ABSTRACT
INTRODUCTION: Incidence of community acquired methicillin resistant staphylococcus aureus (CA-MRSA) is increasing. Toxic shock syndrome (TSS), Necrotizing fasciitis (NF), Symmetrical peripheral gangrene (SPG) as a manifestation of CA-MRSA are rare in pediatrics. CASE PRESENTATION: We report a young boy who presented with TSS, NF and SPG by CA-MRSA following trauma. CONCLUSION: CA-MRSA should be taken into consideration as an etiology for these type of clinical presentations. Early and aggressive surgical and medical intervention are the cornerstone for successful management.
Subject(s)
Community-Acquired Infections/microbiology , Fasciitis, Necrotizing/microbiology , Gangrene/microbiology , Methicillin-Resistant Staphylococcus aureus , Shock, Septic/microbiology , Staphylococcal Infections , Child , Community-Acquired Infections/diagnosis , Community-Acquired Infections/therapy , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/therapy , Gangrene/diagnosis , Gangrene/therapy , Humans , India , Leg Injuries/complications , Male , Shock, Septic/diagnosis , Shock, Septic/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapyABSTRACT
Diaphragmatic injuries are relatively rare and result from either blunt or penetrating trauma. Regardless of the mechanism, diagnosis is often missed and high index of suspicion is vital. The clinical signs associated with a diaphragmatic hernia can range from no outward signs to immediately life-threatening respiratory compromise. Establishing the clinical diagnosis of diaphragmatic injuries (DI) can be challenging as it is often clinically occult. Accurate diagnosis is critical since missed DI may result in grave sequelae due to herniation and strangulation of displaced intra-abdominal organs. We present a case of polytrauma with rib fracture and delayed appearance of diaphragmatic hernia manifesting as difficult weaning from ventilatory support.
ABSTRACT
Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. This occupational hazard is no more an issue restricted to a particular part of the world; it has become a global issue. Accurate statistics of the incidence of snakebite and its morbidity and mortality throughout the world does not exist; however, it is certain to be higher than what is reported. This is because even today most of the victims initially approach traditional healers for treatment and many are not even registered in the hospital. Hence, registering such patients is an important goal if we are to have accurate statistics and reduce the morbidity and mortality due to snakebite. World Health Organization/South East Asian Region Organisation (WHO/SEARO) has published guidelines, specific for the South East Asian region, for the clinical management of snakebites. The same guidelines may be applied for managing snakebite patients in other parts of the world also, since no other professional body has come up with any other evidence-based guidelines. In this article we highlight the incidence and clinical features of different types of snakebite and the management guidelines as per the WHO/SEARO recommendation.
