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Sample records for cellulitis

  1. Cellulitis

    MedlinePlus

    ... cut, bite, or scratch. People who have body piercings may be susceptible to cellulitis because the hole ... of cellulitis are developing. Pay attention to new piercings, too. If they become red, swollen, and painful ...

  2. Cellulitis

    MedlinePlus

    ... deeper and becomes cellulitis, all three layers of skin can become red, swollen, and tender. What Causes It? Different types of bacteria can cause cellulitis. The most common are group A streptococcus (say: strep-toh-KAH-kus) and staphylococcus (say: staf-uh-loh-KAH-kus). You come ...

  3. Cellulitis

    MedlinePlus

    ... skin has layers — three, to be exact. Well, cellulitis is an infection at the deepest layer, called the subcutaneous (say: ... in something like a cut and cause an infection. continue How Do I Know If I Have It? You can get cellulitis on any part of your body, but it ...

  4. Cellulitis

    MedlinePlus

    ... skin and/or the eye socket (orbit) and surrounding tissue. What is the orbital septum? The orbital ... are the complications of orbital cellulitis? Spread to surrounding tissue can cause significant worsening of the illness. ...

  5. Cellulitis

    MedlinePlus

    ... most common ones are group A streptococcus and Staphylococcus aureus . Cellulitis usually begins in an area of ... If you do get a scrape, wash the wound well with soap and water. Apply an antibiotic ...

  6. Cellulitis

    MedlinePlus

    ... Cellulitis occurs when bacteria, most commonly streptococcus and staphylococcus, enter through a crack or break in your skin. The incidence of a more serious staphylococcus infection called methicillin-resistant Staphylococcus aureus (MRSA) is ...

  7. Cellulitis

    MedlinePlus

    Cellulitis is an infection of the skin and deep underlying tissues. Group A strep (streptococcal) bacteria are the most common ... a blood test to identify the bacteria causing infection. Treatment is with ... cases. NIH: National Institute of Allergy and Infectious Diseases

  8. Orbital cellulitis

    MedlinePlus

    ... hemolytic streptococci may also cause orbital cellulitis. Orbital cellulitis infections in children may get worse very quickly and ... in the space around the eye. An orbital cellulitis infection can get worse very quickly. A person with ...

  9. Bilateral cellulitis.

    PubMed

    Batra, Vivek; Baras, Alexander

    2015-09-21

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

  10. Is Cellulitis Contagious?

    MedlinePlus

    ... isn't usually spread from person to person. Cellulitis is an infection of the deeper layers of the skin most ... chills Swollen glands or lymph nodes Left untreated, cellulitis can rapidly ... soft tissue infections. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. ...

  11. Distinguishing cellulitis from its mimics.

    PubMed

    Keller, Emily C; Tomecki, Kenneth J; Alraies, M Chadi

    2012-08-01

    Distinguishing true cellulitis from its many imitators is challenging but critical if we are to avoid unnecessary use of antibiotics and delays in treatment. Common imitators of cellulitis are stasis dermatitis, lipodermatosclerosis, contact dermatitis, lymphedema, eosinophilic cellulitis, and papular urticaria. Specific criteria do not exist for the diagnosis of cellulitis, but the alert physician can find clues in the history and physical examination that point toward cellulitis.

  12. 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

  13. Breast cellulitis after conservative surgery and radiotherapy

    SciTech Connect

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

    1994-04-30

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

  14. Recurrent Cellulitis: How Can I Prevent It?

    MedlinePlus

    ... M.D. To help prevent recurrent episodes of cellulitis — a bacterial infection in the deepest layer of skin — keep skin ... www.merckmanuals.com/professional/dermatologic_disorders/bacterial_skin_infections/cellulitis.html?qt=cellulitis&alt=sh. Accessed Dec. 20, ...

  15. [Cellulitis: clinical manifestations and management].

    PubMed

    Blum, C-L; Menzinger, S; Genné, D

    2013-10-09

    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.

  16. Cellulitis: definition, etiology, and clinical features.

    PubMed

    Gunderson, Craig G

    2011-12-01

    Cellulitis is a common condition seen by physicians. Over the past decade, skin and soft tissue infections from community-associated methicillin-resistant Staphylococcus aureus have become increasingly common. In this article, the definition, etiology, and clinical features of cellulitis are reviewed, and the importance of differentiating cellulitis from necrotizing soft tissue infections is emphasized. Empiric antimicrobial recommendations are suggested, including the most recent recommendations from the Infectious Disease Society of America.

  17. Management of preseptal and orbital cellulitis

    PubMed Central

    Lee, Seongmu; Yen, Michael T.

    2010-01-01

    Orbital cellulitis describes an infection involving the soft tissues posterior to the orbital septum, including the fat and muscle within the bony orbit. This condition may be associated with severe sight and life-threatening complications. Despite significant advances in antimicrobial therapies and diagnostic technologies, the management of orbital cellulitis often remains challenging, and rapid diagnosis and prompt initiation of therapy are important in minimizing complications and optimizing outcomes. This review summarizes the distinctive characteristics of preseptal and orbital cellulitis, with a focus on anatomic considerations, predisposing conditions, approaches to evaluation, and management strategies. PMID:23960899

  18. Cellulitis

    MedlinePlus

    ... Redness, warmth, and swelling of the skin Possible drainage, if there is a buildup of pus ( abscess ) with the skin infection Swollen glands (lymph nodes) near the affected area The provider may ...

  19. Mastoiditis mimicry: retro-auricular cellulitis related to otitis externa.

    PubMed

    Block, Stan L

    2014-09-01

    Retro-auricular cellulitis associated with otitis externa is now the great mimicker of mastoiditis. It may be the most common cause of this specific cellulitis/auricular protrusion when it is associated with otitis externa. This column presents six cases of children who presented with peri-auricular redness, four of whom had protuberant ear and retro-auricular cellulitis.

  20. Vibrio alginolyticus cellulitis following coral injury.

    PubMed Central

    Patterson, T. F.; Bell, S. R.; Bia, F. J.

    1988-01-01

    Infections associated with marine activities, particularly work or recreation in salt water, present unique diagnostic challenges for the infectious disease practitioner. Those caused by halophilic, non-cholera Vibrio species are increasingly being recognized in clinical practice. They typically follow saltwater injuries, especially those associated with coral. Because these infections can be both severe and life-threatening, a consideration of halophilic Vibrio species in the differential diagnosis of marine-acquired infections is important. In this case report, we discuss the diagnosis and treatment of cellulitis in a patient with a Caribbean coral injury associated with Vibrio alginolyticus cellulitis. PMID:3242316

  1. [Eosinophilic cellulitis: About a new pediatric case].

    PubMed

    Makni, Saadia; Kallel, Rim; Chaabène, Hend; Bahloul, Emna; Bahri, Ibtissem; Turki, Hamida; Gouiaa, Naourez; Boudawara, Tahya

    2015-12-01

    Wells' syndrome or "eosinophilic cellulitis" is characterized by clinical features of cellulitis and histological pictures of eosinophils infiltrate of the dermis with some « flame » figures. This is a very rare disease in the pediatric age. We report the case of a 14-month-old boy, presented with two farms painful nodular brownish lesions in the thigh and back of the foot as well as multiple erythematous papular and vesicular lesions on the forehead, cheeks, limbs and trunk. Biological analysis and histological examination confirmed the diagnosis of Wells' syndrome. The outcome was favorable with dermocorticoid.

  2. Bullous leukemia cutis mimicking facial cellulitis*

    PubMed Central

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

    2016-01-01

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

  3. 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.

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

    PubMed

    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.

  5. 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.

  6. 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.

  7. Facial cellulitis revealing choreo-acanthocytosis: a case report.

    PubMed

    Samia, Younes; Yosra, Cherif; Foued, Bellazreg; Mouna, Aissi; Olfa, Berriche; Jihed, Souissi; Hammadi, Braham; Mahbouba, Frih-Ayed; Amel, Letaief; Habib, Sfar Mohamed

    2014-01-01

    We report a 62 year-old-man with facial cellulitis revealing choreo-acanthocytosis (ChAc). He showed chorea that started 20 years ago. The orofacial dyskinisia with tongue and cheek biting resulted in facial cellulitis. The peripheral blood smear revealed acanthocytosis of 25%. The overall of chorea, orofacial dyskinetic disorder, peripheral neuropathy, disturbed behavior, acanthocytosis and the atrophy of caudate nuclei was suggestive of a diagnosis of ChAc. To our knowledge no similar cases of facial cellulitis revealing choreo-acanthocytosis (ChAc) were found in a review of the literature.

  8. [Orbital cellulitis in childhood. Medical-surgical treatment].

    PubMed

    Gómez Campderá, J; Aranguez Moreno, G; Escamilla Carpintero, Y; Urán, M M; García-Món Marañés, F

    2000-03-01

    Orbital cellulitis is an uncommon complication resulting from a spectrum of disorders commonly found in pediatric practice. It usually occurs as a complication of infection of the paranasal sinuses, although it also can be caused by eyelid or dental juries, dental infection and external ocular infection. We studied the clinical, microbiological, and therapeutic features of 152 children diagnosed as periorbital cellulitis and 27 children with orbital cellulitis admitted to our hospital in a 16-year period from January 1983 to December 1998. Twenty-four percent of patients (43 cases) had positive cultures. Thirty children with septal or preseptal cellulitis developed neurological or ophthalmological complications. Intravenous or oral antibiotic administration was effective in 150 patients, but a significant proportion required surgery of the paranasal sinus or orbit (16%).

  9. Serratia marcescens: an unusual pathogen associated with snakebite cellulitis.

    PubMed

    Subramani, Parimala; Narasimhamurthy, Gokul Bindiganavile; Ashokan, Bhaskaran; Madappa, Beena Prasavangada

    2013-02-15

    This study reports a case of Serratia marcescens cellulitis following a snakebite in a 50-year-old woman. The bite was on the dorsum of the right hand with symptoms of envenomation. She developed swelling and cellulitis with tissue necrosis. Wound debridement was performed.  Pus and tissue biopsy cultures yielded Serratia marcescens sensitive to fluoroquinolones, aminoglycosides, third-generation cephalosporins and carbapenems. The patient responded to anti-snake venom (ASV) therapy, ciprofloxacin, local wound management and recovered uneventfully.

  10. Challenges of cellulitis in a lymphedematous extremity: a case report

    PubMed Central

    2009-01-01

    Introduction Lymphedema is a relatively common phenomenon. It is important that clinicians appreciate the relative risks imposed by this condition. While for some it may only represent a flaw in appearance, this condition can potentially have fatal consequences. Our case reports on the challenges of cellulitis in a lymphedematous extremity that progressed to septic shock. Case presentation A 37-year-old Hispanic male was transferred to the Burn Unit from an outside hospital for wound care of an extremely severe case of cellulitis. He suffered massive lymphedema of his lower extremity, with innumerable nodules and chronic skin changes. After 3 days of cellulitis, he was in critical condition and required intubation and vasopressors. With intense wound care and systemic antibiotics, he gradually recovered and was discharged in 16 days with his cellulitis resolved and ambulating independently. Conclusion Our case highlights the special care and attention that chronic lymphedema deserves. These patients can exhibit marked disfigurement and physical disability affecting them on both social and physical levels. They also are at great medical risk, as cellulitis almost cost our patient his life. Evidence indicates that lymphedema, no matter the etiology, is susceptible to cellulitis with both great propensity and virulence. Physicians should be aware of the great risk of lymphedema, strive to prevent deterioration and complications, and be prepared to educate and closely monitor these patients. PMID:20062550

  11. 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.

  12. Oxacillin or cefalotin treatment of hospitalized children with cellulitis.

    PubMed

    Vasconcellos, Angela Gomes de; Leal, Renata Dórea; Silvany-Neto, Anníbal; Nascimento-Carvalho, Christiana Maria

    2012-01-01

    Cellulitis is an important cause of hospitalization in pediatrics. Because Staphylococcus aureus is the main pathogen of cellulitis, medicinal therapeutics should take the changing resistance profile of this organism into consideration. The aim of this study was to evaluate the progression and outcomes of children hospitalized for cellulitis and treated with oxacillin or cefalotin. This retrospective cohort study enrolled 218 children, hospitalized between 2001 and 2008 in Salvador, Northeast Brazil. All were diagnosed with cellulitis and treated with oxacillin or cefalotin (≥100 mg/kg/day). The median age was 2 years and 56.9% were males. Frequencies of signs and symptoms used in the clinical diagnoses were as follows: swelling (91.3%), redness (81.7%), warmth (47.2%), and tenderness (31.7%). All patients were discharged due to clinical recovery and the mean length of hospitalization was 7 ± 4 days. None of the patients died, needed intensive care, or had sequelae. By comparing the daily frequency of clinical findings during hospitalization, significant decreases were found in the frequencies of fever (admission day [42.2%], first day [20.8%], second day [12.9%], third day [8.3%], fourth day [6.1%]), toxemia, irritability, somnolence, vomiting, tachycardia, and need for intravenous hydration. In conclusion, oxacillin or cefalotin remain the drugs of choice for treating uncomplicated cellulitis in regions where community-acquired methicillin-resistant S. aureus is infrequent (<10%).

  13. Is it necrotizing fasciitis or necrotizing cellulitis after varicella zoster infection? Two case reports.

    PubMed

    Gundeslioglu, Ayse Ozlem; Selimoglu, Muhammed Nebil; Toy, Hatice

    2014-08-01

    Necrotizing fasciitis and necrotizing cellulitis are serious cutaneous complications in varicella patients. Differentiation of necrotizing cellulitis from necrotizing fasciitis can initially be challenging because of indistinct clinical course at the onset of infection and the lack of definitive diagnostic criteria. This paper reports 2 children with necrotizing cellulitis that developed after varicella infection to draw the attention of health care providers to necrotizing cellulitis that showed slower clinical course than necrotizing fasciitis and recovered with conservative treatment approaches without aggressive surgical intervention.

  14. Recurrent periorbital cellulitis in a very young child: a case report and review of literature.

    PubMed

    Caulley, Lisa; Corsten, Gerard; Hong, Paul

    2012-04-01

    Recurrent periorbital cellulitis is a rare complication of sinus disease. We present a 4-month-old boy with bilateral recurrent periorbital cellulitis and radiological evidence of bilateral bony dehiscence of the lamina papyracea. To our knowledge, this is the youngest documented presentation of recurrent periorbital cellulitis. As well, only unilateral cases have been reported in the past. In addition to the clinical case report, we reviewed the current literature available regarding recurrent periorbital cellulitis.

  15. Toward an Objective Diagnostic Test for Bacterial Cellulitis

    PubMed Central

    Bry, Lynn; Dwyer, Richard C.; Lipworth, Adam D.; Leung, Donald Y.; Camargo, Carlos A.; Kupper, Thomas S.; Filbin, Michael R.; Murphy, George F.

    2016-01-01

    Background Prior studies repeatedly showed that cultures of skin lesions diagnosed as "cellulitis" are usually negative. However, lack of a gold standard for diagnosis (against which culture might be judged) and failure to assess the human immune response are important limitations of prior work. In this pilot study, we aimed to develop a criterion standard for research on bacterial cellulitis, to evaluate the sensitivity of procalcitonin for bacterial cellulitis, and to use gene expression analysis to find other candidate diagnostic markers. Methods We classified lesions via biopsies, 16s rRNA gene detection, culture, and histopathology. We quantified procalcitonin expression in blood. We also used Nanostring technology to quantify transcription of immunomodulators that may distinguish cases from inflamed controls. Results Of 28 participants, 15 had a clinical diagnosis of cellulitis, six had a diagnosis of non-infectious dermatitis, and seven were normal volunteers. Of the “cellulitis” patients, three (20%) had pathogens isolated, and were designated confirmed cases. Procalcitonin was undetectable in all three. HLA-DQA1 was expressed 34-fold more in confirmed cases vs. controls (fold change of geometric mean). Heat maps depicting multiplex gene expression analysis revealed a distinct profile of gene expression in confirmed cases relative to comparators. Conclusions Most “cellulitis” patients had microbiologically-negative biopsies. Procalcitonin was undetectable, and HLA-DQA1 elevated, in confirmed bacterial cases. Multivariable transcriptomic profiling results supported our algorithm’s ability to identify patients with true bacterial cellulitis. A larger sample may allow discovery of an immunological signature capable of distinguishing bacterial cellulitis from its mimics in clinical practice. PMID:27656884

  16. Nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite.

    PubMed

    Yang, Ching-Huei

    2011-10-01

    A case of nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite in Taiwan is reported. The patient was successfully treated with ciprofloxacin and doxycycline for an extended period. Chromobacterium violaceum should be listed in the differential diagnosis of patients with nonspecific cellulitis associated with marked leukocytosis and rapid progression to septicemia either with or without a distinct history of exposure to water or soil. A combination of prompt diagnosis, optimal antimicrobial therapy, and adequate therapeutic duration for C violaceum infection is the key for successful therapy.

  17. Serum Procalcitonin Level Reflects the Severity of Cellulitis

    PubMed Central

    Noh, Soo Hyeon; Park, Seok Don

    2016-01-01

    Background Cellulitis is a common bacterial infection of the superficial skin. Procalcitonin is one of the precursor proteins of calcitonin, its levels are elevated in bacterial infection, and it has been established as a diagnostic marker for severe bacterial infections. Objective This study evaluated the clinical usefulness of procalcitonin for predicting disease severity and prognosis of cellulitis. Methods We reviewed the medical records of 160 patients diagnosed with cellulitis in the past 3 years. Body temperature, procalcitonin, white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were measured on their first day of admission. The associations of procalcitonin, WBC, ESR, and CRP with the body temperature and the number of hospitalized days were assessed. Results Procalcitonin, WBC, and CRP showed a positive correlation with body temperature. In addition, procalcitonin, WBC, ESR, and CRP showed a positive correlation with number of hospitalized days (p<0.05). Conclusion In patients diagnosed with cellulitis, proclacitonin was a helpful parameter to indicate the severity of disease and also a useful predictor of prognosis. PMID:27904269

  18. Capnocytophaga cynodegmi Cellulitis, Bacteremia, and Pneumonitis in a Diabetic Man

    PubMed Central

    Sarma, Podila S.; Mohanty, Smruti

    2001-01-01

    Capnocytophaga cynodegmi (formerly “DF-2 like organism”), a commensal organism of the canine oral cavity, is a capnophilic, gram-negative, facultative bacillus. C. cynodegmi has rarely been encountered in human diseases. We report the first known case of cellulitis, bacteremia, and pneumonitis caused by C. cynodegmi in a diabetic man from central India following a dog bite. PMID:11326042

  19. 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.

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

    PubMed

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

    2015-07-01

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

  1. Pneumococcal sepsis, peritonitis, and cellulitis at the first episode of nephrotic syndrome.

    PubMed

    Naseri, Mitra

    2013-09-01

    Bacterial infections are common in patients with nephrotic syndrome, including peritonitis, sepsis, meningitis, urinary tract infection, and cellulitis. An 8-year-old boy presented with colicky abdominal pain, vomiting, swollen and painful erythematous lesions around the umbilicus and in anterior surface of left thigh (cellulitis), mild generalized edema, and ascites. The microorganism isolated from peritoneal fluid and blood cultures was Pneumococcus. Association of pneumococcal sepsis, peritonitis, and cellulitis has been rarely reported in nephrotic syndrome.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. Preseptal and orbital cellulitis: 15-year experience with sulbactam ampicillin treatment.

    PubMed

    Devrim, Ilker; Kanra, Güler; Kara, Ateş; Cengiz, A Bülent; Orhan, Mehmet; Ceyhan, Mehmet; Seçmeer, Gülten

    2008-01-01

    The infection of the orbita and ocular tissues can result in severe local and systemic complications. We aimed to determine the predisposing factors for preseptal and orbital cellulitis, the clinical and routine laboratory differences between orbital and preseptal cellulitis, and the change in the spectrum of the pathogens and the antibiotics used in the last 10 years. One hundred thirty-nine patients, hospitalized in Hacettepe University Faculty of Medicine Children's Hospital between 1 January 1990 and 31 December 2003 with diagnosis ofperiorbital or orbital cellulitis, were reviewed retrospectively. Ten of the patients (7%) had orbital and 129 (93%) had preseptal cellulitis. The male/female ratio was 1.7:1. The average age (mean+/-standard deviation) was 5.7+/-4 years. The seasonal distribution was most marked in spring and fall periods. When compared with preseptal cellulitis, the mean blood cell count, erythrocyte sedimentation rate and C-reactive protein levels were significantly higher in patients with orbital cellulitis. Staphylococcus aureus was isolated in 13 (41.9% of total microbiologically confirmed cases), coagulase-negative staphylococcus in 8 (25.8%), and H. influenza type b in 2 patients (6%). Thirty out of 77 clinical sample cultures (39%) were positive. In clinical studies, etiological agents of orbital and preseptal cellulitis could be identified in only 20-30% of cases, so in clinical practice treatment is usually empiric. We observed that sulbactam-ampicillin was a safe and effective choice of treatment in orbital and preseptal cellulitis in our cases.

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

    PubMed

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

    2016-08-01

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

  8. [Recurrent cellulitis due to Helicobacter cinaedi after chemotherapy for malignant lymphoma].

    PubMed

    Ishizawa, Jo; Mori, Takehiko; Tsukada, Yuiko; Matsuki, Eri; Yokoyama, Kenji; Shimizu, Takayuki; Sugita, Kayoko; Murata, Mitsuru; Iwata, Satoshi; Okamoto, Shinichiro

    2012-06-01

    A 62-year-old man with diffuse large B-cell lymphoma received five courses of R-CHOP chemotherapy. The patient developed cellulitis in the bilateral lower extremities without fever, and blood culture yielded Helicobacter cinaedi after five-day culture. Although the response to tazobactam/piperacillin (TAZ/PIPC) was prompt, cellulitis recurred immediately after discontinuation of the drug. Even after two months of treatment with PIPC plus amikacin followed by amoxicillin, it recurred again soon after stopping the antibiotics. H. cinaedi reportedly causes bacteremia and cellulitis in immunocompromised patients mostly in patients with acquired immunodeficiency syndrome. Only sporadic cases have been reported in association with hematological malignancies. Physicians should be aware of H. cinaedi as one of the causative pathogens of bacteremia and cellulitis in patients with hematological malignancies. Longer incubation period of blood culture is needed to detect the microbe and long-term use of antimicrobials is required to prevent recurrent cellulitis.

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

    PubMed

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

    2016-10-01

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

  10. Complete Vision Loss following Orbital Cellulitis Secondary to Acute Dacryocystitis

    PubMed Central

    Pfeiffer, Margaret L.; Hacopian, Alexander; Merritt, Helen

    2016-01-01

    We present a case of a 50-year-old woman with acute dacryocystitis that was complicated by posterior rupture of the lacrimal sac causing an orbital cellulitis with subsequent visual acuity of no light perception. Upon presentation, she was immediately started on broad-spectrum antibiotics and underwent surgical incision and drainage of the lacrimal sac abscess but never regained vision. There are 4 cases in the literature of permanent severe vision loss from acute dacryocystitis. Prompt diagnosis and close monitoring of acute dacryocystitis are therefore essential to prevent extension into the orbit and possible optic nerve compromise. PMID:27803829

  11. Surgical and traumatic wound infections, cellulitis, and myositis in horses.

    PubMed

    Adam, Emma N; Southwood, Louise L

    2006-08-01

    Surgical site infections (SSIs) and traumatic wound management remain challenging clinical scenarios. The prevention of SSIs involves meticulous surgical technique and aftercare. Traumatic wounds require thorough evaluation to assess the involvement of synovial structures and radiographs to check for fractures. Chronic wounds can require a biopsy and histologic evaluation to obtain a diagnosis, because many underlying pathologic processes grossly appear similar but different treatment regimens are required. Early recognition and diagnosis of cellulitis and myositis enable the rapid aggressive intervention necessary for a positive outcome. Any delay in diagnosis and treatment increases the complication and mortality rates and makes these conditions difficult to treat successfully.

  12. Primary skeletal muscle lymphoma presenting as refractory cellulitis.

    PubMed

    Baddour, L M; Haden, K H; Allen, J W

    2001-09-01

    The right torso of a 55-year-old woman showed diffuse skin and soft-tissue changes suggestive of cellulitis. However, several clinical and radiologic features, including the subacute and non-toxic nature of the illness and the patient's lack of response to antibiotic therapy, indicated a noninfectious etiology. Malignancy was suggested by striking changes seen on computed tomographic scanning--including extensive infiltration and enlargement of the musculature of the right shoulder girdle, the intercostal musculature, the latissimus dorsi, and the rhomboids; focal enlargement of the right paraspinal muscles; and enlargement of the psoas and the iliacus muscles and of the musculature around the hip joint. The mediastinal, hilar, and paraaortic regions showed no adenopathy. A large hypodense lesion of approximately 4.5 cm, which was seen in the caudate lobe of the liver, raised the concern of a metastatic focus of malignancy. Because of these findings, an immediate muscle biopsy was performed. Results showed a non-Hodgkin's lymphoma with a B-cell phenotype. Although primary skeletal muscle lymphoma is very uncommon in patients without human immunodeficiency virus infection, clinical presentation of refractory cellulitis, as seen in the current case, is extremely rare.

  13. Bacterial Etiology and Risk Factors Associated with Cellulitis and Purulent Skin Abscesses in Military Trainees

    PubMed Central

    Johnson, Ryan C.; Ellis, Michael W.; Schlett, Carey D.; Millar, Eugene V.; LaBreck, Patrick T.; Mor, Deepika; Elassal, Emad M.; Lanier, Jeffrey B.; Redden, Cassie L.; Cui, Tianyuan; Teneza-Mora, Nimfa; Bishop, Danett K.; Hall, Eric R.; Bishop-Lilly, Kimberly A.

    2016-01-01

    Military trainees are at high risk for skin and soft-tissue infections (SSTIs). Although Staphylococcus aureus is associated with purulent SSTI, it is unclear to what degree this pathogen causes nonpurulent cellulitis. To inform effective prevention strategies and to provide novel insights into SSTI pathogenesis, we aimed to determine the etiology of SSTI in this population. We conducted a prospective observational study in US Army Infantry trainees with SSTI (cutaneous abscesses and cellulitis) from July 2012 through December 2014. We used standard microbiology, serology, and high-throughput sequencing to determine the etiology of SSTI. Furthermore, we compared purported risk factors as well as anatomic site colonization for S. aureus. Among 201 SSTI cases evaluated for SSTI risk factors, cellulitis was associated with lower extremity blisters (P = 0.01) and abscess was associated with methicillin-resistant S. aureus (MRSA) colonization (P<0.001). Among the 22 tested cellulitis cases that were part of the microbiome analysis, only 1 leading edge aspirate was culturable (Coagulase-negative Staphylococcus). Microbiome evaluation of aspirate specimens demonstrated that Rhodanobacter terrae was the most abundant species (66.8% average abundance), while abscesses were dominated by S. aureus (92.9% average abundance). Although abscesses and cellulitis share the spectrum of clinical SSTI, the bacterial etiologies as determined by current technology appear distinct. Furthermore, the presence of atypical bacteria within cellulitis aspirates may indicate novel mechanisms of cellulitis pathogenesis. Clinical Trials Registration: NCT01105767. PMID:27780238

  14. A prospective study of management and litter variables associated with cellulitis in California broiler flocks.

    PubMed

    Schrader, J S; Singer, R S; Atwill, E R

    2004-09-01

    Cellulitis has emerged as an economically important disease of broiler chickens. The impact of environmental risk factors on the incidence of cellulitis has not been evaluated in the United States. Escherichia coli (E. coli), the causative agent, is introduced through skin scratches during the grow out. Our previous work suggested that the litter was an important reservoir for cellulitis-associated E. coli. We hypothesized that factors contributing to a positive environment for E. coli growth would increase the opportunity for exposure of a broiler to an infectious dose of E. coli, capable of initiating a cellulitis lesion. This prospective study of 304 flocks on five farms from two integrated broiler companies was conducted to determine the effect of environmental factors on the prevalence of cellulitis in California broiler flocks. Environmental variables included temperature, wind velocity, and relative humidity (RH) at the litter surface. Litter variables measured included E. coli and total gram-negative bacteria load (colony forming units/g dry matter), water activity, and pH. Management variables such as clean out, the number of flocks reared on the same litter (litter run, LR), and downtime (DT) between flocks were also evaluated. Cellulitis ranged from 0.197% to 6.04%. Significant associations were identified using linear regression between farm, LR, DT, ambient temperature during the brooding period, gram-negative bacteria load in the litter during the brooding period, RH mid-grow out, and E. coli load late in the grow out. The significant variation in the rate of cellulitis between farms combined with the strong association of LR and DT with cellulitis demonstrated that management choices were highly influential in this disease syndrome. Based on these data and our previous findings, managers would be advised to increase DT between flocks and perform a total clean out of the house when a flock processes with a high incidence of cellulitis.

  15. Clinical potential of resistin as a novel prognostic biomarker for cellulitis

    PubMed Central

    ERTURK, AYSE; CURE, MEDINE CUMHUR; CURE, ERKAN; KURT, AYSEL; CICEK, AYSEGUL COPUR; YUCE, SULEYMAN

    2015-01-01

    Cellulitis is an acute, subacute or chronic inflammation of the dermis and subdermal tissues, which is typically caused by bacteria, although other causes are possible. The present study aimed to evaluate the association between resistin levels and the recovery time of patients with cellulitis. In addition, the effect of resistin and insulin resistance on the prognosis of cellulitis was investigated. In total, 52 patients with cellulitis (male, 21; female, 31) and an age-matched group of 42 healthy individuals (male, 18; female, 24) were included in the study. The levels of serum resistin, fasting plasma glucose (FPG), homeostasis model assessment-insulin resistance (HOMA-IR), C-reactive protein (CRP) and other biochemical parameters were compared between the groups. The mean resistin levels in the cellulitis and control groups were 9.4±5.3 and 5.8±3.1 ng/ml, respectively. The levels of resistin, FPG, HOMA-IR and CRP were significantly higher in the cellulitis group compared with the control group (P<0.001). Furthermore, the mean recovery time of the patients with cellulitis was 21.2±5.6 days. Thus, increased levels of resistin (P=0.002) and HOMA-IR (P=0.005) could be used as predictive factors for the recovery time. The enhanced levels of resistin and HOMA-IR were shown to correlate with the high CRP levels in the cellulitis group. Therefore, the results indicated that increased levels of resistin may function as a prognostic marker for cellulitis. PMID:26136908

  16. 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

  17. Acetaminophen-induced cellulitis-like fixed drug eruption.

    PubMed

    Fathallah, Neila; Ben Salem, Chaker; Slim, Raoudha; Boussofara, Lobna; Ghariani, Najet; Bouraoui, Kamel

    2011-03-01

    Acetaminophen is a widely used analgesic drug. Its adverse reactions are rare but severe. An 89-year-old man developed an indurated edematous and erythematous plaque on his left arm 1 day after acetaminophen ingestion. Cellulitis was suspected and antibiotictherapy was started but there was no improvement of the rash; there was a spectacular extension of the lesion with occurrence of flaccid vesicles and blisters in the affected sites. The diagnosis of generalized-bullous-fixed drug eruption induced by acetaminophen was considered especially with a reported history of a previous milder reaction occurring in the same site. Acetaminophen was withdrawn and the rash improved significantly. According to the Naranjo probability scale, the eruption experienced by the patient was probably due to acetaminophen. Clinicians should be aware of the ability of acetaminophen to induce fixed drug eruption that may clinically take several aspects and may be misdiagnosed.

  18. 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.

  19. A rare case of Enterococcus faecalis-induced orbital cellulitis and myositis

    PubMed Central

    Kohli, Piyush; Ichhpujani, Parul; Bansal, Rakesh Kumar; Kumar, Suresh

    2016-01-01

    Orbital cellulitis is an infection of soft tissue behind the orbital septum. Common pathogens isolated include Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae. It is a straightforward diagnosis and usually responds to empirical treatment without any sequela. We report a case of orbital cellulitis caused by Enterococcus faecalis, which was complicated by myositis of levator palpebrae superioris. To the best of our knowledge, only one case report exists dating way back to 1986. PMID:27688288

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

    PubMed

    Zhang, J; Moore, E; Bousfield, R

    2016-06-01

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

  1. Specific PCR, bacterial culture, serology and pharyngeal sampling to enhance the aetiological diagnosis of cellulitis.

    PubMed

    Toleman, Michelle S; Vipond, I Barry; Brindle, Richard

    2016-01-01

    It is often difficult to obtain a bacteriological diagnosis in patients with cellulitis. We examined the utility of molecular techniques and skin and throat cultures, as well as serology, in providing evidence of either Staphylococcus aureus or group A Streptococcus (GAS) presence inpatients with cellulitis. Samples were collected from patients with a clinical diagnosis of cellulitis who were recruited into a prospective placebo-controlled clinical trial (C4C study, EudraCT 2013-001218-14). Specific PCR, paired serology and culture for both organisms were carried out on a variety of samples where appropriate. Despite utilizing a range of diagnostic methods,a bacteriological diagnosis was only achieved in 43 % of patients with a clinical diagnosis of cellulitis. Seventeen per cent of patients tested positive for GAS by any method but only 4 % were positive by PCR, whilst S. aureus was detected in 34% of samples. Bacterial diagnosis in cases of cellulitis remains challenging. This is probably due to a very low bacterial burden with toxin production resulting in inflammation mediating skin damage. Further consideration for the need for long courses of antimicrobial therapy for cellulitis therefore appears merited.

  2. Risk factors for cellulitis in patients with lymphedema: a case-controlled study.

    PubMed

    Teerachaisakul, M; Ekataksin, W; Durongwatana, S; Taneepanichskul, S

    2013-09-01

    Risk factors for cellulitis in lymphedema (LE) have never been evaluated in controlled studies. The objective of this study was to assess the risk factors for cellulitis in patients with LE using a case-controlled study method. Medical records of patients from November 2009 to September 2011 who met the following criteria were retrieved and analyzed: (a) clinical diagnosis of LE of the limb, (b) aged 18 or above, (c) no food allergy history and (d) no medical diagnosis of cancer metastasis. Overall, there were 179 cases of LE with cellulitis. Each case was matched by age (+/- 5 years) and gender with a patient with LE and without cellulitis for controls. Logistic regression with backward selection procedure was used to identify independent risk factors. The area under the receiver operating characteristics (ROC) curve of the final model was calculated. Independent risk factors for cellulitis in patients with LE were percentage difference in circumference of the limb (adjusted odds ratio (AOR)=1.07, 95% confidence interval (CI)=1.04-1.10), primary LE diagnosis (AOR=3.36, 95% CI=1.37-8.22), food-induced complication experiences (FIE: AOR=6.82, 95% CI=2.82-16.51) and systolic blood pressure (AOR=1.02, 95% CI=1.01-1.04). The area under the curve for the model was 0.80 (95% CI=0.75-0.85, p<0.001). No association was observed with hypertension, diabetes mellitus, body mass index and the duration of LE. This first case-controlled study highlights the important roles of dietary factors, percentage difference in circumference of the limb, and systolic blood pressure for developing cellulitis. The results suggest that controlling the percentage difference in circumference of the limb and systolic blood pressure together with restriction of fatty food and meat consumption may result in a decreased incidence of cellulitis among patients with LE.

  3. Adjunctive clindamycin for cellulitis: a clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis

    PubMed Central

    Brindle, Richard; Williams, O Martin; Davies, Paul; Harris, Tim; Jarman, Heather; Hay, Alastair D; Featherstone, Peter

    2017-01-01

    Objective To compare flucloxacillin with clindamycin to flucloxacillin alone for the treatment of limb cellulitis. Design Parallel, double-blinded, randomised controlled trial. Setting Emergency department attendances and general practice referrals within 20 hospitals in England. Interventions Flucloxacillin, at a minimum of 500 mg 4 times per day for 5 days, with clindamycin 300 mg 4 times per day for 2 days given orally versus flucloxacillin given alone. Main outcome measures The primary outcome was improvement at day 5. This was defined as being afebrile with either a reduction in affected skin surface temperature or a reduction in the circumference of the affected area. Secondary outcomes included resolution of systemic features, resolution of inflammatory markers, recovery of renal function, reduction in the affected area, decrease in pain, return to work or normal activities and the absence of increased side effects. Results 410 patients were included in the trial. No significant difference was seen in improvement at day 5 for flucloxacillin with clindamycin (136/156, 87%) versus flucloxacillin alone (140/172, 81%)—OR 1.55 (95% CI 0.81 to 3.01), p=0.174. There was a significant difference in the number of patients with diarrhoea at day 5 in the flucloxacillin with clindamycin allocation (34/160, 22%) versus flucloxacillin alone (16/176, 9%)—OR 2.7 (95% CI 1.41 to 5.07), p=0.002. There was no clinically significant difference in any secondary outcome measures. There was no significant difference in the number of patients stating that they had returned to normal activities at the day 30 interview in the flucloxacillin with clindamycin allocation (99/121, 82%) versus flucloxacillin alone (104/129, 81%)—adjusted OR 0.90 (95% CI 0.44 to 1.84). Conclusions The addition of a short course of clindamycin to flucloxacillin early on in limb cellulitis does not improve outcome. The addition of clindamycin doubles the likelihood of diarrhoea within the first

  4. 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

  5. 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.

  6. 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.

  7. A case of odontogenic orbital cellulitis causing blindness by severe tension orbit.

    PubMed

    Park, Chang Hyun; Jee, Dong Hyun; La, Tae Yoon

    2013-02-01

    We report a very rare case of odontogenic orbital cellulitis causing blindness by severe tension orbit. A 41-yr old male patient had visited the hospital due to severe periorbital swelling and nasal stuffiness while he was treated for a periodontal abscess. He was diagnosed with odontogenic sinusitis and orbital cellulitis, and treated with antibiotics. The symptoms were aggravated and emergency sinus drainage was performed. On the next day, a sudden decrease in vision occurred with findings of ischemic optic neuropathy and central retinal artery occlusion. Deformation of the eyeball posterior pole into a cone shape was found from the orbital CT. A high-dose steroid was administered immediately resulting in improvements of periorbital swelling, but the patient's vision had not recovered. Odontogenic orbital cellulitis is relatively rare, but can cause blindness via rapidly progressing tension orbit. Therefore even the simplest of dental problems requires careful attention.

