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Tamura Y, Abe T. Infective endocarditis associated with atopic dermatitis. Clin Case Rep 2023; 11:e8321. [PMID: 38130851 PMCID: PMC10733789 DOI: 10.1002/ccr3.8321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023] Open
Abstract
Infective endocarditis caused by atopic dermatitis is common in young patients and has a high potential for causing embolism. Because of the high risk of mediastinitis postoperatively, minimally invasive cardiac surgery could be effective.
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Affiliation(s)
- Yamato Tamura
- Department of Cardiovascular SurgeryNara Prefectural Seiwa Medical CenterNaraJapan
| | - Takehisa Abe
- Department of Cardiovascular SurgeryNara Prefectural Seiwa Medical CenterNaraJapan
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Takahashi H, Aoki Y, Taniguchi S, Nakajima A, Sonobe M, Akatsu Y, Saito J, Yamada M, Shiga Y, Inage K, Orita S, Eguchi Y, Maki S, Furuya T, Akazawa T, Koda M, Yamazaki M, Ohtori S, Nakagawa K. Delayed surgical site infection after posterior cervical instrumented surgery in a patient with atopic dermatitis: a case report. J Rural Med 2020; 15:124-129. [PMID: 32704338 PMCID: PMC7369410 DOI: 10.2185/jrm.2020-006] [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: 03/05/2020] [Accepted: 03/25/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: Atopic dermatitis (AD) is one of the known risk factors for
Staphylococcus aureus infection. The authors report the case of a
patient with cervical spondylosis and AD who developed delayed surgical site infection
after posterior cervical instrumented surgery. Patient: A 39-year-old male presented to our hospital with paralysis of the
left upper extremity without any cause or prior injury. He had a history of severe AD. We
performed C3–C7 posterior decompression and instrumented fusion based on the diagnosis of
cervical spondylotic amyotrophy. One year after surgery, his deltoid and bicep muscle
strength were fully recovered. Nevertheless, his neck pain worsened 2 years after surgery
following worsening of AD. One month after that, he developed severe myelopathy and was
admitted to our hospital. Radiographic findings showed that all the screws had loosened
and the retropharyngeal space had expanded. Magnetic resonance imaging and computed
tomography showed severe abscess formation and destruction of the C7/T1 vertebrae. Result: We diagnosed him with delayed surgical site infection.
Methicillin-resistant Staphylococcus aureus was identified on abscess
culture. The patient responded adequately to treatment with antibiotic therapy and two
debridements and the infection subsided. Conclusion: We should consider the possibility of delayed surgical site
infection when conducting instrumented spinal surgery in patients with severe AD.
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Affiliation(s)
- Hiroshi Takahashi
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan.,Department of Orthopaedic Surgery, University of Tsukuba, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Japan
| | - Shinji Taniguchi
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
| | - Arata Nakajima
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
| | - Masato Sonobe
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
| | - Yorikazu Akatsu
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
| | - Junya Saito
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
| | - Manabu Yamada
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Yawara Eguchi
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Tsutomu Akazawa
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, University of Tsukuba, Japan
| | | | - Seiji Ohtori
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Japan
| | - Koichi Nakagawa
- Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Japan
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Nakanishi M, Oota E, Tomita Y, Kato T, Imanishi T. A case of infective endocarditis associated with atopic dermatitis perioperatively treated with dupilumab. J DERMATOL TREAT 2019; 30:674-676. [PMID: 30628496 DOI: 10.1080/09546634.2019.1568379] [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] [Indexed: 10/27/2022]
Abstract
Background: Several case reports and reviews support a relationship between atopic dermatitis (AD) and infective endocarditis (IE). Here, we present a case of severe AD suspected of causing IE. Case presentation: A 21-year-old man with severe AD was admitted to our hospital due to unidentified fever, syncope, and headache. He was diagnosed with IE with cerebral embolism and mitral regurgitation. Before elective cardiac surgery, he was subcutaneously administered dupilumab for 2 months to control AD. Dupilumab improved AD, and cardiac surgery was performed without complications. Conclusions: Dupilumab may be effective in AD cases as preparation for cardiac surgery.
