Surgical infections
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Surgical infections · Jan 2004
Review Case ReportsCryptococcal myositis and vasculitis: an unusual necrotizing soft tissue infection.
Cryptococcus neoformans var. neoformans is an opportunistic yeast that typically infects immunocompromised patients. ⋯ Cryptococcal soft tissue infection serves as a marker of disseminated cryptococcosis in immunocompromised hosts. Owing to its rarity as a cause of soft tissue infections, diagnosis is difficult and mortality is high.
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Surgical infections · Jan 2004
Comparative StudyCauses and consequences of fever complicating critical surgical illness.
Fever may have malign consequences in the postoperative period. This study was performed to determine the causes and consequences of fever in critically ill surgical patients. The specific hypothesis tested is that postoperative fever is associated with adverse clinical outcomes, including increased organ dysfunction and risk of death. ⋯ Postoperative fever is deleterious to critically ill patients. The magnitude of fever is a determinant of mortality, whereas an infectious etiology of fever may not be. The impacts of nosocomial infection and suppression of fever on critically surgical patients deserve further study.
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Surgical infections · Jan 2004
Randomized Controlled Trial Comparative Study Clinical TrialSafety of drotrecogin alfa (activated) in surgical patients with severe sepsis.
We conducted a retrospective evaluation of the overall safety of drotrecogin alfa (activated) in surgical patients with severe sepsis enrolled in PROWESS. ⋯ Although treatment of surgical patients with drotrecogin alfa (activated) for severe sepsis is associated with a higher incidence of serious bleeding and subsequent treatment- emergent bleeding events, the magnitude of this increase is small and clinically acceptable.
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Surgical infections · Jan 2004
Predictors of outcome for children with perforated appendicitis initially treated with non-operative management.
Initial non-operative therapy for children with perforated appendicitis has become increasingly popular with the advent of powerful broad-spectrum antibiotics. However, there is no consensus regarding which patients may be managed effectively with this strategy. We reviewed all children with perforated appendicitis who were treated initially with non-operative therapy to determine those characteristics that may predict a successful outcome. ⋯ Children with perforated appendicitis can be managed effectively with nonoperative therapy, even in the presence of intra-abdominal abscesses. However, the need for abscess drainage increases the failure rate, perhaps due to inadequate source control. Those patients with a phlegmon on CT scan as opposed to an abscess, are most likely to respond to non-operative management. Initial non-operative therapy of perforated appendicitis in children is appropriate under certain clinical circumstances, especially when the body itself or interventional radiology can achieve adequate source control.
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Surgical infections · Jan 2004
Review Comparative StudyNew strategies to improve outcomes in the surgical intensive care unit.
Over the last half-decade, substantial breakthroughs have taken place in terms of routine therapy of critically ill patients. The combination of these strategies has the potential to result in improvement in the overall outcomes for patients in intensive care units. ⋯ Appropriate incorporation of these strategies into everyday practice will likely result in improvements in the care of critically ill surgical patients.