ABSTRACT
Pubic hair grooming is common in many countries, but little is known about this practice in Africa. Grooming has been positively associated with self-reported sexually transmitted infections (STIs). This study aimed to investigate the prevalence and safety of pubic hair grooming in two South African settings. In KwaZulu-Natal province, 1218 women participating in the Evidence for Contraceptive Options and HIV Outcomes Trial completed an interviewer-administered questionnaire on pubic hair grooming practices, and were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and herpes simplex virus type 2 (HSV-2). Pubic hair removal was reported by 705 (58.2%) of women. Common areas for grooming were the pubis (n = 616, 99.4%), vagina/perineum (n = 529, 85.3%) and inner thigh (n = 255, 41.1%). Half (n= 361, 51.4%) removed some or all of their pubic hair at least monthly and 59 (8.4%) once a week or more often. Common side effects reported included itching (n = 439, 77.1%) and pimples and blisters (n = 249, 43.9%). A quarter (n = 173, 24.5%) of groomers had a positive result for either or both of CT and NG compared to a fifth (n = 98, 19.4%) of non-groomers (p-value < 0.033). There was no difference between the groups for HSV-2. After adjusting for age and having more than one sex partner, groomers were significantly more likely to have CT or NG than non-groomers (OR: 1.31; 95% CI: 1.19-1.45). Similarly, those who experienced hair removal-related complications had 1.26 times the odds of testing positive for CT or NG (95% CI: 1.03-1.54). The practice of pubic hair removal is common and reporting of side effects is high in this population. These injuries could put women at a higher risk of STIs.
Subject(s)
Chlamydia Infections/complications , Genitalia, Female/injuries , Genitalia, Male/injuries , Gonorrhea/complications , Hair Removal/adverse effects , Herpes Genitalis/complications , Sexual Behavior/statistics & numerical data , Adult , Animals , Chlamydia Infections/epidemiology , Chlamydia Infections/microbiology , Chlamydia trachomatis , Cross-Sectional Studies , Female , Gonorrhea/epidemiology , Gonorrhea/microbiology , Herpes Genitalis/epidemiology , Herpesvirus 2, Human , Humans , Lacerations/microbiology , Male , Neisseria gonorrhoeae , Prevalence , Sexual Partners , Sexually Transmitted Diseases, Bacterial/complications , Sexually Transmitted Diseases, Bacterial/epidemiology , Sexually Transmitted Diseases, Bacterial/microbiology , South Africa/epidemiologyABSTRACT
Head and neck necrotising soft-tissue infection is exceptionally uncommon in the paediatric population. necrotising soft-tissue infection is severe and often life-threatening. Rapid spread of infection and systemic illness make necrotising soft-tissue infection a challenge for the medical and surgical teams. Early identification and surgical intervention are essential for a favourable patient outcome. This report details the case of periorbital necrotising soft-tissue infection in a 12-year-old male patient following an uncomplicated facial laceration. Prompt surgical debridement with planned return visits to theatre and guided empirical antibiotic therapy ensured that a satisfactory patient outcome was achieved. The failure of current necrotising soft-tissue infection diagnostic scoring tools to be positive in this case may suggest that these tools require refinement and validation.
Subject(s)
Debridement/methods , Eye Infections, Bacterial/microbiology , Fasciitis, Necrotizing/microbiology , Lacerations/microbiology , Plastic Surgery Procedures/methods , Soft Tissue Infections/microbiology , Anti-Bacterial Agents , Child , Eye Infections, Bacterial/therapy , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/therapy , Humans , Lacerations/complications , Male , Soft Tissue Infections/therapy , Surgical Flaps , Treatment OutcomeABSTRACT
Chromoblastomycosis is a chronic infection, caused by pigmented fungi affecting skin and subcutaneous tissues characterized by verrucous nodules or plaques. Fonsecaea pedrosoi and Cladophialophora carrionii are the prevalent agents in the endemic areas. Phoma is an uncommon agent of human infection and involved mainly with phaeohyphomycosis cases. The case of a patient with a history of laceration in foot followed by verrucous aspect and scaly lesions, which had evolved for 27 years is presented. On physical examination disease was clinically compatible with chromoblastomycosis and the microscopic examination of scales showed fumagoid cells. On culture a dematiaceous fungus was grown. The agent was confirmed to be Phoma insulana based on its morphology and PCR-sequencing. This fungal agent has not been previously reported in association with this pathology.
