1/18. dermatomyositis with tuberculous fasciitis.A case of dermatomyositis with tuberculous fasciitis is described. A 69-year-old Japanese man treated with prednisolone for dermatomyositis developed erythema and bilateral swelling of arms and forearms. A diagnosis of tuberculous fasciitis was confirmed by the presence of acid-fast bacilli in a biopsy specimen and the growth of mycobacterium tuberculosis from tissue cultures. The unusual presenting clinical features resulted in delayed diagnosis. We emphasize that tuberculous fasciitis should be considered in an immunocompromised patient who is treated with steroids, especially if the results of initial treatment are not satisfactory.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
2/18. Necrotizing fasciitis of the eyelids.Necrotizing fasciitis is a destructive soft tissue infection that rarely involves the eyelids. Three cases of necrotizing fasciitis of the eyelids are described. Necrotizing fasciitis was preceded by minor forehead soft tissue trauma in two cases and occurred spontaneously in one. In two patients necrotizing fasciitis was bilateral and involved both the upper and lower eyelids. review of these cases, in addition to 18 cases previously reported in the English literature, reveals a predominance in females, preceding minor local soft tissue trauma, frequent bilateral involvement, and an association with alcohol abuse and diabetes. In all of the patients, group A beta-hemolytic streptococci were cultured from the wound. Early recognition of the disease process, prompt surgical debridement of the necrotic tissue, aggressive antimicrobial therapy, and delayed skin grafting combine to minimize morbidity.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
3/18. fasciitis necroticans of the head: a rare localization.A 61-year-old diabetic woman was admitted with high fever, dehydration and acidosis caused by fasciitis necroticans of the forehead. The electrolytes and blood sugar level were corrected, broad spectrum antibiotics started and extensive debridement performed, followed by a second-look operation the next day. After the bacterial culture was known, the antibiotics were adapted. A split-skin graft gave an acceptable result.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
4/18. Eosinophilic fasciitis. Increased collagen production and type I procollagen messenger rna levels in fibroblasts cultured from involved skin.Two patients with eosinophilic fasciitis were studied to elucidate the activation of collagen production in this disorder. Histologic examination of biopsy specimens from the involved area of skin revealed the presence of inflammatory cell infiltrates and various degrees of collagen accumulation in the dermis, subcutis, fascia, and underlying muscle. Fibroblast cultures initiated from the involved skin exhibited 2.0- to 3.7-fold increased collagen production when compared with control fibroblast cultures established from the uninvolved skin of the same patients. Eosinophilic fasciitis fibroblasts also displayed 2.4- to 6.2-fold higher steady-state levels of type I procollagen messenger rna than did the control cells, indicating pretranslational activation of type I procollagen gene expression. In addition, cellular fibronectin messenger rna steady-state levels were elevated 1.9- to 3.3-fold in eosinophilic fasciitis fibroblasts. These results suggest that fibroblasts in the involved skin of patients with eosinophilic fasciitis exhibit an activated phenotype, similar to that of scleroderma fibroblasts, leading to accumulation of collagen in the skin and the underlying structures.- - - - - - - - - - ranking = 6keywords = culture (Clic here for more details about this article) |
5/18. Bacterial gangrene on the cheek of a comatose patient--necrotizing fasciitis or noma.A 68-year-old Japanese woman with sepsis developed a gangrene on her left cheek from a small wound in contact with a gastric tube. klebsiella pneumoniae was cultured from the sputum, wound, and the blood and was assumed to be responsible for this condition, possibly through thrombosis of an artery.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
6/18. Postoperative necrotizing fasciitis in children.Necrotizing fasciitis is a rapidly progressive soft tissue infection, involving the skin, subcutaneous tissue, and superficial fascia. It is a rare but life-threatening complication in the postoperative patient. In the last 7 years, we have treated four children in whom necrotizing fasciitis developed after appendectomy for ruptured appendix, bilateral inguinal herniorrhaphy, or gastrostomy closure. These four patients and seven well-described children from the literature with necrotizing fasciitis following surgery form the basis of this review. The ages ranged from six days to 15 years (mean 4.5 years). There were eight boys and three girls. There were five clean, five clean-contaminated, and one contaminated surgical procedures. No patient had evidence of malignancy or diabetes. Two of our four patients had evidence of failure to thrive. Only one patient had an intraabdominal abscess. In ten, the infection started in the abdominal wall; in one, the infection started in the chest wall. In our four patients, three had neutropenia and fever, four had tachycardia, and two had wound crepitation and radiographic evidence of subcutaneous gas. Cultures of all ten wounds were positive for bacteria; six were positive for more than one organism. blood culture results were positive in five of five patients who died and in only two of five patients who survived. All survivors had wide surgical debridement and were treated with broad-spectrum antibiotics. The mortality rate was 45% in the whole series.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
7/18. Necrotizing fasciitis. A report of five patients.Five patients with necrotizing fasciitis are reported. Streptococci were isolated in all but one patient, in whom staphylococcus albus was responsible. Other organisms were also isolated in culture. Surgical debridement and skin grafting were needed in all our patients, in addition to systemic antibiotics and topical treatment, comprising Eusol paraffin soaks. One patient developed this condition after a skin biopsy; another had chronic venous leg ulcer. There was no predisposing cause in the remaining three patients.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
8/18. Fatal necrotizing fasciitis following suction-assisted lipectomy.Forty-eight hours following extensive blunt suction lipectomy with 3,000 cc of tissue removed, a 36-year-old woman presented to an emergency room with necrotizing fasciitis of both lower extremities extending over the buttock and to the lower third of the back. Tissue cultures and blood culture grew out a pure culture of beta-hemolytic streptococci. The patient rapidly progressed into a comatose state and, despite extensive debridement and appropriate antibiotic therapy, in addition to hyperbaric oxygen treatments, she died on day 9 of her hospitalization (day 11 following the suction lipectomy). To our knowledge this is the first published mortality reported in the united states following this procedure.- - - - - - - - - - ranking = 3keywords = culture (Clic here for more details about this article) |
9/18. The practical management of Fournier's gangrene.Effective early treatment of this serious condition is necessary to prevent death. Urgent exploration by the most experienced surgeon available should include wide excision of all necrotic or dubious tissue, and adequate drainage of deep fascial planes. Deep and apparently healthy tissues must be exposed and the surgeon must be prepared to proceed to laparotomy, and even diverting colostomy and/or suprapubic cystotomy when necessary. Cross matched blood must be available, and we have found hydrogen peroxide irrigation useful. Pus, tissues, and blood samples for bacteriological culture and sensitivity should always be sent, but broad spectrum antibiotics should be started without delay to prevent systemic complications. In addition to the urgent initial surgery, repeated daily examination of all wounds is necessary, usually under general anaesthesia to allow full inspection, further debridement, irrigation and change of dressings, until the infective process is halted. This is a serious condition with a high mortality which we believe may be reduced by early diagnosis and appropriate aggressive surgery.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
10/18. Tuberculous fasciitis with tenosynovitis.A case of tuberculous fasciitis with tenosynovitis is described. No other organs were affected and tissue histology was not diagnostic. The diagnosis was confirmed by tissue culture and our patient was treated by surgical debridement and antituberculous drug therapy. A high index of suspicion for tuberculosis will alert clinicians to the correct diagnosis in unusual clinical presentations.- - - - - - - - - - ranking = 1keywords = culture (Clic here for more details about this article) |
| | Next -> |