4,394 results on '"gas gangrene"'
Search Results
52. Gas Gangrene
- Author
-
Gupta, Parmanand, Shah, Hitesh, Belthur, Mohan V., editor, Ranade, Ashish S., editor, Herman, Martin J., editor, and Fernandes, James A., editor
- Published
- 2022
- Full Text
- View/download PDF
53. Clostridium myonecrosis — a rare and underdiagnosed condition in the elderly: a case with severe skipping lesions and an overview of treatment guidelines
- Author
-
Ellen Van Asbroeck, Ourania Vasileiadou, Sylvie De Laere, Eddy Van Hedent, and Katleen Devue
- Subjects
Spontaneous clostridial myonecrosis ,Gas gangrene ,Clostridial myonecrosis ,Clostridium septicum ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract We present an unusual and severe case of spontaneous clostridial myonecrosis (SCM) in an elderly patient, with severe skipping lesions spread throughout the body. CT imaging, combined with postmortem available blood cultures, confirmed the diagnosis. We noted an underrepresentation of SCM in the cohort of elderly patients (≥ 85 years), upon a review of case reports in the literature over the last decade. Given the worldwide demographic change resulting in an increase in the number of visits to emergency departments for this age group, it is likely that SCM is underdiagnosed in these elderly patients. This case report aims to increase awareness among emergency physicians to recognize the disease as well as to provide a treatment guideline, in order to provide better care and outcome.
- Published
- 2022
- Full Text
- View/download PDF
54. Clinical and Microbiological Features of Fulminant Haemolysis Caused by Clostridium perfringens Bacteraemia: Unknown Pathogenesis.
- Author
-
Suzaki, Ai and Hayakawa, Satoshi
- Subjects
CLOSTRIDIUM perfringens ,BACTEREMIA ,GAS gangrene ,ANAEROBIC bacteria ,CYTOKINE release syndrome - Abstract
Bacteraemia brought on by Clostridium perfringens has a very low incidence but is severe and fatal in fifty per cent of cases. C. perfringens is a commensal anaerobic bacterium found in the environment and in the intestinal tracts of animals; it is known to produce six major toxins: α-toxin, β-toxin, ε-toxin, and others. C. perfringens is classified into seven types, A, B, C, D, E, F and G, according to its ability to produce α-toxin, enterotoxin, and necrotising enterotoxin. The bacterial isolates from humans include types A and F, which cause gas gangrene, hepatobiliary infection, and sepsis; massive intravascular haemolysis (MIH) occurs in 7–15% of C. perfringens bacteraemia cases, resulting in a rapid progression to death. We treated six patients with MIH at a single centre in Japan; however, unfortunately, they all passed away. From a clinical perspective, MIH patients tended to be younger and were more frequently male; however, there was no difference in the toxin type or genes of the bacterial isolates. In MIH cases, the level of θ-toxin in the culture supernatant of clinical isolates was proportional to the production of inflammatory cytokines in the peripheral blood, suggesting the occurrence of an intense cytokine storm. Severe and systemic haemolysis is considered an evolutionary maladaptation as it leads to the host's death before the bacterium obtains the benefit of iron utilisation from erythrocytes. The disease's extraordinarily quick progression and dismal prognosis necessitate a straightforward and expedient diagnosis and treatment. However, a reliable standard of diagnosis and treatment has yet to be put forward due to the lack of sufficient case analysis. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
55. Gas-Producing Infections in the Foot at a Large Academic Medical Center: A 10-Year Retrospective Review.
- Author
-
Martucci, John A. and Riemer, Kevin
- Abstract
Gas-producing infections, such as clostridial and nonclostridial gas gangrene, crepitant cellulitis, and necrotizing fasciitis, are characterized in the literature by a variety of initial presentations, microbial burdens and surgical outcomes—ranging from debridement to amputation to death. The primary aim of this study was to identify the organisms cultured in gas-producing infections of the foot in patients that presented to a large academic medical center over a 10-year period. Our secondary aims were to report the prevalence of sepsis in this population upon presentation, and patient outcomes upon discharge. After a retrospective chart review of 207,534 procedures, 70 surgical cases met inclusion criteria. The most common organisms that grew in operating room cultures were Staphylococcus aureus , Group B Beta Streptococcus, and Enterococcus species. Just over half of the population presented with sepsis. After an average of 2 or more operations, 64% of patients underwent amputation. One death occurred. Gas-producing infections, or "gas gangrene," are primarily polymicrobial infections, rarely due to Clostridium perfringens , that warrant surgical exploration for optimal outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
56. Infectious shock after liposuction
- Author
-
Jinqiang Lu, Xiao Jiang, Hongyin Huang, Lingzhi Tang, Xinhui Zou, Haoran Mao, and Hongwei Liu
- Subjects
Liposuction ,Clostridium perfringens ,Gas gangrene ,Complications ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Liposuction has become one of the most popular cosmetic surgeries in China. However, few studies have discussed infectious shock caused by C. perfringens as one of the causes of death after liposuction. Case presentation A 24-year-old woman was brought to the emergency department (ED) of Guangzhou Chinese Overseas Hospital for treatment. The patient had undergone liposuction in her bilateral lower limbs two days prior. At the ED, the patient was unconscious, and had bilateral equal-sized (diameter, 6 mm) round pupils, no light reflex, a blood pressure (BP) of 71/33 mmHg, a heart rate of 133 bpm, and an SpO2 of 70%. She had bilateral limb swelling, extensive ecchymoses in her lower abdomen and bilateral thighs, local crepitus, blisters, weak pulses on her femoral artery and dorsalis pedis, high skin tension, and hemoglobin of 32 g/L. The patient was diagnosed with Clostridium perfringens infection, and she underwent debridement surgery and supportive treatment. But the patient’s BP could not improve. At 8:28 pm on the day of admission, the patient was declared clinically dead after the electrocardiograph showed a horizontal line and spontaneous respiration ceased. Conclusions Failure to meet surgical disinfection and environmental standards may be the cause of infection of C. perfringens through wounds. Therefore, it is necessary to strengthen the environmental disinfection of the operating room, and standardize the sterile conditions of the operation staff and patients before and during operation. Liposuction surgery necrotizing fasciitis is a rare but fatal complications, especially if diagnosis delay, therefore it is critical for early diagnosis and treatment of gas gangrene.
- Published
- 2022
- Full Text
- View/download PDF
57. Gravis subcutan emphysema a felső végtagon Esettanulmány.
- Author
-
ZOLTÁN, SÁNDOR, ÁKOS, MÁTRAI, ANDRÁS, MESTERHÁZI, ÁRPÁD, FEKETE, and CSABA, BIRÓ
- Abstract
The authors present the case of a 25-year-old female patient with post-traumatic severe subcutaneous emphysema of the upper limb and neck region with a tendency to relapse. On the day of his admission, following a banal trauma, subcutaneous emphysema appeared on the left upper limb without other systemic abnormalities. Surgery became necessary due to the patient’s rapidly deteriorating general condition. The extent of the emphysema gradually increased before stagnating and finally regressing. He was discharged cured, no recurrence or complaints were mentioned during the one-week control examination. The patient presented again one month after the emission, where compared to the previous occasion, subcutaneous emphysema located proximally, covering the entire left upper limb and the neck region was confirmed. Despite the exploration and necrectomy, the patient’s general condition began to deteriorate. Laboratory values did not show any significant differences, gas-forming pathogens could not be detected. Wound revisions were performed every two days, and operative and intravenous antibiotic therapy was supplemented with high-flow mask oxygen therapy. The patient’s general condition finally began to improve, his wounds healed without reaction, the subcutaneous emphysema was absorbed and did not recur. He was discharged cured, appeared in control examinations, and has had no complaints since then. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
