1/39. Vesicular carcinoma erysipelatodes. carcinoma erysipelatodes, also known as inflammatory metastatic carcinoma, is a type of cutaneous metastatic disease. We describe a 64-year-old woman with metastatic breast carcinoma who presented with a blistering erythematous eruption resembling erysipelas with formation of vesicles and bullae. She was found to have carcinoma erysipelatodes with a formation of vesicles and bullae. ( info) |
2/39. Anal colonization of group G beta-hemolytic streptococci in relapsing erysipelas of the lower extremity. Four patients who had frequent relapses of erysipelas but no obvious portal of entry and no beta-hemolytic streptococci in specimens from conventional culture sites all had group G streptococci in cultures of specimens from the anal canal. It is suggested that anal colonization with group G streptococci, and possibly group A and other beta-hemolytic streptococci, may constitute a reservoir for streptococci in such cases. ( info) |
3/39. Cutaneous (non-hiv) infections. Cutaneous infections continue to represent a large proportion of inpatient dermatology. Though most infectious skin diseases do not warrant hospitalization, some do and can rapidly become fatal if not treated promptly. A selected group of infections are reviewed--primary cutaneous infections, exotoxin-mediated syndromes, and systemic infections--that warrant hospitalization. Dermatologists play a critical role in the synthesis of patient history and appreciation of morphologic skin disease, which, when coupled with appropriate lab tests, may help to establish a diagnosis allowing for the timely implementation of effective and targeted therapy. ( info) |
| familial mediterranean fever (FMF) is frequently accompanied by erysipelas-like attacks. These should alert the physician to the correct diagnosis of this systemic disease. Several other nonspecific skin lesions may be seen in FMF. To our knowledge, histologic findings in erysipelas-like skin rashes seen in FMF are not reported elsewhere in the literature. ( info) |
| BACKGROUND: Case description of a patient who developed erysipelas of the surgical wound following appendectomy for acute appendicitis, and literature review of invasive group B streptococcal infections. methods: A 65-year-old man with perforated appendicitis underwent urgent appendectomy and drainage. antibiotic prophylaxis with tobramycin (100 mg) and metronidazole (500 mg) was administered. At surgery, a phlegmon was identified with free perforation of the appendix and purulent peritoneal fluid. appendectomy, irrigation with 0.9% NaCl solution, and drainage with a Silastic closed-suction drain was performed. A literature search in all languages was performed using medline, using the search terms surgical site infection, wound infection, group B streptococcus, streptococcus agalactiae, necrotizing fasciitis, and postoperative infection. RESULTS: erysipelas of the surgical wound developed on the fourth postoperative day. Intravenous penicillin and amoxicillin/clavulanic acid were administered empirically. culture of the wound drainage identified streptococcus agalactiae and a few colonies of escherichia coli. The broad-spectrum antibiotic was discontinued, and a 10-day course of penicillin was completed. CONCLUSIONS: erysipelas of the surgical wound is unusual, and infection with group B streptococci is rare compared with infection by group A streptococci. streptococcus agalactiae is recognized to be increasingly virulent, with an increasing predilection for bacteremic infections in healthy hosts. Although streptococcus agalactiae remains highly susceptible to antimicrobial agents effective against gram-positive cocci, the changing epidemiology and potentially invasive nature of these infections should have clinicians alert to the possibility of infection caused by group B streptococci. ( info) |
6/39. Acute erysipelatous oedema in the scrotum. We present a case of penile and scrotal oedema in a young man. Although oestradiol treatment and compression bandaging provided some relief from the symptoms, neither therapy was ideal. Triangular resection of the foreskin was therefore performed, although the oedema persisted. The aetiology of the condition remains unknown. ( info) |
7/39. Angiosarcoma in a chronically lymphedematous leg: an unusual presentation of Stewart-Treves syndrome. Angiosarcoma arising from chronic lymphedema is referred to as Stewart-Treves syndrome. It typically occurs as a complication of long-lasting lymphedema of the arm after mastectomy and/or radiotherapy for breast cancer. Angiosarcoma associated with idiopathic lymphedema of the lower extremity is extremely rare. We report a case of diffuse angiosarcoma of the leg in a patient with a 25-year history of idiopathic lymphedema. Despite rapid aggressive surgical treatment, the patient died 6 weeks after diagnosis. ( info) |
8/39. Osteoarticular complications of erysipelas. BACKGROUND: Rare osteoarticular complications occurring after erysipelas have been reported. We describe 9 patients in whom various osteoarticular complications developed during erysipelas. OBJECTIVE: We sought to analyze osteoarticular complications during erysipelas, paying special attention to clinical, bacteriologic, and radiologic data. methods: Data were retrospectively recorded from the files of patients seen in 3 dermatologic centers between 1998 and 2000. They included laboratory tests, bacteriologic cultures, radiologic investigations, and treatment modalities and outcome of both erysipelas and osteoarticular complications. RESULTS: We observed 9 patients (7 men and 2 women; mean age 49.6 years) who first presented with typical erysipelas of the lower limb and then osteoarticular complications developed during the course of their disease, always localized to a joint contiguous to the erysipelas plaque. These complications included: relatively benign complications, ie, bursitis (n = 5) or algodystrophy (n = 1), occurring after erysipelas with favorable course; and more severe complications, ie, osteitis (n = 1), arthritis (n = 1), and septic tendinitis (n = 1), occurring after erysipelas characterized by local cutaneous complications (abscess, necrosis). CONCLUSIONS: Osteoarticular complications of erysipelas can be divided into the 2 groups of nonseptic complications (mainly bursitis), which are characterized by a favorable outcome, and septic complications (osteitis, arthritis, tendinitis), which require specific, often prolonged treatment and, sometimes, operation. Their diagnosis is on the basis of clinical and radiologic findings rather than joint aspirations, which are usually not possible through infected skin tissue. ( info) |
9/39. Common infections in clinical practice: dealing with the daily uncertainties. Common infections we see every day in the office--urinary tract infections, vaginitis, upper respiratory tract infections, and soft-tissue infections--present a number of diagnostic and treatment uncertainties. In this age of growing antibiotic resistance, these include if and when to start antibiotic therapy, and which agents to use. ( info) |
10/39. Arthroscopic treatment of septic arthritis in a patient with posterior stabilized total knee arthroplasty. We report on a case of arthroscopic treatment of septic arthritis of the knee in a 73-year-old woman with a posterior stabilized knee endoprosthesis. Six months after arthroplasty of the right knee joint because of osteoarthritis, the patient experienced an erysipelas of the right lower leg after a cat bite. Although given intravenous antibiotic therapy, the patient developed septic arthritis of the right knee. pasteurella multocida could be identified as the causative organism. The joint infection was classified as stage I according to Gachter. Via arthroscopic joint debridement, partial synovialectomy, the use of continuous irrigation-suction drains, and intravenous antibiotic therapy, the empyema could be cured without removal of the total endoprosthesis of the right knee. ( info) |