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Affiliation(s)
- Mika Nakanishi
- a Department of Anesthesia, Osakafu Saiseikai Noe Hospital , Osaka City , Osaka , Japan
| | - Eri Oota
- a Department of Anesthesia, Osakafu Saiseikai Noe Hospital , Osaka City , Osaka , Japan
| | - Yukihiko Tomita
- a Department of Anesthesia, Osakafu Saiseikai Noe Hospital , Osaka City , Osaka , Japan
| | - Takeshi Kato
- a Department of Anesthesia, Osakafu Saiseikai Noe Hospital , Osaka City , Osaka , Japan
| | - Toshihiro Imanishi
- a Department of Anesthesia, Osakafu Saiseikai Noe Hospital , Osaka City , Osaka , Japan
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Kawata M, Sasabuchi Y, Taketomi S, Inui H, Matsui H, Fushimi K, Yasunaga H, Tanaka S. Atopic dermatitis is a novel demographic risk factor for surgical site infection after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2018; 26:3699-3705. [PMID: 29725748 DOI: 10.1007/s00167-018-4958-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/23/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE Although various risk factors for surgical site infection after anterior cruciate ligament reconstruction (ACLR) have been reported, the number of studies with large sample sizes on this topic is limited. The aim of the present study was to clarify the risk factors for early surgical site infection after ACLR in a large cohort using a national database in Japan. METHODS The data of patients who underwent ACLR from 2010 to 2015 were obtained from the Diagnosis Procedure Combination database, which covers approximately half of all hospital admissions in Japan. The outcome measures were the prevalences of surgical site infection and deep surgical site infection after ACLR during hospitalization. The association between the occurrence of surgical site infection and patients' demographic data, including sex, age, body mass index (BMI), smoking status, preoperative steroid use, and comorbidities such as diabetes, hepatic dysfunction, renal dysfunction, and atopic dermatitis, were examined using a multivariable logistic regression model. RESULTS Among 30,536 patients who underwent ACLR, 288 patients with surgical site infection (0.94%) and 86 with deep surgical site infection (0.28%) were identified. The univariate analysis showed that higher prevalences of surgical site infection and deep surgical site infection were associated with male sex, a higher BMI, atopic dermatitis, and preoperative steroid use. Patients with diabetes or hepatic dysfunction had a significantly higher prevalence of surgical site infection. The multivariable analysis showed that surgical site infection was significantly associated with male sex vs. female sex; odds ratio (OR), 2.90; 95% confidence interval (CI), 2.17-3.89, age of ≤ 19 vs. 20-29 years; OR, 1.56; 95% CI 1.13-2.15, BMI of ≥ 30.0 vs. 18.5-22.9 kg/m2; OR, 1.72; 95% CI 1.16-2.54, diabetes (OR, 2.70; 95% CI 1.28-5.71), atopic dermatitis (OR, 7.19; 95% CI 2.94-17.57), and preoperative steroid use (OR, 6.18; 95% CI 2.32-16.52). CONCLUSION Atopic dermatitis, preoperative steroid use, young age (≤ 19 years), obesity (BMI of ≥ 30.0 kg/m2), male sex, and diabetes were independent demographic risk factors for surgical site infection after ACLR. The present study will be useful when surgeons evaluate the risk of SSI after ACLR in terms of demographic aspects. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Manabu Kawata
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yusuke Sasabuchi
- Data Science Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Hiroshi Inui
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kiyohide Fushimi
- Department of Health Informatics and Policy, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Aoyagi S, Oda T, Wada K, Nakamura E, Kosuga T, Yasunaga H. Infective Endocarditis Associated with Atopic Dermatitis. Int Heart J 2018; 59:420-423. [PMID: 29563378 DOI: 10.1536/ihj.17-078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report a case of aortic valve infective endocarditis (IE) in a 24-year-old man with atopic dermatitis (AD). He had a history of balloon valvuloplasty for a stenotic bicuspid aortic valve, and had dental caries but no invasive dental procedure before the onset of IE. On admission, skin lesions of AD with itching and scratches were found on the neck, trunk, and extremities. Echocardiography showed a vegetation on the aortic valve with mild steno-regurgitation, but extension of IE to the annulus was not detected. Magnetic resonance imaging identified fresh cerebral infarction without neurological dysfunction, leading us to suspect an embolism. Blood cultures grew methicillin-sensitive Staphylococcus aureus. During emergency surgery, a vegetation attached to the conjoined cusp was observed, and the aortic valve was replaced with a mechanical valve. The patient recovered uneventfully without any complications such as recurrent IE or mediastinitis. We also review previously reported cases of IE associated with AD.
