Fig 3
Intraoperative findings of surgical debridement. Internal oblique muscle fascia was exposed after debridement of the infected external oblique muscle.
Context in source publication
Context 1
... of necrotizing fasciitis (Table 1) [5]. PTBD was removed 10 days after insertion by radiologist and surgical debridement was performed under general anesthesia on following day. Extensive necrosis of the subcutaneous fat layer, muscular fascia, and the external oblique and internal oblique muscle was accompanied by a foul odor and pus drainage (Fig. 3). Histopathologic findings correlated with characteristics of necrotizing fasciitis by mixed infection (Fig. 4). Wound culture studies revealed a mixed infection by Enterococcus faecalis, Klebsiella pneumoniae, and Candida species (Candida glabrata) which correspond with the most common pathogens causing cholangitis [6]. Intravenous ...
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AimTo compare the technical difficulty, safety, radiation exposure and success rates between right-sided and left-sided percutaneous transhepatic biliary drainage (RPTBD and LPTBD) in patients with malignant biliary obstruction (MBO).Materials and Methods
Fifty patients (28 males, 22 females; mean age 51.78 years) with MBO were randomized to underg...
Citations
... In the case presented by Ku and Park [18], a mid-face NF patient with uncontrolled DM had a wound infected by K. pneumoniae and group B streptococcus. Choi et al. [19] also reported a case of mixed infection by K. pneumoniae, Enterococcus faecalis, and Candida species in a flank NF patient with DM. In this case, however, K. pneumoniae appeared alone in the initial culture, and MRSA appeared as a mixed pathogen afterwards. ...
A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient´s general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.
