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PubMed1978

Epidemiological features of skin diphtheria infection in Rangoon, Burma.

A survey for skin diphtheria was carried out on 493 patients with skin lesions who were attending Veneral Diseases & Dermatology Clinic in Rangoon in 1971. 63.8% of the patients had C. diphtheriae in their skin lesions. All ages and both sexes were equally affected. Skin lesions yielding C. diphtheriae on culture were indistinguishable from those associated with other bacteria including ecthyma, pyoderma and secondarily infected with parasitic infections. Out of 108 strains tested 18.5% were found to be toxigenic, mainly intermedius. No toxigenic gravis strain was encountered. No relation existed between the type of lesion and the type or toxigenicity of the infecting strain. 75% of these toxigenic strains were isolated from children under 5 years of age. The phage types of toxigenic strains isolated were: II-IV, XII, Ph r, 8, 19-20, III, IVII and IV.

Age Factors↗
PubMed2005

Pseudomonas sepsis with Noma: an association?

We report here a 2.5-year-old male child with community-acquired Pseudomonal sepsis showing the characteristic lesions of ecthyma gangrenosum. The child had development of gangrenous changes of the nose and face - the 'cancrum oris' or 'Noma'. We highlight the possible association of Pseudomonas sepsis and Noma, with malnutrition playing a central role in causing both the diseases.

Child Nutrition Disorders↗
PubMedDate not supplied

Prevalence of skin infections in sheltered homeless.

In an attempt to determine the prevalence of various skin infections in the homeless population in Marseilles, France, we undertook a case control study. Cases were recruited among institutionalized homeless subjects during two snapshot investigations conducted in January 2002 and 2003 respectively. The control subjects were recruited from among those who presented at a clinic for pre-travel advice. We recruited 498 cases and 200 control subjects. Compared to control subjects, a significantly higher proportion of cases had skin diseases (38% versus 0.5%; p < 0.0001). Pruritus, body-lice infestation, scratching lesions, folliculitis, tinea pedis, scabies and impetigo (ecthyma) were strongly significantly associated with homelessness. The higher prevalence of skin infections in the homeless people mainly results from the body-louse infestation, scabies, bacterial super-infection of skin surfaces that have been breached by frequent scratching and tinea pedis due to poor foot hygiene.

Adult↗
PubMed1991

[Noma: presentation of a case].

The noma has been rarely seen during these last decades. It is of an infections etiology, primarily affecting malnourished or immunodeficient children. It is easily confused with neoplastic tumors, tuberculosis, mycosis or gangrene ecthyma which may condition errors in treatment with severe undesirable side-effects. It has recently been associated to AIDS. A case is reported, comments are included on the diagnostic method, medical and surgical treatment and the results obtained.

Anti-Bacterial Agents↗
PubMed1990

[Skin changes in drug-dependent patients].

In parenteral drug abuse, cutaneous manifestations are very common. A variety of skin lesions are indicators of a possible drug addiction: obliteration of peripheral veins and hyperpigmentation of the overlying skin, punched-out scars due to subcutaneous injection, persistent edema following thrombophlebitis, and excoriations due to heroin pruritus. Infectious and non-infectious complications may be accompanied by typical skin alterations, such as ecthyma in sepsis caused by Pseudomonas aeruginosa, multiple ulcers due to embolic infarct, or hypersensitivity reactions mediated by an immunological process. A variety of serious complications may develop at the injection sites: abscesses, gangrene, necrosis, or necrotizing fasciitis. These examples show that the dermatologist is in many ways involved in the care for addicted patients. In addition, these patients frequently suffer from sexually transmitted diseases or blood-borne infections; HIV-infection is rapidly spreading in this group. We now face new problems of differential diagnosis, especially since constitutional symptoms of HIV-infection may mimic symptoms of drug abuse and vice versa. Moreover, immunological alterations similar to those in HIV patients may even occur in drug addicts who are not infected with the virus.

Adolescent↗
PubMed1989

Bacteriology of pyodermas and antibiograms of pathogens.

