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Sample records for cellulitis

  1. Cellulitis

    MedlinePlus

    ... that involves areas of tissue just below the surface of the skin. Cellulitis can affect any area ... an opportunity for bacteria to get beneath the surface of the skin more easily. But cellulitis can ...

  2. Cellulitis

    MedlinePlus

    ... results from infection or inflammation. Causes include: • Sinusitis • Local spread of infection from other nearby sites (such as chalazion) • Spread of infection from blood • Insect bite • Allergic reaction How is preseptal cellulitis evaluated? A history and physical is performed. Blood may be tested ...

  3. 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 ...

  4. Retropharyngeal cellulitis in adolescence

    PubMed Central

    Tanaka, Kosuke; Inokuchi, Ryota; Namai, Yoshiyuki; Yahagi, Naoki

    2013-01-01

    A healthy 10-year-old boy presented with fever and progressively worsening sore throat and dysphagia. Physical examination showed pharyngeal erythema with tender left cervical lymphadenopathy. Radiography revealed 9 mm deep prevertebral soft tissues at the C2 level, and contrast-enhanced CT showed fluid collection with no major ring enhancement in the retropharyngeal space. He was diagnosed with retropharyngeal cellulitis and treated with intravenous antibiotics. Retropharyngeal cellulitis or abscess is a relatively rare infection in adolescents but is more frequent in 2–4-year-old children. Retropharyngeal cellulitis may rapidly extend caudally, with fatal consequences. For adolescents, physicians need to be aware of this clinical entity and carefully evaluate imaging findings even when only the mild pharyngeal physical findings are noted. PMID:23687369

  5. [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

  6. Cryptococcal cellulitis in congenital lymphedema.

    PubMed

    Krywonis, N; Kaye, V N; Lynch, P J

    1990-01-01

    A 27-year-old woman with intestinal lymphangiectasia and congenital lymphedema developed cryptococcal cellulitis as a result of her underlying depressed cell-mediated immune responsiveness. Prompt therapy with amphotericin B and 5-fluorocytosine resulted in an excellent outcome. The authors believe that the increasing population of patients with depression of cell-mediated immune response will lead to an increase in the frequency with which cryptococcal cellulitis is seen and emphasize that proper evaluation of a patient with presumptive cellulitis includes consideration of fungal, as well as bacterial, etiology. PMID:2184141

  7. The Hot Orbit: Orbital Cellulitis

    PubMed Central

    Chaudhry, Imtiaz A.; Al-Rashed, Waleed; Arat, Yonca O.

    2012-01-01

    Orbital cellulitis is an uncommon condition previously associated with severe complications. If untreated, orbital cellulitis can be potentially sight and life threatening. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. The infection most commonly originates from sinuses, eyelids or face, retained foreign bodies, or distant soources by hematogenous spread. It is characterized by eyelid edema, erythema, chemosis, proptosis, blurred vision, fever, headache, and double vision. A history of upper respiratory tract infection prior to the onset is very common especially in children. In the era prior to antibiotics, vision loss from orbital cellulitis was a dreaded complication. Currently, imaging studies for detection of orbital abcess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention. PMID:22346113

  8. 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

  9. [Cellulitis: clinical manifestations and management].

    PubMed

    Blum, C-L; Menzinger, S; Genné, D

    2013-10-01

    Cellulitis is an acute bacterial non-necrotizing dermal-hypodermal infection predominantly affecting the lower limbs. It is characterised by a circumscribed erythema with a raised border and fever. The predisposing factors are skin wounds, edema from any cause and systemic factors (diabetes, immunosuppression). The diagnosis is clinical and the most common complication is recurrence. Other complications include local abscess, fasciitis and bacteremia. The germ is rarely identified. The majority of infections (85%) is due to group A beta-hemolytic streptococcus. The treatment of cellulitis consists of an association of an antibiotic with rest of the concerned area. PMID:24191414

  10. [Recurrent erysipelas and cellulitis: management].

    PubMed

    Zürcher, Sven; Trellu, Laurence Toutous

    2015-04-01

    Erysipelas and infectious cellulitis are skin infections that develop following the entry of bacteria through gaps in the skin. The most common complication is recurrence. Control of predisposing factors remains essential to prevent it. Prophylactic antibiotics are sometimes prescribed, but this approach is based on small studies and expert opinion. This article reflects the current state of knowledge and the standard of care. PMID:26021136

  11. Fatal Acute Cellulitis Due to Neisseria meningitidis

    PubMed Central

    Cartolano, Gian-Luigi; Barbier, Christophe; Arnoult, Lela; Simon, Didier; Ricome, Jean-Louis; Hayon, Jan

    2003-01-01

    We describe the first fatal evolution of cellulitis due to Neisseria meningitidis serogroup Y involving an 85-year-old woman. She presented with an extensive cellulitis of the left side of the face, neck, and thorax and septic shock. In spite of active antibiotic therapy, evolution was rapidly fatal. PMID:12904440

  12. Cellulitis

    MedlinePlus

    ... with symptoms such as a fever or red streaks on skin) may need to stay in the hospital for a while and get antibiotic medicine through an intravenous (say: in-truh-VEE-nus) line (a thin plastic tube that goes into a vein, also called an ...

  13. Cellulitis

    MedlinePlus

    ... most often caused by the bacteria Streptococcus or Staphylococcus . These bacteria are able to enter the skin ... deeper into your skin. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a strain of "staph" ...

  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. 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.

  16. Arcanobacterium haemolyticum sinusitis and orbital cellulitis.

    PubMed

    Limjoco-Antonio, Antonietta D; Janda, William M; Schreckenberger, P C

    2003-05-01

    We present a case of sinusitis and orbital cellulitis in a 9-year-old girl caused by the Gram-positive bacillus Arcanobacterium haemolyticum. In addition to antimicrobial chemotherapy, two surgical procedures were required to drain the ethmoid and maxillary sinus cavities and a subperiosteal abscess. PMID:12797314

  17. Group G Streptococcus bacteremia in recurrent cellulitis.

    PubMed

    di Meo, Nicola; Stinco, Giuseppe; Gubertini, Nicoletta; Patriarca, Maria Martina; Trevisan, Giusto

    2014-01-01

    In recent years, group G Streptococcus has been reported with increasing frequency as the cause of a variety of human infections. Underlying host factors such as immunosuppression, malignancy, diabetes mellitus, and rheumatoid arthritis may be predisposing conditions leading to infection. Toxic involvement and post-streptococcal sequalae, once believed to be exclusive to infections caused by group A Streptococcus, are now known to occur following acute group G Streptococcus and group C Streptococcus infections. We report on a case of group G Streptococcus bacteremia and recurrent cellulitis with toxic involvement. Patient blood cultures were always negative for β-hemolytic Streptococci in all the recurrences, except during the last one. Antibiotic therapy based on antibiogram quickly resolved the infection. A regimen of intramuscular injection of 1.2 million units of benzathine penicillin every 15 days for one year prevented recurrences of cellulitis. PMID:25580792

  18. Wells’ Syndrome Mimicking Facial Cellulitis: A Report of Two Cases

    PubMed Central

    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

  19. 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

  20. Prolonged cellulitis due to plant thorn.

    PubMed

    Cengiz, A Blent; Kanra, Gler; Celik, Tolga; Cmert, Bari?; Devrim, Ilker; Ozen, Metehan; Kara, Ate?

    2005-01-01

    We report the case of a five-year-old healthy boy who was admitted with abscess and soft tissue infection between the left wrist and the distal end of the forearm. Postero-anterior X-ray examination of the forearm showed a transverse line on the radius; however, further comparative radiographic examinations of the forearm were not compatible with fracture. Enterobacter cloacae was identified in the pus culture and initial intravenous empiric treatment with sulbactam-ampicillin was continued. Although the microorganism was susceptible to the empiric antimicrobial agent, at the eighth day of the treatment, inflammatory drainage was still present so further evaluations were performed. Ultrasonography of the forearm and wrist revealed only collection; magnetic resonance imaging showed a foreign body on the anterior distal section of the left forearm. The patient underwent operation and a 22 mm wooden foreign body was removed. Detailed history after removing a tree branch particle revealed that the boy had recently fallen from a tree causing an abrasion over the left wrist. The postoperative course was uneventful and clinical response was excellent in two days. In view of this case report, we would like to emphasize the importance of medical history and imaging studies in cases of cellulitis that do not respond to appropriate antimicrobial therapy. Another point to be kept in mind is that Enterobacter cloacae, which is very rarely reported as a causative agent for cellulitis, could be the etiological agent in cases after plant thorn injuries. PMID:16363355

  1. Chlamydial conjunctivitis presenting as pre septal cellulitis.

    PubMed

    Drummond, Suzannah R; Diaper, Charles J M

    2007-01-01

    Chlamydia conjuctivitis results from infection by chlamydia trachomatis, the commonest treatable sexually transmitted infection in Europe. Its clinical manifestations involve the conjunctiva and the cornea. The inflammation under the upper eyelid may be sufficient to present as ptosis, however previously it has not been documented to cause a preseptal cellulitis. We present such a case. A 15-year-old girl was diagnosed with a left viral conjunctivitis. Five days later, she returned with marked oedema of the left upper and lower lids accompanied by erythema. The tarsal conjunctiva revealed follicles and large papillae and extra ocular movements revealed discomfort on elevation. A secondary diagnosis of bacterial pre septal cellulitis was made and the treatment was changed a broad spectrum oral antibiotic. On review at two days, the patient now complained of a large amount of purulent discharge in association with the marked pre septal swelling. As previous bacteriology and virology had been negative, the patient was re swabbed for chlamydia. This proved positive and her symptoms completely resolved following administration of Azithromycin. In this particular case recognition of the pathogen is important to alert the patient to the likelihood of unknown genital infestation. In all cases of positive culture, the patient should be counselled to attend a genitourinary clinic and to alert any sexual partners to the need to do likewise. PMID:17359543

  2. Pre-septal cellulitis--varied clinical presentations.

    PubMed

    Rao, V A; Hans, R; Mehra, A K

    1996-12-01

    Preseptal cellulitis has a typically benign course when treated with antibiotics, the clinical course depending on age of the patient, aetiology and the causative organism. In this study, 14 cases of preseptal cellulitis are documented with the age ranging from 2 to 55 years. The organisms isolated were Staphylococcus aureus (7 cases), Streptococcus pyogenes (2 cases) and Pseudomonas aeruginosa (1 case). In the remaining four patients no organism could be identified. All except four patients were cured within 6 weeks. Complications seen included lagophthalmos, lid abscess, cicatricial ectropion and lid necrosis in one patient each. The prognosis for preseptal cellulitis is good with appropriate antibiotics and surgical therapy. PMID:9251267

  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. Cellulitis-Like Rash Associated with Kawasaki Disease.

    PubMed

    Itamura, Shinji; Ishiguchi, Yukiko; Kuwabara, Kentaro; Yasui, Kozo; Kamada, Masahiro

    2016-01-01

    We present the case of a 5-year-old-boy who developed a fever and cellulitis-like groin rash 5 days before developing conjunctivitis and 6 to 7 days before other typical signs of Kawasaki disease (KD) appeared. The cellulitis failed to respond to antibiotics and no pathogens were isolated. His fever and clinical signs resolved with intravenous immunoglobulin and high-dose aspirin after discontinuation of antibiotics. Nonbacterial cellulitis is a rare presenting sign of KD, but in the appropriate clinical setting and population, a diagnosis of KD should be considered when cellulitis and fever fail to respond to an appropriate antibiotic regimen and no pathogen can be isolated. PMID:26577413

  5. Sweet's syndrome associated with cellulitis - a challenging diagnosis*

    PubMed Central

    Resende, Cristina; Santos, Rui; Pereira, Teresa; Brito, Celeste

    2016-01-01

    Sweet's syndrome is a neutrophilic dermatosis with worldwide distribution that has been associated with inflammatory autoimmune diseases, infections, malignancies, drugs, and pregnancy. The disease is idiopathic in up to 50% of patients. A 64-year-old woman, diagnosed with right limb cellulitis (4 days of evolution), was seen at our department, due to persistent cellulitis and progressive appearance of painful nodules and plaques in both shins and the right forearm (2 days of evolution). Taken together, clinical, laboratory and pathological data suggested the diagnosis of Sweet's syndrome, probably secondary to cellulitis of the right inferior limb. We suggest that cellulitis may be associated with Sweet's syndrome, a rare association in the literature. PMID:26982787

  6. Arcanobacterium hemolyticum orbital cellulitis: a rare but aggressive disease.

    PubMed

    Ramey, Nicholas A; Burkat, Cat N

    2013-01-01

    The clinical presentation and course of orbital cellulitis in a young adult resulting from Arcanobacterium hemolyticum frontal sinusitis are presented in detail. This case illustrates the importance of a multidisciplinary approach for refractory and aggressive orbital cellulitis. A high level of suspicion for A. hemolyticum must be maintained in such cases, because it has proven to be a rare but aggressive, potentially occult, and life-threatening pathogen. PMID:23128539

  7. Bacillus cereus cellulitis from contaminated heroin.

    PubMed

    Dancer, S J; McNair, D; Finn, P; Kolsto, A B

    2002-03-01

    Concern exists over recent unexplained deaths among intravenous drug users. This report describes a patient with crepitant cellulitis who was admitted complaining of severe pain in the right forearm. Ultrasonography demonstrated gas in the tissues and he was referred for early surgical debridement of the arm. He was treated with intravenous benzyl penicillin, gentamicin and metronidazole and made a full recovery. Aspirate samples grew Bacillus cereus, morphologically similar to the isolate obtained from a sample of the patient's own heroin. Antibiogram and API 50CHB profiles were also similar. Further typing included 'H' flagellar serotyping, which found both blood and heroin strains to be non-typable, and amplified fragment polymorphism analysis, which showed that the strains were indistinguishable. Genotyping of two selected genes from B. cereus confirmed almost certain identity between the two strains. This case illustrates the potential virulence of B. cereus when inoculated into tissues, and to our knowledge, is the first report to demonstrate a conclusive microbiological link between contaminated heroin and serious sepsis in a drug user due to B. cereus. PMID:11871624

  8. Orbital cellulitis complicated by central retinal artery occlusion.

    PubMed

    Proctor, Charles M; Magrath, George N; de Castro, Luis E Fernández; Johnson, John H; Teed, Ronald G

    2013-01-01

    The authors present a case of a 16-year-old boy who sought treatment in Storm Eye Institute for orbital cellulitis complicated by central retinal artery occlusion. He was examined for severe signs of orbital cellulitis, including decreased vision and an afferent pupillary defect. Intravenous antibiotics failed to provide timely improvement, and the patient was surgically managed with endoscopic orbital decompression. An ocular examination under anesthesia revealed retinal ischemia in the affected eye, and fluorescein angiography confirmed the diagnosis of central retinal artery occlusion. The patient's vision improved slightly following resolution of the infection. Central retinal artery occlusion is a rare complication of orbital cellulitis in adults and has yet to be reported in the pediatric population. PMID:23128536

  9. A Case of Metastatic Gastric Adenocarcinoma Mimicking Preseptal Cellulitis

    PubMed Central

    Won, Kwang Hee; Lee, Mi Hye; Lee, Woo Jin; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Moon, Kee Chan

    2015-01-01

    Cutaneous metastasis from gastric adenocarcinoma is uncommon, and the eyelid is a rare metastatic site. Three patterns of clinical presentation of eyelid metastasis have been described: nodular, infiltrative, and ulcerated. The infiltrative pattern, also known as an inflammatory diffuse pattern or mask-like metastasis, can be easily misdiagnosed as cellulitis or contact dermatitis. Here, we report a case of gastric adenocarcinoma in a 75-year-old man who presented with a localized erythematous plaque on his eyelid that developed four months earlier. The patient had been treated with an antimicrobial agent owing to suspicion of preseptal cellulitis. Gastric adenocarcinoma metastasis was diagnosed on the basis of histopathological examination and immunophenotyping (i.e., cytoplasmic epithelial membrane antigen, cytokeratin- 7, cytokeratin-20, and carcinoembryonic antigen). For patients with malignant neoplasms, persistent skin lesions similar to cellulitis or contact dermatitis should be suspected of metastasis derived from an internal malignancy, even for very rare sites of metastasis. PMID:26273162

  10. 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

  11. Achromobacter xylosoxidans Bacteremia and Cellulitis: A Report of a Case.

    PubMed

    Dai, Julia; Huen, Auris O; Kestenbaum, Lori A; Sarezky, Margaret D; Coughlin, Carrie C; Yan, Albert C

    2015-01-01

    Achromobacter xylosoxidans is a rare, opportunistic infection most commonly encountered in immunocompromised patients during hospitalization. Primary uncomplicated bacteremia, catheter-associated infections, and pneumonia have been reported as the most common clinical presentations; skin and soft tissue infections from A.xylosoxidans are rare. We describe a case of A.xylosoxidans presenting as cellulitis and bacteremia in an immunocompromised patient. PMID:25973735

  12. Neisseria meningitidis as a cause of facial cellulitis

    PubMed Central

    Ozaki, Brent; Kittai, Adam; Chang, Suzanne

    2014-01-01

    A 68-year-old man presented with facial cellulitis and found to have Neisseria meningitidis bacteraemia with no evidence of infection outside of the facial soft tissue. He was treated with a course of intravenous ceftriaxone and transitioned to oral amoxicillin on discharge with significant improvement of his symptoms. N meningitidis is best recognised as a causal agent of bacterial meningitis. To our knowledge N meningitidis cellulitis has only been described in 12 other cases. In this case series we describe and summarise our case, along with the 12 cases already reported in the literature. We report this case series to highlight the importance of recognising N meningitidis in the differential in patients presenting with acute skin and soft tissue infections especially involving the periorbital, head and neck regions. PMID:24626385

  13. 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

  14. Recurrent cellulitis: risk factors, etiology, pathogenesis and treatment.

    PubMed

    Chlebicki, Maciej Piotr; Oh, Choon Chiat

    2014-09-01

    Erysipelas and uncomplicated cellulitis are common infections that tend to recur in a substantial proportion of affected patients following an initial episode, especially if the predisposing condition is chronic lymphedema. All patients who suffer an episode of cellulitis should be carefully evaluated to establish the risk of recurrence. Several predisposing conditions (such as lymphedema and skin conditions that serve as a portal of entry for bacteria) can be effectively treated in order to reduce the risk of relapse. The medical literature provides convincing evidence that antimicrobial prophylaxis can markedly reduce the frequency of relapse of erysipelas. Two recent studies performed by the 'Prophylactic Antibiotics for the Treatment of Cellulitis at Home' (PATCH) group have clearly confirmed the efficacy of antimicrobial prophylaxis. Penicillin remains the drug of choice. Treatment options in patients with penicillin allergy are limited by the rising prevalence of macrolide resistance among group A streptococci. Further research is required to clarify the optimal penicillin regimen as well as to develop new therapies for patients with allergy to penicillin. PMID:24980389

  15. Orbital cellulitis in a neonate of the tooth bud origin : A case report

    PubMed Central

    Lavaju, Poonam; Badhu, Badri Prasad; Khanal, Basudha; Shrestha, Bhuwan Govinda

    2014-01-01

    Orbital cellulitis is a serious, yet uncommon infection in neonates. It can result in significant sight and life threatening complications. Most commonly, it occurs secondarily as the result of a spread of infection from the sinuses. Orbital cellulitis, secondary to dental infection is rare. We hereby report a case of orbital cellulitis secondary to dental infection in a 15-day-old neonate without any systemic features. PMID:25116779

  16. 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

  17. Eosinophilic cellulitis (Wells’ syndrome) caused by a temporary henna tattoo

    PubMed Central

    Celegen, Mehmet; Karkıner, Canan Sule Unsal; Günay, Ilker; Diniz, Güllden; Can, Demet

    2014-01-01

    Eosinophilic cellulitis (Wells’ syndrome) is an uncommon condition of unknown etiology. Wells’ syndrome is usually seen in adulthood but very rare in childhood. Although pathogenesis of the disease is not very clear, it is a hypersensitivity reaction developing against a variety of exogenous and endogenous antigenic stimuli. Paraphenylenediamine is a strong allergen frequently used as a temporary henna tattoo, which makes the color darker. Here, a 9-year-old male patient with Wells’ syndrome is presented, which developed following a temporary henna tattoo and shown by the patch test sensitivity to paraphenylenediamine. PMID:25395929

  18. Differentiating between red legs and cellulitis and reviewing treatment options.

    PubMed

    Salmon, Michelle

    2015-10-01

    Red legs (RL) is a chronic inflammatory condition often misdiagnosed as cellulitis. Antibiotic therapy is not required and does not resolve the symptoms. The main causes of RL are chronic dermatological and venous disease, including chronic oedema. Raising awareness of this condition among health professionals could prevent misdiagnosis and unnecessary costly and potentially harmful antibiotic therapy. The aim of this paper is to highlight the differential diagnoses and management of red legs, and the author also includes an example through a case history. PMID:26418399

  19. Streptococcal cellulitis following preparation of fresh raw seafood.

    PubMed

    Koh, T H; Sng, L-H; Yuen, S M; Thomas, C K; Tan, P L; Tan, S H; Wong, N S

    2009-05-01

    We describe three zoonotic streptococcal soft tissue infections resulting from fresh seafood contact. One was a localized thumb infection with Streptococcus iniae in an immunocompetent healthy young male resulting from a puncture wound from a crab pincer. The other two were cases of ascending upper limb cellulitis associated with bacteraemia in mastectomy patients. One of these infections was caused by S. iniae while the other was caused by Streptococcus dysgalactiae subsp. dysgalactiae, a species that has not been previously described as a cause of zoonotic infection. Hence when cleaning raw seafood, protective equipment should be used to minimize the risk of percutaneous injuries. PMID:19309483

  20. Leclercia adecarboxylata cellulitis in a child with acute lymphoblastic leukemia.

    PubMed

    Shah, Avnee; Nguyen, Josephine; Sullivan, Lisa M; Chikwava, Kudakwashe R; Yan, Albert C; Treat, James R

    2011-01-01

    Leclercia adecarboxylata is a rare, gram-negative rod that has been infrequently reported in the literature. The organism has been documented to cause solitary infections in immunocompromised hosts and polymicrobial wound infections in the immunocompetent. We present a case of an 8-year-old boy with significant past medical history of acute lymphoblastic leukemia who developed cellulitis due to local infection by L. adecarboxylata. This case is presented to raise awareness of this rare organism's ability to cause common cutaneous disease, especially in the immunocompromised. PMID:21385207

  1. 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

  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. Isolation of Escherichia coli from cellulitis and other lesions of the same bird in broilers at slaughter.

    PubMed Central

    Gomis, S M; Goodhope, R; Kumor, L; Caddy, N; Riddell, C; Potter, A A; Allan, B J

    1997-01-01

    Cellulitis results in substantial losses to the broiler industry due to condemnations at slaughter. This study was conducted to clarify the association between Escherichia coli isolated from cellulitis and other lesions caused by E. coli in individual birds. Fourteen flocks were sampled and 118 birds with cellulitis were examined. Escherichia coli was isolated from all but 2 of the cellulitis lesions, and serogroups O78, O1, and O2 predominated. Thirty-six birds had at least 1 other lesion in addition to the cellulitis lesion. Isolation of E. coli from cellulitis and other lesions occurred in 7 of the 14 flocks. Escherichia coli of the same serogroup were isolated from cellulitis and other lesions in some birds, suggesting that a single E. coli may sometimes be responsible for both types of lesions. PMID:9056066

  4. Late, Late-Onset Group B Streptococcus Cellulitis With Bacteremia.

    PubMed

    Yokouchi, Yukako; Katsumori, Hiroshi; Koike, Yuji

    2016-01-01

    Group B streptococcus (GBS) infection remains a leading cause of serious neonatal and early infantile infection. As the infection often presents with nonspecific symptoms, and is associated with underlying bacteremia, prompt investigation and treatment is required. We report a case of late, late-onset GBS infection with bacteremia in a 94-day-old boy experiencing cellulitis of the left hand. Although late-onset disease or late, late-onset disease has been reported to be common among infants with underlying conditions such as premature birth, immunocompromised status, trauma, or among those using medical devices, no such underlying medical condition predisposed this infant to invasive GBS infection. Recent reports including the present case underscore the risk of GBS infection among previously healthy infants beyond the neonatal period. Thus, clinicians should especially be aware of unusual presentations of GBS invasive disease with bacteremia. PMID:26720063

  5. Osteomyelitis of Maxilla in Infantile With Periorbital Cellulitis

    PubMed Central

    Feng, Zhiqiang; Chen, Xufeng; Cao, Fengdi; Lai, Renfa; Lin, Qiang

    2015-01-01

    Abstract Infantile osteomyelitis (IO) is an uncommon and life-threatening disease that can be misdiagnosed. Early diagnosis and treatment can reduce the incidence of sequel. In this case report, we present a 25-day-old male infant with apparent edema in the entire left periorbital region. Intraorally, the edema occurred in the mucosa of the upper left alveolar region, and 2 draining fistulas with exuded yellow-white pus were present in the left alveolar region. The patient received constant monitoring after admission, and was diagnosed as IO of the maxilla with periorbital cellulitis and sepsis. He also received incision and drainage and anti-inflammatory treatment. After discharge, the patient was followed up for 3 months by phone call, but no recurrence of symptoms was found. Infantile osteomyelitis is rare in clinic. This case report reminds us of the significance of IO and provides some implications on its diagnosis and treatment. PMID:26448016

  6. [Primary cutaneous Nocardia brasiliensis cellulitis in immunocompetent child].

    PubMed

    Shachor-Meyouhas, Yael; Ravid, Sarit; Suhair, Hanna; Kassis, Imad

    2012-08-01

    Primary cutaneous nocardiosis is an infrequent infection among children, generally affecting immunocompromised hosts. It is caused by Gram positive bacteria, partially alcohol and acid resistant which are saprophytes of the soil, water and organic matter. In most cases the causal agent enters through inhalation, and hematogenous dissemination may occur mainly among the immune compromised patients. Direct cutaneous inoculation is less frequent, especially among children. We report an 8-year old female who lives in an urban house with a small garden, who presented with an ulcer on her right shin accompanied by surrounding cellulitis, pain, swelling and fever. The patient's medical history was unremarkable, with no exposure to animals or travelling, except for rafting on the Jordan River the previous week. Culture from the ulcer grew Nocardia brasiliensis, and she recovered after 8 weeks of therapy with trimethoprim-sulphamethoxazole. PMID:23350294

  7. 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

  8. 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

  9. 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

  10. Neonatal retroauricular cellulitis as an indicator of group B streptococcal bacteremia: a case report

    PubMed Central

    2009-01-01

    Introduction The relation between cellulitis and Group B streptococcus infection in newborns and small infants was first reported during the early 1980s and named cellulitis-adenitis syndrome. We report a case of a neonate with cellulitis-adenitis syndrome in an unusual location (retroauricular). Case presentation A 21-day-old Caucasian female infant was brought to the emergency department with fever, irritability and a decreased appetite. Physical examination revealed erythema and painful, mild swelling in the right retroauricular region. The blood count and C-reactive protein level were normal. She was treated with ceftriaxone. The fever and irritability were resolved after 24 hours, and the cellulitis was clearly reduced after two days of hospitalization. Blood culture yielded Group B streptococcus. Conclusion A thorough evaluation must be done, and lumbar punctures for infants with cellulitis must be considered. We emphasize the lack of data about acute phase reactants to predict bacteremia and meningitis and to adjust the duration of parenteral antibiotic therapy to address this syndrome. PMID:20062760

  11. Incidence of deep vein thrombosis in erysipelas or cellulitis of the lower extremities.

    PubMed

    Mortazavi, Mohammadreza; Samiee, Mitra M; Spencer, Frederick A

    2013-03-01

    The incidence of deep vein thrombosis (DVT) in patients with erysipelas and cellulitis of the lower extremities is unknown. As such, the indication and efficacy of prophylactic anticoagulation for prevention of DVT in these patients is unclear. The main goal of this review is to provide an estimate of the incidence of DVT in erysipelas and cellulitis based on existing literature. A comprehensive search of the electronic sources: MEDLINE, EMBASE, CINAHL, LILAC and Cochrane without any language limitation was performed from 1950 to April 2011 for articles focused on the occurrence of DVT in cellulitis or erysipelas of the lower extremities. The selected studies were divided into two groups according to presence or absence of systematic investigation for DVT. Those studies in which the patients received prophylactic or therapeutic anticoagulants before a diagnosis of DVT were excluded. The reported incidence rate of DVT in patients with erysipelas or cellulitis of the lower extremities is highly variable, ranging from 0 to 15%. In this review, the overall incidence rates of DVT in studies with and without systematic investigation for thromboembolism were 2.72% (95% CI: 1.71-3.75%) and 0.68% (95% CI: 0.27-1.07%), respectively. Given the low reported overall incidence of DVT, neither routine prophylactic anticoagulation nor systematic paraclinical investigation for DVT is indicated in low risk patients with erysipelas or cellulitis of the lower extremities. DVT should still be considered in patients with high pretest probability or other thromboembolic risk factors. PMID:22913433

  12. 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.

  13. 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

  14. Cellulitis due to Achromobacter xylosoxidans during bortezomib therapy for multiple myeloma.

    PubMed

    Kikuchi, Taku; Mori, Takehiko; Kohashi, Sumiko; Yamane, Yusuke; Okayama, Mikio; Mashima, Eri; Murakami, Koichi; Shimizu, Takayuki; Kurihara, Yuichi; Ueda, Tomomi; Suzuki, Takeshi; Okamoto, Shinichiro

    2016-01-01

    Achromobacter xylosoxidans (A. xylosoxidans) is a non-fermentative gram-negative rod. This organism is reportedly a causative pathogen of bacteremia mainly in patients with hematological disorders. However, only one case of cellulitis due to A. xylosoxidans associated with hematological malignancy has been reported. An 80-year-old man developed cellulitis and subsequent bacteremia due to A. xylosoxidans during bortezomib therapy for multiple myeloma. Although his condition was serious enough to require intensive care, he fully recovered with appropriate antimicrobial agents and supportive care. The isolate was broadly resistant to antimicrobial agents, including cefepime, amikacin, and ciprofloxacin. Therefore, the identification and selection of appropriate antimicrobial agents were considered to have contributed to the successful outcome in this case. Physicians should recognize A. xylosoxidans as a possible pathogen causing cellulitis and secondary bacteremia, as well as being aware of its broad resistance to antimicrobial agents. PMID:26935636

  15. Abdominal Cellulitis following a Laparoscopic Procedure: A Rare and Severe Complication

    PubMed Central

    Bonnard, Arnaud; Terrasa, Jean Baptiste; Viala, Jerome; Aizenfisz, Sophie; Berrebi, Dominique; Ghoneimi, Alaa El

    2014-01-01

    Advantages of laparoscopic approach in Hirschsprung disease have been already published decreasing the hospital stay and postoperative adhesions. To our knowledge, we report the first case of postoperative abdominal cellulitis after laparoscopic procedure. A laparoscopic Duhamel pull through was done on a 3-month-old child. Full-thickness biopsy under laparoscopy was performed with intraperitoneal inoculation. Large peritoneal irrigation was used. Abdominal necrotizing cellulitis starting from a port site occurred few days after the procedure requiring repeat surgical excision, broad spectrum antibiotics, and hyperbaric oxygen. PMID:25755975

  16. 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

  17. Bergeyella zoohelcum Associated with Abscess and Cellulitis After a Dog Bite.

    PubMed

    Yi, Jumi; Humphries, Romney; Doerr, Laura; Jerris, Robert C; Westblade, Lars F

    2016-02-01

    Cat and dog bites are a common cause of injury in young children. Bergeyella zoohelcum is a rarely reported zoonotic pathogen that is a part of cat and dog oral flora. We present a case of a child with B. zoohelcum abscess and cellulitis after a dog bite and review previously reported cases. PMID:26535880

  18. 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

  19. Clinical and epidemiological characteristics of adult patients hospitalized for erysipelas and cellulitis.

    PubMed

    Perelló-Alzamora, M-R; Santos-Duran, J-C; Sánchez-Barba, M; Cañueto, J; Marcos, M; Unamuno, P

    2012-09-01

    The purpose of this investigation was to analyze the clinical and epidemiological aspects of all cases of erysipelas and infectious cellulitis admitted to a tertiary hospital during a period of five years. All patients admitted with the main diagnosis of erysipelas or cellulitis to the Department of Dermatology of the author's institution from January 2005 to May 2010 were included. Seventy patients were identified and their medical records were retrospectively reviewed so as to record the epidemiological and clinical data. Univariate and multivariable analyses were performed to analyze variables that predicted longer length of stay. The frequency of cellulitis in the lower limbs was higher in men and patients older than 65 years. Moderate/severe cellulitis in patients with basal comorbidity followed by a poor response to oral antibiotic therapy for 48 h were the most common reasons for admission. At arrival, four patients had abscessed areas. Fourteen patients developed local complications and 18 cases developed general in-hospital complications. Most patients improved or were healed with intravenous amoxicillin-clavulanate 1 g-200 mg/8 h. Intravenous amoxicillin-clavulanate 1 g-200 mg/8 h may be a good choice for empiric treatment in our setting. The development of in-hospital complications and the need for changing empiric antibiotic therapy were significant and independent variables associated with longer length of stay. PMID:22298240

  20. Murine model of recurrent group G streptococcal cellulitis: no evidence of protective immunity.

    PubMed Central

    Bisno, A L; Gaviria, J M

    1997-01-01

    Despite the well-known tendency of cellulitis due to beta-hemolytic streptococci to recur, little is known regarding the mechanisms of human immunity to this infection. We established cellulitis in mice by using a strain of group G streptococcus (1750) originally isolated from the bloodstream of a patient with acute cellulitis. This strain, which has been studied extensively in our laboratory, expresses M protein structurally and functionally analogous to that of group A streptococci, and we have cloned and sequenced the gene encoding this protein (emmMG1). Mice injected with 5 x 10(7) CFU of strain 1750 developed nonlethal necrotic skin and soft tissue infections that healed spontaneously after 14 to 16 days. After healing, the mice were repetitively reinoculated three times with the same challenge dose of 1750. Lesion size did not decrease in severity, size, or time to healing after repetitive challenge. The maximum lesion size and tissue concentration of microorganisms increased between the first and fourth challenges. Pretreatment of 1750 cells with opsonic antisera to MG1 diminished neither the maximum lesion size nor the time course of evolution of the lesions. Thus, in the mouse model used here, there was no evidence of acquired protective immunity to experimentally induced cellulitis. PMID:9393777

  1. 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

  2. Prophylactic Antibiotics to Prevent Cellulitis of the Leg: Economic Analysis of the PATCH I & II Trials

    PubMed Central

    Mason, James M.; Thomas, Kim S.; Crook, Angela M.; Foster, Katharine A.; Chalmers, Joanne R.; Nunn, Andrew J.; Williams, Hywel C.

    2014-01-01

    Background Cellulitis (erysipelas) is a recurring and debilitating bacterial infection of the skin and underlying tissue. We assessed the cost-effectiveness of prophylactic antibiotic treatment to prevent the recurrence of cellulitis using low dose penicillin V in patients following a first episode (6 months prophylaxis) and more recurrent cellulitis (12 months prophylaxis, or 6 months in those declining 12 months). Methods Within-trial cost-effectiveness analysis was conducted using the findings of two randomised placebo-controlled multicentre trials (PATCH I and PATCH II), in which patients recruited in the UK and Ireland were followed-up for up to 3 years. Incremental cost, reduction in recurrence, cost per recurrence prevented and cost/QALY were estimated. National unit and reference costs for England in 2010 were applied to resource use, exploring NHS and societal perspectives. A total of 397 patients from the two trials contributed to the analysis. Results There was a 29% reduction in the number of recurrences occurring within the trial (IRR: 0.71 95%CI: 0.53 to 0.90, p = 0.02), corresponding to an absolute reduction of recurrence of 0.31 recurrences/patient (95%CI: 0.05 to 0.59, p = 0.02). Incremental costs of prophylaxis suggested a small cost saving but were not statistically significant, comparing the two groups. If a decision-maker is willing to pay up to £25,000/QALY then there is a 66% probability of antibiotic prophylaxis being cost-effective from an NHS perspective, rising to 76% probability from a secondary, societal perspective. Conclusion Following first episode or recurrent cellulitis of the leg, prophylactic low dose penicillin is a very low cost intervention which, on balance, is effective and cost-effective at preventing subsequent attacks. Antibiotic prophylaxis reduces cellulitis recurrence by nearly a third but is not associated with a significant increase in costs. PMID:24551029

  3. 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

  4. 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

  5. Pulmonary thromboembolism following calf cellulitis: report of an unusual complication of dog bite.

    PubMed

    Falconieri, G; Zanella, M; Malannino, S

    1999-09-01

    We report a case of a 75-year-old woman who died of pulmonary thromboembolism following a dog bite to the calf. The bite caused laceration of the skin and gangrenous cellulitis of leg soft tissues. Six days after hospitalization, the patient died suddenly, despite early antibiotic and heparin administration. Postmortem examination revealed extensive thrombosis of the deep veins of the calf and massive thromboembolism of the main pulmonary arteries. PMID:10507790

  6. Disseminated Cryptococcosis Presenting as Cutaneous Cellulitis in an Adolescent With Systemic Lupus Erythematosus

    PubMed Central

    Valente, Ellen Simionato; Lazzarin, Mauricio Costa; Koech, Bruno Lopes; da Rosa, Ralph Vighi; de Almeida, Rafael; de Oliveira, Umberto Lopes; Neugebauer, Maria Gertrudes Fernandes Pereira; Sacco, Alexander Gonalves

    2015-01-01

    We report here the case of a 17-year-old girl from Pelotas, Brazil, with systemic lupus erythematosus and disseminated cryptococcal infection. Prior to diagnosis, she was a chronic user of corticosteroids and other immunosuppressive drugs. Her first symptoms were skin lesions that simulated bacterial cellulitis. Upon suspicion, we performed a biopsy and fungal infection was confirmed. Appropriate therapy was established, and the patient was discharged after 42 days of treatment in complete remission. PMID:26294948

  7. 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.

