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Benlghazi A, Benali S, Belouad M, Fakri A, El Mangoub F, Kouach J. Uncommon presentation of necrotizing fasciitis affecting the breast in a young breastfeeding patient: Case report. Int J Surg Case Rep 2024; 114:109147. [PMID: 38134617 PMCID: PMC10800673 DOI: 10.1016/j.ijscr.2023.109147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Necrotizing fasciitis is a highly dangerous infection that poses a life-threatening risk as it rapidly spreads and causes tissue necrosis in the subcutaneous tissues and fascia. Although rare, the breasts can be affected by this infection, which adds to the complexity of the condition. CASE PRESENTATION A 26-year-old woman who had been breastfeeding for two months presented with pain, swelling, and fever in her left breast. The left breast showed skin darkening and foul-smelling discharge. The diagnosis was septic shock due to necrotizing fasciitis. Prompt treatment included surgical debridement, broad-spectrum antibiotics, and supportive care. The patient's condition remained challenging, and the infection was caused by multi-resistant bacteria. CLINICAL DISCUSSION Necrotizing fasciitis is a highly severe and aggressive type of soft tissue infection. It can range from minor or mild infections of the soft tissues to severe cases involving septic shock. While it is uncommon, necrotizing fasciitis can also affect the breasts. The diagnosis of breast NF relies on a combination of clinical evaluation, culture results, laboratory findings, and imaging studies. Swift surgical interventions, along with appropriate antibiotic therapy and supportive management, are vital for the patient's survival and improved prognosis. CONCLUSIONS Breast necrotizing fasciitis is frequently misdiagnosed due to the presence of thick breast tissue, which creates challenges in identifying the infection between the skin and deep fascia. Swift and extensive surgical debridement, combined with the administration of broad-spectrum antibiotics, are crucial components for effectively managing and preventing the significant morbidity and mortality associated with this condition.
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Affiliation(s)
- Abdelhamid Benlghazi
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco.
| | - Saad Benali
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Moad Belouad
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Ahmed Fakri
- Department of anesthesia and intensive care unit, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Fatima El Mangoub
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology-Obstetrics, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy of Rabat, University Mohammed V Rabat, Morocco
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Alkaelani MT, Koussayer B, Blount T, Amawi YA, Mahboob O, Le NK, Parus A, Troy J. Complications of Medical Tourism in Aesthetic Surgery: A Systematic Review. Ann Plast Surg 2023; 91:668-673. [PMID: 37962261 DOI: 10.1097/sap.0000000000003683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
INTRODUCTION As medical cost continues to rise, so has the use of medical tourism by patients as a more cost-effective alternative. While the upfront cost savings attract many unsuspecting patients from their country of origin, there are significant patient safety issues surrounding short- and long-term follow-up, as well as the management and cost of complications. METHODS A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses on complications that presented after cosmetic surgeries performed abroad. The literature search was performed on October 18, 2022, using the databases of PubMed, Google Scholar, and Embase. RESULTS From the 44 studies that were included, 589 patients were identified who presented with complications after having a cosmetic procedure abroad. Infection was the most prevalent complication in this study followed by wound dehiscence, seroma/hematoma, and tissue necrosis. Ninety-eight percent of the infectious organisms were bacterial, and 81% of them were from the Mycobacterium genus. CONCLUSIONS Cosmetic tourism is a global phenomenon. This systematic review highlights the nature of complications following cosmetic tourism, the surgeries that resulted in complications, the countries that the primary procedures took place in, and the countries of origin of the patients. To aid in reducing morbidity and mortality from cosmetic tourism, regulatory bodies should educate and empower the public to aid them in making educated medical conditions when seeking care.
