Cases reported "Soft Tissue Infections"

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1/15. vibrio parahemolyticus bacteremia: case report.

    vibrio parahemolyticus (V. parahemolyticus) is a halophilic gram-negative bacillus that lives in the ocean. It is the leading cause of infectious diarrhea in taiwan and sometimes produces soft tissue infections, but it is rarely a cause of bacteremia. There have been only 11 cases reported in the literature. Most of the cases involved a history of ingestion of seafood or exposure to seawater. In addition, those patients were all immunosuppressed, especially with leukemia and cirrhosis. We report a 60-year-old male patient with chronic hepatitis c and adrenal insufficiency. He developed V. parahemolyticus bacteremia following ingestion of seafood one week prior to admission. His condition was complicated with neck and right lower leg soft tissue infection, as well as multiple organ failure. The patient survived after intravenous ceftazidime, oral doxycycline, and surgical debridement. To our knowledge, this is the 12th reported cases on medline, and the second bacteremic case in taiwan. After reviewing the literature, we suggest that all patients with immunosuppressed conditions or adrenal insufficiency should eat foods that are well cooked and avoid raw seafood. Moreover, when patients who are at risk to develop fever, diarrhea, and soft tissue infection after ingestion of seafood, V. parahemolyticus infection should be suspected. All culture specimens should be inoculated on Vibrios selective media.
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keywords = neck
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2/15. A case report of a dactylaria fungal infection in a lung transplant patient.

    Dematiaceous fungi such as Dactylaria gallopava are becoming more prevalent in transplant patients, with 50% of outcomes being fatal. In this report, we describe a 32-year-old woman who presented with swelling in the right shoulder area and right lateral neck. On further investigation with a CT scan, a fluid collection in the shoulder was identified, drained, and subsequently grew D gallopava. We report the successful treatment of an invasive Dactylaria infection in a lung transplant patient predominantly by medical chemotherapy, although surgical incision and drainage was performed on one of the fungal lesions.
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3/15. Necrotizing soft tissue infections of the head and neck: case reports and literature review.

    A small but nevertheless important part of a surgeon's experience comprises necrotizing soft tissue infections of the head and neck. The purpose of this report is to heighten awareness of necrotizing soft tissue infections in any patient with an infection of the head and neck. The article also outlines an appropriate management strategy for use in the treatment of patients with this potentially fatal condition. Prompt diagnosis and early radical surgical debridement are significant factors in avoiding a fatal outcome in these patients. This article reviews the literature on necrotizing soft tissue infections of the head and neck and presents cases from our recent experience.
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4/15. MR spectroscopy in a cervical abscess.

    MR spectroscopy (MRS) has been used to analyse noninvasively tissues at a molecular level. hydrogen and phosphorus MRS have been used for characterisation of intracranial solid and cystic masses, gynaecological tumours and lymph nodes. We report a cystic, tick-walled mass in the soft tissues of the neck. Single-voxel proton MRS revealed a prominent acetate peak at 1.92 ppm and a diagnosis of abscess was suggested. At operation a pyogenic neck abscess was confirmed, with culture of the pus.
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keywords = neck
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5/15. Deep fascial space infection of the neck: a continuing challenge.

    We present our clinical experience with two complex cases of deep fascial space infections of the neck. The first was a case of cervical necrotizing fasciitis involving the submental space. The second was an infection beginning at the soft palate and extending to the anterior mediastinum. Both infections emanated from an oral source in patients with diabetes mellitus, and both patients required multiple surgical debridements and endotracheal intubation for airway protection. Despite the declining incidence of deep space neck infections, our cases illustrate the challenging diagnostic and treatment dilemmas for the clinician managing patients with diabetes.
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keywords = neck
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6/15. Transient hypogammaglobulinemia of infancy presenting as Staphylococcus aureus sepsis with deep neck infection.

