11/44. Localised necrosis of scrotum (Fournier's gangrene) in a spinal cord injury patient - a case report.BACKGROUND: Men with spinal cord injury (SCI) appear to have a greater incidence of bacterial colonisation of genital skin as compared to neurologically normal controls. We report a male patient with paraplegia who developed rapidly progressive infection of scrotal skin, which resulted in localised necrosis of scrotum (Fournier's gangrene). CASE PRESENTATION: This male patient developed paraplegia at T-8 level 21 years ago at the age of fifteen years. He has been managing his bladder by wearing a penile sheath. He noticed redness and swelling on the right side of the scrotum, which rapidly progressed to become a black patch. A wound swab yielded growth of methicillin-resistant staphylococcus aureus (MRSA). Necrotic tissue was excised. culture of excised tissue grew MRSA. A follow-up wound swab yielded growth of MRSA and mixed anaerobes. The wound was treated with regular application of povidone-iodine spray. He made good progress, with the wound healing gradually. CONCLUSION: It is likely that the presence of a condom catheter, increased skin moisture in the scrotum due to urine leakage, compromised personal hygiene, a neurogenic bowel and subtle dysfunction of the immune system contributed to colonisation, and then rapidly progressive infection in this patient. We believe that spinal cord injury patients and their carers should be made aware of possible increased susceptibility of SCI patients to opportunistic infections of the skin. Increased awareness will facilitate prompt recourse to medical advice, when early signs of infection are present.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
12/44. Botryomycosis in an hiv-positive subject.A 28-year-old male AIDS patient with generalized painful skin ulcers, fever and malaise presented to us. The differential diagnosis included varicella zoster infection, herpes simplex infection, actinomycosis, sporotrichosis and botryomycosis. Histopathology revealed clusters of gram-positive coccoid bacteria in the deep dermis, surrounded by a mixed dense inflammatory infiltrate. A bacterial culture grew Staphylococcus aureus. Viral cultures remained negative. Based on these findings botryomycosis was diagnosed. Large lesions were excised surgically and with antimicrobial therapy all skin symptoms disappeared. We discuss this case with reference to a short review of the literature on botryomycosis in relation to hiv infection.- - - - - - - - - - ranking = 0.75keywords = infection (Clic here for more details about this article) |
13/44. Identifying the causes of increased wound pain: the role of the tissue viability nurse.A leg ulcer that had stopped healing was causing a patient increased pain. Heavy infection was identified as the cause, and found to be exacerbated by a range of factors. An assessment resulted in treatment changes, leading to complete healing.- - - - - - - - - - ranking = 0.25keywords = infection (Clic here for more details about this article) |
14/44. Group A streptococcal meningitis as a complication of an infected capillary haemangioma.We report a case of group A streptococcal meningitis in an infant resulting from an infected capillary haemangioma. The child suffered significant morbidity including cerebral infarction, epilepsy, and developmental delay. Treatment of infected capillary haemangiomas remains controversial and inconsistent. CONCLUSION: Our experience of this infant, resulting in profound neurological morbidity suggests that group A Streptococcus can be a virulent organism in the young child and that capillary haemangiomas must be treated aggressively at the first sign of infection.- - - - - - - - - - ranking = 0.25keywords = infection (Clic here for more details about this article) |
15/44. Common pathogens and differential diagnosis of skin and soft tissue infections.The major organisms responsible for skin infections are Staphylococcus aureus and streptococcus pyogenes. To produce a disease state, both organisms must overcome the body's natural defenses, adhere to the skin, invade the tissue, and proliferate. Often, endogenous skin microflora can lead to systemic infections, especially in immunocompromised individuals. The differential diagnosis of skin infections is key to successful therapy and requires a thorough knowledge of the patient's clinical history and immune status. Laboratory analysis often can assist in the pathogenic differentiation. Examples of common skin infections are illustrated herein.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
