scholarly journals Crab bite causing shewanella putrefaciens infection: Introduction to a possibly deadly and emerging threat

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0004
Author(s):  
Kamarul Arifin Abdul Razak ◽  
Terence Michal Dass ◽  
Tan Weng Liang ◽  
Yogeshwarran Nadeson ◽  
Karenjit Kaur
Keyword(s):  
Soft Tissue ◽  
Bacterial Infections ◽  
Shewanella Putrefaciens ◽  
Human Infection ◽  
Cns Infection ◽  
Soft Tissue Infections ◽  
Normal Microflora ◽  
Shewanella Species ◽  
Antibiotics Susceptibility ◽  
The Right

Shewanella species are gram-negative bacteria found in warm, temperate regions and are normal microflora of the marine environment1. Human infections are unusual and have a restricted geographic distribution. Presentation: A 45 years old lady was bitten by a crab while preparing to cook it. She developed fever and swelling of the right thumb with hemoserous discharge and blackish discolouration.Upon examination, the thumb was erythematous and swollen with a hematoma filled blister formation over the dorsal aspect. Deblistering was done and fluid samples were sent for culture and sensitivity which later returned as Shewanella Putrefaciens. Empirically she was started on IV Augmentin. Discussion: Most common clinical manifestation associated with Shewanella spp are superficial soft tissue infection1. Other reported clinical features are primary and secondary bacteremia, hepatobiliary, bone, joint and CNS infection, endocarditis, eye, ear and respiratory infection2. Antibiotics susceptibility includes aminoglycosides, 3rd and 4th generation cephalosporins, carbapenems and fluoroquinolones1. About 79% of patients have underlying conditions such as diabetes mellitus, venous congestion and heart failure; they are immunocompromised, as is our patient3. Conclusion: Proper handling of seafood during preparation should be encouraged as a simple bite may turn deadly. Initiation of antibiotics according to suspected organisms should be performed to prevent worsening of soft tissue infections. References: Diaz, J.H, Lopez, F.A Skin, Soft Tissue and Systemic Bacterial Infections Following Aquatic Injuries and Exposures. The American Journal of the Medical Sciences, 349(3), 269275 Finkelstein,R, Oren,I. Soft Tissue Infections Caused by Marine Bacterial Pathogens: Epidemiology, Diagnosis, and Management. Current Infectious Disease Report (2011)13(5):470–477 N. Vignier et al; Human Infection with Shewanella putrefaciens and S. algae: Report of 16 Cases in Martinique and Review of the Literature; Am. J. Trop. Med. Hyg., 89(1), 2013, pp. 151–156

Skin and Soft Tissue Infections

2015 ◽  
Author(s):  
Daniel J. Pallin
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Bacterial Infections ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Skin Infections ◽  
Soft Tissue Infections ◽  
Protective Mechanisms ◽  
Contact Precautions ◽  
Life Threatening ◽  
Plantar Warts

The skin is the largest organ of the human body, and has diverse functions including protection from infection, temperature regulation, sensation, and immunologic and hormonal functions. Skin infections occur when the skin’s protective mechanisms fail. Some infections may be life-threatening (eg, necrotizing fasciitis) or may require the patient to be placed on contact precautions; thus, the initial goals of assessment of patients with skin and soft tissue infections are to assess the patient’s stability and to determine whether precautions are necessary to protect others. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for a variety of skin and soft tissue infections. Figures show an algorithm for treatment of bacterial infections of the skin, and photographs of  various infections including necrotizing fasciitis, cellulitis, an abscess caused by methicillin-resistant Staphylococcus aureus, a furuncle, a carbuncle, nonbullous and bullous impetigo, echythma, folliculitis, anthrax lesion, tinea corporis, condyloma acuminatum, and plantar warts. Tables list cellulitis treatment with particular exposures, the dermatophytoses, and yeast infections of skin and mucous membranes. This review contains 16 highly rendered figures, 3 tables, and 32 references.