  8. 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

  9. Severe cellulitis and abdominal wall emphysema following laparoscopic colonic surgery: A case report.

    PubMed

    Tanaka, Ryo; Kameyama, Hitoshi; Chida, Tadasu; Kanda, Tatsuo; Kano, Yosuke; Ichikawa, Hiroshi; Hanyu, Takaaki; Ishikawa, Takashi; Kosugi, Shin-Ichi; Wakai, Toshifumi

    2015-05-01

    Abdominal wall emphysema is a common complication of laparoscopic surgery. This condition is usually harmless; however, if an infection occurs, it can develop into a serious condition such as necrotizing fasciitis. We report a case of a 51-year-old woman suffering from severe cellulitis that spread from an area of abdominal wall emphysema after laparoscopic surgery for sigmoid colon cancer. Recognizing this complication, early diagnosis, and prompt treatment are cornerstones for successful management of this potentially fatal disease. PMID:25913586

  10. 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.

  11. 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

  12. 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

  13. All red is not always bacterial cellulitis: a case of Löfgren's syndrome.

    PubMed

    Kumar, Gagan; Kumar, Nilay

    2010-02-01

    Löfgren's syndrome is a rare variant of sarcoidosis characterized by the triad of hilar adenopathy, acute polyarthritis, and erythema nodosum. It can be the first presentation of underlying sarcoidosis. Also, the initial presentation of Löfgren's syndrome may be confused with cellulitis. This is a self-limiting disease with a very good prognosis. Non steroidal anti-inflammatory drugs (NSAIDs), along with supportive care and close monitoring, are the mainstay for treatment. PMID:20942298

  14. Pseudomonas aeruginosa bacteremia secondary to acute right leg cellulitis: case of community-acquired infection

    PubMed Central

    Wahab, Asrul Abdul; Rahman, M.M.

    2013-01-01

    Pseudomonas aeruginosa is a gram-negative bacillus that causes wide spectrum clinical infections. However, it is most frequently associated with hospital-acquired infection. In this case a 58-year-old male with underlying hypertension and dyslipidaemia was admitted for acute right leg cellulitis. Pseudomonas aeruginosa was identified from the case, though it was not a usual suspected organism. It might be due to community-acquired infection.

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

    PubMed

    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

  16. 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

  17. 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

  18. Vancomycin-resistant Aureobacterium species cellulitis and bacteremia in a patient with acute myelogenous leukemia.

    PubMed Central

    Nolte, F S; Arnold, K E; Sweat, H; Winton, E F; Funke, G

    1996-01-01

    A 39-year-old male with acute myelogenous leukemia and concomitant porphyria cutanea tarda was admitted to the hospital for consolidation chemotherapy of his leukemia. During his hospitalization, he developed cellulitis of the left hand and persistent bacteremia with a yellow-pigmented, nonfermenting coryneform bacterium that was identified as Aureobacterium sp. The portal of entry for the Aureobacterium infection was probably through the skin lesions due to porphyria cutanea tarda. The infection developed while the patient was receiving vancomycin prophylaxis, and the vancomycin MIC for the isolate was 32 micrograms/ml. PMID:8818896

  19. 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

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

    PubMed Central

    Wollina, Uwe; Gemmeke, Astrid; Koch, Andr

    2012-01-01

    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

  1. Three cases of Arcanobacterium haemolyticum associated with abscess formation and cellulitis.

    PubMed

    Dobinsky, S; Noesselt, T; Rücker, A; Maerker, J; Mack, D

    1999-11-01

    Arcanobacterium haemolyticum has been described as an unusual pathogen causing pharyngotonsillitis and systemic disease in patients with predisposing conditions. A case of soft tissue abscess with no apparent portal of entry is reported in a healthy 31-year-old man who presented with a breast tumor. A second case of abscess formation in a 50-year-old patient with complicated wound healing is presented. In addition, a case of Arcanobacterium haemolyticum cellulitis in a 25-year-old female is reported. Due to its innocuous, coryneform appearance, this pathogen is probably underreported; therefore, the diagnostic evaluation of this organism is emphasized. PMID:10614955

  2. Imaging by ¹⁸F-FDG PET/CT of diffuse large B-cell lymphoma with cellulitis.

    PubMed

    Zhang, Yiqiu; Li, Beilei; Cai, Liang; Shi, Hongcheng; Hou, Jun

    2015-01-01

    Non-Hodgkin's lymphomas (NHL) quite often present in the neck but are seldom accompanied with cellulitis at the first diagnosis of the disease. We report a 56 year old woman with gradually neck swelling, which was initially treated as cellulitis. After examined by ultrasonography, computed tomography and after pathologically assessments, the diagnosis of large B-cell lymphoma was made. This case highlights the usefulness of fluorine-18-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET/CT) in staging and assessing treatment response in NHL. PMID:26574700

  3. Snake bite induced cellulitis leading to infected open dislocation of the first metacarpophalangeal joint A rare complication

    PubMed Central

    Balaji, Gopisankar; Kumar, Anand; Menon, Jagdish

    2015-01-01

    Non-traumatic open dislocation of the first metacarpophalangeal joint is a rare phenomenon. We present a rare such occurrence secondary to snake bite induced cellulitis. A 22-year-old girl presented with pain and instability of her right thumb two months. She had snake bite two months back following which she developed cellulitis which gradually became infected. She presented with raw area over her dorsal aspect of the thumb with active infection. Radiographs revealed metacarpophalangeal joint dislocation. She underwent debridement, stabilisation and soft tissue coverage. At final follow up, she was pain free and the wound healed completely. PMID:26155057

  4. Sinonasal Melioidosis in a Returned Traveller Presenting with Nasal Cellulitis and Sinusitis

    PubMed Central

    Lim, Rebecca Sin Mei; Flatman, Sam; Dahm, Markus C.

    2013-01-01

    We illustrate a case involving a 51-year-old man who presented to a tertiary hospital with sepsis secondary to an abscess of the nasal vestibule and pustular eruptions of the nasal mucosa. Associated cellulitis extended across the face to the eye, and mucosal thickening of the sinuses was seen on computed tomography. The patient underwent incision and drainage and endoscopic sinus surgery. Blood cultures and swabs were positive for a gram-negative bacillus, Burkholderia pseudomallei. He had multiple risk factors including travel to an endemic area. The patient received extended antibiotic therapy in keeping with published national guidelines. Melioidosis is caused by Burkholderia pseudomallei, found in the soil in Northern Australia and Asia. It is transmitted via cutaneous or inhaled routes, leading to pneumonia, skin or soft tissue abscesses, and genitourinary infections. Risk factors include diabetes, chronic lung disease, and alcohol abuse. It can exist as a latent, active, or reactivated infection. A high mortality rate has been identified in patients with sepsis. Melioidosis is endemic in tropical Northern Australia and northeastern Thailand where it is the most common cause of severe community-acquired sepsis. There is one other report of melioidosis in the literature involving orbital cellulitis and sinusitis. PMID:23936707

  5. 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

  6. A pilot cross-sectional study of patients presenting with cellulitis to emergency departments.

    PubMed

    Quirke, M; Saunders, J; O'Sullivan, R; Milenkovski, H; Wakai, A

    2014-01-01

    To characterise the Emergency Department (ED) prevalence of cellulitis, factors predicting oral antibiotic therapy and the utility of the Clinical Resource Efficiency Support Team (CREST) guideline in predicting patient management in the ED setting, a prospective, cross-sectional study of consecutive adult patients presenting to 3 Irish EDs was performed. The overall prevalence of cellulitis was 12 per 1,000 ED visits. Of 59 patients enrolled, 45.8% were discharged. Predictors of treatment with oral antibiotics were: CREST, Class 1 allocation (odds ratio (OR) 6.81, 95% Cl =1.5-30.1, p=0.012), patient self-referral (OR= 6.2, 95% Cl 1.9- 20.0, p=0.03) and symptom duration longer than 48 hours (OR 1.2, 95% Cl = 1.0-1.5,p=0.049). In conflict with guideline recommendation, 43% of patients in CREST Class 1 received IV therapy. Treatment with oral antibiotics was predicted by CREST Class 1 allocation, self-referral, symptom duration of more than 48 hours and absence of pre-EO antibiotic therapy. PMID:25556256

  7. Combination of cyclosporin A and prednisolone for juvenile cellulitis concurrent with hindlimb paresis in 3 English cocker spaniel puppies

    PubMed Central

    Park, Chul; Yoo, Jong-Hyun; Kim, Ha-Jung; Kang, Byeong-Teck; Park, Hee-Myung

    2010-01-01

    Three 7-week-old, English cocker spaniel littermates were diagnosed as having juvenile cellulitis with concurrent neurologic signs based on history, histopathology, and therapeutic response. The puppies were treated with cyclosporin A and prednisolone. Skin lesions and hindlimb paresis improved following treatment. PMID:21286328

  8. Combination of cyclosporin A and prednisolone for juvenile cellulitis concurrent with hindlimb paresis in 3 English cocker spaniel puppies.

    PubMed

    Park, Chul; Yoo, Jong-Hyun; Kim, Ha-Jung; Kang, Byeong-Teck; Park, Hee-Myung

    2010-11-01

    Three 7-week-old, English cocker spaniel littermates were diagnosed as having juvenile cellulitis with concurrent neurologic signs based on history, histopathology, and therapeutic response. The puppies were treated with cyclosporin A and prednisolone. Skin lesions and hindlimb paresis improved following treatment. PMID:21286328

  9. Comparing short to standard duration of antibiotic therapy for patients hospitalized with cellulitis (DANCE): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Recommended therapy duration for patients hospitalized with cellulitis is 10–14 days. Unnecessary use of antibiotics is one of the key factors driving resistance. Recent studies have shown that antibiotic therapy for cellulitis in outpatients can safely be shortened, despite residual inflammation. This study will compare in hospitalized patients the safety and effectiveness of shortening antibiotic therapy for cellulitis from 12 to 6 days. Methods/design In a multicenter, randomized, double-blind, non-inferiority trial, adult patients admitted with cellulitis will be included. Cellulitis is defined as warmth, erythema, and induration of the skin and/or subcutaneous tissue, with or without pain (including erysipelas). All patients will initially be treated with intravenous flucloxacillin, and will be evaluated after 5–6 days. Those who have improved substantially (defined as being afebrile, and having a lower cellulitis severity score) will be randomized at day 6 between additional 6 days of oral flucloxacillin (n = 198) or placebo (n = 198). Treatment success is defined as resolution of cellulitis on day 14 (disappearance of warmth and tenderness, improvement of erythema and edema), without the need of additional antibiotics for cellulitis by day 28. Secondary endpoints are relapse rate (up to day 90), speed of recovery (using a cellulitis severity score until day 28, and VAS scores on pain and swelling until day 90), quality of life (using the SF-36 and EQ-5D questionnaires) and costs (associated with total antibiotic use and health-care resource utilization up to day 90). Discussion Inclusion is planned to start in Q2 2014. Trial registration ClinicalTrials.gov (NCT02032654) and the Netherlands Trial Register (NTR4360). PMID:24885384

  10. Comparison of the Microbiology and Antibiotic Treatment among Diabetic and Non-Diabetic Patients Hospitalized for Cellulitis or Cutaneous Abscess

    PubMed Central

    Jenkins, Timothy C.; Knepper, Bryan C.; Moore, S. Jason; Saveli, Carla C.; Pawlowski, Sean W.; Perlman, Daniel M.; McCollister, Bruce D.; Burman, William J.

    2014-01-01

    Background Among diabetics, complicated skin infections may involve gram-negative pathogens; however, the microbiology of cellulitis and cutaneous abscess is not well-established. Objective To compare the microbiology and prescribing patterns between diabetics and non-diabetics hospitalized for cellulitis or abscess Design Secondary analysis of two published retrospective cohorts Setting/Patients Adults hospitalized for cellulitis or abscess, excluding infected ulcers or deep tissue infections, at 7 academic and community facilities Methods Microbiological findings and antibiotic use were compared among diabetics and non-diabetics. Multivariable logistic regression was performed to identify factors associated with exposure to broad gram-negative therapy, defined as receipt of at least two calendar days of β-lactamase inhibitors, 2nd – 5th generation cephalosporins, fluoroquinolones, carbapenems, tigecycline, aminoglycosides, or colistin. Results Of 770 total patients with cellulitis or abscess, 167 (22%) had diabetes mellitus. Among the 38% of cases with a positive culture, an aerobic gram-positive organism was isolated in 90% of diabetics and 92% of non-diabetics (p = .59); aerobic gram-negative organisms were isolated in 7% and 12%, respectively (p = .28). Overall, diabetics were more likely than non-diabetics to be exposed to broad gram-negative therapy (54% vs 44% of cases, p = .02). By logistic regression, diabetes mellitus was independently associated with exposure to broad gram-negative therapy (OR 1.66, 95%CI 1.15 – 2.40). Conclusion In cases of cellulitis or abscess associated with a positive culture, gram-negative pathogens were not more common among diabetics compared with non-diabetics. However, diabetics were overall more likely to be exposed to broad gram-negative therapy suggesting this prescribing practice may not be not warranted. PMID:25266293

  11. 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 Central

    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

  12. 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

  13. A 52-Year-Old Man With a Tuft Fracture and Hand Cellulitis.

    PubMed

    McCallum, James; Kamienski, Mary

    2015-01-01

    A 52-year-old man presented to the emergency department (ED) 1 week after getting his right index finger shut in a car door. The patient complained of right index finger pain. His entire hand was edematous and reddened. After evaluation in the ED and x-ray, the patient was diagnosed with a tuft fracture, right index finger/hand cellulitis, and possible osteomyelitis. The patient received tetanus diphtheria i.m., vancomycin 1 g i.v., and ceftriaxone (Rocephin) 2 g i.v. while in the ED and was admitted with referral to a hand specialist. The patient was discharged after 10 days of parental antibiotics. He has a history of sarcoidosis, hypertension, diabetes mellitus, and scleroderma. He is currently not taking any medications and denies allergies to medications and latex. The patient had no significant somatic findings. He was afebrile. PMID:26375833

  14. 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

  15. Prevalence and predictors of initial oral antibiotic treatment failure in adult emergency department patients with cellulitis: a pilot study

    PubMed Central

    Quirke, Michael; Boland, Fiona; Fahey, Tom; O'Sullivan, Ronan; Hill, Arnold; Stiell, Ian; Wakai, Abel

    2015-01-01

    Introduction Assessment of cellulitis severity in the emergency department (ED) setting is problematic. Given the lack of research performed to describe the epidemiology and management of cellulitis, it is unsurprising that heterogeneous antibiotic prescribing and poor adherence to guidelines is common. It has been shown that up to 20.5% of ED patients with cellulitis require either a change in route or dose of the initially prescribed antibiotic regimen. The current treatment failure rate for empirically prescribed oral antibiotic therapy in Irish EDs is unknown. The association of patient risk factors with treatment failure has not been described in our setting. Lower prevalence of community-acquired methicillin-resistant Staphylococcus aureus-associated infection, differing antibiotic prescribing preferences and varying availability of outpatient intravenous therapy programmes may result in different rates of empiric antibiotic treatment failure from those previously described. Methods and analysis Consecutive ED patients with cellulitis will be enrolled on a 24/7 basis from 3 Irish EDs. A prespecified set of clinical variables will be measured on each patient discharged on empiric oral antibiotic therapy. A second independent study recruiter will assess at least 10% of cases for each of the predictor variables. Follow-up by telephone call will occur at 14 days for all discharged patients where measurement of the primary outcome will occur. Our primary outcome is treatment failure, defined as a change in route of antibiotic administration from oral to intravenous antibiotic. Our secondary outcome is change in dose or type of prescribed antibiotic. A cohort of approximately 152 patients is required to estimate the proportion of patients failing oral antibiotic treatment with a margin of error of 0.05 around the estimate. Ethics and dissemination Full ethics approval has been granted. An integrated dissemination plan, involving diverse clinical specialties and enrolled patients, is described. Trial registration number NCT 02230813. PMID:26112223

  16. 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

  17. 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

  18. 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 Melbourne (34254C) and registered with the ClinicalTrials.gov registry (NCT02334124). We aim to disseminate the findings through international peer-reviewed journals and conferences. Clinical trial Pre-results. PMID:26754176

  19. Bacteremic cellulitis caused by non-serogroup O1 Vibrio cholerae acquired in a freshwater inland lake.

    PubMed Central

    Pitrak, D L; Gindorf, J D

    1989-01-01

    The number of reported cases of infections with non-serogroup O1 Vibrio cholerae in the United States has increased recently. These cases have almost invariably been associated with travel, seawater exposure, or the ingestion of shellfish. We report a case of bacteremic cellulitis caused by non-O1 V. cholerae that was acquired in a freshwater inland lake in northern Illinois. The organism is more widely distributed than generally appreciated, and the potential for infection in patients without the usual risk factors exists. PMID:2592550

  20. 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

  1. Genotypes and Pathogenicity of Cellulitis Isolates Reveal Traits That Modulate APEC Virulence

    PubMed Central

    Barbieri, Nicolle Lima; de Oliveira, Aline Luísa; Tejkowski, Thiago Moreira; Pavanelo, Daniel Brisotto; Rocha, Débora Assumpção; Matter, Letícia Beatriz; Callegari-Jacques, Sidia Maria; de Brito, Benito Guimarães; Horn, Fabiana

    2013-01-01

    We characterized 144 Escherichia coli isolates from severe cellulitis lesions in broiler chickens from South Brazil. Analysis of susceptibility to 15 antimicrobials revealed frequencies of resistance of less than 30% for most antimicrobials except tetracycline (70%) and sulphonamides (60%). The genotyping of 34 virulence-associated genes revealed that all the isolates harbored virulence factors related to adhesion, iron acquisition and serum resistance, which are characteristic of the avian pathogenic E. coli (APEC) pathotype. ColV plasmid-associated genes (cvi/cva, iroN, iss, iucD, sitD, traT, tsh) were especially frequent among the isolates (from 66.6% to 89.6%). According to the Clermont method of ECOR phylogenetic typing, isolates belonged to group D (47.2%), to group A (27.8%), to group B2 (17.4%) and to group B1 (7.6%); the group B2 isolates contained the highest number of virulence-associated genes. Clonal relationship analysis using the ARDRA method revealed a similarity level of 57% or higher among isolates, but no endemic clone. The virulence of the isolates was confirmed in vivo in one-day-old chicks. Most isolates (72.9%) killed all infected chicks within 7 days, and 65 isolates (38.1%) killed most of them within 24 hours. In order to analyze differences in virulence among the APEC isolates, we created a pathogenicity score by combining the times of death with the clinical symptoms noted. By looking for significant associations between the presence of virulence-associated genes and the pathogenicity score, we found that the presence of genes for invasins ibeA and gimB and for group II capsule KpsMTII increased virulence, while the presence of pic decreased virulence. The fact that ibeA, gimB and KpsMTII are characteristic of neonatal meningitis E. coli (NMEC) suggests that genes of NMEC in APEC increase virulence of strains. PMID:23977279

  2. 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

  3. Radiorésistance liée à l'hypoxie : de la cellule à l'homme

    NASA Astrophysics Data System (ADS)

    Guichard, M.; Stern, S.; Lartigau, E.

    1998-04-01

    Most experimental tumours contain experimental hypoxic cells located either far from the vessels or close to collaped vessels. The radioresistance of these cellscan be reduced by different treatments and, the best one will depend on the proportion of cells in the two categories of hypoxia. In patients, hypoxic areas have been detected in most solid tumours. The outcome of hypoxia during the course of an accelerated radiotherapy treatment is in progresse as well as the efficacy of carbogen (95% O2 5% CO2) to improve radiotherapy. We participate to the development of predictive assays of the tumour response to an irradiation. La plupart des tumeurs expérimentales renferment des cellules hypoxiques clonogènes situées soit à une certaine distance des vaisseaux soit au contact de vaisseaux collabés. La radiorésistance de ces cellules peut être réduite par différents procédés ; le meilleur traitement dépend de la proportion de celles dans les deux catégories d'hypoxie. Chez l'homme, des zones hypoxiques ont été mises en évidence dans la plupart des tumeurs solides. Le devenir de l'hypoxie au cours d'une radiothérapie accélérée ainsi que l'efficacité du carbogène (95 % O2- 5 % CO2) pour améliorer la radiothérapie sont en cours d'étude. Nous participons également au développement de teste prédicitifs de la réponse tumorale à une irradiation.

  4. 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

  5. Economic evaluation of linezolid, flucloxacillin and vancomycin in the empirical treatment of cellulitis in UK hospitals: a decision analytical model.

    PubMed

    Vinken, A; Li, Z; Balan, D; Rittenhouse, B; Wilike, R; Nathwani, D

    2001-12-01

    Standard antibiotic treatment of infections has become more difficult and costly due to treatment failure associated with the rise in bacterial resistance. New antibiotics that can overcome such resistant pathogens have the potential for great clinical and economic impact. Linezolid is a new antibiotic that is effective in the treatment of both antibiotic-susceptible and antibiotic-resistant Gram-positive bacterial infections, including those resistant to other available antibiotics. This breadth of activity is unique in existing antibiotics for Gram-positive bacteria and serves as the rationale for exploring the hypothesis that linezolid is an appropriate choice when considering empirical treatment of cellulitis in complicated or compromised patients in the nosocomial setting. A decision-modelling approach was used to compare the predicted first-line treatment efficacy and direct medical costs of linezolid with standard treatment of cellulitis among hospitalized patients. For the purposes of this analysis, standard care is defined along two main pathways: (1) initiating care with intravenous (iv) flucloxacillin, switching to vancomycin if the pathogen is found to be resistant to flucloxacillin, or maintaining flucloxacillin if the pathogen is found susceptible, or when culture and sensitivity analysis is inconclusive; or (2) initiating care with vancomycin, switching to iv flucloxacillin if the pathogen is found susceptible to flucloxacillin, maintaining vancomycin if the infection is found resistant, or when culture and sensitivity are inconclusive. For those patients taking iv flucloxacillin, a switch to oral flucloxacillin was allowed when clinically appropriate. We hypothesized that the cost of care of initiating treatment with linezolid would be less than that for both vancomycin and flucloxacillin in resistance risk ranges typically encountered in UK hospitals. In addition, while the registration trials showed equivalence of linezolid with the comparators in known or suspected methicillin-resistant Staphylococcus aureus (MRSA) and in known or suspected methicillin-susceptible Staphylococcus aureus (MSSA) (vancomycin and oxacillin) respectively, we hypothesized that first-line success rates would be higher in empiric treatment with linezolid. Efficacy data were obtained from recent clinical trials with linezolid and standard treatment, and medical resource utilization was obtained from an expert panel of clinicians who were questioned regarding resistant and susceptible infections separately. UK hospital direct medical costs of treatment were determined using standard costing techniques. Base case analyses assumed a residual 80% unknown pathogen rate after culture and susceptibility based on a physician survey and supported in the literature. The analysis in this model predicts that initiating empirical treatment of cellulitis with linezolid will (1) result in higher overall success rates than flucloxacillin for first-line treatment, regardless of resistance risk and (2) be less costly than initiating treatment with flucloxacillin when the likelihood of a patient being infected by a resistant pathogen is greater than 24.1%. Furthermore, initiating treatment with linezolid is predicted to result in higher overall success rates and be less costly than vancomycin across the entire spectrum of the patients' risk of being infected by a resistant pathogen. PMID:11926436

  6. Non-Necrotizing Streptococcal Cellulitis as a Cause of Acute, Atraumatic Compartment Syndrome of the Foot: A Case Report.

    PubMed

    Toney, James; Donovan, Stephanie; Adelman, Vanessa; Adelman, Ronald

    2016-01-01

    Acute compartment syndrome is widely accepted as a surgical emergency. Most cases of acute compartment syndrome occur after high-energy trauma, especially crush injuries. We present a unique case of acute, atraumatic compartment syndrome of the foot associated with infectious cellulitis. A 53-year-old male, with a medical history significant for human immunodeficiency virus, presented to the emergency department secondary to an insidious onset of intense foot pain, swelling, and an inability to bear weight on the affected extremity. He had no history of recent trauma. He was admitted to the hospital because of a suspected infection and subsequently was given intravenous antibiotics. During the admission, he developed a severe infection, and blood cultures demonstrated growth of group A streptococcus. No abscess or hematoma was identified on magnetic resonance imaging or during exploratory surgery. The findings from intraoperative cultures were negative. Despite proper medical care for his infection, the lower extremity pain worsened; therefore, compartmental pressures were obtained at the bedside. Multiple compartment pressures were measured and were >40 mm Hg. Compartment syndrome was diagnosed, and the patient was taken to the operating room for emergent fasciotomies. Surgical release of the medial, lateral, interosseous, and adductor compartments revealed copious amounts of serosanguinous drainage. Again, no definitive hematoma or purulence was identified. The patient's symptoms resolved after the fasciotomies, and he healed uneventfully. Our case highlights the need to consider acute compartment syndrome in the differential diagnosis for pain out of proportion to the clinical situation, even when a traditional etiology is absent. PMID:25981442

  7. Clinical Manifestations and Therapeutic Management of Vulvar Cellulitis and Abscess: Methicillin-resistant Staphylococcus aureus, Necrotizing Fasciitis, Bartholin Abscess, Crohn Disease of the Vulva, Hidradenitis Suppurativa.

    PubMed

    Wood, Sara C

    2015-09-01

    Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to life-threatening 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. Ineffective antibiotics or deferring necessary surgical debridement have proven to be costly to the patient, and the gynecologist must maintain an appropriately high index of suspicion. Employing a multidisciplinary team approach to care for vulvar cellulitis can guide treatment from antibiotic therapies to more aggressive surgical debridement. PMID:26125959

  8. 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 histologic differences. Like HS, DC likely involves both follicular dysfunction and an aberrant cutaneous immune response to commensal bacteria, such as coagulase negative staphylococci. The incidence of DC is likely under-reported. The literature suggests that now most cases of DC can be treated effectively. However, the lack of clinical studies regarding DC prevents full understanding of the disease and limits the ability to define a consensus treatment algorithm. PMID:24852785

  9. 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.

  10. 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; ...

  11. 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 ...

  12. What Is Cellulitis?

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  13. 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

  14. Isolation of a fastidious Bergeyella species associated with cellulitis after a cat bite and a phylogenetic comparison with Bergeyella zoohelcum strains.

    PubMed

    Shukla, Sanjay K; Paustian, David L; Stockwell, Patrick J; Morey, Roger E; Jordan, Jean G; Levett, Paul N; Frank, Daniel N; Reed, Kurt D

    2004-01-01

    Bergeyella zoohelcum is an uncommon zoonotic pathogen typically associated with cat or dog bites. Previously, only five cases of B. zoohelcum infection have been reported. We report the isolation and characterization of a fastidious Bergeyella species from acute cellulitis in the upper extremity of a 60-year-old woman. The organism was too fastidious for identification and susceptibility testing with traditional culture methods. The isolate was characterized further by PCR amplification and sequencing of the 16S rRNA gene with broad-range eubacterial primers. Phylogenetic analysis of the 16S ribosomal DNA sequence indicated that this isolate was a member of the species B. zoohelcum (previously Weeksella zoohelcum), a gram-negative bacillus that is rarely associated with infections in humans. Despite sharing a close genetic relationship with other B. zoohelcum strains, this isolate was extremely fastidious in nature, raising the possibility that similar strains from cat or dog bite wound infections have been underreported. PMID:14715767

  15. 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 ségréger l'influence des différents paramètres en jeu. L'analyse des résultats de l'ensemble de ces tests a permis de constater différents phénomènes au contact bloc-barre, dont la présence systématique de NaF et, surtout, de β-Al 2O3. Outre la carburation inévitable de la barre collectrice, la formation d'une couche Fe-Al a aussi été observée, favorisée par une pénétration rapide du bain électrolytique dans la cathode ainsi que par une composition de bain acide en surface de la barre. Cette couche comportait par ailleurs des cristaux de β-Al 2O3 pouvant nuire à sa conductivité électrique. Ensuite, à des ratios de bain entre 2.5 et 4.9, une mince couche contenant les éléments Al et N peut se former en surface de la barre. Pour un bain très basique (> 6.0), c'est plutôt une couche Na 2O qui a été observée. En conditions d'électrolyse mais sans une pénétration rapide du bain dans la cathode, du Na a pu carrément pénétrer dans la barre collectrice, préférentiellement avec le carbone. De plus, de la corrosion ainsi que des couches de fer et d'oxyde de fer peuvent se former sur la barre et potentiellement dégrader la qualité du contact électrique. Pour la suite des travaux, des mesures de résistivité ainsi que l'analyse des échantillons industriels permettraient d'évaluer l'impact de ces phénomènes sur la qualité du contact. Mots-clés : Électrolyse, aluminium, Hall-Héroult, interface barre-cathode, bain électrolytique.

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

    MedlinePlus

    ... discussed separately. (See "Patient information: Methicillin-resistant Staphylococcus aureus (MRSA) (Beyond the Basics)" and "Patient information: Animal ... a skin infection known as methicillin-resistant Staphylococcus aureus (MRSA). This is discussed separately. (See "Patient information: ...

  1. Chromobacterium violaceum cellulitis and sepsis following cutaneous marine trauma.

    PubMed

    Carter, Elliot; Cain, Kressida; Rutland, Beth

    2008-03-01

    Chromobacterium violaceum is a gram-negative bacillary organism that characteristically produces the purple pigment violacein. Documented as the cause of clinically relevant human infections in only 35 cases in the United States, C violaceum is particularly seen in patients with a history of cutaneous injury or trauma. We report the case of an 18-year-old woman who was struck by a propeller in a boating accident and sustained multiple deep lacerations of her right lower extremity. Shortly after admission to the hospital, the patient became frebrile and developed leukocytosis. Bacterial cultures revealed C violaceum, which demonstrated a characteristic purple pigment production on blood agar. Antimicrobial therapy was initiated, but 2 days after admission, the skin and subcutaneous tissue surrounding the patient's wounds became necrotic, necessitating an above-the-knee amputation of the right lower extremity (transfemoral amputation). The patient's condition improved after continued antimicrobial therapy and she was subsequently discharged in good health. This case represents a successful outcome of a rare but frequently fatal infection due to a morphologically and geographically distinct human pathogen. PMID:18441852

  2. Caracterisation des proprietes acoustiques des materiaux poreux a cellules ouvertes et a matrice rigide ou souple

    NASA Astrophysics Data System (ADS)

    Salissou, Yacoubou

    L'objectif global vise par les travaux de cette these est d'ameliorer la caracterisation des proprietes macroscopiques des materiaux poreux a structure rigide ou souple par des approches inverses et indirectes basees sur des mesures acoustiques faites en tube d'impedance. La precision des approches inverses et indirectes utilisees aujourd'hui est principalement limitee par la qualite des mesures acoustiques obtenues en tube d'impedance. En consequence, cette these se penche sur quatre problemes qui aideront a l'atteinte de l'objectif global precite. Le premier probleme porte sur une caracterisation precise de la porosite ouverte des materiaux poreux. Cette propriete en est une de passage permettant de lier la mesure des proprietes dynamiques acoustiques d'un materiau poreux aux proprietes effectives de sa phase fluide decrite par les modeles semi-phenomenologiques. Le deuxieme probleme traite de l'hypothese de symetrie des materiaux poreux selon leur epaisseur ou un index et un critere sont proposes pour quantifier l'asymetrie d'un materiau. Cette hypothese est souvent source d'imprecision des methodes de caracterisation inverses et indirectes en tube d'impedance. Le critere d'asymetrie propose permet ainsi de s'assurer de l'applicabilite et de la precision de ces methodes pour un materiau donne. Le troisieme probleme vise a mieux comprendre le probleme de transmission sonore en tube d'impedance en presentant pour la premiere fois un developpement exact du probleme par decomposition d'ondes. Ce developpement permet d'etablir clairement les limites des nombreuses methodes existantes basees sur des tubes de transmission a 2, 3 ou 4 microphones. La meilleure comprehension de ce probleme de transmission est importante puisque c'est par ce type de mesures que des methodes permettent d'extraire successivement la matrice de transfert d'un materiau poreux et ses proprietes dynamiques intrinseques comme son impedance caracteristique et son nombre d'onde complexe. Enfin, le quatrieme probleme porte sur le developpement d'une nouvelle methode de transmission exacte a 3 microphones applicable a des materiaux ou systemes symetriques ou non. Dans le cas symetrique, on montre que cette approche permet une nette amelioration de la caracterisation des proprietes dynamiques intrinseques d'un materiau. Mots cles. materiaux poreux, tube d'impedance, transmission sonore, absorption sonore, impedance acoustique, symetrie, porosite, matrice de transfert.

  3. 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

  4. 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

  5. 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.

  6. 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.

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

    PubMed

    Martens, Sabrina M

    2016-02-01

    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

  8. 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.

  9. Simulation numerique de l'effet du reflecteur radial sur les cellules rep en utilisant les codes DRAGON et DONJON

    NASA Astrophysics Data System (ADS)

    Bejaoui, Najoua

    The pressurized water nuclear reactors (PWRs) is the largest fleet of nuclear reactors in operation around the world. Although these reactors have been studied extensively by designers and operators using efficient numerical methods, there are still some calculation weaknesses, given the geometric complexity of the core, still unresolved such as the analysis of the neutron flux's behavior at the core-reflector interface. The standard calculation scheme is a two steps process. In the first step, a detailed calculation at the assembly level with reflective boundary conditions, provides homogenized cross-sections for the assemblies, condensed to a reduced number of groups; this step is called the lattice calculation. The second step uses homogenized properties in each assemblies to calculate reactor properties at the core level. This step is called the full-core calculation or whole-core calculation. This decoupling of the two calculation steps is the origin of methodological bias particularly at the interface core reflector: the periodicity hypothesis used to calculate cross section librairies becomes less pertinent for assemblies that are adjacent to the reflector generally represented by these two models: thus the introduction of equivalent reflector or albedo matrices. The reflector helps to slowdown neutrons leaving the reactor and returning them to the core. This effect leads to two fission peaks in fuel assemblies localised at the core/reflector interface, the fission rate increasing due to the greater proportion of reentrant neutrons. This change in the neutron spectrum arises deep inside the fuel located on the outskirts of the core. To remedy this we simulated a peripheral assembly reflected with TMI-PWR reflector and developed an advanced calculation scheme that takes into account the environment of the peripheral assemblies and generate equivalent neutronic properties for the reflector. This scheme is tested on a core without control mechanisms and charged with fresh fuel. The results of this study showed that explicit representation of reflector and calculation of peripheral assembly with our advanced scheme allow corrections to the energy spectrum at the core interface and increase the peripheral power by up to 12% compared with that of the reference scheme.

  10. 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...

  11. Impetigo

    MedlinePlus

    ... Cellulitis Eczema Skin, Hair, and Nails Abscess MRSA Staph Infections What Are Germs? Cellulitis Abscess Impetigo Ringworm Cellulitis Hand Washing Impetigo Abscess Staph Infections MRSA Contact Us Print Resources Send to a ...

  12. 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.).

  13. 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

  14. 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

  15. Dealing with Cuts (For Parents)

    MedlinePlus

    ... MORE ON THIS TOPIC Cellulitis First Aid: Cuts Staph Infections Bites and Scratches First Aid: Falls First Aid: ... What's a Scab? Cellulitis Cuts, Scratches, and Scrapes Staph Infections Dealing With Cuts and Wounds Babysitting: Dealing With ...

  16. New methods for preparing semi-conductor material: Cu/sub 2/S-CdS solar cells. Nouvelles methodes de preparation de materiau semi-conducteur cellules solaires Cu/sub 2/S-CdS

    SciTech Connect

    Vedel, J.; Lahaye, J.; Martinuzzi, S.; Bougnot, J.

    1984-01-01

    The following research program was undertaken: (1) Cu/sub 2/S deposits were prepared by a chemical spraying technique (atomisation) and characterised, (2) a physicochemical study was done on the influence of the properties of aerosol particles on the conductivity of the CdS films, (3) a physical characterisation of the annealing of thin layers of CdS was carried out, (4) atomisers were further improved for making thin homogeneous films of more than 4 sq cm, (5) the manufacturing technique for Cu/sub 2/S by dipping was reviewed and modified, and (6) a pilot workshop was installed for the fabrication of Cu/sub 2/S/CdS solar cells.

