Fatal Necrotizing Fasciitis as a Consequence of Blunt Trauma: A Case Report

2021 ◽  
Vol 11 (3) ◽  
pp. 170-173
Author(s):  
Chandrakanth HV ◽  
Hemanth Kumar RG ◽  
Smitha Rani
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Signs And Symptoms ◽  
Medicolegal Issues ◽  
Early Debridement

Necrotizing fasciitis is an uncommon lethal bacterial infection that involves the subcutaneous tissue and fascia. It can be mono or polymicrobial infection. The diagnosis is mainly dependent on clinical signs and symptoms. Trauma is the commonest cause for it. The early signs and symptoms may mimic cellulitis. We present a case of necrotizing fasciitis following an assault. The patient was received in a state of shock. Despite all measures, the patient could not be saved. Early debridement and antibiotic therapy have a key role in the prognosis of the disease. Medicolegal issues can arise when the disease develops post-assault because of the vague and unpredictable nature of the disease and its challenging prognosis.

Delayed-Onset Neuropathological Complications From a Foramen Magnum and Occipital Crest Focused Traumatic Brain Injury of the Vietnam War and Other Conflicts: Part I, Case Report

2021 ◽  
Author(s):  
Frederick M Burkle ◽  
Kevin S Hadley ◽  
Leah L Ridge ◽  
Jan K Herman ◽  
Firas H Kobeissy
Keyword(s):  
Case Report ◽  
Vietnam War ◽  
Brain Injuries ◽  
Right Hemisphere ◽  
Clinical Signs ◽  
Vitreous Hemorrhage ◽  
Signs And Symptoms ◽  
Foramen Magnum ◽  
Delayed Onset ◽  
Clinical Signs And Symptoms

ABSTRACT Introduction The diagnosis of traumatic brain injuries is typically based on hemispheric blasts resulting in degrees of unconsciousness and associated cerebral injuries. This case report describes a Vietnam War era setting in which a traumatic blast wave struck the posterior cranium in the region of the foramen magnum, occipital crest, and other skull openings (orbit, oronasal, and ear) and the unique secondary clinical signs and symptoms experienced over time. Materials and Methods This case report describes secondary delayed-onset clinical signs and symptoms consistent with progressive decades-long physical and functional complications. The traumatic blast resulted in brief unconsciousness, decreased vision in left eye, confusion, right sided hemotympanum, deafness, severe tinnitus, severe nasopharynx pain and difficulty swallowing, pain in right posterior and occipital area of the head, and loss of dental amalgams. Subsequent exams revealed progressive hyperacusis, sea sickness, dysdiadochokinesis, diagnosis of 9th and 10th cranial nerve traumatic schwannomas, hyperdense changes to the frontal lobe white matter, progressive tinnitus, chronic vertigo, right-sided high-frequency hearing loss, progressive oculo-gyric crisis of Tumarkin-like seizures, left-sided chronic vitreous hemorrhage, and diminished right hemisphere performance of the brain based on neurophysiological assessment. No post-traumatic stress, depression, or other emotional or psychiatric difficulties were claimed. Conclusion This case report, unique to the English language scientific literature, discusses in detail the secondary signs and symptoms of a foramen magnum and occipital crest focused-associated blast injury.

scholarly journals Appendicitis in puerpeium: Case report

2011 ◽  
Vol 58 (4) ◽  
pp. 111-112 ◽  
Author(s):  
Milica Berisavac ◽  
Biljana Kastratovic-Kotlica ◽  
V. Tosic ◽  
N. Markovic ◽  
S. Ljustina ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Early Detection ◽  
Acute Appendicitis ◽  
Abdominal Wall ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Infection ◽  
Infection Parameters ◽  
Clinical Signs And Symptoms

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atipycal appendix presentation makes difficulties in diagnosis3,4. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chance for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.

scholarly journals Viral and bacterial infection elicit distinct changes in plasma lipids in febrile children

2019 ◽  
Author(s):  
Xinzhu Wang ◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
Heather Jackson ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Bacterial Infections ◽  
Plasma Lipids ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
The Uk

AbstractFever is the most common reason that children present to Emergency Departments in the UK. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. As a result, many children are prescribed antibiotics often unnecessarily, while others with life-threatening bacterial infections can remain untreated. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n=20) and confirmed viral infection (n=20). We show for the first time that bacterial and viral infection elicit distinct changes in the host lipidome. Glycerophosphoinositol, sphingomyelin, lysophosphotidylcholine and cholesterol sulfate were increased in the confirmed virus infected group, while fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were increased in cases with confirmed bacterial infection. A combination of three lipids achieved the area under the receiver operating characteristic (ROC) curve of 0.918 (95% CI 0.835 to 1). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.