58. Gas in the myocardium: a fatal presentation of Clostridium perfringens: a case report.
- Author
-
Khan, Hafiz Muhammad Waqas, Yousaf, Amman, Ahmad, Muhammad, and Changezi, Hameem U
- Subjects
CLOSTRIDIUM perfringens ,GAS gangrene ,ACUTE coronary syndrome ,MYOCARDIUM ,CHEST pain ,COMPUTED tomography ,CLOSTRIDIUM diseases - Abstract
Background Clostridium perfringens is a well-known cause of gas gangrene with a very high mortality rate. Multiple cases of internal organs have been reported in the literature; however, non-traumatic spontaneous gas gangrene due to C. perfringens with solely cardiac involvement in a patient without any risk factors has not been reported before. Case Summary A 52-year-old male presented to the emergency department with chest pain and exertional dyspnoea for three days. The patient was haemodynamically stable initially, and the physical examination was unremarkable. Initial laboratory workup revealed elevated D-dimer and troponin levels. Computerized tomography (CT) of the chest was negative for pulmonary embolism but showed a hypodense focus in the cardiac silhouette. Acute coronary syndrome protocol was initiated; however, invasive cardiac workup was negative. The patient had rapid clinical deterioration with development of respiratory failure, shock, and multiorgan failure within 24 h. A transesophageal echocardiogram demonstrated an abnormal echogenic focus, corresponding to CT chest area. Despite aggressive treatment, the patient passed away within 36 h. Later, the patient's blood culture grew C. perfringens. A limited autopsy showed an abscess cavity in the interventricular septum, pathology of which revealed acute myocarditis and fibrinous pericarditis. Discussion Unlike other reported cases of C. perfringens with cardiac abscess, our patient had no known risk factors, and no other organs were involved. We conclude from this case that an air focus on the CT scan in the myocardium can be suggestive of a spontaneous gas gangrene of the myocardium, and the patients should be treated accordingly. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
59. Myonecrosis caused by Clostridium septicum in a horse from Southern Brazil.
- Author
-
Geribone Seeger, Marlane, Biavaschi Silva, Gabriele, Sleutjes Machado, Carolina, Palma da Silva, Diego Rafael, Desessards De La Corte, Flávio, Flores Vogel, Fernanda Silveira, and Felipetto Cargnelutti, Juliana
- Subjects
- *
HORSE diseases , *GAS gangrene , *CLOSTRIDIUM , *CLOSTRIDIUM perfringens , *HORSES , *SYMPTOMS , *INTRAMUSCULAR injections , *HOSPITAL admission & discharge - Abstract
Clostridial myonecrosis is a highly fatal infectious disease of the muscle that is caused by pathogenic clostridia. When it occurs in equine muscle, the infection can cause a variety of clinical signs. The present report described a case of acute myonecrosis caused by Clostridium septicum in a horse, which had a favorable clinical evolution. A 6-year-old mare was admitted to a veterinary hospital due to increased volume and lameness in the left pelvic limb after an intramuscular injection of an anti-inflammatory drug. The diagnosis of myonecrosis caused by C. septicum was based on clinical and laboratory findings. The animal showed significant improvement after 5 months of treatment and was discharged from the hospital. There is very limited information regarding myonecrosis caused by C. septicum in horses in Brazil; our study showed that early diagnosis and prompt appropriate treatment can ensure significant improvement and recovery of affected animals. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
60. Pathogenicity and virulence of Clostridium perfringens
- Author
-
Iman Mehdizadeh Gohari, Mauricio A. Navarro, Jihong Li, Archana Shrestha, Francisco Uzal, and Bruce A. McClane
- Subjects
clostridium perfringens ,toxins ,sporulation ,quorum sensing ,two-component regulatory systems ,gas gangrene ,enteritis/enterocolitis ,enterotoxemia ,Infectious and parasitic diseases ,RC109-216 - Abstract
Clostridium perfringens is an extremely versatile pathogen of humans and livestock, causing wound infections like gas gangrene (clostridial myonecrosis), enteritis/enterocolitis (including one of the most common human food-borne illnesses), and enterotoxemia (where toxins produced in the intestine are absorbed and damage distant organs such as the brain). The virulence of this Gram-positive, spore-forming, anaerobe is largely attributable to its copious toxin production; the diverse actions and roles in infection of these toxins are now becoming established. Most C. perfringens toxin genes are encoded on conjugative plasmids, including the pCW3-like and the recently discovered pCP13-like plasmid families. Production of C. perfringens toxins is highly regulated via processes involving two-component regulatory systems, quorum sensing and/or sporulation-related alternative sigma factors. Non-toxin factors, such as degradative enzymes like sialidases, are also now being implicated in the pathogenicity of this bacterium. These factors can promote toxin action in vitro and, perhaps in vivo, and also enhance C. perfringens intestinal colonization, e.g. NanI sialidase increases C. perfringens adherence to intestinal tissue and generates nutrients for its growth, at least in vitro. The possible virulence contributions of many other factors, such as adhesins, the capsule and biofilms, largely await future study.
- Published
- 2021
- Full Text
- View/download PDF
61. Wound Infection with Multi-Drug Resistant Clostridium Perfringens: A Case Study
- Author
-
R Khandia, N Puranik, D Bhargava, N Lodhi, B Gautam, and K Dhama
- Subjects
clostridium perfringens ,gas gangrene ,multi-drug resistance ,wound ,Veterinary medicine ,SF600-1100 - Abstract
Wound infections are among public health problems worldwide. However, progress has been made in improving surgical techniques and antibiotic treatments. Misuse/overuse of antibiotics to prevent and treat bacterial infections eventually leads to increased bacterial resistance with rising incidences of multi-drug resistant (MDR) bacterial strains. The wider dissemination of antibiotics may ultimately result in ineffectiveness to antibiotic therapy, thereby complicating/graving the outcome of a patient. In the present study, a 60-year-old male patient having wound infection with MDR bacterium that ultimately required surgical amputation of the toe was investigated. For the confirmation of MDR bacterium, two culture media viz., MacConkeyAgar and Mueller Hinton Agar media were used. The sensitivity of the isolated strain for various antibiotics was tested using the disc diffusion method. The wound sample was found positive for Gram-positive bacterium that was identified as Clostridium perfringens. The bacterium was screened for 40 antibiotics, and among all the antibiotics, it was found sensitive for only Piperacillin/Tazobactam antibiotic combination. C. perfringens bacterium caused the gas gangrene in the infected wound part of the patient. Amputation of the gangrene –affected foot part was performed by surgery, and with good medical care, the person recovered fast. To the best of our knowledge, this is the first-ever report of MDRC. perfringens single isolate harboring resistance against at least 40 antibiotics tested. More research is needed to develop really new and effective medicines that do not cross-react with antibiotics now in use and have robust activity against MDR organisms.
- Published
- 2021
- Full Text
- View/download PDF
62. Clostridium myonecrosis — a rare and underdiagnosed condition in the elderly: a case with severe skipping lesions and an overview of treatment guidelines.
