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Journal of the American Academy of... Mar 1986Eosinophilic pustular folliculitis was first described by Ofuji et al in 1970. It is characterized by pruritic circinate plaques that are studded with follicular papules...
Eosinophilic pustular folliculitis was first described by Ofuji et al in 1970. It is characterized by pruritic circinate plaques that are studded with follicular papules and pustules. Lesions are located chiefly on the face, trunk, and arms. Biopsies of lesions demonstrate an infiltrate of eosinophils and neutrophils within hair follicles, dermis, and epidermis. Peripheral leukocytosis and eosinophilia are common.
Topics: Adult; Eosinophilia; Folliculitis; Hair; Humans; Male; Suppuration; Syndrome
PubMed: 3958258
DOI: 10.1016/s0190-9622(86)70059-5 -
The American Journal of Case Reports Dec 2023BACKGROUND Fish bone ingestion is the most common cause of esophageal perforation (12%). However, it rarely causes esophageal perforation and mediastinal abscess. Most... (Review)
Review
BACKGROUND Fish bone ingestion is the most common cause of esophageal perforation (12%). However, it rarely causes esophageal perforation and mediastinal abscess. Most studies recommend surgical intervention for patients with esophageal perforation and thoracic abscess. However, surgery may not be suitable for extremely critical cases or may have limited effectiveness. In such cases, a combination of surgery and conservative treatment is crucial. The use of double cannula irrigation and drainage in conservative treatment has shown promising results in pus removal. CASE REPORT We report a 28-year-old man with a perforated esophagus with abscess and mediastinal abscess due to fish bone. Emergency surgery was performed after admission. Symptoms of septic shock developed after surgery, and a significant amount of pus was still present in the chest cavity and mediastinum. Conservative treatment was adopted, with double cannula irrigation and drainage. By employing anti-infection measures and continuous irrigation and drainage, the patient was cured after 42 days. CONCLUSIONS In this case, surgical intervention did not yield satisfactory results. However, after using double cannula irrigation and drainage to clear the thoracic and mediastinal abscesses, the patient's infection levels returned to normal. Additionally, the patient was successfully weaned off the ventilator, and the tracheotomy catheter was removed. After discharge, the patient resumed to normal life, without any significant complications during 1 year of follow-up. Double cannula drainage played a vital role in this patient's treatment; however, further clinical evidence is required to determine its suitability for other patients with esophageal perforation complicated by mediastinal abscess.
Topics: Male; Animals; Humans; Adult; Esophageal Perforation; Abscess; Mediastinal Diseases; Drainage; Conservative Treatment
PubMed: 38105546
DOI: 10.12659/AJCR.942056 -
International Wound Journal Mar 2023Management and treatment of pressure ulcers (PUs) are met with great difficulty due to various factors that cause vulnerability of the soft tissue such as location,...
Management and treatment of pressure ulcers (PUs) are met with great difficulty due to various factors that cause vulnerability of the soft tissue such as location, limited mobility, increased friction and shearing forces, as well as other comorbidities that may delay or halt wound healing. The topical autologous blood clot therapy (TABCT) is a point-of-care treatment used as a blood clot to assist in recreating and repairing the extracellular matrix (ECM). The mechanism of action consists of reconstruction of the ECM by incorporating into the ulcer, providing protection from further external destruction, while assisting in advancement through the wound healing phases via interaction of necessary growth factors, mediators, and chemokines. This study aims to assess the efficacy of the TABCT in the treatment of PUs in comparison to standard of care (SOC) treatment. Twenty-four patients, 18 years or older, with PUs ranging from stage 1 to 4, were included in this study. TABCT was created by using the patient's own peripheral blood in a point of care setting. Efficacy in percent area reduction (PAR) on weeks 4 and 12 with TABCT over SOC was assessed. Treatment using TABCT in PUs resulted in 77.9% of the patients achieving a 50% PAR on week 4. The mean PAR on week 12 was 96.23% with 45% of the wounds treated with TABCT achieving complete wound closure. TABCT exhibited efficacy in PAR of PUs. In addition, TABCT use prompted granulation tissue formation over vital structures, such as bone, which is often present in later stage PUs. The potential of bringing an affordable, cost-effective, advanced biologic bedside treatment that is efficacious in resolution of these complex wounds has the potential to drastically reduce the burden of treatment on the health system.
