scholarly journals Fournier Gangrene: Case Report & Litarature Review

2021 ◽  
pp. 642-646
Author(s):  
Ankit Selokar ◽  
Sonali Kolhekar ◽  
Shalini Lokhande ◽  
Suwarna Ghugare ◽  
Ruchira Ankar ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Trauma Surgery ◽  
Health Care Team ◽  
Complex Case ◽  
Fournier Gangrene ◽  
Professional Management ◽  
Human Bites ◽  
Show Evidence ◽  
Comprehensive Health ◽  
Vaginal Pain

Introduction: Necrotizing fasciitis of the perineal and vaginal region is a symptom of Fournier's gangrene, which is caused by a synergistic polymicrobic infection. The clinical presentation varies depending on the original aetiology, ranging from anorectal or vaginal pain with limited evidence of cutaneous necrosis to a rapidly spreading necrosis of the skin and soft tissue, to systemic sepsis without any obvious signs or symptoms. Case history: A 65-year-old male who was admitted in hospital with the chief complaint of Scrotal enlargement, discomfort, hyperemia, pruritus, crepitus, and fever. There may also be a foul-smelling discharge. Symptoms usually appear during a two- to seven-day period. Soft-tissue gas may be present before clinical crepitus is detected. The patient with Fournier gangrene frequently seems poorly on physical examination, with prodromal signs of fever and lethargy lasting 2-7 days. Edema of the overlaying skin is usually present, as is acute pain and tenderness in the genitalia; pruritus may also be present.Skin may show evidence of trauma, surgery, insect or human bites or injection sites, In Respiratory system, B/L Air entry present. In cardiovascular system, S1 and S2 sound heard and Patient get conscious and well oriented to time, place, and person. Then, as quickly as possible, treatment was began; he did not improve after treatment, and treatment would continue till the conclusion of my care. Conclusion: We focus on professional management and superior nursing care in this study so that we may provide the complete treatment that Fournier Gangrene requires while also effectively managing the complex case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and happiness.

scholarly journals Case Report on Chiari Syndrome

2021 ◽  
pp. 406-411
Author(s):  
Asawari Meshram ◽  
Vaishali Tembhare ◽  
Seema Singh ◽  
Ranjana Sharma ◽  
Ruchira Ankar ◽  
...  
Keyword(s):  
Physical Examination ◽  
Chiari Malformation ◽  
Rare Condition ◽  
Health Care Team ◽  
Left Hand ◽  
Professional Management ◽  
Comprehensive Health ◽  
Chiari Syndrome ◽  
Arterial Pulses ◽  
Pedal Edema

Chiari Malformation is a rare condition. A condition known as Chiari malformation occurs when brain tissue spreads into the spinal canal. When a portion of your skull is excessively small or malformed, it presses on your brain and forces it downward. Chiari malformation is a rare occurrence, although the increased use of imaging testing has resulted in more diagnosis. Case Presentation: A 18-year-old boy was admitted to the hospital with the following symptoms: Tingling sensation, numbness over left hand since 2 to 3 months. Neck bend toward right side, pain in left hand since 6 month. Difficulty during eating by hand since 2 to 3 month. On physical examination, indicated a bright attentive person with pale conjunctiva and no symptoms of icterus. He had a tachycardia, bilateral pitting pedal edema and a swollen abdomen with shifting dullness, all of which pointed to as cites. He had a history of intermittent abdominal pain. On admission he complaint of new onset of dyspnea on exertion, fatigue and abdominal swelling. The rest of all physical examination was normal, with no skin changes and an intact arterial pulses in all four extremities. Conclusion: The primary focus of this case study is on professional management and outstanding nursing care, which may provide the holistic care that Chiari Syndrome necessitates while also effectively managing the challenging case. After a full recovery, the patient's comprehensive health care team collaborates to help the patient regain his or her previous level of independence and satisfaction.