- Author
-
Van Asbroeck, Ellen, Vasileiadou, Ourania, De Laere, Sylvie, Van Hedent, Eddy, and Devue, Katleen
- Subjects
- *
SKIN diseases , *BLOOD , *CELL culture , *PROFESSIONS , *MEDICAL protocols , *COMPUTED tomography , *GAS gangrene - Abstract
We present an unusual and severe case of spontaneous clostridial myonecrosis (SCM) in an elderly patient, with severe skipping lesions spread throughout the body. CT imaging, combined with postmortem available blood cultures, confirmed the diagnosis. We noted an underrepresentation of SCM in the cohort of elderly patients (≥ 85 years), upon a review of case reports in the literature over the last decade. Given the worldwide demographic change resulting in an increase in the number of visits to emergency departments for this age group, it is likely that SCM is underdiagnosed in these elderly patients. This case report aims to increase awareness among emergency physicians to recognize the disease as well as to provide a treatment guideline, in order to provide better care and outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
63. SYSTEMIC CLOSTRIDIOSIS DUE TO Clostridiumperfringens INFECTION IN Equus asinus - CASE REPORT.
- Author
-
LEMFERS, T. R., VON AH, R. M. L., GAGLIARDI, B., PUCCI, L. R., STANCIAR, B. P., DÉRCOLI, T. E., and CALEFI, A. S.
- Subjects
- *
GAS gangrene , *EQUUS , *CLOSTRIDIUM perfringens , *INTRAMUSCULAR injections , *INFECTION , *DERMATOMYOSITIS , *MYOSITIS , *DONKEYS - Abstract
Clostridial infections, particularly clostridial myonecrosis, can be fulminant and fatal; they often arise without an obvious history of trauma. The majority of equine clostridial myonecrosis cases are associated with intramuscular injection. This paper presents the first report of clostridial myositis by C. perfringens in a donkey after an injection of flunixin meglumine on the neck, describing the clinical, necroscopic, and histopathological events. Bacterial isolation and biochemical tests confirmed the definitive diagnosis of C. perfringens. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
64. LDLR, LRP1, and Megalin redundantly participate in the uptake of Clostridium novyi alpha-toxin.
- Author
-
Zhou, Yao, Li, Danyang, Li, Diyin, Chen, Aizhong, He, Liuqing, Luo, Jianhua, and Tao, Liang
- Subjects
- *
GAS gangrene , *CLOSTRIDIUM , *LOW density lipoprotein receptors , *LIPOPROTEIN receptors , *CELL membranes , *EXOTOXIN , *NECROTIC enteritis - Abstract
Clostridium novyi alpha-toxin (Tcnα) is a potent exotoxin that induces severe symptoms including gas gangrene, myositis, necrotic hepatitis, and sepsis. Tcnα binds to sulfated glycosaminoglycans (sGAG) for cell-surface attachment and utilizes low-density lipoprotein receptor (LDLR) for rapid entry. However, it was also shown that Tcnα may use alternative entry receptors other than LDLR. Here, we define that LRP1 and Megalin can also facilitate the cellular entry of Tcnα by employing reconstitutive LDLR family proteins. LDLR, LRP1, and Megalin recognize Tcnα via their ligand-binding domains (also known as LDL receptor type A repeats). Notably, LDLR and LRP1 have contrasting expression levels in many different cells, thus the dominant entry receptor for Tcnα could be cell-type dependent. These findings together increase our knowledge of the Tcnα actions and further help to understand the pathogenesis of C. novyi infection-associated diseases. Clostridium novyi alpha-toxin (Tcnα) also uses LRP1 and Megalin as cellular entry receptors besides LDLR, and this might be a response to cell-type dependent receptor availability for the exotoxin. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
65. Clostridial panophthalmitis – An unusual case of localised malignant oedema in Merino lambs associated with Clostridium chauvoei.
- Author
-
Moloney, BJ and Evers, JV
- Subjects
- *
LAMBS , *EWES , *CLOSTRIDIUM diseases , *GAS gangrene , *CLOSTRIDIUM , *EDEMA , *DEATH rate - Abstract
The authors report an unusual case of Clostridium chauvoei causing severe panophthalmitis in Merino lambs. More than half of the lambs affected survived, which is unusual for clostridial disease; however, there have been reports in humans that the mortality risk for ocular gas gangrene is lower than when other body parts are affected. A combination of factors in this case included environmental contamination (specific to a particular paddock), genetics predisposing to entropion (lambs born of maiden 2‐year‐old ewes with some inbreeding), the practice of manually everting eyelids for the entropion and vaccination strategies. C. chauvoei was cultured in pure growth from the eye of a lamb affected by severe panophthalmitis. Histopathology was consistent with severe acute infection, and microscopic sections showed Gram‐positive organisms associated with the inflammatory response in the eye. In the acutely affected animal examined there were no signs that the lesions were long‐standing. Animals that recovered had one or both eyes destroyed. This report describes that malignant oedema in sheep due to C. chauvoei can manifest as acute and severe panophthalmitis. The case fatality rate of lambs with panophthalmitis was less than 50%, lower than normally occurs for clostridial diseases. Clostridial vaccination of the ewes may have provided a low level of protection in reducing the case fatality rate in the affected lambs as well localisation of the infection from the blood–ocular barrier. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
66. Major pathogenic Clostridia in human and progress toward the clostridial vaccines.
- Author
-
Khiav, Lida Abdolmohammadi and Zahmatkesh, Azadeh
- Subjects
- *
CLOSTRIDIA , *GAS gangrene , *VACCINE immunogenicity , *VACCINES , *VACCINE development , *VACCINE effectiveness - Abstract
The Clostridium genus is composed of a large spectrum of heterogeneous bacteria. They are Gram-positive, mostly mesophilic, and anaerobic spore-forming strains. Clostridia are widely distributed in oxygen-free habitats. They are found principally in the soil and intestines of ruminants as normal flora, but also are the cause of several infections in humans. The infections produced by important species in humans include botulism, tetanus, pseudomembranous colitis, antibiotics-associated diarrhea, and gas gangrene. Immunization with toxoid or bacterin-toxoid or genetically modified or other vaccines is a protective way against clostridial infection. Several experimental or commercial vaccines have been developed worldwide. Although conventional vaccines including toxoid vaccines are very important, the new generation of vaccines is an effective alternative to conventional vaccines. Recent advances have made it possible for new vaccines to increase immunogenicity. This review discusses briefly the important species of clostridia in humans, their toxins structure, and vaccine development and usage throughout the world. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
67. PROFILE OF PEDIS GANGRENE PATIENTS WITH TYPE II DIABETES MELLITUS AT BHAYANGKARA HOSPITAL KEDIRI PERIOD JANUARY 2021 - MARCH 2022.
- Author
-
Javier, R. Mohamad, Sukin, Yuswar Nurullah, and Yunus, Mochamad
- Subjects
- *
TYPE 2 diabetes , *GAS gangrene , *GANGRENE , *SOFT tissue infections , *GRAM-positive bacteria - Abstract
Gas gangrene is a disease that is identical to the incidence of type 2 diabetes mellitus with the characteristics of muscle necrosis / myonecrosis and is a very deadly infection of the inner soft tissues, often caused by gram-positive bacteria such as Staphylococcus aureus, Clostridium perifingens. Diabetes mellitus is a collection of symptoms caused by disturbances in the balance between carbohydrates, fats and proteins caused by absolute or relative insulin deficiency, causing hyperglycemia and glucosuria. to describe the profile of patients with gas gangrene pedis caused by type II diabetes mellitus obtained from the results of secondary data research at Bhayangkara Hospital Kediri Period January 2021 - March 2022. This study is an observational study (Non Experimental Design) using a cohort retrospective design method. The sample in this study were patients with Gas Gangrene Pedis who were obtained from the patient's medical records in the period January 2021 - March 2022 at Bhayangkara Hospital Kediri with Type II Diabetes Mellitus. Results: Based on the results of the Association Test between Wagner Grade and Gas Therapy, gangrene pedis has a p value of 0.199. The Wagner Grade variable with gas gangrene pedis therapy had an insignificant relationship with debridement measures n = 8 and the most common bacterium was Pseudomonas aeruginosa with n = 4. Patients with gas gangrene pedis who had a history of not routinely controlling because of their DM treatment, there was a high probability of progressive progression. worsening of his condition due to metabolic neuropathy and the effect of different treatment outcomes for each patient. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
