scholarly journals Cervical Necrotizing Fasciitis Caused by Dental Extraction

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
José Alcides Arruda ◽  
Eugênia Figueiredo ◽  
Pâmella Álvares ◽  
Luciano Silva ◽  
Leorik Silva ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Chronic Renal Disease ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Dental Extraction ◽  
Upper Airways ◽  
Irreversible Damage ◽  
Cervical Area ◽  
Ischemic Ulcers

Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections.

scholarly journals Klebsiella Pneumoniae Necrotizing Fascitis of The Lower Extremity in A 7-Month-Old Male: A Case Report and Literature Review

2021 ◽  
Vol 4 (2) ◽  
pp. 52
Author(s):  
Marelno Zakanito ◽  
Iswinarno Saputro
Keyword(s):  
Soft Tissue ◽  
Klebsiella Pneumoniae ◽  
Lower Extremity ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Initial Period ◽  
Academic Medical Center ◽  
Clinical Manifestations ◽  
Lower Limbs ◽  
Laboratory Evaluation

Introduction: Klebsiella pneumoniae necrotizing fasciitis is an uncommon soft tissue infection characterized by rapidly progressing necrosis involving the skin, subcutaneous tissue, and fascia. This condition may result in gross morbidity and mortality if not treated in its early stages. In fact, the mortality rate of this condition is high, ranging from 25 to 35%. We present a case of 7-month-old male with K. pneumoniae necrotizing fasciitis of the lower extremity. Materials and Methods: A 7-month-old male presented with large areas over both left and right inferior side of the lower limbs to the emergency department of Dr. Soetomo Academic Medical Center Hospital, Surabaya, Indonesia. Physical examination revealed elevated heart rate of 136 times per minute and increased body temperature of 38oC. The large areas on both lower limbs were darkened, sloughed off, and very tender to palpation. A small area over the right hand was erythematous and sloughed off. Laboratory evaluation demonstrated decreased hemoglobin of 6.2 g/dL and elevated leukocyte of 28,850 g/dL. Blood cultures demonstrated that K. pneumoniae was present. Discussion: NF is usually hard to diagnose during the initial period. The findings of NF can overlap with other soft tissue infections including cellulitis, abscess or even compartment syndrome. However, pain out of proportion to the degree of skin involvement and signs of systemic shock should alert the clinical to the possibility of NF. The clinical manifestations of NF start around a week after the initiating event, with induration and edema, followed by 24 to 48 hours later by erythema or purple discoloration and increasing local fever In the next 48 to 72 hours, the skin turns smooth, bright, and serous, or hemorrhagic blisters develop. If unproperly treated, necrosis develops, and by the fifth or sixth day, the lesion turns black with a necrotic crust. Conclusions: K. pneumoniae necrotizing fasciitis is a rare but lifethreatening disease. A high index of suspicion is required for early diagnosis and treatment of this condition

Skin and Soft Tissue Infections

2012 ◽  
pp. 341-350
Author(s):  
Imad M Tleyjeh ◽  
Larry M Baddour
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Skin Infection ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Hair Follicles ◽  
Soft Tissue Infections ◽  
Exposed Skin ◽  
Common Skin ◽  
The Face

Common skin and soft tissue infections covered in this chapter include impetigo, folliculitis, furuncles, carbuncles, cellulitis, and necrotizing fasciitis. Impetigo is a superficial pustular skin infection. Multiple lesions occur on exposed skin of the face and extremities. Staphylococcus aureus causes most cases. Folliculitis is a superficial skin infection of hair follicles. A furuncle is a purulent, painful nodular skin infection involving the hair follicle that is usually a complication of folliculitis. A carbuncle is a cluster of abscesses in subcutaneous tissue that drain through hair follicles. The prevailing pathogen for both furuncles and carbuncles is S aureus. Skin abscesses involve the dermis and deeper skin tissues. Often a pustule is present on the skin. For most cases the pathogen is S aureus. Cellulitis involves skin and subcutaneous tissues. Clinical manifestations of cellulitis include swelling, erythema, tenderness, and warmth. Necrotizing forms of cellulitis are necrotizing fasciitis types I and II. Clinical features include fulminant destruction of tissue and systemic toxicity.