Topics: Humans; Pressure Ulcer; Wound Healing; Ulcer; Thrombosis; Suppuration
PubMed: 36054532
DOI: 10.1111/iwj.13927 -
Actas Dermo-sifiliograficas Feb 2021Pain is a common, important symptom negatively affecting the well-being and quality of life of patients with hidradenitis suppurativa (HS). The aim of this study was to...
BACKGROUND
Pain is a common, important symptom negatively affecting the well-being and quality of life of patients with hidradenitis suppurativa (HS). The aim of this study was to examine self-reported pain alleviating methods among outpatients attending a tertiary referral center.
METHODS
Consecutive patients with HS were invited to complete a questionnaire regarding their self-reported pain alleviating methods for HS associated pain. Additionally, the patients filled out the Dermatology Life Quality Index questionnaire and a visual analog scale for overall distress related to HS and for boil-associated pain in the past month. Information on disease severity and onset was obtained by interview and clinical examination.
RESULTS
A total of 134 patients with a mean age of 38.3 years (SD 12.8) participated; 32% (n=43) had Hurley stage i, 52% (n=70) had Hurley stage ii, and 16% (n=21) had Hurley stage iii. Overall, to achieve pain relief, 82% (n=110) of the patients had previously drained pus from the lesions by manual pressure. Compared to patients who did not alleviate pain, patients who attempted to alleviate pain had a higher mean overall disease related distress score (7.43 [SD 2.81] vs. 5.47 [SD 3.37], P<.003), and a higher boil-associated pain score in the past month (6.56 [SD 3.07] vs. 4.39 [SD 3.88], P=.007).
CONCLUSION
This study demonstrates that a large proportion of HS patients attempt to alleviate pain through various alternative and homespun methods. These results may reflect a major role of pain in HS and its potential insufficient management by dermatologists.
Topics: Adult; Cross-Sectional Studies; Drainage; Female; Furunculosis; Hidradenitis Suppurativa; Hot Temperature; Humans; Male; Middle Aged; Obesity; Pain; Pain Management; Quality of Life; Self Care; Self-Injurious Behavior; Severity of Illness Index; Suppuration; Surveys and Questionnaires; Visual Analog Scale
PubMed: 33232705
DOI: 10.1016/j.ad.2020.08.011 -
BMC Infectious Diseases Apr 2024Diabetic foot ulcer (DFU) is one of the main chronic complications caused by diabetes, leading to amputation in severe cases. Bacterial infection affects the wound...
BACKGROUND
Diabetic foot ulcer (DFU) is one of the main chronic complications caused by diabetes, leading to amputation in severe cases. Bacterial infection affects the wound healing in DFU.
METHODS
DFU patients who met the criteria were selected, and the clinical data were recorded in detail. The pus exudate from the patient's foot wound and venous blood were collected for biochemical analysis. The distribution of bacterial flora in pus exudates of patients was analyzed by 16S rRNA sequencing, and the correlation between DFU and pathogenic variables, pyroptosis and immunity was analyzed by statistical analysis. Then, the effects of key bacteria on the inflammation, proliferation, apoptosis, and pyroptosis of polymorphonuclear leukocytes were investigated by ELISA, CCK-8, flow cytometry, RT-qPCR and western blot.
RESULTS
Clinical data analysis showed that Wagner score was positively correlated with the level of inflammatory factors, and there was high CD3, CD4, and low CD8 levels in DFU patients with high Wagner score. Through alpha, beta diversity analysis and species composition analysis, Corynebacterium accounted for a large proportion in DFU. Logistics regression model and Person correlation analysis demonstrated that mixed bacterial infections could aggravate foot ulcer, and the number of bacteria was closely related to inflammatory factors PCT, PRT, immune cells CD8, and pyroptosis-related proteins GSDMD and NLRP3. Through in vitro experiments, Corynebacterium inhibited cell proliferation, promoted inflammation (TNF-α, PCT, CRP), apoptosis and pyroptosis (IL-1β, LDH, IL-18, GSDMD, NLRP3, and caspase-3).
CONCLUSION
Mixed bacterial infections exacerbate DFU progression with a high predominance of Corynebacterium, and Corynebacterium promotes inflammation, apoptosis and pyroptosis to inhibit DFU healing.
