scholarly journals Shock séptico asociado a gangrena gaseosa - Miositis necrotizante por Clostridium.

2020 ◽  
pp. 136-139
Author(s):  
G CRIADO ALBILLOS ◽  
A D P MARTIN RODRIGUEZ ◽  
L MENDIETA DIEZ ◽  
M MILLAN CID ◽  
A DELGADO GONZALEZ
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Case ◽  
Soft Tissues ◽  
Patient Survival ◽  
Gas Gangrene ◽  
Surgical Debridement ◽  
Aggressive Treatment ◽  
Gastrointestinal Pathology ◽  
Life Threatening ◽  
History Of

Introduction: Gas gangrene, also known as clostridial myonecrosis, is an acute, potentially life-threatening infection of muscular and soft tissues caused by pathogens in the Clostridium genus. Clinical case: We present the case of spontaneous gas gangrene caused by C. Perfringens in a patient with no history of trauma. Discussion: The treatment of gas gangrene consists of prompt surgical debridement combined with antibiotic therapy. Emergency surgical debridement is especially important for patient survival, preserving the limb and preventing complications. If C. Perfringens is confirmed, the antibiotic therapy should consist of penicillin (3-4 million units intravenously every 4h) with clindamycin (900 mg intravenously every 8h) or tetracycline (500 mg intravenously every 6h). Even when we encounter a patient with no history of trauma, gastrointestinal pathology, neutropenia or immunodeficiencies, we should quickly suspect this diagnosis when there is extreme pain in a limb, with or without fever. This suspicion is important due to the need for rapid and aggressive treatment to save the limb and life of the patient and to prevent complications.

scholarly journals Diagnosis and management of necrotizing fasciitis in the light of the recent recommendations

2019 ◽  
Vol 41 part 1 (2) ◽  
pp. 77-84
Author(s):  
C. O. Kosulnikov ◽  
V. N. Lisnichaya ◽  
A. M. Besedin ◽  
S. І. Karpenko ◽  
S. A. Tarnopolsky ◽  
...  
Keyword(s):  
Necrotizing Fasciitis ◽  
Soft Tissues ◽  
Subcutaneous Fat ◽  
Surgical Debridement ◽  
Type I ◽  
Cause Of Deaths ◽  
Life Threatening ◽  
Management Modality ◽  
Closure Method ◽  
Primary Management

Summary: Necrotizing fasciitis is a rare but life-threatening infection of the soft tissues. It is characterized by spreading inflammation and necrosis starting from the fascia, muscles, and subcutaneous fat, with subsequent necrosis of the overlying skin. Necrotizing fasciitis is classified into four types, depending on microbiological findings. The diagnosis of this disease is difficult. Late diagnosis is observed in 85–100% of cases and is considered the only cause of deaths. Emergency surgical debridement is the primary management modality for necrotizing fasciitis. Vacuum assisted closure therapy is fast and effective wound closure method. Antibiotics and surgical debridement play a key role in the treatment of necrotizing fasciitis.In our hospital, there were 75 patients with necrotizing fasciitis in the last 5 years (type I – 92%, type II – 8%). We observed localization of necrotizing fasciitis in the perineum (32%), upper extremities and chest (25%), lower extremities (28%), abdominal wall and retroperitoneal space (15%). Mortality was 9,5%. Keywords: necrotizing fasciitis, sepsis, surgical debridement.

scholarly journals Non Clostridial Gas Gangrene Leading to Stroke in Postoperative Period- A Case Report

2021 ◽  
Author(s):  
Sukhvir Singh ◽  
Gazala Shabeen
Keyword(s):  
Postoperative Period ◽  
Soft Tissues ◽  
Intensive Therapy ◽  
Gas Gangrene ◽  
Diabetic Patients ◽  
Source Of Infection ◽  
Life Threatening ◽  
Systemic Manifestations ◽  
Prompt Diagnosis ◽  
Very High