68. Spontaneous gas gangrene of the lower limb in a patient with rectal cancer: A fatal diagnostic pitfall.
- Author
-
Mahjoubi, Mohamed Farès, Rezgui, Bochra, Mabrouk, Aymen, Essid, Nada, Jedidi, Laila, and Ben Moussa, Mounir
- Subjects
- *
GAS gangrene , *RECTAL cancer , *VENOUS thrombosis , *CANCER patients , *DELAYED diagnosis - Abstract
Spontaneous gas gangrene of lower limb is rare. It may complicate digestive cancer or neutropenia. We report a case of spontaneous gas gangrene of the lower limb complicating a rectal cancer, initially diagnosed as deep vein thrombosis. The diagnostic delay was fatal. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
69. Immunoinformatic analysis of the whole proteome for vaccine design: An application to Clostridium perfringens.
- Author
-
Soto, Luis F., Romanı, Ana C., Jiménez-Avalos, Gabriel, Silva, Yshoner, Ordinola-Ramirez, Carla M., Lopez Lapa, Rainer M., and Requena, David
- Subjects
CLOSTRIDIUM perfringens ,PROTEOMICS ,CLOSTRIDIA ,GAS gangrene ,MEMBRANE proteins ,MOLECULAR dynamics - Abstract
Clostridium perfringens is a dangerous bacterium and known biological warfare weapon associated with several diseases, whose lethal toxins can produce necrosis in humans. However, there is no safe and fully effective vaccine against C. perfringens for humans yet. To address this problem, we computationally screened its whole proteome, identifying highly immunogenic proteins, domains, and epitopes. First, we identified that the proteins with the highest epitope density are Collagenase A, Exo-alpha-sialidase, alpha nacetylglucosaminidase and hyaluronoglucosaminidase, representing potential recombinant vaccine candidates. Second, we further explored the toxins, finding that the non-toxic domain of Perfringolysin O is enriched in CTL and HTL epitopes. This domain could be used as a potential sub-unit vaccine to combat gas gangrene. And third, we designed a multi-epitope protein containing 24 HTL-epitopes and 34 CTL-epitopes from extracellular regions of transmembrane proteins. Also, we analyzed the structural properties of this novel protein using molecular dynamics. Altogether, we are presenting a thorough immunoinformatic exploration of the whole proteome of C. perfringens, as well as promising whole-protein, domain-based and multiepitope vaccine candidates. These can be evaluated in preclinical trials to assess their immunogenicity and protection against C. perfringens infection. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
70. Piceatannol Alleviates Clostridium perfringens Virulence by Inhibiting Perfringolysin O.
- Author
-
Wang, Guizhen, Liu, Hongtao, Gao, Yawen, Niu, Xiaodi, Deng, Xuming, Wang, Jianfeng, Feng, Haihua, Guo, Zhimin, and Qiu, Jiazhang
- Subjects
- *
CLOSTRIDIUM perfringens , *GAS gangrene , *COMPUTATIONAL biology , *POULTRY breeding , *NECROTIC enteritis , *LIVESTOCK breeding - Abstract
Clostridium perfringens (C. perfringens) is an important foodborne pathogen that can cause diseases such as gas gangrene and necrotizing enteritis in a variety of economic animals, seriously affecting public health and the economic benefits and healthy development of the livestock and poultry breeding industry. Perfringolysin O (PFO) is an important virulence factor of C. perfringens and plays critical roles in necrotic enteritis and gas gangrene, rendering it an ideal target for developing new drugs against infections caused by this pathogen. In this study, based on biological activity inhibition assays, oligomerization tests and computational biology assays, we found that the foodborne natural component piceatannol reduced pore-forming activity with an inhibitory ratio of 83.84% in the concentration of 16 µg/mL (IC50 = 7.83 µg/mL) by binding with PFO directly and changing some of its secondary structures, including 3-Helix, A-helix, bend, and in turn, ultimately affecting oligomer formation. Furthermore, we confirmed that piceatannol protected human intestinal epithelial cells from the damage induced by PFO with LDH release reduced by 38.44% at 16 µg/mL, based on a cytotoxicity test. By performing an animal experiment, we found the C. perfringens clones showed an approximate 10-fold reduction in infected mice. These results suggest that piceatannol may be a candidate for anti-C. perfringens drug development. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
71. What are the Alternatives to the LRINEC Score in Identifying Necrotizing Soft Tissue Infections in the Emergency Department?
- Author
-
Çalbay, Ayça, Bayramoğlu, Atıf, and Karadeniz, Erdem
- Subjects
SOFT tissue infections ,NECROTIZING fasciitis ,FOURNIER gangrene ,GAS gangrene ,HOSPITAL emergency services ,SURGICAL clinics - Abstract
Background: The emergency department (ED) is an dynamically high-risk setting. Our aim is to determine the blood parameters associated with necrotizing soft tissue infections (NSTI) to strengthen the LRINEC score. Materials and methods: We analyzed 109 patients who were diagnosed with necrotizing soft tissue infection in the Urology, Dermatology, Plastic surgery and General Surgery clinics of Atatürk University between 2013 and 2016. In the same period, we matched 624 patients diagnosed with cellulitis as a control group. Results: Of four defined clinic's records to Atatürk University Hospital in 2013 to 2016, 109 matched and 624 matched control records were abstracted. Diagnoses associated with the NSTIs were: gangrene (n=47), gas gangrene (n=7), Fournier's gangrene (n=44) and necrotizing fasciitis (n=11). In patients with Necrotizing Soft Tissue Infection, BUN (p=0,00), K (0,011), Neutrofil (p=0,013), Lenfosit (p=0,003), Htc (p=0,00), RDW (p=0,002), Plt (p=0,042), AST (p=0,00), ALT (p=0,00) and INR (p=0,003) values were found to be statistically significant in making the diagnosis. Conclusion: BUN, K, Neutrofil, Lenfosit, Htc, RDW, Plt, AST, ALT and INR values measured from blood tests of patients diagnosed with NSTI can be used in distinctive diagnosis of Soft Tissue Infection (STI). Increased awareness of these values may improve Emergency Department (ED) decision making and prevent miss diagnose. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
72. Prognosis and Treatment of Necrotizing Soft Tissue Infections: A Prospective Cohort Study (ProTreat)
- Author
-
Seventh Framework Programme and Ole Hyldegaard, Clinical Professor
- Published
- 2019
73. Modulation of Biomarkers in Patients With Flesh-eating Bacterial Infections After With Hyperbaric Oxygen Treatment (BIONEC-II)
- Author
-
Ole Hyldegaard, MD, PhD, DMSci
- Published
- 2019
74. [Fatal course of a fulminant gas gangrene of the right hemithorax].
- Author
-
Neumann CJ, Unterberg M, Mesbah D, Sandfort M, and Smektala R
- Abstract
The full clinical picture of a gas gangrene infection is an absolute rarity. The mechanism of development can be either traumatic or spontaneous (e.g., hematogenous seeding in occult colon carcinoma). In particular, the rare pathogen Clostridium septicum appears to be associated with spontaneously occurring gas gangrene. Diabetes mellitus is a significant risk factor. The mortality rate of the disease is around 50%, even with maximum therapeutic efforts, and the course of the disease is fulminant in the majority of cases. Initial symptoms are unspecific and make early diagnosis difficult. Treatment consists of high-dose antibiotics in combination with radical surgical debridement and, if necessary, supplementary hyperbaric oxygen therapy., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
75. Advanced Calciphylaxis in a Patient With End-Stage Renal Disease: A Case Report Highlighting Diagnostic and Therapeutic Challenges in Late-Stage Presentation.