  8. [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

    2016-02-01

    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.

  9. 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.

  10. Providencia stuartii infection in a dog with severe skin ulceration and cellulitis.

    PubMed

    Papadogiannakis, E; Perimeni, D; Velonakis, E; Kontos, V; Vatopoulos, A

    2007-06-01

    The aim of this report is to present a case of severe skin ulceration and cellulitis in a seven year old mongrel dog following cystitis. The Providencia stuartii strain was the only isolate from skin lesions. This bacterium is a Gram-negative rod belonging to the family of Enterobacteriaceae. To the best of our knowledge, even though there are some reports in the literature concerning animal infections with Providencia species, there have been no cases of cellulitis in which this pathogen is involved. The Providencia stuartii strain was highly sensitive to amikacin, and the dog responded quickly to this antibiotic.

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

    PubMed

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

    2012-06-01

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

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

    PubMed Central

    Joubert, Sonia V.; Duarte, Manuel A.

    2016-01-01

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

  13. Eosinophilic cellulitis (Wells' syndrome) successfully treated with low-dose cyclosporine.

    PubMed Central

    Herr, H.; Koh, J. K.

    2001-01-01

    Eosinophilic cellulitis (Wells'syndrome) is an uncommon skin disorder. We report two adult male patients who had recurrent erythematous plaques and a nodular lesion on the abdomen. The histopathologic feature of their skin biopsies similarly indicated a marked infiltrate of eosinophils in the dermis with the fashion of "flame figures". One of the patients demonstrated blood eosinophilia. Given the clinicohistological findings, the patients fulfilled the criteria for the diagnosis of eosinophilic cellulitis. The skin lesions remained refractory to medications such as corticosteroids, sulfones, antihistamines, and minocycline. Considering the beneficial effect of cyclosporine in the treatment of eosinophilia-associated dermatoses, we speculated that eosinophilic cellulitis might respond to cyclosporine therapy. Thus, each of the two patients was given cyclosporine (microemulsion formulation) at a daily dose of 1.25 or 2.5 mg/kg, i.e., 100 or 200 mg, respectively. Complete remission of the skin eruptions was obtained in both patients during a 3- or 4-week period of treatment. No side effects were observed. Neither of the patients experienced relapse of the disease at least over 10 months after the discontinuation of the cyclosporine therapy. We suggest that administration of low-dose cyclosporine be a safe and useful therapeutic option in patients with eosinophilic cellulitis. PMID:11641541

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

    PubMed

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

    2016-06-01

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

  15. 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.

  16. An aggressive group a streptococcal cellulitis of the hand and forearm requiring surgical debridement.

    PubMed

    Bharucha, Neil J; Alaia, Michael J; Paksima, Nader; Christoforou, Dimitrios; Gupta, Salil

    2011-01-03

    Group A streptococcus is responsible for a diverse range of soft tissue infections. Manifestations range from minor oropharyngeal and cellulitic skin infections to more severe conditions such as necrotizing fasciitis and septic shock. Troubling increases in the incidence and the severity of streptococcal infections have been reported over the past 25 years. Cases of streptococcal necrotizing fasciitis have received significant attention in the literature, with prompt surgical debridement being the mainstay of treatment. However, cases of rapidly progressing upper extremity streptococcal cellulitis leading to shock and a subsequent surgical intervention have not been well described. This article presents a case of an 85-year-old woman with a rapidly progressing, erythematous, painful, swollen hand associated with fever, hypotension, and mental status change. Due to a high clinical suspicion for necrotizing fasciitis, the patient was rapidly resuscitated and underwent immediate surgical irrigation and debridement. All intraoperative fascial pathology specimens were negative for necrotizing fasciitis, leading to a final diagnosis of Group A streptococcal cellulitis. Although surgical intervention is not commonly considered in patients with cellulitis, our patient benefited from irrigation and debridement with soft tissue decompression. In cases of necrotizing fasciitis as well as rapidly progressive cellulitis, prompt diagnosis and aggressive treatment may help patients avoid the catastrophic consequences of rapidly progressive group A streptococcal infections.

  17. 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

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

    NASA Technical Reports Server (NTRS)

    Munk, Max M

    1927-01-01

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

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

    PubMed

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

    2001-06-01

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

  20. 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.

  1. Herpes zoster vaccine (Zostavax®): Cellulitic injection site reaction or bacterial cellulitis?

    PubMed

    Cook, Ian F

    2016-10-27

    A 70 y old woman presented with a cellulitic reaction following Zostavax® injection. This reaction could be differentiated from bacterial cellulitis on the basis of the temporal relationship between vaccination and onset of the reaction, its non progression and unresponsiveness to antibiotic therapy. Alerting health care providers to this type of reaction, also seen with pneumococcal and pertussis containing vaccines, should avoid the inappropriate use of antibiotics.

  2. Eosinophilic dermatitis with edema in nine dogs, compared with eosinophilic cellulitis in humans.

    PubMed

    Holm, K S; Morris, D O; Gomez, S M; Peikes, H; Byrne, K P; Goldschmidt, M H

    1999-09-01

    A unique eosinophilic dermatitis with edema in dogs is characterized by extremely erythematous coalescing macules and plaques with associated edema, and is similar to eosinophilic cellulitis (Wells' syndrome) in humans. Histopathologic features include a profound eosinophilic dermal infiltrate, focal areas of collagen fiber degeneration surrounded by eosinophils (flame figures), dilated vessels, and dermal edema. Etiopathogenesis is unknown, but a hypersensitivity reaction to medications, arthropod bites, or other foreign antigens is suspected.

  3. 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.

  4. 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

  5. A Rare and Severe Complication Following Thyroid Fine Needle Aspiration: Retropharyngeal Cellulitis

    PubMed Central

    Cesareo, Roberto; Naciu, Anda; Barberi, Antonio; Pasqualini, Valerio; Pelle, Giuseppe; Manfrini, Silvia; Tabacco, Gaia; Pantano, Angelo Lauria; Campagna, Giuseppe; Cianni, Roberto; Palermo, Andrea

    2016-01-01

    Introduction Fine needle aspiration (FNA) is the most accurate and cost-effective method for evaluating thyroid nodules. We have reported a rare complication related to the procedure: severe retropharyngeal cellulitis. Case Presentation A thirty-five-year-old female was admitted to hospital with hoarseness, laryngeal stridor and dyspnea without fever that emerged about 3 days after a first diagnostic FNA. After the procedure, the patient felt her voice became hoarse and 1 day before presentation began to have dyspnea, without fever. It had become difficult for her to swallow solids, and she felt as if food was sticking in her throat. In the emergency room, hematochemical tests and CT scan of the neck/mediastinum had been performed. This showed leukocytosis with neutrophilia and a severe cellulitis framework with involvement of the laterocervical neck area and in particular, the invasion of the retropharynx and the upper part of the mediastinum. The patient was admitted in hospital for an anti-inflammatory therapy with cortisone and antibiotic therapy. Conclusions For the first time to our knowledge, we have reported a severe retropharyngeal and upper mediastinum cellulitis, probably due to the FNA procedure in an immunocompetent young woman. PMID:28123438

  6. 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.

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

    PubMed

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

    2014-12-01

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

  8. Cellulitis lesions in broiler chickens are induced by Escherichia coli Vacuolating Factor (ECVF).

    PubMed

    Quel, N G; Aragão, A Z B; Salvadori, M R; Farias, A S; Joazeiro, P P; Santos, L M B; Sá, L R M; Ferreira, A J P; Yano, T

    2013-03-23

    Escherichia coli Vacuolating Factor (ECVF) is a heat-labile, vacuolating cytotoxin produced by avian pathogenic E. coli (APEC) isolated from avian cellulitis lesions. In this report, we intend to demonstrate that purified ECVF induces the inflammatory process of cellulitis. Our group is the first to demonstrate the effect of ECVF in a histological analysis by in situ inoculation of broiler chickens with purified ECVF. The animals were inoculated with the APEC AC53 and with purified ECVF subcutaneously on their ventral surface (in the sternum region). The histological analysis showed different grades of an acute inflammatory response in the epidermis, dermis and panniculus. An increase in mRNA expression of the proinflammatory cytokine TNF-α was also demonstrated in the inflamed tissue. When ECVF was systemically administered, increased levels of TNF-α and IL-10 were observed in the serum. These results suggest that ECVF plays a key role in the inflammatory process associated with cellulitis that is mainly mediated by TNF-α. In addition, this inflammation can be downregulated by the anti-inflammatory cytokine IL-10.

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

    PubMed

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

    2013-09-01

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

  10. Infectious diseases specialist management improves outcomes for outpatients diagnosed with cellulitis in the emergency department: a double cohort study.

    PubMed

    Jain, Shilpa R; Hosseini-Moghaddam, Seyed M; Dwek, Philip; Gupta, Kaveri; Elsayed, Sameer; Thompson, Guy W; Dagnone, Robert; Hutt, Kelly; Silverman, Michael

    2017-04-01

    Three hospital emergency rooms (ERs) routinely referred all cases of cellulitis requiring outpatient intravenous antibiotics, to a central ER-staffed cellulitis clinic. We performed a retrospective cohort study of all patients seen by the ER clinic in the last 4months preceding a policy change (ER management cohort [ERMC]) (n=149) and all those seen in the first 3months of a new policy of automatic referral to an infectious disease (ID) specialist-supervised cellulitis clinic (ID management cohort [IDMC]) (n=136). Fifty-four (40%) of 136 patients in the IDMC were given an alternative diagnosis (noncellulitis), compared to 16 (11%) of 149 in the ERMC (P<0.0001). Logistic regression-demonstrated rates of disease recurrence were lower in the IDMC than the ERMC (hazard ratio [HR], 0.06; P=0.003), as were rates of hospitalization (HR, 0.11; P=0.01). There was no significant difference in mortality. Automatic ID consultation for cellulitis was beneficial in differentiating mimickers from true cellulitis, reducing recurrence, and preventing hospital admissions.

  11. [Diagnosis and therapy of a dog with an atypical eosinophilic cellulitis].

    PubMed

    Glardon, O; Pin, D

    2010-11-01

    A 6 years old female bernese mountain dog was seen for a nodular and erythemato-edematous dermatosis resistant to therapy. The histopathological exam showed a eosinophilic cellulitis with flame figures, which are caracteristic for the Wells' syndrome in human. A combined treatment with marbofloxacin and prednisolone brought first a stabilisation of the disease. The cutaneous lesions worsened however at the end of the antibiotic treatment, after reduction of the steroid dosage. The prescription of dapsone did not change the clinical image, which motivated the owner to euthanize the dog. This case report is presented to make practitioners aware of a rare but particularly challenging dermatological problem.

  12. Serratia marcescens Bullous Cellulitis in a Splenectomized Patient: A Case Report and Review of the Literature.

    PubMed

    Fournier, John B; Dabiri, Ganary; Thomas, Vinod; Skowron, Gail; Carson, Polly; Falanga, Vincent

    2016-06-01

    Serratia marcescens is a Gram-negative bacillus belonging to the Enterobacteriaceae family. Cutaneous infection with Serratia is rare, and usually occurs in immunocompromised individuals. Primary cutaneous infections are uncommon, but they are typically severe and are associated with significant morbidity and mortality. The pathogenetic factors leading to S. marcescens infection are not fully understood, but contributing virulence factors include proteases, secreted exotoxins, and the formation of biofilm. We report a case of cellulitis occurring in a splenectomized patient, which led to multiple wound debridements and a transmetatarsal amputation. This dramatic case led us to review the published literature on soft tissue infections caused by S. marcescens.

  13. Dermatitis and lymphadenitis resembling juvenile cellulitis in a four-year-old dog.

    PubMed

    Neuber, A E; van den Broek, A H M; Brownstein, D; Thoday, K L; Hill, P B

    2004-05-01

    A four-year-old, entire male toy poodle was presented with a two-and-a-half-week history of ocular discharge progressing to periorbital alopecia, depigmentation, alopecia and ulceration around the muzzle. There was also a haemorrhagic discharge from the ears, pyrexia, lethargy and generalised lymphadenopathy. The clinical, cytological, bacteriological and histopathological findings were consistent with a diagnosis of dermatitis resembling juvenile cellulitis in an adult dog. Glucocorticoid therapy led to rapid resolution of the clinical signs and the dog has remained in remission for two years after cessation of treatment.

  14. 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

  15. [Acute renal failure in a young male with cellulitis in the lower leg].

    PubMed

    Rodríguez Lorenzo, A; Martelo Villar, F

    2008-06-01

    Necrotizing fascitiis due to Streptococcus Pyogenes has a high mortality rate. Detection of the infection before it developes to the streptococcal toxic shock syndrome is quite challenging and its one of the main goals of its management because at this final stage the treatment is in most of the cases ineffective. In a secuence of events of the progression of the infection to shock, renal failure occurs before hipotension very often. We report the case of a 38-year-old patient affected by a fulminant necrotizing fascitiis by Streptococcus Pyogenes which presented at admission with lower leg cellulitis and acute renal failure.

  16. [Scrotal reconstruction after necrotizing cellulitis of the perineum and external genital organs. Apropos of 21 cases].

    PubMed

    Boukind, H; Ezzoubi, M; Chafiki, N; Alibou, F; Chlihi, A; Bahechar, N; Zerouali, O N

    1995-01-01

    The author report twenty one cases of tissue reconstruction defects secondary to necrotizing cellulitis of perineum and external genital organs, treated at the burns and plastic surgery unit of CHU Ibn Rochd of Casablanca, between 1992 and 1994. Depending on the extent of the defect, the techniques used were gracilis musculocutaneous flap in 8 cases, thigh fasciocutaneous flap in 7 cases, groin flap in 4 cases, simple skin sutures and skin grafts in one case, respectively. The morphological results were satisfactory. The mean hospital stay after reconstruction was 15 days.

  17. 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.

  18. An unusual pathogen in ambulatory care: two cases of Scedosporium soft tissue infections presenting as "unresponsive cellulitis".

    PubMed

    Misselbrook, Gary Peter; Lillie, Patrick; Thomas, Claire P

    2016-01-01

    Soft tissue infections with Scedosporium spp. are an uncommon but serious and emerging cause of infection in immunocompromised patients. Acute Medical Units (AMUs) in the UK are increasingly managing patients with cellulitis in an outpatient setting, therefore acute physicians should be aware of some of the more uncommon causes of soft tissue infection, particularly in patients not responding to initial antibiotic therapy. We present two cases of Scedosporium presenting to the AMU as cellulitis not responding to initial antibiotic therapy and outline the assessment and management of this important condition.

  19. 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.

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

    PubMed

    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

    2015-07-07

    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.

  1. Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis

    PubMed Central

    Zuhaimy, Hanis; Aziz, Hayati Abdul; Vasudevan, Suresh; Hui Hui, Siah

    2017-01-01

    Objective: To report an aggressive case of extranodal natural killer/T-cell lymphoma (NKTCL) of the ethmoid sinus presenting as orbital cellulitis Method: Case report Results: A 56-year-old male presented with right eye redness, reduced vision, and periorbital swelling for 5 weeks duration associated with a two-month history of blocked nose. The visual acuity of the right eye was 6/18. The eye was proptosed with periorbital oedema and conjunctival chemosis. The pupil was mid-dilated but there was no relative afferent pupillary defect. The fundus was normal. The extraocular movements were restricted in all directions of gaze. Nasal endoscopy revealed pansinusitis that corresponded with CT scan orbit and paranasal sinuses findings. Despite treatment, he showed no clinical improvement. Ethmoidal sinus biopsies performed revealed extranodal NKTCL. Further imaging showed involvement of the right orbital contents and its adnexa with intracranial extension into the right cavernous sinus and meninges over right temporal fossa. The patient underwent chemotherapy. However he succumbed to his illness two months after the diagnosis. Conclusion: Extranodal NKTCL is a great mimicker. This case demonstrated how an acute initial presentation of extranodal NKTCL can present as orbital cellulitis with pansinusitis. PMID:28194321

  2. Pneumopathie interstitielle diffuse révélant la leucémie-lymphome à cellules T de l’adulte HTLV1+

    PubMed Central

    Bouanani, Nouama; Lamchahab, Mouna

    2016-01-01

    La leucémie/lymphome à cellules T de l'adulte est une prolifération tumorale de cellules lymphoïdes T matures activées, dont l'agent étiologique est le rétrovirus humain T cell-leukemia virus type 1, ce virus entraine rarement des désordres inflammatoires bronchioloalveolaires. Nous rapportons l'observation d'un patient hospitalisé pour une pneumopathie interstitielle diffuse et dont le bilan étiologique a révélé une leucémie lymphome à cellules T de l'adulte HTLV1+. PMID:28292112

  3. Alcaligenes faecalis Cellulitis After a Dog Bite: Case Report and Literature Review.

    PubMed

    Chu, Andrew S; Harkness, Julia

    2016-01-12

    Alcaligenes faecalis is a gram-negative organism that is commonly found in the environment and may also be a part of normal fecal flora in humans. Although various infections with this bacteria have been described in the pediatric population, it has not been previously identified in infections as the pathogen after a dog bite. A case of a 19-month-old boy is presented with a cellulitis secondary to a dog bite, which failed oral antibiotic therapy, and progressed to worsening fever and swelling. The patient ultimately required hospitalization, intravenous antibiotics, and incision and drainage. The wound culture grew A. faecalis, whose identity was confirmed through recombinant DNA sequence analysis. Although it has been identified in cat bite wounds, A. faecalis has not been cited in the literature before in an infection after a dog bite.

  4. Osteomyelitis of Maxilla in Infantile With Periorbital Cellulitis: A Case Report.

    PubMed

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

    2015-10-01

    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.

  5. Dermatitis and cellulitis in leopard geckos (Eublepharis macularius) caused by the Chrysosporium anamorph of Nannizziopsis vriesii.

    PubMed

    Toplon, D E; Terrell, S P; Sigler, L; Jacobson, E R

    2013-07-01

    An epizootic of ulcerative to nodular ventral dermatitis was observed in a large breeding colony of 8-month to 5-year-old leopard geckos (Eublepharis macularius) of both sexes. Two representative mature male geckos were euthanized for diagnostic necropsy. The Chrysosporium anamorph of Nannizziopsis vriesii (CANV) was isolated from the skin lesions, and identification was confirmed by sequencing of the internal transcribed spacer region of the rRNA gene. Histopathology revealed multifocal to coalescing dermal and subcutaneous heterophilic granulomas that contained septate fungal hyphae. There was also multifocal epidermal hyperplasia with hyperkeratosis, and similar hyphae were present within the stratum corneum, occasionally with terminal chains of arthroconidia consistent with the CANV. In one case, there was focal extension of granulomatous inflammation into the underlying masseter muscle. This is the first report of dermatitis and cellulitis due to the CANV in leopard geckos.

  6. Serum sickness-like reaction after the treatment of cellulitis with amoxicillin/clavulanate.

    PubMed

    Patterson-Fortin, Jeffrey; Harris, Che Mathew; Niranjan-Azadi, Ashwini; Melia, Michael

    2016-10-18

    Serum sickness-like reaction is a rare disease presentation. We describe a case of a man aged 58 years who presented with acute-onset polyarthralgia, intense pruritus of hands and feet, fever to 39.5°C and leucocytosis to 17.2×10(3)/mm(3) 5 days after completing a 10-day course of amoxicillin/clavulanate for the treatment of finger cellulitis. With history, symptoms, physical examination findings and reported cases in the literature of serum sickness-like reactions to amoxicillin, a clinical diagnosis of serum sickness-like reaction was made. The patient was treated with non-steroidal anti-inflammatories with improvement in symptoms by the time of discharge.

  7. 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.

  8. Leprosy type-I reaction episode mimicking facial cellulitis-the importance of early diagnosis*

    PubMed Central

    Fernandes, Tania Rita Moreno de Oliveira; Brandão, Graziele Áquila de Souza; Souza, Bruno de Castro e

    2015-01-01

    Leprosy is aneasily recognizable disease due to its dermato-neurological manifestations. It must be present in the physician’s diagnostic repertoire, especially for those working in endemic areas. However, leprosy reaction is not always easily recognized by non-dermatologists, becoming one of the major problems in the management of patients with leprosy, as it presents clinical complications characterized by inflammatory process, accompanied by pain, malaise and sometimes the establishment or worsening of the patient’s disabilities. We report the case of a patient with type-1 periorbital reaction admitted to the hospital, diagnosed and treated as facial cellulitis, whose late diagnosis may have contributed to the appearance or worsening of facial neuritis. PMID:26312679

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

    PubMed

    Zhang, Shuping; Wilson, Floyd; Pace, Lanny

    2006-03-01

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

  10. 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

  11. Negative pressure wound therapy aids recovery following surgical debridement due to severe bacterial cellulitis with abdominal abscess post-cesarean

    PubMed Central

    Young, Christopher N.J.; Ng, Ka Ying Bonnie; Webb, Vanessa; Vidow, Sarah; Parasuraman, Rajeswari; Umranikar, Sameer

    2016-01-01

    Abstract Introduction: Bacterial cellulitis post-Cesarean section is rare. Negative pressure wound therapy (NPWT) is widely used in various medical specialities; its effectiveness in obstetrics however remains the topic of debate—used predominantly as an adjunct to secondary intention specific to high-risk patient groups. Its application in the treatment of actively infected wounds post-Cesarean is not well documented. Here, we document NPWT in the treatment of an unusually severe case of bacterial cellulitis with abdominal abscess postpartum. We provide a unique photographic timeline of wound progression following major surgical debridement, documenting the effectiveness of 2 different NPWT systems (RENASYS GO and PICO, Smith & Nephew). We report problems encountered using these NPWT systems and “ad-hoc” solutions to improve efficacy and patient experience. A 34-year-old primiparous Caucasian female with no prior history or risk factors for infection and a normal body mass index (BMI) presented with severe abdominal pain, swelling, and extensive abdominal redness 7 days postemergency Cesarean section. Examination revealed extensive cellulitis with associated abdominal abscess. Staphylococcus aureus was identified in wound exudates and extensive surgical debridement undertaken day 11 postnatally due to continued febrile episodes and clinical deterioration, despite aggressive intravenous antibiotic therapy. Occlusive NPWT dressings were applied for a period of 3 weeks before discharge, as well as a further 5 weeks postdischarge into the community. NPWT was well tolerated and efficacious in infection clearance and wound healing during bacterial cellulitis. Wound healing averaged 1 cm2 per week before NPWT withdrawal; cessation of NPWT before full wound closure resulted in significantly reduced healing rate, increased purulent discharges, and skin irritation, highlighting the efficacy of NPWT. Five-month follow-up in the clinic found the wound to be fully

  12. L'effet de p53 sur la radiosensibilité des cellules humaines normales et cancéreuses

    NASA Astrophysics Data System (ADS)

    Little, J. B.; Li, C. Y.; Nagasawa, H.; Huang, H.

    1998-04-01

    The radiosensitivity of normal human fibroblasts in p53 dependent and associated with the loss of cells from the cycling population as the result of an irreversible G1 arrest; cells lacking normal p53 function show no arrest and are more radioresistant. Under conditions in which the repair potentially lethal radiation damage is facilitated, the fraction of cells arrested in G1 is reduced and survival is enhanced. The response of human tumor cells differs significantly. The radiation-induced G1 arrest is minimal or absent in p53+ tumor cells, and loss of normal p53 function has no consistent effect on their radiosensitivity. These results suggest that p53 status may not be a useful predictive marker for the response of human solid tumors to radiation therapy. La radiosensibilité des fibroblastes diploïdes humains est liée à l'expression de p53, et à la perte de cellules en cycle résultant d'un arrêt irréversible en phase G1 ; dans les cellules n'ayant pas une fonction p53 normale, on ne constate aucun arrêt, et elles sont plus radio-résistantes. Dans des conditions favorables à la réparation de lésions potentiellement léthales dues à l'irradiation, la proportion de cellules bloquées en phase G1 baisse, et les chances de survie sont accrues. Bien différente est la réaction des cellules cancéreuses humaines. Le blocage par irradiation en phase G1 est minime ou inexistant dans les cellules cancéreuses p53^+, et la perte de la fonction normale p53 n'a pas d'effet constant sur leur radiosensibilité. Ces résultats laissent penser que l'expression de p53 n'est pas un indice fiable permettant de prévoir la réaction des tumeurs solides à la radiothérapie.

  13. Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

    PubMed Central

    Kong, Benjamin Y.; Chou, Shaun; Wakade, Deepal; Carlino, Matteo S.; Fernandez-Penas, Pablo

    2017-01-01

    There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event. PMID:28182109

  14. Carcinome neuroendocrine à grandes cellules primitif du sein: une tumeur rare chez l’homme

    PubMed Central

    Safini, Fatima; Bouchbika, Zineb; Bennani, Zineb; Belkheiri, Sara; Attar, Hicham El; Benchakroun, Nadia; Jouhadi, Hassan; Tawfiq, Nezha; Sahraoui, Souha; Benider, Abdellatif

    2016-01-01

    Le carcinome neuroendocrine à grandes cellules primitif du sein est une entité extrêmement rare. Moins de dix cas ont été rapportés dans la littérature. Nous présentons un nouveau cas survenu chez un homme de 61 ans qui s’est présenté pour une tumeur localement avancée du sein droit d’emblée métastatique aux poumons et à la plèvre, classée cT4bN1M1. Le patient avait reçu huit cycles de chimiothérapie à base de Docetaxel tous les 21 jours, avec une bonne réponse clinique et radiologique (>50%), puis mis sous hormonothérapie à base de tamoxifène avec une stabilisation pendant 18 mois. L’étude immuni-histochimique reste indispensable pour déterminer la nature neuroendocrine de cette tumeur. Le traitement n’est pas bien codifié vu la rareté de ce type de cancer. PMID:28292162

  15. A case of cellulitis of the hands caused by a predatory bird attack

    PubMed Central

    Khan, M Adil Abbas; Farid, Mohammed; Sobani, Zain A; Ali, Syed Nadir; Malick, Huzaifa; Baqir, Maryam; Sharif, Hasanat; Beg, M Asim

    2011-01-01

    Many species have been drastically affected by rapid urbanization. Harris's hawks from their natural habitat of open spaces and a supply of rodents, lizards and other small prey have been forced to change their natural environment adapting to living in open spaces in sub- and peri-urban areas. Specific areas include playgrounds, parks and school courtyards. The migration of this predatory species into these areas poses a risk to individuals, and especially the children are often attacked by claws, talons and beaks intentionally or as collateral damage while attacking rodent prey. In addition, the diverse micro-organisms harbored in the beaks and talons can result in wound infections, presenting a challenge to clinical management. Here we would like to present a case of an 80-year-old man with cellulitis of both hands after sustaining minor injuries from the talons of a Harris's hawk and review the management options. We would also like to draw attention to the matter that, even though previously a rarity, more cases of injuries caused by birds of prey may be seen in hospital settings. PMID:23569751

  16. 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.

  17. Peritonsillar abscess and cellulitis and their relation to a positive antigen detection test for streptococcal infection.

    PubMed

    Risberg, Stefan; Engfeldt, Peter; Hugosson, Svante

    2010-10-01

    The microbiological cause of peritonsillar abscess and the role of group A β-haemolytic Streptococcus (GAS) are unclear. We performed a retrospective study at the ear, nose and throat clinic (ENT) of Orebro University Hospital, Sweden, and included 376 events of peritonsillitis between 2002 and 2004. We determined if the patients had visited a primary healthcare centre (PHCC) within 30 days prior to inclusion. The results of the rapid antigen detection test for GAS (Strep A) taken at the PHCC were compared with the occurrence of peritonsillar abscess (PTA) and peritonsillar cellulitis (PTC). A Strep A test was performed in 61% (229/376) of the events studied. Strep A was positive in 22% of PTA events and in 35% of PTC events (p = 0.036). Of 48,000 Strep A tests taken in primary healthcare, mainly for sore throat, 22% were positive. We examined the relationship between age, the incidence of PTA, and positive Strep A tests. We also determined if there was a monthly correlation between number of positive Strep A tests and number of PTA events. We found no significant correlations. In conclusion, our findings indicate that GAS does not play a major role in the development of PTA/PTC.

  18. Phenotypic and genotypic characterization of virulence factors of Escherichia coli isolated from broiler chickens with simultaneous occurrence of cellulitis and other colibacillosis lesions.

    PubMed Central

    Gomis, S M; Riddell, C; Potter, A A; Allan, B J

    2001-01-01

    The objective of this study was to characterize virulence factors of Escherichia coli isolates from broilers with simultaneous occurrence of cellulitis and other colibacillosis lesions. Thirty flocks were sampled and 237 birds with cellulitis were examined. Eighty-two (34.6%) of 237 birds condemned for cellulitis had gross lesions in the heart, air sacs, joints, or liver. In 58 chickens, E. coli was isolated from both the cellulitis and other lesions of colibacillosis, and 18.9% of the E. coli isolates from the 2 types of lesions belonged to the same O group. Escherichia coli of serogroups O78, O1, and O2 predominated. Isolates of the same serogroup that were derived from different lesions in the same birds had similar patterns of biotype, aerobactin production, serum sensitivity profile, antibiotic sensitivity, and K1 capsule production. Escherichia coli derived from cellulitis lesions produced virulence factors similar to those found in E. coli isolated from other colibacillosis lesions in poultry. PMID:11227188

  19. 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

  20. [Infectious cellulitis of the face complicating injection for esthetic nasolabial sulcus by hyaluronic acid: report of seven cases].

    PubMed

    Chader, H; Bosc, R; Hersant, B; Lange, F; Hermeziu, O; Zehou, O; Chosidow, O; Meningaud, J-P

    2013-12-01

    We report a case series of seven patients with bacterial cellulitis of the face complicating a filler injection for cosmetic reason, treated in a university hospital from 2005 to 2012. There were seven women aged 34 to 57 years. Two patients had a deep collection requiring surgical excision combined with antibiotics. Five patients were treated with antibiotics only. In two cases the bacteria was found streptococcus A and in one case Staphylococcus aureus. One patient required hospitalization in an intensive care unit. Only patients who needed surgical treatment showed moderate aesthetic sequelae.

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

    NASA Astrophysics Data System (ADS)

    Homier, Ram

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-09-01

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

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

    NASA Technical Reports Server (NTRS)

    Valentine, E Floyd

    1935-01-01

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

  4. Non-suppurative cellulitis: risk factors and its association with Staphylococcus aureus colonization in an area of endemic community-associated methicillin-resistant S. aureus infections.

    PubMed

    Eells, S J; Chira, S; David, C G; Craft, N; Miller, L G

    2011-04-01

    Suppurative methicillin-resistant Staphylococcus aureus (MRSA) skin infections are common and associated with MRSA colonization, but little is known about non-suppurative cellulitis and its relationship with MRSA colonization in areas endemic for community-associated MRSA. We prospectively enrolled patients hospitalized for non-suppurative cellulitis (n=50) and matched controls (n=100) and found S. aureus colonization was similar in cases and controls (30% vs. 25%, P=0·95). MRSA was uncommon in cases (6%) and controls (3%) (P=0·39). All MRSA isolates were USA300 by pulsed-field gel electrophoresis. Independent risk factors for non-suppurative cellulitis were diabetes (OR 3·5, 95% CI 1·4-8·9, P=0·01) and homelessness in the previous year (OR 6·4, 95% CI 1·9-20·9, P=0·002). These findings suggest that MRSA may only rarely be causative of non-suppurative cellulitis.

  5. 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

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

    PubMed Central

    Kaszkin-Bettag, Marietta

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  8. 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.

  9. 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

  10. Tumeur à cellules de Sertoli-Leydig de l’ovaire: à propos d’un cas chez une jeune fille de 22 ans

    PubMed Central

    Moussa, Diallo; Aziz, Diouf Abdoul; Niassy, Diallo Astou Coly; Espérence, Koulimaya Cyre; Youssou, Niang; Charles, Moreau Jean; Alassane, Diouf

    2016-01-01

    Les tumeurs à cellules de Sertoli et Leydig sont des tumeurs sécrétantes rares du mésenchyme et des cordons sexuels. Cependant elles constituent l’une des tumeurs le souvent responsables de syndrome de virilisation. La certitude diagnostique est histologique après la chirurgie et il n’ y'a pas de signe échographie spécifique malgré la forte présomption clinique. Le pronostic comme la plupart des néoplasies est lié au degré de différenciation cellulaire et la présence d’éléments hétérologue en leur sein. L’objectif de notre travail était de rapporter un authentique syndrome de virilisation chez une jeune fille de 22 ans secondaire à une tumeur non épithéliale de l’ovaire à cellule de Sertoli et à cellule de Leydig. Les formes peu différenciées des tumeurs de Sertoli-Leydig ont un potentiel de malignité non négligeable. Le traitement est chirurgical, la chimiothérapie par association de sels de platine et de taxanes constitue un adjuvant intéressant. Le pronostic après la chirurgie est dominé par des récidives. PMID:28154727

  11. Supermicrosurgical anastomosis of superficial lymphatic vessel to deep lymphatic vessel for a patient with cellulitis-induced chronic localized leg lymphedema.

    PubMed

    Yamamoto, Takumi; Koshima, Isao

    2015-01-01

    Supermicrosurgical lymphaticovenular anastomosis (LVA) has been reported to be useful for the treatment of obstructive lymphedema. However, LVA has a potential risk of anastomosis site thrombosis. It is more physiological to use a lymphatic vessel as a recipient vessel of lymphatic bypass surgery, because there is no chance for blood to contact the anastomosis site. We report a chronic localized lower leg lymphedema case treated with supermicrosurgical superficial-to-deep lymphaticolymphatic anastomosis (LLA). A 66-year-old male with a 60-year history of cellulitis-induced left lower leg lymphedema suffered from very frequent episodes of cellulitis and underwent LLA under local infiltration anesthesia. LLA was performed at the dorsum of the left foot. A dilated superficial lymphatic vessel was found in the fat layer, and a nondilated intact deep lymphatic vessel was found along the dorsalis pedis artery below the deep fascia. The superficial lymphatic vessel was supermicrosurgically anastomosed to the deep lymphatic vessel in a side-to-end fashion. After the surgery, the patient had no episodes of cellulitis, and the left lower leg lymphedematous volume decreased. Superficial-to-deep LLA may be a useful option for the treatment of secondary lymphedema due to obstruction of only the superficial lymphatic system.

  12. 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

  13. Lymphome B à grandes cellules primitif du médiastin chez la femme: à propos de cinq cas

    PubMed Central

    Ouassou, Safaa; Herrak, Laila; Achachi, Leila; Nachite, Fatima; Znati, Kaoutar; Ftouh, Mustapha El

    2016-01-01

    Le lymphome médiastinal primitif à grandes cellules B (LBPM) est un lymphome survenant dans le médiastin antérieur à partir des cellules B de la zone médullaire thymique. Il s’agit d’une entité rare qui présente des particularités tant sur le plan épidémiologique, clinique et évolutif, que sur le plan anatomo-pathologique et immuno-histochimique. Nous rapportons une série de 5 patientes hospitalisées au service de pneumologie de l’hôpital Ibn Sina entre Janvier 2012 et Mai 2016, et chez qui on a retenu le diagnostic de LBPM. L’âge moyen était de 34 ans, le délai moyen de consultation était de 2 mois. Les symptômes rapportés étaient la dyspnée, la douleur thoracique, la toux sèche; deux patientes présentaient un syndrome cave supérieur. Le taux de LDH était élevé chez 4 patientes. L’imagerie thoracique montrait chez les 5 patientes un processus tissulaire médiastinal antérieur. Le diagnostic histologique était posé sur ponction biopsie transpariétale scanno-guidée chez les 5 patientes, et l’apport de l’immunohistochimie était déterminant dans tous les cas. Les patientes ont été adressées à l’institut national d’oncologie pour prise en charge thérapeutique. Le pronostic du LBPM est réservé, il survient volontiers chez des femmes jeunes, ce qui rend d’autant plus nécessaire une thérapeutique agressive afin d’améliorer le taux de survie. PMID:27795778

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

    PubMed Central

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

    2016-01-01

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

  15. 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.

  16. Nasal Type Extranodal Natural Killer/T (NK/T) Cell Lymphoma Presenting as Periorbital Cellulitis: A Case Report

    PubMed Central

    Shawabkeh, Ma’in Ali Al; Sulaiti, Mansour Al; Sa’ey, Hamad Al; Ganesan, Shanmugam

    2016-01-01

    Patient: Male, 25 Final Diagnosis: Nasal type • extra nodal NK/T-cell lymphoma Symptoms: Left periorbital swelling • redness • pain for 25 days • yellowish eye discharge associated • headache • fever Medication: — Clinical Procedure: — Specialty: Otolaryngology Objective: Unusual clinical course Background: Extranodal lymphoma of the paranasal sinuses is a rare clinical entity seen in only 5–8% of extranodal lymphomas of the head and neck. Nasal natural killer/T cell lymphoma (Nasal NKTCL), which is a subtype of peripheral T cell lymphoma, constitutes about 1.4% of all lymphomas. NKTCL is usually diagnosed at a late stage because it presents with nonspecific symptoms in the early stages. Case Report: We report the case of a 25-year-old male patient who presented with periorbital swelling treated as fungal sinusitis but proven to have NKTCL. We review the literature and discuss the clinical manifestations of the disease, its relation to EBV virus, the histological and radiological characteristics, the prognostic indicators, and treatment options. This case report shows physicians that NKTCL lymphoma can present as periorbital cellulitis, although few similar cases are found in the literature. Conclusions: NKTCL is a destructive midline tumor that should be kept in mind as a differential diagnosis of paranasal sinus lesions to help in early diagnosis, which can improve the prognosis. PMID:27932776

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

    NASA Astrophysics Data System (ADS)

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

    1998-04-01

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

  18. 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.

  19. 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

    2014-05-16

    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

  20. 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.

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

    PubMed

    Kato, Hirofumi; Sasaki, Shugo; Sekiya, Noritaka

    2016-06-01

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

  2. Perianal streptococcal cellulitis

    MedlinePlus

    ... acute glomerulonephritis ) Severe skin and soft tissue infection ( necrotizing fasciitis ) When to Contact a Medical Professional Call ... of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, ...

  3. What Is Cellulitis?

    MedlinePlus

    ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians and Nurses ...