scholarly journals Guillain Barre Syndrome: A Case Report and Literature Review

2021 ◽  
pp. 158-161
Author(s):  
Ragini Joshi ◽  
Deeplata Mendhe ◽  
Mayur Wanjari
Keyword(s):  
Health Care Team ◽  
Lower Limbs ◽  
Guillain Barre Syndrome ◽  
Professional Management ◽  
Reflected Light ◽  
Guillain Barré Syndrome ◽  
Comprehensive Health ◽  
Chief Complaints ◽  
Gag Reflex ◽  
Guillain Barré

Introduction: The arrival of Guillain-Barre Syndrome is sudden. It’s a type of neuropathy caused by the immune system. Nutrition is very crucial. In impoverished countries, it is a disabling disease. Autoantibodies against diverse antigens can be seen in the outlying site. The occurrence links 0.4 to 1.7 million individuals per year. Case Presentation: A 5-year-old boy was taken to the hospital with chief complaints of Weakness in bilateral upper and lower limbs, trouble in swallowing, inability to hold the neck, mouth-frothing, fever spikes. On physical examination, the patient has experienced weakness in bilateral upper and lower limbs, Bulbar weakness is present, pain experienced in both legs, the gag reflex is absent, In Cardiovascular System, S1 and S2 sound are present, In Respiratory System, Air entry is bilaterally equal, pupils are reflected light, tone, and power of upper and lower limbs are decreased, then treatment was started as soon as possible, he has not improved after receiving treatment, and the patient is on ventilator support, with treatment continuing until the end of my care. Conclusion: In this study, we primarily focus on professional management, and outstanding nursing care may give the holistic care that Guillain Barre Syndrome requires while also effectively managing the challenging case. The comprehensive health care team collaborates to help the patient achieve their prior level of independence and satisfaction after a full recovery. 

Atypical Form of Cervicofacial Actinomycosis Involving the Skull Base and Temporal Bone

2018 ◽  
Vol 128 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Adam McCann ◽  
Sameer A. Alvi ◽  
Jessica Newman ◽  
Kiran Kakarala ◽  
Hinrich Staecker ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Skull Base ◽  
Temporal Bone ◽  
Soft Tissues ◽  
Trauma Surgery ◽  
Oral Antibiotic ◽  
Facial Skeleton ◽  
Atypical Form ◽  
Unsuccessful Treatment ◽  
The Right

Background: Cervicofacial actinomycosis is an uncommon indolent infection caused by Actinomyces spp that typically affects individuals with innate or adaptive immunodeficiencies. Soft tissues of the face and neck are most commonly involved. Actinomyces osteomyelitis is uncommon; involvement of the skull base and temporal bone is exceedingly rare. The authors present a unique case of refractory cervicofacial actinomycosis with development of skull base and temporal bone osteomyelitis in an otherwise healthy individual. Methods: Case report with literature review. Results: A 69-year-old man presented with a soft tissue infection, culture positive for Actinomyces, over the right maxilla. Previous unsuccessful treatment included local debridement and 6 weeks of intravenous ceftriaxone. He was subsequently treated with conservative debridement and a prolonged course of intravenous followed by oral antibiotic. However, he eventually required multiple procedures, including maxillectomy, pterygopalatine fossa debridement, and a radical mastoidectomy to clear his disease. Postoperatively he was gradually transitioned off intravenous antibiotics. Conclusions: Cervicofacial actinomycosis involves soft tissue surrounding the facial skeleton and oral cavity and is typically associated with a history of mucosal trauma, surgery, or immunodeficiency. The patient was appropriately treated but experienced disease progression and escalation of therapy. Although actinomycosis is typically not an aggressive bacterial infection, this case illustrates the need for prompt recognition of persistent disease and earlier surgical intervention in cases of recalcitrant cervicofacial actinomycosis. Chronic actinomycosis has the potential for significant morbidity.

