ABSTRACT
There is an error in the name of one of the author in the original publication. The correct name is I Rodríguez-Delourme and not Delourne.
ABSTRACT
PURPOSE: This work seeks to verify the utility of the KLIC score as a predictor of treatment success or failure in patients with knee and hip acute prosthetic joint infections (APJI). These patients were treated in our centre, which is not a prosthetic joint infection reference centre. The KLIC score assesses factors such as chronic kidney failure (2 points) (Kidney), liver disease (1.5 points) (Liver), revision surgery or femoral neck fracture (1.5 points)and cemented prosthesis (2 points) (Index surgery) and a C-reactive protein level (CRP) greater than 11.5 mg/dL (2.5 points), as a predictor of treatment success or failure in patients with knee and hip acute prosthetic joint infections (APJI). METHODS: We retrospectively reviewed 30 patients with APJI who were treated using debridement, antibiotics, irrigation and retention (DAIR) treatment between January 2007 and December 2016. Patients' KLIC scores were calculated. The main outcome was success or failure of DAIR treatment of APJI. RESULTS: DAIR treatment succeeded in 21 cases and failed in nine cases. Differences in outcome were found according to the KLIC score. For KLIC scores >2 and ≤4, there were three successes and zero failures; for scores 4-5, there were nine successes and two failures; for scores >5 and ≤7,there were nine successes and four failures; and for scores >7, there were zero successes and three failures (p = 0.025). We found a positive predictive value and negative predictive value of 33% and 100% for scores ≤4 (score for calculations: 3.5), 43% and 84% for scores 4-5 (4.5), 50% and 68% for scores >5 and ≤7 (5.5), and 100% and 76% for scores >7 (7.5), respectively. The area under the ROC curve was 0.762 (95% confidence interval, 0.569-0.955). CONCLUSIONS: The KLIC score was useful in predicting success or failure of DAIR treatment of APJI. This supports the conclusion that with a score < 3.5, treatment is likely to succeed and with a score of >6, it is likely to fail.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Debridement/methods , Prosthesis-Related Infections/therapy , Therapeutic Irrigation/methods , Aged , Aged, 80 and over , Arthroplasty/adverse effects , C-Reactive Protein/analysis , Female , Hip Joint/surgery , Humans , Joint Prosthesis/adverse effects , Kidney/pathology , Knee Joint/surgery , Liver/pathology , Male , Middle Aged , Retrospective Studies , Treatment Failure , Treatment OutcomeABSTRACT
OBJECTIVES: To describe the characteristics of patients admitted in hospitals with soft tissue infections, and analyse the variables whose died, in order to define risk groups. METHOD: retrospective analysis of medical reports of all patient admitted during 2002 year for soft tissue infections in public malacitans hospitals. We excluded the patient with soft tissue infections associated with burns, surgery, pressure ulcers, and orbit cellulitis. We analysed clinical, biochemical variables and indications for yields and imaging tests, so the empiric antibiotic treatment established and its correlations with practice guidelines. RESULTS: We analysed 391 admissions of 374 patients. Cellulitis was the most frequent diagnosis (69.3%). We did imaging tests in 51.6%. In 94.3% of cases were treated with empirics antibiotics. The most prescribed drug was amoxiciline plus clavulanate (39%). 27 patients died, 40.7% of them for septic cause. All deceased patients had chronic diseases. The only biochemical parameters associated with mortality were serum proteins and albumina (55 +/- 9 g/L vs. 63 +/- 8 g/L; p = 0.0231) and (22 +/- 7 g/L vs. 29 +/- 7 g/L; p = 0.0125) respectively. CONCLUSIONS: Cellullitis are the most frequent soft tissue infections that requires admissions in hospitals. We overuse imaging test and don t follow the practice guidelines recommendations in antibiotic therapy. Primary soft issue infection s mortality is low and it s restricted to people with chronic illness, deep infections and bad nutritional status.