- Author
-
Chaganlal PP, Kalandoor V, Jones DT, Pace C, and Silver SA
- Abstract
Calciphylaxis, also known as calcific uremic arteriolopathy, is a rapidly progressive, rare, and severe condition characterized by vascular calcification and skin necrosis. The pathophysiology involves cutaneous arteriolar calcification followed by subsequent tissue ischemia and infarction, which eventually causes extremely painful skin lesions. The condition is associated with substantial morbidity due to severe pain, non-healing wounds, increased susceptibility to infections, and frequent hospitalizations. Calciphylaxis is a highly fatal condition with one-year mortality rates greater than 50%, most frequently due to sepsis. This report presents a case of a 63-year-old male with end-stage kidney disease (ESKD) who presented with altered mental status and was found to have notable necrotic skin ulcers on the bilateral anterior thighs, a stage IV sacral decubitus ulcer, and necrotic lesions on the scrotum and penis. This case underscores the importance of maintaining a high clinical suspicion for rare conditions like calciphylaxis in patients with multiple risk factors. Diagnosing the disease earlier in its course may improve outcomes and overall prognosis. Unfortunately, in this case, the patient presented too late into the disease course, and ultimately discussions/placement with palliative care were undertaken., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chaganlal et al.)
- Published
- 2024
- Full Text
- View/download PDF
76. Fatal Clostridium septicum gas gangrene complicating ECMO: case report and review of literature.
- Author
-
Turban A, Joussellin V, Piau C, Cattoir V, Launey Y, and Eustache G
- Abstract
Clostridium septicum gas gangrene is a severe and deadly infection caused by an anaerobic, spore-forming, Gram-positive bacillus. As previously described, two entities are observed: traumatic and spontaneous (or non-traumatic) forms. In this report, we aim to describe the case of a fulminant and ultimately fatal C. septicum myonecrosis occurring in a patient who was first admitted for refractory cardiac arrest and placed on veino-arterial extracorporeal membrane oxygenation (ECMO). Building upon prior studies that have documented cases of spontaneous gas gangrene caused by C. septicum , we provide an updated compilation, focusing on microbiological characteristics of C. septicum , along with the diagnostic and therapeutic challenges associated with spontaneous gas gangrene. Additionally, the specific clinical situation of our case illustrates the seriousness of this infectious complication that combined both spontaneous and traumatic gas gangrene risk factors. We thus, discuss the antibiotic coverage prior to the initiation of ECMO procedure., Competing Interests: The authors have no competing interests to declare., (Copyright © 2024 The Authors.)
- Published
- 2024
- Full Text
- View/download PDF
77. Skin and Soft Tissue Infections Among Cancer Patients
- Author
-
Szvalb, Ariel D., Rolston, Kenneth V. I., Nates, Joseph L., editor, and Price, Kristen J., editor
- Published
- 2020
- Full Text
- View/download PDF
78. Right Leg Pain, Swelling, and Erythema for Two Days
- Author
-
Lee, Monica, Chen, David C., Grigorian, Areg, Frank, Paul N., de Virgilio, Christian, de Virgilio, Christian, editor, and Grigorian, Areg, editor
- Published
- 2020
- Full Text
- View/download PDF
79. Coinfection of Clostridium perfringens and Escherichia coli in gas-producing perianal abscess diagnosed by 16S rDNA sequencing: a case report
- Author
-
Yang Sun, Haotian Bai, Ji Qu, Jichao Liu, Jincheng Wang, Zhenwu Du, and Linlin Feng
- Subjects
Gas-producing perianal abscess ,16S rDNA ,DNA sequencing ,Clostridial infection ,Non-clostridial infection ,Gas gangrene ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Gas-producing perianal abscess raises the possibility of clostridial infection, with Clostridium perfringens being the most common causative agent, which is highly lethal if untreated timely. As the treatment of clostridial infections often differs from that of non-clostridial infections, which they may closely resemble, the importance of accurate pathogenic organism identification cannot be overemphasized. The 16S rDNA of bacteria is highly conserved within a species and among species of the same genus but demonstrates substantial variation between different species, thus making it a suitable genomic candidate for bacterial detection and identification. Case presentation Here, we report the case of a 53-year-old patient who was admitted to the hospital for a gas-producing perianal abscess. The patient was managed with ceftizoxime and ornidazole and then received debridement and drainage at the lesion on the second day after admission. The bacterial cultures of the patient isolates from the debridement showed a coinfection of Escherichia coli and Enterococcus faecium. Although perianal redness and swelling subsided obviously after the surgery, the patient was febrile to 38.3℃ with his left upper thigh red and swollen, aggravated with tenderness and crepitus. Considering insufficient debridement and the risk of incorrect identification of pathogens, a second debridement and drainage were performed 4 days after the primary operation, and 16S rDNA sequencing of the isolates implicated Clostridium perfringens infection. Given the discrepancies in diagnostic results and the treatment outcomes, Enterococcus faecium was identified as sample contamination, and a diagnosis of coinfection of Clostridium perfringens and Escherichia coli in gas-producing perianal abscess was confirmed. The patient was then successfully treated with meropenem and vancomycin and was discharged at 27 days of admission. Conclusions This case represents the first report of coinfection of both clostridial and non-clostridial organisms in gas-producing perianal abscess and the first case reporting the use of 16S rDNA sequencing in the diagnosis of perianal abscess. Timely pathogen identification is critical for treating gas-producing perianal abscess and an antibiotic regimen covering both aerobic and anaerobic organisms is recommended before true pathogens are identified.
- Published
- 2021
- Full Text
- View/download PDF
80. Clostridium septicum-induced gangrene in the right lower extremity complicating pneumatosis in the right ventricle and the pulmonary artery and occlusion of right femoral artery: a case report
- Author
-
Hui-Dan Jing, Lei Li, Jun-Ying Tian, and Dong-Po Jiang
- Subjects
Clostridium septicum ,Gas gangrene ,Air embolism ,Artery occlusion ,Case report ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Gas gangrene is usually manifested as myonecrosis and subcutaneous gas accumulation, but rarely manifested as arterial occlusion or pneumatosis in the right ventricle and the pulmonary artery. Case presentation We report a case of gas gangrene caused by Clostridium septicum. The patient developed gas gangrene after being pecked by a chicken but turned for the better following antibiotic treatment and debriment. Imaging test revealed a rare occlusion of the right femoral artery and pneumatosis in the right ventricle and the main pulmonary artery. Conclusions In the presence of gas gangrene, special care must be taken to prevent against the formation of circulatory air embolism. The gas gangrene-induced gangrene in the limb of this patient might be attributed to the combined action of infection and arterial occlusion. MDT (Multidisciplinary team)-Green Channel mode is conductive to treatment success of gas gangrene.
- Published
- 2021
- Full Text
- View/download PDF
81. Spontaneous gas gangrene of the lower limb in a patient with rectal cancer: A fatal diagnostic pitfall
- Author
-
Mohamed Farès Mahjoubi, Bochra Rezgui, Aymen Mabrouk, Nada Essid, Laila Jedidi, and Mounir Ben Moussa
- Subjects
delayed diagnosis ,gas gangrene ,rectal neoplasms ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Spontaneous gas gangrene of lower limb is rare. It may complicate digestive cancer or neutropenia. We report a case of spontaneous gas gangrene of the lower limb complicating a rectal cancer, initially diagnosed as deep vein thrombosis. The diagnostic delay was fatal.
