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    4407 results match your criteria Necrotizing Fasciitis

    1 OF 89

    Emphysematous osteomyelitis of the forefoot.
    Proc (Bayl Univ Med Cent) 2018 Jan 8;31(1):100-101. Epub 2017 Dec 8.
    Department of Radiology, Yale New Haven Health Bridgeport Hospital, Bridgeport, Connecticut.
    Emphysematous osteomyelitis is a very rare, potentially fatal infection that requires immediate diagnosis and prompt treatment. Emphysematous osteomyelitis is usually considered whenever intraosseous gas is detected on imaging. Most organisms implicated in emphysematous osteomyelitis are members of the Enterobacteriaceae family or anaerobes; sometimes the infection is polymicrobial. Read More

    Necrotizing Fasciitis of the Neck due to an Odontogenic Infection: A Case Report.
    J Infect Chemother 1996 5;2(4):290-293. Epub 2014 Apr 5.
    Department of Dentistry and Oral Surgery, Iwaki Kyoritsu Hospital, Iwaki, Japan.
    Deep fascial space infections of the neck are most frequently odontogenic in origin. We describe a case of odontogenic infection of the mandible which extended to the lateral pharyngeal space and resulted in a severe life-threatening necrotizing fasciitis of the neck. A 69-year-old nondiabetic male complained of dysphagia and a severe toothache of the lower left molar and was transported to the emergency ward. Read More

    Human streptococcal necrotizing fasciitis histopathology mirrored in a murine model.
    Am J Pathol 2018 Apr 20. Epub 2018 Apr 20.
    Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Rämistrasse 100 U RAE, 8091 Zürich, Switzerland. Electronic address:
    Streptococcal necrotizing fasciitis (NF) causes high morbidity and mortality despite state-of-the-art therapy. Low incidence and rapid disease progression, necessitating immediate initiation of therapy, have proven challenging aspects for setting up prospective randomized trials. This has resulted in little therapeutic progress over the last decade. Read More

    Cervicofacial emphysema following unilateral external dacryocystorhinostomies: A case report.
    Indian J Ophthalmol 2018 May;66(5):722-724
    Haydarpasa Numune Education and Research Hospital, Eye Clinic, Istanbul, Turkey.
    Cervicofacial emphysema (CFE), mostly seen after trauma or dental procedures, is an unexpected, extremely rare condition after uncomplicated dacryocystorhinostomy (DCR). It may be misdiagnosed as angioedema or necrotizing fasciitis. In this article, we present the case of a 40-year-old female with CFE twice after uncomplicated unilateral DCR for left and right sides on different operative days. Read More

    Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis.
    Ann Surg 2018 Apr 18. Epub 2018 Apr 18.
    Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
    Objective: We sought to summarize accuracy of physical examination, imaging, and Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score in diagnosis of necrotizing soft tissue infection (NSTI) in adults with a soft tissue infection clinically concerning for NSTI.

    Summary Of Background Data: NSTI is a life-threatening diagnosis. Delay to diagnosis and surgical management is associated with increased mortality. Read More

    Diabetes and necrotizing soft tissue infections-A prospective observational cohort study: Statistical analysis plan.
    Acta Anaesthesiol Scand 2018 Apr 19. Epub 2018 Apr 19.
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Background: Necrotizing soft tissue infections (NSTIs) are rare but carry a high morbidity and mortality. The multicenter INFECT project aims to improve the understanding of the pathogenesis, clinical characteristics, diagnosis, and prognosis of NSTIs. This article describes the study outline and statistical analyses that will be used. Read More

    Proteomic analysis at the sites of clinical infection with invasive Streptococcus pyogenes.
    Sci Rep 2018 Apr 13;8(1):5950. Epub 2018 Apr 13.
    Faculty of Medicine, Imperial College London, London, U.K..
    Invasive Streptococcus pyogenes infections are rare, with often-unexplained severity. Prompt diagnosis is desirable, as deaths can occur rapidly following onset and there is an increased, but preventable, risk to contacts. Here, proteomic analyses of clinical samples from invasive human S. Read More

    Validation of the AAST EGS grade for Skin and Soft Tissue Infection.
    J Trauma Acute Care Surg 2018 Feb 27. Epub 2018 Feb 27.
    Division of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, Minnesota, USA.
    Introduction: Skin and soft tissue infections (SSTI) present with variable severity. The American Association for the Surgery of Trauma (AAST) developed an emergency general surgery (EGS) grading system for several diseases. We aimed to determine whether the AAST EGS grade corresponds with key clinical outcomes. Read More

    A successful treatment of necrotizing fasciitis following the surgery of distal radius plate removal: A case report and literature review.
    Medicine (Baltimore) 2018 Apr;97(15):e0305
    Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
    Rationale: Necrotizing fasciitis (NF) is defined as a rare, rapidly progressive, and highly lethal skin infection characterized by necrosis of the fascia and subcutaneous tissue.

