Gangrene Research Today is a free monthly online journal that collates and summarizes the latest research about Gangrene, including details on smoking, treatment, causes, amputation, necrosis.

Necrotizing Candida Infection After Percutaneous Endoscopic Gastrostomy: A Fatal and Rare Complication.

Wirth R, Bauer J, Sieber C

Clinic for Internal Medicine and Geriatrics, St Marien-Hospital Borken, Borken, Germany, and Friedrich-Alexander-Universität Erlangen-Nuremberg, Clinic for Internal Medicine II, Nuremberg Hospital, Nuremberg, Germany. Rainer Wirth provided the case treatment and preparation of the article; Jürgen Bauer and Cornel Sieber provided the critical review.

Gastrostomy site infections following percutaneous endoscopic gastrostomy (PEG) are the most common complication after PEG placement. Recent meta-analyses were able to show that PEG site infections can be reduced significantly with a systemic antimicrobial prophylaxis. This mostly cephalosporin- or penicillin-based prophylaxis does not cover fungal infections. Although Candida skin infections after PEG placement are rarely described, a mucosal colonization or infection of the upper GI tract with Candida species is very common, especially in severely ill patients such as those requiring artificial nutrition. The authors report a rare and lethal case of a necrotizing PEG site infection with Candida albicans in a patient with diabetes with multiple comorbidities, presenting like gas gangrene. In patients with probable immunodeficiency or visible candidiasis of the skin, oropharynx, or esophagus, a Candida infection should be considered in case of a gastrostomy site infection.

Published 29 April 2008 in JPEN J Parenter Enteral Nutr, 32(3): 285-287.
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Articles on Gangrene published 29 April 2008:

Some historical aspects of diabetic foot disease.   Diabetes Metab Res Rev, 24: S7-S13.

During the 19th century and for much of the 20th century, disease of the lower limb in diabetic patients was conceptualized not, as it is now, as 'the diabetic foot' or as 'a diabetic foot ulcer' but as 'gangrene in the diabetic foot' or as 'diabetic gangrene'. The prognostically and therapeutically important distinction between gangrene due to vascular insufficiency and gangrene due to infection in a limb with a normal or near normal blood supply was not made until about 1893. The advent of ... [Abstract] [Full-text]

Orthodeoxia-platypnea syndrome presenting as paradoxical peripheral embolism.   Ann Thorac Surg, 85(5): 1798-800.

A paradoxical embolus associated with orthodeoxia-platypnea syndrome and intracardiac shunting is extremely uncommon. We present a patient who was found to have a positional change in desaturation after a right pneumonectomy who suffered from gangrene of the right foot and simultaneous deep venous thrombosis of the left arm. Workup revealed a patent foramen ovale as a cause for both the right-to-left shunt and the paradoxical emboli. After percutaneous closure the orthodeoxia resolved. This ... [Abstract] [Full-text]

Neuropathic plantar forefoot ulcers treated with tendon lengthenings.   Foot Ankle Int, 29(4): 378-84.

BACKGROUND: Foot ulcers are a common cause of infection and amputation in patients with neuropathy. This retrospective study evaluated the healing and recurrence rates after treating neuropathic ulcers plantar to the metatarsal heads with tendon lengthenings in the leg. MATERIALS AND METHODS: Between 1995 and 2003, 20 ulcers plantar to the metatarsal heads in 17 patients were treated with tendon lengthenings. All patients had gastroc-soleus recession (Vulpius procedure). Patients with first ... [Abstract] [Full-text]

Articles on Gangrene published 18 April 2008:

Fournier's gangrene and scrotal ulcerations during all-trans-retinoic acid therapy for acute promyelocytic leukemia.   Pediatr Blood Cancer.

Scrotal ulcers are a rare manifestation in patients with acute promyelocytic leukemia. Fournier's gangrene (FG) is even rarer. We describe three adolescents and young adults who developed scrotal ulcerations during induction with all-trans-retinoic acid. One patient developed FG. These lesions are predominantly seen in Asian population. A good outcome with supportive management occurred in all the cases. Pediatr Blood Cancer (c) 2008 Wiley-Liss, Inc. [Abstract] [Full-text]

Articles on Gangrene published 16 April 2008:

Metastatic Gas gangrene and Colonic Perforation: a case report.   World J Emerg Surg, 3: 15.

ABSTRACT: Clostridium septicum myonecrosis is associated with diabetes, colorectal and haematological malignancies. We present a case of metastatic myonecrosis in a diabetic patient with a perforated caecal tumour. The literature since 1989 is reviewed and 28 cases of Clostridium septicum myonecrosis are discussed. [Abstract] [Full-text]

Lactate dehydrogenase activity is increased in plasma of infants with advanced necrotizing enterocolitis.   Pediatr Surg Int.

In infants with necrotizing enterocolitis (NEC), intestinal gangrene defines advanced disease. Since intestinal ischemia is considered a pathogenetic factor for intestinal gangrene, serum activity of mucosal and seromuscular enzymes may be elevated in these patients. Our aim was to evaluate if serum enzymes activity is increased in infants with NEC associated with intestinal gangrene. We performed a retrospective review of the case notes of infants operated on for NEC between 1998 and 2006. ... [Abstract] [Full-text]

Community-Acquired Methicillin-Resistant Staphylococcus Aureus As a Cause of Fournier's Gangrene.   Am J Med Sci, 335(4): 327-8.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become an important pathogen in aggressive skin and soft-tissue infections in patients without risk factors for nosocomial infections. We describe a case of a previously healthy adult who developed fulminant sepsis from Fournier's gangrene caused by a strain of CA-MRSA containing the Panton-Valentine leukocidin genes. [Abstract] [Full-text]

Drug eluting stents for below the knee lesions in patients with critical limb ischemia : long-term follow-up.   Catheter Cardiovasc Interv.

OBJECTIVES:: The purpose of this study was to assess the long-term limb preservation and/or healing of ulcers in patients with critical limb ischemia (CLI) and severe infrapopliteal atherosclerotic disease treated with drug eluting stents (DES). BACKGROUND:: Percutaneous revascularization has become an effective treatment for CLI in patients with infrapopliteal atherosclerotic disease. Recent reports using DES in patients with CLI have documented excellent short-term infrapopliteal vessel ... [Abstract] [Full-text]

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