Diagnosis Of Skin Infections Research Articles

Target Recognition Initiated Self-Assembly-Based Signal Amplification Strategy for Sensitive and Colorimetric Staphylococcus aureus Detection and Diagnosis of Skin Infection.

Staphylococcus aureus (S. aureus), as a Gram-positive bacterium, is commonly encountered in various infectious diseases, such as acute skin and soft tissue infections. Despite that many efforts have been made, sensitive and reliable quantitative determination of S. aureus remains a huge challenge. Here, we depict a novel colorimetric approach for sensitive and accurate detection by combining allosteric probe-based target recognition and chain extension-based dual signal recycling. The single-strand DNA (ssDNA) products generated by the chain extension process lead to the liberation of G-quadruplex sequences, which can fold into active DNAzyme under the assistance of hemin. The active DNAzyme can work as peroxidase mimics to catalyze the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS2-)-H2O2 system, causing the color change of the system. Eventually, the method exhibits a wide detection range from 103cfu/mL to 106cfu/mL. The limit of detection of the approach was determined 232cfu/mL. Considering the robust capability of the approach in S. aureus detection, we believe that it will be a potential alternative tool for biomedical research and clinical molecular diagnostics.

Hybrid Approach for Skin Disease Classification: Integrating Machine learning and Deep Learning

Abstract: Skin infections are more common than many other diseases, and they can be caused by various factors such as infectious pollution, microorganisms, awareness, and infections. With the advancement of lasers and photonics-based medical technology, the diagnosis of skin infections has become faster and more accurate. However, the cost of such diagnosis is still limited and expensive. Therefore, image processing techniques are used to develop an automated assessment system for dermatology at an early stage. The extraction of features plays a crucial role in accurately and quickly diagnosing skin diseases. PC vision plays an important role in the detection of skin diseases in various ways. This study focuses on four skin diseases: ringworm, nail parasite, psoriasis, and atopic dermatitis. Convolutional neural networks have achieved close to or even better performance than humans in the imaging field. The skin diseases are classified using a machine learning algorithm, i.e., random forest, which achieves an accuracy of 98.23% after 100 epochs.

Skin manifestations of Pseudomonas aeruginosa infections.

Pseudomonas aeruginosa is an opportunistic pathogen with considerable morbidity and mortality, particularly in vulnerable hosts. Skin manifestations are common, either representing local inoculation or secondary skin seeding following bloodstream infections. As patients with various predisposing conditions are expanding, we sought to review the most recent published evidence regarding epidemiology, risk factors and diagnosis of skin manifestations of P. aeruginosa. New data exist on epidemiology and diagnosis of skin infections; systemic infections are impacted by multidrug-resistance issues and host immune status. Green nail syndrome, toe web infection, hot tub folliculitis, hot hand-foot infection and external otitis are the most common infections originating from the skin per se. Local treatments are the cornerstone and prognosis is favorable in immunocompetent hosts. Ecthyma gangrenosum and P. aeruginosa subcutaneous nodules are usually associated with bloodstream infections and occur primarily in immunocompromised hosts. Necrotizing skin and soft tissue infections occur in diabetic, alcoholic and immunocompromised patients; management requires a multidisciplinary team with surgical approach. Burn wound infections may also be challenging, requiring a specialized team. In all the four latter types of P. aeruginosa skin infections portending significant morbidity and mortality, systemic antibiotics are an integral part of the treatment.

Difficulties in the diagnosis of fish tank granuloma – case report

Introduction: Fish tank granuloma is a rare dermatitis caused by Mycobacterium marinum. Infection occurs through contact of damaged skin with water or aquatic animals infected with these bacteria. Aim: It is likely that skin infection caused by M. marinum transmitted from Clarias gariepinus has as yet not been reported in literature. Our case report is presumably the first publication. Dermatoscopy as a useful method in the diagnosis of skin infections caused by atypical mycobacteria. Our article presents new dermatoscopic features of fish tank granuloma. Case study: The case report applies to a 30-year old, white, Caucasian man referred because of a single, well-demarcated plaque measuring 2 × 4 cm, localized on third finger on left hand above proximal phalanx, without subjective symptoms. The diagnosis was confirmed by medical history, dermoscopy and histopathological examination. Patient was successfully treated with sulfamethoxazole and trimethoprim. Results and discussion: Due to the fact that M. marinum infection is uncommon, in case of clinical suspicion it is necessary to perform skin biopsy, culture and tissue PCR analysis. Knowledge about the opportunities and limitations of theses laboratory tests is pivotal to reasonable clinical decision-making. Conclusions: Dermoscopy is useful to make a diagnosis, but there are still too few accounts in literature. The correct diagnosis determines the effective treatment.