scholarly journals Expanding spontaneous pneumothorax in COVID-19 pneumonia: Case report and review of literature

2021 ◽  
Vol 13 (3) ◽  
pp. 258-262
Author(s):  
Afshin Mohammadi ◽  
Behdad Boroofeh ◽  
Alisa Mohebbi ◽  
Mohammad Mirza-Aghazadeh-Attari
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Present Article ◽  
Spontaneous Pneumothorax ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Review Of Literature ◽  
Pneumonia Case ◽  
Rapid Deterioration ◽  
Clinical Signs And Symptoms

Coronavirus disease 2019 has presented itself with a variety of clinical signs and symptoms. One of these has been the accordance of spontaneous pneumothorax which in instances has caused rapid deterioration of patients. Furthermore pneumothorax may happen secondary to intubation and the resulting complications. Not enough is discussed regarding cases with COVID-19 related pneumothorax and proper management of these patients. The present article reports an elderly patient with spontaneous pneumothorax secondary to COVID-19 and reviews the existing literature.

scholarly journals Plasma lipid profiles discriminate bacterial from viral infection in febrile children

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Xinzhu Wang ◽  
◽  
Ruud Nijman ◽  
Stephane Camuzeaux ◽  
Caroline Sands ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Viral Infection ◽  
Clinical Signs ◽  
Plasma Lipid ◽  
Signs And Symptoms ◽  
Infected Group ◽  
Cholesterol Sulfate ◽  
Inappropriate Use ◽  
Clinical Signs And Symptoms ◽  
Metabolic Biomarkers

AbstractFever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The ‘omics’ approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics.

scholarly journals Epinephrine auto-injection radically increases risk for Clostridial infection and necrotizing fasciitis

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Kenneth Larson ◽  
Gary Grone ◽  
Cindy L. Austin ◽  
Simon J. Thompson
Keyword(s):  
Necrotizing Fasciitis ◽  
Rapid Development ◽  
Diagnostic Delay ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Optimal Growth ◽  
Growth Environment ◽  
Epinephrine Injection ◽  
Skin Flora ◽  
Clinical Signs And Symptoms

<em>Clostridial perfringens</em> is a bacteria commonly found on skin flora. Due to the optimal growth environment intramuscular epinephrine injections predispose patients to the rapid development of <em>Clostridial</em> myonecrosis. There have been only four cases, including this one, reported in the last 60 years of pediatric <em>Clostridium perfringens</em> infections post-epinephrine injection. We detail the successful management of a 16 year old, immunocompetent female who developed gas gangrene and necrotizing fasciitis on her thigh secondary to <em>Clostridial</em> infection after utilization of an Epinephrine Auto-Injector and review the pediatric literature of patients with <em>Clostridial perfringens</em> secondary to epinephrine injection. We define common clinical signs and symptoms of <em>Clostridial</em> infection from the review of the literature. The relevance of our findings is to raise awareness among emergency physicians when patients present following an injection in order to reduce diagnostic delay that could result in amputation or death.

scholarly journals Aspergillus fumigatus spondylodiscitis with bilateral psoas abscess in a renal transplant patient with pulmonary tuberculosis : A rare case report

2015 ◽  
Vol 3 (2) ◽  
pp. 51
Author(s):  
Ravikumar Tv ◽  
Raghvendra Rao ◽  
Amit Grover ◽  
Daksh Gadi
Keyword(s):  
Case Report ◽  
Pulmonary Tuberculosis ◽  
Invasive Aspergillosis ◽  
Aspergillus Fumigatus ◽  
Psoas Abscess ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Rapid Progression ◽  
Mortality And Morbidity ◽  
Clinical Signs And Symptoms

<p><strong>Background:</strong> Aspergillus spondylodiscitis is increasingly described in immune-compromised patients. Its diagnosis is challenging and its delay results in high mortality and morbidity in view of its relative infrequency and the non- specific clinical signs and symptoms.</p><p><strong>Case report:</strong>We report a case of thoracic spondylodiscitis caused by Aspergillus fumigatus in a patient of renal transplantation and with proven pulmonary tuberculosis.</p><p><strong>Conclusion:</strong>We reiterate that transplantist and the treating physician should have high grade of suspicion for the invasive Aspergillosis even when the patient complains of vague non-specific back pain, and aggresively aim to rule out fungal infection. Early surgical debridement and antifungal therapy to be executedto prevent rapid progression of invasive aspergillosis and neurological damage.</p>

RADICULAR CYST ENUCLEATION, APICOECTOMY AND MANAGEMENT OF OSSEOUS CAVITY USING ALLOPLAST AND PLATELET RICH FIBRIN IN RELATION TO NON-VITAL TEETH- A CASE REPORT