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Affiliation(s)
| | - Bilal Koussayer
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
| | - Taylor Blount
- From the Florida State University College of Medicine
| | - Yusuf A Amawi
- From the Florida State University College of Medicine
| | - Omar Mahboob
- From the Florida State University College of Medicine
| | - Nicole K Le
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
| | - Anamaria Parus
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
| | - Jared Troy
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
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Gilardi R, Galassi L, Del Bene M, Firmani G, Parisi P. Infective complications of cosmetic tourism: A systematic literature review. J Plast Reconstr Aesthet Surg 2023; 84:9-29. [PMID: 37320953 DOI: 10.1016/j.bjps.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 04/16/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cosmetic tourism has increased dramatically over the years. We performed a systematic review of the literature to find reports of infective complications following cosmetic surgery, focusing on epidemiology, clinical, and surgical management. In addition, we identified cosmetic tourism trends in terms of mobilization from the country of origin and travel destinations. METHODS A search on PubMed, Embase, and Web of Science was performed between March and August 2022. The search was not restricted based on study date. Only English manuscripts were assessed. Reviews, short communications, letters, and correspondences were excluded after reviewing their references for potentially relevant studies. Articles related to non-cosmetic surgeries were also excluded from the study. RESULTS We identified 152 articles, of which 31 were duplicates and 47 were excluded based on title/abstract assessment. Three non-English manuscripts, 13 reviews, 12 letters to the editor, and 10 articles that did not feature clinical cases were also rejected. Thirty-six articles were included for analysis. We found 370 patients with infective complications following cosmetic surgery. The severity of complications was stratified according to the Clavien-Dindo classification. Most reports were from the United States (56.5%), followed by Switzerland and the United Kingdom. Travel destinations included the Dominican Republic (34.3%), Turkey, and Colombia. CONCLUSION Infective complications commonly occurred after abdominoplasties in patients who underwent cosmetic surgeries in Latin America or Asia. Most infective complications required management with surgical procedures that involved the administration of local, regional, or general anesthesia. Gluteal augmentations were the fourth most common cosmetic procedures; however, they were associated with the highest number of severe cases, which required intensive care treatment.
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Affiliation(s)
- Roberta Gilardi
- Division of Plastic & Reconstructive Surgery, San Gerardo Hospital of Monza, Italy
| | - Luca Galassi
- Division of Vascular Surgery, San Gerardo Hospital of Monza, Italy
| | - Massimo Del Bene
- Division of Plastic & Reconstructive Surgery, San Gerardo Hospital of Monza, Italy
| | - Guido Firmani
- Faculty of Medicine and Psychology, Sapienza University of Rome - Department of Plastic Surgery Sant'Andrea Hospital, Rome, Italy
| | - Paola Parisi
- Department of Plastic and Regenerative Surgery, San Gallicano Dermatological Institute IRCCS Rome, Italy.
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TROIANO GIANMARCO, NANTE NICOLA. Emerging fungal infections: focus on Saksenaea Erythrospora. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E382-E385. [PMID: 34604577 PMCID: PMC8451331 DOI: 10.15167/2421-4248/jpmh2021.62.2.1953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/02/2021] [Indexed: 11/20/2022]
Abstract
Introduction In recent times, improved diagnostic techniques have revealed an alarming number of cases of mucormycosis in immunocompetent individuals. The Saksenaea species, is a rare cause of mucormycosis, and is often associated with skin and subcutaneous infection due to trauma in both immunocompromised and immunocompetent subjects. The purpose of this study was therefore, through a review of the literature, to investigate the problem of infections caused by Saksenaea Erythrospora, evaluating the clinical manifestations of the infection, the triggering factors, the therapies and patients’ outcomes, implementing and updating what already reported in literature. Methods A research of peer-reviewed literature in the electronic databases MEDLINE (PubMed) and Scopus was conducted in the period June 2020-January 2021 using the key word “Saksenaea erythrospora”. Studies in Italian, English, French, Spanish focused on cases of Saksenaea erythrospora were included, without time restrictions. Studies that provided ambiguous or insufficient data were excluded. Results Bibliographic research yielded 23 publications; 7 were included in the review. The studies were published between 2011 and 2015 and involved a total of 11 patients of average age 37.9 years (SD 17.23) hospitalized in several hospitals in: USA, India, Argentina, Colombia, Thailand. 6 patients were women, 5 men. All patients had an almost normal immune status. The causes of the infection were: injections, traumas, surgery. Two patients, despite surgical and medical therapy, died. Conclusions Our review partially updated what already published, because only one new study was found. Serious necrotizing infections from Saksenaea erythrospora have been observed in recent years and a early identification and timely management are essential to reduce morbidity and mortality. A greater awareness and education about the risks deriving from carrying out surgical procedures abroad, especially in precarious hygiene situations, could be additional effective weapons to reduce the incidence of these infections.
