Nonbacterial Causes of Lymphangitis with Streaking
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A Fatal Case of Necrotising Fasciitis of the Eyelid
Br J Ophthalmol: first published as 10.1136/bjo.72.6.428 on 1 June 1988. Downloaded from British Journal of Ophthalmology, 1988, 72, 428-431 A fatal case of necrotising fasciitis of the eyelid R WALTERS From Southampton Eye Hospital, Wilton A venue, Southampton S09 4XW SUMMARY A fatal case of necrotising fasciitis in a 35-year-old man is described and the differential diagnosis and management discussed. Necrotising fasciitis is a potentially fatal skin were taken. The Gram stain revealed Gram-positive infection which is being increasingly recognised as an cocci. He was then treated with intravenous underdiagnosed condition. It requires prompt diag- cefotaxime and gentamicin and topical chlor- nosis, investigation, and treatment. Early surgical amphenicol and gentamicin drops. Because of the debridement is, in combination with suitable intra- poor visual acuity of the right eye it was thought that venous antibiotics, the mainstay of treatment. an orbital cellulitis could not be excluded despite the normal eye movements and absence of proptosis. He Case report was therefore transferred to the General Hospital under the care of an ear, nose, and throat consultant In December 1985 a previously fit 35-year-old factory in order to exclude underlying sinus disease and an manager was referred by his general practitioner to associated abscess. the Casualty Department of the Southampton Eye Skull x-rays (including sinus views) revealed no Hospital with a 12-hour history of increasing redness abnormality and he was therefore continued on his and swelling of his right upper lid. He said that two medical treatment (with the addition of intravenous http://bjo.bmj.com/ days previously he had been poked in the same eye by metronidazole), the presumed diagnosis being his daughter (who had been playing with her guinea- preseptal cellulitis. -
Ehrlichiosis and Anaplasmosis Are Tick-Borne Diseases Caused by Obligate Anaplasmosis: Intracellular Bacteria in the Genera Ehrlichia and Anaplasma
Ehrlichiosis and Importance Ehrlichiosis and anaplasmosis are tick-borne diseases caused by obligate Anaplasmosis: intracellular bacteria in the genera Ehrlichia and Anaplasma. These organisms are widespread in nature; the reservoir hosts include numerous wild animals, as well as Zoonotic Species some domesticated species. For many years, Ehrlichia and Anaplasma species have been known to cause illness in pets and livestock. The consequences of exposure vary Canine Monocytic Ehrlichiosis, from asymptomatic infections to severe, potentially fatal illness. Some organisms Canine Hemorrhagic Fever, have also been recognized as human pathogens since the 1980s and 1990s. Tropical Canine Pancytopenia, Etiology Tracker Dog Disease, Ehrlichiosis and anaplasmosis are caused by members of the genera Ehrlichia Canine Tick Typhus, and Anaplasma, respectively. Both genera contain small, pleomorphic, Gram negative, Nairobi Bleeding Disorder, obligate intracellular organisms, and belong to the family Anaplasmataceae, order Canine Granulocytic Ehrlichiosis, Rickettsiales. They are classified as α-proteobacteria. A number of Ehrlichia and Canine Granulocytic Anaplasmosis, Anaplasma species affect animals. A limited number of these organisms have also Equine Granulocytic Ehrlichiosis, been identified in people. Equine Granulocytic Anaplasmosis, Recent changes in taxonomy can make the nomenclature of the Anaplasmataceae Tick-borne Fever, and their diseases somewhat confusing. At one time, ehrlichiosis was a group of Pasture Fever, diseases caused by organisms that mostly replicated in membrane-bound cytoplasmic Human Monocytic Ehrlichiosis, vacuoles of leukocytes, and belonged to the genus Ehrlichia, tribe Ehrlichieae and Human Granulocytic Anaplasmosis, family Rickettsiaceae. The names of the diseases were often based on the host Human Granulocytic Ehrlichiosis, species, together with type of leukocyte most often infected. -
Spider Bite Inducing Superficial Lymphangitis: a Case Report