scholarly journals Concurrent Pseudomonas Periorbital Necrotizing Fasciitis and Endophthalmitis: A Case Report and Literature Review

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 854
Author(s):  
Yu-Kuei Lee ◽  
Chun-Chieh Lai
Keyword(s):  
Soft Tissue ◽  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Superficial Fascia ◽  
Upper Eyelid ◽  
Case Presentation ◽  
Phthisis Bulbi ◽  
Eyelid Swelling ◽  
The Rich

(1) Background: Necrotizing fasciitis (NF) is an infection involving the superficial fascia and subcutaneous tissue. Endophthalmitis is an infection within the ocular ball. Herein we report a rare case of concurrent periorbital NF and endophthalmitis, caused by Pseudomonas aeruginosa (PA). We also conducted a literature review related to periorbital PA skin and soft-tissue infections. (2) Case presentation: A 62-year-old male had left upper eyelid swelling and redness; orbital cellulitis was diagnosed. During eyelid debridement, NF with the involvement of the upper Müller’s muscle and levator muscle was noted. The infection soon progressed to scleral ulcers and endophthalmitis. The eye developed phthisis bulbi, despite treatment with intravitreal antibiotics. (3) Conclusions: Immunocompromised individuals are more likely than immunocompetent hosts to be infected by PA. Although periorbital NF is uncommon due to the rich blood supply in the area, the possibility of PA infection should be considered in concurrent periorbital soft-tissue infection and endophthalmitis.

Noma and Necrotizing Fasciitis of the Face and Neck

2021 ◽  
Author(s):  
Lauren E. Miller ◽  
David A. Shaye
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Head And Neck ◽  
Subcutaneous Tissue ◽  
Neck Region ◽  
Superficial Fascia ◽  
Soft Tissue Infections ◽  
Head And Neck Region ◽  
Necrotizing Soft Tissue Infections ◽  
The Face

AbstractNecrotizing fasciitis (NF) is part of the class of necrotizing soft tissue infections characterized by rapid fascial spread and necrosis of the skin, subcutaneous tissue, and superficial fascia. If left untreated, NF can rapidly deteriorate into multiorgan shock and systemic failure. NF most commonly infects the trunk and lower extremities, although it can sometimes present in the head and neck region. This review provides an overview of NF as it relates specifically to the head and neck region, including its associated clinical features and options for treatment. Noma, a related but relatively unknown disease, is then described along with its relationship with severe poverty.

Orbital and Periorbital Cellulitis

1995 ◽  
Vol 16 (5) ◽  
pp. 163-167
Author(s):  
Keith R. Powell
Keyword(s):  
Inflammatory Process ◽  
Subcutaneous Tissue ◽  
Acute Onset ◽  
Orbital Cellulitis ◽  
The Body ◽  
Vein Thrombosis ◽  
Orbital Septum ◽  
Specific Complication ◽  
Thin Skin ◽  
Doctor's Office

The acute onset of eyelid redness and swelling in a child usually results in a quick visit to the doctor's office or an emergency room. The differential diagnosis for these signs ranges from relatively innocuous problems, such as allergy or an insect sting, to potentially vision-affecting or even life-threatening diseases, such as orbital cellulitis or cavernous vein thrombosis. The orbital contents often are protected from an inflammatory process by the orbital septum, a continuation of the periosteum of the bony orbit to the margins of both the upper and lower eyelids (Figure 1). An inflammatory process occurring in the structures superficial to the orbital septum is defined as preseptal or periorbital cellulitis; an inflammatory process in structures deep to the orbital septum is defined as orbital cellulitis of a specific complication thereof. Bacterial infection can cause both periorbital and orbital cellulitis. Another anatomic feature of importance is that the skin of the eyelid is the thinnest skin of the body. The subcutaneous tissue of the eyelid is composed of musculofibrous tissue and no fat. This combination of thin skin and loose subcutaneous tissues makes it possible for the eyelid to swell dramatically as it fills with edematous fluid. Epidemiology and Pathogenesis of Periorbital Cellulitis

HEREDITARY ANGIOEDEMA – A PROBLEM AT THE INTERSECTION OF IMMUNOLOGY AND ALLERGOLOGY: ANALYSIS OF LITERATURE DATA AND DESCRIPTION OF A SERIES OF 34 CASES

