1/420. Chronic clostridium septicum infection of a tibial fracture: a case report. An open transverse fracture of the mid-shaft of the tibia of a professional footballer became infected by clostridium septicum and, after early compression plating, required surgical intervention on three further occasions and extensive antibiotic treatment before healing occurred. Clostridial infection is a recognized complication of open fractures contaminated with soil, and the necrotizing toxins produced by the C. septicum were probably responsible for the persistence of this infection. Infection occurred in less than 1 per cent of our series of 215 operations of compression plating of fresh fractures of the tibial shaft. Infection by clostridium species is a serious complication of open fractures. This patient did not show the spreading inflammation and necrosis, or the marked systemic upset, characteristic of acute clostridial infection, but persistent local infection necessitated prolonged surgical and antibiotic treatment. ( info) |
2/420. Marine vibrios associated with superficial septic lesions. Three cases are reported in which a marine vibrio, vibrio alginolyticus, was isolated from superficial septic lesions. All cases had been exposed to sea-water. The possible significane of these findings and the need for further investigations are discussed. ( info) |
3/420. Induction of a critical elevation of povidone-iodine absorption in the treatment of a burn patient: report of a case. A critical elevation of povidone-iodine absorption which occurred in a burn patient who was topically treated with 10% povidone-iodine (PI) gel is herein reported. A 65-year-old man was admitted to our hospital for deep second- and third-degree burns covering 26% of his total body surface area. The intravenous administration with lactated Ringer's solution and topical treatment with silver sulfadiazine were applied in addition to such treatments as debridement and skin grafting. However, wound infection occurred due to pseudomonas aeruginosa. Topical treatment with PI gel was effective for this condition. Persistent nodal bradycardia with hypotension, metabolic acidosis, and renal failure occurred 16 days after the start of PI gel treatment. Iodine toxicosis caused by PI gel was suspected with a serum iodine level of 20600 microg/dl (normal range 2-9 microg/dl). The PI gel treatment was therefore discontinued immediately, and hemodialysis was scheduled. However, the patient's family refused hemodialysis and he died 44 days after admission. To our knowledge, only eight patients with iodine toxicosis have been reported in burn patients treated with PI gel. ( info) |
4/420. Fulminant infection by uncommon organisms in animal bite wounds. In 1995 and 1996, 215 patients exposed to different species of animals were treated at the Amarnath Polyclinic, Balasore, in india. Among them were two children infected by uncommon organisms, i.e., capnocytophaga canimorsus and pasteurella multocida; the patients recovered with appropriate antibiotic therapy. ( info) |
5/420. Primary cutaneous nocardiosis in a husband and wife. A 62-year-old woman suffered from acute purulent skin disease with multiple subcutaneous abscesses. At the same time, her 65-year-old husband presented with multiple subcutaneous nodules along the lymphatic vessels of his right arm. Both had a history of a minor scratch by a thorn of a bush at the site of infection. nocardia was identified as causative bacterium from the woman's lesions. Therefore the rare phenomenon of 2 different forms of acute primary cutaneous nocardiosis after simultaneous infection, lymphocutaneous infection, and superficial skin infection was diagnosed. ( info) |
6/420. A human bite. We report the transmission of group A streptococci by a human bite leading to severe necrotising fasciitis. Rapid surgical and antibiotic treatment led to healing without fractional loss of the patient's infected leg. ( info) |
7/420. neisseria canis infection: a case report. The third case report, which is the first in australia, of human infection with neisseria canis is documented. This is the first case report in which the pathogenicity of this organism for humans is unequivocally demonstrated. ( info) |
| methemoglobinemia is a rare complication in individuals exposed to nitrates or nitrites. Whereas methemoglobinemia is a recognized potential complication in burn patients treated with topical 0.5% silver nitrate solution, no report of methemoglobinemia in burn patients has been present in the literature for more than 15 years. We raise consciousness about this complication with a case report of a 12-month-old child with necrotizing fasciitis resulting from a cutaneous flank infection. The patient developed cyanosis 20 days after initiation of topical treatment with 0.5% silver nitrate solution. Intravenous injection of methylene blue can restore normal blood oxygenation. ( info) |
9/420. Accidental hanging with delayed death in a lift. While hanging is a common method of committing suicide in india, accidental hanging is uncommon. However, it does occur when people are engaged in auto-erotic practices. An adult male who was helping passengers trapped in the lift of an outpatient department at a teaching hospital was accidentally hanged. He survived for 39 days. This case highlights a rare but serious hazard in the use of lifts. ( info) |
10/420. Usefulness of procalcitonin in Pseudomonas burn wound sepsis model. Procalcitonin (PCT), a precursor of calcitonin, and endotoxin were determined in the burn wound sepsis model in which 21 Sprague-Dawley rats were scalded approximately 30% on their back. On day 2 post burn, the wounds were inoculated 1 x 10(8) colony-forming units of pseudomonas aeruginosa. On day 5 post burn P. aeruginosa was detected by blood culture in 10 of the 21 rats (47.6%). The mortality rate 7 days after burn was 90.5%. Significant correlations were observed between serum endotoxin levels and serum PCT levels on day 5 post burn (r = 0.860, p<0.001). It was suggested that endotoxin may induce the release of PCT and that measuring the levels of PCT may be useful in diagnosing burn wound sepsis. ( info) |