ISSN: 2574-1241 Volume 5- Issue 4: 2018 DOI: 10.26717/BJSTR.2018.12.002232 El Anzi Ouiam. Biomed J Sci & Tech Res Case Report Open Access Spider Bite Inducing Superficial Lymphangitis: A Case Report El Anzi Ouiam*, Meziane Mariam and Hassam Badredine Department of Dermatology-Venereology, Morocco Received: Published: *Corresponding: December author: 04, 2018; : December 17, 2018 El Anzi Ouiam, Department of Dermatology-Venereology, Morocco Abstract Superficial lymphangitis after insect bite is the result of an allergic reaction to the insect antigen. We present the case of a 22-year-old patient with no notable medical history, presented with a pruritic rash on the chest, two days after an insect bite. Unlike bacterial lymphangitis, the site of insectKeywords: bite is not painful but pruritic. Spider Bite; Lymphangitis; Allergic Reaction Introduction lymphadenopathy. Different authors assume that superficial Superficial lymphangitis after insect bite is the result of an lymphangitis after spider sting is the consequence of an allergic allergic reaction to the insect antigen, which is injected into the skin immune reaction due to insect toxins [3]. Unlike bacterial andClinical drained Case by lymphatic vessels [1]. lymphangitis, the site of insect bite is not painful but pruritic. It’s also characterised by the absence of fever and lymph node A 22-year-old female with no notable medical history, presented enlargement and a rapid spontaneous regression [1-3] (Figure 1). with a pruritic rash on the chest. She mentioned intense pruritus and low pain. Two days before she had been bitten on the shoulder by a spider. Physical examination showed a red linear lesion starting from erythematous macule of the shoulder and extending toward the anterior wall of the chest. -
Tick-Borne Diseases in Maine a Physician’S Reference Manual Deer Tick Dog Tick Lonestar Tick (CDC Photo)
tick-borne diseases in Maine A Physician’s Reference Manual Deer Tick Dog Tick Lonestar Tick (CDC PHOTO) Nymph Nymph Nymph Adult Male Adult Male Adult Male Adult Female Adult Female Adult Female images not to scale know your ticks Ticks are generally found in brushy or wooded areas, near the DEER TICK DOG TICK LONESTAR TICK Ixodes scapularis Dermacentor variabilis Amblyomma americanum ground; they cannot jump or fly. Ticks are attracted to a variety (also called blacklegged tick) (also called wood tick) of host factors including body heat and carbon dioxide. They will Diseases Diseases Diseases transfer to a potential host when one brushes directly against Lyme disease, Rocky Mountain spotted Ehrlichiosis anaplasmosis, babesiosis fever and tularemia them and then seek a site for attachment. What bites What bites What bites Nymph and adult females Nymph and adult females Adult females When When When April through September in Anytime temperatures are April through August New England, year-round in above freezing, greatest Southern U.S. Coloring risk is spring through fall Adult females have a dark Coloring Coloring brown body with whitish Adult females have a brown Adult females have a markings on its hood body with a white spot on reddish-brown tear shaped the hood Size: body with dark brown hood Unfed Adults: Size: Size: Watermelon seed Nymphs: Poppy seed Nymphs: Poppy seed Unfed Adults: Sesame seed Unfed Adults: Sesame seed suMMer fever algorithM ALGORITHM FOR DIFFERENTIATING TICK-BORNE DISEASES IN MAINE Patient resides, works, or recreates in an area likely to have ticks and is exhibiting fever, This algorithm is intended for use as a general guide when pursuing a diagnosis. -
Leptospirosis: a Waterborne Zoonotic Disease of Global Importance
August 2006 volume 22 number 08 Leptospirosis: A waterborne zoonotic disease of global importance INTRODUCTION syndrome has two phases: a septicemic and an immune phase (Levett, 2005). Leptospirosis is considered one of the most common zoonotic diseases It is in the immune phase that organ-specific damage and more severe illness globally. In the United States, outbreaks are increasingly being reported is seen. See text box for more information on the two phases. The typical among those participating in recreational water activities (Centers for Disease presenting signs of leptospirosis in humans are fever, headache, chills, con- Control and Prevention [CDC], 1996, 1998, and 2001) and sporadic cases are junctival suffusion, and myalgia (particularly in calf and lumbar areas) often underdiagnosed. With the onset of warm temperatures, increased (Heymann, 2004). Less common