Fournier's Gangrene at HIV Positive Patient With Normal CD4 Count

2014 ◽  
Vol 3 (2) ◽  
pp. 180-182
Author(s):  
Ruchan Bahadir Celep ◽  
Mustafa Ozsoy ◽  
Ahmet Bal ◽  
Ziya Taner Ozkececi ◽  
Ogun Ersen ◽  
...  
Keyword(s):  
Fournier’S Gangrene ◽  
Cd4 Count ◽  
Positive Patient ◽  
Hiv Positive ◽  
Fournier's Gangrene

scholarly journals A clinical study of Fournier’s gangrene and use of honey dressing in treatment

2018 ◽  
Vol 6 (3) ◽  
pp. 932
Author(s):  
Subodh P. Ugane ◽  
Shrikant K. Kalbagwar ◽  
Sanjot B. Kurane
Keyword(s):  
Chronic Alcoholism ◽  
Fournier’S Gangrene ◽  
Hiv Positive ◽  
Fournier's Gangrene ◽  
Coagulase Negative Staphylococci ◽  
Lower Socioeconomic ◽  
Initial Symptoms ◽  
Male Patients ◽  
Dressing Materials ◽  
Small Work

Abstract- backgroundFournier’s gangrene is necrotizing fasciitis involving genitals and perineal regions.  Fournier’s gangrene is a surgical emergency. If not treated immediately it spreads rapidly causing septicemia leading to death. Mainstay of treatment is surgical and regular dressing. Various dressing materials are available like eusol,  in our study we use Honey as dressing material. This is a small work to attempt to study incidence, etiology and pathogenesis and use of dressing for the treatment of Fournier’s Gangrene.Materials and methods in our study we study 40 male patients of Fournier’s gangrene. We studied clinico- pathology of disease and use of honey dressing for the management of Fournier’s gangrene. Out of 40 patients 18 were treated with honey as dressing material and remaining 22 with eusol.Results- 40 patients were admitted and majority of patients were in age group > 60 years mean age was 54.08 _ 15.47 years. Majority of patients belonged to lower socioeconomic class 82.5%. Most of patients presented in hospital within 7 days of initial symptoms. In this study etiological causes found in 85% of patients and among which most common were urogenital causes 32.5%. Majority of patients had chronic alcoholism and bad hygiene as predisposing factors. 25% were associated with diabetes mellitus. In this study 12% of patients were HIV positive. Most common organism found in pus culture was E.coli (42.5%) followed by Coagulase negative Staphylococci in 32.5%, Klebsiella in 12.5%, Pseudomonas in 7.5% and no organism were isolated in 5%.Mean days required for healthy granulation by honey dressing was 9.62+- 4.5 days and for eusol was 10.5 +- 3.79 days. In our study mortality was 22.5%.

scholarly journals Bacteremia due to Kocuria rosea in a HIV positive patient with low CD4 count: A case report

2014 ◽  
Vol 9 (6) ◽  
pp. 01-03
Author(s):  
Biswajeet Sahoo ◽  
◽  
Sanjeeb Sharma ◽  
Sudipta Naorem ◽  
Khuraijam Ranjana Devi ◽  
...  
Keyword(s):  
Case Report ◽  
Cd4 Count ◽  
Positive Patient ◽  
Hiv Positive ◽  
Kocuria Rosea

A Case of Severe Colitis in an HIV-Positive Patient With CD4 Count >200cells/μL

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hrede Afsana ◽  
John Geevarghese ◽  
Anu Salwan ◽  
Craig Gross ◽  
Miriam A. Smith
Keyword(s):  
Cd4 Count ◽  
Positive Patient ◽  
Hiv Positive ◽  
Severe Colitis

scholarly journals Fournier's Gangrene as Seen in University of Maiduguri Teaching Hospital

ISRN Urology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
S. Aliyu ◽  
A. G. Ibrahim ◽  
N. Ali ◽  
A. M. Waziri
Keyword(s):  
Poor Prognosis ◽  
Obstructive Uropathy ◽  
Fournier’S Gangrene ◽  
Hiv Positive ◽  
Fournier's Gangrene ◽  
Scrotal Pain ◽  
Wound Debridement ◽  
Aggressive Management ◽  
The Tropics ◽  
Predisposing Conditions

Background. Fournier’s gangrene is uncommon but increasingly being seen over the last two decades probably due to increasing socioeconomic problems including an upsurge in HIV infection especially in the tropics. Patients and Methods. The study retrospectively reviewed all patients with Fournier’s gangrene managed in UMTH between January 2007 and December 2012. Results. Thirty-eight males aged 2 weeks to 80 years (mean 37.82) were reviewed, with most aged 30–39 years (13 (34.21%)). Clinical features were scrotal pain and swelling, 36 (94.74%), fever, 19 (50.00%), and discharging scrotal wound, 19 (50.00%). The predisposing conditions were UTI secondary to obstructive uropathy in 11 (28.95%), perianal suppuration, and HIV, in 8 (21.05%) patients each. Wound biopsy culture revealed mixed organisms in 27 (71.05%). Twenty-six (68.42%) had blood transfusions. Thirty-seven (97.37%) patients had wound debridement. Twenty (52.63%) had flap rotation for skin cover. There were 6 (15.79%) mortalities, of which 4 (10.53%) were HIV positive, 1 (2.63%) was diabetic, and 1 (2.63%) was both diabetic and HIV positive. Conclusion. Fournier’s gangrene is a fulminant synergistic necrotising fasciitis of the perineum and genitalia with poor prognosis especially when associated with HIV and diabetes, requiringprompt and aggressive management for good outcome.