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Affiliation(s)
| | - Takeshi Oda
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Eiji Nakamura
- Department of Cardiovascular Surgery, St. Mary's Hospital
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Liao Y, Long X, Zhu S, Tu J, Wen H, Xu J, Wu Y. Minimally access via left anterior mini-thoracotomy for repair of adult subarterial ventricular septal defects. J Cardiothorac Surg 2017; 12:48. [PMID: 28606107 PMCID: PMC5469133 DOI: 10.1186/s13019-017-0611-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/06/2017] [Indexed: 11/10/2022] Open
Abstract
Background Minimally invasive cardiac surgical techniques are increasingly applied in the treatment and management of a variety of adult ventricular septal defects (VSDs). However, repair of adult subarterial VSDs via left anterior mini-thoracotomy is rarely reported. The present study aimed to determine the feasibility and safety of the left anterior mini-thoracotomy for the repair of adult subarterial VSDs. Methods Twenty-seven adult patients underwent repair of subarterial VSDs via left anterior mini-thoracotomy. The approach includes two options for skin incision access, longitudinal and transverse skin incisions. The skin incision length was 4.1–6.1 cm (mean, 5.1 ± 0.6 cm). The closure of the VSDs was obtained through the main pulmonary artery under direct visualization. Results Successful repair of the defects was achieved in all the patients. No patients died or converted to median sternotomy. Average durations of cardiopulmonary bypass (CPB) and aortic cross-clamp were 102.5 ± 13.6 min (range, 85–127 min) and 54.6 ± 6.9 min (range, 45–66 min), respectively. No patients required blood transfusion. The average postoperative hospital stay was 5.1 ± 0.7 days (range, 4–6 days). There were no postoperative complications related to the operative procedures or peripheral cannulation. During the follow-up of 5.4–32.3 months, no patients were found to have residual shunt, wound infections, pericardial effusion, neurologic or other complications. Conclusion Our experiences demonstrate that minimally invasive cardiac surgical technique via left anterior mini-thoracotomy can be served as a novel, feasible and safe alternative for the repair of adult subarterial VSDs.
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Affiliation(s)
- YunFei Liao
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China
| | - Xiang Long
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China
| | - ShuQiang Zhu
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China
| | - Jun Tu
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China
| | - Hua Wen
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China
| | - JianJun Xu
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China
| | - YongBing Wu
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China.
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Pagliarello C, Scrivani S, Fabrizi G, Feliciani C, Di Nuzzo S. An under-recognized, life-threatening complication of atopic dermatitis. Clin Exp Dermatol 2017; 42:831-832. [PMID: 28597997 DOI: 10.1111/ced.13171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2016] [Indexed: 10/19/2022]
Affiliation(s)
- C Pagliarello
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Scrivani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Fabrizi
- Istituto Dermopatico dell'Immacolata, IDI IRCCS, Rome, Italy
| | - C Feliciani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Di Nuzzo
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Abstract
Colonization with Staphylococcal aureus is markedly more frequent in individuals with atopic dermatitis (AD) than in unaffected individuals. Chronic scratching leads to worsening of an existing defect in the epidermal barrier, which can allow S. aureus invasion into the bloodstream and subsequent systemic infections. We report two unusual cases of systemic illness in individuals with AD. One developed infective endocarditis followed by a stroke and the other developed septic arthritis and osteomyelitis. We performed an extensive literature review of reported systemic complications caused by S. aureus in patients with AD. Although reports are rare, practitioners should be aware of these important, albeit unlikely, complications of staphylococcal superinfections in individuals with AD.
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Affiliation(s)
- Devika Patel
- Department of Dermatology, Henry Ford Hospital, Children's Hospital of Michigan, Detroit, Michigan
| | - Marla N Jahnke
- Department of Dermatology, Henry Ford Hospital, Children's Hospital of Michigan, Detroit, Michigan
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Hu CX, Tan J, Chen S, Ding H, Xu ZW. Comparison of clinical outcomes and postoperative recovery between two open heart surgeries: minimally invasive right subaxillary vertical thoracomy and traditional median sternotomy. ASIAN PAC J TROP MED 2014; 7:625-629. [DOI: 10.1016/s1995-7645(14)60105-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/15/2014] [Accepted: 07/15/2014] [Indexed: 11/25/2022] Open
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