechanisms of orbital infarction, and present a review of the literature on the topic. The prompt recognition of clinical pictures and rapid diagnosis is essential for the early treatment of orbital infarction, since its progression is very rapid and it can be even fatal. PMID:11213734

  2. Diffusion-weighted and diffusion-tensor imaging of normal and diseased uterus

    PubMed Central

    Kara Bozkurt, Duygu; Bozkurt, Murat; Nazli, Mehmet Ali; Mutlu, Ilhan Nahit; Kilickesmez, Ozgur

    2015-01-01

    Owing to technical advances and improvement of the software, diffusion weighted imaging and diffusion tensor imaging (DWI and DTI) greatly improved the diagnostic value of magnetic resonance imaging (MRI) of the pelvic region. These imaging sequences can exhibit important tissue contrast on the basis of random diffusion (Brownian motion) of water molecules in tissues. Quantitative measurements can be done with DWI and DTI by apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values respectively. ADC and FA values may be changed by various physiological and pathological conditions providing additional information to conventional MRI. The quantitative DWI assists significantly in the differentiation of benign and malignant lesions. It can demonstrate the microstructural architecture and celluler density of the normal and diseased uterine zones. On the other hand, DWI and DTI are useful for monitoring the treatment outcome of the uterine lesions. In this review, we discussed advantages of DWI and DTI of the normal and diseased uterus. PMID:26217454

  3. Potential flow about arbitrary biplane wing sections

    NASA Technical Reports Server (NTRS)

    Garrick, I E

    1937-01-01

    A rigorous treatment is given of the problem of determining the two-dimensional potential flow around arbitrary biplane cellules. The analysis involves the use of elliptic functions and is sufficiently general to include the effects of such elements as the section shapes, the chord ratio, gap, stagger, and decalage, which elements may be specified arbitrarily. The flow problem is resolved by making use of the methods of conformal representation. Thus the solution of the problem of transforming conformally two arbitrary contours into two circles is expressed by a pair of simultaneous integral equations, for which a method of numerical solution is outlined. As an example of the numerical process, the pressure distribution over certain arrangements of the NACA 4412 airfoil in biplane combinations is presented and compared with the monoplane pressure distribution.

  4. Complicated coexisting pyogenic and tuberculous otitis media affecting the temporozygomatic, infratemporal, and parotid areas: report of a rare entity.

    PubMed

    Brar, Tripti; Mrig, Sumit; Passey, J C; Agarwal, A K; Jain, Shayma

    2013-01-01

    We report an unusual case in which a 28-year-old woman presented with a long-standing history of ear discharge, hearing loss, facial weakness with ipsilateral facial swelling and cellulitis, a postauricular fistula, and an abscess of the temporozygomatic, infratemporal, and parotid areas. The pus stained positive for bacteria and acid-fast bacilli, and culture was positive for Proteus vulgaris and mycobacteria. Based on these findings, a diagnosis of tuberculous otitis media with complications was made. Computed tomography showed extensive destruction of the tympanic and mastoid part of the temporal bone, as well as lytic lesions in the skull. The patient was placed on antituberculosis drug therapy. Although her facial nerve palsy and hearing loss persisted, she otherwise responded well and did not require surgery. PMID:23354894

  5. Soft tissue infections with Arcanobacterium haemolyticum: report of three cases.

    PubMed

    Malini, A; Deepa, E K; Manohar, P V; Borappa, K; Prasad, S R

    2008-01-01

    We report here three polymicrobial wound infections associated with Arcanobacterium haemolyticum in rural patients aged between 60-65 years. In two patients, one with cellulitis and the other with postoperative wound infection following amputation of the limb, Arcanobacterium haemolyticum was isolated repeatedly along with beta haemolytic streptococci (BHS). The BHS belonged to Lancefield's group G and group C respectively. In another patient, who was a diabetic with chronic osteomyelitis, Arcanobacterium haemolyticum was isolated along with Proteus vulgaris . All the three isolates of Arcanobacterium haemolyticum isolated by us were uniformly resistant to cotrimoxazole and sensitive to penicillin, erythromycin, clindamycin, ciprofloxacin and gentamicin. Erythromycin alone or combined therapy of penicillin with erythromycin or penicillin with ciprofloxacin was effective in treating these infections. PMID:18445965

  6. Primary scarring alopecias.

    PubMed

    Rigopoulos, Dimitrios; Stamatios, Gregoriou; Ioannides, Dimitrios

    2015-01-01

    Scarring alopecia or cicatricial alopecia results from follicular damage that is sufficient to cause the destruction and replacement of pilosebaceous structures by scar tissue. Primary scarring alopecias represent a group of disorders that primarily affect the hair follicles, as opposed to secondary scarring alopecias, which affect the dermis and secondarily cause follicular destruction. Inflammation may predominantly involve lymphocytes or neutrophils. Cicatricial alopecias that mainly involve lymphocytic inflammation include discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, central centrifugal alopecia, and pseudopelade (Brocq). Cicatricial alopecias that are due to predominantly neutrophilic inflammation include folliculitis decalvans, tufted folliculitis, and dissecting cellulitis of the scalp. Folliculitis keloidalis is a cicatricial alopecia with a mixed inflammatory infiltrate. PMID:26370646

  7. Infectious coryza in meat chickens in the San Joaquin Valley of California.

    PubMed

    Droual, R; Bickford, A A; Charlton, B R; Cooper, G L; Channing, S E

    1990-01-01

    Two cases of infectious coryza in meat chickens are reported. The first case involved 6-week-old broiler chickens in which only Haemophilus paragallinarum was isolated. The second case involved 11-week-old roaster chickens in which H. paragallinarum and Mycoplasma synoviae were isolated. Both farms were in close proximity to layer-chicken farms where infectious coryza had been previously diagnosed. In both cases, only certain houses on the farm were affected, and mortality in these houses increased slightly. At processing, the condemnation rates for affected houses were considerably higher than rates for unaffected houses. Condemnations for affected houses were mostly due to airsacculitis. A dissecting fibronopurulent cellulitis was a prominent lesion in the second case. This lesion could lead to confusion with chronic fowl cholera and swollen-head syndrome. PMID:2282006

  8. Osteomyelitis: detection with US.

    PubMed

    Abiri, M M; Kirpekar, M; Ablow, R C

    1989-08-01

    To evaluate the role of ultrasound (US) in the detection of osteomyelitis, the authors prospectively studied 48 patients clinically suspected of having osteomyelitis. A sonographic diagnosis was made if fluid was seen directly in contact with bone, without intervening soft tissues. Twelve of the 48 patients were subsequently found to have osteomyelitis. In 10 of them, US demonstrated abnormal fluid adjacent to the bone. This fluid was thought to represent an inflammatory exudate dissecting in a subperiosteal and/or extraperiosteal location. Eight of the 48 patients had soft-tissue fluid collections. The rest of the patients either had no abnormalities or had cellulitis. The authors conclude that US can be useful in the detection of osteomyelitis. PMID:2664872

  9. Death due to an unrecognized groin abscess in a drug addict: a retrospective study.

    PubMed

    D'Ovidio, Cristian; Vellante, Paola; Costantini, Sara; Carnevale, Aldo

    2013-07-01

    Intravenous drug injection persists despite health risks and medical complications. Venous thrombosis, septic thrombophlebitis, artery necrosis, arterio-venous fistula, mycotic aneurysm, dissecting hematoma, pseudoaneurysm formation, and soft tissues infections (i.e. abscesses, cellulitis, infected ulcers), are some of the major clinical consequences lives threatening. The aim of this work is to present this unusual autoptic case of a drug addict man died for an unrecognized groin abscess referred to the Institute of Legal Medicine, University of Chieti, causing femoral vein's erosion, and to analyse the most common patterns of vascular lesions among drug addicts. It could be stimulated a new scientific debate because groin injections and their vascular complications increase over years; while soft tissue infections may hide vascular lesions' diagnosis. So physicians should have a high index of suspicion for serious vascular problems, among intravenous drug users (IDUs): prevention for avoiding groin injection and a proper treatment are necessary. PMID:23756501

  10. Ethnic hair disorders.

    PubMed

    Lindsey, Scott F; Tosti, Antonella

    2015-01-01

    The management of hair and scalp conditions is difficult in any patient, especially given the emotional and psychological implications of hair loss. This undertaking becomes even more challenging in the ethnic patient. Differences in hair care practices, hair shaft morphology, and follicular architecture add complexity to the task. It is imperative that the physician be knowledgeable about these practices and the phenotypic differences seen in ethnic hair in order to appropriately diagnose and treat these patients. In this chapter, we will discuss cultural practices and morphologic differences and explain how these relate to the specific disorders seen in ethnic populations. We will also review the most prominent of the ethnic hair conditions including acquired trichorrhexis nodosa, traction alopecia, central centrifugal cicatricial alopecia, pseudofolliculitis barbae, dissecting cellulitis, and acne keloidalis nuchae. PMID:26370652

  11. Perifolliculitis capitis abscedens et suffodiens successfully controlled with topical isotretinoin.

    PubMed

    Karpouzis, Anthony; Giatromanolaki, Alexandra; Sivridis, Efthymios; Kouskoukis, Constantin

    2003-01-01

    Perifolliculitis capitis abscedens et suffodiens (or dissecting folliculitis of the scalp or dissecting cellulitis of the scalp or dissecting perifolliculitis of the scalp) is a rare entity and constitutes the equivalent over the scalp, of hidradenitis suppurativa and acne conglobata. Etiologic factors are unknown. Diagnosis is proven histologically. Management is very difficult and consists in systemic administration or intralesional injection of several drugs or in surgical manipulations. An 18 year-old white patient with cystic infiltrations, alopecia plaques, pustules and other inflammatory elements (clinicohistological features consistent with dissecting folliculitis of the scalp), is presented. Isotretinoin topical application assured successful control of the disease and averted the evolution of the clinical aspect to scarring alopecia and nodule formation. Topical isotretinoin exercises a curative, inhibitory and antiproliferative action, in perifolliculitis capitis abscedens et suffodiens. PMID:12695138

  12. Ethmoid Osteoma as a Culprit of Orbital Emphysema

    PubMed Central

    Zhuang, Ai; Li, Yinwei; Lin, Ming; Shi, Wodong; Fan, Xianqun

    2015-01-01

    Abstract Orbital emphysema is generally recognized as a complication of orbital fractures involving any paranasal sinuses. The recognition about its etiology has extended beyond sole trauma, but few articles mentioned tumors to be a possible cause. In this case report, we present a patient with orbital emphysema associated with ethmoid osteoma without orbital cellulitis or trauma history. The patient developed sudden proptosis, eyelid swelling, and movement limitation of the left eye, peripheral diplopia, and left periorbital crepitus after a vigorous nose blowing. Complete surgical resection of ethmoid osteoma followed by repair of the orbital medial wall was performed with assistance of combined endoscopy and navigational techniques. Twelve-month follow-up showed no residual lesion or recurrence; the orbital medial wall was accurately repaired with good visual function and facial symmetry. Tumors should be considered for differential diagnosis of orbital emphysema, and combined endoscopy and navigational techniques may improve safety, accuracy, and effectiveness of orbital surgeries. PMID:25950683

  13. Experimental infections of the musculoskeletal system: evaluation with MR imaging and Tc-99m MDP and Ga-67 scintigraphy

    SciTech Connect

    Beltran, J.; McGhee, R.B.; Shaffer, P.B.; Olsen, J.O.; Bennett, W.F.; Foster, T.R.; McCalla, M.S.; Iskra, L.A.; Blagg, R.L.; Biller, D.S.

    1988-04-01

    Acute osteomyelitis, soft-tissue infection, or both were experimentally produced in 38 New Zealand white rabbits, and three-phase technetium-99m methylene diphosphonate, gallium-67, and magnetic resonance (MR) images were obtained 7 or 14 days after infection. There was no significant difference between radionuclide studies and MR images in the detection of osteomyelitis, but MR imaging was significantly more sensitive (100% vs. 69%; P less than .01) in the detection of soft-tissue infection. In addition, cellulitis could not be distinguished from soft-tissue abscess on radionuclide studies, whereas MR imaging was 92% accurate in depicting soft-tissue abscesses. Further research is necessary to determine how to relate these findings to true human clinical situations.

  14. The technetium phosphate bone scan in the diagnosis of osteomyelitis in childhood

    SciTech Connect

    Howie, D.W.; Savage, J.P.; Wilson, T.G.; Paterson, D.

    1983-04-01

    We reviewed the technetium phosphate scans of 280 patients who had been referred with a clinical diagnosis of osteomyelitis in order to establish the diagnostic accuracy of this procedure. Strict criteria were established to define two subgroups: one of patients with proved osteomyelitis and one of patients who definitely did not have osteomyelitis. The scan correctly identified osteomyelitis at fifty-five of sixty-two sites, and was correctly negative in seventy-four of seventy-nine patients without osteomyelitis. The scan correctly distinguished all cases of cellulitis or soft-tissue abscess from osteomyelitis, but identified osteomyelitis in eight of thirty-nine patients with septic arthritis. The phosphate bone scan maintained this accuracy through any duration of symptoms, and performed almost equally well at all skeletal sites and in all age groups.

  15. Streptococcus agalactiae Meningitis in Adult Patient: A Case Report and Literature Review.

    PubMed

    Khan, Fahmi Yousef

    2016-01-01

    We report a case of group B streptococcus meningitis in a 72-year-old female patient who was admitted in our hospital with a 21-day history of bilateral lower thigh pain and swelling associated with fever, headache, and vomiting. Her past medical history was remarkable for DM type 2, hypertension, and hypothyroidism. Upon admission, examination showed bilateral warmth and tender soft tissue swelling around the knees and MRI showed cellulitis of distal thirds of both thighs. The next day, the patient became drowsy. Neurologic examination showed neck rigidity and right sided hemiparesis. Cerebrospinal fluid and blood cultures yielded group B streptococcus sensitive to ceftriaxone, penicillin G, and vancomycin. The patient received ceftriaxone for a total of 14 days after which she improved and was discharged from the hospital with right sided weakness. PMID:26904325

  16. Primary Cutaneous Cryptococcosis Treated with Debridement and Fluconazole Monotherapy in an Immunosuppressed Patient: A Case Report and Review of the Literature

    PubMed Central

    Wang, Jennifer; Bartelt, Luther; Yu, Deborah; Joshi, Anjali; Weinbaum, Bradley; Pierson, Tiffany; Patrizio, Michael; Warren, Cirle A.; Hughes, Molly A.; Donowitz, Gerald

    2015-01-01

    Cryptococcus neoformans is an opportunistic yeast present in the environment. Practitioners are familiar with the presentation and management of the most common manifestation of cryptococcal infection, meningoencephalitis, in patients with AIDS or other conditions of immunocompromise. There is less awareness, however, of uncommon presentations where experience rather than evidence guides therapy. We report a case of primary cutaneous cryptococcosis (PCC) in a patient who had been immunosuppressed by chronic high-dose corticosteroid for the treatment of severe asthma. This case highlights the importance of early recognition of aggressive cellulitis that fails standard empiric antibiotic treatment in an immunocompromised patient. It also demonstrates successful treatment of PCC with a multispecialty approach including local debridement and fluconazole monotherapy. PMID:25722900

  17. Tonsil ultrasound: technical approach and spectrum of pediatric peritonsillar infections.

    PubMed

    Bandarkar, Anjum N; Adeyiga, Adebunmi O; Fordham, M Taylor; Preciado, Diego; Reilly, Brian K

    2016-06-01

    Peritonsillar infections are one of the most common deep neck space infections, particularly in adolescents. Inaccurate diagnosis can lead to delay in management and potentially life-threatening complications. Contrast-enhanced computed tomography (CT) scan of the neck traditionally has been used to diagnose suspected peritonsillar abscess. With growing concern over radiation exposure, there has been increasing utilization of ultrasound (US) using intraoral and transcutaneous approaches. We chose the transcutaneous US technique due to its ease of performance in children. The purpose of this article is twofold: a) to describe our technique of performing transcutaneous US of the tonsil showing sonographic appearance of normal tonsil, highlighting pertinent anatomy and unique considerations for this modality in children, and b) to illustrate the sonographic findings in the spectrum of pediatric peritonsillar infections, which includes uncomplicated tonsillitis, peritonsillar cellulitis, small intratonsillar abscess and frank peritonsillar abscess. Parapharyngeal abscess can sometimes be detected. PMID:26637999

  18. Transfert d'énergie linéique et radiosensibilité cellulaire

    NASA Astrophysics Data System (ADS)

    Courdi, A.; Pignol, J. P.; Iborra-Brassart, N.; Hérault, J.; Fares, G.; Hachem, A.; Chauvel, P.

    1998-04-01

    The response of human tumour cell lines to in vitro irradiation by high LET particles depends on several factors. For charged particles, there is an increase in radio-sensitivity with LET up to LET values of about 200 KeV/m, then it decreases for higher values. In clinical practice, the increase in the average LET value with depth leads to a continuous increase in relative biological effectiveness (RBE). The probability of particle traversal through the nucleus producing lethal damage is almost 1 for particles with very high LET values such as 7 MeV Ar (LET = 1500 KeV/μm); it is only 0.02 for 400 MeV O ions (LET = 20 KeV/μm). RBE is inversely related with dose, this relation being more marked for cells with small α/beta values after photon irradiation according to the linear-quadratic formula. Particles that are less efficient than photons in terms of average cell death induce heavy individual cell damage, as shown by the yield of multiple micronuclei (MN). With regard to RBE and intrinsic radiosensitivity, recent data using both the clonogenic method and the MN assay indicate that the higher the radioresistance to photon irradiation, the higher the RBE. La réponse des cellules tumorales humaines à l'irradiation in vitro par des particules de TEL élevé dépend de plusieurs facteurs. Pour les particules chargées, la radiosensibilité augmente avec le TEL jusqu'à des valeurs de TEL voisines de 200 KeV/μm, puis diminue pour des valeurs de TEL supérieures. En clinique, l'augmentation du TEL moyen de la particule chargée en profondeur est responsable d'une efficacité biologique relative (EBR) croissante. La probabilité de mortalité de la cellule par une particule traversant le noyau est proche de 1 pour les particules de TEL très élevé comme l'Ar de 7 MeV par nucléon (TEL = 1500 KeV/μm) ; elle n'est que de 0,02 pour les ions d'O de 400 MeV (TEL = 20 KeV/μm). L'EBR est plus élevée pour les petites doses, la relation EBR/dose étant plus marqu

  19. Deadly case of Pasteurella multocida aortitis and mycotic aneurysm following a cat bite

    PubMed Central

    Cho, Dennis Dane; Berliner, Yaniv; Carr, David

    2016-01-01

    Animal bites are frequently encountered in the emergency department (ED). Aortitis leading to mycotic abdominal aortic aneurysm is a rare and potentially deadly complication of Pasteurella multocida (P. multocida) following an animal bite. We present the case of a 68-year-old male who presented to the ED after falling at home. He complained of weakness and abdominal pain. He was in septic shock and was treated empirically with broad-spectrum antibiotics and intravenous fluids. He reported previous antibiotic treatment of a cellulitis secondary to a cat bite injury to his right thumb four weeks prior. Abdominal ultrasound and subsequent computed tomography scan revealed a leaking mycotic abdominal aneurysm that was surgically repaired. Blood cultures and aortic wall tissue cultures grew P. multocida. Given how common animal bite presentations are in the ED, this case highlights the need to consider aortitis and mycotic abdominal aortic aneurysm in an unwell patient with an animal bite. PMID:27326399

  20. Cutaneous Cryptococcus: marker for disseminated infection.

    PubMed

    Srivastava, G N; Tilak, Ragini; Yadav, Jyoti; Bansal, Manish

    2015-01-01

    Cryptococcosis is an infection caused by the encapsulated yeast, Cryptococcus neoformans, a dimorphic fungus recovered from pigeon excreta, soil, dust and human skin. After a primary infection in the lungs, the disease can disseminate via a haematogenous route to various organs, including the central nervous system and skin, in susceptible individuals. Cryptococcosis can present with a variety of skin and soft tissue manifestations including acneiform lesions, purpura, vesicles, nodules, abscesses, ulcers, granulomas, pustules, draining sinuses and cellulitis. We present a case of a young man with HIV infection who developed molluscum-like cutaneous lesions secondary to pulmonary cryptococcosis. The diagnosis was confirmed by Indian ink preparation of the cutaneous lesions. Primary cutaneous infection occurs rarely due to direct inoculation. Cutaneous lesions are usually secondary and act as a key marker of disseminated infection, especially in patients with impaired cell-mediated immunity, such as those infected with HIV, solid-organ transplant recipients, and those on chronic corticosteroid therapy. PMID:26199299

  1. Antiadipogenic properties of retinol in primary cultured differentiating human adipocyte precursor cells.

    PubMed

    Garcia, E; Lacasa, D; Agli, B; Giudicelli, Y; Castelli, D

    2000-04-01

    The aim of this study was to investigate the effect of retinol on the human adipose conversion process using primary cultured human adipocyte precursor cells. When these cells were seeded in a medium containing retinol (concentrations ranging from 3.5 nM to 3.5 muM), cell proliferation was slightly inhibited by high concentrations of retinol, as demonstrated by cell counting and [(3)H]-thymidine incorporation. Moreover, the differentiation capacities of these cells were markedly and dose-dependently inhibited by retinol, as shown by the reduced expression of the lipogenic enzyme glycerol-3-phosphate dehydrogenase and by microscopic morphological analysis. These results strongly suggest that retinol, by inhibiting the ability of human preadipocytes to convert into mature adipocytes, could be of potential interest in the prevention of human adipose tissue development in general and of cellulitis in particular. PMID:18503465

  2. Plasmocytome costal solitaire: à propos d'un cas

    PubMed Central

    Razafimanjato, Narindra Njarasoa Mihaja; Ravoatrarilandy, Manjakaniaina; Rakotoarisoa, Andriamihaja Jean Claude; Hasiniatsy, Rodrigue; Hunald, Allen Francis; Rakototiana, Auberlin Felantsoa; Rafaramino, Florine; Rakotovao, Hanitrala Jean Louis

    2014-01-01

    Les auteurs rapportent un cas de plasmocytome solitaire particulière par leur localisation costale. Le diagnostic est basé sur la mise en évidence d'une tumeur localisée, constituée de cellules plasmocytaires monoclonales cytologiquement identiques à celles du myélome multiple, en l'absence d'autres signes en faveur d'une forme disséminée. Nous rapportons un cas de plasmocytome solitaire à localisation costale et nous discutons les aspects diagnostiques et thérapeutiques de cette affection potentiellement menacée dans son évolution par la transformation en myélome multiple. PMID:25419306

  3. Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case

    PubMed Central

    Bhattarai, Balkrishna; Biswas, Binay K; Khatiwada, Sindhu

    2011-01-01

    Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations. PMID:21716610

  4. Streptococcus agalactiae Meningitis in Adult Patient: A Case Report and Literature Review

    PubMed Central

    Khan, Fahmi Yousef

    2016-01-01

    We report a case of group B streptococcus meningitis in a 72-year-old female patient who was admitted in our hospital with a 21-day history of bilateral lower thigh pain and swelling associated with fever, headache, and vomiting. Her past medical history was remarkable for DM type 2, hypertension, and hypothyroidism. Upon admission, examination showed bilateral warmth and tender soft tissue swelling around the knees and MRI showed cellulitis of distal thirds of both thighs. The next day, the patient became drowsy. Neurologic examination showed neck rigidity and right sided hemiparesis. Cerebrospinal fluid and blood cultures yielded group B streptococcus sensitive to ceftriaxone, penicillin G, and vancomycin. The patient received ceftriaxone for a total of 14 days after which she improved and was discharged from the hospital with right sided weakness. PMID:26904325

