• Title/Summary/Keyword: Skin infection

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The First Neonatal Case of Panton-Valentine Leukocidin-Positive Staphylococcus aureus Causing Severe Soft Tissue Infection in Korea

  • You Hoon Kim;Seung Hyun Shin;Hyeri Seok;Dae Won Park;Young Hwan Park;Yoonsun Yoon;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.152-158
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    • 2023
  • Staphylococcus aureus (SA) is a common cause of skin and soft tissue infections. Panton-Valentine leukocidin (PVL) toxin-producing strain of SA has been discovered worldwide and is known to cause serious infections. However, reports of neonatal infections caused by PVL-positive SA are rare. Here, we report a case of severe skin and soft tissue infection caused by PVL-positive SA in a 7-day-old neonate. The patient was admitted to the emergency room with a history of fever for one day, tenderness, and sensation of buttocks heating. The infant presented with fever, tachycardia, poor general health, progressive tenderness, and edema of the buttocks on the day of admission. Ultrasonography and magnetic resonance imaging revealed necrotizing fasciitis involving the skin, soft tissue, and muscles. Specimens drained from the buttock lesions confirmed the presence of PVL-positive methicillin-resistant SA (MRSA), and there was no bacteremia. She recovered after one month of intravenous antibiotics and surgical drainages. One month after discharge, she was rehospitalized for otitis externa and was infected with MRSA again. Considering the PVL-positive strain, the patient was treated with intravenous linezolid and dressing. The patient underwent decolonization therapy in a 0.5% chlorhexidine bath and recovered completely without sequelae. This case suggests that aggressive drainage and antibiotic treatment are essential for PVL-producing MRSA infections, and additional decolonization is needed to prevent recurrence and community spread.

A Survey on Paragonimus Infection Among School Population in Kyodong and Samsan Island, Gangwha-Gun (강화군(江華郡) 교동도(喬桐島) 및 삼산도내(三山島內) 학교입구(學校入口)의 폐흡충감염(肺吸虫感染) 조사(調査))

  • Han, Kyung-Min;Ahn, Yung-Kyum;Lee, Keun-Tae
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.66-73
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    • 1982
  • Paragonimus westermani is one of the most popular endemic parasitic diseases in Korea. The nation-wide prevalence survey were carried out by Gobayashi (1921) with sputum examination and by Walton and Chyu (1959) with the intradermal skin test respectively. Recent studies showed the decline of positive rate in intradermal skin test of the local inhabitants and also showed the less distribution of intermediate host. The fact seemed that caused by economic improvement of village people, decrease of intermediate host by increasing use of pesticides, becoming lower water level at streams and rivers and better irrigation and finally by better community health education etc. Gangwha area of Gyeonggi-Do was found out as an endemic area of Paragonimus westermani through some studies in the past, however, in the vicinity area of Gangwha, the study in Kyodong island (myon) was carried out in 1965 by Yun et al. Therefore author carried out the intradermal skin test for 2,380 students of primary, middle and high school in Kyodong island and Samsan island. The results showed as follows : 1) The positive rate of intradermal test for paragonimus westermani infection showed positive in 152 among 1,845 students (8.2%) in Kyodong island, and 21 among 637 students (3.3%) in Samsan island respectively. 2) According to grade levels, 49 among 973 students (5.0%) in primary school, 62 among 962 students (6.4%) in middle school and 53 among 445 students (11.9%) in high school showed positive rate. This showed the higher grade the higher positive rate. 3) Among these total 164 positive cases in the intradermal skin test, only in 3 cases eggs were found in sputum. 4) Finding out the intermediate host, only 28 crayfishes from Kyodong island and 12 from Samsan island were collected and examined for metacercaria infection, however, none of metacercaria was found. 5) As a control group, 2 primary schools from the main island were selected. In these schools from the sixth grade students showed positive rate of 4.8% in Naega primary school and 0% in Hajeom Primary school respectively. Those results showed much decrease than studies carried out in the past. 6) The survey for food habit showed that 15 among 1,274 students (1.2%) had experiences of eating raw intermediate host(crayfish) and 266 among 988 students (27.0%) ate cooked.