Gas gangrene is a life threatening infection of muscles and soft tissues which is associated with very high mortality rate. Non clostridial gas gangrene is a rare phenomenon that mostly occurs in diabetic patients. Gas gangrene leads to various systemic manifestations. A 66-year-old female patient, diabetic with chronic kidney disease, on haemodialysis was presented as a rare case of non clostridial right great toe gas gangrene, which progressed to systemic toxicity and stroke within a period of 72 hours in postoperative period. The source of infection in this case may have been Acinetobacter which is a gram-negative bacterium. Despite prompt diagnosis and intensive therapy, the patient died 15 days after the operation. After going through literature, no case was found to be reported of stroke in postoperative period due to non clostridial gas gangrene thus making it a unique case to report. Also, only few cases of life threatening non clostridial gas gangrene are reported in literature.

scholarly journals Dental Management of a Child with Incidentally Detected Hemophilia: Report of a Clinical Case

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Ricardo Martínez-Rider ◽  
Arturo Garrocho-Rangel ◽  
Raúl Márquez-Preciado ◽  
María Victoria Bolaños-Carmona ◽  
Socorro Islas-Ruiz ◽  
...  
Keyword(s):  
Medical Management ◽  
Clinical Case ◽  
Soft Tissues ◽  
Hemophilia A ◽  
Incidental Finding ◽  
Dental Management ◽  
Life Threatening ◽  
Bleeding Episodes ◽  
Risk For Bleeding ◽  
Uncontrolled Bleeding

Children with hemophilia (A or B) are at risk for bleeding episodes, which rank from mild mucosal/soft tissues bleeding to life-threatening hemorrhages. This report describes the dental/medical management provided to an 8.10-year-old patient suffering from uncontrolled bleeding after a surgical procedure to expose both permanent upper central incisors, in which hemophilia was a pure incidental finding. Additionally, diverse precautions to be considered during the dental clinical treatment of hemophilic children are discussed.

scholarly journals Estatus epiléptico refractario no convulsionante en postoperatorio de pancreatectomía total: A propósito de un caso

2019 ◽  
Vol 10 (12) ◽  
pp. 2
Author(s):  
José Antonio García Martínez ◽  
Maria Candelaria Benimeli López ◽  
Francisco García-Legaz Navarro ◽  
Carlos García Palenciano
Keyword(s):  
Antibiotic Therapy ◽  
Side Effect ◽  
Clinical Case ◽  
Probable Relationship ◽  
History Of ◽  
History Of Epilepsy

Se presenta un caso clinico de Estatus Epileptico No convulsionante en el posopoeratorio de una paciente de 79 años sin antecedentes de epilepsia, y su probable relación con la antibioterapia pautada. Seguidamente se realiza una discusion acerca del estatus epileptico y su aparicion como efecto secundario del tratamiento con ciertos antibioticos.  ABSTRACT We present a clinical case of non-convulsive epileptic status in the post-operative of a 79-year-old patient with no history of epilepsy, and its probable relationship with scheduled antibiotic therapy. Then a discussion about the epileptic status and its appearance as a side effect of the treatment with certain antibiotics is made.

scholarly journals Uncommon Locations of Gas Gangrene Treated Successfully With Surgical Debridement and the Vacuum-Assisted Closure Device

2016 ◽  
Vol 101 (11-12) ◽  
pp. 517-523
Author(s):  
Evangelos P. Misiakos ◽  
Nick Zabras ◽  
George Bagias ◽  
Panagiotis Tzanetis ◽  
Lignos Michail ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Gas Gangrene ◽  
Surgical Debridement ◽  
Closure Device ◽  
Surgical Wound ◽  
Vacuum Assisted Closure ◽  
Lateral Abdominal Wall ◽  
Threatening Condition ◽  
Life Threatening ◽  
Closure Method