One hundred and seventy six cases of various clinical types of pyodermas were investigated to find the causative organism of the disease. Folliculitis formed the largest clinical group followed by infectious eczematoid dermatitis, secondary infection, furuncles, impetigo, ecthyma and carbuncle in descending order of frequency. A total of 189 micro-organisms were isolated from the specimens examined. A single infecting organism was isolated from 74.43% and more than one type of organism from 16.48% of cases. Coagulase positive staphylococcus (73.02%) was the predominant species followed by beta-haemolytic streptococcus (26.98%). Coagulase positive staphylococcus was isolated from 109 (61.93%), beta-haemolytic streptococcus from 22 (12.5%) and both these organisms from 29 (16.48%) cases. The antibiotic resistance pattern showed maximum resistance to penicillin followed by ampicillin. None of the strain was found to be resistant to kanamycin. Low percentage of strains were found to be resistant to streptomycin, oxytetracycline, trimethoprim, cloxacillin, erythromycin, chloramphenicol, cephalexin, gentamycin and neomycin.

Ampicillin↗
PubMed1985

[Vaccination of animals and human health].

Prophylactic immunization of animals against obligat and nonobligat pathogenic zoonoses benefit human health in many ways both directly and indirectly. Typical examples of a direct protective effect are the vaccinations of dogs, cats and foxes against rabies as well as the vaccinations against respiratory diseases in cows, horses, dogs and cats to which the most varied species of pathogens of noncompulsory zoonoses contribute. A considerable contribution to the protection of human health is made by the vaccination against salmonellosis and leptospirosis, against vesicular stomatitis, American equine encephalitis and against other zoonoses spread by arthropods, against ecthyma and stomatitis papulosa as well as against brucellosis, anthrax, Q-fever, Newcastle disease and foot-and-mouth disease. The indirect effects of prophylactic vaccination of animals on human health are very complex and still need investigation. An example of this are the vaccinations of animals against human and animal influenza A viruses which can inhibit hybridisation and recombination between human and animal influenza viruses in an ecological system. Occasionally prophylactic vaccinations of animals can do harm to human health. This is invariably a rare incidence in immuno-suppressed persons caused by live vaccines i.e. prophylactic vaccination against Newcastle disease in fowl or against orthopox in animals by the use of the common vaccinia strains, after compulsory vaccination for humans had been cancelled. Prophylactic vaccinations of animals must be constantly followed up and their action on human health must be checked. In the case of positive results prophylactic vaccinations must be carried out selectively and in a wide range.

Animals↗
PubMed1986

Topical antibiotic treatment of impetigo with mupirocin.

Because the effectiveness of topical antimicrobials in the treatment of ecthyma, impetigo, and pyoderma is not well established, the US Food and Drug Administration has recently proposed guidelines for tests of topical antimicrobial efficacy in primary skin infections. The guidelines require both comparison with the agent's base and microbiologic documentation of efficacy. These guidelines were followed in this double-blind, eight-day evaluation of impetigo/ecthyma treated with mupirocin, a new agent that is only active topically. All cultures, before and after therapy, were taken using swabs dipped in neutralizing broth plus 10% fetal bovine serum to minimize antimicrobial "carry over" to the culture plate. Staphylococcus aureus, which was isolated from 94% of the patients before therapy, was eliminated in 88% of the mupirocin-treated patients and 47% of the vehicle-treated patients. Group A beta-hemolytic streptococci were eliminated in 100% of the mupirocin-treated and 0% of the vehicle-treated patients. To our knowledge, this is the first topical antibacterial treatment for primary skin infections proved superior to its vehicle using the proposed US Food and Drug Administration guidelines.

Administration, Topical↗
PubMed1988

[Infectious cutaneous gangrene in infants].

The authors review 6 cases of severe cutaneous gangrene complicating infectious diseases in more or less debilitated infants. The evoked diagnoses were 1 case of septicemic gangrene, 4 cases of extensive cutaneous necrosis of the infant, and 1 severe case of ecthyma gangrenosum. However, the authors believe this classic nosological background while being precise, is restricting and poses the problem of knowing how to classify necrotizing fasciitis.