Human Immunodeficiency Virus–Positive Patient Presenting With Acute Renal Failure and Hypercalcemia Diagnosed With Sarcoidosis

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S87-S87
Author(s):  
Amir Dehghani ◽  
Elham Yousefi ◽  
Mohamed Alshal ◽  
Qiang Xie ◽  
Alejandro Zuretti
Keyword(s):  
Renal Failure ◽  
T Lymphocytes ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Renal Involvement ◽  
Pulmonary Involvement ◽  
Cd4 Count ◽  
Positive Patient ◽  
Hiv Positive ◽  
Bilateral Hilar Lymphadenopathy

Abstract Objectives A 42-year-old African American man with a history of HIV infection on highly active antiretroviral therapy (HARRT) presented with excessive thirst, polydipsia, polyuria, weight loss, and abnormal kidney function tests. Physical examination was normal. Methods The patient workup results were as follows: calcium 13.8 mg/dL (8.4-10.3 mg/dL), ACE 88 U/L (8-52 U/L), PTH 7.34 pg/mL (14-72 pg/mL), 1,25 (OH)2 vitamin D 125 pg/mL (19.9-79.3 pg/mL), BUN 38 mg/dL (6-20 mg/dL), Cr 2.42 mg/dL (0.4-1.2 mg/dL), glucose 87 mg/dL (70-99 mg/dL), CD4 count 303/μL (544-1,894/μL). Chest CT scan showed diffuse pulmonary nodules with mediastinal and bilateral hilar lymphadenopathy. A transbronchial biopsy was performed. Results Biopsy revealed noncaseating granuloma and Schaumann bodies. AFB and GMS stains were negative for micro-organisms. These findings were compatible with sarcoidosis. The patient received prednisone and showed significant improvement in his renal function (creatinine: 1.23 mg/dL) and calcium level (9.12 mg/dL). Conclusion CD4+ T lymphocytes have a crucial role in the formation of sarcoid granulomas. However, HIV infection is characterized by a profound loss of the CD4+ T-lymphocytes. Therefore, sarcoidosis in HIV-positive patients is rare. The development of sarcoidosis usually occurs when a significant increase in CD4+ T-cell count induced by HAART has taken place. Pulmonary involvement and symptoms are responsible for the majority of the morbidity and mortality in sarcoidosis. Renal involvement is significantly less common than respiratory symptoms. This patient was one out of two HI- positive cases of sarcoidosis among 200 patients who were diagnosed with sarcoidosis in our three major affiliated hospitals from 2000 to 2019. This case is unique and rare both in terms of unusual presentation of renal failure and hypercalcemia and also the co-occurrence of sarcoidosis in an HIV-positive patient while the CD4 count is lower than the normal limit.

scholarly journals Prospective study of tubercular co-infection in HIV infected patients in VIMSAR, Burla, Sambalpur, Odisha, India

2018 ◽  
Vol 5 (3) ◽  
pp. 530
Author(s):  
P. K. Bariha ◽  
U. P. Pujari ◽  
B. K. Kullu ◽  
A. Thakur
Keyword(s):  
Prospective Study ◽  
Cd4 Count ◽  
Positive Patient ◽  
Hiv Positive ◽  
Mortality And Morbidity ◽  
Cd4 Cell Count ◽  
Pulmonary Tb ◽  
Common Opportunistic Infection ◽  
Extra Pulmonary ◽  
A Prospective Study

Background: Tuberculosis is the most common opportunistic infection in HIV positive patient. This is a major challenge faced by HIV positive patient.  Methods: This study was carried out at Medicine Department and ART Centre, VIMSAR, Burla to know the epidemiology and clinical profile of HIV and TB co-infection. This is a prospective study in which all adult patients attending to our hospital for period of one year with HIV-TB co infection are enrolled. There were 269 patients. The clinical parameters are studied after all detailed history and clinical examination. The diagnosis of Tuberculosis was made by relevant investigation like Sputum AFB, Chest X-ray, CSF Study, CT Scan, Pleural Fluid Study, Ascitic fluid study etc.Results: The results indicate majority of the patients out of 211 patients 74 (82.52%), were male 34(16.35%)were female and TGTS were-3(1.42%). Age group mostly affected were 26-35 years (38.1%) and 36-45 years (38.1 %). Extra-pulmonary TB constituted 56.28% and Pulmonary TB-43.72%. 41.99% completed anti-TB treatment and mortality was 12.99%. Mean CD4 count at the time of diagnosis-218iu/l; and patients with low CD4 cell count at the time of diagnosis had high mortality.Conclusions: Extra-pulmonary TB is predominant among HIV TB co-infection and the working-class population affected more than the rest TB Meningitis and Disseminated TB are associated with a bad prognosis when compare to other forms of TB. A low CD4 count at the time of Tuberculosis diagnosis is associated with a higher mortality and early suspicion diagnosis of tuberculosis and early initiation of ATT in HIV patients reduces mortality and morbidity significantly.

Fournier's gangrene as Amyand's hernia complication

2019 ◽  
Vol 98 (7) ◽  
pp. 291-296
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Rare Condition ◽  
Sporadic Case ◽  
Fournier’S Gangrene ◽  
Amyand’S Hernia ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Based Medicine ◽  
Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

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