By Bobby Buka, Annemarie Uliasz, Karthik Krishnamurthy
This publication bargains thorough insurance of emergencies in dermatology, from the fundamentals of serious deal with dermatologic emergencies, to neonatal and pediatric emergencies, infectious emergencies, drug eruptions and HIV-AIDS-related emergencies, between many others.
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Additional info for Buka's Emergencies in Dermatology
Necrotizing fasciitis commonly presents with localized pain and erythema . Within hours to days the infection can progress to a large area of necrosis, ulceration, and bullae, as well as septic shock . Imaging studies may aid in the diagnosis of necrotizing fasciitis. However, imaging should not delay surgical inspection to identify and debride deep soft tissue infection, as well as to obtain surgical specimens for Gram culture and stain. Delay in surgical debridement is a signiﬁcant modiﬁable contributor to increased mortality.
Although less than 5% of varicella cases occur in immunocompetent adults, 55% of deaths due to varicella occur in adults. Adults with varicella infection are at increased risk of pneumonitis and most commonly expire secondary to pneumonia with respiratory failure . A live attenuated varicella vaccine was approved for use in children in the United States in 1995 . The vaccine is indicated for children 12 months to 12 years of age in addition to individuals greater than 13 years old who have no evidence of immunity.
Necrotizing fasciitis can be divided into three categories based on etiologic agent. Type I is polymicrobial and can include Group A β-hemolytic Streptococcus Streptococcus pyogenes or GAS), Staphylococcus aureus, Klebsiella species, Enterococci, Escherichia coli, as well as Clostridium and Bacteroides species. Type II is caused by GAS only and Type III is associated with Vibrio vulnificus, which is introduced into the subcutaneous tissue by puncture wounds from ﬁsh or marine creatures . The initial clinical features may be nonspeciﬁc, often leading to misdiagnosis.