  5. Australian Diabetes Foot Network: management of diabetes-related foot ulceration - a clinical update.

    PubMed

    Bergin, Shan M; Gurr, Joel M; Allard, Bernard P; Holland, Emma L; Horsley, Mark W; Kamp, Maarten C; Lazzarini, Peter A; Nube, Vanessa L; Sinha, Ashim K; Warnock, Jason T; Alford, Jan B; Wraight, Paul R

    2012-08-20

    Appropriate assessment and management of diabetes-related foot ulcers (DRFUs) is essential to reduce amputation risk. Management requires debridement, wound dressing, pressure off-loading, good glycaemic control and potentially antibiotic therapy and vascular intervention. As a minimum, all DRFUs should be managed by a doctor and a podiatrist and/or wound care nurse. Health professionals unable to provide appropriate care for people with DRFUs should promptly refer individuals to professionals with the requisite knowledge and skills. Indicators for immediate referral to an emergency department or multidisciplinary foot care team (MFCT) include gangrene, limb-threatening ischaemia, deep ulcers (bone, joint or tendon in the wound base), ascending cellulitis, systemic symptoms of infection and abscesses. Referral to an MFCT should occur if there is lack of wound progress after 4 weeks of appropriate treatment. PMID:22900873

  6. The Charcot foot: medical and surgical therapy.

    PubMed

    Ulbrecht, Jan S; Wukich, Dane K

    2008-12-01

    Charcot neuro-osteoarthropathy (CN) is among the most devastating complications of neuropathy and now most commonly occurs in the feet of diabetic patients. Because it is relatively rare and because most patients and practitioners do not expect major bone pathology in the absence of significant pain, CN is often misdiagnosed as cellulitis, deep venous thrombosis, or gout. Also, radiographs early in the process are often relatively unremarkable. Although MRI findings are characteristic, treatment should not wait for the MRI result. The hot swollen erythematous neuropathic foot suspected to be CN should be emergently mechanically protected, usually in an irremovable total contact cast. Mechanical protection is the mainstay of conservative therapy, but surgical reconstruction of a deformed foot can usually also be successful. Unless diagnosed very early, significant decrements in quality of life result. Controlled studies are urgently needed to identify best practices. PMID:18990300

  7. A diabetic woman with a swollen forearm.

    PubMed

    Fatemi, Alimohammad; Samadi, Golnaz; Hekmatnia, Ali; Iraj, Bijan; Saber, Mina

    2012-09-01

    Diabetic muscle infarction (DMI) is an unusual complication of diabetes mellitus. It is usually seen in long-standing diabetes mellitus. This article presents a case of DMI in the left forearm of a 58-year-old woman. She had a swollen forearm. The level of creatine kinase was 5930 U/L. Her condition was initially suspected for either cellulitis or venous thrombosis. A magnetic resonance imaging (MRI) study of the forearm showed diffuse edema and abnormal signals of the left forearm. The diagnosis of DMI was made. She was treated conservatively and her symptoms resolved within a short period of time. DMI should be considered as a differential diagnosis of any painful and swollen limb in diabetic patients. PMID:23826021

  8. Pyoderma gangrenosum mimicking a diabetic foot infection: a case report.

    PubMed

    Lee, Ho Seong; Choi, Young Rak; Ha, Sung Hoon; Jeong, Jae Jung

    2013-01-01

    An adult with ulcerative colitis and diabetes presented with a painful, swollen, edematous left foot. Diagnostic images and laboratory tests were inconclusive. Antibiotics were started immediately but aggravated his symptoms, and the laboratory results worsened. His foot was debrided twice per protocol for treating diabetic foot ulcers or cellulitis. After debridement, his condition worsened rapidly. Pyoderma gangrenosum was correctly diagnosed on the basis of massive neutrophilic infiltration detected in the biopsy tissue and because the lesion was well-defined and colored deep red to violet, unlike the bullosis diabeticorum blisters observed in the diabetic foot. His foot improved with systemic corticosteroids and topical wound care, and a skin defect was treated with a skin graft. After 9 months, his foot was well healed. Pyoderma gangrenosum can be diagnosed by careful examination and must be distinguished from an ulcerated diabetic foot lesion. PMID:23073270

  9. Rhinocerebral mucormycosis in a patient with type 1 diabetes presenting as toothache: a case report from Himalayan region of India.

    PubMed

    Singh, Vikram; Singh, Mridu; Joshi, Chitra; Sangwan, Jyoti

    2013-01-01

    Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. It is a rapidly progressive fatal infection mostly reported in susceptible individuals, such as those with poorly controlled diabetes or those with defects in phagocytic function. Rhinocerebral mucormycosis is the most common type of mucormycosis in diabetic patients. This case report describes a 17-year-old girl with type 1 diabetes mellitus presenting with rhinocerebral mucormycosis. The patient presented with a history of toothache and facial pain with oedema of left half of face, periorbital oedema and depressed conciousness. She had hyperglycaemia with diabetic ketoacidosis and rapidly developed hemiparesis progressing to quadriparesis and died within 3 days of admission. The current report emphasises the importance of having a high index of suspicion when dealing with patients with diabetes presenting with facial pain or cellulitis and prompt initiation of medical therapy along with surgical debridement for control of rhinocerebral mucormycosis. PMID:24172773

  10. Computerized tomography of pelvic osteomyelitis in patients with spinal cord injuries

    SciTech Connect

    Firooznia, H.; Rafii, M.; Golimbu, C.; Sokolow, J.

    1983-12-01

    Computerized tomography (CT) was performed in 19 patients with spinal cord injury (SCI) who had large pressure sores and in whom other complications were suspected. CT detected the depth, extent, and degree of undermining of the edges of the pressure sores in 19 of 27 lesions. Conventional radiography detected four cases of pelvic osteomyelitis. CT detected eight additional cases of pelvic osteomyelitis, as well as eight clinically unsuspected peripelvic and intrapelvic abscesses. Technetium-99m bone scanning was not very helpful because of localization in chronic proliferative changes of bone and widespread foci of myositis ossificans, as well as in osteomyelitis. Gallium-67 scanning detected only one of six abscesses. It was not very helpful because of confusion of abscess and osteomyelitis with intense soft tissue swelling and cellulitis, which are often associated with pressure sores in patients with chronic SCI. CT was found to be, by far, the modality of choice for detection of pelvic osteomyelitis and abscess in patients with SCI.

  11. Pseudomonas aeruginosa ecthyma gangrenosum in a woman with recurrent Graves' disease.

    PubMed

    Zhu, Cheng-Yao; Zhang, Guo-Xue; Yu, Zuo-Zhong; Li, Zhao-Jun; Fan, Yi-Ming

    2014-04-01

    A 35-year-old woman with postoperative recurrent Graves' disease presented with a 5-day history of a red swelling on the right cheek associated with 4 days of remittent hyperpyrexia. Investigations revealed fever, a gangrenous ulcer on the right cheek, submandibular lymphadenopathy, and thyroid gland enlargement. Her white blood cell count, immunoglobulins, and lymphocyte subsets were unremarkable. Thyroid function tests showed low thyroid-stimulating hormone, high free thyroxine, and elevated radioactive iodine uptake. Repeated pus cultures grew Pseudomonas aeruginosa, but blood cultures were negative. An ill-demarcated erythematous plaque occurred on the right leg on hospital day 3. She was treated with intravenous antibiotics with topical gentamicin, recombinant bovine basic fibroblast growth factor, and radioiodine therapy with anti-thyroid drugs. The ulcer healed leaving a depressed scar at 35 days after discharge. This patient may represent the first case of P. aeruginosa ecthyma gangrenosum and cellulitis in postoperative recurrent Graves' disease. PMID:24560831

  12. Longitudinal Analysis of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Carriage in Healthy Adolescents

    PubMed Central

    Wang, Shao-Chung; Chang, Hsin-Yu; Huang, Yhu-Chering

    2013-01-01

    To determine the long-term carriage patterns, strain relatedness, and incidence of subsequent infections among methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) carriers, we screened 154 high school students for nasal carriage of S. aureus on 8 occasions over 11 months. Persistent carriage was defined as a positive culture on ≥7 occasions. Two consecutive isolates from the same subject comprised a pair, and strain relatedness was determined for each pair by molecular typing. Of 1,232 nasal swab cultures obtained on 8 occasions, 323 (26.2%) were positive for S. aureus. Forty-five isolates (3.7%) were MRSA and 278 isolates (22.6%) were MSSA from 12 and 63 subjects, respectively. Thirty-five (77.8%) MRSA isolates harbored a type IV or VT staphylococcal chromosomal cassette mec element. Among the 154 subjects, 52 (33.8%) were intermittent (1 to 6 positive swabs) carriers. Persistent carriage was identified in 23 (14.9%) subjects, and the incidence was not significantly different for MRSA and MSSA carriers (3/12 [25%] versus 20/63 [31.7%]; P = 0.7449). The MRSA and MSSA isolates were composed of 33 and 215 strain pairs, respectively. Of them, an indistinguishable genotype was identified in 33 (100%) MRSA pairs and 173 (80.5%) MSSA pairs (P = 0.0053). Five subjects developed cellulitis, and the incidence of this was higher for MRSA carriers (2/12 [16.7%]) than for MSSA carriers (1/63 [1.58%]; P = 0.0632) and noncarriers (2/79 [2.56%]; P = 0.0828). In conclusion, the long-term carriage patterns for MRSA and MSSA in healthy individuals were similar. MRSA carriers were more likely to carry a single strain, with a trend toward a higher chance of developing cellulitis than for MSSA carriers. PMID:23678067

  13. Elaboration du Ge mesoporeux et etude de ses proprietes physico-chimiques en vue d'applications photovoltaiques

    NASA Astrophysics Data System (ADS)

    Tutashkonko, Sergii

    Le sujet de cette these porte sur l'elaboration du nouveau nanomateriau par la gravure electrochimique bipolaire (BEE) --- le Ge mesoporeux et sur l'analyse de ses proprietes physico-chimiques en vue de son utilisation dans des applications photovoltaiques. La formation du Ge mesoporeux par gravure electrochimique a ete precedemment rapportee dans la litterature. Cependant, le verrou technologique important des procedes de fabrication existants consistait a obtenir des couches epaisses (superieure a 500 nm) du Ge mesoporeux a la morphologie parfaitement controlee. En effet, la caracterisation physico-chimique des couches minces est beaucoup plus compliquee et le nombre de leurs applications possibles est fortement limite. Nous avons developpe un modele electrochimique qui decrit les mecanismes principaux de formation des pores ce qui nous a permis de realiser des structures epaisses du Ge mesoporeux (jusqu'au 10 mum) ayant la porosite ajustable dans une large gamme de 15% a 60%. En plus, la formation des nanostructures poreuses aux morphologies variables et bien controlees est desormais devenue possible. Enfin, la maitrise de tous ces parametres a ouvert la voie extremement prometteuse vers la realisation des structures poreuses a multi-couches a base de Ge pour des nombreuses applications innovantes et multidisciplinaires grace a la flexibilite technologique actuelle atteinte. En particulier, dans le cadre de cette these, les couches du Ge mesoporeux ont ete optimisees dans le but de realiser le procede de transfert de couches minces d'une cellule solaire a triple jonctions via une couche sacrificielle en Ge poreux. Mots-cles : Germanium meso-poreux, Gravure electrochimique bipolaire, Electrochimie des semi-conducteurs, Report des couches minces, Cellule photovoltaique

  14. The Effect of Statins Use on the Risk and Outcome of Acute Bacterial Infections in Adult Patients

    PubMed Central

    Ghorbani, Raheb; Afshar, Reza Kiaee

    2015-01-01

    Background Beyond their lipid-lowering abilities, statins have anti-inflammatory and immunomodulatory properties. In view of these effects, a growing interest has emerged in the possible role of statins, in preventing or decreasing morbidity and mortality from infection. Objectives The aim of this study was to determine whether previous statin use is associated with reduced risk of acute bacterial infections and better outcome of these infections. Materials and Methods In this historical cohort study, consecutive adult patients admitted with acute bacterial infection were enrolled. Control group were selected from adult outpatient and without history of acute bacterial infections. Acute bacterial infections included in this study were; pneumonia, acute pyelonephritis, cellulitis and sepsis with unknown origin. Data about baseline characteristics, co-morbidities and statins use of two groups was obtained. Results Finally 144 patients met inclusion criteria and were enrolled. Same numbers of controls were selected. Two groups were matched based on most baseline characteristics and co-morbidities. The patients’ categories were as follows: pneumonia 42.3%, acute pyelonephritis 23.6%, cellulitis 16% and sepsis 18%. From all participants 29.9% of patients and 45.8% controls were statin users. There was significant association between previous statin use and reduced risk of acute bacterial infections (Mantel Haenszel Weighted Odds Ratio=0.51, 95% CI: 0.30-0.85, p=0.009). Duration of hospitalization was significantly shorter in statin users (p=0.002). Hospital mortality rate was lower (14.6%) in statins users when compared with non-users (18.8%) with significant difference (p=0.028). Conclusion Prior therapy with statins is associated with considerably reduced onset of acute bacterial infections and better outcome in adult patients. PMID:26676277

  15. Bacterial skin infections in the elderly: diagnosis and treatment.

    PubMed

    Laube, Simone; Farrell, Anne M

    2002-01-01

    Skin and soft tissue infections are quite common in elderly people. A number of special conditions and circumstances need to be considered in the diagnosis and therapy. It is important to try to establish the causative organism, exclude other cutaneous disorders and identify precipitating factors. Treatment modalities include antiseptics, topical and systemic antibacterials, dressings and biotherapy. Skin infections presenting with erythema, blisters, pustules, and ulcerations or in body folds are described in detail. Cellulitis and infected ulcers are the most commonly encountered cutaneous infections in the elderly. Accurate and quick diagnosis and treatment are imperative to prevent significant morbidity and mortality. Appropriate antibacterials, antiseptics and dressings are necessary depending on the severity of the clinical presentation and resistance patterns. Laboratory tests, such as skin swabs, to establish the exact pathogen take time and the results might represent colonisation rather than infection of the skin. Cellulitis should be clinically distinguished from erysipelas and necrotising fasciitis. The latter is a life-threatening condition, which in the majority of cases requires surgical debridement of the infected tissue. Blisters and honey-coloured crusts are typical features of impetigo. It is very contagious and close contacts should be examined. Folliculitis is a commonly seen skin infection, which often responds to the use of antiseptics and topical antibacterials. More severe pustular skin eruptions, such as furunculosis and carbunculosis, usually require treatment with systemic antibacterials. Intertrigo and erythrasma have a predilection for the body folds, especially the axillae and groin, and topical therapy is usually sufficient. Secondary skin infections are often the result of persistent pruritus associated with increasing dryness of the aging skin. Emollients and antihistamines are useful measures. Primary cutaneous disorders and

  16. Dermatology for the practicing allergist: Tinea pedis and its complications

    PubMed Central

    Al Hasan, Muhannad; Fitzgerald, S Matthew; Saoudian, Mahnaz; Krishnaswamy, Guha

    2004-01-01

    Tinea pedis is a chronic fungal infection of the feet, very often observed in patients who are immuno-suppressed or have diabetes mellitus. The practicing allergist may be called upon to treat this disease for various reasons. Sometimes tinea infection may be mistaken for atopic dermatitis or allergic eczema. In other patients, tinea pedis may complicate allergy and asthma and may contribute to refractory atopic disease. Patients with recurrent cellulitis may be referred to the allergist/immunologist for an immune evaluation and discovered to have tinea pedis as a predisposing factor. From a molecular standpoint, superficial fungal infections may induce a type2 T helper cell response (Th2) that can aggravate atopy. Th2 cytokines may induce eosinophil recruitment and immunoglobulin E (IgE) class switching by B cells, thereby leading to exacerbation of atopic conditions. Three groups of fungal pathogens, referred to as dermatophytes, have been shown to cause tinea pedis: Trychophyton sp, Epidermophyton sp, and Microsporum sp. The disease manifests as a pruritic, erythematous, scaly eruption on the foot and depending on its location, three variants have been described: interdigital type, moccasin type, and vesiculobullous type. Tinea pedis may be associated with recurrent cellulitis, as the fungal pathogens provide a portal for bacterial invasion of subcutaneous tissues. In some cases of refractory asthma, treatment of the associated tinea pedis infection may induce remission in airway disease. Very often, protracted topical and/or oral antifungal agents are required to treat this often frustrating and morbid disease. An evaluation for underlying immuno-suppression or diabetes may be indicated in patients with refractory disease. PMID:15050029

  17. Modelisation par elements finis du muscle strie

    NASA Astrophysics Data System (ADS)

    Leonard, Mathieu

    Ce present projet de recherche a permis. de creer un modele par elements finis du muscle strie humain dans le but d'etudier les mecanismes engendrant les lesions musculaires traumatiques. Ce modele constitue une plate-forme numerique capable de discerner l'influence des proprietes mecaniques des fascias et de la cellule musculaire sur le comportement dynamique du muscle lors d'une contraction excentrique, notamment le module de Young et le module de cisaillement de la couche de tissu conjonctif, l'orientation des fibres de collagene de cette membrane et le coefficient de poisson du muscle. La caracterisation experimentale in vitro de ces parametres pour des vitesses de deformation elevees a partir de muscles stries humains actifs est essentielle pour l'etude de lesions musculaires traumatiques. Le modele numerique developpe est capable de modeliser la contraction musculaire comme une transition de phase de la cellule musculaire par un changement de raideur et de volume a l'aide des lois de comportement de materiau predefinies dans le logiciel LS-DYNA (v971, Livermore Software Technology Corporation, Livermore, CA, USA). Le present projet de recherche introduit donc un phenomene physiologique qui pourrait expliquer des blessures musculaires courantes (crampes, courbatures, claquages, etc.), mais aussi des maladies ou desordres touchant le tissu conjonctif comme les collagenoses et la dystrophie musculaire. La predominance de blessures musculaires lors de contractions excentriques est egalement exposee. Le modele developpe dans ce projet de recherche met ainsi a l'avant-scene le concept de transition de phase ouvrant la porte au developpement de nouvelles technologies pour l'activation musculaire chez les personnes atteintes de paraplegie ou de muscles artificiels compacts pour l'elaboration de protheses ou d'exosquelettes. Mots-cles Muscle strie, lesion musculaire, fascia, contraction excentrique, modele par elements finis, transition de phase

  18. Postoperative Expansion is not a Primary Cause of Infection in Immediate Breast Reconstruction with Tissue Expanders.

    PubMed

    Avraham, Tomer; Weichman, Katie E; Wilson, Stelios; Weinstein, Andrew; Haddock, Nicholas T; Szpalski, Caroline; Choi, Mihye; Karp, Nolan S

    2015-01-01

    Perioperative infection is the most common and dreaded complication associated with tissue expander (TE) breast reconstruction. Historically, the expansion period was thought to be the time of greatest hazard to the implant. However, recent institutional observations suggest infectious complications occur prior to expansion. This investigation, therefore, was conducted to determine the timing of infectious complications associated with two-stage TE breast reconstructions. Following IRB approval, a retrospective review of all consecutive two-stage immediate TE breast reconstructions at a single institution from November 2007 to November 2011 was conducted. Reconstructions were then divided into two cohorts: those suffering infectious complications and those that did not. Infectious complications including minor cellulitis, major cellulitis, abscess drainage, and explantation were identified. Various operative and patient variables were evaluated in comparison. Eight hundred ninety immediate two-stage TE breast reconstructions met inclusion criteria. Patients suffering infection were older (55.4 years versus 49.3 years; p < 0.001), and more likely to have therapeutic mastectomy (94% versus 61%; p < 0.0001), the use of acellular dermal matrix (ADM; 72.5% versus 54.9%; p = 0.001), and greater initial TE fill (448.6 mL versus 404.7 mL; p = 0.0078). The average time to developing of infectious symptoms was 29.6 days (range 9-142 days), with 94.6% (n = 87) of infections prior to the start of expansion. Perioperative infections in immediate two-stage TE to implant breast reconstructions are significant and occur mostly prior to the start of expansion. Thus, challenging the conventional wisdom that instrumentation during expander filling as the primary cause of implant infections. Possible etiologic factors include greater age, therapeutic mastectomy versus prophylactic mastectomy, larger initial TE fill, and the use of ADM. PMID:26132336

  19. Surgical management of maxillary and premaxillary osteomyelitis in a reticulated python (Python reticulatus).

    PubMed

    Latney, La'Toya V; McDermott, Colin; Scott, Gregory; Soltero-Rivera, Maria M; Beguesse, Kyla; Sánchez, Melissa D; Lewis, John R

    2016-05-01

    CASE DESCRIPTION A 1-year-old reticulated python (Python reticulatus) was evaluated because of a 2-week history of wheezing and hissing. CLINICAL FINDINGS Rostral facial cellulitis and deep gingival pockets associated with missing rostral maxillary teeth were evident. Tissues of the nares were swollen, resulting in an audible wheeze during respiration. Multiple scars and superficial facial wounds attributed to biting by live prey were apparent. Radiographic examination revealed bilateral, focal, rostral maxillary osteomyelitis. TREATMENT AND OUTCOME Wound irrigation, antimicrobials, and anti-inflammatory drug treatment resulted in reduced cellulitis. A 3-week regimen that included empirical antimicrobial treatment and improved husbandry resulted in resolution of the respiratory sounds and partial healing of bite wounds, but radiographic evaluation revealed progressive maxillary osteomyelitis. Microbial culture of blood yielded scant gram-positive cocci and Bacillus spp, which were suspected sample contaminants. Bilateral partial maxillectomies were performed; microbial culture and histologic examination of resected bone confirmed osteomyelitis with gram-positive cocci. Treatment with trimethoprim-sulfamethoxazole was initiated on the basis of microbial susceptibility tests. Four months later, follow-up radiography revealed premaxillary osteomyelitis; surgery was declined, and treatment with trimethoprim-sulfamethoxazole was reinstituted. Eight months after surgery, the patient was reevaluated because of recurrent clinical signs; premaxillectomy was performed, and treatment with trimethoprim-sulfamethoxazole was prescribed on the basis of microbial culture of bone and microbial susceptibility testing. Resolution of osteomyelitis was confirmed by CT 11 months after the initial surgery. CONCLUSIONS AND CLINICAL RELEVANCE Focal maxillectomies and premaxillectomy were successfully performed in a large python. Surgical management and appropriate antimicrobial treatment

  20. Wound infections on board ship--prevention, pathogens, and treatment.

    PubMed

    Dahl, Eilif

    2011-01-01

    Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5-10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2-3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea. PMID:22258845

