scholarly journals Lytic parasitic: a case of bone destructing echinococcosis

2021 ◽  
Vol 8 ◽  
pp. 204993612110476
Author(s):  
Avaan Govindasamy ◽  
Pushpa Raj Bhattarai ◽  
Jeff John
Keyword(s):  
Soft Tissue ◽  
Iliac Fossa ◽  
Disease Process ◽  
Bone Destruction ◽  
Pelvic Mass ◽  
Cystic Mass ◽  
Iliac Bone ◽  
Best Interest ◽  
Gluteus Muscle ◽  
Posterior Soft Tissue

Pelvic hydatid bone disease is a rare and debilitating condition. Patients often present with symptoms and signs when the disease process is advanced and curative resection is not possible. We present a case of destructive bone hydatid disease affecting the left iliac bone. A 45-year-old woman presented initially 5 years ago with a left pelvic mass to the gynaecology department. Computed tomography (CT) scan done at that time showed a large pelvic, left iliac fossa cystic mass with the destruction of the left iliac bone. Extension of the cystic mass transversed the iliac bone into the posterior soft tissue. Percutaneous biopsy taken showed hydatid cystic disease. The patient was planned for surgery and, however, was lost to follow-up. Four years later, she presented with a history of worsening left pelvic pain with an enlarging, left pelvic mass, and another mass in the posterior gluteal area. In addition, CT imaging showed extensive left iliac bone destruction with posterior soft tissue extension to the gluteus muscle. A multidisciplinary team concluded that complete excision would not result in cure. Thus, complete iliac wing bone reconstruction was not an option in this patient. Instead, palliative measures were deemed in the patient’s best interest to control disease progression and relieve painful pressure-related symptoms from the hydatid cystic mass. The patient received preoperative albendazole and underwent an extraperitoneal debulking of the soft tissue hydatid infiltration and debridement of bony fragments from left iliac bone destruction. Postoperatively, the patient did well, and her main complaint of pain related to the cystic mass pressure had improved significantly.

scholarly journals Dynamics of hip joint effusion after posterior soft tissue repair in total hip arthroplasty

2006 ◽  
Vol 30 (4) ◽  
pp. 233-236 ◽  
Author(s):  
Sarunas Tarasevicius ◽  
Uldis Kesteris ◽  
Romas Jonas Kalesinskas ◽  
Hans Wingstrand
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Joint ◽  
Hip Arthroplasty ◽  
Tissue Repair ◽  
Joint Effusion ◽  
Soft Tissue Repair ◽  
Total Hip ◽  
Posterior Soft Tissue

Soft Tissue Reconstruction Pyramid in the Diabetic Foot

2010 ◽  
Vol 3 (5) ◽  
pp. 241-248 ◽  
Author(s):  
Claire M. Capobianco ◽  
John J. Stapleton ◽  
Thomas Zgonis
Keyword(s):  
Soft Tissue ◽  
Diabetic Foot ◽  
Weight Bearing ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Best Interest ◽  
Foot Complications ◽  
Uncontrolled Diabetes ◽  
Wound Healing Response ◽  
Tissue Reconstruction

Foot complications and ulceration are well-known sequelae to uncontrolled diabetes. Patients with chronic foot ulcers or wounds resulting from surgical debridement of deep-space infections are at continued risk for development of osteomyelitis and potential amputation. Moreover, these wounds often necessitate multiple outpatient clinic visits, daily dressing care, and prolonged periods of non—weight bearing, all of which have been shown to adversely affect the patient’s quality of life. After a prudent period of wound-healing response, the authors believe that early and aggressive soft tissue reconstruction is in the patient’s best interest and is crucial for resolution of the chronic nonhealing wound. The options for soft tissue coverage and the logical progression of application of these techniques in the diabetic foot will be described.

Soft Tissue Infections

2019 ◽  
pp. 102-108
Author(s):  
Sumer N. Shikhare ◽  
Wilfred C. G. Peh
Keyword(s):  
Soft Tissue ◽  
Early Diagnosis ◽  
Disease Process ◽  
Conventional Radiography ◽  
Diagnostic Value ◽  
Soft Tissue Infections ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Cross Sectional Imaging ◽  
Diagnostic Capabilities

Chapter 88 outlines the key radiologic features of soft tissue infections and the diagnostic value of the different imaging modalities such as conventional radiography, US, CT, and MRI. Soft tissue infections present in various forms that involve varying depths from skin to deeper tissues. Early diagnosis may be challenging because of nonspecific clinical presentations, resulting in delay in management. The advent of cross-sectional imaging has improved diagnostic capabilities dramatically, with US, CT, and particularly MRI being the pillars of evaluation. Prompt and appropriate imaging workup of the various MSK soft tissue infections aids early diagnosis and in demonstrating the extent of the disease process, as treatment delay significantly reduces the cure rate and increases the risk of complications.

