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barberry bush thorn infection

The tests for sporotrichosis usually involve a biopsy of one of the nodules, followed by an exam of the biopsy sample under a microscope to identify the mold. Jim was industriously off at the store purchasing cement blocks, and I was in While plant thorn arthritis is technically noninfectious, these two forms of infectious arthritis can occur from plant thorn puncture of a joint, with or without true plant thorn arthritis. Ulcers should be kept clean and covered until they are healed. “Imaging of Plant-Thorn Synovitis.”. A fungal disease that occasionally infects this shrub is Septoria berberidis. Most people who have sporotrichosis only in their skin or lymph nodes make a full recovery. The area may pain badly for some time. In about 60% of cases, the mold spreads along the lymph nodes. Terms of Use. Over time, the nodule may develop an open sore (ulcer) that may drain clear fluid. Blackberry branches have thorns that can cause puncture wounds for gardeners. Is it possible to prevent plant thorn arthritis? From: £3.99. Once a synovectomy for plant thorn arthritis has been performed, the joint tends to heal well without residual problems. son-in-law, Jim, as well as enjoy their company during a concentrated effort, I In case of a thorn injury, you should try the following steps to make a fast recovery from the condition. Powdery mildew looks just as it sounds — like a white powder covering the plant. If you still notice any broken thorn part of any other foreign body inside, wash the affected area under cool water. It occurs when the fungus gets into the skin via a small cut, scrape, or puncture, such as from a rose thorn. This is hardly a reason to worry about Barberry thorn poisoning as there is rarely any complication. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout. The sooner the synovectomy is performed, the better the outcome as chronic joint inflammation can risk damage to cartilage of the joint. This may wash it away. A ‘Stunning’ Alternative Rx for Arthritic Joints? Barberry can be of great medicinal use. The plant thorn fragments cause a localized inflammation reaction in the joint lining tissue that leads to swelling, stiffness, loss of range of motion, and pain. Ultimately, the diagnosis of plant thorn arthritis requires either detection of a piece of thorn within the joint by radiology testing or surgical removal of the thorn fragments and identification of the fragments microscopically in the laboratory. Barberry, if taken to excess may cause nose bleeds, lethargy, kidney irritation, skin and eye inflammation, in addition to headaches and low blood sugar. A branch of thorn stuck with her saree in between legs near ankle level and a thorn … Kindly provided by Xiaohui (Sheila) Zhao, MD, PhD, of the Department of Pathology and Laboratory Medicine, University of California, Irvine Medical Center. In the fa What is the prognosis of plant thorn arthritis? Sign Up to Receive Our Free Coroanvirus Newsletter, When to Seek Medical Care for Sporotrichosis, Staph Infections: Symptoms, Stages, Causes, Treatment, Contagiousness, Staph Infections and MRSA in Children: Prevention, Symptoms, and Treatment. If yo… Ultrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as: Facts you should know about plant thorn arthritis. Doctors who perform operative treatments include orthopedic surgeons and plastic surgeons. The most important step in preventing sporotrichosis is preventing mold spores from entering the skin. Plant thorn arthritis causes the involved joint to be swollen, slightly reddish, stiff, and painful. Sporotrichosis in the skin or lymph nodes should not be dangerous or life threatening. Treatment involves antibiotics and the drainage of the infected joint. If you are already being treated for sporotrichosis, contact a doctor if new sores develop or if the old ones appear to be growing. The most common joints affected by plant thorn arthritis are those that can be exposed to being stabbed by falling into or brushing up against plants with thorns. Punctures often don’t bleed much and may close up quickly, which is one reason they can be dangerous. I was wearing gloves that had extra padding over Several characteristics of Japanese barberry, including early leaf-out, dense thorns and an a wealth of fruit, all combine to create an ideal habitat for mice that is free from predators and has abundant food. Synovectomy is the surgical procedure that is used to cure plant thorn arthritis. It can help to wear protective clothing, gloves, etc., as well as being cautious when near or working with thorny plants. Examples include plants in the Boraginaceae family, including the borage plant, which is often used as an herb in cooking. And those wounds can allow infections from pathogens in the soil. Barberry is loaded with sharp thorns, so deer don’t touch it. For several years a bacterial leaf spot of Barberry, of Japanese, green and purple-leafed Barberry, has been noted at various places in the State. Pathology photo showing multinucleated giant cell granulomatous reaction (triangle point), synovial hyperplasia, fibrosis, and adjacent foreign vegetable matter (arrow with thorn fragments) with hematoxylin and eosin stain (H&E stain). With permission, these are intraoperative photos of the author’s right third metacarpophalangeal joint exposing inflamed joint lining tissue (synovium) from which a 1 mm thorn tip from the common palm tree, With permission, photos of joint lining tissue (yellowish synovium) resected from author’s right third metacarpophalangeal joint after thorn puncture with 1 mm thorn tip (dark dot on thorn covered with joint lining tissue) from the common palm tree. a hurry to get the pruning completed so as not slow the construction of a block Infections involving the brain, lungs, joints, or other areas of the body are much more difficult to treat. Stevens, K.J., et al. Many plants bear trichomes on their stems or leaves. The nodule is usually painless or only mildly tender. Sometimes tiny pieces of thorns can be visualized using magnetic resonance imaging (MRI scanning), high-resolution computerized tomography (HR-CAT scanning), or ultrasound imaging. Want More News? Physical therapy rehabilitation exercises can be helpful to restore normal joint function. From: £5.49. diseases of the male reproductive organs. Its leaves are purple during spring and summer, then turn orange, red and yellow in autumn. retaining wall upon his return. Genus Berberis can be deciduous or evergreen shrubs with spiny shoots bearing simple, often spine-toothed leaves, and small yellow or orange flowers in axillary clusters or racemes, followed by small berries Details B. thunbergii is a spiny medium-sized deciduous shrub of compact habit. And, any break in the skin can lead to infection. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet. The mold is found on rose thorns, hay, sphagnum moss, twigs, and soil. During a synovectomy, the surgeon will remove the affected and surrounding joint lining tissue (synovium) to be certain that microscopic joint fragments within the joint and its lining are eliminated from the body. As its popularity as a spice led to wider cultivation, its subsequent association with the spread of disease in wheat made it extremely unpopular with farmers. Stretch the affected skin area gently and apply an adhesive tape or a simple cello tape over it . If a thorn happens to inject Sporothrix into the knuckle of your finger or your elbow, it can cause an arthritic infection that is very painful. Plant thorn arthritis is suspected in a patient who presents with a single joint that is inflamed after it has been punctured by a plant thorn. These can also last for years. Sporotrichosis is an infection of the skin caused by a fungus, Sporothrix schenckii. The fungus is found on rose thorns, hay, sphagnum moss, twigs, and soil. Waste Exposure Linked to Anti-CCP Antibodies in RA, Knee or Hip Replacements Cut Risk for Falls. More rarely, cats or armadillos can transmit the disease. the knuckles… Risk factors for plant thorn arthritis include gardening, especially without gloves, and exposure to thorn-bearing plants, including palm trees, roses, black-thorn shrubs, cacti, bougainvillea, yucca, pyracantha, plum trees, and mesquite trees. It can be difficult to treat and may be life threatening. Plant thorn arthritis requires operative intervention. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. Berberry contains the plant alkaloid berberine, a compound that appears to have some anti-inflammatory and antimicrobial activity. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn’t Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts. If you think you might have sporotrichosis, see a doctor about diagnosis and treatment. It is not uncommon for the person affected by plant thorn arthritis to remove the thorn immediately after the puncture and then develop the arthritis many days or weeks later and not even recall that the joint had been punctured previously! Septic arthritis, or infectious arthritis, is infection of one or more joints by bacteria, viruses, or fungi. If you see some black soot, don’t bother wiping it off. For plant thorn arthritis, anti-inflammatory medications may quiet some of the inflammation. These forms of arthritis require urgent antibiotic treatment. The affected joint lining tissue (synovium) is examined in the pathology department using microscopes. Sporotrichosis is a cutaneous (skin) infection caused by a fungus, Sporothrix schenckii. View Product. These plants include palm trees, roses, black-thorn shrubs, cacti, bougainvillea, yucca, pyracantha, plum trees, and mesquite trees. What causes them, and what you can do about them. Treatment of sporotrichosis depends on the site infected. It is used to treat skin infections, psoriasis, gastritis, ulcers, diarrhea, gallstones and inflammation of gall bladder, and even malaria. Arthritis is inflammation of one or more joints. What are risk factors for plant thorn arthritis? The microscopic thorn fragments are easily identified using a polarized light microscope as they appear brilliantly shiny (birefringent) to the examining pathologist. Removal of joint fluid (joint aspiration) is performed to rule out bacterial or fungal infection of the joint. Most rarely from rose-thorn pricks, sporotrichosis can become a systemic, or body-wide, infection, including the central nervous system. Berberis thunbergii DC. ) What specialties of doctors treat plant thorn arthritis? Tiny portions of the broken thorn are likely to get stuck to it. ©1996-2020 MedicineNet, Inc. All rights reserved. Pathology photo showing thorn material (blue and yellow birefringent material) visualized under polarized light microscopy. A huge 8 ft Barberry bush. The name holy thorn derives from the Italian’s belief that it was used in the crown of thorns placed on Christ at his crucifixion. Kindly provided by Xiaohui (Sheila) Zhao, MD, PhD, of Department of Pathology and Laboratory Medicine, University of California, Irvine Medical Center. The tissue forms a characteristic reaction, called a granulomatous reaction, within the synovium (granulomatous synovitis). In other cases, histamine is released; the victim has a puncture wound plus local itching. The joint lining tissue is called the synovium. One day my mother went out and it was a dry land with heavy breeze in the fields. © 2005 – 2019 WebMD LLC. It has been grown in Europe since the 19 th century. This is because the original thorn has actually left behind small fragments of thorn vegetable matter that gradually cause the inflammation of plant thorn arthritis. Over time, new nodules and ulcers spread in a line up the infected arm or leg. will have thorns . Wintergreen Barberry shrub. It has spiny leaves, and bright yellow flowers from April through June. In early April to May, tiny pale yellow flowers hang in clusters along the length of the stem. Answered by Dr. Andrew Germanovich: This could be: Sporotrichosis, a fungal infection of skin. Sterilize a tweezer with rubbing alcohol and leave it … Barberry can be an effective treatment for bladder, urinary, yeast and gastrointestinal infections. Arthritis: 16 Bad Habits That Cause Joint Pain, Plant Thorn Arthritis (Plant Thorn Synovitis or Thorn Arthritis) Center, Patient Comments: Plant Thorn Synovitis – Symptoms & Signs, Patient Comments: Plant Thorn Synovitis – Treatments, Patient Comments: Plant Thorn Arthritis – Types of Plants, Read about Dr. Shiel’s diagnosis and treatment of plant thorn arthritis, Arthritis Drug Combo for COVID-19 Authorized. The following website gives specific things to look for. Deep thorn wounds in the foot, or even hands if there is contact with soil, greatly increase the risk of tetanus. (Ariel Dowski ’14 (CLAS)/UConn Photo) Worthley explains that the Japanese Barberry was brought to this country because it is an attractive, hardy plant that requires little maintenance. It can also infect the eye and surrounding delicate tissues. MedicineNet does not provide medical advice, diagnosis or treatment. Pictures and symptoms of the red, scaly rash. Known scientifically as Berberis Vulgaris, barberry is also called Chinese Goldthread, European barberry, holy thorn, and pepperidge bush. Barberry The barberry is a shrub that can grow up to nine feet tall. What joints are typically involved in plant thorn arthritis? Barberry is a dense, round, thorny shrub that grows 2 to 6 ft. high. This fungal infection causes white, powdery patches to appear on diseased foliage. See additional information. The suddenness of the wilting suggests verticillium wilt. A Barberry thorn prick can make a skin region red and swollen. If this is the disease, it is in the soil and will continue to infect the bush. • Mature Japanese barberry is the perfect height for questing adult ticks to attach themselves to deer as they pass by. Author: Kevin T Merrell, MD, PhD, Staff Physician, Department of Emergency Medicine, Denver Health Medical Center, University of Colorado. Once the mold spores move into the skin, the disease takes days or even months to develop. Plant thorn arthritis typically affects only a single joint — the joint that was pierced by the plant thorn. Barberry here in Wisconsin is a low thorny bush found in open woodlands. In very rare cases, the infection can spread to other parts of the body, such as the bones, joints, lungs, and brain. The first symptom of sporotrichosis is a firm bump (nodule) on the skin that can range in color from pink to nearly purple. The diagnosis of plant thorn arthritis requires either detection of a piece of thorn within the joint by radiology testing or surgical removal of the thorn fragments and identification of the fragments microscopically in the laboratory. Learn more about Berberis thunbergii Berberis thunbergii, native to Japan, is considered a thorn bush, but they are much less prominent than other species in the same family, since its thorns aren’t as sharp. Once the disease goes away, further follow-up care is generally not needed. Tom Worthley reaches for a berry on a Japanese Barberry bush in the UConn Forest near Horsebarn Hill. [9] Other irritant members of the borage family with similar trichomes include the herb comfrey (Symphytum spp) and the flowering plan… There is no specific medication or home remedy for plant thorn arthritis. Untreated, the nodule and the ulcer become chronic and may remain unchanged for years. Joints that are commonly affected by plant thorn synovitis include the small joints of the hands (metacarpophalangeal joints, proximal interphalangeal joints), feet, elbows, knees, and ankles. This may help determine the causes of joint swelling or arthritis. Barberry is a perennial shrub that grows in sandy soil up to a height of ten feet 2. The roots of barberry are bright yellow because of the medicinal berberine it contains. It can also be used to treat a sore throat, sinusitis, bronchitis, nasal congestion and respiratory inflammation. It is important to recognize that puncturing a joint with a foreign material, such as a plant thorn, can lead to bacterial infection (septic arthritis) or fungal infection (fungal arthritis) of the joint. In rare cases, the fungus can be inhaled or ingested, causing infection in parts of the body other than the skin. … Monitor the area for signs of infection. Plant thorn arthritis can be prevented by avoiding exposure to the thorns of plants. Other infections can mimic sporotrichosis, so a doctor performs tests to confirm the diagnosis. MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. This is true even if the patient recalls removing the thorn, as described above, because the thorn can leave behind tiny fragments of thorn matter that leads to the chronic inflammation of plant thorn arthritis. The risk of infection is high. The surgical operation that can cure plant thorn arthritis is called a synovectomy with joint lavage (joint washout cleaning). Multiple follow-up visits may be needed with a doctor to make sure sporotrichosis is disappearing. Inflammation of this tissue is medically referred to as synovitis. The borage plant contains many coarse stiff trichomes that can elicit an MICD when the plant is handled. However, chronic arthritis eventually develops even long after the plant thorn injury because of the thorn fragments remaining in the joint. This arthritis persists until the fragments are removed with a surgical operation. Exposure to these plants is the greatest risk factor for plant thorn arthritis. Unfortunately for the barberry shrub, it is host to a strain of rust which affects wheat. People who work with roses, hay, or sphagnum moss should cover any scratches or breaks in their skin. Many people have been seduced by its autumn shades of red, orange and purple, and its bright red winter berries. Sign Up for MedicineNet Newsletters! Normal Blood Sugar Levels (Ranges) In Adults with Diabetes. The symptoms of plant thorn arthritis may occur long after the thorn is removed from the affected joint. Thorns on plants or thorn-like seeds can cause nasty puncture wounds for gardeners. The joint lining tissue is called the synovium. Editors: Mitchell J Goldman, DO, FAAP, FAAEM, Director of Pediatric Emergency Medicine, Emergency Medicine, St Vincent Emergency Physicians, Inc; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Thomas Rebbecchi, MD, FAAEM, Program Director, Assistant Professor, Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey. This form of single joint arthritis (monoarthritis) then becomes chronic until appropriately treated. Sporotrichosis is an infection of the skin caused by a fungus, Sporothrix schenckii. Photomicrograph of Sporothrix schenckii. Without surgical resection of the plant fragments, joint inflammation persists and permanent joint destruction can occur. The plants that commonly cause plant thorn arthritis are those that produce thorns. Anthracnose and powdery mildew are the two most common types of fungal infections on barberry plants. Classic beauties such as rose bushes and bougainvillea – just two examples of thorny shrubs — are notoriously prickly. Preventive measures such as selecting disease-resistant plants and regular pruning go a long way toward assuring that all your shrubs, whether single specimens or as part of a hedge, remain vibrant and problem-free for years. Body-Wide, infection, including the borage plant contains many coarse stiff trichomes that can elicit an MICD the. Septic arthritis, or fungi winter berries many plants bear trichomes on their stems leaves! 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Sporotrichosis | DermNet NZ

Author: Vanessa Ngan, Staff Writer, 2005.


