1/133. Unusual presentation of polyarteritis nodosa.We describe an unusual presentation of a localized form of polyarteritis nodosa (PAN) manifested by acute onset of severe calf pain. Biopsies of the gastrocnemius muscle and fascia revealed an acute necrotizing arteritis with fasciitis. The lumens of affected vessels were occluded by thrombi. PAN localized to calf muscles is extremely rare. To our knowledge this is the first report of evidence of fascial involvement believed to contribute to the severity of the clinical features of PAN. The occurrence of multiple intraluminal thrombi in conjunction with anticardiolipin antibodies suggested the possibility of a coexisting coagulopathy, and they were also likely contributors to the severity of the pain.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
2/133. Candida fasciitis following renal transplantation.BACKGROUND: We describe a rare case of necrotizing fasciitis involving candida albicans, an organism that has been reported to have a minimal potential for invasive soft tissue infection. In this case, immunosuppression, chronic renal failure, and a history of diabetes mellitus were predisposing factors. methods: The medical record and histopathologic material were examined. The clinical literature was reviewed for previous cases of C albicans necrotizing fasciitis. RESULTS: A review of the literature showed that in solid organ transplant recipients, localized fungal soft tissue infection is infrequent, with only 35 cases reported between 1974 and 1992. Necrotizing fasciitis caused by C albicans is extremely rare in the modern era of solid organ transplantation. CONCLUSIONS: The management of transplant patients at risk for invasive fungal infection warrants a high index of suspicion for fungal necrotizing fasciitis in the setting of wound infection and merits a thorough investigation for atypical pathogens.- - - - - - - - - - ranking = 3keywords = necrotizing (Clic here for more details about this article) |
3/133. Group A streptococcal fasciitis after submental tumescent liposuction.Tumescent liposuction is a procedure with a good safety record. Local infection is rare but can result in devastating consequences. We report a rare case of group A streptococcal fasciitis complicating tumescent liposuction and highlight the importance of early diagnosis and treatment of this condition. A 62-year-old woman presented 8 days after submental liposuction and a platysmal plication procedure with signs and symptoms of cervical fasciitis. Microbiological analysis confirmed a group A streptococcal infection. By using early aggressive medical and surgical treatments, the disease was arrested before the onset of any necrotizing process. A high index of suspicion is required to make an early diagnosis of this potentially disfiguring and life-threatening infection.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
4/133. Necrotizing myositis and toxic strep syndrome in a pediatric patient.Group A beta hemolytic streptococcus (GABHS) is a common pathogen in infections of skin, soft tissue structures, and muscle. Most infections, when recognized and treated appropriately, result in a benign course. The development of more virulent forms of this organism have resulted in severe life-threatening infections. The following case of an immunocompetent host with necrotizing myositis and septic shock emphasizes the potential morbidity of GABHS infection. The spectrum of soft tissue and muscle infections is reviewed. The pathophysiology and emergency management of septic shock from GABHS is discussed.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
5/133. Necrotizing fasciitis of the neck and chest. Report of a case.A case is presented of necrotizing fasciitis of the neck and chest characterized by rapid progressive necrosis of subcutaneous tissue, fascia and skin. The diagnosis and management is discussed.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
6/133. Necrotizing cervical fasciitis of unknown origin.Necrotizing fasciitis is an acute soft-tissue infection rarely seen in the head and neck area. The case of a 29-year-old female with necrotizing cervical fasciitis of unknown origin is presented. These infections usually result from dental infections; this patient, however, denied any associated dental problems. The patient presented with an erythematous swelling over the anterior neck associated with a choking sensation and an elevated WBC suggestive of acute thyroiditis. After three days of hospitalization the skin over the anterior neck area became necrotic. Surgical debridement of the area was undertaken with significant improvement. Once wound healing had commenced a pedicled flap was used to reconstruct the large defect. Flap selection for closure of the defect is discussed. It is apparent that early recognition and surgical debridement of necrotizing fasciitis is vital to ensure a rapid recovery.- - - - - - - - - - ranking = 2keywords = necrotizing (Clic here for more details about this article) |
7/133. groin infection following cardiac catheterization: a case report.A 56 year old female with insulin dependent diabetes mellitus developed a severe wound infection after a cardiac catherization. The clinical features and treatment of progressive bacterial synergistic gangrene and necrotizing fasciitis are discussed.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
8/133. Necrotizing fasciitis of the neck.Necrotizing fasciitis (N.F.) is a rare but serious infection of subcutaneous tissues and deep fascia with resulting skin gangrene and septicaemia. It is due to mixed anaerobic and aerobic organisms. It has been reported under a variety of synonyms. We describe two cases of necrotizing fasciitis of the neck probably secondary to chronic dental infection, one was diagnosed early and the other late with very different outcomes. We highlight the importance of early and aggressive surgical treatment to complement parenteral antibiotics covering both aerobic and anaerobic organisms.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
9/133. Necrotizing fasciitis of the face without significant trauma.Necrotizing fasciitis is a rare but well recognized clinical entity which most often occurs on the trunk, perineum or legs following surgery or trauma. The condition is much less common in the head and neck and it is particularly uncommon in the midface/periorbital region. In almost all the cases occurring in the neck the condition follows obvious dental or oropharyngeal sepsis and in all the cases of the scalp there is a history of previous surgery or trauma. However, necrotizing fasciitis of the midface/periorbital region may lack any obvious traumatic aetiology or may follow relatively minor trauma. The diagnosis in these cases may not be suspected and treatment may be delayed with fatal consequences. Treatment by wide excision of all affected skin can lead to disastrous cosmetic consequences in facial disease and it is suggested that disease control can be achieved by raising wide based skin flaps with excision of the underlying necrotic tissue. The flaps are then returned onto normal muscle with much improved cosmetic results. This paper discusses the diagnosis and treatment of patients with necrotizing fasciitis of the face which has arisen without significant trauma.- - - - - - - - - - ranking = 2keywords = necrotizing (Clic here for more details about this article) |
10/133. Carcinoma of the sigmoid colon: an unusual cause of Fournier's gangrene.We report a case of perforated adenocarcinoma of the sigmoid colon in an inguinal hernia presenting as Fournier's gangrene. Bowel perforation has been known to cause this disease but, to our knowledge, perforation in an inguinal hernia due to benign or malignant disease has not been reported elsewhere. Gastrointestinal tract perforation should be sought as a potential etiology in patients with necrotizing fasciitis of the genitalia. When such a perforation exists occult malignancy should be ruled out.- - - - - - - - - - ranking = 1keywords = necrotizing (Clic here for more details about this article) |
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