- Published
- 2022
- Full Text
- View/download PDF
82. Infectious shock after liposuction.
- Author
-
Lu, Jinqiang, Jiang, Xiao, Huang, Hongyin, Tang, Lingzhi, Zou, Xinhui, Mao, Haoran, and Liu, Hongwei
- Subjects
- *
LIPOSUCTION , *GAS gangrene , *CLOSTRIDIUM diseases , *PLASTIC surgery , *CLOSTRIDIUM perfringens , *NECROTIZING fasciitis , *EPIDERMOLYSIS bullosa - Abstract
Background: Liposuction has become one of the most popular cosmetic surgeries in China. However, few studies have discussed infectious shock caused by C. perfringens as one of the causes of death after liposuction.Case Presentation: A 24-year-old woman was brought to the emergency department (ED) of Guangzhou Chinese Overseas Hospital for treatment. The patient had undergone liposuction in her bilateral lower limbs two days prior. At the ED, the patient was unconscious, and had bilateral equal-sized (diameter, 6 mm) round pupils, no light reflex, a blood pressure (BP) of 71/33 mmHg, a heart rate of 133 bpm, and an SpO2 of 70%. She had bilateral limb swelling, extensive ecchymoses in her lower abdomen and bilateral thighs, local crepitus, blisters, weak pulses on her femoral artery and dorsalis pedis, high skin tension, and hemoglobin of 32 g/L. The patient was diagnosed with Clostridium perfringens infection, and she underwent debridement surgery and supportive treatment. But the patient's BP could not improve. At 8:28 pm on the day of admission, the patient was declared clinically dead after the electrocardiograph showed a horizontal line and spontaneous respiration ceased.Conclusions: Failure to meet surgical disinfection and environmental standards may be the cause of infection of C. perfringens through wounds. Therefore, it is necessary to strengthen the environmental disinfection of the operating room, and standardize the sterile conditions of the operation staff and patients before and during operation. Liposuction surgery necrotizing fasciitis is a rare but fatal complications, especially if diagnosis delay, therefore it is critical for early diagnosis and treatment of gas gangrene. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
83. Fatal non-traumatic gas gangrene caused by Clostridium perfringens type A in a Siberian Husky dog.
- Author
-
Sprohnle-Barrera, Cleide H., Gibson, Justine S., Price, Rochelle, Graham, Rikki M., Jennison, Amy V., Ricca, Madeline R., and Allavena, Rachel E.
- Subjects
GAS gangrene ,CLOSTRIDIUM perfringens ,AUTOPSY ,SUBCUTANEOUS emphysema ,NUCLEOTIDE sequencing ,MULTIPLE organ failure - Abstract
An 8-y-old, castrated male Siberian Husky dog was admitted to an emergency clinic with acute collapse and severe swelling of both forelimbs, ventral thorax, and axillary region. The clinical assessment, with laboratory tests and radiologic investigation, confirmed severe subcutaneous emphysema and multi-organ failure. The animal died while receiving emergency treatment. On postmortem examination, Clostridium perfringens was isolated from the subcutaneous fluid and the effusion from the thoracic and abdominal cavities. Relevant histopathology findings included subcutaneous emphysema and multi-organ perivascular and intravascular, intralesional myriad 0.5–3-µm gram-positive rod bacteria, with no associated inflammation. Whole-genome sequencing and phylogenetic analysis identified C. perfringens type A. Virulence genes detected included cpa (alpha toxin), cadA (v-toxin), colA (collagenase A), nagH (hyaluronidase), nanH, nanI, nanJ (sialidases), and pfoa (perfringolysin). These virulence genes have previously been reported to act synergistically with alpha toxin in C. perfringens– mediated gas gangrene. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
84. Ask Our Vet: Can blackquarter be prevented?
- Author
-
McCrindle, Cheryl
- Subjects
- *
GAS gangrene , *GOATS - Abstract
The article presents answer to a question related to a fatal gas gangrene caused by Clostridium chauvoei, affects unvaccinated cattle and sheep, often breaking out suddenly after heavy rains.
- Published
- 2024
85. New Soft Tissue Infections Findings from Yale University School of Medicine Outlined (A Cross-sectional Analysis of Pediatric Necrotizing Soft Tissue Infection Cases and Racial Disparities From the 2016 To 2020 National Inpatient Sample).
- Subjects
SOFT tissue infections ,FOURNIER gangrene ,NOSOLOGY ,GAS gangrene ,NECROTIZING fasciitis - Abstract
A new report from Yale University School of Medicine provides insights into pediatric necrotizing soft tissue infections (NSTIs) and racial disparities. The study analyzed data from the National Inpatient Sample from 2016 to 2020 and identified 355 pediatric patients with NSTIs. Black and Hispanic patients accounted for the most admissions in certain years, and there were disparities in insurance coverage and income quartiles. However, there were no significant differences in treatment or outcomes based on race. The study concludes that while black patients are disproportionately diagnosed, these disparities do not extend to disease treatment or outcomes. [Extracted from the article]
- Published
- 2024
86. Findings from University of Health Sciences Turkey Broaden Understanding of Chalcogens (Our Experiences with Hyperbaric Oxygen Therapy in Paediatric Orthopaedics).
- Subjects
HYPERBARIC oxygenation ,GAS gangrene ,SOFT tissue infections ,CHILDREN'S hospitals ,CHILD patients ,PEDIATRIC orthopedics - Abstract
A study conducted by researchers at the University of Health Sciences Turkey aimed to determine the most common orthopedic indications for hyperbaric oxygen therapy (HBOT) in pediatric patients. The study reviewed the files and system records of pediatric patients who underwent HBOT between 2006 and 2016. Out of 31 patients, 24 completed the treatment as planned, with 19 achieving a cure. The study concluded that HBOT can be safely used in pediatric orthopedics, but larger patient series are needed for further research. [Extracted from the article]
- Published
- 2024
87. Data from Teaching Hospital Provide New Insights into Gangrene (Association Between Insurance Status and Outcomes of Hospitalizations for Necrotizing Soft Tissue Infections).
- Subjects
GAS gangrene ,SOFT tissue infections ,FOURNIER gangrene ,HEALTH maintenance organizations ,HEALTH insurance - Abstract
A study conducted at a teaching hospital in Jos, Nigeria examined the impact of insurance status on the outcomes of hospitalizations for necrotizing soft tissue infections (NSTIs), specifically necrotizing fasciitis, gas gangrene, and Fournier gangrene. The study analyzed approximately 29,705 adult hospitalizations for NSTIs and found that uninsured status was not associated with significant differences in NSTI outcomes. However, Medicare insurance was correlated with greater odds of mortality, while Medicaid insurance was associated with increased odds of amputation and longer hospital stays. Private insurance was associated with lower odds of amputation. The study highlights the importance of insurance coverage in improving outcomes for patients with NSTIs. [Extracted from the article]
- Published
- 2024
88. Recurrent Idiopathic Pancreatitis Complicating as Emphysematous Pancreatitis and Gastroduodenal Artery Pseudoaneurysm: A Rare Case Report.