scholarly journals Necrotizing fasciitis: A review of three clinical encounters

2018 ◽  
Vol 5 (1) ◽  
pp. 5
Author(s):  
Jaron Pettis ◽  
Neelam Mulji ◽  
Fernando A. Navarro
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Case Reports ◽  
Disease Process ◽  
The United States ◽  
Soft Tissue Infections ◽  
Wound Debridement ◽  
The Third ◽  
First Case ◽  
Necrotizing Soft Tissue Infections

Background: Necrotizing fasciitis is a potentially lethal soft tissue infection characterized by rampant necrosis and destruction of subcutaneous tissues. Current estimates of necrotizing soft tissue infections in the United States are 4.3 infections per 100,000 of the population. Although the incidence of necrotizing soft tissue infections has decreased in the last decade, the toxic and lethal nature of the disease process lends utmost importance to accurate diagnosis and immediate management. The purpose of this review article is to report three cases of necrotizing fasciitis and provide literature review in regards to hallmark characteristics, predisposing risk factors and treatment optimization.Case: The first case depicts a newly diagnosed 43-year-old male HIV patient with necrotizing fasciitis infection characterized by Klebsiella, Serratia and anaerobic bacteria cultures. The second case describes the course of a 71-year-old male diagnosed with necrotizing fasciitis in the setting of a complicated anal fistula characterized by B. fragilis, S. anginosus and Prevotella species. The third and final case describes the course of a 44-year-old female diagnosed with necrotizing fasciitis in the setting of Ludwig’s Angina characterized by Klebsiella and Dubliensis species. Treatment was initiated with extensive wound debridement, multiple washouts and broad antibiotic regimens in all three cases. Additional hyperbaric oxygen therapy was administered in the third case.Conclusions: These case reports illustrate the range of severity and settings in which necrotizing fasciitis can occur. Significant morbidity and mortality rates are associated with a delay in treatment initiation. Given this, it is of utmost importance to develop and maintain a high clinical acumen for necrotizing soft tissue infections.

scholarly journals Outcomes of β-Hemolytic Streptococcal Necrotizing Skin and Soft-tissue Infections and the Impact of Clindamycin Resistance

2020 ◽  
Author(s):  
Dara L Horn ◽  
Emma A Roberts ◽  
Jolie Shen ◽  
Jeannie D Chan ◽  
Eileen M Bulger ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Disease Process ◽  
Patient Characteristics ◽  
Routine Care ◽  
Limb Loss ◽  
Streptococcal Toxic Shock Syndrome ◽  
Soft Tissue Infections ◽  
Surgical Wound ◽  
Resistance Patterns ◽  
The Impact

Abstract Background β-Hemolytic streptococci are frequently implicated in necrotizing soft-tissue infections (NSTIs). Clindamycin administration may improve outcomes in patients with serious streptococcal infections. However, clindamycin resistance is growing worldwide, and resistance patterns in NSTIs and their impact on outcomes are unknown. Methods Between 2015 and 2018, patients with NSTI at a quaternary referral center were followed up for the outcomes of death, limb loss, and streptococcal toxic shock syndrome. Surgical wound cultures and resistance data were obtained within 48 hours of admission as part of routine care. Risk ratios for the association between these outcomes and the presence of β-hemolytic streptococci or clindamycin-resistant β-hemolytic streptococci were calculated using log-binomial regression, controlling for age, transfer status, and injection drug use–related etiology. Results Of 445 NSTIs identified, 85% had surgical wound cultures within 48 hours of admission. β-Hemolytic streptococci grew in 31%, and clindamycin resistance was observed in 31% of cultures. The presence of β-hemolytic streptococci was associated with greater risk of amputation (risk ratio, 1.80; 95% confidence interval, 1.07–3.01), as was the presence of clindamycin resistance among β-hemolytic streptococci infections (1.86; 1.10–3.16). Conclusions β-Hemolytic streptococci are highly prevalent in NSTIs, and in our population clindamycin resistance was more common than previously described. Greater risk of limb loss among patients with β-hemolytic streptococci—particularly clindamycin-resistant strains—may portend a more locally aggressive disease process or may represent preexisting patient characteristics that predispose to both infection and limb loss. Regardless, these findings may inform antibiotic selection and surgical management to maximize the potential for limb salvage.

scholarly journals Urachal Mucinous Cystadenocarcinoma

2019 ◽  
Vol 12 (1) ◽  
pp. e228089
Author(s):  
Ryan Pereira ◽  
Stephen McGeorge ◽  
Marlon Perera ◽  
Ian Vela
Keyword(s):  
Bladder Wall ◽  
Pelvic Mass ◽  
Pubic Symphysis ◽  
Cystic Mass ◽  
Pelvic Lymphadenectomy ◽  
Urachal Remnant ◽  
Urinary Tract Symptoms ◽  
History Of ◽  
Open Excision ◽  
Lower Urinary

