Cervical necrotizing fasciitis and tonsillitis

1994 ◽  
Vol 108 (5) ◽  
pp. 435-437 ◽  
Author(s):  
P. M. J. Scott ◽  
R. S. Dhillion ◽  
P. J. McDonald
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Clinical Signs ◽  
Surgical Debridement ◽  
Healthy Man

AbstractWe present a case of cervical necrotizing fasciitis following quinsy in a previously fit and healthy man. This is a potentially fatal condition with few specific clinical signs that requires early diagnosis and surgical debridement. Other features of the disease are discussed.

Limb Salvage in a Diabetic with Necrotizing Fasciitis: Case Report and Literature Review

Foot & Ankle ◽  
1986 ◽  
Vol 6 (4) ◽  
pp. 199-207
Author(s):  
Steven B. Carlow ◽  
Richard L. Jacobs ◽  
Danica K. Vedder
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Early Diagnosis ◽  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Limb Salvage ◽  
Clinical Signs ◽  
Tissue Biopsy ◽  
Functional Limb

Necrotizing fasciitis must be considered in a diabetic with cutaneous ulceration. A case report of limb salvage in a 48-year-old diabetic female with progressive necrotizing fasciitis is presented. Methods of early diagnosis including clinical signs, radiographs, and soft tissue biopsy of the involved extremity are reviewed. The microbiology of the disease is also discussed. A modification of the Orr technique using infrequent dressing changes in the management of necrotizing fasciitis is presented. In our case this resulted in preservation of life and a functional limb.

scholarly journals Necrotizing Fasciitis in Neonate and Use of Allograft

2019 ◽  
Vol 8 (1) ◽  
pp. 8
Author(s):  
Nitinkumar Borkar ◽  
Phalguni Padhi ◽  
Jiten Kumar Mishra ◽  
Shamendra Anand Sahu ◽  
Debajyoti Mohanty ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Subcutaneous Fat ◽  
Surgical Debridement ◽  
Split Thickness Skin Graft ◽  
Superficial Fascia ◽  
Thickness Skin

Necrotising fasciitis is a fulminant and rapidly progressive infection of the superficial fascia and subcutaneous tissue. It is rare in newborn. Trunk is the commonest site of involvement in newborns. Early diagnosis and prompt surgical debridement is the preferred treatment. Debridement in NF leads to a large raw area which may not heal by primary intention and may a split thickness skin graft for healing. Presence of minimum subcutaneous fat, loose skin and large raw area at donor site like back in some neonate poses difficulty for harvesting of skin graft. In such neonates allograft make a valuable option temporarily. Herein we report a case of a neonate with NF in whom post debridement raw area was covered with allograft from mother.

scholarly journals Necrotizing Fasciitis Case Series: Improved Outcomes with Early Diagnosis and Effective Surgical Interventions in Low Resource Settings

2018 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Fluid Resuscitation ◽  
Broad Spectrum ◽  
Community Hospital ◽  
Case Series ◽  
Surgical Debridement ◽  
Necrotising Fasciitis ◽  
Surgical Interventions ◽  
Improved Outcomes

Necrotizing fasciitis (NF) is a severe, rare, potentially lethal and fulminant soft tissue infection. It is marked by necrosis of the superficial fascia, neutrophil infiltration of the deep dermis and fascia, thrombosis of the cutaneous microcirculation, and the presence of the infecting organism in the necrotic tissue. The infection progresses rapidly with systemic signs of toxicity and septic shock may ensue; hence, the mortality rate is high (median mortality 32.2%). Prognosis becomes poorer in the presence of co-morbidities, such as diabetes mellitus, immunosuppression, chronic alcohol disease, and in poor resource settings. Early and aggressive meticulous surgical debridement constitutes the mainstay of treatment along with broad spectrum antibiotics and fluid resuscitation. Postoperative management of the surgical wound is also important for the patient’s survival, along with proper nutrition. Objective: To determine improved outcomes with early diagnosis and cost effective surgical interventions for patients necrotizing fasciitis at Bwindi community hospital,Uganda. Design: These are case series of 6 patients who presented with fulminant necrotising fasciitis admitted to the hospital through the emergency wing. Materials and methods: Six patients presented with fulminant nectrozing fasciitis admitted at Bwindi community Hospital between August 2015 and June 2017, were analysed, and appropriate effective surgical management based on these patients is suggested. Results: These patients were all admitted after a minimum of 3.8 days from the on onset of the infection. The average timing of debridement through fish fillet incisions was 14 and 4 hours from the time of admission and diagnosis respectively. The average number of redebreidments were six. There was 83.3% survival after treatment, with 16.6% mortality. Vacuum dressings were used for one paediatric case. 50% of the wounds healed by secondary intention, 16.6% by secondary closure and 16.6% done full thickness skin grafting. Placement of the testicles in subcutaneous pockets in the thigh was done for one patient. In 100% were of the patients dressing with honey gauze was used for the alternate day bed side dressing. Conclusion: The diagnosis of necrotising fasciitis is a challenge, however early meticulous surgical debridement, supported by fluid resuscitation and broad spectrum antibiotic clinical administration is key to survival of these patients.