    Patient Concerns: The present study aims to discuss the case of a 35-year-old man who developed NF following a routine sterile right distal radius bone plate removal surgery.

    Diagnoses: The patient was suspected of NF based on his clinical manifestations, laboratory tests, and imaging results. Read More

    Necrotizing fasciitis. Possible profiles of professional liability with reference to two cases.
    Ann Ital Chir 2018 ;89:70-74
    Necrotizing fasciitis is one of the most dangerous complication of an abscess and it is still a disease with a high mortality. In this work, we decided to consider two cases: the first one concerns a male subject, aged 66, deceased because of a fatal necrotizing fasciitis associated to a cervical descending mediastinitis, which evolved from a primary peritonsillar abscess; the second is about a 50-year-old woman with a perineal abscess, then evolved into necrotizing fasciitis associated to a fatal septis shock. After a systematic consideration of necrotizing fasciitis as pathology and an analysis of the possible related risks to a diagnostic or therapeutic delay, we analyzed the particular history of both cases to underline the possible critical issues in professional behavior of the medical staff intervened. Read More

    Scrotal Reconstruction with Integra Following Necrotizing Fasciitis.
    J Emerg Trauma Shock 2018 Jan-Mar;11(1):57-59
    Department of Surgery, Division of Plastic Surgery, Harlem Hospital Center, Columbia University, New York, USA.
    Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. Integra bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. Read More

    Necrotizing fasciitis: case series and review of the literature on clinical and medico-legal diagnostic challenges.
    Int J Legal Med 2018 Apr 7. Epub 2018 Apr 7.
    Department of Legal and Occupational Medicine, Toxicology and Public Health, University-Hospital of Padova, Via Falloppio 50, 35128, Padova, Italy.
    Necrotizing fasciitis (NF) is a life-threatening infection of soft tissues spreading along the fasciae to the surrounding musculature, subcutaneous fat and overlying skin areas that can rapidly lead to septic shock and death. Due to the pandemic increase of medical malpractice lawsuits, above all in Western countries, the forensic pathologist is frequently asked to investigate post-mortem cases of NF in order to determine the cause of death and to identify any related negligence and/or medical error. Herein, we review the medical literature dealing with cases of NF in a post-mortem setting, present a case series of seven NF fatalities and discuss the main ante-mortem and post-mortem diagnostic challenges of both clinical and forensic interests. Read More

    Necrotising fasciitis: a fatal case of sepsis and a diagnostic challenge - case report and review of literature.
    Int J Emerg Med 2018 Apr 6;11(1):23. Epub 2018 Apr 6.
    Emergency Medicine Department, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK.
    Background: Necrotising fasciitis (NF) is a severe, devastating soft tissue infection characterised by rapidly progressing tissue necrosis. This rare condition has a high mortality rate and poses diagnostic and management challenges to the clinician. There is usually a history of trauma, which maybe trivial. Read More

    Human IgG Increases Virulence of through Complement Evasion.
    J Immunol 2018 Apr 6. Epub 2018 Apr 6.
    Division of Medical Protein Chemistry, Department of Translational Medicine, Lund University, 214 28 Malmo, Sweden.
    is an exclusively human pathogen that can provoke mild skin and throat infections but can also cause fatal septicemia. This gram-positive bacterium has developed several strategies to evade the human immune system, enabling to survive in the host. These strategies include recruiting several human plasma proteins, such as the complement inhibitor, C4b-binding protein (C4BP), and human (hu)-IgG through its Fc region to the bacterial surface to evade immune recognition. Read More