Bacterial Infections↗
PubMed1987

Serologic survey of viral antibodies in the Peruvian alpaca (Lama pacos).

Sera from more than 100 alpacas (Lama pacos) from the Peruvian southern sierra were examined for antibodies to 8 viruses known to infect other domestic animals. On the basis of these serologic findings and previously published serologic or clinical data, it is now known that the alpaca can be infected with the following viruses: parainfluenza-3, bovine respiratory syncytial virus, bovine herpesvirus-1, bluetongue virus, border disease virus, influenza A virus, rotavirus, rabies virus, vesicular stomatitis virus, foot-and-mouth disease virus, and contagious ecthyma virus.

Animals↗
PubMed1983

Reaction of convalescent bovine antisera with strain-specific antigens of parapoxviruses.

Two strains of papular stomatitis (PS) virus, 1 of milker's nodules (MN) virus and 1 of contagious ecthyma (CE) virus possessed 2 distinct external structures when examined by electron microscopy. The innermost, designated coat was closely apposed to the tubular surface, whereas the outer envelope loosely surrounded the virion. When convalescent sera from cattle infected with PS virus were used for immunoelectron microscopy, antibody reacted with coats and envelopes of the PS virus strains, but only with coats of MN and CE viruses. Convalescent sera from cattle infected with PS or MN virus contained complement-dependent antibodies cytolytic to cells infected with the homologous virus. In an indirect immunofluorescence test, the sera reacted with homologous strains to higher titers than with heterologous strains.

Animals↗
PubMedDate not supplied

Mycoplasma pneumoniae infection detected by immunofluorescence in patients with certain skin diseases.

The presence of Mycoplasma pneumoniae and/or herpes antigens was investigated by indirect immunofluorescence (IF) reactions in exfoliated cells or biopsy specimens from 43 patients with different skin diseases (treatment-resistant cutaneous herpes, genital herpes, acne, urticaria, dermatitis, erythema multiforme, ecthyma contagiosum). Either M. pneumoniae or herpes antigen could be detected in 21 (55.26%) and 12 (31.57%) of the 38 IF-positive cases, respectively, while the associated occurrence of mycoplasma and herpes antigens was observed in 5 (13.15%) of the patients.

Adolescent↗
PubMed1980

[Experimental and clinical studies on cefoperazone (author's transl)].

Experimental and clinical studies were conducted on a new synthetic cephalosporin antibiotic cefoperazone (CPZ). Antibacterial activity of CPZ against S. aureus, E. coli, Klebsiella sp., Proteus sp. and P. aeruginosa was compared with that of cefazolin (CEZ), cephalothin (CET), gentamicin (GM) and cefotaxime (CTX). Ordinary cephalosporin C antibiotics, CEZ and CET showed an excellent antibacterial activity against S. aureus, while CPZ showed a low MIC of 3.13 mcg/ml even 10(6)/ml inoculation. CPZ showed an antibacterial activity against Gram-negative bacteria such as E. coli, Klebsiella sp. and Proteus sp. Its activity was very similar to CTX and superior to CET and CEZ. CPZ showed the greatest activity against P. aeruginosa, i.e., 2 tubes greater than CTX. By intravenous injection, the peak of blood concentration of CPZ treated with 25 mg/kg was 42 mcg/ml (4 cases); in the case of 1 hr. drip infusion, the peak of blood concentration with same dose was 41.25 mcg/ml at the end of drip infusion. By both routes of administration, the half lives were noted to be as long as 101.4 and 84.8 minutes, respectively. The recovery rates (3 cases) in the urine were quite different: 60.8%, 22.6% and 76.8% at 6 hours after administration. The spinal fluid concentration of CPZ was about 5 mcg/ml in the acute stage during the first 5 days and the CSF/serum ratio was above 10%. Clinical evaluation of CPZ was performed in a total of 31 cases; 13 cases of respiratory tract infection, 8 cases of urinary tract infection, 2 cases of staphylococcal scalded skin syndrome, 2 cases of enterocolitis, 2 cases of septicemia and 4 cases of purulent meningitis. Of 31 cases, CPZ proved to be markedly effective or effective in 28 cases, an efficacy rate of 90.3%. CPZ was found to e ineffective in 1 case of pyothorax and 2 cases of septicemia. Of the two cases of septicemia, one who had been also suffering from ecthyma gangrenosum suspected to be caused by P. aeruginosa and died within 10 hours of admission. Therefore, it may be better to consider this case an unknown case. Side effects observed during the therapy were 1 case of rash and 1 case of a rise of BUN.

