RESUMEN
We observed a case of Aeromonas genus infection in soft tissue caused by an underwater trauma. The patient was a 67-year-old male. His chief complaint was the left cruralgia, and his medical history was unremarkable. The clinical history was that he fell into a rice field while riding a bicycle on July 22, 2005, and suffered a blow to the left eras. On the same day, he was emergently referred to our hospital. He was diagnosed with a left eras bruise; after his wound was washed and sewed up, antibiotics were administered. When he visited our hospital again on July 24, he was hospitalized because of aggravated infection. His wound was urgently washed, drained, and debrided.<br>Aeromonas genus was detected in a bacterial culture. The wound was opened and debrided on August 5 because skin necrosis appeared on the sewed portion of the wound due to continued infection. As the infection receded, granulation was promoted by bFGF and the patient was declared healed on September 22. The Aeromonas genus is a gram-negative, rod-shaped genus of bacteria that lives underwater, and a fatal course due to infection with it is possible even from a mild trauma. Although few cases of Aeromonas infection in soft tissue during spa treatment have been reported, springs could always be polluted by them because they are environmental bacteria. It is important to suspect bacterial infection in the case of an underwater trauma and administer appropriate treatment. In addition, it is necessary to consider the possibility of contamination of spa water with bacteria when we receive spa treatment. We want to enlighten spa operators and users about preventing infection in the future.
RESUMEN
We report one case where contrast bathing produced a remarkable effect on RSD (reflex sympathetic dystrophy) that occurred without trauma. The subject was a 58-year-old woman. Her chief complaint was the painful right upper extremity. She had gastric catarrh in her medical history and was being treated with internal medicines. Since about March 2003, the chief complaint developed with no trauma. She received medical treatment (pain killers) in another medical office, but the symptom did not improve. She subsequently visited our hospital on August 12. Because we observed aberrant aching, swelling, cutaneous chromatotropism, and articular contracture of the right hand as well as bone atrophy on roentgenogram, we diagnosed her as having RSD and began treating her with contrast bathing (4min at 40°C, 1min at 15°C x 4 sessions) and range of motion exercises (active, passive) on August 14. Swelling went down in one week, thumb opposition was enabled in one month, and grip recovered to 8kg in three months after the beginning of the treatment.<br>Since the patient was satisfied by such improvement and was able to perform normal daily life, she is now receiving rehabilitation mainly consisting of range of motion exercise.<br>Finally, we report that we applied contrast bathing to RSD that occurred without trauma and obtained good results. We consider that contrast bathing is simple and easy and, therefore, it is effective for patients who are highly motivated toward the treatment.