Group B and F Beta Streptococcus Necrotizing Infection–Surgical Challenges with a Deep Central Plantar Space Abscess

2016 ◽  
Vol 106 (3) ◽  
pp. 218-224 ◽  
Author(s):  
Jason M. Mendivil ◽  
David Jolley ◽  
Jodi Walters ◽  
Jim Dancho ◽  
Billy Martin
Keyword(s):  
Daily Living ◽  
Type Ii ◽  
Timely Manner ◽  
Lateral Aspect ◽  
Wound Culture ◽  
Necrotizing Infection ◽  
Deep Wound ◽  
Foot Function ◽  
Transmetatarsal Amputation ◽  
Group B

We present the case of a 66-year-old, type II diabetic male with a deep wound to the plantar-lateral aspect of his right hallux. On examination, the central plantar compartment of his right foot was moderately erythematous and tender on palpation. After obtaining a deep wound culture, treatment was complicated by a progression of a group B and F beta streptococcus, necrotizing infection. The patient underwent a right hallux amputation, followed by a plantar medial incision for drainage of an abscess to the medial and central plantar compartments of the foot. Due to the extent and limb threat of the infection, the patient ultimately underwent a transmetatarsal amputation. Advanced healing modalities were also employed to decrease wound healing times, which allowed the patient to achieve early weightbearing and return to activities of daily living. This study depicts how the astute podiatric surgeon needs to make a decision in a timely manner to surgically debride all nonviable and necrotic tissue in order to minimize further amputation and preserve foot function.

scholarly journals Isolation, chemical composition, and molecular size of extracellular type II and type Ia polysaccharides of group B streptococci.

1983 ◽  
Vol 41 (2) ◽  
pp. 527-534 ◽  
Author(s):  
B J De Cueninck ◽  
T F Greber ◽  
T K Eisenstein ◽  
R M Swenson ◽  
G D Shockman
Keyword(s):  
Chemical Composition ◽  
Molecular Size ◽  
Type Ii ◽  
Group B Streptococci ◽  
Type Ia ◽  
Group B

scholarly journals Deformation of the Internal Connection of Narrow Implants after Insertion in Dense Bone: An in Vitro Study

Materials ◽  
2019 ◽  
Vol 12 (11) ◽  
pp. 1833 ◽  
Author(s):  
Rafael Delgado-Ruiz ◽  
Ana Nicolas Silvente ◽  
Georgios Romanos
Keyword(s):  
In Vitro Study ◽  
Surface Damage ◽  
Insertion Torque ◽  
Type Ii ◽  
Before And After ◽  
Post Test ◽  
Group A ◽  
Group B ◽  
Connection Length

Implant connections must resist surgical and prosthetic procedures without deformation. This study evaluated the deformation of different internal connections (IC) of narrow dental implants (NDI) after their insertion in artificial dense bone. Thirty NDI, with different IC geometries, Group A (internal hexagon), Group B (tri-channeled), and Group C (four-channeled), with the same length and similar narrow diameters, were inserted in type II density bone blocks. Drilling protocols for dense bone from each implant manufacturer were followed. The Insertion torque (IT), connection length, vertex angles, and wall deformations were analyzed before and after the insertion of the implants. ANOVA (Analysis of Variance) and Tukey post-test were used for statistical comparisons. IT values were higher for Group A, surface damage, and titanium particles were observed in the IC in all the groups. Angle deformations between 5 and 70 degrees were present in all the groups, and the walls of Group B connection were the most affected by deformations (p < 0.05). Within the limitations of this experiment, it can be concluded that narrow diameter implants will suffer deformation of the implant connection and will also experience surface damage and titanium particle release when inserted in type II bone density.