  1. Optimizing antimicrobial therapy in children.

    PubMed

    Long, Sarah S

    2016-07-01

    Management of common infections and optimal use of antimicrobial agents are presented, highlighting new evidence from the medical literature that enlightens practice. Primary therapy of staphylococcal skin abscesses is drainage. Patients who have a large abscess (>5 cm), cellulitis or mixed abscess-cellulitis likely would benefit from additional antibiotic therapy. When choosing an antibiotic for outpatient management, the patient, pathogen and in vitro drug susceptibility as well as tolerability, bioavailability and safety characteristics of antibiotics should be considered. Management of recurrent staphylococcal skin and soft tissue infections is vexing. Focus is best placed on reducing density of the organism on the patient's skin and in the environment, and optimizing a healthy skin barrier. With attention to adherence and optimal dosing, acute uncomplicated osteomyelitis can be managed with early transition from parenteral to oral therapy and with a 3-4 week total course of therapy. Doxycycline should be prescribed when indicated for a child of any age. Its use is not associated with dental staining. Azithromycin should be prescribed for infants when indicated, whilst being alert to an associated ≥2-fold excess risk of pyloric stenosis with use under 6 weeks of age. Beyond the neonatal period, acyclovir is more safely dosed by body surface area (not to exceed 500 mg/m(2)/dose) than by weight. In addition to the concern of antimicrobial resistance, unnecessary use of antibiotics should be avoided because of potential later metabolic effects, thought to be due to perturbation of the host's microbiome. PMID:27263076

  2. Clinical, Trichoscopic, and Histopathological Features of Primary Cicatricial Alopecias: A Retrospective Observational Study at a Tertiary Care Centre of North East India

    PubMed Central

    Thakur, Binod Kumar; Verma, Shikha; Raphael, Vandana

    2015-01-01

    Background: The primary cicatricial alopecias (PCAs) are a rare group of diseases where hair follicle is the primary target of destruction. There are a few studies on histopathological and trichoscopic features of PCA. Aims: To study the clinical, trichoscopic, and histopathological characteristics of PCAs of the scalp and to find out the concordance between trichoscopic and histopathological diagnosis. Materials and Methods: We retrospectively analyzed the clinical, trichoscopic, and histopathological features of 24 PCA patients. Fisher's Chi-square exact test was done to find the significant trichoscopic and histopathological features. Cohen's kappa coefficient was used to determine the agreement between histopathological and trichoscopic diagnosis. Results: A total of 24 patients of PCA were seen with a male: female ratio of 2:1. There were 10 (41.7%) patients of discoid lupus erythematosus (DLE), 5 (20.8%) of lichen planopilaris (LPP), 3 (12.5%) of dissecting cellulitis of scalp, and 2 (8.3%) each of pseudopelade of brocq, folliculitis decalvans, and frontal fibrosing alopecia. The important histopathological findings of DLE were follicular plugging, vacuolar changes in the basal layer, necrotic keratinocytes, and superficial and deep perifollicular and perivascular lymphocytic infiltrate. Histopathology of LPP showed vacuolar changes in the basal layer and lichenoid infiltrate involving the infundibulum and isthmus. Trichoscopy of DLE showed follicular plugging, yellow dots, and thick arborizing blood vessels. The peripilar cast was important finding in LPP. The characteristic yellow dot with three-dimensional structure was noted in dissecting cellulitis of the scalp. The Cohen's kappa agreement was 0.89 between histopathological and trichoscopic diagnosis. Conclusion: The diagnosis of PCA is challenging because of overlapping features clinically and histopathologically. Trichoscopy may provide quick and reliable diagnosis and obviate the necessity of scalp

  3. Complicating osteomyelitis imaged with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate

    SciTech Connect

    Schauwecker, D.S.; Park, H.M.; Mock, B.H.; Burt, R.W.; Kernick, C.B.; Ruoff, A.C. III; Sinn, H.J.; Wellman, H.N.; Vamc, R.L.R.

    1984-01-01

    Gallium-67 and 3-phase bone scan (3P) studies, though very sensitive, are not very specific in evaluating suspected osteomyelitis (OM) which is superimposed upon other diseases that cause increased bone turnover (IBT). The authors compared In-111 acetylacetone labeled granulocytes (In-111) GRAN) with 3P in 57 such patients; 29 of these patients had Ga-67 studies as well. In-111 GRAN had a sensitivity of 100% in acute OM, 62% in chronic OM, and a specificity of 96%. Gallium-67 ruled out OM when the study was normal; it diagnosed OM when the relative uptake of Ga-67 exceeded the uptake of Tc-99m MDP, or when the skeletal distribution of Ga-67 was different from that of the TC-99m MDP. Unfortunately, these criteria were met in only 28% of the subjects. The simple approach of increased Ga-67 activity meant OM gave a sensitivity of 100%, but an unacceptable specificity of 38%. Chronic cellulitis or long-standing decubiti were seldom detected by IN-111 GRAN. Clinically obvious soft tissue infections or cellulitis were seen with In-111 GRAN 27% of the time, and 17% of the time with Ga-67. The authors conclude that when added to 3P, In-111 GRAN provided more useful information than did Ga-67. A combination of all 3 studies did not significantly increase the diagnostic yield. Performing In-111 GRAN without 3P in patients with IBT is not recommended since the 3P provides anatomic information that aids in the differentiation of OM from soft tissue infections.

  4. METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS OF THE EYE AND ORBIT (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    PubMed Central

    Blomquist, Preston Howard

    2006-01-01

    Purpose To ascertain if methicillin-resistant Staphyloccocus aureus (MRSA) ophthalmic infections are increasing. Methods A retrospective review of all patients with a culture positive for MRSA in the Parkland Health and Hospital System, the urban public healthcare system for Dallas County, Texas, for the years 2000 through 2004 was performed. Patients with ocular, orbital, and ocular adnexal infection were identified, and isolates were categorized as nosocomial or community-acquired (CA). Results A total of 3,640 patients with a culture positive for MRSA were identified, with 1,088 patients (30%) considered to have acquired the isolate via nosocomial transmission and 2,552 patients (70%) considered to have CA-MRSA. Forty-nine patients (1.3%) had ophthalmic MRSA involvement. For both ophthalmic and nonophthalmic cases, the number of CA-MRSA patients increased each year, whereas the numbers of nosocomial patients remained fairly constant. Patients with ophthalmic MRSA tended to be younger than other MRSA patients (P = .023). The most common manifestation of ophthalmic MRSA infection was preseptal cellulitis and/or lid abscess followed by conjunctivitis, but sight-threatening infections, including corneal ulcers, endophthalmitis, orbital cellulitis, and blebitis, also occurred. Empirical antibiotic coverage was initially prescribed in 48 (98%) of ophthalmic cases and did not adequately cover for the MRSA isolate in 24 (50%). Conclusions CA-MRSA is becoming increasingly prevalent, and ophthalmologists will see more ophthalmic MRSA infections. Although ophthalmic CA-MRSA commonly presents as preseptal lid infection and conjunctivitis, sight-threatening infections also occur. Ophthalmologists must identify MRSA patients, adjust empirical treatment regimens where MRSA is endemic, and take steps to control emergence of resistant organisms in both inpatient and outpatient practices. PMID:17471350

  5. Les biofilms bactériens : leur importance en santé animale et en santé publique

    PubMed Central

    Tremblay, Yannick D.N.; Hathroubi, Skander; Jacques, Mario

    2014-01-01

    Résumé Les biofilms bactériens sont des amas structurés de cellules bactériennes enrobés d’une matrice polymérique et attachés à une surface. Le biofilm protège les bactéries et leur permet de survivre dans des conditions environnementales hostiles. Les bactéries du biofilm peuvent résister à la réponse immunitaire de l’hôte et sont beaucoup plus résistantes aux antibiotiques et aux désinfectants que les cellules bactériennes planctoniques. La capacité de former un biofilm est maintenant reconnue comme une caractéristique propre à plusieurs microorganismes. La présence de biofilms lors d’infections demande donc de nouvelles méthodes de prévention, de diagnostic et de traitement. De même, la présence de biofilms sur des surfaces retrouvées à la ferme, à l’abattoir ou à l’usine de transformation affectera l’efficacité du protocole de désinfection. De façon surprenante, la formation de biofilms chez les bactéries pathogènes des animaux et les bactéries zoonotiques est un sujet relativement peu étudié. Ce bref compte rendu a pour objectif de sensibiliser les intervenants en santé animale à l’importance des biofilms. PMID:24688172

  6. Eosinophilic Skin Diseases: A Comprehensive Review.

    PubMed

    Long, Hai; Zhang, Guiying; Wang, Ling; Lu, Qianjin

    2016-04-01

    Eosinophilic skin diseases, commonly termed as eosinophilic dermatoses, refer to a broad spectrum of skin diseases characterized by eosinophil infiltration and/or degranulation in skin lesions, with or without blood eosinophilia. The majority of eosinophilic dermatoses lie in the allergy-related group, including allergic drug eruption, urticaria, allergic contact dermatitis, atopic dermatitis, and eczema. Parasitic infestations, arthropod bites, and autoimmune blistering skin diseases such as bullous pemphigoid, are also common. Besides these, there are several rare types of eosinophilic dermatoses with unknown origin, in which eosinophil infiltration is a central component and affects specific tissue layers or adnexal structures of the skin, such as the dermis, subcutaneous fat, fascia, follicles, and cutaneous vessels. Some typical examples are eosinophilic cellulitis, granuloma faciale, eosinophilic pustular folliculitis, recurrent cutaneous eosinophilic vasculitis, and eosinophilic fasciitis. Although tissue eosinophilia is a common feature shared by these disorders, their clinical and pathological properties differ dramatically. Among these rare entities, eosinophilic pustular folliculitis may be associated with human immunodeficiency virus (HIV) infection or malignancies, and some other diseases, like eosinophilic fasciitis and eosinophilic cellulitis, may be associated with an underlying hematological disorder, while others are considered idiopathic. However, for most of these rare eosinophilic dermatoses, the causes and the pathogenic mechanisms remain largely unknown, and systemic, high-quality clinical investigations are needed for advances in better strategies for clinical diagnosis and treatment. Here, we present a comprehensive review on the etiology, pathogenesis, clinical features, and management of these rare entities, with an emphasis on recent advances and current consensus. PMID:25876839

  7. Limb-threatening and life-threatening diabetic extremities: clinical patterns and outcomes in 56 patients.

    PubMed

    Bahebeck, Jean; Sobgui, Eugene; Loic, Fonkoue; Fonfoe, Loic; Nonga, Bernadette Ngo; Mbanya, Jean Claude; Sosso, Maurice

    2010-01-01

    Limb- and life-threatening hand and foot infections in diabetic patients account for a large proportion of amputations and a substantial number of deaths. Between August 2006 and the end of July 2008, we conducted a prospective cohort study of consecutive diabetic patients with serious hand or foot infections, in an effort to identify clinical patterns and outcomes related to the treatment of these infections. Infections were categorized as dry, gas, and wet gangrene; necrotizing fasciitis or cellulitis; acute extensive osteomyelitis; and any of these infections involving the hand. All of the patients underwent a standard examination and treatment protocol, although none of the patients received vascular surgical care. End points included healing following debridement or minor amputation, major (transtibial or more proximal) amputation, or death. A total of 56 patients were included in the final analyses, and their mean age was 70 (range 51 to 86) years. Of the patients, 17 (30.36%) had necrotizing cellulitis, 12 (21.43%) had wet gangrene, 9 (16.07%) had acute extensive osteomyelitis, 5 (8.93%) had dry gangrene, 5 (8.93%) had gas gangrene, 4 (7.14%) had necrotizing fasciitis, and 4 (7.14) had diffuse hand infections. Five (8.93%) patients died (2 after prior amputation), 26 (46.43%) underwent debridement and/or minor amputation, and 27 (48.21%) required major amputations. Based on our findings, we concluded that 7 patterns of serious limb- or life-threatening infection were identified and, in the absence of vascular surgical intervention, mortality can be reduced at the expense of more amputations. PMID:20123286

  8. Complete lymph flow reconstruction: A free vascularized lymph node true perforator flap transfer with efferent lymphaticolymphatic anastomosis.

    PubMed

    Yamamoto, Takumi; Yoshimatsu, Hidehiko; Yamamoto, Nana

    2016-09-01

    Treatment of primary lower extremity lymphedema (LEL) is challenging, and lymph node transfer (LNT) can be a choice of treatment for progressive LEL. However, LNT has a risk of donor site lymphedema and possible lymph node (LN) sclerosis due to efferent lymphatic vessel (ELV) obstruction. Here, we report the first case of complete lymph flow reconstruction with true perforator LNT with efferent lymphaticolymphatic anastomosis (ELLA) for a patient with primary LEL and severe lymphosclerosis. A 49-year-old female suffered from primary progressive unilateral left LEL refractory to conservative treatments with frequent episodes of cellulitis. A true perforator LN flap was selectively harvested from the left lateral thoracic region under indocyanine green (ICG) lymphography navigation and transferred to the left groin with perforator-to-perforator anastomosis. The ELV of the transplanted LN was supermicrosurgically anastomosed to the contralateral iliac lymphatic vessel that was subcutaneously transferred to the left groin. Postoperatively, the patient experienced no episode of cellulitis with reduced degree of compression treatment, and lymphedematous volume decreased from 306 to 264 in terms of LEL index. Postoperative ICG lymphography showed evidence of reconstructed lymph flow from the left foot to the left groin and to the right inguinal LN through the transplanted LN flap and the ELLA. There were no subjective or objective findings of donor site lymphedema of the left arm or the right back and the lower extremity. True perforator LN flap with ELLA is a safe and effective treatment and has the potential to be a useful therapeutic option for primary unilateral LEL. PMID:27449876

  9. Utilisation de l'essai comete et du biomarqueur gamma-H2AX pour detecter les dommages induits a l'ADN cellulaire par le 5-bromodeoxyuridine post-irradiation

    NASA Astrophysics Data System (ADS)

    La Madeleine, Carole

    Ce memoire est presente a la Faculte de medecine et des sciences de la sante de l'Universite de Sherbrooke en vue de l'obtention du grade de maitre es sciences (M.Sc.) en radiobiologie (2009). Un jury a revise les informations contenues dans ce memoire. Il etait compose de professeurs de la Faculte de medecine et des sciences de la sante soit : Darel Hunting PhD, directeur de recherche (departement de medecine nucleaire et radiobiologie), Leon Sanche PhD, directeur de recherche (departement de medecine nucleaire et radiobiologie), Richard Wagner PhD, membre du programme (departement de medecine nucleaire et radiobiologie) et Guylain Boissonneault PhD, membre exterieur au programme (departement de biochimie). Le 5-bromodeoxyuridine (BrdU), un analogue halogene de la thymidine reconnu depuis les annees 60 comme etant un excellent radiosensibilisateur. L'hypothese la plus repandue au sujet de l'effet radio sensibilisant du BrdU est qu'il augmente le nombre de cassures simple et double brin lorsqu'il est incorpore dans l'ADN de la cellule et expose aux radiations ionisantes. Toutefois, de nouvelles recherches semblent remettre en question les observations precedentes. Ces dernieres etudes ont confirme que le BrdU est un bon radiosensibilisateur, car il augmente les dommages radio-induits dans l'ADN. Mais, c'est en etant incorpore dans une region simple brin que le BrdU radiosensibilise l'ADN. Ces recherches ont egalement revele pour la premiere fois un nouveau type de dommages produits lors de l'irradiation de l'ADN contenant du BrdU : les dimeres interbrins. Le but de ces travaux de recherche est de determiner si la presence de bromodeoxyuridine dans l'ADN augmente l'induction de bris simple et / ou double brin chez les cellules irradiees en utilisant de nouvelles techniques plus sensibles et specifiques que celles utilisees auparavant. Pour ce faire, les essais cometes et la detection des foci H2AX phosphorylee pourraient permettre d'etablir les effets engendres par

  10. Étude des anomalies chromosomiques après radiothérapie chez des patients traités pour lymphome malin non-Hodgkinien

    NASA Astrophysics Data System (ADS)

    Mahe, M. A.; André, M. J.; Moyon, E.; Le Mevel, A.; Soubeyran, P.; Hamidou, M.; Milpied, N.; Bourdin, S.; Cuillière, J. C.; Chatal, J. F.

    1998-04-01

    Structural chromosome defects were evaluated in the lymphocytes of 30 patients (pts) who had undergone radiotherapy for non Hodgkin's lymphoma (NHL). Twelve had received 20 Grays (Gy) over the abdomen (group I), 12 whole body irradiation at 1.5 Gy (group II) and 6 whole body irradiation at 15 Gy (group III). A cohort of 468 unirradiated pts served as controls. For the irradiated group, 7% of cells had aberrations compared to 0.4% in controls {P <10-6}. The frequency of abnormal cells was statistically higher in group I (12%) than in group II (3.5%) and III (2.5%) . In group I, frequency of aberrations was statistically higher in pts who had additionnal extra-abdominal involved field irradiation, those with evolutive NHL and those receiving chemotherapy at the time of the cytogenetic analysis. Les aberrations chromosomiques ont ,été, mesurées sur les lymphocytes de 30 patients (pts) irradiés pour lymphome malin non-hodgkinien (LNH) selon 3 modalités : 20 Grays (Gy) sur l'abdomen (groupe I : 12 pts), Irradiation corporelle totale 1,5 Gy (groupe II : 12 pts), ou 15 Gy (groupe III : 6 pts). Une population non irradiée de 468 pts a servi de témoin. Dans le groupe irradié, 7 % des cellules présentaient des anomalies contre 0,4 % dans le groupe témoin {P <10-6}. Les aberrations ,étaient statistiquement plus nombreuses dans le groupe I (12 % des cellules) que dans les groupes II (3,5 %) et III (2,5 %). Dans le groupe I, les anomalies , étaient statistiquement plus fréquentes chez les pts ayant eu une irradiation localisée extra-abdominale en complément de celle de l'abdomen ainsi que chez ceux en rechute de leur LNH et ceux recevant une chimiothérapie lors de l',étude cytogénétique.

  11. Defining parasite biodiversity at high latitudes of North America: new host and geographic records for Onchocerca cervipedis (Nematoda: Onchocercidae) in moose and caribou

    PubMed Central

    2012-01-01

    Background Onchocerca cervipedis is a filarioid nematode of cervids reported from Central America to boreal regions of North America. It is found primarily in subcutaneous tissues of the legs, and is more commonly known as ‘legworm’. Blackflies are intermediate hosts and transmit larvae to ungulates when they blood-feed. In this article we report the first records of O. cervipedis from high latitudes of North America and its occurrence in previously unrecognized host subspecies including the Yukon-Alaska moose (Alces americanus gigas) and the Grant’s caribou (Rangifer tarandus granti). Methods We examined the subcutaneous connective tissues of the metacarpi and/or metatarsi of 34 moose and one caribou for parasitic lesions. Samples were collected from animals killed by subsistence hunters or animals found dead in the Northwest Territories (NT), Canada and Alaska (AK), USA from 2005 to 2012. Genomic DNA lysate was prepared from nematode fragments collected from two moose. The nd5 region of the mitochondrial DNA was amplified by PCR and sequenced. Results Subcutaneous nodules were found in 12 moose from the NT and AK, and one caribou from AK. Nematodes dissected from the lesions were identified as Onchocerca cervipedis based on morphology of female and male specimens. Histopathological findings in moose included cavitating lesions with multifocal granulomatous cellulitis containing intralesional microfilariae and adults, often necrotic and partially mineralized. Lesions in the caribou included periosteitis with chronic cellulitis, eosinophilic and lymphoplasmacytic infiltrate, and abundant granulation associated with intralesional adult nematodes and larvae. Sequences of the nd5 region (471bp), the first generated for this species, were deposited with Genbank (JN580791 and JN580792). Representative voucher specimens were deposited in the archives of the United States National Parasite Collection. Conclusions The geographic range of O. cervipedis is broader than

  12. Tumeur brune du maxillaire révélatrice d'hyperparathyroidie primaire: à propos d'un cas et revue de la littérature

    PubMed Central

    Malika, Fassih; Taali, Loubna; Akssim, Mohamed; Reda, Abada; Rouadi, Sami; Mahtar, Mohamed; Roubal, Mohamed; Essaadi, Mustapha; Kadiri, Mohamed Fatmi El

    2013-01-01

    Les tumeurs brunes sont des lésions ostéolytiques rarement révélatrices des hyperparathyroïdies. Elles surviennent habituellement au stade terminal de l'hyperparathyroïdie primaire ou secondaire. Durant les 3 dernières décennies, le diagnostic des hyperparathyroïdies est le plus souvent fait à la phase asymptomatique grâce aux dosages systématiques du calcium et l'avènement des nouvelles techniques, de dosage de la parathormone. Nous rapportons l'observation d'une patiente avec hyperparathyroïdie primaire révélée par une tumeur du maxillaire, dont la TDM avait mis en évidence un processus ostéolytique agressif. L'intervention chirurgicale a consisté en une maxillectomie droite avec reconstruction. Le résultat anatomo-pathologique a conclu en une tumeur à cellule géantes bénigne du maxillaire. Le diagnostic de tumeur brune a été évoqué et confirmé après la réalisation d'un bilan phosphocalcique qui a mis en évidence une hypercalcémie, avec une hypophosphorémie. La recherche étiologique a objectivé à la TDM cervicale un processus en situation rétro et infra thyroïdienne droite en faveur d'un adénome parathyroïdien. Le dosage de la parathormone: 322 pmol/L a confirmé le diagnostic. Nous rappelons à travers cette observation la difficulté d’établir un diagnostic correct chez les patients avec un processus ostéolytique du maxillaire et la nécessité de rechercher une hyperparathyroïdie devant une lésion à cellules géantes vue le caractère insidieux de cette endocrinopathie. PMID:23503933

  13. An atlas of the morphological manifestations of hidradenitis suppurativa.

    PubMed

    Scheinfeld, Noah

    2014-01-01

    This article is dermatological atlas of the morphologic presentations of Hidradenitis Suppurativa (HS). It includes: superficial abscesses (boils, furnucles, carbuncles), abscesses that are subcutaneous and suprafascial, pyogenic granulomas, cysts, painful erythematous papules and plaques, folliculitis, open ulcerations, chronic sinuses, fistulas, sinus tracts, scrotal and genital lyphedema, dermal contractures, keloids (some that are still pitted with follicular ostia), scarring, skin tags, fibrosis, anal fissures, fistulas (i.e. circinate, linear, arcuate), scarring folliculitis of the buttocks (from mild to cigarette-like scarring), condyloma like lesions in intertrigous areas, fishmouth scars, acne inversa, honey-comb scarring, cribiform scarring, tombstone comedones, and morphia-like plaques. HS can co-exist with other follicular diseases such as pilonidal cysts, dissecting cellulitis, acne conglobata, pyoderma gangrenosum, and acanthosis nigricans. In sum, the variety of presentations of HS as shown by these images supports the supposition that HS is a reaction pattern.HS is a follicular based diseased and its manifestations involve a multitude of follicular pathologies [1,2]. It is also known as acne inversa (AI) because of one manifestation that involves the formation of open comedones on areas besides the face. It is as yet unclear why HS is so protean in its manifestations. HS severity is assessed using the Hurley Staging System (Table 1). It also remains unclear why hidradentitis may remain limited to Hurley Stage 1, evolve to the more confluent (Hurley Stage 2), or progress even further to the fully confluent (Hurley Stage 3).In addition, HS can be associated with other follicular based diseases such as pilonidal cysts (PCs) of the sacrum and buttocks, dissecting cellulitis (DC), and acne conglobata (AC), which usually involves the face, chest, When HS occurs with PCs, DC, and/or AC it is referred to as the follicular occlusion triad or tetrad [2]. HS

