Acute paronychia
Dimitris Rigopoulos, Chander Grover, Eckart Haneke in Nail Therapies, 2021
The most common cause of acute paronychia is direct or indirect trauma to the cuticle or the nail fold. Such trauma may be relatively minor, resulting from ordinary events, such as dishwashing, injury from a splinter or thorn, onychophagia (nail biting), biting or picking at a hangnail, finger sucking, ingrown nail, manicure procedures (trimming or pushing back the cuticles), artificial nail application, or other nail manipulation. Such trauma enables bacterial inoculation of the nail and subsequent infection. The most common causative pathogen is Staphylococcus aureus , although Streptococcus pyogenes , Pseudomonas pyocyanea , and Proteus vulgaris can also cause paronychia. In patients with exposure to oral flora, other anaerobic Gram-negative bacteria may also be involved. Acute paronychia can also develop as a complication of an episode of chronic paronychia. Acute paronychia can also occur as a manifestation of other disorders affecting the digits, such as pemphigus vulgaris, lichen planus, psoriasis, acrodermatitis enteropathica, diabetes mellitus, drugs (acitretin, indinavir), or tumors (Bowen’s disease, keratoacanthoma).
Toxic Shock Syndrome and Other Related Severe Infections
Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy in Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Toxic shock syndrome (TSS) is a life-threatening condition that fortunately is rare. This condition can be associated with other related severe infections. Obstetricians and gynecologists may encounter these conditions, which can be caused by specific microorganisms. Early recognition and treatment of TSS are crucial. On many occasions, the use of antimicrobials alone is sufficient; however, in some instances, even with antimicrobials, early surgical intervention is necessary to treat the source of infection and prevent further dissemination. This chapter focuses on the epidemiology, diagnosis, and management of some of the aggressive microorganisms encountered in obstetrics and gynecology that result in TSS and other related severe infections. The most common microorganisms that result in these conditions are clostridial species, Streptococcus pyogenes , and Staphylococcus aureus , which are discussed in this chapter given their aggressive ability to progress to disseminating sepsis, TSS, and necrotizing soft tissue infections. This chapter outlines the steps needed to make an early diagnosis and treatment plan, which can be lifesaving decisions for these critically ill patients.
Infections of the Respiratory Tract
Keith Struthers in Clinical Microbiology, 2017
With its direct access to the outside, and the various sources of organisms, it is not surprising that the list of organisms that can cause disease in the respiratory tract is vast. Included are pneumococcus, Streptococcus pyogenes , Mycoplasma pneumoniae , Chlamydophila pneumoniae and Mycobacterium tuberculosis . Important viruses to consider are influenza, metapneumovirus, parainfluenza, respiratory syncytial virus (RSV) and the ‘common cold’ rhinoviruses. In countries where vaccination programmes are in place, infection caused by Corynebacterium diphtheriae (diphtheria), Bordetella pertussis (whooping cough) and Haemophilus influenzae serogroup b (childhood epiglottitis) are uncommon.
Preclinical immunogenicity and safety of a Group A streptococcal M protein-based vaccine candidate
Published in Human Vaccines & Immunotherapeutics, 2016
Michael R. Batzloff, Anne Fane, Davina Gorton, Manisha Pandey, Tania Rivera-Hernandez, Ainslie Calcutt, Grace Yeung, Jon Hartas, Linda Johnson, Catherine M. Rush, James McCarthy, Natkunam Ketheesan, Michael F. Good
Streptococcus pyogenes (group A streptococcus, GAS) causes a wide range of clinical manifestations ranging from mild self-limiting pyoderma to invasive diseases such as sepsis. Also of concern are the post-infectious immune-mediated diseases including rheumatic heart disease. The development of a vaccine against GAS would have a large health impact on populations at risk of these diseases. However, there is a lack of suitable models for the safety evaluation of vaccines with respect to post-infectious complications. We have utilized the Lewis Rat model for cardiac valvulitis to evaluate the safety of the J8-DT vaccine formulation in parallel with a rabbit toxicology study. These studies demonstrated that the vaccine did not induce abnormal pathology. We also show that in mice the vaccine is highly immunogenic but that 3 doses are required to induce protection from a GAS skin challenge even though 2 doses are sufficient to induce a high antibody titer.
Contribution of cryptic epitopes in designing a group A streptococcal vaccine
Published in Human Vaccines & Immunotherapeutics, 2018
Victoria Ozberk, Manisha Pandey, Michael F. Good
A successful vaccine needs to target multiple strains of an organism. Streptococcus pyogenes is an organism that utilizes antigenic strain variation as a successful defence mechanism to circumvent the host immune response. Despite numerous efforts, there is currently no vaccine available for this organism. Here we review and discuss the significant obstacles to vaccine development, with a focus on how cryptic epitopes may provide a strategy to circumvent the obstacles of antigenic variation.
Streptococcal toxic shock syndrome with primary group A streptococcus peritonitis in a healthy female
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
A 47-year-old female with a history of chronic alcoholism presented with nausea, vomiting and mild epigastric tenderness. She reported subjective fever, abdominal fullness and loose, watery stools and had stable vitals on arrival. Examination was positive for mild epigastric tenderness with hepatic enlargement. Computed tomography of the abdomen showed circumferential thickening of the stomach wall, lower esophagus and the first part of the duodenum in addition to peritoneal ascites. She was admitted for alcohol-related gastritis, acute alcoholic hepatitis, and acute kidney injury. She was started on fluid resuscitation and supportive management. After 8-hours, the patient became hemodynamically unstable with subsequent intubation and fluid resuscitation. She was started on empiric antibiotics. Blood and ascitic fluid cultures were obtained showing group A beta-hemolytic streptococci (GAS). The patient was diagnosed with primary GAS peritonitis along with diffuse gastritis and streptococcal toxic shock syndrome. No cutaneous source of Streptococcus pyogenes was identified, and there was no personal or family history of streptococcal pharyngitis. Antibiotics were switched to IV ampicillin and clindamycin. However, the patient continued to deteriorate and succumbed to death within 2-days.
Related Knowledge Centers
- Rheumatic Fever
- Streptococcus
- Scarlet Fever
- Hemoglobin
- Red Blood Cell
- Group A Streptococcal Infection
- Alpha-Hemolytic