Necrotizing fasciitis is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. We report the case of a 35-year-old female with uncontrolled diabetes mellit...Necrotizing fasciitis is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. We report the case of a 35-year-old female with uncontrolled diabetes mellitus, presenting with edema of the neck, facial and left mammary gland, secondary to untreated dental infection, progressing to a full-blown necrotizing fasciitis in a short period of time with sepsis. The patient was managed with aggressive multidisciplinary medical and surgical treatment. Despite the technologic advances in diagnosis and treatment, complications still result with astounding high mortality. Clearly, the morbidity associated to this infection, even in diabetic patients, can be minimized if an early diagnosis and effective debridement are done.展开更多
Cavernous lymphangioma of the chest wall is a very rare disease entity, and only a few cases have ever been documented in the literature. Cases of recurrent cavernous lymphangioma after surgical excision of a cystic l...Cavernous lymphangioma of the chest wall is a very rare disease entity, and only a few cases have ever been documented in the literature. Cases of recurrent cavernous lymphangioma after surgical excision of a cystic lymphangioma on the same side of the chest wall are quite uncommon. We report a case of a 10-year-old girl, with a giant cavernous lymphangioma of the left lateral chest wall extending into the axilla, who had undergone surgical excision of a cystic lymphangioma 9 years earlier.展开更多
Drainage by chest tube thoracostomy is widely used in treatment of early empyema thoracis in children, but drainage with antiseptic lavage-irrigation is more frequent in our context since the last 20 years. This study...Drainage by chest tube thoracostomy is widely used in treatment of early empyema thoracis in children, but drainage with antiseptic lavage-irrigation is more frequent in our context since the last 20 years. This study was to determine which was more effective in our experience comparing chest tube drainage with catheter antiseptic lavage-irrigation versus drainage by chest tube thoracostomy alone in the management of empyema thoracis in children. Patients and Methods: Demographic, clinical and microbiological data on children with thoracic empyema undergoing drainage by chest tube thoracostomy alone or with antiseptic lavage-irrigation were obtained from 2 thoracic surgical centers from September 2008 to December 2014. It was a retrospective study included 246 children (137 boys and 109 girls) who were managed for empyema thoracis at the author’s different department of surgery. Outcomes analysis with respect to treatment efficacy, hospital duration, chest tube duration, hospital costs, and need for subsequent procedures was analyzed and compared in the 2 groups. Results: Drainage of pus and antiseptic irrigation resulted in resolution of pyrexia with improvement in general condition in 85.82% of patients in group 1 and by tube thoracostomy alone in 73.95% in group 2. There are a significant difference in the length of hospital stay (p = 0.022), duration of chest tubes in situ (p = 0.040), treatment coast (p = 0.015) and outcome of stage 2 empyema disease (p = 0.037) between the 2 groups. Conclusion: it seems that chest tube drainage with antiseptic lavage-irrigation method is associated with a higher efficacy, shorter length of hospital stay, shorter duration of chest tube in situ, less cost and better outcome of stage 2 empyema diseases than a treatment strategy that utilizes chest tube thoracostomy alone.展开更多
文摘Necrotizing fasciitis is an uncommon infection, but potentially lethal, especially when associated with systemic disorders such as diabetes. We report the case of a 35-year-old female with uncontrolled diabetes mellitus, presenting with edema of the neck, facial and left mammary gland, secondary to untreated dental infection, progressing to a full-blown necrotizing fasciitis in a short period of time with sepsis. The patient was managed with aggressive multidisciplinary medical and surgical treatment. Despite the technologic advances in diagnosis and treatment, complications still result with astounding high mortality. Clearly, the morbidity associated to this infection, even in diabetic patients, can be minimized if an early diagnosis and effective debridement are done.
文摘Cavernous lymphangioma of the chest wall is a very rare disease entity, and only a few cases have ever been documented in the literature. Cases of recurrent cavernous lymphangioma after surgical excision of a cystic lymphangioma on the same side of the chest wall are quite uncommon. We report a case of a 10-year-old girl, with a giant cavernous lymphangioma of the left lateral chest wall extending into the axilla, who had undergone surgical excision of a cystic lymphangioma 9 years earlier.
文摘Drainage by chest tube thoracostomy is widely used in treatment of early empyema thoracis in children, but drainage with antiseptic lavage-irrigation is more frequent in our context since the last 20 years. This study was to determine which was more effective in our experience comparing chest tube drainage with catheter antiseptic lavage-irrigation versus drainage by chest tube thoracostomy alone in the management of empyema thoracis in children. Patients and Methods: Demographic, clinical and microbiological data on children with thoracic empyema undergoing drainage by chest tube thoracostomy alone or with antiseptic lavage-irrigation were obtained from 2 thoracic surgical centers from September 2008 to December 2014. It was a retrospective study included 246 children (137 boys and 109 girls) who were managed for empyema thoracis at the author’s different department of surgery. Outcomes analysis with respect to treatment efficacy, hospital duration, chest tube duration, hospital costs, and need for subsequent procedures was analyzed and compared in the 2 groups. Results: Drainage of pus and antiseptic irrigation resulted in resolution of pyrexia with improvement in general condition in 85.82% of patients in group 1 and by tube thoracostomy alone in 73.95% in group 2. There are a significant difference in the length of hospital stay (p = 0.022), duration of chest tubes in situ (p = 0.040), treatment coast (p = 0.015) and outcome of stage 2 empyema disease (p = 0.037) between the 2 groups. Conclusion: it seems that chest tube drainage with antiseptic lavage-irrigation method is associated with a higher efficacy, shorter length of hospital stay, shorter duration of chest tube in situ, less cost and better outcome of stage 2 empyema diseases than a treatment strategy that utilizes chest tube thoracostomy alone.