  17. Nikolsky sign

    MedlinePlus

    Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious ...

  18. 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

  19. 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...

  20. 21 CFR 520.88h - Amoxicillin trihydrate and clavulanate potassium for oral suspension.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., abscesses and cellulitis/dermatitis due to susceptible strains of beta-lactamase (penicillinase) producing S. aureus, nonbeta-lactamase S. aureus, Staphylococcus spp., Streptococcus spp., E. coli, Pasteurella... (penicillinase) producing Staphylococcus aureus, nonbeta-lactamase Staphylococcus aureus, Staphylococcus...

  1. Pets and Pasteurella Infections

    MedlinePlus

    ... scratched. The doctor can order tests such as cultures and smears of the drainage from the wound ... the cellulitis may not be known. If a culture shows the infection is caused by Pasteurella, oral ...

  2. Fever in Infants and Children

    MedlinePlus

    ... of rest and lots of fluids. See your child's doctor right away if your child is having problems breathing ... infection of the skin called CELLULITIS. See your child's doctor right away. This condition needs to be treated with ...

  3. 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 ...

  4. LUDWIG’S ANGINA FOLLOWING SELF APPLICATION OF AN ACIDIC CHEMICAL

    PubMed Central

    Gbolahan, O.O.; Olowookere, S.; Aboderin, A.; Omopariola, O.

    2012-01-01

    Ludwig’s angina is a potentially life threatening diffuse cellulitis usually resulting from odontogenic infection. We report a case of Ludwig’s angina resulting from self administration of an acidic chemical to treat toothache. PMID:25161404

  5. Group A Streptococcal Infections

    MedlinePlus

    ... throat and skin) occur every year. Types of GAS Infections Cellulitis and Erysipelas Impetigo Scarlet Fever Severe ... fasciitis (commonly called flesh-eating disease) Complications Untreated GAS infections can result in rheumatic fever and post- ...

  6. 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 ...

  7. Osteomyelitis

    MedlinePlus

    ... Kids For Parents MORE ON THIS TOPIC MRSA Staph Infections Dealing With Cuts First Aid & Safety Center Cellulitis ... Care Dealing With Broken Bones Osteomyelitis Hand Washing Staph Infections MRSA Bones, Muscles, and Joints Contact Us Print ...

  8. Toxic Shock Syndrome (For Parents)

    MedlinePlus

    ... can affect someone who has any type of staph infection , including pneumonia, an abscess, a skin or wound ... Talking to Your Child About Menstruation Cellulitis MRSA Staph Infections What Are Germs? Why Is Hand Washing So ...

  9. Hib Disease (Haemophilus Influenzae Type b)

    MedlinePlus

    ... can cause permanent brain damage and even death. Pneumonia. Someone with pneumonia will have a cough and problems with breathing. ... Parents MORE ON THIS TOPIC Cellulitis Immunizations Meningitis Pneumonia Why Should I Care About Germs? HIV and ...

  10. 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 ...

  11. Hib Photos

    MedlinePlus

    ... Children’s Immunization Project, St. Paul, Minnesota Cerebrospinal fluid culture positive for Haemophilus influenzae , type b (Gram stain) ... b. Cellulitis of the arm proven by blood culture www.vaccineinformation.org/photos/hib_aap002.jpg Copyright ...

  12. Skin, Hair, and Nails

    MedlinePlus

    ... the skin, often resulting in an itchy rash. Scabies and lice are examples of parasitic infestations. Both ... Tinea (Ringworm, Jock Itch, Athlete's Foot) Impetigo Paronychia Scabies Diaper Rash Cellulitis Word! Ringworm Fungal Infections Help! ...

  13. 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

  14. Bilateral septic cavernous sinus thrombosis following the masticator and parapharyngeal space infection from the odontogenic origin: a case report.

    PubMed

    Kiddee, Weerawat; Preechawai, Passorn; Hirunpat, Siriporn

    2010-09-01

    Neglect of odontogenic infections can have serious consequences. If they spread through fascial planes and intracranially they can cause an abscess, orbital cellulitis, and eventually cavernous sinus thrombosis. The authors report a case of rapid progressive bilateral orbital cellulitis and cavernous sinus thrombosis that originated from dental caries. Septic cavernous sinus thrombosis is a medical emergency. Early recognition and prompt treatments direct to the underlying sources of infection are crucial. Broad-spectrum intravenous antibiotics are the mainstay of treatment to reduce morbidity and mortality from this lethal condition. Management should be based on early diagnosis and prompt management with intravenous broad-spectrum antibiotics and surgical intervention. PMID:20873087

  15. 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

  16. 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

  17. 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

  18. 38 CFR 4.104 - Schedule of ratings-cardiovascular system.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... pulse pressure, and tachycardia 60 Without cardiac involvement but with edema, stasis dermatitis, and either ulceration or cellulitis: Lower extremity 50 Upper extremity 40 With edema or stasis dermatitis... nose and ears are involved. 7118Angioneurotic edema: Attacks without laryngeal involvement lasting...

  19. 38 CFR 4.104 - Schedule of ratings-cardiovascular system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... pulse pressure, and tachycardia 60 Without cardiac involvement but with edema, stasis dermatitis, and either ulceration or cellulitis: Lower extremity 50 Upper extremity 40 With edema or stasis dermatitis... nose and ears are involved. 7118Angioneurotic edema: Attacks without laryngeal involvement lasting...

  20. Squamous cell carcinoma arising from pilonidal sinus.

    PubMed

    Pandey, Mithilesh K; Gupta, Puneet; Khanna, Ajay K

    2014-08-01

    Pilonidal sinus is usually present in the sacrococcygeal region. The common presentations are cellulitis, abscess or sinus. Rarely malignant change may be seen in chronic pilonidal sinus. We report a case of chronic pilonidal sinus complicated with squamous cell carcinoma. PMID:23050944

  1. Skin Infections

    MedlinePlus

    ... Signing Kids Up for Sports Pregnant? Your Baby's Growth Cerebral Palsy: Caring for Your Child All About Food Allergies ... Skin abscesses or boils (a collection of pus in the skin) and cellulitis (bacterial infection of the deeper layers of the skin ...

  2. 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...

  3. 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

  4. 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

  5. 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.

  6. 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.…

  7. Carcinome mucineux primitif cutan: propos de deux cas et d'une revue de la literature

    PubMed Central

    Souaf, Ihsane; Ameurtesse, Hassania; Debbagh, Fatema Zehra; Idrissi, Karima; Znati, Kawter; Amarti, Affaf

    2014-01-01

    Le carcinome mucineux primitif cutan est une tumeur annexielle rare, dveloppe partir des glandes sudoripares. Il se localise en gnrale l'extrmit cphalique, surtout la rgion priorbitaire. Nous rapportons deux observations d'un carcinome mucineux primitif de la face et de la rgion axillaire, chez deux patients gs de 60 ans. Ltude histologique montrait une prolifration tumorale dermohypodermique, faite de cellules organises en cordons, en amas et en massif cribriformes, au sein d'une substance mucode. En immunohistochimie les cellules tumorales exprimaient la cytokratine 7, l'EMA et les rcepteurs hormonaux. L'actine musculaire lisse a bien marqu les cellules myopithliales au niveau de la composante in situ dans un seul cas. Le carcinome mucineux primitif cutan est difficile diffrencier d'une mtastase mammaire ou digestive. La mise en vidence de carcinome in situ ou de cellules myopithliale est en faveur de l'origine cutane primitive. C'est une tumeur croissance lente, avec des mtastases exceptionnelles. Le traitement est chirurgical et le taux de rcidive est trs lev. Et travers ces deux observations, les auteurs mettent en relief les principaux aspects cliniques, histologiques, thrapeutiques de cette entit avec une revue de la littrature. PMID:25574316

  8. 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.

  9. 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

  10. 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

  11. 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…

  12. 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

  13. Registration of 'UFCP 78-1013' Sugarcane

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sugarcane (a complex hybrid of Saccharum sp.) cultivar UFCP 78-1013 (Reg. no. ) was developed through the collaborative effort of the University of Florida (UF) and the United States Department of Agriculture-Agricultural Research Services (USDA-ARS), Canal Point (CP) for its potential use in cellul...

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

    PubMed

    Maluta, Renato P; Nicholson, Bryon; Logue, Catherine M; Nolan, Lisa K; Rojas, Thaís C G; Dias da Silveira, Wanderley

    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

  15. 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 a la surface opposee du recepteur pour evacuer la chaleur injectee. Les resultats mettent egalement en evidence l'importance des interfaces thermiques et les avantages de diffuser la chaleur dans les couches metalliques avant de la conduire au travers des couches dielectriques du recepteur. Des recepteurs de multiples compositions ont ete caracterises, demontrant que les outils developpes peuvent definir la capacite de diffusion thermique. La repetabilite de la plateforme est evaluee par l'analyse de l'etendue des mesures repetees sur des echantillons selectionnes. La plateforme demontre une precision et reproductibilite de +/- 0.14 ° C/W. Ce travail fournit des outils pour la conception des recepteurs en proposant une mesure qui permet de comparer et d'evaluer l'impact thermique de ces recepteurs integres a uri module de refroidissement. Mots-cles : cellule solaire, photovoltaique, transfert de chaleur, concentration, resistances thermiques, plateforme de caracterisation, refroidissement

  16. An unusual complication of epistaxis: cerebral abscess formation after anterior ethmoidal artery ligation.

    PubMed

    Murer, Karin; Holzmann, David; Burkhardt, Jan-Karl; Soyka, Michael Benjamin

    2015-01-01

    Epistaxis is a very common emergency in otorhinolaryngology. Anterior ethmoidal artery ligation using an external approach is one of the surgical options in posterior epistaxis. We present, to the best of our knowledge, the first reported case of an intracerebral abscess after epistaxis treatment with ligation of the anterior ethmoidal artery using an endoscopic-assisted external approach in a 56-year-old patient. The patient presented 4 days postoperatively with an orbital cellulitis. A CT was performed and a frontobasal hypodensity was found. An additional MR tomography the next day showed a lesion suspicious for an intracerebral abscess. Despite intravenous antibiotic therapy, the lesion increased and was successfully treated by the neurosurgeons, with abscess resection over a craniotomy and frontobasal repair using a pedicled periosteal flap. Surgeons have to be aware of this rare but possibly lethal severe complication and should consider early imaging studies, especially if a periorbital cellulitis appears. PMID:26715141

  17. Neonatal orbital abscess

    PubMed Central

    Gogri, Pratik Y.; Misra, Somen L.; Misra, Neeta S.; Gidwani, Hitesh V.; Bhandari, Akshay J.

    2015-01-01

    Orbital abscess generally occurs in older children but it can rarely affect infants and neonates too. We report a case of community acquired methicillin resistant staphylococcus aureus (CA-MRSA) neonatal orbital abscess in a 12-day-old term female neonate with no significant past medical history or risk factor for developing the infection. The case highlights the importance of consideration of CA-MRSA as a causative agent of neonatal orbital cellulitis even in a neonate without any obvious predisposing condition. Prompt initiation of appropriate medical therapy against MRSA and surgical drainage of the abscess prevents life threatening complications of orbital cellulitis which more often tend to be fatal in neonates. PMID:26622145

  18. Pelvic Surgical Site Infections in Gynecologic Surgery

    PubMed Central

    Lachiewicz, Mark P.; Moulton, Laura J.; Jaiyeoba, Oluwatosin

    2015-01-01

    The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery. PMID:25788822

  19. Complications of suture ligation ablation for ulnar polydactyly: a report of two cases.

    PubMed

    Patillo, Dominic; Rayan, Ghazi M

    2011-03-01

    We report two cases resulting in complications following suture ligation treatment for ulnar polydactyly. One case consisted of bilateral, retained gangrene and cellulitis, and a second case consisted of a residual, sensitive skin tag. The case involving gangrene and cellulitis developed after an unsuccessful suture ligation of bilateral pedunculated duplicated digits. The second case developed after suture ligature ablation of a rudimentary digit in the nursery but presented 3 years later with a residual symptomatic nubbin. Both cases were treated by surgical excision of the residual tissue in the operating room. The first case illustrates a morbid complication following unsuccessful ligature while the second case demonstrates the inevitable suboptimal long-term outcome associated with what has traditionally been considered "successful" suture ligation. PMID:22379449

  20. 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.

  1. OPHTHALMIC MANIFESTATIONS OF PAEDERUS DERMATITIS.

    PubMed

    Laovirojjanakul, Wipada; Pipatbanditsakul, Sasinun; Yospaiboon, Yosanan

    2015-01-01

    A 30-year-old Chinese female presented with progressive periorbital swelling of unknown cause and redness of her left eye. She was given an antibiotic eyedrop and oral cloxacillin to treat periorbital cellulitis. The clinical picture did not improve and she returned with swelling of the fellow eye. We stopped the medication and sent her to a dermatologist because of the abnormal periorbital skin pattern. Her diagnosis was Paederus dermatitis. Intramuscular dexamethasone was administered due to severe periorbital edema. The skin lesion was improved one week later. The ophthalmic manifestations of Paederus dermatitis are periorbital dermatitis, conjunctivitis and persistent epithelial defects. The challenge in diagnosis of this condition is that it can mimic other diseases, such as infectious periorbital cellulitis and Herpes viral infection. Therefore, a clear appreciation of the clinical manifestations will lead us to the proper management of the condition and minimize complications. PMID:26513900

  2. Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection.

    PubMed

    Rantala, S

    2014-08-01

    The importance of group C and G Streptococcus dysgalactiae subspecies equisimilis (S. dysgalactiae subsp. equisimilis) as a significant pathogen has recently been better recognized. S. dysgalactiae subsp. equisimilis disease can range in severity from milder skin and soft-tissue conditions such as wound infection, erysipelas, and cellulitis, to life-threatening necrotizing fasciitis and streptococcal toxic shock syndrome, thus sharing the clinical picture with S. pyogenes. The most common clinical manifestation of bacteremia is cellulitis. An increase in the incidence of S. dysgalactiae subsp. equisimilis bacteremia has been recognized. Invasive forms of this infection are most commonly found in elderly patients with underlying comorbidities and skin breakdown. The case fatality in bacteremia has been reported to be 15-18%. In this review, the epidemiology, clinical characteristics, and emm types of S. dysgalactiae subsp. equisimilis bacteremia are summarized. PMID:24682845

  3. 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

  4. 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.

  5. 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

  6. 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

  7. [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

  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. An unusual presentation of a dural arteriovenous fistula of the sphenoparietal sinus

    PubMed Central

    Macdonald, Andrew; Plaha, Puneet; Byrne, James

    2014-01-01

    Dural arteriovenous fistulae (DAVFs) are a rare form of intracranial arteriovenous malformation. We present the case of a patient who presented in a previously undescribed manner with facial swelling and bruising initially misdiagnosed as cellulitis. He was found subsequently to have DAVFs of the sphenoparietal sinus that had hemorrhaged. The rarity of DAVFs at this location may account for this unique presentation. Successful treatment was achieved by transarterial embolization. PMID:24632907

  10. Mycoplasma infection of the hand acquired from a cat.

    PubMed

    McCabe, S J; Murray, J F; Ruhnke, H L; Rachlis, A

    1987-11-01

    Mycoplasmas, the smallest known organism capable of a free existence, have been recognized as human pathogens for 25 years. However, a soft tissue cellulitis caused by a mycoplasma has never been reported in a human subject. This case report of a mycoplasma infection of the hand acquired from an infected cat describes the clinical presentation, operative findings, mycoplasmology, and treatment of this infection. PMID:3693844

  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. 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

  14. 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.

  15. 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.

  16. 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

  17. Lime-induced phytophotodermatitis

    PubMed Central

    Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

    2014-01-01

    This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

  18. Lime-induced phytophotodermatitis.

    PubMed

    Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

    2014-01-01

    This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

  19. Is Leclercia adecarboxylata a New and Unfamiliar Marine Pathogen?

    PubMed Central

    Keshet, Doron; Eidelman, Mark; Geffen, Yuval; Raz-Pasteur, Ayelet; Hussein, Khetam

    2014-01-01

    Leclercia adecarboxylata infection is rarely reported in the context of human infections. In the scant cases reported in the literature, it usually involves individuals who are immunocompromised with infections of a polymicrobial nature. Recently, data have begun to accumulate suggesting that L. adecarboxylata is a pathogen associated with water environments. We review the literature regarding L. adecarboxylata infections and present a case of cellulitis and soft-tissue infection in the foot of a healthy surfer. PMID:24523466

  20. Is Leclercia adecarboxylata a new and unfamiliar marine pathogen?

    PubMed

    Keren, Yaniv; Keshet, Doron; Eidelman, Mark; Geffen, Yuval; Raz-Pasteur, Ayelet; Hussein, Khetam

    2014-05-01

    Leclercia adecarboxylata infection is rarely reported in the context of human infections. In the scant cases reported in the literature, it usually involves individuals who are immunocompromised with infections of a polymicrobial nature. Recently, data have begun to accumulate suggesting that L. adecarboxylata is a pathogen associated with water environments. We review the literature regarding L. adecarboxylata infections and present a case of cellulitis and soft-tissue infection in the foot of a healthy surfer. PMID:24523466

  1. Ruptured Baker's cyst with compartment syndrome: an extremely unusual complication.

    PubMed

    Hamlet, Mark; Galanopoulos, Ilias; Mahale, Avinash; Ashwood, Neil

    2012-01-01

    A 69-year-old man presented with sudden onset of pain with acute tense swelling of his left leg. Initially he was treated empirically with antibiotics for cellulitis while the possibility of deep vein thrombosis was ruled out. His symptoms gradually worsened with progressive distal neurological deficit and increasing pain. Further investigations suggested that he had a ruptured Baker's cyst in the calf with development of compartment syndrome. PMID:23264161

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

    PubMed

    Borschitz, Thomas; Schlicht, Svenja; 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

  3. [Treatment of the wound surrounding skin].

    PubMed

    Leskovec, Nada Kecelj; Huljev, Dubravko

    2012-10-01

    Skin barrier function around the ulcer is usually impaired. Additionally, the skin can be atrophic, thinned, without skin adnexa and elastic fibers, dry and prone to callus formation. Skin barrier function can be improved with regular use of emollients. It is important to differentiate erythema around the ulcer induced by hypostatic eczema from cellulitis or erysipelas and from allergic or toxic contact dermatitis or eczema vulgaris because therapy is completely different. PMID:23193827

  4. 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

  5. [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

  6. 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

  7. Differential Diagnosis of the Swollen Red Eyelid.

    PubMed

    Carlisle, Robert Thomas; Digiovanni, John

    2015-07-15

    The swollen red eyelid is a common presentation in primary care. An understanding of the anatomy of the orbital region can guide care. Factors that guide diagnosis and urgency of care include acute vs. subacute onset of symptoms, presence or absence of pain, identifiable mass within the eyelid vs. diffuse lid swelling, and identification of vision change or ophthalmoplegia. Superficial skin processes presenting with swollen red eyelid include vesicles of herpes zoster ophthalmicus; erythematous irritation of contact dermatitis; raised, dry plaques of atopic dermatitis; and skin changes of malignancies, such as basal or squamous cell carcinoma. A well-defined mass at the lid margin is often a hordeolum or stye. A mass within the midportion of the lid is commonly a chalazion. Preseptal and orbital cellulitis are important to identify, treat, and differentiate from each other. Orbital cellulitis is more often marked by changes in ability of extraocular movements and vision as opposed to preseptal cellulitis where these characteristics are classically normal. Less commonly, autoimmune processes of the orbit or ocular tumors with mass effect can create an initial impression of a swollen eyelid. PMID:26176369

  8. Compression therapy and liposuction of lower legs for bilateral hereditary primary lymphedema praecox.

    PubMed

    Espinosa-de-Los-Monteros, Antonio; Hinojosa, Carlos A; Abarca, Leonardo; Iglesias, Martín

    2009-01-01

    In this report, we describe a case of bilateral non-syndromic hereditary lymphedema praecox of lower legs. The patient was diagnosed at age 16. Ten years later, he was unable to ambulate due to increased bilateral lower leg volume, continuous pain, and recurrent episodes of cellulitis. He was treated at our tertiary-care center with compression therapy and circumferential liposuction of lower legs, ankles, and dorsum of feet in order to remove hypertrophic fat deposits, facilitate conservative therapy, and decrease further risk of cellulitis. No complications were seen and compression therapy was continued. Fourteen month follow-up reveals no increase in leg volume over time, absence of pain, and no further episodes of cellulitis with complete ability to ambulate and return to normal activities. Even when it does not eliminate the underlying cause of primary lymphedema, combined therapy consisting of compression and liposuction is safe and is able to achieve control, at least on a short term, of clinically disabling conditions associated with advanced stages. PMID:19174259

  9. Allergic rhinitis as a risk factor for orbital complication of acute rhinosinusitis in children.

    PubMed

    Holzmann, D; Willi, U; Nadal, D

    2001-01-01

    The purpose of this article is to determine allergic rhinitis and age as potential risk factors for the development of orbital complications of acute rhinosinusitis in children. One hundred two children presenting with orbital swelling were investigated by computed tomography (CT) of the paranasal sinuses and the orbit as well as for underlying allergic rhinitis. Sixty (58.8%) patients had orbital complications of clinical and radiological acute rhinosinusitis. They were grouped accordingly: preseptal cellulitis (n = 24), periostitis (n = 10), and subperiosteal abscess (n = 26). No abscess within the orbit or cavernous sinus thrombosis was found. Thirty-four (56.7%) of the 60 patients underwent allergy investigation. Allergic rhinitis was found in 9 (64.3%) of 14 children with preseptal cellulitis, in 1 (25%) out of 4 children with periostitis, and in 13 (76.5%) out of 17 children with subperiosteal abscess. The prevalence of allergic rhinitis was significantly higher in patients presenting in pollen season from February to August (17:4) than in patients presenting in the period between September and January (6:7). Thus, allergic rhinitis may be a cofactor in the pathogenesis of orbital complications of acute rhinosinusitis. According to our study population, age only influences the type of orbital complication of acute rhinosinusitis in the sense that older children are more likely to develop subperiosteal abscess, whereas younger children develop preseptal cellulitis. PMID:11777246

  10. 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

  11. Carcinome muco-épidermoide chez une jeune fille de 21 ans

    PubMed Central

    Khouchilia, Fatima Zahra; El khattabi, Wiam; Bopaka, Régis Gothard; Aichane, Abdelaziz; Afif, Hicham

    2015-01-01

    Les carcinomes muco-épidermoïdes font partie d'un groupe rare de tumeurs pulmonaires malignes. Ces tumeurs sont le plus souvent retrouvées chez lessujets jeunes. La croissance de la tumeur est en général endo-bronchique et concerne les bronches de grande taille. L'aspect histo-pathologique révèle des cellules produisant du mucus, des cellules épithéliales et des cellules mixtes. Dans cet article nous rapportons l'observation d'une jeune fille de 21 ans avec une tumeur de la bronche souche droite, qui après résection endo-bronchique s'est avéré être un carcinome muco-épidermoïde pulmonaire. La patiente a subi une pneumonectomie droite élargie à la carène avec un curage ganglionnaire médiastinale. Elle est actuellement en rémission après un suivi de 7 mois. Aucun traitement standard n'est défini pour ces tumeurs. Le pronostic dépend du grade histologique, et peut, notamment chez les sujets âgés, être très péjoratif. PMID:25995803

  12. Three-Layered Photovoltaic Cell with an Enlarged Photoactive Region of Codeposited Dyes

    NASA Astrophysics Data System (ADS)

    Antohe, S.; Ruxandra, V.; Tugulea, L.; Gheorghe, V.; Ionascu, D.

    1996-08-01

    Three-layered organic solar cells with an interlayer of codeposited dyes of p-type Copper Phthalocyanine (CuPc) and n-type 5,10,15,20-Tetra (4-Pyridil) 21H,23H-Porphine (TPyP) between the respective dye layers were prepared and characterised. The analysis of their dark current-voltage (I - U) characteristics at room temperature has been presented in order to elucidate the conduction mechanisms and to evaluate the cell parameters. The analysis of photovoltaic properties shows that the photocurrent of three-layered cells is about ten times larger than that of a double layered cell, due to the efficient carrier photogeneration in the code-posited layer. The best power conversion efficiency, at 0.35% was obtained under illumination with monochromatic light of 30 μW cm^{-2}, at 520 nm. Nous avons élaboré des cellules photovoltaïques avec trois couches minces de colorants organiques entre deux électrodes : ITO et Al. Les cellules ont été faites en utilisant CuPc comme semi-conducteur de type-p et TPyP comme semi-conducteur de type-n. Entre les deux couches de CuPc et TPyP, une couche mince de CuPc+TPyP a été deposée par co-évaporation thermique des deux matériaux organiques. L'analyse des caractéristiques électriques (I - U) des cellules dans l'obscurité est présentée pour comprendre les mécanismes mis en jeu et pour évaluer leur paramètres électriques. L'analyse des propriétés photovoltaïques a montré que le photocourant des cellules avec trois couches minces est 10 fois plus grand que celui mesuré sur les cellules à deux couches minces, grâce à une création plus efficace des photoporteurs dans la couche mince co-évaporée. Le rendement de conversion énergétique est maximal à 0,35% pour la lumière avec une longueur d'onde de 520 nm et une intensité lumineuse de 30 μW cm^{-2}.

  13. Clindamycin versus Trimethoprim–Sulfamethoxazole for Uncomplicated Skin Infections

    PubMed Central

    Miller, Loren G.; Daum, Robert S.; Creech, C. Buddy; Young, David; Downing, Michele D.; Eells, Samantha J.; Pettibone, Stephanie; Hoagland, Rebecca J.; Chambers, Henry F.

    2015-01-01

    Background Skin and skin-structure infections are common in ambulatory settings. However, the efficacy of various antibiotic regimens in the era of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is unclear. Methods We enrolled outpatients with uncomplicated skin infections who had cellulitis, abscesses larger than 5 cm in diameter (smaller for younger children), or both. Patients were enrolled at four study sites. All abscesses underwent incision and drainage. Patients were randomly assigned in a 1:1 ratio to receive either clindamycin or trimethoprim–sulfamethoxazole (TMP-SMX) for 10 days. Patients and investigators were unaware of the treatment assignments and microbiologic test results. The primary outcome was clinical cure 7 to 10 days after the end of treatment. Results A total of 524 patients were enrolled (264 in the clindamycin group and 260 in the TMP-SMX group), including 155 children (29.6%). One hundred sixty patients (30.5%) had an abscess, 280 (53.4%) had cellulitis, and 82 (15.6%) had mixed infection, defined as at least one abscess lesion and one cellulitis lesion. S. aureus was isolated from the lesions of 217 patients (41.4%); the isolates in 167 (77.0%) of these patients were MRSA. The proportion of patients cured was similar in the two treatment groups in the intention-to-treat population (80.3% in the clindamycin group and 77.7% in the TMP-SMX group; difference, −2.6 percentage points; 95% confidence interval [CI], −10.2 to 4.9; P = 0.52) and in the populations of patients who could be evaluated (466 patients; 89.5% in the clindamycin group and 88.2% in the TMP-SMX group; difference, −1.2 percentage points; 95% CI, −7.6 to 5.1; P = 0.77). Cure rates did not differ significantly between the two treatments in the subgroups of children, adults, and patients with abscess versus cellulitis. The proportion of patients with adverse events was similar in the two groups. Conclusions We found no significant difference between clindamycin and TMP-SMX, with respect to either efficacy or side-effect profile, for the treatment of uncomplicated skin infections, including both cellulitis and abscesses. (Funded by the National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences, National Institutes of Health; ClinicalTrials.gov number, NCT00730028.) PMID:25785967

  14. 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

  15. Leg Swelling Caused by Heterotopic Ossification Mimicking Deep Vein Thrombosis in a Paraplegic Patient

    PubMed Central

    Bang, Jin Hyuk; Lee, Ho Jun

    2015-01-01

    Leg swelling in patients with paraplegia due to spinal cord injury (SCI) occurs for various reasons, including heterotopic ossification (HO), deep vein thrombosis (DVT), fracture, or cellulitis. The clinical presentations of these conditions may overlap in part or in whole and it may occasionally be difficult to distinguish. Of these conditions, DVT and subsequent pulmonary embolism remain significant causes of morbidity and mortality in patients with SCI. Therefore, a prompt diagnostic work-up, particularly for DVT, is essential in patients with SCI, who present with leg swelling. Here, we report a case of leg swelling in a paraplegic patient, resulting from HO mimicking DVT and discuss the differential diagnosis. PMID:27169085

  16. A one-stage marsupialization procedure for management of infected umbilical vein remnants in calves and foals.

    PubMed

    Edwards, R B; Fubini, S L

    1995-01-01

    Five Holstein calves and two foals with omphalophlebitis were treated by surgical marsupialization of the umbilical vein remnant because complete resection of the infected tract was not possible. The infected umbilical stalk was resected, and the umbilical vein remnant was marsupialized in a one-stage procedure by suturing it into the abdominal wall lateral to the abdominal incision. Antimicrobial drugs were administered, and the marsupialized tract was irrigated until closure by second intention healing. Cellulitis associated with the marsupialization site occurred in two calves but resolved with antimicrobial therapy. Owners reported that, 9 to 60 months after surgery, there were no complications associated with the procedure. PMID:7701768

  17. 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

  18. 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

  19. Necrotizing Fasciitis of the Nose Complicated with Cavernous Sinus Thrombosis

    PubMed Central

    Swaminath, D.; Narayanan, R.; Orellana-Barrios, M. A.; Temple, B.

    2014-01-01

    Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative. PMID:24876978

  20. Necrotizing fasciitis of the nose complicated with cavernous sinus thrombosis.

    PubMed

    Swaminath, D; Narayanan, R; Orellana-Barrios, M A; Temple, B

    2014-01-01

    Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative. PMID:24876978

  1. Pilonidal Abscess Associated With Primary Actinomycosis

    PubMed Central

    Abdul Malik, Mohamad Hashir; Keh, Chris Hang Liang

    2015-01-01

    Pilonidal disease in the sacrococcygeal region usually presents as abscesses, recurrent inflammation, cellulitis or fistula tracks. However, few reports on actinomycosis affecting pilonidal sinuses have been published. We report a case of a 25-year-old woman who presented with a pilonidal abscess who underwent surgical drainage and debridement. Pus from the pilonidal abscess was sent for microbiology, which grew actinomyces turicensis associated with prevotella bivia and peptostreptococci. She was treated with oral amoxicillin-clavulanate after surgical drainage for one week and recovered well. Actinomycosis associated with pilonidal abscesses, though uncommon, should be recognized and can be satisfactorily treated with a combination of surgical drainage and antibiotics. PMID:26817020

  2. 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

  3. 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

  4. Atraumatic Subdural Hematoma in a Third-Trimester Gravid Patient

    PubMed Central

    Traficante, D. C.; Marin, A.; Catapano, A.

    2016-01-01

    Acute atraumatic subdural hematoma is a rare occurrence and there exist few case studies which describe suspected cases and causes for this condition. We present a case of a 36-year-old female at 32-week gestation who initially presented to the emergency department for evaluation of lower extremity cellulitis but had acute neurologic change while being in the ED. Computed tomography revealed a right subdural hematoma with midline shift and mass effect. The primary cause for the patient's subdural hematoma is unknown; however, this patient had several risk factors for developing an atraumatic subdural hematoma. PMID:26989526

  5. More than meets the eye: a rapidly progressive skin infection in a football player.

    PubMed

    Geissler, Kyle E; Borchers, James R

    2015-05-01

    Fournier gangrene (FG) is a rare polymicrobial infection of perineum that carries a high mortality rate. Survival depends on rapid identification of the infection with early and extensive debridement of necrotic tissue. We present a case of an otherwise healthy American football offensive lineman who was initially hospitalized for gluteal abscess and advancing cellulitis. The patient was discovered to have FG during intraoperative debridement of the abscess and was subsequently treated with several weeks of broad-spectrum antibiotics. This case highlights the importance that team physicians play in the identification and appropriate management of potentially life-threatening infections. PMID:24942620

  6. [Postoperative complications of Bartholin's duct abscess. About two cases].

    PubMed

    Chêne, G; Tardieu, A-S; Nohuz, E; Rabischong, B; Favard, A; Mage, G

    2006-01-01

    Bartholinitis is the most common infectious vulvar disease and develops in approximately 2% of all women. The choice concerning treatment may be uneasy between medical or surgical modalities, and we have to be cautious because of the risk of severe complications associated with the procedure. We report two cases: one case of sepsis and the other one of bacterial cellulitis after Bartholin's duct abscess marsupialization. In the light of epidemiological and bacteriological date referring to Bartholinitis, we recommend a safe and effective management (particularly the use of broad-spectrum antibiotics) that we will describe. PMID:16777462

  7. Radiation-induced localized scleroderma in breast cancer patients.

    PubMed

    Bleasel, N R; Stapleton, K M; Commens, C; Ahern, V A

    1999-05-01

    Radiation-induced scleroderma in breast cancer patients appears to occur in approximately one out of every 500 patients. We report four cases that developed within 3 months of conservative breast surgery and postoperative radiation treatment. The reaction was contained entirely within the treatment field and demonstrated the typical features of this condition where the breast becomes erythematous, violaceous, indurated, retracted, and progressively pigmented. The breast tends to soften and become more comfortable over 1-4 years; however, significant induration, retraction and pigmentary changes remain. There appears to be no predictive factors. Radiation-induced scleroderma must be differentiated from cellulitis and recurrent breast cancer. PMID:10333622

  8. Fatal necrotizing fasciitis and myositis in a captive common bottlenose dolphin (Tursiops truncatus) associated with Streptococcus agalactiae.

    PubMed

    Zappulli, Valentina; Mazzariol, Sandro; Cavicchioli, Laura; Petterino, Claudio; Bargelloni, Luca; Castagnaro, Massimo

    2005-11-01

    A common bottlenose dolphin (Tursiops truncatus) was presented for necropsy after acute onset of gastrointestinal signs and cutaneous lesions that rapidly progressed to death. Gross and microscopic findings were characterized by locally extensive severe necrohemorrhagic fasciitis and cellulitis, and severe necrotizing myositis in the head and dorsocranial thorax, with numerous disseminated gram-positive cocci. Streptococcus agalactiae was isolated from the lesions and from visceral organs (liver and lung), and it was identified by standard microbiology techniques. This communication is the first report of necrotizing fasciitis in a marine mammal associated with S. agalactiae. PMID:16475528

  9. Acute complications of tattooing presenting in the ED.

    PubMed

    Kluger, Nicolas

    2012-11-01

    Permanent decorative tattooing involves the introduction of exogenous pigments and/or dyes into the dermis to produce the permanent design. Despite improved hygiene in the tattoo parlors of Western countries, this procedure still carries risk. Various complications may occur right after tattooing, from benign complications such as transient limb edema, palpable lymph nodes, and contact eczema, to more severe ones such as the inoculation of virulent microorganisms into the dermis, potentially life-threatening cellulitis, and necrotizing fasciitis or cutaneous vasculitis. This review focuses specifically on the complications that occur within the first month of tattooing that emergency physicians may have to manage. PMID:22944541

  10. 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

  11. 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.

  12. Submasseteric Infection: A Rare, Deep Space Cheek Infection Causing Trismus.

    PubMed

    Schwartz, Richard H; Bahadori, Robert S; Willis, Andrea

    2015-11-01

    Submasseteric space infections are rare at any age but particularly so in primary school children. The origin of the infection is usually odontogenic, from pericoronitis in a third molar. Submasseteric inflammation is a deep facial space inflammation, often progressing to mature abscess, and usually misdiagnosed as staphylococcal or streptococcal lymphadenitis or pyogenic parotitis. The hallmark of a masticatory space infection is trismus. The cardinal signs of this infection include a firm mass in the body of the masseter muscle with overlying cellulitis with trismus. PMID:25411856

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. Derm diagnoses you can't afford to miss.

    PubMed

    Hazin, Ribhi; Abuzetun, Jamil Y; Khatri, Khalil A

    2009-06-01

    Management of hereditary angioedema should include fresh frozen plasma containing C1 inhibitor (C1-INH), whenever possible; if C1-INH-containing plasma is unavailable, fresh frozen plasma can be used instead. Do not give neomycin to patients with suspected cellulitis; the drug may promote antibiotic resistance in Staphylococcus aureus, a pathogen often associated with this condition. Whenever a patient presents with erythematous skin lesions and a recent history of receiving penicillin or a cephalosporin antibiotic, a sulfa derivative, or an anticonvulsant, the suspected medication should be stopped until Stevens-Johnson syndrome is ruled out. PMID:19508842

  20. 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

  1. Multiple nontuberculous scrofulodermas showing dramatic response to clarithromycin

    PubMed Central

    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

  2. Puncture wounds to the foot.

    PubMed

    Verdile, V P; Freed, H A; Gerard, J

    1989-01-01

    Puncture wounds to the foot are common presenting problems in most busy emergency departments. Although seemingly benign, the sequelae after simple puncture wounds to the foot can include cellulitis, retained foreign bodies, or even osteomyelitis. Inadequate scientific research on this topic has left only anecdotal or retrospective reports for review in the medical literature. Antibiotics, radiographs, or surgical exploration in the management of puncture wounds to the foot all lack clinical studies to support their use. This review summarizes the literature and points to the inconsistencies in the management of puncture wounds to the foot. PMID:2567749

  3. 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.

