amoxicillin-potassium-clavulanate-combination and Fasciitis--Necrotizing

Necrotizing soft tissue infections (NSTIs) are rare but often lethal. Early diagnosis and aggressive surgical debridement are essential to achieve the best possible outcome.. A 12-year old boy was diagnosed with a necrotizing soft tissue infection following elective revision surgery for functional impairment resulting from scar tissue of the neck. Fever and inflammation of the surgical wound manifested 24-36 hours postoperatively. Antibiotic therapy with amoxicillin-clavulanic acid was initiated, but the patient was unresponsive. Ultrasonography, a wound culture and surgical exploration confirmed the diagnosis. The culture was positive for a Streptococcus pyogenes infection and antibiotic treatment was switched to penicillin and clindamycin. Following the diagnosis, surgical debridement was performed subcutaneously, and only necrotic tissue was removed to preserve as much skin tissue as possible. After eradication of the infection, vacuum-assisted closure of the wound was used to close the subcutaneous space. The patient was discharged after 40 days.. In this patient, we treated a necrotizing soft tissue infection with antibiotics, skin sparing surgeries and negative pressure wound therapy (NPWT). We used ultrasonography as imaging technique to help with the diagnosis. The extensiveness of surgical debridement was rather limited. We focused on opening all affected fascial layers. The surgical debridement was subcutaneous, and only necrotic tissue was removed. Because of the location in the neck, we tried to avoid an aggressive skin debridement to preserve as much skin tissue as possible. Negative pressure wound therapy is not frequently used in this context but it contributed to an enhanced wound healing. Ultrasonography for diagnosing NSTIs is useful, but the clinical findings and an explorative surgery will remain most important.

Topics: Amoxicillin-Potassium Clavulanate Combination; Child; Cicatrix; Debridement; Elective Surgical Procedures; Fasciitis, Necrotizing; Humans; Male; Negative-Pressure Wound Therapy; Soft Tissue Infections; Wound Healing

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Fasciitis, Necrotizing; Humans; Male; Middle Aged; Treatment Outcome

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Compartment Syndromes; Debridement; Fasciitis, Necrotizing; Fasciotomy; Female; Forearm; Humans; Linezolid; Neisseria meningitidis; Reoperation; Treatment Outcome

Incidence and severity of invasive group A Streptococcus infections are of increasing concern in France and worldwide. The risk for secondary infection of close contacts is known but rarely described. We report a case of intrafamilial and life-threatening transmission of emm12 group A Streptococcus.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Bursitis; Contraindications, Drug; Disease Transmission, Infectious; Fasciitis, Necrotizing; Female; Humans; Male; Spouses; Streptococcal Infections; Streptococcus pyogenes

Periorbital infections after strabismus surgery are rare. We describe the first reported case of necrotizing group A streptococcal infection of the conjunctiva and Tenon's capsule complicating uneventful strabismus surgery in a 23-month-old boy, successfully managed with conservative intraoperative debridement and with targeted local and systemic antibiotics.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; beta-Lactamase Inhibitors; Conjunctivitis, Bacterial; Esotropia; Eye Infections, Bacterial; Fasciitis, Necrotizing; Humans; Infant; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Penicillin G; Streptococcal Infections; Streptococcus pyogenes; Tenon Capsule; Trimethoprim, Sulfamethoxazole Drug Combination

Necrotising fasciitis is a rapidly progressive, aggressive bacterial infection of the subcutis associated with significant morbidity and mortality in both man and domestic animals. To the best of our knowledge, this is the first veterinary report of magnetic resonance imaging findings in necrotising fasciitis, and the first reported case in a dog to be successfully treated with minimally invasive surgical intervention.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; Dog Diseases; Dogs; Drainage; Fasciitis, Necrotizing; Female; Radiography; Streptococcal Infections; Streptococcus

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Deglutition Disorders; Drainage; Dysphonia; Fasciitis, Necrotizing; Humans; Male; Mediastinitis; Neck; Streptococcal Infections; Streptococcus constellatus; Tomography, X-Ray Computed

