Ear, Nose and Throat
Kelvin Yan in Surgical and Anaesthetic Instruments for OSCEs, 2021
Patient refusal especially when patient cooperation is important. Conditions such as furunculosis and vestibulitis may render it too painful to proceed. Patient refusal especially when patient cooperation is important in nasal examination. Before insertion, a topical anaesthetic is used to numb the area and prevent sneezing. Nasal decongestants are usually given to reduce any nasal membrane swelling to ease passage of the endoscope. It is usually done as an outpatient procedure. Therapeutically, it can be used for the treatment of epistaxis, retrieval or foreign bodies, irrigation and balloon dilatation of sinuses. It is also used during functional endoscopic sinus surgery. Patient refusal, especially when patient cooperation is important given the nature of the procedure. Depending on the indication of the procedure, patients may need to stop their anticoagulants prior to it. Acute epiglottitis, when stimulated, can result in laryngospasm which could lead to respiratory compromise and death.
Bacterial Diseases
Tomasz F. Mroczkowski, Larry E. Millikan, Lawrence Charles Parish MD in Genital and Perianal Diseases, 2014
Perianal streptococcal dermatitis1-4 and erysipelas5-7 are relatively superficial infections that are almost invariably caused by Streptococcus pyogenes. The syndromes overlap considerably. Perianal streptococcal dermatitis is defined as a bright red, sharply demarcated eruption that is caused by group A beta-hemolytic streptococci, whereas erysipelas is a superficial cutaneous infection that may extend into the lymphatics, almost invariably recognized by a raised red border, sharply demarcating the infected from the uninvolved tissue. Impetigo is an acute, superficial skin infection characterized by exudation and crusting, occasionally involving the dermis but also presenting as a bullous eruption in young children. Folliculitis is defined as inflammation/infection of the hair follicle, whereas furunculosis occurs when the infection extends deeper into the dermis, with the formation of an abscess.
Female Genital Tract Infections
Itzhak Brook in Anaerobic Infections, 2008
Female genital infections include vulvovaginitis (VV), vulvovaginal pyogenic infections (abscesses of Bartholin’s and Skene’s glands, infected labial inclusion cysts, labial abscesses, furunculosis, and hidradenitis), endometritis, pyometritis, salpingitis, pelvic inflammatory disease (PID), and tubo-ovarian (TOA) and pelvic abscess.
Common Bacterial Dermatoses
Published in The Physician and Sportsmedicine, 2004
Jeffrey A. Levy, William Dexter
Athletes competing in a wide variety of sports are at risk of contracting and spreading bacterial skin infections. Bacteria proliferate in environments of wet, macerated skin that is repeatedly abraded against competing athletes, equipment, clothing, or objects in the field of play. Common infections include impetigo, folliculitis, furunculosis, pitted keratolysis, and otitis externa. Diagnosis and treatment are often straightforward and vary little from care for nonathletes. However, knowledge of preventive strategies and return-to-play criteria, as outlined by the National Collegiate Athletic Association, are paramount for clinicians who care for competitive athletes.
Prevention of chronic furunculosis with low‐dose azithromycin
Published in Journal of Dermatological Treatment, 2007
Arya Aminzadeh, Zeynep Demircay, Kerem Ocak, Guner Soyletir
Background: Chronic furunculosis is a recurrent staphylococcal abscess of the hair follicle. Besides ensuring personal hygiene, the management consists of long‐term treatment with topical and systemic antibiotics. Objective: An open‐labeled, prospective study was conducted to assess the clinical and in vitro efficacy of azithromycin in the long‐term suppressive treatment of chronic furunculosis. Methods: Patients with a history of three or more episodes of furuncles were assigned to receive 12 weeks of suppressive treatment with azithromycin at a weekly dosage of 500 mg. In vitro susceptibility of azithromycin was evaluated with E‐test. The primary efficacy parameter was complete absence of furuncles during the 3 months of azithromycin treatment. The secondary efficacy parameter was further absence of furuncles during the 3‐month follow‐up period. Results: At the end of 3 months of therapy, azithromycin was found to be effective in 19 (79.2%) of 24 patients; 18 of these patients remained in remission during the 3 months of follow‐up. All of the strains were methicillin‐sensitive. The results of the E‐test showed that 15 of 18 strains (83.3%) were susceptible to azithromycin. Conclusion: The results of this study indicate that azithromycin is an effective and safe alternative in the treatment of chronic furunculosis caused by methicillin‐sensitive Staphylococcus aureus.
Treatment of staphylococcal scalded skin syndrome
Published in Expert Review of Anti-infective Therapy, 2004
Humans are a natural reservoir for Staphylococcal aureus. Colonization begins soon after birth and predisposes to infection. S. aureus is one of the most common causes of skin infection, giving rise to folliculitis, furunculosis, carbuncles, ecthyma, impetigo, cellulitis and abscesses. In addition, S. aureus may cause a number of toxin-mediated life-threatening diseases, including staphylococcal scalded skin syndrome (SSSS). Epidermolytic toxins released by certain S. aureus strains cause SSSS by cleaving the epidermal cell adhesion molecule, desmogelin-1, resulting in superficial skin erosion. Recent experiments have revealed similarities in the pathophysiology of SSSS and pemphigus foliaceus, an autoimmune disorder that is characterized by antibodies targeting the same epidermal attachment protein. SSSS typically affects neonates and infants but may also occur in predisposed adults. It is painful and distressing for the patient and parents, although most cases respond to antibiotic treatment. Mortality is low in infants but can be as high as 67% in adults, and is dependent on the extent of skin involvement and the comorbid state. Thus, the management of adults who develop SSSS remains a major therapeutic challenge. The antibody response against the toxins neutralizes their effect and prevents recurrence or limits the effects to the area of infection, which is known as bullous impetigo.
Related Knowledge Centers
- Aeromonas Salmonicida
- Folliculitis
- Staphylococcus Aureus
- Staphylococcus
- Staphylococcal Skin Infections
- Fish Diseases
- Salmonids