Wound Culture Utility in Negative Surgical Exploration for Necrotizing Soft Tissue Infection

2019 ◽  
Vol 85 (10) ◽  
pp. 1175-1178
Author(s):  
Erin C. Howell ◽  
Jessica A. Keeley ◽  
Alexis L. Woods ◽  
Amy H. Kaji ◽  
Molly R. Deane ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Group A Streptococcus ◽  
Necrotizing Soft Tissue Infection ◽  
Management Culture ◽  
Wound Culture ◽  
Deep Wound ◽  
Necrotizing Soft Tissue Infections ◽  
Group A ◽  
Early Surgical Intervention

Early surgical intervention decreases mortality in necrotizing soft tissue infections (NSTIs). Yet, a subset of patients will not have NSTIs (non-NSTIs) at the time of exploration. We hypothesized that NSTI and non-NSTI patients had similar causative organisms and that intraoperative wound cultures could help guide management. Culture results and outcomes were compared for all patients undergoing surgery for suspected NSTIs over a seven-year-period. Of 295 patients, 240 (81.4%) had NSTIs. Of the 55 non-NSTI patients (18.6%), 50 had cellulitis and 5 had abscesses. NSTI and non-NSTI patients had similar rates of bacteremia (20.4% vs 17.6%, P = 0.66), septic shock (15.9% vs 12.7%, P = 0.68), and mortality (10.4% vs 7.2%, P = 0.62). Wound cultures were collected more often in NSTI patients (229/240, 95.4%) than in non-NSTI patients (42/55, 76.4%, P < 0.01). Non-NSTI patients had positive deep wound cultures more than half of the time (23/42, 54.8%). The microbiologic profile was similar between groups, with Methicillin Resistant Staphylococcus aureus and Group A Streptococcus occurring with the same frequency. We advocate for deep wound cultures in all patients being evaluated operatively for NSTIs even if the exploration is considered negative because these patients have similar clinical characteristics and virulent microbiology, and culture results can help guide antimicrobial therapy.

scholarly journals Circulating and Storage Neutrophil Changes in Experimental Type II Group B Streptococcal Sepsis

1980 ◽  
Vol 14 (6) ◽  
pp. 806-808 ◽  
Author(s):  
Robert D Christensen ◽  
Ann O Shigeoka ◽  
Harry R Hill ◽  
Gerald Rothstein
Keyword(s):  
Type Ii ◽  
Experimental Type ◽  
Streptococcal Sepsis ◽  
Group B ◽  
And Storage

Use of Perioperative Steroids with Microvascular Decompression Operations

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 353-357 ◽  
Author(s):  
Donald W. Marion ◽  
Peter J. Jannetta
Keyword(s):  
Postoperative Complications ◽  
Microvascular Decompression ◽  
Cranial Nerves ◽  
Wound Infections ◽  
Related Complication ◽  
Deep Wound ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Single Blind

Abstract Complications associated with the use of perioperative steroids in elective craniotomies were evaluated in a single-blind prospective study of 222 consecutive microvascular decompression operations. Patients were randomized into one of three groups: Group A received steroids preoperatively and for 4 days postoperatively, Group B received steroids preand postoperatively for 1 day, and Group C received no steroids. There were 17 complications in Group A; 12 of these were wound-related. There were significantly fewer complications in Groups B and C (P &lt; 0.01). Group B had 3 complications, Group C had 4, and there was only 1 wound-related complication in Group C. There were no deaths, deep wound infections, or life-threatening complications. Severe postoperative headaches, a symptom that steroids were intended to minimize, occurred in 38% of patients in Group A, 42% of patients in Group B, and 25% of patients in Group C. The use of perioperative steroids did not reduce the length of postoperative hospitalization. Duration of the operation had no significant effect on the incidence of postoperative complications or the length of postoperative hospitalization. We conclude that there is no indication for the routine perioperative use of steroids with microvascular decompression operations of the posterior fossa cranial nerves and that such use leads to a higher incidence of postoperative complications. (Neurosurgery 22:353-357, 1988)

scholarly journals Seroepidemiology of group B streptococcus type II antibody specificity

1988 ◽  
Vol 101 (2) ◽  
pp. 347-354 ◽  
Author(s):  
B. M. Gray ◽  
D. G. Pritchard ◽  
J. D. Springfield ◽  
R. J. Benak ◽  
H. C. Dillon
Keyword(s):  
Sialic Acid ◽  
Antibody Level ◽  
Specific Antibody ◽  
Group B Streptococcus ◽  
Antibody Specificity ◽  
Type Ii ◽  
Elisa System ◽  
Human Antibodies ◽  
Group B