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Affiliation(s)
- GIANMARCO TROIANO
- ASST Melegnano e della Martesana, Vizzolo Predabissi (MI), Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Correspondence: Gianmarco Troiano, ASST Melegnano e della Martesana, via Pandina 1, 20070 Vizzolo Predabissi (MI), Italy - Department of Molecular and Developmental Medicine, University of Siena, via A. Moro 2, 53100 Siena, Italy - Tel.: +39 347-9512771 - E-mail: /
| | - NICOLA NANTE
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Medical Tourism in Aesthetic Breast Surgery: A Systematic Review. Aesthetic Plast Surg 2021; 45:1895-1909. [PMID: 33876284 PMCID: PMC8054849 DOI: 10.1007/s00266-021-02251-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
Introduction Medical tourism is expanding on a global basis, with patients seeking cosmetic surgery in countries abroad. Little information is known regarding the risks and outcomes of cosmetic tourism, in particular, for aesthetic breast surgery. The majority of the literature involves retrospective case series with no defined comparator. We aimed to amalgamate the published data to date to ascertain the risks involved and the outcomes of cosmetic tourism for aesthetic breast surgery on a global basis.
Methods A systematic review of PubMed, Google Scholar, EMBASE, the Cochrane library and OVID Medline was conducted using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines. Keywords such as “medical tourism”, “cosmetic tourism”, “tourism”, “tourist”, “surgery”, “breast” and “outcomes” were used. Seven hundred and seventy-one titles were screened, and 86 abstracts were reviewed leaving 35 full texts. Twenty-four of these met the inclusion criteria and were used to extract data for this systematic review. Results One hundred and seventy-one patients partook in cosmetic tourism for aesthetic breast surgery. Forty-nine percent of patients had an implant-based procedure. Other procedures included: mastopexy (n=4), bilateral breast reduction (n=11) and silicone injections (n=2). Two-hundred and twenty-two complications were recorded, common complications included: wound infection in 39% (n=67), breast abscess/ collection in 12% (n=21), wound dehiscence in 12% (n= 20) and ruptured implant in 8% (n=13). Clavien–Dindo classification of the complications includes 88 (51%) IIIb complications with 103 returns to theatre, 2 class IV complications (ICU stay) and one class V death of a patient. Explantation occurred in 39% (n=32) of implant-based augmentation patients. Conclusions Aesthetic breast surgery tourism is popular within the cosmetic tourism industry. However, with infective complications (39%) and return to theatre rates (51%) significantly higher than expected, it is clear that having these procedures abroad significantly increases the risks involved. The high complication rate not only impacts individual patients, but also the home country healthcare systems. Professional bodies for cosmetic surgery in each country must highlight and educate patients how to lower this risk if they do choose to have cosmetic surgery abroad. In this current era of an intra-pandemic world where health care is already stretched, the burden from cosmetic tourism complications must be minimised. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Pavli A, Maltezou HC. Infectious complications related to medical tourism. J Travel Med 2021; 28:5959955. [PMID: 33159509 DOI: 10.1093/jtm/taaa210] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Medical tourism has been increasing dramatically globally, with people travelling from developed countries to low-income or middle-income countries, often to avoid high costs or long delays associated with seeking healthcare in their countries of origin. The current review summarizes healthcare-related infections associated with medical tourism, focusing on cosmetic surgery and organ transplantation. METHODS A systematic MEDLINE and PubMed search from January 2010 to December 2019 yielded 80 relevant articles, including 49 articles on medical tourism-related infections focusing on cosmetic surgery and organ transplantation, which were included in this reviews. RESULTS The literature reveals specific types of cross-border, healthcare-related infections depending on medical intervention. Destinations include low-income countries such as countries of Asia and the Indian subcontinent, middle-income countries including Central and South America, and high-income countries such as the United States and Europe. In terms of type of infections, in 36 (68%) and 15 (28.3%) studies, wound and blood-borne infections were documented, respectively, while in 21 studies (58.3%) non-tuberculous mycobacteria were isolated, including Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium senegalense and Mycobacterium fortuitum. The choices of medical tourists could have significant consequences for them and their home countries, including infectious complications and importation of pathogens, particularly antibiotic-resistant microorganisms, with public health implications. CONCLUSIONS There is a need for public health strategies in order to prevent morbidity and mortality as well as future management and education of patients engaging in medical tourism.