What is sporotrichosis?

Sporotrichosis is a fungal infection of the skin caused by the fungus Sporothrix schenckii, which is found on decaying vegetation, rosebushes, twigs, hay, sphagnum moss and mulch-rich soil. Because of its tendency to present after a thorn injury, it is also called rose gardener disease.

How does sporotrichosis arise?

The most common route of infection with S schenckii is via the skin through small cuts, scratches or punctures from thorns, barbs, pine needles or wires. Sporotrichosis does not appear to be transmitted from person to person but there are reported cases of transmission from infected cats to humans. In very rare cases, spore-laden dust can be inhaled or ingested and in people with a weakened immune system cause disseminated (widespread) sporotrichosis.

People at risk of contracting sporotrichosis include farmers, nursery workers, landscapers and gardeners. Adult males are, by their occupation, most exposed to the risk of infection.

What are the clinical features of sporotrichosis?

Depending on the severity of infection and the overall well-being of the individual, sporotrichosis can present in several ways. Skin disease is the most common.

Presentation Features
Skin disease
  • Patients are typically well without fever
  • Lesion develops at the site of a scratch
  • Nodules appear under the skin along the lymphatic channels
Lung disease
  • Patients usually have severe underlying chronic lung disease and present with pneumonia
  • They may or may not have skin lesions
Bones and joint disease
  • Patients typically present with a subacute or chronic inflammatory arthritis involving one or more joints
  • They may or may not have skin lesions
Disseminated disease
  • Patients present with skin lesions but may have other organ involvement including the eye, prostate, oral mucosa, larynx and brain
  • Spreading usually occurs only in people with a weakened immune system, e.g. HIV or AIDS patient

Cutaneous and lymphocutaneous sporotrichosis

The lymphocutaneous route is the most common presentation of sporotrichosis and is sometimes described as sporotrichoid spread. It occurs following the implantation of spores in a wound. Lesions usually appear on exposed skin and often the hand or forearm is affected, as these areas are a common site of injury. Features of cutaneous sporotrichosis include:

  • The first lesion can take up to 20-90 days to appear after initial cutaneous inoculation. Usually the first visible nodule occurs within 20 days.
  • The first sign is a firm bump (nodule) on the skin that can range in colour from pink to nearly purple. It is usually painless or only mildly tender.
  • The nodule gradually grows bigger, reddens, becomes pustular, and ulcerates. The open sore (ulcer) may drain clear fluid.
  • If left untreated, the nodule and the ulcer become chronic and remain unchanged for years.
  • In about 60% of cases, the infection spreads along the lymph nodes and a chain of lymphatic nodules develop in a line up the infected arm (or leg) leading away from the initial ulcer. These also develop into ulcers and can last for years if left untreated.

How is sporotrichosis diagnosed?

Other lymphocutaneous infections can mimic the lesions of sporotrichosis so it is important to perform tests to confirm diagnosis. Microscopy and culture of infected tissue is performed to identify the presence of Sporothrix schencki

Skin biopsy can be helpful. Histopathology reveals a granulomatous infection with abscess formation. The organisms may be identified using special stains.

What is the treatment of sporotrichosis?

Treatment of sporotrichosis depends on the site infected.

Site of infection Treatment
Skin
Bones and joints
  • Difficult to treat and rarely respond to potassium iodide.
  • Itraconazole orally for months or even up to a year.
  • Amphotericin IV if oral therapy ineffective.
  • Surgery to remove infected bone.
Lungs
  • Potassium iodide, itraconazole and amphotericin used with varying degrees of success.
  • Infected areas of lung may need to be surgically removed.
Disseminated (e.g. brain infection)
  • Itraconazole may be tried
  • Amphotericin plus 5-fluorocytosine is generally recommended.
Treatment of sporotrichosis

Treatment of sporotrichosis can be prolonged but should continue until all lesions have resolved. This may take months or years, and scars may remain at the original site of infection. However, most people can expect a full recovery. Systemic or disseminated sporotrichosis is usually more difficult to treat and in some cases life-threatening for people with weakened immune systems.

Patients should be advised of measures to take to prevent sporotrichosis. These include wearing gloves, boots and clothing that covers the arms and legs when handling rose bushes, hay bales, pine seedlings or other materials that may scratch or break the skin surface. It is also advisable to avoid skin contact with sphagnum moss.

 

References

  • Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.

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Fungal Disease (Sporotrichosis) of the Skin in Dogs

Sporotrichosis in Dogs

Sporotrichosis is a fungal disease that affects the skin, respiratory system, bones and sometimes the brain. Infection is caused by the virtually ubiquitous dimorphic (mold and yeast) fungus, Sporothrix schenckii, which typically infects via direct inoculation – that is, through abrasions of the skin or by inhalation. The origin of the fungus is environmental; it is naturally found in soil, plants and sphagnum moss, but it can be communicated zoonotically between different animal species, and between animals and humans.

In dogs, the disease occurs more commonly in hunting dogs because of the increased likelihood of puncture wounds associated with thorns or splinters.

Symptoms and Types

Cutaneous sporotrichosis

  • Bumps, or lesions on the skin surface, swollen lymph glands
  • Numerous nodules that may drain or crust, typically affecting the head or trunk
  • Previous trauma or puncture wound in the affected area is a variable finding
  • Poor response to previous antibacterial therapy
  • Combination of cutaneous and lymph form—usually an extension of the cutaneous form, which spreads via the lymphs, resulting in the formation of new nodules and draining tracts or crusts.
  • Lymphadenopathy (disease of the lymphs) is common

Disseminated sporotrichosis

  • Rare, occurs when the initial infection spreads into the body to a secondary location
  • Systemic signs of malaise and fever
  • Osteoarticular sporotrichosis occurs when the infection spreads into the bones and joints
  • Sporotrichosis meningitis occurs when the infection spreads into the nervous system and brain
  • Symptoms include loss of appetite (anorexia), and weight loss (cachexia)

Pulmonary sporotrichosis

  • Occurs as a result of inhalation of  Sporothrix schenckii spores
  • Infected animal is more at risk of developing pneumonia

Causes

  • Animals exposed to soil rich in decaying organic debris appear to be predisposed
  • In dogs, puncture wounds associated with foreign bodies provide an increased opportunity for infection. Cat scratches provide a similar opportunity
  • Exposure to other infected animals increases the risk factor
  • Immunosuppressive disease should be considered a risk factor

Diagnosis

Your veterinarian will perform a thorough physical exam on your dog, taking into account the background history of symptoms and possible incidents that might have led to this condition. A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, and a urinalysis.

It is important to note that this is a zoonotic disease, meaning that it is communicable to humans and other animals, and proper precautions will need to be taken to prevent the spread of infection. Even if you do not have a break in your skin, you are not protected against acquiring the disease.