Subject(s)
Ascomycota/isolation & purification , Chromoblastomycosis/microbiology , Foot Injuries/microbiology , Wound Infection/microbiology , Aged , Ascomycota/pathogenicity , Chromoblastomycosis/etiology , Fatal Outcome , Foot Injuries/complications , Humans , Lacerations/complications , Lacerations/microbiology , Leg Ulcer/complications , Leg Ulcer/parasitology , Male , Myiasis/complications , Shoes/adverse effects , Time Factors , Treatment Refusal , Wound Infection/etiologyABSTRACT
BACKGROUND: Mycoplasma hominis frequently colonizes the urogenital and respiratory tracts of healthy individuals. It has also been associated with genitourinary tract and extragenital syndromes. CASE: We present a 14-year-old girl who developed a pelvic abscess secondary to M. hominis after a vaginal laceration during sexual intercourse. Despite drainage and broad-spectrum antimicrobial therapy, the patient remained symptomatic until M. hominis was identified and specific therapy instituted. SUMMARY AND CONCLUSION: Health care providers need to be aware of the potential for M. hominis as a causal agent in patients who present with pelvic abscesses after vaginal trauma. This case highlights the challenges that exist in the diagnosis and treatment of M. hominis, because bacterial cultures are often negative and empiric antimicrobial agents do not provide adequate antimicrobial coverage.
Subject(s)
Lacerations/complications , Mycoplasma Infections/diagnosis , Mycoplasma hominis/isolation & purification , Vagina/injuries , Abscess/drug therapy , Abscess/surgery , Adolescent , Anti-Bacterial Agents/therapeutic use , Drainage , Female , Humans , Lacerations/microbiology , Mycoplasma Infections/complications , Mycoplasma Infections/drug therapy , Tomography, X-Ray Computed , Vagina/microbiologyABSTRACT
Cutaneous dipththeria is an infectious bacterial disease endemic in tropical regions, but rarely diagnosed in Germany. Following travel in Sri Lanka, a 60-year-old German presented to our dermatological clinic with a skin ulcer and extensive erythematous erosive edema of his left foot. Corynebacterium diphtheriae was isolated from a swab of the lesion. There were no clinical signs of toxic diphtheria. The patient was treated with penicillin G and erythromycin, followed by a slow healing of the lesion. The isolated strain could be identified as toxigenic C. diphtheriae mitis. Due to increased travel activity, dermatologists should have uncommon infections like cutaneous diphtheria in mind.
Subject(s)
Diphtheria/diagnosis , Diphtheria/drug therapy , Foot Ulcer/diagnosis , Foot Ulcer/drug therapy , Lacerations/drug therapy , Travel , Anti-Bacterial Agents/therapeutic use , Corynebacterium diphtheriae/isolation & purification , Diphtheria/microbiology , Drug Therapy, Combination , Erythromycin/administration & dosage , Foot Ulcer/microbiology , Germany , Humans , Lacerations/diagnosis , Lacerations/microbiology , Middle Aged , Penicillin G/administration & dosage , Sri Lanka , Treatment OutcomeSubject(s)
Animal Shells , Foreign Bodies/diagnostic imaging , Heel/injuries , Lacerations/diagnostic imaging , Animals , Anti-Bacterial Agents/administration & dosage , Bacterial Infections/etiology , Bacterial Infections/prevention & control , Cefazolin/administration & dosage , Child , Ciprofloxacin/administration & dosage , Foreign Bodies/microbiology , Foreign Bodies/surgery , Heel/pathology , Heel/surgery , Humans , Lacerations/microbiology , Lacerations/pathology , Lacerations/surgery , Male , RadiographyABSTRACT
Tetanus is a major worldwide health problem, and its global incidence has been estimated to be approximately 1 million cases per year. In particular, tetanus is more frequent in the elderly as compared with adults. We report a case of an octogenarian who presented with dysphagia and tremors as the only clinical symptoms. During hospitalization, the patient's clinical conditions worsened rapidly, and, although in absence of the classic clinical presentation (trisma, nuchal rigidity, and opisthotonus), a diagnosis of tetanus was suspected. Thus, the patient underwent a tetanus immunoglobulin immunization and antibiotic therapy with excellent clinical recovery.
Subject(s)
Deglutition Disorders/etiology , Tetanus/complications , Acute Disease , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Humans , Lacerations/complications , Lacerations/microbiology , Leg Injuries/complications , Leg Injuries/microbiology , Male , Tetanus/diagnosis , Tetanus/drug therapy , Tetanus Toxoid/therapeutic useSubject(s)
Fractures, Open/microbiology , Fungemia/etiology , Humeral Fractures/microbiology , Lacerations/microbiology , Mucormycosis/etiology , Multiple Trauma/complications , Opportunistic Infections/etiology , Recovery Room , Thigh/injuries , Wound Infection/etiology , Accidental Falls , Accidents, Traffic , Aged, 80 and over , Amphotericin B/therapeutic use , Amputation, Surgical , Antifungal Agents/therapeutic use , Combined Modality Therapy , Debridement , Fatal Outcome , Female , Fractures, Bone/etiology , Fractures, Open/complications , Fungemia/diagnosis , Fungemia/drug therapy , Fungemia/surgery , Humans , Humeral Fractures/complications , Immunocompetence , Lacerations/complications , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Mucormycosis/surgery , Multiple Trauma/surgery , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , Opportunistic Infections/microbiology , Opportunistic Infections/surgery , Postoperative Complications/diagnosis , Postoperative Complications/drug therapy , Postoperative Complications/etiology , Postoperative Complications/microbiology , Postoperative Complications/surgery , Splenectomy/adverse effects , Splenic Rupture/etiology , Splenic Rupture/surgery , Thigh/surgery , Transfusion Reaction , Wound Infection/diagnosis , Wound Infection/drug therapy , Wound Infection/microbiology , Wound Infection/surgeryABSTRACT
BACKGROUND: The influence of wound age on the risk of infection in simple lacerations repaired in the emergency department (ED) has not been well studied. It has traditionally been taught that there is a "golden period" beyond which lacerations are at higher risk of infection and therefore should not be closed primarily. The proposed cutoff for this golden period has been highly variable (3-24h in surgical textbooks). Our objective is to answer the following research question: are wounds closed via primary repair after the golden period at increased risk for infection? METHODS: We searched MEDLINE, EMBASE, and other databases as well as bibliographies of relevant articles. We included studies that enrolled ED patients with lacerations repaired by primary closure. Exclusion: (1) delayed primary repair or secondary closure, (2) wounds requiring intra-operative repair, skin graft, drains, or extensive debridement, and (3) grossly contaminated or infected at presentation. We compared the outcome of wound infection in two groups of early versus delayed presentations (based on the cut-offs selected by the original articles). We used "Grading of Recommendations Assessment, Development and Evaluation" (GRADE) criteria to assess the quality of the included trials. RESULTS: 418 studies were identified. Four trials enrolling 3724 patients in aggregate met our inclusion/exclusion criteria. The overall quality of evidence was low. The infection rate in the wounds that presented with delay ranged from 1.4% to 32%. One study with the smallest sample size (only 19 delayed wounds), which only enrolled lacerations to hand and forearm, showed higher rate of infection in patients with delayed (older than 12h) wounds (relative risk of infection: 4.8, 95% confidence interval, 1.9-12.0). The infection rate in delayed wound groups in the remaining three studies was not significantly different. CONCLUSION: The existing evidence does not support the existence of a golden period nor does it support the role of wound age on infection rate in simple lacerations.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Lacerations/surgery , Surgical Wound Dehiscence/pathology , Wound Healing , Wound Infection/pathology , Esthetics , Female , Humans , Lacerations/microbiology , Lacerations/pathology , Male , Skin Transplantation , Sutures , Time Factors , Treatment Outcome , United States , Wound Infection/microbiologyABSTRACT
Cutaneous alternariosis is a rare infection typically observed only in immunocompromised adults, but we report here that the infection can occur in apparently healthy adolescents. We saw a clinically healthy adolescent boy who presented with cutaneous alternariosis 6 weeks after suffering a laceration to his right ankle. Treatment with itraconazole resulted in significant improvement after 1 month.
Subject(s)
Alternaria/isolation & purification , Dermatomycoses/immunology , Dermatomycoses/pathology , Immunocompetence , Lacerations/microbiology , Adolescent , Ankle Joint , Humans , Lacerations/complications , Male , Mycoses/immunology , Mycoses/pathologyABSTRACT
PURPOSE: To report the first case of fungal keratitis caused by presumed Carpoligna species. METHODS: A 37-year-old gardener sustained a full-thickness, stellate corneal laceration while cutting wood outdoors with a circular saw. Two months after surgical repair, he developed a severe infectious keratitis with descemetocoele at the apex of the original stellate laceration. RESULTS: Culture results confirmed fungal elements without evidence of bacteria. Oral and topical voriconazole were initiated. Due to compliance and cost issues, voriconazole was replaced with natamycin 5% prior to discharge from hospital. The patient improved and healed without perforation. The patient was left with a central stromal scar. DNA extraction from the fungal colony allowed PCR amplification of the 28s ribosomal RNA region of the fungus that led to the diagnosis of Carpoligna pleurothecii. Corticosteroids were never used during the patient's treatment. CONCLUSION: This is the first reported case of infectious keratitis caused by presumed Carpoligna species. The treatment for Carpoligna pleurothecii keratitis includes voriconazole, natamycin, and possibly amphotericin B.
Subject(s)
Corneal Injuries , Corneal Ulcer/microbiology , Eye Infections, Fungal/microbiology , Eye Injuries/microbiology , Lacerations/microbiology , Mitosporic Fungi/isolation & purification , Adult , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Base Sequence , Corneal Ulcer/diagnosis , Corneal Ulcer/drug therapy , DNA, Fungal/genetics , Eye Infections, Fungal/diagnosis , Eye Infections, Fungal/drug therapy , Eye Injuries/diagnosis , Eye Injuries/drug therapy , Humans , Lacerations/diagnosis , Lacerations/drug therapy , Male , Mitosporic Fungi/genetics , Molecular Sequence Data , Natamycin/therapeutic use , Polymerase Chain Reaction , Pyrimidines/therapeutic use , RNA, Fungal/genetics , RNA, Ribosomal, 28S/genetics , Triazoles/therapeutic use , VoriconazoleSubject(s)
Cladosporium/isolation & purification , Corneal Diseases/microbiology , Corneal Injuries , Eye Infections, Fungal/microbiology , Eye Injuries/microbiology , Mycoses/microbiology , Wound Infection/microbiology , Accidents, Traffic , Adult , Antifungal Agents/therapeutic use , Base Sequence , Cladosporium/classification , Cladosporium/genetics , Corneal Diseases/diagnosis , Corneal Diseases/drug therapy , DNA, Fungal/analysis , Eye Infections, Fungal/diagnosis , Eye Infections, Fungal/drug therapy , Eye Injuries/diagnosis , Eye Injuries/drug therapy , Humans , Lacerations/diagnosis , Lacerations/drug therapy , Lacerations/microbiology , Male , Molecular Sequence Data , Mycological Typing Techniques , Mycoses/diagnosis , Mycoses/drug therapy , Natamycin/therapeutic use , Polymerase Chain Reaction , Wound Infection/diagnosis , Wound Infection/drug therapyABSTRACT
Human myiasis is the parasitism of human tissues by fly larvae. Diagnoses are based on clinical pattern of tissue damage and presence of insect stages. Herein, a case myiasis is described in a seven-year-old female child. She presented with fever associated with abscessed scalp lesions containing exposed larvae. Severe pediculosis was also observed. The patient was hospitalized and treated with clindamycin, gentamicin (for bacterial secondary infections) and ivermectin (treatment for lice) after which the patient showed clinical improvement and was discharged four days later. Since human myiasis can be caused by a number of different species, larvae were collected from the patient and identified as those of Cochliomyia hominivorax (Diptera: Calliphoridae). Because other cases of coinfestation of flies and lice are on record, health workers are to be alerted about the possible pediculosis-myasis risk.
Subject(s)
Diptera , Myiasis/parasitology , Scalp/parasitology , Abscess/drug therapy , Abscess/etiology , Analgesics/therapeutic use , Animals , Anti-Bacterial Agents/therapeutic use , Antiparasitic Agents/therapeutic use , Child , Child Abuse , Colombia , Combined Modality Therapy , Debridement , Drug Therapy, Combination , Female , Hospitals, University , Humans , Ivermectin/therapeutic use , Lacerations/microbiology , Lacerations/parasitology , Lice Infestations/complications , Lice Infestations/drug therapy , Myiasis/complications , Myiasis/drug therapy , Myiasis/surgery , Scalp/injuries , Skin Diseases, Bacterial/drug therapy , Skin Diseases, Bacterial/etiology , Species SpecificityABSTRACT
Gas gangrene due to clostridia infections is commonly seen in war injuries and is much less commonly seen in civilian life. When such problems do occur, they present a challenge to the surgeon due to the associated high morbidity and mortality associated. A case is presented where a patient developed gas gangrene in a limb consequent to trauma that had been treated surgically. It is vital to make a correct diagnosis at the earliest to limit disease progression and to avoid complications.
Subject(s)
Clostridium Infections/diagnosis , Gas Gangrene/diagnosis , Heel/surgery , Lacerations/surgery , Surgical Wound Infection/microbiology , Suture Techniques/adverse effects , Adult , Clostridium Infections/etiology , Clostridium perfringens/isolation & purification , Fatal Outcome , Female , Gas Gangrene/microbiology , Heel/injuries , Heel/microbiology , Humans , Lacerations/microbiology , Leg/microbiology , Necrosis/microbiology , Surgical Wound Infection/pathology , Thigh/microbiologySubject(s)
Finger Injuries/therapy , Lacerations/therapy , Occupational Diseases/therapy , Adult , Animals , Finger Injuries/etiology , Finger Injuries/microbiology , Humans , Lacerations/etiology , Lacerations/microbiology , Male , Occupational Diseases/etiology , Occupational Diseases/microbiology , Rural Health , Seals, EarlessSubject(s)
Leptospira interrogans/isolation & purification , Leptospira/immunology , Leptospirosis/diagnosis , Vaccination , Weil Disease/diagnosis , Adult , Female , Humans , Lacerations/microbiology , Leptospirosis/prevention & control , Skin/injuries , Soil Microbiology , Tropical Climate , Weil Disease/prevention & control , Zoonoses/microbiology , Zoonoses/transmissionABSTRACT
Surfers are prone to acute injuries as well as conditions resulting from chronic environmental exposure. Sprains, lacerations, strains, and fractures are the most common types of trauma. Injury from the rider's own surfboard may be the prevailing mechanism. Minor wound infections can be treated on an outpatient basis with ciprofloxacin or trimethoprim-sulfamethoxazole. Jellyfish stings are common and may be treated with heat application. Other treatment regimens have had mixed results. Seabather's eruption is a pruritic skin reaction caused by exposure to nematocyst-containing coelenterate larvae. Additional surfing hazards include stingrays, coral reefs, and, occasionally, sharks. Otologic sequelae of surfing include auditory exostoses, tympanic membrane rupture, and otitis externa. Sun exposure and skin cancer risk are inherent dangers of this sport.
Subject(s)
Athletic Injuries/classification , Athletic Injuries/physiopathology , Animals , Anthozoa , Athletic Injuries/etiology , Dermatitis, Contact/etiology , Exostoses/etiology , Humans , Lacerations/etiology , Lacerations/microbiology , Marine Toxins/poisoning , Oceans and Seas , Otitis Externa/etiology , Sea Urchins , Seawater/adverse effects , Seawater/microbiology , Skin Neoplasms/etiology , Sports Equipment/adverse effects , Sunburn/complications , Tympanic Membrane Perforation/etiology , Urticaria/etiologyABSTRACT
A 12-year-old hunter gelding became severely lame as a result of a laceration to the sheath of the digital flexor tendons of its left hindlimb, but there was no apparent damage to the tendons. The injury became chronically infected with Pseudomonas and Streptococcus species and Escherichia coli which did not respond to antibiotic treatment, and the horse remained lame. A postmortem examination revealed that the tendons had ruptured.