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Di Bella S, Luzzati R, Mearelli F, Papa G, Spazzapan L, Nunnari A, D’Aleo F, Papola C, Principe L. Anti-infective management of infected skin ulcers. LE INFEZIONI IN MEDICINA 2024; 32:138-147. [PMID: 38827836 PMCID: PMC11142418 DOI: 10.53854/liim-3202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/19/2024] [Indexed: 06/05/2024]
Abstract
Infected skin ulcers represent a frequent and intricate clinical challenge, necessitating prompt and comprehensive multidisciplinary interventions to avert complications. Anti-infective therapy constitutes a cornerstone in the therapeutic paradigm. This manuscript delineates our approach to anti-infective management of infected ulcers, encompassing insights into clinical classifications, diagnostic features, exampless of early clinical decision-making in anti-infective treatment, comprehensive evaluation of infectious diseases encompassing host clinical considerations and potential interventions, determination of antibiotic therapy duration, methodologies for assessing clinical response, identification of potential causes for lack of clinical response, as well as strategies for outpatient parenteral antibiotic therapy and a diagnostic and therapeutic algorithm.
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Affiliation(s)
- Stefano Di Bella
- Clinical Department of Medical, Surgical, and Health Sciences, Trieste University, Trieste,
Italy
| | - Roberto Luzzati
- Clinical Department of Medical, Surgical, and Health Sciences, Trieste University, Trieste,
Italy
| | - Filippo Mearelli
- Internal Medicine Unit, Trieste University Hospital (ASUGI), Trieste,
Italy
| | - Giovanni Papa
- Clinical Department of Medical, Surgical, and Health Sciences, Trieste University, Trieste,
Italy
| | - Luca Spazzapan
- Plastic Surgery Unit, Trieste University Hospital (ASUGI), Trieste,
Italy
| | - Alessio Nunnari
- Internal Medicine Unit, Trieste University Hospital (ASUGI), Trieste,
Italy
| | - Francesco D’Aleo
- Clinical Microbiology and Virology Unit, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli”, Reggio Calabria,
Italy
| | - Carmelo Papola
- Clinical Microbiology and Virology Unit, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli”, Reggio Calabria,
Italy
| | - Luigi Principe
- Clinical Microbiology and Virology Unit, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli”, Reggio Calabria,
Italy
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Eikeland R, Henningsson AJ, Lebech AM, Kerlefsen Y, Mavin S, Vrijlandt A, Hovius JW, Lernout T, Lim C, Dobler G, Fingerle V, Gynthersen RM, Lindgren PE, Reiso H. Tick-borne diseases in the North Sea region-A comprehensive overview and recommendations for diagnostics and treatment. Ticks Tick Borne Dis 2024; 15:102306. [PMID: 38183851 DOI: 10.1016/j.ttbdis.2023.102306] [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: 08/14/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/08/2024]
Abstract
As part of the NorthTick project, co-funded by the European Union through the European Regional Development Fund and the North Sea Region Programme, specialists in the field of tick-borne diseases from seven North Sea countries co-operated with patient organisations and governmental health care institutions to provide this comprehensive overview of diagnostics and treatment recommendations in the region for Lyme borreliosis, Borrelia miyamotoi infection, tick-borne encephalitis, human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis and babesiosis. The main conclusion is that the recommendations in these northern countries are essentially the same, with very few differences. This overview presents the current diagnostics and provides useful clinical guidance.
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Affiliation(s)
- Randi Eikeland
- Norwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital, Kristiansand, Norway; Faculty of Health and Sport science, University of Agder, Grimstad, Norway.
| | - Anna J Henningsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; National Reference Laboratory for Borreliosis and Other Tick-Borne Bacteria, Clinical Microbiology, Laboratory Medicine, Region Jönköping County, Sweden
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Yvonne Kerlefsen
- Norwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital, Kristiansand, Norway
| | - Sally Mavin
- Scottish Lyme Disease and Tick-borne Infections Reference Laboratory, Raigmore Hospital, Inverness, UK
| | - Amber Vrijlandt
- Amsterdam UMC, location AMC, Department of Internal Medicine, Section of Infectious Diseases, Amsterdam UMC Multidisciplinary Lyme borreliosis Center, Amsterdam, The Netherlands
| | - Joppe W Hovius
- Amsterdam UMC, location AMC, Department of Internal Medicine, Section of Infectious Diseases, Amsterdam UMC Multidisciplinary Lyme borreliosis Center, Amsterdam, The Netherlands
| | - Tinne Lernout
- Sciensano Epidemiology of infectious diseases, Brussels, Belgium
| | - Chin Lim
- Scottish Lyme Disease and Tick-borne Infections Reference Laboratory, Raigmore Hospital, Inverness, UK
| | - Gerhard Dobler
- Nationales Konsiliarlabor FSME, Institut für Mikrobiologie der Bundeswehr, Munich, Germany
| | - Volker Fingerle
- German National Reference Center for Borreliae, Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
| | - Rosa M Gynthersen
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Harald Reiso
- Norwegian National Advisory Unit on Tick-Borne Diseases, Sørlandet Hospital, Kristiansand, Norway
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Heger F, Schindler S, Pleininger S, Fueszl A, Blaschitz M, Lippert K, Hyden P, Hufnagl P, Mutschlechner D, Gremmel T, Hofer E, Markowicz M, Indra A. Three Cases of Tickborne Francisella tularensis Infection, Austria, 2022. Emerg Infect Dis 2023; 29:2349-2352. [PMID: 37877608 PMCID: PMC10617340 DOI: 10.3201/eid2911.230460] [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] [Indexed: 10/26/2023] Open
Abstract
Tularemia is increasing in Austria. We report Francisella tularensis subspecies holarctica isolated from 3 patients who had been bitten by arthropods. Next-generation sequencing showed substantial isolate similarity. Clinicians should consider bloodstream F. tularensis infections for patients with signs/symptoms of ulceroglandular tularemia, and surveillance of potential vectors should be intensified.
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4
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Francisella tularensis infection: variable clinical aspects with persistent pulmonary nodules presentation, a case series of human tularemia in Franche-Comté, France. Ticks Tick Borne Dis 2022; 13:101941. [DOI: 10.1016/j.ttbdis.2022.101941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022]
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