An examination of the fluid from the lesions is often necessary to confirm an infection. In dogs, special fungal stains may aid in the diagnosis, but a negative finding does not rule out the disease. Laboratory cultures of the deeply affected tissue often require surgery to obtain an adequate sample. These samples will be sent for analysis, along with a special note to the laboratory listing sporotrichosis as a differential diagnosis. Secondary bacterial infections are common.

Treatment

Because of its potential for infection in humans, your dog may be hospitalized for the initial treatment. In many situations, outpatient therapy may be a consideration. Several antifungal drugs are available for treatment of this infection. Your veterinarian will choose the type that is best suited to your dog. The treatment generally takes some time; at least several weeks after the initial treatment before the patient is considered recovered.

Prevention

Although difficult to prevent because of its prevalence in the environment, it is helpful to determine the source of the Sporothrix schenckii, so that you can take steps to prevent repeat infections.

Living and Management

Your veterinarian will set up a schedule of follow-up appointments at around every 2–4 weeks in order to re-evaluate your dog. Clinical signs will be monitored and liver enzymes will be assessed. Side effects associated with treatment will be evaluated, and treatment will be adapted according to your dog’s reactions. If your dog does not respond to therapy, your veterinarian will make changes in the medication.

the diagnosis and treatment of acacia thorn injuries

100 Injury: the British Journal of Accident Surgery (1990) Vol. 21/No. 2

the complete thorn; the tip or fragments of the tip remain in

sifu (Kelly, 1966). I am also grateful to Mr D. C. Jaffray for his help in

preparing the manuscript.

Nearly all the patients will give the diagnosis if a history

is taken. This is all that the clinician needs (Surgam et al.,

1977). Examination does not add to but merely confirms the

diagnosis. Blood tests are superfluous. The diagnosis should

be made before radiographs are taken because the appear-

ances of the radiographs can alarm the unwary clinician. The

radiographs can reveal a picture that can be confused with

other infections such as tuberculosis. There may be a real

difficulty in excluding a neoplasm (Gerle, 1971).

Treatment must always be surgical if an early resolution is

to be achieved. A wide exposure may be required because

limb movement may have caused migration of the thorn

(Maylahn, 1952). The thorn, together with surrounding

inflamed tissue should be excised. Sometimes a small piece

cannot easily be found at operation. No attempt should be

made to find a needle in a haystack. The wound is left open

to granulate and the limb is splinted. Adjuvant antibiotics

may be given but they must not substitute a proper wound

excision. With established osteomyelitis, however, it may be

necessary to continue with antibiotics for a longer period.

With this programme of treatment the disease process is

halted. We rely on the support of the physiotherapists to

restore as much function as possible. Those cases treated

non-operatively perhaps resolve with time. They face a

prolonged period of disability and more morbidity.

References

Chittenden F. J. (ed.) (1951) Acacia arabica. RoyaZ Horfimlfa4ral

Sociefy: Dicfionay of Gardening. Vol. I. Oxford: Clarendon Press,

10.

Dickson R. D. and Kemp F. H. (1976) Thorn induced granuloma of

bone. Hand. 8,69.

Gerle R. D. (1971) Thorn induced pseudoturnours of bone. Br. J.

RadioI. 44, 642.

Kelly J. J. (1966) Black thorn infJammation. 1. Bone Joint Surg. 43B,

474.

Maylahn D. H. (1952) Thorn induced ‘tumours’ of bone. 1. BOW

Joint Surg. 34A, 486.

Rosenfield R. et al. (1978) Thorn induced periosteitis associated

with Enferobacfer agglomeram infection. Can. Med. Assoc. 1. 119,

925.

Surgam M. et al. (1977) Plant thorn synovitis. Arfhrifis Rkeum. 20,

1125.

Yousefzadeh D. K. and Jackson J. H. (1978) Organic foreign body

reaction. Skeletal Radial. 3, 167.

Acacia thorn injuries provide a useful model for the

clinician dealing with any thorn injury. Diagnosis is easy if a

history is taken but is difficult otherwise. What may appear

to be a minor injury can produce distressing morbidity.

Resolution can be achieved early if adequate early surgery is

performed.

Paper accepted 17 July 1989.

Acknowledgements

My sincere thanks to Professor B. Das and Doctor

V. P. Middha for helping me to conduct this study.

Requests for reprhfs shouti be addressed to: R. Vaishya, c/o Robert

Jones and Agnes Hunt Orthopaedic Hospital, Oswestry,

Shropshire, UK.

How to Remove a Splinter (and When to Call the Doctor) – Cleveland Clinic

It’s a familiar situation for many parents: Your child is playing in the yard barefoot and comes in complaining that they stepped on something.

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You take a look at their foot. Sure enough, you notice a tiny splinter.

Should you grab the tweezers from the medicine cabinet, or take your child to urgent care to have it removed? Or does it even need to be taken out at all?

It is especially important to have organic material – say, a piece of wood or a thorn – removed as soon as possible, as it may become infected more quickly than inorganic material such as metal or glass, says pediatrician Kyle Mudd, DO. It should be removed that day, if possible.

When to leave it to a doctor

Once you’ve determined that a splinter needs to come out, it’s time to decide if you’re the best person for the job. Most often, you’ll be able to save a trip to the doctor by removing it yourself. But Dr. Mudd suggests leaving it to the pros if:

  • The splinter has entered the skin near the eye or under the fingernail.
  • You notice any signs of infection, like red or hardened skin, or discharge that is white or yellow.
  • The splinter has entered the skin vertically. These can be especially difficult to remove at home, but doctors have additional tools that can help.
  • The splinter is deep or has broken during attempts to remove it.
  • You’ve tried unsuccessfully to remove it for more than 10 to 15 minutes.

Tools, tips and tricks

Wash. If you’re going to try to remove the splinter at home, the first step is to wash your hands and the affected area with soap and water.

Soak (optional). Soaking the splintered area in warm water for a few minutes before trying to take it out can make the skin more pliable but isn’t necessarily required, Dr. Mudd says. Younger children already tend to have soft skin, so if you do soak, you should only need to do it for a few minutes.

Sterilize. If the splinter has entered the skin fairly horizontally and part of it is sticking out, a pair of tweezers and a needle wiped down with rubbing alcohol can be helpful in getting it out. In a situation where the entire splinter is underneath the skin, a sterilized needle may be the best tool.

Remove. When you go to remove the splinter, don’t pinch the skin, Dr. Mudd cautions, because that can put pressure on the splinter and cause it to break into fragments.

“I tell people to visualize the splinter and use the needle to feather open the top layer of skin to expose the material you are trying to remove,” he explains. “Once the splinter is exposed, you may attempt to grab it using tweezers and pull it out along the same route that it entered the skin.”

Prevent infection. If you are successful in removing the splinter, wash the affected area with soap, put some antibiotic ointment or Vaseline over it, and cover it with a bandage.

Don’t panic. If you aren’t able to get the splinter out after 10 or 15 minutes of trying, it’s time to seek help from a medical professional. “You don’t want to cause unnecessary anxiety in your child,” Dr. Mudd says. “Head to urgent care or your pediatrician that day, if possible.”

Talk about tetanus

Regardless of how it’s removed, if your child gets a splinter, it’s important to make sure they are up to date on their tetanus vaccine, to prevent a rare but possible serious infection. The CDC recommends that children receive their childhood tetanus series including the DTaP immunizations at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years old, in addition to a Tdap immunization at 11 to 12 years old. A tetanus booster is required every 10 years after this to help boost waning immunity.­­

Sporotrichosis – WikEM

Background

  • Also known as “Rose gardener’s disease”[1]
  • Caused by the fungus Sporothrix schenckii[2] found on rose thorns
  • Usually affects skin, although other rare forms can affect the lungs, joints, bones, and brain
  • Enters skin through small cuts and abrasions, and inhalation for pulmonary disease
  • Can also be acquired from handling cats with the disease

Clinical Features

Fixed cutaneous sporotrichosis. A crusted/verrucous plaque develops at inoculation site, seen here over face of a child.
Lymphocutaneous sporotrichosis.
Lymphocutaneous sporotrichosis. Noduloulcerative lesions appear along the lymphatics proximal to the initial inoculation injury site.