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 Abdominal Implantation of Testicles in the Management of Intractable Testicular Pain in Fournier Gangrene

2013 ◽  
Vol 98 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Cyrus C. Chan ◽  
Khaled Shahrour ◽  
Ronald D. Collier ◽  
Marlene Welch ◽  
Shiliang Chang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Severe Pain ◽  
Skin Grafts ◽  
Suitable Alternative ◽  
Necrotizing Soft Tissue Infection ◽  
Advantages And Disadvantages ◽  
Testicular Pain ◽  
Fournier Gangrene ◽  
Thickness Skin ◽  
Definitive Management

Abstract Fournier gangrene (FG) is a necrotizing soft tissue infection involving the superficial and fascial planes of the perineum. In many cases of FG, debridement of the scrotum is necessary, leaving definitive management of the exposed testicles a significant surgical challenge. Frequent incidental trauma to the testicles can cause severe pain, especially in laborers. Practical surgical solutions are few and not well detailed. Various options exist, including creating a neoscrotum with adjacent thigh tissue, split-thickness skin grafts (STSGs), or even creating a subcutaneous thigh pocket. We describe a case of abdominal implantation of bilateral testicles for persistent testicular pain in a case where STSGs did not provide adequate protection, adjacent thigh skin was not available for creation of a neoscrotum, and significant cord contracture occurred. We detail the advantages and disadvantages of the commonly described techniques, including this approach, and how in select individuals this may be a suitable alternative.

scholarly journals NEW METHOD FOR RESTORATION OF LOWER FACE

2017 ◽  
Vol 21 (4) ◽  
pp. 207-210
Author(s):  
Mikhail Borisovich Shvyrkov
Keyword(s):  
Soft Tissue ◽  
Trauma Surgery ◽  
Functional Results ◽  
New Method ◽  
Minor Trauma ◽  
Soft Tissue Defects ◽  
Lower Face ◽  
Distraction Device ◽  
The Face ◽  
Tissue Defects

Application of the method developed by the author of the restoration of the lower of the face with his proposed technique free osteoplasty of the mandible in conjunction with komressionno-distraction device (KDD) own design allowed simultaneously to replace extensive bone and soft tissue defects immediately after they are lost or in distant time. Minor trauma surgery postoperative high aesthetic and functional results, allows widely recommend this type of plastic in the practice of maxillofacial surgeons.

scholarly journals MANAGEMENT OF ACQUIRED SOFT TISSUE DEFECTS OF FACE

2020 ◽  
pp. 1-3
Author(s):  
Mehvash Khan ◽  
Shaarang Gupta ◽  
Aayushi Aayushi ◽  
Ratnakar Sharma
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Normal Function ◽  
Soft Tissue Defects ◽  
Recipient Site ◽  
Reconstructive Procedures ◽  
Contour Matching ◽  
Human Bites ◽  
The Face ◽  
Tissue Defects

Background: Since time immemorial, soft-tissue defects of face due to injuries have been documented in literature and even depicted in sculptures, reflecting the image of society. Facial injuries themselves are rarely life-threatening, but are indicators of the energy of injury. Soft-tissue defects of the face can arise out of various causes which may include simple or complex contused lacerations with loss of tissue, avulsions, bites and burns. Common etiologies are road traffic accidents, foreign bodies, defects secondary to tumor excision, homicidal trauma, thermal, chemical and electrical burn, suicidal injuries, human bites, animal bites, gunshot injuries and blast injuries. The management of acquired soft tissue defects of face requires precise planning and coverage by a modality which is functionally and aesthetically pleasant. Objectives: To study the epidemiology of acquired soft tissue defects of face. To restore the aesthetics of the face by resorting to appropriate modality of reconstruction. Materials & Methods: This study was conducted in the Department of Surgery, Govt. Medical College Jammu, J&K, India and included 40 patients having been diagnosed with acquired soft-tissue defects of the face admitted in surgery ward from November 2018 to October 2019 (Prospective study). All the defects were evaluated for size, depth, and status of the base of the defect (presence of gross contamination or infection, integrity, and viability of the wound edges) along with evaluation and documentation of cranial nerve function, particularly the facial and trigeminal nerves. The management depended upon the defect site, size, status and type. 52.5 % patients underwent flap coverage whereas 22.5% underwent skin grafting for coverage of defects. 25% of the patients underwent primary closure of the facial defects. Results: Majority of the patients had restoration of anatomy and normal function after reconstructive procedures with colour and contour matching of that of the recipient site. No major complication was encountered in any of the patients. Conclusion: Acquired soft tissue defects of the face can be reconstructed by a variety of modalities which should not only be functionally adequate but also aesthetically appealing. Flaps are a versatile modality of reconstruction with the choice of flap being governed by the site and size of the defect.