  14. Various clinical conditions can mimic Crimean-Congo hemorrhagic fever in pediatric patients in endemic regions.

    PubMed

    Kara, Soner S; Kara, Duygu; Fettah, Ali

    2016-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease with high mortality. Many disorders can mimic CCHF. It is important to recognize the condition and to perform differential diagnosis in endemic countries. Twenty-one children aged 18 years or less with a preliminary diagnosis of CCHF were retrospectively evaluated. Real-time PCR and a confirmatory indirect immunofluorescence assay for negative results were performed. The diagnoses determined that 9 patients had (42.9%) CCHF; 7 patients had (33.3%) viral upper respiratory tract infections (URTI); 2 patients had (9.5%) brucellosis; 1 patients had (4.7%) periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome episode; 1 patient had (4.7%) cerebral palsy, diabetes insipidus, acute gastroenteritis, and hypernatremic dehydration; and 1 patient had (4.7%) cellulitis after a tick bite. The mean age of patients with CCHF was greater than that of the other patients (116.1±53.6 vs. 94.1±52.1 months, p=0.02). Seventeen (81%) of the children included had a history of tick bites, 2 (9.5%) had a history of contact with a patient with CCHF, and 2 (9.5%) had no exposure, but were living in an endemic region. Three patients had an underlying disorder: cerebral palsy and diabetes insipidus, epilepsy, or PFAPA. All of the children experienced fever. Other frequent symptoms were malaise, diarrhea, vomiting, and abdominal pain, but none of these differed statistically between the patient groups. CCHF patients had a longer mean duration of symptoms (10.56±1.42 vs. 6.75±3.62 days, p=0.008) and a longer mean length of hospitalization (8.00±2.08 vs. 3.58±1.56 days, p<0.001) than the other patients. At laboratory examination, patients with CCHF had statistically significant lower leukocyte and platelet counts, more prolonged coagulation parameters, and greater AST, ALT, LDH, and CK levels than the other patients. No mortality or complications occurred in the study. Both infectious causes, such as

  15. Effect of Allium cepa and Allium sativum on some immunological cells in rats.

    PubMed

    Mirabeau, Tatfeng Y; Samson, Enitan S

    2012-01-01

    Extracts of some spices have been reported to play a contributory role in enhancing immune function. We evaluated and compared the effect(s) of single and combined oral administration of fresh aqueous onion (Allium cepa) and garlic (Allium sativum) extracts at different concentrations on some immunological determinants in rats. CD₄ cells of the rats were estimated using Partec flow cytometric technique, while total and differential white blood cell (WBC) counts were estimated using the Sysmsex® automated haematology analyzing technique. Our findings revealed that, CD4 and total WBC counts were significantly increased (P≤0.05) in a dose-dependent manner in both onion (250mg/Kg/d: 349±11cell/ul and 2.75±0.15X10³cell/l; 500mg/Kg/d: 389±10cells/µl and 3.05±0.05 X10³cell/l; 750mg/Kg/d: 600±11cell/µl and 3.25±0.05X10³cells/l) and garlic (250mg/Kg/d: 410±10cell/ul and 2.85±0.15X10³cell/l; 500mg/Kg/d: 494±32cells/µl and 3.30±0.10 X10³cell/l; 750mg/Kg/d: 684±11cell/µl and 3.55±0.05X10³cells/l) treated rats when compared to the zero control (200±11cells/µl and 1.55±0.05X10³cells/l, respectively). Extract of garlic at 750mg/Kg/d had significantly increased the CD4 cells and total white cell count when compared to other concentrations (P≤0.05). However, no significant effect was observed on these parameters when extracts were combined (250mg/Kg/d: 252±21cell/µl and 1.80±0.10X10³cells/l; 500mg/Kg/d: 315±21cells/ul and 2.10±0.10X10³cells/l; 750mg/Kg/d: 368±10cells/µl and 2.35±0.05X10³cells/l, respectively), the differential WBC count showed a significant increase in the proportion of cell types (lymphocytes, neutophils and monocytes) (P≤0.05). The results from this study revealed the immune boosting capabilities of Allium cepa and Allium sativum, but underscored their synergistic activities. PMID:23983369

  16. Cost of a lymphedema treatment mandate-10 years of experience in the Commonwealth of Virginia.

    PubMed

    Weiss, Robert

    2016-12-01

    Treatment of chronic illness accounts for over 90 % of Medicare spending. Chronic lymphedema places over 3 million Americans at risk of recurrent cellulitis. Health insurers and legislators have taken an active role in fighting attempts to mandate the treatment of lymphedema for fear that provision of the physical therapy and compression materials would result in large and uncontrollable claim costs. The author knows of no open source of lymphedema treatment cost data based on population coverage or claims. Published studies compare cost of treatment versus cost of non-treatment for a select group of lymphedema patients. They do not provide the data necessary for insurance underwriters' estimations of expected claim costs for a larger general population with a range of severities, or for legislators' evaluations of the costs of proposed mandates to cover treatment of lymphedema according to current medical standards. These data are of interest to providers, advocates and legislators in Canada, Australia and England as well as the U.S.The Commonwealth of Virginia has had a lymphedema treatment mandate since 2004. Reported data for 2004-2013, representing 80 % of the Virginia healthcare insurance market, contains claims and utilization data and claims-based estimates of the premium impact of its lymphedema mandate. The average actual annual lymphedema claim cost was $1.59 per individual contract and $3.24 per group contract for the years reported, representing 0.053 and 0.089 % of average total claims. The estimated premium impact ranged 0.00-0.64 % of total average premium for all mandated coverage contracts. In this study actual costs are compared with pre-mandate state mandate commission estimates for proposed lymphedema mandates from Virginia, Massachusetts and California.Ten years of insurance experience with a lymphedema treatment mandate in Virginia shows that costs of lymphedema treatment are an insignificant part of insured healthcare costs, and that

  17. Stewart-Treves Syndrome: A Case Report and Review of the Literature.

    PubMed

    Berebichez-Fridman, Roberto; Deutsch, Yehuda E; Joyal, Thomas M; Olvera, Pablo Montero; Benedetto, Pasquale W; Rosenberg, Andrew E; Kett, Daniel H

    2016-01-01

    The Stewart-Treves syndrome is a rare and deadly entity, which is defined as angiosarcoma arising in the setting of chronic lymphedema. It typically presents in women who develop lymphedema in the upper extremity secondary to axillary lymph node dissection for breast cancer surgery. It is extremely uncommon in the lower extremities as a result of idiopathic chronic lymphedema. Here, we present the case of a 63-year-old female patient with idiopathic chronic lymphedema of the lower extremities having morbid obesity (BMI 82.6) and multiple comorbidities. She developed multiple confluent, hemorrhagic and necrotic elevated purple-black papules in the lower extremities, for which the initial diagnosis was cellulitis. Because there was no improvement with antibiotics, a lower extremity ultrasound and biopsy was performed which showed multiple masses in the left inner upper calf with solid and cystic components. The pathology results of the punch biopsies were consistent with angiosarcoma. Immunohistochemical studies revealed positivity for CD31, FLI-1, and a high Ki-67 proliferation rate. Because of the patient's weight and medical comorbidities, no further extensive diagnostic tests were performed to detect metastatic disease, and because of contraindications, no further medical treatment was provided. The patient subsequently died 1 month after diagnosis. PMID:27099606

  18. [Extensive swelling reaction after a pentavalent vaccination].

    PubMed

    Gébus, M; Barbier, C; Bost-Bru, C; Michard-Lenoir, A P; Plantaz, D

    2015-09-01

    Injection site reactions (ISRs) are quite common side effects defined by a local adverse drug reaction directly caused by a vaccine. Twenty-four hours after an intramuscular injection (in the deltoid muscle) of the diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis, Haemophilus influenza type b (DTPCa-Hib) combined vaccine, a 3-year-old boy developed fever. A few hours later, local redness and swelling appeared at the injection site, with rapid extension to the entire limb, it was pain-free, and no other clinical anomalies were present. The patient received intravenous antibiotics for suspected cellulitis. The progression was favorable in 12h (apyrexia and decreased limb swelling), allowing the intravenous antibiotic treatment to be discontinued. Since the child was in excellent general health and recovery was fast, an ISR was diagnosed. Extensive limb swelling is frequent, mostly after the fourth dose of DTPCa-Hib. Deltoid muscle injection of DTP vaccine increases the risk of ISR compared to injection in the thigh, before the age of 3 years. The introduction of acellular pertussis vaccine decreased the risk of general side effects but may increase the risk of ISR. These reactions disappear with symptomatic treatment and do not contraindicate the product. PMID:26239287

  19. Silicone-induced Granuloma After Buttock Augmentation

    PubMed Central

    Singh, Mansher; Solomon, Isaac H.; Calderwood, Michael S.

    2016-01-01

    Summary: Liquid silicone is inexpensive, minimally antigenic, and likely noncarcinogenic. Its simplicity of use has made it popular as a soft-tissue filler in some parts of the world for patients seeking rapid soft-tissue augmentation of the face, breast, and buttocks. However, multiple reports describe the complications of silicone injections such as cellulitis, abscess, ulceration, and foreign body migration. We present an unusual complication of granulomatous reaction secondary to silicone injection for buttock augmentation, with a literature review of this entity and treatment options. Our patient was a 54-year-old woman who underwent bilateral buttock augmentation in the Dominican Republic using percutaneous injection of liquid silicone. She presented to our facility 1 year after this procedure with pain and inflammation of both buttocks. She was diagnosed with multiple silicone granulomas. Her symptoms completely resolved with a 3-week course of minocycline. Granulomatous reactions to silicone may occur months to years after the silicone injection. The incidence of such complications may be increased when nonmedical-grade silicone is used, and hence, when these procedures are performed in developing countries. Tetracycline antibiotics, especially minocycline, may be used to achieve sustained remission. PMID:27014553

  20. Inflammasome Activation Can Mediate Tissue-Specific Pathogenesis or Protection in Staphylococcus aureus Infection.

    PubMed

    Melehani, Jason H; Duncan, Joseph A

    2016-01-01

    Staphylococcus aureus is a Gram-positive coccus that interacts with human hosts on a spectrum from quiet commensal to deadly pathogen. S. aureus is capable of infecting nearly every tissue in the body resulting in cellulitis, pneumonia, osteomyelitis, endocarditis, brain abscesses, bacteremia, and more. S. aureus has a wide range of factors that promote infection, and each site of infection triggers a different response in the human host. In particular, the different patterns of inflammasome activation mediate tissue-specific pathogenesis or protection in S. aureus infection. Although still a nascent field, understanding the unique host-pathogen interactions in each infection and the role of inflammasomes in mediating pathogenesis may lead to novel strategies for treating S. aureus infections. Reviews addressing S. aureus virulence and pathogenesis (Thammavongsa et al. 2015), as well as epidemiology and pathophysiology (Tong et al. 2015), have recently been published. This review will focus on S. aureus factors that activate inflammasomes and their impact on innate immune signaling and bacterial survival. PMID:27460814

  1. The burden of bone, native joint and soft tissue infections on orthopaedic emergency referrals in a city hospital.

    PubMed

    Howell, A; Parker, S; Tsitskaris, K; Oddy, M J

    2016-01-01

    Introduction Bone, native joint and soft tissue infections are frequently referred to orthopaedic units although their volume as a proportion of the total emergency workload has not been reported previously. Geographic and socioeconomic variation may influence their presentation. The aim of this study was to quantify the burden of such infections on the orthopaedic department in an inner city hospital, determine patient demographics and associated risk factors, and review our current utilisation of specialist services. Methods All cases involving bone, native joint and soft tissue infections admitted under or referred to the orthopaedic team throughout 2012 were reviewed retrospectively. Prosthetic joint infections were excluded. Results Almost 15% of emergency admissions and referrals were associated with bone, native joint or soft tissue infection or suspected infection. The cohort consisted of 169 patients with a mean age of 43 years (range: 1-91 years). The most common diagnosis was cellulitis/other soft tissue infection and the mean length of stay was 13 days. Two-thirds of patients (n=112, 66%) underwent an operation. Fifteen per cent of patients were carrying at least one blood borne virus, eleven per cent were alcohol dependent, fifteen per cent were using or had been using intravenous drugs and nine per cent were homeless or vulnerably housed. Conclusions This study has shown that a significant number of patients are admitted for orthopaedic care as a result of infection. These patients are relatively young, with multiple complex medical and social co-morbidities, and a long length of stay. PMID:26688397

  2. Soft tissue injury of the lower extremity complicated by type II necrotising fasciitis highlighting the need for astute clinical practices and proper treatment

    PubMed Central

    Sabre, Alexander; Robles, Carlos G; Krisar-White, Patricia; Farricielli, Laurie

    2014-01-01

    Necrotising fasciitis (NF) is a soft tissue bacterial-derived infection characterised clinically by fulminant tissue destruction of the poorly blood-supplied muscle fascia and overlying subcutaneous fat. Although these infections first appear as minor superficial manifestations, they are capricious in nature and often lead to sepsis, organ failure and high mortality. We report a case of type II necrotising fasciitis in a 39-year-old Caucasian female patient who presented to the emergency department with cellulitis of her right foot and lower leg that rapidly developed into tissue necrosis. The patient course is of unique interest due to progressive history over a 104 days time frame with complications following surgical treatments and outpatient follow-up. We highlight the importance of early detection and pertinent clinical awareness from a wide range of medical specialties that were involved in this case, and how this process is critical, in order to properly diagnose and treat NF-derived tissue infections. PMID:24973350

  3. Imaging of orbital disorders.

    PubMed

    Cunnane, Mary Beth; Curtin, Hugh David

    2016-01-01

    Diseases of the orbit can be categorized in many ways, but in this chapter we shall group them according to etiology. Inflammatory diseases of the orbits may be infectious or noninfectious. Of the infections, orbital cellulitis is the most common and typically arises as a complication of acute sinusitis. Of the noninfectious, inflammatory conditions, thyroid orbitopathy is the most common and results in enlargement of the extraocular muscles and proliferation of the orbital fat. Idiopathic orbital inflammatory syndrome is another cause of inflammation in the orbit, which may mimic thyroid orbitopathy or even neoplasm, but typically presents with pain. Masses in the orbit may be benign or malignant and the differential diagnosis primarily depends on the location of the mass lesion, and on the age of the patient. Lacrimal gland tumors may be lymphomas or epithelial lesions of salivary origin. Extraocular muscle tumors may represent lymphoma or metastases. Tumors of the intraconal fat are often benign, typically hemangiomas or schwannomas. Finally, globe tumors may be retinoblastomas (in children), or choroidal melanomas or metastases in adults. PMID:27432687

  4. Design and Development of a Telerehabilitation Self-Management Program for Persons with Chronic Lower Limb Swelling and Mobility Limitations: Preliminary Evidence

    PubMed Central

    Faett, Becky L.; Geyer, Mary Jo; Hoffman, Leslie A.; Brienza, David M.

    2012-01-01

    This paper describes design and development of a self-management program, delivered by telerehabilitation (TR), to address the problem of chronic lower limb swelling in persons with limited mobility. The 18.6 million persons with limited mobility in the USA are at increased risk for chronic lower limb swelling and related secondary complications, including cellulitis and skin ulcers. Over time, chronic swelling often progresses to lymphedema, an incurable condition requiring lifelong care. Without successful self-management, lymphedema and its related complications inevitably worsen. Access and adherence to appropriate treatment are challenging for persons with limited mobility. Program development involved a structured process to establish content validity (videos and manuals), readability, suitability, and selection of a TR platform to deliver the educational program. Our goal was to develop a program that would engage patients in self-management skills. The TR software platform chosen, Versatile and Integrated System for Telerehabilitation (VISYTER) was designed to facilitate face-to-face delivery of an interactive home-based self-management program via the internet in real time. Results demonstrated validity of the educational program and ease of use with TR. Future plans are to evaluate ability of this approach to promote self-management skills, home monitoring, and improved management of persons with lymphedema and limited mobility. PMID:23227323

  5. Enhanced pore filling of spiro-OMeTAD by enlarging the porosity of TiO2 films and its effects on the photovoltaic performance of ss-DSCs

    NASA Astrophysics Data System (ADS)

    Fang, Yanling; Wang, Qi; Huang, Jianguo; Wu, Tao

    2015-03-01

    Four kinds of TiO2 electrodes with different porosities were prepared by adding different ratios of ethyl cellulous into a Dyesol 18-NRT paste. Higher polymer ratios contributed to the higher porosity of TiO2 films. All electrodes were spin-coated with spiro-OMeTAD and fabricated into solid-state dye-sensitized solar cells (ss-DSCs). This simple method allowed more spiro-OMeTAD penetrated into the more porous TiO2 films. This result demonstrated the pore-filling effect of hole transport materials on the photovoltaic performance of ss-DSCs. Photoluminescence and electrical impedance spectra measurements were introduced to investigate the dye regeneration, charge transport, and recombination kinetics of the solar cells. The increased pore filling of spiro-OMeTAD could enhance hole injection, hole transport, and recombination retardation, thus providing good charge collection efficiency and long recombination lifetime and resulting in the high short-circuit current density, open-circuit voltage, fill factor, and energy conversion efficiency of the solar cells. An efficiency enhancement of 34 % was obtained by using this method. However, further increasing the TiO2 porosity decreased the electron transport, thus causing a low charge collection and reducing cell performance.

  6. Griffe cubitale d'origine lépreuse traitée par transfert tendineux de Lasso Zancolli: à propos d'un cas

    PubMed Central

    El Alaoui, Adil; Sbiyaa, Mouhcine; Bah, Aliou; Rabhi, Ilyas; mezzani, Amine; Marzouki, Amine; Boutayeb, Fawzi

    2015-01-01

    La lèpre est une maladie infectieuse due à une mycobactérie (M. Leprae, Bacille de Hansen, ou BH) dont le tropisme nerveux est destructeur pour les cellules de Schwann. La localisation préférentielle des neuropathies tronculaire secondaire à la lèpre restent dominé par les zones ou les troncs nerveux traversent les défilés ostéo-ligamentaires inextensibles comme le défilé rétro-épitrochléen ou passe le nerf ulnaire. De nombreux travaux ont été consacrés à la souffrance nerveuse secondaire à la lèpre et surtout l'atteinte du nerf ulnaire qui se manifeste par une griffe des doigts. Le traitement dans ce cas est palliatif et fait appel à plusieurs techniques décrites dans la littérature. Nous rapportons dans ce travail un cas de griffe cubitale chez un patient lépreux traité par transfert tendineux de Lasso Zancolli. PMID:26985277

  7. Surgical Removal of Neglected Soft Tissue Foreign Bodies by Needle-Guided Technique

    PubMed Central

    Ebrahimi, Ali; Radmanesh, Mohammad; Rabiei, Sohrab; kavoussi, Hossein

    2013-01-01

    Introduction: The phenomenon of neglected foreign bodies is a significant cause of morbidity in soft tissue injuries and may present to dermatologists as delayed wound healing, localized cellulitis and inflammation, abscess formation, or foreign body sensation. Localization and removal of neglected soft tissue foreign bodies (STFBs) is complex due to possible inflammation, indurations, granulated tissue, and fibrotic scar. This paper describes a simple method for the quick localization and (surgical) removal of neglected STFBs using two 23-gauge needles without ultrasonographic or fluoroscopic guidance. Materials and Methods: A technique based on the use of two 23-gauge needles was used in 41 neglected STFBs in order to achieve proper localization and fixation of foreign bodies during surgery. Results: Surgical removal was successful in 38 of 41 neglected STFBs (ranging from 2–13mm in diameter). Conclusion: The cross-needle-guided technique is an office-based procedure that allows the successful surgical removal of STFBs using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin. PMID:24303416

  8. Énergie photovoltaïque : matériaux utilisés et perspectives

    NASA Astrophysics Data System (ADS)

    Marfaing, Y.

    2002-04-01

    Les matériaux pour la conversion photovoltaïque sont des semi-conducteurs dont la largeur de bande interdite peut se situer dans l'intervalle 1 - 1,8 eV. Les principes physiques de l'effet photovoltaïque sont d'abord rappelés afin de mettre en évidence les relations nécessaires entre les caractéristiques optiques et électroniques du semi-conducteur et l'épaisseur de la structure de conversion ou cellule. Les matériaux actuellement utilisés ou étudiés sont ensuite passés en revue en commençant par le silicium cristallin massif puis en décrivant le vaste secteur des couches minces : silicium amorphe, composés polycristallins, silicium cristallisé en film mince. Les développements attendus dans chacune de ces filières sont présentés ainsi que les recherches en cours sur d'autres types de matériaux et de structures.

  9. Reliability and validity of an instrument to measure tissue hardness in breasts.

    PubMed

    Roberts, K L

    The author investigated the effectiveness of the Roberts Durometer, an instrument developed to measure human tissue hardness for a study on breast engorgement. The instrument is a small portable pressure gauge comprising a probe attached to a spring and contained in a tubular housing, connected to a dial gauge. The instrument was first trialed using foam rubber of differing hardness and football bladders of differing hardness. It was then used to measure the hardness of a non-pregnant, non-lactating human breast, followed by trials on postpartum women comparing breast tissue hardness on the day of birth with that of subsequent days. The instrument detected significant differences in hardness of foams, football bladders and human breast tissue. It was therefore considered suitable for measuring, in both research and clinical applications, hardness of breast tissue, which is a major physical feature of breast engorgement. Other clinical applications could include the hardness of abdominal and other skin tissues in conditions such as ascites, peritonitis and cellulitis. PMID:10196872

  10. A Simple Approach to Specimen Retrieval via Posterior Colpotomy Incision

    PubMed Central

    Menderes, Gulden; Tower, Amanda M.; Silasi, Dan-Arin; Azodi, Masoud

    2015-01-01

    Introduction: Posterior colpotomy incision for specimen retrieval is infrequently used in gynecologic laparoscopic surgery unless a concomitant hysterectomy is performed. We aim to describe a simple and unique technique for creating the colpotomy incision and to describe intraoperative and postoperative outcomes. Methods: Fifty patients underwent adnexal specimen retrieval through a posterior colpotomy incision. After devascularization and detachment of the adnexal specimen, the posterior cul-de-sac was visualized. The colpotomy incision was created by introducing a 12- or 15-mm laparoscopic trocar through the vagina into the posterior vaginal fornix under direct visualization. Specimens were placed into laparoscopic bags and removed through the vagina. The colpotomy incision was closed vaginally. Charts were reviewed for intraoperative and postoperative outcomes. Results: Twenty-nine women underwent adnexal surgery for an adnexal mass, 14 women underwent surgery for pelvic pain, and 7 women underwent adnexal surgery for primary prevention of malignancy. The specimens removed ranged in size from 2 to 16 cm (mean 5.7). The mean time patients were under anesthesia was 103 minutes (SD 57.3). There were no operative complications related to the colpotomy incision and no cases of postoperative vaginal cellulitis or pelvic infection were reported. Only 1 woman with a prior vaginal delivery reported dyspareunia postoperatively. Conclusion: This simple technique for posterior colpotomy incision can easily be added to the gynecologic surgeon's armamentarium and can be safely used for most women. PMID:25901107

  11. Comparison of VITEK2, MALDI-TOF MS, and 16S rDNA sequencing for identification of Myroides odoratus and Myroides odoratimimus.