Progresses slowly: first symptoms may appear 1 to 12 weeks (average 3 weeks) after the initial exposure to the fungus

Forms and Symptoms

  • Cutaneous or skin
    • Most common form
    • Symptoms include nodular lesions or bumps in the skin, at the point of entry and also along lymph nodes and vessels
      • Lesion starts off small and painless, and ranges in color from pink to purple
      • Left untreated, lesion becomes larger and looks similar to an abscess. More lesions will appear until a chronic ulcer develops
  • Pulmonary sporotrichosis
  • Disseminated sporotrichosis
    • May affect joints and bones (osteoarticular sporotrichosis) and or CNS (sporotrichosis meningitis)
    • Symptoms include weight loss, anorexia, and appearance of bony lesions

Differential Diagnosis

Skin and Soft Tissue Infection

Look-A-Likes

Hand Infection

Hand and finger infections

Evaluation

  • Fungal culture of skin, sputum, synovial fluid, or CSF

Management

  • Antifungal medication
    • Itraconazole
      • Drug of choice (more effective than fluconazole)
    • Fluconazole
      • Fluconazole (for patients who cannot tolerate itraconazole)
    • Amphotericin B IV
      • For disseminated of severe disease
  • Surgery
  • Standard antibiotics
    • Lesions sometimes become superinfected, consider as necessary

Disposition

  • Normally treated as outpatient

See Also

References

  1. ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
  2. ↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 654–6. ISBN 0-8385-8529-9.

Puncture Wounds – ACFAS

What Is a Puncture Wound?

Puncture wounds are not the same as cuts. A puncture wound has a small entry hole caused by a pointed object, such as a nail that you’ve stepped on. In contrast, a cut is an open wound that produces a long tear in the skin. Puncture wounds require different treatment from cuts because these small holes in the skin can disguise serious injury.

Puncture wounds are common in the foot, especially in warm weather when people go barefoot. But even though they occur frequently, puncture wounds of the foot are often inadequately treated. If not properly treated, infection or other complications can develop.

Proper treatment within the first 24 hours is especially important with puncture wounds because they carry the danger of embedding the piercing object (foreign body) under the skin. Research shows that complications can be prevented if the patient seeks professional treatment right away.

Foreign Bodies in Puncture Wounds
A variety of foreign bodies can become embedded in a puncture wound. Nails, glass, toothpicks, sewing needles, insulin needles, and seashells are some common ones. In addition, pieces of your own skin, sock, and shoe can be forced into the wound during a puncture, along with dirt and debris from the object. All puncture wounds are dirty wounds because they involve penetration of an object that isn’t sterile. Anything that remains in the wound increases your chance of developing other problems, either in the near future or later.

Severity of Wounds
There are different ways of determining the severity of a puncture wound. Depth of the wound is one way to evaluate it. The deeper the puncture, the more likely it is that complications such as infection will develop. Many patients cannot judge how far their puncture extends into the foot. Therefore, if you’ve stepped on something and the skin was penetrated, seek treatment as soon as possible.

The type and the “cleanliness” of the penetrating object also determine the severity of the wound. Larger or longer objects can penetrate deeper into the tissues, possibly causing more damage. The dirtier an object, such as a rusty nail, the more dirt and debris are dragged into the wound, increasing the chance of infection.

Another thing that can determine wound severity is if you were wearing socks and shoes, particles of which can get trapped in the wound.

Treatment
A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications.

Even if you have gone to an emergency room for immediate treatment of your puncture wound, see a foot and ankle surgeon for a thorough cleaning and careful follow-up. The sooner you do this, the better: within 24 hours after injury, if possible.

The surgeon will make sure the wound is properly cleaned and no foreign body remains. He or she may numb the area, thoroughly clean inside and outside the wound, and monitor your progress. In some cases, x-rays may be ordered to determine whether something remains in the wound or if bone damage has occurred. Antibiotics may be prescribed if necessary.

Avoiding Complications
Follow the foot and ankle surgeon’s instructions for care of the wound to prevent complications (see “Puncture Wounds: What You Should Do”).

Infection is a common complication of puncture wounds that can lead to serious consequences. Sometimes a minor skin infection evolves into a bone or joint infection, so you should be aware of signs to look for. A minor skin infection may develop in two to five days after injury. The signs of a minor infection that show up around the wound include soreness, redness, and possibly drainage, swelling, and warmth. You may also develop a fever. If these signs have not improved, or if they reappear in 10 to 14 days, a serious infection in the joint or bone may have developed.

Other complications that may arise from inadequate treatment of puncture wounds include painful scarring in the area of the wound or a hard cyst where the foreign body has remained in the wound.

Although the complications of puncture wounds can be quite serious, early and proper treatment can play a crucial role in preventing them.


Puncture Wounds: What You Should Do

  • Seek treatment right away.
  • Get a tetanus shot if needed (usually every ten years).
  • See a foot and ankle surgeon within 24 hours.
  • Follow your doctor’s instructions:

    • Keep your dressing dry.
    • Keep weight off of the injured foot.
    • Finish all your antibiotics (if prescribed).
    • Take your temperature regularly.
    • Watch for signs of infection (pain, redness, swelling, fever). Call your doctor if these signs appear.

 

 

 

 

 

90,000 Treatment of Elbow bursitis – Orthopedics Ruslan Sergienko

Ulnar bursitis (bursitis of the ulnar bursitis, bursitis of the elbow joint) is an inflammation of the ulnar bursa, which is located between the skin and the olecranon of the ulna.

The bag is located on the back surface in the area of ​​the elbow joint. With inflammation, an inflammatory fluid appears in the bag, and the walls of the bag thicken and become painful. Elbow bursitis can cause a number of problems due to limited elbow function.

Reasons for the development of ulnar bursitis (bursitis of the ulnar bursa, bursitis of the elbow joint)

The causes of inflammation can be different, from a banal trauma to infection. According to the classification, septic (infectious) and aseptic (inflammatory) bursitis are distinguished. Both types of bursitis are characteristic of the ulnar bursa.

In some cases, the elbow bag can be damaged as a result of a direct mechanism of injury, for example, a blow or a fall on the elbow joint area.The injury causes tears of the tissues of the ulnar bursa and hemorrhage into the cavity of the ulnar bursa. In some cases, the blood can completely fill the cavity of the ulnar bursa and the bursa can swell, as a result of which the elbow joint takes on a characteristic shape.

It is believed that the accumulated blood in the cavity of the ulnar bursa triggers an inflammatory reaction. As a result of inflammation, the walls of the ulnar bursa thicken, become less elastic and their sliding properties disappear. As a result, bursitis of the ulnar bursa develops.

Bursitis of the ulnar bursa can occur due to constant pressure on the area of ​​the elbow joint. Some workers perform work in a position with their elbows resting on a hard surface. If the elbow is constantly injured, this leads to the development of inflammation and bursitis of the ulnar bursa develops.

Bursitis of the ulnar bursa can be caused by an infection. A small scratch or injection in the area of ​​the elbow bag can lead to its infection. Or, after an injury, the infection can enter the damaged tissues of the elbow bag with blood flow from the focus of a chronic infection in the body, for example, a carious tooth.

The infection leads to the accumulation of pus in the cavity of the ulnar bursa. The consequences of an infectious ulnar bursitis can be quite serious.

Symptoms of the ulnar bursitis

Bursitis of the ulnar bursa is manifested by pain and swelling in the area of ​​the olecranon. When viewed during palpation (feeling), the elbow bursa is painful. In this condition, it is very painful to put the hand with the elbow on a hard surface.

If the bursitis of the ulnar bursa does not go away for a long time, the inflammation becomes chronic.There may be a feeling that lumps have appeared in the inflammatory fluid in the elbow bursa. This suggests that the elbow bag in response to chronic inflammation has become even thicker, and folds have formed. These folds also feel like lumps.

