ABSTRACT
Las infecciones de piel y partes blandas son una causa frecuente de consulta en los centros de atención primaria de la salud. Los datos de la epidemiología local de estas infecciones son escasos; el Staphylococcus aureus y el Streptococcus pyogenes son los principales agentes etiológicos. La emergencia, en los últimos años, de cepas de S. aureus meticilino resistentes provenientes de la comunidad y S. pyogenes resistentes a eritromicina plantea controversia en la elección del tratamiento empírico inicial. Este consenso nacional está dirigido a médicos pediatras, de familia, dermatólogos, infectólogos y otros profesionales de la salud. Trata el manejo clínico, especialmente el diagnóstico y tratamiento, de las infecciones de piel y partes blandas de origen bacteriano provenientes de la comunidad en pacientes inmunocompetentes menores de 19 años de edad.
Skin and soft tissue infections are a common reason for consultation in primary health care centers. Data from the local epidemiology of these infections are rare, but Staphylococcus aureus and Streptococcus pyogenes are known to be the major etiologic agents. The appearance in recent years of community-originated strains of methicillin-resistant S. aureus and erythromycin-resistant pyogenes raises controversy in the choice of initial empirical treatment. This national consensus is for pediatricians, dermatologists, infectologists and other health professionals. It is about clinical management, especially the diagnosis and treatment of community-originated skin and soft tissue infections in immunocompetent patients under the age of 19.
Subject(s)
Humans , Child , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/therapy , Soft Tissue Infections/diagnosis , Soft Tissue Infections/therapyABSTRACT
Las infecciones de piel y partes blandas son una causa frecuente de consulta en los centros de atención primaria de la salud. Los datos de la epidemiología local de estas infecciones son escasos; el Staphylococcus aureus y el Streptococcus pyogenes son los principales agentes etiológicos. La emergencia, en los últimos años, de cepas de S. aureus meticilino resistentes provenientes de la comunidad y S. pyogenes resistentes a eritromicina plantea controversias en la elección del tratamiento empírico inicial. Este consenso nacional está dirigido a médicos pediatras, de familia, dermatólogos, infectólogos y otros profesionales de la salud. Trata el manejo clínico, especialmente el diagnóstico y tratamiento, de las infecciones de piel y partes blandas de origen bacteriano provenientes de la comunidad en pacientes inmunocompetentes menores de 19 años de edad.
Skin and soft tissue infections are a common reason for consultation in primary health care centers. Data from the local epidemiology of these infections are rare, but Staphylococcus aureus and Streptococcus pyogenes are known to be the major etiologic agents. The appearance in recent years of community-originated strains of methicillin-resistant S. aureus and erythromycin-resistant pyogenes raises controversy in the choice of initial empirical treatment. This national consensus is for pediatricians, dermatologists, infectologists and other health professionals. It is about clinical management, especially the diagnosis and treatment of commu-nity-originated skin and soft tissue infections in immunocompetent patients under the age of 19.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/therapy , Soft Tissue Infections/diagnosis , Soft Tissue Infections/therapy , Erysipelas/diagnosis , Erysipelas/therapy , Folliculitis/diagnosis , Folliculitis/therapy , Furunculosis/diagnosis , Furunculosis/therapy , Impetigo/diagnosis , Impetigo/therapyABSTRACT
Paciente de 30 anos, do sexo masculino, apresentou, após vacinação contra influenza comum, dor intensa, edema e eritema em membro superior esquerdo no local da aplicação e febre contínua não aferida. Foi hospitalizado, porém houve agravamento progressivo do quadro e resistência ao tratamento com anti-inflamatórios e antibióticos, culminando em queda do estado geral, formação de coleção no local e convulsão febril. Optou-se por tratamento cirúrgico, submetendo-se o paciente a procedimentos para fasciotomia, desbridamento, drenagem de coleção e sutura de extenso ferimento em membro superior esquerdo.
A 30-year-old male patient, after being vaccinated against the common influenza, presented severe pain, swelling and erythema at the site of injection on the left upper limb and had continuous fever that was not checked. He was admitted to the hospital,, but his clinical condition got worse, with no response to treatment with anti-inflammatory drugs and antibiotics. He developed an abscess at the site of vaccine injection, and high fever with febrile seizures. Surgical treatment was chosen, and the patient underwent debridement and drainage of the abscess, upper arm fasciotomy and repair of the extensive surgical wounds of the left arm.
Subject(s)
Humans , Male , Adult , Skin Diseases, Infectious/therapy , Infections/chemically induced , Influenza, Human/complications , Macular Edema/surgery , Upper ExtremityABSTRACT
La criptococosis es una infección oportunista, causada por el hongo Cryptococcus neoformans; sus manifestaciones cutáneas pueden ser o no secundarias a enfermedad diseminada, forma característica de aparición en individuos con Infección por el virus de la Inmunodeficiencia Humana, caracterizándose por su polimorfismo clínico. Se presenta el caso de un varón adulto con criptococosis cutánea generalizada como expresión de enfermedad diseminada, en el que se evidenciaron diferentes tipos de lesiones como pápulas con o sin umbilicación central, nódulos, y placa; además el paciente presentó criptococosis meníngea, isosporidiasis y candidiasis orofaríngea. Cabe señalar que la criptococosis cutánea, al poder ser la primera manifestación clínica asociada a SIDA, puede permitir una fuerte sospecha diagnóstica de Infección por VIH. Se revisa la literatura respecto a los tipos de criptococosis cutánea, agente causal, cuadro clínico y tratamiento.