    Severe snakebite envenomation in French Guiana: When antivenom is not available.
    Toxicon 2018 May 3;146:87-90. Epub 2018 Apr 3.
    Intensive Care Unit, Fort de France University Hospital, Martinique.
    In French Guiana, Bothrops atrox, Bothrops brazili, Bothrops bilineatus, Lachesis muta and Micrurus sp are responsible for most cases of snakebite envenomation. The clinical features in patients suffering from envenomations by viperid snakes involve local tissue damage and systemic manifestations, such as hemorrhage, coagulopathies and hemodynamic instability. We report a severe case of envenomation in a patient bitten by a large unidentified pit viper in French Guiana. Read More

    Fournier's gangrene in an obese female in third trimester of pregnancy.
    Saudi Med J 2018 Apr;39(4):415-418
    Department of Accident and Trauma, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
    Fournier gangrene is a rapidly progressive necrotizing fasciitis of the perianal and genitourinary area. Although typically affects men, we present here a rare disease founding in a pregnant woman. An obese 36-year-old female patient in her third trimester of pregnancy presented with a history of perianal pain and swelling. Read More

    Application of medicinal plants as a source for therapeutic agents against Streptococcus pyogenes infections.
    Curr Drug Metab 2018 03 29. Epub 2018 Mar 29.
    Department of Plant, Food, and Environmental Sciences, Faculty of Agriculture, Dalhousie University, Truro, Nova Scotia, Canada
    Streptococcus pyogenes, a major human pathogen, causes a wide variety of invasive systemic infections such as acute pharyngitis, skin and soft-tissue infections, especially necrotizing fasciitis. This Gram-positive bacterium has an ability to form mature biofilm and this sessile lifestyle plays an important role in S. pyogenes pathogenicity. Read More

    Ocular involvement in melioidosis: a 23-year retrospective review.
    J Ophthalmic Inflamm Infect 2018 Mar 27;8(1). Epub 2018 Mar 27.
    Department of Ophthalmology, Khon Kaen Hospital, Khon Kaen, Thailand.
    Background: Ocular involvement in melioidosis is rare and has devastating outcomes. Although there have been few reports on the condition, Khon Kaen, a city in northeast Thailand, has been called the "capital of melioidosis" due to the high prevalence of the condition in the region. We retrospectively reviewed all admitted cases of melioidosis with ocular involvement from the two largest hospitals in Khon Kaen. Read More

    Atypical Presentation of Escherichia coli Monomicrobial Necrotizing Fasciitis in a Renal Transplant Patient: A Case Report.
    Transplant Proc 2018 Apr 24;50(3):891-894. Epub 2018 Mar 24.
    Department of Pharmacy, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, Texas, USA.
    Skin and soft tissue infections (SSTIs) are one of most frequent infectious causes for referral to the emergency department and one of the most frequent infectious causes of hospital admissions. Escherichia coli, the most commonly occurring gram-negative pathogen involved in these infections, contributes to about 7% of all SSTIs cases where gram-positive organisms reign dominant. Patients are more susceptible to these gram-negative SSTIs if they are neutropenic, have hematologic malignancies, have undergone solid organ or hematopoietic transplantation, or have cirrhotic liver disease. Read More

    Dextromethorphan Attenuates NADPH Oxidase-regulated GSK-3β and NF-κB Activation and Reduces Nitric Oxide Production in Group A Streptococcal Infection.
    Antimicrob Agents Chemother 2018 Mar 26. Epub 2018 Mar 26.
    Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Group A streptococcus (GAS) is an important human pathogen that causes a wide spectrum of diseases, including necrotizing fasciitis and streptococcal toxic shock syndrome. Dextromethorphan (DM), an antitussive drug, has been demonstrated to efficiently reduce inflammatory responses thereby contributing to an increased survival rate of GAS-infected mice. However, the anti-inflammatory mechanisms underlying DM treatment in GAS infection remain unclear. Read More

    A case of severe soft tissue infection due to Streptococcus tigurinus diagnosed by necropsy in which genomic analysis was useful for clarifying its pathogenicity.
    Pathol Int 2018 Mar 23. Epub 2018 Mar 23.
    Department of Legal Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871 Japan.
    Post-mortem detection of pathogenetic microorganisms in severe infectious death is significantly important for diagnosing the cause of death as well as for public health. However, it is difficult to recognize whether a microorganism detected from post-mortem materials is truly pathogenic or not. We report a case of severe soft tissue infection due to Streptococcus oralis subsp. Read More

    Necrotizing fasciitis after scrotum skin injury in an infant: A case report.
    Medicine (Baltimore) 2018 Mar;97(12):e0140
    Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou Medical University.
    Rationale: Necrotizing fasciitis (NF) is a life-threatening situation that is rare in children, especially infants, and early diagnosis is challenging. Timely identification and broad-spectrum antibiotic and supportive treatment before surgical debridement are very important for survival and may reduce scar formation.

