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Hand infections
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
The tendon sheath must be explored urgently. The tendon sheath is opened proximally at the A1-pulley level and distally at the level of the A5 pulley/DIP joint. With a small catheter the sheath is rinsed with saline. Do not close the incisions! A permanent flushing system is not indicated. The patient should be admitted and administered intravenous antibiotics aimed at a staphylococcus aureus infection. Hand therapy is started immediately. In case of a fulminant infection with a necrotic flexor tendon and sheath, the finger must be opened according to Bruner. After necrosectomy and rinsing of the wound, the skin is closed with as little as possible sutures.
Epidural Abscess
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
Q: The patient has a history of intravenous drug use (IVDU) and diabetes. Examination reveals she is haemodynamically stable but has a high white cell count. Blood cultures are positive for Staphylococcus aureus. She is in too much pain to mobilise but has grade 4/5 power throughout all myotomes in her lower limbs. MRI scan is as shown. Please comment on the MRI.
Inflammation and Infection
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Judith Hall, Christopher K. Harding
Renal abscessesAlso termed renal cortico-medullary abscesses.Can occur during or after an episode of pyelonephritis.Range from focal lobar nephronia to significant pan-renal infections (e.g., EPN and xanthogranulomatous pyelonephritis [XGP]).Renal abscesses can be exclusively cortical.Haematogenous spread commonly with Staphylococcus aureus (~90% of cases).
Bioprospecting of aqueous phase from pyrolysis of plant waste residues to disrupt MRSA biofilms
Published in Biofouling, 2023
Srividhya Krishnan, Subramaniyasharma Sivaraman, Sowndarya Jothipandiyan, Ponnusami Venkatachalam, Saravanan Ramiah Shanmugam, Nithyanand Paramasivam
Staphylococcus aureus, is a well-known human pathogen, which causes infection upon colonization with varying degree of infectivity from mild skin irritation to pneumonia, mostly, spreading in healthcare and hospital environments. Hospital equipment and surfaces (which included door handles, floors, bed surfaces, stethoscopes, etc.) have been reported to be colonised with S. aureus isolates (Jabłońska-Trypuć et al. 2022). Studies also show that S. aureus can remain viable on dry surfaces over a time period of 1 week to 3 years (Chaibenjawong and Foster 2011). The major contact surfaces in hospitals are plastic (polyvinyl or polypropylene) surfaces, ceramic tiles and stainless-steel surfaces. These pathogens survive under hospital conditions depending on the porosity, free surface, hydrophobicity, adhesion and biofilm formation ability (Sinde and Carballo 2000; Donlan 2001, 2002). It is also reported that stainless steel promotes easy formation of biofilm and plastic surfaces can act as a source of disease transmission from inanimate surfaces (Lagha et al. 2015).
Biological treatment for erythrodermic psoriasis
Published in Expert Opinion on Biological Therapy, 2022
Etanercept is a recombinant human fusion protein that blocks binding of TNF-α to TNF receptors. Esposito et al. reported use of etanercept in 10 EP patients [22]. PASI75 was attained in five patients (50%) at week 12 and six patients (60%) at week 24. Two patients (20%) maintained improvement between PASI50 and PASI75 at week 24. No serious adverse effects were observed. A multicentric, retrospective study described six EP patients treated with etanercept [23]. PASI75 was attained in 67% patients at week 12 and in 50% at week 24. Two serious adverse events were observed: pneumonia and Staphylococcus aureus septicemia in one patient each. Safe and efficacious treatment of EP has been reported in a child [24], in hepatitis C infection [25], and in patients with treatment failure to prior infliximab infusion [26].
MRSA Decolonization and the Eye: A Potential New Tool for Ophthalmologists
Published in Seminars in Ophthalmology, 2022
Jeremy B Hatcher, Alex de Castro-Abeger, Richard W LaRue, Melanie Hingorani, Louise Mawn, Sean P Donahue, Paul Sternberg, Christine Shieh
Methicillin-Resistant Staphylococcus Aureus (MRSA) is an opportunistic pathogen resistant to several antibiotics commonly used to treat Staphylococcus aureus. The rise in prevalence of both hospital- and community-acquired MRSA strains in the early twenty-first century is attributed to widespread antibiotic use in prior decades, leading to international challenges with multi-drug resistance.1 The ecologic niche of MRSA in humans is the anterior nares. Healthy individuals may be “colonized” with MRSA but without active clinical infection. However, MRSA colonization plays a key role in the epidemiology and pathogenesis of disease in the body, with patterns of increased persistent nasal carriage in immunocompromised patients.2 MRSA is also readily transmitted between patients. Risk factors for MRSA carriage include advanced age, prior or recent hospital admission, and residence in a nursing home. Once considered a nosocomial pathogen, surveillance studies have noted the increasing prevalence of community-acquired MRSA isolates.2,3 MRSA infections affect the care of patients in all medical settings, complicating medical care in the inpatient setting (particularly the intensive care unit), operating room and the outpatient clinics. Some authors have even gone as far as to call for universal MRSA screening in adults admitted through the Emergency Department.4 Evidence suggests that up to 1/4 of colonized patients may develop an MRSA infection within a year of being identified as MRSA-colonized.5