Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mucormycosis is a rare, rapidly progressive and often fatal fungal infection. The rarity of the condition lends itself to unfamiliarity, delayed treatment, and poor outcomes. Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients. A 56-year-old male with a history of diabetes mellitus II, hepatitis C, and intravenous drug abuse was involved in a rollover motor vehicle accident. He sustained circumferential partial and full-thickness burns to his lower extremities with 20% BSA burns. He ultimately required a below-knee amputation of his right lower extremity due to poor wound healing and nonviability of the soft tissue and foot. Debridement found muscle fibers that were necrotic and purulent. Pathology revealed Mucor species with extensive vascular invasion. This case and discussion highlights the importance of maintaining vigilance for mycotic infections and acting appropriately when there are concerning signs and symptoms of serious wound complications. Caretakers of severe trauma patients should have a high level of suspicion for complications and be cognizant of the American Burn Association's guidelines for systemic inflammatory response syndrome and sepsis. Progressive necrosis outside the confines of the original burn wound should raise concern for impaired wound healing, an immunocompromised state or an underlying infection.
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PMID:Burn Wound Mucormycosis: A Case Study on Poor Wound Healing. 2761 6

We present the rare case of a non-painful compartment syndrome of the forearm in a 35-year old man with a history of intravenous drug abuse, and lessons learned which would have enabled earlier consideration of this limb threatening condition and earlier therapeutic intervention.On initial assessment in the emergency department, the patient was drowsy, tachycardic and pyrexic. There was no obvious pain outwith expectation, and his forearm was erythematous and swollen. Due to the constellation of symptoms and signs, he was presumed to be septic from a forearm cellulitis and was thus treated for sepsis with intravenous antibiotics under the care of the medical team. As his arm swelling continued, he was then thought to possibly have a vascular issue and was given a therapeutic dose of low molecular weight heparin. He was otherwise pain free throughout and had no evidence of neurological compromise. A subsequent orthopaedic review raised the concern of compartment syndrome, and this, alongside a clinically evolving picture, resulted in a diagnosis of developing compartment syndrome being made. The patient underwent subsequent surgical management with dual incision fasciotomies and definitive wound management with split skin graft under the care of plastic surgery.This is a rare presentation of a masked developing compartment syndrome. This case highlights the importance of considering atypical presentations of compartment syndrome in high risk patients, and the importance of early specialist orthopaedic referral, particularly in those who do not present with typical features in their history and examination. We summarise the lessons learned in this case which would have enabled earlier identification of this limb-threatening diagnosis and could have improved further definitive outcome.
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PMID:Lessons learned in the challenging case of evolving compartment syndrome with atypical presentation. 3171 35


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