  4. Tonsillar Cellulitis and Abscess

    MedlinePlus

    ... redness of the tonsils, white patches (exudates), swollen lymph nodes in the neck, and severe bad breath ( ... and tries to draw out pus. Treatment Antibiotics Drainage of pus Sometimes tonsillectomy Antibiotics, such as penicillin ...

  5. 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

  6. Campylobacter fetus infection presenting with bacteremia and cellulitis in a 72-year-old man with an implanted pacemaker: a case report

    PubMed Central

    2012-01-01

    Introduction Campylobacter is an important causative agent of intestinal infections in humans. Bacteremia is detected in less than 1% of patients, mainly in immunocompromised patients and in extreme age groups. Cellulitis is a relatively common manifestation of Campylobacter infection, but concomitant bacteremia is a rare event. Infections of the pacemaker area are caused primarily by staphylococci, followed by fungi, streptococci and Gram-negative rods. To the best of our knowledge, this is the first case report of pacemaker pocket infection and bacteremia caused by Campylobacter fetus. Case presentation A 72-year-old Croatian Caucasian man with myelodysplasia, impaired fasting glucose levels and a recently implanted permanent pacemaker was admitted to hospital after six days of fever, development of red swelling of the pacemaker pocket area and worsening of his general condition. No antibiotic therapy was introduced in the outpatient setting. He denied any recent gastrointestinal disturbances. With the exception of an elevated leukocyte count, erythrocyte sedimentation rate, and C-reactive protein and blood glucose levels, other laboratory findings were normal. Treatment with vancomycin plus netilmicin was introduced, and a surgical incision with drainage of the pacemaker pocket was performed. The entire pacemaker system was removed and a new one re-implanted after 14 days of antibiotic therapy. Transesophageal echocardiography showed no pathological findings. Three subsequent blood cultures obtained on admission as well as swab culture of the incised pacemaker area revealed Campylobacter fetus; stool and pacemaker lead cultures were negative. According to the microbiological results, antibiotic therapy was changed to ciprofloxacin plus netilmicin. A clinical examination and the results of a laboratory analysis performed after two weeks of therapy were within normal limits. Conclusion Myelodysplasia, impaired fasting glucose levels and older age could be

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

    NASA Astrophysics Data System (ADS)

    Lebeuf, Martin

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

  8. Community-acquired methicillin-resistant Staphylococcus aureus: skin infection presenting as an axillary abscess with cellulitis in a college athlete.

    PubMed

    Cohen, Philip R

    2005-01-01

    A healthy 19-year-old black man without any methicillin-resistant Staphylococcus aureus risk factors developed axillary boils after he began lifting weights at the university gym in Houston, TX. He presented with a large tender erythematous fluctuant abscess of his right axillae and a superiorly located smaller painful red indurated nodule; the surrounding cellulitis extended into the adjacent tissue (Figure). The abscess was incised, drained, and cultured. Empiric treatment with cephalexin 500 mg q.i.d. was given for 7 days. The culture grew methicillin-resistant S. aureus. Susceptibility testing of the S. aureus isolate was performed by Laboratory Corp. of America (Houston, TX); the Vitek system (Biomerieux, Hazelwood, MO) was used, and the specimen was incubated for 8 hours. Confirmation of methicillin resistance was performed using a methicillin-resistant S. aureus plate and the specimen was incubated for 24 hours. In addition to resistance to methicillin, the bacterial isolate was also resistant to ciprofloxacin, erythromycin, and penicillin. The S. aureus strain had intermediate susceptibility to levofloxacin and was susceptible to clindamycin, gentamicin, rifampin, tetracycline, trimethoprim/sulfamethoxazole, and vancomycin. The infection persisted and the antibiotic was changed to double strength trimethoprim/sulfamethoxazole, taken twice daily for 15 days. In addition, topical care included lesional and intranasal application of mupirocin 2% ointment and daily cleaning of the area with 10% povidone-iodine liquid soap. The skin infection completely resolved without recurrence within 2 weeks.

  9. Régulation de la production, par des cellules endothéliales, de cytokines pro-inflammatoires après irradiation

    NASA Astrophysics Data System (ADS)

    van der Meeren, A.; Lafont, H.; Mathé, D.

    1998-04-01

    Gamma irradiation leads to an increased production of interleukin- (IL)-6 and IL-8 by human endothelial cells. In order to regulate the radio-induced production of these pro-inflammatory cytokines, we used the immunoregulatory cytokines IL-4 and IL-10. These agents were added either before or after a 10 Gy-irradiation. Our results show that it is possible to decrease the radio-induced production of IL-6 and IL-8 with the use of IL-4 and IL-10. Differences in the intensity of the response have been observed according to the time of treatment. The anti-inflammatory potential of both IL-4 and IL-10 was more pronounced when added after irradiation. Après irradiation gamma, des cellules endothéliales humaines ont une production accrue des interleukines (IL-) -6 et -8. Dans le but de réguler la production de ces cytokines pro-inflammatoires, nous avons utilisé des cytokines dites anti-inflammatoires, l'IL-4 et l'IL-10. Ces agents ont été ajoutés soit avant soit après une irradiation de 10Gy. Nos résultats montrent qu'il est possible de diminuer les productions radio-induites d'IL-6 et d'IL-8 par l'IL-4 et l'IL-10. Des différences dans l'intensité de la réponse ont toutefois été observées selon que l'IL-4 ou l'IL-10 ont été ajoutées avant ou après irradiation; leur efficacité anti-inflammatoire étant plus marquée lorsque les cytokines sont ajoutées après l'irradiation.

  10. 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.

  11. Infantile Maxillary Sinus Osteomyelitis Mimicking Orbital Cellulitis

    PubMed Central

    Krishnan, Nagarajan; Ramamoorthy, Nathan; Panchanathan, Suresh; Balasundaram, Jothiramalingam S

    2014-01-01

    Periorbital soft tissue swelling may result due to primary orbital pathology or from adjacent facio-maxillary or sino-nasal inflammatory causes. Osteomyelitis of maxilla in the pediatric age group is a rare entity in this era of antibiotics. We present an 11-month-old female infant who was brought with peri-orbital selling and purulent nasal discharge. Computed Tomography showed erosions of the walls of maxillary sinus suggestive of osteomyelitis. Culture of sinus scraping showed Staphylococcus aureus growth and the child improved with intravenous cloxacillin therapy. This case is presented due to the rarity of its presentation in this age group and for awareness to consider this entity in children having fever and peri-orbital swelling. PMID:25191055

  12. Intracranial brain abscess preceded by orbital cellulitis and sinusitis.

    PubMed

    Yeh, Chung-Hsin; Chen, Wen-Chao; Lin, Maggie S F; Huang, Hua-Tzu; Chao, Shih-Chun; Lo, Yi-Chen

    2010-05-01

    A 17-year-old boy with pyrexia, headache, and frequent drop attacks reported an acute onset of periorbital pain and swelling 1 month previously. Coronal computed tomography (CT) identified an ethmoid sinusitis, which was treated with functional endoscopic sinus surgery and intravenous gentamicin, prostaphylline, and metronidazone. Because of persistent symptoms, the patient returned 1 month later. The CT identified accumulation of debris in both frontal sinuses and a multilobulated lesion over the right frontal lobe. Bicoronal craniotomy was performed, and a mass located in the right frontal lobe was excised; the mass comprised chronic inflammatory tissues without evidence of malignancy. A postoperative brain CT confirmed the absence of a residual mass, and no recurrence or neurologic deficits were noted during the 3-month follow-up period. Intracranial complications cannot be prevented entirely even with the judicious use of antibiotics. Early application of the appropriate imaging modality and institution of aggressive therapy in any patient, not just pediatric patients, to prevent potential long-term disabilities and death are essential.

  13. Ciprofloxacin-resistant Aeromonas hydrophila cellulitis following leech therapy.

    PubMed

    Giltner, Carmen L; Bobenchik, April M; Uslan, Daniel Z; Deville, Jaime G; Humphries, Romney M

    2013-04-01

    We report a case of surgical site infection with ciprofloxacin-resistant Aeromonas hydrophila following leech therapy. Antimicrobial and genetic analyses of leech and patient isolates demonstrated that the resistant isolates originated from the leech gut microbiota. These data suggest that ciprofloxacin monotherapy as a prophylaxis regimen prior to leech therapy may not be effective in preventing infection.

  14. Ciprofloxacin-Resistant Aeromonas hydrophila Cellulitis following Leech Therapy

    PubMed Central

    Giltner, Carmen L.; Bobenchik, April M.; Uslan, Daniel Z.; Deville, Jaime G.

    2013-01-01

    We report a case of surgical site infection with ciprofloxacin-resistant Aeromonas hydrophila following leech therapy. Antimicrobial and genetic analyses of leech and patient isolates demonstrated that the resistant isolates originated from the leech gut microbiota. These data suggest that ciprofloxacin monotherapy as a prophylaxis regimen prior to leech therapy may not be effective in preventing infection. PMID:23363826

  15. 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.

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

    PubMed

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

    2015-02-01

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

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

    NASA Technical Reports Server (NTRS)

    Noyes, Richard W

    1933-01-01

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

  18. 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.

  19. Cellulitis in a Liver Transplant Patient as an Initial Manifestation of Disseminated Cryptococcal Disease

    PubMed Central

    Gomes de Sousa, Marcos Davi; Bernardes Filho, Fred; Barros Costa Fernandes, Luís Eduardo; Guedes Leal, Cássia Regina; Rocha Magalhães, Cristiane; Custódio Neto da Silva, Marcos Antonio; Silva Barcaui, Halime

    2016-01-01

    A 50-year-old male underwent liver transplantation due to cryptogenic cirrhosis and was admitted with severe pain in the left leg as well as phlogosis. Amoxicillin/clavulanic acid was prescribed, assuming bullous erysipelas. Among the tests performed, the latex agglutination test for the Cryptococcus sp. antigen was positive, and in both the blood culture and blister culture Cryptococcus sp. was isolated. Daily fluconazole was started. Even though liposomal amphotericin B has been started on the fifth day of hospitalization, the patient progressed to death. PMID:28101016

  20. 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.

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

    PubMed Central

    Martens, Sabrina M.

    2016-01-01

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

  2. 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

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

    PubMed

    Chakrabortti, Alolika; Li, Jinming; Liang, Zhao-Xun

    2016-07-21

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

  4. 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

  5. Integrated Airframe Design Technology (Les Technologies pour la Conception Integree des Cellules)

    DTIC Science & Technology

    1993-12-01

    such assembled early in design and then evolved as, "Can X performance be built for Y cost"? from conceptual design through manufacture. The benefits of...can incorporate manufacturing and de- and X -terminal environment especially suit- tail design considerations in the conceptual and ble for the...while static RAM (SRAM) does not. subquarter micron (< 0.25 x 10-6 m); and b) increasing the However. advances in DRAM permit double the amount of speed

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

    PubMed

    Barkey, Elisabeth; Kaszkin-Bettag, Marietta

    2012-05-01

    大拿山金车 (Arnica montana)是一 种菊 (Compositae) 科植物,在用 于缓解肌肉和关节疼痛和/或炎 症方面具有悠久历史,因此有望 成为非甾体类抗炎药的替代品, 而这些非甾体类抗炎药往往效果 不佳或容易导致许多负面作用。 顺势山金车药贴(根据《美国顺 势疗法药典》(Homeopathic Pharmacopoeia of the United States) 3 倍稀释)已开发用于缓解背部和 颈部肌肉及关节疼痛症状。案例简报: 此案例报告描述了一 位 55 岁的女性患者因手掌部位患 蜂窝织炎而出现右手疼痛,第四 指麻痹后,接受山金车药贴治疗 的效果。她曾接受抗生素治疗蜂 窝组织炎,但即使口服布洛芬并 口服及局部外用含山金车的复合 顺势疗法的产品,疼痛症状仍维 持在视觉模拟量表 (visual analog scale, VAS)(将疼痛分为 0 至 10 级)中的 7 级。医生向该患者配发了十张山金车 药贴。她将药贴裁成条状贴在手 上所有疼痛的部位,并在夜间用 药。3 天后,她报告疼痛症状大为 减轻 (VAS = 1) 且麻木的症状和 第三掌骨部位疼痛结节的大小均 显著减小。此外,该患者还能够 彻夜安睡而不被疼醒。在接下来 的 2 天里,症状进一步缓解。 结论: 此案例证实,在患者手上 施用山金车药贴后,经过相对较 短的时间,可显著减轻疼痛并恢 复手部功能。

  7. 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.

  8. Cirrhosis, cellulitis and cats: a 'purrfect' combination for life-threatening spontaneous bacterial peritonitis from Pasteurella multocida.

    PubMed

    Hey, Penelope; Gow, Paul; Torresi, Joseph; Testro, Adam

    2012-11-11

    Pasteurella multocida is a Gram-negative coccobacillus that colonises the upper airways of many animals, in particular, dogs and cats. It acts as an opportunistic infection in humans following an animal bite or scratch and is associated with soft tissue infections, septicaemia and pneumonia, particularly in patients with a compromised immune response, such as patients with liver failure. Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis with a death rate of 10-15%. We report a case of a 47-year-old man with cirrhosis who presented with life-threatening P multocida SBP and bacteraemia secondary to a lick from a cat to a cellulitic leg wound. This case highlights the potential severity of an infection from domestic animals and an otherwise innocuous organism in an immunocompromised host.

  9. Necrotizing cellulitis of the abdominal wall, caused by Pediococcus sp., due to rupture of a retroperitoneal stromal cell tumor

    PubMed Central

    Michalopoulos, Nick; Arampatzi, Stergiani; Papavramidis, Theodossis S.; Kotidis, Efstathios; Laskou, Styliani; Papavramidis, Spiros T.

    2013-01-01

    INTRODUCTION Soft tissue necrotizing infections are a significant cause of morbidity and mortality. The aim of this study is to present a patient with necrotizing infection of abdominal wall resulting from the rupture of a retroperitoneal stromal tumor. PRESENTATION OF CASE We present a 60-year-old Caucasian male patient with necrotizing infection of abdominal wall secondary to the rupture of a retroperitoneal stromal tumor. The patient was initially treated with debridement and fasciotomy of the anterior abdominal wall. Laparotomy revealed purulent peritonitis caused by infiltration and rupture of the splenic flexure by the tumor. Despite prompt intervention the patient died 19 days later. The isolated microorganism causing the infection was the rarely identified as cause of infections in humans Pediococcus sp., a gram-positive, catalase-negative coccus. DISCUSSION Necrotizing infections of abdominal wall are usually secondary either to perineal or to intra-abdominal infections. Gastrointestinal stromal cell tumors could be rarely complicated with perforation and abscess formation. In our case, the infiltrated by the extra-gastrointestinal stromal cell tumor ruptured colon was the source of the infection. The pediococci are rarely isolated as the cause of severe septicemia. CONCLUSION Ruptured retroperitoneal stromal cell tumors are extremely rare cause of necrotizing fasciitis, and before this case, Pediococcus sp. has never been isolated as the responsible agent. PMID:23357010

  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. Silencage du gene MDR1 et resensibilisation des cellules MCF-7 MDR a la doxorubicine en utilisant les nanoparticules chitosane/MDR1-siARN

    NASA Astrophysics Data System (ADS)

    El-Ariss, Mohamad

    Cancer is the leading cause of death in Canada and is responsible for about 30% of all deaths in the country.[1] It is estimated that by 2015, one in four Canadians (24% women and 29% men) will die from cancer. In the world and only for 2012, 14 million new cancer cases and 8.2 million deaths from the disease were reported.[2] The worst is yet to come because, according to World Health Organization, the number of new cases is expected to increase by about 70% over the next two decades. The high mortality associated with cancer is partly explained by the acquisition of drug resistance that make patients refractory to chemotherapy. In fact, cancer cells exposed to a cytotoxic agent during chemotherapy, may develop a resistance to this agent as well as various agents sharing structural or functional similarities. These cancer cells are known for multidrug resistance ("Multiple Drug resistant cells"). The development of resistance to chimiodrogues is a major public health problem that presents an obstacle for the development of new cancer treatments. MCF-7 MDR are established cell lines of human breast cancer that have developed resistance to chimiodrogues such as doxorubicin. MCF-7 MDR have the particularity to over-express P-gp protein that is responsible for the detoxification of cells by reflux of chimiodrogues. The purpose of this study was therefore to reduce the expression of P-gp, encoded by the MDR1 gene (also called gene ABCB1) in cancer cells MCF-7, and re-sensitize MCF-7 MDR cells to anti-cancer treatments. In order to modify MDR1 gene expression, we used small RNAi called siRNA that are specific to the MDR1 gene. In total, 4 duplexes of siRNA have been used: siRNA_1, siRNA_1M, siRNA_2 and siRNA_2M. Each of the duplexes strands is consists of 21 nucleic acids and has two protruding nucleic acids (overhangs) at the 3' end. siRNA_1 and siRNA_1M are complementary to the nucleic acid sequence (577-595 nucleic acids ) of the MDR1 gene, whereas siARN_2 and siARN_2M are complementary to a sequence shifted slightly downstream in the same gene (583-607 nucleic acids). RNA duplexes siRNA_1 and siARN_2 consist exclusively of DNA while "modifed" siRNA_1M and si RNA_2M consist of RNA overhangs. siRNA duplexes (siRNA_1 and siRNA_2) were chosen from the work published by Hao Wu et al. (2003), Stege et al. (2004) and Miletti-Gonzalez et al. (2005) which showed that these siRNA sequences are effective to silence MDR1 gene in cancer cells (breast cancer cells MCF-7 / AdrR and MCF-7 / BC-19 and stomach cancer cells: EPG85-257RDB).[3-5] Moreover, Strapps et al. (2010) showed that the use of siRNA having overhangs formed of ribonucleotides leads to a similar silencing but lasting longer in vivo and in vitro compared to the use of siRNA containing deoxyribonucleotides overhangs.[6] Thus siARN_1M and siARN_2M sequences correspond to siARN_1 and siARN_2 sequences but whose overhangs are formed of ribonucleotides. These siRNA specific to the MDR1 gene (MDR1-siRNA) were combined to chitosan to form nanoparticles capable of protecting these MDR1-siRNA and delivering it into the MCF-7 MDR cells. Chitosan used here as a delivery system, is a natural and biodegradable polysaccharide whose biological properties are defined by its average molecular weight (MW) and by its degree of deacetylation (DD). When the positively charged chitosan is added with the negatively charged siRNA, there is formation of nanoparticles by electrostatic attraction. In this project, chitosan 92-10 (DDA- MW) was used as a delivery system with a N:P (ratio chitosan amino groups: RNA phosphate) of 5. Analysis by dynamic light scattering (DLS) demonstrated that the nanoparticles have a diameter between 62.56 and 82.72 nm and a zeta potential ranging from 17.4 to 23.5 mV. Analysis by confocal microscopy showed that chitosan (92-10-5)/labeled siRNA are internalized in MCF-7 MDR cells and that siRNAs are released in the cytoplasm. MCF-7 cells resistant MDR were transfected in vitro with different chitosan nanoparticles 92-10/MDR1-siRNA. qPCR quantification showed that transfection of MCF-7 MDR cells leads to inhibition of the expression of the MDR1 gene by 71%. In addition, induced cytotoxicity tests showed that the use of nanoparticles allows resensitizing cells to doxorubicin. In fact, the mortality rate of MDR MCF-7 cells exposed to doxorubicin increased to 60% after transfecting the cells with the nanoparticles chitosane (92-10-5)/ MDR1-siRNA. In conclusion, we have developed Chitosan (92-10-5)/ MDR1-siRNA nanoparticles that reduce the expression of P-gp in cells and allow the latter to re-sensitize to Doxorubicin. This study demonstrated the potential of chitosan nanoparticles (92-10-5)/ MDR1-siRNA for the treatment of cancers resistant to chemotherapy.

  12. 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

  13. Champ dynamique dans une cellule d'échangeur à vortex : 1. Régime d'entrée laminaire

    NASA Astrophysics Data System (ADS)

    Petitot, Stéphane; Lyazid, Abdel; Devienne, René

    Numerical simulation and LDV measurements are performed for laminar inlet flow condition in a vortex exchange chamber with isothermal conditions. Newtonian and non-Newtonian fluids were used. Experimental measurements are compared to results of numerical computations with good agreement. Both show the existence of a secondary flow generated by hydrodynamical instabilities due to streamline curvature. The main vortex flow appears then to be restricted by this secondary flow.

  14. Dealing with Cuts (For Parents)

    MedlinePlus

    ... For Kids For Parents MORE ON THIS TOPIC Cellulitis First Aid: Cuts Staph Infections Bites and Scratches ... Animal Bites Blood Childproofing and Preventing Household Accidents Cellulitis How Stitches Help Kids Heal The Story on ...

  15. Hib Disease (Haemophilus Influenzae Type b)

    MedlinePlus

    ... a sore throat, drooling, and serious breathing trouble. Cellulitis . Someone with this skin infection may have skin ... For Kids For Parents MORE ON THIS TOPIC Cellulitis Immunizations Meningitis Pneumonia Why Should I Care About ...

  16. Aerodynamic Engine/Airframe Integration for High Performance Aircraft and Missiles (L’Integration Aerodynamique des Moteurs et des Cellules dans les Avions et les Missiles a Hautes Performances)

    DTIC Science & Technology

    1992-09-01

    nations. I le conimtent i 4 this putilicmtioii has beccii reproduced direct Ifr hmmi material supplied b\\ A.( iAR) iir thle authors Published September...to move in military A/C development, problem Steady and unsteady distortion of total pressures obtained with hot gas (afterburner) simulation. in...to be made with increased regard to fuel HGR Hot Gas Reingestion economy, environmental noise and first cost; the expanded use M1, MCC) M Local

  17. ETUDE QUANTITATIVE PAR RADIOAUTOGRAPHIE AU MICROSCOPE ELECTRONIQUE DE L'UTILISATION DE LA DL-LEUCINE-3H PAR LES CELLULES DE L'HYPOPHYSE DU CANARD EN CULTURE ORGANOTYPIQE

    PubMed Central

    Tixier-Vidal, A.; Picart, R.

    1967-01-01

    The synthesis, intracellular transport, storing, and excretion of proteins by duck hypophyseal cells in organ culture were studied with tritiated DL-leucine and high resolution radioautography (pulse-labeling experiments). Quantitative study of the radioautographs allowed a determination of the relative proportions of cytoplasmic radioactivity located in each cellular compartment (ergastoplasm, Golgi apparatus, and protein granules) as well as the variations in these proportions as a function of time. The number of labeled protein granules as opposed to the total number of granules in the cell was also determined (RSg). These data were separately analyzed for the two types of cells present in the explants: prolactin cells and "MSH" cells. The synthetic process follows a course common to both cell types, each of which is distinguished by its particular modalities. The labeled proteins, synthesized within several minutes in the ergastoplasm, are concentrated in the Golgi zone within 30 min. They then migrate out of this area, the emptying of which is accomplished in about 4 hr. These proteins become equally distributed between the protein granules, on the one hand, and the cytoplasm ("sedentary" proteins), on the other. The RSg reaches its maximum when the Golgi zone is emptied, but this figure remains very low (3%). The RSg then decreases slowly (1% in 40 hr). It is concluded that hypophyseal cells are able to store protein in their granules and that their processes of synthesis and excretion are not continuous. The prolactin cells differ from the "MSH" cells in that they have a slower migration of newly synthesized proteins, and these proteins pass via the dilated ergastoplasmic cisterns in which they may possibly be stored. PMID:6064363

  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. Facial swelling

    MedlinePlus

    ... transfusion reaction Cellulitis Conjunctivitis (inflammation of the eye) Drug reactions, including those due to aspirin, penicillin, sulfa, glucocorticoids, and others Head, nose, or jaw surgery ...

  20. Elevated soft tissue activity in early but not delayed phase of bone scan in Klippel-Trenaunay syndrome.

    PubMed

    Liu, Bin; Servaes, Sabah; Zhuang, Hongming

    2013-03-01

    Triple-phase bone scan is commonly used in the diagnosis of osteomyelitis. Elevated bone tracer activity in early but not delayed phase of the study favors cellulitis over osteomyelitis. We reported that Klippel-Trenaunay syndrome, a congenital disorder characterized by malformations of the capillary, venous, and lymphatic systems, can have images similar to cellulitis on triple-phase bone scan.

  1. Acute adduction deficit in a 7-week-old infant.

    PubMed

    Jain, Sunila; Goulstine, David; Gottlob, Irene

    2002-12-01

    A 7-week-old infant with sudden onset adduction deficit and proptosis is reported. The main differential diagnoses included orbital myositis, orbital cellulitis, capillary haemangioma and rhabdomyosarcoma. A CT scan revealed a postseptal cellulitis-like picture with thickening of the medial rectus muscle. He was given a course of antibiotics, withholding steroids and biopsy. His condition resolved completely on high-dose antibiotics alone. To our knowledge this is the youngest patient with infectious orbital myositis and postseptal cellulitis described in the literature. The clinical course emphasizes the importance of administering sufficiently high doses of antibiotics.

  2. Mouth ulcers

    MedlinePlus

    ... include: Canker sores Gingivostomatitis Herpes simplex ( fever blister ) Leukoplakia Oral cancer Oral lichen planus Oral thrush A ... chap 22. Read More Canker sore Cellulitis Gingivostomatitis Leukoplakia Lichen planus Mouth sores Oral cancer Tooth abscess ...

  3. Skin Infections

    MedlinePlus

    ... to the touch may have yellow drainage Of cellulitis: a red, inflamed area on the skin that is tender to the touch may occur in an area of a scratch or cut redness often spreads rapidly over the skin's surface ...

  4. Checking Out Cuts, Scratches, and Abrasions

    MedlinePlus

    ... to get rid of the infection. Luckily, most cuts, scratches, and abrasions will go away on their own, thanks to your body's amazing ability to heal ... Story on Scars Cellulitis Taking Care of Your Skin What's a Scab? ...

  5. 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 ...

  6. Superficial thrombophlebitis

    MedlinePlus

    ... Risks for thrombophlebitis include: Cancer or liver disease Deep vein thrombosis Disorders that involve increased blood clotting ( ... Possible problems may include the following: Infections ( cellulitis ) Deep vein thrombosis When to Contact a Medical Professional ...

  7. Management of orbital complications of sinusitis in pediatric patients.

    PubMed

    Kinis, Vefa; Ozbay, Musa; Bakir, Salih; Yorgancilar, Ediz; Gun, Ramazan; Akdag, Mehmet; Sahin, Muhammed; Topcu, Ismail

    2013-09-01

    The most common reason of orbital infections is sinusitis. Orbital complications of sinusitis are mostly seen in children. Loss of vision and intracranial infections are among the complications of sinusitis. Prompt diagnosis and treatment is very important in the management of orbital complications. The orbital complication can be in the form of cellulitis or abscess. A retrospective review of 26 pediatric patients with orbital complications due to sinusitis was presented in this study. Of 26 patients, there were 13 cases of preseptal cellulitis, 2 cases of orbital cellulitis, and 11 cases of subperiosteal abscess. We grouped the preseptal and orbital cellulites in one category and the subperiosteal abscess in the other. All patients in the cellulitis group recovered by medical treatment. All the patients were treated by surgical drainage. Early diagnosis and appropriate treatment method are vital for the treatment of orbital complications secondary to sinusitis.

  8. Sepsis

    MedlinePlus

    ... Bones (common in children) Bowel (usually seen with peritonitis ) Kidneys (upper urinary tract infection , pyelonephritis or urosepsis) ... More Avian influenza Cellulitis Confusion Intravenous Meningitis Osteomyelitis Peritonitis Pneumonia - adults (community acquired) Septic shock Shock Urinary ...

  9. 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 ...

  10. Fibrinopeptide A blood test

    MedlinePlus

    ... early treatment, and during a relapse Some infections Systemic lupus erythematosus ( SLE ) Risks Veins and arteries vary in size ... Elsevier Saunders; 2011:chap 39. Read More Cellulitis Systemic lupus erythematosus Review Date 3/13/2015 Updated by: Debra ...

  11. 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...

  12. 76 FR 67736 - Implementation of Section 2695 (42 U.S.C. 300ff-131) of Public Law 111-87: Infectious Diseases...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... mirrors usual infection control terminology, which will facilitate comprehension and optimal... notification, exposure alone without clinical infection would not necessitate any type ] of screening or... conditions such as wound infections or cellulitis associated with abscesses, carbuncles, or...

  13. Ludwig's angina

    MedlinePlus

    ... Complications Complications may include: Airway blockage Generalized infection ( sepsis ) Septic shock When to Contact a Medical Professional ... Mosby; 2013:chap 75. Read More Cellulitis CPR Sepsis Septic shock Tooth abscess Review Date 2/13/ ...

  14. Lymphadenitis

    MedlinePlus

    ... seen in lymphadenitis that is due to tuberculosis) Sepsis (bloodstream infection) When to Contact a Medical Professional ... More Abscess Acute Cellulitis Lymphangitis Protein in diet Sepsis Swollen lymph nodes Systemic Thrombophlebitis Review Date 5/ ...

  15. Skill Set Requirements for Nurses Deployed with an Expeditionary Medical Unit Based on Lessons Learned

    DTIC Science & Technology

    2008-01-01

    followed by a trip to the Battalion Aid Station, Forward Resuscitation Surgical Support unit, or Shock Trauma Platoon . At these stations, a physi- cian...prior months of February and March revealed that chest pain, appendicitis/status-post appen- dectomy, hernia /status-post hernia repair, and cellulitis...of the Alaris MedSystem III infusion pump (Cardinal Health, Dublin, Ohio), cellulitis, care of the patient with wounds, hernias /status-posthernia

  16. High Speed Propulsion: Engine Design - Integration and Thermal Management (Propulsion a vitesse elevee : Conception du moteur - integration et gestion thermique)

    DTIC Science & Technology

    2010-09-01

    conception et optimisation des entrées d’air, moteurs à cycle combiné, intégration moteur- cellule , gestion thermique. Le fait que plusieurs programmes de...la conception de l’unité de propulsion et son intégration dans la cellule . En premier lieu, ont été traitées la physique, la conception et

  17. Development of a Dynamic Biomechanical Model for Load Carriage: Phase II Part C&D. User’s Manual V 3.0: Dynamic Load Carriage Compliance Tester Automated Test Cell

    DTIC Science & Technology

    2005-08-01

    cellule d’essai automatisée. Le rapport a pour objet les éléments matériels et logiciels du système ainsi que les instructions d’utilisation du système. Si...fréquence des systèmes de suspension de transport de charge et 5) création d’une cellule d’essai automatisée peu coûteuse nécessitant peu de...4) détermination de la réponse en fréquence des systèmes de suspension de transport de charge et 5) création d’une cellule d’essai automatisée peu

  18. Periorbital cellulits--a mistaken diagnosis!

    PubMed

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

    2011-08-17

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

  19. Propriétés optiques du silicium mésoporeux et ses applications potentielles

    NASA Astrophysics Data System (ADS)

    Lévy-Clément, C.; Bastide, S.

    2002-04-01

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

  20. Burn to leg: full thickness lower limb burn associated with laptop power adaptor.

    PubMed

    Patel, Shivali M; Leon-Villapalos, Jorge

    2011-03-10

    There has been much media attention in recent years on laptops and their accessories overheating and even causing fires. Here, the authors report a case of a laptop power adaptor causing a full thickness burn requiring surgical intervention in a young, fit man. The total contact time was less than 1 h. Initial surgical management involved debridement and allografting of the wound due to a concomitant cellulitis. A week later, once the cellulitis had resolved, an autograft was applied. The graft take was satisfactory (100%) and the patient had a good postoperative outcome.

  1. 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.

  2. Antimicrobial therapy for skin infections.

    PubMed

    Hirschmann, Jan V

    2007-06-01

    The most common skin infections are caused by Staphylococcus aureus, group A streptococci (Streptococcus pyogenes), or the normal skin flora. An antistaphylococcal oral antibiotic is the preferred treatment for nonbullous and bullous impetigo, and a therapeutic agent that is effective against both S aureus and streptococci is appropriate for most cases of cellulitis. For furuncles, carbuncles, cutaneous abscesses, and inflamed epidermal cysts, the most important therapy is incision and drainage, and in most cases there is no need for antimicrobial therapy. Patients with venous ulcers and atopic eczema do not benefit from systemic antimicrobial therapy unless obvious infection is present, as indicated by clinical features such as fever, cellulitis, and lymphangitis.

  3. 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

  4. Extraintestinal Vibrio infections in Mauritius.

    PubMed

    Issack, Mohammad I; Appiah, Deoraz; Rassoul, Ameen; Unuth, Mahesswaree N; Unuth-Lutchun, Nehma

    2008-10-01

    Few extraintestinal Vibrio infections have been reported in the African region. We report 3 cases from Mauritius: one case of Vibrio alginolyticus otitis externa; one case of soft tissue infection caused by non-O1 Vibrio cholerae and Vibrio parahaemolyticus; and one fatal case of non-O1 V. cholerae cellulitis and septicaemia.

  5. 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.…

  6. 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

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

    PubMed

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

    2016-01-01

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

  8. Business Case Analysis: Identifying Concerns for the Continuum of Care for United States Air Force Cadets with the Implementation of Base Realignment and Close Initiatives at the Air force Academy Hospital

    DTIC Science & Technology

    2006-12-31

    a convenience for the cadet and the Academy. Criteria for this was any admission with a diagnosis of cellulitis without complications, simple...organization’s strategic plan (Woodard, et al, 1999). A proactive approach is better than a reactionary one. A poor plan can result in broad cuts

  9. 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...

  10. 38 CFR 4.104 - Schedule of ratings-cardiovascular system.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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...

  11. 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...

  12. 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...

  13. 38 CFR 4.104 - Schedule of ratings-cardiovascular system.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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...

  14. 38 CFR 4.104 - Schedule of ratings-cardiovascular system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 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...

  15. Sclerosing idiopathic orbital inflammation.

    PubMed

    Brannan, Paul A; Kersten, Robert C; Kulwin, Dwight R

    2006-01-01

    A 5-year-old girl referred for orbital cellulitis was found to have a right orbital mass. Computed tomography revealed a mass occupying the inferotemporal orbit, extending into the maxillary sinus. Biopsy yielded a diagnosis of sclerosing idiopathic orbital inflammation. She was successfully treated with prednisone.

  16. 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…

  17. An Overview of the Special Operations Interactive Medical Training Program (SOIMTP).

    DTIC Science & Technology

    2007-11-02

    carbohydrates, tendonitis, amino acids, human anatomy, sprains, strains, dislocations, and other related topics. Medical Administration by LCDR Clifton...provides information about cellulitis, urinary infections, herpes simplex, upper respiratory infections, immersion (trench) foot, otitis externa, ringworm ...Atlanta, GA : U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, (1991). 52. Pediatric Infectious

  18. Biological Detector Performance with a 402 nm Laser Diode

    DTIC Science & Technology

    2001-07-01

    conventionnelle des spores r6v&le trts peu leur contenu cellulaire . Par contre, les cellules v6g6tatives sont des meilleurs sujets A examen parce qu’elles peuvent...spores of Bacillus subtilis var niger, BG) was accomplished with a Hudson nebulizer (model 1700, Hudson Oxygen Therapy Sales Co.,Wadsworth, OH) driven

  19. Journal of Special Operations Medicine. Volume 2, Edition 4, Fall 2002

    DTIC Science & Technology

    2002-01-01

    clostridial myonecrosis must encompass other gas-forming infections, including necrotizing fasciitis , streptococ- cal myositis, acute streptococcal...REFERENCES 1. Riseman J, Zamboni W, Curtis A, et al: Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the need for...hemolytic gangrene, crepitant cellulitis, and synergistic necrotizing celluli- tis. The crepitance should be differentiated from other causes of

  20. Complete genome sequence of Helicobacter cinaedi type strain ATCC BAA-847.

    PubMed

    Miyoshi-Akiyama, Tohru; Takeshita, Nozomi; Ohmagari, Norio; Kirikae, Teruo

    2012-10-01

    Here we report the completely annotated genome sequence of the Helicobacter cinaedi type strain (ATCC BAA-847), which is an emerging pathogen that causes cellulitis and bacteremia. The genome sequence will provide new insights into the diagnosis, pathogenic mechanisms, and drug resistance of H. cinaedi.

  1. Anthrax

    DTIC Science & Technology

    2007-07-01

    Skin Cellulitis; Brown recluse spider bite; Cat- scratch disease; Rat bite fever; Rickettsial spotted fever; Carbuncle; Cowpox; Bullous erysipelas...with inhalational anthrax be treated? − A: 60 days. This recommendation is based on studies done in monkeys , where relapse after therapy was noted when medications were discontinued after 30 days.

  2. Skin Infections

    MedlinePlus

    ... it can get infected by them. Some common types of skin infections are Bacterial: Cellulitis and impetigo. Staphylococcal infections can also affect the skin. Viral: Shingles, warts, and herpes simplex Fungal: Athlete's foot and yeast infections Parasitic: Body lice, head lice, and scabies ...

  3. 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.

  4. Contingency Contracting: A Framework for Reform

    DTIC Science & Technology

    2010-05-14

    medical sick-call records showed 38 cases that an attending medical official said could be attributed to water, such as skin abscesses, cellulitis ...skin infections , and diarrhea. (Report No. D-2008-060) DCMA inspected the M2 gun parts at the contractor’s facility and inappropriately approved

  5. Small molecules that recapitulate the early steps of urodele amphibian limb regeneration and confer multipotency.

    PubMed

    Kim, Woong-Hee; Jung, Da-Woon; Kim, Jinmi; Im, Sin-Hyeog; Hwang, Seung Yong; Williams, Darren R

    2012-04-20

    In urodele amphibians, an early step in limb regeneration is skeletal muscle fiber dedifferentiation into a cellulate that proliferates to contribute new limb tissue. However, mammalian muscle cannot dedifferentiate after injury. We have developed a novel, small-molecule-based method to induce dedifferentiation in mammalian skeletal muscle. Muscle cellularization was induced by the small molecule myoseverin. Candidate small molecules were tested for the induction of proliferation in the cellulate. We observed that treatment with the small molecules BIO (glycogen synthase-3 kinase inhibitor), lysophosphatidic acid (pleiotropic activator of G-protein-coupled receptors), SB203580 (p38 MAP kinase inhibitor), or SQ22536 (adenylyl cyclase inhibitor) induced proliferation. Moreover, these proliferating cells were multipotent, as confirmed by the chemical induction of mesodermal-derived cell lineages. Microarray analysis showed that the multipotent, BIO-treated cellulate possessed a markedly different gene expression pattern than lineage-restricted C2C12 myoblasts, especially for genes related to signal transduction and differentiation. Sequential small molecule treatment of the muscle cellulate with BIO, SB203580, or SQ22536 and the aurora B kinase inhibitor, reversine, induced the formation of cells with neurogenic potential (ectodermal lineage), indicating the acquirement of pluripotency. This is the first demonstration of a small molecule method that induces mammalian muscle to undergo dedifferentiation and rededifferentiation into alternate cell lineages. This method induces dedifferentiation in a simple, stepwise approach and has therapeutic potential to enhance tissue regeneration in mammals.

