Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Review Case Reports
Varicella gangrenosa with toxic shock-like syndrome due to group A streptococcus infection in an adult: case report.
Varicella gangrenosa is a rare and serious complication of chickenpox that has been described in children only. We describe a case of an adult with varicella gangrenosa that presented as necrotizing fasciitis of a limb. ⋯ It can be misdiagnosed, with fatal consequences. Because of prompt recognition and aggressive surgical and medical treatment, the patient survived without loss of the affected limb.
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Randomized Controlled Trial Clinical Trial
A randomized, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit.
A randomized, double-blind, placebo-controlled trial of selective decontamination of the oropharynx and gastrointestinal tract was conducted on 61 intubated patients in a medical-surgical intensive care unit (ICU) to determine the impact on nosocomial pneumonia, other infections, and emergence of colonization or infection with antibiotic-resistant bacteria. Over 8 months, 30 patients received an oral paste and solution containing polymyxin, gentamicin, and nystatin; 31 patients received a placebo paste and solution. ⋯ There was no difference in infections caused by antibiotic-resistant gram-negative bacilli, although a trend towards more frequent infection with gentamicin-resistant enterococci was found for study patients. Selective decontamination did not appear to be effective in our very ill medical-surgical ICU patients, although the number of patients in our trial was sufficient to detect only a 50% or greater reduction in pneumonia rates.