Infections of the Skin among Children in Ho Teaching Hospital of the Volta Region, Ghana

Skin infections are common disorders responsible for hospital attendance in the pediatric practice. Unfortunately, the epidemiology of these infections in tertiary facilities is both unstudied and underreported. Therefore, the burden of skin infections among children in Ghana remains indistinct. This hospital-based study sought to evaluate skin infections among children attending the Ho Teaching Hospital (HTH). In this retrospective study, the electronic medical records of children aged 0 to 14 years (12, 170) who attended the HTH’s pediatric unit outpatient clinic between January 1, 2015 and December 31, 2016 were reviewed. All (1, 877) identified dermatological case records from the database were retrieved. They were then double-checked to further affirm demographic information (age and sex) and diagnosis of skin infection with the medical folders to clarify unclear observations. Pearson chi square was used to evaluate the association between the different age group of the children and the types of skin infection as well as comorbidities. Only 1, 887 (15.5%) of all case records reported with a presenting dermatological complaint. Sixty-five percent (65%) of these (1226 of 1887) were diagnosed with a form of skin infection. Sixty-nine percent (69%) of children with skin infection were admitted into the ward for further management. Majority (441, 35.97%) of skin infected children were between 1 - 4 yrs. Impetigo (393, 46.6%) and furunculosis (410, 48.6%) were the most prevalent skin infections compared to herpes (3, 6.5%) and warts (4, 8.7%). The parasitic skin infection recorded in this study was scabies (23, 100%). Gender disparity existed, with female children aged 10 - 14 years significantly having more skin infection than males (

Cutaneous sporotrichosis with dermoscopic features: A case report

Objective: Sporotrichosis is a fungal skin infection caused by Sporothrix schenckii. We report a 70- year-old female presenting with an erythematous nodule on her right forefinger after a rose thorn prick. Material and Methods: The nodule was histopathologically diagnosed as sporotrichosis. Dermoscopy of the nodule revealed structureless white areas with a lobular arrangement, prominent scaling, blood spots, and polymorphous vessels including coiled, punctate and looped vessels. Dermoscopy has opened a new horizon in the diagnosis of skin infections in recent years. Conclusion: The dermoscopic features of sporotrichosis have not yet been reported as far as we are aware. We believe that coexistence of the above features, which could be thought to be nonspecific when seen separately, may be of diagnostic significance and a helpful tool in the diagnosis of cutaneous sporotrichosis.

1928. Comparisons of 30-Day Admission and 30-Day Total Healthcare Costs Between Patients Who Were Treated With Oritavancin (ORI) or Vancomycin (VAN) for a Skin Infection in the Outpatient Setting

BackgroundHospital admission is a key cost driver in ABSSSI patients. Data suggest many ABSSSI patients are unnecessarily hospitalized and can be effectively and safely managed as outpatient (OP) at substantially lower cost. ORI a single-dose treatment has the potential to shift care from the inpatient (IP) to the OP setting in selected patients. In phase III trials, a single dose of ORI had comparable efficacy and safety to twice daily VAN for 7–10 days in ABSSSI patients who were treated in OP. Real-world comparative data on outcomes in ABSSSI patients using ORI in OP are limited. This study sought to compare the 30 day hospital admission rates and mean (standard deviation (SD)) healthcare costs among ABSSSI patients who received ORI or VAN as an OP.MethodsRetrospective cohort analysis of ORI and VAN patients in the Truven Health MarketScan® Databases in 2016. Inclusion criteria: age ≥18 years; OP claim for ORI or VAN (index day (d)); a diagnosis of skin infection ≤7 d prior and 3 d after the index day; no IP discharge in 3 d prior to index day; ≥180 d of continuous enrollment prior to index day; ≥60 d of continuous enrollment post index day. Outcomes: 30 d hospital admissions and 30 d total healthcare costs.ResultsIn 2016, 120 and 6,695 patients who received ORI and VAN, respectively, met inclusion criteria. Groups were well balanced at baseline (table). ORI patients had a significantly lower 30 d admission rate vs. VAN patients (5.8% vs. 16.2%, respectively, P = 0.002). Mean (SD) cost 30 d post index were comparable between ORI and VAN patients ($10,096 (8,865) vs. 12,779 (28,773), respectively, P = 0.3).ConclusionResults suggest ORI provides a single-dose alternative to multi-dose VAN for treatment of ABSSSI in OP and may result in lower 30 d hospital admission rates.ORIVANBaseline characteristicsMean (SD) age, years54.9 (16.8)52.8 (16.5)Mean (SD) Deyo Charlson comorbidity index1.3 (1.8)1.5 (2.2)Skin infection Cellulitis/abscess90.0%86.6% Wound infection10.0%14.4% Other skin infections17.5%14.0%Life-threatening condition13.3%12.%Non-life-threatening systemic symptoms14.2%19.1%Hospitalization during baseline43.3%36.1%Prior mean (SD) total healthcare costs$47,354 ($33,567)$35,183 ($74,109)Disclosures T. Lodise, Melinta Therapeutics, Inc.: Consultant, Consulting fee. E. Packnett, Melinta Therapeutics, Inc.: Research Contractor, Research grant. S. Armstrong, The Medicine’s Company: Employee, Salary. M. Redell, Melinta Therapeutics, Inc.: Employee and Shareholder, Salary.

