RESUMO
Necrotizing fasciits (NF) is a rapidly progressive disease characterized by extensive necrosis of the fascia, skin, and subcutaneous tissue, with characteristical sparing of the underlying muscle. It is considered to be a rare entity and is associated with a high mortality rate since early recognition and treatment are not provided. Extensive surgical debridement of all necrotic tissues and appropriate antimicrobial treatment are the cornerstones for a successful treatment. We present a case of NF in a 36-year-old man and discuss it's pathophysiology, clinical manifestations and the best therapeutic choice for this potential life threatening disease.
Assuntos
Fasciite Necrosante , Adulto , Desbridamento , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/tratamento farmacológico , Fasciite Necrosante/fisiopatologia , Humanos , MasculinoRESUMO
A two year old girl with chronic neurologic convulsive disease was admitted with a six day history of pneumonia and, despite treatment, died on hospital day 3. The X-ray revealed right upper lobar pneumonia. The results of pleural effusion and blood cultures drawn on admission yielded a non-typable Escherichia coli. No other source of infection was identified. The authors discuss the clinical and pathophysiological aspects of Escherichia coli pneumonia.
Assuntos
Infecções por Escherichia coli , Pneumonia Bacteriana/microbiologia , Pré-Escolar , Infecções Comunitárias Adquiridas/microbiologia , Feminino , HumanosRESUMO
Twenty-eight children with septicaemia and positive blood cultures for Klebsiella pneumoniae were retrospectively studied and compared with 190 children with sepsis caused by other organisms, identified or not in blood cultures. Septicaemia due to Klebsiella pneumoniae occurred more frequently in children older than 2 years of age, especially those who had an underlying disease and, therefore, were malnourished or had an impaired immune defense system that had required invasive procedures and previous hospitalization. Although the case fatality rate was high in both groups, Klebsiella pneumoniae did not contribute to elevate the relative risk of death. In this study, Klebsiella pneumoniae isolates were highly sensitive to colistin (92.9%) and cefoxitin (82.1%), but poorly sensitive to third generation cephalosporin and imipenen.