- Author
-
Taneja, Vinus, Shah, Darshit, Dessai, Rishikesh, Sondhi, Manuj, Nautiyal, Manishi, and Garg, Ambuj
- Subjects
- *
PANCREATITIS , *GAS gangrene , *FALSE aneurysms , *CHRONIC pancreatitis , *DIABETES , *COMPUTED tomography - Abstract
Emphysematous pancreatitis (EP) is a rare and potentially fatal condition of the pancreas. It is associated with gas-forming bacteria and is characterized by the presence of gas in or around the pancreas. It is identified by a computed tomography scan of the abdomen. Although predisposing factors are not precisely known, diabetes mellitus, which predisposes to gas gangrene, is seen to be commonly associated with patients of EP. EP being potentially fatal requires immediate management. Surgery is generally indicated in EP. However, EP can also managed conservatively. In our case, the patient developed recurrent pancreatitis, the cause being idiopathic, and the second episode of acute pancreatitis was complicated by EP and gastroduodenal artery pseudoaneurysm. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
89. Clostridium perfringens Sialidases: Potential Contributors to Intestinal Pathogenesis and Therapeutic Targets.
- Author
-
Li, Jihong, Uzal, Francisco A, and McClane, Bruce A
- Subjects
Animals ,Humans ,Clostridium perfringens ,Clostridium Infections ,Intestinal Diseases ,Neuraminidase ,Bacterial Proteins ,Bacterial Toxins ,Virulence ,Gene Expression Regulation ,Fungal ,gas gangrene ,intestinal infections ,sialidase inhibitors ,sialidases ,toxins ,Gene Expression Regulation ,Fungal ,Foodborne Illness ,Emerging Infectious Diseases ,Prevention ,Infectious Diseases ,Digestive Diseases ,2.2 Factors relating to physical environment ,Infection ,Biochemistry and Cell Biology ,Pharmacology and Pharmaceutical Sciences - Abstract
Clostridium perfringens is a major cause of histotoxic and intestinal infections of humans and other animals. This Gram-positive anaerobic bacterium can produce up to three sialidases named NanH, NanI, and NanJ. The role of sialidases in histotoxic infections, such as gas gangrene (clostridial myonecrosis), remains equivocal. However, recent in vitro studies suggest that NanI may contribute to intestinal virulence by upregulating production of some toxins associated with intestinal infection, increasing the binding and activity of some of those toxins, and enhancing adherence of C. perfringens to intestinal cells. Possible contributions of NanI to intestinal colonization are further supported by observations that the C. perfringens strains causing acute food poisoning in humans often lack the nanI gene, while other C. perfringens strains causing chronic intestinal infections in humans usually carry a nanI gene. Certain sialidase inhibitors have been shown to block NanI activity and reduce C. perfringens adherence to cultured enterocyte-like cells, opening the possibility that sialidase inhibitors could be useful therapeutics against C. perfringens intestinal infections. These initial in vitro observations should be tested for their in vivo significance using animal models of intestinal infections.
- Published
- 2016
90. Is air an issue? A severe case of subcutaneous emphysema in an immunocompromised patient
- Author
-
Eloy F. Ruiz and David O. Rahni
- Subjects
gas gangrene ,gastrostomy ,glioblastoma ,subcutaneous emphysema ,surgical wound dehiscence ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Abdominal crepitus and air in the subcutaneous tissue should be recognized early, as the most common etiologies for subcutaneous emphysema are fatal if not treated acutely. We present the case of a patient who developed subcutaneous emphysema as a consequence of the dehiscence of a previously closed gastrocutaneous fistula.
- Published
- 2022
- Full Text
- View/download PDF
91. Current incidence of certain clostridial infections: gas gangrene and tetanus
- Author
-
E. I. Komarovskaya and O. V. Perelygina
- Subjects
clostridia ,anaerobic infection ,gas gangrene ,myonecrosis ,necrotizing infections ,tetanus ,tetanospasmin ,wound infections ,vaccination refusal ,surgical skin and soft-tissue infections ,vaccination ,Biotechnology ,TP248.13-248.65 ,Medicine - Abstract
Clostridial myonecrosis or gas gangrene (myonecrosis) and tetanus are relatively rare nowadays, but they are still considered serious conditions associated with poor prognosis and high mortality. Life-threatening infections caused by Clostridium species have been known and studied for centuries, as they differed from other infections in terms of typical clinical manifestations, challenges of therapy and prevention. The aim of the study was to analyse the global incidence of gas gangrene and tetanus and challenges of prevention and treatment of these diseases. The review of up-to-date scientific literature demonstrated that gas gangrene continues to be a problem due to its rapid progression and challenging treatment. There are two main forms of the disease—traumatic and spontaneous. Traumatic gas gangrene is usually caused by C. perfringens, C. septicum, C. novyi (oedematiens), or C. histolyticum. Its incidence increases dramatically during wars, natural disasters, and other calamities. The literature review demonstrated that over the past 40 years there has been a rise in the frequency of spontaneous gas gangrene caused by C. septicum in people with compromised immune systems, in injecting drug users, and in women during various gynecological procedures and during normal delivery. Despite the effectiveness of the tetanus immunisation programme, the infection remains widespread in countries with insufficient vaccination coverage. The risk of tetanus in developed countries is high among elderly unvaccinated or partially vaccinated people, among injecting drug users, and vaccine refusers. The paper describes some clinical cases of gas gangrene and tetanus which demonstrate problems associated with challenging diagnosis and treatment, low awareness among primary healthcare personnel about mechanisms of anaerobic infection development, and anti-vaccination movement.
- Published
- 2021
- Full Text
- View/download PDF
92. Hyperbaric Oxygen Therapy Registry (HBOTR)
- Author
-
Undersea and Hyperbaric Medical Society (UHMS)
- Published
- 2018
93. Outcomes of Patients with Necrotizing Soft Tissue Infections: A Propensity-Matched Analysis Using the National Inpatient Sample.
- Author
-
Collins, Courtney M., McCarty, Adara, Jalilvand, Anahita, Strassels, Scott, Schubauer, Kathryn, Gonzalez-Gallo, Kathia, Young, Andrew, and Wisler, Jonathan
- Subjects
- *
SOFT tissue infections , *HOSPITAL mortality , *HEALTH facilities , *GAS gangrene , *NURSING care facilities , *FOURNIER gangrene ,MORTALITY risk factors - Abstract
Background: Necrotizing soft tissue infections (NSTIs) are severe, rapidly spreading infections with high morbidity and mortality. Attempts to identify risk factors for mortality and morbidity have produced variable results. We hope to determine which factors across the NSTI population impact mortality, morbidities, and discharge disposition. Patients and Methods: Retrospective data from the National Inpatient Sample from 2012-2018 of patients with primary diagnosis of NSTI (gas gangrene, necrotizing faciitis, cutaneous gangrene, or Fournier gangrene) were identified for analysis. A 1:4 greedy match was performed and risk factors for in-hospital mortality and discharge disposition were examined. Continuous variables were assessed using t-tests and Wilcoxon rank sum tests. Categorical variables were assessed using χ2 and Fisher exact tests. Statistical significance was defined as p < 0.05. Results: A total of 6,608 patients were identified. Weighted, this represents 33,040 patients; 32,390 are in the no-mortality cohort and 650 in the mortality cohort. Advanced age group was a risk factor for both in-hospital mortality and morbidity, but not for discharge to a skilled nursing or rehabilitation facility. Having two or more comorbidities was a risk factor for mortality, morbidity, and discharge to skilled nursing or rehabilitation facility. Cancer, liver disease, and kidney disease were predictors of in-hospital mortality. Diabetes mellitus and kidney disease were predictors of experiencing an in-hospital complication. Diabetes mellitus, heart disease, and kidney disease were predictors for discharge to skilled nursing or rehabilitation facility. Conclusions: Necrotizing soft tissue infections are associated with substantial morbidity and mortality. Identifying patients at higher risk for mortality, morbidity, and higher level of care at discharge can help providers properly allocate resources to improve patient outcomes and reduce the financial burden on patients and healthcare facilities. Special attention should be paid to those with existing or acute kidney dysfunction because this was the only comorbidity associated with increased risk mortality, morbidity, and discharge to higher level of care. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
94. Severe Skin and Soft-Tissue Infections.
- Author
-
Stieferman, Addison E., Mazi, Patrick, and Burnham, Jason P.