    PubMed

    Schröttner, Percy; Rudolph, Wolfram W; Eing, Bodo R; Bertram, Sebastian; Gunzer, Florian

    2014-06-01

    The genus Myroides comprises the 2 medically relevant species Myroides odoratus and Myroides odoratimimus that are rare opportunistic pathogens and cause infections in immunocompromised patients. A fast identification of Myroides is of importance because these bacterial strains show multiple resistance against antibiotics and therefore limit treatment options. They are associated, for instance, with urinary tract infections, sepsis, meningitis, pneumonia, and infectious cellulitis. Since more and more Myroides spp. are being described, additional potentially pathogenic bacteria may be identified in the future demanding the need for fast and reliable identification methods at species level. However, to date, only molecular approaches meet these demands. In this study, we, therefore, attempt to define an appropriate method other than DNA fingerprinting that will permit a comparable efficacy and, possibly, a more economical strain identification. For this purpose, we compared 2 widely used automated diagnostic systems (VITEK 2 [bioMérieux, Nürtingen, Germany] and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) [Bruker Daltonics, Bremen, Germany]) and correlated the results to 16S rDNA sequencing data. In total, we analyzed 22 strains collected in the course of routine diagnostics. In this study, we demonstrate that VITEK 2 reliably identifies the genus Myroides but cannot differentiate between M. odoratimimus and M. odoratus. In contrast to this, both MALDI-TOF MS and 16S rDNA sequencing efficiently distinguish between the 2 species. PMID:24666701

  12. Techniques for early diagnosis and management of cervicofacial necrotising fasciitis

    PubMed Central

    Lee, Judy W; Immerman, Sara B; Morris, Luc GT

    2010-01-01

    Background Cervicofacial necrotising fasciitis carries high rates of morbidity and mortality, and is not often initially suspected due to its rarity and misleadingly innocuous presentation. We propose an algorithm for the timely diagnosis and management of cervicofacial necrotising fasciitis. Methods Retrospective review of seven patients ultimately diagnosed with cervicofacial necrotising fasciitis. Results In these seven patients, common presenting symptoms included sore throat, fever and neck pain. On initial examination and imaging, only three had obvious findings. One patient’s diagnosis was facilitated via a bedside cut-down procedure. Six patients underwent surgical debridement. Four required tracheotomy, and five wounds closed via secondary intention. There were two deaths. Conclusion The severity of cervical necrotising fasciitis and its rapid spread necessitate early diagnosis and timely surgical management. The presentation often appears benign. A high index of clinical suspicion should be maintained in cases of neck cellulitis with nonspecific clinical findings, especially in diabetic or otherwise immunocompromised patients. A normal computed tomography scan does not rule out necrotising fasciitis. A cut-down procedure may be critical to early diagnosis in some cases. PMID:20298644

  13. [Large-scale questionnaire surveillance concerning invasive infections with group C and G streptococci].

    PubMed

    Ubukata, Kimiko; Sunaoshi, Katsuhiko; Kobayashi, Reiko; Okuzumi, Katsuko

    2006-09-01

    A large-scale questionnaire surveillance was conducted regarding the onset of invasive infections with beta-hemolytic group C (GCS) and group G (GGS) streptococci from clinical specimens that are normally aseptic and the backgrounds of these cases. The surveillance period of the questionnaire was 8 months from January to August 2005. Completed questionnaires were received from the clinical laboratories of 193 medical institutions. One hundred two clinical laboratories (52.8%) had isolated these beta-hemolytic streptococci. Of all the isolates, GCS and GGS accounted for 25 and 216 cases, respectively, or a ratio of almost 1:10. Isolates from blood cultures accounted for half the number of all isolates, followed by isolates from atretic pus or joint fluid. The isolates gradually became more prevalent from patients in their 40s, and peaked in patients in their 70s. The most prevalent disorder, described in 184 cases, was suppurative disease followed by (in descending order), bacteremia, sepsis, arthritis purulenta and cellulitis. A small number of patients had developed with streptococcal toxic shock syndrome, empyema or meningitis. Most of the patients had an underlying disease, such as diabetes mellitus, malignancy or cerebrovascular disease (in descending order). We conclude from the above findings that background factors in patients as well as identification of the pathogen should be made public when GCS or GGS is isolated from normally aseptic clinical specimens. PMID:17073260

  14. Relapsing polychondritis with different types of ocular inflammations

    PubMed Central

    Furuya, Nana; Oshitari, Toshiyuki; Yotsukura, Jiro; Baba, Takayuki; Yamamoto, Shuichi

    2015-01-01

    We were presented with two cases of relapsing polychondritis (RP) associated with different types of ocular inflammation. The first case was a 35-year-old man who had bilateral hyperemic conjunctiva and ocular pain, and was referred to Chiba University Hospital with a diagnosis of episcleritis refractory. He was treated with dexamethasone eye drops. He developed tinnitus, deafness in both ears, and left auriculitis. A left auricular biopsy showed an infiltration of lymphocytes surrounding the cartilage. He was diagnosed with RP and treated with 30 mg/day oral prednisolone. After tapering the prednisolone, the scleritis in both eyes improved. The second case was a 71-year-old man who was deaf in both ears and had bilateral scleritis. At the first visit to our hospital, his left eyelid and right auricula were reddish and swollen, and he reported some pain. He was treated with intravenous antibiotics, and the left orbital cellulitis quickly improved. However, he developed right scleritis and left gonitis. Magnetic resonance imaging showed bilateral posterior scleritis and right auricular perichondritis. Auricular biopsy showed an infiltration of lymphocytes into the periauricular tissue. He was diagnosed with RP, and 40 mg/day oral prednisolone was given and his symptoms improved. Although RP is rare, it is a life-threatening disease. Thus, ophthalmologists should consider RP in patients with both ocular and auricular inflammation. PMID:26425107

  15. Successful medical treatment for globe penetration following tooth extraction in a dog.

    PubMed

    Guerreiro, Cleo E; Appelboam, Helen; Lowe, Robert C

    2014-03-01

    A five-year-old entire male Tibetan Terrier was referred for left-sided periorbital swelling and blepharospasm 4 days following ipsilateral maxillary tooth extraction. Examination of the left eye revealed mild exophthalmos, pain on retropulsion, and absent menace response and pupillary light reflexes. Examination of the posterior segment was not possible owing to the anterior segment pathology. Differential diagnoses considered were iatrogenic globe penetration and peribulbar abscess/cellulitis. Ocular ultrasound was consistent with a penetrating wound to the globe. Treatment with systemic prednisolone and marbofloxacin, and topical atropine sulfate 1%, prednisolone acetate, and brinzolamide was started. Marked clinical improvement allowed visual confirmation of the perforation. Oral prednisolone was tapered over the following 10 weeks. At final re-examination (10 months), the patient was visual, and fundic examination revealed an additional chorioretinal scar, most likely an exit wound that was obscured by vitreal debris on initial examinations. Neither scar was associated with retinal detachment. To the authors' knowledge, this is the first reported case of successful medical management of iatrogenic globe penetration following exodontic procedures. PMID:23869648

  16. [Molecular features of beta-hemolytic streptococci isolated from blood in adult invasive infection and the clinical background factors].

    PubMed

    Asami, Ryoko; Okada, Keisuke; Chiba, Naoko; Ubukata, Kimiko; Takahashi, Takashi

    2010-05-01

    We studied the relationship between features of beta-hemolytic streptococci (n = 45) isolated from blood in adult invasive infection and the clinical background factors observed from January 2001 through August at a hospital for the elderly. The meanage of subjects having invasive streptococcal infection with 22 invasive Streptococcus dysgalactiae subspecies equisimilis (SDSE) strains, 2 S. pyogenes isolates, and 21 S. agalactiae (GBS) was 80 years, and 85.7% and 86.4% had underly diseases in the GBS and SDSE infections. SDSE-infected were mainly emergency woman outpatients and GBS infected were mainly man inpatients. The clinical syndrome involved pneumonia, urosepsis, and cellulitis. GBS mortality was 14.3% and SDSE mortality 27.3%. Compared to survivors, nonsurvivors had more thrombocytopenia and marked serum C-reactive protein elevation when blood culture were performed. No difference was seen in white blood cell count between bath groups. Our observations suggest that blood culture should be obtained before antimicrobials administration in elderly individuals with underlying illness who are seen at the emergency department and have laboratory blood data suggestive of infectious disease. PMID:20560419

  17. Electrospinning of Nanodiamond-Modified Polysaccharide Nanofibers with Physico-Mechanical Properties Close to Natural Skins.

    PubMed

    Mahdavi, Mina; Mahmoudi, Nafiseh; Rezaie Anaran, Farzad; Simchi, Abdolreza

    2016-01-01

    Electrospinning of biopolymers has gained significant interest for the fabrication of fibrous mats for potential applications in tissue engineering, particularly for wound dressing and skin regeneration. In this study, for the first time, we report successful electrospinning of chitosan-based biopolymers containing bacterial cellulous (33 wt %) and medical grade nanodiamonds (MND) (3 nm; up to 3 wt %). Morphological studies by scanning electron microscopy showed that long and uniform fibers with controllable diameters from 80 to 170 nm were prepared. Introducing diamond nanoparticles facilitated the electrospinning process with a decrease in the size of fibers. Fourier transform infrared spectroscopy determined hydrogen bonding between the polymeric matrix and functional groups of MND. It was also found that beyond 1 wt % MND, percolation networks of nanoparticles were formed which affected the properties of the nanofibrous mats. Uniaxial tensile testing of the woven mats determined significant enhancement of the strength (from 13 MPa to 25 MP) by dispersion of 1 wt % MND. The hydrophilicity of the mats was also remarkably improved, which was favorable for cell attachment. The water vapor permeability was tailorable in the range of 342 to 423 µg·Pa(-1)·s(-1)·m(-1). The nanodiamond-modified mats are potentially suitable for wound healing applications. PMID:27399726

  18. The pathogenic potential of Helicobacter cinaedi isolated from non-human sources: adherence, invasion and translocation ability in polarized intestinal epithelial Caco-2 cells in vitro.

    PubMed

    Taniguchi, Takako; Yamazaki, Wataru; Saeki, Yuji; Takajo, Ichiro; Okayama, Akihiko; Hayashi, Tetsuya; Misawa, Naoaki

    2016-05-01

    Helicobacter cinaedi infection has been recognized as an increasingly important emerging disease in humans. Infection with H. cinaedi causes bacteremia, cellulitis and enteritis. H. cinaedi has been isolated from non-human sources, including dogs, cats and rodents; however, it remains unclear whether animal strains are pathogenic in humans and as zoonotic pathogens. In this study, H. cinaedi isolates were recovered from a dog and a hamster, and the ability of these isolates to adhere to, invade and translocate across polarized human intestinal epithelial Caco-2 cells was examined in vitro. To better understand the pathogenic potential of animal H. cinaedi isolates, these results were compared with those for a human strain that was isolated from a patient with bacteremia. The animal and human strains adhered to and invaded Caco-2 cells, but to a lesser degree than the C. jejuni 81-176 strain, which was used as a control. The integrity of tight junctions was monitored by measuring transepithelial electrical resistance (TER) with a membrane insert system. The TER values for all H. cinaedi strains did not change during the experimental periods compared with those of the controls; however, translocation of H. cinaedi from the apical side to the basolateral side was confirmed by cultivation and H. cinaedi-specific PCR, suggesting that the H. cinaedi strains translocated by transcellular route. This study demonstrated that H. cinaedi strains of animal origin might have a pathogenic potential in human epithelial cells as observed in a translocation assay in vitro with a human isolate. PMID:26685883

  19. GIA-Aneurysmorrhaphy and Dermal Detachment: A Novel Technique to Repair Arteriovenous Fistula Aneurysms.

    PubMed

    Chang, Jason; Prema, Jateen; Pedersen, Rose; Li, Yiping; Liebl, Max; Patel, Kaushal; Mueller, Mark

    2016-05-01

    This report describes a simplified technique for management of aneurysmal arteriovenous fistulas along with results of initial clinical experience in 12 patients. Various techniques have been described which seek to repair the arteriovenous fistula and lengthen its duration of use. Here, we introduce the GIA-aneurysmorrhaphy and dermal detachment (GADD) procedure, a novel technique which requires minimal dissection to decompress tension on the overlying skin. Transverse incisions were made proximally and distally to the aneurysmal segment, which was then bluntly dissected along its length on either side. A GIA stapler is then fired along the longitudinal axis, narrowing the lumen of the fistula and separating the aneurysm from the skin. After the operation, the arteriovenous fistulae were used continuously until death (1 patient for 12 months), until thrombosis (1 patient for 13 months), or continue to be in use (9 patients, mean patency 18 months). One patient underwent conversion to open aneurysmorrhaphy due to intraoperative fistula occlusion. Five patients resumed hemodialysis immediately, while the remaining resumed hemodialysis within 3 months. The most common complication was cellulitis (3 patients). The GADD procedure as described in this report offers an effective and low-risk option for the management of venous aneurysms with threatened skin in hemodialysis patients. PMID:26965822

  20. A clinical evaluation of sulbactam/ampicillin in the treatment of pediatric infections.

    PubMed

    Huang, L M; Lee, C Y; Lee, M J; Hsu, C Y; Liu, C C; Hong, J Y; Chen, J M

    1989-01-01

    We have treated 42 episodes of pediatric infections with sulbactam/ampicillin since 1987. Included were 9 cellulitis, 9 urinary tract infections, 5 cervical lymphadenitis, 4 meningitis, 2 thoracic empyema, 2 osteomyelitis, 2 sepsis, 1 furuncle, 1 perianal abscess, 1 dental abscess, 1 peritonsillitis, 1 salmonellosis, 1 shigellosis, 1 peritonitis, 1 suppurative thyroiditis, 1 infective endocarditis. Responsible pathogens were Escherichia coli in 8, Staphylococcus aureus in 6, Hemophilus influenzae in 2, Streptococcus pneumoniae in 3, Streptococcus viridans in 2, Staphylococcus epidermidis in 1, Bacteroides fragilis in 1, Salmonella D1 in 1, Shigella sonnei in 1, Klebsiella pneumoniae in 1, Enterobacter agglomerans in 1, Acinetobacter calcoaceticus in 1, Enterobacter cloacae in 1, group A beta-hemolytic streptococcus in 1, and polymicrobial infection in 4 cases. Thirty-nine out of 41 (95%) clinically evaluable patients cured and all (34/34) bacteriologically evaluable patients eradicated their pathogens after treatment with sulbactam/ampicillin. Side reactions were seen in five patients; one maculopapular skin rash, one hemolytic anemia, two diarrhea, and one liver function impairment plus leukopenia. All these reactions were transient and did not require interruption of therapy. These results indicate that sulbactam/ampicillin is safe and effective in the treatment of common pediatric infections beyond the neonatal period. PMID:2637593

  1. Positive amplitudes in the amplituhedron

    NASA Astrophysics Data System (ADS)

    Arkani-Hamed, Nima; Hodges, Andrew; Trnka, Jaroslav

    2015-08-01

    The all-loop integrand for scattering amplitudes in planar SYM is determined by an "amplitude form" with logarithmic singularities on the boundary of the amplituhedron. In this note we provide strong evidence for a new striking property of the superamplitude, which we conjecture to be true to all loop orders: the amplitude form is positive when evaluated inside the amplituhedron. The statement is sensibly formulated thanks to the natural "bosonization" of the superamplitude associated with the amplituhedron geometry. However this positivity is not manifest in any of the current approaches to scattering amplitudes, and in particular not in the cellulations of the amplituhedron related to on-shell diagrams and the positive grassmannian. The surprising positivity of the form suggests the existence of a "dual amplituhedron" formulation where this feature would be made obvious. We also suggest that the positivity is associated with an extended picture of amplituhedron geometry, with the amplituhedron sitting inside a co-dimension one surface separating "legal" and "illegal" local singularities of the amplitude. We illustrate this in several simple examples, obtaining new expressions for amplitudes not associated with any triangulations, but following in a more invariant manner from a global view of the positive geometry.

  2. Longitudinal evaluation of manual lymphatic drainage for the treatment of gynoid lipodystrophy*

    PubMed Central

    Schonvvetter, Bianca; Soares, Juliana Laudicéia Marques; Bagatin, Ediléia

    2014-01-01

    BACKGROUND The gynoidlypodystrophy, known as cellulitis or cellulite, refers to a condition that gives the skin an undulating and uneven appearance, affecting 80-90% of women after puberty. OBJECTIVES to investigate the efficacy and safety of manual lymphatic drainage for cellulite management. METHODS this was an open, prospective, intervention study including 20 women aged from 20 to 40 years. Fourteen sessions of manual lymphatic drainage were performed once a week on lower limbs and buttocks. RESULTS Fifteen women completed the study. A significant improvement on quality of life was observed (p=0.018). A significant reduction (p=0.023), estimated at 0.3±0.8 cm, in hip circumference was found, but no difference was found in thighs circumference (p>0.05). A significant reduction elastic recuperation of skin on buttocks, which means skin elasticity worsening, was observed. All measures obtained by ultrasound images showed no changes (p>0.05). CONCLUSION manual lymphatic drainage was safe but not effective as an isolated approach for cellulite management. Further randomized, controlled or comparative studies about manual lymphatic drainage for cellulite control, as unique or combined therapeutic modality, are necessary. PMID:25184909

  3. Vaccination trials against Mycoplasma mycoides subsp. mycoides (large-colony-type) infection in goats.

    PubMed

    Bar-Moshe, B; Rapoport, E; Brenner, J

    1984-10-01

    Vaccination trials against Mycoplasma mycoides subsp. mycoides in suckling and weaned kids are described. A formalin-killed vaccine with adjuvant was used. Challenge to the vaccinated suckling kids was by ingestion of dam's infected milk and by subcutaneous inoculation of 10(6) organisms, and to the vaccinated weaned kids, by subcutaneous inoculation alone. The weaned 6-week-old kids were vaccinated, given a booster 3 weeks later and challenged 1 month after that. Serological monitoring was by enzyme-linked-immunosorbent assay (ELISA). The six control kids remained serologically negative and after challenge were pyrexic and mycoplasmaemic. All died or were killed in extremis, with a characteristic cellulitis at the site of inoculation, arthritis and swollen spleen. In contrast, the vaccinated kids remained healthy. There was a modest antibody response to the initial vaccination and a further steep rise after the booster. After challenge the organism was recovered only from the lymph nodes proximal to the site of challenge in some animals, and from the liver and kidney in two animals. All the vaccinated suckling kids were unaffected by ingestion of their dam's infected milk. The kids that received only one vaccine inoculation on the day of birth, and one control kid, succumbed to subcutaneous challenge, whereas the kids that were given a booster, except for one, remained healthy. PMID:6511322

  4. Adverse Outcomes after Major Surgery in Patients with Pressure Ulcer: A Nationwide Population-Based Retrospective Cohort Study

    PubMed Central

    Chou, Chia-Lun; Lee, Woan-Ruoh; Yeh, Chun-Chieh; Shih, Chun-Chuan

    2015-01-01

    Background Postoperative adverse outcomes in patients with pressure ulcer are not completely understood. This study evaluated the association between preoperative pressure ulcer and adverse events after major surgeries. Methods Using reimbursement claims from Taiwan’s National Health Insurance Research Database, we conducted a nationwide retrospective cohort study of 17391 patients with preoperative pressure ulcer receiving major surgery in 2008-2010. With a propensity score matching procedure, 17391 surgical patients without pressure ulcer were selected for comparison. Eight major surgical postoperative complications and 30-day postoperative mortality were evaluated among patients with pressure ulcer of varying severity. Results Patients with preoperative pressure ulcer had significantly higher risk than controls for postoperative adverse outcomes, including septicemia, pneumonia, stroke, urinary tract infection, and acute renal failure. Surgical patients with pressure ulcer had approximately 1.83-fold risk (95% confidence interval 1.54-2.18) of 30-day postoperative mortality compared with control group. The most significant postoperative mortality was found in those with serious pressure ulcer, such as pressure ulcer with local infection, cellulitis, wound or treatment by change dressing, hospitalized care, debridement or antibiotics. Prolonged hospital or intensive care unit stay and increased medical expenditures were also associated with preoperative pressure ulcer. Conclusion This nationwide propensity score-matched retrospective cohort study showed increased postoperative complications and mortality in patients with preoperative pressure ulcer. Our findings suggest the urgency of preventing and managing preoperative pressure ulcer by a multidisciplinary medical team for this specific population. PMID:26000606

  5. Shewanella and Photobacterium spp. in oysters and seawater from the Delaware Bay.

    PubMed

    Richards, Gary P; Watson, Michael A; Crane, Edward J; Burt, Iris G; Bushek, David

    2008-06-01

    Shewanella algae, S. putrefaciens, and Photobacterium damselae subsp. damselae are indigenous marine bacteria and human pathogens causing cellulitis, necrotizing fasciitis, abscesses, septicemia, and death. Infections are rare and are most often associated with the immunocompromised host. A study was performed on the microbiological flora of oysters and seawater from commercial oyster harvesting sites in the Delaware Bay, New Jersey. From 276 water and shellfish samples tested, 1,421 bacterial isolates were picked for biochemical identification and 170 (12.0%) of the isolates were presumptively identified as S. putrefaciens, 26 (1.8%) were presumptively identified as P. damselae subsp. damselae, and 665 (46.8%) could not be identified using the API 20E identification database. Sequencing of the 16S rRNA genes of 22 S. putrefaciens-like isolates identified them as S. abalonesis, S. algae, S. baltica, S. hafniensis, S. marisflavi, S. putrefaciens, Listonella anguillarum, and P. damselae. Beta-hemolysis was produced by some S. algae and P. damselae isolates, while isolates of S. baltica and L. anguillarum, species perceived as nonpathogenic, also exhibited beta-hemolysis and growth at 37 degrees C. To our knowledge, this is the first time these beta-hemolytic strains were reported from shellfish or seawater from the Delaware Bay. Pathogenic Shewanella and Photobacterium species could pose a health threat through the ingestion of contaminated seafood, by cuts or abrasions acquired in the marine environment, or by swimming and other recreational activities. PMID:18378645

  6. Carcinome cutané de Merkel: apport de la TEP-TDM au18FDG

    PubMed Central

    Amal, Guensi; Sara, Taleb; Ghofrane, Cherkaoui Salhi; Malika, Ait Idir; Majdouline, Houjami; Souha, Sahraoui; Abdelatif, Benider; Najoua, Touil; Ghita, Benmoussa; Zineb, Baroudi; Nabil, Chikhaoui