2021 ◽  
pp. 79-80
Author(s):  
Namburi Rajesh ◽  
Rajendran Poornima
Keyword(s):  
Case Report ◽  
Tissue Regeneration ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Radicular Cyst ◽  
Present Case Report ◽  
Platelet Rich Fibrin ◽  
Dental Examination ◽  
Clinical Signs And Symptoms ◽  
Osseous Defect

One of the most common dental cysts to affect the human jaw is radicular cyst. The tooth/teeth associated with radicular cysts are usually non-vital and rarely presents with clinical signs and symptoms until diagnosed during routine dental examination. The present case report highlights on radicular cyst enucleation, apicoectomy of the involved teeth and periodontal management of the resultant osseous defect using alloplast bone graft, platelet-rich brin (PRF) and guided tissue regeneration (GTR) membrane.

Retrospective Evaluation of Daptomycin, a Lipopeptide Antibiotic, in Bone Marrow Transplant and Hematology/Oncology Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5531-5531
Author(s):  
Emily R. Stuntebeck ◽  
Daryl D. DePestel ◽  
Curtis D. Collins ◽  
Brian Donovan ◽  
Kenneth C. Lamp
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Antibiotic Therapy ◽  
Peripheral Blood Stem Cell ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Marrow Transplant ◽  
Clinical Signs And Symptoms ◽  
Lipopeptide Antibiotic ◽  
Blood Stem Cell Transplantation

Abstract Background: Daptomycin is a lipopeptide antibiotic with potent activity against many Gram-positive organisms. Efficacy in immunocompromised patients is unknown because these patients have been excluded from daptomycin premarketing studies. Methods: Patients with documented infections treated at the University of Michigan Health System in either the bone marrow transplant or hematology/oncology service were identified in the Cubicin® Outcomes Registry and Experience (COREsm 2004 and 2005). Demographic, disease state, clinical, and microbiologic data were collected. Clinical outcomes were assessed using the following definitions: Cure - clinical signs and symptoms are resolved and/or no additional antibiotic therapy is necessary or infection cleared with a negative culture reported at the end of daptomycin therapy; Improved - partial resolution of clinical signs and symptoms and/or additional antibiotic therapy is necessary at the end of daptomycin therapy; Failure - inadequate response to therapy or resistant, worsening or new/recurrent signs and symptoms, or the need for a change in antibiotic therapy or a positive culture reported at the end of daptomycin therapy; Nonevaluable - unable to determine response at the end of daptomycin therapy. Success was defined as cure or improved. Results: Fourteen patients are included in this analysis. Nine (64%) patients were female; 6 (43%) were ≥ 51 years of age. Two patients had an initial CrCl <30 mL/min, 1 was on hemodialysis. Eight (57%) patients had undergone allogeneic peripheral blood stem cell transplantation primarily for acute myeloid leukemia. The remaining 6 patients had papillary adenocarcinoma, endometrial carcinoma, dermatofibrosarcoma protuberans, acute lymphoblastic lymphoma, non-Hodgkin lymphoma, and Hodgkin lymphoma. The most common infection (n=11, 79%) was bacteremia; 7 (50%) patients had catheter-related bacteremia; 1 each (7%) had discitis, necrotizing fasciitis and urinary tract infection. Nine (64%) patients had vancomycin-resistant Enterococcus faecium (VRE) as a pathogen; 8 were bacteremic (3 with concurrent coagulase-negative staphylococci; CoNS). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated in 3 (21%) patients; 2 were bacteremic (1 with concurrent CoNS). One additional patient had CoNS bacteremia. The patient with necrotizing fasciitis was culture negative. The initial daptomycin dose was 4 mg/kg in 8 (57%) patients and 6 mg/kg in 6 (43%) patients. All patients receiving 6 mg/kg were bacteremic. The dosing frequency was adjusted for renal function in all patients. The median duration of therapy was 14.5 days (range, 2 – 62). Nine (64%) patients received an antibiotic prior to daptomycin and 43% of patients received an antibiotic concomitantly. Seven catheters were removed; 5 from patients with catheter-related bacteremia. The median time to clinical response was 2 days (n=10, range 1 – 13). All patients with an outcome reported (n=11) were successfully treated, 3 (21%) patients were nonevaluable. Of the 11 bacteremic patients, 5 received 4 mg/kg and 6 received 6 mg/kg; 2 were nonevaluable (both 6 mg/kg) and 9 of 11 (82%) were successes. Conclusion: These data demonstrate that daptomycin therapy is associated with clinical success in hem/onc patients including those who have undergone allogeneic peripheral blood stem cell transplantation where bacteremia and VRE are prevalent.

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