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Affiliation(s)
- Androula Pavli
- Department of Travel Medicine, National Public Health Organization, Athens, Greece
| | - Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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Chelliah S, Khan MJ, Atabakhshi Kashi AB. Antecedents of perceived beneficial destination image: a study on Middle-Eastern medical tourists visit Iran. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2020. [DOI: 10.1108/ijphm-07-2018-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to investigate the relationship between travel motivation, perceived risks, travel constraints and perceived beneficial destination image that leads to visit intention among Middle-Eastern medical tourists. Some previous studies have explained these factors in detail, however, studies that explore the relationship between these factors in the Iranian context is scarce. Moreover, there are relatively very few studies, which focused on actual medical tourists in empirical investigation, therefore, there is still a lack of clarity in the literature regarding travel behavior and travel decision-making of medical tourists.
Design/methodology/approach
A quantitative study was performed on 161 Middle-Eastern medical tourists who visited Iran in early months of 2018. Purposive sampling method was used to collect the data from two private hospitals. Structural equation modeling with partial least square (PLS) approach was used and PLS 3.2.8 data analysis tool was used to test the hypotheses.
Findings
The data analysis results have found that perceived destination image was the strongest predictor of visit intention among medical tourists. The results have also found a positive effect of travel motivation and negative effect of perceived travel risks on perceived beneficial destination image.
Originality/value
This study aims to enrich the body of knowledge by investigating the relationship between the factors, which have important roles in travel behavior and decision-making of medical tourists. The study also bridges the gap in the literature by explaining the behavior of actual medical tourists. The findings of the study provide the much needed insight on the behavioral intention of medical tourists, which will help the service providers and policymakers to reform their strategies and policies accordingly.
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Cai Y, Cai Y, Shi W, Feng Q, Zhu L. Necrotizing Fasciitis of the Breast: A Review of the Literature. Surg Infect (Larchmt) 2020; 22:363-373. [PMID: 33026953 DOI: 10.1089/sur.2020.071] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Necrotizing fasciitis (NF) is a rare, rapidly progressing, and potentially fatal tissue infection involving subcutaneous tissue, superficial fascia, and the overlying skin. Breast NF is often misdiagnosed because of the thick breast tissue between the skin and deep fascia. Only early diagnosis followed by prompt antibiotic treatment and surgical therapy can prevent disastrous consequences. There are many case reports on breast NF, but a systematic review is lacking. Methods: Using PubMed and Scopus we performed a systematic review of the literature covering a period of 20 years. We reviewed articles with predisposing comorbidities (risk factors), triggering factors, laboratory examinations, culture of organisms, antibiotic treatment, surgical interventions, the presence of septic shock, and final outcome. We also performed statistical tests of all these factors in relation to death. Results: Forty cases identified from 38 articles were included in our literature review. Twenty-one cases (52.5%) were primary, whereas 15 cases (37.5%) occurred after surgery. In 15 cases (37.5%), the single organism responsible for NF was Streptococcus pyogenes, whereas mixed organisms were found in 17 cases (42.5%). Surgical debridement was performed in 39 (97.5%) cases. Septic shock was found in all five (12.5%) deceased cases and was associated with patient's mortality (p < 0.001). Conclusions: Breast NF is a rare, severe, and easily misdiagnosed complication. Breast NF could differ from that in other body regions in etiology pattern and clinical manifestations. Confirmed diagnosis of breast NF is based on the combination of clinical, cultural, laboratory, and imaging findings. Urgent subsequent treatments, including surgical debridement, antibiotic therapy, and reconstructive surgery, are critical for better prognosis and survival of patients.