    2016-01-01

    Le carcinome à cellules de Merkel (CCM) est une tumeur cutanée neuroendocrinerare d’évolution imprévisible et à grand potentiel métastatique. Ce néoplasme survient habituellement chez le sujet âgé au niveau des zones photo exposées. L'avidité constante du CCM au 18 fluorodésoxyglucose (FDG) justifie l'intérêt de la tomographie par émission de positon (TEP) au cours de cette pathologie. Toutefois, aucun consensus n'est établi à ce jour. Cette étude rapporte le cas d'une patiente de 25 ans suivie pour CCM métastatique, afin d'attirer l'attention sur cette tumeur particulière et d'illustrer l'intérêt de la TEP au 18 FDG dans la prise en charge de cette entité rare. PMID:27303574

  7. Molecular Characterization of Invasive Streptococcus dysgalactiae subsp. equisimilis, Japan

    PubMed Central

    Wajima, Takeaki; Morozumi, Miyuki; Hanada, Shigeo; Sunaoshi, Katsuhiko; Chiba, Naoko; Iwata, Satoshi

    2016-01-01

    We collected β-hemolytic streptococci (1,611 isolates) from patients with invasive streptococcal infections in Japan during April 2010–March 2013. Streptococcus dysgalactiae subsp. equisimilis (SDSE) was most common (n = 693); 99% of patients with SDSE infections were elderly (mean age 75 years, SD ±15 years). We aimed to clarify molecular and epidemiologic characteristics of SDSE isolates and features of patient infections. Bacteremia with no identified focus of origin and cellulitis were the most prevalent manifestations; otherwise, clinical manifestations resembled those of S. pyogenes infections. Clinical manifestations also differed by patient’s age. SDSE isolates were classified into 34 emm types; stG6792 was most prevalent (27.1%), followed by stG485 and stG245. Mortality rates did not differ according to emm types. Multilocus sequence typing identified 46 sequence types and 12 novel types. Types possessing macrolide- and quinolone-resistance genes were 18.4% and 2.6%, respectively; none showed β-lactam resistance. Among aging populations, invasive SDSE infections are an increasing risk. PMID:26760778

  8. Escherichia Coli-Related Necrotizing Fasciitis After Renal Transplantation: A Case Report.

    PubMed

    Turunç, V; Eroğlu, A; Cihandide, E; Tabandeh, B; Oruğ, T; Güven, B

    2015-06-01

    A 39-year-old man who had received cadaveric renal transplantation (RT) 1 month previously presented with rash and pain on his left lower extremity. Initially, bacterial cellulitis was suspected, and ampicillin/sulbactam was initiated; however, 3 days later, skin necrosis occurred and pain increased. Ampicillin/sulbactam was replaced with imipenem+ciprofloxacin, and surgical debridement was performed. Escherichia coli was identified in the wound culture, urine culture, and blood culture. After repeated debridement, wound care, and appropriate antimicrobial treatment, wounds began to heal and skin grafting was planned at the 4th month of therapy. However, the patient died of viral pneumonia. To date, 20 cases of necrotizing fasciitis (NF) after RT have been reported (including our case), and, as far as we know, this is the second E coli-related NF case. An analysis of all 20 cases showed that the most common infection site was the extremities (90%) and that 45% of pathogens were fungus. The mortality rate was 30%. NF is a rare but rapidly developing and life-threatening soft-tissue infection in RT patients. To reduce mortality rates, early diagnosis, recurrent surgical debridement, and aggressive therapy are mandatory. PMID:26093756

  9. Advancement flap as a novel treatment for a pododermatitis lesion in a red-tailed hawk (Buteo jamaicensis).

    PubMed

    Sander, Samantha; Whittington, Julia K; Bennett, Avery; Burgdorf-Moisuk, Anne; Mitchell, Mark A

    2013-12-01

    Pododermatitis is a pathologic condition commonly reported in captive raptors and characterized by swelling, excoriation, ulceration, cellulitis, or abscessation of the plantar aspect of the foot. Its cause can be multifactorial, often involving abnormal weight bearing or poor sanitation, and medical and surgical techniques, in addition to environmental alterations, are hallmarks of treatment. In this case, a single pedicle advancement flap was used to treat chronic, nonresponsive grade V/VII pododermatitis of the right metatarsal pad in a red-tailed hawk (Buteo jamaicensis). The advancement flap was formed by using the interdigital skin between digits 3 and 4. The double layer of skin was incised and separated, and the leading edge of the flap was then advanced over the defect and secured with simple interrupted subcutaneous and skin sutures. The foot was bandaged after surgery to take pressure off the surgical site. At 58 days after the surgery, the hawk was deemed medically sound with no signs of pododermatitis and was released to a wildlife rehabilitator. The use of a single pedicle advancement flap has not previously been reported for the treatment of pododermatitis. PMID:24640931

  10. [LOXOCELES BITE WOUND TREATMENT WITH SYNTHETIC POLYMER MATRIX].

    PubMed

    Navarro Caballero, Ma Ascensión

    2015-05-01

    Loxocelism is a toxic condition produces by the venom inoculated by the bit of the recluse spider (genus Loxosceles). In can appear in two clinical forms: cutaneous loxocelism and viscerocutaneous Ioxocelim. The species Loxoceles rufescens, found in Spain, is responsible of cases of cutaneous loxocelism. Cutaneous loxocelism starts with an itch, later giving rise to intense pain, and it later takes either a more or less severe necrotic form or an edematous form. The latter, with a better prognosis, is the one we focus on here. The diagnosis is clinical. The systemic treatment consists in analgesics, antihistamines, corticosteroids, broad-spectrum antibiotics, and dapsone in severe cases. The local treatment is based on the cleaning and debridement of the wound, and in advanced treatments for complex wounds. It is not uncommon that such wounds require skin grafting. We present the case of an 18-year female bitten by a loxosceles on the dorsal area of the foot. She developed a deep tissue necrosis in the area. She presented systemic complications such as leucocitosis, fever, local infection and cellulitis. Systemic treatment and hospitalization were required, as well as advanced therapeutic care. Finally, cutaneous integrity was restored after 84 days. PMID:26540898

  11. Complications and outcomes of brown recluse spider bites in children.

    PubMed

    Hubbard, Jonathan J; James, Laura P

    2011-03-01

    Brown recluse spider bites may cause severe local and systemic morbidity, but data regarding morbidity in children are limited. This study reviewed inpatient medical records (n = 26; 10 years) with a discharge diagnosis of "spider bite" from a tertiary pediatric hospital. The majority (85%) of children had an inflammatory response accompanying necrosis, usually with signs of secondary cellulitis (77%). Hemolytic anemia (50%), rhabdomyolysis (27%), and acute renal failure (12%) were the most prevalent systemic effects. Hemolytic anemia was bimodal in distribution relative to the time-of-onset of the bite (early, 2.2 ± 0.4; late, 6.9 ± 1.5 days postbite, respectively; P = .004). Although no fatalities occurred in the population, 65% of children had major morbidity, including wound complications requiring surgical care and acute orbital compartment syndrome. The findings emphasize the importance of anticipatory patient/family education for outpatients and careful monitoring for systemic morbidity in inpatients. Timely and appropriate supportive care should yield favorable outcomes in most cases. PMID:21307081

  12. Community-acquired methicillin-resistant Staphylococcus aureus: a potential diagnosis for a 16-year-old athlete with knee pain

    PubMed Central

    Larkin-Thier, Susan M.; Barber, Virginia A.; Harvey, Phyllis; Livdans-Forret, Anna B.

    2010-01-01

    Objective This case report aims to raise awareness in chiropractic physicians of the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in adolescents who participate in sports activities and to alert the chiropractic physician of the necessity to consider potential diagnoses that are not within their typical clinical heuristic. Clinical Features A 16-year-old adolescent girl entered the clinic with a complaint of left knee pain that had an insidious onset during her involvement in sports activities. Later that same day, her knee became enlarged, red, and had pustular formations with a discharge. She was taken to an urgent care facility and subsequently diagnosed with MRSA. Her history included treatment of a left knee musculoskeletal condition 6 weeks prior to which she had responded favorably. Interventions and Outcomes She was treated medically with an aggressive course of antibiotic therapy and excision of the furuncle. The chiropractic physician played a role in patient education and notifying local school authorities of the case. Conclusion Doctors of chiropractic must prepare themselves for the unexpected and remain open to diagnostic possibilities outside of the normal scope of practice. Knee pain or cellulitis of any type may require additional diagnostic and patient care protocols to make the correct diagnosis. With the incidence of community-acquired MRSA increasing at an alarming rate, it is certainly a diagnosis doctors of chiropractic should be aware of when treating patients, especially those involved in sports activities. PMID:21629397

  13. Use of the comet assay to measure DNA damage in cells exposed to photosensitizers and gamma radiation

    NASA Astrophysics Data System (ADS)

    Pouget, J.-P.; Ravanat, J.-L.; Douki, T.; Richard, M.-J.; Cadet, J.

    1999-01-01

    We used the comet assay associated with DNA-glycosylases to estimate DNA damage in cells exposed to gamma irradiation or photosensitized either with methylene blue or orange acridine. A calibration performed using irradiation allowed the measurement of the steady-state level and the yield of 8-oxodGuo as well as strand breaks and alkali-labile sites. Nous avons utilisé la méthode des comètes associée à des ADN-glycosylases, pour estimer les dommages de l'ADN dans des cellules après l'exposition à un rayonnement gamma ou après photosensibilisation par le bleu de méthylène ou l'acridine orange. Une calibration de la méthode des comètes a permis de mesurer le niveau basal et les taux de formation de 8-oxodGuo ainsi que le nombre de cassures de brins et de sites alcali labiles.

  14. Hepatosplenic alphabeta T cell lymphoma.

    PubMed

    Nagai, Yuya; Ikegame, Kazuhiro; Mori, Minako; Inoue, Daichi; Kimura, Takaharu; Shimoji, Sonoko; Togami, Katsuhiro; Tabata, Sumie; Kurata, Masayuki; Imai, Yukihiro; Matsushita, Akiko; Nagai, Kenichi; Ogawa, Hiroyasu; Takahashi, Takayuki

    2010-04-01

    A 32-year-old male with chronic hepatitis B was admitted to a hospital with cellulitis in the right leg in September 2006. Pancytopenia, hepatosplenomegaly, and systemic superficial lymph node swelling were noted, and he was referred to our hospital. He developed fever and liver dysfunction in June 2007 and underwent a splenectomy. His pancytopenia subsequently improved. A pathologic diagnosis of hepatosplenic alphabeta T cell lymphoma was made by examining spleen tissue and biopsy specimens of the liver and mesenteric lymph node. He had stage IVB disease because neoplastic T cells were noted in the bone marrow. The response of the lymphoma to conventional chemotherapy including the CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone) and DeVIC (dexamethasone, etoposide, ifoshamide, carboplatin) regimens was poor and transient. A partial remission was obtained with an ESHAP (etoposide, cisplatin, cytarabine, methylprednisolone) regimen. Therefore, we planned a bone marrow transplantation (BMT) from an HLA-haploidentical sibling donor. He was moved to the Department of Hematology, Hyogo Medical College, to receive this BMT as part of a clinical trial. During the conditioning procedure for the transplantation, however, he died of septicemia. Since hepatosplenic alphabeta T cell lymphoma is very rare with only 23 reported cases to date, herein we report this case and discuss the therapeutic strategy. PMID:20217452

  15. Recurrent SDSE bacteraemia resulting in streptococcal toxic shock syndrome in a patient with Noonan syndrome.

    PubMed

    Suzuki, Kei; Nakamura, Akiko; Ishikura, Ken; Imai, Hiroshi

    2016-01-01

    A 19-year-old man with chronic lymphoedema due to Noonan syndrome presented at our hospital with septic shock and pain in his lower leg. Blood cultures were positive for Streptococcus dysgalactiae subsp equisimilis (SDSE), resulting in a diagnosis of cellulitis with toxic involvement. He was treated with ampicillin for 3 weeks. Although he did well for 6 weeks, septic shock recurred. Blood culture again revealed SDSE, with the strain being identical to the first episode, suggesting that this infection had relapsed. He was treated with ampicillin for 6 weeks and prophylactically with trimethoprim-sulfamethoxazole for 12 months. Although SDSE bacteraemia occurs commonly in elderly patients, findings in this patient showed that it can also develop in younger persons with predisposing factors. This case also indicates that SDSE has the potential to recur, despite generally sufficient antibiotic administration, and that patients who experience recurrent episodes may require prolonged treatment with antibiotics, including prophylaxis. PMID:27485878

  16. Sex differences in the incidence of skin and skin-related diseases in Olmsted County, Minnesota, United States, and a comparison with other rates published worldwide.

    PubMed

    Andersen, Louise K; Davis, Mark D P

    2016-09-01

    Many skin and skin-related diseases affect the sexes unequally, with attendant implications for public health and resource allocation. To evaluate better the incidence of skin and skin-related diseases affecting males vs. females, we reviewed published population-based epidemiology studies of skin disorders performed utilizing Rochester Epidemiology Project data. Females had a higher incidence of the following diseases: connective tissue diseases (scleroderma, morphea, dermatomyositis, primary Sjögren syndrome, systemic lupus erythematosus [not in all studies]), pityriasis rosea, herpes progenitalis, condyloma acuminatum, hidradenitis suppurativa, herpes zoster (except in children), erythromelalgia, venous stasis syndrome, and venous ulcers. Males had a higher incidence of psoriasis and psoriatic arthritis, basal cell carcinoma (exception, females aged ≤40 years), squamous cell carcinoma, and lentigo maligna. Incidence rates were equal in males and females for cutaneous malignant melanoma (exception, higher in females aged 18-39 years), lower-extremity cellulitis, cutaneous nontuberculous mycobacterial infection, Behçet disease, delusional infestation, alopecia areata, and bullous pemphigoid. Many of the population-based sex-specific incidence rates of skin and skin-related diseases derived from the Rochester Epidemiology Project are strikingly different from those estimated elsewhere. In general, females are more commonly affected by skin and skin-related diseases. The reasons for this imbalance remain to be determined and are likely multifactorial. PMID:27009931

  17. Infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature

    PubMed Central

    Zouein, Elie; Wetz, Robert; Mobarakai, Neville; Hassan, Samer; Tong, Iris

    2012-01-01

    Primary aortic graft infection early after aortic graft insertion is well described in the literature. Here, we present a unique case of late aortic graft infection 5 years after insertion secondary to mitral valve endocarditis, resulting from cellulitis in a patient with severe venous varicosities. A 63-year-old male presented for severe low back pain, constipation, and low-grade fever. An abdominal computed tomography scan with oral and intravenous contrast showed a normal spine and urinary tract. Blood and urine cultures, done at the same time, grew Staphylococcus aureus. A transesophageal echocardiogram confirmed the diagnosis of endocarditis. Subsequently, a gallium scan showed increased uptake in the vertebral bodies, aortic graft, left patella, and left ankle. After 3 months of antibiotic therapy, the patient’s low back pain resolved with normalization of his laboratory values. He remained free of infection at a 2-year follow-up. We reviewed the literature concerning the atypical presentation of infective endocarditis, with a focus on distant metastases at initial presentation, such as osteomyelitis and aortic graft infection, as well as the different treatment modalities. This report describes successful medical treatment with intravenous followed by oral antibiotics for an infected endovascular graft without any surgical intervention. PMID:22866008

  18. Stewart-Treves Syndrome: A Case Report and Review of the Literature

    PubMed Central

    Berebichez-Fridman, Roberto; Deutsch, Yehuda E.; Joyal, Thomas M.; Olvera, Pablo Montero; Benedetto, Pasquale W.; Rosenberg, Andrew E.; Kett, Daniel H.

    2016-01-01

    The Stewart-Treves syndrome is a rare and deadly entity, which is defined as angiosarcoma arising in the setting of chronic lymphedema. It typically presents in women who develop lymphedema in the upper extremity secondary to axillary lymph node dissection for breast cancer surgery. It is extremely uncommon in the lower extremities as a result of idiopathic chronic lymphedema. Here, we present the case of a 63-year-old female patient with idiopathic chronic lymphedema of the lower extremities having morbid obesity (BMI 82.6) and multiple comorbidities. She developed multiple confluent, hemorrhagic and necrotic elevated purple-black papules in the lower extremities, for which the initial diagnosis was cellulitis. Because there was no improvement with antibiotics, a lower extremity ultrasound and biopsy was performed which showed multiple masses in the left inner upper calf with solid and cystic components. The pathology results of the punch biopsies were consistent with angiosarcoma. Immunohistochemical studies revealed positivity for CD31, FLI-1, and a high Ki-67 proliferation rate. Because of the patient's weight and medical comorbidities, no further extensive diagnostic tests were performed to detect metastatic disease, and because of contraindications, no further medical treatment was provided. The patient subsequently died 1 month after diagnosis. PMID:27099606

  19. The death of Henry II, King of France (1519-1559). From myth to medical and historical fact.

    PubMed

    Zanello, Marc; Charlier, Philippe; Corns, Robert; Devaux, Bertrand; Berche, Patrick; Pallud, Johan

    2015-01-01

    On 30 June 1559, Henry II, King of France, was mortally wounded in the head by a lance during a jousting match. Despite the best efforts of his physicians, Ambroise Paré and Andreas Vesalius, King Henry died 11 days later. This article, based on previously unpublished evidence, aims at examining the historical account of his death against modern medical practice to establish the probable cause of the king's death. We also discuss what treatments the doctors in the sixteenth century may have had to offer. Historical accounts of the joust provide details of the incident including the position of the visor of the king's helmet. Descriptions of the wood fragments removed from the right orbit by Italian observers and a new translation of the autopsy by Andreas Vesalius allow an accurate description of the actual injury. Our research counters previous theories and concludes that Henry II was the victim of craniofacial trauma involving the right eye and that he died from periorbital cellulitis caused by a retained foreign body in the wound, complicated by a left interhemispheric empyema preceded by a traumatic interhemispheric haematoma. It would appear that the royal court doctors advocated a wait-and-see strategy, with little actual input from Ambroise Paré or Andreas Vesalius, with a clearly regrettable outcome. PMID:25421951

  20. Bacterial skin infections, active component, U.S. Armed Forces, 2000-2012.

    PubMed

    2013-12-01

    From 2000 through 2012, health care records of the Military Health System documented 998,671 incident cases of bacterial skin infections among active component members of the U.S. Armed Forces. Most cases (97.3%) were identified from records of outpatient medical encounters rather than hospitalizations. Cellulitis accounted for half (50.9%) of all cases of bacterial skin infection but 96 percent of associated hospital bed days. Of all cases, 42.3 percent were "other" skin infections (i.e., folliculitis, impetigo, pyoderma, pyogenic granuloma, other and unspecified infections). The remainder were attributable to carbuncles/furuncles (6.6%) and erysipelas (0.1%). Rates of infection were higher among female service members except for "other" skin infections. In general, the highest rates were associated with youth, recruit trainee status, and junior enlisted rank; however, rates of erysipelas were highest among those 50 years and older. Annual incidence rates of all bacterial skin infections have increased greatly since 2000. During the entire period, such infections required more than 1.4 million health care encounters and 94,000 hospital bed-days (equivalent to 257 years of lost duty time). The prevention, early diagnosis, and treatment of bacterial skin infections, particularly in high risk settings, deserve continued emphasis. PMID:24428536

  1. Mass Spectrometry-Based Bacterial Proteomics: Focus on Dermatologic Microbial Pathogens.

    PubMed

    Soufi, Youcef; Soufi, Boumediene

    2016-01-01

    The composition of human skin acts as a natural habitat for various bacterial species that function in a commensal and symbiotic fashion. In a healthy individual, bacterial flora serves to protect the host. Under certain conditions such as minor trauma, impaired host immunity, or environmental factors, the risk of developing skin infections is increased. Although a large majority of bacterial associated skin infections are common, a portion can potentially manifest into clinically significant morbidity. For example, Gram-positive species that typically reside on the skin such as Staphylococcus and Streptococcus can cause numerous epidermal (impetigo, ecthyma) and dermal (cellulitis, necrotizing fasciitis, erysipelas) skin infections. Moreover, the increasing incidence of bacterial antibiotic resistance represents a serious challenge to modern medicine and threatens the health care system. Therefore, it is critical to develop tools and strategies that can allow us to better elucidate the nature and mechanism of bacterial virulence. To this end, mass spectrometry (MS)-based proteomics has been revolutionizing biomedical research, and has positively impacted the microbiology field. Advances in MS technologies have paved the way for numerous bacterial proteomes and their respective post translational modifications (PTMs) to be accurately identified and quantified in a high throughput and robust fashion. This technological platform offers critical information with regards to signal transduction, adherence, and microbial-host interactions associated with bacterial pathogenesis. This mini-review serves to highlight the current progress proteomics has contributed toward the understanding of bacteria that are associated with skin related diseases, infections, and antibiotic resistance. PMID:26925048

  2. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions.

    PubMed

    Hay, Roderick J; Johns, Nicole E; Williams, Hywel C; Bolliger, Ian W; Dellavalle, Robert P; Margolis, David J; Marks, Robin; Naldi, Luigi; Weinstock, Martin A; Wulf, Sarah K; Michaud, Catherine; J L Murray, Christopher; Naghavi, Mohsen

    2014-06-01

    The Global Burden of Disease (GBD) Study 2010 estimated the GBD attributable to 15 categories of skin disease from 1990 to 2010 for 187 countries. For each of the following diseases, we performed systematic literature reviews and analyzed resulting data: eczema, psoriasis, acne vulgaris, pruritus, alopecia areata, decubitus ulcer, urticaria, scabies, fungal skin diseases, impetigo, abscess, and other bacterial skin diseases, cellulitis, viral warts, molluscum contagiosum, and non-melanoma skin cancer. We used disability estimates to determine nonfatal burden. Three skin conditions, fungal skin diseases, other skin and subcutaneous diseases, and acne were in the top 10 most prevalent diseases worldwide in 2010, and eight fell into the top 50; these additional five skin problems were pruritus, eczema, impetigo, scabies, and molluscum contagiosum. Collectively, skin conditions ranged from the 2nd to 11th leading cause of years lived with disability at the country level. At the global level, skin conditions were the fourth leading cause of nonfatal disease burden. Using more data than has been used previously, the burden due to these diseases is enormous in both high- and low-income countries. These results argue strongly to include skin disease prevention and treatment in future global health strategies as a matter of urgency. PMID:24166134

  3. A challenge for diagnosing acute liver injury with concomitant/sequential exposure to multiple drugs: can causality assessment scales be utilized to identify the offending drug?

