Based on the information provided, this patient is presenting with signs and symptoms consistent with rhinoscleroma. Key features include chronic inflammation and pain over the face and nasal mucosa for an extended period of time. Rhinoscleroma is a chronic granulomatous infection caused by Klebsiella pneumoniae subspecies rhinoscleromatis that commonly affects the nose and paranasal sinuses. It tends to affect adults living in tropical or subtropical regions. Treatment involves long-term antibiotics such as doxycycline or clarithromycin
Based on the information provided, this case is most consistent with a diagnosis of actinomycosis. Key features include:
- Chronic (2 month) infection
- Inflammation and pain over facial region and nasal area
- Occupation as a farmer (exposure to soil/animals which are risk factors)
Actinomycosis is a chronic bacterial infection caused by Actinomyces species, which are gram positive bacteria commonly found in the mouth and GI tract. Risk factors include poor dental hygiene or penetrating injuries that allow entry into tissues. The infection can spread locally or systemically and form draining sinus tracts and abscesses. The facial region is a common site of infection. Treatment requires prolonged high dose
Similaire à Based on the information provided, this patient is presenting with signs and symptoms consistent with rhinoscleroma. Key features include chronic inflammation and pain over the face and nasal mucosa for an extended period of time. Rhinoscleroma is a chronic granulomatous infection caused by Klebsiella pneumoniae subspecies rhinoscleromatis that commonly affects the nose and paranasal sinuses. It tends to affect adults living in tropical or subtropical regions. Treatment involves long-term antibiotics such as doxycycline or clarithromycin
Similaire à Based on the information provided, this patient is presenting with signs and symptoms consistent with rhinoscleroma. Key features include chronic inflammation and pain over the face and nasal mucosa for an extended period of time. Rhinoscleroma is a chronic granulomatous infection caused by Klebsiella pneumoniae subspecies rhinoscleromatis that commonly affects the nose and paranasal sinuses. It tends to affect adults living in tropical or subtropical regions. Treatment involves long-term antibiotics such as doxycycline or clarithromycin (20)
Based on the information provided, this patient is presenting with signs and symptoms consistent with rhinoscleroma. Key features include chronic inflammation and pain over the face and nasal mucosa for an extended period of time. Rhinoscleroma is a chronic granulomatous infection caused by Klebsiella pneumoniae subspecies rhinoscleromatis that commonly affects the nose and paranasal sinuses. It tends to affect adults living in tropical or subtropical regions. Treatment involves long-term antibiotics such as doxycycline or clarithromycin
1. Project: Ghana Emergency Medicine Collaborative
Document Title: Oral and Facial Infections
Author(s): Shannon Langston (University), MD, 2011
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3. Oral
and
Facial
Infec.ons
12-‐06-‐2011
Shannon Langston, MD
3
33. Treatment
• An.bio.c
Therapy
– Ampicillin-‐sulbactam
(3
g
IV
every
six
hours)
or
– Clindamycin
(600
mg
IV
every
six
to
eight
hours)
PLUS
– Vancomycin
(15
to
20
mg/kg
IV
every
12
hours)
or
– Linezolid
(600
mg
orally
or
IV
every
12
hours).
33
34. Ludwigs
Angina
• Take
Home
Points
– Aggressive
airway
management
– An.bio.cs
– CT
Scan
– Surgical
Consulta.on
Early
34
52. An.bio.cs
Or
Vancomycin 15-20 mg/kg IV Q 12 h
Or
Linezolid 600 mg orally or IV Q 12 h
PLUS
Either metronidazole 500 mg IV Q 6-8 h
52
53. Case
• 65
year
old
farmer
presents
with
2
month
history
of
inflamma.on
and
pain
over
the
facial
region
and
nasal
mucosa.
• Denies
fevers
or
systemic
symptom.
• PMH:
Unremarkable.
• Course
of
an.bio.cs
“the
white
one”
unsuccessful.
53
62. Mucocutaneous
Leishmaniasis
• Leishmaniasis: vector-borne diseases
caused by parasites of the genus
Leishmania
• Multifaceted clinical manifestations:
– Mucocutaneous
– Cutaneous
– Visceral
62
63. Leishmanaisis
§ The global annual incidence is estimated at
1.5-2 million new cases per year:
§ 1-1.5 million cases of CL
§ 500,000 cases of VL.
§ Overall prevalence of 12 million cases.
§ 500 US Soldiers in 18 month period
63
64. Mucocutaneous
Leishmanisis
• Distribu.on:
– Present
in
88
countries
within
Central
America,
South
America,
Africa,
India,
the
Middle
East,
Asia,
southern
Europe,
and
the
Mediterranean.
64
67. Vectors
• Transmided
by
the
bite
of
female
sandflies
– Genus
Lutzomyia
in
the
New
World
– Genus
Phlebotumus
in
the
Old
World
• Reservoir
host:
– Domes.c
and/or
wild
animals
– Humans.
67
68. Leishmania
Species
• Two
Groups
(15
species
cause
disease)
– Those
restricted
to
the
skin
and
cause
dermal
leishmaniasis:
• L.
mexicana,
• L.
braziliensis
• L.
tropica,
L.
major,
L.
aethiopica.
– Visceral:
• L.
donovani
68