The elbow bag can be increased in size several times. This is due to the thickening of the walls of the ulnar bursa and the filling of the ulnar bursa with inflammatory fluid. The amount of inflammatory fluid is usually associated with the phase of inflammation.If inflammation is in the active phase, then the amount of inflammatory fluid increases and the bursa increases in size. With large sizes of the elbow bag, the elbow joint, when viewed from the side, takes on a characteristic appearance.

If an ulnar bursa infection occurs, the elbow becomes swollen, very painful and warm to the touch. In this case, in addition to local signs of inflammation (pain, redness, an increase in local temperature, edema), general ones develop – an increase in temperature, chills, changes in the blood test.An urgent surgical intervention is required – opening and draining the elbow bursa.

If you do not go to the doctor and do not open the elbow bag, the abscess can break through on its own, but systemic complications may occur.

Diagnosis of elbow bursitis

Differential diagnosis of bursitis of the ulnar bursa is carried out with diseases such as gout, rheumatoid arthritis, septic arthritis of the elbow joint.

The diagnosis of bursitis of the ulnar bursa becomes apparent after examination of the patient.The diagnosis is so obvious that no special examination methods are required, with the exception of a lateral X-ray (picture) of the elbow joint.

An X-ray is not required to establish a diagnosis, but to assess the condition of the olecranon of the ulna. Sometimes, as a result of injury or chronic inflammation, an osteophyte (bone spike) forms on the olecranon.

Osteophyte often additionally injures the elbow bursa, maintaining inflammation.The X-ray helps to decide the choice of the method of treatment for bursitis of the ulnar bursa. If the osteophyte on the olecranon is large enough, then it is advisable to perform surgical treatment of bursitis with osteophyte resection.

If it is not clear to the doctor whether the bursitis is inflammatory or infectious, a puncture of the ulnar bursa is performed and the resulting fluid sample is sent to the laboratory for examination. Sowing of liquid is carried out to identify microflora and determine its sensitivity to antibacterial drugs.

Thus, the doctor receives an answer to two questions: is the bursitis infectious or inflammatory and, if the bursitis is infectious, what antibiotic should it be treated with?

treatment of ulnar bursitis

Conservative treatment.
Traumatic bursitis of the ulnar bursa can be treated conservatively. If a significant amount of blood has accumulated as a result of an injury, then a puncture with a thick needle is performed or a small incision is made to remove all the accumulated blood from the cavity of the ulnar bursa.

The question of the appropriateness of the puncture is decided by the doctor. There is a small risk of infection of the elbow bag during these manipulations, therefore, the puncture is performed in the dressing room in compliance with all the rules of asepsis and antiseptics. After the puncture is performed, a sterile bandage is applied.

Chronic bursitis of the ulnar bursa is a problem that can reduce disability and quality of life. Swelling and pain are the main manifestations. Normal daily activities can be uncomfortable.

Treatment usually begins with an attempt to relieve the inflammatory syndrome. Measures to relieve inflammation are rest in the elbow joint and the use of anti-inflammatory drugs. Drugs such as diclofenac, voltaren, ibuprofen are used to relieve inflammation and swelling.

If there is an inflammatory fluid in the bag, a puncture can be performed in order to remove the fluid and further its laboratory examination. During the puncture, provided that there are no signs of infection in the cavity of the elbow bag, and there are no other contraindications, a small amount of a steroid, such as cortisone, may be injected.Steroid medications are powerful anti-inflammatory drugs. Its anti-inflammatory effect can last for several weeks.

Consultation with a physiotherapist required. A physiotherapist will help you choose physiotherapy procedures, taking into account all the features and contraindications.

The use of heat, cold, ultrasound, or UHF usually helps relieve pain and swelling. Using cold or heat treatments can help improve the condition at home.Cold is usually indicated immediately after injury, thermal procedures – during chronic inflammation; in any case, the use of any methods of exposure should be discussed with a doctor.

If bursitis is infectious, the ulnar bursa must be completely drained, that is, all inflammatory fluid or pus must be removed.

A prerequisite is to ensure peace of the elbow joint and the appointment of antibacterial drugs. Patients with infectious bursitis are observed by a doctor until the inflammation disappears completely.

Surgical treatment

Drainage of the ulnar bursa.
If an acute infection develops or microorganisms have been sown as a result of a study of the fluid obtained from the ulnar bursa, then drainage of the ulnar bursa is necessary. The elbow bursa is surgically opened, that is, a small incision is made through which the discharge can be completely drained.

Sometimes, to improve the outflow, it is advisable to use a tube or half-tube. After the drainage of the discharge is ensured, the patient is observed until the wound is completely healed.Usually, improvement occurs within a few days. With infectious bursitis, antibacterial drugs are necessarily prescribed.

Removal of the bursa (bursectomy).
In chronic bursitis, the walls of the bursa thicken, the bursa increases in size, and folds of the bursa appear. With conservative treatment, it is possible to relieve inflammation, but after a while, the inflammatory process aggravates again. It becomes difficult to carry out work and daily activities.

In this case, it is worth thinking about surgical treatment – removal of the elbow bursa.

An incision is made in the projection of the ulnar bursa. The bag is excised. Determining the boundaries of the bag is usually not difficult, since its walls are significantly thickened.

After removal of the bursa itself, the olecranon process must be examined. Any unevenness on the olecranon must be removed and its surface smoothed out. After that, the skin is sutured in layers.

After the operation, it is advisable to place the arm in the splint for a few days to ensure rest and better healing of the postoperative wound, after which rehabilitation measures can be started.

Since in this area it is necessary to ensure the sliding of the skin over the olecranon, a new bag of connective tissue is formed in the body. This happens during the rehabilitation process some time after the operation. In order for this process to proceed without complications, it is advisable to go through the prescribed rehabilitation program.

Rehabilitation after treatment of ulnar bursitis

During conservative treatment, no special rehabilitation is usually required.It is necessary to limit motor activity in the elbow joint during the period of development of inflammation.

After the inflammation begins to resolve, an increase in the load and range of motion in the elbow joint is allowed. Some people are not worried about the enlarged elbow bag. Elbow bursitis, which is not associated with an infectious process, may resemble on its own without any treatment.

After the operation, for better wound healing, the elbow joint is fixed with a plaster splint.If the wound healing takes place without complications, then the splint is removed for 3-5 days and the rehabilitation process begins.

The first few sessions are conducted with a physical therapy instructor to guide you through the required exercises. Usually, rehabilitation does not cause problems, and after a few sessions, patients can study at home without the supervision of an instructor. The recovery is fast enough.

If the work is not associated with constant movements in the elbow joint and support on the elbow, then it is possible to return to daily activities in 3-4 weeks.If support is required on the elbow, then rehabilitation may take 2-3 months. During this time, support on the elbow joint must be completely avoided.

TRUST YOUR HEALTH CARE TO REAL PROFESSIONALS!

Respiratory syncytial virus: diagnostic methods

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.For a diagnosis and correct treatment, you should contact your doctor.

Respiratory syncytial virus (RSV) belongs to the paramyxovirus family. The viral particle contains a single-stranded RNA surrounded by a helical capsid and a spiked outer envelope. Spines are formed by two surface functionally important glycoproteins: fusion protein F and attachment protein G. Protein F ensures the penetration of the virus into the cell and fusion of the infected cell with neighboring cells, which leads to the formation of syncytium.Protein G ensures the attachment of the virus to the target cell.

Respiratory syncytial virus is ubiquitous, with outbreaks of infection occurring during the cold season. The infection is transmitted by airborne droplets. The incubation period of the disease is 2 – 4 days. The virus is secreted by a sick person within 5 – 7 days from the onset of the disease. RSV is the most common causative agent of viral infections of the lower respiratory tract in children in the first two years of life (the characteristic and clinically most important manifestation of RSV infection is bronchiolitis).In older children and adults, RSV can cause flu-like syndrome, bronchopneumonia, or exacerbation of chronic bronchitis. The development of hypoxemia is characteristic. Usually, RSV infection in adults is mild, although with immunodeficiency and in the elderly, it can lead to severe pneumonia. Immunity after a previous infection is weak and unstable, repeated infections are frequent, but these infections are rarely severe.