The necrotizing fasciitis (NF) is a soft tissue infection affecting the superficial fascia, the subcutaneous tissue and the skin, the latter being affected tardively. This diagnosis is confirmed only after surgery, which consists of debridement of the necrotized tissue. The discordance between the symptomatology and physical exam made that the diagnosis is mistaken in 35% of cases. However, it seems important to remember that the prompt recognition and surgical treatment depend on the morbidity and mortality. We report the case of a patient with NF of the upper limb after a right elbow blunt trauma.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Infective Agents; Fasciitis, Necrotizing; Female; Humans; Middle Aged; Skin Transplantation; Streptococcal Infections; Streptococcus pyogenes; Wounds, Nonpenetrating

The skin infections are common in pediatrics, ranging from furonculosis or impetigo to the severe forms of necrotizing dermohypodermitis. The general antibiotic treatments are not always indicated but when they are, they must take into account the resistance of two main species of bacteria (Staphylococcus aureus and Streptococcus pyogenes), the pharmacokinetics-pharmacodynamic parameters and the severity and type of infection. Two situations should be treated by topical treatements: limited impetigo and furonculosis. The two topical antibiotics used preferentially are mupirocine and fucidic acid. Soon, a third topical antibiotic, reptamuline will complete these. For uncomplicated superficial skin infections justifying an oral antibiotic, amoxicillin-clavulanate offers the best guarantee of efficiency. Poor pharmacodynamic-pharmacokinetic must lead to not prescribe oral M penicillins. In case of allergy, a first-generation cephalosporin, a macrolide (if the susceptibility of the strain was checked) or pristinamycine (after 6 years of age) are acceptable alternatives. For dermohypodermitis bacterial antibiotic of choice remains amoxicillin-clavulanate through IV route, to be active against S. pyogenes but also S. aureus and anaerobic bacteria. The IV route is maintained until regression general signs and a relay orally by the same drug is then possible. For toxinic syndromes and necrozing fascitis clindamycin should be added to a beta-lactam because of its action on protein synthesis in particular reducing the toxins production.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Cephalosporins; Child; Drug Resistance, Bacterial; Fasciitis, Necrotizing; Furunculosis; Fusidic Acid; Humans; Impetigo; Injections, Intravenous; Macrolides; Methicillin-Resistant Staphylococcus aureus; Mupirocin; Penicillins; Pristinamycin; Skin Diseases, Bacterial; Soft Tissue Infections; Staphylococcal Scalded Skin Syndrome; Staphylococcal Skin Infections; Staphylococcus aureus; Stevens-Johnson Syndrome; Streptococcal Infections; Streptococcus pyogenes

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Atrial Fibrillation; Diabetes Mellitus, Type 2; Fasciitis, Necrotizing; Female; Humans; Middle Aged

Inadequate treatment or neglect of odontogenic infections can have serious consequences. The potential for spreading through fascial planes and intracranially can cause compromise of the airway and cavernous sinus thrombosis respectively. On rare occasions this can lead to a rapidly progressing necrotising fasciitis, with destruction of soft tissue, making reconstruction difficult. Antibiotic administration without removal of the cause is inadequate and can complicate subsequent management. We report the presentation and successful management of a 13-year-old boy, who developed necrotising fasciitis in the submandibular region as a result of inadequate initial treatment of a carious, lower molar resulting in significant skin and soft tissue loss.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Fasciitis, Necrotizing; Focal Infection, Dental; Humans; Male; Neck; Periapical Abscess; Streptococcal Infections

Necrotizing soft tissue infections constitute some of the most potentially threatening infections that may be acquired in the community or in the hospital milieu as they are associated with a high mortality rate. In most cases they are produced by Streptococcus pyogenes. We report a case of a necrotizing soft tissue infection caused by Streptococcus agalactiae (group B beta hemolytic streptococcus) that involved the leg of an elderly man with chronic lymphatic leukemia and diabetes mellitus. The lesions notably improved after initiating intravenous antibiotic treatment with amoxicillin-clavunate and clindamycin.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clindamycin; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Elbow Injuries; Fasciitis, Necrotizing; Humans; Immunocompromised Host; Leg; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Soft Tissue Infections; Streptococcus agalactiae; Wound Infection