Topics: Humans; Diabetic Foot; RNA, Ribosomal, 16S; NLR Family, Pyrin Domain-Containing 3 Protein; Pyroptosis; Diabetes Mellitus; Bacteria; Inflammation; Bacterial Infections; Suppuration
PubMed: 38561650
DOI: 10.1186/s12879-024-09235-x -
The Medical Journal of Malaysia Mar 2024The study's objectives are to investigate the level of knowledge, attitude, and performance (KAP) of nurses on the prevention of pressure ulcers (PUs) prevention in the...
INTRODUCTION
The study's objectives are to investigate the level of knowledge, attitude, and performance (KAP) of nurses on the prevention of pressure ulcers (PUs) prevention in the intensive care (ICU) and also to identify the relationship between nurses' KAP toward the implementation of preventive measures for PUs.
MATERIALS AND METHODS
This cross-sectional study was conducted among 60 registered nurses in the ICU at Taiping Hospital. to assess the nurses' knowledge and attitude level using the Knowledge and Attitude on prevention of PUs questionnaire. A descriptive analysis and Pearson Correlation were used to analyze the data.
RESULT
From a total of 60 nurses 36 (60%) of nurses demonstrated a moderate level of KAP, and 17 (28%) demonstrated a high level of knowledge. They also exhibited neutral attitudes towards PUs prevention 49 (82%). The findings revealed a positive relationship between nurses' KAP toward implementing preventive measures on PUs (p=0.04; r=0.3). The findings show that nurses regularly performed the assessment of the risk factors of PUs for all hospitalized patients when performing PUs care. However, the plan for preventive nursing care was not properly reviewed.
CONCLUSION
This study suggested that appropriate guidelines, education programs, and an environment that makes it possible to provide continuing education should be created for nurses to prevent PUs in the ICU.
Topics: Humans; Cross-Sectional Studies; Pressure Ulcer; Clinical Competence; Health Knowledge, Attitudes, Practice; Intensive Care Units; Surveys and Questionnaires; Suppuration
PubMed: 38555882
DOI: No ID Found -
BMJ Case Reports Jan 2020A 76-year-old man presented with neck swelling associated with pain and fever. On examination, there was a submental neck swelling. His initial CT scan showed...
A 76-year-old man presented with neck swelling associated with pain and fever. On examination, there was a submental neck swelling. His initial CT scan showed multiloculated abscess centred in the left submandibular gland. He remained febrile despite on intravenous ceftriaxone and metronidazole. A repeat CT scan revealed significant worsening with multiple pockets of fluids with gas locules in the deep neck spaces. He subsequently underwent neck exploration and drainage of neck abscess. Extensive necrotic tissue was found intraoperatively and thick pus was drained from the bilateral parapharyngeal, submental spaces and anterior mediastium. Pus culture profusely grew of species. Patient recovered well following further intravenous antibiotic therapy. Diabetes mellitus and odontogenic infections are the common risk factors in deep neck infections. Our patient is however non-diabetic and edentulous. Current case is presented to serve as a rare case of neck abscess with unusual cause in a non-diabetic patient.
Topics: Abscess; Actinobacteria; Aged; Anti-Bacterial Agents; Combined Modality Therapy; Diagnosis, Differential; Humans; Male; Neck; Prevotella; Tomography, X-Ray Computed
PubMed: 31919070
DOI: 10.1136/bcr-2019-233467 -
Turkish Neurosurgery 2011Subtentorial subdural empyema is a rare form of intracranial suppuration. We present two cases treated at our department within the last 11 years. The common source was... (Review)
Review
Subtentorial subdural empyema is a rare form of intracranial suppuration. We present two cases treated at our department within the last 11 years. The common source was an ear infection. Both patients presented with headache, fever, vomiting and stiff neck. Only one patient had disturbed consciousness. Both patients received aggressive antibiotic therapy. The first patient was treated with suboccipital craniectomy and evacuation of pus collection, while the second patient was treated conservatively with antibiotics and ventriculoperitoneal shunt for his associated supratentorial hydrocephalus. Both blood cultures and empyema collection were sterile. Neuroimaging with computed tomography and magnetic resonance imaging permitted accurate diagnosis and localization of the purulent collections. At follow up of 11 years for the first case and 10 months for the second, both patients had complete neurological recovery except for right mild sixth nerve palsy in the patient with conservative treatment.