scholarly journals Massive necrotizing fasciitis following bellow-knee arterial surgery: A therapeutic challenge

2015 ◽  
Vol 72 (5) ◽  
pp. 469-472
Author(s):  
Petar Popov ◽  
Slobodan Tanaskovic ◽  
Vuk Sotirovic ◽  
Dragoslav Nenezic ◽  
Djordje Radak
Keyword(s):  
Necrotizing Fasciitis ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Systemic Infection ◽  
Surgical Debridement ◽  
Bypass Grafting ◽  
Superficial Fascia ◽  
Wound Swab ◽  
Life Threatening ◽  
Skin Reconstruction

Introduction. Necrotizing fasciitis is a rare, progressive bacterial infection of superficial fascia followed by secondary subcutaneous tissue necrosis. We pressented a patient with massive fulminant lifethreatening necrotising fasciitis after bellow-knee femoro-popliteal vein bypass grafting successfully treated by antibiotics, surgical debridement and final skin reconstruction using the Tierch method. Case report. A 61-year-old patient was ad-mitted to the Vascular Surgery Clinic for below-knee femoro-popliteal bypass grafting. He complained of intermittent claudication in the left leg after 50 m, ankle brachial indexes were 0.45 on the left and 1.0 on the right side. Femoropopliteal below-knee bypass grafting was done using the autologous great saphenous vein. In the very next day, initial signs of skin infection appeared including local inflammation, erythema, swelling and cellulitis restricted to saphenectomy site. These changes had rapidly spread in the following days on the deep tissue of the whole upper and lower leg, including the groin and with clinical signs of life-threatening systemic infection. Immediate surgical debridement was done followed by extensive wound packing and wide spectrum antibiotics administration for the next 33 days when final skin reconstruction by the Tierch method was performed. Interesting point is that this entire time wound swab was sterile. Conclusion. In the presented case immediate surgical debridement, wide spectrum antibiotics administration and consistent wound packing gave satisfactory results in this life-threatening systemic infection. Wound swab is not always a reliable indicator of the infection while clinical findings and surgeons? experience are of great significance in rapid reaction to this rare surgical complication.

scholarly journals Osteoarthritis in pet guinea pigs: an update on diagnosis, treatment and management

2021 ◽  
Vol 26 (6) ◽  
pp. 100-106
Author(s):  
Emma Keeble
Keyword(s):  
Quality Of Life ◽  
Early Diagnosis ◽  
Guinea Pigs ◽  
Advanced Disease ◽  
Early Stage ◽  
Clinical Signs ◽  
Nutritional Supplements ◽  
Lifestyle Changes ◽  
Early Age

This article reviews the current literature on osteoarthritis in pet and laboratory guinea pigs. The associated clinical signs, diagnosis and treatment of osteoarthritis in pet guinea pigs will be discussed, with options for analgesia detailed. This condition is thought to be common in pet guinea pigs, even from an early age in some genetic lines, although osteoarthritis often goes undiagnosed in this species until advanced disease is present, posing a major welfare concern. Increasing awareness of this condition in veterinary practitioners should aid early diagnosis in pets and help improve their quality of life. Prevention may be possible using oral protective nutritional supplements to slow down the progression of this disease at an early stage. Lifestyle changes are also discussed for the management of this condition in pet guinea pigs.

scholarly journals The relevance of a fast and early diagnosis of necrotizing fasciitis in the Emergency Department: a case report

