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Abstract
Drug based treatment of superficial fungal infections, such as onychomycosis, is not the only defense. Sanitization of footwear such as shoes, socks/stockings, and other textiles is integral to the prevention of recurrence, and reduction of spread for superficial fungal mycoses. The goal of this review was to examine the available methods of sanitization for footwear and textiles against superficial fungal infections. A systematic literature search of various sanitization devices and methods that could be applied to footwear and textiles using PubMed, Scopus, and MEDLINE was performed. Fifty-four studies were found relevant to the different methodologies, devices, and techniques of sanitization as it pertains to superficial fungal infections of the feet. These included topics of basic sanitization, antifungal and antimicrobial materials, sanitization chemicals and powder, laundering, ultraviolet, ozone, non-thermal plasma, microwave radiation, essential oils, and natural plant extracts. In management of onychomycosis it is necessary to think beyond treatment of the nail, as infections enter through the skin. Those prone to onychomycosis should examine their environment, including surfaces, shoes, and socks, and ensure that proper sanitization is implemented.
A case of human myiasis caused by the black blowfly, P. regina, has been presented. Although various reports have documented the therapeutic effects of maggot infestation, infection and mortality by gas-forming anaerobic organisms also have been reported. The removal of maggots from a wound can be accomplished using various methods. The authors successfully used topical application of dichlorotetrafluoroethane.
The case presented is a rare example of subcutaneous emphysema isolated to an extremity. This is a benign condition and should not be confused with necrotizing gas-producing infections. In most cases, the condition rapidly resolves without treatment, usually in less than 48 hr. In rare cases where the mechanical process causing the subcutaneous emphysema persists, interruption of this process is required.
In this case presentation, the diagnosis was based solely on the histopathologic examination of tissue taken at the time of the first surgery. Subsequent cultures did not reveal any growth of organisms that would cause Madura foot. The patient must be monitored periodically, for it is rare that such an infection is cured with surgery other than amputation.
A maculopapular rash has been associated with the administration of imipenem-cilastatin, an antibiotic that was used for treatment of a postoperative infection. This is a first-time association of imipenem with a leukocytoclastic vasculitic reaction. Leukocytoclastic vasculitis has been previously documented with ciprofloxacin, zidovudine, piperazine, and lithium.
Bite wounds of the lower extremities present a challenge in diagnosis and management. Primary care of the initial injury remains controversial. Innocuous as these wounds may appear, severe infections are frequent. The microbial flora of the animal mouth harbor a multitude of unusual bacteria, aerobic and anaerobic, that make antibiotic selection difficult. A protocol for initial management and antibiotic selection is presented.
Although tetanus is a preventable disease, several cases are reported to the Centers for Disease Control and Prevention each year. Many conditions treated by podiatric physicians carry the risk of infection by Clostridium tetani, and it is advisable for podiatrists to update a patient's tetanus immunization status if the patient presents with a tetanus-prone wound.
Stingray injuries are most commonly characterized by localized pain, ulceration, and edema; however, potentially serious sequelae may result, including tissue necrosis and life-threatening infection. This case report describes a stingray injury that had progressed to ulceration and was treated with topical application of recombinant human platelet-derived growth factor-BB (becaplermin gel 0.01%) and a standardized regimen of wound care.
The authors present a case of bullous dermatosis in a diabetic patient. The lesions were drained and deroofed, and at 1-year follow-up, the patient related no problems. Proper diagnosis and treatment of these lesions will avoid infection and ulceration.
A study on the incidence and causative organisms of pedal superficial white onychomycosis within several patient populations is presented. Early recognition, debridement, and topical antifungal therapy for several weeks with attention to biomechanical factors should resolve the infection and prevent progression to a more destructive form of onychomycosis.
