سال:1399 | دوره: | شماره: |تعداد مقالات:5

Necrotizing fasciitis is a severe infection involving skin, subcutaneous tissue and superficial fascia, which has lethal outcome. Risk factors associated with this condition include diabetes mellitus, anemia, and immunosuppressive states such as AIDS, or prolonged steroid use. Surgery is an independent risk factor. Serial surgical debridement with appropriate broad spectrum antibiotics is the mainstay of treatment. We are reporting two cases. First is necrotizing soft tissue infection of the anterior abdominal wall in post cesarean patient, which was very fulminant and fatal. The second is Fournier’ s gangrene in a patient with episiotomy during normal vaginal delivery. Postpartum necrotizing soft tissue infection is very challenging and fatal. Nowadays these are very rare cases due to antibiotics.

Background: Antimicrobial resistance surveillance and infection risk assessment are important for optimizing the quality of healthcare in hospitals. Objectives: This study aimed to evaluate the antimicrobial resistance and infection risks in Tertiary hospitals in Benin. Methods: Bacteriological examinations were carried outonswab samples from the hospital environment at Saké té-Ifangni Hospital and Menontin Hospital in Benin. The environmental swabs were supplemented withwoundswabs from Menontin Hospital. In both hospitals, antibiotic susceptibility of the isolated strains was determined by the agar diffusion method. Results: The results showed that coagulase-negative staphylococci (45%) comprised the most isolated species in the environment of the Surgery and Operating Departments of Saké té-Ifangni Hospital, followed by Staphylococcus aureus (27. 50%) and Proteus spp. (15%). At Menontin Hospital, only one specimen was sterile from wound swabs. From environmental swabs, 29 out of 45 samples were positive. Staphylococcus aureus (31%), Escherichia coli (15%), and coagulase-negative staphylococci (12%) were the most isolated species from wounds. Strains of coagulase-negative staphylococci (29%), Pseudomonas aeruginosa (15%), and Proteus mirabilis (12%) were the most common strains in swabs. The study of the adequacy of treatment of infections caused by bacteria responsible for wound suppuration showed that 52% of the wounded received appropriate antibiotic treatment. At Menontin Hospital, many isolated strains from room environment samples were found in the wounds of the patients. In both hospitals, the isolated strains were multiresistant to conventional antibiotics. Conclusions: These data show how surveillance of infection risks and antimicrobial resistance is important to prevent healthcare associated infections.

Background: There are over one million patients with a prosthetic joint replacement in the United States. Majority of patients who receive joint arthroplasties are over 65 years of age. Objectives: There are no studies evaluating the best options for antibiotic management in prosthetic joint infection. It is important to evaluate alternative treatment modalities for this age group. Methods: This is a retrospective study evaluating studies published between the years 2000-2019. Patients over the age of sixty-five with total joint replacement who had confirmed prosthetic joint infection and received treatment with oral antimicrobial treatment were included in the study. Results: A total of 409 patients were included in this study. 306 patients were successfully treated, whereas treatment failure was noted in 103 patients. Adverse events were only noted on 3 out of 7 studies. Of the events noted, renal failure was the most common and diarrhea was the second most common. Conclusions: Due to the lack of data available, there is a need for prospective study that evaluates the response of oral antimicrobial therapy in the elderly. At this time there is very little data to recommend oral antimicrobial therapy in the literature to make definitive recommendations. However, in the author’ s experience, there may be a role for oral antimicrobial therapy in patients who have undergone single stage revision with no significant co-morbidities with a non-multidrug resistant pathogen.

In December 2019 the world has come to know a new coronavirus disease named COVID-19. It has affected mainland China mostly and has spread to all continents of the world except Antarctica. Patients mostly have come with a flu-like illness and non-specific gastrointestinal symptoms to a lesser extent. In most cases, home isolation is effective. However, cases of moderate to severe pneumonia and acute respiratory distress syndrome (ARDS) require hospitalization and few cases need mechanical ventilation. Older adults with a pre-existing medical illness suffer more. Different newer molecular techniques are developed to confirm the diagnosis. Currently, there is no existing treatment and vaccine. Different anti-microbials are on trial. Infection prevention practice is the best for now. With its highly contagious nature and increasing panic among nations, the world is waiting for definitive newer treatment options and a potential vaccine. This narrative review has compiled the updated information about COVID-19 in the hope that it will be helpful to the medical professionals in their knowledge and be prepared for the outbreak of a pandemic.

Background: Acute viral hepatitis is a common infection in developing countries among children. Different diagnostic methods for acute hepatitis has been introduced. Objectives: In this study, we have determined the prevalence of sonographic signs in children with acute hepatitis. Methods: A total of 383 children with acute hepatitis were studied in Zahedan city, southeast of Iran. The sampling method was by the enumeration of the cases. Patients underwent ultrasonography in which their sonographic signs of acute hepatitis were investigated and analyzed. Results: The mean age of children was 6. 1 2. 8 years, with 211 (55. 1%) males and 172 (44. 9%) females. The prevalence of gallbladder wall edema was 20. 1% (77 children), periportal lymphadenopathy 15. 1% (58 children), hepatomegaly 4. 9% (19 children), increased liver echogenicity 53. 0% (203 children), decreased liver echogenicity 15. 4% (59 children), splenomegaly 1. 8% (7 children), and periportal hyperechogenicity 32. 4% (124 children). Conclusions: The results indicate that the most common sonographic signs of patients with acute hepatitis were increased liver echogenicity and periportal hyperechogenicity.