Gas gangrene is a life-threatening condition implying necrosis of dermis and hypodermis, along with necrosis of the superficial muscular aponeurosis. Fournier s gangrene is a subtype of the disease affecting the perineal and genital area. The aim of this study is to analyze the clinical presentation, diagnosis, medical, and surgical treatment of three cases of gas gangrene affecting uncommon locations in the human body, treated with extensive surgical debridement followed by the vacuum assisted closure method in two of these cases. Three cases of gas gangrene affecting uncommon locations treated surgically in our Department are presented. In one case the perineal and scrotal region was infected with invasion of the lateral abdominal wall and the peritoneal cavity. In the second case the axillary regions were infected bilaterally and in the third case the left axillary and subscapular regions were infected after a left arm disarticulation. All cases were treated successfully with successive surgical debridement and/or the vacuum-assisted closure method. Gas gangrene is a curable disease if diagnosed early and treated effectively with successive surgical wound cleaning and debridement. The vacuum assisted closure method can be helpful in promoting wound healing.

scholarly journals A rare case of varicella gangrenosum in adult

2020 ◽  
Vol 7 (2) ◽  
pp. 599
Author(s):  
M. Sabari Girieasen ◽  
Naveenkumar Viswanathan ◽  
M/ S. Kalyankumar
Keyword(s):  
Soft Tissues ◽  
Rare Complication ◽  
Purpura Fulminans ◽  
The Body ◽  
Surgical Debridement ◽  
Chicken Pox ◽  
Serous Discharge ◽  
Threatening Condition ◽  
Life Threatening ◽  
Split Skin

Varicella gangrenosum is a gangrenous ulceration of varicella lesions involving the skin and soft tissues of the body. It most commonly occurs in children less than 5 years of age and life threatening. This is a very rare complication of chicken pox in adults which deserves early diagnosis and management. 21-year-old male presented with blackish discoloration in the lateral aspect of right thigh for 5 days. He has positive history of chicken pox for his brother and sister following which he acquired it 15 days back. During that episode he had fever, headache and blisters which ruptured to heal by scab. But scab in right thigh coalesced to form the gangrenous area with serous discharge. On presentation he had no fever with local lesion and surrounding erythema. Patient underwent radical surgical debridement and regular dressing. Pus culture was sent which showed no growth. He gradually improved and the ulcer granulated well and split skin graft is done. Varicella gangrenosum is a life-threatening condition which can be either wet, moist or purpura fulminans. Patients who develop disseminated intravascular coagulation and have a grave prognosis. Surgical debridement is the only proven treatment which has led to better outcome. Only about 10 cases reported in literature so far regarding this condition. 

How serious are oral infections?

2004 ◽  
Vol 118 (7) ◽  
pp. 561-565 ◽  
Author(s):  
Zaid H. Baqain ◽  
Laurence Newman ◽  
Nicholas Hyde
Keyword(s):  
Antibiotic Therapy ◽  
Head And Neck ◽  
Soft Tissues ◽  
Early Recognition ◽  
Surgical Drainage ◽  
Intravenous Antibiotic ◽  
Oral Infections ◽  
The World ◽  
Life Threatening ◽  
Dental Infections

Life-threatening conditions following dental infections have been rare since antibiotics were introduced into the world of medicine. However, infections spreading through the soft tissues of the head and neck are encountered occasionally and mortality is still reported as a result of sepsis or airway embarrassment. A case of Ludwig’s angina from odontogenic infection that progressed into mediastinitis and pericarditis is presented. The steps adopted in the management of this case highlight the significance of early recognition and diagnosis of the source of deep cervical infections, the importance of securing the airway, effecting surgical drainage and aggressive intravenous antibiotic therapy.

scholarly journals Fatal Morganella morganii bacteraemia in a diabetic patient with gas gangrene

2009 ◽  
Vol 58 (7) ◽  
pp. 965-967 ◽  
Author(s):  
Sujoy Ghosh ◽  
Abhijit M. Bal ◽  
Iqbal Malik ◽  
Andrew Collier
Keyword(s):  
Antibiotic Therapy ◽  
Diabetic Patient ◽  
Surgical Intervention ◽  
Bacterial Species ◽  
Gas Gangrene ◽  
Blood Cultures ◽  
Radiological Imaging ◽  
Morganella Morganii ◽  
History Of ◽  
The Right