    PubMed

    Lim, Roxanne; Choudry, Hassan; Conner, Kim; Karnsakul, Wikrom

    2014-01-01

    Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin/sulbactam, and clindamycin) for cervical lymphadenitis/retropharyngeal cellulitis. Histopathology of the liver biopsy specimen revealed acute cholestatic hepatitis. All known causes of acute liver injury were appropriately excluded and (only) drug-induced liver injury was left as a cause of his cholestasis. Liver-specific causality assessment scales such as Council for the International Organization of Medical Sciences/Roussel Uclaf Causality Assessment Method scoring system (CIOMS/RUCAM), Maria and Victorino scale, and Digestive Disease Week-Japan were applied to seek the most likely offending drug. Although clindamycin is the most likely cause by clinical diagnosis, none of causality assessment scales aid in the diagnosis. PMID:25506455

  4. Endoscopic sinus surgery for orbital subperiosteal abscess secondary to sinusitis.

    PubMed

    Bhargava, D; Sankhla, D; Ganesan, A; Chand, P

    2001-09-01

    Subperiosteal orbital abscess (SPA) is a serious complication of paranasal sinusitis, which can lead to blindness or even death. A quick response is necessary as this condition is treatable. Early surgical intervention is indicated if there is risk of visual loss, or if no improvement is observed within 48 hours of starting medical therapy. Three patients with orbital SPA secondary to sinusitis treated successfully by Functional Endoscopic Sinus Surgery (FESS) are presented in this case series. The surgical indications were impending visual loss with an abscess and cellulitis impinging on the optic nerve in one child and in the other two patients, a lack of clinical response within 48 hours after starting systemic antibiotic. CT scans, nasal endoscopy, and ophthalmologic examinations are mandatory during the evaluation process. The advantages of FESS in these patients were the avoidance of external ethmoidectomy and its external facial scar, an early drainage of the affected sinuses, SPA, and the eradication of the disease from the fronto-ethmoidal region leading to an enhanced recovery and a reduced hospital stay. FESS is also a safe, convenient and minimally invasive procedure in patients presenting with serious complications of sinusitis. PMID:11721506

  5. Incorporating novel solutions to lower-limb problems into compression formularies.

    PubMed

    Smith, Glenn; Simon, Deborah; McDermott, Emma; Gibson, Elaine

    2014-06-01

    This study investigates the effect of a new short-stretch two-layer compression system in eight patients with common chronic lower-limb conditions in three locations in the UK. Chronic leg ulcers are the most common type of lower-limb ulceration with 70% caused by chronic venous hypertension. An appropriate level of compression is proven to heal chronic venous leg ulcers. The study was only a small sample of patients; however, the underlying conditions included chronic venous eczema, diabetes, sarcoma, cellulitis and mixed-aetiology ulcers. During the study, the UK experienced some of the hottest temperatures in the last 30 years. This had an impact on five patients, who noted an increase in malodour associated with their leg ulcers. CoFlex TLC (Aspen Medical Europe Ltd) foam comfort layer is impregnated with cyclodextrin-a naturally based oligosaccharide known to reduce malodour. The zinc-impregnated foam bandages in this study were viewed very favourably by both patients and staff, particularly those who had chronic venous eczema. PMID:24912834

  6. Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.

    PubMed

    Bethea, Jane; Makki, Sophia; Gray, Steve; MacGregor, Vanessa; Ladhani, Shamez

    2016-06-16

    In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts. PMID:27336327

  7. Transilluminated powered phlebectomy surgery for varicose veins: a review of 339 consecutive patients.

    PubMed

    Franz, Randall W; Knapp, Eric D

    2009-01-01

    Transilluminated powered phlebectomy (TIPP) is a promising alternative to traditional ambulatory phlebectomy procedures. This retrospective review of 339 patients represents the senior author's first consecutive series of 400 cases performed using TIPP for the treatment of varicose veins in a 6-year period. Patients were followed for 12 weeks postoperatively. Data analyzed included operative time, intraoperative complications, stab incision ranges, postoperative complications, and patient satisfaction. The mean operative time was 19.7 minutes, and 246 (61.5%) cases involved 10 to 20 incisions. Postoperative complications included an episode of symptomatic deep vein thrombosis in one (0.3%) patient, excessive or hypertrophic scarring in two (0.6%) patients, discoloration of the lower extremity skin due to hemosiderin staining in eight (2.3%) patients, and cellulitis in one (0.3%) patient. No recurrences were observed at a follow-up of 12 weeks. Three hundred thirty-eight (99.7%) patients reported good outcomes and were satisfied with the procedure. This review by an individual surgeon is beneficial in analyzing the outcomes and complications associated with TIPP, as a standard protocol was followed and an adequate volume was performed to advance past the learning curve associated with the technique. When concomitant saphenous vein incompetence is present, staged treatment of varicosities with TIPP after endovenous laser ablation is recommended. With proper training and experience, utilization of TIPP with a lower oscillation frequency and secondary tumescence results in good outcome and high patient satisfaction. PMID:18774685

  8. Medical management of venous ulcers.

    PubMed

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. PMID:26358306

  9. Helicobacter cinaedi kidney cyst infection and bacteremia in a patient with autosomal dominant polycystic kidney disease.

    PubMed

    Mandai, Shintaro; Kasagi, Yuri; Kusaka, Keita; Shikuma, Satomi; Akita, Wataru; Kuwahara, Michio

    2014-11-01

    A 48-year-old man with autosomal dominant polycystic kidney disease (ADPKD) was admitted to our hospital with a 5-day history of lower right back pain, high-grade fever, and arthralgia. He was diagnosed with right kidney cyst infection and bacteremia due to Helicobacter cinaedi (H. cinaedi) based on these symptoms, highly elevated CRP (32.25 mg/dL), abdominal magnetic resonance imaging findings, and the identification of H. cinaedi from blood cultures using PCR and sequence analysis of the 16S ribosomal DNA gene. Intravenous cefotaxime 0.5 g twice daily followed by meropenem 0.5 g twice daily and ciprofloxacin 200 mg twice daily were partially effective; oral doxycycline added at 200 mg/day finally eradicated the infection. Total duration of antimicrobial therapy was 9 weeks. H. cinaedi infections typically present as bacteremia with or without cellulitis in immunocompromised patients such as those with AIDS or malignant disease. To our knowledge, this is the first report describing an ADPKD patient with H. cinaedi cyst infection. Although H. cinaedi infections are increasingly recognized, even in immunocompetent subjects, numerous cases may still be overlooked given that this bacterium is slow-growing, and is difficult to culture, be Gram-stained, and identify on phenotypic tests. Consideration of this bacterium as a possible pathogen and sufficient duration of incubation with molecular testing are necessary in treating ADPKD patients with cyst infection. PMID:25131293

  10. Scald Burns From Hair Braiding.

    PubMed

    Meizoso, Jonathan P; Ramaley, Stephen R; Ray, Juliet J; Allen, Casey J; Guarch, Gerardo A; Varas, Robin; Teisch, Laura F; Pizano, Louis R; Schulman, Carl I; Namias, Nicholas

    2016-01-01

    Only one previous case report has described scald burns secondary to hair braiding in pediatric patients. The present case study is the largest to date of scald burns as a result of hair braiding in children and adults. Charts of all 1609 female patients seen at a single burn center from 2008 to 2014 were retrospectively reviewed to identify patients with scald burns attributed to hair braiding. Demographics, injury severity, injury patterns, and complications were analyzed. Twenty-six patients (1.6%) had scald burns secondary to hair braiding with median TBSA 3%. Eighty-five percent of patients were pediatric with median age 8 years. Injury patterns were as follows: back (62%), shoulder (31%), chest (15%), buttocks (15%), abdomen (12%), arms (12%), neck (12%), and legs (4%). No patients required operative intervention. Three patients were admitted to the hospital. Two patients required time off from school for 6 and 10 days post burn for recovery. Complications included functional limitations (n = 2), hypertrophic scarring (n = 1), cellulitis requiring antibiotics (n = 1), and anxiety requiring medical/psychological therapy (n = 2). This peculiar mechanism of injury not only carries inherent morbidity that includes the risks of functional limitations, infection, and psychological repercussions but also increases usage of resources through hospital admissions and multiple clinic visits. Further work in the form of targeted outreach programs is necessary to educate the community regarding this preventable mechanism of injury. PMID:26594857

  11. Helicobacter fennelliae Bacteremia

    PubMed Central

    Saito, Sho; Tsukahara, Mika; Ohkusu, Kiyofumi; Kurai, Hanako

    2016-01-01

    Abstract Helicobacter fennelliae is a gram-negative, spiral bacillus that appears as thin-spread colonies on sheep blood agar and is similar to Helicobacter cinaedi. H fennelliae is diagnosed by genetic testing, which is not readily available in all laboratories. Therefore, H fennelliae bacteremia has only been reported sporadically, and little is known about its clinical characteristics. We describe 3 cases of H fennelliae bacteremia with gastrointestinal symptoms, including nausea, vomiting, and diarrhea. Isolates could be differentiated from H cinaedi by biochemical reaction testing, including nitrate reduction and alkaline phosphatase hydrolysis. We retrospectively reviewed 24 cases of H fennelliae bacteremia reported in the literature. Most of the patients had immunosuppressive backgrounds, including solid tumors, hematological malignancies, and autoimmune diseases. Although gastrointestinal symptoms were common, cellulitis was not often observed in patients with H fennelliae bacteremia. Clinicians should bear in mind that H fennelliae may be a differential diagnosis in patients with gastrointestinal manifestations and gram-negative, spiral bacilli. In addition, biochemical reactions, such as nitrate reduction and alkaline phosphatase hydrolysis, are useful in differentiating H fennelliae from H cinaedi. PMID:27149471

  12. Mucocèle appendiculaire: à propos d'un cas observé à Lubumbashi

    PubMed Central

    Wakunga, Eric; Mukuku, Olivier; Bugeme, Marcellin; Tshiband, Moïse; Kipili, Audifax; Mobambo, Pitchou; Arung, Willy; Wakunga, Warach

    2014-01-01

    La mucocèle appendiculaire est une entité pathologique rare, mais potentiellement dangereuse, elle se présente sous différentes formes cliniques. Nous rapportons ici un cas d'une patiente âgée de 49 ans sans antécédents chirurgicaux chez qui nous avons découvert d'une façon fortuite cette affection. La clinique était celle d'un syndrome appendiculaire aigu patent et elle révélait une masse dans la fosse iliaque droite. Les examens de laboratoire ont montré une hyperleucocytose et une vitesse de sédimentation augmentée. L’échographie a démontré une masse kystique péricaecal. La patiente a subi une appendicectomie avec cæcectomie partielle et la pièce opératoire appendiculaire mesurait 153 mm de longueur et 64 mm de diamètre. L'analyse anatomopathologique de celle-ci a confirmé le diagnostic de mucocèle appendiculaire sans cellules de malignité. Les suites opératoires ont été simples et la patiente est sortie au cinquième jour postopératoire. PMID:25368725

  13. A case of factitious subfascial emphysema.

    PubMed

    Schulz, Brian M; Strauch, Robert J

    2008-05-01

    A 44-year-old woman with a history of borderline personality disorder, Hepatitis C, and multiple hospital admissions for cellulitis and cutaneous abscesses presented with pain of several days duration in her left upper extremity following getting her left arm "stuck" in a subway turnstile. The pain and swelling had progressively worsened following the injury. At the time of presentation the patient's temperature was 98.6 degrees F, heart rate was 82 beats/minute, blood pressure of 116/60, and an oxygen saturation of 98% on room air. The left upper extremity was diffusely swollen but minimally tender throughout. Crepitus was noted along the left arm, elbow and forearm areas. No open wounds were visualized during the examination. Radiographs and computed tomography revealed diffuse subcutaneous emphysema extending from the left axillary region to the wrist, as well as gas beneath the fascia extending between multiple muscles in both the upper and lower areas of her left upper extremity. The possibility of necrotizing fasciitis or gas gangrene prompted immediate operative exploration. No evidence of infection was found during the exploration. Stat gram stains sent during the procedure revealed no organisms. Aerobic, anaerobic, fungal, and acid-fast bacteria cultures taken during the operation revealed no final growth. The patient was stable throughout the hospitalization, remaining afebrile with a normal white blood cell count. The gas in the subcutaneous and subfascial layers was not caused by infection but presumably was due to factitious self-injection of air. PMID:19292308

  14. Morganella morganii, a non-negligent opportunistic pathogen.

    PubMed

    Liu, Hui; Zhu, Junmin; Hu, Qiwen; Rao, Xiancai

    2016-09-01

    Morganella morganii belongs to the tribe Proteeae of the Enterobacteriaceae family. This species is considered as an unusual opportunistic pathogen that mainly causes post-operative wound and urinary tract infections. However, certain clinical M. morganii isolates present resistance to multiple antibiotics by carrying various resistant genes (such as blaNDM-1, and qnrD1), thereby posing a serious challenge for clinical infection control. Moreover, virulence evolution makes M. morganii an important pathogen. Accumulated data have demonstrated that M. morganii can cause various infections, such as sepsis, abscess, purple urine bag syndrome, chorioamnionitis, and cellulitis. This bacterium often results in a high mortality rate in patients with some infections. M. morganii is considered as a non-negligent opportunistic pathogen because of the increased levels of resistance and virulence. In this review, we summarized the epidemiology of M. morganii, particularly on its resistance profile and resistant genes, as well as the disease spectrum and risk factors for its infection. PMID:27421818

  15. Bacterial vaginosis.

    PubMed Central

    Spiegel, C A

    1991-01-01

    Bacterial vaginosis (BV) is the most common of the vaginitides affecting women of reproductive age. It appears to be due to an alteration in the vaginal ecology by which Lactobacillus spp., the predominant organisms in the healthy vagina, are replaced by a mixed flora including Prevotella bivia, Prevotella disiens, Porphyromonas spp., Mobiluncus spp., and Peptostreptococcus spp. All of these organisms except Mobiluncus spp. are also members of the endogenous vaginal flora. While evidence from treatment trials does not support the notion that BV is sexually transmitted, recent studies have shown an increased risk associated with multiple sexual partners. It has also been suggested that the pathogenesis of BV may be similar to that of urinary tract infections, with the rectum serving as a reservoir for some BV-associated flora. The organisms associated with BV have also been recognized as agents of female upper genital tract infection, including pelvic inflammatory disease, and the syndrome BV has been associated with adverse outcome of pregnancy, including premature rupture of membranes, chorioamnionitis, and fetal loss; postpartum endometritis; cuff cellulitis; and urinary tract infections. The mechanisms by which the BV-associated flora causes the signs of BV are not well understood, but a role for H2O2-producing Lactobacillus spp. in protecting against colonization by catalase-negative anaerobic bacteria has been recognized. These and other aspects of BV are reviewed. PMID:1747864

  16. Cancer métaplasique du sein: à propos d'un cas

    PubMed Central

    Babahabib, Moulay Abdellah; Chennana, Adil; Hachi, Aymen; Kouach, Jaoud; Moussaoui, Driss; Dhayni, Mohammed

    2014-01-01

    Les carcinomes métaplasiques du sein sont des tumeurs rares. Ils constituent un groupe hétérogène de tumeurs définis selon l'organisation mondiale de la santé comme étant un carcinome canalaire infiltrant mais comportant des zones de remaniements métaplasiques (de type épidermoïde, à cellules fusiformes, chondroïde et osseux ou mixte), qui varient de quelques foyers microscopiques à un remplacement glandulaire complet. Les aspects cliniques et radiologiques ne sont pas spécifiques. Le traitement associe la chirurgie, la radiothérapie et la chimiothérapie. L'hormonothérapie n'a pas de place. Le pronostic est sombre. L'histopathologie combinée à l'immunohistochimie permet de poser un diagnostic sure. Etant donné que la prise en charge thérapeutique est limitée, une nouvelle approche moléculaire pourrait modifier cette contribution faible et mal cernée des traitements systémiques classiques. Les patientes atteintes de carcinome métaplasique mammaire pourraient bénéficier de traitements ciblés, ce qui reste à confirmer par des essais cliniques. PMID:25870723

  17. Teeth syndrome: diagnosis, complications and management

    PubMed Central

    Sbai, Mohamed Ali; Benzarti, Sofien; Boussen, Monia; Maalla, Riadh

    2015-01-01

    Teeth syndrome or fight bite is a specific entity in hand surgery that is little known. It includes infectious complications of the hand following a fist against the teeth. Neglected or misdiagnosed this injury frequently leads to serious complications that could compromise the function of the hand. A retrospective study was performed on 20 patients treated for teeth syndrome at our department, during a period of 12 years (January 2003 to April 2015). All young adults with a mean age of 28 years and a significant male predominance. The dominant side was involved in 15 patients. Lesions were divided into 4 cases of simple dorsal wounds facing the MP joint, 8 cases of dorsal hand cellulitis, and 8 cases of arthritis and osteoarthritis of the metacarpophalangeal (MP) joint of the long fingers. The index was the most affected finger. Treatment consisted in debridement of necrotic tissues, stabilization with external fixation for arthritis, skin reconstruction was performed secondarily. Result was assessed as good in 60% of cases. Clenched fist injuries to the mouth (teeth syndrome or fight bite) are known as being the worst human bites. Usually treated as minor injuries, without realizing a breach of the joint capsule, a lesion of the extensor tendon, or a contamination by oral flora. Any patient with a wound near the joint of the hand and was involved in a fight, need an appropriate evaluation and a specialized treatment to avoid serious complications. PMID:26834924

  18. [The Paris cell for collecting preoccupying information (la CRIP 75): an organization at the heart of child protection].

    PubMed

    Magny, J; Reveillère, C

    2011-09-01

    Within the objective of coordinating actions of the different partners whose mission involves childhood protection measures, and to allow convergence of preoccupying information toward a centralized unit, law n(o) 2007-293 of 5 March 2007 reforming child protection requires the creation of a departmental cell for the collection, processing, and assessment of preoccupying information (cellule départementale, de recueil, de traitement, et d'évaluation des informations préoccupantes, CRIP) on the circumstances of a minor in danger or at risk of being so. The CRIP 75 is a multidisciplinary cell comprising an administrative pole, a socio-educational pole, and a medical health officer. Its mission is to participate in assessing preoccupying information and directing it appropriately, with a preference toward treating situations within an administrative framework and in accordance with the parents. The public prosecutor is only called in when the recommended measures have not provided an adequate response to the danger. Situations that are a matter for prosecution as a criminal offence are transmitted directly to the public prosecutor's office, as are situations for which the social or medico social services are unable to make an assessment. PMID:21816589

  19. Advances in vaccination against avian pathogenic Escherichia coli respiratory disease: potentials and limitations.

    PubMed

    Ghunaim, Haitham; Abu-Madi, Marwan Abdelhamid; Kariyawasam, Subhashinie

    2014-08-01

    Avian pathogenic Escherichia coli (APEC) is one of the most economically devastating pathogens affecting the poultry industry. This group of extra-intestinal E. coli causes a variety of clinical conditions including airsacculitis and cellulitis. The economic impact of APEC is mainly due to mortality, slower growth rates, and carcass downgrading. In commercial broiler operations, APEC infections are controlled indirectly by vaccination against other respiratory diseases and minimizing stress conditions, and directly by administration of antimicrobial agents to suppress the infection in already infected flocks. The fact that most APEC strains possess some common virulence factors suggests that an effective vaccine against APEC is a viable option. The most important virulence factors that have been investigated over the years include type I and P fimbriae, aerobactin iron-acquisition system, and serum resistance traits. Despite the potential for developing an efficacious vaccine to combat this economically important poultry disease, several obstacles hinder such efforts. Those obstacles include the cost, vaccine delivery method and timing of vaccination as the birds should be immune to APEC by 21 days of age. Herein, we review the various attempts to develop an effective vaccine against the respiratory form of APEC diseases in poultry. We also discuss in-depth the potentials and limitations of such vaccines. PMID:24878325

  20. Management of simple insect bites: where's the evidence?

    PubMed

    2012-04-01

    Many insects bite in order to obtain a blood meal and, in the process, inject the victim with saliva that may contain a number of substances, some of which can be immunogenic. The consequences of insect bites include local reactions, immune (allergic) reactions including anaphylaxis, and secondary bacterial infections (e.g. impetigo, cellulitis). Although insect bites are perceived to be common in the UK, the exact incidence is difficult to estimate since most are likely to go unreported: only those causing the more serious reactions are seen in primary care settings. Simple insect bites are those that are not accompanied or followed by anaphylactic shock or systemic infection. Many preparations for the treatment of insect bites, including antihistamines and topical corticosteroids, are available for purchase over the counter (OTC) in the UK. However, there is a lack of evidence for the efficacy of these treatments and, in general, recommendations for treatment are based on expert opinion and clinical experience. This article reviews the evidence for the management of simple bites by insects commonly encountered in the UK, but excludes ticks, mites and lice. PMID:22495051

  1. Preliminary results of a phase I/II clinical trial using in situ photoimmunotherapy combined with imiquimod for metastatic melanoma patients

    NASA Astrophysics Data System (ADS)

    Li, Xiaosong; Naylor, Mark F.; Nordquist, Robert E.; Teague, T. Kent; Howard, C. Anthony; Murray, Cynthia; Chen, Wei R.

    2010-02-01

    In Situ Photoimmunotherapy (ISPI), a newly developed modality for cancer therapy, has been shown to be able to modulate the body's own immune response. This clinical trial was designed to evaluate the safety and therapeutic effect of ISPI, using imiquimod as its immunoadjuvant for metastatic melanoma patients. ISPI consisted of three main components applied directly to the cutaneous metastases: 1) local application of topical imiquimod; 2) injection of indocyanine green; and 3) an 805 nm laser for local irradiation. All patients completed at least one cycle of treatment. All the patients completed at least one cycle of treatments; one patient received 6 cycles. The most common adverse effects were rash, pruritus, pain, fatigue and anorexia. Fever, chills, vomiting and cellulitis were relative rare. No grade 4 toxicity was observed. Complete Response (CR) was observed in 6 patients. Median overall survival of the 11 evaluated patients was 12.2 months. Six of the eleven patients were still alive at the time of this report. Treatment of ISPI using imiquimod is safe and well tolerant. Our preliminary clinical results suggest that this new method can be a promising modality for metastatic melanoma.

  2. Guideline for the management of wounds in patients with lower-extremity venous disease: an executive summary.

    PubMed

    Kelechi, Teresa J; Johnson, Jan J

    2012-01-01

    This article provides an executive summary of the lower extremity venous disease (LEVD) evidence-based guideline produced by the WOCN Wound Guidelines Task Force. The target audience for this guideline is health care professionals who specialize in, direct, or provide wound care for patients at risk for or with lower-extremity venous disease. The full guideline opens with an overview of definitions of LEVD, its prevalence, clinical relevance, etiology, related physiology and pathophysiology, and overall management goals for patients at risk for developing venous leg ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. Two approaches to interventions are provided: one addresses prevention strategies to reduce the risk of developing LEVD with ulcers. Methods to prevent ulcer recurrence are summarized including compression therapy, adjunctive therapies, medications, and patient education. A second approach presents treatment interventions including wound cleansing, debridement, infection control, antibiotic use, along with management of the periwound skin, nutrition, pain, and edema. This section also discusses limb elevation, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and appendices on cellulitis and venous eczema, types of edema, and compression therapy are available at the end of the guideline. This article provides an executive summary of the essential features of the guideline. PMID:23138493

  3. General biplane theory

    NASA Technical Reports Server (NTRS)

    Munk, Max M

    1923-01-01

    This report deals with the air forces on biplane cellule. The first part of the report deals with the two-dimensional problem neglecting viscosity. The variation of the section, chord, gap, stagger, and decalage are investigated, a great number of examples are calculated, and all numerical results are given in tables. For the biplane without stagger it is found that the loss of lift in consequence of the mutual influence of the two wing sections is only half as much if the lift is produced by the curvature of the section as it is when the lift is produced by the inclination of the chord to the direction of motion. The second part deals with the influence of the lateral dimensions. It is found that the loss of lift due to induction is almost unchanged, whether the biplane is staggered or not. In the third part conclusions from previous investigations are drawn, viscosity and experimental experience are brought in, and the method is simplified for practical application. Simple formulas give the drag, lift, and moment. In order to make use of the simple formulas more convenient, tables for the dynamical pressure, induced drag, and angle of attack are added so that practically no computation is needed for the application of the results.

