Necrotizing Fasciitis Case Study

African- American female, 71 years old, has been admitted to the hospital from her primary care provider ten days post-op following a right below the knee amputation. Her only complaint is that of abdmonial pain. Her vitals are as follows: BP 100/70, HR 122, RR 22, Temp 101.1, and oxygen level 96% on room air. Glucose level is 563mg/dl on glucometer and the patient states that she takes a round white pill for her diabetes. She has also been diagnosed with hypertension in the past and takes a white oval pill for it. Head to toe assessment that has been completed noted a foul smell omiting from the bandage where the leg has been amputated. Clearly this patient is exhibiting clinical signs of sepsis. The initial thought is that the source of infection is the surgical wound since the foul odor is present. The next few hours are critical in initating treatment for sepsis. Multi-organ failure can result if treatment is not received in

In recent years, surgical site infections are verified as one of the most errors that are common in the healthcare; however, they are also preventable. These research papers will synthesis information about surgical infections, patient experience, hospital-acquired conditions and achievement of expected treatment for specific clinical diagnoses. A surgical site infection is an infected condition in the body after surgery has occurred. Surgical site infections are caused by germs, called bacteria. Different types of bacteria from the environment may cause a delay in healing. The infection may come from surgical tools or bacteria on the skin if it is not clean correctly. Healthcare professionals use certain guidelines and

1. Write a client outcome to help Mrs. Ross resolve the symptoms (i.e., defining characteristics). Refer to Section III (beginning on p. 119) of the Ackley and Ladwig text.

HISTORY AND PHYSICAL EXAMINATION_______________________ Patient Name: Chapman Robert Kinsey Patient ID: 110589 Room No.: 322-B Date of Admission: 23 February ---Admitting Physician: Martha C. Eaton, MD, Geriatrics Chief Complaint: Admitted from Dr. Max Hirsch’s office due to deep ulcer on left toe. Admitting Diagnoses 1. Severe peripheral vascular disease, status post deep ulcer on left toe. Rule out thrombolysis. The patient was admitted to a regular floor. Condition is serious. 2. ALLERGY TO PENICILLIN, which puts patient into anaphylactic shock. 3. Continue with home medications. DETAILS OF PRESENT ILLNESS: Mr. Kinsey is an 87-year-old white gentleman with history of (1) Chronic atrial fibrillation, on Coumadin. (2) Chronic deafness,

Catheter-Associated Urinary Tract Infection (UTI) 8.Vascular Catheter-Associated Infection 9. Deep vein thrombosis or pulmonary embolism following total knee replacement and hip replacement procedures 10. Certain Surgical Site Infections, including Mediastinitis after Coronary Artery Bypass Graft (CABG), following certain orthopedic procedures, and following bariatric surgery for obesity.

The Joint Commission Accreditation Body assesses health care organization’s compliance with National Patient Safety Goals. The goal of the Joint Commission Body is to focus on critical aspects and patient safety issues in health care organizations, which can vary according to the setting of the health care being performed (Chassin, 2008). Infections occurring in surgical sites of patients account for 15% of all infections that transpire in a hospital setting, and the risk of death doubles in patients who develop infections. The dangers of surgical site infections include superficial, deep, and organ or space infections. The different infections include cellulitis, gangrene, MRSA, and wound sinus, which can lead to amputation, organ

Necrotizing fasciitis is still a very real and very big problem even in 2016. It is a “rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues” (Edlich 2016). It commonly occurs as a complication from surgery or an existing medical condition. The three most important bacteria to cause necrotizing fasciitis are polymicrobial, group A streptococcal, and clostridial myonecrosis. Cases of necrotizing fasciitis have been increasing in recent years due to so much of the population being immunocompromised due to diseases or special issues. These include but are not limited to “diabetes mellitus, cancer, alcoholism, vascular insufficiencies, organ transplants, HIV infection, or neutropenia” (Edlich 2016). The most common age of patients is between 38-44 years with it rarely