Soft Tissue Infection

2019 ◽  
Author(s):  
Mark A. Malangoni ◽  
Christopher R McHenry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Toxic Shock Syndrome ◽  
Bacterial Infections ◽  
Subcutaneous Tissue ◽  
Tissue Infection ◽  
Soft Tissue Infections ◽  
Toxic Shock ◽  
Necrotizing Soft Tissue Infection ◽  
Human Bites

Soft tissue infections are a diverse group of diseases that involve the skin and underlying subcutaneous tissue, fascia, or muscle. The authors review the diagnosis and management of the main soft tissue infections seen by surgeons, including both superficial infections and necrotizing infections. When the characteristic clinical features of necrotizing soft tissue infection are absent, diagnosis may be difficult. In this setting, laboratory and imaging studies become important. Studies emphasizes that computed tomography should continue to be used judiciously as an adjunct to clinical judgment. The delay between hospital admission and initial débridement is the most critical factor influencing morbidity and mortality. Once the diagnosis of necrotizing soft tissue infection is established, patient survival and soft tissue preservation are best achieved by means of prompt operation. Bacterial infections of the dermis and epidermis are covered in depth, along with animal and human bites. Methicillin-resistant Staphylococcus aureus (MRSA) accounts for up to 70% of all S. aureus infections acquired in the community and is the most common organism identified in patients presenting to the emergency department with a skin or soft tissue infection. The more classic findings associated with deep necrotizing infections—skin discoloration, the formation of bullae, and intense erythema—occur much later in the process. It is important to understand this point so that an early diagnosis can be made and appropriate treatment promptly instituted. The review’s discussion covers in depth the etiology and classification of soft tissue infection, pathogenesis of soft tissue infections, toxic shock syndrome, and reports on mortality from necrotizing soft tissue infection. This review 8 figures, 22 tables, and 58 references. Keywords: Erysipelas, cellulitis, soft tissue infection, necrotizing fasciitis, myonecrosis, toxic shock syndrome

scholarly journals 785. Treatment of Mycobacterium immunogenum Skin and Soft-Tissue Infections: A Case in a Peritoneal Dialysis Patient

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S281-S281
Author(s):  
Walid El-Nahal ◽  
Abhishek Shenoy ◽  
McCall Walker ◽  
Tushar Chopra ◽  
Greg Townsend ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Soft Tissue ◽  
Case Series ◽  
Peritoneal Dialysis Patient ◽  
Empiric Therapy ◽  
Human Infection ◽  
Surgical Debridement ◽  
Nontuberculous Mycobacterium ◽  
Peritoneal Dialysis Catheter ◽  
Soft Tissue Infections

Abstract Background Mycobacterium immunogenum is a somewhat recently identified species of rapidly growing nontuberculous mycobacteria, genetically related to M. abscessus and M. chelonae. Resistance patterns of rapidly growing nontuberculous mycobacterium species can make them difficult to treat. This is particularly true of M. immunogenum, in part due to the infrequency of reported cases of human infection and limited data to guide therapy. Methods We present here a case of M. immunogenum skin and soft-tissue infection at the site of insertion of a peritoneal dialysis catheter in a patient with end-stage renal disease. He initially presented with nodular subcutaneous lesions around his catheter site that progressed through oral antibiotics. This led to sampling which confirmed the diagnosis of M. immunogenum. We conducted a review of the literature to identify previously reported cases of M. immunogenum, including skin and soft-tissue infections, and used these data to guide management. Results We reviewed 11 reports (cases and case series) of Mycobacterium immunogenum in the literature. Susceptibilities often take weeks to return, and so empiric therapy is based on case series, and then later adjusted based on susceptibilities. Patients received combined antimicrobial regimens with durations of 2 weeks to 12 months, with variable outcomes. Several required surgical debridement, as was the case with our patient. His PD catheter was removed and he was treated empirically with amikacin, azithromycin, and tigecycline intravenous induction. His ultimate long-term regimen was later switched to azithromycin, clofazimine, and tedizolid due to side effects and the eventually available susceptibility profile. Conclusion The treatment of M. immunogenum remains a challenge due to the relative scarcity of data to guide treatment, and consequent lack of systemic approach to therapy. Most reported cases involve the use of a macrolide, often in combination with an aminoglycoside or a fluoroquinolone. Several started with intravenous induction, followed by transition to oral therapy on the order of weeks to months. Others also require surgical debridement. More data are required to develop a standardized approach to the treatment of M. immunogenum. Disclosures All authors: No reported disclosures.

Invasive Bacterial Infections in Infants Younger Than 60 Days With Skin and Soft Tissue Infections

2018 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dana M. Foradori ◽  
Michelle A. Lopez ◽  
Matt Hall ◽  
Andrea T. Cruz ◽  
Jessica L. Markham ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bacterial Infections ◽  
Soft Tissue Infections

Prevalence of Invasive Bacterial Infections in Infants <60 Days with Skin and Soft Tissue Infections

2018 ◽  
Author(s):  
Dana Foradori ◽  
Sowdhamini Wallace ◽  
Michelle Lopez ◽  
Matt Hall ◽  
Andrea Cruz ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bacterial Infections ◽  
Soft Tissue Infections

scholarly journals Severe and Progressive Cellulitis Caused by Serratia marcescens Following a Dog Scratch