  6. Beta-hemolytic streptococcal erythroderma syndrome: a clinical and pathogenic analysis.

    PubMed

    Tyner, Harmony L; Schlievert, Patrick M; Baddour, Larry M

    2011-10-01

    The syndrome of erythroderma due to beta-hemolytic streptococci is rarely seen and should be distinguished from cellulitis and toxic shock-like syndrome. The authors describe a novel syndrome of nongroup A, beta-hemolytic streptococcal infection truncal erythroderma. The characteristics of this syndrome suggest that local factors were likely operative in the cutaneous manifestations of an exotoxin-associated erythroderma.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  8. 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

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

    NASA Astrophysics Data System (ADS)

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

    1999-01-01

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

  10. 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

  11. [Antibiotherapy of severe ENT infections in children: complicated sinusitis].

    PubMed

    Haas, H; Lorrot, M; Hentgen, V; Cohen, R; Grimprel, E

    2013-11-01

    Intra or extra orbital cellulitis or abscesses are the most frequent bacterial complications of acute sinusitis. Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus (SA), and anaerobic bacteria are predominant, and more rarelyHaemophilus influenzae (especially since vaccination against type b). Because of bacterial sensitivity, PK/PD parameters of antibiotics, and depending on the classification of Chandler, different probabilistic regimens may be proposed: In class 1 by Chandler (preseptal cellulitis), amoxicillinclavulinate (80 mg/kg/d) in 2 oral doses, and ceftriaxone in intramuscular injection; in cases of class 2 to 5 by Chandler, high doses of intravenous amoxicillin-clavulinate (until 150 mg/kg/d of amoxicillin), or intravenous association of ceftriaxone (100 mg/kg/d) or cefotaxim (200 mg/kg/d), with anti-anaerobic like metronidazole (30 mg/kg/d) or clindamycine (40 mg/kg/d).

  12. Angiomyolipome épithélioïde rénal mimant un carcinome rénal

    PubMed Central

    Bouaziz, Hanen; Khiari, Ramzi; Dridi, Mohamed; Ghozzi, Samir; Rais, Nawfel Ben

    2016-01-01

    L'angiomyolipome épithélioide est une forme rare d'angiomyolipome à potentiel malin, considéré récemment par l'OMS comme une entité à part dans la classification des tumeurs rénales. Cette lésion pose un problème dans le diagnostic différentiel avec les carcinomes à cellules claires. Il n'y a pas de critère spécifique clinique ou radiologique caractérisant cette tumeur. L'immunohistochimie en révélant la positivité des cellules épithélioide au marqueur HMB45 est essentielle au diagnostic. Le traitement doit être discuté en concertation pluridisciplinaire. PMID:27642438

  13. 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.

  14. Management of community-associated methicillin-resistant Staphylococcus aureus skin abscesses in children

    PubMed Central

    Robinson, Joan L; Salvadori, Marina I

    2011-01-01

    Uncomplicated skin abscesses in previously well children are typically managed with drainage alone. An increasing percentage of such abscesses are due to methicillin-resistant Staphylococcus aureus infections. Although definitive data are lacking, drainage alone appears to be a reasonable strategy for methicillin-resistant S aureus skin abscesses, with antibiotics reserved for infants younger than three months of age, or for children who are systemically unwell, have underlying medical problems or have significant surrounding cellulitis. PMID:22294871

  15. Notes from the field: Contamination of alcohol prep pads with Bacillus cereus group and Bacillus species--Colorado, 2010.

    PubMed

    2011-03-25

    In October 2010, a child at The Children's Hospital (TCH) in Aurora, Colorado, with newly diagnosed leukemia developed clinical sepsis 24 hours after insertion of an implanted vascular access device. The child also developed extensive cellulitis at the insertion site, requiring surgical debridement, intensive care, antibiotics, prolonged wound management, and outpatient treatment. Cultures of the child's blood and tissue specimens grew Bacillus cereus. An investigation found neither breach of infection control procedures nor any violations of sterile surgical technique.

  16. 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.

  17. Carcinome mucineux primitif cutané: à 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 cutané est une tumeur annexielle rare, développée à partir des glandes sudoripares. Il se localise en générale à l'extrémité céphalique, surtout la région périorbitaire. Nous rapportons deux observations d'un carcinome mucineux primitif de la face et de la région axillaire, chez deux patients âgés de 60 ans. L’étude histologique montrait une prolifération tumorale dermohypodermique, faite de cellules organisées en cordons, en amas et en massif cribriformes, au sein d'une substance mucoïde. En immunohistochimie les cellules tumorales exprimaient la cytokératine 7, l'EMA et les récepteurs hormonaux. L'actine musculaire lisse a bien marqué les cellules myoépithéliales au niveau de la composante in situ dans un seul cas. Le carcinome mucineux primitif cutané est difficile à différencier d'une métastase mammaire ou digestive. La mise en évidence de carcinome in situ ou de cellules myoépithéliale est en faveur de l'origine cutanée primitive. C'est une tumeur à croissance lente, avec des métastases exceptionnelles. Le traitement est chirurgical et le taux de récidive est très élevé. Et à travers ces deux observations, les auteurs mettent en relief les principaux aspects cliniques, histologiques, thérapeutiques de cette entité avec une revue de la littérature. PMID:25574316

  18. Ocular sparganosis from Assam

    PubMed Central

    Nath, Reema; Gogoi, Rajendra Nath

    2015-01-01

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

  19. 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

  20. 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.

  1. Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management.

    PubMed

    Brook, Itzhak

    2009-09-01

    This review describes the microbiology, and medical management of orbital and intracranial complications of sinusitis in children. The most common complications are orbital cellulitis, subperiosteal abscess, orbital abscess, brain abscess, subdural empyema and meningitis. The predominate organisms recovered from these infection are anaerobic, aerobic, and microaerophilic bacteria of oral flora origin. Establishing the microbiology by obtaining appropriate cultures for both aerobic and anaerobic bacteria are essential for proper antimicrobial selection. Early recognition and appropriate surgical and medical therapy are essential to ensure recovery.

  2. Battlefield Acquired Immunogenicity to Metals Affects Orthopedic Implant Outcome

    DTIC Science & Technology

    2013-10-01

    include minor bruising/ hematoma (12.3%), diaphoresis with hypotension (2.6%), syncope (ə%), and cellulitis or phlebitis (ə%). Standard aseptic...PROBLEMS, AND DEVIATIONS Possible adverse events Possible adverse events following phlebotomy include: • Minor bruising/ hematoma (12.3...Lucht U. Metal sensitivity in patients treated for tibial fractures with plates of stainless steel. Acta Orthopedica Scandinavia 1977;48:245-9. Page 11

  3. 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.

  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.

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

    PubMed

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

    2012-12-20

    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.

  6. 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).

  7. Risk Factors Associated with Diagnoses of Heterotopic Ossification in Recent Combat Amputees

    DTIC Science & Technology

    2009-07-22

    infection 20/69 (29%) 82/313 (26%) Osteomyelitis 22/69 (32%) 62/313 (20%)* Cellulitis 18/69 (26%) 51/313 (16%) Amputation stump...several complications: osteomyelitis, infections , deep vessel thrombosis, and pulmonary embolism. Conclusions: The present study extended previous...complications13-23, such as infections , phantom limb syndrome, deep vessel thrombosis, and pulmonary embolism have not received systematic study as possible

  8. Combined endovascular treatment of aorto-oesophageal fistula with mediastinitis

    PubMed Central

    Berna, Pascal; Pequignot, Aurélien; De Temmerman, Pierre; De Dominicis, Florence

    2013-01-01

    False aortic aneurysm is an uncommon complication after oesophageal perforation and results in a high rate of mortality. A 63-year-old patient presented with acute chest pain. Biochemical tests (cardiac enzymes) and electrocardiogram were normal. A thoracic and abdominal CT scan was performed, and showed a foreign body in the posterior mediastinum, with mediastinal cellulitis and a false aortic aneurysm. Surgical endovascular management was performed, with stenting of the thoracic aorta and oesophageal exploration. PMID:23042800

  9. “Dry tap” during spinal anaesthesia turns out to be epidural abscess

    PubMed Central

    Sahu, Dinesh Kumar; Kaul, Vinca; Parampill, Reena

    2012-01-01

    We report a case of “dry tap” during spinal anaesthesia in a patient posted for incision and drainage of lower limb with cellulitis. When the patient was being given sub-arachnoid block (SAB) for regional anaesthesia, it turned out to be a case of pyogenic ilio-psoas abscess extended up to the paravertebral and epidural spaces. The causative organism was Staphylococcus aureus. This is probably the first case reported when epidural abscess is diagnosed during SAB. PMID:22923830

  10. Lymphangitis From Scolopendra heros Envenomation: The Texas Redheaded Centipede.

    PubMed

    Essler, Shannon E; Julakanti, Maneesha; Juergens, Andrew L

    2017-03-01

    Envenomation by Scolopendra heros, the Texas redheaded centipede, can present variably. Although transient pain and erythema are often treated conservatively, complications may include cellulitis, necrosis, myocardial infarction, and rhabdomyolysis. We present a case of an elderly man who came to the emergency department with lymphangitis and dermatitis secondary to a centipede sting that awoke him from sleep. It is important to recognize the potential of centipede envenomation to have severe local and systemic manifestations.

  11. Bacillus laterosporus endophthalmitis.

    PubMed

    Yabbara, K F; Juffali, F; Matossian, R M

    1977-12-01

    A strain of Bacillus laterosporus was isolated from the aqueous and vitreous humors of a patient with endophthalmitis that developed after a penetrating injury of the cornea. Intravitreal inoculation of the isolate into rabbits produced severe panophthalmitis, corneal perforation, orbital cellulitis, and even meningitis. These observations suggest that B laterosporus, hitherto classified as nonpathogenic, is an opportunist that can cause disease when conditions are favorable.

  12. [Feet dermatophytosis in soccer players].

    PubMed

    Purim, Kátia Sheylla Malta; de Freitas, Camila Fernanda Novak Pinheiro; Leite, Neiva

    2009-01-01

    Athletes present risk of cutaneous mycosis. A study was carried out with 23 soccer players using clinical and mycological examination (direct microscopic examination and culture) and nail clipping. Eighteen (78.26%) did not present mycosis; two (8.70%) presented tinea pedis, and three (13.04%) presented onychomycosis associated to tinea pedis, mainly for Trichophyton mentagrophytes. Infected tinea pedis has produced cellulitis in one of the athletes. It is necessary to create an educative program of skin care during sports practice.

  13. Primary cicatricial alopecia: Other lymphocytic primary cicatricial alopecias and neutrophilic and mixed primary cicatricial alopecias.

    PubMed

    Bolduc, Chantal; Sperling, Leonard C; Shapiro, Jerry

    2016-12-01

    Primary cicatricial alopecias can be frustrating for both patients and physicians. Proper diagnosis guides more successful management of these challenging conditions. Part II will cover the remaining lymphocytic primary cicatricial alopecias, which include pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. It will also discuss the neutrophilic and mixed primary cicatricial alopecias, namely folliculitis decalvans, dissecting cellulitis, folliculitis keloidalis, folliculitis (acne) necrotica, and erosive pustular dermatosis.

  14. 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

  15. 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

  16. Dexamethasone immunosuppression resulting in turkey clostridial dermatitis: a retrospective analysis of seven studies, 1998-2009.

    PubMed

    Huff, G R; Huff, W E; Rath, N C

    2013-12-01

    We have studied the etiology of turkey osteomyelitis complex (TOC) for the past 20 yr and have determined that this syndrome is caused by the inability of some fast-growing male turkeys to cope with production stressors. Although immunosuppressive viruses have often been associated with susceptibility to gangrenous dermatitis (cellulitis), we hypothesize that production stressors alone can also undermine resistance to opportunistic pathogens by both increasing bacterial translocation from the intestine and disrupting the skin's antimicrobial barrier, resulting in subcutaneous lesions referred to as cellulitis and recently named turkey clostridial dermatitis (CD). Some common characteristics between TOC and CD are that they are both caused by opportunistic bacterial species that are prevalent in the environment and are both most common in adolescent male birds. In both diseases the affected birds are often large, healthy, and from the best-performing flocks. Our TOC studies using dexamethasone immunosuppression result in a high incidence of cellulitis lesions in dead turkeys that were given either Escherichia coli or Staphylococcus aureus respiratory challenges. The natural presence of Clostridium spp. in the poultry intestine and environment suggests that they may also have been concomitant pathogens. We suggest that a useful and repeatable model for CD can be developed by focusing on the ability of stress to increase diuresis and wet litter conditions and undermine both intestinal and cutaneous bacterial resistance in fast-growing male turkeys.

  17. 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.

  18. 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

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

    PubMed Central

    2010-01-01

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

  20. Expression and localization of aromatase during fetal mouse testis development.

    PubMed

    Borday, Caroline; Merlet, Jorge; Racine, Chrystèle; Habert, René

    2013-01-01

    Les androgènes et les oestrogènes sont indispensables au développement et aux fonctions du testicule. Le testicule est particulièrement sensible aux perturbateurs endocriniens pendant le développement fœtal et beaucoup de perturbateurs endocriniens agissent en modifiant la balance oestrogènes/androgènes. Physiologiquement, cette balance est régulée par une cascade enzymatique qui convertit irréversiblement les androgènes en oestrogènes. Le composant principal de cette cascade est le cytochrome p450 19A1 (appelé couramment aromatase). Le but de ce travail a été d’étudier l’expression de l’aromatase testiculaire au cours du développement fœtal chez la souris.En utilisant une approche par RT-PCR et par western blot, nous avons montré que l’aromatase est exprimée dès 12,5 jours post-conception (jpc) et que l’expression est maximum à 17,5 jpc. Deux transcripts tronqués ont également été détectés par RT-PCR. La localisation cellulaire de l’aromatase a été étudiée par immunohistologie et par immunomarquage après séparation des cellules testiculaires. Cette enzyme est très fortement exprimée dans les cellules de Leydig fœtales. Elle est également exprimée dans les gonocytes mais plus faiblement et à un niveau variable selon les cellules. En revanche, elle est indétectable dans les cellules de Sertoli.En conclusion, cette étude montre pour la première fois chez la souris que 1) l’aromatase est exprimée dès le début de l’ontogenèse testiculaire, 2) elle est exprimée dans les gonocytes suggérant que ces cellules interviennent dans l’endocrinologie testiculaire et que le rapport oestrogènes/androgènes est plus important dans les gonocytes que dans le liquide interstitiel. En outre, on sait que, chez le fœtus de rat l’aromatase est essentiellement exprimée par les cellules de Sertoli. Nous proposons de prendre en compte cette différence inter-espèces comme un nouveau concept pour comprendre les diff

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

    PubMed Central

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

    2015-01-01

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

  2. 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

  3. Diffuse cutaneous allergic reaction to Dermabond.

    PubMed

    Ricci, Joseph A; Parekh, Nirav N; Desai, Naman S

    2014-10-01

    Wound closure with 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, New Jersey USA) has recently increased in popularity across a wide spectrum of physicians ranging from surgeons to emergency medicine practitioners. Generally, very few complications are associated with Dermabond and are usually related to application techniques. Uncommonly, patients present with allergic reactions to the adhesive compounds; these allergies are often misdiagnosed as cellulitis or another infectious process, and are incorrectly treated. This report describes a rare case of a diffuse cutaneous allergic reaction to Dermabond following its use to close a surgical incision, its prompt identification, and treatment after presentation to an emergency department.

  4. Sonographic appearance of angioedema in local allergic reactions to insect bites and stings.

    PubMed

    Tay, Ee Tein; Tsung, James W

    2014-09-01

    Soft tissue infections and angioedema from insect bites and stings may be difficult to differentiate by inspection. We present sonographic findings of 4 cases of soft tissue swelling from insect bites and stings suggestive of angioedema. Sonographic features of soft tissue angioedema consist of thickened subcutaneous tissue layers with multiple linear, horizontal, striated, and hypoechoic lines following the tissue planes between soft tissue layers. In addition to the history and physical examination, sonographic findings may assist in differentiating between local allergic reactions and cellulitis in patients with insect bites and stings. Further study is warranted for clinical application.

  5. Case report of vancomycin-induced pancytopenia.

    PubMed

    Gupta, Sorab; Sharma, Shorabh; Menon, Nandini; Ahuja, Shradha; Dahdouh, Michelle

    2016-04-01

    Vancomycin is the first-line agent for the treatment of bacteremia, endocarditis, pneumonia, cellulitis, and osteomyelitis. Pancytopenia is an uncommon adverse effect of vancomycin therapy, with only a few cases of vancomycin-related neutropenia and pancytopenia described in the literature. We describe a case of a 56-year-old man who was diagnosed with chronic paraspinal abscess and started on intravenous vancomycin. He was re-admitted two weeks later with new-onset pancytopenia. Discontinuation of vancomycin resulted in improved cell counts. Physicians should monitor cell counts in patients who are on long-term intravenous vancomycin.

  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. Parenteral organophosphorus poisoning in a rural emergency department: a case report

    PubMed Central

    2013-01-01

    Background Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world. Case presentation Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result. Conclusion Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure. PMID:24321121

  8. 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.

  9. Sporadic (nonepidemic) puerperal mastitis.

    PubMed

    Niebyl, J R; Spence, M R; Parmley, T H

    1978-02-01

    Sporadic puerperal mastitis is an acute cellulitis, characterized by fever and segmental erythema in the breast. Staphylococcus aureus can be cultured in approximately one-half of the cases. With early antibiotic therapy, the infection can be cleared and abscess formation prevented. Breast engorgement may also contribute to abscess formation, and so nursing should not be discontinued. No ill effects are observed in infants who continue to nurse. Twenty women with acute puerperal mastitis had breast milk cultures, and Staphylococcus aureus was recovered in seven cases. All patients were treated with antibiotics and continued nursing. No abscesses developed, and no ill effects were observed in any infants.

  10. Lupus vulgaris: unusual presentations over the face.

    PubMed

    Khandpur, S; Reddy, B S N

    2003-11-01

    Lupus vulgaris (LV) is the most common morphological variant of cutaneous tuberculosis. However, the occurrence of bizarre clinical presentations over atypical sites often leads to misdiagnosis and inappropriate treatment causing significant morbidity. This report seeks to highlight two unusual cases of lupus vulgaris occurring on the face of immunocompetent women and remarkably mimicking periorbital cellulitis and basal cell carcinoma, respectively. The diagnosis was confirmed by histopathology, an enzyme-linked immunosorbent assay (ELISA) test for Mycobacterium tuberculosis and polymerase chain reaction (PCR). With four-drug antitubercular therapy, both patients had a dramatic response.

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2015-01-01

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

  13. System Identification for Integrated Aircraft Development and Flight Testing (l’Identification des systemes pour le developpement integre des aeronefs et les essais en vol)

    DTIC Science & Technology

    1999-03-01

    essais environ. Un outil d’optimisation param6trique IDLATNL a donc 6t6 naturellement d~velopp6 pour aider 5. IDLATNL Fing~nieur A r~soudre ce probl~me...support h de nombreux essais en vol sous contrat des Services Officiel Franqais (SPA6). 3. CAPTEURS Ce dispositif experimental a W utilis6 dans le...proviennent d’une travaillant dans le domaine fr~quentiel, fournit une centrale h inertic et de capteurs sp~cifiques cellule en cc qui estimation des

  14. Three eyelid localized cutaneous anthrax cases.

    PubMed

    Esmer, Oktay; Karadag, Remzi; Bilgili, Serap Gunes; Gultepe, Bilge; Bayramlar, Huseyin; Karadag, Ayse Serap

    2014-12-01

    Anthrax is primarily seen in the developing countries, but it can be a worldwide medical concern due to bioterrorism threats. Palpebral anthrax is a rare form of cutaneous anthrax. Untreated cutaneous anthrax can be lethal. Patients with palpebral anthrax can develop complications including cicatrisation and ectropion. Thus, anthrax should be considered in differential diagnosis for patients presenting with preseptal cellulitis in high-risk regions. Herein, we report three anthrax cases (with different age) involving eyelids that were cured without any complications due to early diagnosis and treatment.

  15. 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

  16. 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)

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

    PubMed Central

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

    2015-01-01

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

  18. A 52 Kilodalton Protein Vaccine Candidate for Francisella tularensis

    DTIC Science & Technology

    2004-12-01

    stratdgie pour la mise au point de vaccins sub- cellulaires s~curitaires et efficaces contre les agents biologiques dangereux tels que la tular6mie. La...production d’oxyde de diazote chez certaines lign6es cellulaires mammaliennes et qu’en grandes quantit6s, elle cause la mort de la cellule. La vaccination de...60%) unless antibiotic therapy is given [1]. The bacterium is readily grown on simple medium, is highly virulent when delivered as an aerosol or in

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

    PubMed Central

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

    2016-01-01

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

  20. 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.

  1. Medicolegal aspects of necrotizing fasciitis of the neck.

    PubMed

    Sperry, K; McFeeley, P J

    1987-01-01

    Necrotizing fasciitis of the neck (NFN) is a relatively rare, fulminating infectious process of the cervicofacial tissues which may cause sudden and unexpected death. Although often the result of a dental infection, injuries of the soft tissues of the neck may also initiate rampant cellulitis, and recognition of the underlying etiology of such cases is necessary to determine properly the manner of death. Five cases of NFN are presented with a review of the causative factors and usual bacteriology, and specific factors of medicolegal interest are addressed.

  2. Squamous cell carcinoma and pilonidal cyst disease.

    PubMed

    Esposito, Francesco; Lauro, Mario; Tirone, Lucio Pasquale; Festa, Rosa Maria; Peluso, Gaia; Mazzoni, Giada; Scognamiglio, Marco; Grimaldi, Simona; Fresini, Antonio

    2015-02-20

    Il carcinoma a cellule squamose insorgente su malattia del seno pilonidale è una patologia abbastanza rara che sopraggiunge in presenza di malattia con decorso decennale. È caratterizzato da una crescita lenta ma da un’elevata invasività locale. Gli autori riportano il caso di un paziente di 63 anni con storia pluridecennale di malattia del seno pilonidale con ascessualizzazioni ricorrenti trattato chirurgicamente con resezione ampia e ricostruzione mediante uso di lembi. A distanza di 30 mesi non sono state osservate complicanze o recidive locali.

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

    PubMed

    Sunderkötter, Cord; Becker, Karsten

    2015-06-01

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

  4. [Orbital complications of sinusitis].

    PubMed

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, 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

  5. Pyoderma gangrenosum induced by episiotomy.

    PubMed

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

    2016-01-19

    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.

  6. 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.

  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. Ethmoidal pneumocele following drainage of an ethmoidal mucocele.

    PubMed

    Gupta, Aanchal; Durkin, Shane R; Muecke, James S; Casson, Robert J; Wormald, Peter-John; Selva, Dinesh

    2008-01-01

    Ethmoidal pneumocele is a rare condition with little known about its etiology. We report a 5-year-old boy who had recurrent right orbital cellulitis, non-axial proptosis, and inferolateral globe displacement. Initial radiological investigations demonstrated an ethmoidal mucocele. There was complete resolution of inflammatory signs with endoscopic drainage of the mucocele; however, repeat CT revealed a residual pneumocele with continued proptosis and lateral displacement of the globe. This case illustrates the potential for chronic sinusitis and iatrogenic drainage of an ethmoidal mucocele to progress to a pneumocele.

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

    PubMed

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

    2016-03-01

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

  10. New developments in clinical aspects of lymphatic disease

    PubMed Central

    Mortimer, Peter S.; Rockson, Stanley G.

    2014-01-01

    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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  13. Disseminated Panton-Valentine Leukocidin-Positive Staphylococcus aureus infection in a child.

    PubMed

    Karli, Arzu; Yanik, Keramettin; Paksu, Muhammet S; Sensoy, Gulnar; Aykanat, Alper; Yener, Nazik; Belet, Nursen; Ceyhan, Meltem

    2016-04-01

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

  14. Radiation Induced Bystander Effects in Human Lymphoblastoid Cells

    DTIC Science & Technology

    2003-12-01

    34 observ6 peut etre caus6 par les interactions cellulaires via les prot~ines s~cr~toires 1ib~r~es par les cellules irradi~es en agissant sur les...l’accident du r~acteur de Chernobyl. Nous avons formulk l’hypoth~se que l’effet "bystander" observ6 pouvait 6tre une consdquence d’interactions cellulaires ...qui seraient indicatifs d’expositions biologiques ou chimiques. 11 est pr~vu que certains de ces marqueurs seront communs aux trois agents stressants

  15. 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.

  16. Nodular colitis: endoscopic image an unusual finding.

    PubMed

    Loza Vargas, L A; Núñez Rodríguez, Henar; Benito Sanz, Marina; Zamora Martínez, Tomás; Díez Redondo, Pilar; Pérez Miranda, Manuel

    2016-10-01

    An 82-year-old male with a history of high blood pressure, COPD, chronic myeloid leukemia, and stage-4 chronic renal failure. Admitted to hospital for lower-limb cellulitis and severe COPD exacerbation, he received antibiotic therapy and bronchodilators. During his hospital stay he developed severe anemia and had an hematochezia event with no diarrhea. A complete colonoscopy found small (4-7 mm) nacreous elevated lesions, circumferential in shape, in the cecum and ascending colon with some bleeding stigmata and submucosal bleeding suggestive of infectious colitis; stool culture was negative and Clostridium difficile toxins were positive. The condition was histologically confirmed.

  17. Wall teichoic acids prevent antibody binding to epitopes within the cell wall of Staphylococcus aureus.

    PubMed

    Gautam, Samir; Kim, Taehan; Lester, Evan; Deep, Deeksha; Spiegel, David A

    2016-01-15

    Staphylococcus aureus is a Gram-positive bacterial pathogen that produces a range of infections including cellulitis, pneumonia, and septicemia. The principle mechanism in antistaphylococcal host defense is opsonization with antibodies and complement proteins, followed by phagocytic clearance. Here we use a previously developed technique for installing chemical epitopes in the peptidoglycan cell wall to show that surface glycopolymers known as wall teichoic acids conceal cell wall epitopes, preventing their recognition and opsonization by antibodies. Thus, our results reveal a previously unrecognized immunoevasive role for wall teichoic acids in S. aureus: repulsion of peptidoglycan-targeted antibodies.

  18. Muscular abscess caused by Cupriavidus gilardii in a renal transplant recipient.

    PubMed

    Tena, Daniel; Losa, Cristina; Medina, María José; Sáez-Nieto, Juan Antonio

    2014-05-01

    Cupriavidus gilardii is a rare cause of human infection. We report a muscular abscess on the right thigh caused by this organism in a renal transplant recipient, who had suffered a septic shock associated with an extensive cellulitis caused by Streptococcus pyogenes. The patient was successfully treated with surgical drainage and intravenous ciprofloxacin for 13 days. This is the first time that C. gilardii is isolated from a human abscess. C. gilardii should be considered as a cause of human infection, especially in immunocompromised patients. Infection caused by this organism may be underdiagnosed because the identification is very difficult.

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

    PubMed Central

    Al Shukry, S; Ommen, J

    2013-01-01

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

  20. Successfully treated descending necrotizing mediastinitis through thoracotomy using a pedicled muscular serratus anterior flap.

    PubMed

    Haremza, Céline; De Dominicis, Florence; Merlusca, Geoni; Berna, Pascal

    2011-10-01

    Descending necrotizing mediastinitis (DNM) is rare and aggressive. A 68-year-old female with no medical history, was admitted to our institution for cervical cellulitis. After a conventional medical treatment, multiple abscesses of the upper mediastinum appeared on computed tomography (CT) findings. Although two cervicotomies were performed, a new necrotic abscess appeared in the anterior upper and middle mediastinum. An extensive debridement of cellulitis and abscess extended to the pericardium was made by thoracotomy. Middle mediastinum and pericardium were covered and reconstructed by a right pedicled serratus anterior flap. After radical surgery, follow-up was uneventful. Early extensive and complete debridement of cervical and mediastinal collections and irrigation with broad-spectrum intravenous antibiotics is essential. Combined surgery is the best approach in DNM. The use of a pedicled muscular flap helps control the sepsis. In such cases, serratus anterior flap is a flap of choice because it is reliable and always available even in a skinny patient, contrary to omentum. In this life-threatening disease, an early aggressive combined surgery with debridement of all necrotic tissues extended to the pericardium if necessary associated with a pedicled flap is mandatory.

  1. Obesity-related Risk Factors in Implant-based Breast Reconstruction Using AlloDerm

    PubMed Central

    Coleman, Cathryn A.; Erickson, Stephen W.

    2017-01-01

    With a population in which 70% of the patients were overweight or obese, we reviewed retrospectively 135 breasts of 70 consecutive patients who underwent implant-based immediate breast reconstruction using freeze-dried AlloDerm as the acellular dermal matrix. Several obesity-related parameters were evaluated to determine their possible correlation to early postoperative complications. We found that breast width and surface area of AlloDerm usage correlated with the development of infection and mastectomy skin flap necrosis. Increased breast width and size of AlloDerm matrix implanted were correlated with higher rates of both minor and significant skin necrosis and of cellulitis. Body mass index was correlated with the development of cellulitis and minor and major skin necrosis but not with seroma or reconstruction failure. Preexisting breast cup size correlated with the development of seroma but not the other complications. We observed no statistically significant association between reconstruction failure and any of the parameters reviewed, but this is likely due to the small number of failures in our data set (n = 10). PMID:28280672

  2. Sonographic Diagnosis in a Rare Aetiology of Neonatal Scrotal Swellings: A Case Report of Congenital Nephrotic Syndrome

    PubMed Central

    Grover, Shabnam Bhandari; Kumar, Nishith; Grover, Hemal; Taneja, Dinesh Kumar; Katyan, Amit

    2016-01-01

    Summary Background Common etiologies of scrotal swelling in neonates include hydrocoele, inguinal hernia and testicular torsion; less common is epididymo-orchitis. Congenital nephrotic syndrome (CNS), a rare entity, is known to present as progressive renal failure and its leading presentation with scrotal involvement has not been reported. Material/Methods We report a rare case of CNS with primary clinical presentation as scrotal cellulitis and epididymo-orchitis. In this neonate, scrotal and abdominal ultrasound examination was performed and the laboratory data were obtained. Results Sonography revealed bilaterally enlarged echogenic kidneys, testis and epididymis with echogenic peritoneal fluid tracking into both scrotal sacs. Laboratory data revealed proteinuria and severe depletion of serum IgG. Culture of the peritoneal fluid showed gram-negative organisms. A final diagnosis of CNS, complicated with peritonitis tracking into the scrotal sacs was arrived at. Conclusions CNS may have a rare presentation with distracting symptoms of scrotal cellulitis and epididymo-orchitis, as seen in our patient. However, diligent use of abdomino-scrotal sonography, supported by relevant laboratory data can clinch the accurate diagnosis. PMID:27757175

  3. Spectrum of dermatoses in 165 travelers returning from the tropics with skin diseases.

    PubMed

    Ansart, Séverine; Perez, Lucia; Jaureguiberry, Stéphane; Danis, Martin; Bricaire, François; Caumes, Eric

    2007-01-01

    The spectrum of dermatoses occurring in travelers returning from tropical areas is poorly documented. We analyzed the relative frequency of travel-associated dermatoses and their possible relationships to travel characteristics in all persons who came to our hospital between November 2002 and May 2003 for a cutaneous disorder related to travel in a tropical country. One hundred sixty-five travelers were included. The main dermatoses identified were infectious cellulitis (12.7%), scabies (10.3%), and pruritus of unknown origin (PUO) (9.1%). Tropical dermatoses accounted for 33.9% of the cutaneous disorders. Univariate analysis showed statistically significant correlations of infectious cellulitis with females, PUO with older age and immigrant status, pyoderma with expatriate status, scabies with tourism and travel to Africa, myiasis with tourism and travel to Africa and America, filariasis with travel to Africa and immigrant status, and cutaneous larva migrans with tourism. Dermatoses diagnosed in travelers returning from the tropics seemed to be influenced by traveler status and region visited.

  4. 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.

  5. 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.

  6. Morbidity of Inguinofemoral Lymphadenectomy in Vulval Cancer

    PubMed Central

    Soliman, A. A.; Heubner, M.; Kimmig, R.; Wimberger, P.

    2012-01-01

    Background. The aim of this study is to detect possible risk factors for development of short- and long-term local complications after inguinofemoral lymphadenectomy for vulval cancer. Methods. This retrospective cohort study included 34 vulval cancer patients that received inguinofemoral lymphadenectomy. The detected complications were wound cellulitis, wound seroma formation, wound breakdown, wound infection, and limb lymphoedema. Followup of the patient ran up to 84 months after surgery. Results. Within a total of 64 inguinofemoral lymphadenectomies, 24% of the inguinal wounds were affected with cellulitis, 13% developed a seroma, 10% suffered wound breakdown, 5% showed lower limb edema within a month of the operation, and 21.4% showed lower limb edema during the long-term followup. No significant correlation could be found between saphenous vein ligation and the development of any of the local complications. The 3-year survival rate in our cohort was 89.3%. Conclusions. Local complications after inguino-femoral lymphadenectomy are still very high, with no single pre-, intra-, or postoperative factor that could be incriminated. Saphenous vein sparing provided no significant difference in decreasing the rate of local complications. More trials should be done to study the sentinel lymph node detection technique. PMID:22262953

  7. 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

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

    PubMed Central

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

    2016-01-01

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

  9. Reactions to small pox vaccine in naïve and previously-vaccinated individuals.

    PubMed

    Auckland, Cressida; Cowlishaw, Alexandra; Morgan, Dilys; Miller, Elizabeth

    2005-07-14

    Two hundred health care workers in England and Wales were vaccinated with the Lister/Elstree strain of the vaccinia virus, and completed health diaries for 21 days or until the lesion had scabbed over. Pain and temperature were measured daily, and all other symptoms recorded freehand by the vaccinee. One hundred and forty two (71%) vaccinees reported pain, of which 25% considered it to be moderate or severe; 32 vaccinees (16%) recorded a temperature of >37.7 degrees C, two of which exceeded 39 degrees C. Other, mainly trivial, adverse events were common; itch was reported in 72%, erythema in 27%, axillary pain or lymphadenopathy in 38%, malaise or flu-like symptoms in 40% and headache in 23%. The incidences of minor adverse events were lower in re-vaccinees, compared with naïve vaccine recipients, significantly so in the case of erythema and general malaise (p=0.001 and 0.006, respectively), perhaps reflecting pre-existing immunity. Major adverse events occurred in two vaccinees (hospital admission, one with cellulitis and one with headache and possible encephalitis), and a further five were treated with antibiotics for local cellulitis. This is the first study to report results derived from active follow-up by diaries in recipients of the Lister/Elstree strain of vaccinia, and to document reductions in trivial adverse events in re-vaccinees.

  10. Hémangiome fusiforme: une localisation inhabituelle

    PubMed Central

    Nasreddine, Fatima Zahra; Baghad, Bouchra; Chiheb, Soumiya

    2016-01-01

    L'hémangiome à cellules fusiformes été décrit par Weiss et Enzinger en 1986 et anciennement nommé hémangioendothéliome à cellules fusiformes. Depuis l'avènement des études immunohistochimique il n'est plus considéré en tant qu'angiosarcome de bas grade. C'est une tumeur bénigne vasculaire. Il touche presque exclusivement le derme des extrémités distales. Nous rapportons le premier cas avec localisation au niveau de l'omoplate, du sein, des cuisses et de la mandibule. Selon la littérature, seulement 9 cas localisés au niveau de la tête et le cou ont été rapportés. Nous rapportons un nouveau cas de cette entité rare et mal connue qui peut prêter confusion avec les tumeurs malignes. Notre patient avait une localisation au niveau de l'omoplate, du sein, des cuisses et de la mandibule. Une biopsie-exérèse était réalisée. L’évolution a été favorable avec un recul de 6 mois, sans rechute. PMID:27642429

  11. MDCT of hand and wrist infections: emphasis on compartmental anatomy.

    PubMed

    Ahlawat, S; Corl, F M; LaPorte, D M; Fishman, E K; Fayad, L M

    2017-04-01

    Hand and wrist infections can present with a spectrum of manifestations ranging from cellulitis to deep-space collections. The various infectious processes can be categorised as superficial or deep infections based on their respective locations relative to the tendons. Superficial hand infections are located superficial to the tendons and are comprised of cellulitis, lymphangitis, paronychia, pulp-space infections, herpetic whitlow, and include volar as well as dorsal subcutaneous abscesses. Deep hand infections are located deep to the tendon sheaths and include synovial space infections, such as infectious tenosynovitis, deep fascial space infections, septic arthritis, necrotising fasciitis, and osteomyelitis. Knowledge of hand and wrist compartmental anatomy is essential for the accurate diagnosis and management of hand infections. Although early and superficial infections of the hand may respond to non-surgical management, most hand infections are surgical emergencies. Multidetector computed tomography (MDCT), with its muliplanar reformation (MPR) and three-dimensional (3D) capabilities, is a powerful tool in the emergency setting for the evaluation of acute hand and wrist pathology. The clinical and imaging features of hand and wrist infections as evident on MDCT will be reviewed with emphasis on contiguous and closed synovial and deep fascial spaces. Knowledge of hand compartmental anatomy enables accurate characterisation of the infectious process and localise the extent of disease in the acute setting.

