1/4. Clostridial myonecrosis cluster among injection drug users: a molecular epidemiology investigation.A molecular epidemiologic investigation was performed on a cluster of severe necrotizing clostridium infections in 5 injection drug users admitted to an urban community hospital. Interviews with survivors suggested a point source of infection. Pulsed-field gel electrophoresis of SmaI restriction digests was performed to determine the molecular relatedness of clinically obtained isolates and isolates obtained from heroin samples and the home environment. A common clonal strain was found in clostridium sordellii isolates from 2 socially unrelated patients and from drug paraphernalia. Clonality of a clostridium perfringens strain from another patient isolate was identical to an isolate from a syringe found in her home. Other C perfringens isolates from patients, heroin, and the environment were determined to be polyclonal. We postulate that rapid recognition and public health notification led to rapid resolution of the outbreak.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/4. Locally invasive cutaneous Apophysomyces elegans infection acquired from snapdragon patch test.Apophysomyces elegans is an environmental fungus related to other well-known agents of zygomycosis. We report a case of locally invasive A elegans soft tissue infection resulting from the application of a skin patch to test for snapdragon sensitivity. The infection was limited to skin and soft tissue, and treatment consisted of local debridement and liposomal amphotericin b. Outcome was successful.- - - - - - - - - - ranking = 0.5keywords = environment (Clic here for more details about this article) |
3/4. Hand infections caused by delayed inoculation of vibrio vulnificus: does human skin serve as a potential reservoir of vibrios?vibrio vulnificus may cause severe soft tissue infections of the upper extremity. This pathogen usually gains access to soft tissues either by direct inoculation through a penetrating injury by an infected marine animal or by exposing abraded skin to contaminated water. We report five patients with vibrio vulnificus hand infections following superficial hand injuries incurred within 24 hours after uneventful handling of fish. This clinical observation, together with the fact that the physiologic characteristics of human sweat simulate the natural environment of the vibrio vulnificus, support the assumption that human skin may serve as a reservoir for Vibrios. The anamnesis in patients presenting with hand infection should essentially include an inquiry regarding recent, albeit uneventful, fish handling.- - - - - - - - - - ranking = 0.5keywords = environment (Clic here for more details about this article) |
4/4. aeromonas hydrophila--its implications in freshwater injuries.lacerations or puncture wounds sustained in freshwater environments are susceptible to contamination by aeromonas hydrophila. Numerous cases have been reported of cellulitis secondary to water-related injuries requiring hospitalization where A. hydrophila was the isolated organism. The typical presentation of an infection of A. hydrophila mimics a streptococcal soft tissue infection, which may result in delay in administration of appropriate antibiotics. A case is presented of a nonimmunocompromised patient who developed an A. hydrophila infection following freshwater-related injuries.- - - - - - - - - - ranking = 0.5keywords = environment (Clic here for more details about this article) |