signs include a biphasic fever, meningitis, outdoor activities, and travel, Georgia may expect to see more leptospirosis photosensitivity, rash, and hepatic or renal failure. cases. DIAGNOSIS OF LEPTOSPIROSIS Leptospirosis is a zoonosis caused by infection with the bacterium Leptospira Detecting serum antibodies against leptospira interrogans. The disease occurs worldwide, but it is most common in temper- • Microscopic Agglutination Titers (MAT) ate regions in the late summer and early fall and in tropical regions during o Paired serum samples which show a four-fold rise in rainy seasons. It is not surprising that Hawaii has the highest incidence of titer confirm the diagnosis; a single high titer in a per- leptospirosis in the United States (Levett, 2005). The reservoir of pathogenic son clinically suspected to have leptospirosis is highly leptospires is the renal tubules of wild and domestic animals. -
Sclerosing Lymphangitis of the Penis
Brit. J. vener. Dis. (1972) 48, 545 Br J Vener Dis: first published as 10.1136/sti.48.6.545 on 1 December 1972. Downloaded from Sclerosing lymphangitis of the penis A. LASSUS, K. M. NIEMI, S.-L. VALLE, AND U. KIISTALA From the Department of Dermatology and Venereology, University Central Hospital, Helsinki, Finland Non-venereal sclerosing lymphangitis of the penis of the lesion was perforated a clear yellowish fluid leaked (NSLP) has been considered a rare condition, and out and the lesion became softer and smaller. A biopsy only fourteen cases have been reported (Hoffmann, was taken from the wall of the lesion. After the operation, 1923, 1938; von Berde 1937; Nickel and Plumb, the lesion had clinically disappeared. 1962; Kandil and Al-Kashlan, 1970). The disorder was originally described by Hoffmann (1923), who referred to it as 'simulation of primary syphilis by gonorrhoeal lymphangitis (gonorrhoeal pseudo- chancre)'. In a later paper Hoffmann (1938) called the condition a 'non-venereal plastic lymphangitis of the coronary sulcus of the penis with circumscribed edema'. The aetiology of the disorder is not known, copyright. but its non-venereal nature has been stressed in subsequent reports (Nickel and Plumb, 1962; Kandil and Al-Kashlan, 1970). It has been suggested that it may be related to mechanical trauma, virus infection, irritation by menstrual blood, or tuber- culosis. NSLP appears suddenly as a firm, cordlike, encircle the translucent lesion, which may almost http://sti.bmj.com/ penis in the coronal sulcus. The histological findings suggest that it results from fibrotic thickening of a large lymph vessel. -
Stanford Emergency Department & Clinical
STANFORD EMERGENCY DEPARTMENT & CLINICAL DECISION UNIT EMPIRIC ANTIBIOTIC GUIDELINES FOR ACUTE BACTERIAL SKIN AND SKIN-STRUCTURE INFECTIONS PURULENT CELLULITIS (cutaneous abscess, carbuncle, furuncle) Common pathogen: Staphylococcus aureus Duration of Therapy: 5-10 days Condition/Severity Admit/CDU/Discharge Cultures? Antibiotic Recommendation Mild < 5 cm Discharge No I&D Only ± TMP-SMX DS 1-2 PO BID Mild > 5 cm Discharge Yes – I&D plus Antibiotics: wound TMP-SMX DS 1-2 PO BID Typical abscess +/- cellulitis with no I&D systemic signs of infection Alternative: Doxycycline 100 mg PO BID Moderate Discharge Yes – TMP-SMX DS 1-2 PO BID wound only one Purulent infection with I&D Alternative: Doxycycline 100 mg PO BID systemic sign of infection: CDU if any factors below1,2: EMPIRIC ANTIBIOTICS: temp>38°C - • Concern for poor adherence to therapy TMP-SMX DS 1-2 PO BID HR >90 bpm - • Exacerbation of comorbidities RR>24 bpm Alternative: - • Significant clinical concern Yes – abnormal WBC >12K or <400 • Doxycycline 100 mg PO BID - Note: cutaneous inflammation and systemic wound cells/mcg/L features often worsen after initiating therapy I&D Lymphangitis DEFINITIVE ANTIBIOTICS: - and failure to improve at 24 hours NOT MRSA: TMP-SMX DS 1-2 PO BID considered clinical failure MSSA: dicloxacillin 500mg PO QID or cephalexin 500mg PO QID Severe EMPIRIC ANTIBIOTICS: Vancomycin Per Pharmacy • Hypotension Alternatives: Consult pharmacy for restricted antibiotics • 2 or more systemic signs of Admission Yes - infection blood DEFINITIVE ANTIBIOTICS: - temp>38°C MRSA: Vancomycin - HR >90 bpm MSSA: Cefazolin 2g IV Q8H - RR>24 bpm - abnormal WBC >12K or <400 cells/mcg/L - Lymphangitis • Immunocompromised** CELLULITIS (NON-PURULENT) Common pathogens: Streptococcus spp (usually S. -
