Subject(s)
Carotid Stenosis/pathology , Cavernous Sinus Thrombosis/pathology , Cerebral Angiography , Fusobacterium Infections/complications , Hemiplegia/pathology , Adolescent , Anti-Bacterial Agents/therapeutic use , Carotid Stenosis/etiology , Cavernous Sinus Thrombosis/etiology , Diffusion Magnetic Resonance Imaging , Fusobacterium Infections/drug therapy , Fusobacterium necrophorum , Hemiplegia/etiology , Humans , Male , Respiratory Tract Infections/complications , Tomography, X-Ray ComputedSubject(s)
HIV Infections/diagnosis , Adult , Diagnosis, Differential , Humans , Male , Sarcoidosis/diagnosisABSTRACT
Streptococcus pneumoniae can be responsible for spinal, joints, pulmonary or infrequently cutaneous septic localisations. The association between different septic localisation is extremely rare with this microorganism. We describe the first case of concomitant spinal, joints and cutaneous septic localisations in a critically ill patient with S. pneumoniae septicaemia. This observation illustrates that heterogeneity of clinical features depends on the pathogen characteristic and its interaction with the host.
Subject(s)
Pneumococcal Infections/pathology , Sepsis/complications , Streptococcus pneumoniae/pathogenicity , Critical Illness , Humans , Joints/microbiology , Joints/pathology , Male , Middle Aged , Skin Diseases, Bacterial/microbiology , Skin Diseases, Bacterial/pathology , Spine/microbiology , Spine/pathology , Streptococcus pneumoniae/isolation & purificationABSTRACT
Stonefish (Synanceja verrucosa) sting has been known for a long time to be a medical hazard. It is a common cause of severe marine envenomation. Immediate complications (collapsus, pulmonary oedema) have been described extensively. Late complications (oedema, tissue necrosis) have not been studied in details although they are common and a cause of invalidity and pain. We have observed six travellers with complications of stonefish sting over a 10 year-period in our department. All the patients were coming back from the Indo-Pacific maritime region. They presented with cutaneous abcess (in one) or necrotic complications (foot ulcers in two, cellulitis in three) associated with painfull oedema in two and lymphangitis in three. Surgery has been performed in four patients, two of them undergoing many operations. Two had long term sequelae. Such complications could be avoided. Appropriate initial treatment (i.e., neutralization of the venom by hot water, disinfection, antivenom and antibioprophylaxis) seems to be able to reduce late complications. Antivenom is indicated in severe systemic manifestations which are life threatening and in case of crucial pains. Prevention is the most important part of therapy and relies on appropriate information of the travellers.