Virological methods (the isolation of the virus from the discharge of the nasopharynx is possible on some cell cultures) require a long execution time (from 3 to 14 days).More rapid methods of diagnosing this infection include the detection of virus antigens in samples taken from the respiratory tract using immunofluorescence or ELISA methods.

Determination of viral RNA by PCR method, due to the genome instability inherent in this virus, is not widely used. When using serological tests (blood tests to detect antibodies to RSV), the characteristics of the immune response to RSV should be taken into account. In this infection, the IgM response is sometimes not recorded or is too weak for clinical interpretation of the results.The presence of antibodies in a single sample of IgG is not evidence of acute infection, therefore, for serological diagnosis of acute infection with respiratory syncytial virus, it is recommended to study paired sera to assess the increase in IgG titers.

Test number 249. Antibodies of the IgM class to Respiratory syncyt. vir.

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.For a diagnosis and correct treatment, you should contact your doctor.

Tooth granuloma – what is it and how to treat granulomatous inflammation

Tooth granuloma is an inflammatory formation at the apex of the root. It is an overgrowth of granulation tissue. A granuloma is formed as a result of the action of protective mechanisms, in which the body localizes the focus of infection and seeks to isolate it from other tissues. According to ICD-10, the disease code is K04.5.

Usually, a granuloma is formed against the background of inflammation of the neurovascular bundle – the pulp. In the absence of treatment for pulpitis, its root part becomes inflamed, and the infection extends beyond the tooth, into the peri-root tissues. As a result, a kind of sac is formed, filled with decay products of dead cells.

A granuloma is considered to be a formation up to 0.5 cm in size, but it can grow, while as it grows, it transforms into a cystogranuloma, the size of which reaches 1 cm.When a diameter of more than 10 mm, we are talking about a tooth root cyst.There is no cavity in the granuloma; it is a tissue site surrounded by a capsule. Due to the latter, the granuloma is firmly attached to the apex of the tooth root.

Reasons for the development of pathology

There are two reasons for the development of granulomas at the root of the tooth.

1. Untreated pulpitis. The development of caries results in a deep cavity in the tooth. Pathogenic microorganisms enter the pulp, it becomes inflamed, and severe pain appears. Lack of medical attention leads to the gradual death of the pulp.Bacteria penetrate the outside of the tooth through the root canals. A focus of inflammation appears at the apex of the root. We’re talking about periodontitis.

A deep carious cavity in this case is not always observed. Inflammation can develop internally when secondary caries appears under the filling.

2. Poor endodontic treatment. Granuloma can develop at the root of a tooth in which root canal filling was previously performed. Underfilling is usually observed: the doctor did not completely fill the canals with material.In the remaining voids, pathogenic bacteria develop, and the tissues surrounding the root react with inflammation.

These causes cause the majority of cases of granuloma formation. But there are others, less common:

  • poor quality orthodontic treatment;

  • postponed tooth trauma;

  • other inflammatory diseases – tonsillitis, abscess, etc.

In the latter case, the infection enters the tissues with the flow of blood or lymph.

Granuloma symptoms and complications

Symptoms of a tooth granuloma are nonspecific. Often the patient is unaware of the disease, since signs may be absent altogether. Usually, the tooth does not bother, but occasionally there is moderate pain when biting, drinking hot drinks or food. Such symptoms are characteristic of all forms of periodontitis.

It should be noted that from time to time the disease may worsen. For example, with hypothermia, an infectious disease, undergoing surgery – in all cases when the body’s defenses are reduced.With an exacerbation, the following symptoms appear:

  • acute pain, aggravated by biting, tightly closing the jaws;

  • swelling of the gums in the projection of the root apex;

  • pain in the gums when touched.

An exacerbation can pass on its own, and the disease returns to a chronic form. But sometimes inflammation develops before the appearance of purulent contents in the tissues – periostitis or flux.

Inflammation can cause resorption or resorption of the jawbone. The appearance of purulent complications is dangerous in its consequences: from tooth loss and damage to surrounding units to tissue melting and sepsis. Therefore, it is important to get timely medical help. A dentist-therapist deals with the treatment of tooth granulomas, and if removal is required, you need to contact a dentist-surgeon.

Diagnostic features

Granulomatous inflammation can only be detected on X-ray.It looks like a darkening at the root apex. The dentist will conduct an examination and a series of samples, after which he will direct the tooth to an aimed X-ray. The picture will help not only to make an accurate diagnosis, but also to see the size of the granuloma, to differentiate it with other forms of periodontitis.

Conservative treatment

For granulomas, conservative treatment is more often used. It consists in the mechanical treatment of the root canals. After that, they are filled with a temporary healing material – calcium hydroxide-based pastes.After 2-3 weeks, a control image can be taken, and if the inflammation is eliminated, the canals are filled with a permanent material – gutta-percha. A new permanent filling is placed on the crown of the tooth.

There are two treatment tactics, depending on the initial condition of the tooth.

1. Treatment of tooth granulomas in which root canals are not sealed. In this case, the treatment includes the following steps:

  • removal of carious tissues, old filling on the crown, if any;

  • mechanical treatment of canals – with the help of special tools they expand, the walls are smoothed;

  • antiseptic treatment of canals.

Further actions depend on the size of the granuloma. If it is small, up to 3 mm, simultaneous filling is allowed. If the formation is more than 3 mm, then the root canals are filled with a temporary paste. It helps the granuloma to shrink or disappear completely.

It will take no more than 3 weeks to walk with temporary material. At the end of the term, the doctor will send for a second X-ray, and if he sees a positive trend, he will fill the root canals with permanent material.The restoration of the tooth crown is also carried out.

2. Treatment of a tooth in which the root canals are already sealed. In this case, the doctor will first remove the old material. If there is a crown on the tooth, it must be removed. The root canals must be sealed, and the treatment tactics are as described above: sometimes a temporary healing filling is required.

Surgical treatment

Surgical treatment of a tooth granuloma may be required only in a few cases:

  • obstruction of root canals – complex, tortuous structure, too thin, narrow canals;

  • impossibility to unseal the canals;

  • Presence of a pin in the root canal – attempts to remove it may cause injury;

  • patient’s unwillingness to remove the crown.

Many patients prefer granuloma removal because they do not want to resort to long treatment and remove a good crown. In this case, the apex resection is performed – part of the root is removed along with the granuloma through a small gum incision. Less commonly, hemisection is used – the removal of one root of a multi-rooted tooth together with a part of the crown. In this case, further restoration of the crown part of the tooth with a prosthesis will be required.

In rare cases, it is impractical to preserve a tooth with a granuloma.For example, if the crown is badly damaged and cannot be restored. In this case, the doctor, when removing the tooth, must remove the granuloma from the hole in order to prevent the development of inflammation.

If purulent complications develop against the background of granulomas, it is important to get medical help immediately. The specialist will provide first aid: relieve acute pain by opening the tooth. Previously sealed canals are opened, and purulent contents are subsequently excreted through them. In this case, relief comes instantly.

If severe swelling of the gums or cheeks appears, this may be due to the release of inflammatory contents under the periosteum or oral mucosa. In this case, a small incision is made to drain the pus. Further treatment is possible only after the relief of acute symptoms. You will also need drug therapy – the doctor will prescribe a course of antibiotics. You should not take them yourself. Moreover, it makes no sense to be treated only with antibiotics in the hope that the inflammation will pass – they are not able to eliminate the focus of the disease and even reduce it, it is important to take local measures to eliminate the inflammatory process.

