A Case Report of Candida albicans Costochondritis after a Complicated Esophagectomy

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.We present an unusual case of Candida albicans costochondritis after a complicated Ivor Lewis esophagectomy. This case exhibits that pain, erythema, and swelling over the costal cartilages should alert the possibility of infective costochondritis, especially in a postoperative patient. If a fungal agent is identified, aggressive surgical debridement and early commencement of antifungal therapy are likely determinants for a satisfactory outcome

Thoracic osteomyelitis secondary to a complicated digital mucous cyst infection: a case report

Since the first description by Hyde in 1883,1 the pathogenesis and clinical features of digital mucous (DM) cysts, as well as treatment options, have been well described in the literature.2 Complications associated with surgical treatment include cyst recurrence, loss of range of motion of the distal interphalangeal (DIP) joint, joint stiffness, post-surgical infection and nail dystrophies.3 Digital mucous cyst infection prior to treatment is not well documented. This report describes a complicated case of a DM cyst infection upon presentation with subsequent development of DIP joint septic arthritis, bacteremia and thoracic spinal osteomyelitis

Are pressure injuries related to skin failure in critically ill patients?

Background: Pressure injuries contribute significantly to patient morbidity and healthcare costs. Critically ill patients are a high risk group for pressure injury development and may suffer from skin failure secondary to hypoperfusion. The aim of this study was to report hospital acquired pressure injury incidence in intensive care and non-intensive care patients; and assess the clinical characteristics and outcomes of ICU patients reported as having a hospital acquired pressure injury to better understand patient factors associated with their development in comparison to ward patients. Methods: The setting for this study was a 630 bed, government funded, tertiary referral teaching hospital. A secondary data analysis was undertaken on all patients with a recorded PI on the hospital’s critical incident reporting systems and admitted patient data collection between July 2006 to March 2015. Results: There were a total of 5280 reports in 3860 patients; 726 reports were intensive care patients and 4554 were non-intensive care patients, with severe hospital acquired PI reported in 22 intensive care patients and 54 non-intensive care patients. Pressure injury incidence increased in intensive care patients and decreased in non-intensive care patients over the study period. There were statistically significant differences in the anatomical location of severe hospital acquired pressure injuries between these groups (p = 0.008). Conclusion: Intensive care patients have greater than 10-fold higher hospital acquired pressure injury incidence rates compared to other hospitalised patients. The predisposition of critically ill patients leaves them susceptible to pressure injury development despite implementation of pressure injury prevention strategies. Skin failure appears to be a significant phenomenon in critically ill patients and is associated with the use of vasoactive agents and support systems such as extra corporeal membrane oxygenation and mechanical ventilation

Persistent median artery carpal tunnel syndrome: a case series and literature review

Persistent median artery (PMA) thrombosis is a rare cause of carpal tunnel syndrome (CTS) with only a few cases reported in the literature. The bifid median nerve (BMN) is often associated with PMA and may be a factor in the development of CTS. There is a paucity of information in the literature on the management options for CTS secondary to PMA thrombosis. This paper presents two cases of CTS with associated PMA thrombosis and BMN and offers a discussion on diagnostic and management options

The Superiorly Based Partial Rectus Abdominis and External Oblique Flap: A New Technique for Breast Asymmetry Reconstruction

Summary:. Breast asymmetry has a wide spectrum of presentations with several employable strategies for surgical correction. Historically, the external oblique muscle has proven to be a versatile flap option for the reconstruction of both local and distant defects. It has also been described for use in breast reconstruction for coverage of the lower pole of implant prostheses. The external oblique muscle flap can be harvested in several ways to capture overlying fat and skin. In this study, we describe the use of a superiorly based partial rectus and external oblique flap for surgical correction of lower pole breast hypoplasia. This flap provides vascularized autologous volume to the lower pole of the breast with minimal donor morbidity. Other advantages of this flap are that it can increase the nipple to inframammary fold distance and lower the inframammary fold. This technique represents an evolution of an under-utilized flap and is the first study describing the use of the external oblique flap in the management of breast asymmetry