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Affiliation(s)
- Yuchen Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, Shanghai, China
| | - Youquan Cai
- Department of Orthopedic Surgery, Hunan Want Want Hospital, Changsha, Hunan, China
| | - Wenjun Shi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, Shanghai, China
| | - Qiuyun Feng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, Shanghai, China
| | - Lian Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, Shanghai, China
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Dellière S, Rivero-Menendez O, Gautier C, Garcia-Hermoso D, Alastruey-Izquierdo A, Alanio A. Emerging mould infections: Get prepared to meet unexpected fungi in your patient. Med Mycol 2020; 58:156-162. [PMID: 31111906 DOI: 10.1093/mmy/myz039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/01/2019] [Accepted: 04/05/2019] [Indexed: 01/19/2023] Open
Abstract
Invasive fungal diseases are increasing issues in modern medicine, where the human immunodeficiency virus (HIV) pandemic and the wider use of immunosuppressive drugs generate an ever-growing number of immunocompromised patients with an increased susceptibility to uncommon fungal pathogens. In the past decade, new species have been reported as being responsible for disseminated and invasive fungal diseases in humans. Among them, the following genera are rare but seem emerging issues: Scopulariopsis, Hormographiella, Emergomyces, Westerdykella, Trametes, Actinomucor, Saksenaea, Apophysomyces, and Rhytidhysteron. Delay in diagnosis, which is often the case in these infections, jeopardizes patients' prognosis and leads to increased mortality. Here we summarize the clinical and biological presentation and the key features to identify these emerging pathogens and we discuss the available antifungal classes to treat them. We focused on Pubmed to recover extensively reported human invasive cases and articles regarding the nine previously cited fungal organisms. Information concerning patient background, macroscopic and microscopic description and pictures of these fungal organisms, histological features in tissues, findings with commonly used antigen tests in practice, and hints on potential efficient antifungal classes were gathered. This review's purpose is to help clinical microbiologists and physicians to suspect, identify, diagnose, and treat newly encountered fungi in hospital settings.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Olga Rivero-Menendez
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Cécile Gautier
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Alexandre Alanio
- Université de Paris, Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France.,Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Magaki S, Minasian T, Bork J, Harder SL, Deisch JK. Saksenaea infection masquerading as a brain tumor in an immunocompetent child. Neuropathology 2019; 39:382-388. [PMID: 31373069 DOI: 10.1111/neup.12585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/16/2019] [Accepted: 06/16/2019] [Indexed: 11/30/2022]
Abstract
Saksenaea species are a rare cause of mucormycosis, the majority associated with cutaneous and subcutaneous infections resulting from trauma in both immunocompromised and immunocompetent individuals. Unlike other causative agents of mucormycosis, cerebral infections are exceptionally rare. We describe the first case of isolated cerebral infection by Saksenaea in a 4-year-old previously healthy male child who presented with headaches. He had no past medical history other than an episode of febrile seizures. In addition to raising the awareness of an unusual presentation of infection by Saksenaea, this case highlights the importance of pathologic examination for the prompt diagnosis of mucormycosis as well as the specific fungal identification for treatment as Saksenaea spp. may be more susceptible to posaconazole and less susceptible to amphotericin B compared to more common causes of mucormycosis.
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Affiliation(s)
- Shino Magaki
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Tanya Minasian
- Department of Neurosurgery, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Jane Bork
- Division of Infectious Diseases, Department of Pediatrics, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Sheri L Harder
- Department of Radiology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
| | - Jeremy K Deisch
- Department of Pathology, Loma Linda University Medical Center and School of Medicine, Loma Linda, California, USA
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Mukherjee B, Kundu D. Necrotizing fungal infection due to Saksenaea erythrospora: A case report and review of literature. Indian J Ophthalmol 2018; 66:1513-1516. [PMID: 30249859 PMCID: PMC6173015 DOI: 10.4103/ijo.ijo_389_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mucormycosis caused by Saksenaea erythrospora is an emerging infection seen with soil contamination, burns and/or nosocomial infections. PCR amplification and internal transcribed spacer sequencing is gold standard for its identification. Here, we report a case of necrotizing fungal orbital infection by S. erythrospora in an immunocompetent child.