- Subjects
- *
SKIN infections , *HYPERBARIC oxygenation , *FOURNIER gangrene , *GAS gangrene , *DRUG resistance in microorganisms , *IMMUNITY , *COMPLEX regional pain syndromes - Abstract
Skin and soft-tissue infections (SSTIs) are a common reason for hospital admission. Severe SSTIs, particularly necrotizing infections, often require intensive care. Source control (often with surgical debridement) and broad-spectrum antimicrobials are paramount for minimizing significant morbidity and mortality. Rapid diagnostic tests may help in selection and de-escalation of antimicrobials for SSTIs. Besides early source control and early effective antimicrobial therapy, other patient-level factors such as comorbidities and immune status play a role in clinical outcomes. Intravenous immunoglobulin continues to be studied for severe SSTI, though recruitment in trials continues to be an issue. Severe SSTIs are complex to manage, due in part to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses. This review includes descriptions of source control, antimicrobial therapies, intravenous immunoglobulin, and hyperbaric oxygen therapy, as well as host factors in severe SSTIs. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
95. Chateau de Chanteloup
- Author
-
Thomas, Adrian, Duck, Francis, Thomas, Adrian, and Duck, Francis
- Published
- 2019
- Full Text
- View/download PDF
96. Complications of Fractures
- Author
-
Iyer, K. Mohan, Iyer, K. Mohan, editor, and Khan, Wasim S., editor
- Published
- 2019
- Full Text
- View/download PDF
97. General Affections of the Soft Tissues
- Author
-
Iyer, K. Mohan, Iyer, K. Mohan, editor, and Khan, Wasim S., editor
- Published
- 2019
- Full Text
- View/download PDF
98. A rare case of fetal gas gangrene following premature rupture of membranes in the second trimester diagnosed with the aid of computed tomography.
- Author
-
Gupta, K, Ajith Kumar, A, Bhattacharya, Modhulika, Murthy, Pooja, and Sarath, K
- Subjects
- *
GAS gangrene , *PREMATURE rupture of fetal membranes , *COMPUTED tomography , *DELIVERY (Obstetrics) , *ADULT respiratory distress syndrome , *INDUCED labor (Obstetrics) - Abstract
Introduction: To report a rare case of foetal gas gangrene following premature rupture of membranes in the second trimester diagnosed with the aid of computed tomography. Case Report: A 33-year-old lady, with G4A2L1, booked and vaccinated, developed premature rupture of membranes at 25 weeks of gestation. She developed severe abdominal pain with high-grade fever on the fourth night after expectant management with intravenous antibiotics and close monitoring. As there was a new-onset shock, she was referred to the higher centre from the obstetric care unit. The ultrasound of the abdomen and pelvis in the emergency room ruled out other causes of shock but confirmed intrauterine death. After planning for vaginal delivery, she had further deterioration requiring intubation and vasopressors. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis was performed which showed foetal gas gangrene and bilateral acute cortical necrosis. Emergency hysterotomy, performed under high-risk consent delivered macerated foetus. She had atonic uterus and required obstetric hysterectomy under general anaesthesia (GA). Her post-partum course was complicated by disseminated intravascular coagulopathy (DIC), acute respiratory distress syndrome (ARDS) and multiorgan dysfunction syndrome requiring multiple transfusions, prone ventilation and multiorgan support. However, she could not be salvaged and died on the 2nd day of surgery. Conclusion: We describe a rare fatal case of foetal gas gangrene in the second trimester following premature rupture of membranes which was diagnosed by a computed tomography (CT) scan of the abdomen and pelvis. The CT scan reliably identifies emphysematous changes in the amniotic cavity and foetal parts which helps in decision-making from the induction of labour to early surgical approach to prevent peritonitis and multiorgan failure. We recommend early CT scan in pregnancies complicated by intrauterine infections with shock which can change the line of management. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
99. Gas gangrene, not a common infection: case report of post-traumatic fulminant death.
- Author
-
Di Fazio, N., Baldari, B., Del Fante, Z., De Simone, S., Aromatario, M., and Cipolloni, L.
- Subjects
POST-traumatic stress disorder ,GAS gangrene ,CLOSTRIDIUM ,TOXINS ,EDEMA - Abstract
Post-traumatic gas gangrene is a rare but potentially life-threatening condition due to soft tissues infection by Clostridium species. These anaerobic microaerophile bacteria are highly resistant to external insults related to their ability to produce spores, which can survive on any surface for long periods. Under certain conditions suitable for proliferation (such as in ischemic tissues), bacteria produce many toxins. In particular, Clostridium perfringens type A represents the most frequent cause of traumatic gas gangrene nowadays. It produces toxins responsible for thrombotic and necrotic phenomena in soft tissues and rapid disease diffusion to muscles. Clinical manifestations usually start as local edema and emphysema but rapidly evolve into a septic state. Prognosis is poor in 20-30% of cases, and death occurs due to multiorgan failure. Because of its rapid evolution, clinical diagnosis is not always obtained, thus determining the need for post-mortem investigation. This case report presents a rare case of fulminant gas gangrene due to Clostridium Perfrigens infection developed after traumatic injury. Despite the prompt antibiotic administration and surgical intervention on the site of trauma, gas gangrene rapidly evolved into septic shock, leading to the patient's death. Post-mortem investigations were conducted and confirmed multiorgan failure as the cause of death. Cultural analysis was also performed but showed no bacterial growth. Negativity on culture tests should be related to antibiotic administration before blood sampling and bacterial characteristics. In such cases, the correct identification of the cause of death was only possible following a careful and detailed forensic methodological approach. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
100. A Case of Forearm Soft Tissue Infection Caused by Hypervirulent K. pneumoniae in an Otherwise Healthy 24-Year-Old Woman.
- Author
-
Kong, Lingwei, Wang, Yu, Ji, Hairu, Li, Zhehong, Sun, Yupeng, Liu, Yanchao, Cao, Sheng, Zhao, Jingxin, Shi, Litao, and Jin, Yu
- Subjects
SOFT tissue infections ,GAS gangrene ,LUNG infections ,KLEBSIELLA infections ,FOREARM ,KLEBSIELLA pneumoniae ,PEOPLE with diabetes - Abstract
In recent years, hypervirulent Klebsiella pneumoniae (hvKp) has received greater attention. It mainly infects diabetic patients and typically causes a hepatic abscess. Here, we report a case of hvKp that caused forearm muscle and soft tissue infection in addition to bacteremia, hepatic and pulmonary abscess, and hyperglycemia. The patient's condition stabilized after comprehensive treatment. She eventually recovered and was discharged after several debridement and flap operations. At 9 months of follow-up, no signs of infectious recurrence were noted, and the hyperglycemia resolved. Here, we detail important clinical features of a severe hvKp case diagnosed in an otherwise healthy individual. This report underscores the potential of hvKp to cause deep tissue infection and present with clinical symptoms similar to gas gangrene. Symptom onset in the setting of hvKp infection is usually gradual and misdiagnosis is common. The diagnosis of hvKp should be routinely considered in the clinical setting, and be strongly suspected when presenting with characteristic epidemiological, clinical and laboratory features. Although diabetes is a predisposing factor to hvKp infection, hyperglycemia appeared to manifest as a consequence of hvKp infection in this patient. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.