ABSTRACT
Streptococcus spp. and Staphylococcus aureus are the most common pathogens causing skin and soft tissue infections (SSTI). Guideline-recommended empiric antibiotics targeting these organisms would also treat coagulase negative Staphylococci, which are not typically considered skin and soft tissue pathogens. Coagulase negative Staphylococci are, however, well known for their propensity to cause indolent infections in the setting of prosthetic material. Here, we present a case of a patient with surgical clips from a femoral artery surgical repair one year prior, presenting with cellulitis at the prior surgical site, complicated by high-grade Staphylococcus hominis bacteremia. Signs of infection persisted after 4 days of appropriate antibiotic therapy and resolved rapidly upon non-steroidal anti-inflammatory administration. This case highlights the importance of recognizing coagulase negative Staphylococci as a possible etiology of cellulitis in patients with prosthetic material, and of considering anti-inflammatory medications as a supplement to antibiotic therapy to hasten resolution of cellulitis in appropriate patients.
ABSTRACT
The embolus trap (ET) is a new device that interrupts the inferior vena cava (IVC) for the prevention of pulmonary embolism. It has a central column from which six wires extend in two tiers. The adjacent wires are formed into loops with hooks at the distal ends that grip the vein wall. Each tier contains three wire loops, and the loops are staggered circumferentially between the tiers. The ET was implanted into the IVC in 26 dogs via a femoral or jugular venotomy. IVC patency was evaluated by venacavagrams. Autologous clots were embolized via the femoral vein to test the efficacy of the ET. The animals were followed for 1 to 4 months prior to postmortem examination. The ET remained patent in all animals and consistently trapped the thromboemboli while preserving blood flow. Lysis of the trapped emboli was observed in 4 to 6 weeks. There was no evidence of malpositioning, penetration through the vein wall, or migration of the ET.