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Affiliation(s)
- Bipasha Mukherjee
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetics, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Debi Kundu
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetics, Medical Research Foundation, Chennai, Tamil Nadu, India
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Morales-López S, Ceballos-Garzón A, Parra-Giraldo CM. Zygomycete Fungi Infection in Colombia: Literature Review. CURRENT FUNGAL INFECTION REPORTS 2018. [DOI: 10.1007/s12281-018-0326-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Sigera LSM, Gamage KKK, Jayawardena MN, Abeydeera WPH, Malkanthi MA, Jayasekera PI, Patabendige CGUA, Fernando AHN. Cutaneous mucormycosis caused by Saksenaea vasiformis in a patient with systemic lupus erythematosus. Clin Case Rep 2018; 6:1730-1734. [PMID: 30214752 PMCID: PMC6132151 DOI: 10.1002/ccr3.1698] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 01/15/2023] Open
Abstract
Primary cutaneous mucormycosis due to Saksenaea vasiformis is a rare clinical manifestation and the actual number of the disease condition is underestimated due to lack of sporulation in the absence of molecular diagnosis. Combination therapy of antifungal and repetitive debridement is mandatory in curing the patients.
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14
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Pereira RT, Malone CM, Flaherty GT. Aesthetic journeys: a review of cosmetic surgery tourism. J Travel Med 2018; 25:5039932. [PMID: 29924349 DOI: 10.1093/jtm/tay042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/23/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Medical tourism has witnessed significant growth in recent years. The emerging trend towards international travel for cosmetic surgical interventions has not previously been reviewed. The current review aims to critically address the scale and impact of cosmetic surgical tourism and to delineate the complication profile of this form of medical tourism. METHODS Articles published in the English language on the PubMed database that were relevant to surgical tourism and the complications of elective surgical procedures abroad were examined. Reference lists of articles identified were further scrutinized. The search terms used included combinations of 'surgery abroad', 'cosmetic surgery abroad', 'cosmetic surgery tourism', 'cosmetic surgery complications' and 'aesthetic tourism'. RESULTS This article critically reviews the epidemiology of cosmetic surgical tourism and its associated economic factors. Surgical complications of selected procedures, including perioperative complications, are described. The implications for travel medicine practice are considered and recommendations for further research are proposed. CONCLUSION This narrative literature review focuses on the issues affecting travellers who obtain cosmetic surgical treatment overseas. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Original research exploring the motivation and pre-travel preparation, including the psychological counselling, of cosmetic surgical tourists is indicated.
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Affiliation(s)
| | - Carmel M Malone
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - Gerard T Flaherty
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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15
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Burden of Fungal Infections in Colombia. J Fungi (Basel) 2018; 4:jof4020041. [PMID: 29561795 PMCID: PMC6023354 DOI: 10.3390/jof4020041] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/14/2018] [Accepted: 03/19/2018] [Indexed: 12/11/2022] Open
Abstract
Data with respect to the epidemiological situation of fungal diseases in Colombia is scarce. Thus, the aim of this study is to estimate the burden of fungal infections. A population projection for 2017 from the Colombian Department for National Statistics was used, as well as official information from the Ministry of Health and National Institute of Health. A bibliographical search for Colombian data on mycotic diseases and population at risk (chronic obstructive pulmonary disease, HIV infection/AIDS, cancer, and transplant patients) was done. The Colombian population for 2017 was estimated at 49,291,609 inhabitants, and the estimated number of fungal infections for Colombia in 2017 was between 753,523 and 757,928, with nearly 600,000 cases of candidiasis, 130,000 cases of aspergillosis, and 16,000 cases of opportunistic infection in HIV, affecting around 1.5% of the population. In conclusion, fungal infections represent an important burden of disease for the Colombian population. Different clinical, epidemiological, and developmental scenarios can be observed in which fungal infections occur in Colombia.