2016 ◽  
Vol 10 ◽  
Author(s):  
Marianna Gregorio ◽  
Antonio Villa
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Case Report ◽  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Multiorgan Failure ◽  
Left Thigh ◽  
Popliteal Fossa ◽  
Leg Pain ◽  
Movement Limitation

We report a case of necrotizing fasciitis in an 84 year-old man affected by diabetes mellitus. The patient was admitted in the Emergency Department of our hospital because of an acute and strong left leg pain that began almost 8 hours before admission. The left leg had an increased size and a movement limitation, with a hard haemathoma in the left thigh with subcutaneous crepitus. The lesion became worse and larger rapidly, with a wide extension from the back to the popliteal fossa. An antimicrobial therapy was immediately started with morphine for pain. A surgical debridment was performed, but the patient died for multiorgan failure. Necrotizing fasciitis is a rare and mortal disease, the early diagnosis is a challenge for the Emergency Department where patients are admitted and assessed primarly.

scholarly journals Detectability of the peripheral and axial manifestations of psoriatic arthritis in patients with psoriasis in dermatological practice

2019 ◽  
Vol 13 (4) ◽  
pp. 48-54
Author(s):  
M. N. Chamurlieva ◽  
E. Yu. Loginova ◽  
T. V. Korotaeva
Keyword(s):  
Back Pain ◽  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Clinical Signs ◽  
Severity Index ◽  
The Body ◽  
Inflammatory Back Pain ◽  
Patient Complaints ◽  
Asas Criteria ◽  
Mechanical Back Pain

Psoriatic arthritis (PsA) is a heterogeneous disease manifested by peripheral arthritis, dactylitis, spondylitis, and enthesitis. PsA is often undiagnosed by dermatovenerologists because of the difficulty in identifying a variety of clinical signs. The early diagnosis of PsA and the accurate assessment of all its symptoms are necessary for the timely choice of optimal therapy.Objective: to assess the detectability of clinical signs of PsA in patients with psoriasis in dermatological practice.Patients and methods. The investigation enrolled 103 patients (47 men and 56 women) (mean age, 44.0±13.7 years) with psoriasis (its mean duration, 10.7±10.2 years), the average prevalence and severity according to the Body Surface Area (BSA) and the Psoriasis Area and Severity Index (PASI) were 9.3±13.6% and 15.4±12.5 scores, respectively. All the patients completed the Psoriasis Epidemiology Screening Tool (mPEST) and were examined by a dermatovenerologist and a rheumatologist. The diagnosis of PsA was based on the Classification Criteria for Psoriatic Arthritis (CASPAR). The investigators evaluated arthritis, dactylitis, enthesitis, and inflammatory back pain (IBP) according to the rheumatological standards: IBP by the Assessment of SpondyloArthritis International Society (ASAS) criteria, and enthesitis by the Leeds Enthesitis Index (LEI).Results and discussion. Sixty-one (59.2%) of the 103 patients with psoriasis were found to have PsA on the basis of the CASPAR criteria and the rheumatologist's examination. The dermatovenerologist diagnosed arthritis in a significantly smaller number of cases than did the rheumatologist: in 15 (24.6%) and 35 (57.4%) of the 61 patients (p<0.001), respectively. The dermatovenerologist and the rheumatologist demonstrated no significant differences in their clinical evaluation of dactylitis: it was detected in 37 (60.7%) and 40 (65.6%) of the 61 patients, respectively (p=0.32). Based on patient complaints and mPEST findings, the dermatovenerologist recorded pain in the calcaneal region in 32 (52.5%) patients. The rheumatologist identified ulnar, knee, and calcaneus enthesitis in 11 (18%), 8 (13.1%), and 25 (41%) patients, respectively. Based on complaints and mPEST findings, the dermatovenerologist detected back pain in 30 (49.2%) of the 61 patients. The rheumatologist diagnosed IBP in 21 (70%) of these 30 patients and mechanical back pain in 9 (30%). Thus, IBP was noted in 34.4% of PsA patients. Tendonitis was undiagnosed by the dermatovenerologist; the rheumatologist identified wrist tendonitis in 13 (21.3%) of the 61 patients with PsA.Conclusion. Dermatovenerologists frequently underestimate damage to the spine and entheses in patients with psoriasis. The introduction of the ASAS criteria for IBP and methods for assessing enthesitis in dermatological practice can improve the early diagnosis of axial lesion in PsA in patients with psoriasis.

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