  4. Leech-borne Serratia marcescens infection following complex hand injury.

    PubMed

    Pereira, J A; Greig, J R; Liddy, H; Ion, L; Moss, A L

    1998-12-01

    Leeches are commonly used in the postoperative course of plastic surgical operations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. It is known that leeches can carry Aeromonas hydrophila infection, and a second or third generation cephalosporin antibiotic has traditionally been given as prophylaxis against infection. We report a new observation that leeches can carry Serratia marcescens and give rise to clinically significant infection. The implication for prophylaxis and treatment of leech-associated cellulitis is discussed. PMID:10209471

  5. Nasal dermoid sinus cysts: an unusual presentation, computed tomographic scan findings, and surgical results.

    PubMed

    Posnick, J C; Bortoluzzi, P; Armstrong, D C

    1994-05-01

    Midline nasal dermoid cysts are congenital lesions resulting from aberrant embryological development. Accurate diagnosis and effective treatment are essential to avoid craniofacial skeletal deformations, cyst rupture, and infection that could cause cutaneous, ocular, or intracranial complications. We report an unusual case of congenital midline nasal dermoid cysts in which an 18-month-old child presented to a hospital emergency department with periorbital cellulitis. It resulted from multiple midline nasal dermoid cysts involving the nasal, forehead, and both orbital regions but without intracranial extension. The patient was successfully managed with a craniofacial approach. PMID:8060077

  6. 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.

  7. 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.

  8. 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.

  9. Tracheostomy Wound Myiasis in a Child: Case Report and Review of the Literature

    PubMed Central

    Blejter, J.

    2012-01-01

    An 8-year-old tracheostomized, gastrostomized, and with cerebral palsy boy was admitted for tracheostomy wound myiasis and cellulitis. Ether was applied in the wound, and then all the accessible larvae were removed. Antibiotic therapy was initiated. The procedure had to be repeated three more times to extract all the larvae. An airway endoscopy was performed and ruled out the presence of larvae in the airway, as well as any damage to the wall of the trachea. The patient recovered uneventfully and was discharged. PMID:22606531

  10. Surgical Site Infection Caused by Aeromonas hydrophila in a Patient with Underlying Malignancy

    PubMed Central

    Ahmed, Nishat Hussain; Grover, Rajesh Kumar

    2015-01-01

    Aeromonas skin and soft tissue infections in cancer patients can lead to serious life threatening conditions such as cellulitis, necrotizing fasciitis and myonecrosis. We report here a case of surgical site infection, post radical mastectomy, in a 58-year-old female with carcinoma breast. Cultures of exudates from the wound grew Aeromonas hydrophila on repeated occasions. Recovery was uneventful following targeted antimicrobial therapy and regular dressing of the wound. Early suspicion, diagnosis, and treatment with potent antibiotics are needed to prevent any further complications resulting from infection by this emerging pathogen. PMID:25737989

  11. 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

  12. [Septicemic cutaneous localization of cryptococcosis following renal transplantation in a female].

    PubMed

    Dupond, A S; Humbert, P; Faivre, B; Hory, B; Barale, T; Laurent, R; Agache, P

    1993-01-01

    Cryptococcosis is a systemic disease caused by the yeast-like fungus Cryptococcus neoformans. Cutaneous manifestations, although rare, may precede other organ involvements. A case of cutaneous cryptococcosis is described herein. The skin lesions in our patient (a 47-year old female with renal transplant) consisted of acute cellulitis over her left and right thighs, revealing a septicemic infection. The patient received immunosuppressive drugs (prednisone, azathioprine). Clinical, mycological and histopathological data are described in details. Amphotericin B and fluconazole were initially successful, but a relapse with Cryptococcus meningitis required the adjunction of itraconazole to treatment. This case report underlines the insufficient effectiveness of fluconazole and the success of itraconazole. PMID:8161115

  13. Pilonidal Abscess Associated With Primary Actinomycosis.

    PubMed

    Oh, Han Boon; Abdul Malik, Mohamad Hashir; Keh, Chris Hang Liang

    2015-12-01

    Pilonidal disease in the sacrococcygeal region usually presents as abscesses, recurrent inflammation, cellulitis or fistula tracks. However, few reports on actinomycosis affecting pilonidal sinuses have been published. We report a case of a 25-year-old woman who presented with a pilonidal abscess who underwent surgical drainage and debridement. Pus from the pilonidal abscess was sent for microbiology, which grew actinomyces turicensis associated with prevotella bivia and peptostreptococci. She was treated with oral amoxicillin-clavulanate after surgical drainage for one week and recovered well. Actinomycosis associated with pilonidal abscesses, though uncommon, should be recognized and can be satisfactorily treated with a combination of surgical drainage and antibiotics. PMID:26817020

  14. 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

  15. [Orbital complications of sinusitis].

    PubMed

    ucha?, M; Hor?k, M; Kaliarik, L; Krempask, S; Kotialov, T; Kova?, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal endoscopic surgery (FEES). In case of superior subperiosteal abscess, combined endonasal and external approach (external orbitotomy) was needed. Combined therapy facilitated quick improvement of local and systematic symptoms. Average time of hospitalisation was 7 days. Early diagnosis and agresive combined therapy prevent loss of vision and life threatening complications. PMID:25640234

  16. Dental Procedures: Is it a Risk Factor for Injectable Dermal Fillers?

    PubMed

    Ramzi, Abbas Al; Kassim, Maysoun; George, Joju V; Amin, Ashraf

    2015-03-01

    Dental procedures done in the vicinity of dermal fillers may result in complications of the dermal fillers such as infections which may mimic a dental infection. These infections of dermal fillers must be differentiated from facial cellulitis or from dental infection as treatment for infection from dermal fillers may be prolonged with repeated use of antibiotics, incision and drainage or removal of the filler material itself. Dental surgeons need to be aware of this potential risk in order to recognize and manage it appropriately. PMID:25838691

  17. New developments in clinical aspects of lymphatic disease.

    PubMed

    Mortimer, Peter S; Rockson, Stanley G

    2014-03-01

    The lymphatic system is fundamentally important to cardiovascular disease, infection and immunity, cancer, and probably obesity--the four major challenges in healthcare in the 21st century. This Review will consider the manner in which new knowledge of lymphatic genes and molecular mechanisms has demonstrated that lymphatic dysfunction should no longer be considered a passive bystander in disease but rather an active player in many pathological processes and, therefore, a genuine target for future therapeutic developments. The specific roles of the lymphatic system in edema, genetic aspects of primary lymphedema, infection (cellulitis/erysipelas), Crohn's disease, obesity, cancer, and cancer-related lymphedema are highlighted. PMID:24590276

  18. 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 required. Adherence to the diagnostic criteria and to evidence-based or consensus-derived treatment recommendations as presented herein should allow for an antibiotic therapy with a good balance of efficacy, tolerability by patients and low selection pressure for highly resistant bacteria. PMID:26018361

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

    PubMed

    Somuk, Battal Tahsin; Gktas, Gksel; zer, Samet; Sapmaz, Emrah; Bas, Yalc?n

    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

  20. 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

  1. 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)

  2. Tumeur d'Abrikossoff juxta axillaire: une localisation rare d'une tumeur très rare, à propos d'un cas

    PubMed Central

    Amourak, Sarah; Bouzoubaa, Wael; Jayi, Sofia; Alaoui, Fatimazahra Fdili; Chaara, Hikmat; Melhouf, Moulay Abdelilah

    2015-01-01

    Décrite pour la première fois en 1926 par Abrikossoff, les tumeurs à cellules granuleuses (TCG) sont bénignes et uniques dans la grande majorité des cas. Les principales localisations sont la cavité orale, puis les tissus sous-cutanés de la tête et du cou et les seins. La pathogenèse a été longtemps débattue, après avoir proposé initialement une origine musculaire striée les études récentes sont en faveur d'une origine neurogène schwannienne confirmées par une étude immunohistochimique. Le traitement de la tumeur à cellules granuleuses est un traitement chirurgical, il permet un diagnostic de certitude par l'examen anatomo-pathologique de la pièce d'exérèse qui doit rechercher les limites d'exérèse et la présence de critères de malignité. Leur évolution est souvent favorable si la résection chirurgicale est complète. Nous rapportons ici le cas d'une tumeur d'Abrikossoff à localisation juxta axillaire et nous profitons de faire une revue de la littérature afin de mettre le point sur cette entité rare. PMID:26328001

  3. [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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Rare complication of silicone fluid injection presenting as multiple calcification and skin defect in both legs: a case report.

    PubMed

    Lee, Jun Ho; Choi, Hwan Jun

    2015-03-01

    In the past, many materials have been injected for soft tissue augmentation including paraffin (mineral oil) and other non-biocompatible products. Liquid silicone as one of these materials has a long and notorious history as an injectable material for soft tissue augmentation. However, complications, including cellulitis, ulcerations, migration, and nodule formation, have also been reported with silicone injections. This article aims to demonstrate the diagnosis and treatment of multiple calcification and skin defect after silicone fluid injection for soft tissue augmentation. A 65-year-old female presented with skin defect and calcifications had been steadily increasing in size over a 3-month period. Examination confirmed pain, swelling, induration, and 5 × 5 cm sized skin defect with marginal and adjacent calcification in the left lateral malleolar area. She had been injected silicone fluid for soft tissue of lower extremity augmentation and contouring 30 years ago. Serial surgical debridement of this entire zone of calcification and ulceration was undertaken. The defect was closed by a split thickness skin graft. She was satisfied with the aesthetic appearance of the lateral malleolar area, relieving the symptoms of cellulitis. PMID:25564484

  11. 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

  12. Fibromatose desmoïde du sein: à propos d'un cas et une revue de la literature

    PubMed Central

    Amourak, Sarah; Alaoui, Fatimazahra Fdili; Jayi, Sofia; Chaara, Hikmat; Melhouf, Moulay Abdelilah

    2015-01-01

    La fibromatose desmoïde mammaire est une entité rare, mimant sur le plan clinique et échographique un cancer du sein. Seule l'histologie apportera le diagnostic en objectivant une prolifération de cellule fusiforme (fibro et myofibroblastique sans atypies nucléaires), agencée en faisceaux, mêlés à des bandes de collagène, sans composante épithéliale. Le diagnostic différentiel se pose essentiellement avec le carcinome métaplasique à cellules fusiformes. L’évolution est strictement locale, avec un grand pouvoir récidivant. L'exérèse chirurgicale complète avec des marges saines (jusqu’à 3cm) est le traitement de choix, la radiothérapie reste une option thérapeutique en complément de la chirurgie dans les exérèses incomplètes et en cas de récidives multiples. A travers notre cas et une revue de la littérature, nous essayerons de mettre le point sur le diagnostic de cette entité rare et de sa prise en charge puisqu'elle va conditionner le pronostic. PMID:26491531

  13. 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.

  14. 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

  15. 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 de confirmer l'efficacite du procede de preparation de surface et d'identifier les conditions de croissance optimales. Les resultats de caracterisation indiquent que les materiaux obtenus presentent une tres faible rugosite de surface, une bonne qualite cristalline et un dopage residuel relativement important. De plus, l'interface GaAs/Ge possede une faible densite de defauts. Finalement, la diffusion d'arsenic dans le substrat de germanium est comparable aux valeurs trouvees dans la litterature pour la croissance a basse temperature avec les autres procedes d'epitaxie courants. Ces resultats confirment que la technique d'epitaxie par faisceaux chimiques (CBE) permet de produire des couches de GaAs sur Ge de qualite adequate pour la fabrication de cellules solaires a haute performance. L'apport a la communaute scientifique a ete maximise par le biais de la redaction d'un article soumis a la revue Journal of Crystal Growth et la presentation des travaux a la conference Photovoltaics Canada 2010 . Mots-cles : Epitaxie par jets chimiques, Chemical beam epitaxy, CBE, MOMBE, Germanium, GaAs, Ge

  16. A cell suspension agar diffusion test using Neutral Red release to assess the relative irritancy potential of cosmetic ingredients and formulations.

    PubMed

    Butler, N J; Langley, G R; Winwood, J

    1993-02-01

    Synopsis An established cytotoxicity test for plastic materials in medical devices has been adapted and used to assess the relative potential irritancy of cosmetic ingredients and formulations during product development. Serum-free medium containing a novel protein supplement supported growth in suspension of LS mouse fibroblast cells. Release of the vital dye Neutral Red from pre-loaded cells suspended in agar was the endpoint. Test substances and reference standards were applied to a central well cut into the agar, a sensitive method which allowed accurate dose application and yielded consistent results. Relative irritancy potential was measured quantitatively by comparing the diameters of the clear zones of damaged cells which surround the central well. The test has been used with raw materials such as surfactants, preservatives and herbal extracts, as well as finished products ranging from shampoos and conditioners to creams, lotions and coloured cosmetics. The method is practical, versatile, reproducible and economic to use. Résumé Un test de cytotoxicité utilisé pour la détection de toxines dans les plastiques des appareils médicaux a été adapté pour prévenir le potentiel d'irritation relative. Le point mesuré est la libération de la teinture vitale rouge neutre des cellules chargées au préalable, résultant de l'incubation avec des substances tests. La mesure des diamétres de la zone claire de dilutions sequentielles de substances tests permet de calculer l'irritation potentielle d'un produit testé par rapport à un standard. Parmi les modifications, on a pu constater à l'aide d'une ligne de cellules en suspension dérivées de fibroblastes de souris L-929, la pousse en milieu sans sérum pour éviter les produits d'abattoir. A la place du sérum de veau, on a ajouté au milieu une nouvelle protéine innovatrice supportant la pousse normale en suspension. Durant la procédure de test les cellules se trouvaient en suspension dans une solution agar et les substances tests ont été appliquées sur une cellule centrale bien délimitéc sur la gélose plutôt qu'à l'aide d'un disque de papier filtre. L'application par une cellule centrale était plus sensible qu'avec un disque, permettant l'application d'une dose précise et fournissant des résultats plus fiables. Le test modifié a été utilisé sur une période de 4 ans pour des matiéres premières telles que tensioactifs, conservateurs et extraits de plantes, ainsi que des formules de shampooings, savons, lotions hydratantes et cosmétiques colorés. Ces produits ont étéévalués sur des panels de volontaires, et les produits testés sont commercialisés depuis 2 ans au moins. Le test est un moyen pratique, versatile, reproductible et économique de calculer le potentiel d'irritation relative d'une gamme de produits et ingrédients cosmktiques. PMID:19272118

  17. An improved directional growth apparatus for liquid crystals: applications to thermotropic and lyotropic systems

    NASA Astrophysics Data System (ADS)

    Oswald, P.; Moulin, M.; Metz, P.; Géminard, J. C.; Sotta, P.; Sallen, L.

    1993-09-01

    We have built a directional growth apparatus adapted for the study of thermotropic or lyotropic liquid crystals. This cell allows us to work under inert gas, to orient the sample from outside with respect to the temperature gradient, and to measure the front temperature within 0.1°C. Three applications are described. The first deals with the growth of a monocrystal of pivalic acid when the easy growth axis makes an angle with the heat flow direction. The second experiment is concerned with the fast growth of a discotic liquid crystal and the measurement of the molecular attachment kinetic coefficient at the interface between the columnar hexagonal mesophase and the isotropic liquid. A dynamical anchoring transition between domains of planar and homeotropic orientation will be also described. The last example focuses on the growth of a hexagonal phase of a water-surfactant binary mixture and the first observation of the Mullins-Sekerka instability in a lyotropic system. Nous avons construit une cellule de croissance directionnelle adaptée à l'étude des cristaux liquides thermotropes ou lyotropes. Cette cellule permet de travailler en atmosphère inerte, d'orienter l'échantillon de l'extérieur par rapport au gradient de température, et de mesurer la température du front à 0.1°C près. Trois exemples d'application sont décrits. Le premier porte sur la croissance d'un monocristal d'acide pivalique quand l'axe de croissance facile des cellules fait un angle avec la direction du flux de chaleur. La seconde expérience porte sur la croissance rapide d'un cristal liquide discotique et la mesure du coefficient cinétique d'attachement moléculaire à l'interface entre la mésophase colonnaire hexagonale et le liquide isotrope. Une transition d'ancrage dynamique entre des domaines d'orientations planaire et homéotrope sera également décrite. Le dernier exemple porte sur la croissance d'une phase hexagonale d'un mélange binaire eau-surfactant et la première observation de l'instabilité de Mullins-Sekerka dans un système lyotrope.

  18. Differents aspects du fer dans l'organisme

    PubMed Central

    Bessis, Marcel; Breton-Gorius, Janine

    1959-01-01

    Des cellules réticulaires remplies de molécules de ferritine et d'hémosidérine se trouvent au centre "d'ilots érythroblastiques." Dans la zone de contact entre la cellule réticulaire chargée de ferritine et les érythroblastes, on voit des invaginations et des petites vacuoles au bord desquelles adhérent des molécules de ferritine. Il est postulé que la ferritine passe de la cellule réticulaire centrale dans les érythroblastes par ce mécanisme, apparenté à la pinocytose (rhophéocytose). Dans tous les érythroblastes normaux, il existe du fer sous forme de ferritine. Celle-ci peut se trouver à l'état dispersé ou agglomérée en amas. Lorsque ces amas sont assez gros, ils sont visibles au microscope optique: ce sont les granules des sidéroblastes. On trouve du fer dans les mitochondries, mais rarement à l'état normal. Il est soit sous forme de granules ferritiniques soit sous forme de micelles ferrugineuses. Dans les thalassémies et d'autres maladies s'accompagnant d'un trouble de l'hémoglobinogénèse, on trouve, en grande quantité, du fer visible au microscope électronique, dans les érythroblastes. Il s'y trouve sous forme de ferritine, en amas ou dispersé. Il existe parfois en grande quantité dans les mitochondries soit sous forme de ferritine, soit sous forme de micelles ferrugineuses. Il semble que soit objectivé ainsi le trouble de la synthèse de l'hémoglobine: le fer inutilisé s'accumule dans des érythroblastes hypochromes. Il est probable qu'à l'etat normal, le fer est métabolisé dans les mitochondries. Dans le thalassémies et les anémies hypochromes hypersidérémiques, il semble souvent bloqué dans ces organites. PMID:13800105

  19. 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 refroidissement est souvent invoquée. Ainsi, il est possible d'éviter les dommages liés à la cristallisation : contrainte mécanique due à l'augmentation de volume, effets de sel dus à l'existence d'un gradient de pression osmotique de part et d'autre de la membrane cellulaire. Les conditions d'obtention et de maintien de cet état vitreux lors des opérations de congélation peuvent être définies par des études physiques dont nous proposons une revue.

  20. Possible disease transmission by contaminated mouthguards in two young football players.

    PubMed

    Glass, R Thomas; Wood, C Rieger; Bullard, James W; Conrad, Robert S

    2007-01-01

    Previous studies have demonstrated that athletic mouthguards worn by ice hockey and football players harbor large numbers of bacteria, yeasts, and molds, some of which are either opportunistic or frank pathogens. This article details the clinical history of two junior high school football players. The first player had cellulitis of the leg after a non-break injury. The same unusual bacterium was isolated from both the athletic mouthguard and abscess cultures from the wound. The second patient suffered an attack of exercise-induced asthma so severe that his inhaler could not control the symptoms enough for him to resume play. This child's mouthguard was contaminated with five different species of mold. The clinical implications of mouthguard contamination, possible avenues of disease transmission, and recommendations for mouthguard care are discussed. PMID:17899722

  1. Carcinome neuroendocrine du sein: à propos d'un cas et revue de la littérature

    PubMed Central

    El Fatemi, Hinde; Hammas, Nawal; Moumna, Kaoutar; Bedahou, Mouhcine; Mellas, Nawfel; Mesbahi, Omar

    2012-01-01

    Le carcinome neuroendocrine primitif du sein est une tumeur rare qui a été reconnue par la dernière édition de la classification OMS du cancer du sein publiée en 2003. Le diagnostic est évoqué sur des critères morphologiques et confirmé par l'expression des marqueurs neuroendocrines (chromogranine et synaptophysine) par plus de 50% des cellules tumorales. Nous rapportons un nouveau cas de carcinome neuroendocrine primitif du sein, et à travers une revue de la littérature, nous détaillons les aspects épidémiologiques, morphologiques et immuno-histochimiques de cette tumeur rare. PMID:23330031

  2. Une tumeur exceptionnelle du doigt: la tumeur fibreuse solitaire

    PubMed Central

    Harmouch, Taoufiq; Hamas, Nawal; Daoudi, Abdelkrim; Amarti, Afaf

    2011-01-01

    La tumeur Fibreuse solitaire (TFS) est une prolifération fusocellulaire rare, souvent de localisation intra-thoracique. Nous rapportons le cas d'une localisation exceptionnelle au niveau du 3ème doigt de la main droite. En l'absence de marqueur spécifique l'interprétation de l'immuno-marquage dépend du contexte histo-morphologique. La similitude avec les différents néoplasmes à cellules fusiformes des tissus mous rend le diagnostic de ces tumeurs mésenchymateuses difficile et tardif. Dans 20à 30% des cas le comportement de la TFS est celui d'une tumeur maligne localement agressive et récidivante, avec des métastases rares et tardives. Ce comportement impose une surveillance prolongée après exérèse chirurgicale. PMID:22384295

  3. [Anesthetic management of a patient with adrenoleukodystrophy].

    PubMed

    Shinohara, Maki; Hirose, Yohsuke; Boku, Aiji; Kimura, Keiji Richard; Morimoto, Yoshinari; Niwa, Hitoshi

    2014-01-01

    Adrenoleukodystrophy (ALD) is a genetic disorder with demyelination of the central nervous system and adrenal insufficiency. A 24-year-old man with ALD was scheduled for dental treatment under general anesthesia. He was diagnosted as having ALD at the age of 5. Past medical history included recurrent cervical cellulitis, adrenal insufficiency, mental retardation, muscle weakness and seizure disorder. General anesthesia was induced using betamethasone as a steroid cover, sevoflurane and nitrous oxide-oxygen and maintained with sevoflurane and nitrous oxide-oxygen. Nasal intubation was performed without using a muscle relaxant. Patients with ALD cannot metabolize very long chain fatty acid, so we did not use propofol containing long chain fatty acid. Operation and anesthesia were uneventful. There were no complications during and after anesthesia. PMID:24558940

  4. 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

  5. Treatment of skin and soft tissue infections with cefadroxil, a new oral cephalosporin.

    PubMed

    Cordero, A

    1976-01-01

    Oral cefadroxil in doses of 0-6-1-8 g per day given on twice or three times daily schedules was effective in the treatment of thirty-six patients with infections such as abscesses, carbuncles, cellulitis, furunculosis and impetigo. Staphylococcus aureus strains and beta-haemolytic streptococci, alone or in combination, were cultured from lesions before treatment. In vitro studies with test discs showed that all the organisms were sensitive to cefadroxil, but twenty-three of twenty-nine S aureus strains and one of the seven streptococci strains were resistant to penicillin G. Pre- and post-treatment laboratory tests of renal, hepatic and haematopoietic functions produced no evidence of drug toxicity. The cefadroxil dosage effective in this study is lower than that recommended for currently available oral cephalosporins, which must be given on a four times daily schedule. PMID:1026545

  6. Association sarcodose et maladie de Horton: propos d'un cas

    PubMed Central

    Marzouk, Sameh; Hriz, Hela; Jallouli, Moez; Cherif, Yosra; Bahloul, Zouhir

    2015-01-01

    La sarcodose peut tre associe d'autres maladies inflammatoires. Elle est exceptionnellement associe une maladie de Horton posant un problme nosologique sur le caractre fortuit ou non de cette association. Nous rapportons l'observation d'une patiente, ge de 68 ans, chez qui le diagnostic de sarcodose avec atteinte rnale, hpatique, oculaire, articulaire et signes gnraux a t retenu et ayant t traite par corticothrapie avec une bonne volution. 3 ans plus tard elle a prsent des cphales fronto-temporales associes une claudication masstrienne et un syndrome inflammatoire biologique. La biopsie de l'artre temporale a conclu une artrite cellules gantes. Lvolution a t favorable sous corticothrapie. L'association d'une maladie de Horton une sarcodose suggre un lien ventuel entre ces deux affections. PMID:26213599

  7. 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

  8. [Erysipelothrix rhusiopathiae endocarditis].

    PubMed

    Ambăruş, Aurora; Ambaruş, V; Moldovanu, Cătălina; Cosovanu, A

    2006-01-01

    Erysipelothrix rhusiopathiae is a thin, non-sporulating, gram-positive rod found worldwide and hosted by many domestic or savage animals, birds, fish, and shell/fish. It is extremely resistant in the external environment (soil, surface waters). Human infection is prevalently related to occupational exposure to sick or infected contaminated animals (anthropozoonosis). Frequently, the disease manifests itself as an acute cellulitis on the skin around the gate of entry. Systemic infection is uncommon, most commonly involving the endocardium or joints. We present a case of subacute E. rhusiopathiae endocarditis in a male patient at occupational hazard for this infection (animal genitor in a zoo). The patient was treated with cefoperazone, the course being favorable. Later on, he required mitral valvuloplasty. PMID:17571546

  9. A case of misconstrue proptosis.

    PubMed

    Chiam, Patrick J T; Ho, Vivian W-M; Hubbard, Alan D; Weerasinghe, Suboda

    2013-01-01

    This case illustrates an overlooked metastatic lung carcinoma to the orbit. The rapid onset of symptoms and oedema mimicked a cellulitis. The patient was initially treated with a broad-spectrum topical and intravenous antibiotic therapy. The white blood cell count (WBC) and C reactive protein (CRP) were normal. Compressive optic neuropathy and serous retinal detachment ensued. The initial chest x-ray revealed lung shadows; however, this was not reviewed. Eventually, CT of the chest was organised and showed a lung mass. The management of such a case remains a challenge for the uninitiated, and high index of suspicion is required to ensure early appropriate management. Despite complete resolution of the swelling with sequential chemotherapy (cisplatin and etoposide) and radiotherapy, the visual prognosis remained grim. PMID:23616314

  10. A case of misconstrue proptosis

    PubMed Central

    Chiam, Patrick J T; Ho, Vivian W-M; Hubbard, Alan D; Weerasinghe, Suboda

    2013-01-01

    This case illustrates an overlooked metastatic lung carcinoma to the orbit. The rapid onset of symptoms and oedema mimicked a cellulitis. The patient was initially treated with a broad-spectrum topical and intravenous antibiotic therapy. The white blood cell count (WBC) and C reactive protein (CRP) were normal. Compressive optic neuropathy and serous retinal detachment ensued. The initial chest x-ray revealed lung shadows; however, this was not reviewed. Eventually, CT of the chest was organised and showed a lung mass. The management of such a case remains a challenge for the uninitiated, and high index of suspicion is required to ensure early appropriate management. Despite complete resolution of the swelling with sequential chemotherapy (cisplatin and etoposide) and radiotherapy, the visual prognosis remained grim. PMID:23616314

  11. 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

  12. 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

  13. 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

  14. 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.

  15. Severe penile erosion after use of a vacuum suction device for management of erectile dysfunction in a spinal cord injured patient. Case report.

    PubMed

    LeRoy, S C; Pryor, J L

    1994-02-01

    We report a case of severe erosion and cellulitis at the base of the penis as a result of vacuum suction device constriction bands left on for 4 hours in a spinal cord injured patient with paraplegia and hypesthesia of the genital area. All patients using vacuum suction devices need to be properly educated regarding usage and risks with adequate follow up; patients with hypesthesias and spinal cord injuries need information specifically related to their decreased or absent level of sensation. Only two out of seven vacuum suction device brochures reviewed warn of the risk to patients with decreased sensation in the penis, but none specifically address usage or risks to men with spinal cord injuries. PMID:8015845

  16. [The role of endoscopy in gastroenteropancreatic neuroendocrine tumors].

    PubMed

    Magno, L; Sivero, L; Napolitano, V; Ruggiero, S; Fontanarosa, G; Massa, S

    2010-01-01

    Versione italiana Riassunto: Il ruolo dell'endoscopia nei tumori neuroendocrini gastroenteropancreatici. L. Magno, L. Sivero, V. Napolitano, S. Ruggiero, G. Fontanarosa, S. Massa I tumori neuroendocrini (NET) gastro-entero-pancreatici (GEP) sono neoplasie rare che originano dalle cellule neuroendocrine del tubo digerente e del pancreas. L'endoscopia digestiva e l'ecoendoscopia rivestono un ruolo importante nella diagnosi, stadiazione e sorveglianza dei pazienti con NET. Inoltre, in casi selezionati, le tecniche endoscopiche operative consentono il trattamento di queste neoplasie in fase precoce. English version Summary: The role of endoscopy in gastroenteropancreatic neuroendocrine tumors. L. Magno, L. Sivero, V. Napolitano, S. Ruggiero, G. Fontanarosa, S. Massa Gastroenteropancreatic (GEP) neuroendocrine tumors (NET) are rare neoplasia arisen from neuroendocrine cells present in the gut mucosa and pancreas. Digestive endoscopy and endoscopic ultrasonography play a relevant role in NET diagnosis, stadiation and surveillance. Moreover, in selected patients, surgical endoscopy allows the tratment of these cancers at an early stage. PMID:20646389

  17. Skin and soft-tissue infections caused by Actinobaculum schaalii: report of two cases and literature review.

    PubMed

    Tena, Daniel; Fernández, Cristina; Lago, María R; Arias, Marta; Medina, María José; Sáez-Nieto, Juan Antonio

    2014-08-01

    Skin and soft-tissue infections (SSTIs) caused by Actinobaculum spp. are very rare. In the present study, we report two cases and review the literature. The first case was an immunocompromised patient with an extensive cellulitis secondary to an inguinal abscess, and the second case was a patient with a pilonidal abscess. Clinical outcomes of both patients were good after surgical drainage and treatment with cloxacillin. The review of the literature showed that SSTIs caused by Actinobaculum spp. are usually located on the perineal and inguinal regions and can be severe, particularly in immunocompromised patients. SSTIs caused by Actinobaculum spp. can be overlooked because identification is often difficult and they can be considered as contaminants. PMID:24923266

  18. Atlanto-axial infection after acupuncture.

    PubMed

    Robinson, A; Lind, C R P; Smith, R J; Kodali, V

    2015-01-01

    A 67-year-old man presented with neck cellulitis following acupuncture for cervical spondylosis. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. Increased neck pain and bacteraemia prompted MRI, which showed atlanto-axial septic arthritis without signs of infection of the tissues between the superficial cellulitic area and the atlanto-axial joint, thus making direct extension of infection unlikely. It is more likely that haematogenous spread of infection resulted in seeding in the atlanto-axial joint, with the proximity of the arthritis and acupuncture site being coincidental. Acupuncture is a treatment option for some indolent pain conditions. As such, acupuncture services are likely to be more frequently utilised. A history of acupuncture is rarely requested by the admitting doctor and seldom offered voluntarily by the patient, especially where the site of infection due to haematogenous spread is distant from the needling location. Awareness of infectious complications following acupuncture can reduce morbidity through early intervention. PMID:26655668

  19. Skin Abscess due to Serratia marcescens in an Immunocompetent Patient after Receiving a Tattoo.

    PubMed

    Diranzo García, J; Villodre Jiménez, J; Zarzuela Sánchez, V; Castillo Ruiperez, L; Bru Pomer, A

    2015-01-01

    The incidence of skin infections caused by Serratia marcescens is extremely low and such infections are typically observed in immunocompromised patients. The clinical manifestations of these infections include cellulitis, abscesses, fluctuant nodules, or granulomatous lesions. Infections caused by S. marcescens are very difficult to treat due to their resistance to many antibiotics, which often leads to specific and prolonged treatment. Infections after receiving a tattoo are very rare and are caused by unhygienic conditions or the inexperience of the tattooist. In this paper we present the case of a 32-year-old male with no comorbidity, who presented an abscess caused by S. marcescens in a area that was tattooed one month earlier. The case was resolved with surgery and antimicrobial therapy that was based on the antibiogram. To our knowledge, this is the first reported case of a S. marcescens skin infection following a tattoo, in the absence of immunosuppression. PMID:26356072

  20. [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

  1. 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

  2. Pig bite injuries and infection: report of seven human cases.

    PubMed Central

    Barnham, M.

    1988-01-01

    Six patients developed local infection after being bitten or gored by swine. Wounding was often deep and occurred characteristically on the posterior aspect of the thigh. Severity of infection varied from simple wound infection with discharge and slough to cellulitis and abscess formation; pathogens included haemolytic streptococci, pasteurellae, Bacteroides sp., Proteus sp. and Escherichia coli and were usually isolated in mixed culture. A patient with Pasteurella aerogenes infection appears to be the first reported in England. A seventh patient developed Streptococcus milleri septicaemia after wounding himself while cutting teeth from piglets. It is suggested that a course of broad-spectrum antibiotics should be given as part of the initial treatment when patients present with the more severe pig bite injuries. PMID:3215292

  3. 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

  4. 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

  5. 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

  6. Disseminated Mycobacterium chelonae infection: Complicating a case of hidradenitis suppurativa

    PubMed Central

    Patnaik, Satyadarshi; Mohanty, Indrani; Panda, Pritilata; Sahu, Susmita; Dash, Muktikesh

    2013-01-01

    Mycobacteium chelonae is a rapidly growing atypical mycobacteria known to be pathogenic in humans. We report a case of Hidradenitis Suppurativa (HS) with diabetes complicated by infection of the lesions with Staphylococcus aureus and M. chelonae leading to non-healing and discharging lesions. HS is a rare, insidious and debilitating disease characterized by swollen, painful, inflamed lesions in the axillae, groin, and other parts of the body that contain apocrine glands. Discharge from HS lesions are often found to be sterile, however, polymicrobial bacterial colonization commonly occurs within sinus tracts which can lead to offensive smelling discharge, infection, cellulitis, and superinfection. The incidence of HS is very low and the association with M. chelonae makes it a rare and interesting case. PMID:24350020

  7. 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 marquée dans les cellules ayant un rapport α/beta plus faible après exposition aux photons, selon le modèle linéaire-quadratique. Les particules moins efficaces que les photons en terme de mortalité cellulaire moyenne induisent des dégâts individuels importants, révélés par la production de micronoyaux (MN) multiples. Concernant le lien entre l'EBR et la radio-sensibilité intrinsèque, les données récentes utilisant à la fois la technique des colonies et la méthode des MN, montrent que l'EBR est d'autant plus élevée que les cellules sont radiorésistantes aux photons.

  8. An Illustrative Case of Subcutaneous Panniculitis-Like T-Cell Lymphoma

    PubMed Central

    Bagheri, Farshad; Cervellione, Kelly L.; Delgado, Belkis; Abrante, Luis; Cervantes, Jose; Patel, Jitendra; Roth, Alan

    2011-01-01

    Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a very rare form of skin lymphoma that is localized primarily to the subcutaneous adipose tissue without palpable involvement of the lymph nodes. Diagnosis of SPTCL is a challenge, especially during its early phases when symptoms mimic other, more common conditions, such as benign panniculitis, eczema, dermatitis, psoriasis and cellulitis. Clinical and systemic features are nonspecific and can include fever, chills, and weight loss. Further complicating diagnosis is the high number of false negatives provided by biopsy. Here we present a case of SPTCL that illustrates the full course of the disease, from presentation and multiple misdiagnoses to correct disease recognition and successful treatment. A review of the challenges of diagnosis is provided with recommendations for more accurate and timely recognition of SPTCL. PMID:21461360

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Gastric adenocarcinoma in the context of X-linked agammaglobulinemia: case report and review of the literature.