A 57-year-old man presented with a 6-month history of pelvic fullness. He had no lower urinary tract symptoms or altered bowel habits. On examination, there was a non-tender pelvic mass which extended from the pubic symphysis to the level of the umbilicus. CT scan of the abdomen demonstrated a 22×11×11 cm cystic mass arising from the pelvis extending into the midline and superiorly to the umbilicus. Other than raised carcinoembryonic antigen of 7.6 ng/mL (<5.0), the remainder of his blood test were unremarkable. Flexible cystoscopy demonstrated a convex deformity of the bladder wall in keeping with the compression and displacement as seen on the CT. The patient underwent an open excision of the cystic structure (urachal remnant), partial cystectomy, partial excision of anterior abdominal wall and pelvic lymphadenectomy. A check cystogram performed 12 days following the initial operation was unremarkable.

scholarly journals  Hypertrophic osteopathy in a dog associated with intra-thoracic lesions: a case report and a review

2011 ◽  
Vol 56 (No. 12) ◽  
pp. 595-601 ◽  
Author(s):  
MA Cetinkaya ◽  
B. Yardimci ◽  
C. Yardimci
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Formation ◽  
Disease Process ◽  
Radical Mastectomy ◽  
New Bone Formation ◽  
Cross Sectional ◽  
Hind Limbs ◽  
Metatarsal Bones ◽  
Periosteal New Bone Formation

This paper reviews hypertrophic osteopathy and describes one case report. Hypertrophic osteopathy is a rare pathologic disease process and is observed secondary to a mass in the thorax. In response to the presence of a mass(es), nonoedematous soft tissue swellings and a diffuse periosteal new bone formation develop in all four limbs. The result is mild to severe lameness. A twelve-year-old sexually intact female Cocker spaniel had undergone radical mastectomy on both sides in another veterinary hospital about two years before presentation in our hospital with lameness of both hind limbs. Pain and soft tissue swelling on the distal parts of extremities were determined in clinical examinations. Radiographs revealed periosteal new bone formation on all the long bones of all four limbs, pelvis and sternum; additionally, intrathoracic masses were observed. Euthanasia was performed five months later. Macroscopic examinations of the lungs revealed diffuse and exuberant masses with grizzled whitish cross-sectional colour and with necrotic and haemorrhagic foci. The radius-ulna, tibia, metacarpal and metatarsal bones of both limbs were examined and collected after the necropsy examination. Bone specimens were thicker and the outer surfaces seemed to be rough. At the histopathologic examination of the lung tissue, ovoid or round shaped and hyperchromatic nucleated diffuse anaplastic mammary gland epithelial cells were observed. According to these findings, these masses were diagnosed as the metastasis of malignant mixed tumours. &nbsp;

scholarly journals Transosseous versus transmuscular repair of the posterior soft tissue in primary hip arthroplasty: a meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Changjiao Sun ◽  
Xiaofei Zhang ◽  
Qi Ma ◽  
Ruiyong Du ◽  
Xu Cai ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Dislocation Rate ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Vas Score ◽  
Transosseous Repair ◽  
Posterior Soft Tissue

Abstract Background During the posterior approach, it has been shown that a significant reduction in dislocation rate can be achieved with the repair of the posterior soft tissue. However, no consensus exists about the best way to perform this repair. This review aimed to compare the transosseous with transmuscular repair of the posterior soft tissue in total hip arthroplasty (THA). Methods We conducted a meta-analysis to identify studies involving transosseous versus transmuscular repair of the posterior soft tissue in THA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, Wanfang database, up to July 2020. Finally, we identified 1417 patients (1481 hips) assessed in seven studies. Results Compared with transmuscular repair, transosseous repair resulted in less incidence of dislocation (P = 0.003), less blood loss during operation (P < 0.00001) and lower VAS score within 3 months (P = 0.02). There were no significant differences in terms of trochanteric fracture rate (P = 0.56), Harris hip score at 3 months (P = 0.35) and 6 months (P = 0.89), VAS score within 6 months (P = 0.53), and operation time (P = 0.70) between two groups. Conclusion The lower dislocation rate, less blood loss, and lower VAS scores after operation supported transosseous repair's superiority to transmuscular repair. Besides, no additional medical cost and operating time were associated with transosseous repair compared with transmuscular repair. Hence, we recommend that transosseous repair be chosen first by orthopedists when performing reconstruction of the posterior soft tissue in THA via a posterolateral approach. Given the relevant possible biases in our meta-analysis, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.

Sign in / Sign up

Export Citation Format

Share Document