Antifungal Therapy in Fungal Necrotizing Soft Tissue Infections

Khoury, Mitri K.; Heid, Christopher A.; Cripps, Michael W.; Pickett, Maryanne L.; Nagaraj, Madhuri B.; Johns, Meagan; Lee, Francesca; Hennessy, Sara

doi:10.1016/j.jss.2020.06.013

Cited by 8 publications

(7 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These are the findings of most other authors who have written about the subject [1][2][3][4][5][7][8][9]11,13,19 . Delayed or suboptimal primary or subsequent serial debridements 13 and the presence of Clostridial, 20 Acinobacter, 21,22 MRSA or Fungi 15,16,17 as the infecting organisms was related to a higher mortality. Overwhelming sepsis was the cause of death in most of our patients except two who died due to major cardiac events during recovery in the hospital.…”

Section: Diabetesmentioning

confidence: 99%

“…15 However, early recognition of the problem in a patient unresponsive to repeated serial debridement and broad-spectrum antibiotic cover, empiric treatment with antifungals should be given, particularly in those patients who are on immunosuppressive therapy, as it has shown to decrease mortality in admitted patients with fungal NSTIs. 15,16,17 A recent landmark systematic review and metaanalysis by Nawijn et al showed that although average mortality rates reported for NSTIs have remained constant (around 20%) over the past 2 decades or more, surgical debridement to fresh healthy bleeding margins at the earliest possible time after admission lowers the mortality rate for NSTI by almost 50%. Early surgical debridement of NSTIs within 12 hours is essential for reducing the mortality rate, while surgical intervention within 6 hours even further improve outcomes.…”

Section: Diabetesmentioning

confidence: 99%

“…11,13 Like most other authors our data also shows a mean of 5 debridements for the survivors thus highlighting the importance of timely repeat serial debridements to arrest the spread of the NSTIs and to ensure improved survival. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Twenty three (32%) patients in our series were received in shock with raised white cell counts and evidence of impaired renal function. The mortality among these patients was 39% (9/23 patients) compared to 16.32% mortality in patients who were not received in shock (8/49 patients).…”

Section: Diabetesmentioning

confidence: 99%

“…20 Type 3 is very rare and caused by Vibrio vulnificans (seawater organism), and Type 4 i.e., Fungal. 7,15,16,17 Certain monomicrobial infections include communityassociated MRSA. Different terms can be used to describe NSTIs of various anatomic sites, for example necrotizing infection of the perineum is called Fournier's gangrene.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Predictors of Mortality in Necrotizing Soft Tissue Infections in Adults – Experience at A Tertiary Care Hospital in Pakistan

Majid

Anwar²,

Khalid³

et al. 2021

Proceedings S.Z.M.C

View full text Add to dashboard Cite

Introduction: Necrotizing soft tissue infection is a potentially fatal ‘flesh-eating’ disease that requires prompt intervention to save a patient’s life. Identification of parameters that indicate worsening of the disease (predictors of mortality) is an important part in management that guides a surgeon towards rapid surgical treatment. Aims & Objectives: This retrospective study aims to identify factors that are associated with mortality in adults with NSTIs. This study also aims to propose solutions for the better management of these infection to improve surgical outcome and survival. Place and duration of study: OPD & Emergency of Surgical Unit I and II of Shaikh Zayed Hospital, Lahore over a period of 10 years between the years 2010 to 2021. Material & Methods: This is a cross-sectional epidemiological, retrospective study conducted on patients presenting in the Outpatients Department, as well as the Emergency of Surgical Unit I and II. A total of 72 patients meeting the inclusion criteria were enrolled in this study. SPSS version 23 was used for data analysis. Results: Out of 72 patients, 31.94% of patients were receiving some form of immunosuppressive treatment (n=23), out of which 7 patients lost their life (30.43%, p=0.000). There was a preexisting immunosuppressive disease in 48.61% patients (n=35), and in this subset, a total of 10 patients didn’t recover (28.57%, p=0.000). 13 out of 17 patients who died received first debridement after 12 hours from presentation (p=0.021). High mortality was seen in patients who had the presence of shock at hospital admission. Conclusion: Delay in diagnosis and surgical treatment, the presence of shock at admission accompanied by evidence of organ dysfunction, increasing comorbidity index are reasons for the higher mortality seen in these patients of NSTIs. The timing of the first surgery is of the essence thus highlighting the importance of the “Golden Hour” for the Management of NSTIs.

show abstract

Section: Diabetesmentioning

confidence: 99%

Section: Diabetesmentioning

confidence: 99%

Section: Diabetesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Mortality in Necrotizing Soft Tissue Infections in Adults – Experience at A Tertiary Care Hospital in Pakistan

Majid

Anwar²,

Khalid³

et al. 2021

Proceedings S.Z.M.C

View full text Add to dashboard Cite

show abstract

“…From ancient times, fungal infections have been significantly contributing to the ever-increasing morbidity and mortality rate (Ardi et al, 2020;Friedman et al, 2020;Khoury et al, 2020). The fungicidal and fungistatic activity of nanoparticles is being studied to control outbreaks caused by pathogenic fungi.…”

Section: Application Of Nanoparticles In Fungal Infectionsmentioning

confidence: 99%

Nanoparticles as antimicrobial and antiviral agents: A literature-based perspective study

Sharmin

Rahaman

Sarkar

et al. 2021

Heliyon

184

View full text Add to dashboard Cite

The scientific explorations of nanoparticles for their inherent therapeutic potencies as antimicrobial and antiviral agents due to increasing incidences of antibiotic resistance have gained more attention in recent time. This factor amongst others necessitates the search for newer and more effective antimicrobial agents. Several investigations have demonstrated the prospects of nanoparticles in the treatment of various microbial infections. The therapeutic applications of nanoparticles as either delivery agent or broad spectrum inhibition agents in viral and microbial investigations can no longer be overlooked. Their large surface area to volume ratio made them an indispensable substance as delivery agents in many respect. Various materials have been used for the synthesis of nanoparticles with unique properties channelised to meet specific therapeutic requirement. This review focuses on the antibacterial, antifungal, and antiviral potential of nanoparticles with their probable mechanism of action.

show abstract

Necrotising Fasciitis

Schröder

Sochaczewski

2022

Pediatric Musculoskeletal Infections

View full text Add to dashboard Cite

Antifungal Therapy in Fungal Necrotizing Soft Tissue Infections

Cited by 8 publications

References 27 publications

Predictors of Mortality in Necrotizing Soft Tissue Infections in Adults – Experience at A Tertiary Care Hospital in Pakistan

Predictors of Mortality in Necrotizing Soft Tissue Infections in Adults – Experience at A Tertiary Care Hospital in Pakistan

Nanoparticles as antimicrobial and antiviral agents: A literature-based perspective study

Necrotising Fasciitis

Contact Info

Product

Resources

About