Clinical Presentation, Treatment Options, And The Prognosis Of This Disease

Acting on a hunch, he called for a second opinion who also believed it was a severe case of cellulitis, but ordered a biopsy of her leg tissue to prove Gawande’s hunch wrong. To their surprise, his past experience with a patient and seeing a flesh-eating virus up front paid off, Bratton did indeed have necrotizing facscitis and because of Gawande, her case was caught early enough that her life as well as her leg were

Necrotizing Fasciitis is a medical infection which requires emergency professional help as soon as it is indicated. The break down of this name can create an idea of the common symptoms relating to the bacteria. For example "it is" means inflammation describing how the skin gets due to the dead skin tissue. This requires medical diagnosis before being able to be treated. Lab tests and/or imaging are always required. This can be short-term or long-term eventually being deadly. Fewer than 20,000 cases in the United States occur per year.

Skin and or soft tissue infections often occur following a break in normal skin integrity from either trauma or skin disease (Brown & Ebright, 2002). The vast majority of these infections are caused by the gram-positive bacteria Staphylococcus aureus, part of the normal flora existing on the skins surface. Abscess has been found to be the most commonly found SSTI in PWID (Brown & Ebright, 2002). Symptoms of abscess include pain and or tenderness at and around the site of infection, swelling, and redness topped with a pustule. If left untreated, spread and progression of the SSTI leading to tissue ischemia and death, gangrene, sepsis and death can occur (Brown & Pieper, 2002). Hospital treatment of a SSTI is costly. Analysis of the Nationwide Inpatient Sample by the Agency for Healthcare research estimated that in 2009, costs associated with hospital treatment of SSTI reached an estimated $4.8 billion, which is approximately $11,000 per patient (Suya et al., 2009).

ALS, better known as Amyotrophic Lateral Sclerosis, is considered as a complex genetic disorder, in which multiple hereditary and environmental factors combine to cause this disease. This is seen as an illness of parts of the nervous system that control voluntary muscle movement. In ALS, the motor neurons (nerve cells that control muscle cells) are gradually lost. When these motor neurons turn out to be lost, the muscles they control become weak and ultimately nonfunctional. We see that “amyotrophic” is rooted in Greek origin meaning without nourishment to muscles and refers to the loss of signals nerve cells normally send to muscle cells. “Lateral” simply means to the side and refers to the location of the damage in the spinal cord. “Sclerosis” means hardened and refers to the toughened nature of the spinal cord in advanced ALS. This progressive neurodegenerative disease, that was first discovered 150 years ago, is associated with a life expectancy of approximately three years after symptom onset. In the United States, ALS is also known as Lou Gherig’s Disease, named after the Yankees Baseball player who passed away because of it in 1941. In the United Kingdom and other parts of the world, it’s often referred to as motor neuron disease in reference to the cells that are lost in the disorder (ALS Association, 2015).

In the research, fourteen patients in Los Angeles contracted the MRSA necrotizing fasciitis strain. Most of the patients reported having some type of a preexisting condition, like hepatitis C or a history of intravenous

This case is about 55 years old Mrs. Celeste with an end-stage lung disease. Currently, she is unconscious and is under aggressive life support. The health care team feels that she will not be able to be off of the ventilator, and that she had actually, although there is no proof, told the physician that she did not want to be on life support if there were no other choices. Since Mrs. Celeste did not assign anyone to hold her power of attorney, the doctors turn to her four children. Three of the children are religious and believe that a miracle is possible, and that she should not be taken off of life support, and she should be left as she is. One of her children, who is different from the other three, believes that her mother should be taken off of life support and should be left to die comfortably. In this paper, I will first state my stance as to why Mrs. Celeste should be taken off of life support using ethical concepts. I will then debate about possible counterarguments, and explain any sociological concept related to this case. I will conclude with how this case should be handled and, how it could be applied to related cases.

(Nagel), “…The erysipelas would quickly spread widely in all directions. Flesh, sinews, and bones fell away in large quantities...Fever was sometimes present and sometimes absent...There were many deaths.The course of the disease was the same to whatever part of the body, it spread (Green 220)." The first known case of necrotizing fasciitis in America was described by a confederate soldier in 1883 (Edlich 2016). This bacterial infection was named hospital gangrene until it earned its permanent name as necrotizing fasciitis in 1952, because of the necrosis that occurred in the skin (Amanda 2002). During 19th and 20th centuries necrotizing fasciitis included, but was not limited to military hospitals during wartimes due to the lack of sanitation as well as the close quarters of the soldiers. A small number of civilian outbreaks have occurred over time. In 80’s and 90’s more virulent strains of streptococci reemerged to cause a variety of life-threatening infections, which included necrotizing fasciitis (Britannica 578). There was a worldwide spike in the number of reported cases in the mid-1980’s to early 1990s (Amanda 2002). By 1999, approximately 600 cases of necrotizing fasciitis were reported, as of 2010 there have been around 700 to 1,100 cases reported