We report a case of a 60-year-old lady with a history of a heel ulcer that had not responded to antibiotic therapy. This progressed to involve the right leg, which was swollen and erythematous. Radiological imaging revealed the presence of gas within the fascial planes. Blood cultures on admission yielded Morganella morganii. Due to the extent of the gas gangrene and her co-morbidities the patient was not suitable for surgical intervention and was treated conservatively with antibiotics. She deteriorated and died within 72 h of presentation. Non-clostridial gas gangrene is relatively rare, and diagnosis is frequently delayed and often missed. Early aggressive surgical intervention combined with appropriate antibiotic therapy is essential. Bacterial species other than Clostridium should be considered in all cases of gas gangrene.

scholarly journals Choice of Allograft in Patients Requiring Intestinal Transplantation: A Critical Review

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Genevieve Huard ◽  
Thomas Schiano ◽  
Jang Moon ◽  
Kishore Iyer
Keyword(s):  
Patient Survival ◽  
Intestinal Failure ◽  
Intestinal Transplantation ◽  
Advanced Fibrosis ◽  
Polyposis Syndrome ◽  
Gastrointestinal Pathology ◽  
Life Threatening ◽  
Intestine Transplantation ◽  
Waitlist Mortality

Intestinal transplantation (ITx) is indicated in patients with irreversible intestinal failure (IF) and life-threatening complications related to total parenteral nutrition (TPN). ITx can be classified into three main types. Isolated intestinal transplantation (IITx), that is, transplantation of the jejunoileum, is indicated in patients with preserved liver function. Combined liver-intestine transplantation (L-ITx), that is, transplantation of the liver and the jejunoileum, is indicated in patients with liver failure related to TPN. Thus, patients with cirrhosis or advanced fibrosis should receive a combined allograft, while patients with lower grades of liver fibrosis can usually safely undergo ITx. Reflecting their degree of sickness, the waitlist mortality rate and the early posttransplant outcomes of patients receiving L-ITx are worse than IITx. However, L-ITx is associated with better long-term graft and patient survival. Multivisceral transplantation (MVTx), that is, transplantation of the organs dependent on the celiac axis and superior mesenteric artery, can be classified into full MVTx if it includes the liver and modified MVTx if it does not. The most common indications for MVTx are extensive portomesenteric thrombosis and diffuse gastrointestinal pathology such as motility disorders and polyposis syndrome. Every patient with IF should undergo a multidisciplinary evaluation by an experienced ITx team.

scholarly journals Necrotizing fasciitis of head – neck

1970 ◽  
Vol 14 (1) ◽  
pp. 9-14
Author(s):  
Sudhangshu Shekhar Biswas ◽  
Zaheer Al-Amin
Keyword(s):  
Antibiotic Therapy ◽  
Necrotizing Fasciitis ◽  
Primary Source ◽  
Good Control ◽  
Surgical Debridement ◽  
Electrolyte Imbalance ◽  
Diabetic Patients ◽  
Source Of Infection ◽  
Life Threatening ◽  
Head Neck

Necrotizing Fasciitis of head -neck is not so uncommon in diabetic patients which is a progressive, destructive and potentially life threatening soft tissue infection primarily affecting superficial fascial planes. It is caused by group A streptococci or by a synergistic combination of aerobe and anaerobe micro organisms. This is a retrospective study which makes an attempt to analyze various parameters such as demography, aetiology, complications, and management methods determining the overall prognosis. Odontogenic infection was the primary source of infection. Diabetes, anaemia, chronic renal failure and electrolyte imbalance were the most commonly associated illness. Surgical debridement with combined antibiotic therapy was used in the management of necrotizing fasciitis along with good control of diabetes and correction of anaemia and electrolyte imbalances. Overall mortality was low. The late referral and associated complications had increased the hospital stay. With proper control of infection by early diagnosis, surgical debridement and combined antibiotic therapy, along with timely control of complications and associated illness - better results can be possible. Key words: necrotizing fasciitis, antibiotics, debridement  DOI: 10.3329/bjo.v14i1.3274 Bangladesh J of Otorhinolaryngology 2008; 14(1) : 9-14

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