Erysipelas Following a Fracture: About a Case
Journal of Dermatology & Cosmetology Case Report Open Access Erysipelas following a fracture: about a case Abstract Volume 3 Issue 1 - 2019 Erysipelas on postoperative scar is a rare entity. In orthopedic traumatology, Abdelhafid El Marfi,1 Mohamed El Idrissi,1 El we have only the 3cases reported in the work of Dhrif occurred during prosthetic Ibrahimi Abdelhalim,1 Abdelmajid El Mrini,1 implantation. We present through this article, the case of postoperative erysipelas on 2 2 an osteosynthesis scar of a fracture of the lower quarter of the leg in a 58-year-old Kaoutar Laamari, Fatima Zahra Mernissi 1 woman. Department of Traumatology Orthopedy B4, University Hospital Hassan II Fez, Morocco 2Department of Dermatology, University Hospital Hassan II Fez, Morocco Correspondence: Abdelhafid El Marfi, Department of Traumatology Orthopedy B4, University Hospital Hassan II Fez, Morocco, Tel 0021 2678 3398 79, Email Received: January 04, 2018 | Published: January 28, 2019 Introduction Erysipelas is an infectious disease of the dermis and subcutaneous tissue commonly caused by streptococci.1 It is a clinical form of acute cellulitis.2 Clinically, it is characterized by the acute onset of local signs of inflammation such as erythema, oedema, pain and heat. In its classic form, it is accompanied by systemic signs such as fever, chills and malaise and sometimes nausea and vomiting.3,4 Erysipelas can be serious but rarely fatal. It has a rapid and favorable response to antibacterial therapy.5,6 From an epidemiological point of view, we consider the existence of a portal of entry, lymphoedema and obesity as the main risk factors for occurrence. -
Periorbital Necrotising Fasciitis
Eye (1991) 5, 736--740 Periorbital Necrotising Fasciitis GEOFFREY E. ROSE,! DAVID 1. HOWARD,2 MARK R. WATTS! London Summary Three cases of periorbital necrotising fasciitis are described, one occurring in a three-year-old child. The cases in adults required debridement of necrotic tissue, in one of whom there was extensive disease involving the face and orbital fat. ft is probable that the early stages of this condition are under-recognised; the importance of early signs and intensive treatment of this life-threatening disease are illustrated. N ecrotising fasciitis is an ischaemic necrosis of periorbital (and, in one case, facial and intra subcutaneous tissues (fascia), generally due orbital) tissues was required. to an overwhelming infection with �-haemo lytic Streptococcus pyogenes.1,2 The disease Case Reports has a rapid onset, often within a few days of minor breaks in the skin, and spreads exten Case 1 sively and rapidly through subcutaneous fas A 3l-year-old, otherwise healthy, girl was admitted cial planes. to the referring hospital with a 24-hour history of The condition occurs most frequently in the periorbital pain, general malaise, lethargy and a rapidly increasing severe periorbital swelling. For limbs or the abdominal wall, where it has been three days prior to admission, she had been treated given various terms, such as haemolytic strep with oral nystatin for perineal candidiasis and for tococcus gangrene/ gangrenous or necrotis two days had symptoms of an infection of the upper lng erysipelas, suppurative fasciitis and respiratory tract. Her right eyelids were closed by Fournier's gangrene. Periorbital necrotising gross erythematous swelling, but her eye move fasciitis is reported rarely, with a total of only ments were normal and there was no relative affe 16 cases cited in a recent review.1 The low inci rent pupillary defect. -
Ehrlichiosis in Brazil