Subject(s)
Soft Tissue Infections/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Comorbidity , Female , Hospitals, Public/statistics & numerical data , Humans , Male , Middle Aged , Patient Admission , Retrospective Studies , Risk Factors , Soft Tissue Infections/diagnosis , Soft Tissue Infections/drug therapy , Spain/epidemiologyABSTRACT
Objetivos: Describir las características de los pacientes hospitalizados con infecciones de piel y partes blandas (IPPB) y analizar las variables de los que fallecen durante el ingreso para definir grupos de riesgo. Metodo: Análisis retrospectivo de las historias clínicas de todos los pacientes que fueron dados de alta con IPPB durante el año 2002, en los hospitales públicos de la provincia de Málaga. Se excluyen infecciones secundarias a pie diabético, cirugía, quemados, úlceras por decúbito y la celulitis orbitaria. Se analizaron variables clínicas, bioquímicas, indicación y validez diagnóstica de pruebas microbiológicas y de imagen, así como el tratamiento antibiótico empírico iniciado y su correlación con las recomendaciones terapéuticas establecidas. Resultados: Analizamos 391 ingresos de 374 pacientes. La celulitis fue el diagnóstico más frecuente (69,3%). Se realizaron pruebas de imagen en el 51,6% de los casos. El antibiótico más empleado fue la amoxicilina con ácido clavulánico (39%). Fallecieron 27 (6,7%), el 40,7% por el proceso séptico en sí. Todos los fallecidos, tenían algún tipo de enfermedad crónica asociada. Las únicas variables analíticas que se asociaron de forma significativa a mayor mortalidad fueron las proteínas totales (55 ± 9 g/L vs. 63 ± 8 g/L; p = 0,0231) y los concentraciones séricas de albúmina (22 ± 7 g/L vs. 29 ± 7 g/L; p = 0,0125). Conclusiones: Las celulitis es la IPPB que mayor número de ingresos genera en nuestro medio. Apreciamos una sobreutilización de pruebas de imagen y una desviación sobre las recomendaciones terapéuticas y el tratamiento aplicado en nuestros hospitales. La mortalidad global observada es baja y afecta de manera exclusiva a pacientes con mal estado nutricional al ingreso, enfermedades crónicas o infecciones profundas
Objectives: To describe the characteristics of patients admitted in hospitals with soft tissue infections, and analyse the variables whose died, in order to define risk groups. Method: retrospective analysis of medical reports of all patient admitted during 2002 year for soft tissue infections in public malacitans hospitals. We excluded the patient with soft tissue infections associated with burns, surgery, pressure ulcers, and orbit cellulitis. We analysed clinical, biochemical variables and indications for yields and imaging tests, so the empiric antibiotic treatment established and its correlations with practice guidelines. Results: We analysed 391 admissions of 374 patients. Cellulitis was the most frequent diagnosis (69.3%).We did imaging tests in 51.6%. In 94.3% of cases were treated with empirics antibiotics. The most prescribed drug was amoxiciline plus clavulanate (39%). 27 patients died, 40.7% of them for septic cause. All deceased patients had chronic diseases. The only biochemical parameters associated with mortality were serum proteins and albumina (55 ± 9 g/L vs. 63 ± 8 g/L; p = 0.0231) and (22 ± 7 g/L vs. 29 ± 7 g/L; p = 0.0125) respectively. Conclusions: Cellullitis are the most frequent soft tissue infections that requires admissions in hospitals. We overuse imaging test and dont follow the practice guidelines recommendations in antibiotic therapy. Primary soft issue infections mortality is low and its restricted to people with chronic illness, deep infections and bad nutritional status
Subject(s)
Humans , Skin Diseases, Infectious/epidemiology , Soft Tissue Infections/epidemiology , Hospital Mortality/trends , Risk Factors , Retrospective Studies , Multicenter Studies as TopicABSTRACT
Si bien es frecuente que la actinomicosis se manifieste clínicamente como un cuadro seudotumoral, la presentación sincrónica de actinomicosis y cáncer es excepcional. La actinomicosis puede aparecer como una infección oportunista que complica el tratamiento antineoplásico, o bien el cáncer puede actuar como factor etiopatogénico favorecedor de la actinomicosis. Describimos un paciente con cáncer orofaríngeo avanzado (T4 N1 M0) que en el momento del diagnóstico presentaba una infección actinomicótica asociada. Lo excepcional de la asociación y la importancia de su detección precoz creemos justifican la comunicación del caso (AU)
Subject(s)
Aged , Male , Middle Aged , Humans , Actinomycosis , Carcinoma, Squamous Cell , Head and Neck Neoplasms , Pharyngeal Neoplasms , Actinomycosis/complications , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/secondary , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/secondary , Pharyngeal Neoplasms/complications , Pharyngeal Neoplasms/pathologyABSTRACT
Although actinomycosis frequently presents as a pseudotumoral syndrome, the simultaneous diagnosis of actinomycosis and cancer is exceptional. Actinomycosis can occur as an opportunistic infection secondary to the antineoplastic treatment and even the cancer itself can act as facilitating factor. We report a patient who was diagnosed simultaneously of advanced oropharinx cancer (T4-N1-M0) and actinomycosis associated to the tumoral mass. This exceptional association and the importance of its early diagnosis justify the communication of the case.
