Necrotizing fasciitis in the head and neck region-three case reports and a  review of the literature.

[Necrotizing fasciitis in the head and neck region-three case reports and a review of the literature]. HNO. 2020 Jul 02;: Authors: Huber L, Budjan J, Rotter N, Lammert A Abstract Necrotizing fasciitis (NF) is a life-threatening, usually bacterial, soft tissue infection that rarely affects the head and neck region. Rapid progression and systemic illness are typical for the disease and complicate diagnosis. Immediate surgical and antimicrobial therapy is required. Three cases of cervicofacial NF are presented in this case report. All patients showed a rapidly progressing, painful swelling and redness in the cervicofacial region. After diagnosing NF based on clinical symptoms, laboratory parameters, and CT, the patients were treated with systemic antibiotics and multiple extensive debridements. Two of the three patients died within 48 h from systemic illness with septic organ failure; one patient was discharged after intensive care treatment and reconstruction of the tissue defects caused by debridement. NF is a fast-developing soft tissue infection associated with high mortality and morbidity, and is often recognized too late. Diagnosis is based on clinical signs such as progressive diffuse swelling, pain, erythema, and early systemic illness. Laboratory parameters (Laboratory Risk Indicator for Necrotizing Fasciitis [LRINEC] score) and imaging via CT or MRT are helpful. CT/MRT images can show soft tissue swelling with pathognomonic...
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research

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Abstract Acute pyelonephritis is a bacterial infection of the kidney and renal pelvis and should be suspected in patients with flank pain and laboratory evidence of urinary tract infection. Urine culture with antimicrobial susceptibility testing should be performed in all patients and used to direct therapy. Imaging, blood cultures, and measurement of serum inflammatory markers should not be performed in uncomplicated cases. Outpatient management is appropriate in patients who have uncomplicated disease and can tolerate oral therapy. Extended emergency department or observation unit stays are an appropriate option...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
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Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Item Source Type: research
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Source: Medicina Oral, Patologia Oral y Cirugia Bucal - Category: ENT & OMF Tags: Med Oral Patol Oral Cir Bucal Source Type: research
Rationale: A deep neck infection (DNI) with descending necrotizing mediastinitis (DNM) has great clinical importance because of its high morbidity and mortality, particularly when associated with predisposing underlying disease. With the expanding clinical use of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), it may be necessary to perform FDG PET/CT for immediate diagnosis and treatment of DNM. To the best of our knowledge, this is the first case report of DNI with DNM diagnosed based on FDG PET/CT findings. Patient concerns: A 65-year-old man who underwent chemotherapy for st...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Introduction: Irritable bowel syndrome (IBS) and diverticulitis share clinical features. Misdiagnosed diverticulitis can cause unnecessary antibiotic therapy. Among IBS and non-IBS patients, we compared outpatient, clinically diagnosed (no computed tomography) diverticulitis rates. Among primary-care, diverticulitis-diagnosed IBS patients, we assessed imaged diverticulosis and probable misdiagnosed diverticulitis. Methods: Among 3836-patient IBS and 67,827-patient non-IBS cohorts identified from 2000 to 2002, we retrospectively compared the frequency of outpatient, clinically diagnosed, antibiotic-treated diverticulitis f...
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Original Research Source Type: research
Authors: Knabl L, Mango M, Stögermüller B, Kirchmair L, Posch W, Lass-Flörl C, Fuchs S Abstract The Gram negative pathogen Capnocytophaga canimorsus is a frequent commensal in the oral cavity of cats and dogs. Although the bacterium is generally considered harmless, infections in humans can occur displaying a broad spectrum of clinical syndromes. This makes a clinical diagnosis difficult. The patient in the present case was 67 years old and presented to the emergency room (ER) with pain in the upper right abdomen and clinical signs of a feverish infection. The only noticeable record in the patient&ac...
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
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Source: Oral Surgery - Category: ENT & OMF Authors: Tags: CASE REPORT Source Type: research
Quintero EA Abstract Pyomyositis commonly presents with fever, muscle pain and abscess formation involving deep soft-tissue compartments. Staphylococcus aureus is the main causative organism and diagnosis is usually established clinically, supported by imaging, but confirmation may be achieved by histopathological examination. Broad-spectrum antibiotic therapy and surgical debridement are the cornerstone of treatment. Its prognosis is good but, as in all soft-tissue infections, it depends on early intervention, directed antibiotics and, if indicated, prompt surgery. In this paper, we describe a case of pelvic pyom...
Source: Tropical Doctor - Category: Tropical Medicine Authors: Tags: Trop Doct Source Type: research
Authors: Colman S, Cattoir L, Van Vaerenbergh K, De Beenhouwer H, Boel A Abstract Entamoeba histolytica infections are rare in developed countries such as Belgium. A 53-year-old female patient presented with 10 days of fever and mild persisting pain in the right hypochondriac despite 6 days of antibiotic therapy. The anamnesis further revealed that the patient was born in Colombia and visits her native country on a regular basis. An abdominal CT-scan demonstrated a large hepatic abscess of 10×8 cm. The diagnosis of Entamoeba histolytica- infection was confirmed with real-time PCR (RT-PCR) from the aspirated m...
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
Conclusion: The idiopathic NF may still potentially occur after a clean ORIF of the hip region. The implementation of intensive guideline-based treatments may show improvements, but the risk of unexpected NF spread to the abdomen should be anticipated, which may increase the mortality rates in diabetic or immunocompromised patients.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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