1/122. rhinosporidiosis presenting with two soft tissue tumors followed by dissemination.rhinosporidiosis is caused by rhinosporidium seeberi. Most mycologists believe that R. seeberi is either a Chytridium related to the Olpidiaceae (order Chytridialis, class Chytridiomycetes) or a Synchytrium. This is the first documented case of tumoral rhinosporidiosis in a Sri Lankan and the third documented case in the world literature. A 44 year old male presented with a large mass above the thigh and a similar mass over the anterior chest wall, both masses contained R. seeberi. Later examination of the patient revealed nasal polyps, confirming that the tumors were due to systemic spread of this infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/122. Mohs micrographic surgery for fungal soft tissue infections.BACKGROUND: Invasive fungal infections of the integument are relatively rare. In the immunocompromised patient, however, they may show an extremely aggressive biological behavior despite high dosed topical or systemic antifungal therapy. As the fungal tissue invasion usually reaches well beyond the area of clinical necrosis or other visible changes, standard surgical excision often proves to be inadequate, resulting in the need for repeated relatively wide excisions with the resulting substantial loss of initially healthy tissues. OBJECTIVE: To present the use of mohs surgery as a safe and effective treatment modality for invasive fungal infections in a patient with a zygomycetes infection of his scalp. RESULTS: The micrographic excision of the highly aggressive fungal infection, the acute postoperative course, and the delayed reconstruction with a split-thickness skin graft were all well tolerated without complications. CONCLUSION: Mohs micrographic excision deserves serious consideration in the treatment of aggressive localized fungal infections.- - - - - - - - - - ranking = 9keywords = infection (Clic here for more details about this article) |
3/122. aeromonas sobria infection with severe soft tissue damage and segmental necrotizing gastroenteritis in a patient with alcoholic liver cirrhosis.A 49-year-old man, who had a 3-year history of liver dysfunction but had not been treated, was admitted to the hospital with a sudden onset of fever and generalized muscle pain. He subsequently developed generalized purpura with scattered hemorrhagic bullae of the skin and massive bloody stools. aeromonas sobria was proven by culture of both blood and bullous fluid. In spite of the extensive treatment with antibiotics and other medications in the intensive care unit (ICU), the patient went into septic shock and died 2 days after admission. Pathological examination on autopsy revealed segmental necrotizing gastroenteritis with bacterial colonies and alcoholic liver cirrhosis, in addition to extensive severe soft tissue damage involving cellulitis and rhabdomyolysis and epidermolysis. Although the prognosis for vibrio vulnificus infection with severe soft tissue damage in patients with liver cirrhosis, malignancy, diabetes mellitus or other pre-existing diseases is poor, the unfavorable progression of aeromonas species, especially A. sobria infection is rare. This is thought to be the first report of an autopsied case.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
4/122. Rhinocerebral mucormycosis: report of two cases.Rhinocerebral mucormycosis is a rare opportunistic infection caused by fungi. It is commonly fatal and aggressive infection localised paranasal sinuses and orbit. We report two cases had necrotising infection on the left nasolabial region. Despite aggressive surgical debridement and medical treatment, the patients died 6 and 7 days after admission. Plastic Surgeons should be aware when they have a patient with rapidly developing soft tissue infection over the paranasal sinuses and periorbital region. Combined treatment is mandatory for these patients. It usually results in death, but powerful efforts may save the patient.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
5/122. Vibrio parahemolyticus bacteremia: case report.Vibrio parahemolyticus (V. parahemolyticus) is a halophilic gram-negative bacillus that lives in the ocean. It is the leading cause of infectious diarrhea in taiwan and sometimes produces soft tissue infections, but it is rarely a cause of bacteremia. There have been only 11 cases reported in the literature. Most of the cases involved a history of ingestion of seafood or exposure to seawater. In addition, those patients were all immunosuppressed, especially with leukemia and cirrhosis. We report a 60-year-old male patient with chronic hepatitis c and adrenal insufficiency. He developed V. parahemolyticus bacteremia following ingestion of seafood one week prior to admission. His condition was complicated with neck and right lower leg soft tissue infection, as well as multiple organ failure. The patient survived after intravenous ceftazidime, oral doxycycline, and surgical debridement. To our knowledge, this is the 12th reported cases on medline, and the second bacteremic case in taiwan. After reviewing the literature, we suggest that all patients with immunosuppressed conditions or adrenal insufficiency should eat foods that are well cooked and avoid raw seafood. Moreover, when patients who are at risk to develop fever, diarrhea, and soft tissue infection after ingestion of seafood, V. parahemolyticus infection should be suspected. All culture specimens should be inoculated on Vibrios selective media.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