Review Article Rev. Bras. Parasitol. Vet., Jaboticabal, v. 20, n. 1, p. 1-12, jan.-mar. 2011 ISSN 0103-846X (impresso) / ISSN 1984-2961 (eletrônico) Ehrlichiosis in Brazil Erliquiose no Brasil Rafael Felipe da Costa Vieira1; Alexander Welker Biondo2,3; Ana Marcia Sá Guimarães4; Andrea Pires dos Santos4; Rodrigo Pires dos Santos5; Leonardo Hermes Dutra1; Pedro Paulo Vissotto de Paiva Diniz6; Helio Autran de Morais7; Joanne Belle Messick4; Marcelo Bahia Labruna8; Odilon Vidotto1* 1Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina – UEL 2Departamento de Medicina Veterinária, Universidade Federal do Paraná – UFPR 3Department of Veterinary Pathobiology, University of Illinois 4Department of Veterinary Comparative Pathobiology, Purdue University, Lafayette 5Seção de Doenças Infecciosas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul – UFRGS 6College of Veterinary Medicine, Western University of Health Sciences 7Department of Clinical Sciences, Oregon State University 8Departamento de Medicina Veterinária Preventiva e Saúde Animal, Universidade de São Paulo – USP Received June 21, 2010 Accepted November 3, 2010 Abstract Ehrlichiosis is a disease caused by rickettsial organisms belonging to the genus Ehrlichia. In Brazil, molecular and serological studies have evaluated the occurrence of Ehrlichia species in dogs, cats, wild animals and humans. Ehrlichia canis is the main species found in dogs in Brazil, although E. ewingii infection has been recently suspected in five dogs. Ehrlichia chaffeensis DNA has been detected and characterized in mash deer, whereas E. muris and E. ruminantium have not yet been identified in Brazil. Canine monocytic ehrlichiosis caused by E. canis appears to be highly endemic in several regions of Brazil, however prevalence data are not available for several regions. -
Lymphographic Studies in Acute Lymphogranuloma Venereum Infection
Brit. J7. vener. Dis. (1976) 52, 399 Br J Vener Dis: first published as 10.1136/sti.52.6.399 on 1 December 1976. Downloaded from Lymphographic studies in acute lymphogranuloma venereum infection A. 0. OSOBA AND C. A. BEETLESTONE From the Special Treatment Clinic and the Departments of Medical Microbology and Radiology, University of Ibadan, Nigeria Summary 1954) described a convenient method of cannulating Lymphography, a radiological method of demon- the lymph vessels and injecting water-soluble strating lymphatic channels and nodes, has been contrastmedium, the procedurehas become extensively used to investigate three cases of acute bubonic used. Lymphography has been used in a variety of lymphogranuloma venereum (LGV). There is conditions in which the pathological process origi- nates in or is associated with lymph nodes (Koehler, general agreement that LGV has a predilection for 1968a, b). In lymphomas, the lymphographic lymphatic channels and lymph nodes. However, appearance can be pathognomonic, hence much very little is known of the extent of lymph node excellent work has been done in this field (Abrams, involvement in the early bubonic stage and whether Takahashi, and Adams, 1968; Lee, 1968; Rosenberg, there is merely a lymphangitis or complete lymph- 1968). However, little work has been done on atic obstruction. inflammatory conditions such as tuberculosis, syphilis The present study was undertaken to determine and lymphogranuloma venereum (LGV), which copyright. the lymphographic appearance in acute bubonic produce lesions in lymph glands. Because lympho- LGV, the extent of lymphatic node involvement in graphy is the only direct method of visualizing the early LGV, and the usefulness of the procedure in lymphatics and lymph nodes, and since it can objectively evaluate the inaccessible pelvic and the management of LGV patients. -
Diabetic Gangrene of the Lower Extremities
University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1939 Diabetic gangrene of the lower extremities Henry Sydow University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Sydow, Henry, "Diabetic gangrene of the lower extremities" (1939). MD Theses. 779. https://digitalcommons.unmc.edu/mdtheses/779 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. DIABETIC GANGRE!E Ql ~ LOWER El?!'lJIMIT!ES Henry Sydow SEI IOR THESIS r-·. Senior Thesis presented to College of Medicine University of Nebraska Omaha 1939 ~81070 TABLE of CONTENTS l, Introduction --- 1,2 2. Biochemical Rhysiology --- 3-9 3. Effects of Altered .Physiology 10,11 4. Arteriosclerosis --- 12-17 6. Gangrene 18,19 6, Etiology --- 20-25 7. Diagnosis --- 26-35 a. Treatment --- 36-37 9, Prognosis --- 38 lo.Prophylaxis --- 59-41 11.Caaea in u. of N, Hospital --- 42 12,Conelusion ----43 13.Bibliography --- 44-48 DIABETIC GANGRENE Introduction Diabetes mellitus is a constitutional disease, char acterized by glycosuria and hyperglycemia, which gener ally result from subnormal insulin production by the islands of Langerhans in the pancreas and as a result, a diminution of the ability of the body to utilize glu cose.