BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of...BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.展开更多
BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emer...BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.展开更多
Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechan...Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.展开更多
Necrotising fasciitis is a rare rapidly progressive, life threatening, soft tissue infection which spreads along fascial planes. We present a patient who was diagnosed with a primary cutaneous Diffuse Large B-Cell Lym...Necrotising fasciitis is a rare rapidly progressive, life threatening, soft tissue infection which spreads along fascial planes. We present a patient who was diagnosed with a primary cutaneous Diffuse Large B-Cell Lymphoma (leg type) following initial presentation as probable necrotising fasciitis. Presentation was of a painful swollen leg, septic shock and MRI findings consistent with the clinical signs. Diagnosis of necrotising fasciitis remains challenging and it is often missed in the early stages. Early fascial biopsy and histopathological analysis is useful in cases where the diagnosis is unclear. We feel that this case highlights these important issues and will benefit others in their management of similar cases in the future.展开更多
文摘BACKGROUND We planned this study considering that complications of deep neck infections can be seriously life threatening.AIM To raise awareness that introthoracic complications and necrotizing fasciitis are causes of serious mortality and morbidity.METHODS This study was carried out with the participation of 188 patients who were treated at Mersin University Department of Otorhinolaryngology and Head and Neck Surgery at January 1,2024.When the patient files were retrospectively examined,16 of 188 patients(8.5%)were included in the study because they were observed to have necrotizing fasciitis and/or intrathoracic complications.RESULTS There were a total of 16 patients in this study,9 males(56.25%)and 7 females(43.75%).All patients were adults(>18 years)and the mean age was 50.37 years±15.37 years.Female patients had a mean age of 40.42 years±13.38 years,whereas for male patients was 58.11 years±12.44 years.CONCLUSION Patients with necrotizing fasciitis and/or intrathoracic complications require more complicated and serious surgeries,intensive care unit monitoring,and mechanical ventilator support.Higher rates of morbidity and mortality should be expected in Bal KK et al.Deep neck infections mortal complications WJCC https://www.wjgnet.com 6384 October 26,2024 Volume 12 Issue 30 these patients who are hospitalized for longer periods of time.
文摘BACKGROUND Necrotising enterocolitis(NEC)is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates.Serum amyloid A(SAA),procalcitonin(PCT),and high-mobility group box 1(HMGB1)have emerged as potential biomarkers for NEC due to their roles in inflammatory response,tissue damage,and immune regulation.AIM To evaluate the diagnostic value of SAA,PCT,and HMGB1 in the context of NEC in newborns.METHODS The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital.Clinical,radiological,and laboratory findings,including serum SAA,PCT,and HMGB1 Levels,were collected,and specific detection methods were used.The diagnostic value of the biomarkers was evaluated through statistical analysis,which was performed using chi-square test,t-test,correlation analysis,and receiver operating characteristic(ROC)analysis.RESULTS The study demonstrated significantly elevated levels of serum SAA,PCT,and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls.The correlation analysis indicated strong positive correlations among serum SAA,PCT,and HMGB1 Levels and the presence of NEC.ROC analysis revealed promising sensitivity and specificity for serum SAA,PCT,and HMGB1 Levels as potential diagnostic markers.The combined model of the three biomarkers demonstrating an extremely high area under the curve(0.908).CONCLUSION The diagnostic value of serum SAA,PCT,and HMGB1 Levels in NEC was highlighted.These biomarkers potentially improve the early detection,risk stratification,and clinical management of critical conditions.The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.
文摘Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.
文摘Necrotising fasciitis is a rare rapidly progressive, life threatening, soft tissue infection which spreads along fascial planes. We present a patient who was diagnosed with a primary cutaneous Diffuse Large B-Cell Lymphoma (leg type) following initial presentation as probable necrotising fasciitis. Presentation was of a painful swollen leg, septic shock and MRI findings consistent with the clinical signs. Diagnosis of necrotising fasciitis remains challenging and it is often missed in the early stages. Early fascial biopsy and histopathological analysis is useful in cases where the diagnosis is unclear. We feel that this case highlights these important issues and will benefit others in their management of similar cases in the future.