    PubMed

    Staines Boone, Aidé Tamara; Torres Martínez, María Guadalupe; López Herrera, Gabriela; de Leija Portilla, Julia O; Espinosa Padilla, Sara Elva; Espinosa Rosales, Francisco J; Lugo Reyes, Saúl Oswaldo

    2014-02-01

    The hallmarks of X-linked Agammaglobulinemia (XLA) are panhypogammaglobulinemia, absent B-cells, and recurrent sinopulmonary and gastrointestinal infections starting at an early age, as well as other infections like cellulitis, meningitis, arthritis and sepsis. A number of non-infectious complications have been reported in these patients, including autoimmune diseases and malignancy, especially lymphomas. Here, we report the case of a 30-year old man who developed gastric adenocarcinoma in the context of XLA. Previous reports of, and hypotheses addressing the development of cancer in patients with XLA, are also summarized. Solid cancer in XLA affects mainly the gastrointestinal tract and seems to be related to chronic infection. A natural evolution can be traced back from gastric adenocarcinoma to megaloblastic anemia due to achlorhydria in the context of chronic infection; periodic endoscopy thus seems justified to detect and treat carcinoma in early stages. PMID:24338562

  18. Isolated extraocular muscle abscess presenting 40 years after squint surgery

    PubMed Central

    Lim, Wei Sing; Aclimandos, Wagih; Pringle, Edward; Shah, Brinda

    2014-01-01

    A 57-year-old man presented with an abscess localised to the lateral rectus region. He was treated as a case of orbital cellulitis because of the presence of soft tissue swelling with a localised abscess discharging through the conjunctiva with associated reduction of visual acuity and restriction of ocular movements laterally. No specific risk factors were identified but an ultrasound scan picked up a hyperechoic signal suggestive of a foreign body within the abscess. Surgical exploration did not identify a foreign body but fibrotic changes between the globe and the lateral rectus muscle were found which was suggestive of previous squint surgery. This was confirmed by the patient later on specific questioning. Periorbital infection is a rare occurrence after squint surgery and reported cases are mainly within a week after surgery. Orbital abscess probably related to an old suture granuloma 40 years after surgery has not been documented before. PMID:24706710

  19. 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.

  20. Antimicrobial Prophylaxis in Adults

    PubMed Central

    Enzler, Mark J.; Berbari, Elie; Osmon, Douglas R.

    2011-01-01

    Antimicrobial prophylaxis is commonly used by clinicians for the prevention of numerous infectious diseases, including herpes simplex infection, rheumatic fever, recurrent cellulitis, meningococcal disease, recurrent uncomplicated urinary tract infections in women, spontaneous bacterial peritonitis in patients with cirrhosis, influenza, infective endocarditis, pertussis, and acute necrotizing pancreatitis, as well as infections associated with open fractures, recent prosthetic joint placement, and bite wounds. Perioperative antimicrobial prophylaxis is recommended for various surgical procedures to prevent surgical site infections. Optimal antimicrobial agents for prophylaxis should be bactericidal, nontoxic, inexpensive, and active against the typical pathogens that can cause surgical site infection postoperatively. To maximize its effectiveness, intravenous perioperative prophylaxis should be administered within 30 to 60 minutes before the surgical incision. Antimicrobial prophylaxis should be of short duration to decrease toxicity and antimicrobial resistance and to reduce cost. PMID:21719623

  1. Recurrent primary paediatric herpetic whitlow of the big toe.

    PubMed

    Murphy, Alexander P; Martin, Premkumar; Jukka, Cecilia M; Memon, Aamir; Ng, Sze May

    2013-01-01

    A 9-month-old baby girl presented multiple times with an erythematous, papular and pustular big toe in an otherwise healthy infant. A diagnosis of cellulitis was made and she was started on oral antibiotics, and bacterial swabs were taken. After 2 weeks of worsening appearance she was admitted for intravenous antibiotics. Inflammatory markers remained normal and viral swabs were taken. No improvement was seen after 2 days and she was referred for orthopaedic and dermatological opinions. The orthopaedic team recommended debridement whereas the dermatologist suspected a primary herpetic whitlow and recommended intravenous acyclovir in addition to intravenous antibiotics. A viral swab for Herpes simplex virus type 1 (HSV1) was positive by PCR on day 3. The toe continued to improve clinically and the patient received 21 days of acyclovir in total. 27 days after discharge the infection relapsed. She was treated with a further 14 days of oral acyclovir and recovered completely. PMID:23436893

  2. 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

  3. Plates-formes de microscopie et fluorescence par resonance de plasmons de surface appliquees a l'imagerie cellulaire

    NASA Astrophysics Data System (ADS)

    Chabot, Vincent

    L'elaboration de nouveaux medicaments repose sur les etudes pharmacologiques, dont le role est d'identifier de nouveaux composes actifs ou de nouvelles cibles pharmacologiques agissant entre autres au niveau cellulaire. Recemment, la detection basee sur la resonance des plasmons de surface (SPR) a ete appliquee a l'etude de reponses cellulaires. Cette methode de detection, permettant d'observer des variations d'indice de refraction associes a de faibles changements de masse a la surface d'un metal, a l'avantage de permettre l'etude d'une population de cellules vivantes en temps reel, sans necessiter l'introduction d'agents de marquage. Pour effectuer la detection au niveau de cellules individuelles, on peut employer la microscopie SPR, qui consiste a localiser spatialement la detection par un systeme d'imagerie. Cependant, la detection basee sur la SPR est une mesure sans marquage et les signaux mesures sont attribues a une reponse moyennee des differentes sources cellulaires. Afin de mieux comprendre et identifier les composantes cellulaires generant le signal mesure en SPR, il est pertinent de combiner la microscopie SPR avec une modalite complementaire, soit l'imagerie de fluorescence. C'est dans cette problematique que s'insere ce projet de these, consistant a concevoir deux plates-formes distinctes de microscopie SPR et de fluorescence optimisees pour l'etude cellulaire, de sorte a evaluer les possibilites d'integration de ces deux modalites en un seul systeme. Des substrats adaptes pour chaque plate-forme ont ete concus et realises. Ces substrats employaient une couche d'argent passivee par l'ajout d'une mince couche d'or. La stabilite et la biocompatibilite des substrats ont ete validees pour l'etude cellulaire. Deux configurations permettant d'ameliorer la sensibilite en sondant les cellules plus profondement ont ete evaluees, soit l'emploi de plasmons de surface a longue portee et de guides d'onde a gaine metallique. La sensibilite accrue de ces configurations a aussi ete demontree pour un usage en biodetection cellulaire. Une plate-forme permettant de mesurer la spectroscopie SPR simultanement avec l'acquisition d'images de fluorescence a ete realisee. Cette plate-forme a ensuite ete validee par l'etude de reponses cellulaires suite a une stimulation pharmacologique. Puis, un systeme base sur la microscopie SPR a ete concu et caracterise. Son emploi pour l'etude de reponses au niveau de cellules individuelles a ete demontre. Finalement, les forces et faiblesses des substrats et des plates-formes realisees au cours de la these ont ete evaluees. Des possibilites d'amelioration sont mises de l'avant et l'integration des modalites de microscopie SPR et de fluorescence suite aux travaux de la these est discutee. Les realisations au cours de cette etude ont donc permis d'identifier les composantes cellulaires impliquees dans la generation du signal mesure en biodetection SPR. Mots-cles : Resonance des plasmons de surface, microscopie SPR, plasmons de surface a longue portee LRSPR, guide d'onde a gaine metallique MCWG, fluorescence exaltee par plasmons de surface SPEF, biodetection cellulaire, imagerie SPR.

  4. 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.

  5. Simultaneous Bilateral Submental Lymph Node Flaps for Lower Limb Lymphedema Post Leg Charles Procedure

    PubMed Central

    Ito, Ran; Lin, Miffy Chia-Yu

    2015-01-01

    Summary: We summarize the case of a 59-year-old woman with left lower limb lymphedema for 4 years post hysterectomy, pelvic lymph node dissection, radiation therapy, and chemotherapy for endometrial cancer. She underwent the Charles procedure on her left leg 2 years before being referred to our hospital and developed several cellulitis episodes and progressive lymphedema affecting her left toes and thigh. Bilateral vascularized submental lymph node flaps were transferred to her left ankle and thigh, respectively. After a 5-month follow-up, the leg became softer and lighter without relapsing cellulites, and the circumferential reduction rates at 15 cm above knee, 15 cm below knee, and 10 cm above ankle were 23.3%, 50%, and 22.2%, respectively. The patient was satisfied with the functional recovery and discontinued use of compression garment postoperatively. PMID:26495226

  6. Clostridium septicum myositis in a western lowland gorilla (Gorilla gorilla gorilla).

    PubMed

    Fontenot, Deidre K; Terrell, Scott P; Miller, Michele; Robbins, Patricia K; Stetter, Mark; Weber, Martha

    2005-09-01

    A 10-yr-old male gorilla (Gorilla gorilla gorilla) with a history of conspecific bite wounds was evaluated for acute onset of depression, anorexia, and right hemiparesis. The animal was immobilized for diagnostic examination and treatment for suspected toxic shock from a necrotizing, emphysematous wound infection, but was euthanized due to complications during recovery. Gross and histopathologic examination revealed acute necrotizing myositis, fasciitis, cellulitis, and emphysema in the affected wound area, with large numbers of large Gram-positive rods among necrotic muscle fibers. Severe pulmonary edema with airways containing fibrin, acute hemorrhage in multiple body sites, thrombosis in blood vessels in the skeletal muscle, liver, and lung, and lymph node hyperplasia with lymphoid necrosis and hemorrhage. Immunohistochemical fluorescent antibody staining of muscle from the wound site was positive for PMID:17312773

  7. Novel ELANE Gene Mutation in a Korean Girl with Severe Congenital Neutropenia

    PubMed Central

    Shim, Ye Jee; Kim, Hee-Jin; Suh, Jang Soo

    2011-01-01

    Severe congenital neutropenia is a heterozygous group of bone marrow failure syndromes that cause lifelong infections. Mutation of the ELANE gene encoding human neutrophil elastase is the most common genetic alteration. A Korean female pediatric patient was admitted because of recurrent cervical lymphadenitis without abscess formation. She had a past history of omphalitis and isolated neutropenia at birth. The peripheral blood showed a markedly decreased absolute neutrophil count, and the bone marrow findings revealed maturation arrest of myeloid precursors at the promyelocyte to myelocyte stage. Her direct DNA sequencing analysis demonstrated an ELANE gene mutation (c.607G > C; p.Gly203Arg), but her parents were negative for it. She showed only transient response after subcutaneous 15 µg/kg/day of granulocyte colony stimulating factor administration for six consecutive days. During the follow-up observation period, she suffered from subsequent seven febrile illnesses including urinary tract infection, septicemia, and cellulitis. PMID:22148006

  8. 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.

  9. Skin Abscess due to Serratia marcescens in an Immunocompetent Patient after Receiving a Tattoo

    PubMed Central

    Diranzo García, J.; Villodre Jiménez, J.; Zarzuela Sánchez, V.; Castillo Ruiperez, L.; Bru Pomer, A.

    2015-01-01

    The incidence of skin infections caused by Serratia marcescens is extremely low and such infections are typically observed in immunocompromised patients. The clinical manifestations of these infections include cellulitis, abscesses, fluctuant nodules, or granulomatous lesions. Infections caused by S. marcescens are very difficult to treat due to their resistance to many antibiotics, which often leads to specific and prolonged treatment. Infections after receiving a tattoo are very rare and are caused by unhygienic conditions or the inexperience of the tattooist. In this paper we present the case of a 32-year-old male with no comorbidity, who presented an abscess caused by S. marcescens in a area that was tattooed one month earlier. The case was resolved with surgery and antimicrobial therapy that was based on the antibiogram. To our knowledge, this is the first reported case of a S. marcescens skin infection following a tattoo, in the absence of immunosuppression. PMID:26356072

  10. 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.

  11. 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.

  12. Atlanto-axial infection after acupuncture.

    PubMed

    Robinson, A; Lind, C R P; Smith, R J; Kodali, V

    2016-04-01

    A 67-year-old man presented with neck cellulitis following acupuncture for cervical spondylosis. Blood cultures were positive for methicillin-sensitiveStaphylococcus aureus Increased neck pain and bacteraemia prompted MRI, which showed atlanto-axial septic arthritis without signs of infection of the tissues between the superficial cellulitic area and the atlanto-axial joint, thus making direct extension of infection unlikely. It is more likely that haematogenous spread of infection resulted in seeding in the atlanto-axial joint, with the proximity of the arthritis and acupuncture site being coincidental. Acupuncture is a treatment option for some indolent pain conditions. As such, acupuncture services are likely to be more frequently utilised. A history of acupuncture is rarely requested by the admitting doctor and seldom offered voluntarily by the patient, especially where the site of infection due to haematogenous spread is distant from the needling location. Awareness of infectious complications following acupuncture can reduce morbidity through early intervention. PMID:27048966

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

    PubMed

    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

  14. Bacterial skin infections: management of common streptococcal and stapylococcal lesions.

    PubMed

    Witkowski, J A; Parish, L C

    1982-10-01

    Skin infection occurs in any age-group, sex, and race but is particularly common in children. It is usually minor, but may indicate underlying systemic disease or may lead to systemic infection. Streptococci and staphylococci are common causes. Group A beta-hemolytic streptococci account for the majority of streptococcal infections in man. Infection most often involves the lower extremities and produces spreading erythema and necrosis but little purulence. Staphylococcal infections most commonly involve the face, the hair follicles and eccrine sweat ducts being the initial sites. Lesions appear as bullae and pustules with a narrow rim of erythema. Intense cellulitis surrounding the lesions usually points to a virulent, penicillin-resistant strain of Staphylococcus. Treatment of both types of infection consists of cleansing with antibacterial agents, removal of crusts, application of warm compresses, and use of topical or systemic antibiotics, depending on the severity of the infection and the type of pyoderma involved. PMID:7122351

  15. Aeromonas hydrophila folliculitis associated with an inflatable swimming pool: mimicking Pseudomonas aeruginosa infection.

    PubMed

    Julià Manresa, Marc; Vicente Villa, Asunción; Gené Giralt, Amadeu; González-Enseñat, M Antonia

    2009-01-01

    Aeromonas species are ubiquitous, facultative, anaerobic, gram-negative flagellated rods, mainly found in aquatic ecosystems worldwide. Skin and soft-tissue infections, including cellulitis and wound infections, are the second most frequent location of isolations of Aeromonas spp. in clinical samples, after the gastrointestinal tract. All three major Aeromonas species (A. hydrophila, A. caviae, and A. veroni biotype sobria) have been associated with wound infections, but A. hydrophila predominates. Typically, infection occurs after trauma and subsequent exposure to contaminated fresh water or soil. However, Aeromonas folliculitis has been rarely reported. We report the first two pediatric cases of Aeromonas hydrophila folliculitis associated with the use of recreational water facilities that clinically and epidemiologically mimic Pseudomonas folliculitis. Clinical and microbiological studies may be necessary to clarify the role of Aeromonas spp. in this newly-reported infection. PMID:19840320

  16. Melioidosis of the head and neck.

    PubMed

    Lim, W K; Gurdeep, G S; Norain, K

    2001-12-01

    Melioidosis is a potentially deadly infection that can affect any organ system. Reports of melioidosis of the ENT/head and neck region are relatively uncommon. Four cases are presented: (i) parotid abscess evolving into necrotising fasciitis, (ii) acute sinusitis and parapharyngeal cellulitis resulting in upper airway obstruction, (iii) acute suppurative lymphadenitis (iv) and chronic suppurative otitis media causing meningoencephalitis. Three of the four cases are believed to be unique, as a literature review of melioidosis in ENT/head and neck is also presented. Some practical issues of management are also discussed. Not suspecting melioidosis does not change contemporary empirical broadspectrum antibiotic therapy. The value of suspicion or on confirmation of diagnosis lies in anticipating and planning for rapid change. PMID:12014768

  17. 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.

  18. Kaposiform hemangioendothelioma with Kasabach-Merritt syndrome mistaken for child abuse in a newborn.

    PubMed

    Cyrulnik, Amanda A; Dawkins, Manju C; Smalberger, Gert J; Young, Scott; Mann, Ranon E; Jacobson, Mark I; Friedman, Adam J

    2014-03-01

    Kaposiform hemangioendothelioma is a rare vascular neoplasm of childhood that may have an alarming and potentially misleading clinical presentation. Awareness of this entity is important to provide appropriate and immediate medical care. We report the case of a 24-day-old female newborn who presented with a large bruiselike lesion on the left leg. A diagnosis of cellulitis suspected to be secondary to child abuse was made and the patient subsequently was placed in foster care; however, the lesion did not resolve after treatment and relocation. On reevaluation at our institution, physical examination revealed a round, 3 x 4-cm, violaceous, indurated, fixed, nonblanching, nontender plaque with an ivory center and peripheral erythema over the anteromedial aspect of the left leg. Biopsy demonstrated a vascular neoplasm consistent with kaposiform hemangioendothelioma (KHE), and laboratory evaluation revealed thrombocytopenia, low fibrinogen levels, and elevated D-dimer levels, confirming a diagnosis of Kasabach-Merritt syndrome (KMS). PMID:24738105

  19. [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

  20. [Cutaneous loxoscelism mainly edematous: a case report].

    PubMed

    de la Barra, Paula; Vial, Verónica; Labraña, Yenis; Álvarez, Ana María; Seguel, Helena

    2015-08-01

    In Chile, loxoscelism is caused by the bite of the Loxosceles laeta spider. The clinical presentation has two different forms: cutaneous loxoscelism (CL) and vicero-cutaneous loxoscelism, which is less frequent. Cutaneous loxoscelism includes an uncommon clinical variation (4%), called CL with edematous predominance (CLEP). We present a 5-year-old patient with sudden pain and edema on his right eyelid associated with fever, which progressed rapidly involving the right hemifacial area, frontal region, and left eyelid. Angioedema and pre-orbital cellulitis were discarded and CLEP was suspect. Cutaneous loxoscelism with an edematous predominance is self-limited, benign and with little or no necrotic injury due to the edema, which dilutes the toxin-induced enzymatic process causing necrosis. As in the reported cases it usually responds well to medical treatment and does not cause visceral involvement. PMID:26436796

  1. Pedal Gangrenous Changes in the Digits of an Adolescent With Ulcerative Colitis: A Case Report.

    PubMed

    Bhoola, Prashant H; Shtofmakher, Garry; Bahri, Ankur; Patel, Ankur A; Barlizo, Sharon R; Trepal, Michael

    2016-01-01

    Ulcerative colitis is an autoimmune inflammatory disease of the colon and is occasionally associated with thrombosis. We report the case of an adolescent with ulcerative colitis who presented with bilateral gangrenous toes without signs of ascending cellulitis. Radiographs indicated the presence of bilateral and erosive changes in the distal phalanges. The vascular team referred the patient for podiatric intervention for distal vasculitis and thrombosis of the digital vessels. Transphalangeal amputations were performed, and postoperative antibiotics were initiated. The surgical sites healed uneventfully, and the patient was able to resume daily activities. Thrombosis of the foot in the context of ulcerative colitis is a rare, but serious, complication that can lead to serious comorbidities, including amputation. PMID:25135104

  2. Opana ER abuse and thrombotic thrombocytopenic purpura (TTP)-like illness: a rising risk factor in illicit drug users

    PubMed Central

    Kapila, Aaysha; Chhabra, Lovely; Chaubey, Vinod K; Summers, Jeffery

    2014-01-01

    We report the case of a 22 year-old-woman who presented with upper extremity cellulitis secondary to an infiltration of illicit intravenous drug use. She confessed to the intravenous use of Opana ER (an extended release oral formulation of oxymorphone) which is an opioid drug approved only for oral use. She was found to have clinical evidence of profound thrombotic microangiopathy which resulted due to the intravenous use of Opana ER. She showed full clinical improvement after withholding drug and supportive clinical care. Recent report of Opana ER intravenous abuse was published from Tennessee county and has now been increasingly recognised as one of the causes of thrombocytopenia which mimicks clinically as thrombotic thrombocytopenic purpura. Physicians should be aware of this association as the lack of familiarity to this can pose serious management dilemmas for our patients (especially the polysubstance abusers). PMID:24591390

  3. 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

  4. Actinobacillus lignieresii infection in two horses.

    PubMed

    Carmalt, J L; Baptiste, K E; Chirino-Trejo, J M

    1999-09-15

    A 10-year-old pregnant Norwegian Fjord horse was examined for gross swelling of the muzzle of 2 years' duration. Examination of biopsy specimens revealed diffuse dermal fibrosis, micropustule formation, and vascular thrombosis; large numbers of Actinobacillus lignieresii were isolated in pure culture. Prolonged treatment with i.v. administration of sodium iodide and oral administration of trimethoprim-sulfamethoxazole caused regression of the swelling and did not induce abortion. A 5-month-old American Paint filly was examined for swelling in the udder region. Bacteriologic culture of purulent material obtained from the left teat revealed A lignieresii. Treatment with oral administration of rifampin and trimethoprim-sulfamethoxazole resulted in complete resolution of clinical signs. To the authors' knowledge, these findings represent the first report of mastitis and chronic nasal cellulitis caused by A lignieresii infection in horses. PMID:10496138

  5. Brown-Squard, a restless mind.

    PubMed

    Engelhardt, Eliasz; Gomes, Marleide da Mota

    2014-01-01

    Brown-Squard, a remarkable medical personality of the 19 th century, was born in a small island of the Indian Ocean. He travelled over the world exerting his skills: a successful physician, and an innovative researcher, with a very ample range of interests. His favored subject was the nervous system. The spinal cord was studied extensively, with novel and important discoveries on the sensory pathways. He identified cases with spinal cord hemisection, and described the clinical presentation corresponding to a syndrome which bears his name (Brown-Squard syndrome), for which he is best known among neurologists. Regarding the brain, he proposed nine mental and physical functions (organs) related to dynamically interconnected cell clusters, in harmony with the " rseau de cellules anastomoses ", " activits dynamogeniques et inhibitrices ", and " action distance " concepts. Finally, he is considered by some as the "father" of endocrinology, due to his studies on glands and their secretions. PMID:24637985

  6. Le schwannome malin du nerf grand sciatique chez l'enfant

    PubMed Central

    Lechqar, Maryem; Elbiache, Imad; Atarraf, Karima; Bouabdellah, Youssef; Afifi, My Abderahman

    2012-01-01

    Le schwannome malin est une tumeur très rare chez l'enfant (1 à 2% des tumeurs des tissus mous), elle se développe au dépend des cellules de schwanne. Dans ce travail, les auteurs rapportent un cas de schwannome malin développé au dépend du nerf grand sciatique. La radiographie de la cuisse de face et de profil était normale. L'imagerie par résonance magnétique a identifié une lésion le long du trajet du nerf grand sciatique. La tumeur a été réséquée en totalité emportant le nerf grand sciatique. L'examen anatomo-pathologique a confirmé le diagnostic. PMID:23133710

  7. 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

  8. Tumor on shoulder arising after excision of a cyst.

    PubMed

    Kopf, A W; Bart, R S

    1976-06-01

    A primary cutaneous myxosarcoma of the skin developed at the site from which an epithelial cyst had been excised. Following this surgical excision a "keloid" developed which was injected with intralesional corticosteroids. At this site an enlarging tumor developed which was initially thought to be myxoma on the histologic examination but subsequently gave rise to a solitary lymphnode metastasis. Wide local excision of the primary lesion with skin graft and radical axillary lymphadenectomy resulted in cure. Now, nine years post surgery the only problem that remains is repeated bouts of acute cellulitis in the slightly lymphe dematous upper extremity. Myxosarcomas of the skin are rare tumours. Metastases from such lesions are exceedingly rare. PMID:932298

  9. Bacteriological characteristics of Arcanobacterium haemolyticum isolated from seven patients with skin and soft-tissue infections.

    PubMed

    Miyamoto, Hitoshi; Suzuki, Takashi; Murakami, Shinobu; Fukuoka, Mina; Tanaka, Yuri; Kondo, Takuya; Nishimiya, Tatsuya; Suemori, Koichiro; Tauchi, Hisamichi; Osawa, Haruhiko

    2015-04-01

    Bacteriological examinations were conducted for seven Arcanobacterium haemolyticum strains isolated from elderly patients with skin and soft-tissue infections, such as cellulitis and skin ulcers. Streptococcus dysgalactiae or Gram-positive cocci were isolated together with A. haemolyticum from all patients. The strains were identified as A. haemolyticum based on their being catalase negative, reverse Christie, Atkins and Munch-Petersen (CAMP) positive and phospholipase D gene positive in respective tests. Moreover, API Coryne and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry confirmed the identification of A. haemolyticum. All strains showed good susceptibility to minocycline, vancomycin and β-lactam antibiotics, but several strains were resistant to gentamicin and levofloxacin. PMID:25666838

  10. 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

  11. 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 Central

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

    2015-01-01

    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

  12. 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

  13. [Leg discoloration].

    PubMed

    Unger, L; Wollina, U; Machetanz, J; Stelzner, C; Schellong, S

    2013-11-01

    Many patients present with discolouration of the legs or with non-ulcerating skin lesions, the most frequent causes being chronic venous insufficiency or other chronic or acute states of congestion. Erysipelas (cellulitis) is also a frequent example of a bacterial skin infection. A complex differential diagnosis arises from all types of immune-mediated skin lesions, opening up the broad spectrum of inflammatory systemic disease, such as vasculitis and sarcoidosis. Livedo like lesions and skin involvement in borreliosis are challenging to classify but of considerable clinical importance. The present review focuses on the description of underlying diseases as well as on diagnosis and differential diagnosis. Therapeutic considerations are discussed in less detail. PMID:24026790

  14. Disseminated Mycobacterium avium complex infection in three Siamese cats.

    PubMed

    Jordan, H L; Cohn, L A; Armstrong, P J

    1994-01-01

    Disseminated infection with Mycobacterium avium complex is described in 3 adult Siamese cats. All cats were the result of father-daughter matings. Clinical signs included anorexia, weight loss, and lethargy. Physical examination revealed pale mucous membranes, lymphadenopathy, splenomegaly, and pyrexia. Nonregenerative anemia was detected in all 3 cats, and macrocytosis was observed in 2. An antemortem diagnosis of mycobacterial infection was made on the basis of identification of acid-fast bacilli in tissue aspirates. The cats died or were euthanatized owing to clinical deterioration, despite antibiotic treatment. Necropsy findings included granulomatous lymphadenitis, enterocolitis, pneumonia, cellulitis, myelitis, and hepatitis. Organisms from the Mycobacterium avium complex were identified in bacteriologic cultures of tissue samples. PMID:8125827

  15. [Recent advances in laser therapy and other technologies].

    PubMed

    Boixeda, P; Calvo, M; Bagazgoitia, L

    2008-05-01

    Laser technology and other energy sources are rapidly finding a place in dermatology clinics. In the field of skin rejuvenation by fractional photothermolysis, although few controlled studies have been undertaken, several devices have emerged in recent years that appear less effective than laser ablation techniques but that are safer. The aim of this short article is to provide an introduction, though not treat in depth, the different emerging technologies in dermatology. We will focus particularly on lasers and light sources in improving applications such as the treatment of vascular lesions, acne, and encapsulated ink tattoos; light-emitting diodes; developments in the treatment of cellulitis; photodynamic therapy; suction methods; scarring; and finally the recent and doubtlessly future introduction of home devices for use in a range of dermatologic applications (depilation, rejuvenation, treatment of acne, etc). PMID:18394401

  16. [Lipedema complicated with lymphedema and chyloderma].

    PubMed

    Ignjatović, M; Jevtić, M; Cerović, S

    2000-01-01

    Lipedema never reveals clinical picture of extreme lymphedema-elephantiasis, and skin signs and complications have not been observed. Aim of this paper is to present a case of lipedema with the initial lymphedema in which, after one episode of lymphangiitis and cellulitis, came to the rapid development of lymphedema followed by chyloderma. During the local treatment of extreme chyloderma with excessive exudation, semiocclusive synthetic dressings have been used for moist wound healing. The treatment was completed after 20 weeks with total epithelizsation, without maceration and irritation, without additional spreading of the chyloderma field, without wound infections, with fast and full relief of the pain. Lipedem with extreme lymphedema can be followed by skin complications of lymphedema like chylodermia. PMID:11039316

  17. [Invasive pneumococcal disease of serotype 6C with skin and soft tissue infections in an immunocompetent adult].

    PubMed

    Suzuki, Kiyozumi; Hayashi, Yuta; Otsuka, Hiromasa; Hashimoto, Kenichi; Kasamaki, Yuji; Yanai, Mitsuru; Kato, Kimitoshi; Nagai, Yu; Soma, Masayoshi

    2014-11-01

    We report herein on a rare case of deep-soft tissue infection due to invasive pneumococcal disease (IPD). A 77-year-old woman was admitted to our hospital with progressive pain in the right upper arm and the distal leg associated with swelling. We diagnosed the condition as multiple instances of cellulitis that were initially treated with ceftriaxone and clindamycin. Penicillin-susceptible Streptococcus pneumoniae (PSSP) was isolated from blood cultures on admission. Although inflammatory marker levels improved following susceptive antibiotic therapy (ampicillin), multiple abscesses, septic arthritis and osteomyelitis were detected with image testing. The antibiotic was then changed to meropenem and arthroscopic surgery was performed for the right shoulder; the patient's clinical symptoms improved. Since pneumococcal infection including skin and soft tissue infection (SSTI) often causes blood stream invasion or metastatic suppurative complications, metastatic lesions or multiple abscesses should be taken care of. PMID:25764807

  18. Pyomyositis after vaginal delivery

    PubMed Central

    Gaughan, Eve; Eogan, Maeve; Holohan, Mary

    2011-01-01

    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted. PMID:22693277

  19. 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

  20. 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

  1. Clostridium Perfringens Infection in a Febrile Patient with Severe Hemolytic Anemia.

    PubMed

    Hashiba, Masamitsu; Tomino, Atsutoshi; Takenaka, Nobuyoshi; Hattori, Tomonori; Kano, Hideki; Tsuda, Masanobu; Takeyama, Naoshi

    2016-01-01

    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

  2. Métastase vésicale d'un adénocarcinome gastrique en bague à chaton

    PubMed Central

    Seddik, Youssef; Al Jarroudi, Ouissam; Brahmi, Sami Aziz; Afqir, Said

    2014-01-01

    Bien que le cancer primitif de la vessie représente le deuxième cancer urologique après le cancer de la prostate, les métastases vésicales sont rares et le primitif gastrique reste exceptionnel. On rapporte le cas d'un patient âgé de 46 ans, avec des épigatsralgies chroniques, qui présentait une hématurie totale avec des signes irritatifs urinaires. La cystoscopie a montré une vessie inflammatoire sans lésion tumorale décelable. La biopsie vésicale avec une étude anatomopathologique a été en faveur d'un adénocarcinome peu différencié à cellules indépendantes. Le scanner thoraco-abdomino-pelvien a montré un épaississement vésical et gastrique. La fibroscopie oeso-gastroduodénale a montré une tumeur bourgeonnante ulcérée fundique qui a été biopsiée. L’étude anatomo-pathologique a montré un adénocarcinome gastrique à cellules indépendantes mucipares. Le patient a eu 6 cures de chimiothérapie palliative de première ligne type EOX à base d'Epirubicine, Oxaliplatine, et Capécitabine, avec une légère régression tumorale puis une chimiothérapie de maintenance à base de Capécitabine. PMID:25821549

  3. 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 resulted in a good outcome. PMID:27074611

  4. 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

  5. Lymphadiposal Flaps and Lymphaticovenular Anastomoses for Severe Leg Edema: Functional Reconstruction for Lymph Drainage System.

    PubMed

    Koshima, Isao; Narushima, Mitsunaga; Mihara, Makoto; Yamamoto, Takumi; Hara, Hisako; Ohshima, Azusa; Kikuchi, Kazuki; Todokoro, Ken; Seki, Yukio; Iida, Takuya; Nakagawa, Masahiro

    2016-01-01

    Background Collecting lymphatics have lymph-drainage function with contraction of smooth muscle cells. Patients with edema have lost this drainage function due to degeneration of smooth muscle cells. Lymphaticovenular (LV) anastomosis salvages smooth muscle cells from reversible degeneration (mild edema), but muscle cells cannot be recovered from irreversible degeneration (severe edema). Therefore, in severe edema, LV anastomoses cannot reestablish the drainage function of the lymphatic system.To overcome this weakness of LV bypass methods for severe edema, new methods were instituted for repair of this missing drainage function using a lymphadiposal flap from the contralateral foot for hemilateral edema, or transfer of lateral thoracic lymph nodes for bilateral edema. Methods A total of 13 cases were repaired with lymphadiposal flaps and additional LV anastomoses. These cases have frequent phlegmon or cellulitis or resisted to previous LV anastomoses and/or compression therapy. The ages ranged from 15 to 75 years. There were four cases of primary edema and nine cases of secondary edema. Results Regarding the lymphadiposal flap (n = 8), three cases showed an excellent response (37.5%; no need for compression therapy), four cases had a good response (50%; improvement with compression), one case showed no change (12.5%; no improvement), and there were no cases of deterioration. Regarding the lateral thoracic lymph nodes transfer (n = 5), two cases had a good response (40%), three showed no improvement (60%), and there were no cases of deterioration. Conclusion It is concluded that lymphadiposal flap or lymph nodes transfer is suitable for severe edema having frequent cellulitis in unilateral or bilateral lower extremities resisting previous LV anastomoses and/or compression therapy. PMID:26258914

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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 biopsy in busy clinics. PMID:26622153

  13. 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.

  14. 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

  15. Ostéosarcome primitif du rein avec évolution métastatique au foie. Étude de cas et revue de la littérature

    PubMed Central

    Gharbi, Olfa; Trabelsi, Amel; Hochlef, Makram; Kriaa, Soulef; Limam, Sami; Ben Fatma, Leila; Landolsi, Amel; Gahbiche, Selma; Mokni, Moncef; Mosbeh, T.A.; Ben Ahmed, Slim

    2009-01-01

    Résumé L’ostéosarcome primitif du rein est une pathologie très rare dont l’histogénèse n’est pas claire. Les récidives locales et les métastases sont fréquentes et le pronostic est très mauvais. Nous décrivons ici le cas d’une patiente de 59 ans qui présentait des douleurs lombaires gauches et un amaigrissement. Une échographie abdominale et une tomodensitométrie abdominale ont révélé une masse rétropéritonéale de 13 × 8 × 9 cm avec macrocalcifications. Le bilan d’extension n’a pas révélé d’autres lésions. On a procédé à une néphrectomie élargie gauche; l’examen histologique a révélé une prolifération tumorale constituée de cellules fusiformes de taille variable, ces cellules manifestement atypiques produisant directement du tissu ostéoïde évoquant un ostéosarcome rénal. Dix mois plus tard, la patiente présentait des lésions métastatiques au niveau hépatique sans autre lésion secondaire ni récidive locale. La patiente est actuellement en cours de traitement par chimiothérapie par doxorubicine et cisplatine avec un recul de 17 mois. Les caractéristiques anatomocliniques et les modalités thérapeutiques de cette pathologie rare sont discutées ci-dessous. PMID:19424475

  16. Correlations between Clinical Features and Mortality in Patients with Vibrio vulnificus Infection

    PubMed Central

    Zhao, Hong; Xu, Lichen; Dong, Huihui; Hu, Jianhua; Gao, Hainv; Yang, Meifang; Zhang, Xuan; Chen, Xiaoming; Fan, Jun; Ma, Weihang

    2015-01-01

    Vibrio vulnificus is a common gram-negative bacterium, which might cause morbidity and mortality in patients following consumption of seafood or exposure to seawater in Southeast China. We retrospectively analyzed clinical data of patients with laboratory confirmed V. vulnificus infection. Twenty one patients were divided into a survival group and a non-surviving (or death) group according to their clinical outcome. Clinical data and measurements were statistically analyzed. Four patients (19.05%) died and five patients gave positive cultures from bile fluid, and 16 other patients gave positive culture from blood or blisters. Ten patients (47.62%) had an underlying liver disease and marine-related events were found in sixteen patients (76.2%). Patients with heavy drinking habits might be at increased mortality (p = 0.028). Clinical manifestations of cellulitis (47.6%), septic shock (42.9%) and multiple organ failure (28.6%) were statistically significant when comparing survivors and non-survivors (p = 0.035, p = 0.021 and p = 0.003, respectively). The laboratory results, including hemoglobin < 9.0 g/L (p = 0.012), platelets < 2.0×109 /L, prothrombin time activity (PTA) <20%, decreased serum creatinine and increased urea nitrogen were statistically significant (p = 0.012, p = 0.003, p = 0.028 and p = 0.028, respectively). Patients may be at a higher risk of mortality under situations where they have a history of habitual heavy alcoholic drink consumption (p = 0.028, OR = 22.5, 95%CI 1.5–335.3), accompanied with cellulitis, shock, multiple organ failure, and laboratory examinations that are complicated by decreased platelets, hemoglobin and significantly prolonged prothrombin time (PT). PMID:26274504

  17. 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 le BrdU au niveau cellulaire. Notre hypothese (basee sur des resultats preliminaires effectues dans notre laboratoire) est que l'irradiation de l'ADN cellulaire en presence de BrdU augmentera le nombre de bris simple brin sans toutefois augmenter le nombre de bris double brin. Les resultats presentes dans ce memoire semblent corroborer cette hypothese. Les nouvelles methodes d'analyse, soient l'essai comete et la detection des foci gamma-H2AX remettent en question ce qui a ete dit sur le BrdU au sujet de l'induction des cassures double brin depuis plusieurs annees. L'ensemble de ces nouveaux resultats effectue a l'aide de cellules ayant incorporees du BrdU sont en correlation avec de precedents resultats obtenus dans notre laboratoire sur des oligonucleotides bromes. Ils reaffirment que l'irradiation combinee au BrdU augmente l'induction de bris simple brin mais pas de bris double brin. L'investigation approfondie des mecanismes d'action non elucides du BrdU au niveau cellulaire et son utilisation a des moments strategiques pendant le traitement de radiotherapie pourraient accroitre son efficacite a des fins d'utilisation clinique. Mots cles : 5-bromodeoxyuridine, dimeres interbrins, dommage a l'ADN, essai comete, H2AX, radiosensibilisateur, radiotherapie

  18. Approche expérimentale nouvelle pour l'étude de cinétiques réactionnalles de surface à hautes températures (2 000-3 000K)

    NASA Astrophysics Data System (ADS)

    Blaise, G.; Seghrouchni, E.

