Rapidly progressive soft tissue infections

Vinh, Donald C.; Embil, John M.

doi:10.1016/s1473-3099(05)70191-2

Cited by 101 publications

(73 citation statements)

References 134 publications

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“…Traumatic damage to skin and the internal epithelium in soft tissues can cause infections that account for 7% to 10% of hospitalizations in the United States (4). Moreover, wound infections and sepsis are an increasing cause of death in severely ill patients, especially those with immunosupression due to exposure to cytotoxic agents and chronic inflammation (4).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, wound infections and sepsis are an increasing cause of death in severely ill patients, especially those with immunosupression due to exposure to cytotoxic agents and chronic inflammation (4). I t i s w e l l a c c e p t e d t h a t b r e a k d o w n o f t h e host-bacterial symbiotic homeostasis and associated infections are the major consequences of impairment of the "first line" of antimicrobial defense barriers such as the mucosal layers, MALT and reticuloendothelium (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

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Autophagy-Mediated Defense Response of Mouse Mesenchymal Stromal Cells (MSCs) to Challenge with Escherichia coli

Gorbunov¹,

Garrison²,

Zhai³

et al. 2012

Protein Interactions

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Autophagy-Mediated Defense Response of Mouse Mesenchymal Stromal Cells (MSCs) to Challenge with Escherichia coli

Gorbunov¹,

Garrison²,

Zhai³

et al. 2012

Protein Interactions

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“…Most infections are localized to the upper respiratory tract and the skin and are in many cases self-limiting or can be successfully treated with antibiotics. However, this bacterium, when disseminated, can cause severe lifethreatening infections in the bloodstream and soft tissues (Stevens , 2003 ;Vinh and Embil , 2005 ;Olsen and Musser , 2010 ). Streptococcus pyogenes has evolved a remarkable array of systems to avoid recognition by, or the effects of, the human immune system.…”

Section: Introduction and History Of The Streptococcal Cysteine Protementioning

confidence: 99%

Cysteine proteinase SpeB from Streptococcus pyogenes – a potent modifier of immunologically important host and bacterial proteins

Nelson¹,

Garbe

Collin

2011

BCHM

144

111

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Group A streptococcus ( Streptococcus pyogenes ) is an exclusively human pathogen that causes a wide spectrum of diseases ranging from pharyngitis, to impetigo, to toxic shock, to necrotizing fasciitis. The diversity of these disease states necessitates that S. pyogenes possess the ability to modulate both the innate and adaptive immune responses. SpeB, a cysteine proteinase, is the predominant secreted protein from S. pyogenes . Because of its relatively indiscriminant specifi city, this enzyme has been shown to degrade the extracellular matrix, cytokines, chemokines, complement components, immunoglobulins, and serum protease inhibitors, to name but a few of the known substrates. Additionally, SpeB regulates other streptococcal proteins by degrading them or releasing them from the bacterial surface. Despite the wealth of literature on putative SpeB functions, there remains much controversy about this enzyme because many of reported activities would produce contradictory physiological results. Here we review all known host and bacterial protein substrates for SpeB, their cleavage sites, and discuss the role of this enzyme in streptococcal pathogenesis based on the current literature.

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“…In patients presenting with shock, a suspicion of NSTI should be raised and a prompt surgical intervention should be done. 17 A 8.33% of patients of NSTI presented in shock to us and required debridement under anaesthesia and ICU care. The patients had type II diabetes mellitus in 38.9% of the NSTI and 29.7% of the Non NSTI patients.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological profile and management outcome of skin and soft tissue infections at tertiary care centre of sub Himalayan region

Nautiyal¹,

Agarwal²,

Sachdev³

et al. 2018

Int Surg J

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INTRODUCTIONHippocrates first described NSTI in the 5 th century BC. He described it as a complication of acute streptococcal infection, writing "many were attacked by the erysipelas all over the body when the exciting cause was a trivial accident flesh, sinews, and bones fell away in large quantities". There were many deaths.1 But first Englishlanguage descriptions of NSTIs were by the British surgeon Leonard Gillespie and British physicians Gilbert Blaine and Thomas Trotter in the late 18 th century. The disease was known as phagedaenic ulcer, gangrenous, gangrenous ulcer, malignant ulcer, putrid ulcer, or hospital gangrene. 2 ABSTRACTBackground: Many times, it is difficult to differentiate between Necrotizing soft tissue infections (NSTI) and Non NSTI based on symptoms, signs and investigations. Only early diagnosis and debridement can prevent high morbidity associated with it. Methods: This prospective observational, study was conducted in the department of General Surgery, over a period of 1 year on consecutive 100 admitted patients. Clinical signs, symptoms and vital parameters of NSTI group and Non NSTI group were compared. Biochemical investigations, systemic involvement and treatment received was also evaluated. Chi-square analysis was performed to compare categorical variables. Results: A 77.8% of the NSTI and 54.7% of the Non NSTI infections occurred in males. Significant difference was found in mean age in patients with NSTI (50.9±13.1) and Non NSTI (41.1±15). Type II DM (38.9%) and hypertension (8.3%) were more commonly associated with NSTI patients. Mean pulse rate, respiratory rate and body temperature were significantly more in NSTI group. Patients with NSTI had significantly less hemoglobin and increased creatinine as compared to Non NSTI group. In NSTI group, 83% of patients had necrotizing fasciitis along with myonecrosis followed by Fournier's gangrene (13.8%). Among Non NSTI group perianal abscess and subcutaneous abscess constituted 45.31% of patients. Methicillin sensitive staphylococcus aureus was found in 43.8% and 38.9% of Non NSTI and NSTI groups respectively. Conclusions: Classical symptoms and signs of NSTI are not reliable and often investigations also fail to differentiate between NSTI and Non NSTI. Type 2 diabetes mellitus patients are more prone to it. High level of clinical suspicion is required for early diagnosis. Timely and adequate debridement of NSTI is necessary to decrease morbidity and mortality.

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Rapidly progressive soft tissue infections

Cited by 101 publications

References 134 publications

Autophagy-Mediated Defense Response of Mouse Mesenchymal Stromal Cells (MSCs) to Challenge with Escherichia coli

Autophagy-Mediated Defense Response of Mouse Mesenchymal Stromal Cells (MSCs) to Challenge with Escherichia coli

Cysteine proteinase SpeB from Streptococcus pyogenes – a potent modifier of immunologically important host and bacterial proteins

Clinicopathological profile and management outcome of skin and soft tissue infections at tertiary care centre of sub Himalayan region

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