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Survey of Major Viruses in Commercial Nursery Trees of Major Pear Cultivars in Korea

  • Kim, Nam-Yeon;Lee, Hyo-Jeong;Kim, Na-Kyeong;Oh, Jonghee;Lee, Su-Heon;Kim, Hongsup;Moon, Jae Sun;Jeong, Rae-Dong
    • Research in Plant Disease
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    • v.25 no.1
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    • pp.43-47
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    • 2019
  • Apple chlorotic leaf spot virus (ACLSV), Apple stem pitting virus (ASPV), Apple stem grooving virus (ASGV), and Apple scar skin viroid (ASSVd) are economically important viruses that infect pear tree species worldwide. To evaluate the prevalence of these viruses in Korea, we investigated infection degree of three viruses and one viroid for the commercial nursery trees of the pear cultivars, Niitaka, Chuwhang, Wonwhang, and Whasan in 2017 and 2018. The results showed that the infection ratio of ACLSV, ASPV, ASGV, and ASSVd for the scion of pear cultivar Niitaka was 10%, 45%, 77%, and 50%, respectively. From the scion of pear cultivar Chuwhang, infection ratios of ASPV, ASGV, and ASSVd were found to be 70%, 50%, and 60%, respectively. From the scion of pear cultivar Whasan, infection ratios of ACLSV, ASPV, ASGV and ASSVd were found to be 40%, 60%, 93%, and 20%, respectively. From the root stock of pear cultivar Wonwhang, infection ratios of ACLSV, ASPV, ASGV, and ASSVd showed 28%, 57%, 100%, and 14%, respectively. ASGV had the highest recorded infection rate, and ACLSV was characterized by the lowest infection rate. The mixed infection ratio of Niitaka, Chuwhang, Whasan, and Wonwhang was 45%, 60%, 70%, and 85%, respectively.

Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair

  • Shim, Jung-Hwan;Hwang, Na-Hyun;Yoon, Eul-Sik;Dhong, Eun-Sang;Kim, Deok-Woo;Kim, Sang-Dae
    • Archives of Plastic Surgery
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    • v.43 no.1
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    • pp.26-31
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    • 2016
  • Background The global prevalence of myelomeningocele has been reported to be 0.8-1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical outcomes of recent cases of myelomeningocele at our institution. Methods Patients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed. Results A total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct skin repair, while two cases required local skin flaps to cover the skin defects. Three cases of infection occurred, requiring incision and either drainage or removal of allogenic materials. One case of partial flap necrosis occurred, requiring secondary revision using a rotational flap and a full-thickness skin graft. Despite these complications, all wounds eventually healed completely. Conclusions Most myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local flaps may be used to cover the defect. Complications such as wound dehiscence and partial flap necrosis occurred in this study; however, all such complications were successfully managed with simple ancillary procedures.

Development of Quantitative Lymphedema Screening System to Monitor Change in Skin Elasticity through the Measurement of Indentation Force and Return Time (피부의 탄성변화에 따른 피부 가압과 복귀시간 측정을 통한 정량적 림프부종 진단 시스템 개발)

  • Seo, Jong Hyun;Cho, Chang Nho;Kim, Sung Chun;Chung, Seung Hyun;Koh, Eun Sil;Kim, Kwang Gi
    • Journal of Biomedical Engineering Research
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    • v.34 no.4
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    • pp.170-176
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    • 2013
  • Lymphedema is a phenomenon in which fluid is accumulated inside tissues due to the damaged lymphatic systems. Lymphedema can cause complications such as lymphangitis, infection, changes in skin texture, fibrosis, and lymphangiosarcoma. In this study, a lymphedema screening system based on the elasticity of the skin is proposed to easily quantify lymphedema. The developed probe consists of touch sensors, a load cell and hall-effect sensors to measure the indentation force on the skin and the return time of the skin. The developed system can be used to estimate the change in the elasticity of the skin to quantify lymphedema. The system was tested with a thyroid phantom and gelatin phantoms of different concentrations and the resulting force and the time were recorded. It was found that the increase in the elasticity leads to a higher indentation force and shorter return time. This shows that the developed system can monitor the change in the skin elasticity by measuring the return time and the indentation force. The feasibility of the system in clinical applications will be evaluated in the future study.