    1991-06-01

    A fraction of the material sputtered from a sample by an ion beam is collected in a tantalum cell brought at a high temperature where it is thermalized and partly ionized. Ions are extracted from the cell and analyzed in a mass spectrometer. A method based on this principle was proposed a few years ago for the analysis of thin layers. Here we are using the same device for studying the surface reaction kinetics of atoms injected in the cell with the tantalum walls. The interaction of uranium with tantalum is described in the present study. From 3 000 K to 2 700 K we have observed an adsorption process characterized by an activation energy E_a=2.4 eV and a pre-exponential factor of the resident time 1/ν0simeq 3 × 10^{-6} s. At a lower temperature a chemical diffusion of uranium in the tantalum wall is observed with the formation of a solid solution, the concentration limit of which imposes a permanent diffusion flux J_{DT}(trightarrowinfty)ne 0. The thickness of this phase is growing in proportion to the diffusion time with a velocity which increases when the temperature is decreasing (from 1.8 × 10^{-2} Å/s at 2 600 K to 1.4 × 10^{-1} Å/s at 1 850 K). La matière d'un échantillon prélevée par pulvérisation ionique pénètre en partie dans une cellule en tantale portée à haute température dans laquelle elle est thermalisée et en partie ionisée. Les ions produits sont extraits de la cellule et identifiés par spectrométrie de masse. Ce dispositif qui a donné lieu à une méthode d'analyse de couches minces est utilisé ici pour étudier la cinétique réactionnelle de surface des atomes introduits dans la cellule avec la paroi de Ta. La présente étude porte sur l'interaction uranium-tantale. Entre 3 000 K et 2 700 K on observe un simple processus d'adsorption désorption dont l'énergie d'activation est égale à E_a=2,4 eV et dont le coefficient pré-exponentiel du temps de résidence a pour valeur 1/ν0simeq 3 × 10^{-6} s. A plus basse température, on observe une diffusion chimique de l'uranium dans le tantale marquée par la formation d'une solution solide dont la limite de concentration impose un flux permanent de diffusion J_{DT}(trightarrowinfty)ne 0. L'épaisseur de cette phase croît proportionnellement au temps de diffusion avec une vitesse qui augmente lorsque la température diminue (1,8 × 10^{-2} Å/s à 2 600 K à 1,4 × 10^{-1} Å/s à 1 850 K).

  19. Cycloconvertisseurs mixtes thyristors/GTO a haut facteur de puissance

    NASA Astrophysics Data System (ADS)

    Richardeau, Frédéric; Chéron, Yvon

    1997-04-01

    This paper deals with a reactive power suppression technique inside phase-controlled structures such as rectifier bridges and cycloconverters. The concept is based on an association between dual-switching cells by means of thyristors (natural zero current switching) and reverse blocking abilities GTOs (natural zero voltage switching). Thyristor cells work with a lagging phase shifting control and draw a positive reactive power. On the contrary, GTO cells use a leading phase shifting control and draw a negative reactive power. The total average reactive power in the power system is zero and the power factor is only given by the line current form factor. The application of this concept to cycloconverters gives three basic structures. Two of them have a natural current reversibility. These two structures use, either a mixed full bridges association with a pulse number of 6, or a mixed bridges association with a pulse number of 3. The first one gives a high power factor but draws a low frequency fluctuating reactive power. The second one yields no reactive power but with a less power factor. The study and the comparison of these structure have been carried out on a 20kVA three-phase laboratory prototype. Cet article présente une technique de suppression de la puissance réactive au sein même de convertisseurs à contrôle de phase tels que les commutateurs de courant et les cycloconvertisseurs. Le concept repose sur l'association de cellules d'interrupteurs à mécanismes de commutation duaux au moyen de thyristors (commutation naturelle au zéro du courant) et de GTO symétriques (commutation naturelle au zéro de la tension aux bornes). Les cellules à thyristors travaillent avec un angle de retard à l'amorçage et consomment de la puissance réactive. À l'opposé, les cellules à GTO utilisent un angle d'avance à l'amorçage et produisent de la puissance réactive. La puissance réactive moyenne résultante est nulle et le facteur. de puissance se réduit au facteur de forme du courant de ligne. L'extension aux montages cycloconvertisseurs conduit à trois structures de base. Parmi celles-ci, deux présentent l'avantage d'être naturellement réversibles en courant. Ces deux structures utilisent soit une association de ponts complets d'indice de pulsation 6, mixtes entre eux, soit une association de ponts mixtes d'indice de pulsation3. La première association produit un facteur de puissance élevé aux dépends d'une ondulation basse fréquence de puissance réactive. La seconde association ne possède pas cet inconvénient avec cependant un facteur de puissance moindre. La caractérisation et la comparaison de ces structures ont été validées par un prototype de laboratoire triphasé-triphasé à un niveau de puissance de 20kVA.

  20. Further analysis of the analogy between cellular solidification and viscous fingering

    NASA Astrophysics Data System (ADS)

    Hennenberg, M.; Billia, B.

    1991-01-01

    Neglecting capillarity, the analogy between cellular solidification and viscous fingering is revisited in the limit of small Pclet numbers P_{?}=?/l_s, where ? is the periodicity and l_s the solutal length. Actually, cellular growth also depends on a second Pclet number P_t based on the shift of the tip from the position of the planar front. When P_t is small, the analogy with viscous fingering is legitimate which gives an expression for the tip supersaturation ? which fits nicely with the available experimental data on succinonitrile-acetone alloys. Neverthless, it turns out that P_t is large for real cells which leads us to develop a step-by-step approach, up to the second order in the small parameter P_{?}. At the first order, the Brody-Flemings relation for ? is recovered but in a rigorous way. The second order results in an integral equation for the profile which is explicitly derived for finite amplitude cells. En l'absence de tension de surface et dans la limite des petits nombres de Pclet P_{?}=?/l_s, ou' ? est la priode et l_s la longueur solutale, nous rexaminons l'analogie entre la solidification cellulaire et la digitation visqueuse. En ralit, la croissance cellulaire dpend aussi d'un second nombre de Pclet P_t bas sur le dcalage du sommet par rapport la position de l'interface plane. Lorsque P_t est petit, l'analogie avec la digitation visqueuse s'avre fonde ce qui conduit une expression de la sursaturation au sommet ?, qui est en excellent accord avec les donnes exprimentales disponibles pour les alliages succinonitrile-actone. De fait, il apparat que P_t est grand pour les cellules relles ce qui nous amne dvelopper une approche pas pas, jusqu'au second ordre en le petit paramtre P_{?}. Au premier ordre, nous retrouvons de manire rigoureuse la relation de Brody-Flemings pour ?. Le second ordre aboutit une quation intgrale du profil cellulaire, tablie de manire explicite dans le cas des cellules d'amplitude finie.

  1. A δ-Doped Substructure in Solar Cells: Carriers Confinement and Photocurrent

    NASA Astrophysics Data System (ADS)

    Pélanchon, F.; Moreau, Y.; Mialhe, P.

    1997-01-01

    This paper presents a modelling of the Low-High interfaces effects due to the implantation, in the emitter of a silicon solar cell, of a complex structure consisting of a δ-doping profile coincident with a defect layer. It leads to analytical expressions of the potential barriers and the drift electric fields due to these interfaces. The confinement of the holes generated by the infrared absorption is studied. In parallel, we propose a numerical approach for the electric phenomena occurring in the cell emitter with a complex interface: it confirms our theoretical results. The electron photocurrent due to the normal absorption is shown not to be altered by the complex structure. The hole confinement, near the front surface, can improve the performances of the cell. Both our theoretical expressions and our numerical results predict this photocurrent increase. Ce travail présente une modélisation des effets d'interfaces créés par l'implantation, dans l'émetteur d'une cellule solaire au silicium, d'une structure complexe consistant en un δ-dopage coïncidant avec une couche de défauts. Les expressions analytiques des barrières de potentiel et des champs d'entraînement montrent l'intérêt de ce δ-dopage additionnel : le confinement des trous générés par l'absorption infra-rouge ; le photocourant dû à l'absorption normale n'est cependant pas altéré par cette structure additionnelle. Une approche numérique parallèle, fondée sur les équations de transports complètes, confirme les résultats théoriques, tant au niveau du confinement des trous, que de l'amélioration des performances de la cellule sous éclairement AM1.5 : courant de court-circuit, tension de circuit ouvert et puissance maximale disponible.

  2. 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 can more rarely be associated with pyoderma gagrenosum (PG) or Crohn disease (CD), other inflammatory diseases of the skin that are not follicular. The reason for this is unclear [2]. What AC, DC, HS, CD, and PG share is that they occur in bacterially rich environments. HS probably occurs with acanthosis nigricans because many HS patients are obese [2]. This concurrence seems under reported. PMID:24746309

  3. 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

  4. Critical boiling phenomena observed in microgravity

    NASA Astrophysics Data System (ADS)

    Garrabos, Y.; Chabot, C.; Wunenburger, R.; Delville, J.-P.; Beysens, D.

    1999-06-01

    We report experimental observations of the critical boiling when co-existing gas and liquid phases of pure fluid are heated under weigthlessness through the critical point. We find that when the system's temperature T is being increased to the critical temperature Tc so that it's slightly out of equilibrium, the apparent contact angle becomes very large (up to 110 circ). The gas appears to "web" the solid surface. In addition, we detect large temperature gradients between the (hot) gas phase and the (cold) liquid phase in the interferometric cell. These unexpected results are robust: they are observed either under continuous heating (ramping) or stepping by positive temperature quenches, for various morphologies of the gas bubble and in different fluids (SF6 and CO2). The difference in isentropic thermal responses of gas and liquid during heating, due to the adiabatic heating by the "Piston Effect", is responsible for the temperature non-homogeneities. The vapour recoil force due to liquid evaporation, which is involved in the boiling crisis in heat exchangers, is presumably at the origin of the interface deformation. Nous rapportons les observations expérimentales obtenues en chaffant un fluide pur diphasique gaz-liquide en coexistence au cours de la traversée de son point critique en absence de pesanteur. Lorsque la température du système diphasique hors d'équilibre est augmentée vers la température critique, nous observons en transmission un angle de contact apparent de la vapeur très important (atteignant 110 circ), le gaz semblant "mouiller" la surface solide. De plus, d'importants gradients de température entre la phase gaz chaude et la phase liquide froide sont mesurés dans les cellules observées par interférométrie. Ces résultats inattendus sont observés pour un chauffage continu (rampe) et par trempe positive (échelon), pour différents rapports d'aspect du système diphasique, pour des cellules de CO2 et de SF6, démontrant ainsi une grande robustesse. Les réponses isentropiques différentes du gaz et du liquide lors du chauffage par effet piston sont certainement responsables des inhomogénéités de température. La force de recul de la vapeur due à l'évaporation pourrait être la cause dominante de la déformation de l'interface liquide-vapeur à l'approche de la température de transition.

  5. 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.

  6. A Study on the Acute Kidney Injury in Snake Bite Victims in A Tertiary Care Centre

    PubMed Central

    L, Harshavardhan; A J, Lokesh; H L, Tejeshwari; B R, Halesha; Metri, Siddharama S

    2013-01-01

    Introduction: Snake bite is a common medical emergency and an occupational hazard, more so in tropical India, where farming is a major source of employment. Viper bites are more common than other poisonous snakebites in humans. The World Health Organization has estimated that there are approximately 1,25,000 deaths among 2,50,000 poisonous snake bites worldwide every year, of which India accounts for 10,000 deaths. Acute kidney Injury (AKI) is an important consequence of a snake bite and its proper supportive management after the anti-venom administration is of utmost importance, for a good patient outcome. Aims and Objectives: 1. To assess the risk factors and the prognostic factors in snake-bite induced Acute Kidney Injury.2. To determine the outcome of snake bite patients with AKI in a tertiary care centre in Karnataka, India. Methodology: This prospective study was carried out at Vijaynagar Institute of Medical Sciences, Bellary, Karnataka, India. This institute is a referral government hospital in north Karnataka, India. Study Design: This was a prospective and descriptive type of study. Results: A total of 246 cases of venomous snakebite were included in this study, who were admitted in the hospital from November 2007 to October 2008. Among the AKI and the non-AKI patients, Illiteracy was more among the patients who suffered from AKI (75%). In our study, among all the patients (both AKI and non-AKI patients), viper bite was the commonest and it was seen in 31(91.6%) cases among the AKI patients and in 142 (67.6%) cases among the non-AKI patients. In our study, a majority of the patients who developed AKI had initially visited traditional healers before visiting our hospital, which was found to be statistically significant. In the present study, disseminated intravascular coagulation (DIC) and intravascular haemolysis were found to be predominant among the AKI patients. The “Bite to Needle” time was significantly more in the patients who developed AKI as compared to that in those who developed non-AKI. Out of 36 patients who suffered from AKI, 28 (77.7%) patients survived. Among them, 27(96.7%) patients developed cellulitis, 25(89.5%) had regional lymphadenopathy, 22(81.2%) were bitten at their lower limbs, and 6 (23.8%) patients developed bleeding manifestations. Conclusion: This study concludes that acute kidney injury occurs in 14.6% of the victims of snake bite. The common manifestations include cellulitis, bleeding manifestations and gangrene at the site of the bite. PMID:23814727

  7. 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

  8. Facteurs influençant l'initiation au traitement antirétroviral des personnes vivant avec le VIH dans les Centres de Traitement Agréés de Bamenda et de Bertoua au Cameroun

    PubMed Central

    Mbopi-Keou, Francois-Xavier; Voundi, Esther Voundi; Kalla, Ginette Claude Mireille; Emah, Irène; Angwafo, Fru; Muna, Walinjom

    2014-01-01

    Introduction L'objectif de ce travail était de déterminer les facteurs influençant l'initiation au traitement antirétroviral des personnes vivant avec le VIH (PVVIH) dans les centres de traitements agrées (CTA) de Bamenda et de Bertoua au Cameroun. Méthodes Il s'agissait d'une étude transversale, analytique réalisée de Janvier à Avril 2011, dans les CTA de Bamenda et de Bertoua. Pour cette étude, nous avons obtenu une clairance éthique. Résultats Nous avons étudiés 460 dossiers de patients séropositifs en phase d'initiation au traitement antirétroviral dans les CTA de Bamenda et de Bertoua, 53,9% et 46,1% respectivement. L ‘âge médian était de 36 ans. La plupart des séropositifs à Bertoua (41) avaient fait un dépistage volontaire du VIH par rapport à ceux de Bamenda (22) (p= 0.008). Il y ‘avait plus de VIH de type 1 et 2 dans le CTA de Bamenda (15) par rapport à Bertoua (3) (p= 0.011). La majorité des patients était classé au stade clinique II à Bamenda (54,0%) tandis qu ‘à Bertoua le stade clinique III était prédominant (52,4%) (p = 0,000). Le taux médian de CD4 était de 133 cellules/mm3 dans le CTA de Bamenda et de 175 cellules/mm3 à Bertoua (p = 0,008). La Zidovudine était plus prescrit à Bamenda et le Ténofovir à Bertoua (p = 0,000). L ‘Efavirenz était plus prescrit à Bertoua tandis que la Névirapine l ‘était plus à Bamenda (p = 0,000). Le Lopinavir/r était plus prescrit à Bamenda qu ‘à Bertoua (p = 0,017). Conclusion Il apparait urgent de standardiser la prise en charge des PVVIH dans les CTA du Cameroun. PMID:25184023

  9. 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 previously thought, and extends into subarctic regions of western North America, at least to latitude 66°N. The host range is now recognized to include two additional subspecies: the Yukon-Alaska moose and Grant’s caribou. Accelerated climate change at high latitudes may affect vector dynamics, and consequently the abundance and distribution of O. cervipedis in moose and caribou. Disease outbreaks and mortality events associated with climatic perturbations have been reported for other filarioids, such as Setaria tundra in Fennoscandia, and may become an emerging issue for O. cervipedis in subarctic North America. PMID:23110962

  10. 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

  11. Lymphangioléiomyomatose pulmonaire de révélation inhabituelle au cours d'une sclérose en plaque

    PubMed Central

    Jaafoura, Neirouz Ghannouchi; Guigua, Ahmed; Zaghouani, Houneida; Atig, Amira; Bakir, Dajla; Khalifa, Mabrouk; Bahri, Fethi

    2015-01-01

    La lymphangioléiomyomatose pulmonaire est une pathologie rare de la femme jeune, caractérisée par une prolifération de cellules musculaires lisses immatures, aboutissant à la destruction kystique des poumons avec possibilité d’évolution vers l'insuffisance respiratoire chronique. La découverte est souvent fortuite lors de la prise en charge d'une autre pathologie pulmonaire. Son association à une sclérose en plaque n'a jamais été rapportée, de même que l'embolie pulmonaire in situ comme manifestation inaugurale. Nous rapportons l'observation d'une patiente âgée de 39 ans, suivie pour sclérose en plaque depuis 20 ans, chez qui le diagnostic d'une lymphangioléiomyomatose pulmonaire a été posé, à l'occasion d'une broncho-pneumopathie bilatérale avec une embolie pulmonaire associée motivant la réalisation d'un angioscanner thoracique. PMID:26185588

  12. 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

  13. 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

  14. Le syndrome de Vogt-Koyanagi Harada dans sa forme purement oculaire: à propos d'un cas

    PubMed Central

    Louaya, Shamil; Bennouk, Youssef; Kriet, Mohamed; Oubaaz, Abdelbarre

    2014-01-01

    Le syndrome de Vogt-Koyanagi-Harada (VKH) est une affection systémique rare, sévère mettant en jeu le pronostic visuel malgré les traitements agressifs, caractérisée par l'association de plusieurs symptômes: oculaires, méningés, auditifs et cutanés secondaire à une auto-immunisation où le mélanocyte serait la cellule cible. Nous rapportons un nouveau cas rare où l'atteinte oculaire est isolée. La sévérité de l'uvéite réside dans la fréquence des récidives, dans la cortico-résistance et dans la forte incidence des complications qui conditionnent le pronostic et expliquent les acuités visuelles finales médiocres. La prise en charge doit être précoce afin d'essayer d'améliorer le pronostic visuel. PMID:25667692

  15. 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 Central

    TANIGUCHI, Takako; YAMAZAKI, Wataru; SAEKI, Yuji; TAKAJO, Ichiro; OKAYAMA, Akihiko; HAYASHI, Tetsuya; MISAWA, Naoaki

    2015-01-01

    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

  16. 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

  17. Pressure Distribution Tests on PW-9 Wing Models from -18 Degree Through 90 Degree Angle of Attack

    NASA Technical Reports Server (NTRS)

    Loeser, Oscar E , Jr

    1929-01-01

    At the request of the Army Air Corps, an investigation of the pressure distribution over PW-9 wing models was conducted in the atmospheric wind tunnel of the National Advisory Committee for Aeronautics. The primary purpose of these tests was to obtain wind-tunnel data on the load distribution on the cellule to be correlated with similar information obtained in flight tests, both to be used for design purposes. Because of the importance of the conditions beyond the stall as affecting the control and stability, this investigation was extended through 90 degree angle of attack. The results for the range of normal flight have been given in NACA Technical Report No. 271. The present paper presents the same results in a different form and includes, in addition, those over the greater range of angle of attack, -18 degrees through 90 degrees. The results show that: (1) at angles of attack above maximum lift, the biplane upper wing pressures are decreased by the shielding action of the lower wing. (2) the burble of the biplane lower wing, with respect to the angle of attack, is delayed, due to the shielding action of the lower wing. (3) the center of pressure of the biplane upper wing (semispan) is, in general, displaced forward and outward with reference to that of the wing as a monoplane, while for the lower wing there is but slight difference for both conditions. (4) the overhanging portion of the upper wing is little affected by the presence of the lower wing.

  18. Moxifloxacin versus Clindamycin/Ceftriaxone in the management of odontogenic maxillofacial infectious processes: A preliminary, intrahospital, controlled clinical trial

    PubMed Central

    Gómez-Arámbula, Hansel; Hidalgo-Hurtado, Antonio; Rodríguez-Flores, Rosaura; González-Amaro, Ana-María; Garrocho-Rangel, Arturo

    2015-01-01

    Background The aim of this study was to compare the days of hospitalization length between patients treated with Moxifloxacin with that of patients treated with a Clindamycin/Ceftriaxone combination and additionally, to isolate and identify the oral pathogens involved in orofacial odontogenic infections. Material and Methods A pilot-controlled-clinical-trial was carried out on hospitalized patients with cervicofacial odontogenic abscesses or cellulitis, who were randomly asigned to two study groups: 1) patients who received Moxifloxacin, and 2) patients receiving Clindamycin/Ceftriaxone combination. Infiltrate samples were collected through transdermic or transmucosal punction and later cultured on a media specific for aerobic and anaerobic microorganisms. Mean hospitalization duration in days until hospital discharge and susceptibility assessment in rates were established. Results Mean hospitalization time in days of patients treated with Moxifloxacin was 7.0 ± 1.6 days, while in the Clindamycin/Ceftriaxone group, this was 8.4 ± 1.8 days, although significant difference could not be demonstrated (p=0.074). A total of 43 strains were isolated, all of these Gram-positive. These strains appeared to be highly sensitive to Moxifloxacin (97.5%) and Ceftriaxone (92.5%). Conclusions Moxifloxacin and Ceftriaxone appear to be potential convenient and rational alternatives to traditional antibiotics, for treating severe odontogenic infections, in conjunction with surgical extraoral incision, debridement, and drainage. Key words:Orofacial odontogenic infections, antimicrobial susceptibility, antimicrobial resistance. PMID:26644841

  19. Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations

    SciTech Connect

    Gloviczki, P.; Calcagno, D.; Schirger, A.; Pairolero, P.C.; Cherry, K.J.; Hallett, J.W.; Wahner, H.W.

    1989-05-01

    Lymphoscintigraphy (LS), performed with technetium 99m-labeled antimony trisulfide colloid, was used as a noninvasive diagnostic examination to evaluate the lymphatic circulation in 190 extremities of 115 patients. Forty-six patients had primary lymphedema, 48 had secondary lymphedema, and 21 patients had other causes of limb swelling. To determine the value of LS in surgical decision making, preoperative and postoperative LS of 16 patients who underwent surgical repair of the lymphatic abnormality were studied separately. Semiquantitative evaluation of the lymphatic drainage and visual interpretation of the image patterns were reliable to differentiate lymphedema from edemas of other origin (sensitivity: 92%, specificity: 100%). Although certain image patterns were characteristic of either primary or secondary lymphedema, LS could not consistently differentiate between the two types. Episodes of cellulitis in lymphedema clearly delayed lymph transport. LS was helpful in patient selection and follow-up after lymphatic surgery, but it did not prove patency of lymphovenous anastomoses. It was diagnostic in the evaluation of lymphangiectasia and was used to document successful surgical treatment of reflux of chyle. LS is safe and reliable and has no side effects. It should replace contrast lymphangiography in the routine evaluation of the swollen extremity.

  20. Helicobacter fennelliae Bacteremia: Three Case Reports and Literature Review.

    PubMed

    Saito, Sho; Tsukahara, Mika; Ohkusu, Kiyofumi; Kurai, Hanako

    2016-05-01

    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

  1. The role of primary care prescribers in the diagnosis and management of community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections.

    PubMed

    Lawrence, Kenneth R; Golik, Monica V; Davidson, Lisa

    2009-01-01

    Nosocomial infections caused by methicillin-resistant Staphylococcus aureus were first reported in the United States in the early 1960s. Beginning in the 1990s, healthy individuals from the community with no risk factors for resistant bacteria began presenting with methicillin-resistant Staphylococcus aureus infections, acquiring the name "community-associated methicillin-resistant Staphylococcus aureus" (CA-MRSA). CA-MRSA has a tendency to affect the skin and skin structures, generally in the form of abscesses and furuncles, carbuncles, and cellulitis. Cases of invasive infections including bacteremia, endocarditis, and necrotizing pneumonia have also been reported. A patient complaint of a "spider bite" is frequently associated with CA-MRSA. CA-MRSA and the traditional health care-associated methicillin-resistant Staphylococcus aureus are distinguished by their genetic composition, virulence factors, and susceptibility patterns to non-beta-lactam antibiotics. Appropriate management of CA-MRSA skin and skin structure infections includes incision and drainage of infected tissue and appropriate antimicrobial therapy. It has been suggested that when prevalence of CA-MRSA within a community eclipses 10%-15%, empiric use of non-beta-lactam antibiotics with in vitro activity against CA-MRSA be initiated when treating skin and skin structure infections. CA-MRSA retains susceptibility to a range of older antibiotics available in oral formulations such as minocycline, doxycycline, sulfamethoxazole-trimethoprim, moxifloxacin, levofloxacin, and clindamycin. Local susceptibility patterns and individual patient factors should guide the selection of antibiotics. PMID:19617720

  2. Necrotizing fasciitis – a diagnostic dilemma: two case reports

    PubMed Central

    2014-01-01

    Introduction Necrotizing soft tissue infections can affect various tissue planes. Although predisposing etiologies are many, they mostly center on impaired immunity occurring directly or indirectly and loss of integrity of protective barriers which predispose to infection. The nonspecific presentation may delay diagnosis and favor high mortality. Case presentation Two case vignettes are presented. The first patient, a 44-year-old healthy South Asian man with a history of repeated minor traumatic injury presented to a primary health care center with a swollen left lower limb. He was treated with antibiotics with an initial diagnosis of cellulitis. Because he deteriorated rapidly and additionally developed intestinal obstruction, he was transferred to our hospital which is a tertiary health care center for further evaluation and management. Prompt clinical diagnosis of necrotizing soft tissue infection was made and confirmed on magnetic resonance imaging as necrotizing fasciitis. Urgent debridement was done, but the already spread infection resulted in rapid clinical deterioration with resultant mortality. The second patient was a 35-year-old South Asian woman with systemic lupus erythematous receiving immunosuppressive therapy who developed left lower limb pain and fever. Medical attention was sought late as she came to the hospital after 4 days. Her condition deteriorated rapidly as she developed septic shock and died within 2 days. Conclusions Necrotizing fasciitis can be fatal when not recognized and without early intervention. Clinicians and surgeons alike should have a greater level of suspicion and appreciation for this uncommon yet lethal infection. PMID:24965382

  3. 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

  4. Experience with 224 percutaneous dilatational tracheostomies at an adult intensive care unit in Bahrain: A descriptive study

    PubMed Central

    Hameed, Akmal A.; Mohamed, Hasan; Al-Ansari, Mariam

    2008-01-01

    Tracheostomy is one of the most commonly performed procedures in critically ill patients. Over the past 15 years, many large university hospitals have reported their experience with percutaneous dilatational tracheostomy (PDT). We have described and compared our experience with 224 PDTs that we performed in the last four and a half years. We have also compared PDT performed with and without bronchoscopic guidance at our setting and PDT verses surgical tracheostomy. OBJECTIVE: The purposes of this study are to evaluate the safety of PDT in our hospital setting and to compare our results with those published in the literature. DESIGN: A retrospective study for our experiences about safety and efficacy of 224 PDTs in an intensive care unit (ICU) setting. SETTING: A 11-bedded adult medical, surgical, neuro-trauma ICU at Salmaniya Medical Complex, Bahrain. MATERIALS AND METHODS: This is based on our experiences about complications/timings of all PDTs performed from October 2002 to February 2007. A retrospective chart analysis. RESULTS: There were 15 mechanical complications in total, including nine patients developing bleeding during or post-procedure, three patients developing pneumothorax and two patients developing cellulitis; in one procedure, a tracheostomy tube was misplaced. The proportion of total complications was 6.6% and no death. CONCLUSIONS: From our experience, bronchoscope can be used during PDTs performed in ICU by inexperienced intensivists who do not have good exposure to procedures, but after gaining adequate experience, PDT can be performed safely without using bronchoscope. PMID:19561878

  5. 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

  6. 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

  7. Moist wound healing under a vapor permeable membrane.

    PubMed

    Alper, J C; Welch, E A; Ginsberg, M; Bogaars, H; Maguire, P

    1983-03-01

    Ten ambulatory patients with unilateral and eight with bilateral ulcers of various etiologies were studied to determine the effects of keeping a wound bed moist under a water vapor and oxygen permeable membrane (VPM). In the bilateral group, VPM healing was compared with a debriding enzyme ointment and 10% benzoyl peroxide in the same patient. The faster healing rate with VPM was compared to the healing rate with control substances by the paired t test, with significance at less than 0.05 level. In the unilateral group two patients with ulcers to bone or joint capsule and one patient who had failed grafting healed without surgery. Two patients failed to heal with the VPM. All healing occurred in the face of gross bacterial contamination. Three patients treated with VPM developed cellulitis. Wound healing under a vapor permeable membrane occurs with an increase of the average healing rate by a factor of 2.6 when compared to control substances in ambulatory patients. PMID:6833534

  8. Molecular defects in the mannose binding lectin pathway in dermatological disease: Case report and literature review

    PubMed Central

    2010-01-01

    Mannose-binding lectin (MBL) and the Mannose-binding lectin-associated serine proteases (MASPs) are an essential aspect of innate immune responses that probably play an important but understudied role in cutaneous function. The MBL-MASP pathway appears to exert its primary role by assisting in the clearance of apoptotic skin cells (thus preventing accumulation and a subsequent autoimmune response) and promoting opsonophagocytosis of invading pathogens, limiting their dissemination. Deficiencies of the pathway have been described and are associated with infectious, autoimmune and vascular complications. However, the role of this pathway in dermatological disease is essentially unexplored. We describe 6 patients presenting with recurrent inflammatory and/or infectious skin conditions who also demonstrated severely low MBL levels. One patient also had a defect in the MASP2 gene. Genotype analysis revealed specific point mutations in the MBL2 promoter in all 6 patients and a variant MASP-2 gene in one patient. Five patients presented recurrent pustular skin infections (cellulitis, folliculitis and cutaneous abscess). A case of Grover's disease and one forme fruste of Behcet's syndrome (orogenital ulcers) were also observed. The patients responded to antimicrobial therapy, although in some, recurrence of infection was the rule. It appears that MBL deficiency may contribute to recurrent skin infections and to certain forms of inflammatory skin disease. The mechanisms may relate to the role of this pathway in innate immunity, removal of apoptotic cells and in immune complexes. Further study of MBL pathway defects in dermatological disease is required. PMID:20338057

  9. A Case Report of Herpetic Whitlow with Positive Kanavel's Cardinal Signs: A Diagnostic and Treatment Difficulty.

    PubMed

    Brkljac, Milos; Bitar, Samer; Naqui, Zafar

    2014-01-01

    Herpetic whitlow is an acute viral infection of the hand caused by either herpes simplex virus (HSV) 1 or 2. Its characteristic findings are significant pain and erythema with overlying nonpurulent vesicles. The differential diagnosis includes flexor tenosynovitis. We present a case of recurrent infection of the middle finger in an immunocompetent 19-year-old girl. Multiple painful pustules with tracking cellulitis were partially treated by oral antibiotics. A recurrence with positive Kanavel's signs suggested flexor tenosynovitis at seven months. Her symptoms improved transiently following emergent surgical open flexor sheath exploration and washout however, she required two further washouts; at eleven and thirteen months to improve symptoms. Viral cultures were obtained from the third washout as HSV infection was disclosed from further history taking. These were positive for HSV2. Treatment with acyclovir at thirteen months after presentation led to a complete resolution of her symptoms with no further recurrences to date. This rare case highlights the similarity in presentation between flexor sheath infection and herpetic whitlow which can lead to diagnostic confusion and mismanagement. We emphasise the importance of careful past medical history taking as well as considering herpetic whitlow as a differential diagnosis despite the presence of strongly positive Kanavel's signs. PMID:25436164

  10. 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.

  11. Fine Structure of Diffuse Scattering Rings in Al-Li-Cu Quasicrystal: A Comparative X-ray and Electron Diffraction Study

    NASA Astrophysics Data System (ADS)

    Donnadieu, P.; Dénoyer, F.

    1996-11-01

    A comparative X-ray and electron diffraction study has been performed on Al-Li-Cu icosahedral quasicrystal in order to investigate the diffuse scattering rings revealed by a previous work. Electron diffraction confirms the existence of rings but shows that the rings have a fine structure. The diffuse aspect on the X-ray diffraction patterns is then due to an averaging effect. Recent simulations based on the model of canonical cells related to the icosahedral packing give diffractions patterns in agreement with this fine structure effect. Nous comparons les diagrammes de diffraction des rayon-X et des électrons obtenus sur les mêmes échantillons du quasicristal icosaèdrique Al-Li-Cu. Notre but est d'étudier les anneaux de diffusion diffuse mis en évidence par un travail précédent. Les diagrammes de diffraction électronique confirment la présence des anneaux mais ils montrent aussi que ces anneaux possèdent une structure fine. L'aspect diffus des anneaux révélés par la diffraction des rayons X est dû à un effet de moyenne. Des simulations récentes basées sur la décomposition en cellules canoniques de l'empilement icosaédrique produisent des diagrammes de diffraction en accord avec ces effects de structure fine.

  12. [Septic thrombosis of the cavernous sinus complicated by intracerebral hemorrhage].

    PubMed

    Doroszewska, Grazyna; Winiarski, Piotr; Zmudziński, Aleksander; Wrzesiński, Witold

    2005-01-01

    A case of septic cavernous sinus thrombosis in 41 year old men is described. One week prior to hospitalisation he had an influenza infection. During influenza nose furunculus, labial herpes and viral left otitis media with facial nerve paresis occurred. Patient manipulated furunculus nasi. On admission to hospital he complained of severe hedeache, left ear pain and left visual loss. He had left orbital cellulitis with immobile eyeball, the left part of the face, neck and throat were swollen. Lumbar puncture showed cerebrospinal fluid containing protein 156 mg/dl, glucose 94 mg/dl, and 5888 polymorphonuclear cells. Cranial CT scan showed left exophatlmos with periorbital swelling, left ethmoid sinusitis, and probable thrombosis of cerebral vessels. Involvement of the right eye appeared after two days. He was treated with high dose of antibiotics, steroids and anticoagulants. After four days in the control cranial CT scan two focus of intracerebral hemorrhage were found in the frontal lobe. We excluded anticoagulants from the therapy. The patients improved slowly and he was discharged after 22 days of hospitalisation with the left abducent and facial nerve paresis. PMID:16521456

  13. Infected facial tissue fillers: case series and review of the literature.

    PubMed

    Schtz, Petr; Ibrahim, Hussein Hassan Hamed; Hussain, Sabreyah Saleh; Ali, Tamer Sabry; El-Bassuoni, Khalid; Thomas, John

    2012-10-01

    Since 2007, 21 female and 1 male patient aged 25 to 55 years, who either did not have any obvious causative infection source or, despite the presence of nonvital teeth, did not display typical symptoms of odontogenic infection, were treated for acute facial inflammation. All these patients admitted previous application of injectable soft tissue fillers (ISTFs) performed in either private plastic surgery and dermatology practices or cosmetic salons. The period between injection and infection varied from 1 week to 6 years. The injected substance remained unknown in many cases. Of the 22 patients, 3 were diagnosed with facial cellulitis, 4 with periorbital abscess, and 15 with a buccal space abscess. ISTFs provide an attractive option in facial rejuvenation. With their increasing use, the prevalence of complications is also expected to increase. Infectious complications of ISTFs were previously unknown in Kuwait. Although these products are primarily meant for treatment of the aging face, the age pattern of our patients suggests their frequent misuse and spurious indications. Especially worrisome is the recently observed application of fillers in cosmetic salons. We believe that the use of ISTFs should be regulated and their administration in nonmedical facilities prohibited. Patients with an atypical course of facial inflammation should be questioned about a history of cosmetic procedures. PMID:22342250

  14. Cloning and Characterization of Surface-Localized α-Enolase of Streptococcus iniae, an Effective Protective Antigen in Mice

    PubMed Central

    Wang, Jun; Wang, Kaiyu; Chen, Defang; Geng, Yi; Huang, Xiaoli; He, Yang; Ji, Lili; Liu, Tao; Wang, Erlong; Yang, Qian; Lai, Weimin

    2015-01-01

    Streptococcus iniae is a major fish pathogen that can also cause human bacteremia, cellulitis and meningitis. Screening for and identification of protective antigens plays an important role in developing therapies against S. iniae infections. In this study, we indicated that the α-enolase of S. iniae was not only distributed in the cytoplasm and associated to cell walls, but was also secreted to the bacterial cell surface. The functional identity of the purified recombinant α-enolase protein was verified by its ability to catalyze the conversion of 2-phosphoglycerate (2-PGE) to phosphoenolpyruvate (PEP), and both the recombinant and native proteins interacted with human plasminogen. The rabbit anti-rENO serum blockade assay shows that α-enolase participates in S. iniae adhesion to and invasion of BHK-21 cells. In addition, the recombinant α-enolase can confer effective protection against S. iniae infection in mice, which suggests that α-enolase has potential as a vaccine candidate in mammals. We conclude that S. iniae α-enolase is a moonlighting protein that also associates with the bacterial outer surface and functions as a protective antigen in mice. PMID:26121302

  15. Infections requiring hospital readmission following face lift surgery: incidence, treatment, and sequelae.

    PubMed

    LeRoy, J L; Rees, T D; Nolan, W B

    1994-03-01

    This retrospective study evaluates 11 infections requiring hospital readmission following 6166 consecutive face lifts (0.18 percent). Seven patients had surgical drainage of an abscess, and four patients were treated for severe cellulitis, Staphylococcus was the predominant organism in all abscess cultures. Of three patients admitted 3 weeks after surgery, two cultured gram-negative organisms in addition to Staphylococcus. This suggests that all patients should be treated initially with Staphylococcus coverage. If a patient is readmitted more than 1 week postoperatively, gram-negative coverage should be considered, pending culture results. There was no consistent finding regarding past medical history, the use of perioperative antibiotics, surgical equipment used, complexity of the surgical dissection, drains, or hematoma formation. No patients demonstrated systemic signs or grossly abnormal laboratory results on readmission. Eight patients had no sequelae from the infection. Three patients developed scarring that was considered minor by the affected patients. These data support the conclusion that major infections following a face lift are rare occurrences. Standard medical and surgical care, given in a timely fashion, usually results in a satisfactory outcome with minimal morbidity. PMID:8115508

  16. Multidrug Efflux Systems in Helicobacter cinaedi

    PubMed Central

    Morita, Yuji; Tomida, Junko; Kawamura, Yoshiaki

    2012-01-01

    Helicobacter cinaedi causes infections, such as bacteremia, diarrhea and cellulitis in mainly immunocompromised patients. This pathogen is often problematic to analyze, and insufficient information is available, because it grows slowly and poorly in subculture under a microaerobic atmosphere. The first-choice therapy to eradicate H. cinaedi is antimicrobial chemotherapy; however, its use is linked to the development of resistance. Although we need to understand the antimicrobial resistance mechanisms of H. cinaedi, unfortunately, sufficient genetic tools for H. cinaedi have not yet been developed. In July 2012, the complete sequence of H. cinaedi strain PAGU 611, isolated from a case of human bacteremia, was announced. This strain possesses multidrug efflux systems, intrinsic antimicrobial resistance mechanisms and typical mutations in gyrA and the 23S rRNA gene, which are involved in acquired resistance to fluoroquinolones and macrolides, respectively. Here, we compare the organization and properties of the efflux systems of H. cinaedi with the multidrug efflux systems identified in other bacteria.