SUMMARYThe specificity of human antibodies for the two major sidechain determinants of the type II group B streptococcal (GBS) polysaccharide was examined in 90 pairs of maternal and cord sera. Using an ELISA system, total antibody was measured against the complete (sialylated) type II antigen and the proportion of antibody against the galactose determinant was estimated by inhibition with free β–methylgalactopyranosided. Mothers colonized by type II or by other GBS types had higher levels of total specific antibody (means, 33 and 4–7 µg/ml, respectively) than those not colonized (mean, 2–2 µg/ml). Cord sera averaged 1–2 µg/ml lower than maternal sera. Colonization with GBS was also associated with higher levels against the galactose determinant (mean, 1.5&µg/ml, compared to 0–7µg/ml for those not colonized). The distribution of specificities favoured antibodies against the sialic acid determinant in maternal but not cord sera. Specificity as well as antibody level may play a role in the epidemiology of GBS type II.

Timely manner application of hand orthoses to patients with amyotrophic lateral sclerosis: A case report

2013 ◽  
Vol 38 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Kazunari Tanaka ◽  
Koji Horaiya ◽  
Junya Akagi ◽  
Nagatoshi Kihoin
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Case Report ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Timely Manner ◽  
Clinical Algorithm ◽  
Hand Muscles ◽  
Finger Motion ◽  
Lateral Sclerosis

Background: In patients with amyotrophic lateral sclerosis, the atrophy of hand muscles often causes impairment of thumb/finger motion and disabilities in their activities of daily living. Hand orthoses are effective for such impairment and disabilities; however, there are some difficulties in their application. Case description and methods: In this case report, we present the timely application of hand orthoses and introduce our clinical algorithm for the application of hand orthoses to patients with amyotrophic lateral sclerosis. Findings and outcomes: Our clinical algorithm was applied to 11 patients. The numbers of applications and the durations of the use of orthoses were as follows: 4, web spacer; 4, short thumb spica; 8, long thumb spica; and 2, cock-up splint; and 2.75, 2.0, 0.63, and 2.0 months, respectively. Conclusions: The clinical algorithm for the application of hand orthoses is helpful in choosing the optimal orthoses and contributes to maximizing patients’ function, independence, and quality of life. Clinical relevance Hand orthoses are useful for improving the activities of daily living of patients with amyotrophic lateral sclerosis. The clinical algorithm might be helpful for many physicians in choosing the optimal orthoses in a timely manner.

Group B streptococcus type II antisera have anti-galactan specificities

1985 ◽  
Vol 259 (2) ◽  
pp. 179-187
Author(s):  
Gerhard Uhlenbruck ◽  
Rudolf Lütticken ◽  
Gabriele Böhmer ◽  
Eveline Janssen ◽  
Gerhard Pulverer
Keyword(s):  
Group B Streptococcus ◽  
Type Ii ◽  
Group B

scholarly journals FOURNIER'S SYNDROME RECURRENCE

2019 ◽  
Vol 6 (2) ◽  
pp. 35-37
Author(s):  
Viviane de Deus Silva ◽  
Luis Fernando Barbosa Silva ◽  
João Guilherme Silva Oliveira ◽  
Larissa Mendonça Ferreira ◽  
Pedro Manuel Gonzalez Cuellar
Keyword(s):  
Mortality Rate ◽  
Medical Practice ◽  
Surgical Techniques ◽  
Tissue Loss ◽  
Lower Abdomen ◽  
Timely Manner ◽  
Necrotizing Infection ◽  
Changes Over Time ◽  
Over Time ◽  
Grade Iii

The Fournier’s Syndrome is characterized by a necrotizing infection that can affect regions such as perineum, thighs, scrotum, thigh roots and lower abdomen. It begins insidiously, but progresses with great tissue loss and is of difficult handling. It is an uncommon morbidity of the population at large. Recurrence is poorly documented, which makes its occurrence atypical in medical practice. The mortality rate varies from 10% to 30.8% in Brazil without changes over time despite advances in technology and in surgical techniques. The objective of this study is to demonstrate a recurrence of the syndrome in a male, 46-year-old patient, with diabetes, hypertension and grade III obesity. The patient was treated in a timely manner with satisfactory clinical and aesthetic outcomes.

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