Patient flow upon arrival to the emergency department is clearly laid out by the Office of the Auditor General of Ontario (2010) in the following order: triage and registration; nurse assessment; physical assessment accompanied by the use of diagnostic and laboratory services; treatment; and decision on whether the patient is discharged home, or admitted or transferred to another hospital. Hospital admission is based on emergency physicians’ clinical judgment and is only reserved for patients who are suffering from life-threatening situations that require intensive medical attention (Office of the Auditor General of Ontario, 2010). Upon admission, Rick’s symptoms of fever, rash, and pruritus were consistent with the symptoms of a localized pocket infection (Tarakaji et al., 2010). Infected cardiac implantable electrical devices (CIED) put patients at a high risk for suffering catastrophic clinical complications including sepsis and secondary to multiple organ failures, which can result in death (Deharo et al., 2012; Uslan et al., 2010 ). Therefore, immediate hospital admission is critical to Rick because CIED failure requires competent health professionals, such as physicians and nurses, to medically manage his infection (Padeletti et al., 2011). The cardiologist ordered a blood culture for Rick and the result was positive for Methicillin-resistant Staphylococcus aureus, which is the common cause of monomicrobial CIED infection

C. perfringens is the species most commonly involved in gangrene, but other clostridia and several other bacteria can also grow in such wounds (Tortora, Funke, & Case, 2004). When ischemia and the subsequent necrosis created by loss of blood supply have developed, gas gangrene can advance in muscle tissue. The surgical elimination of necrotic tissue and amputation are the prevalent medical treatments for gas gangrene. When gas gangrene occurs in such regions as the abdominal cavity, the patient can be treated in a hyperbaric chamber, which contains a pressurized oxygen-rich atmosphere (Tortora, Funke, Case, 2004). Antibiotics such as Penicillin are effective against to C. perfringens. Symptoms consist of swelling, a blister that has gas bubbles near the area of infection, elevated heart rate, and

Osteomyelitis is a broad and debilitating disease typically triggered by a variety of conditions. Osteomyelitis starts off as inflammation seen within bone and bone marrow that can quickly progress into a large, subclassified infection. The length of time the infection has been present in the body and whether or not there is a pus formation or increased density among the infected bone is commonly used to classify severity. Pyrogenic bacteria or mycobacteria systematically attack the route and anatomic location of the infection evolving acute conditions into chronic ones. “Staphylococcus Aureus is a gram-positive, round shaped, non-mobile cocci typically found in clusters inside these wounds. Staphylococcus Aureus is one of the most common causes of infections after injury or surgery and affects nearly 500,000 patients in hospitals each year. Staphylococcus Aureus belongs to the family Staphylcoccaceae and survives by affecting all known mammalian species including humans” (www.news-medical.net). Osteomyelitis can start in one area of the body while spreading through the blood stream into other bone regions. Typical treatment options for Osteomyelitis includes antibiotics, removal of

They can be single or multiple, and are sometimes multi-loculated. The main differences between ANCs and APFCs are that ANCs contain necrotic materials, and also develop from necrotizing pancreatitis (Fig 28), sometimes associated with pancreatic ducts disruption, and occasionally they can get infected. Because of CT’s low contrast resolution, MRI may be indicated in the early course of the disease to differentiate ANCs from APFCs. With time, parenchymal necrosis becomes more obvious, which aids in the distinction of ANCs from APFCs. MRI is more sensitive in depicting solid tissue within ANCs (Manikkavasakar et al, 2014).

Anna died from a stroke. For starters, blurred vision is a sign of a stroke, which Anna had, according to her blood vessels in her eyes and to the medical report of external examination that her vision had been compromised. Another cause for her stroke is her sickle cell anemia. Because Anna has sickle cell anemia, her red blood vessels would stick together around her arteries (as a result of the shape) blocking other vessels leading other places in the body, such as the brain. There were also signs of early necrosis according to the internal examination (2.2.1) because of ketones and her diabetes, her kidneys were starting to shut down. She had ketones in her urine meaning she wasn’t getting enough insulin. Since Anna wasn’t getting enough

soft tissue. The importance of early diagnosis is vital to the management and surgical removal of

Gangrene itself is the term given to the death of tissues resulting from lack of blood supply or bacterial infection. It is usually characterized by necrosis, tissue death, a discoloration of the skin that turns the skin blackish blue which most of the time needs to be removed. There are two types of gangrene wet and dry. Dry gangrene is strictly related to tissue death due to lack of blood flow. Wet gangrene or gas gangrene is caused by a bacterial infection. I’ve broken down the disease into 6 categories (etiology, transmission, virulent factors, geographic prevalence, and treatment) to better understand its

A 67year old female patient was scheduled for a laparoscopic hysterectomy. However 5 weeks prior to hospitalization she was hospitalized and the case was converted to an open procedure due to excessive bleeding. After being discharged she developed fever and drainage and was readmitted again for possible postoperative infection seven days ago. On day two of admission she underwent surgery for post operative abscess and insertion for a central line for long-term antibiotics.