1
|
Kubota S, Nemoto M, Sakaeyama Y, Nakada C, Mikai M, Fuchinoue Y, Kondo K, Harada N, Sugo N. Repeated intracranial empyema following cranioplasty in a patient with atopic dermatitis: a case report. J Med Case Rep 2021; 15:373. [PMID: 34261534 PMCID: PMC8281563 DOI: 10.1186/s13256-021-02898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Atopic dermatitis is a chronic inflammatory skin disease associated with pruritus. Skin affected by atopic dermatitis not only shows a high percentage of Staphylococcus aureus colonization, but corneal barrier dysfunction is also known to occur. It is considered a risk factor for bacterial infections in various areas of the body. However, the relationship between atopic dermatitis and bacterial infection following neurological surgery has not yet been reported. Here, we present a case of atopic dermatitis in which the surgical site became infected twice and finally resolved only after the atopic dermatitis was treated. Case presentation A 50-year-old Japanese woman with atopic dermatitis underwent cerebral aneurysm clipping to prevent impending rupture. Postoperatively, she developed repeated epidural empyema following titanium cranioplasty. As a result of atopic dermatitis treatment with oral antiallergy medicines and external heparinoids, postoperative infection was suppressed by using an absorbable plastic plate for cranioplasty. The patient’s postoperative course was uneventful for 16 months. Conclusions Atopic dermatitis is likely to cause surgical-site infection in neurosurgical procedures, and the use of a metal implant could promote the development of surgical-site infection in patients with dermatitis.
Collapse
Affiliation(s)
- Shuhei Kubota
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan.
| | - Masaaki Nemoto
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Yuki Sakaeyama
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Chie Nakada
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Masataka Mikai
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Yutaka Fuchinoue
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Kosuke Kondo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Naoyuki Harada
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Nobuo Sugo
- Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-Ku, Tokyo, 143-8541, Japan
| |
Collapse
|
2
|
Abstract
UNLABELLED Osteomyelitis of the hand is uncommon, but if not adequately and promptly treated the detrimental effects on hand function can be devastating. The majority of literature on osteomyelitis relates to the lower limb, but the principles of management are applicable to the hand, with good surgical debridement and culture-guided antimicrobial therapy. For osteomyelitis in general, antibiotic therapy of 4-6 weeks' duration (intravenous and/or oral) is typically recommended. In the hand, length and mode of antibiotic administration are still under study. LEVEL OF EVIDENCE V.
Collapse
Affiliation(s)
- R Pinder
- Department of Plastic, Hand and Reconstructive Surgery, Castle Hill Hospital, Cottingham, UK
| | - G Barlow
- Department of Infection & Tropical Medicine, Castle Hill Hospital, Cottingham, UK
| |
Collapse
|
3
|
Kerr S, Kusmak JM, Stratman EJ. Dermatology for the general surgeon. Surg Clin North Am 2009; 89:563-86. [PMID: 19465197 DOI: 10.1016/j.suc.2009.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Preparation of the patient with preexisting skin disease for surgery can be challenging. In addition to encountering the skin with nearly every procedure, the surgeon will also likely experience skin-related conundrums, concerns, and associated conditions in the preoperative, perioperative, or postoperative periods. These concerns are reviewed using best available evidence.
Collapse
Affiliation(s)
- Sarah Kerr
- Department of Dermatology, Marshfield Clinic, Marshfield, WI 54449, USA
| | | | | |
Collapse
|