Asunto(s)
Medios de Contraste/administración & dosificación , Enfermedades de los Genitales Masculinos/diagnóstico por imagen , Aumento de la Imagen/métodos , Escroto/irrigación sanguínea , Escroto/diagnóstico por imagen , Ultrasonografía Doppler en Color/métodos , Absceso/diagnóstico por imagen , Enfermedad Aguda , Diagnóstico Diferencial , Epidídimo/irrigación sanguínea , Epidídimo/diagnóstico por imagen , Epididimitis/diagnóstico por imagen , Erisipela/diagnóstico por imagen , Análisis de Fourier , Gangrena de Fournier/diagnóstico por imagen , Humanos , Hiperemia/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Orquitis/diagnóstico por imagen , Flujo Sanguíneo Regional/fisiología , Sensibilidad y Especificidad , Cordón Espermático/irrigación sanguínea , Cordón Espermático/diagnóstico por imagen , Hidrocele Testicular/diagnóstico por imagen , Testículo/irrigación sanguínea , Testículo/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
The treatment of lower limb erysipelas is based on anti-streptococcal antibiotherapy. The indication of adjuvant anticoagulant therapy is not clear because of the lack of data about the incidence of deep venous thrombosis (DVT) in these patients. We performed a prospective study using a colour Doppler vein exploration combined with ultrasonography within the first 48 h, with evaluation of clinical probability of DVT according to the Wells score to assess the incidence of DVT in patients with erysipelas of the lower limb. Of 30 patients studied, 3 DVT were diagnosed: 2 distal DVT (posterior tibial vein) and 1 proximal DVT (superficial femoral vein) in patients having a clinical score > or = 3. Pulmonary embolism was diagnosed in 2 cases. The incidence of DVTin our study was 10%.DVT should be considered in patients with erysipelas of the lower limb having a high pretest clinical probability.
Asunto(s)
Erisipela/complicaciones , Trombosis de la Vena/etiología , Anciano , Servicio de Urgencia en Hospital , Erisipela/diagnóstico por imagen , Femenino , Humanos , Incidencia , Pierna/irrigación sanguínea , Pierna/diagnóstico por imagen , Pierna/patología , Masculino , Persona de Mediana Edad , Probabilidad , Estudios Prospectivos , Ultrasonografía Doppler Dúplex , Trombosis de la Vena/diagnóstico por imagenRESUMEN
Erysipleas, also known as Saint Anthony's fire, is an acute infection of the skin caused, in most of cases, by group A streptococci. In the past, the most common site of involvement was the face and, in the pre-antibiotic era, mortality was high. In this retrospective study, we highlight the clinical and bacteriological features and report follow-up in 92 patients hospitalized in an internal medicine unit between 1st March 1992 and 31st December 1996 for 94 episodes of erysipelas. The involvement of the lower limbs predominated as involvement of the face is becoming very rare. Streptococci from others groups and Staphylococcus aureus have been implicated on occasions. Recovery is usual even if this infection may greatly weaken these often fragilized patients. In this paper, antibiotic treatment as well as the place of anticoagulants and Doppler ultrasound are discussed. Hospitalization is often necessary but it must not be systematic.
Asunto(s)
Erisipela/fisiopatología , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Anticoagulantes/uso terapéutico , Erisipela/diagnóstico por imagen , Erisipela/tratamiento farmacológico , Erisipela/microbiología , Dermatosis Facial/microbiología , Dermatosis Facial/fisiopatología , Femenino , Estudios de Seguimiento , Hospitalización , Humanos , Pierna/irrigación sanguínea , Dermatosis de la Pierna/diagnóstico por imagen , Dermatosis de la Pierna/microbiología , Dermatosis de la Pierna/fisiopatología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Infecciones Cutáneas Estafilocócicas/fisiopatología , Streptococcus/clasificación , Streptococcus pyogenes/fisiología , Ultrasonografía Doppler , Trombosis de la Vena/diagnóstico por imagenRESUMEN
Erysipelas (cellulitis/lymphangitis) is a superficial cutaneous infection spread by the lymphatic system which may result in permanent injury to the lymphatic vessels. The study evaluated the lymphatic drainage in the lower limbs of 30 patients with at least two episodes of erysipelas by means of lymphoscintigraphy. Twenty-two (73%) were female and 8 (27%) were male with ages ranging from 26 to 77 years (mean 52 years). Lymphoscintigraphy was performed by intradermal administration of 500 microCi (20 Mbq) of 99mTc antimony sulfur-colloid in two interdigital spaces of the feet. Whole body scintigraphy was performed 45 minutes after the administration of the radiopharmaceutical using a computerized gamma camera. Significant lymphatic abnormalities were found in 23 (77%) of these patients. We conclude that most patients with repeated erysipelas have significant and even permanent abnormalities in regional lymphatic drainage. Recurrent erysipelas suggests underlying primary or secondary lymphedema.
Asunto(s)
Erisipela/diagnóstico por imagen , Linfedema/etiología , Linfocintigrafia , Adulto , Anciano , Antimonio , Erisipela/complicaciones , Femenino , Humanos , Linfedema/diagnóstico por imagen , Linfedema/patología , Masculino , Persona de Mediana Edad , Cintigrafía , Radiofármacos , Recurrencia , Azufre Coloidal Tecnecio Tc 99mRESUMEN
A study is presented of 89 patients with primary and recurrent erysipelas of the lower extremities. Ultrasound sonography, dopplerography and tetrapolar rheography were used in the examination. It was found that disorders of the peripheral circulation remain stable in the inter-recurrence period, are manifested by lymphovenous insufficiency, continuous state of pre-edema, trophic disorders of the lower extremities.
Asunto(s)
Erisipela/fisiopatología , Adulto , Anciano , Erisipela/diagnóstico por imagen , Femenino , Hemodinámica , Humanos , Pierna/irrigación sanguínea , Masculino , Persona de Mediana Edad , Pletismografía de Impedancia , Recurrencia , Factores de Tiempo , UltrasonografíaRESUMEN
The study group included 171 patients suffering from postmastectomy syndrome which had developed either after combined treatment for breast cancer or after radical mastectomy alone. Lymphographic examination of 146 cases carried out long after treatment for primary treatment revealed frequent roentgenologic features characteristic of all patterns of secondary obstructive lymphatic edema. In 20 patients, lymphographically-detectable changes were followed at early stages (until day 40 after radical mastectomy) before edema became clinically apparent. Radiation therapy and erysipelatous inflammation were shown to have an effect on lymphatic lesions.