  17. 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.

  18. Pyoderma GangrenosumLike Ulcer in a Patient With X-Linked Agammaglobulinemia

    PubMed Central

    Murray, Patrick R.; Jain, Ashish; Uzel, Gulbu; Ranken, Raymond; Ivy, Cristina; Blyn, Lawrence B.; Ecker, David J.; Sampath, Rangarajan; Lee, Chyi-Chia Richard; Turner, Maria L.

    2011-01-01

    Background Pyoderma gangrenosumlike ulcers and cellulitis of the lower extremities associated with recurrent fevers in patients with X-linked (Bruton) agammaglobulinemia have been reported to be caused by Helicobacter bilis (formerly classified as Flexispira rappini and then Helicobacter strain flexispira taxon 8). Consistent themes in these reports are the difficulty in recovering this organism in blood and wound cultures and in maintaining isolates in vitro. We confirmed the presence of this organism in a patients culture by using a novel application of gene amplification polymerase chain reaction and electrospray ionization time-of-flight mass spectrometry. Observation An adolescent boy with X-linked agammaglobulinemia presented with indurated plaques and a chronic leg ulcer whose origin was strongly suspected to be an H bilis organism. Histologic analysis demonstrated positive Warthin-Starry staining of curvilinear rods, which grew in culture but failed to grow when sub-cultured. They could not be identified by conventional techniques. A combination of gene amplification by polymerase chain reaction and electrospray ionization time-of-flight mass spectrometry confirmed the identity of this organism. Conclusions This novel technology was useful in the identification of a difficult-to-grow Helicobacter organism, the cause of pyoderma gangrenosumlike leg ulcers in patients with X-linked agammaglobulinemia. Correct identification of this organism as the cause of pyoderma gangrenosumlike ulcers in patients with X-linked agammaglobulinemia is of great importance for the early initiation of appropriate and curative antibiotic therapy. PMID:20479300

  19. Molecular Characterization of Invasive Streptococcus dysgalactiae subsp. equisimilis, Japan.

    PubMed

    Wajima, Takeaki; Morozumi, Miyuki; Hanada, Shigeo; Sunaoshi, Katsuhiko; Chiba, Naoko; Iwata, Satoshi; Ubukata, Kimiko

    2016-02-01

    We collected ?-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 ?-lactam resistance. Among aging populations, invasive SDSE infections are an increasing risk. PMID:26760778

  20. Lab on a chip sensor for rapid detection and antibiotic resistance determination of Staphylococcus aureus.

    PubMed

    Abeyrathne, Chathurika D; Huynh, Duc H; Mcintire, Thomas W; Nguyen, Thanh C; Nasr, Babak; Zantomio, Daniela; Chana, Gursharan; Abbott, Iain; Choong, Peter; Catton, Mike; Skafidas, Efstratios

    2016-03-01

    The Gram-positive bacterium, Staphylococcus aureus (S. aureus), is a major pathogen responsible for a variety of infectious diseases ranging from cellulitis to more serious conditions such as septic arthritis and septicaemia. Timely treatment with appropriate antibiotic therapy is essential to ensure clinical defervescence and to prevent further complications such as infective endocarditis or organ impairment due to septic shock. To date, initial antibiotic choice is empirical, using a "best guess" of likely organism and sensitivity- an approach adopted due to the lack of rapid identification methods for bacteria. Current culture based methods take up to 5 days to identify the causative bacterial pathogen and its antibiotic sensitivity. This paper provides proof of concept for a biosensor, based on interdigitated electrodes, to detect the presence of S. aureus and ascertain its sensitivity to flucloxacillin rapidly (within 2 hours) in a cost effective manner. The proposed method is label-free and uses non-faradic measurements. This is the first study to successfully employ interdigitated electrodes for the rapid detection of antibiotic resistance. The method described has important potential outcomes of faster definitive antibiotic treatment and more rapid clinical response to treatment. PMID:26811849

  1. Léiomyosarcome de la veine cave inférieure: un cas clinique

    PubMed Central

    Hammoune, Nabil; El Guendouz, Faycal; Elhaddad, Siham; Latib, Rachida; Chami, Imane; Boujida, Najib; Hommadi, Abdelaziz

    2015-01-01

    Le léiomyosarcome de la veine cave inférieure est une tumeur maligne rare développée aux dépens des cellules musculaires lisses de la paroi vasculaire. L'imagerie radiologique par tomodensitométrie ou résonance magnétique nucléaire est un élément important au diagnostic et au bilan d'extension tumorale. Le traitement est chirurgical. Nous illustrons l'apport de l'imagerie à travers un cas de léiomyosarcome révélé par des épigastralgies paroxystiques, dont le diagnostique était orienté par la TDM, et confirmé par l’étude histologique. L’évolution était favorable. Après 2 ans de recul, la patiente était indemne de toute récidive tumorale. PMID:26161206

  2. 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

  3. A survey of Campylobacter bacteremia in three Danish counties, 1989 to 1994.

    PubMed

    Schønheyder, H C; Søgaard, P; Frederiksen, W

    1995-01-01

    Over a 5-year period (April 1989 to March 1994) bacteremia caused by Campylobacter species was diagnosed in 15 patients in a population of 1.3 million in three counties in Jutland province, Denmark. The incidence was 0.2/100,000/year and the ratio of blood to fecal isolates, was 0.008. Campylobacter coli and Campylobacter jejuni accounted for 6 cases each, Campylobacter fetus for 2, and in 1 case the species diagnosis was uncertain. Seven patients were males and 8 females; median age was 42 (range 15-90) years. 11 patients had underlying disorders, including immunological, neoplastic and vascular disease. In a 67-year-old man a Starr-Edwards prosthesis of the aortic valve was probably infected by C. fetus, as recurrent bacteremia resolved following valve replacement. Eight patients had pyrexia and diarrhea, whereas 7 had pyrexia with only slight intestinal discomfort or none at all. In 4 patients the bacteremia was associated with cutaneous cellulitis or vasculitis. 14 of 15 patients survived. Campylobacter bacteremia seems to be more common in Denmark than hitherto thought. PMID:7660078

  4. Posterior Spinal Artery Aneurysm Presenting with Leukocytoclastic Vasculitis

    PubMed Central

    Tanweer, Omar; Thomas, Cheddhi; Engler, John; Shapiro, Maksim; Becske, Tibor

    2016-01-01

    Rupture of isolated posterior spinal artery (PSA) aneurysms is a rare cause of subarachnoid hemorrhage (SAH) that presents unique diagnostic challenges owing to a nuanced clinical presentation. Here, we report on the diagnosis and management of the first known case of an isolated PSA aneurysm in the context of leukocytoclastic vasculitis. A 53-year-old male presented to an outside institution with acute bilateral lower extremity paralysis 9 days after admission for recurrent cellulitis. Early magnetic resonance imaging was read as negative and repeat imaging 15 days after presentation revealed SAH and a compressive spinal subdural hematoma. Angiography identified a PSA aneurysm at T9, as well as other areas suspicious for inflammatory or post-hemorrhagic reactive changes. The patient underwent a multilevel laminectomy for clot evacuation and aneurysm resection to prevent future hemorrhage and to establish a diagnosis. The postoperative course was complicated by medical issues and led to the diagnosis of leukocytoclastic vasculitis that may have predisposed the patient to aneurysm development. Literature review reveals greater mortality for cervical lesions than thoracolumbar lesions and that the presence of meningitic symptoms portents better functional outcome than symptoms of cord compression. The outcome obtained in this case is consistent with outcomes reported in the literature. PMID:27114966

  5. Keratitis with Kocuria palustris and Rothia mucilaginosa in Vitamin A Deficiency

    PubMed Central

    Mattern, R.M.; Ding, Jiaxi

    2014-01-01

    Purpose To present a case of unusual corneal infection early in the course of peripheral ulcerative keratitis in a patient with severe vitamin A deficiency. Method Single observational case report in urban USA. Case Presentation An alcoholic patient with pancreatitis, chronic diarrhea, and vitamin A deficiency presented with a marginal corneal ulcer from which two bacteria of the family Micrococcaceae were cultured and identified by genome sequence analysis, namely Kocuria palustris and Rothia mucilaginosa. Soon after, severe bilateral peripheral ulcerative keratitis developed, later accompanied by eyelid cellulitis of one lid. These conditions improved with antibiotics, treatment of the underlying gastrointestinal conditions, and treatment of the vitamin deficiency. Conclusion Susceptibility to keratitis with unusual bacteria of the Micrococcaceae family can occur in the setting of alcoholism-related gastrointestinal disease with severe vitamin A deficiency. To our knowledge, K. palustris is a species not previously identified in any human disease, and the Kocuria genus has not previously been reported as a participant in eye infection. Documented cases of R. mucilaginosa in ocular disease are rare. These unusual infections heralded the onset of severe marginal corneal melts. PMID:24707276

  6. Local envenoming by the Western hognose snake (Heterodon nasicus): a case report and review of medically significant Heterodon bites.

    PubMed

    Weinstein, Scott A; Keyler, Daniel E

    2009-09-01

    A case of clinically significant local envenoming resulting from a bite inflicted by a Western hognose snake, Heterodon nasicus, is described. The patient was bitten while offering a juvenile mouse to a captive snake. The snake maintained a grip on the patient's arm (left anticubital fossa) for several minutes. The bite resulted in marked edema, ecchymoses, lymphadenopathy, cutaneous signs suggestive of mild cellulitis and blister formation. There were no systemic effects. Recovery was complete after approximately five months. Several documented Heterodon sp. bites with significant clinical effects are reviewed. This common xenodontine colubrid must be considered capable of inflicting medically significant bites. It is currently unclear whether the pathological changes associated with these bites are due to specific Duvernoy's secretion components, Type I hypersensitivity or a combination of these. The influence of the feeding response on the severity of clinical effects is considered as is the discrepancy between experimentally verified pharmacological activities of Duvernoy's secretions from Heterodon sp. and medical sequelae of documented bites. Although hognose snakes may uncommonly produce medically significant bites, they should not be considered dangerous or venomous. Captive specimens should be handled carefully, particularly when offered food. PMID:19393681

  7. Efficacy of Antibiotic-Impregnated Polymethylmethacrylate Beads in a Rhesus Macaque (Macaca mulatta) with Osteomyelitis

    PubMed Central

    Kelly, Kristi R; Kapatkin, Amy R; Zwingenberger, Allison L; Christe, Kari L

    2012-01-01

    Here we describe the successful surgical implementation of antibiotic-impregnated polymethylmethacrylate beads in a rhesus macaque (Macaca mulatta) with marked osteomyelitis. The macaque presented to the veterinary clinic with grossly contaminated bite wounds in the left ankle secondary to conspecific trauma. Radiographic findings were highly suggestive of osteomyelitis. Additional differential diagnoses included bony infarct, fracture, and cellulitis. In light of the location of the lesion and extensive tissue trauma, the animal had a poor prognosis. Systemic, broad-spectrum antibiotics were instituted. After 2 wk of care, lesions did not respond to empirical therapies. On consultation, a veterinary orthopedic surgeon at another facility recommended placement of antibiotic-impregnated polymethylmethacrylate beads at the sites of osteomyelitis. The animal underwent minor surgery in which beads were introduced into the wound. The monkey had a positive response to therapy. The animal regained full function and was returned to outdoor social housing. Veterinarians are encouraged to consider using antibiotic-impregnated polymethylmethacrylate beads when treating osteomyelitis in other nonhuman primates and in other traditional laboratory animal species. PMID:23043785

  8. 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

  9. Epidemiology of severe Streptococcus pyogenes disease in Europe.

    PubMed

    Lamagni, Theresa L; Darenberg, Jessica; Luca-Harari, Bogdan; Siljander, Tuula; Efstratiou, Androulla; Henriques-Normark, Birgitta; Vuopio-Varkila, Jaana; Bouvet, Anne; Creti, Roberta; Ekelund, Kim; Koliou, Maria; Reinert, Ralf René; Stathi, Angeliki; Strakova, Lenka; Ungureanu, Vasilica; Schalén, Claes; Jasir, Aftab

    2008-07-01

    The past 2 decades have brought worrying increases in severe Streptococcus pyogenes diseases globally. To investigate and compare the epidemiological patterns of these diseases within Europe, data were collected through a European Union FP-5-funded program (Strep-EURO). Prospective population-based surveillance of severe S. pyogenes infection diagnosed during 2003 and 2004 was undertaken in 11 countries across Europe (Cyprus, the Czech Republic, Denmark, Finland, France, Germany, Greece, Italy, Romania, Sweden, and the United Kingdom) using a standardized case definition. A total of 5,522 cases were identified across the 11 countries during this period. Rates of reported infection varied, reaching 3/100,000 population in the northern European countries. Seasonal patterns of infection showed remarkable congruence between countries. The risk of infection was highest among the elderly, and rates were higher in males than in females in most countries. Skin lesions/wounds were the most common predisposing factor, reported in 25% of cases; 21% had no predisposing factors reported. Skin and soft tissue were the most common foci of infection, with 32% of patients having cellulitis and 8% necrotizing fasciitis. The overall 7-day case fatality rate was 19%; it was 44% among patients who developed streptococcal toxic shock syndrome. The findings from Strep-EURO confirm a high incidence of severe S. pyogenes disease in Europe. Furthermore, these results have identified targets for public health intervention, as well as raising awareness of severe S. pyogenes disease across Europe. PMID:18463210

  10. Epidemiology of Severe Streptococcus pyogenes Disease in Europe▿

    PubMed Central

    Lamagni, Theresa L.; Darenberg, Jessica; Luca-Harari, Bogdan; Siljander, Tuula; Efstratiou, Androulla; Henriques-Normark, Birgitta; Vuopio-Varkila, Jaana; Bouvet, Anne; Creti, Roberta; Ekelund, Kim; Koliou, Maria; Reinert, Ralf René; Stathi, Angeliki; Strakova, Lenka; Ungureanu, Vasilica; Schalén, Claes; Jasir, Aftab

    2008-01-01

    The past 2 decades have brought worrying increases in severe Streptococcus pyogenes diseases globally. To investigate and compare the epidemiological patterns of these diseases within Europe, data were collected through a European Union FP-5-funded program (Strep-EURO). Prospective population-based surveillance of severe S. pyogenes infection diagnosed during 2003 and 2004 was undertaken in 11 countries across Europe (Cyprus, the Czech Republic, Denmark, Finland, France, Germany, Greece, Italy, Romania, Sweden, and the United Kingdom) using a standardized case definition. A total of 5,522 cases were identified across the 11 countries during this period. Rates of reported infection varied, reaching 3/100,000 population in the northern European countries. Seasonal patterns of infection showed remarkable congruence between countries. The risk of infection was highest among the elderly, and rates were higher in males than in females in most countries. Skin lesions/wounds were the most common predisposing factor, reported in 25% of cases; 21% had no predisposing factors reported. Skin and soft tissue were the most common foci of infection, with 32% of patients having cellulitis and 8% necrotizing fasciitis. The overall 7-day case fatality rate was 19%; it was 44% among patients who developed streptococcal toxic shock syndrome. The findings from Strep-EURO confirm a high incidence of severe S. pyogenes disease in Europe. Furthermore, these results have identified targets for public health intervention, as well as raising awareness of severe S. pyogenes disease across Europe. PMID:18463210

  11. 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

  12. 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

  13. Mass Spectrometry-Based Bacterial Proteomics: Focus on Dermatologic Microbial Pathogens

    PubMed Central

    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

  14. Establishment of a model of Streptococcus iniae meningoencephalitis in Nile tilapia (Oreochromis niloticus).

    PubMed

    Baums, C G; Hermeyer, K; Leimbach, S; Adamek, M; Czerny, C-P; Hörstgen-Schwark, G; Valentin-Weigand, P; Baumgärtner, W; Steinhagen, D

    2013-07-01

    Streptococcus iniae is an invasive pathogen causing meningitis and other lesions in various fish species. Furthermore, S. iniae is an emerging zoonotic agent that causes cellulitis in man. The aims of this study were to establish an intraperitoneal infection model for S. iniae in Nile tilapia (Oreochromis niloticus) and to develop a new histopathological scoring system to reflect the degree and extent of inflammation as well as the presence of necrosis in the brain and eye. Intraperitoneal administration of 10(6) colony-forming units (CFU) led to 80% mortality and numerous fish developing clinical signs of central nervous system dysfunction. Microscopical examination of four regions of the brain (olfactory bulb, cerebellum, cerebrum and optical lobe) and the eye revealed the presence of lymphohistiocytic leptomeningitis, meningoencephalitis and endophthalmitis. Lesions were dominated by macrophages that often contained intracellular bacteria. Necrosis was recorded in some cases. Bacteriological screening revealed that multiple organs, including brain and eye, were infected with S. iniae and S. iniae colonized the scales and gills in high number. S. iniae was detected in tank water during the first week post infection, suggesting that infected tilapia might shed up to 3 × 10(7) CFU of S. iniae within 24 h. A multiplex polymerase chain reaction allowed confirmation of the challenge strain by detection of the virulence factors simA, scpI, cpsD, pgi, pgm and sagA. PMID:23218409

  15. Dermatological Complaints of the Elderly Attending a Dermatology Outpatient Clinic in Turkey: A Prospective Study over a One-year Period.

    PubMed

    Polat, Muhterem; İlhan, Mustafa N

    2015-12-01

    The geriatric population is continuously growing, which leads to more aged patients being admitted to dermatology clinics. The aim of this study is to determine the dermatological complaints of the elderly attending a dermatology outpatient clinic. All of the patients aged 65 years and older admitted to our dermatology outpatient clinic over a 1-year period were included. Patients were divided into 2 groups according to their ages as group I (65-74 years) and group II (≥75 years). The patients were asked about their dermatologic complaints. A total of 240 geriatric patients attended to the dermatology outpatient clinic over a 1-year period. Overall, the five most frequent dermatologic complaints of the patients were eczematous dermatitis (21.7%), pruritus (19.6%), fungal infections (16.7%), precancerous and malignant lesions (9.6%), and bacterial infections (7.1%). The most frequent types of eczematous dermatitis were asteatotic eczema (26.9%), neurodermatitis (26.9%), and stasis dermatitis (17.3%). Among fungal infections, the most frequent was tinea pedis (62.5%), followed by onychomycosis (32.5%) and tinea versicolor (5.0%). The most common precancerous lesion was actinic keratosis (78.3%). Bacterial infections encountered were pyoderma (58.8%), cellulitis (23.5%), and erythrasma (17.6%). Most of the skin problems in the elderly are preventable or treatable, so proper skin care and treatment of skin diseases should be emphasized in general health care for the elderly. PMID:26724880

  16. Systemic CA-MRSA infection following trauma during soccer match in inner Brazil: clinical and molecular characterization.

    PubMed

    Camargo, Carlos Henrique; da Cunha, Maria de Lourdes Ribeiro de Souza; Bonesso, Mariana Fávero; da Cunha, Fabiana Picoli; Barbosa, Alexandre Naime; Fortaleza, Carlos Magno Castelo Branco

    2013-07-01

    Even though community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) was described a decade ago, reports from Brazil are scarce and cases occurred in large urban centers. We report MRSA sepsis in a 16-year-old male from a small town and who had no history of exposure to healthcare or recent travel. After trauma during a soccer match, he presented swelling in the right thigh, which evolved in a month to cellulitis complicated by local abscess, orchitis and pneumonia. The patient presented severe sepsis, with fever and respiratory failure. Laboratory findings included blood leukocyte counts above 40,000/mm(3) and thrombocytopenia. He was submitted to mechanical ventilation and therapy with vancomycin and imipenem. He had a slow but favorable response to therapy and was discharged after six weeks of hospitalization. MRSA grew from blood cultures and respiratory aspirates obtained before antimicrobial therapy. The isolate belonged to sequence type 5, spa type t311, harbored SCCmec type IV and genes for Panton-Valentine leukocidin and Enterotoxin A. The pulsed-field gel electrophoresis pattern was distinct from North American classic CA-MRSA clones. However, the sequence type and the spa type revealed that the clone belong to the same clonal complex isolated in Argentina. This is the first CA-MRSA infection reported in that region, with significant epidemiologic and clinical implications. PMID:23602786

  17. Going Out on a Limb: Do Not Delay Diagnosis of Necrotizing Fasciitis in Varicella Infection.

    PubMed

    Sturgeon, Jonathan P; Segal, Laura; Verma, Anita

    2015-07-01

    Necrotizing fasciitis (NF) is a rare complication of varicella zoster (chicken pox) infection. Its diagnosis can be delayed or missed, which increases mortality and morbidity, because it initially presents similarly to cellulitis. We present the case of a 5-year-old boy who presented with a swollen leg, the difficulties in the diagnosis of NF, and a review of the literature. Necrotizing fasciitis complicating varicella zoster in children is associated with 3.4% mortality, although this rises to 13.6% in streptococcal toxic shock syndrome. Seventy-one percent of cases are confirmed as being caused by group A β-hemolytic Streptococcus. The association of NF with chicken pox is discussed along with the difficulties in diagnosis and treatment options. Necrotizing fasciitis is a surgical emergency and should be considered by all emergency department acute care practitioners in cases of varicella in which fever is enduring and swelling or pain is disproportionate. Because of the difficulty in diagnosis, senior opinion should be sought early. PMID:25356828

  18. 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

  19. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

    PubMed

    Gethin, Georgina; Byrne, Danielle; Tierney, Sean; Strapp, Helen; Cowman, Seamus

    2012-04-01

    Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management. PMID:21910829

  20. 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

  1. Diabetes mellitus, hemoglobin A1C, and the incidence of total joint arthroplasty infection.

    PubMed

    Iorio, Richard; Williams, Kelly M; Marcantonio, Andrew J; Specht, Lawrence M; Tilzey, John F; Healy, William L

    2012-05-01

    Patients with diabetes have a higher incidence of infection after total joint arthroplasty (TJA) than patients without diabetes. Hemoglobin A1c (HbA1c) levels are a marker for blood glucose control in diabetic patients. A total of 3468 patients underwent 4241 primary or revision total hip arthroplasty or total knee arthroplasty at one institution. Hemoglobin A1c levels were examined to evaluate if there was a correlation between the control of HbA1c and infection after TJA. There were a total of 46 infections (28 deep and 18 superficial [9 cellulitis and 9 operative abscesses]). Twelve (3.43%) occurred in diabetic patients (n = 350; 8.3%) and 34 (0.87%) in nondiabetic patients (n = 3891; 91.7%) (P < .001). There were 9 deep (2.6%) infections in diabetic patients and 19 (0.49%) in nondiabetic patients. In noninfected, diabetic patients, HbA1c level ranged from 4.7% to 15.1% (mean, 6.92%). In infected diabetic patients, HbA1c level ranged from 5.1% to 11.7% (mean, 7.2%) (P < .445). The average HbA1c level in patients with diabetes was 6.93%. Diabetic patients have a significantly higher risk for infection after TJA. Hemoglobin A1c levels are not reliable for predicting the risk of infection after TJA. PMID:22054905

  2. 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

  3. Mouth in Foot Disease

    PubMed Central

    DeRosa, Daniel C; Agee, Willie A; Pires, Valerie L; Yim, Duke G; Ngauy, Viseth

    2015-01-01

    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

  4. MRI evaluation of bone marrow changes in the diabetic foot: a practical approach.

    PubMed

    Toledano, Talya R; Fatone, Eliana A; Weis, Adina; Cotten, Anne; Beltran, Javier

    2011-07-01

    One of the most important roles of magnetic resonance (MR) in imaging of the diabetic foot is to differentiate between the common and often comorbid pathologies that present with abnormal bone marrow signal. The primary diagnostic challenges in this setting are to distinguish osteomyelitis from reactive bone marrow edema, neuroarthropathy from osteomyelitis, and the sterile from the superinfected neuropathic joint. Whereas both osteomyelitis and reactive marrow edema share increased T2 signal, osteomyelitis is confirmed by T1 hypointensity in the bone marrow and reactive edema demonstrates isolated T2 signal hyperintensity. In distinguishing osteomyelitis from neuroarthropathy, a localized or contiguously spreading forefoot focus of abnormal bone marrow away from the subchondral surface and adjacent to a skin ulcer, cellulitis, abscess, or sinus tract would be indicative of osteomyelitis. A midfoot, subchondral, periarticular, or polyarticular distribution of findings in the absence of a contiguous focus of skin disruption would strongly support neuroarthropathy. Parameters that have been successfully correlated with acute infection superimposed on neuroarthropathy include diffuse bone marrow signal abnormality, progressive subarticular enhancement, loss of subchondral cysts, and the presence of the MRI "ghost sign." PMID:21644199

  5. Chronic interdigital dermatophytic infection: a common lesion associated with potentially severe consequences.

    PubMed

    Vanhooteghem, Olivier; Szepetiuk, Gregory; Paurobally, Dilshad; Heureux, Françoise

    2011-01-01

    Interdigital intertrigo and onychomycosis has the potential cause of severe bacterial infectious complications with pain, mobility problems, abscess, erysipelas, cellulitis, fasciitis and osteomyelitis. In another hand, diabetic neuropathy, which affects 60-70% of those with diabetes mellitus, is one of the most troubling complications for persons with diabetes. These people are high suspecting to be infected by dermatophytic infections in interdigital spaces or onychomycosis witch are frequently induce damage to the stratum corneum, leading to bacterial proliferation and secondary infection. A patient presented with an asymptomatic warm, painless, erythematous swelling of the second left toe, which had been present for a few weeks. Clinically, the lesion was categorized as erysipelas upon an insidious abscess formation. Further investigation was undertaken to confirm the presence of diabetes. Leg erysipelas is a common affection which, according to various studies, has both local concomitants (interdigital intertrigo, lymphoedema, surgical antecedents) and/or general causes (immune suppression, diabetes, alcoholism, etc). Interdigital intertrigo, tinea pedis, and onychomycosis present as public health problems that could trigger serious deterioration in patient quality of life, due to complications induced by secondary bacterial infections. PMID:21035887

  6. 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

  7. The treatment of diabetic foot infections: focus on ertapenem.

    PubMed

    Edmonds, Michael

    2009-01-01

    Clinically, 3 distinct stages of diabetic foot infection may be recognized: localized infection, spreading infection and severe infection. Each of these presentations may be complicated by osteomyelitis. Infection can be caused by Gram-positive aerobic, and Gram-negative aerobic and anaerobic bacteria, singly or in combination. The underlying principles are to diagnose infection, culture the bacteria responsible and treat aggressively with antibiotic therapy. Localized infections with limited cellulitis can generally be treated with oral antibiotics on an outpatient basis. Spreading infection should be treated with systemic antibiotics. Severe deep infections need urgent admission to hospital for wide-spectrum intravenous antibiotics. Clinical and microbiological response rates have been similar in trials of various antibiotics and no single agent or combination has emerged as most effective. Recently, clinical and microbiological outcomes for patients treated with ertapenem were equivalent to those for patients treated with piperacillin/tazobactam. It is also important to judge the need for debridement and surgery, to assess the arterial supply to the foot and consider revascularization either by angioplasty or bypass if the foot is ischemic. It is also important to achieve metabolic control. Thus infection in the diabetic foot needs full multidisciplinary treatment. PMID:19997576

  8. Use of MR imaging in diagnosing diabetes-related pedal osteomyelitis.

    PubMed

    Donovan, Andrea; Schweitzer, Mark E

    2010-05-01

    The clinical diagnosis of diabetes-related osteomyelitis relies on the identification and characterization of an associated foot ulcer, a method that is often unreliable. Magnetic resonance (MR) imaging is the modality of choice for imaging evaluation of pedal osteomyelitis. Because MR imaging allows the extent of osseous and soft-tissue infection to be mapped preoperatively, its use may limit the extent of resection. At MR imaging, the simplest method to determine whether osteomyelitis is present is to follow the path of an ulcer or sinus tract to the bone and evaluate the signal intensity of the bone marrow. Combined findings of low signal intensity in marrow on T1-weighted images, high signal intensity in marrow on T2-weighted images, and marrow enhancement after the administration of contrast material are indicative of osteomyelitis. Secondary signs of osteomyelitis include periosteal reaction, a subtending skin ulcer, sinus tract, cellulitis, abscess, and a foreign body. The location of a marrow abnormality is a key distinguishing feature of osteomyelitis: Whereas neuroarthropathy most commonly affects the tarsometatarsal and metatarsophalangeal joints, osteomyelitis occurs distal to the tarsometatarsal joint, in the calcaneus and malleoli. In the midfoot, secondary signs of infection help differentiate between neuroarthropathy and a superimposed infection. PMID:20462990

  9. Magnetic resonance imaging of diabetic muscle infarction: report of two cases.

    PubMed

    Jawahar, Anugayathri; Balaji, Ravikanth

    2014-01-01

    Diabetic muscle infarction (DMI) occurs as a rare complication of long standing or severe diabetes mellitus. The condition usually occurs spontaneously and patients usually present with acute pain and swelling of affected muscles which persists for weeks, and resolves spontaneously without intervention. Magnetic resonance (MR) imaging is the modality of choice in patients with suspected DMI based on appropriate clinical setting and plays a major role in the diagnosis, assessing the extent of involvement and differentiating DMI from other conditions. The DMI affected muscles are bulky and appear heterogeneous with hyperintense signals on T2-weighted and STIR sequences, hypo or isointense on T1-weighted images with loss of normal fatty intramuscular septae. Subcutaneous and perifascial edema can be present. On postgadolinium scans, there is diffuse heterogeneous enhancement with non-enhancing foci, which may represent areas of necrosis. Biopsy can be avoided as MR findings are highly sensitive and specific. Treatment is usually conservative. Surgical intervention is required only in patients who do not respond to conservative management. The common differential diagnosis includes cellulitis, abscess, necrotizing fasciitis and polymyositis. We present two cases below to highlight the clinical, MR imaging findings and differential diagnosis of DMI. PMID:25328463

  10. Laboratory-acquired vaccinia virus infection in a recently immunized person--Massachusetts, 2013.

    PubMed

    Hsu, Christopher H; Farland, Julien; Winters, Thomas; Gunn, Julia; Caron, Donna; Evans, Jennifer; Osadebe, Lynda; Bethune, Leon; McCollum, Andrea M; Patel, Nishi; Wilkins, Kimberly; Davidson, Whitni; Petersen, Brett; Barry, M Anita

    2015-05-01

    On November 26, 2013, the CDC poxvirus laboratory was notified by the Boston Public Health Commission (BPHC) of an inadvertent inoculation of a recently vaccinated (ACAM2000 smallpox vaccine) laboratory worker with wild type vaccinia virus (VACV) Western Reserve. A joint investigation by CDC and BPHC confirmed orthopoxvirus infection in the worker, who had reported a needle stick in his thumb while inoculating a mouse with VACV. He experienced a non-tender, red rash on his arm, diagnosed at a local emergency department as cellulitis. He subsequently developed a necrotic lesion on his thumb, diagnosed as VACV infection. Three weeks after the injury, the thumb lesion was surgically debrided and at 2 months post-injury, the skin lesion had resolved. The investigation confirmed that the infection was the first reported VACV infection in the United States in a laboratory worker vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommendations. The incident prompted the academic institution to outline biosafety measures for working with biologic agents, such as biosafety training of laboratory personnel, vaccination (if appropriate), and steps in incident reporting. Though vaccination has been shown to be an effective measure in protecting personnel in the laboratory setting, this case report underscores the importance of proper safety measures and incident reporting. PMID:25928468

  11. 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.

  12. [Erythropoietin and neuroprotection].

    PubMed

    Chatagner, A; Hüppi, P S; Ha-Vinh Leuchter, R; Sizonenko, S

    2010-09-01

    Erythropoietin (Epo) has long been recognised for its role in the control of erythropoiesis and therefore in the treatment of anemia including anemia of prematurity. The erythropoietin receptor (Epo-R) though is expressed in many other organs including the CNS. This review focuses on the role of erythropoietin during the development of the CNS and its potential role as a neuroprotective agent. Epo-R is expressed in many different cellules of the CNS during development including neural progenitor cells, neurons, astrocytes and oligodendrocytes. In the event of hypoxia CNS cells respond with increase of erythropoietin release with subsequent stimulation of neurogenesis through Epo-R on neural progenitor cells. In an Epo-R knock-out model therefore cerebral development is severely impaired. In models of hypoxia-ischemia exogenous Epo has been shown to reduce lesion size and improve structural and functional recovery. Human studies are emerging using Epo as a neuroprotective agent both for the term infant with hypoxia-ischemia as well as for the extremely preterm infant. PMID:20728813

  13. Primary breast lymphoma presenting as non-healing axillary abscess.

    PubMed

    Anele, Chukwuemeka; Phan, Yih Chyn; Wong, Suanne; Poddar, Anil

    2015-01-01

    A 67-year-old woman with non-insulin dependent diabetes mellitus with a history consistent with a right axillary abscess, presented to her general practitioner (GP). A diagnosis of folliculitis was made and the GP started a course of flucloxacillin. Despite antibiotics, the patient's symptoms worsened and the abscess increased in size. This prompted her GP to perform an incision and drainage procedure of the abscess. The practice nurse subsequently oversaw the follow-up care of the wound. Two months after the incision and drainage, and after regular wound dressing, the patient was referred to the acute surgical team with a complicated, non-healing right axillary abscess cavity and associated generalised right breast cellulitis. There was no history of breast symptoms prior to the onset of the axillary abscess. The patient underwent wound debridement, washout and application of negative pressure vacuum therapy. Biopsies revealed primary breast lymphoma (B-cell). She underwent radical chemotherapy and is currently in remission. PMID:26446318

  14. Skin, soft tissue and systemic bacterial infections following aquatic injuries and exposures.

    PubMed

    Diaz, James H; Lopez, Fred A

    2015-03-01

    : Bacterial infections following aquatic injuries occur commonly in fishermen and vacationers after freshwater and saltwater exposures. Internet search engines were queried with the key words to describe the epidemiology, clinical manifestations, diagnostic and treatment strategies and outcomes of both the superficial and the deeper invasive infections caused by more common, newly emerging and unusual aquatic bacterial pathogens. Main findings included the following: (1) aquatic injuries often result in gram-negative polymicrobial infections with marine bacteria; (2) most marine bacteria are resistant to 1st- and 2nd-generation penicillins and cephalosporins; (3) nontuberculous, mycobacterial infections should be considered in late-onset, culture-negative and antibiotic-resistant marine infections; (4) superficial marine infections and pre-existing wounds exposed to seawater may result in deeply invasive infections and sepsis in immunocompromised patients. With the exception of minor marine wounds demonstrating localized cellulitis, most other marine infections and all gram-negative and mycobacterial marine infections will require therapy with antibiotic combinations. PMID:25374398

  15. An alternative method to achieve one-lung ventilation by surgical pneumothorax in difficult lung isolation patient: a case report.