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16
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Brightman L, Ng S, Ahern S, Cooter R, Hopper I. Cosmetic tourism for breast augmentation: a systematic review. ANZ J Surg 2017; 88:842-847. [DOI: 10.1111/ans.14326] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Louise Brightman
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine, Monash University, Melbourne; Victoria Australia
- Australasian Foundation for Plastic Surgery; Sydney; New South Wales Australia
| | - Sze Ng
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine, Monash University, Melbourne; Victoria Australia
- Australasian Foundation for Plastic Surgery; Sydney; New South Wales Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine, Monash University, Melbourne; Victoria Australia
- Australasian Foundation for Plastic Surgery; Sydney; New South Wales Australia
| | - Rodney Cooter
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine, Monash University, Melbourne; Victoria Australia
- Australasian Foundation for Plastic Surgery; Sydney; New South Wales Australia
| | - Ingrid Hopper
- Department of Epidemiology and Preventive Medicine; School of Public Health and Preventive Medicine, Monash University, Melbourne; Victoria Australia
- Australasian Foundation for Plastic Surgery; Sydney; New South Wales Australia
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17
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Khan MJ, Chelliah S, Haron MS, Ahmed S. Role of Travel Motivations, Perceived Risks and Travel Constraints on Destination Image and Visit Intention in Medical Tourism: Theoretical model. Sultan Qaboos Univ Med J 2017; 17:e11-e17. [PMID: 28417022 DOI: 10.18295/squmj.2016.17.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/17/2016] [Accepted: 12/08/2016] [Indexed: 11/16/2022] Open
Abstract
Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation.
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Affiliation(s)
- Mohammad J Khan
- International Business Section, School of Management, Universiti Sains Malaysia, Penang, Malaysia
| | - Shankar Chelliah
- International Business Section, School of Management, Universiti Sains Malaysia, Penang, Malaysia
| | - Mahmod S Haron
- Department of Marketing, School of Management, Universiti Sains Malaysia, Penang, Malaysia
| | - Sahrish Ahmed
- Department of Organizational Behaviour, School of Management, Universiti Sains Malaysia, Penang, Malaysia
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18
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Chander J, Singla N, Kaur M, Punia RS, Attri A, Alastruey-Izquierdo A, Cano-Lira JF, Stchigel AM, Guarro J. Saksenaea erythrospora, an emerging mucoralean fungus causing severe necrotizing skin and soft tissue infections - a study from a tertiary care hospital in north India . Infect Dis (Lond) 2016; 49:170-177. [PMID: 27701965 DOI: 10.1080/23744235.2016.1239027] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Saksenaea erythrospora is an emerging and recently described pathogenic fungus mainly causing invasive cutaneous infections. Globally, very few human cases, caused by S. erythrospora, have been reported. In India, among the genus Saksenaea, S. vasiformis was the only reported pathogenic species, until recently when a case of fungal rhinosinusitis was reported to be caused by S. erythrospora. We observed five human cases of necrotizing skin and soft tissue infections caused by S. erythrospora following traumatic implantation over 1-year study period. METHODS The study was conducted for a year observing the causative role of Saksenaea species in primary cutaneous necrotizing infections. The clinical entities were diagnosed by both microbiological and histopathological examination of the skin biopsies. The final identification of fungal strains was done by comparing internal transcribed spacer (ITS) and D1-D2 domains of the LSU (larger subunit) of the nuclear ribosomal RNA (rRNA) sequences with those of type strains of the different species of Saksenaea. RESULTS Out of total 23 cases of necrotizing skin and soft tissue infections, 5 were caused by S. erythrospora. Intramuscular injection into the gluteal region was the predisposing factor in four patients, while upper limb involvement, following medicated adhesive tape application, was seen in one patient. All patients were treated with liposomal amphotericin B (LAMB) along with extensive debridement of necrotic tissues. Four patients responded well however one died. CONCLUSION Saksenaea erythrospora is an emerging mucoralean fungus isolated in India among patients undergoing inadvertent I/M injections entailing necrotizing fasciitis at the local site.
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Affiliation(s)
- Jagdish Chander
- a Department of Microbiology , Government Medical College Hospital , Chandigarh , India
| | - Nidhi Singla
- a Department of Microbiology , Government Medical College Hospital , Chandigarh , India
| | - Mandeep Kaur
- a Department of Microbiology , Government Medical College Hospital , Chandigarh , India
| | - Rajpal Singh Punia
- a Department of Microbiology , Government Medical College Hospital , Chandigarh , India
| | - Ashok Attri
- a Department of Microbiology , Government Medical College Hospital , Chandigarh , India
| | | | - José F Cano-Lira
- c Medical School and IISPV, Universitat Rovira i Virgili , Reus , Spain
| | | | - Josep Guarro
- c Medical School and IISPV, Universitat Rovira i Virgili , Reus , Spain
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