  12. The Urban Dental Index: a Method for Measuring and Mapping Dental Health Disparities across Urban Areas.

    PubMed

    Coles, Emily; Kruger, Estie; Anjrini, Abed Aktam; Tennant, Marc

    2017-02-06

    The aim of this study was to create an Urban Dental Index (UDI) for Perth, Western Australia, adapting a method utilised by the World Health Organisation. Dental health indicators were derived from the 2011 census, standardised on a (0,1) interval, amalgamated using a geometric mean, and mapped to identify dental health inequity. The validity of the UDI was tested by comparison with oral cellulitis data. Dental health disparities were examined using a ratio of the mean of the highest to lowest decile and slope of the eight middle deciles. The robustness of the UDI was tested using indicator correlation, weighting, and systematic indicator removal. There were a high proportion of low UDI census areas outside the inner city. Adult public dental clinics were unevenly distributed across these low UDI areas. The UDI was significantly correlated with oral cellulitis data and had a moderate disparity ratio (1.69) and slope (0.23). All dental indicators were highly correlated, and UDIs calculated with weighted indicators and indicators removed were significantly correlated with the original UDI. These results indicate that the UDI is a robust tool which can be used by policy makers to target dental health initiatives to high-risk areas.

  13. Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

    PubMed Central

    Wan, Yuzhu; Shi, Guanggang; Wang, Haibo

    2016-01-01

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

  14. 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

  15. 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.

  16. 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

  17. Gastric paraganglioma: a case report and a review of the literature.

    PubMed

    Pruiti, Vincenzo; Mazzeo, Francesca; Rossitto, Maurizio; Foti, Agata; Macrì, Antonio; Cucinotta, Eugenio

    2014-12-29

    I paragangliomi sono tumori neuroendocrini derivati dalla cresta neurale, provenienti dai paragangli, organi neuroendocrini dispersi e caratterizzati da cellule producenti catecolamine e peptidi. Presentano un’incidenza annuale stimata in 1 / 100.000, rappresentando il 10% dei tumori secernenti catecolamine. Riportiamo il caso di un uomo di 76 anni giunto alla nostra osservazione per la presenza di una lesione polipoide di 4 cm, vegetativaulcerata, tra il corpo e dell’antro gastrico rilevata durante una gastroscopia per la comparsa di anemia. Il paziente è stato sottoposto a gastrectomia subtotale con omentectomia e anastomosi gastrodigiunale. L’esame istologico ha rivelato un carcinoma gastrico polipoide ulcerato con cellule scarsamente aderenti con infiltrazione della parete gastrica muscolare e incidentalmente è stata identificata una lesione della parete gastrica posteriore incidentale che si rilevava essre un paraganglioma con la positività alle indagini di immunocitochimica per NSE e negatività per CD117, S100, CD34 e SMA. Con il termine di feocromocitoma si indica esclusivamente i tumori derivanti dalla midollare del surrene, mentre il paraganglioma extra-surrenalico suggerisce tumori delle cellule cromaffini con altre posizioni. La localizzazione gastrica o perigastrica, come nel nostro caso, è molto rara per queste neoplasie, e in letteratura vi sono solo pochi case report. La predisposizione genetica si osserva nel 30% di questi tumori e può essere responsabile della malattia ereditaria caratterizzata da differenze nella distribuzione del tumore, nella produzione di catecolamine, nel rischio di metastasi, e nell’associazione con altri tipi di tumori. In conclusione, nei pazienti con sintomi di tumore secernente cromaffini o in pazienti con una storia familiare di feocromocitoma-paraganglioma, che portano mutazioni e sottoposti a screening per il tumore asintomatico, la prima indagine diagnostica è determinare i livelli di metanefrina

  18. [Various aspects of iron in the organism. I. Ferritin and ferruginous micelles].

    PubMed

    BESSIS, M; BRETON-GORIUS, J

    1959-10-01

    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.

  19. 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 premi

  20. Phenomenological Approach to Cellular Pattern Formed during Directional Solidification

    NASA Astrophysics Data System (ADS)

    WolczyńSki, W.; Kloch, J.

    1997-10-01

    The approach to the solid/liquid (s/l) interface geometry for a 1D experiment of cellular growth is presented. It is based on a periodical function which comprises fundamental undulation of the planar s/l interface and some disfigurements of this undulation. Four regions of the cellular structure formation are distinguished versus growth rate: finite cells, doublets, deep cells and gothic cells (predendritic region). The fundamental undulation is expressed by the same formula within all the regions and the intercellular spacing is treated as equal to the wavelength of undulation. The differentiation among the regions is expressed by some terms responsible for the disfigurements of undulation. The fitting of the presented equations to the observed cellular morphology is the subject of the method. The selection of the intercellular spacing with the use of the criterion of minimum entropy production is suggested. However, only the formal calculation of the undulation amplitude is presented. L'approche de géométrie de l'interface cellulaire pour l'observation unidimensionelle est montrée. Elle est basée sur une fonction périodique qui comprend les deux: l'ondulation fondamentale du front plan et certaines déformations de cet ondulation. Quatre régions de la formation des structures cellulaires ont été différenciées en fonction de vitesse de croissance: des cellules finies, des cellules profondes, doubletons et des cellules gothiques (la région prédendritique). L'ondulation fondamentale est exprimée par le même terme dans toutes les régions et la taille cellulaire est traitée comme equivalent à la longueur d'onde de l'ondulation. La différenciation parmis les régions est exprimée par les termes responsables de déformations de l'ondulation. L'ajustement des équations proposées à la morphologie cellulaire observée est le sujet du procédé. La sélection de la taille cellulaire à l'aide d'un critère de production d'entropie minimum est propos

  1. 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

  2. [Persistent swelling after flushing of an abscess with Octenisept®].

    PubMed

    Bauer, B; Majic, M; Rauthe, S; Bröcker, E-B; Kerstan, A

    2012-12-01

    We report the case of a long-lasting cutaneous side effect after inappropriate use of Octenisept® solution (containing octenidine and phenoxyethanol). Following lavage of an abscess in the inguinal region, a painful erythematous induration mimicking cellulitis persisted for several months. Manual lymphatic drainage considerably improved the symptoms. Octenisept® shows considerable tissue toxicity in vivo including - but not restricted to - blood vessel damage. Deterioration of endothelial cells followed by oedema and continued tissue damage can be seen histologically. Despite the fact that there is a circular letter issued by the manufacturer as well as a boxed warning on the bottles, the awareness to avoid this misuse of Octenisept® is still lacking.

  3. Treatment of metastatic cutaneous Crohn disease with certolizumab.

    PubMed

    Kiuru, Maija; Camp, Brendan; Adhami, Katayun; Jacob, Vinita; Magro, Cynthia; Wildman, Horatio

    2015-11-18

    Metastatic Crohn disease is a rare cutaneous manifestation of Crohn disease characterized by granulomatous lesions discontinuous with the diseased areas of the gastrointestinal tract. We report a case of a 32-year-old woman with history of Crohn disease who was admitted for treatment of cellulitis after presenting with a tender erythematous plaque of the left calf. Microbiological tests including tissue cultures were negative. A skin biopsy revealed granulomatous dermatitis consistent with metastatic cutaneous Crohn disease. Owing to concomitant perianal fistulas and abscesses and prior infusion reaction to infliximab, the patient was treated with certolizumab, a pegylated tumor necrosis factor (TNF) inhibitor combined with methotrexate resulting in complete resolution of the skin lesion. This case emphasizes the importance of recognizing this rare skin manifestation of Crohn disease and adds certolizumab as one of TNF inhibitors useful in the treatment of metastatic cutaneous Crohn disease.

  4. A case of histiocytoid variant eccrine sweat gland carcinoma of the orbit.

    PubMed

    Kim, Young Min; Kim, Jeong Won; Oh, Dong-Eun

    2011-02-01

    A 79-year-old male presented with left ocular pain. Evisceration and silicone ball implantation were performed after a diagnosis of phthisis. He returned six weeks later because of left facial erythematous swelling, tenderness, mild fever, chills and cough. His condition was diagnosed as orbital cellulitis. Despite two weeks of empirical antibiotic therapy, the symptoms worsened. A subsequent orbital computed tomography scan revealed enhanced soft tissue infiltrations in his left orbit and eyelid. Biopsy showed a diffusely infiltrating tumor of signet ring cell cytology. A systemic evaluation revealed multiple bone metastases. Based on this evidence, the patient was diagnosed with a very rare case of histiocytoid variant eccrine sweat gland carcinoma with multiple bone metastases.

  5. 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.

  6. Diagnosis and management decisions in infections of the deep fascial spaces of the head and neck utilizing computerized tomography.

    PubMed

    Endicott, J N; Nelson, R J; Saraceno, C A

    1982-06-01

    Infections of the deep spaces of the head and neck may still result in major consequences despite the advent of antibiotics. Abscesses in these areas merit special consideration by today's head and neck surgeon because of their relative rarity and the life-threatening complications that may follow inadequate treatment. Diagnosis and management decisions are enhanced by use of computerized tomography (CT) as an adjunctive study. The EMI scan may demonstrate either cellulitis of the neck requiring no surgery or a space abscess displacing the adjacent structures thus requiring surgical drainage. Anatomy of the significant fascial planes and spaces of the neck will reviewed employing CT utilizing 3 mm cuts. Specific case presentations feature early diagnosis and management.

  7. Canaliculitis in supernumerary puncta and canaliculi

    PubMed Central

    Yong, Ku Chui; Kah, Tan Aik; Annuar, Faridah Hanom

    2011-01-01

    We report the first case of supernumerary puncta and canaliculi presented with canaliculitis. A-59 year-old gentleman presented with painful swelling of the left lower lid for a week, which was associated with epiphora. The swelling was confined to the nasal aspect of the left lower lid (0.5×0.5 mm) with inflamed overlying skin. Two puncta (0.5 mm apart) were noted. The outer punctum at the normal anatomical position was a cul-de-sac while the inner punctum it the caruncle was patent. We described the embryology leading to supernumerary puncta and canaliculi to explain the paradoxical patency of the abnormally located punctum as well as the pathomechanism leading to canaliculitis. The patient was treated with oral cloxacillin 500 mg, 6 hourly for 5 days; the cellulitis subsided after three days. PMID:24765320

  8. Canaliculitis in supernumerary puncta and canaliculi.

    PubMed

    Yong, Ku Chui; Kah, Tan Aik; Annuar, Faridah Hanom

    2011-07-01

    We report the first case of supernumerary puncta and canaliculi presented with canaliculitis. A-59 year-old gentleman presented with painful swelling of the left lower lid for a week, which was associated with epiphora. The swelling was confined to the nasal aspect of the left lower lid (0.5×0.5 mm) with inflamed overlying skin. Two puncta (0.5 mm apart) were noted. The outer punctum at the normal anatomical position was a cul-de-sac while the inner punctum it the caruncle was patent. We described the embryology leading to supernumerary puncta and canaliculi to explain the paradoxical patency of the abnormally located punctum as well as the pathomechanism leading to canaliculitis. The patient was treated with oral cloxacillin 500 mg, 6 hourly for 5 days; the cellulitis subsided after three days.

  9. 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.

  10. Antimicrobial prophylaxis in adults.

    PubMed

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

    2011-07-01

    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.

  11. Venous ulcers--an evidence-based update.

    PubMed

    Spear, Marcia

    2012-01-01

    Leg ulceration can be defined as any chronic ulcer of the lower leg excluding those on the forefoot or toes (Lees & Lambert, 1992). Venous or stasis ulcers account for 80%-85% of all leg ulcers with an overall prevalence of approximately 1% in the United States (Collins & Seraj, 2010; O'Meara, Al-Kurdi, & Ovington, 2008). Venous ulcers are more common in women and the older population (Abbade & Lastoria, 2005; Bergqvist, Lindholm, & Nelzen, 1999). Venous ulcers are often recurrent and chronic and can persist from weeks to even years. Severe complications include cellulitis, osteomyelitis, and malignant changes (Collins & Seraj, 2010). This column discusses the pathophysiology of venous insufficiency and ulcerations, presentation, diagnosis, and current treatment.

  12. 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.

  13. Lymphome non Hodgkinien intramusculaire primitif chez le sujet jeune: à propos d’un cas et revue de la littérature

    PubMed Central

    Majdoul, Soufya; Omari, Nabil; Allali, Youness; Ghabri, Reda; Benchakroun, Nadia; Fadili, Mostafa; Tawfiq, Nezha; Jouhadi, Hassan; Sahraoui, Souha; Nechad, Mohamed; Benider, Abdelatif

    2016-01-01

    Le lymphome non hodgkinien (LNHK) extra-ganglionnaire primitif est rare et sa localisation intramusculaire primitive est exceptionnelle puisqu'elle est observée chez moins de 0,5% des patients. Ils touchent généralement des hommes dont l'âge moyen est de 70 ans. Le traitement standard associe l'exérèse chirurgicale, la chimiothérapie et la radiothérapie. Nous rapportons un cas d'un jeune patient de 31 ans qui s'est présenté pour un syndrome pseudotumorale musculaire au niveau de la jambe droite dont l'examen anatomopathologique avait conclu un lymphome malin non hodgkinien à grandes cellules B intramusculaire. Le patient a été traité par chimiothérapie exclusive avec une rémission complète. PMID:28293339

  14. Pasteurella multocida Bacteremia in an Immunocompromised Patient

    PubMed Central

    Parekh, Jai; Townley, Theresa

    2016-01-01

    We present the case of a 61-year-old Caucasian gentleman who presented with a one-day history of fever, chills, and altered mental status. His symptoms were initially thought to be secondary to cellulitis. Blood cultures grew Pasteurella multocida, a rare pathogen to cause bacteremia. Our patient was treated with ciprofloxacin for two weeks and made a complete and uneventful recovery. Our patient's uncontrolled diabetes mellitus and chronic kidney disease put him at a higher risk for developing serious P. multocida infection. The patient's dog licking the wounds on his legs was considered as the possible source of infection. As P. multicoda bacteremia is rare, but severe with a high mortality rate, it is imperative to have a high index of suspicion for this infection especially in the vulnerable immunocompromised population. PMID:27847521

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

    PubMed

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

    2014-03-03

    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).

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

    PubMed

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

    2016-08-01

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

  17. Sepsis, parenteral vaccination and skin disinfection

    PubMed Central

    Cook, Ian F.

    2016-01-01

    ASBSTRACT Disinfection should be required for all skin penetrative procedures including parenteral administration of vaccines. This review analyses medically attended infectious events following parenteral vaccination in terms of their microbiological aetiology and pathogenesis. Like ‘clean’ surgical site infections, the major pathogens responsible for these events were Staphylococcal species, implicating endogenous con-tamination as a significant source of infection. As 70% isopropyl alcohol swabbing has been shown to effectively disinfect the skin, it would be medico-legally difficult to defend a case of sepsis with the omission of skin disinfection unless the very low risk of this event was adequately explained to the patient and documented prior to vaccination. There was a significant cost-benefit for skin disinfection and cellulitis. Skin disinfection in the context of parenteral vaccination represents a new paradigm of medical practice; the use of a low cost intervention to prevent an event of very low prevalence but of significant cost. PMID:27295449

  18. 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

  19. Amoxicillin combined with clavulanic acid for the treatment of soft tissue infections in children.

    PubMed Central

    Fleisher, G R; Wilmott, C M; Campos, J M

    1983-01-01

    We compared responses to amoxicillin combined with clavulanic acid (ACA) with a cefaclor regimen in children with skin and soft tissue infections (impetigo and cellulitis) due to Staphylococcus aureus, Streptococcus pyogenes, and Haemophilus species. All isolates from the 41 patients we were able to evaluate were susceptible to ACA by disk susceptibility testing at the onset of treatment. The 21 children receiving ACA and 18 (90%) of 20 taking cefaclor responded to therapy. Clinical cure was achieved in 18 (86%) of 21 and 18 (90%) of 20 in the two groups, respectively. Bacteriological failure occurred in 2 (10%) patients in the cefaclor group and none in the group receiving ACA; however, there were 2 (9%) relapses and 1 (5%) reinfection among the 21 children taking ACA. Adverse effects, although mild, occurred more commonly (9 of 21 versus 1 of 20; P = 0.005) with ACA than with cefaclor. PMID:6660847

  20. Performance Comparison of RADARSAT-2 Advanced Moving Object Detection Experiment Modes

    DTIC Science & Technology

    2007-12-01

    détectées au moyen d’une combinaison du traitement adaptatif espace-temps (STAP) pondéré et du détecteur de taux de fausse alarme constant à pondération sur...STAP) pondéré et du détecteur de taux de fausse alarme constant à pondération sur cellule (CA-CFAR). Les résultats montrent une légère différence (c...Pulse 1 Pulse 2 Pulse 1 Pulse 2 Pulse 1 Pulse 2 •3 chans •2×PRF •d = 3.75 m •some aliasing •3 chans •2×PRF •d = 1.875 m •no aliasing •4 chans •2×PRF •d

  1. Laser picoseconde à cavité géante

    NASA Astrophysics Data System (ADS)

    Papadopoulos, D.; Forget, S.; Delaigue, M.; Balembois, F.; Georges, P.

    2004-11-01

    Nous présentons l'étude d'un laser Nd :YVO{4} pompé par diode à modes synchronisés passivement fonctionnant à la cadence de 1,2 MHz. Pour atteindre ce taux de répétition extrêmement bas (le plus bas reporté à ce jour pour ce type de laser), nous avons réalisé une cavité de plus de 120 m en utilisant une cellule multipassage repliée. Des impulsions de 16.3 ps et une puissance moyenne de 470 mW ont été obtenues à 1064 nm.

  2. 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

  3. Complicated coexisting pyogenic and tuberculous otitis media affecting the temporozygomatic, infratemporal, and parotid areas: report of a rare entity.

    PubMed

    Brar, Tripti; Mrig, Sumit; Passey, J C; Agarwal, A K; Jain, Shayma

    2013-01-01

    We report an unusual case in which a 28-year-old woman presented with a long-standing history of ear discharge, hearing loss, facial weakness with ipsilateral facial swelling and cellulitis, a postauricular fistula, and an abscess of the temporozygomatic, infratemporal, and parotid areas. The pus stained positive for bacteria and acid-fast bacilli, and culture was positive for Proteus vulgaris and mycobacteria. Based on these findings, a diagnosis of tuberculous otitis media with complications was made. Computed tomography showed extensive destruction of the tympanic and mastoid part of the temporal bone, as well as lytic lesions in the skull. The patient was placed on antituberculosis drug therapy. Although her facial nerve palsy and hearing loss persisted, she otherwise responded well and did not require surgery.

  4. 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.

  5. Severe odontogenic infection: An emergency. Case report

    PubMed Central

    Crisosto-Jara, Claudia; Diaz-Ricouz, Camilo; Peñarrocha-Diago, Miguel; Peñarrocha-Oltra, David

    2017-01-01

    Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. However, some OI can spread to vital and deep structures, overcome the host immune system - especially in diabetic, immunocompromised or weakened patients - and even prove fatal. Ludwig’s angina is a severe form of diffuse cellulitis that can have an acute onset and spread very rapidly, bilaterally affecting areas of the head and neck, and may prove life threatening. A case of severe dental infection is presented in which emphasis is placed on the importance of airway maintenance, followed by surgical decompression under adequate antibiotic coverage. Key words:Ludwig’s angina, severe odontogenic infection, surgical decompression, dental infection. PMID:28210456

  6. 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

    2013-10-30

    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.

  7. Infective endocarditis and septic pulmonary embolism following scorpion sting envenoming in an 11-year-old child.

    PubMed

    Prakash, Vellasamy; Krishnamurthy, Sriram; Mahadevan, Subramanian; Bethou, Adhisivam; Deepak Barathi, S

    2014-05-01

    Scorpion sting is one of the common paediatric toxicological problems encountered in southern India. This rural emergency often results in an autonomic storm causing peripheral circulatory failure and/or congestive cardiac failure, leading to pulmonary oedema. A rare case of scorpion sting envenoming in an 11-year-old boy that led to local cellulitis, dyspnoea and congestive heart failure is presented. This was followed by a persistent high-grade fever which lasted for more than 2 weeks and was complicated by fatal Staphylococcus aureus infective endocarditis and septic pulmonary embolism. Although infective endocarditis has been reported occasionally in adults following scorpion sting, this is the first case of infective endocarditis in a native valve in a child following scorpion sting. The literature is reviewed and the mechanisms for this association are discussed.

  8. [Panniculitic T-cell lymphoma].

    PubMed

    Rodríguez-Vázquez, María; García-Arpa, Mónica; Martín, Francisco; Calle, Carmen; Marchán, Enrique; Romero, Guillermo; Cortina, Pilar

    2005-03-01

    Panniculitic T-cell lymphoma is a rare, aggressive variant of cutaneous T-cell lymphoma, with fewer than 100 cases described. The main problem is its diagnosis, as both the clinical and the histological features may simulate benign panniculitis. We present the case of a 34-year-old male patient, who had presented with an indurated plaque, sclerodermiform in appearance, on the front of the right thigh for 4 months, later accompanied by fever and constitutional symptoms. The initial diagnosis was cellulitis, but no clinical improvement was seen despite systemic antibiotic therapy. After two skin biopsies, the patient was diagnosed with panniculitic cutaneous T-cell lymphoma. The patient was treated with 8 cycles of CHOP chemotherapy, with resolution of the symptoms.

  9. A ''not so superficial" skin infection in a patient with diabetes.

    PubMed

    Carr, James Michael; Hagan, Guy; Guest, Peter; Gompertz, Simon

    2012-10-30

    A woman in her 60s with type 2 diabetes presented with a 4-week history of a rash on her chest wall, flu-like symptoms and a red right eye. On examination, there was a cellulitic rash over the right chest wall, breast and neck and a hypopyon in the right eye. Chest x-ray demonstrated right upper lobe opacification, with subsequent CT and MRI revealing bilateral collections at the lung apices, and a possible permeative bone destruction of the manubrium, respectively. A diagnosis of primary sternal osteomyelitis with associated lung abscesses, chest wall cellulitis and hypopyon due to endogenous endophthalmitis was made, with microbiological assessment identifying group B β-haemolytic streptococci. The patient underwent surgical debridement of the affected tissue and received 6 weeks of intravenous antibiotics. This case highlights the role of multidisciplinary team involvement in management of infections and the need to consider deep-seated infection in diabetics.

  10. Plants used to treat skin diseases

    PubMed Central

    Tabassum, Nahida; Hamdani, Mariya

    2014-01-01

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

  11. Bordetella holmesii meningitis in an asplenic patient with systemic lupus erythematosus.

    PubMed

    Livovsky, Dan M; Leibowitz, David; Hidalgo-Grass, Carlos; Temper, Violeta; Salameh, Shaden; Korem, Maya

    2012-08-01

    Bordetella holmesii is a slow-growing, Gram-negative, non-oxidizing bacillus with colonies that produce a brown soluble pigment and was originally described by Weyant et al. (1995) as CDC nonoxidizer group 2 (NO-2). It has recently been shown that B. holmesii may be isolated from nasopharyngeal specimens of up to 20% of patients with pertussis-like symptoms. However, invasive B. holmesii has rarely been reported and in the vast majority of cases the patients were immune deficient, mostly as a result of splenectomy or functional asplenia. Clinical presentations have included endocarditis, pneumonia, cellulitis, suppurative arthritis, pyelonephritis and septicaemia but no previous reports have documented meningitis secondary to this organism. Here we report what we believe to be the first clinical description of an adult with B. holmesii meningitis and bacteraemia with a brief review of published cases.

  12. Reporting a Case of Injecting Methylphenidate (Ritalin) Tablets, Intensified Symptoms of Schizoph-renia or Induce Separate Mental Disorder?

    PubMed Central

    Ghaffarinejad, Alireza; Kheradmand, Ali

    2009-01-01

    Background: Methylphenidate is one of the classic amphetamines which can cause or exacerbate psychotic symptoms in schizophrenia patients. Case Report: In this paper, a young man is presented with injection of methylphenidate tablets with acute cellulitis due to this injection and the related symptoms. In the first hospitalization and after recovery from psychotic disorder due to tablet injections, he was under treatment with anti-psychotics because of other symptoms related to schizophrenia. Although the patient was regularly under schizophrenic medication after discharge, he was hospitalized twice more due to psychotic symptoms that appeared after injecting methylphenidate. Conclusion: This report shows psychotic symptoms in schizophrenic patients after injecting methylphenidate. These symptoms cannot be prevented even by anti-psychotic medication of background disease. This case shows the existence of two kinds of psychoses, functional (due to schizophrenia) and organic psychoses (due to methylphenidate use) in the same patient. PMID:24494093

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

    PubMed Central

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

    2016-01-01

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

  14. Lamb pays lip service: two cases of ecthyma contagiosum (orf).

    PubMed

    de Wet, Carl; Murie, Jill

    2011-02-01

    Ecthyma contagiosum (orf) is caused by a parapox virus, which results in ulcerative stomatitis of mainly sheep and goats. The disease may be transmitted to humans through direct contact. Complications are rare in healthy individuals, who rarely report the disease. Two married, recreational sheep farmers, were bitten on their index fingers by an affected lamb. While the husband made an uneventful recovery after oral flucloxacillin, his wife was admitted to hospital with necrosis of her finger, cellulitis and lymphangitis requiring intravenous clindamycin. She subsequently developed a generalized maculo-papular rash, which was initially thought to be an adverse drug reaction, but, on hindsight, may have been erythema multiforme associated with orf. Orf is a common zoonosis, rarely reported in general practice. The disease is usually self-limiting and resolves in 6-8 weeks, but complications may occur. The diagnosis should be considered in at-risk occupational and religious groups.

  15. Pneumopathie à éosinophile révélant un lymphome non hodgkinien de type B

    PubMed Central

    Fikal, Siham; Sajiai, Hafsa; Serhane, Hind; Aitbatahar, Salma; Amro, Lamyae

    2016-01-01

    Le diagnostic de pneumonie à éosinophile est rare et l'étiologie maligne reste exceptionnelle. Les étiologies sont variables et sont dominées essentiellement par les affections allergiques et les causes médicamenteuses. Nous rapportons le cas d'un lymphome non hodgkinien de type B révélé par une pneumonie à éosinophile chez un patient de 61 ans. Le diagnostic de pneumonie à éosinophile a été confirmé par un taux d'éosinophile à 56% au lavage bronchoalvéolaire. L'étude immunohistochimique de la biopsie ostéomédullaire a révélé un lymphome malin non hodgkinien à petites cellules de phénotype B. PMID:28154647

  16. Le plasmocytome solitaire osseux: à propos de 3 cas et revue de la littérature

    PubMed Central

    Masmoudi, Karim; Elleuch, Emna; Akrout, Rim; Mnejja, Mohamed Amine; Feki, Afef; Ezzeddine, Mariam; Baklouti, Sofiène; Jemaâ, Ben

    2016-01-01

    Les plasmocytomes solitaires sont rares et représentent moins de 5 % de l'ensemble des proliférations plasmocytaires. Son diagnostic repose 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 d'une forme disséminée. Le but de ce travail est d'effectuer une étude rétrospective de 3 observations de plasmocytomes solitaires osseux associée à une revue détaillée de la littérature décrivant les caractéristiques diagnostiques, thérapeutiques et évolutives de cette entité rare. PMID:28292172

  17. 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.

  18. [Transformation from chronic subdural hematoma into subdural empyema following cat bites: a case report].

    PubMed

    Konno, Takuya; Yamada, Kei; Kasahara, Sou; Umeda, Yoshitaka; Oyake, Mutsuo; Fujita, Nobuya

    2015-01-01

    A 69-year-old man developed motor aphasia and right hemiparesis with severe headache, during the treatment of cellulitis and sepsis due to cat bites. Brain CT showed a low density, crescent-shaped lesion in the left subdural space, which was hypointense on brain diffusion-weighted imaging (DWI). One week later, when his neurological symptoms had worsened, the signal of the subdural lesion had changed to hyperintense on DWI. The lesion was capsule-shaped when enhanced by Gadolinium. The signal changes on DWI of the lesion indicated the existing hematoma had changed to an empyema, or so-called infected subdural hematoma, due to a hematogenous bacterial infection. Pasteurella multocida, a resident microbe in the oral cavity of cats, could be the responsible pathogen in this case. The patient recovered completely after treatment with intravenous high dose antibiotics. This is an important case report describing the transformation from a chronic subdural hematoma into a subdural empyema by DWI.

  19. Pseudomonas aeruginosa ecthyma gangrenosum in a woman with recurrent Graves' disease.

    PubMed

    Zhu, Cheng-Yao; Zhang, Guo-Xue; Yu, Zuo-Zhong; Li, Zhao-Jun; Fan, Yi-Ming

    2014-04-01

    A 35-year-old woman with postoperative recurrent Graves' disease presented with a 5-day history of a red swelling on the right cheek associated with 4 days of remittent hyperpyrexia. Investigations revealed fever, a gangrenous ulcer on the right cheek, submandibular lymphadenopathy, and thyroid gland enlargement. Her white blood cell count, immunoglobulins, and lymphocyte subsets were unremarkable. Thyroid function tests showed low thyroid-stimulating hormone, high free thyroxine, and elevated radioactive iodine uptake. Repeated pus cultures grew Pseudomonas aeruginosa, but blood cultures were negative. An ill-demarcated erythematous plaque occurred on the right leg on hospital day 3. She was treated with intravenous antibiotics with topical gentamicin, recombinant bovine basic fibroblast growth factor, and radioiodine therapy with anti-thyroid drugs. The ulcer healed leaving a depressed scar at 35 days after discharge. This patient may represent the first case of P. aeruginosa ecthyma gangrenosum and cellulitis in postoperative recurrent Graves' disease.

  20. Nocardia cyriacigeorgica as the causative agent of mandibular osteomyelitis (lumpy jaw) in a cat.

    PubMed

    Soto, Esteban; Arauz, Maziel; Gallagher, Christa Ann; Illanes, Oscar

    2014-07-01

    An unusual case of osteomyelitis caused by Nocardia cyriacigeorgica infection and resulting in mandibular osteomyelitis and cellulitis (lumpy jaw) is described in a young cat. A 1-cm hard nodular mass was an incidental finding in the right mandible of a 14-month-old cat during routine physical examination. The lesion was fast growing, reaching up to 6 cm in its largest dimension over a 5-week period. A core biopsy of the affected mandible revealed foci of osteolysis, woven bone formation, and a few large clusters of filamentous bacteria surrounded by fine eosinophilic amorphous material bordered by neutrophils, plasma cells, macrophages, and occasional multinucleated giant cells. Pure cultures of acid-fast variable, Gram-positive filamentous bacteria were recovered on blood and chocolate agar plates at 48-hr postinoculation. On amplification and sequencing of the 16S ribosomal RNA and 65-kDa heat shock protein genes, the microorganisms were identified as N. cyriacigeorgica, within the actinomycetes.

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

    PubMed

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

    2016-06-16

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

  2. 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.

  3. 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.

  4. 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.

  5. Morganella morganii, a non-negligent opportunistic pathogen.

    PubMed

    Liu, Hui; Zhu, Junmin; Hu, Qiwen; Rao, Xiancai

    2016-09-01

    Morganella morganii belongs to the tribe Proteeae of the Enterobacteriaceae family. This species is considered as an unusual opportunistic pathogen that mainly causes post-operative wound and urinary tract infections. However, certain clinical M. morganii isolates present resistance to multiple antibiotics by carrying various resistant genes (such as blaNDM-1, and qnrD1), thereby posing a serious challenge for clinical infection control. Moreover, virulence evolution makes M. morganii an important pathogen. Accumulated data have demonstrated that M. morganii can cause various infections, such as sepsis, abscess, purple urine bag syndrome, chorioamnionitis, and cellulitis. This bacterium often results in a high mortality rate in patients with some infections. M. morganii is considered as a non-negligent opportunistic pathogen because of the increased levels of resistance and virulence. In this review, we summarized the epidemiology of M. morganii, particularly on its resistance profile and resistant genes, as well as the disease spectrum and risk factors for its infection.

  6. [Pott's puffy tumor: a rare complication of frontal sinusitis].

    PubMed

    Aínsa Laguna, D; Pons Morales, S; Muñoz Tormo-Figueres, A; Vega Senra, M I; Otero Reigada, M C

    2014-05-01

    Pott's puffy tumor is a rare complication of frontal sinusitis characterized by swelling and edema in the brow due to a subperiosteal abscess associated with frontal osteomyelitis. Added complications are cellulitis by extension to the orbit and intracranial infection by posterior extension, with high risk of meningitis, intracranial abscess, and venous sinus thrombosis. Early diagnosis and aggressive medical or surgical treatment are essential for optimal recovery of affected patients. In the antibiotic age it is extremely rare, with very few cases described in the recent literature. A case is presented of a Pott inflammatory tumor in a 7 year-old boy, as a complication of acute pansinusitis who presented with front preseptal swelling and intracranial involvement with thrombosis of ophthalmic and superior orbital veins and frontal epidural abscess extending to the subarachnoid space.

  7. Diffusion-weighted and diffusion-tensor imaging of normal and diseased uterus

    PubMed Central

    Kara Bozkurt, Duygu; Bozkurt, Murat; Nazli, Mehmet Ali; Mutlu, Ilhan Nahit; Kilickesmez, Ozgur

    2015-01-01

    Owing to technical advances and improvement of the software, diffusion weighted imaging and diffusion tensor imaging (DWI and DTI) greatly improved the diagnostic value of magnetic resonance imaging (MRI) of the pelvic region. These imaging sequences can exhibit important tissue contrast on the basis of random diffusion (Brownian motion) of water molecules in tissues. Quantitative measurements can be done with DWI and DTI by apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values respectively. ADC and FA values may be changed by various physiological and pathological conditions providing additional information to conventional MRI. The quantitative DWI assists significantly in the differentiation of benign and malignant lesions. It can demonstrate the microstructural architecture and celluler density of the normal and diseased uterine zones. On the other hand, DWI and DTI are useful for monitoring the treatment outcome of the uterine lesions. In this review, we discussed advantages of DWI and DTI of the normal and diseased uterus. PMID:26217454

  8. [Classification of lymphedema].

    PubMed

    Lazareth, I

    2002-06-01

    Classification of lymphedema is debated, because authors don't agree with the disordered physiology. Kinmonth divided all cases into primary and secondary lymphedema. Three types of primary lymphedema have been recognized: congenital, precox and tarda. Secondary lymphedema develops as a consequence of disruption or obstruction of the lymphatic pathways. Iatrogenic lymphedema are caused by surgery and/or radiation therapy. Post-infectious lymphedema are mainly caused by filariasis in tropical areas, and by cellulitis in occidental areas. Neoplastic disease (breast, prostatic cancer, Kaposi's sarcoma) are a major cause of secondary lymphedema. Less frequent etiologies are rheumatoid lymphedema, pathomimic lymphedema, pretibial myxoedema. Reduced lymphatic drainage is associated with severe chronic venous insufficiency and contributes to the leg swelling and the risk of infection.

  9. Heparin in the long-term management of ligneous conjunctivitis: a case report and review of literature.

    PubMed

    Hiremath, Mandira; Elder, James; Newall, Fiona; Mitchell, Susan; Dyas, Roxanne; Monagle, Paul

    2011-10-01

    Ligneous conjunctivitis, secondary to inherited homozygous plasminogen deficiency, is a poorly understood condition that has the potential to hinder normal childhood development if not managed adequately. We report the clinical progression of a child with ligneous conjunctivitis, controlled with daily heparin eye drops, postsurgical excision, for a duration of approximately 5 years at a cost of approximately 30 USD per month. During this time, the patient's progress has been complicated by one occurrence of periorbital cellulitis and also otitis media. The patient has also experienced ocular complications due to the remaining membranous lesion. This case indicates that individual patient factors including plasminogen levels and exposure to triggers of ocular inflammation may influence the clinical progression of ligneous conjunctivitis. Furthermore, this study is one of the first to present over 5-year follow-up of a patient with ligneous conjunctivitis effectively managed with long-term heparin eye drops.

  10. 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.

  11. [Malignant external otitis. When and which imaging].

    PubMed

    Marsot-Dupuch, K; Tiyriboz, A; Meyer, B; Hagege, E; Achouche, J; Guillausseau, P D; Chouard, C H

    1991-01-01

    Malignant external otitis (MEO) is a severe infection of the external auditory canal (EAC), most often caused by Pseudomonas aeruginosa, although a few cases are caused by an Aspergillus (4). Mortality remains high (20%) in spite of an early general antibiotic treatment. This infection of the soft tissue of the EAC causes cellulitis, chondritis and osteomyelitis, and there are risks of diffusion into the base of the skull. Our work is aimed at placing computed tomography and magnetic resonance imaging into the context of exploration of this infection, in relation to radionuclide scanning, owing to our experience with 10 patients. Imaging appreciates the anatomical extension of the infection beyond the EAC and towards the base of the skull and the infratemporal fossa, this being a key element for prognosis. It assesses the efficiency and duration of treatment, although the criteria of healing are still difficult to appreciate and late recurrence is frequent. Exceptionally, it is useful for diagnosis in some particular clinical forms.

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

    NASA Astrophysics Data System (ADS)

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

    1998-06-01

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

  13. 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

  14. Rhinocerebral mucormycosis in a patient with type 1 diabetes presenting as toothache: a case report from Himalayan region of India

    PubMed Central

    Singh, Vikram; Singh, Mridu; Joshi, Chitra; Sangwan, Jyoti

    2013-01-01

    Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. It is a rapidly progressive fatal infection mostly reported in susceptible individuals, such as those with poorly controlled diabetes or those with defects in phagocytic function. Rhinocerebral mucormycosis is the most common type of mucormycosis in diabetic patients. This case report describes a 17-year-old girl with type 1 diabetes mellitus presenting with rhinocerebral mucormycosis. The patient presented with a history of toothache and facial pain with oedema of left half of face, periorbital oedema and depressed conciousness. She had hyperglycaemia with diabetic ketoacidosis and rapidly developed hemiparesis progressing to quadriparesis and died within 3 days of admission. The current report emphasises the importance of having a high index of suspicion when dealing with patients with diabetes presenting with facial pain or cellulitis and prompt initiation of medical therapy along with surgical debridement for control of rhinocerebral mucormycosis. PMID:24172773

  15. 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

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

    PubMed Central

    Nayak, Madhurima K.