Bacteria↗
PubMed1983

Pseudomonas septicemia in childhood.

A 5-year study of Pseudomonas aeruginosa septicemia in children was conducted in two large hospitals. The average age of the patients was 20 months. Fourteen (93%) of the 15 patients were debilitated by underlying diseases or by a major invasive procedure. Most of the patients had received broad-spectrum antibiotic therapy prior to the development of Pseudomonas septicemia. The overall mortality was 53%. Ecthyma gangrenosum appeared in only three cases. The serotype H-11 was found in 53% of the septicemic patients, suggesting that Pseudomonas septicemia was a nosocomial disease in most of these cases. The adequate evaluation of the patient at risk, prevention, and early therapy are essential.

Child↗
PubMed1983

Studies on the therapeutic effect of Wratizolin in selected dermatoses.

Clinical investigations of ITCL drug ("Polfa") were carried out on 50 patients (15 women, 16 men, 19 children, at the age of 4-80). ITCL has been successful in non-specific inflammations accompanying some virus dermatoses (zoster, herpes simplex), in streptococcal pyoderma (impetigo, ecthyma), and in some allergic dermatoses (disseminated eczema and atopic dermatitis). Encouraging results were obtained with ITCL in the treatment of psoriasis. It seems that the further attempts with this should be continued in psoriasis. The capillaroscopic examinations in 6 patients revealed ITCL to have vasoconstrictive effect on the nail wall cutis capillaries 6 h after its application. This may be associated with the anti-inflammatory effect of the drug.

Administration, Topical↗
PubMed1982

[Pseudomonas aeruginosa bacteriaemia: new clinical and therapeutic aspects ].

Fifty one cases of Pseudomonas aeruginosa bacteriaemia observed during the last 12 years are reported. Thirty five patients were over fifty years old; 92 p. cent were admitted for several days and about 50 p. cent were in post-operative period. A previous antibiotherapy and an impaired status are promotive factors. The respiratory or peritoneal origins are the most frequent. All patients were feverish; 24 have had an infectious shock which was inaugural in 12 cases. Seven pneumonitis, 3 endocarditis, one pericarditis and 2 osteitis were observed. An ecthyma gangrenosum was noted in three patients. Mortality was 70 p. cent. Comparison between recovered and died patients improved bad prognosis of old age, post operative period, neoplasic, previous organica weakness and pulmonary or peritoneal origins. Used alone, colimycin has seemed to be more effective than aminosid antibiotics; but their association with betalactamins was better. An in vitro study of the susceptibility of 100 Pseudomonas aeruginosa strains has proved the interest of piperacillin and cefsulodin; azlocillin, cefoperazone and ceftriaxone are just less effective.

Aged↗
PubMed1982

Infectious facial and nasal cutaneous necrosis: evaluation and diagnosis.

A review of the literature reveals that pyogenic gangrenosum (ecthyma gangrenosum) is fatal to most patients, especially infants. In this article, the authors review the differential diagnosis of facial necrosis, present two cases of infants who succumbed to the systemic manifestations of the disorder, and a third case of survival in an adult with concomitant systemic lupus erythematosus and pyogenic gangrenosum. Finally, a brief discussion of Pseudomonas gastroenteritis, Pseudomonas septicemia, and pseudomembranous enterocolitis is presented.

Adult↗