Microorganisms that are cultured from the wounds have two types that exist. Type 1 necrotizing fasciitis is a polymicrobial infection which consist of infection with aerobic and anaerobic bacteria. Which consists of clostridium and bacteroides species, these work synergistically in the progression of necrotizing fasciitis. Type 2 necrotizing fasciitis consists of group A streptococcus and with or without a coexisting staphylococcal infection. The Type 2 also consists of staphylococcus aureus, clostridium perfringens, bacteroides fragilis, and aeromonas hydrophila. The microscopic level would include the laboratory of necrotizing fasciitis the bacteria that is seen with a microscope. “The micrograph of necrotizing fasciitis shows necrosis of the dense connective tissues and fascia interposed between fat lobules”. The gross anatomy is the structures visible to the naked eye, such as the

Necrotizing fasciitis is an abnormal soft-tissue infection typically caused by toxin-producing, lethal bacteria, which is characterized by extensive fascial necrosis with corresponding sparing of underlying muscle as well as skin (Goldman, Schafer, and Cecil). This disease frequently targets diabetics, alcoholics, IV drug users, immunosuppressed patients, patients with peripheral vascular disease, and young, formerly healthy individuals. Necrotizing fasciitis is capable of occurring in any region of the body however it is commonly found in the abdominal wall, extremities, and perineum (Raffin, Green, and Dafoe 221). However, this pathogen is one of the most important bacterial pathogens in humans since it is the most frequent bacterial

Pressure ulcers, also known as pressure sores, bedsores, and decubitus ulcers, result from pressure or shear friction and pressure that cause skin and underlying tissue to breakdown (Pamaiahgari, 2014, p.1). This is commonly seen over bony prominences such as the sacrum or the heel. Pressure ulcers prove to be an issue for the patient and require the determination of best practice to prevent the pressure ulcer and the complications that can accompany it. Pressure ulcers can be infected, increase in size, odor, and drainage, have necrotic tissue, be indurated, warm, and painful (Lewis et. al, 2014, p.184). Furthermore, untreated pressure ulcers can lead to more serious conditions such as cellulitis, chronic infection, sepsis, and possibly death (Lewis et. al, 2014, p.184). Recurrence of pressure ulcers

Necrotizing Fasciitis (NF) is a severe but rare flesh-eating disease which is believed to be infected by bacteria called Streptococcus pyogenes or group A beta-hemolytic streptococci. This rapidly spreading infection can result in damaged and dead tissue (also known as necrosis).

Osteitis deformans or as we all know it as Paget’s disease, was first described in the year 1876 by an English surgeon named Sir James Paget. This disease results in enlarged or deformed bones due to excessive breakdown and formation of bone tissue (Reumatología Clínica). Since there is a disturbance in the bone remodeling stage, the bones may look enlarged but it is brittle, softer, and weaker which leads to fractures and deformities (MedicineNet). This disease is a chronic bone disorder, which means that it is long term and cannot be prevented or cured by medications. Also, this disease is mostly asymptomatic meaning it does not produce or show any symptoms, which is quite terrifying. It is mostly detected when patients get an x-ray for something else. This is most commonly located in the

Further Infection due to the effects of age, location of the wound, malnourishment, and diabetes mellitus.

A 37 year-old female presents to the ER indicating she is experiencing pain in the anterior portion of the groin. She is unable to bear weight when walking and you observe an antalgic gait (stance phase of the gait cycle is abnormally shortened). When asked if there are any factors that alleviate or aggravate the pain, she says it hurts more when she goes for her evening walk and feels better after lying supine. The patient has a temperature of 37°C (98.6°F), heart rate of 115 BPM, and a blood pressure of 120/80 mmHg. The patient also reports generalized fatigue, epistaxis (nose bleeds), and weight loss. You visually observe alopecia of the eyebrows and hair thinning during the examination. An x-ray is ordered in addition to a complete

Patient is a Caucasian 56years old male admitted for blood sugar above 500 and blood serum acidosis. The patient admission diagnosis was Diabetic Ketone Acidosis and treated for DKA per hospital protocol. Patient shows microvascular and macrovascular complications as a result of his long history of diabetes mellitus. This poorly managed and uncontrolled diabetes mellitus causes the patient to suffer from poor vision, slow wound healing which is on his right knee, hypertension and had cardiac surgery due to his coronary artery disease (Hinkle & Cheever, 2014). Patient lost a lot of weight and his BMI is only 17.01. This also causes electrolyte imbalance, which is one of the reason patient gets admitted to the hospital. Besides