    2016-01-01

    Multiple myeloma cripples the human body in many ways, one of them being decreased immunity. Infections occurring spontaneously can increase the morbidity. We report a case of an elderly lady with multiple myeloma on treatment and uncontrolled diabetes, who developed loss of vision, swelling and redness of left eye of 4 days duration. There was no history of injury or entry of a foreign body. She also had left arm cellulitis. Ocular examination revealed visual acuity of 6/36 in right eye and no perception of light in left eye. Anterior segment of the right eye was insignificant while the left eye showed features suggestive of panophthalmitis. B scan revealed choroidal detachment and confirmed panophthalmitis. She underwent evisceration of the left eye. The cause of spontaneous infections is an immunocompromised state due to multiple myeloma and uncontrolled diabetes. This case report highlights the propensity of multiple myeloma to cause infections of the eye debilitating enough to cause severe visual morbidity. PMID:27630876

  17. Histopathology of marine vibrio wound infections.

    PubMed

    Beckman, E N; Leonard, G L; Castillo, L E; Genre, C F; Pankey, G A

    1981-12-01

    Although marine vibrio wound infections and septicemia are being reported with increasing frequency, description of the histopathologic changes has been scanty. The histologic alterations in three patients with primary marine vibrio wound infections are presented. The lesions are characterized by intense acute cellulitis of the subcutis with much tissue destruction and extension into the adjacent dermis. The superficial dermis is devitalized and lacks an inflammatory cellular infiltrate. Subepidermal noninflammatory bullae are formed. Many organisms are seen both within the areas of intense acute inflammation and in devitalized areas. Organisms and inflammation are especially oriented around vessels, with associated acute vasculitis. It is concluded that the morphologic picture in marine vibrio wound infections is nonspecific yet characteristic.

  18. 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

  19. [Osteomyelitis due to Shewanella putrefaciens: case report and literature review].

    PubMed

    Guinetti-Ortiz, Katia; Bocanegra-Jesús, Alejandra; Gómez de la Torre-Del Carpio, Andrea

    2016-11-29

    Shewanella putrefaciens is a Gram-negative bacillus and marine pathogen that rarely causes disease in humans. We report a case of osteomyelitis by this organism in a 48-year-old male patient, who presented with pain and erythema of the right foot that was initially diagnosed as cellulitis and did not revert despite treatment. He was transferred to Lima where osteomyelitis was diagnosed and started on empirical treatment with partial regression. A biopsy and culture of the compromised area found S. putrefaciens. The infection was treated according to the antibiotic sensitivity profile of the pathogen. S. putrefaciens infection represents a rare opportunistic infection of devitalized or exposed areas of the body. It is associated with residence in coastal areas and commonly affects the skin and soft tissues. Exceptional cases of osteomyelitis have been reported, but this is the first that involves the metatarsal bones.

  20. Understanding and communicating the benefits and risks of denosumab, raloxifene, and teriparatide for the treatment of osteoporosis.

    PubMed

    Lewiecki, E Michael; Miller, Paul D; Harris, Steve T; Bauer, Douglas C; Davison, K Shawn; Dian, Larry; Hanley, David A; McClung, Michael R; Yuen, Chui K; Kendler, David L

    2014-01-01

    The number needed to treat is a valuable metric to determine the benefit of therapy, but it must be viewed against the respective number needed to harm. Denosumab and teriparatide (TPTD) have proven antifracture efficacy at vertebral and nonvertebral sites, whereas raloxifene has proven antifracture efficacy at the spine only. Denosumab use has been associated with a small, yet statistically significant, increased incidence of eczema and serious cellulitis. Raloxifene use has been associated with statistically significant increases in the risk of venous thromboembolism and possibly deadly stroke, although not an increase in total strokes. No significant, nontransient adverse events have been reported with TPTD use. When used for the treatment of postmenopausal osteoporosis, denosumab, raloxifene, and TPTD all generally have favorable risk-to-benefit profiles, but therapy-specific contraindications necessitate thoughtful consideration of all available clinical information and individualization of treatment decisions.

  1. Serratia marcescens-contaminated baby shampoo causing an outbreak among newborns at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

    PubMed

    Madani, T A; Alsaedi, S; James, L; Eldeek, B S; Jiman-Fatani, A A; Alawi, M M; Marwan, D; Cudal, M; Macapagal, M; Bahlas, R; Farouq, M

    2011-05-01

    During November 2008 to January 2009, 11 babies in the neonatal intensive care (NICU) and three babies in the nursery were infected with Serratia marcescens at King Abdulaziz University Hospital in Saudi Arabia. Overall, fifteen infections were identified among 11 newborns in the NICU: septicaemia (five cases), purulent conjunctivitis (three), urinary tract infection (two), meningitis (two) and cellulitis (one). Three newborns in the nursery had three infections: purulent conjunctivitis (two cases) and omphalitis (one). Thirteen of 14 babies recovered fully but one died from S. marcescens meningitis and septicaemia. All infections were traced to intrinsically contaminated baby shampoo introduced to the units five days before the first reported case. The outbreak terminated following withdrawal of the shampoo product.

  2. Medical Surveillance Monthly Report (MSMR). Volume 6, Number 4, April 2000

    DTIC Science & Technology

    2000-04-01

    Contact dermatitis and other eczema 15,725 25.1 692 Contact dermatitis and other eczema 4,784 24.4 706 Diseases of sebaceous glands 7,817 12.5 706 Diseases...dermatitis and other eczema 6 8.1 686 Other local infections of skin 11 3.2 681 Cellulitis and abscess of finger and toe 4 5.4 706 Diseases of sebaceous...14,358 8 Masters 19,766 4 13,133 4 32,961 9 2,724 2 Doctorate 8,106 2 5,266 1 8,657 2 417 0 Rank (grade) PVT (E1) - PFC (E3) 108,389 23 90,506 25

  3. Differential diagnosis of leukocoria and strabismus, first presenting signs of retinoblastoma

    PubMed Central

    Balmer, Aubin; Munier, Francis

    2007-01-01

    Leukocoria in infants is always a danger signal as retinoblastoma, a malignant retinal tumor, is responsible for half of the cases in this age group. More common signs should also be considered suspicious until proved otherwise, such as strabismus, the second most frequent sign of retinoblastoma. Less frequent manifestations are inflammatory conditions resistant to treatment, hypopyon, orbital cellulitis, hyphema or heterochromia. Other causal pathologies, including persistent hyperplastic primary vitreous (PHPV), Coats’ disease, ocular toxocariasis or retinopathy of prematurity, may also manifest the same warning signs and require specialized differential diagnosis. Members of the immediate family circle are most likely to notice the first signs, the general practitioner, pediatrician or general ophthalmologist the first to be consulted. On their attitude will depend the final outcome of this vision and life-threatening disease. Early diagnosis is vital. PMID:19668520

  4. Frontal sinus mucocele in association with fibrous dysplasia: review and report of two cases.

    PubMed

    Derham, Chris; Bucur, Sorin; Russell, John; Liddington, Mark; Chumas, Paul

    2011-02-01

    We present two paediatric cases of fibrous dysplasia (FD) who presented to the craniofacial neurosurgical clinic with ophthalmological symptoms associated with sinus mucoceles. The first patient presented with a history of orbital cellulitis and an increasing bony swelling around the orbit associated with proptosis. Radiological imaging revealed monostotic FD associated with an obstructive mucocele in the frontal sinus with extension into the orbit. The second patient presented with recurrent conjunctivitis, painful proptosis, rhinitis and a bony peri-orbital swelling. Both patients had histological diagnoses of frontal mucoceles invading the orbit in association with FD. They both underwent frontal craniotomies and excision of the mucocele/fibrous dysplastic complex. In summary, mucocele development is an unusual complication of FD, likely to occur secondary to occlusion of the sinus drainage system. Orbital involvement may lead to visual disturbance caused by pressure effects. A multi-disciplinary approach including maxillofacial surgeons, plastic surgeons and neurosurgeons is advocated.

  5. An atypical presentation of a Pasteurella multocida infection following a cat bite: a case report.

    PubMed

    Collins, Chris; Flanagan, Brigitte; Henning, J Scott

    2012-06-01

    Pasteurella multocida is a bacterial organism that commonly causes cellulitis after animal bites, especially cat bites. We report an unusual vesiculopustular infection of the hand following a domestic cat bite. Pasteurella multocida and Staphylococcus aureus were cultured from the wound and the patient was treated with amoxicillin-clavulanate potassium. Further history revealed that the patient's cat had nibbled on her hand. Pasteurella usually is resistant to many of the typical empiric antibiotics used to treat skin infections. Amoxicillin-clavulanate potassium (500 mg 3 times daily) is the treatment of choice for patients who have an infected cat or dog bite with no known bacterial cause. A thorough patient history is needed to promptly arrive at a proper diagnosis for an atypical presentation of a common disease.

  6. 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

  7. A rural worker infected with a bovine-prevalent genotype of Campylobacter fetus subsp. fetus supports zoonotic transmission and inconsistency of MLST and whole-genome typing.

    PubMed

    Iraola, G; Betancor, L; Calleros, L; Gadea, P; Algorta, G; Galeano, S; Muxi, P; Greif, G; Pérez, R

    2015-08-01

    Whole-genome characterisation in clinical microbiology enables to detect trends in infection dynamics and disease transmission. Here, we report a case of bacteraemia due to Campylobacter fetus subsp. fetus in a rural worker under cancer treatment that was diagnosed with cellulitis; the patient was treated with antibiotics and recovered. The routine typing methods were not able to identify the microorganism causing the infection, so it was further analysed by molecular methods and whole-genome sequencing. The multi-locus sequence typing (MLST) revealed the presence of the bovine-associated ST-4 genotype. Whole-genome comparisons with other C. fetus strains revealed an inconsistent phylogenetic position based on the core genome, discordant with previous ST-4 strains. To the best of our knowledge, this is the first C. fetus subsp. fetus carrying the ST-4 isolated from humans and represents a probable case of zoonotic transmission from cattle.

  8. Management of hand infection in Khartoum.

    PubMed

    Ezeldeen, K; Fahal, A H; Ahmed, M E

    1992-11-01

    One hundred and fifty patients with hand infection seen during 6 months period at Khartoum Teaching Hospital were studied. The disease is more common among young males manual and industrial workers (M:F = 2:1). Common types of hand infections were paronychia in (41%) of patients, volar infections in (30.6%) and subcutaneous infections in (30%) of patients. 30% of patients needed hospital admission including all diabetics (n = 15). Two patients had serious complications that resulted in above elbow amputation. The first was a diabetic with spreading cellulitis and the second was a mentally retarded with gas gangrene. Initial empirical antibiotic therapy was prescribed in 89% of patients and later was modified according to sensitivity results. 90% of patients needed surgical drainage. Bacteriological examination showed Staph. aureus in 51% of cultures and the staphylococcus was resistant to penicillin in 77% of cultures. Apart from two deaths, the rest of the patients had satisfactory outcome.

  9. "Hot potato voice" in peritonsillitis: a misnomer.

    PubMed

    Bhutta, Mahmood F; Worley, George A; Harries, Meredydd L

    2006-12-01

    The "hot potato voice" is widely recognized as a symptom of peritonsillar cellulitis or abscess; yet there have been no studies assessing the resonance characteristics of the vocal tract in peritonsillitis. Analysis was undertaken of formant frequencies in the articulation of the vowels /i:/. /a:/ and /u:/ in six subjects with peritonsillitis and compared with articulation once the peritonsillitis had settled. Significant variation was found in F1 when articulating /i:/ and in F2 when articulating /a:/, which are explainable by dyskinesis of the peritonsillar musculature. These findings were compared with six subjects articulating the same vowels with and without a hot potato in their mouth. Variation was found in both F1 and F2 when articulating /i:/, which can be related to interference of the potato with movement of the anterior tongue. The changes in the vocal tract differ in these two cases and the title "hot potato voice" in peritonsillitis is a misnomer.

  10. [Hyper-immunoglobulin E syndrome: report of one case].

    PubMed

    Aguilera, Guillermo; Cárcamo, Guillermo; Sepúlveda, Juan; Vinet, Ana María; Martínez, Carlos

    2015-06-01

    The Hyperimmunoglobulin E syndrome (HIES) is a rare sporadic or autosomal dominant immune and connective tissue disorder characterized by chronic eczema, cutaneous abscesses, pneumonias, invasive infections, high levels of Immunoglobulin E, primary teeth retention and bone abnormalities. We report a 24-year-old male with a history of cutaneous abscesses and esophageal candidiasis. He was admitted due to a left gluteal cellulitis. During the fifth day of hospitalization he presented a distal necrosis of the fourth finger of the right hand. Laboratory results showed high levels of IgE and positive cryoglobulins. The patient was discharged and was admitted again five days later with a new gluteal abscess. IgE levels were even higher. Applying Grimbacher scale, the diagnosis of Hyperimmunoglobulin E syndrome was reached.

  11. Infective Endocarditis Caused by Neisseria elongata on a Native Tricuspid Valve and Confirmed by DNA Sequencing

    PubMed Central

    Yoo, Yeon Pyo; Kang, Ki-Woon; Yoon, Hyeon Soo; Yoo, Seungmin; Lee, Myung-Shin

    2014-01-01

    Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies. PMID:24808790

  12. Pyomyositis after vaginal delivery.

    PubMed

    Gaughan, Eve; Eogan, Maeve; Holohan, Mary

    2011-07-07

    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.

  13. Molecular and pathological characterization of Fusarium solani species complex infection in the head and lateral line system of Sphyrna lewini.

    PubMed

    Pirarat, Nopadon; Sahatrakul, Komsil; Lacharoje, Sitthichok; Lombardini, Eric; Chansue, Nantarika; Techangamsuwan, Somporn

    2016-08-09

    A severe fungal infection affecting the head and lateral line system was diagnosed in 7 captive scalloped hammerhead sharks Sphyrna lewini in an aquarium in Thailand. Extensive and severe necrotizing cellulitis was consistently observed microscopically along the cephalic and lateral line canals in conjunction with positive fungal cultures for Fusarium sp. Molecular phylogenetic analysis was performed from 3 isolates based on the nucleotide sequences containing internally transcribed spacer (ITS) and a portion of 5.8S and 28S rDNA. The fungus was highly homologous (100%) and closely related to F. solani species complex 2 (FSSC 2), which belongs to Clade 3 of the FSSC. Our results illustrate the histopathological findings and expand upon our knowledge of the prevalence of invasive fusariosis in the head and lateral line system of hammerhead sharks.

  14. Importance des communications intercellulaires en radiopathologie expérimentale : le syndrôme inflammatoire radioinduit

    NASA Astrophysics Data System (ADS)

    Agay, D.; Clarencon, D.; Multon, E.; Mestries, J.-C.; van der Meeren, A.; Mouthon, M.-A.; Gourmelon, P.

    1998-04-01

    The monolithic image of radiation pathology, the physiopathological mechanisms of which are limited to the conventional concept of specific “target cell" with mitotic and apoptotic cell death, is changing owing to our increasing knowledge about intercellular communications. The cellular radiationbiology is currently enriched by the “humoral" radiationbiology with its concept of “target network" including cells and intercellular messengers. The radiation-induced disorders observed in these networks take shape in the inflammatory reaction, which is largely involved, in the physiopathological development of the acute radiation syndrome. These concepts of a perpetual cascade of cytokines, leading to radiation-induced late effects with no biological latent period, are especially illustrated by the radiation-induced pneumonitis and pulmonary fibrosis. L'image monolithique de la radiopathologie dont les mécanismes physiopathologiques sont réduits aux concepts classiques de “cellule cible" spécifique avec mort cellulaire mitotique et apoptotique, se modifie grâce à l'accroissement de nos connaissances sur les communications intercellulaires. La radiobiologie cellulaire s'enrichit aujourd'hui de la radiobiologie “humorale" avec son concept de “réseau cible" tant au niveau des cellules que des messagers intercellulaires. Les désordres radio-induits observés au niveau de ces réseaux se concrétisent dans la réaction inflammatoire qui est fortement impliquée dans l'évolution physiopathologique du syndrome aigu d'irradiation. Ces concepts d'une cascade perpétuelle de cytokines, sans période de latence biologique et qui amènent aux effets tardifs radio-induits, sont particulièrement illustrés dans la pneumonie et la fibrose pulmonaire radio-induites.

  15. Apports de la spéciation biologique en dosimétrie interne

    NASA Astrophysics Data System (ADS)

    Paquet, F.; Ansoborlo, E.; Chazel, V.; Hengé-Napoli, M. H.; Houpert, P.

    1998-04-01

    Speciation studies consist in the determination of the molecular characteristics of the elements. The research currently carried out in that field is aimed at describing the intracellular deposit of the radionuclides and the complexation mechanisms which determine their behaviour. Such studies are developed in order to contribute towards the solution of two major problems in the field of internal dosimetry: the realistic assessment of the dose received by the target cells and the therapeutic removal of neptunium or uranium after internal contamination. The work presented thereafter resumes the main results obtained in that field. La spéciation est l',étude des caract,ristiques moléculaires des ,éléments radioactifs. Un des axes majeurs développé, dans ce domaine cherche à? décrire les mécanismes de complexation et de dépt des radionucléides dans les cellules. Ces ,études sont effectuées pour tenter d'élucider deux problèmes majeurs de la dosimétrie interne: l'estimation réaliste des doses reçues par les cellules cibles après contamination interne et amélioration des thérapeutiques proposées après incorporation accidentelle. Le présent rapport fait le point sur les derniers travaux réalisés, sur le Np et résume les principales avancées dans ce domaine.

  16. Wound infections on board ship--prevention, pathogens, and treatment.

    PubMed

    Dahl, Eilif

    2011-01-01

    Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5-10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2-3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea.

  17. Interface dynamics and anisotropy effects in directional solidification

    NASA Astrophysics Data System (ADS)

    de Cheveigné, S.; Guthmann, C.

    1992-02-01

    A study of the dynamics of the cellular solid-liquid interface in directional solidification of dilute CBr{4} alloy has allowed us to observe a number of secondary instabilities (travelling states, optical modes, anomalous cells, etc.) some of which were well known and traditionally attributed to the effect of crystalline anisotropy. However, most of these instabilities are also observed in a hydrodynamic analog of directional solidification, directional viscous fingering (M. Rabaud, S. Michalland and Y. Couder, Phys. Rev. Lett. 64 (1990) 184). This analogy enables us to discuss the interplay of crystalline anisotropy and of the dynamics generic to one-dimensional systems in directional solidification. Une étude de la dynamique de l'interface cellulaire en solidification directionnelle d'un alliage binaire dilué de CBr4 nous a permis d'observer un certain nombre d'instabilités secondaires (propagation de cellules inclinées, modes optiques, cellules anormales, etc.) dont certaines étaient bien connues et traditionnellement attribuées à des effets de l'anisotropie cristalline. Cependant, la plupart de ces instabilités sont observables dans une expérience qui est l'analogue hydrodynamique de la solidification directionnelle, la digitation visqueuse dirigée ou instabilité de l'imprimeur (M. Rabaud, S. Michalland and Y. Couder, Phys. Rev. Lett. 64 (1990) 184). Cette analogie va nous permettre de discuter les rôles respectifs de l'anisotropie cristalline et de la dynamique propre aux systèmes uni-dimentionnels.

  18. 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

  19. Routes of early enteral nutrition following oesophagectomy.

    PubMed

    Elshaer, M; Gravante, G; White, J; Livingstone, J; Riaz, A; Al-Bahrani, A

    2016-09-01

    Introduction Oesophagectomy for cancer is a challenging procedure with a five-year overall survival rate of 15-20%. Early enteral nutrition following oesophagectomy is a crucial component of the postoperative recovery and carries a significant impact on the outcome. Different methods of enteral feeding were conducted in our unit. The aim of this study was to examine the efficacy and safety of nasojejunal tube (NJT), jejunostomy tube (JT) and pharyngostomy tube (PT) feeding after oesophagectomy. Methods A retrospective review was carried out of prospectively collected data on patients with oesophageal cancer who underwent an oesophagectomy between 2011 and 2014. The primary outcome was feeding tube related complications such as occlusion, dislocation and leak. The secondary outcomes were length of stay and 30-day morbidity. Results A total of 90 oesophagectomies were included in the study. A NJT was inserted in 41 patients (45.6%), a JT was used in 14 patients (15.5%) and a PT was the route for enteral nutrition in 35 patients (38.9%). In total, five patients (5.5%) developed tube related complications. There were no tube related complications in the NJT group but one JT patient (7.1%) developed tube related cellulitis (p=0.189) and four PT patients (11.4%) developed tube related haemorrhage (p=0.544), tube dislocation (p=0.544) or cellulitis (p=0.189). The median length of stay and 30-day postoperative morbidity were similar between the groups. Conclusions NJT feeding is a less invasive, feasible route for early enteral nutrition following oesophagectomy. A randomised controlled trial is recommended to verify these findings.

  20. In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and meta-analysis

    PubMed Central

    Chenkin, Jordan; Cho, Dennis D; Jelic, Tomislav; Scheuermeyer, Frank X

    2017-01-01

    Objectives The primary objective of this systematic review was to determine the accuracy of point-of-care ultrasonography (POCUS) in diagnosing abscess in emergency department (ED) patients with skin and soft tissue infections (SSTI). The secondary objective was the accuracy of POCUS in the paediatric population subgroup. Setting Prospective studies set in emergency departments. Participants Emergency department patients (adult and paediatric) presenting with SSTI and suspected abscess. Primary and secondary outcome measures This systematic review was conducted according to Cochrane Handbook guidelines, and the following databases were searched: PubMed, MEDLINE, EMBASE and the Cochrane database of systematic reviews (1946–2015). We included prospective cohort and case–control studies investigating ED patients with SSTI and abscess or cellulitis, a defined POCUS protocol, a clearly defined gold standard for abscess and a contingency table describing sensitivity and specificity. Two reviewers independently ascertained all potentially relevant citations for methodologic quality according to QUADAS-2 criteria. The primary outcome measure was the sensitivity and specificity of POCUS for abscess. A preplanned subgroup (secondary) analysis examined the effects in paediatric populations, and changes in management were explored post hoc. Results Of 3028 articles, 8 were identified meeting inclusion criteria; all were rated as good to excellent according to QUADAS-2 criteria. Combined test characteristics of POCUS on the ED diagnosis of abscess for patients with SSTI were as follows: sensitivity 96.2% (95% CI 91.1% to 98.4%), specificity 82.9% (95% CI 60.4% to 93.9%), positive likelihood ratio 5.63 (95% CI 2.2 to 14.6) and negative likelihood ratio 0.05 (95% CI 0.01 to 0.11). Conclusions A total of 8 studies of good-to-excellent quality were included in this review. The use of POCUS helps differentiate abscess from cellulitis in ED patients with SSTI. Trial registration

  1. 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

  2. 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

  3. Complicating osteomyelitis imaged with Tc-99m MDP, In-111 granulocytes, and Ga-67 citrate

    SciTech Connect

    Schauwecker, D.S.; Park, H.M.; Mock, B.H.; Burt, R.W.; Kernick, C.B.; Ruoff, A.C. III; Sinn, H.J.; Wellman, H.N.; Vamc, R.L.R.

    1984-01-01

    Gallium-67 and 3-phase bone scan (3P) studies, though very sensitive, are not very specific in evaluating suspected osteomyelitis (OM) which is superimposed upon other diseases that cause increased bone turnover (IBT). The authors compared In-111 acetylacetone labeled granulocytes (In-111) GRAN) with 3P in 57 such patients; 29 of these patients had Ga-67 studies as well. In-111 GRAN had a sensitivity of 100% in acute OM, 62% in chronic OM, and a specificity of 96%. Gallium-67 ruled out OM when the study was normal; it diagnosed OM when the relative uptake of Ga-67 exceeded the uptake of Tc-99m MDP, or when the skeletal distribution of Ga-67 was different from that of the TC-99m MDP. Unfortunately, these criteria were met in only 28% of the subjects. The simple approach of increased Ga-67 activity meant OM gave a sensitivity of 100%, but an unacceptable specificity of 38%. Chronic cellulitis or long-standing decubiti were seldom detected by IN-111 GRAN. Clinically obvious soft tissue infections or cellulitis were seen with In-111 GRAN 27% of the time, and 17% of the time with Ga-67. The authors conclude that when added to 3P, In-111 GRAN provided more useful information than did Ga-67. A combination of all 3 studies did not significantly increase the diagnostic yield. Performing In-111 GRAN without 3P in patients with IBT is not recommended since the 3P provides anatomic information that aids in the differentiation of OM from soft tissue infections.

  4. 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

  5. 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

  6. Routes of early enteral nutrition following oesophagectomy

    PubMed Central

    Gravante, G; White, J; Livingstone, J; Riaz, A; Al-Bahrani, A

    2016-01-01

    Introduction Oesophagectomy for cancer is a challenging procedure with a five-year overall survival rate of 15-20%. Early enteral nutrition following oesophagectomy is a crucial component of the postoperative recovery and carries a significant impact on the outcome. Different methods of enteral feeding were conducted in our unit. The aim of this study was to examine the efficacy and safety of nasojejunal tube (NJT), jejunostomy tube (JT) and pharyngostomy tube (PT) feeding after oesophagectomy. Methods A retrospective review was carried out of prospectively collected data on patients with oesophageal cancer who underwent an oesophagectomy between 2011 and 2014. The primary outcome was feeding tube related complications such as occlusion, dislocation and leak. The secondary outcomes were length of stay and 30-day morbidity. Results A total of 90 oesophagectomies were included in the study. A NJT was inserted in 41 patients (45.6%), a JT was used in 14 patients (15.5%) and a PT was the route for enteral nutrition in 35 patients (38.9%). In total, five patients (5.5%) developed tube related complications. There were no tube related complications in the NJT group but one JT patient (7.1%) developed tube related cellulitis (p=0.189) and four PT patients (11.4%) developed tube related haemorrhage (p=0.544), tube dislocation (p=0.544) or cellulitis (p=0.189). The median length of stay and 30-day postoperative morbidity were similar between the groups. Conclusions NJT feeding is a less invasive, feasible route for early enteral nutrition following oesophagectomy. A randomised controlled trial is recommended to verify these findings. PMID:27388543

  7. 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

  8. Implications of adult hippocampal neurogenesis in antidepressant action

    PubMed Central

    Malberg, Jessica E.

    2004-01-01

    In the dentate gyrus of the hippocampus, cell birth and maturation into neurons, or neurogenesis, occur throughout the lifetime of animals and humans. Multiple factors have been shown to regulate adult neurogenesis, and a number of findings in this field have had a large impact on basic and clinical research in depression. It has been reported that both physical and psychosocial stress paradigms, as well as some animal models of depression, produce a decrease in hippocampal cell proliferation and neurogenesis. Conversely, long-term, but not short-term, treatment with different classes of antidepressant drug increases cell proliferation and neurogenesis. Patients with depressive disorders or post-traumatic stress disorder have reduced hippocampal volume. Given this interaction of stress, depression and neurogenesis, a current hypothesis is that reduced adult hippocampal cell proliferation or neurogenesis may be involved in the pathophysiology of depression and that reversal or prevention of the decrease in neurogenesis may be one way in which the antidepressant drugs exert their effects. Research from this emerging field will further our understanding of the effects of stress and depression on the brain and the mechanism of action of antidepressant drugs. Dans le gyrus denté de l'hippocampe, la naissance des cellules et leur maturation en neurones, ou neurogenèse, se produisent pendant toute la vie des animaux et des êtres humains. On a démontré que de multiples facteurs régularisent la neurogenèse chez l'adulte, et de nombreuses constatations dans ce domaine ont eu un effet important sur la recherche fondamentale et clinique sur la dépression. On a signalé que des paradigmes de stress à la fois physique et psychosocial, ainsi que certains modèles animaux de dépression, entraÎnent une diminution de la prolifération des cellules dans l'hippocampe et une baisse de la neurogenèse. Par ailleurs, le traitement avec différentes catégories d

  9. 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

  10. Various clinical conditions can mimic Crimean-Congo hemorrhagic fever in pediatric patients in endemic regions.

    PubMed

    Kara, Soner S; Kara, Duygu; Fettah, Ali

    2016-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease with high mortality. Many disorders can mimic CCHF. It is important to recognize the condition and to perform differential diagnosis in endemic countries. Twenty-one children aged 18 years or less with a preliminary diagnosis of CCHF were retrospectively evaluated. Real-time PCR and a confirmatory indirect immunofluorescence assay for negative results were performed. The diagnoses determined that 9 patients had (42.9%) CCHF; 7 patients had (33.3%) viral upper respiratory tract infections (URTI); 2 patients had (9.5%) brucellosis; 1 patients had (4.7%) periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome episode; 1 patient had (4.7%) cerebral palsy, diabetes insipidus, acute gastroenteritis, and hypernatremic dehydration; and 1 patient had (4.7%) cellulitis after a tick bite. The mean age of patients with CCHF was greater than that of the other patients (116.1±53.6 vs. 94.1±52.1 months, p=0.02). Seventeen (81%) of the children included had a history of tick bites, 2 (9.5%) had a history of contact with a patient with CCHF, and 2 (9.5%) had no exposure, but were living in an endemic region. Three patients had an underlying disorder: cerebral palsy and diabetes insipidus, epilepsy, or PFAPA. All of the children experienced fever. Other frequent symptoms were malaise, diarrhea, vomiting, and abdominal pain, but none of these differed statistically between the patient groups. CCHF patients had a longer mean duration of symptoms (10.56±1.42 vs. 6.75±3.62 days, p=0.008) and a longer mean length of hospitalization (8.00±2.08 vs. 3.58±1.56 days, p<0.001) than the other patients. At laboratory examination, patients with CCHF had statistically significant lower leukocyte and platelet counts, more prolonged coagulation parameters, and greater AST, ALT, LDH, and CK levels than the other patients. No mortality or complications occurred in the study. Both infectious causes, such as

  11. 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.

  12. 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.

  13. 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.

  14. Application of subcutaneous talc in hernia repair and wide subcutaneous dissection dramatically reduces seroma formation and postoperative wound complications.

    PubMed

    Klima, David A; Brintzenhoff, Rita A; Tsirline, Victor B; Belyansky, Igor; Lincourt, Amy E; Getz, Stanley; Heniford, B Todd

    2011-07-01

    Wound complications after large ventral hernia repairs when combined with wide subcutaneous dissection (OVHR/WSD) are common (33 to 66%). We evaluate a novel technique of applying talc to wound subcutaneous tissues to decrease wound complications. We accessed our prospectively collected surgical outcomes database for OVHR/WSD procedures performed. Patients were divided into those that did and did not receive subcutaneous talc (TALC vs NOTALC). Demographics intraoperative and outcomes data were collected and analyzed. The study included 180 patients (n = 74 TALC, n = 106 NOTALC). Demographics were all similar, but hernias were larger in the TALC group. TALC patients had their drains removed earlier (14.6 vs 25.6 days; P < 0.001) with dramatic reduction in postoperative seromas requiring intervention (20.8 to 2.7%; P < 0.001) and cellulitis (39.0 to 20.6%; P = 0.007). Short-term follow-up demonstrates significantly higher recurrence rates in the NOTALC group with each recurrence related to infection. The use of talc in the subcutaneous space of OVHR/WSD results in significantly earlier removal of subcutaneous drains, fewer wound complications, and a decrease in early hernia recurrence. Use of talc in the subcutaneous space at the time of wound closure is an excellent technique to decrease wound complications in large subcutaneous dissections.

  15. 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.

  16. Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group

    PubMed Central

    Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; Cecco, Valentina De; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena; Dellaversana, Cristina; Luminari, Stefano; Bonifazi, Francesca

    2016-01-01

    Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses’ areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not. PMID:27594906

  17. Hospitalization for ambulatory care sensitive conditions at health insurance organization hospitals in Alexandria, Egypt.

    PubMed

    Mosallam, Rasha A; Guirguis, Wafaa W; Hassan, Mona Ha

    2014-01-01

    This study aimed at estimating the percentage of hospital discharges and days of care accounted for by Ambulatory Care Sensitive Conditions (ACSCs) at Health Insurance Organization (HIO) hospitals in Alexandria, calculating hospitalization rates for ACSCs among HIO population and identifying determinants of hospitalization for those conditions. A sample of 8300 medical records of patients discharged from three hospitals affiliated to HIO at Alexandria was reviewed. The rate of monthly discharges for ACSCs was estimated on the basis of counting number of combined ACSCs detected in the three hospitals and the hospitals' average monthly discharges. ACSCs accounted for about one-fifth of hospitalizations and days of care at HIO hospitals (21.8% and 20.8%, respectively). Annual hospitalization rates for ACSCs were 152.5 per 10,000 insured population. The highest rates were attributed to cellulitis/abscess (47.3 per 10,000 population), followed by diabetes complications and asthma (42.8 and 20.8 per 10,00 population). Logistic regression indicated that age, number of previous admissions, and admission department are significant predictors for hospitalization for an ACSC.

  18. 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

  19. Mycobacterial Arthritis and Synovitis in Painted Reed Frogs (Hyperolius marmoratus).

    PubMed

    Barrows, M; Koeppel, K; Michel, A; Mitchell, E

    2017-02-20

    Several species of atypical mycobacteria have been isolated from wild and captive amphibians. In captive anurans, cutaneous and visceral mycobacteriosis are common and can result in significant mortality, particularly when animals are immunocompromised. Mycobacterial arthritis and synovitis are reported rarely in amphibians. We describe 20 cases in painted reed frogs (Hyperolius marmoratus), which presented with cachexia, limb paresis or paralysis or 'spindly leg syndrome'. Histopathology revealed multifocal histiocytic to granulomatous synovitis affecting appendicular, rib or spinal intervertebral joints. Periarticular granulomata, granulomatous cellulitis and skeletal muscle atrophy, necrosis and degeneration were also present. In one case, granulomatous spinal osteomyelitis was recorded. Ziehl-Neelsen stains showed large numbers of acid-fast bacteria in macrophages and histiocytes. The mycobacterial isolates obtained from culture were identified as members of the Mycobacterium chelonae complex (either M. chelonae or Mycobacteriumabscessus). This was confirmed by 5'-16S ribosomal ribonucleic acid (rRNA) sequencing. In 17 cases mycobacterial lesions were present only in the joints and skeleton, highlighting the importance of not ruling out mycobacterial infection on the basis of absence of cutaneous or visceral lesions.

  20. 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.

  1. 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.

  2. Monoclonal gammopathy of undetermined significance and risk of infections: a population-based study.

    PubMed

    Kristinsson, Sigurdur Y; Tang, Min; Pfeiffer, Ruth M; Björkholm, Magnus; Goldin, Lynn R; Blimark, Cecilie; Mellqvist, Ulf-Henrik; Wahlin, Anders; Turesson, Ingemar; Landgren, Ola

    2012-06-01

    No comprehensive evaluation has been made to assess the risk of viral and bacterial infections among patients with monoclonal gammopathy of undetermined significance. Using population-based data from Sweden, we estimated risk of infections among 5,326 monoclonal gammopathy of undetermined significance patients compared to 20,161 matched controls. Patients with monoclonal gammopathy of undetermined significance had a 2-fold increased risk (P<0.05) of developing any infection at 5- and 10-year follow up. More specifically, patients with monoclonal gammopathy of undetermined significance had an increased risk (P<0.05) of bacterial (pneumonia, osteomyelitis, septicemia, pyelonephritis, cellulitis, endocarditis, and meningitis), and viral (influenza and herpes zoster) infections. Patients with monoclonal gammopathy of undetermined significance with M-protein concentrations over 2.5 g/dL at diagnosis had highest risks of infections. However, the risk was also increased (P<0.05) among those with concentrations below 0.5 g/dL. Patients with monoclonal gammopathy of undetermined significance who developed infections had no excess risk of developing multiple myeloma, Waldenström macroglobulinemia or related malignancy. Our findings provide novel insights into the mechanisms behind infections in patients with plasma cell dyscrasias, and may have clinical implications.

  3. [Cytological study of the post-embryonic development of the digestive gland of Sepia officinalis L. Mollusca : Cephalopoda (author's transl)].

    PubMed

    Yim, M; Boucaud-Camou, E

    1980-01-01

    A histological and ultrastructural study of the development of the digestive gland of Sepia officinalis L. was carried out on young Sepia reared in the laboratory, during the first month of post-embryonic life. The increasing complexity of the histological structure of the gland is related to the successive appearance of several cell types : immature cell, synthetizing cell, mature digestive cell ("cellule à boules"), and resting cell. These types are, in fact, just the evolutive stages of the same cell, the digestive cell. The sequence of appearance of the different cell types and the changes occurring in feeding can be used to define three stages in the post-embryonic development of the Sepia officinalis L. digestive gland : a multiplication stage (from hatching to the 5th day), a maturation stage (5th to 30th day), and adult stage (after the first month of post-embryonic life). These stages are identical to the three periods previously described by Richard and Decleir (1969) in the life of Sepia.

  4. The fleur-de-lis upper gracilis flap for breast reconstruction: flap design and outcome.

    PubMed

    McKane, Brice W; Korn, Peter T

    2012-10-01

    We evaluated a fleur-de-lis design for the gracilis myocutaneous flap to improve flap volume for breast reconstruction. Thirty-one flaps were used in 17 consecutive patients undergoing the procedure for either thin body habitus (23 flaps) or prior abdominal surgery (8 flaps). The flap success rate was 100%. The fleur-de-lis flap provided proportionate breast reconstructions in all patients. Complications included 6 (19.3%) donor-site dehiscence and 4 (12.9%) episodes of cellulitis. Applying a negative pressure dressing to the donor site (n=26) significantly reduced the initially high dehiscence rate to 7.7% (P<0.01). There was no incidence of lower extremity edema or sensory loss. The fleur-de-lis gracilis flap can be performed with a low flap related complication rate and acceptable donor-site morbidity. Because of its standardized flap design, improved volume, and favorable breast shaping, it may allow autologous breast reconstruction to be offered to a greater number of patients.