2021 ◽  
Vol 100 (2) ◽  
pp. 49-57
Author(s):  
M.N. Guseva ◽  
◽  
E.I. Zinina ◽  
E.N. Suspitsyn ◽  
M.M. Kostik ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hereditary Angioedema ◽  
Positive Family History ◽  
Clinical Manifestations ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Peripheral Edema ◽  
Dominant Disease ◽  
Characteristic Features ◽  
Head Neck

Hereditary angioedema (HAE) is a rare autosomal dominant disease characterized by isolated recurrent angioedema (AE) of various localizations: skin, the submucosa in the gastrointestinale tract, the respiratory tract. The characteristic features of edema in HAE are the absence of itching, skin flushing, accompanying urticaria, as well as the absence of pronounced effect of systemic corticosteroid therapy, systemic antihistamines therapy and adrenaline. The aim of our study was to present a descriptive characteristics of the group of patients with HAE and to access efficacy and safety of treatment. Materials and methods: the retrospective multicenter continuous nonrandomized uncontrolled study included data on 34 patients: 19 men (56%) and 15 women (44%) with HAE. The diagnosis of HAE was based on clinical and laboratorial data, according to the clinical guidelines of the Russian Association of allergologists and clinical immunologists on HAE (2014). Results The age range of patients at the time of inclusion in the study was 5–82 years, median – 38,8 (20,6; 46,9) years. Median age of first HAE episode was 12,5 (5,8; 16,3) years, ranged from 2 to 40, 22/28 (79%) of the patients manifested before 18 years. HAE was diagnosed at the median age of 30 years (17,5; 44,8) years, in 14,0 (9,0; 25,0) years after onset of the clinical manifestations. Most of the observations described have a positive family history of HAE (91%), in total 9 families were described. In 67% of families the disease manifested itself in two generations and in 33% of families – in three generations. At the onset of HAE peripheral edema was in 29/31 (94%) of the patients, and 22/31 (71%) had edema confined to the distal extremities. 7/31 (29%) patients had peripheral edema combined with edema of other locations. Abdominal attacks were in 6/31 (19%), head, neck and upper airways edema were in 7/31 (23%). The frequency of swelling of head, neck, upper respiratory tract increased statistically significantly from 23% (7/31) to 35% (7/20, p=0,003). 24 patients have recieved Icatibant treatment. No deaths were recorded against the background of this treatment. Conclusions HAE is diagnosed with significant time delays. Icatibant treatment is safe and effective.

scholarly journals Pyelonephritis can be a source of a life threatening necrotizing myofasciitis

2014 ◽  
Vol 8 (5-6) ◽  
pp. 462
Author(s):  
Haytham Kamel ◽  
Mohamed Soliman Edris Awed ◽  
Ahmed Fouad Kotb
Keyword(s):  
Necrotizing Fasciitis ◽  
Adult Male ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Relevant Literature ◽  
Deep Fascia ◽  
Necrotizing Myositis ◽  
Life Threatening

Necrotizing fasciitis is a progressive, rapidly spreading, inflammatory infection located in deep fascia. It may cause necrosis of skin and subcutaneous tissue and can even result in involvement of adjacent soft tissues such as muscles resulting in necrotizing myositis. We report the case of an adult male presenting with necrotizing myofasciitis secondary to left pyelonephritis. We also review the relevant literature.

scholarly journals “I am tired of the disease and eating too many medicines”: seeking adolescent’s lived experiences about chronic renal disease

2020 ◽  
Vol 7 (10) ◽  
pp. 3988
Author(s):  
Rohit Shah ◽  
Neha Adsul
Keyword(s):  
Renal Disease ◽  
Chronic Renal Disease ◽  
Medical Problem ◽  
Qualitative Approach ◽  
Lifestyle Changes ◽  
Husserlian Phenomenology ◽  
Irreversible Damage ◽  
Descriptive Phenomenology ◽  
Indian Study ◽  
Major Shift