Ex vivo confocal microscopy: an emerging technique in dermatology

This review aims to give an overview of the current available applications of ex vivo confocal microscopy (EVCM) in dermatology. EVCM is a relatively new imaging technique that allows microscopic examination of freshly excised unfixed tissue. It enables a rapid examination of the skin sample directly in the surgery room and thus represents an alternative to the intraoperative micrographic control of the surgical margins of cutaneous tumors by standard microscopic examination on cryopreserved sections during Mohs surgery. Although this technique has mainly been developed for the margin’s control of basal cell carcinoma, many other skin tumors have been studied, including melanoma. Use of EVCM is continuing to evolve, and many possible applications are under investigation, such as the study of nails and hair diseases and the diagnosis of skin infections.

Dermatophyte and non dermatophyte fungi in Riyadh City, Saudi Arabia

BackgroundDermatophytes are a scientific label for a group of three genera (Microsporum, Epidermophyton and Trichophyton) of fungus that causes skin disease in animals and humans. Conventional methods for identification of these fungi are rapid and simple but are not accurate comparing to molecular methods. ObjectiveThis study aimed to isolate human pathogenic dermatophytes which cause dermatophytosis in Riyadh City, Saudi Arabia and to identify these fungi by using conventional and molecular methods. MethodsThe study was conducted in Medical Complex, Riyadh and King Saud University. Samples of infected skin, hairs and nails were collected from 112 patients. Diagnosis of skin infections, direct microscopic test, isolation and identification of dermatophytes by conventional and molecular methods were carried out. ResultsThe results indicated that the tinea capitis infection had the highest prevalence among the patients (22.3%) while Tinea barbae had the lowest. In this study the identified dermatophyte isolates belong to nine species as Trichophyton violaceum, Trichophyton verrucosum, Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton schoenleinii, Trichophyton concentricum, Microsporum canis, Microsporum audouinii and Epidermophyton floccosum which cause skin infections were isolated during this study. Non dermatophyte isolates included 5 isolates from Aspergillus spp. 4 isolates from Acremonium potronii and 15 isolates from Candida spp. M. canis were the most common species (25% of isolated dermatophytes). Out of the 52 dermatophyte isolates identified by conventional methods, there were 45 isolates identified by the molecular method. ConclusionsThe results concluded that approximately M. canis caused a quarter of dermatophyte cases, tinea capitis infection was prevalent and the molecular method was more accurate than conventional methods.

The Comparison of Skin Infectious Diseases Pattern in 1998 With 2011

Background: Skin infectious diseases are common worldwide. Epidemiologic studies lead to better understanding of disease profiles and health service organization. Objectives: This study aimed at comparing skin infections status in 1998 and 2011. Materials and Methods: Data on all otherwise healthy outpatients with diagnosis of skin infections in 1998 and 2011 were reviewed. Data on demographic characteristics and clinical diagnosis were recorded. According to the microbial origin, all infected dermatoses were classified into four groups: bacterial, fungal, viral and parasitic. At the end of the study, data were analyzed by the SPSS software. Results: Mean age of patients in 1998 and 2011 were 24.52 and 25.75, respectively. Fungal infections comprised 4.4% of total diagnosed skin disorders in 1998 and 3.1% in 2011, viral infections were 3.1% in 1998 and 3.2% in 2011, bacterial infections were 1.2% in 1998 and 1.1% in 2011 and parasitic infections were 3% in 1998 and 0.64 in 2011. Totally cutaneous infectious diseases comprised 11.7% in 1998 and 8.04% in 2011of all skin diseases in two comparative years. The most common infections were fungal followed by viral infections during both years. Conclusions: In our study fungal and viral infections were the most common infectious diseases. We think epidemiological studies to determine the burden of skin infections are useful for proper health care planning.