    Patient Concerns: A previously healthy 4-month-old infant was admitted to our pediatric intensive care unit (PICU) with a history of fever and cough for 5 days and extreme swelling of the scrotum for one day. Read More

    Subacute Peristomal Necrotizing Fasciitis Detected During Adjuvant Chemotherapy for Adenocarcinoma Rectum: Case Report on a Unique Presentation and Description of a Simple Surgical Strategy for Treatment.
    Cureus 2018 Jan 16;10(1):e2075. Epub 2018 Jan 16.
    Hepatopancreatobiliary and Liver Transplant Unit, Dow University of Health Sciences (DUHS), Karachi, Pakistan.
    Necrotizing fasciitis (NF) is a rare entity with its subacute form being even rarer. The condition has also been described to occur in the peristomal area in relation to different clinical scenarios. However, it has not been described in the setting of adjuvant chemotherapy where these medications have already been given. Read More

    Successfully treated necrotizing fasciitis using extracorporeal life support combined with hemoadsorption device and continuous renal replacement therapy.
    Int J Artif Organs 2018 Mar 20;41(3):178-182. Epub 2018 Feb 20.
    1 Cardiac Surgery Unit, University Hospital of Angers, Angers, France.
    Introduction: Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device.

    Methods: A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure. Read More

    Successful management of bilateral periorbital necrotising fasciitis with ocular involvement.
    BMJ Case Rep 2018 Mar 15;2018. Epub 2018 Mar 15.
    RSCM, Jakarta, Indonesia.
    A 4-year-old girl had suffered from multiple pustules and severely swollen eyelids for a week which led to difficulties in opening her eyes. The pustules burst 2 days prior to admission, causing blood and pus to come out. As a result, the evaluation of eye movement, visual acuity and intraocular pressure was hindered. Read More

    Necrotizing Fasciitis of Thoracic and Abdominal Wall with Emphysematous Pyelonephritis and Retroperitoneal Abscess.
    J Clin Imaging Sci 2018 21;8. Epub 2018 Feb 21.
    Department of Radio-Diagnosis, Dr. D. Y. Patil Medical College and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
    Emphysematous pyelonephritis is a life-threatening severe form of pyelonephritis usually occurring in patients with diabetes mellitus with or without obstructive uropathies in whom there is necrotizing infection leading to the gas production of an unclear mechanism involving the renal parenchyma and the collecting system. Necrotizing fasciitis is characterized by progressive necrosis of fat and fascia due to deep-seated infection of subcutaneous tissue. It has a fulminant course with considerable mortality. Read More

    Necrotizing fasciitis of the lower extremity: imaging pearls and pitfalls.
    Br J Radiol 2018 Mar 28:20180093. Epub 2018 Mar 28.
    1 Department of Radiology, Massachusetts General Hospital , Boston, MA , USA.
    Objective: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease.

    Conclusion: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, ultrasound, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis. Read More

    Atraumatic Clostridial Myonecrosis in an Immunocompromised Host.
    J Emerg Med 2018 Mar 10. Epub 2018 Mar 10.
    Division of Community Internal Medicine, Mayo Clinic, Jacksonville, Florida.
    Background: Necrotizing fasciitis is usually associated with a surgical or traumatic wound. Clostridial myonecrosis is an uncommon but deadly infection that can develop in the absence of a wound and is often associated with occult gastrointestinal cancer or immunocompromise, or both.

    Case Report: We report a case of catastrophic atraumatic Clostridium septicum infection in an immunocompromised host. Read More

    Factors predicting health-related quality of life following necrotizing fasciitis.
    J Plast Reconstr Aesthet Surg 2018 Feb 14. Epub 2018 Feb 14.
    Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Department of Surgery, Section of Plastic Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Departments of Surgery and Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address:
    Background: Necrotizing fasciitis (NF) is a debilitating soft tissue infection that results in disfiguring scars and often amputations. While mortality rates have improved, long-term outcomes in survivors of NF are poorly understood.

