Pseudomonas aeruginosa folliculitis after shower/bath exposure.

BACKGROUND: Pseudomonas aeruginosa folliculitis (PF) can develop after exposure to contaminated water in heated swimming pools, whirlpools, and hot-tubes, or after diving suit dressing. METHODS: We observed and studied 14 cases of PF after shower/bath exposure, an underestimated pathogenic event. Cutaneous and environmental microbiological evaluations were performed. RESULTS: In our cases, the clinical expression of dermatitis was constant, PF being a clinically well recognizable skin infection, presenting with follicular, macular, and papulopustular lesions located on the lateral aspect of the trunk, axillary folds, hips, buttocks, and suprapubic area. In all cases, Pseudomonas aeruginosa was isolated from lesional skin; seven cases were serotyped revealing, in three cases, serotype 0 : 1, in two cases 0 : 8, in one case 0 : 10, and in one case 0 : 11. In three families, Pseudomonas aeruginosa was isolated in the well water. In a further three families, Pseudomonas aeruginosa was isolated from bathroom and kitchen components. CONCLUSIONS: Based on our experience, we suggest that shower/bath exposure should be definitively included amongst the possible pathogenic events causing PF. Pseudomonas aeruginosa is responsible for a number of clinical pictures, e.g. otitis externa, conjunctivitis, toe web intertrigo, green nail syndrome, infection of burns and wounds, and folliculitis. Pseudomonas aeruginosa folliculitis (PF) has been reported to develop as a consequence of exposure to contaminated water in heated swimming pools, whirlpools, and hot-tubes, or related to diving suits and leg waxing.1-4 We observed 14 cases of PF after shower/bath exposure. This is probably an underestimated pathogenic event; to our knowledge, only one case has been reported to date.5 In our patients, the clinical expression of dermatitis was constant, PF being a clinically well recognizable skin condition.

[Potential role of gravity in computerized tomography in neoplasms]. / Possibili ruoli delle forze gravitazionali nelle indagini con Tomografia Computerizzata in oncologia.

PURPOSE: The possible evolution of the usual CT signs in oncology makes the logical premise of our experience. Our goal was to transform instrumental findings in information richer in clinical yield, in compliance with the guidelines of the National Cancer Institute (Bethesda, Md, USA). MATERIAL AND METHODS: Our study was developed over a 3-year period and involved 432 selected patients with primary neoplasms. The lesions were in pulmonary, gastroenteric and genitourinary sites and stages differed (T2/T3, N0/N3, M0/M1); the Karnofsky score ranged 60-90. We integrated the tumor staging obtained with CT with gravitational tests by means of simple changes in the position of forced decubitus resulting in procubitus and triclinium-like positions (right and left lateral decubitus). We restudied only the cT class of each lesion, looking for a better depiction of the lesion-adjacent, fat, and compared the results the examinations in the standard versus the modified decubitus. Judgements were relative to the technical quality of the modified examination and to the potential impact of these findings on the following pTNM staging. RESULTS: In our 432 patients and only relative to the cT parameter, CT with standard decubitus correctly staged 312 lesions (mean accuracy: 72.2%) versus 352 for CT with modified decubitus (mean accuracy: 81.5%). Improvements were more marked in gastric (22.9% of 48 cases), vesical (23% of 26 cases) and colic (22.3% of 76 cases) lesions, and less marked in pulmonary (10.6% of 132 cases), ovarian (14% of 71 cases) and endometrial (17.1% of 70 cases) lesions. The routine application of pTNM verifications to CT staging helped show the most frequent causes of cTNM mistaging in solid lesions which, in most of the T2/T3 classes, involve the direct spread to an adjacent organ and the depth of invasion of adjacent structures. CONCLUSIONS: The combination and comparison of cTNM with pTNM are useful not only for final tumor staging but also to assess the pretreatment diagnostic accuracy of CT studies. Introducing gravitational tests and reading examinations in pairs improved lesion location, which is the most important technical information for subsequent prognosis and treatment and can help decrease pre-/post-treatment management costs.