6/122. 'Popping': a cause of soft tissue sepsis in chronic drug abusers.Septic complications arising from drug misuse are well documented. It is likely that most complications occur as a result of attempted intravenous (i.v.) injection. We report four cases of soft tissue infections where the patients were unable to obtain i.v. access and gave injections of drugs using a technique known as 'popping'. 'Popping' is the deliberate injection of drugs subcutaneously or intramuscularly when i.v. access is not possible. This practice is further discussed and the literature associated with soft tissue infections from drug misuse is reviewed.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
7/122. Localized Mycobacterium genavense soft tissue infection in an immunodeficient hiv-negative patient.An hiv-negative woman with chronic lymphopenia related to past sarcoidosis situated in the bone marrow presented with an inflammatory lesion in the iliac region due to a localized Mycobacterium genavense soft tissue infection. The lesion resolved after 12 months of antibiotic therapy with clarithromycin, ethambutol and ciprofloxacin. The patient had no recurrence of the subcutaneous abscess during a follow-up period of 14 months after the end of the treatment.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
8/122. mycobacterium marinum hand infection: case reports and review of literature.Three patients with mycobacterium marinum infection are described. Key elements in the diagnosis of this infection are a high index of suspicion, taking a history with an emphasis on exposure to tropical fish or other potential sources of M. marinum infection, and tissue biopsy for culture and histology. The microbiologist should be informed about the suspicion of M. marinum infection so that appropriate cultures can be performed. As M. marinum does not grow under routine culture conditions, the diagnosis is easily missed resulting in delayed treatment. The treatment is essentially antimicrobial therapy for the superficial lesions supplemented by an appropriate surgical debridement especially when deep structures are involved.- - - - - - - - - - ranking = 8keywords = infection (Clic here for more details about this article) |
9/122. staphylococcus lugdunensis: report of first case of skin and soft tissue infection in singapore.We report the first case of skin and soft tissue infection due to Staphylococcus lugdunensis in singapore. This is a coagulase negative Staphylococcus species known to cause a wide variety of more serious infections--brain abscess, sepsis, chronic osteomyelitis and infective endocarditis.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
10/122. limb salvage of lower-extremity wounds using free gracilis muscle reconstruction.An extensive series reviewing the benefits and drawbacks of use of the gracilis muscle in lower-extremity trauma has not previously been collected. In this series of 50 patients, the use of microvascular free transfer of the gracilis muscle for lower-extremity salvage in acute traumatic wounds and posttraumatic chronic wounds is reviewed. In addition, the wound size, injury patterns, problems, and results unique to the use of the gracilis as a donor muscle for lower-extremity reconstruction are identified. In a 7-year period from 1991 to 1998, 50 patients underwent lower-extremity reconstruction using microvascular free gracilis transfer at the University of maryland shock Trauma Center, Johns Hopkins Hospital, and Johns Hopkins Bayview Medical Center. There were 22 patients who underwent reconstruction for coverage of acute lower-extremity traumatic soft-tissue defects associated with open fractures. The majority of patients were victims of high-energy injuries with 91 percent involving motor vehicle or motorcycle accidents, gunshot wounds, or pedestrians struck by vehicles. Ninety-one percent of the injuries were Gustilo type IIIb tibial fractures and 9 percent were Gustilo type IIIc. The mean soft-tissue defect size was 92.2 cm2. Successful limb salvage was achieved in 95 percent of patients. Twenty-eight patients with previous Gustilo type IIIb tibia-fibula fractures presented with posttraumatic chronic wounds characterized by osteomyelitis or deep soft-tissue infection. Successful free-tissue transfer was accomplished in 26 of 28 patients (93 percent). All but one of the patients in this group who underwent successful limb salvage (26 of 27, or 96 percent) are now free of infection. Use of the gracilis muscle as a free-tissue transfer has been shown to be a reliable and predictable tool in lower-extremity reconstruction, with a flap success and limb salvage rate comparable to those in other large studies.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
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