2019 ◽  
Vol 7 ◽  
pp. 232470961983233 ◽  
Author(s):  
Deeti J. Pithadia ◽  
Erena N. Weathers ◽  
Rhonda E. Colombo ◽  
Stephanie L. Baer
Keyword(s):  
Soft Tissue ◽  
Serratia Marcescens ◽  
Bacterial Infections ◽  
Substantial Improvement ◽  
Resistant Bacteria ◽  
Soft Tissue Infections ◽  
Amoxicillin Clavulanate ◽  
Chemotherapy Induced Neutropenia ◽  
Bacteria And Fungi ◽  
Oral Ciprofloxacin

Soft tissue infections occur in over 30% of patients with chemotherapy-induced neutropenia. Gram-positive bacterial infections predominate early in neutropenia, and likelihood of infection by resistant bacteria and fungi increases with prolonged neutropenia. Prior infections and exposures influence the risk of rare pathogens. A 55-year-old woman with chemotherapy-induced neutropenia was scratched on her forearm by a dog. She cleaned the wound with isopropanol and was treated empirically with amoxicillin-clavulanate. Over the next 4 days, she developed fever along with erythema, edema, and mild tenderness of the forearm without purulence or crepitus. She was hospitalized and received empiric treatment with intravenous vancomycin, piperacillin-tazobactam, tobramycin, and voriconazole. Despite therapy, her fevers persisted and the cellulitis progressed for over a week. After 10 days of hospitalization, her neutrophil count began to recover and a bulla developed at the wound site. Culture of the bullous fluid grew Serratia marcescens, and antibiotics were switched to cefepime based on susceptibility. She defervesced and showed substantial improvement of cellulitis within 48 hours and was discharged on oral ciprofloxacin. Serratia marcescens skin infections are rare, and this may be the first report of Serratia cellulitis associated with trauma from dog contact. This case highlights the need to consider unusual pathogens based on exposure history and immune status and to obtain cultures from fluid collections or tissue in cases of treatment-resistant soft tissue infections.

scholarly journals 2-es típusú diabetesesek és nem cukorbetegek területen szerzett, belgyógyászati osztályos felvételt igénylő bakteriális infekcióinak klinikai összehasonlítása

2019 ◽  
Vol 160 (41) ◽  
pp. 1623-1632
Author(s):  
László József Barkai ◽  
Emese Sipter ◽  
Dorottya Csuka ◽  
Tímea Baló ◽  
Zsuzsa Nébenführer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bacterial Infections ◽  
Respiratory Infections ◽  
Mortality Rates ◽  
Medical Ward ◽  
Soft Tissue Infections ◽  
General Medical Ward ◽  
International Data ◽  
Tract Infections

Abstract: Introduction: Previous data showed bacterial infections among diabetic patients to be more serious and frequent, with higher mortality rates in comparison with non-diabetics. Recent investigations, however, are contradictory. Aim: The goal of our prospective, observational study was to compare patients hospitalized on a general medical ward due to community-acquired bacterial infections with type 2 diabetes mellitus (T2DM) to those of non-diabetics (K) by 1) infection localization, 2) spectrum of pathogens, 3) three-month mortality rates. Method: Patients were consecutively involved (T2DM: n = 205, K: n = 202). We characterized the infections, clinical parameters, mortalities of the two groups, and matched them to international data. Results: No difference regarding clinical details of the groups were found except for glycemic parameters and BMI. In the T2DM group the skin- and soft tissue- (37.1%), in the K patients respiratory infections (37.1%) were the most common, followed by urinary ones (31.2% and 31.7%, respectively). Skin- and soft tissue infection incidence among T2DM subjects were higher compared to international results (37.1% vs. 16%). Co-presence of Gram positive and Gram negative bacteria in the skin- and soft tissue infections (23/76 vs. 5/46, p = 0.0149), and polymicrobial origin in the urinary tract infections (34.0% vs. 15.1%, p = 0.0335) were found to be more frequent in T2DM than in K. No difference regarding mortality rates were detected. In T2DM the skin- and soft tissue while in the K group the respiratory infections had the most death counts. Conclusions: We found higher rates of skin- and soft tissue infections among T2DM patients hospitalized on a general medical ward compared to international data. In total we did not find difference regarding three-month mortality between the groups. Our results highlight the importance of primary prevention and shows its inadequacy concerning skin and soft tissue infections among type 2 diabetics in Hungary. Orv Hetil. 2019; 160(41): 1623–1632.

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