    Objectives: The objective of this study is to analyze the impact of NF on survivors' health-related quality of life (HRQoL) influenced by age, sex, comorbidities, %TBSA, and confidence with appearance. Read More

    Delayed diagnosis of post-surgical pyoderma gangrenosum: A multicenter case series and review of literature.
    Int J Surg Case Rep 2018 19;44:152-156. Epub 2018 Feb 19.
    Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
    Introduction: Pyoderma gangrenosum is a chronic neutrophilic dermatosis which can occur following trauma or surgery and can mimic infection. Surgical intervention can lead to progression of disease.

    Presentation Of Cases: This case series describes 3 cases of post-surgical pyoderma gangrenosum with delayed diagnosis from two large medical centers. Read More


    WHO/IVI global stakeholder consultation on group A Streptococcus vaccine development: Report from a meeting held on 12-13 December 2016.
    Vaccine 2018 Feb 26. Epub 2018 Feb 26.
    Group A Streptococcal Research Group, Murdoch Children's Research Institute, Melbourne 3052, Australia.
    While progress towards a Group A Streptococcus (GAS) vaccine has been stalled by a combination of scientific, regulatory, and commercial barriers, the problem persists. The high and globally-distributed burden of disease attributable to GAS makes vaccination an imperative global public health goal. Advances across a range of scientific disciplines in understanding GAS diseases have made the goal a realistic one and focused attention on the need for coordinated global action. Read More

    Fournier gangrene: a rare case of necrotizing fasciitis of the entire right hemi-pelvis in a diabetic female.
    Oxf Med Case Reports 2018 Feb 9;2018(2):omx094. Epub 2018 Feb 9.
    Department of Emergency Medicine, Beaumont Hospital, Teaching Hospital of Michigan State University, Farmington Hills, MI, USA.
    Fournier's gangrene, a rare polymicrobial infection that affects the genitals and perineum, can present as an insidious onset to a rapid and fulminant course. Early recognition, diagnosis, initiation of broad-spectrum antibiotics and prompt surgical treatment remain the foundation of management. If treatment is not initiated aggressively, the patient will likely rapidly deteriorate, leading to organ failure and death. Read More

    Progressive subcutaneous emphysema of unknown origin: a surgical dilemma.
    Acta Chir Belg 2018 Feb 23:1-3. Epub 2018 Feb 23.
    a Department of Plastic, Reconstructive and Aesthetic Surgery , ZNA Middelheim Hospital , Antwerp , Belgium.
    Objective: Subcutaneous emphysema can be an alarming sign of a necrotizing soft tissue infection. However, non-infectious etiologies exist that can be treated conservatively. This case report describes a subcutaneous emphysema of unknown origin and highlights the importance of distinguishing these clinical entities. Read More

    Bullous eyelid.
    BMJ Case Rep 2018 Feb 22;2018. Epub 2018 Feb 22.
    Postgraduate Medicine, University of Toronto, Toronto, Canada.
    Periocular necrotising fasciitis is a rare but sight-threatening condition, which relies on clinical judgement to detect in a timely manner. A 51-year-old woman presented to a rural hospital with rapid onset bilateral eye swelling, erythema and pain and was started on broad spectrum intravenous antibiotics. Upon admission, she became septic and required fluid resuscitation and transfer to a higher level of care. Read More

    Necrotizing infection of the heart.
    Clin Imaging 2018 Feb 6;51:111-113. Epub 2018 Feb 6.
    Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States.
    A case of necrotizing infection of the heart is presented. A 70-year-old woman presented with vague chest and abdominal pain. CT of the abdomen and pelvis was initially obtained, which demonstrated gas in the myocardium of the left ventricle. Read More

    Scrotal reconstruction with superomedial fasciocutaneous thigh flap.
    Rev Col Bras Cir 2018 15;45(1):e1389. Epub 2018 Feb 15.
    Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
    Objective: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier's gangrene).

    Methods: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015.

    Results: fifteen patients underwent scrotal reconstruction using the proposed flap. Read More

    Group B Streptococcal Cellulitis and Necrotizing Fasciitis in Infants: A Systematic Review.
    Pediatr Infect Dis J 2018 Feb 7. Epub 2018 Feb 7.
    Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
    Background: There is no consensus regarding approaches to infantile group B streptococcal (GBS) head and neck cellulitis and necrotizing fasciitis. We present a case of GBS necrotizing cellulitis and summarizes the literature regarding the presentation and management of infantile head and neck GBS cellulitis and necrotizing fasciitis.