Community‐acquired skin infections caused by Staphylococcus aureus: What is the role of the Panton‐Valentine leukocidin toxin?

The data concerning frequency and relevance of the toxin Panton-Valentine leukocidin (PVL) in skin infections caused by Staphylococcus aureus is controversial. The objective of the study was the identification of the role of the toxin in community-acquired skin infections caused by S. aureus. We performed a retrospective analysis of 112 patients with the diagnosis of skin infections caused by S. aureus. Frequency of PVL was investigated by PCR for the lukSF gene. Risk factors and severity of the disease were analyzed. Furthermore, spa typing was done in 55 of the isolated S. aureus. PVL occurred in 45 % of patients with skin infections caused by methicillin-susceptible S. aureus; methicillin-resistant strains were positive in 63 %. Mean age was 30.9 years in PVL-positive infections and thus statistically highly significantly lower than in PVL-negative infections. There was no correlation between presence of PVL and severity and course of skin infections or presence of special risk factors. The spa types showed a high variability in PVL-positive as well as in PVL-negative strains. In our study the PVL status of S. aureus isolated from skin infections was neither correlated with methicillin-resistance nor with the severity of disease. Remarkably, PVL-positive S. aureus strains appeared to be more frequent in younger than in older patients. Our results demonstrate that routine determination of PVL status is not required since the outcome has no diagnostic or therapeutic consequences in daily dermatological practice.

Identifying patients with cellulitis who are likely to require inpatient admission after a stay in an ED observation unit

BackgroundEmergency department observation units (EDOU) are often used for patients with cellulitis to provide intravenous antibiotics followed by a transition to an oral regimen for discharge. Because institutional regulations typically limit EDOU stays to 24 hours, patients lacking a clinical response within this period will often be subsequently admitted to the hospital for further treatment. ObjectiveThe aim of this study was to determine the rate of hospital admission and characteristics predictive of admission in patients with cellulitis who are initially placed in an ED observation unit. MethodsA retrospective cohort study of patients placed into EDOU with a diagnosis of skin infection was conducted. Age, sex, history of diabetes mellitus, immunosuppression, intravenous drug use, location of cellulitis, presence of abscess, laboratory infectious markers, vital signs, and outpatient antibiotic treatment were recorded. The primary outcome was a hospital admission due to failure to respond to treatment within the 24-hour observation time window. Significant variables on univariate analysis were used to create a multivariate analysis, which identified predictive characteristics. ResultsFour hundred six patient charts were reviewed, with 377 meeting inclusion criteria; the inpatient admission rate from EDOU was 29.2%. Using logistic regression techniques, we created a model of independent predictors for need of admission after 24 hours: cellulitis of the hand (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.8-4.9), measured temperature higher than 100.4°F (OR, 2.5; 95% CI, 1.1-5.5), and lactate greater than 2 (OR, 3.1; 95% CI, 1.3-7.3) were predictive of failure of ED observation. ConclusionsPatients with cellulitis placed into ED observation status were more likely to fail an observation trial if they had an objective fever in the ED, an elevated lactate, or a cellulitis that involved the hand.

Nokardioseinfektion einer Gefäßendoprothese

A 61-year-old woman presented with purple-red subcutaneous nodules on her right leg. She had experienced fever up to 40 degrees C for the past 10 days and felt generally weak over the last two months. Four months earlier, a vascular graft had been implanted in her right femoral artery. Based on the diagnosis of skin infection due to implantation of an infected prosthesis, she was hospitalized and treated with an antibiotic regime. During the initial antibiotic treatment, the symptoms deteriorated, and she developed joint, hepatic and CNS abscesses. Finally, a microbiologic culture with an extended incubation time revealed the diagnosis of an infection with the slowly growing bacterium Nocardia ssp. Hereupon the patient was treated purposefully with Meropenem over six months. This treatment resulted in complete recovery.