    PubMed

    Yeh, Pin-Hung; Hsu, Po-Kai

    2016-04-01

    It is challenging to establish one-lung ventilation in difficult airway patients. Surgical pneumothorax under spontaneous breathing to obtain well-collapsed lung is a feasible method for thoracic surgery. A 76-year-old man with right empyema was scheduled for decortication. The patient had limited mouth opening due to facial cellulitis extending from the left cheek to neck. Generally, lung isolation is achieved by double-lumen endotracheal tube or bronchial blocker. Double-lumen tube insertion is difficult for patients with limited mouth opening and right-side placement of bronchial blocker usually causes insufficient deflation. We introduce an alternative lung isolation technique by surgical pneumothorax under spontaneous breathing simply with an endotracheal tube placement. This technique has never been applied into the management of difficult one-lung ventilation. By this method, we provide an ideal surgical condition with safer, less time-consuming, and less skill-demanding anesthesia. It would be an alternative choice for management of one-lung ventilation in the difficult lung isolation patient. PMID:26721826

  16. Hemorrhagic septicemia in fallow deer (Dama dama) caused by Pasteurella multocida multocida.

    PubMed

    Eriksen, L; Aalbaek, B; Leifsson, P S; Basse, A; Christiansen, T; Eriksen, E; Rimler, R B

    1999-06-01

    Four outbreaks of hemorrhagic septicemia caused by Pasteurella multocida multocida occurred in a population of 1,800 fallow deer (Dama dama) during 1992-1996. A total of 340 fallow deer were submitted for postmortem examination. Pasteurellosis was diagnosed in 273 of 312 deer suspected of having septicemia. Pasteurella multocida was isolated from 257 animals, and the diagnosis was based on typical pathologic changes alone in the other 16 animals. Pasteurella multocida was isolated in pure culture from 219 of 248 samples of cerebrospinal fluid. Eighteen animals were observed moribund with severe depression, foamy nasal discharge, and respiratory distress, and 257 were found dead. Major clinical signs and pathologic changes included extensive swelling of the head and the neck and peracute or acute septic pneumonia, petechial and ecchymotic hemorrhages on serous membranes, and severely hemorrhagic adrenal glands and abomasum. Rhinitis and necrotic pharyngeal mucosae were common. Histologically, the most advanced lesions were in the nasal mucosa and pharynx. The swelling of the head and the neck arose from a diffuse cellulitis in the subcutaneous and intermuscular tissues. The earliest lesions in the lungs included large numbers of bacteria in the pulmonary capillaries, but various degrees of fibrinous exudation to the alveoli and infiltration with heterophils usually were observed. PMID:10484148

  17. Une tumeur du vagin à ne pas méconnaitre, l'adénocarcinome mésonephrique: à propos d'un cas et revue de la literature

    PubMed Central

    Amal, Bennani; Hind, El Fatemi; Hanane, Saadi; Hayat, Rabhi; Kaoutar, Moumna; Abdelaziz, Banani; Taoufik, Harmouch; Affaf, Amarti

    2015-01-01

    L'adénocarcinome mésonéphrique du vagin est une tumeur maligne extrêmement rare avec uniquement trois cas publiés dans la littérature jusqu’à maintenant. Il dérive des reliquats embryonnaires des canaux mésonéphriques au niveau du vagin. Nous rapportons un cas d'adénocarcinome mésonéphrique du vagin survenant chez une femme de 50 ans, et révélé par une masse polyploïde du vagin. L'IRM a montré un envahissement du périnée et de la branche inférieure du pubis. L’étude anatomo-pathologique était en faveur d'un adénocarcinome mésonéphrique dont les cellules tumorales expriment la pancytokératine et le CD10. Elles ne sont pas marquées par les anticorps anti récepteurs ostrogéniques et progestatifs. La patiente a été adressée pour radiothérapie avant la prise en charge chirurgicale. Les auteurs soulignent à travers cette observation les aspects étiopathogéniques, histologiques et thérapeutiques de cette tumeur rare. PMID:26327963

  18. 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

  19. 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

  20. Serious soft tissue infections of the head and neck

    SciTech Connect

    Herr, R.D.; Murdock, R.T.; Davis, R.K. )

    1991-09-01

    The head and neck contain a number of spaces that can be invaded by organisms of the mouth or by spread of cervical osteomyelitis. Infection in these spaces may progress from superficial infection to cellulitis to the formation of an abscess requiring immediate drainage. Spread of infection between spaces depends on anatomic location. Most patients require hospitalization and intravenous antibiotic therapy. Because a deep space infection may be occult, a high index of suspicion is required for diagnosis. Early recognition is necessary to avoid tissue damage, bacteremia or airway compromise. The possibility of deep space infection should be considered in any patient who does not respond to the usual treatment of an abscessed tooth or tonsillitis. This type of infection also should be considered in a toxic patient who has a fever of unknown origin, with or without blood cultures that show anaerobic organisms. Computed tomography or magnetic resonance imaging is usually necessary to locate the infection and to detect suppuration that will be amenable to surgical exploration and drainage. 25 references.

  1. 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

  2. A forensic case of Munchausen's syndrome.

    PubMed

    Canogullari, Gulsin; Ulupinar, Emel; Teyin, Muharrem; Balci, Yasemin

    2007-04-01

    The case of a 37-year-old cleaning worker, who applied to the court with a claim of being fired from her job due to permanent functional loss of her left arm triggered by a stroke following a work accident, is presented. The court has forwarded the case to the forensic medicine department for further evaluation and documentation of the judicial report. Examination of the medical files has revealed that the person applied to our and other hospitals with various symptoms simulating urologic, neurological, musculoskeletal, cardiovascular, and pulmonary disorders. The person had been hospitalized for extensive, costly, and often invasive medical examinations and/or treatment, and deceived the physicians into carry out unnecessary diagnostic procedures. No objective signs or evidence related to a work accident or stroke was obtained from the medical records. She has been followed up with the diagnosis of lymphangitis, thrombophlebitis and repeated cellulities since 2001, and the infection had been caused by intentional insertion of glass pieces into her left arm. The reason why she was unable to use her left arm was because of contraction related to the repeated soft tissue infection rather than the claimed work accident. This case was not only trying the medical personnel to make errors and confusion, but also attempting to mislead the judgment. Therefore, in forensic cases, medical history of patient must be evaluated carefully. PMID:16725365

  3. Rail external fixation for stabilization of closing base wedge osteotomies and lapidus procedures: a retrospective analysis of sixteen cases.

    PubMed

    Treadwell, Joseph R

    2005-01-01

    This is a retrospective study of 16 cases of proximal first-ray procedures with rail external fixation. Arthrodesis of the first metatarsal-cuneiform joint was performed on 11 feet, and a closing base-wedge osteotomy was performed on 5 feet. Heel weightbearing in a surgical shoe with ankle joint mobilization was the standard postoperative protocol. Thirteen women and one man with an average age of 41 years (range, 16-64 years) were evaluated, with an average follow-up of 15.12 months (range, 10-24 months). The mean duration of frame application among all patients was 6.75 weeks (range, 2-10 weeks; 7 weeks for the base wedge procedures; 6.64 weeks for the lapidus). Multiple complications developed. Ten patients developed pin-tract infections: 5 required isolated pin removal, whereas 2 required removal of the entire frame because of the severity of infection. Seven patients developed pin loosening. Two patients developed cellulitis requiring long-term intravenous antibiotic therapy. Two nonunions occurred, both with the lapidus procedure, and one was symptomatic. Ten of the 16 patients reported they would have surgery again. Monolateral external rail fixation in combination with heel weightbearing and ankle mobilization demonstrated a high complication rate when used for proximal first-ray procedures. The technique as described is not recommended for routine use with the lapidus and base wedge osteotomy procedures. PMID:16257671

  4. Double-blind randomized study of oral temafloxacin and cefadroxil in patients with mild to moderately severe bacterial skin infections.

    PubMed

    Neldner, K H

    1991-12-30

    A randomized, double-blind, multicenter study was conducted in 374 patients to evaluate the safety and efficacy of a 7-10-day regimen of oral temafloxacin (600 mg b.i.d.) or oral cefadroxil (500 mg b.i.d.) in the treatment of mild to moderate staphylococcal or streptococcal infection of the skin or skin structure. Specimens from the infected skin lesion were obtained for culture. A dermatologic assessment was made within 48 hours of starting therapy, 0-48 hours post-treatment, and once during the 5-9 days following the last dose of study drug. The most common diagnoses were abscess, superficial skin infection, cellulitis, and infection of the hair follicle/sweat gland. Clinical response rates exceeded 95% in both the temafloxacin and cefadroxil groups. A higher bacterial eradication rate was demonstrated in the temafloxacin-treated patients (91%) than in those receiving cefadroxil (84%). This was statistically significant in the subset of infections caused by Staphylococcus epidermidis (100% versus 81%, respectively; p = 0.032). Both regimens were well tolerated. These results indicate that temafloxacin is useful in the treatment of mild to moderate skin and skin structure infections caused by staphylococci or streptococci. PMID:1662879

  5. [Case of prostate cancer associated with bisphosphonate-related osteonecrosis of the jaw followed by retropharyngeal abscess].

    TOXLINE Toxicology Bibliographic Information

    Soda T; Fukumoto R; Hayashi T; Oka D; Fujimoto N; Koide T

    2013-09-01

    A 67-year-old man with castration-resistant prostate cancer associated with multiple bone metastases had been treated with zoledronic acid and docetaxel. Although there was no evidence of damage around the right lower jaw bone, the patient complained of pain in May 2011, which worsened during the next 2 weeks and was followed by difficulty with breathing. Computed tomographic (CT) findings of the cervical area showed swelling of the cervical tissue with air and tightening of the trachea, suggesting cellulitis caused by gas gangrene. He was intubated and treated with antibiotics. On the 12th hospital day, CT scan revealed a pharyngeal abscess and we performed a drainage operation. On the 20th hospital day, bone of the intraoral lower jaw was exposed, revealing that the infection was caused by osteonecrosis. Additional CT findings showed the abscess extending to the mediastinum and multiple liver metastases. Although antibiotic therapy was continued, the patient died of liver failure on the 61st day.

  6. 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

  7. Post-mortem findings in Irish culled hounds.

    PubMed

    Jahns, H; Callanan, J J; McElroy, M C; Sammin, D J; Bassett, H F

    2011-07-01

    Little is known of the common diseases of hunting dogs or of the reasons why they are culled. To address these questions, necropsy examinations were conducted on 52 hounds aged 1.5-12 years (mean 6.5 ± 2.5 years) and culled from 10 Irish hunting kennels over a 3-year period. Progressive systemic disease was seen in six dogs only and encompassed individual cases of tuberculosis caused by Mycobacterium bovis, bronchioalveolar carcinoma with metastasis to regional lymph nodes, renal amyloidosis, suppurative pneumonia, extramedullary plasmacytoma in the atrial wall of the heart and foreign body-induced hepatitis with focal peritonitis. Single or multiple localized tumours were identified in five dogs and, apart from the aforementioned, included two cutaneous haemangiomas, a trichoepithelioma, a lipoma and a mammary ductal adenoma. Three dogs were culled for lameness; one of these dogs had torn musculature, another had cellulitis and the third had a healed fracture of the tibia and fibula. Chronic renal changes were present in 48% of the dogs and included focal proliferative, exudative or crescentic glomerulonephritis (33%) or low-grade interstitial inflammatory changes (50%). The most frequently diagnosed skin lesions reported in this study were mild healed decubitus ulcers (33%), scars (33%) and stereotypic dermatitis (13%). These findings indicate that hounds are likely to be culled for reasons other than the presence of disease in most cases. In addition, this survey highlights different disease patterns in hounds than are typically observed in pet dogs. PMID:21247584

  8. [Methane production by anaerobic co-digestion of chicken manure and Spartina alterniflora residue after producing methane].

    PubMed

    Chen, Guang-Yin; Chang, Zhi-Zhou; Ye, Xiao-Mei; Du, Jing; Xu, Yue-Ding; Zhang, Jian-Ying

    2012-01-01

    The characteristics of Spartina alterniflora residue after producing methane (SAR) digested alone and co-digestion of various proportions of chicken manure and SAR were investigated by batch model at 35 degrees C +/- 1 degrees C. The initial total solid (TS) loading of all treatments was 8.0%. The results indicated that there was still some biogas produced by SAR with TS biogas yield of 107.25 mL x g(-1) and average methane content of 76.92%. The cellulose crystallinity of re-digested SAR was destructed by anaerobic microorganisms, and the destruction rate was 5.55%. Co-digestion meliorated the environment where microorganisms lived in and increased the cumulative biogas yield. When the ratio of chicken manure to SAR was 4 : 1, the cumulative biogas yield was highest while the cumulative biogas yield of T1 (the rate of chicken manure to SAR is 5 : 0 based on TS), T3-T6 (the rate of chicken manure to SAR are 3 : 2, 2 : 3, 1 :4 and 0 : 5 based on TS, respectively) were 61.31%, 62.09%, 52.15%, 39.74% and 31.67% of it. The anaerobic fermentation type of co-digestion is mix acid type fermentation. Co-digested with chicken manure promoted the destruction of cellulous crystallinity by 1.13% - 21.61% and especially when the rate of chicken manure to SAR was 4 : 1. PMID:22452211

  9. 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

  10. Tumeur neuroendocrine mammaire primitive: à propos d'un cas rare

    PubMed Central

    Laabadi, Kamilia; Jayi, Sofia; El Houari, Aziza; Tawfic, Harmouch; Bouguern, Hakima; Chaara, Hikmat; Melhouf, Abdilah; Amarti, Afaf

    2013-01-01

    Les carcinomes neuroendocrine primitifs du sein sont des tumeurs rares et représentent 2 à 5% des cancers mammaires. Nous rapportons le cas de localisation mammaire chez une patiente de 50 ans. Il s'agit d'une tumeur classée T4d N1 M0. La tumeur est suspecte radiologiquement. Une microbiopsie est réalisée. L’étude anatomopathologique et immunohistochimique est en faveur d'une tumeur neuroendocrine primitive du sein à grande cellules exprimant les récepteurs progestéroniques seulement. Vu le caractère inflammatoire de la tumeur une chimiothérapie est démarrée avec bonne évolution clinique. A la fin de la chimiothérapie on prévoit de réaliser une mastectomie avec curage axillaire et en fonction des résultats définitifs, une radiothérapie. Une hormonothérapie sera envisagée une 2ème étude immunohistochimique sur la pièce de mastectomie. Vu la rareté des carcinomes neuroendocrines mammaires primitifs, il n'existe pas de standard thérapeutique et le pronostic demeure difficile à déterminer. PMID:24772221

  11. 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

  12. 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.

  13. Control of Cellular Morphology by Mechanical Factors

    NASA Astrophysics Data System (ADS)

    Thoumine, Olivier

    1996-11-01

    This short review deals with the influence of mechanical factors on eucaryotic cell morphology and structure. We classify these factors into two types: i) external forces (e.g. gravitational forces or hemodynamic stresses), which when applied experimentally allow characterization of passive mechanical properties; and ii) internal forces, e.g. generated by molecular motors or polymerization processes. Perturbation of one or more of these forces induces significant changes in cell shape, cytoskeleton and pericellular matrix organization. We describe these phenomena in view of current models. Cette brève revue traite de l'influence des facteurs mécaniques sur la morphologie et la structure des cellules eucaryotes. Nous classifions ces facteurs en deux catégories : i) les forces externes (par exemple les forces de gravitation et les contraintes hèmodynamiques) qui, imposées in vitro, permettent de caractériser les propriétés mécaniques passives ; et ii) les forces internes, par exemple celles générées par les moteurs moléculaires ou les processus de polymérisation. La perturbation de l'une ou de l'autre de ces forces provoque des changements significatifs de la morphologie cellulaire ainsi que l'organisation du cytosquelette et de la matrice péricellulaire. Nous décrivons ces phénomènes en fonction de modèles existants.

  14. 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

  15. Design and development of a telerehabilitation self-management program for persons with chronic lower limb swelling and mobility limitations: preliminary evidence.

    PubMed

    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

  16. Etude Statistique du Champ de Vitesse de quelques Regions H II Galactiques

    NASA Astrophysics Data System (ADS)

    Boily, Edouard

    1993-01-01

    Des observations en interferometrie Fabry-Perot ont ete utilisees afin de tracer des cartes de vitesse des nebuleuses galactiques S158, M42, M17 et S142 dans diverses fenetres spectrales. Ces observations ont toutes ete obtenues au telescope de 1.60 m de l'Observatoire du mont Megantic. Une panoplie de logiciels ont ete developpes sous environnement IRAF afin de traiter et d'analyser les interferogrammes dont, entre autre, un logiciel de calcul des fonctions statistiques d'autocorrelation et de structure 1D et 2D. Les fonctions d'autocorrelation et de structure ont ete calculees pour les champs de vitesse corriges des quatres objets sus-mentionnes. Toutes ces regions H II montrent une longueur de correlation de 0.02 +/- 0,01 pc. Le dimension maximale des cellules de turbulence pour tous les objets traites est de l'ordre de 0.1 pc. Ce resultat peut etre explique par la presence d'instabilites de Rayleigh-Taylor et de Kelvin-Helmoltz dans les nebuleuses. Les fonctions de structure calculees ne peuvent ni confirmer, ni infirmer les predictions du modele de Kolmogoroff.

  17. 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

  18. Skin rash in the intensive care unit: Stevens-Johnson syndrome, toxic epidermal necrolysis, or a rare manifestation of a hidden cutaneous malignancy: A case report

    PubMed Central

    AL-SAFFAR, FARAH; IBRAHIM, SAIF; PATEL, PUJAN; JACOB, RAFIK; PALACIO, CARLOS; CURY, JAMES

    2016-01-01

    Skin rashes are infrequently encountered in the intensive care units, either as a result or as a cause of admission. The entities of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) form a spectrum of desquamating skin diseases that have multiple etiologies, the most common being drug-related reactions; very rarely, the cause may be cutaneous malignancies. We herein present a unique case of a 54-year-old male patient with psoriasis treated with methotrexate, who presented with a cellulitis-like clinical picture, then developed a severe progressive systemic inflammatory response syndrome, and progressed clinically to SJS, then TEN even after discontinuing the antibiotics and methotrexate. A skin biopsy demonstrated an aggressive and rapidly-progressing T-cell lymphoma. The present case highlights the necessity of skin biopsy when encountering SJS and TEN in the ICU in order to identify potentially treatable/controllable causes. Although it appeared reasonable to correlate TEN solely to medications, the skin biopsies clearly demonstrated an aggressive T-cell skin lymphoma. In a patient with a better general condition it may have been helpful to treat this malignancy. TEN is a life-threatening condition and skin biopsy is the cornerstone of diagnosis, despite the presence of multiple risk factors and the typical physical findings of a drug-induced reaction.

  19. 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

  20. Flame Hair

    PubMed Central

    Miteva, Mariya; Tosti, Antonella

    2015-01-01

    Background ‘Flame hairs’ is a trichoscopic feature described as hair residue from pulling anagen hairs in trichotillomania. Objective: To detect whether flame hairs are present in other hair loss disorders. Methods We retrospectively, independently and blindly reviewed the trichoscopic images of 454 consecutive patients with alopecia areata (99 cases), trichotillomania (n = 20), acute chemotherapy-induced alopecia (n = 6), acute radiotherapy-induced alopecia (n = 2), tinea capitis (n = 13), lichen planopilaris (n = 33), frontal fibrosing alopecia (n = 60), discoid lupus erythematosus (n = 30), dissecting cellulitis (n = 11), central centrifugal cicatricial alopecia (n = 94) and traction alopecia (n = 86) for the presence of flame hairs. We prospectively obtained trichoscopy-guided scalp biopsies from flame hairs in trichotillomania, alopecia areata, traction alopecia and central centrifugal cicatricial alopecia (1 case each). Results Flame hairs were detected in 100% of the acute chemotherapy- and radiotherapy-induced alopecias, where they were the predominant hair abnormality. They were also found in trichotillomania (55%), alopecia areata (21%), traction alopecia (4%) and central centrifugal cicatricial alopecia (3%). On pathology, they corresponded to distorted hair shafts. Conclusion The flame hair is a type of broken hair which can be seen in various hair loss disorders. It results from traumatic pulling of anagen hairs or from anagen arrest due to inflammation or drugs. © 2015 S. Karger AG, Basel PMID:27171360

  1. [Invasive infections caused by Haemophilus influenzae type b after the institution of the conjugated vaccine on the expanded programm on immunization in Chile].

    PubMed

    Cruces R, Pablo; Donoso F, Alejandro; Camacho A, Jorge; Llorente H, Marcela

    2006-03-01

    After almost a decade since the introduction of Haemophilus influenzae type b (Hib) conjugate vaccines in Chile (in a 2-4-6 month schedule), Hib invasive infections have dramatically decreased, albeit they remain to occasionally produce disease in pediatric patients. We report our experience with children whom developed Hib invasive disease in children since 2000 to 2004. Medical records of children with Hib were reviewed in order to describe the epidemiology, main clinical and laboratory findings, management and complications. Twenty three patients (17 male), between 1 and 71 months (median 30 months) were identified: pneumonia (7), meningitis (4), pleuropneumonia (2), empyema (2), sepsis (2), cellulitis (2), meningitis and pleuropneumonia (1), purpura fulminans (1), miositis (1) and epiglottitis (1). No deaths were observed and four patients presented severe sequelae at hospital discharge. Twenty patients were considered vaccine failures. Hib remains as a sporadic cause of severe disease in Chile and thus for physicians should still keep it in mind. Case analysis and active surveillance are necessary to monitor the current immunization regimen. PMID:16462964

  2. 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

  3. Fatal skin and soft tissue infection of multidrug resistant Acinetobacter baumannii: A case report

    PubMed Central

    Ali, Aqsa; Botha, John; Tiruvoipati, Ravindranath

    2014-01-01

    INTRODUCTION Acinetobacter baumannii is usually associated with respiratory tract, urinary tract and bloodstream infections. Recent reports suggest that it is increasingly causing skin and soft tissue infections. It is also evolving as a multidrug resistant organism that can be difficult to treat. We present a fatal case of multidrug resistant A. baumannii soft tissue infection and review of relevant literature. PRESENTATION OF CASE A 41 year old morbidly obese man, with history of alcoholic liver disease presented with left superficial pre-tibial abrasions and cellulitis caused by multidrug resistant (MDR) A. baumannii. In spite of early antibiotic administration he developed extensive myositis and fat necrosis requiring extensive and multiple surgical debridements. He deteriorated despite appropriate antibiotic therapy and multiple surgical interventions with development of multi-organ failure and died. DISCUSSION Managing Acinetobacter infections remains difficult due to the array of resistance and the pathogens ability to develop new and ongoing resistance. The early diagnosis of necrotizing soft tissue infection may be challenging, but the key to successful management of patients with necrotizing soft tissue infection are early recognition and complete surgical debridement. CONCLUSION A. baumannii is emerging as an important cause of severe, life-threatening soft tissue infections. Multidrug resistant A. baumannii soft tissue infections may carry a high mortality in spite of early and aggressive treatment. Clinicians need to consider appropriate early empirical antibiotic coverage or the use of combination therapy to include MDR A. baumannii as a cause of skin and soft tissue infections. PMID:25016080

  4. Stripping out pus in lactational mastitis: a means of preventing breast abscess.

    PubMed Central

    Bertrand, H; Rosenblood, L K

    1991-01-01

    OBJECTIVE: To determine whether manual stripping of pus from the breasts of women with lactational mastitis is effective in preventing the formation of breast abscesses. DESIGN: Case series (chart review). SETTING: Family practice in Montreal. PATIENTS: All (475) charts of patients with lactational mastitis were reviewed; 61 women were excluded because they already had a breast abscess. Most of the patients had been referred. OUTCOME MEASURES: Abscess formation, length of illness after treatment, rate of recurrence of mastitis, illness in the mother or infant within the 6 weeks after the mastitis and continuance of breast-feeding. MAIN RESULTS: The duration of symptoms before treatment was 1 to 56 (mean 5.3) days. In 9% of the cases both breasts were affected, and in 23% at least one episode of mastitis had previously occurred. The stripping technique was applied to all the patients. Pus was removed in 210 women; the remaining women were considered to have cellulitis. Only four patients (less than 1%) had breast abscesses. The mean length of illness after treatment was 7.2 days. The rate of recurrence was 14%. In all, 6% of the mothers and 9% of the infants became ill in the 6 weeks after the mastitis. Most (92%) of the patients continued to breast-feed. CONCLUSIONS: The rate of abscess formation was considerably lower than the rates reported in the literature. Therefore, manual stripping of pus from the infected breasts of lactating women appears to be effective in preventing breast abscesses. PMID:1873763

  5. 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 Central

    Lim, Roxanne; 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

  6. Flight and Wind-tunnel Tests of an XBM-1 Dive Bomber

    NASA Technical Reports Server (NTRS)

    Donely, Philip; Pearson, Henry A

    1938-01-01

    Results are given of pressure-distribution measurements made in flight over the right wing cellule and the right half of the horizontal tail surfaces of a dive-bombing biplane. Simultaneous measurements were also taken of the air speed, control-surface positions, control forces, and normal accelerations during various abrupt maneuvers in vertical plane. These maneuvers consisted of push-downs and pull-ups from level flight, dives and dive pull-ups from inverted flight. Besides the pressure measurements, flight tests were made to obtain (1) wing-fabric deflections during dives and (2) variation of the minimum drag coefficient with Reynolds Number. Supplementary tests were also done in the full-scale wind tunnel to obtain the characteristics of the airplane under various propeller conditions and with various tail settings. The results indicate that: (1) by increasing the fabric deflection between pressure ribs, the span load distribution was considerably modified near the center and the wing moment relations were changed; and (2) the minimum drag was less for the idling propeller than for the propeller locked in a vertical position. The value of C(sub D sub min) was equal to K(Reynolds Number)(exp -0.03) for a range from 2,800,000 to 13,100,000.

  7. Axillary sampling in the definitive treatment of breast cancer by radiation therapy and lumpectomy

    SciTech Connect

    Rose, C.M.; Botnick, L.E.; Weinstein, M.; Harris, J.R.; Koufman, C.; Silen, W.; Hellman, S.

    1983-03-01

    Between January, 1967 and July, 1980, 176 women who were referred to the Joint Center for Radiation Therapy (JCRT) for definitive breast irradiation underwent low axillary dissection. A typical operative technique is described. The dissection stops short of the axillary vein although the vein is usually visualized. One hundred thirty-two axillae were thought to be N/sub 0/ or N/sub 1a/. Forty-six axillae were felt to be N/sub 1b/. Seventeen percent of the T/sub 1/ N/sub 0/ patients had pathologically positive nodes. Twenty-seven percent of the T/sub 2/ N/sub 0/ patients had positive nodes. When 5 or less nodes were removed at axillary sampling the incidence of nodal involvement was very low. There were no differences in nodal positivity when comparing under quadrant to lower or central lesions. Ninety-four percent of axillae with N/sub 1b/ lesions were pathologically confirmed. The complication rate for this procedure was low. There was 5 transient non-surgical complications and 1 cellulitis resulting in a frozen shoulder, which required corrective surgery. There were no cases of moderate or severe arm edema. Axillary sampling is compared to axillary dissection as a diagnostic procedure. Axillary sampling may underestimate the true pathologic positive rate, but diagnostic accuracy appears excellent if level 1 and 2 nodes are sampled.

  8. Preterm labor and neonatal sepsis caused by intrauterine Helicobacter cinaedi infection.

    PubMed

    Maki, Yohei; Furukawa, Seishi; Kodama, Yuki; Sumiyoshi, Kaeko; Kino, Emi; Sameshima, Hiroshi

    2016-06-01

    Helicobacter cinaedi is a rare pathogen but known to cause bacteremia, cellulitis and enterocolitis. Recently, cases of involving various organs are increasingly reported such as endocarditis, meningitis, and kidney cyst infection. We report a case of intrauterine H. cinaedi infection leading preterm birth and neonatal sepsis. A 29-year-old pregnant women who was no underlying disease hospitalized due to threatened preterm labor at 22 weeks of gestation. Clinical findings showed uterine tenderness, fever, leukocytosis and elevated C-reactive protein. H. cinaedi was isolated from amniotic fluid obtained by transabdominal amniocentesis. We diagnosed as intrauterine H. cinaedi infection and administered intravenous ampicillin followed by oxytocin to terminate pregnancy. A live 446 g male infant was delivered. The patient was no signs of infection throughout postpartum course and discharged on post-delivery day 5. The neonate was admitted in neonatal intensive care unit and administered ampicillin and amikacin. H. cinaedi was isolated from umbilical cord blood culture. He has no signs of infection on day 5 but died from uncontrollable hyperglycemia and ketoacidosis on 15 days of age. H. cinaedi can cause intrauterine infection during pregnancy and lead preterm labor and neonatal sepsis. PMID:26806147

  9. Acute suppurative thyroiditis as a rare complication of aggressive chemotherapy in children with acute myelogeneous leukemia.

    PubMed

    Imai, Chihaya; Kakihara, Toshio; Watanabe, Akihiro; Ikarashi, Yukie; Hotta, Hiromitsu; Tanaka, Atsushi; Uchiyama, Makoto

    2002-06-01

    Acute suppurative thyroiditis (AST) is quite rare, even in immunocompromised patients. The authors describe 2 cases of AST during aggressive chemotherapy for acute myelogeneous leukemia (AML). They were treated with aggressive combination chemotherapy and achieved complete remission. After several courses of chemotherapy, they developed fever and pain in the region of the thyroid gland. Laboratory tests showed hyperthyroidism and elevated levels of thyroglobulin and C-reactive protein. Ultrasonography revealed hypoechoic areas in the thyroid gland. A diagnosis of AST was made. Bacterial infections were suspected because they were sucessfully treated with antibiotics. After a month, the patients' thyroid function and thyroglobulin levels returned to normal without a period of transient hypothyroidism. A pyriform sinus fistula was not demonstrated. The results suggest that neutropenia and preceding cellulitis around the thyroid gland, which might be subsequent to oral mucosal damage induced by anticancer drugs, may play a role in the development of AST. AST should be considered a potential complication of aggressive chemotheragy for leukemia. PMID:12051591

  10. 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

  11. 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

  12. Clinical and bacteriological characteristics of Helicobacter cinaedi infection.

    PubMed

    Kawamura, Yoshiaki; Tomida, Junko; Morita, Yuji; Fujii, Shigemoto; Okamoto, Tatsuya; Akaike, Takaaki

    2014-09-01

    Helicobacter cinaedi was first isolated from rectal cultures from homosexual men in 1984. In the 1980s to mid 1990s, the microorganism was mainly isolated from samples from homosexual men or immunocompromised patients; however, during the last two decades, H. cinaedi has been isolated from immunocompromised and from immunocompetent individuals worldwide. In Japan, the isolation of this microorganism was first reported in 2003. Since then, many cases have been reported in hospitals across the country. Despite many reports, the etiological properties and pathogenicity of H. cinaedi remain elusive; however, we are increasingly able to recognize some of the features and the clinical relevance of infection. In particular, a long incubation period is essential for detection in an automatic blood culture system and many of the recent isolates are resistant to both macrolides and quinolones. Furthermore, there is an association between infection and severe or chronic illnesses, such as meningitis or arteriosclerosis, in addition to mild diseases such as fever, abdominal pain, gastroenteritis, proctitis, diarrhea, erysipelas, cellulitis, arthritis, and bacteremia. In this review, we introduce the current knowledge and our latest findings relating to H. cinaedi. PMID:25022901

  13. 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

  14. Rarely seen infections.

    PubMed

    Amer, Mohamed; Amer, Amin

    2014-01-01

    There are many rare cutaneous infections of the face. This phrase seems irrelevant, because rare infections in certain parts of the world are common in others. This is more apparent if applied to different sites of the body (eg, face). For instance, cutaneous leishmaniasis (CL) is common in Central and South America and uncommon in the United States. Because most medical practitioners in this country have never seen a case, it is easy for them to miss a diagnosis. Cutaneous leishmaniasis, a protozoan infection transmitted by phlebotomine sand flies, is typically divided into two forms: one found in the Middle East, Asia, Africa, and southern Europe, called Old World leishmaniasis, and one found in Latin and Central America, called New World leishmaniasis. Also atypical mycobacterial infection has been described in the medical literature since the mid-1950s. The development and introduction of a rapid radiometric mycobacterial detection system has advanced the field of mycobacteriology over the past 20 years. This method has allowed the distinction of Mycobacterium tuberculosis from other mycobacteria and enabled the performance of antimicrobial susceptibility testing of mycobacteria. The increased frequency of atypical mycobacterial infection stems from advances in the diagnostic procedures concerning the infection paired with the prevalence of mycobacterial disease in immunocompromised patients infected with HIV. Erysipelas and facial cellulitis are covered briefly in this paper. PMID:25441467

  15. Soft tissue injury of the lower extremity complicated by type II necrotising fasciitis highlighting the need for astute clinical practices and proper treatment.

    PubMed

    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

  16. 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

  17. Tungiasis presenting as a soft tissue oral lesion

    PubMed Central

    2014-01-01

    Background The sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. For patients who present abroad treatment may be surgical excision or amputation. Case presentation An adult female Musoga by tribe, resident in a Kampala City suburb presented at Mulago National Referral and Teaching Hospital’s Oral Surgery and Jaw Injuries Unit with a discoloured swollen tongue, facial cellulitis and submandibular lymphadenopathy. A swelling palpable in the body of her tongue was excised and sent for histology. Tungiasis of the tongue was diagnosed after microscopic examination of formalin-fixed paraffin-embedded Haematoxylin and Eosin-stained tissue sections. Conclusion Lingual tungiasis is a rare diagnosis that was made on histological examination. Atypical presentation outside an endemic area predisposed the patient to partial glossectomy instead of the less invasive flea enucleation. Ectopic disease in a city-resident highlights the plight not only of visitors to infested areas but also of the communities and their domestic animals. PMID:25186303

  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. Subcutaneous Injection of Percocet: A Case of Severe Soft Tissue Loss.

    PubMed

    Baskin, Sean M; Abboud, Christine; Chen, Wendy; Tolchin, Eric; Kelly, Robert W; Aballay, Ariel M

    2015-07-01

    Prescription drug abuse ranks as the second most common class of illicit drug use in the United States, and one mechanism of opiate abuse involves intravenous injection of enteral narcotics such as oxycodone or hydrocodone. The authors describe a patient who sustained significant soft tissue necrosis after intravenously injecting a solution made from crushed enteral narcotics, with a focus on the operative course that resulted due to a delay in initial definitive treatment. The patient's wounds encompassed 8% total body surface area and covered 247 cm2. A 55-year-old female was admitted to the burn unit (West Penn Burn Center, Western Pennsylvania Hospital, Pittsburgh, PA) after she initially presented with infection and cellulitis to her bilateral upper extremities 3 weeks after intravenously injecting herself with crushed oxycodone/acetaminophen. She underwent numerous sequential operative repairs including initial debridement, placement of dermal replacement templates, and several split-thickness autografts and xenografts. Her total length of stay was 59 days, broken into an initial 47-day stay, and a subsequent 12-day readmission due to graft failure secondary to poor follow-up. As the number of prescription drug abusers rises, it is possible that an increase in attempts to intravenously abuse enteral narcotics may also rise. As such, burn centers should be prepared for the extent of potential limb necrosis and the operative treatment that may ensue. PMID:26192735

  20. [Lipedema: a misdiagnosed entity].

    PubMed

    Vignes, S

    2012-07-01

    Lipedema is a clinical entity frequently misdiagnosed or confound with primary lymphedema. Lipedema is a disorder of adipose tissue that occurs almost exclusively in obese women. It is characterized by bilateral enlargement from hip to ankle due to abnormal depositions of subcutaneous fat associated with often mild edema, usually sparing the feet. Disease onset is usually at or soon after puberty. Lipedema results in considerable frustration and distress resulting from the cosmetic appearance. Patients may complain of pain, tenderness, easy bruising of the affected areas with moderate to severe sensitivity to digital pressure or pinching. Imaging studies using computed tomography, magnetic resonance imaging, ultrasound, lymphoscintigraphy are not indicated, except if the diagnosis is atypic or doubtful. Long-term evolution may alter lymphatic system and lead to a lipo-lymphedema with specific complications such as cellulitis. Lipedema management is not codified and included weight loss (poorly improving leg appearance or discomfort), psychological counselling and compression therapy. Liposuction, especially using tumescent local anaesthesia, may reduce edema, spontaneous pain, sensitivity to pressure, bruising and improve appearance resulting in a important increase in quality of life. PMID:22698628