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References 1. Hsiao C.T., Weng H.H., Yuan Y.D., Chen C.T. & Chen I.C. (2008). Predictors of mortality in patients with necrotizing fasciitis. Am J Emerg Med. 26(2), 170-175. DOI: 10.1016/j. ajem.2007.04.023 2. Ngan V. (2013). Necrotising fasciitis, http:// www.dermnetnz.org/bacterial/necrotisingfasciitis. html, Created 2003. Last updated 29 Apr 2013, Accessed 24 December 2013 3. Speers D. & Shurr D. (2001). Necrotizing Fasciitis: An Overview. Journal of Prosthetics and Orthotics. 13(3), 83-86 4. Bisno A.L. & Stevens D.L. (1996). Streptococcal infections of skin

Dis. 1999; 179:275-8. 15. Halow KD, Harner RC, Fontenelle LJ. Primary skin infections secondary to Vibrio vulnificus: the role of operative intervention. J Am Coll Surg. 1996; 183: 329-34. 16. Kuo YL, Shieh SJ, Chiu HY, Lee JW. Necrotizing fasciitis caused by Vibrio vulnificus: epidemiology, clinical findings, treatment and prevention. Eur J Clin Microbiol Infect Dis. 2007; 26:785-92. 17. Fernandez A, Justiniani FR. Massive rhabdomyolysis: a rare presentation of primary Vibrio vulnificus septicemia. Am J Med. 1990; 89:535-6.

patients with AIDS. Mycoses 1994, 37: 209-215. 8. Biberstein EL, Hirsh DC (1999) Streptococci. In: Veterinary Microbiology , Eds Hirsh DC, Zee YC. Malden, MA: Blackwell Science; 1999, 120-126. 9. Naidoo SL, Campbell DL, Miller LM, Nicastro A: Necrotizing fasciitis: A Review. J Am Anim Hosp Assoc 2005, 41: 104-109. 10. Lamm CG, Ferguson AC, Lehenbauer TW, Love BC: Streptococcal Infection in Dogs: A Retrospective Study of 393 Cases. Vet Pathol 2010, 47: 387-395. 11. Prescott JF, DeWinter L: Canine streptococcal toxic shock syndrome and necrotising fasciitis. Vet Rec 1997

. Figure 2 (a) CT scan showing massive infestation of the bilateral thoracic wall with sucutaneous emphysema. (b) CT scan showing massive myolysis of the left thigh with subcutaneous emphysema. The diagnosis of necrotizing fasciitis and gas gangrene was considered, and emergent surgical consultation was obtained. Despite immediate intravenous antibiotherapy (clindamycin, amoxycillin–clavulanate acid, and amikacin 25 mg/kg), abundant perfusions of crystalloid and colloid fluids, and blood transfusions, the situation deteriorated rapidly necessitating instauration of

, and ankle ulcer, but the abovementioned symptoms are unspecific. Given that pathogenic bacteria can be spread rapidly, early disease diagnosis is crucial to save the patient’s life. Diagnosis relies on the biopsy of the affected tissue, which is represented by a wide, zonal, and membrane-free hyphae. The main treatments include controlling diabetes, removing necrotic bone tissue, and applying antifungal treatments, such as amphotericin B [ 16 , 17 ]. 2.2.3 Necrotizing fasciitis Necrotizing fasciitis is considered as a serious soft tissue infection that leads to

J. Neonatal omphalitis: a review of its serious complications. Acta Paediatr 2006; 95:519-522. 5. yoon Ty, Jung SK, Chang SH. Cellulitis due to Escherichia coli in three immunocompromised subjects. Br J Dermatol 1998; 139:85-888. 6. Afifi Ry, El-Hindawi AA. Acute necrotizing fasciitis in Egyptian patients: a case series. Int J Surg 2008; 6:6-14. 7. Li DM, Lun LD, Chen XR. Necrotising fasciitis with Escherichia coli. Lancet Infect Dis 2006; 6:456. 8. Tourmousoglou CE, yiannakopoulou EC, Kalapothaki V, Bramis J, Papadopoulos J. Surgical-site infection surveillance

;114:772-5. Sakamoto H, Aoki T, Kise Y, et al. Descending necrotizing mediastinitis due to odontogenic infections. Oral Surg Oral Med Oral Pathol 2000;89:412-9. Moncada R, Warpeha R, Pickleman J, et al. Mediastinitis from odontogenic and deep cervical infections - anatomic pathways of propagation. Chest 1978;73:497-502. Tung-Yiu W, Jehn-Shyun H, Ching-Hung C, et al. Cervical necrotizing fasciitis of odontogenic origin: A report of 11 cases. J Oral Maxillofac Surg 2000;58:1347-53. Kinzer SA, Pfeiffer JB, Becker SR, et al. Severe deep neck space infections and mediastinitis of

References Balkan ME, Oktar GL, Oktar MA. Descending necrotizing mediastinitis: a case report and review of the literature. Int Surg 2001; 86 : 62-6. Izadi K, Lazow SK, Berger JR. Mediastinitis secondary to an odontogenic infection. A case report. N Y State Dent J 2003; 69 : 28-30. Tung-Yiu W, Jehn-Shyun H, Ching-Hung C, Hung-An C. Cervical necrotizing fasciitis of odontogenic origin: a report of 11 cases. J Oral Maxillofac Surg 2000; 58 : 1347-53. Sobolewska E, Skokowski J, Jadezuk E. Pleural empyema as a complication of the descending necrotizing

References 1. Shari J. Lynn. Dealing with the dangers of dog bite. American nurse today. 2009; 4(9): 52-54. 2. Dryden MS. Skin and soft tissue infection: microbiology and epidemiology. International Journal of Antimicrobial Agents. 2009; 34 (51): 52-57. 3. Chang K, Siu LK, Chen YH, et al. Fatal Pasteurella multocida septicemia and necrotizing fasciitis related with wound licked by a domestic dog. Scand J Infect Dis. 2007; 39:167. 4. Chun ML, Buekers TE, Sood AK, Sorosky JI. Postoperative wound infection with Pasteurella multocida from a pet cat. Am J Obstet

. Injection therapy for sub acute and chronic low back pain: an update Cochrane review. Spine 2009; 34: 49-59. 21. Verfaillie G, Knape S, Corne I. A case of fatal necrotizing fasciitis after intramuscular administration of diclofenac. Eur J Emerg Med 2002; 9: 270-273. 22. Schabitz WR, Berger C, Knauth M, Meinick HM, Steiner T. Hypoxic brain damage after intramuscular self-injection of diclofenac for acute low back pain. Eur J Anasthesiol 2001; 18: 763-765. 23. Švab, Petek Šter M, Kersnik J, Živčec Kalan G, Car J. Presečna študija o delu zdravnikov splošne medicine v