    Methods: The literature was searched using PubMed, Web of Science, EMBASE, and Medline (inception to April 2017) by two independent review authors. Read More

    Coverage of the scrotum after Fournier's gangrene.
    GMS Interdiscip Plast Reconstr Surg DGPW 2018 15;7:Doc01. Epub 2018 Jan 15.
    Plastic Surgery Center, Faculty of Medicine, Mansoura University, Egypt.
    Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene. Read More

    Streptococcal Cysteine Protease-Mediated Cleavage of Desmogleins Is Involved in the Pathogenesis of Cutaneous Infection.
    Front Cell Infect Microbiol 2018 24;8:10. Epub 2018 Jan 24.
    Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan.
    is responsible for a wide variety of cutaneous infections ranging from superficial impetigo to fulminant invasive necrotizing fasciitis. Dysfunction of desmosomes is associated with the pathogenesis of cutaneous diseases. We identified streptococcal pyrogenic exotoxin B (SpeB) as a proteolytic factor that cleaves the extracellular domains of desmoglein 1 and 3. Read More

    Sacral Pressure Ulcer-induced Fournier's Gangrene Extending to the Retroperitoneum: A Case Report.
    Wounds 2018 Jan;30(1):E5-E8
    National Hospital Organization Nagasaki Medical Center, Ohmura City, Japan.
    Introduction: Fournier's gangrene (FG) is a type of necrotizing fasciitis of the perineum and scrotum that is characterized by very rapid progression. Sacral pressure ulcers are one of the causes of FG.

    Case Report: An 85-year-old man was referred to the National Hospital Organization Nagasaki Medical Center (Ohmura City, Japan) with a diagnosis of FG extending to the retroperitoneum caused by a sacral pressure ulcer. Read More

    Cellulitis and Soft Tissue Infections.
    Ann Intern Med 2018 Feb;168(3):ITC17-ITC32
    University of California, San Francisco, California (R.B., H.C.).
    Cellulitis and soft tissue infections are a diverse group of diseases that range from uncomplicated cellulitis to necrotizing fasciitis. Management of predisposing conditions is the primary means of prevention. Cellulitis is a clinical diagnosis and thus is made on the basis of history and physical examination. Read More

    Acute appendicitis complicated with necrotizing fasciitis in a patient with adult-onset Still's disease: A case report.
    Medicine (Baltimore) 2018 Feb;97(5):e9794
    Division of Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital.
    Rationale: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, spiking fever, arthralgia/ arthritis, and lymphadenopathy. AOSD sometimes was fatal when it is complicated by macrophage activation syndrome (MAS) or hemophagocytic lymphohistiocytosis (HLH). Nonetheless, the literature provides no recommendations for treatment of AOSD patients with severe sepsis. Read More

    Should we consider IgG hypogammaglobulinemia a risk factor for severe complications of Ludwig angina?: A case report and review of the literature.
    Medicine (Baltimore) 2017 11;96(47):e8708
    Intensive Care Unit.
    Rationale: Cervical necrotizing fasciitis (CNF) and descending necrotizing mediastinitis (DNM) are rare forms of complication of Ludwig angina. These potentially lethal infections are difficult to recognize in early stages and are often associated with predisposing factors like diabetes and immunocompromised states. Moreover, IgG hypogammaglobulinemia (hypo-IgG) is considered to be a risk factor of mortality in patients with septic shock; however, it is not routinely quantified in patients with extremely serious infections, particularly in cases with no history or evidence of immunocompromising disorders. Read More

    Pathogenic mechanisms of invasive group A Streptococcus infections by influenza virus-group A Streptococcus superinfection.
    Microbiol Immunol 2018 Mar;62(3):141-149
    Department of Laboratory Sciences, Faculty of Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan.
    Group A Streptococcus (GAS) are pathogenic bacteria of the genus Streptococcus and cause severe invasive infections that comprise a wide range of diverse diseases, including acute respiratory distress syndrome, renal failure, toxic shock-like syndrome, sepsis, cellulitis and necrotizing fasciitis. The essential virulence, infected host and external environmental factors required for invasive GAS infections have not yet been determined. Superinfection with influenza virus and GAS induced invasive GAS infections was demonstrated by our team in a mouse model, after which clinical cases of invasive GAS infections secondary to influenza virus infection were reported by other investigators in Japan, USA, Canada, UK China, and other countries. Read More

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