ABSTRACT
Popliteal artery entrapment syndrome is a rare but important condition, which all military health practitioners should be aware of. It should be considered in all young military personnel presenting with symptoms of calf claudication. This article explains the condition, its classification and the key examination findings, allowing differentiation from other diagnoses, as well as advice on management, definitive treatment and prognosis.
Subject(s)
Intermittent Claudication/diagnosis , Jogging , Military Personnel , Muscle, Skeletal/surgery , Popliteal Artery/diagnostic imaging , Adult , Endovascular Procedures , Humans , Imaging, Three-Dimensional , Intermittent Claudication/etiology , Intermittent Claudication/surgery , Leg , Magnetic Resonance Imaging , Male , Myotomy/methods , Tomography, X-Ray Computed , Ultrasonography, Doppler, DuplexABSTRACT
Perianal actinomycosis infection is a very rare occurrence and is challenging to diagnose. Nicorandil is a potassium channel agonist, which is used in the treatment of ischaemic heart disease. Its usage is associated with perianal ulceration and delayed surgical wound healing. We report a case of actinomycosis complicating a chronic perianal ulcer, which was associated with long-term nicorandil usage. It raised the suspicion of malignancy and required over six months of antimicrobial treatment to achieve satisfactory healing. Perianal actinomycosis results in chronic infection which spreads across tissue planes and can resemble an ulcerated malignancy. Nicorandil usage can result in perianal ulceration and produces conditions which are conducive to actinomycosis infection. In such cases, nicorandil therapy should be discontinued, if possible, and long-term systemic antibiotics form the mainstay of treatment.
Subject(s)
Actinomycosis/complications , Anus Diseases/chemically induced , Myocardial Ischemia/drug therapy , Nicorandil/adverse effects , Ulcer/chemically induced , Vasodilator Agents/adverse effects , Actinomycosis/diagnosis , Aged , Anus Diseases/complications , Anus Diseases/diagnosis , Humans , Male , Treatment Outcome , Ulcer/complications , Ulcer/diagnosis , Wound HealingABSTRACT
Primary necrotizing fasciitis of the breast is extremely rare. We describe a case of a 51-year-old diabetic smoker who presented with primary necrotizing fasciitis of the breast, with signs of severe systemic sepsis. She required intravenous antibiotics, radical emergency surgery, intensive care treatment and inotropic support. After daily wound inspections and changes of dressings, the wound was amenable to delayed primary closure on day 6. We describe this case in detail and review the literature on this extremely rare, but potentially fatal, infection.