Cryptococcosis is an oportunistic infection caused by the fungus Cryptococcus neoformans; cutaneous manifestations may be secondary to disseminated disease, typical form of appearance in individuals with Human Immunodeficiency Virus Infection, it presents clinical polymorphism. We report the case of an adult man with generalized cutaneous cryptococcosis, he presented different types of lesions such as papules with central umbilication or not, nodules, and plaques; also he was diagnosed of meningeal cryptococcosis, isosporidiasis and oral candidiasis. As cutaneous cryptococcosis might be the first clinical manifestation associated with AIDS, it may allow to suspect HIV infection. We review literature about types of cutaneous cryptococcosis, agent, clinical manifestations and treatment.
Subject(s)
Humans , Male , Middle Aged , HIV , Cryptococcosis , Skin Diseases, Infectious/therapy , Acquired Immunodeficiency SyndromeABSTRACT
Background: A resurgence of group A õ hemolytic Streptococcus infections such as fasciitis, cellulitis and Strptococcal Toxic Syndrome has been observed recently. Aim: To study the clinical features of patients with group A õ hemolytic Streptococcus infections in a regional hospital. Patients and methods: Retrospective review of medical records of patients notified as having a group A õ hemolytic Streptococcus tissue infection, between 1994 and 1999. Results: twenty four patients were notified in the period as having a group A õ hemolytic Streptococcus infection and 18 (13 male, mean age 39 tears old) had tissue involvement. Eleven patients had a fasciitis (61 percent), six had a cellulitis (33 percent) and 14 patients (77 percent), a Streptococcal Toxic Shock Syndrome. Eight patients died during hospital stay. The infection portal of entry was identify in 13 patients (the skin in 10 and intramuscular injections in three). Deceased patients had a longer lapse of disease before admission than patients discharged alive (5(range 3h-7 days) and 2.1 (range 6h-5 days) respectively). In seven patients a quick serological test, designed for pharyngeal infections was performed and it was positive in five. Blood cultures were positive in seven patients and in 11, the germ was isolated from the lesions. Conclusions: As the early diagnosis of group A õ hemolytic Streptococcus tissue infections has a prognostic value, the population should be instructed to recognize early signs and symptoms of these infections
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Middle Aged , Skin Diseases, Infectious/epidemiology , Streptococcus/pathogenicity , Streptococcal Infections/epidemiology , Skin Diseases, Infectious/therapy , Fasciitis/epidemiology , Amputation, Surgical/statistics & numerical data , Streptococcal Infections/complications , Shock, Septic/epidemiologyABSTRACT
Objetive:To analyze the clínical and bacteriologicalefficacy of mupirocina in the treatment of pediatric patients with skin and solf tissue infectons. Design : Prospective, open, non-comparative clinical trial. Materials and methods: Patiens between 6 months and 12 years old with the clinical and bacteriological diagnosis of a skin of soft tissue infection were included in this trial. Material from the affected site was obtained for culture and susceptibility testing using the kirby - Bauer techique. All the patients were treated with topical mupirocin for 7 days. Follow up visits for clinical evaluations and adverse events were perform during (day 3) and at the end of therapy (day 7-8). Results: From 32 patients enrolled, 23 were considered evaluable. The initial diagnosis were impetigo (29 cases) and pyodermitis (3 cases). The ethiologic agents obtained from the 23 evaluable patients were S. aureus (14), S pyogenes (2), S. aureus and S. Pyogenes (1), Candida albicans (1) and Klebsiella (2). 87.7 porcent (13/5), Of the S. aureus strains and 100 porcent (2/2) of the S. pyoenes strains were mupirocin susceptible. The 2 klepsiella sp. strains were mupirocin resistant. Twenty of the 23 evaluable patients (87 porcent) were considered cured or improved at the end of therapy. Conclusion: The results of this clinical trial, together with other larger trials, suggest that topical mupirocin is a valid and safe alternative for this treatment of pediatric patients with skin and soft tissue infectious
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Mupirocin , Skin Diseases, Infectious/therapy , Skin/pathology , Soft Tissue Infections/therapy , Costa RicaABSTRACT
O presente estudo tem como objetivo avaliar o uso do açúcar mascavo no tratamento de lesöes ulcerativas de pacientes internos do Hospital Universitário da Universidade Federal de Juiz de Fora. O estudo consiste, primeiramente, na mensuraçäo, observaçäo e fotografia das úlceras, passando-se para a utilizaçäo do açúcar mascavo diretamente no local ulcerado. Os resultados mostram que o açúcar mascavo ativou a regeneraçäo dos tecidos, iniciando o processo de diminuiçäo do exsudato, que desapareceu após 72 horas, tendo o processo de granulaçäo iniciado num período mínimo de 36 horas, até no máximo de 72 horas do início da intervençäo.