Topics: Anti-Bacterial Agents; Child; Combined Modality Therapy; Decompressive Craniectomy; Drainage; Empyema, Subdural; Female; Humans; Male; Ventriculoperitoneal Shunt; Young Adult
PubMed: 22194137
DOI: No ID Found -
BMC Research Notes Feb 2017Tropical diabetic hand syndrome describes a complex hand sepsis affecting patients with diabetes across the tropics and often results from a trivial hand trauma. The...
BACKGROUND
Tropical diabetic hand syndrome describes a complex hand sepsis affecting patients with diabetes across the tropics and often results from a trivial hand trauma. The clinical presentation of this syndrome is variable and ranges from localised swelling and cellulitis, with or without ulceration of the hand to progressive fulminant hand sepsis, and gangrene affecting the entire limb which may be fatal. Tropical diabetic hand syndrome could lead to permanent disability and death as a result of delay in presentation, late diagnosis and late medical and surgical intervention. This indexed case acts as an eye opener for physicians to the existence of this hand sepsis.
CASE PRESENTATION
We report the case of a 57 year-old black African female diabetic who was referred to our centre for the management of a suppurating ulcer and swelling of the left hand of two weeks duration. On examination and work-up, the patient was found to have Lawal Group III left diabetic hand syndrome and was managed with parenteral antibiotics, radical debridement and the hand was eventually amputated. She died 7 days following amputation from overwhelming sepsis.
CONCLUSION
Though tropical diabetic hand syndrome is a relatively rare complication of diabetes, it can be fatal as in this case report. Early diagnosis and proper management would yield better outcome. Initial management should include aggressive intravenous broad-spectrum antibiotics with anaerobic coverage. Classification of tropical diabetic hand syndrome will assist physicians and surgeons in decision making, proper management and easy communication.
Topics: Amputation, Surgical; Diabetes Complications; Fatal Outcome; Female; Hand; Humans; Middle Aged; Sepsis; Suppuration
PubMed: 28193286
DOI: 10.1186/s13104-017-2405-3 -
Clinical Microbiology and Infection :... Jul 2011Actinobaculum schaalii is a new species that has so far been isolated from human blood, urine and pus. Its importance has probably been underestimated and other...
Actinobaculum schaalii is a new species that has so far been isolated from human blood, urine and pus. Its importance has probably been underestimated and other Actinobaculum spp. may also have been underdiagnosed. This retrospective study comprises all known cases of A. schaalii infections identified since 2004 in the canton of Neuchâtel (170,000 inhabitants), Switzerland. Strains were cultivated and isolated in the bacteriology laboratory using its routine procedure. Identification included a Rapid ID 32 A strip (bioMérieux) and 16S rRNA gene sequencing. Twenty-one positive samples were found in 19 patients (11 male, 8 female) of all ages (range 16-91 years): 10 from urine (50%), six from blood (30%), one from both blood and urine (5%), and three from pus (15%). Thirteen out of 17 (76%) cases with either blood or urine specimens had underlying genitourinary tract pathologies. When urine cultures were positive for A. schaalii, leucocytes were found in all samples (10/10, 100%) but all nitrite tests were negative (10/10, 100%). The onset of appropriate treatment was delayed due to the diminished sensitivity of A. schaalii to the antibiotics commonly used for UTIs (i.e. ciprofloxacin and trimethoprim/sulfamethoxazole) and to the delay in microbiological diagnosis. A. schaalii should specifically be searched in all cases of leukocyturia with a negative nitrite test but with Gram-positive rods in the Gram stain, in patients with underlying genitourinary tract pathology, instead of dismissing these findings as clinically irrelevant colonization by coryneform bacteria. This infection may be much more common than previously thought.
Topics: Actinomycetaceae; Actinomycetales Infections; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Typing Techniques; Blood; DNA, Bacterial; DNA, Ribosomal; Female; Humans; Male; Middle Aged; RNA, Ribosomal, 16S; Retrospective Studies; Sequence Analysis, DNA; Suppuration; Switzerland; Urine; Young Adult
PubMed: 20854424
DOI: 10.1111/j.1469-0691.2010.03370.x