Sural Artery Flap for Skin Defect of Lower Legs (비복동맥 피판술을 이용한 하지 피부결손의 치료)

  • Jin, Jin-Woo;Yoon, Jong-Ho;Jung, Sung-Weon;Paeng, Jung-Wook
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.119-124
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    • 2007
  • Purpose: We reconstructed the skin defect of lower legs exposing muscles, tendons and bone with fasciocutaneous sural artery flap and report our cases. Materials and Methods: Between March 2005 and September 2006, 8 cases of skin defect were reconstructed with fasciocutaneous sural artery flap. Defect site were 4 case of ankle and foot and 4 cases of lower leg. The average defect size was $4{\times}4\;cm^2$. There were 5 men and 3 women and mean age was 52.2 years. We evaluated the viability of flap, postoperative complication, healing time, patient's satisfaction. Results: There was no flap failure in 8 cases. But recurrent discharge in 2 cases was healed through several times adequate debridement and delayed suture without complication. Flap edema may be due to venous congestion was healed through leg elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence in follow up period. Cosmetic results as judged by patients were that 5 cases are good and 3 cases are fair. Conclusion: Sural artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Sural artery flap is useful method for the skin defect of lower legs because it is simple procedure, has constant blood supply and relatively good cosmetic effect.

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Immediate Implant Reconstruction using Silicone Prosthesis in Breast Cancer Patients after Skin Sparing Mastectomy (유방암 환자에서 피부보존 유방절제술 후 실리콘 보형물을 이용한 즉시 유방재건술)

  • Cho, Young-Kyoo;Yang, Jung-Dug;Kim, Gui-Rak;Chung, Ho-Yun;Cho, Byung-Chae;Park, Ho-Yong
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.749-757
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    • 2010
  • Purpose: Since skin sparing mastectomy removes the mammary gland and the nipple-areolar complex preserving all mammary skin, it makes the widespread use of implants in immediate reconstruction. This article reports our experience in immediate breast reconstruction after skin sparing mastectomy by using the silicone implants in patients especially who have small to moderate sized and minimal ptotic breast. Methods: From September of 2007 to July of 2009, we performed breast reconstruction for 44 breasts of 40 women with silicone implant after mastectomy. Tumors were divided into 5 malignant types (21 IDC, 18 DCIS, 2 ILC, 2 phylloides tumor, 1 mucinous carcinoma). The implant is placed in a submuscular pocket or in a submuscularsubfascial pocket depending upon the condition of the muscles and skin flaps after mastectomy. Results: The mean age was 47 years and the average follow-up period was 11 months. Cosmetic outcome was assessed by evaluation of photographs and assessment of breast volume and shape, breast symmetry, and overall outcome. About 80% of each of these parameters was scored as good or excellent. Breast complication was developed in a total of 6 cases including 2 capsular contracture, 2 partial skin necrosis due to blue dye injection and 2 implant infection. Conclusion: The use of definitive implants in a skin sparing mastectomy is a one-stage immediate breast reconstruction with low morbidity and acceptable result. This method is considered reliable with favorable aesthetic result.

Discordance between Tuberculin Skin Test and Interferon-gamma Release Assays for Diagnosis of Tuberculosis Infection in Korean Children (국내 소아 결핵감염 진단에서의 결핵피부반응 검사와 Interferon-gamma Release Assay (IGRA)의 비교 연구)