  4. Septicaemia and meningitis caused by infection of New Zealand sea lion pups with a hypermucoviscous strain of Klebsiella pneumoniae.

    PubMed

    Roe, W D; Rogers, L; Pinpimai, K; Dittmer, K; Marshall, J; Chilvers, B L

    2015-04-17

    This study describes a syndrome of neonatal septicemia and meningitis in New Zealand sea lions, caused by a strain of Klebsiella pneumoniae that is phenotypically similar to strains causing environmentally-acquired septicemia and neuro-invasive disease in humans. Between late 2006 and early 2010, 123 pups from the Enderby Island breeding colony died of K. pneumoniae infection, with lesions including fibrinous to fibrinosuppurative meningitis, subdural hemorrhage, septic arthritis, herniation and hemorrhage of the cerebellar vermis, lymphadenitis and cellulitis. This infection was responsible for 58% of observed pup mortality over this time period, with most deaths occurring in the latter part of the breeding season (mid February onwards). The results of this study suggest that the pattern of this disease has changed since it was first described in 2002, when most deaths occurred early in the season (early to mid-January), and that it is an important and consistent cause of pup mortality in this population. In addition, a similar disease syndrome and bacterial strain was diagnosed in a single pup in a fragile recolonizing New Zealand sea lion population on mainland New Zealand, and the potential effect on this population is unknown but could have a negative impact on recolonisation at this site. PMID:25682024

  5. Multisystemic toxoplasmosis associated with a type II-like Toxoplasma gondii strain in a New Zealand fur seal (Arctocephalus forsteri) from New South Wales, Australia.

    PubMed

    Donahoe, Shannon L; Rose, Karrie; Slapeta, Jan

    2014-09-15

    We report the first confirmed case of toxoplasmosis in an Australian pinniped. Presence of Toxoplasma gondii DNA was detected in the brain of a free-ranging subadult New Zealand fur seal (Arctocephalus forsteri) with nonsuppurative meningoencephalitis, hypophysitis, posterior uveitis, retrobulbar cellulitis, and myocarditis associated with protozoan cysts and tachyzoites. The emaciated seal stranded moribund on a beach in northern Sydney in New South Wales. Histopathology coupled with specific immunohistochemistry and PCR assays confirmed the presence of T. gondii. The T. gondii sample (NZfs8825) identified in this study has an identical genotype as the type II (ToxoDB PCR-RFLP genotype #1) based on the direct sequencing and virtual RFLP of multilocus DNA markers including SAG1, 5'- and 3'-SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico. Direct sequencing of T. gondii B1 DNA marker from the T. gondii sample (NZfs8825) identified a type II-like strain, based on presence of non-archetypal B1 gene polymorphisms previously reported as unique to Australia. This study suggests that T. gondii oocysts originating from mainland Australia, which has a large population of feral cats, may act as a disease threat to native marine fauna. Therefore, emerging toxoplasmosis in the Arctic has a relevant parallel in the Southern Ocean within Australian waters with yet unknown relevance to Antarctica. PMID:25123611

  6. Neglected Foreign Body, the Cause of Navicular Osteomyelitis in A Paediatric Foot: A Case Report

    PubMed Central

    Chandrashekara, C.M; George, M.A; Al-Marboi, Bader Said Khamis

    2013-01-01

    Introduction: Foreign body injuries with date thorns, metal and wooden splinters are common in Middle East region, as most of it is desert. Some of the injuries lead to cellulitis or abscess formation, if neglected or improperly managed results in osteomyelitis or septic arthritis of foot structures. This is the first report of isolated navicular osteomyelitis following neglected foreign body in a paediatric foot. Case Report: A 10 year old male patient presented with discharging sinus in left mid-foot 3 years after penetrating injury with wooden splinter. The diagnosis of navicular osteomelitis is confirmed with plain radio-graphs. The ultrasound of foot was done to localize the foreign bodies. Patient was treated with complete removal of foreign body (wooden splinters), surgical debridement and combination of IV and oral cloxacillin for period of 6 weeks. At 18 months follow up, patient had painless foot with no recurrence or collapse of navicular bone. Conclusion: The neglected foreign body can result in osteomyelitis of small bones of foot in pediatric patient. The ultrasound is more useful tool in localizing foreign bodies; those are not radio-opaque. Early and prompt diagnosis with adequate treatment of established osteomyelitis by complete removal of foreign body, curettage and antibiotics can give good results. PMID:27298914

  7. Clinical Predictors of Acute Kidney Injury Following Snake Bite Envenomation

    PubMed Central

    Dharod, Mrudul V; Patil, Tushar B; Deshpande, Archana S; Gulhane, Ragini V; Patil, Mangesh B; Bansod, Yogendra V

    2013-01-01

    Background: Snake bite envenomation is a major public health concern in developing countries. Acute kidney injury (AKI) is as important cause of mortality in patients with vasculotoxic snake bite. Aims: This study was to evaluate the clinical profile of snake bite patients and to determine the predictors of developing AKI following snake bite. Materials and Methods: Two hundred and eighty-one patients with snake envenomation were included. Eighty-seven patients developed AKI (Group A) and 194 (Group B) did not. History, examination findings and investigations results were recorded and compared between the two groups. Results: In group A, 61 (70.11%) patients were male and in group B, 117 (60.30%) patients were male. Out of 281 patients, 232 had cellulitis, 113 had bleeding tendencies, 87 had oliguria, 76 had neuroparalysis, and 23 had hypotension at presentation. After multivariate analysis, bite to hospital time (P = 0.016), hypotension (P = 0.000), albuminuria (P = 0.000), bleeding time (P = 0.000), prothrombin time (P = 0.000), hemoglobin (P = 0.000) and total bilirubin (P = 0.010) were significant independent predictors of AKI. Conclusions: AKI developed in 30.96% of patients with snake bite, leading to mortality in 39.08% patients. Factors associated with AKI are bite to hospital time, hypotension, albuminuria, prolonged bleeding time, prolonged prothrombin time, low hemoglobin and a high total bilirubin. PMID:24350071

  8. Pharmacokinetics of a single subcutaneous dose of sustained release buprenorphine in northern elephant seals (Mirounga angustirostris).

    PubMed

    Molter, Christine M; Barbosa, Lorraine; Johnson, Shawn; Knych, Heather K; Chinnadurai, Sathya K; Wack, Raymund F

    2015-03-01

    Information regarding analgesics in pinnipeds is limited. This study aimed to establish the pharmacokinetic parameters of a single subcutaneous dose of sustained release buprenorphine (Buprenorphine SR) in juvenile northern elephant seals (Mirounga angustirostris) with regard to its potential to provide long-lasting analgesia that requires infrequent dosing. Seals (n=26) were administered a single dose of sustained release buprenorphine at 0.12 mg/kg s.c. Blood samples were collected from the extradural intervertebral vein at 0 hr and at three or four of the following time points: 0.5, 1, 2, 6, 12, 24, 36, 48, 60, 96, 120, and 144 hr. Seals were examined daily for systemic and local adverse reactions. Plasma was analyzed by liquid chromatography tandem-mass spectrometry for buprenorphine and norbuprenorphine concentrations. A noncompartmental analysis for pharmacokinetic parameters was calculated using standard methods and equations. An average maximum concentration of 1.21 ng/ml (0.3-2.9 ng/ml) was detected 12 hr postadministration. Concentrations were quantifiable up to 144 hr postadministration but were below those expected to provide analgesia in some other species. No systemic adverse effects were noted in healthy seals receiving sustained release buprenorphine. Cellulitis or abscesses at the injection site were observed in 6/26 (23%) seals between 24 and 168 hr postadministration. Adverse local effects suggest that this drug should be used with caution in northern elephant seals. PMID:25831576

  9. Laparoscopic insertion of gastric electrodes for electrical stimulation.

    PubMed

    Brody, Fred; Nam, Arthur; Drenon, Elizabeth; Ali, Aamir; Soffer, Edy

    2007-02-01

    Gastric electrical stimulation can provide symptomatic relief for patients with refractory gastroparesis. Traditionally, these wires are placed through a midline laparotomy. This paper describes and illustrates, in detail, the laparoscopic technique for successful implantation. Thirty-one consecutive patients from October 2003 to March 2005 underwent laparoscopic insertion of gastric stimulating wires for gastroparesis. Twenty-six patients were female. Four laparoscopic ports were used to insert a pair of electrodes. Anterior, cephalad retraction of the gastric wall is critical for accurate seromuscular placement of gastric leads. Intraoperative endoscopy was used to verify the seromuscular placement of the leads. Both leads were secured to a subcutaneous generator and electrical parameters were immediately established in the operating room. Patient demographics, operative details, and postoperative morbidities were recorded. All procedures were completed laparoscopically. The mean operative time was 114.4 +/- 20.9 minutes (range, 95-140). No perioperative mortality occurred. Two patients developed cellulitis at the generator site postoperatively and oral antibiotics were prescribed for one week postoperatively. No hardware was removed. Two patients had their generators repositioned due to pain at the pocket site. Gastric electrical stimulation is a novel treatment modality for patients with refractory gastroparesis and can be accomplished safely via laparoscopy. Laparoscopic insertion is successful even in patients with prior surgery and intact gastrointestinal tubes. Long-term follow-up and the current prospective multicenter trial continue to assess the efficacy of this treatment modality. PMID:17362169

  10. Clostridium Perfringens Infection in a Febrile Patient with Severe Hemolytic Anemia

    PubMed Central

    Hashiba, Masamitsu; Tomino, Atsutoshi; Takenaka, Nobuyoshi; Hattori, Tomonori; Kano, Hideki; Tsuda, Masanobu; Takeyama, Naoshi

    2016-01-01

    Patient: Male, 82 Final Diagnosis: Clostridium perfringens infection Symptoms: Anemia • fever • shock Medication: — Clinical Procedure: Antimicrobial chemotherapy Specialty: Infectious Diseases Objective: Rare disease Background: Clostridium perfringens (C. perfringens) can cause various infections, including gas gangrene, crepitant cellulitis, and fasciitis. While C. perfringens sepsis is uncommon, it is often rapidly fatal because the alpha toxin of this bacterium induces massive intravascular hemolysis by disrupting red blood cell membranes. Case Report: We present the case of a male patient with diabetes who developed a fatal liver abscess with massive intravascular hemolysis and septic shock caused by toxigenic C. perfringens. The peripheral blood smear showed loss of central pallor, with numerous spherocytes. Multiplex PCR only detected expression of the cpa gene, indicating that the pathogen was C. perfringens type A. Conclusions: C. perfringens infection should be considered in a febrile patient who has severe hemolytic anemia with a very low MCV, hemolyzed blood sample, and negative Coombs test. The characteristic peripheral blood smear findings may facilitate rapid diagnosis. PMID:27049736

  11. Foot ischemia after a free fibula flap harvest: immediate salvage with an interpositional sapheneous vein graft.

    PubMed

    Saydam, Funda Akoz; Basaran, Karaca; Ceran, Fatih; Mert, Bulent

    2014-09-01

    The most dreaded major donor-site complication of free fibula flap is a foot ischemia, which is fortunately rare. Various authors have discussed the efficacy of the use of preoperative imaging methods including color Doppler, magnetic resonance angiography, and conventional angiography. A 25-year-old man presented with a 10-cm mandibular defect after a facial gunshot injury. Lower extremity color Doppler revealed triphasic peroneal, tibialis anterior, and posterior artery flows. A fibula osteocutaneous flap was harvested, and the mandible was reconstructed. However, the suture sites at the donor site began to demonstrate signs of necrosis, abscess formation, and widespread cellulitis beginning from postoperative day 9. Angiogram of the lower extremity on the 13th day demonstrated no flow in the right posterior tibial artery distal to the popliteal artery, whereas the anterior tibial artery had weak flow with collateral filling distally. An emergency bypass with a saphenous vein graft between the popliteal artery and the distal posterior tibial artery was performed. Repeated debridements, local wound care, and vacuum-assisted closure were applied. A skin graft was placed eventually. The extremity healed without severe functional disability. In conclusion, although the arterial anatomy is completely normal in preoperative evaluation, vascular complications may still ocur at the donor fibula free flap site. In addition, emergency cardiovascular bypass surgery, as we experienced, may be necessary for limb perfusion. PMID:25119400

  12. Mouth in Foot Disease.

    PubMed

    Melton, Katie S; DeRosa, Daniel C; Agee, Willie A; Pires, Valerie L; Yim, Duke G; Ngauy, Viseth

    2015-09-01

    Toothpicks are commonly used household items that rarely cause serious injury or infection. Toothpick-related injuries often occur due to ingestion with subsequent trauma/infection at distal sites within the gastrointestinal tract; however, cardiovascular, pleural, and soft tissue infections have been reported. Eikenella corrodens is a gram-negative, facultative anaerobic bacillus found in oral flora associated with bite wound infections. A few case reports describe E. corrodens osteomyelitis from toothpick puncture wounds. We report a case of foot cellulitis and abscess in an elderly diabetic after toothpick puncture injury that was unresponsive to empiric antibiotics. Wound cultures grew E. corrodens and rare Peptostreptococcus species. E. corrodens is resistant to first-generation cephalosporins, macrolides, aminoglycosides, clindamycin, and metronidazole. This case highlights the insidious nature of E. corrodens infections and the need to tailor empiric antibiotics for skin and soft tissue infections based on the mechanism of injury. In addition, this case stresses the importance of protective footwear in diabetics and serves as a cautionary tale regarding the use of seemingly innocuous toothpicks. PMID:26793413

  13. [Autoimmune lymphoproliferative syndrome].

    PubMed

    Rodrigues, Vera; Conde, Marta; Figueiredo, António; Vasconcelos, Júlia; Dias, Alexandra

    2011-01-01

    The Autoimmune Lymphoproliferative Syndrome (ALPS) is an impairment of lymphocyte apoptosis expressed by generalized non-malignant lymphoproliferation, lymphadenopathy and/or splenomegaly. This article describes a seven and 14 year old males. The first one was admitted at 3 years of age with fever, bicytopenia and generalized lymphadenopathy. Hystopathological analysis of lymph nodes showed reactive follicular hyperplasia and marked paracortical expansion. He was readmitted three years later presenting herpes zoster and similar clinical features. High levels of IL-10 and increasing tendency of Fas-L in plasma and serum. The second child was admitted at 13 years of age presenting thigh and gluteus cellulitis, anemia and neutropenia. T lymphocytes aß+CD4-CD8- 3,1%. Hystopathological analysis of lymph nodes showed marked paracortical hyperplasia. Both children are treated with mycophenolate mofetil with good response. ALPS is an underestimated entity that must be considered in non malign lymphoproliferation, autoimmunity and expansion of an unusual population of a/ßCD3+CD4-CD8-(double-negative T cells>1%). PMID:22525637

  14. Antral bony wall erosion, trigeminal nerve injury, and enophthalmos after root canal surgery

    PubMed Central

    Ferreira, Eduardo; Antunes, Luís; Dinis, Paulo Borges

    2016-01-01

    Introduction: The frequently used irrigant in dental surgery, sodium hypochlorite, is occasionally the cause of minor, usually circumscribed, adverse effects. Severe, extensive complications, with lasting sequelae, however, also can occur, as in the case we report herein. Case Report: A 55-year-old woman underwent an endodontic procedure on a maxillary molar, whose roots, unknown to the surgeon, were protruding into the maxillary sinus. After sodium hypochlorite root canal irrigation, the patient immediately developed intense facial pain, facial edema, and periorbital cellulitis. An emergency department evaluation diagnosed an intense inflammatory disease of the maxillary sinus, with significant destruction of its bony walls, accompanied by midface paraesthesia due to infraorbital nerve injury. In the following weeks, the patient slowly developed enophthalmos due to bone erosion of the orbit floor. Treatment, besides prolonged oral steroids, required the endoscopic endonasal opening of the maxillary sinus for profuse irrigation. Two years later, the patient maintained a complete loss of function of the maxillary sinus, anesthesia-paraesthesia of the midface, and inferior dystonia of the eye with an enophthalmos. Conclusion: Dentists, maxillofacial surgeons, and otorhinolaryngologists should all be aware of the whole spectrum of complications of even the simplest dental work. Sodium hypochlorite irrigations should be used cautiously in root canal surgery, with the full awareness of its potential for causing soft-tissue damage. PMID:27465790

  15. Silicone-induced Granuloma After Buttock Augmentation.

    PubMed

    Singh, Mansher; Solomon, Isaac H; Calderwood, Michael S; Talbot, Simon G

    2016-02-01

    Liquid silicone is inexpensive, minimally antigenic, and likely noncarcinogenic. Its simplicity of use has made it popular as a soft-tissue filler in some parts of the world for patients seeking rapid soft-tissue augmentation of the face, breast, and buttocks. However, multiple reports describe the complications of silicone injections such as cellulitis, abscess, ulceration, and foreign body migration. We present an unusual complication of granulomatous reaction secondary to silicone injection for buttock augmentation, with a literature review of this entity and treatment options. Our patient was a 54-year-old woman who underwent bilateral buttock augmentation in the Dominican Republic using percutaneous injection of liquid silicone. She presented to our facility 1 year after this procedure with pain and inflammation of both buttocks. She was diagnosed with multiple silicone granulomas. Her symptoms completely resolved with a 3-week course of minocycline. Granulomatous reactions to silicone may occur months to years after the silicone injection. The incidence of such complications may be increased when nonmedical-grade silicone is used, and hence, when these procedures are performed in developing countries. Tetracycline antibiotics, especially minocycline, may be used to achieve sustained remission. PMID:27014553

  16. Prevalence of toenail onychomycosis among diabetics at a primary care facility in Malaysia.

    PubMed

    Leelavathi, M; Azimah, M N; Kharuddin, N F; Tzar, M N

    2013-05-01

    Onychomycosis increases the risk of developing secondary bacterial infection and cellulitis if left untreated. The aim of this study was to determine the prevalence of onychomycosis among diabetics and its associated factors. A cross sectional study using universal sampling of all type 1 and 2 diabetic patients attending a primary care facility of the Universiti Kebangsaan Malaysia (UKM) from January to March 2011 was conducted. Samples were taken from clinically abnormal nails and from the first right toenail in the absence of nail abnormalities and cultured for fungal elements. A total of 151 diabetics participated in the study. The mean patient age was 60.7 +/- 9.1 years. A total of 123 nail samples (81.5%) were culture positive for fungal elements. A positive correlation was found between onychomycosis and increasing age (p = 0.011) and clinically abnormal nails (p < 0.05). There were no significant correlations with gender, ethnic group, duration of diabetes, types of diabetes or glycemic control. The prevalence of onychomycosis among diabetics in our study was high. PMID:24050080

  17. Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

    PubMed

    Trestrail, J H; al-Mahasneh, Q M

    1989-04-01

    From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world. PMID:2929130

  18. Delay in diagnosis and lessons learnt from a case of abdominal wall abscess caused by fishbone perforation

    PubMed Central

    Shanmugam, V; Badrinath, K; Dube, M; Panto, P

    2015-01-01

    Complications following foreign body (FB) ingestion are an uncommon clinical problem. A 59-year-old man presented with a 4-week history of left iliac fossa pain and 1 episode of dark red blood mixed with stools. Inflammatory markers were elevated, and computed tomography (CT) of the abdomen and pelvis showed an ill defined abdominal wall inflammatory collection in close contact with the small bowel loops. He was treated with antibiotics, and follow-up CT, colonoscopy and small bowel enema were mostly unremarkable. The patient presented again ten months later with left iliac fossa cellulitis and fever. Multiplanar CT (the patient’s fourth scan) demonstrated a 10cm abdominal wall collection with a linear hyperdense structure in the collection. The radiologists suspected a FB and on close scrutiny of the previous scans, they noted it to have been present on all of them. A targeted incision led to the removal of a 3cm fishbone from the collection. This case highlights the need to consider the possibility of a FB being the underlying cause in any unexplained intra-abdominal or abdominal wall inflammatory process so that the diagnosis is made in a timely manner. PMID:26263825

  19. Bacillus cereus bacteremia and multiple brain abscesses during acute lymphoblastic leukemia induction therapy.

    PubMed

    Hansford, Jordan R; Phillips, Marianne; Cole, Catherine; Francis, Joshua; Blyth, Christopher C; Gottardo, Nicholas G

    2014-04-01

    Bacillus cereus can cause serious infections in immunosuppressed patients. This population may be susceptible to B. cereus pneumonia, bacteremia, cellulitis, and rarely cerebral abscess. Here we report an 8-year-old boy undergoing induction therapy for acute lymphoblastic leukemia who developed multifocal B. cereus cerebral abscesses, highlighting the propensity for B. cereus to develop cerebral abscesses. A review of the literature over the past 25 years identified another 11 cases (3 children and 8 adults) of B. cereus cerebral abscess in patients undergoing cancer therapy. B. cereus cerebral abscesses were associated with a high mortality rate (42%) and significant morbidity. Notably, B. cereus bacteremia with concomitant cerebral abscess was associated with induction chemotherapy for acute leukemia in both children and adults (10 of 12 case reports). Our case report and review of the literature highlights the propensity for B. cereus to develop cerebral abscess(es). Therefore, early consideration for neuroimaging should be given for any neutropenic cancer patient identified with B. cereus bacteremia, in particular those with acute leukemia during induction therapy. PMID:23619116

  20. Expression and characterization of group A Streptococcus extracellular cysteine protease recombinant mutant proteins and documentation of seroconversion during human invasive disease episodes.

    PubMed

    Gubba, S; Low, D E; Musser, J M

    1998-02-01

    A recent study with isogenic strains constructed by recombinant DNA strategies unambiguously documented that a highly conserved extracellular cysteine protease expressed by Streptococcus pyogenes (group A Streptococcus [GAS]) is a critical virulence factor in a mouse model of invasive disease (S. Lukomski, S. Sreevatsan, C. Amberg, W. Reichardt, M. Woischnik, A. Podbielski, and J. M. Musser, J. Clin. Invest. 99:2574-2580, 1997). To facilitate further investigations of the streptococcal cysteine protease, recombinant proteins composed of a 40-kDa zymogen containing a C192S amino acid substitution that ablates enzymatic activity, a 28-kDa mature protein with the C192S replacement, and a 12-kDa propeptide were purified from Escherichia coli containing His tag expression vectors. The recombinant C192S zymogen retained apparently normal structural integrity, as assessed by the ability of purified wild-type streptococcal cysteine protease to process the 40-kDa molecule to the 28-kDa mature form. All three recombinant purified proteins retained immunologic reactivity with polyclonal and monoclonal antibodies. Humans with a diverse range of invasive disease episodes (erysipelas, cellulitis, pneumonia, bacteremia, septic arthritis, streptococcal toxic shock syndrome, and necrotizing fasciitis) caused by six distinct M types of GAS seroconverted to the streptococcal cysteine protease. These results demonstrate that this GAS protein is expressed in vivo during the course of human infections and thereby provide additional evidence that the cysteine protease participates in host-pathogen interactions in some patients. PMID:9453639