  5. 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

  6. Infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature

    PubMed Central

    Zouein, Elie; Wetz, Robert; Mobarakai, Neville; Hassan, Samer; Tong, Iris

    2012-01-01

    Primary aortic graft infection early after aortic graft insertion is well described in the literature. Here, we present a unique case of late aortic graft infection 5 years after insertion secondary to mitral valve endocarditis, resulting from cellulitis in a patient with severe venous varicosities. A 63-year-old male presented for severe low back pain, constipation, and low-grade fever. An abdominal computed tomography scan with oral and intravenous contrast showed a normal spine and urinary tract. Blood and urine cultures, done at the same time, grew Staphylococcus aureus. A transesophageal echocardiogram confirmed the diagnosis of endocarditis. Subsequently, a gallium scan showed increased uptake in the vertebral bodies, aortic graft, left patella, and left ankle. After 3 months of antibiotic therapy, the patient’s low back pain resolved with normalization of his laboratory values. He remained free of infection at a 2-year follow-up. We reviewed the literature concerning the atypical presentation of infective endocarditis, with a focus on distant metastases at initial presentation, such as osteomyelitis and aortic graft infection, as well as the different treatment modalities. This report describes successful medical treatment with intravenous followed by oral antibiotics for an infected endovascular graft without any surgical intervention. PMID:22866008

  7. Electrospinning of Nanodiamond-Modified Polysaccharide Nanofibers with Physico-Mechanical Properties Close to Natural Skins

    PubMed Central

    Mahdavi, Mina; Mahmoudi, Nafiseh; Rezaie Anaran, Farzad; Simchi, Abdolreza

    2016-01-01

    Electrospinning of biopolymers has gained significant interest for the fabrication of fibrous mats for potential applications in tissue engineering, particularly for wound dressing and skin regeneration. In this study, for the first time, we report successful electrospinning of chitosan-based biopolymers containing bacterial cellulous (33 wt %) and medical grade nanodiamonds (MND) (3 nm; up to 3 wt %). Morphological studies by scanning electron microscopy showed that long and uniform fibers with controllable diameters from 80 to 170 nm were prepared. Introducing diamond nanoparticles facilitated the electrospinning process with a decrease in the size of fibers. Fourier transform infrared spectroscopy determined hydrogen bonding between the polymeric matrix and functional groups of MND. It was also found that beyond 1 wt % MND, percolation networks of nanoparticles were formed which affected the properties of the nanofibrous mats. Uniaxial tensile testing of the woven mats determined significant enhancement of the strength (from 13 MPa to 25 MP) by dispersion of 1 wt % MND. The hydrophilicity of the mats was also remarkably improved, which was favorable for cell attachment. The water vapor permeability was tailorable in the range of 342 to 423 µg·Pa−1·s−1·m−1. The nanodiamond-modified mats are potentially suitable for wound healing applications. PMID:27399726

  8. Five Cases of Phytophotodermatitis Caused by Fig Leaves and Relevant Literature Review

    PubMed Central

    Son, Jin-Hwa; Jin, Hyunju; You, Hyang-Suk; Shim, Woo-Haing; Kim, Jeong-Min; Kim, Gun-Wook; Kim, Hoon-Soo; Ko, Hyun-Chang; Kim, Moon-Bum

    2017-01-01

    Phytophotodermatitis is a condition caused by sequential exposure to photosensitizing substances present in plants followed by ultraviolet light. Several plants (e.g., limes, celery, fig, and wild parsnip) contain furocoumarin compounds (psoralens). It is important for dermatologists to be aware of phytophotodermatitis because it may be misdiagnosed as cellulitis, tinea, or allergic contact dermatitis. We present five patients with a sharply defined erythematous swollen patch with bullae on both feet. They described soaking their feet in a fig leaves decoction to treat their underlying dermatologic diseases. Within 24 hours, all patients had a burning sensation in their feet, and erythema and edema had developed on the feet dorsa with exception of the portion of the skin covered by the sandals. Histopathologic examinations revealed sub-epithelial blisters with intensive epidermal necrosis. Phytophotodermatitis was ultimately diagnosed and, after several days, the patients' skin lesions began to recover upon treatment with systemic and topical corticosteroids. Unfortunately, since there are no studies providing sufficient evidence on the benefits of fig leaves, they should be used with caution. PMID:28223753

  9. Permeation of topically applied caffeine from a food by-product in cosmetic formulations: Is nanoscale in vitro approach an option?

    PubMed

    Rodrigues, Francisca; Alves, Ana Catarina; Nunes, Claudia; Sarmento, Bruno; Amaral, M Helena; Reis, Salette; Oliveira, M Beatriz P P

    2016-11-20

    The aim of the present work was to develop and evaluate the potential of nanostructured lipid carriers associated with caffeine extracted from Coffee Silverskin (NLC-CS), a food by-product, as a new possible topical therapy of cellulitis. Caffeine gain increasing research interest due to their cosmetic potential, particularly in gynoid lipodystrophy, commonly known as cellulite. NLC-CS were prepared via double emulsion technique using polysorbate 60 as surfactant and characterized for their morphology, particle size, zeta potential, association encapsulation and stability. The in vitro skin permeation studies were performed on Franz diffusion cells using pig skin ear as permeation membrane and the optimized formulation was compared with a hydroalcoholic solution of Coffee silverskin (CS) extract. NLC-CS were within the nanosized range (≈200nm), with a low polydispersity index (<0.25) and zeta potential values around -30Mv, presenting storage stability up to 180days at 25°C/65% relative humidity (RH) and 40°C/75% RH. The association efficiency (AE) of caffeine was about 30% at production time and after storage period. Cryo-SEM images confirmed the spherical shape of NLC-CS. The in vitro skin permeation study demonstrated that NLC-CS had a similar skin permeation profile when compared to caffeine in CS extract.

  10. Effectiveness of Decongestive Lymphatic Therapy in Patients with Lymphedema Resulting from Breast Cancer Treatment Regardless of Previous Lymphedema Treatment.

    PubMed

    Bozkurt, Mehtap; Palmer, Lynn J; Guo, Ying

    2017-03-01

    Decongestive lymphatic therapy (DLT) has gained wide acceptance as an effective treatment for patients with lymphedema resulting from breast cancer treatment. It is unclear whether DLT is effective for patients with lymphedema who have received lymphedema treatment previously. Our purpose was to compare the effectiveness of DLT in patients who had received lymphedema treatment previously with those who had never received treatment. We retrospectively reviewed the medical records of 98 patients who received outpatient lymphedema therapy for upper extremity lymphedema following surgery. Seventy-two eligible patients with a breast cancer diagnosis and complete medical records were divided into two groups: group 1; previously treated (PT) patients (n = 38, 53%) had previously received lymphedema treatment, while group 2 (no PT, n = 34, 47%) had never received lymphedema treatment. The primary outcome was the percent change in volume in the lymphedematous arm, measured by perometer, after DLT treatment. The two groups did not differ significantly in age, comorbidities, body mass index, and median time from surgery to current treatment, surgical procedure, previous radiation treatment, or history of cellulitis/lymphangitis. DLT significantly reduced arm volume in both groups (group 1, p < 0.001; group 2, p = 0.003). The mean percent volume reduction did not differ significantly between the groups (p = 0.619). This study is the first to show that, DLT reduce limb volume significantly with post-mastectomy lymphedema, regardless of previous lymphedema therapy.

  11. Pressure ulcers: critical considerations in prevention and management.

    PubMed

    Alvarez, O M

    1991-01-01

    Pressure ulcer development is a serious problem occurring predominately among elderly persons, who are confined to bed or chair. Factors associated with pressure ulcer development include: cerebrovascular accident, impaired nutritional intake, fecal incontinence, lymphocytopenia and a high comorbidity score. Implementation of preventative measures, such as: in-depth assessment for mobility, a pressure relieving device combined with adequate repositioning, thorough evaluation for nutritional status and urinary incontinence, significantly reduce pressure ulcer incidence. If the pressure ulcer is a partial thickness (Stage II) wound, the causative factors are probably friction and/or moisture. If the ulcer is full thickness (Stage III, IV) it is secondary to pressure and/or shearing forces. The development of wound infection is the most common complication. Osteomyelitis is not an uncommon occurrence and must be initially ruled out in all full thickness pressure ulcers. Surgical debridement of necrotic tissue is necessary prior to further treatment and /or assessments. Cultures and antibiotic therapy are indicated only upon evidence of infection (erythema, edema, cellulitis, osteomyelitis, leukocytosis, bandemia or fever). Topical pharmacologic agents may be used to prevent or treat infection but must be carefully controlled to avoid such adverse effects as toxicity to the wound, allergic reaction and development of resistant pathogens. Proper use of occlusive dressings increase patient comfort, enhance healing, decrease the possibility of infection, save time and reduce costs. A patient presenting an ulcer which fails to improve, or due to its size will take a great deal of time to heal, should be evaluated for surgical closure.

  12. The prevention and management of pressure ulcers.

    PubMed

    Goode, P S; Allman, R M

    1989-11-01

    Pressure ulcers are a common problem for older persons. Complications associated with pressure ulcers include infection and even death for some patients. Pressure is the primary pathogenic factor, but shearing forces, friction, and moisture are also important. Immobility, nutritional status, and age-related factors seem to be significant risk factors. Preventive care includes use of assessment tools to identify high risk patients, frequent repositioning, air or foam mattresses that reduce pressure over bony prominences, as well as careful attention to optimizing the overall patient condition. When pressure ulcers do develop, the treatment plan should include adequate nutrition including protein, vitamin C, and zinc supplements as indicated; systemic antibiotics for sepsis, cellulitis, osteomyelitis, or the prevention of bacterial endocarditis; and local wound care that eliminates necrotic tissue, decreases bacterial load, and provides a physiologic, pressure-free environment allowing the wound to heal. Specialized beds may be considered in some patients, particularly those with larger ulcers. Surgery is an option in older persons who are operative candidates. For some patients with pressure ulcers, appropriate treatment goals may focus on providing comfort rather than curing the ulcer.

  13. Pressure ulcers. Physical, supportive, and local aspects of management.

    PubMed

    Alvarez, O M; Childs, E J

    1991-10-01

    Pressure ulcers are a common and serious problem predominately among elderly persons who are confined to bed or chair. Additional factors associated with pressure ulcer development include cerebrovascular accident, impaired nutritional intake, urinary or fecal incontinence, hypoalbuminemia, and previous fracture. Implementation of preventive measures, such as an in-depth assessment for mobility, a pressure-relieving device combined with adequate repositioning, and thorough evaluation for nutritional status and urinary incontinence, significantly reduce pressure ulcer incidence. If the pressure ulcer is a partial thickness (stage II) wound, the causative factors are probably friction or moisture. If the ulcer is full thickness (stage III and IV), it is secondary to pressure or shearing forces. The development of wound infection is the most common complication in the management approach. Osteomyelitis is not an uncommon occurrence and must be initially ruled out in all full thickness pressure ulcers. Surgical debridement of necrotic tissue is necessary prior to further treatment and assessments. Antibiotic therapy is indicated only upon evidence of infection (cellulitis, osteomyelitis, leukocytosis, bandemia, or fever). Topical pharmacologic agents may be used to prevent or treat infection but must be carefully controlled to avoid such adverse effects as toxicity to the wound, allergic reaction, and development of resistant pathogens. Proper use of occlusive dressings increase patient comfort, enhance healing, decrease the possibility of infection, save time, and reduce costs. A patient presenting an ulcer that fails to improve or, because of its size, will take a great deal of time to heal should be evaluated for surgical closure.

  14. Electrospinning of Nanodiamond-Modified Polysaccharide Nanofibers with Physico-Mechanical Properties Close to Natural Skins.

    PubMed

    Mahdavi, Mina; Mahmoudi, Nafiseh; Rezaie Anaran, Farzad; Simchi, Abdolreza

    2016-07-07

    Electrospinning of biopolymers has gained significant interest for the fabrication of fibrous mats for potential applications in tissue engineering, particularly for wound dressing and skin regeneration. In this study, for the first time, we report successful electrospinning of chitosan-based biopolymers containing bacterial cellulous (33 wt %) and medical grade nanodiamonds (MND) (3 nm; up to 3 wt %). Morphological studies by scanning electron microscopy showed that long and uniform fibers with controllable diameters from 80 to 170 nm were prepared. Introducing diamond nanoparticles facilitated the electrospinning process with a decrease in the size of fibers. Fourier transform infrared spectroscopy determined hydrogen bonding between the polymeric matrix and functional groups of MND. It was also found that beyond 1 wt % MND, percolation networks of nanoparticles were formed which affected the properties of the nanofibrous mats. Uniaxial tensile testing of the woven mats determined significant enhancement of the strength (from 13 MPa to 25 MP) by dispersion of 1 wt % MND. The hydrophilicity of the mats was also remarkably improved, which was favorable for cell attachment. The water vapor permeability was tailorable in the range of 342 to 423 µg·Pa(-1)·s(-1)·m(-1). The nanodiamond-modified mats are potentially suitable for wound healing applications.

  15. Free jejunal flap for pharyngoesophageal reconstruction in head and neck cancer patients: An evaluation of donor site complications

    PubMed Central

    Razdan, Shantanu N.; Albornoz, Claudia R.; Matros, Evan; Paty, Philip B.; Cordeiro, Peter G.

    2016-01-01

    Background Free jejunal transfer for pharyngoesophageal reconstruction has often been criticized for its associated donor site morbidity. Conversely, the same argument has been invoked to support use of fasciocutaneous flaps, given their low incidence of donor site complications. The purpose of the current study was to document donor site complication rate with free jejunal flaps for pharyngoesophageal reconstruction, in the hands of an experienced surgeon. Methods A retrospective chart review was performed of consecutive patients who underwent free jejunal transfer between 1992 and 2012 by the senior author. Demographic data, abdominal complications, surgical characteristics of small bowel anastomoses and postoperative bowel function were specifically noted. Results Ninety-two jejunal flap reconstructions were performed in 90 patients. Mean follow up time was 29 months. Twelve (13%) patients had prior abdominal surgery. Donor site complications included ileus (n=2), wound cellulitis (n=1), wound dehiscence (n=1) and small bowel obstruction (n=1). Mean time to initiation of tube feeds after reconstruction was 5 days. Seventy-seven (86.5%) patients were discharged on an oral diet. The perioperative mortality rate of 2% was not associated with any donor site complication. Conclusion Free jejunal transfer is associated with minimal and acceptable donor site complication rates. The choice of flap for pharyngoesophageal reconstruction should be determined by the type of defect, potential recipient site complications and the surgeon’s familiarity with the flap. Potential donor site complications should not be a deterrent for free jejunal flaps given the low rate described in this study. PMID:26220434

  16. Miliary tuberculosis and acquired immunodeficiency syndrome – ‘a cursed duet’

    PubMed Central

    Tatari, Atif; Ramanujam, Sahana; Mathai, Suja; Karabulut, Nigahus; Moser, Robert L.; Wallach, Sara L.

    2016-01-01

    Tuberculous osteomyelitis is rare and usually involves the vertebrae but is seldom found in the foot. The uncommon site and ability to mimic other disorders clinically and radiographically leads to diagnostic and therapeutic delays. We report a case of a 40-year-old man who initially presented to his podiatrist with intermittent pain and swelling of his right ankle and foot that lasted for a year. He also started to exhibit significant weight loss and unexplained fevers and was subsequently hospitalized for cellulitis of his right foot. On further workup, patient was found to have miliary tuberculosis (TB) and acquired immunodeficiency syndrome (AIDS). Patient was treated with anti-TB therapy for 9 months and highly active anti-retroviral therapy. Our patient presented with ongoing chronic right foot and ankle pain that was proven to be secondary to TB osteomyelitis of cuneiform bones of the right ankle in the setting of AIDS. The patient's clinical presentation was unusual due to symptom duration and lack of systemic characteristics. Like our case, reported incidence of osteomyelitis of bone/joint in extrapulmonary TB is estimated to be 10%, and out of all bones/joint TB cases, only 1% are found to be in the foot. PMID:27802849

  17. Only 33% of visits for skin disease in the US in 1995 were to dermatologists: is decreasing the number of dermatologists the appropriate response?

    PubMed

    Thompson, T T; Feldman, S R; Fleischer, A B

    1998-10-01

    The National Ambulatory Medical Care Survey conducted in 1995 provides an assessment of ambulatory medical practice including diagnoses, physician specialties, and insurance information. The National Center for Health Statistics collected data from non-federally employed physicians of all specialties using their standardized sampling technique. The database was reviewed for aspects of visits for skin diseases for all patients. The total number of visits for dermatologic disease in 1995 was estimated to be 22.0 million. 21.7% of these were first time visits and 24.3% were referrals. The leading dermatologic diagnoses in 1995 in order of frequency were acne, contact dermatitis, hypertrophic and atrophic conditions of skin, viral warts, malignant neoplasm of skin, benign neoplasm of skin, psoriasis, cellulitis and abscess, disorders of skin and subcutaneous tissue, and localized superficial swelling/mass/lump. Dermatology led all specialties in providing 32. 6% of the dermatologic outpatient care in 1995, followed by general/family medicine (22.7%), internal medicine (12.8%), pediatrics (11.2%), and all other specialties (20.7%). Of the visits to dermatologist in 1995, 3.78% were paid for by Medicaid. This paper presents dermatologic information pertaining to insurance, first time visits, referrals, diagnoses, and physician specialties.

  18. Granulomatous pneumonia caused by Pythium insidiosum in a central American jaguar, Panthera onca.

    PubMed

    Camus, Alvin C; Grooters, Amy M; Aquilar, Roberto E

    2004-11-01

    A 7-month-old, male jaguar presented with dyspnea and leukocytosis unresponsive to antibiotic therapy. Radiographs revealed unilateral pulmonary consolidation. An exploratory thoracotomy was performed, and the left lung, which contained a large multilobular mass with extensive fibrosis and numerous caseonecrotic foci, was removed. Microscopically, eosinophilic granulomatous inflammation surrounded broad (4.4-8.3 microm) rarely septate hyphae. A diagnosis of Pythium insidiosum infection was confirmed by immunohistochemistry, immunoblot serology, culture, and polymerase chain reaction. Dyspnea recurred despite treatment, and the animal succumbed 3 weeks after surgery. Necropsy findings indicated that death resulted from occlusion of the right main stem bronchus by a fungal granuloma. The oomycete P. insidiosum typically causes granulomatous disease of the skin or gastrointestinal tract in animals and arteritis, keratitis, or cellulitis in humans. Infection is uncommon in felines, and pulmonary involvement is rare. This report details the first case of P. insidiosum infection in an exotic felid and provides the first description of primary pulmonary pythiosis in any species.

  19. Septicaemia and meningitis caused by infection of New Zealand sea lion pups with a hypermucoviscous strain of Klebsiella pneumoniae.

    PubMed

    Roe, W D; Rogers, L; Pinpimai, K; Dittmer, K; Marshall, J; Chilvers, B L

    2015-04-17

    This study describes a syndrome of neonatal septicemia and meningitis in New Zealand sea lions, caused by a strain of Klebsiella pneumoniae that is phenotypically similar to strains causing environmentally-acquired septicemia and neuro-invasive disease in humans. Between late 2006 and early 2010, 123 pups from the Enderby Island breeding colony died of K. pneumoniae infection, with lesions including fibrinous to fibrinosuppurative meningitis, subdural hemorrhage, septic arthritis, herniation and hemorrhage of the cerebellar vermis, lymphadenitis and cellulitis. This infection was responsible for 58% of observed pup mortality over this time period, with most deaths occurring in the latter part of the breeding season (mid February onwards). The results of this study suggest that the pattern of this disease has changed since it was first described in 2002, when most deaths occurred early in the season (early to mid-January), and that it is an important and consistent cause of pup mortality in this population. In addition, a similar disease syndrome and bacterial strain was diagnosed in a single pup in a fragile recolonizing New Zealand sea lion population on mainland New Zealand, and the potential effect on this population is unknown but could have a negative impact on recolonisation at this site.

  20. Barbed versus conventional 2-layer continuous running sutures for laparoscopic vaginal cuff closure

    PubMed Central

    Kim, Jin Hwi; Byun, Seung Won; Song, Jae Yeon; Kim, Yeon Hee; Lee, Hee Joong; Park, Tae Chul; Lee, Keun Ho; Hur, Soo Young; Park, Jong Sup; Lee, Sung Jong

    2016-01-01

    Abstract We compared results using unidirectional barbed sutures and conventional sutures for vaginal cuff closure during total laparoscopic hysterectomy (TLH).The electronic medical records and surgical videos of 170 patients who underwent TLH between January 2013 and March 2015 at Uijeong-bu St. Mary's Hospital of Catholic University of Korea were reviewed. Vaginal cuffs were closed using the 2-layer continuous running technique with unidirectional barbed sutures (V-Loc; Covidien, Mansfield, MA) in 64 patients and with polycolic acid Vicryl; Ethicon, Somerville, NJ sutures in 106 patients. Procedure time, clinical characteristics, and postoperative complications were compared between the 2 study groups. There were no differences in clinical characteristics (age, body mass index, and demographic data) between groups. The mean suturing time was significantly reduced in the barbed group (7.2 vs 12.2 minutes; P < 0.001), although the mean number of stitches was greater than in the Vicryl group (14.1 vs 12.3, P < 0.001). Perioperative complications, including episodes of vaginal bleeding, vaginal cuff cellulitis, and postoperative fever, did not differ between groups. There were no instances of vaginal cuff dehiscence in either group. Unidirectional barbed sutures can be used safely to reduce procedure time and surgical difficulty relative to conventional sutures in laparoscopic vaginal cuff closure. PMID:27684850

  1. Microbiology of skin and soft tissue infections in the age of community-acquired methicillin-resistant Staphylococcus aureus.

    PubMed

    Ray, G Thomas; Suaya, Jose A; Baxter, Roger

    2013-05-01

    The objectives of this study were to determine the etiology of skin and soft-tissue infections (SSTIs) in a general population, and to describe patient characteristics, SSTI types, frequency of microbiologic testing, and the role of methicillin-resistant Staphylococcus aureus (MRSA) over time. Using electronic databases, we identified SSTI episodes and microbiologic testing among members of a large US health plan. Between 2006 and 2009, 648699 SSTI episodes were identified, of which 23% had a specimen, of which 15% were blood. A pathogen was identified in 58% of SSTI cultures. S. aureus was the most common pathogen (80% of positive cultures). Half of S. aureus isolates were MRSA. Among cellulitis and abscess episodes with a positive blood culture, 21% were methicillin-sensitive S. aureus, 16% were MRSA, 21% were beta-hemolytic streptococci and 28% were Gram negative bacteria. Between 1998 and 2009, the percentage of SSTIs for which a culture was obtained increased from 11% to 24%. In SSTI episodes with a culture-confirmed pathogen, MRSA increased from 5% in 1998 to 9% in 2001 to 42% in 2005, decreasing to 37% in 2009. These data can inform the choice of antibiotics for treatment of SSTIs.

  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. A Systemic Review on Staphylococcal Scalded Skin Syndrome (SSSS): A Rare and Critical Disease of Neonates.

    PubMed

    Mishra, Arun K; Yadav, Pragya; Mishra, Amrita

    2016-01-01

    The symptoms of Staphylococcal scalded skin syndrome (SSSS) include blistering of skin on superficial layers due to the exfoliative toxins released from Staphylococcus aureus. After the acute exfoliation of skin surface, erythematous cellulitis occurs. The SSSS may be confined to few blisters localized to the infection site and spread to severe exfoliation affecting complete body. The specific antibodies to exotoxins and increased clearence of exotoxins decrease the frequency of SSSS in adults. Immediate medication with parenteral anti-staphylococcal antibiotics is mandatory. Mostly, SSSS are resistant to penicillin. Penicillinase resistant synthetic penicillins such as Nafcillin or Oxacillin are prescribed as emergency treatment medicine. If Methicillin-resistant Staphylococcus aureus (MRSA) is suspected), antibiotics with MRSA coverage (e.g., Vancomycin or Linezolid) are indicated. Clindamycin is considered as drug of choice to stop the production of exotoxin from bacteria ribosome. The use of Ringer solution to to balance the fluid loss, followed by maintainence therapy with an objective to maintain the fluid loss from exfoliation of skin, application of Cotrimoxazole on topical surface are greatlly considered to treat the SSSS. The drugs that reduce renal function are avoided. Through this article, an attempt has been made to focus the source, etiology, mechanism, outbreaks, mechanism, clinical manisfestation, treatment and other detail of SSSS.

  4. 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.

  5. Prevention of Evisceration or Enucleation in Endogenous Bacterial Panophthalmitis with No Light Perception and Scleral Abscess

    PubMed Central

    Chen, Kuan-Jen; Chen, Yen-Po; Chao, An-Ning; Wang, Nan-Kai; Wu, Wei-Chi; Lai, Chi-Chun; Chen, Tun-Lu

    2017-01-01

    Panophthalmitis is the most extensive ocular involvement in endophthalmitis with inflammation in periocular tissues. Severe inflammation of the anterior and posterior segments is frequently accompanied by corneal opacity, scleral abscess, and perforation or rupture. Enucleation or evisceration was the only remaining viable treatment option when all options to salvage the eye had been exhausted. The purpose of this retrospective study is to examine the outcomes of patients with endogenous bacterial panophthalmitis, no light perception and scleral abscess who were treated with multiple intravitreal and periocular injections of antibiotics and dexamethasone. Evaluation included spreading of infection to contiguous or remote sites, following evisceration or enucleation, and sympathetic ophthalmia. Eighteen patients were diagnosed with EBP, with liver abscesses in eight patients, retroperitoneal infection in four, pneumonia in two, infective endocarditis in one, cellulitis in one, drug abuse in one, and mycotic pseudoaneurysm in one. Culture results were positive for Klebsiella pneumoniae in 12 patients, Streptococcus spp. in three, Pseudomonas aeruginosa in one, Escherichia coli in one, and Staphylococcus aureus in one. The average number of periocular injections was 2.2, and the average number of intravitreal injections was 5.8. No eye required evisceration or enucleation and developed the spreading of infection to contiguous or remote sites during the follow-up. No sympathetic ophthalmia was observed in the fellow eye of all patients. Prevention of evisceration or enucleation in patients with EBP, NLP and scleral abscess can be achieved by multiple intravitreal and periocular injections of antibiotics and dexamethasone. PMID:28056067

  6. 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.

  7. Acute infection of a total knee arthroplasty caused by Pasteurella multocida: a case report and a comprehensive review of the literature in the last 10 years.

    PubMed

    Heydemann, John; Heydemann, Jacob S; Antony, Suresh

    2010-09-01

    Total knee arthroplasty (TKA) infection are most commonly due Staphylococcus aureus followed by coagulase-negative staphylococci, and streptococci, while gram-negative rods are seldom isolated.(1,3,4) In the last 20 years, cases of Pasteurella multocida TKA and total hip arthroplasty (THA) infection resulting from cat and dog bites, scratches, or licks have been published reporting varying presentations and treatment options. Most commonly, P. multocida infected arthroplasties result in local tenderness, cellulitis, and purulent discharge followed by regional adenopathy, and in immunocompromised patients it may progress to septicemia, meningitis, and septic arthritis.(5) Treatment antibiotics include penicillins or 2nd and 3rd generation cephalosporins, and surgical options involve one-stage, or two-stage revision arthroplasties.(6,9,17,19) We report a case of P. multocida TKA infection in a patient who was treated successfully with a 3rd generation cephalosporin, synovectomy and tibial interspacer exchange, along with a review of the literature published in the last 10 years. Our findings show that there is usually a history of exposure to the animal, early appearance of cat bite related infections, and multifactorial decision making for the treatment of P. multocida joint infections.

  8. [Autoimmune lymphoproliferative syndrome].

    PubMed

    Rodrigues, Vera; Conde, Marta; Figueiredo, António; Vasconcelos, Júlia; Dias, Alexandra

    2011-01-01

    The Autoimmune Lymphoproliferative Syndrome (ALPS) is an impairment of lymphocyte apoptosis expressed by generalized non-malignant lymphoproliferation, lymphadenopathy and/or splenomegaly. This article describes a seven and 14 year old males. The first one was admitted at 3 years of age with fever, bicytopenia and generalized lymphadenopathy. Hystopathological analysis of lymph nodes showed reactive follicular hyperplasia and marked paracortical expansion. He was readmitted three years later presenting herpes zoster and similar clinical features. High levels of IL-10 and increasing tendency of Fas-L in plasma and serum. The second child was admitted at 13 years of age presenting thigh and gluteus cellulitis, anemia and neutropenia. T lymphocytes aß+CD4-CD8- 3,1%. Hystopathological analysis of lymph nodes showed marked paracortical hyperplasia. Both children are treated with mycophenolate mofetil with good response. ALPS is an underestimated entity that must be considered in non malign lymphoproliferation, autoimmunity and expansion of an unusual population of a/ßCD3+CD4-CD8-(double-negative T cells>1%).

  9. 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.

  10. 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

  11. Pharmacokinetics of a single subcutaneous dose of sustained release buprenorphine in northern elephant seals (Mirounga angustirostris).

    PubMed

    Molter, Christine M; Barbosa, Lorraine; Johnson, Shawn; Knych, Heather K; Chinnadurai, Sathya K; Wack, Raymund F

    2015-03-01

    Information regarding analgesics in pinnipeds is limited. This study aimed to establish the pharmacokinetic parameters of a single subcutaneous dose of sustained release buprenorphine (Buprenorphine SR) in juvenile northern elephant seals (Mirounga angustirostris) with regard to its potential to provide long-lasting analgesia that requires infrequent dosing. Seals (n=26) were administered a single dose of sustained release buprenorphine at 0.12 mg/kg s.c. Blood samples were collected from the extradural intervertebral vein at 0 hr and at three or four of the following time points: 0.5, 1, 2, 6, 12, 24, 36, 48, 60, 96, 120, and 144 hr. Seals were examined daily for systemic and local adverse reactions. Plasma was analyzed by liquid chromatography tandem-mass spectrometry for buprenorphine and norbuprenorphine concentrations. A noncompartmental analysis for pharmacokinetic parameters was calculated using standard methods and equations. An average maximum concentration of 1.21 ng/ml (0.3-2.9 ng/ml) was detected 12 hr postadministration. Concentrations were quantifiable up to 144 hr postadministration but were below those expected to provide analgesia in some other species. No systemic adverse effects were noted in healthy seals receiving sustained release buprenorphine. Cellulitis or abscesses at the injection site were observed in 6/26 (23%) seals between 24 and 168 hr postadministration. Adverse local effects suggest that this drug should be used with caution in northern elephant seals.

  12. 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.

  13. 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

  14. Elephantiasis nostras verrucosa in a patient with systemic sclerosis.

    PubMed

    Chatterjee, S; Karai, L J

    2009-12-01

    Elephantiasis nostras verrucosa (ENV) is an unusual skin condition characterized by dermal fibrosis and hyperkeratotic verrucous lesions resulting from chronic nonfilarial lymphoedema. The condition is similar to 'elephantiasis tropica', in which elephantiasis develops secondary to filariasis. Lymphatic obstruction can be primary or due to various causes such as surgery, tumour, radiation, congestive heart failure or obesity. Recurrent attacks of cellulitis lead to further impairment of lymphatic drainage, causing permanent swelling, dermal fibrosis and epidermal thickening. We report a case of a 56-year-old man with systemic sclerosis (SS), who presented with painful lesions on both legs, consistent with ENV. He developed extensive, fungating, papillomatous lesions on the skin of the legs, toes and dorsa of the feet over a period of 3 years. Histology revealed dense dermal fibrosis, oedema of the papillary dermis and extensive pseudo-epitheliomatous changes. To our knowledge, this is the first report of ENV in which SS was considered to be the primary cause for the impairment of lymphatic flow.

  15. Otophyma: a case report and review of the literature of lymphedema (elephantiasis) of the ear.

    PubMed

    Carlson, J Andrew; Mazza, Jill; Kircher, Kenneth; Tran, Tien Anh

    2008-02-01

    Phymas (swellings, masses, or bulbs) are considered the end-stage of rosacea and mostly affect the nose (rhinophyma), and rarely involve the chin (gnatophyma), the cheek (metophyma), eyelids (blepharophyma), or ears (otophyma). Herein, we report the case of a 57-year-old man who developed unilateral enlargement of his left ear over 2 years. Biopsy revealed changes of rosaceous lymphedema associated with Demodex infestation. Corticosteroid and minocycline therapies resulted in partial reduction of the ear enlargement. Literature review examining for cases of lymphedema (elephantiasis) of the ear revealed that chronic inflammatory disorders (rosacea (most frequent), psoriasis, eczema), bacterial cellulitis (erysipelas), pediculosis, trauma, and primary (congenital) lymphedema can all lead to localized, lymphedematous enlargement of the ear. Depending on the severity, medical treatment directed at the inflammatory condition for mild, diffuse enlargement to surgical debulking for extensive diffuse enlargement or tumor formation can improve the signs and symptoms of otophyma. Decreased immune surveillance secondary to rosaceous lymphedema may explain why Demodex infestation is common in rosacea and support the suspicion that phymatous skin is predisposed to skin cancer development.

  16. Corynebacterium equi Infections in Horses, 1958-1984: A Review of 131 Cases.

    PubMed

    Zink, M C; Yager, J A; Smart, N L

    1986-05-01

    Of 131 cases of Corynebacterium equi infection in horses submitted for necropsy to the Ontario Veterinary College or Veterinary Laboratory Services, OMAF, Guelph, Ontario from 1958 to 1984, 115 were diagnosed as suppurative pneumonia, and of these 55 had associated ulcerative enterocolitis. Only five animals had intestinal involvement without pulmonary lesions. The remaining 11 cases included arthritis/cellulitis, skin abscesses and submandibular lymphadenitis. While the lung, intestine and associated lymph nodes yielded C. equi most frequently, in 21% of cases C. equi was also cultured from parenchymatous organs (spleen, liver or kidney) or blood. Corynebacterium equi infection accounted for 10% of all foals submitted for postmortem examination and 45% of all foals with pneumonia. Affected foals were one to four months of age. Submissions occurred between the months of May and August with a peak during July. There was a significantly greater prevalence of C. equi infection in Standardbreds when compared with other breeds. Of foals in this study, 36% were from farms which had had other horses succumb to this disease. Of the foals with pulmonary involvement, 21% did not have fever or clinical signs referable to the respiratory or gastrointestinal systems, findings which indicated that a large percentage of cases were subclinical.

  17. 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.

  18. [Vibrio vulnificus infection outside of the fish ponds in northern Israel: acquisition in the "Einot Tzukim" springs near the Dead Sea].

    PubMed

    Schlesinger, Yechiel; Ben-Shalom, Efrat; Raveh, David P; Yinnon, Amos M; Miskin, Hagit; Rudensky, Bernard

    2009-11-01

    Vibrio vulnificus is a Gram-negative bacterium that may cause severe skin and systemic infection after exposure of open wounds to contaminated water, especially in patients with underlying disease such as immune-deficiency, iron overload or end stage liver or renal disease. The V. vulnificus infection has been reported in Israel almost exclusively after exposure to Tilapia fish cultivated in fresh water fish ponds in northern Israel. The authors report the first case of V. vulnificus infection acquired in a nature reserve in southeastern Israel, with no connection to fish handling. A 14.5-years-old girl with transfusion-dependant thalassemia major presented with high fever and a rapidly progressive bullous cellulitis of the ankle. The infection occurred around a cut on the left lateral malleolus, after bathing in the fresh water ponds of Einot Tzukim (Ein Feshcha) in south-eastern Israel, and progressed despite the use of broad-spectrum antibiotics. Blood and wound cultures eventually yielded Vibrio vulnificus and appropriate treatment was commenced. The fever subsided after a few days but resolution of the local findings was very gradual and lasted for weeks. The presence of V. vulnificus in natural springs far from the northern artificial fish ponds broadens the danger of this infection. We find it prudent to advise people at risk for V. vulnificus infection, such as those suffering from immunedeficiency, iron overload and end stage liver or renal disease, to refrain from bathing in natural ponds whilst injured.

  19. 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.

  20. A Systemic Review on Staphylococcal Scalded Skin Syndrome (SSSS): A Rare and Critical Disease of Neonates

    PubMed Central

    Mishra, Arun K.; Yadav, Pragya; Mishra, Amrita

    2016-01-01

    The symptoms of Staphylococcal scalded skin syndrome (SSSS) include blistering of skin on superficial layers due to the exfoliative toxins released from Staphylococcus aureus. After the acute exfoliation of skin surface, erythematous cellulitis occurs. The SSSS may be confined to few blisters localized to the infection site and spread to severe exfoliation affecting complete body. The specific antibodies to exotoxins and increased clearence of exotoxins decrease the frequency of SSSS in adults. Immediate medication with parenteral anti-staphylococcal antibiotics is mandatory. Mostly, SSSS are resistant to penicillin. Penicillinase resistant synthetic penicillins such as Nafcillin or Oxacillin are prescribed as emergency treatment medicine. If Methicillin-resistant Staphylococcus aureus (MRSA) is suspected), antibiotics with MRSA coverage (e.g., Vancomycin or Linezolid) are indicated. Clindamycin is considered as drug of choice to stop the production of exotoxin from bacteria ribosome. The use of Ringer solution to to balance the fluid loss, followed by maintainence therapy with an objective to maintain the fluid loss from exfoliation of skin, application of Cotrimoxazole on topical surface are greatlly considered to treat the SSSS. The drugs that reduce renal function are avoided. Through this article, an attempt has been made to focus the source, etiology, mechanism, outbreaks, mechanism, clinical manisfestation, treatment and other detail of SSSS. PMID:27651848

  1. Collagenolytic (necrobiotic) granulomas: part II--the 'red' granulomas.

    PubMed

    Lynch, Jane M; Barrett, Terry L

    2004-07-01

    A collagenolytic or necrobiotic non-infectious granuloma is one in which a granulomatous infiltrate develops around a central area of altered collagen and elastic fibers. The altered fibers lose their distinct boundaries and exhibit new staining patterns, becoming either more basophilic or eosinophilic. Within the area of altered collagen, there may be deposition of acellular substances such as mucin (blue) or fibrin (red), or there may be neutrophils with nuclear dust (blue), eosinophils (red), or flame figures (red). These color distinctions can be used as a simple algorithm for the diagnosis of collagenolytic granulomas, i.e. 'blue' granulomas vs. 'red' granulomas. Eight diagnoses are included within these two groupings, which are discussed in this two-part article. In the previously published first part, the clinical presentation, pathogenesis and histologic features of the 'blue' collagenolytic granulomas were discussed. These are the lesions of granuloma annulare, Wegener's granulomatosis, and rheumatoid vasculitis. In this second half of the series, the 'red' collagenolytic granulomas are discussed; these are the lesions of necrobiosis lipoidica, necrobiotic xanthogranuloma, rheumatoid nodules, Churg-Strauss syndrome, and eosinophilic cellulitis (Well's Syndrome).