scholarly journals A study on faciomaxillary injuries in a tertiary care hospital

2017 ◽  
Vol 4 (8) ◽  
pp. 2450
Author(s):  
Ravikumar G. ◽  
. Manoharan ◽  
Sugapradha G. R.
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Soft Tissue Injuries ◽  
Treatment Modalities ◽  
Road Traffic Accidents ◽  
The People ◽  
Human Bites ◽  
The Face ◽  
Tissue Injuries

Background: Faciomaxillary injuries are increasing in frequency and severity due to road traffic accidents and violence among the people of the delta districts of Tamilnadu. Alcohol plays a major role both in road traffic accidents and assaults resulting in faciomaxillary injuries. Human bites play a significant role in the soft tissue injuries of the face resulting in loss of lobule of ear, nasal tip loss and partial loss of lower lip. The purpose of this study was to evaluate the aetiology, incidence, patterns and treatment modalities of faciomaxillary injuries which include both soft tissue and bony injuries.Methods: The study was conducted in the Department of Plastic and Reconstructive Surgery of Thanjavur Medical College, Tamil Nadu, India between 2012-2015. About 850 patients in and around the delta districts of Tamilnadu admitted with various soft tissue and bony injuries of the faciomaxillary region were studied. Age, sex, time, mechanism and aetiology of injury, history of bleeding, unconsciousness and prior first aid, type of vehicle and use of preventive measures, type of fracture, associated injuries and treatment modalities were evaluated.Results: Faciomaxillary injuries were mostly due to road traffic accidents. Highest number of fractures was predominantly occurring in the age group of 21-30 years. Males incurred more fractures with a male to female ratio of 7.4:1.1. Fracture mandible was the most common followed by zygoma, nasal and naso ethmoid fractures. Pan facial fractures were more common among alcoholics. 28 patients had associated head injury and 14 patients had cervical spine injuries. Open reduction and internal fixation was the preferred modality for mandible whereas the mid face fractures were treated more often by closed methods. Soft tissue injuries involving ear, nose, lip and eyelids were more common.Conclusions: Drunken driving should be curbed in the society. Educating the people about road safety rules will bring down the faciomaxillary injuries. Motivating the public against violence will reduce human bites and soft tissue injuries of the face. 

scholarly journals A Case Report on Tuberculous Meningitis

2021 ◽  
pp. 274-278
Author(s):  
Shreya Kapgate ◽  
Ranjana Sharma ◽  
Deeplata Mendhe ◽  
Mayur Wanjari
Keyword(s):  
Tuberculous Meningitis ◽  
Health Care Team ◽  
Clonic Seizure ◽  
Nursing Management ◽  
Prodromal Phase ◽  
Case Presentation ◽  
Disease Symptoms ◽  
Comprehensive Health ◽  
T1 Hyperintensity ◽  
One Year

Introduction: The most common cause of tuberculous meningitis is a hematogenous spread of mycobacteria from the lungs. tuberculous meningitis is a fatal disease. Symptoms typically worsen over time, and there are three clinical stages to the disease (prodromal phase, phase of neurological symptoms and phase of paresis) Case Presentation:  The chief complaint of a one-year-old boy was fever, irritability, vomiting, and Generalized Tonic-Clonic Seizure convulsions. The patient's pupils were found to be unequal on physical examination, prompting a repeat neuroimaging. It was done on MRI (magnetic resonance imaging) with T1 hyperintensity on T2 and restricted diffusion on DWI (diffusion-weighted imaging) he has not improved after taking treatment and the patient is on a ventilator as well, we nasogastric tube also. I was receiving treatment and will continue to do so until the end of my care. Conclusion: In our environment, tuberculous meningitis that presents late is not uncommon. It arrived late at our medical facility. After a full recovery, the patient's comprehensive health care team collaborates to help him regain his previous level of independence and satisfaction. This report is intended to raise clinician awareness of tuberculous meningitis' unusual clinical presentation. Tuberculous meningitis is treated holistically with a focus on medical and nursing management.

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