Background: Chronic renal disease (CRD), results from a range of conditions that cause irreversible damage to the kidneys and is a recognised major medical problem worldwide. CRD in children and adolescent’s is an enervating condition requiring lifelong treatment in order ‘to survive’. Several researchers have criticised the research on children with CRD as most of these studies rely on standardized tools which seem to be grounded in objectivity and quantification.Methods: In this milieu, this Indian study adopts a qualitative approach underpinned by the philosophy of Husserlian phenomenology with descriptive phenomenology as a method. The primary purpose of the study was to delve into the lives of adolescents suffering from CRDs to understand their perceptions about how this challenging condition affects and changes their lives.Results: CRD is a chronic condition that confines the lives of these adolescents by demanding a major shift to more prescribed and restrictive lifestyle.Conclusions: The lives of the adolescent participants conveyed a paradoxical nature in terms of suffering; struggling to cope with the stringent lifestyle changes and yet trying to be adapting to the disease to moving forward in life.

scholarly journals Tonsillectomy in IgA Nephropathy - Clinical Case

2021 ◽  
Vol 26 (3) ◽  
pp. 59-61
Author(s):  
Livia Mirela Popa ◽  
Livia Popa ◽  
Cătălin-Bogdan Osalciuc
Keyword(s):  
Antibiotic Therapy ◽  
Iga Nephropathy ◽  
Clinical Case ◽  
Acute Infection ◽  
Acute Onset ◽  
First Episode ◽  
Urinary Volume ◽  
Upper Airways ◽  
Macroscopic Hematuria ◽  
Nephritic Syndrome

Abstract This article presents the clinical case of IgA nephropathy of a patient hospitalized in order to investigate a nephritic syndrome, apparently with acute onset, discovered in the following circumstances: recurrent macroscopic hematuria, decreased urinary volume, the first episode occurring about a month ago in the context of an acute infection of upper airways, remitted under antibiotic therapy, with reappearance every 2 weeks, also accompanied by odynophagia and decreased urinary volume.

scholarly journals Systemic lupus erythaematosus in a multiethnic US cohort (LUMINA) LIII: disease expression and outcome in acute onset lupus

2007 ◽  
Vol 67 (4) ◽  
pp. 500-504 ◽  
Author(s):  
A M Bertoli ◽  
L M Vilá ◽  
J D Reveille ◽  
G S Alarcón ◽  
Keyword(s):  
Disease Activity ◽  
Renal Involvement ◽  
Multivariable Analysis ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Acute Disease ◽  
Stepwise Logistic Regression ◽  
Systemic Lupus ◽  
Damage Accrual

Objective:To determine the features associated with acute onset systemic lupus erythaematosus (SLE).Methods:A total of 631 SLE patients from LUMINA (for “lupus in minority populations: nature vs nurture”), a multiethnic (Hispanics, African–Americans and Caucasians) cohort, were studied. Acute disease onset was defined as the accrual of ⩾4 American College of Rheumatology (ACR) criteria for the classification of SLE in ⩽4 weeks. Socioeconomic demographic features, clinical manifestations, disease activity, damage accrual, mortality, autoantibodies, HLA class II and FCGR alleles, behavioural/psychological variables were compared between patients with acute and insidious disease onset by univariable (χ2 and Student t test) and multivariable (stepwise logistic regression) analyses.Results:A total of 94 (15%) patients had acute disease onset. In the multivariable analysis, patients with acute onset lupus had more renal involvement (odds ratio (OR) = 1.845, 95% CI 1.076–3.162; p = 0.026) and higher disease activity (OR = 1.057, 95% CI 1.005–1.112; p = 0.030). By contrast, age (OR = 0.976, 95% CI 0.956–0.997; p = 0.025), education (OR = 0.901, 95% CI 0.827–0.983, p = 0.019), health insurance (OR = 0.423, 95% CI 0.249–0.718; p = 0.001) and skin involvement (OR = 0.346, 95% CI 0.142–0.843; p = 0.019) were negatively associated with acute onset lupus. No differences were found regarding the serological, genetic and behavioural/psychological features; this was also the case for damage accrual and mortality.Conclusions:Patients with acute onset lupus seem to be younger, have a lower socio-economic status and display more severe disease in terms of clinical manifestations and disease activity. However, intermediate (damage) and long-term (mortality) outcomes appear not to be influenced by the type of disease onset in SLE.

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