Subject(s)
Altitude Sickness/complications , Foot/pathology , Hand/pathology , Paresthesia/diagnosis , Paresthesia/etiology , Female , Humans , Tibet , Young AdultABSTRACT
BACKGROUND: Pin-site myiasis is a rare complication of external fixation of open fractures of the tibia. METHODS: Case report and literature review. RESULTS: A 32 year-old man with a history of alcohol and drug abuse presented with an open fracture of the middle third of the fibula and tibia (Gustilo type IIIA) after a motor vehicle crash. Definitive surgical correction of the fracture was made with the insertion of an external skeletal fixator, type Baummer, with 2 bars, 6 pins, and 12 rotules. After three weeks, he presented again with a primary complaint of purulent secretion and maggots at the distal pin site. On removal of the pin, significant destruction of peripheral tissue was evidenced, with a wound approximately 5 cm diameter, from which 105 maggots were extracted, being identified as Cochliomyia hominivorax. CONCLUSIONS: There have been no previous reports of myiasis involving an external skeletal fixation and pin, and only one similar case has been reported in a patient with a halo orthosis for the management of a gunshot wound of the neck. As in that case, presumably, in our patient, myiasis occurred via the small infected wound adjacent to the distal pin. Adequate treatment for myiasis requires complete removal of the maggots, as well as antimicrobial therapy.
Subject(s)
Diptera , External Fixators/parasitology , Fractures, Open/complications , Myiasis/etiology , Surgical Wound Infection/parasitology , Tibial Fractures/complications , Adult , Animals , Diptera/growth & development , Fracture Fixation/methods , Fractures, Open/surgery , Humans , Larva , Male , Myiasis/parasitology , Surgical Wound Infection/etiology , Tibial Fractures/surgeryABSTRACT
OBJECTIVE: There have been few studies evaluating snakebite mortality in Venezuela and South America. In this study we evaluate trends in fatal snakebites occurring in Venezuela between 1995 and 2002. METHODS: Epidemiological data for this study were retrieved from the records of the Ministry of Health of Venezuela. Using these data, we analyzed the impact of snakebites in Venezuela during the study period. RESULTS: During the study period, there were 266 reports of death due to snakebite; 79.7% were males, and 20.3% were females (P < .01). Annual mean deaths numbered 33 per year. Of total deaths, 24.1% occurred in victims 55-70 years old. Deaths in young children (<5 years old) accounted for 7.1% of the total. Mortality rate by age showed an age-dependent rate, with higher rates in older ages (P = .038). CONCLUSION: Snake envenomations are an important cause of injury and deaths in Venezuela as in many American countries. Surveillance of envenomations is essential for establishing guidelines, planning therapeutic supplies, and training medical staff on snakebite treatment, as well as assessing risk zones for travelers.