16/44. Toxic shock syndrome occurring in children with abrasive injuries beneath casts.Staphylococcal toxic shock syndrome has been reported in a number of nonmenstrual settings, including orthopedic patients with postoperative staphylococcal wound infections. We describe two cases of toxic shock syndrome in children with focal cutaneous staphylococcal infections occurring beneath casts placed for limb immobilization. These cases illustrate a new and potentially hidden site of staphylococcal infection leading to toxic shock syndrome.- - - - - - - - - - ranking = 0.75keywords = infection (Clic here for more details about this article) |
17/44. A recalcitrant, erythematous, desquamating disorder associated with toxin-producing staphylococci in patients with AIDS.Although staphylococcal infections are common in patients with AIDS, staphylococcal toxin-related disorders have rarely been described. Five cases of a staphylococcal toxin-associated syndrome characterized by prolonged erythema, extensive cutaneous desquamation, hypotension, tachycardia, and multiple organ involvement are described in patients with AIDS. These illnesses were recurrent and recalcitrant with a mean duration of 50 days. Toxic shock syndrome toxin-1-producing staphylococci were isolated from three and staphylococcal enterotoxins B and A from one patient each. Sources of organisms were blood, one patient, and soft tissues and nasal accessory sinuses, two patients each. Three of the five patients died of renal failure and central nervous system abnormalities. One survivor required intubation for respiratory failure. All individuals manifested a marked diminution of CD4 cells. Other laboratory abnormalities included azotemia and prolongation of partial thromboplastin time. oliguria occurred in three patients. Thus, this recalcitrant erythematous desquamative disorder appears to be a variant of staphylococcal toxic shock syndrome in certain subsets of immunocompromised individuals.- - - - - - - - - - ranking = 0.25keywords = infection (Clic here for more details about this article) |
18/44. Bacterial infection-induced generalized Hailey-Hailey disease successfully treated by etretinate.Hailey-Hailey disease (HHD; familial benign chronic pemphigus) is a hereditary blistering disorder characterized by episodic maceration and erosions mainly in intertriginous areas, and generalized eruptions are rarely seen. We report here a 51-year-old woman with generalized HHD who was successfully treated with oral etretinate. The present case suggests that oral etretinate is effective against the generalized eruptions even in cases in which bacterial infection has triggered the generalization of HHD.- - - - - - - - - - ranking = 1996.4983382531keywords = bacterial infection, infection (Clic here for more details about this article) |
19/44. Management of a difficult-to-heal chronic wound infected with methycillin-resistant staphylococcus aureus in a patient with psoriasis following a complex knee surgery.This report presents the difficulties encountered in managing a wound colonized with methycillin-resistant Staphylococcus aureus (MRSA) following a complex knee surgery in an elderly female patient with generalized psoriasis. The patient's chronic wound was successfully treated with nanocrystalline silver-releasing dressings (Acticoat). The patient did not develop a deep-seated infection, nor was removal of the implant needed. However, the wound infection persisted for 6 months. At 3 years follow-up, the patient has satisfactory skin over the implant on the knee.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
20/44. Community-acquired methicillin-resistant staphylococcus aureus skin infection presenting as a periumbilical folliculitis.Community-acquired methicillin-resistant staphylococcus aureus (CAMRSA) infection is a clinical problem of increasing global incidence. CAMRSA most commonly presents as abscess and cellulitis of the skin and soft tissue. However, the lesions of cutaneous CAMRSA infection are pleomorphic and may appear as erythematous pustules of superficial folliculitis. This report presents the cases of 2 patients with CAMRSA skin infection that presented as a superficial folliculitis. The distribution of CAMRSA-related, erythematous, folliculocentric pustules was periumbilical, in contrast to the lesional location of methicillin-susceptible S. aureus (MSSA)-associated folliculitis, which typically appears on the axillae, bearded area, buttocks, and extremities. CAMRSA should be considered in the diagnosis of periumbilical folliculitis or superficial folliculitis arising in areas not typically affected by MSSA-related folliculitis, such as the chest, flanks, and scrotum.- - - - - - - - - - ranking = 1.75keywords = infection (Clic here for more details about this article) |
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