  2. Successful medical treatment for globe penetration following tooth extraction in a dog.

    PubMed

    Guerreiro, Cleo E; Appelboam, Helen; Lowe, Robert C

    2014-03-01

    A five-year-old entire male Tibetan Terrier was referred for left-sided periorbital swelling and blepharospasm 4 days following ipsilateral maxillary tooth extraction. Examination of the left eye revealed mild exophthalmos, pain on retropulsion, and absent menace response and pupillary light reflexes. Examination of the posterior segment was not possible owing to the anterior segment pathology. Differential diagnoses considered were iatrogenic globe penetration and peribulbar abscess/cellulitis. Ocular ultrasound was consistent with a penetrating wound to the globe. Treatment with systemic prednisolone and marbofloxacin, and topical atropine sulfate 1%, prednisolone acetate, and brinzolamide was started. Marked clinical improvement allowed visual confirmation of the perforation. Oral prednisolone was tapered over the following 10 weeks. At final re-examination (10 months), the patient was visual, and fundic examination revealed an additional chorioretinal scar, most likely an exit wound that was obscured by vitreal debris on initial examinations. Neither scar was associated with retinal detachment. To the authors' knowledge, this is the first reported case of successful medical management of iatrogenic globe penetration following exodontic procedures.

  3. Current role of community-acquired methicillin-resistant Staphylococcus aureus among children with skin and soft tissue infections.

    PubMed

    Teran, Carlos G; Sura, Sunitha; Mohamed, Tarek; Lin, Thant; Meadows, Marsha; Cynthia, Donkor; Wong, Sze H

    2012-01-02

    Community-acquired methicillin-resistant Staphylococcus aureus has become a well-established pathogen with alarming rates during the last decade. The current situation of this bacteria in pediatric infections is very limited and motivated us to conduct this study. This is a retrospective and analytical study including patients less than 18 years of age with the diagnosis of skin or soft tissue infections in 2008 and 2009 meeting the criteria of Community-acquired infection. A prevalence of 41.9% among skin and soft tissue infections was found. Inducible resistance to clindamycin was detected in 1.3% of the strains and the infection shows a seasonal predilection for summer (P=0.003); 57.8% of the cases required hospitalization with a mean stay of 3.3±2.5 days. The susceptibility to clindamycin and co-trimoxazole is 88 and 97% respectively. The resistance to erythromycin has reached 92%. The main diagnoses at presentation was gluteal abscess plus cellulitis (34.2%).The prevalence of CA-MRSA is trending up and seems to become a large burden for the health system in our community. Clindamycin is still an excellent option in the community setting since inducible clindamycin resistance is extremely low in this community. Co-trimoxazole should be kept as a reserved drug to avoid the rapid resurgence resistance in the community.

  4. 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.

  5. MRI in necrotizing fasciitis of the extremities.

    PubMed

    Ali, S Z; Srinivasan, S; Peh, W C G

    2014-01-01

    Necrotizing fasciitis is a life-threatening soft-tissue infection of bacterial origin, which involves mainly the deep fascia. Early recognition of this condition may be hampered by the uncommon nature of the disease and non-specificity of initial clinical signs and symptoms in less fulminant cases, making the role of imaging important. MRI is the most useful imaging modality in the diagnosis of necrotizing fasciitis. The presence of thick (>3 mm) hyperintense signal in the deep fascia (particularly intermuscular fascia) on fat-suppressed T2 weighted or short tau inversion-recovery images is an important marker for necrotizing fasciitis. Contrast enhancement of the thickened necrotic fascia can be variable, with a mixed-pattern of enhancement being more commonly encountered. Involvement of multiple musculofascial compartments increases the likelihood of necrotizing fasciitis. It is important to remember that T2-hyperintense signal in the deep fascia is not specific to necrotizing fasciitis and can also be seen in cases such as non-infective inflammatory fasciitis or muscle tear. In this pictorial essay, we aim to review the MRI findings in necrotizing fasciitis, discuss its limitations and pitfalls and identify differentiating features from non-necrotizing soft-tissue infections, such as cellulitis and infective myositis/pyomyositis, conditions which may clinically mimic necrotizing fasciitis.

  6. Cryptococcal necrotizing fasciitis in a patient after renal transplantation--a case report.

    PubMed

    Yoneda, T; Itami, Y; Hirayama, A; Saka, T; Yoshida, K; Fujimoto, K

    2014-01-01

    A 50-year-old man, who had received an ABO-incompatible living related preemptive renal transplantation 1 year before, presented with painful lesions on both lower extremities and fever. At first, bacterial cellulitis was suspected and antibiotic therapy was initiated, but it was not effective. The serum cryptococcal antigen titer was 1:4,098, and pathologic examination of debrided tissue and wound pus culture revealed cryptococcal necrotizing fasciitis. Liposomal amphotericin B and fluconazole were started, and repeated debridement and skin grafting were performed. Because his graft function deteriorated because of antibody-mediated rejection and polyoma viral nephropathy, hemodialysis was induced on day 9 of hospitalization. During the treatment, he suffered repeated urinary tract infections, which were treated with antibiotics, and cytomegalovirus retinopathy, which was treated with ganciclovir. His cryptococcal necrotizing fasciitis was successfully cured by the combination of antimicrobial treatment and surgical procedures. He could walk with a cane and was discharged on day 298 of hospitalization. Cryptococcal necrotizing fasciitis in renal transplant recipients is so rare that only 14 cases have been reported. The mortality is not very high, but the prognosis of the patient is complicated by worsening of the cryptococcal infection of the central nervous system (CNS). Early detection and treatment to prevent spreading to other sites, especially the CNS or disseminated disease, is very important in cases of cryptococcal necrotizing fasciitis.

  7. 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.

  8. Techniques for early diagnosis and management of cervicofacial necrotising fasciitis

    PubMed Central

    Lee, Judy W; Immerman, Sara B; Morris, Luc GT

    2010-01-01

    Background Cervicofacial necrotising fasciitis carries high rates of morbidity and mortality, and is not often initially suspected due to its rarity and misleadingly innocuous presentation. We propose an algorithm for the timely diagnosis and management of cervicofacial necrotising fasciitis. Methods Retrospective review of seven patients ultimately diagnosed with cervicofacial necrotising fasciitis. Results In these seven patients, common presenting symptoms included sore throat, fever and neck pain. On initial examination and imaging, only three had obvious findings. One patient’s diagnosis was facilitated via a bedside cut-down procedure. Six patients underwent surgical debridement. Four required tracheotomy, and five wounds closed via secondary intention. There were two deaths. Conclusion The severity of cervical necrotising fasciitis and its rapid spread necessitate early diagnosis and timely surgical management. The presentation often appears benign. A high index of clinical suspicion should be maintained in cases of neck cellulitis with nonspecific clinical findings, especially in diabetic or otherwise immunocompromised patients. A normal computed tomography scan does not rule out necrotising fasciitis. A cut-down procedure may be critical to early diagnosis in some cases. PMID:20298644

  9. 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

  10. Characterization of transcription within sdr region of Staphylococcus aureus.

    PubMed

    Sitkiewicz, Izabela; Babiak, Ireneusz; Hryniewicz, Waleria

    2011-02-01

    Staphylococcus aureus is an opportunistic pathogen responsible for various infections in humans and animals. It causes localized and systemic infections, such as abscesses, impetigo, cellulitis, sepsis, endocarditis, bone infections, and meningitis. S. aureus virulence factors responsible for the initial contact with host cells (MSCRAMMs-microbial surface components recognizing adhesive matrix molecules) include three Sdr proteins. The presence of particular sdr genes is correlated with putative tissue specificity. The transcriptional organization of the sdr region remains unclear. We tested expression of the sdrC, sdrD, or sdrE genes in various in vitro conditions, as well as after contact with human blood. In this work, we present data suggesting a separation of the sdr region into three transcriptional units, based on their differential reactions to the environment. Differential reaction of the sdrD transcript to environmental conditions and blood suggests dissimilar functions of the sdr genes. SdrE has been previously proposed to play role in bone infections, whilst our results can indicate that sdrD plays a role in the interactions between the pathogen and human immune system, serum or specifically reacts to nutrients/other factors present in human blood.

  11. 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

  12. Soft tissue infection due to Mycobacterium fortuitum following acupuncture: a case report and review of the literature.

    PubMed

    Guevara-Patiño, Armando; Sandoval de Mora, Marisol; Farreras, Aileen; Rivera-Olivero, Ismar; Fermin, Danibeth; de Waard, Jacobus H

    2010-09-03

    We report the first case of a post-acupuncture soft tissue infection due to Mycobacterium fortuitum. Two months after finishing an acupuncture treatment session, an immunocompetent 23-year-old woman developed cellulitis at the side of the needle insertions and the acid-fast bacillus was isolated from a closed abscess. The patient was successfully treated with a proper drug combination. We review the literature concerning the infection source and the risks for skin and soft tissue infection due to mycobacteria after acupuncture. The infection source in most cases is unknown but is probably associated with the inadequate sterilization of the needles or the puncture site. We show that these infections are not rare but difficult to diagnose. To avoid delays in the definitive diagnosis, infection with mycobacteria should be considered for skin and soft tissue infections, in particular late-onset infections, which are negative for routine bacterial cultures and without a clinical response to antibiotics used for acute pyogenic infections. Bacterial cultures from this lesion should be maintained for at least six weeks before discharged as negative.

  13. 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

  14. Shewanella and Photobacterium spp. in oysters and seawater from the Delaware Bay.

    PubMed

    Richards, Gary P; Watson, Michael A; Crane, Edward J; Burt, Iris G; Bushek, David

    2008-06-01

    Shewanella algae, S. putrefaciens, and Photobacterium damselae subsp. damselae are indigenous marine bacteria and human pathogens causing cellulitis, necrotizing fasciitis, abscesses, septicemia, and death. Infections are rare and are most often associated with the immunocompromised host. A study was performed on the microbiological flora of oysters and seawater from commercial oyster harvesting sites in the Delaware Bay, New Jersey. From 276 water and shellfish samples tested, 1,421 bacterial isolates were picked for biochemical identification and 170 (12.0%) of the isolates were presumptively identified as S. putrefaciens, 26 (1.8%) were presumptively identified as P. damselae subsp. damselae, and 665 (46.8%) could not be identified using the API 20E identification database. Sequencing of the 16S rRNA genes of 22 S. putrefaciens-like isolates identified them as S. abalonesis, S. algae, S. baltica, S. hafniensis, S. marisflavi, S. putrefaciens, Listonella anguillarum, and P. damselae. Beta-hemolysis was produced by some S. algae and P. damselae isolates, while isolates of S. baltica and L. anguillarum, species perceived as nonpathogenic, also exhibited beta-hemolysis and growth at 37 degrees C. To our knowledge, this is the first time these beta-hemolytic strains were reported from shellfish or seawater from the Delaware Bay. Pathogenic Shewanella and Photobacterium species could pose a health threat through the ingestion of contaminated seafood, by cuts or abrasions acquired in the marine environment, or by swimming and other recreational activities.

  15. Neglected Foreign Body, the Cause of Navicular Osteomyelitis in A Paediatric Foot: A Case Report

    PubMed Central

    Chandrashekara, C.M; George, M.A; Al-Marboi, Bader Said Khamis

    2013-01-01

    Introduction: Foreign body injuries with date thorns, metal and wooden splinters are common in Middle East region, as most of it is desert. Some of the injuries lead to cellulitis or abscess formation, if neglected or improperly managed results in osteomyelitis or septic arthritis of foot structures. This is the first report of isolated navicular osteomyelitis following neglected foreign body in a paediatric foot. Case Report: A 10 year old male patient presented with discharging sinus in left mid-foot 3 years after penetrating injury with wooden splinter. The diagnosis of navicular osteomelitis is confirmed with plain radio-graphs. The ultrasound of foot was done to localize the foreign bodies. Patient was treated with complete removal of foreign body (wooden splinters), surgical debridement and combination of IV and oral cloxacillin for period of 6 weeks. At 18 months follow up, patient had painless foot with no recurrence or collapse of navicular bone. Conclusion: The neglected foreign body can result in osteomyelitis of small bones of foot in pediatric patient. The ultrasound is more useful tool in localizing foreign bodies; those are not radio-opaque. Early and prompt diagnosis with adequate treatment of established osteomyelitis by complete removal of foreign body, curettage and antibiotics can give good results. PMID:27298914

  16. Ocular and multicentric lymphoma in a young racehorse.

    PubMed

    Germann, Stephanie E; Richter, Marianne; Schwarzwald, Colin C; Wimmershoff, Julia; Spiess, Bernhard M

    2008-09-01

    A 6-year-old thoroughbred gelding was presented with a history of blepharospasm and opacity in the OS of 1 weeks' duration. Ophthalmic examination findings were consistent with acute uveitis in the OS, and traditional treatment was initiated with systemic antibiotics and anti-inflammatory drugs, topical mydriatics, and corticosteroids. During the total treatment period of 4 weeks response to treatment was weak and the horse developed further problems such as cellulitis of the right hind limb with fever and eventually weight loss and dependent edema. Blood work was indicative of liver disease. Abdominal sonography revealed severe splenomegaly and slight hepatomegaly, and a liver biopsy confirmed malignant T-cell lymphoma. The horse was euthanized due to deteriorating general condition and subsequently underwent postmortem examination. Necropsy and histologic examination revealed a multicentric lymphoma with involvement of spleen, mesenteric lymph nodes, and OU. The findings in this case demonstrate that the differential diagnosis of intraocular and systemic lymphoma should be considered in any horse presenting with anterior uveitis, especially when uveitis is unresponsive to treatment and when additional systemic signs of illness such as lethargy, fever, weight loss, or dependent edema arise. Cytological examination of aqueous humor may provide a rapid diagnosis of intraocular lymphoma in eyes with clinical uveitis.

  17. [Extranodal NK/T-cell lymphoma arising from soft tissue of the left forearm].

    PubMed

    Kunami, Naoko; Takamatsu, Yasushi; Fujita, Mana; Katsuya, Hiroo; Sasaki, Hidenori; Wakamatsu, Shinichi; Ishitsuka, Kenji; Nabeshima, Kazuki; Tamura, Kazuo

    2010-06-01

    A 72-year-old man with extranodal natural killer cell lymphoma (ENKL) presented with a painless swelling of the left forearm. He was initially diagnosed as having a bacterial cellulitis and received antimicrobial therapy. However, his left arm became increasingly swollen in association with fever and redness of the lesion. Therefore, he underwent focal dissection. Because of persistent swelling, the left arm was rebiopsied 9 months later, and a diagnosis of ENKL developing in the subcutis was established. He was treated with focal radiation therapy in combination with dexamethasone, etoposide, ifosfamide, methotrexate and L-asparaginase. The lesion was significantly reduced in size but did not disappear completely. Two months later the lesion became necrotic, although swelling of the forearm lesion, left axillary and cervical lymph nodes were kept under control. We then performed amputation of the left forearm since it could not be saved medically. The patient currently remains alive and well without progression 2 years after amputation. When evaluating panniculitis, which is difficult to cure, ENKL should be considered in the differential diagnosis and treated appropriately.

  18. 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.

  19. Value and Clinical Impact of an Infectious Disease-Supervised Outpatient Parenteral Antibiotic Therapy Program

    PubMed Central

    Petrak, Russell M.; Skorodin, Nathan C.; Fliegelman, Robert M.; Hines, David W.; Chundi, Vishnu V.; Harting, Brian P.

    2016-01-01

    Background. Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. This study was undertaken to define the value of OPAT in a multicentered infectious disease (ID) private practice setting. Methods. Over a period of 32 months, 6120 patients were treated using 19 outpatient ID offices in 6 states. Analysis included patient demographics, indications of OPAT, diagnoses, therapeutic agent, duration of therapy, and site of therapy initiation. Outcomes were stratified by therapeutic success, clinical relapse, therapeutic complications, and hospitalizations after initiating therapy. Statistical analysis included an ordinal logistic regression analysis. Results. Forty-three percent of patients initiated therapy in an outpatient office, and 57% began therapy in a hospital. Most common diagnoses treated were bone and joint (32.2%), abscesses (18.8%), cellulitis (18.5%), and urinary tract infection (10.8%). Ninety-four percent of patients were successfully treated, and only 3% were hospitalized after beginning therapy. Most common cause of treatment failure was a relapse of primary infection (60%), progression of primary infection (21%), and therapeutic complication (19%). Conclusions. An ID-supervised OPAT program is safe, efficient, and clinically effective. By maximizing the delivery of outpatient care, OPAT provides a tangible value to hospitals, payers, and patients. This program is a distinctive competency available to ID physicians who offer this service to patients. PMID:27807591

  20. Récidive après dix ans de tumeur de granulosa de l’ovaire: à propos de deux cas et revue de la littérature

    PubMed Central

    Majdoul, Soufya; Tawfiq, Nezha; Bourhaleb, Zouhour; Naqos, Nora; Taleb, Amina; Bouchbika, Zineb; Benchakroun, Nadia; Jouhadi, Hassan; Sahraoui, Souha; Benider, Abdelatif

    2016-01-01

    Les tumeurs à cellules de la granulosa (TG) de l’ovaire sont des tumeurs rares appartenant au groupe des tumeurs des cordons sexuels et du stroma. Elles représentent 0,6 à 3 % de l’ensemble des tumeurs de l’ovaire et 5 % des tumeurs malignes On distingue deux types: le type juvénile (TGJ) qui se caractérise par son agressivité et le type adulte (TGA) qui est le type le moins agressif et le plus fréquent. Les rechutes de TG de l'ovaire surviennent généralement dans les cinq ans, elles sont rarement sous forme de métastases péritonéales ou locales. Bien que, des options de traitement y compris la chirurgie avec ou sans chimiothérapie et ou radiothérapie ont été rapportés pour le traitement des récidives des TG, il n'y a aucune prise en charge standardisée de récidive de cette maladie. Ici, nous rapportons notre stratégie thérapeutique dans la prise en charge des récidives tardives, après dix ans, de la TG sous forme de carcinose péritonéale pour deux patientes avec une revue de la littérature. PMID:28154722

  1. Structure of a group A streptococcal phage-encoded virulence factor reveals a catalytically active triple-stranded beta-helix.

    PubMed

    Smith, Nicola L; Taylor, Edward J; Lindsay, Anna-Marie; Charnock, Simon J; Turkenburg, Johan P; Dodson, Eleanor J; Davies, Gideon J; Black, Gary W

    2005-12-06

    Streptococcus pyogenes (group A Streptococcus) causes severe invasive infections including scarlet fever, pharyngitis (streptococcal sore throat), skin infections, necrotizing fasciitis (flesh-eating disease), septicemia, erysipelas, cellulitis, acute rheumatic fever, and toxic shock. The conversion from nonpathogenic to toxigenic strains of S. pyogenes is frequently mediated by bacteriophage infection. One of the key bacteriophage-encoded virulence factors is a putative "hyaluronidase," HylP1, a phage tail-fiber protein responsible for the digestion of the S. pyogenes hyaluronan capsule during phage infection. Here we demonstrate that HylP1 is a hyaluronate lyase. The 3D structure, at 1.8-angstroms resolution, reveals an unusual triple-stranded beta-helical structure and provides insight into the structural basis for phage tail assembly and the role of phage tail proteins in virulence. Unlike the triple-stranded beta-helix assemblies of the bacteriophage T4 injection machinery and the tailspike endosialidase of the Escherichia coli K1 bacteriophage K1F, HylP1 possesses three copies of the active center on the triple-helical fiber itself without the need for an accessory catalytic domain. The triple-stranded beta-helix is not simply a structural scaffold, as previously envisaged; it is harnessed to provide a 200-angstroms-long substrate-binding groove for the optimal reduction in hyaluronan viscosity to aid phage penetration of the capsule.

  2. Kodamaea ohmeri fungemia in an immunocompetent patient treated with micafungin: case report and review of the literature.

    PubMed

    Shaaban, Hamid; Choo, Hoo Feng; Boghossian, Jack; Perez, George

    2010-10-01

    Kodamaea (Pichia) ohmeri is an unusual yeast-form fungus that has recently been identified as an important etiology of fungemia, endocarditis, cellulitis, funguria and peritonitis in immunocompromised patients. We report a case of K. ohmeri fungemia in a 34-year-old hospitalized patient with thrombophlebitis. The patient was admitted to the hospital for evaluation and management of an acquired tracheo-esophageal fistula secondary to an impacted denture. Fever developed on hospital day 22, and physical exam revealed right arm superficial thrombophlebitis at the site of the peripheral venous catheter that was confirmed by Doppler ultrasound. The peripheral vein was removed and blood cultures from hospital day 22 and 23 grew yeast species. The yeast was subsequently identified to be K. ohmeri by Vitek II and API20C and was confirmed by 18S rRNA gene sequencing. The fungemia and right arm phlebitis was successfully treated with a 2-week course of micafungin therapy. This is the first case of K. ohmeri fungemia in a patient that was successfully treated with micafungin.

  3. A ten year retrospective review of orbital complications secondary to acute sinusitis in children.

    PubMed

    Suhaili, D N Pengiran; Goh, B S; Gendeh, B S

    2010-03-01

    Acute sinusitis is most often a mild self-limiting disease. However, it may progress into severe and life threatening complications. One of the commonest being orbital complication of which visual loss is a direct consequence. In this 10 year retrospective study, the nature of orbital complication, clinical presentation and treatment modalities and outcome seen in children with acute sinusitis in a tertiary referral institute were reviewed. Of six patients, there was a case of preseptal cellulitis, 4 cases of subperiosteal abscess and one case of orbital abscess. Periorbital swelling was a common presenting feature. In 5 cases this was associated with proptosis with one case of impending optic nerve compression. The value of computed tomography and opthalmological examination as a component in the management plan is highlighted. All patients were treated with intravenous antibiotics but evidence of abscess collection warranted urgent surgical drainage in 5 patients, 3 being endoscopic drainage while external approach was done for the remaining 2 patients. Thus a child exhibiting orbital complication of acute sinusitis, prompt diagnosis and treatment is essential in obtaining the best outcome for the child.

  4. Critical analysis of Strattice performance in complex abdominal wall reconstruction: intermediate-risk patients and early complications.

    PubMed

    Patel, Ketan M; Albino, Frank P; Nahabedian, Maurice Y; Bhanot, Parag

    2013-01-01

    The purpose of this study was to analyze the performance of a porcine-derived acellular dermal matrix (Strattice Reconstructive Tissue Matrix) in patients at increased risk for perioperative complications. We reviewed medical records for patients with complex abdominal wall reconstruction (AWR) and Strattice underlay from 2007 to 2010. Intermediate-risk patients were defined as having multiple comorbidities without abdominal infection. Forty-one patients met the inclusion criteria (mean age, 60 years; mean body mass index, 35.5 kg/m(2)). Comorbidities included coronary artery disease (63.4%), diabetes mellitus (36.6%), and chronic obstructive pulmonary disease (17.1%). Fascial closure was achieved in 40 patients (97.6%). Average hospitalization was 6.4 days (range, 1-24 days). Complications included seroma (7.3%), wound dehiscence with Strattice exposure (4.9%), cellulitis (2.4%), and hematoma (2.4%). All patients achieved abdominal wall closure with no recurrent hernias or need for Strattice removal. Patients with multiple comorbidities at intermediate risk of postoperative complications can achieve successful, safe AWR with Strattice.

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

    PubMed

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

    2015-06-25

    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.

  6. 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 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.

  7. Obturator internus pyomyositis. A case report.

    PubMed

    Birkbeck, D; Watson, J T

    1995-07-01

    Pyomyositis appears to be increasing in prevalence in temperate climates, and often the orthopaedist is integral in the decision making and care of these patients. This is the first reported case of spontaneous bacterial pyomyositis involving the obturator internus muscle. Deep pelvic infections involving the psoas, iliacus, piriformis, and obturator internus can be a significant cause of morbidity and mortality. The infection subsequently may exit the pelvis, and conceivably may progress to a septic hip, bursitis, or lower extremity cellulitis. Improvements in noninvasive imaging such as ultrasound, computed tomography, and magnetic resonance imaging have produced finer resolution of tissue planes. Because of the pathology's deep location within the pelvis of the patient described here, all 3 tests were integral in the surgical planning, exposure, and proper diagnosis. Although 95% of pyomyositis cases are caused by Staphylococcus aureus, cases of pyomyositis with negative cultures have been described. Consideration should be made of disseminated Neisseria gonorrhoeae in sexually active individuals, and cultures should include Thayer-Martin agar to decrease the likelihood of a false-negative culture result.

  8. Pyoderma Gangrenosum–Like 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 gangrenosum–like 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 patient’s 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 gangrenosum–like leg ulcers in patients with X-linked agammaglobulinemia. Correct identification of this organism as the cause of pyoderma gangrenosum–like ulcers in patients with X-linked agammaglobulinemia is of great importance for the early initiation of appropriate and curative antibiotic therapy. PMID:20479300

  9. 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.

  10. Patient considerations in the management of toe onychomycosis – role of efinaconazole

    PubMed Central

    LaSenna, Charlotte E; Tosti, Antonella

    2015-01-01

    Onychomycosis is a difficult diagnosis to manage and treatment is sometimes avoided, as this diagnosis is often wrongly perceived as a cosmetic problem. However, onychomycosis has a negative impact on patients’ quality of life, affecting social interaction, psychological well-being, and physical activities. Onychomycosis is also a risk factor for patients with diabetes, with proven increased rates of cellulitis, gangrene, and foot ulcers. Treatments are only mild to moderately effective, and rates of relapse and reinfection are high. Oral treatments require laboratory monitoring due to risk of hepatotoxicity and may be contraindicated in some patients due to risk of drug–drug interactions. Topical treatments require prolonged application and are not very effective. Efinaconazole 10% solution is a new topical triazole treatment for mild to moderate distal subungual onychomycosis, with good efficacy and without the need for debridement of nails. In onychomycosis of the toenails, efinaconazole 10% solution is documented to have a statistically significant, positive impact on patient satisfaction and quality of life. PMID:26170638

  11. The burden of bone, native joint and soft tissue infections on orthopaedic emergency referrals in a city hospital.

    PubMed

    Howell, A; Parker, S; Tsitskaris, K; Oddy, M J

    2016-01-01

    Introduction Bone, native joint and soft tissue infections are frequently referred to orthopaedic units although their volume as a proportion of the total emergency workload has not been reported previously. Geographic and socioeconomic variation may influence their presentation. The aim of this study was to quantify the burden of such infections on the orthopaedic department in an inner city hospital, determine patient demographics and associated risk factors, and review our current utilisation of specialist services. Methods All cases involving bone, native joint and soft tissue infections admitted under or referred to the orthopaedic team throughout 2012 were reviewed retrospectively. Prosthetic joint infections were excluded. Results Almost 15% of emergency admissions and referrals were associated with bone, native joint or soft tissue infection or suspected infection. The cohort consisted of 169 patients with a mean age of 43 years (range: 1-91 years). The most common diagnosis was cellulitis/other soft tissue infection and the mean length of stay was 13 days. Two-thirds of patients (n=112, 66%) underwent an operation. Fifteen per cent of patients were carrying at least one blood borne virus, eleven per cent were alcohol dependent, fifteen per cent were using or had been using intravenous drugs and nine per cent were homeless or vulnerably housed. Conclusions This study has shown that a significant number of patients are admitted for orthopaedic care as a result of infection. These patients are relatively young, with multiple complex medical and social co-morbidities, and a long length of stay.

  12. 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.

  13. Diagnosis and Percutaneous Treatment of Soft-Tissue Hydatid Cysts

    SciTech Connect

    Akhan, Okan Gumus, Burcak; Akinci, Devrim; Karcaaltincaba, Musturay; Ozmen, Mustafa

    2007-06-15

    The purpose of this study is to demonstrate and discuss the radiological features of four patients with muscular hydatid disease and to evaluate the results of percutaneous treatment in these patients. Four patients (three female and one male) with six muscular hydatid cysts underwent percutaneous treatment and were followed up. The mean age of patients was 35 years (range: 12-60 years). Type I (n = 2), type II (n = 1), and type III (n = 3) hydatid cysts were observed in the thigh (n = 3) and gluteal (n = 1) region on radiologic examination. All interventions were performed under sonographic and fluoroscopic guidance. According to the type of the cyst, the procedure was carried out by either a 'catheterization technique with hypertonic saline and alcohol' or a 'modified catheterization technique.' The mean cathaterization time was 13.7 days, ranging from 1 to 54 days. The dimensions of the residual cavity were noted at every sonographic control, and an average of 96.1% volume reduction was obtained in six cysts of four patients. No sign of viability was observed during the follow-up period. Cavity infection and cellulitis were observed as complications, which resolved after medical therapy. Percutaneous treatment is a safe and effective procedure in patients with soft-tissue hydatid cysts and should be considered as a serious alternative to surgery.

  14. Splenic hypofunction in the nephrotic syndrome of childhood

    SciTech Connect

    McVicar, M.I.; Chandra, M.; Margouleff, D.; Zanzi, I.

    1986-05-01

    The reticuloendothelial system, including the spleen, subserves important immunologic functions. Loss of splenic function results in an increased incidence of severe bacterial infections and is accompanied by thrombocytosis. Several nephrotic children were noted to have remarkably high platelet counts and predisposition to bacterial infection with encapsulated organisms. We, therefore, investigated the splenic function of nine children with primary nephrotic syndrome and measured the phagocytic function of the spleen by sequestration of Technetium-99-labelled heat-treated autologous RBC, administered intravenously. Four children had decreased splenic function. Repeat studies performed in two of these children after remission of the nephrotic syndrome gave normal results. There were six episodes of bacterial infection (3 peritonitis, 1 septic arthritis, 1 cellulitis, and 1 Escherichia coli urinary tract infection) among the four patients with decreased splenic function. There were no episodes of bacterial infection among the five nephrotic children with normal splenic function. Nephrotic patients with decreased splenic function had significantly increased platelet counts (921,000 +/- 196,000; mean +/- SEM) compared to those with normal function (435,000 +/- 46,000; P less than 0.001). Our findings suggest the possibility that some nephrotic children may have decreased splenic function in association with increased susceptibility to bacterial infections.

  15. [The Paris cell for collecting preoccupying information (la CRIP 75): an organization at the heart of child protection].

    PubMed

    Magny, J; Reveillère, C

    2011-09-01

    Within the objective of coordinating actions of the different partners whose mission involves childhood protection measures, and to allow convergence of preoccupying information toward a centralized unit, law n(o) 2007-293 of 5 March 2007 reforming child protection requires the creation of a departmental cell for the collection, processing, and assessment of preoccupying information (cellule départementale, de recueil, de traitement, et d'évaluation des informations préoccupantes, CRIP) on the circumstances of a minor in danger or at risk of being so. The CRIP 75 is a multidisciplinary cell comprising an administrative pole, a socio-educational pole, and a medical health officer. Its mission is to participate in assessing preoccupying information and directing it appropriately, with a preference toward treating situations within an administrative framework and in accordance with the parents. The public prosecutor is only called in when the recommended measures have not provided an adequate response to the danger. Situations that are a matter for prosecution as a criminal offence are transmitted directly to the public prosecutor's office, as are situations for which the social or medico social services are unable to make an assessment.

  16. Sex differences in the incidence of skin and skin-related diseases in Olmsted County, Minnesota, United States, and a comparison with other rates published worldwide.

    PubMed

    Andersen, Louise K; Davis, Mark D P

    2016-09-01

    Many skin and skin-related diseases affect the sexes unequally, with attendant implications for public health and resource allocation. To evaluate better the incidence of skin and skin-related diseases affecting males vs. females, we reviewed published population-based epidemiology studies of skin disorders performed utilizing Rochester Epidemiology Project data. Females had a higher incidence of the following diseases: connective tissue diseases (scleroderma, morphea, dermatomyositis, primary Sjögren syndrome, systemic lupus erythematosus [not in all studies]), pityriasis rosea, herpes progenitalis, condyloma acuminatum, hidradenitis suppurativa, herpes zoster (except in children), erythromelalgia, venous stasis syndrome, and venous ulcers. Males had a higher incidence of psoriasis and psoriatic arthritis, basal cell carcinoma (exception, females aged ≤40 years), squamous cell carcinoma, and lentigo maligna. Incidence rates were equal in males and females for cutaneous malignant melanoma (exception, higher in females aged 18-39 years), lower-extremity cellulitis, cutaneous nontuberculous mycobacterial infection, Behçet disease, delusional infestation, alopecia areata, and bullous pemphigoid. Many of the population-based sex-specific incidence rates of skin and skin-related diseases derived from the Rochester Epidemiology Project are strikingly different from those estimated elsewhere. In general, females are more commonly affected by skin and skin-related diseases. The reasons for this imbalance remain to be determined and are likely multifactorial.

  17. Syndrome de levée d’obstacle : physiopathologie et prise en charge

    PubMed Central

    Ziouziou, Imad; Daoudi, Anass; Nouri, Anass; Karmouni, Tarik; El Khader, Khalid; Koutani, Abdellatif; Andaloussi, Ahmed Iben Attya

    2012-01-01

    Résumé Le syndrome de levée d’obstacle est une polyurie massive faisant suite au traitement d’une insuffisance rénale obstructive. Les mécanismes physiopathologiques sont multiples : un état de surcharge hydrique qui dépend du caractère complet ou incomplet de l’obstacle, des anomalies tubulaires (atteinte de la capacité de dilution et de concentration des urines, diminution de la réabsorption du sodium, fuites de potassium, troubles de l’acidification des urines, insensibilité des cellules tubulaires à l’hormone antidiurétique), ainsi que des facteurs biochimiques et immunologiques sont mis en jeu. La levée d’un obstacle nécessite une surveillance clinique et biologique stricte (diurèse horaire, état hémodynamique, état d’hydratation, créatininémie, urémie, ionogramme sanguin). Le traitement a pour but d’éviter les troubles hémodynamiques et métaboliques graves, et repose sur le principe de la compensation des pertes hydroélectrolytiques. PMID:23283096

  18. Avian trichomonosis in spotted owls (Strix occidentalis): Indication of opportunistic spillover from prey.

    PubMed

    Rogers, Krysta H; Girard, Yvette A; Woods, Leslie; Johnson, Christine K

    2016-12-01

    Avian trichomonosis, caused by the flagellated protozoan parasite Trichomonas gallinae, has variable pathogenicity among bird species ranging from asymptomatic infections to severe disease periodically manifesting in epidemic mortality. Traditionally, columbids are identified as highly susceptible to infection with occasional spillover into raptors that prey on infected birds. We identified avian trichomonosis in two dead California spotted owls (Strix occidentalis occidentalis) and three dead northern spotted owls (S. o. caurina) in California during 2011-2015; infection was confirmed in four owls by PCR. Pathologic lesions associated with trichomonosis in the owls included caseonecrotic lesions of the upper palate accompanied by oropharyngitis, cellulitis, myositis, and/or sinusitis. Spotted owls are known to mainly feed on small mammals; therefore, the source of infection as well as the significance of the disease in spotted owls is unclear. These owl trichomonosis cases coincided temporally and spatially with three trichomonosis epidemics in band-tailed pigeons (Patagioenas fasciata monilis). The same parasite, T. gallinae subtype A2, was isolated from the spotted owls and band-tailed pigeons, suggesting the owls became infected when opportunistically feeding on pigeons during mortality events. Avian trichomonosis is an important factor in the decline of the Pacific Coast band-tailed pigeon population with near-annual mortality events during the last 10 years and could have conservation implications for raptor species at risk, particularly those that are facing multiple threats.

  19. An easy method for diagnosis of lymphedema.

    PubMed

    Richards, T B; McBiles, M; Collins, P S

    1990-05-01

    Lymphoscintigraphy has been very useful in determination of lymphatic abnormalities. However, the radioactive isotopes used have been investigational and difficult obtain. The purpose of this study was to examine patients with extremity edema by lymphoscintigraphy using a radioactive colloid readily available in our nuclear pharmacy, Technetium 99m sulfur minicolloid. Forty limbs in 20 patients were evaluated using Technetium 99m sulfur minicolloid lymphoscintigraphy. All patients had lower extremity edema initially attributed to a venous or lymphatic etiology. There were 12 patients with normal bilateral studies. Seven patients exhibited unilateral obstruction to lymphatic flow, and one had unilateral enhanced flow of lymph. Those with normal studies included five patients with nonspecific edema, four with varicosities, and one patient each with acute deep vein thrombosis, chylous ascites, and excision of the greater saphenous vein for arterial bypass grafting. Five patients with obstructed patterns had previous arterial bypass procedures, one had trauma to the extremity, and one had lymphedema tarda. The one enhanced lymphoscintigraphic pattern was seen in a patient with acute cellulitis. All patients had Doppler venous examinations and other studies included strain gauge phlethysmography, venograms, computed tomography, magnetic resonance imaging, and ultrasound. As with other scintigraphic imaging agents used to study lymphatic flow, Technetium 99m provides clinically useful information in evaluating the swollen extremity noninvasively.

  20. Clinical use of denosumab for the treatment for postmenopausal osteoporosis.

    PubMed

    Lewiecki, E Michael

    2010-12-01

    Denosumab is a fully human monoclonal antibody with high affinity and specificity for human receptor activator of nuclear factor kappa B ligand (RANKL), the principal regulator of osteoclastic bone resorption. By binding to RANKL, denosumab prevents it from binding to its receptor on the cell surface of pre-osteoclasts and mature osteoclasts, thereby reducing the formation, activity, and survival of osteoclasts and inhibiting osteoclastic bone resorption. In a large, randomized, placebo-controlled clinical trial in postmenopausal women with osteoporosis, denosumab 60 mg administered subcutaneously every 6 months reduced levels of bone turnover markers, increased bone mineral density, and reduced the risk of vertebral fractures, hip fractures, and non-vertebral fractures. There was no significant difference between denosumab and placebo in the overall risk of adverse events or serious adverse events. Denosumab was associated with a significant increase in the risk of eczema and cellulitis, and a significant decrease in the risk of falling and concussions. Denosumab recently received regulatory approval for the treatment of postmenopausal women with osteoporosis at high risk for fracture, with no dose adjustment in patients with renal impairment. Denosumab is a new therapeutic option to reduce fracture risk in women with postmenopausal osteoporosis, especially for those with impaired renal function or with intolerance or poor response to oral therapy.