  • Yoo, Reenar;Kim, Joon-Il;Kim, Seohee;Lee, Jina
    • Pediatric Infection and Vaccine
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    • v.23 no.1
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    • pp.18-24
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    • 2016
  • Purpose: There is a the great diagnostic challenge in pediatric tuberculosis especially in high burden setting. The purpose of this preliminary study is to evaluate the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) including T-SPOT$^{(R)}$.TB and QuantiFERON$^{(R)}$-TB Gold (QFT-G) in Korean children. Method: This retrospective study included children and adolescents who visited to Asan Medical Center to evaluate tuberculosis infection using at least two assays of TST, T-SPOT.TB and QFT-G, from January 2014 to April 2015. Results: A total of 20 patients were included, whose median age was 13.3 years (range, 3.8-18.1 years), and all of them had history of BCG vaccination. Eleven patients had underlying diseases including 7 patients with immunosuppressant medication. The concordance rate between T-SPOT.TB and QFT-G was 90%. However, the concordance rate between TST and T-SPOT.TB was 50%, and between TST and QFT-G was 42.9%. Specificity for the diagnosis of tuberculosis infection of T-SPOT.TB, QFT-G, and TST was 93.3%, 86.7%, and 58.3%, respectively. Conclusions: Although there was a discrepancy between TST and IGRA to diagnose tuberculosis, agreement between T-SPOT.TB and QFT-G was relatively high. Further prospective study to validate the clinical usefulness of each assay for immunologic evidence of tuberculosis infection in Korean children will be mandatory.

A Study on the Nosocomial Infection in One Burn Unit (일 화상 치료실에 입원한 화상환자의 감염실태조사)

  • 김정애
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.227-240
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    • 1987
  • Infection has assumed increased importance as a cause of death among thermally injured individuals. Decreased treatment effectiveness and an increase in mortality are the hallmarks of nosocomial infection. Infection control is a monumental task that must be achieved to reduce mortalities. This was a retrospective study to survey the epidemiological features of nosocomial infections in a burn unit and to identify the possibilities for infection control. During the past 6 year 2 month period from July, 1981 to August, 1987, 306 burn patients were treated in the burn unit of university hospital. Among of these, 290 cases were the subjects of this study. The data were collected from the patients' records after discharge. All data collected were analyzed using percent, x$^2$-test, t-test with SPSS program. The results of this study are summariged as follows: 1) Infection rate was 40%. According to site, there were 67 cases of wound infection, 60 cases of post-operative skin graft infection, 20 cases of septicemia and 20 cases of donor site infection. As far as the burn size was concerned, the infection rate for patients whose burn size ranged 61 to 70%, was shown to be 100%, followed by the infection rate of 93.8%, for patients whose burn size ranged from 41~50%. As far as the period of time over which the infection developed, 5 to 7 days showed the highest frequency. Further infection was the main cause of deaths and complications. 2) Based upon the results obained by comparing the general characteristics, between a hospital infection-group and non-hospital infection group, there was a significant defference according to age, the time of the year when the accident happened, the place of accident or length of hospital-admission. And according to the result obtained by comparing the general characteristics of the burn, there was a significant difference according to burn size, burn depth, burn type, and burn site. And also based upon the result obtained by comparing the two groups according to method of treatment, there was a significant difference according to the use of antibiotics and to the type of wound-treatment, and for the 8 different binds of treatment related to infection, there was a significant difference for all. In conclusion, age, length of hospital-admission, burn size, burn type, burn site, burn depth, type of woundtreatment and the 8 different binds of treatment, which are related to burns, were shown to be the factors which affect the infection rate in burn patients.

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Histopathological observation of jeju aquaculture rock sea-bream, Oplegnathus fasciatus by cold water disease (냉수성 질병에 대한 제주 양식 돌돔, Oplegnathus fasciatus의 병리조직학적 관찰)

  • Moon, Kyung-Mi;Ko, Dae-Hee;Kim, Dong-Hwi;Park, Geun-Tae;Heo, Moon-Soo
    • Journal of fish pathology
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    • v.26 no.2
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    • pp.123-128
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    • 2013
  • The outbreak of haemorrhagic speticemia and dermal lesions in cultured Rock sea breem in Jeju Island are frequently associated with keratitis. Prolonged infection leads to the symptoms accompanied by necrosis of fin and skin and the fishes died. Present study aims to study the histopathological changes of diseased fish muscle tissue. The tissue at the initial stage of infection showed normal muscular texture, however in the late stages of infection, muscular lesion had been expanded and hence, necrosis had progressed deeply into muscle tissue. Mild tissue in caudal fin was found with more necrosis, and gill tissues were also collapsed. In Kidney, renal tubules were teared along with tissue destruction (Espada, J et al, 1993). Hence in the present study, we examined the histopathological variation of the infection fishes, and this basic data would be used for future research of in haemorrhagic specticemia and dermal diseases.