    Transient hypogammaglobulinemia of infancy (THI) is characterized by a prolongation and accentuation of the physiologic hypogammaglobulinemia normally occurring during the first 3 to 6 months of life and recovers spontaneously between 18 and 36 months of age. Infants with THI may remain asymptomatic or develop recurrent sinopulmonary infections, but severe or life-threatening infections are rare. We report a case of THI in a previously healthy 1-year-old girl with Staphylococcus aureus sepsis who subsequently developed deep neck infection confirmed by magnetic resonance imaging. Intravenous oxacillin was administered for 21 days and she recovered completely. Immunologic studies were normal except for decreased immunoglobulin g levels. Under the impression of hypogammaglobulinemia with severe infection she received regular intravenous immunoglobulins (IVIG) replacement therapy every 4 weeks. One year later, the immunoglobulin concentrations had returned to the normal range even though IVIG had been discontinued for 4 months. This case report highlights the possibility of severe infection in THI, a disease which usually has a benign clinical course. As the diagnosis of THI can only be made with certainty in retrospect, long-term follow-up of clinical and immune system status is necessary.
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keywords = neck
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7/15. Acute upper airway obstruction caused by stenotrophomonas maltophilia soft tissue infection.

    A previously healthy 71-y-old male developed acute upper airway obstruction caused by a stenotrophomonas maltophilia infection of the mucocutaneous and soft tissue of the neck. Ventilator support was provided via a small-calibre endotracheal tube. Stenotrophomonas was susceptible only to levofloxacin and cotrimoxazole. Antibiotic therapy rapidly improved the soft tissue oedema, allowing extubation and discharge from the intensive care unit.
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keywords = neck
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8/15. Neglected peritonsillar abscess resulting in necrotizing soft tissue infection of the neck and chest wall.

    Necrotizing soft tissue infection (NSTI) of the neck and chest wall resulting from neglected peritonsillar abscess is a relatively rare but highly lethal surgical condition which has received little attention in the literature. The case of a 54-year-old male patient affected by this unusual infection is reported. Our recent experience and literature data suggest that NSTI resulting from peritonsillar abscess is rapidly spreading and life threatening. High index of suspicion, early diagnosis, broad-spectrum antibiotics and aggressive surgical debridement are essential to its successful treatment.
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keywords = neck
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9/15. actinomycosis: a rare soft tissue infection.

    actinomycosis is a chronic and suppurative infection caused by an endogenous Gram-positive bacterium. The usual sites of infection are the head and neck, thorax, and abdomen. Primary cutaneous actinomycosis is very rare and usually associated with external trauma and local ischemia. We report on the case of a primary cutaneous actinomycosis of the thigh in a 34-year-old man. The patient was treated successfully with surgical resection and combined antibiotic therapy, and eventually cutaneous reconstructive surgical procedure.
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10/15. Recurrent neck infection in a person with hiv/AIDS.

    A case of recurrent methicillin-resistant staphylococcus aureus (MRSA) neck infection in an hiv-infected patient is presented. hiv infection is a known risk factor for the development of MRSA infections; this report suggests that hiv infection may also increase the risk of recurrent disease. Among hiv-infected persons, risk factors for MRSA infection include injection drug use, low CD4 cell count, high hiv viral load, sex partners with skin infections, absence of trimethoprim/sulfamethoxazole prophylaxis, and recent receipt of a beta-lactam antibiotic. The diagnosis of MRSA infection should be entertained and the appropriate cultures obtained when hiv-infected persons present with soft tissue infections. Given the rising rates of MRSA infection among hiv-infected persons, empiric antibiotics may be recommended. Since inducible resistance to clindamycin is increasing in MRSA isolates, an erythromycin/clindamycin "D-zone" test should be performed before this antibiotic is used. Educating hiv-infected patients about the risk factors for MRSA infection and hygienic measures to potentially reduce infection is advocated; further studies of preventive strategies in this population are needed.
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keywords = neck
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