1/4. Anaerobic bacteremia and necrotizing fasciitis in a patient with Crohn's disease.Crohn's disease is a chronic, granulomatous disease that affects the gut that is frequently treated with immunosuppressive therapy. Infectious complications are common and are usually related to the transmural nature of the inflammation, frequently manifesting as abscesses or perianal sepsis. Necrotizing fasciitis has not been reported in Crohn's disease. A case of a fatal necrotizing fasciitis in a patient with Crohn's disease after gut biopsies and corticosteroid therapy is reported.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. Invasive streptococcal infection of the periorbita and forehead.Recent epidemiological reports suggest an increased frequency of invasive streptococcal infections linked to the appearance of a dominant group A Streptococcus serotype. Necrotizing streptococcal infections involving the skin and soft tissues of the face are uncommon. This case demonstrates the aggressive and invasive nature of these infections. The patient presented with symptoms of angioedema and was treated with corticosteroids. Her condition worsened and plastic surgery was consulted. There was extensive necrosis of the periorbital and forehead soft tissue, requiring extensive debridement to control the invasive process. Multiple reconstructive procedures were performed to close the defects and to preserve function of the facial muscles and eyelids. The literature indicates less than 50 reported cases of necrotizing streptococcal infections limited to the periorbita. This case reflects the importance of rapid diagnosis, and emphasizes the need for prompt and appropriate surgical treatment.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. Fatal group A streptococcal necrotizing fasciitis and toxic shock syndrome in a patient with psoriasis and chronic renal impairment.A 78-year-old woman presented with rapid onset of skin pain which evolved into oedema, discoloration and infarction. She was diagnosed with group A beta-haemolytic streptococcus (streptococcus pyogenes) necrotizing fasciitis and streptococcal toxic shock syndrome. The patient had a past history of psoriasis and end-stage renal impairment. Despite treatment with multiple antibiotics in an intensive care unit, the skin infarction involving the upper trunk continued to expand and the patient died within 24 hours of hospital admission. Group A streptococcus and staphylococcus aureus were cultured from a tissue biopsy. Renal failure and compromised skin barrier function are known to predispose to invasive streptococcal infections, but necrotizing fasciitis has only rarely been reported in association with psoriasis. This case illustrates the fulminant nature of the infection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. Cryptococcal necrotizing fasciitis with multiple sites of involvement in the lower extremities.BACKGROUND: Cryptococcal necrotizing fasciitis that is localized to the lower extremities is very rare. OBJECTIVE: We describe a case of a renal transplant recipient who presented with necrotizing fasciitis of the legs caused by cryptococcus neoformans, a fungus that is rarely associated with this disease. methods: This is a case report with literature review. RESULTS: The patient was hospitalized, and the site of infection was debrided to the level of the periosteum. Cultures and histopathologic examination of biopsy material revealed an invasive deep-seated infection with a fungal organism that was consistent with C. neoformans. After 21 days on parenteral amphotericin b (Ambisome; Er-Kim Pharmaceuticals) treatment, the patient was switched to oral itraconazole (Itraspor; Janssen-Cilag Pharmaceuticals) 200 mg/day. He was discharged after 30 days of hospitalization with his wounds completely healed. He continued on oral fluconazole for a total course of 6 weeks. CONCLUSION: Systemic fungal infections continue to be an important cause of morbidity and mortality in transplant recipients. The insidious nature and atypical manifestations of these infections often delay diagnosis and therapy. In immunosuppressed patients, persistent fever that does not respond to antibacterial therapy should alert the physician to the possibility of fungal infection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |