Salmonella typhimurium necrotizing fasciitis: a case report.

BACKGROUND: Necrotizing fasciitis is an aggressive disease that causes necrosis in the muscular fascia and subcutaneous tissues. The infection spreads rapidly along the fascia and perifascial planes, followed by extension of the infection to nearby soft tissues and muscles. Necrotizing fasciitis can be attributed to different pathogens, namely Staphylococcus aureus, group A streptococci, and Clostridium perfringes. Only a few cases of skin and soft tissue infections from Salmonella species have been reported to date. Herein we report a case of Salmonella non-typhi necrotizing fasciitis, an exceedingly rare entity. This case report may serve as a potential management plan in similar cases in light of the scarcity of evidence. CASE PRESENTATION: A 20-year-old Caucasian male patient with congenital cardiac anomaly presented with diarrhea and unilateral lower extremity cellulitis causing septic shock. Cultures from blood and the bullae associated with the lower extremity cellulitis grew Salmonella typhimurium. Surgical debridement was performed. Intraoperative tissue cultures were positive for Salmonella typhimurium, and surgical pathology confirmed the diagnosis of necrotizing fasciitis. After a total of 6 weeks of appropriate antimicrobial therapy, another surgical debridement was executed for poor wound healing. New intraoperative cultures grew Fusarium species, and the patient received voriconazole with an adequate response. Immunologic studies showed humoral and cellular immunodeficiency. CONCLUSION: It is important to maintain a high index of suspicion for rare entities that can cause skin and soft tissue infections, such as Salmonella non-typhi, in particular in immunosuppressed patients where a delay in diagnosis and management may have significant morbidity and mortality.

Association Between Personality Traits and Procrastination and the Mediating Effect of Emotional Intelligence in Lebanese Medical Students.

Objective: To investigate the relationship between personality traits and procrastination and the mediating role of emotional intelligence (EI) among a sample of Lebanese medical students.Methods: This cross-sectional study was conducted between June and December 2019. A total of 296 students filled out a questionnaire that consisted of sociodemographic characteristics and the following scales: Procrastination Assessment Scale for Students, Big Five Personality Test, and Quick Emotional Intelligence Self-Assessment Scale.Results: Since no bivariate associations were found between sociodemographic variables, they were not included in the mediation analysis. EI mediated the association between neuroticism and procrastination. Neuroticism was significantly associated with lower EI (P < .01) and lower procrastination (P < .001), whereas higher EI was significantly associated with lower procrastination (P < .001). EI mediated the association between openness to experience and procrastination. Openness to experience was significantly associated with higher EI and higher procrastination (P < .001), whereas higher EI was significantly associated with lower procrastination (P < .001).Conclusions: The results emphasize the role of EI in personality and procrastination and highlight its importance in clinical settings. It is important for clinicians, especially school and university counselors, to identify risk factors beyond low levels of adaptive personality traits such as EI within the clinical setting to reduce irrational procrastination and improve academic performance.