Features of prevention

The main condition for the prevention of tooth granulomas is the timely help of the dentist in the event of caries. You should not allow severe tooth decay, the development of pulpitis. The peri-root tissues are healthy until the pulp becomes inflamed. Therefore, when symptoms of caries or pulpitis appear, it is important to urgently consult a doctor.

Endodontic treatment also increases the likelihood of developing periodontitis. Therefore, it is better to eliminate caries in the early stages and avoid the need to fill the root canals.If you cannot do without this, it is important to carefully choose a dental clinic – the professionalism of a specialist will help eliminate possible mistakes and prevent complications.

How the coronavirus infects the body (diagram)

SARS-CoV-2 coronavirus earlier than 2019-nCoV, the virus that causes coronavirus infection (COVID-19), is currently spreading around the world. At least six other types of coronavirus are known to infect humans, with some causing the common cold and two causing epidemics: SARS in 2002 and MERS in 2012.

Spiked

The coronavirus is named for the crown-like spines protruding from its surface. The virus is enclosed in a bubble of oily lipid molecules that breaks down on contact with soap.

Entrance to vulnerable cell

The virus enters the body through the nose, mouth, or eyes and then attaches to cells in the airways that produce a protein called ACE2. The virus is believed to have originated in bats, where it could attach to a similar protein.

Release of viral RNA

The virus infects a cell by merging its oil membrane with the cell membrane. Once inside, the coronavirus releases a piece of genetic material called RNA.

Emptying the chamber

The genome of the virus is less than 30,000 genetic “letters” in length. (We have over 3 billion.) An infected cell reads RNA and starts making proteins that will keep the immune system at bay and help build new copies of the virus.

Antibiotics kill bacteria and do not work against viruses. But researchers are testing antiviral drugs that can destroy viral proteins and stop infection.

Creation of viral proteins

As the infection progresses, the cell machinery begins to produce new adhesions and other proteins that will make more copies of the coronavirus.

Assembling new copies

New copies of the virus are collected and transferred to the outer edges of the cell.

Spread of infection

Each infected cell can release millions of copies of the virus before the cell finally collapses and dies. Viruses can infect nearby cells or get caught in droplets that leave the lungs.

Immune response

Most Covid-19 infections cause fever as the immune system fights to clear the virus. In severe cases, the immune system can overreact and start attacking lung cells.The lungs become clogged with fluid and dying cells, making breathing difficult. A small percentage of infections can lead to acute respiratory distress syndrome and possibly death.

Leaving the body

Coughing and sneezing can spread viral droplets onto nearby people and surfaces, where the virus can remain infectious for hours to days. Infected people can avoid spreading the virus by wearing a mask, but healthy people do not need to wear a mask unless they are caring for the sick person.

How to deal with a possible vaccine

A future vaccine could help the body produce antibodies that target the SARS-CoV-2 virus and prevent it from infecting human cells. The flu vaccine works in a similar way, but the antibodies derived from the flu vaccine do not protect against the coronavirus.

The best way to avoid contracting coronavirus and other viruses is to wash your hands with soap, avoid touching your face, stay away from sick people, and regularly clean frequently used surfaces.

Sources : Dr. Matthew B. Freeman and Dr. Stuart Weston, Univ. Maryland School of Medicine; Fields of virology; Fenner & White’s Medical Virology; Nature; The science; Lancet; New England Journal of Medicine; Centers for Disease Control and Prevention.
https://www.nytimes.com/interactive/2020/03/11/science/how-coronavirus-hijacks-your-cells.html

90,000 a new way of COVID-19 infection has been discovered // Watching

Scientists called this finding “terrible”, since antibodies or vaccines can become powerless if the virus enters cells in a new way.

At the beginning of the COVID-19 pandemic, scientists determined that the SARS-CoV-2 virus, which causes COVID-19, enters the human body, clinging to the ACE2 receptors on the cell surface with its spikes. All COVID-19 vaccines and antibody-based drugs have been designed to disrupt this particular cell entry pathway.

Researchers at the University of Washington in St. Louis have found that mutated SARS-CoV-2 can enter cells without the help of ACE2.The discovery proves that the virus can change unexpectedly and find new ways to cause infection. This means that antibodies or vaccines against COVID-19 may not be effective.

The find was accidental. The scientists planned to study the molecular changes taking place inside cells infected with SARS-CoV-2. Most researchers study SARS-CoV-2 on primate kidney cells because the virus grows well in them, but this time the scientists decided to conduct a study on human lung cancer cells that lacked ACE2.

The virus that was used for the experiments was obtained from an infected with COVID-19 resident of Washington state, but in the laboratory it mutated over time, which also alerted scientists.

“The virus is under selective pressure to enter cells without using ACE2. It’s scary to imagine the world fighting a virus that is constantly looking for new ways to get to cells. Perhaps the virus uses ACE2 until the cells run out. with ACE2, and then it will switch to using this alternative path, “the scientists concluded.

Is the coronavirus of natural or laboratory origin? Scientists from different countries are fighting over this issue. Health Minister Mikhial Murashko said that there is no final position on this issue yet.

90,000 Respiratory syncytial virus

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.For a diagnosis and correct treatment, you should contact your doctor.

Respiratory syncytial virus (RSV) belongs to the paramyxovirus family. The viral particle contains a single-stranded RNA surrounded by a helical capsid and a spiked outer envelope. Spines are formed by two surface functionally important glycoproteins: fusion protein F and attachment protein G. Protein F ensures the penetration of the virus into the cell and fusion of the infected cell with neighboring cells, which leads to the formation of syncytium.Protein G ensures the attachment of the virus to the target cell.

Respiratory syncytial virus is ubiquitous, with outbreaks of infection occurring during the cold season. The infection is transmitted by airborne droplets. The incubation period of the disease is 2 – 4 days. The virus is secreted by a sick person within 5 – 7 days from the onset of the disease. RSV is the most common causative agent of viral infections of the lower respiratory tract in children in the first two years of life (the characteristic and clinically most important manifestation of RSV infection is bronchiolitis).In older children and adults, RSV can cause flu-like syndrome, bronchopneumonia, or exacerbation of chronic bronchitis. The development of hypoxemia is characteristic. Usually, RSV infection in adults is mild, although with immunodeficiency and in the elderly, it can lead to severe pneumonia. Immunity after a previous infection is weak and unstable, repeated infections are frequent, but these infections are rarely severe.

Virological methods (the isolation of the virus from the discharge of the nasopharynx is possible on some cell cultures) require a long execution time (from 3 to 14 days).More rapid methods of diagnosing this infection include the detection of virus antigens in samples taken from the respiratory tract using immunofluorescence or ELISA methods.

Determination of viral RNA by PCR method, due to the genome instability inherent in this virus, is not widely used. When using serological tests (blood tests to detect antibodies to RSV), the characteristics of the immune response to RSV should be taken into account. In this infection, the IgM response is sometimes not recorded or is too weak for clinical interpretation of the results.The presence of antibodies in a single sample of IgG is not evidence of acute infection, therefore, for serological diagnosis of acute infection with respiratory syncytial virus, it is recommended to study paired sera to assess the increase in IgG titers.

Test number 249. Antibodies of the IgM class to Respiratory syncyt. vir.

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.For a diagnosis and correct treatment, you should contact your doctor.

Agovirax | Effective Antiviral Therapy

Agovirax | Effective antiviral therapy

N

Designed for the prevention and treatment of viral respiratory diseases. Suitable for adults and children over 1 year old.

Effective protection against more than 200 viruses. Clinically proven

Diseases resembling colds and flu are caused by various viruses, which include rhinoviruses, coronaviruses and others.Most often, infections enter the body through the nose. Viruses that enter the nose attach to the surface of the mucous membrane and infect its cells, in which they multiply and spread.

Agovirax® forms a barrier against cold viruses and prevents them from adhering to mucous membranes. In addition, the multiplication and spread of viruses responsible for respiratory tract infections is reduced.

Iota-carrageenan creates a protective barrier and blocks the entry of viruses into your body

Iota-carrageenan creates a protective barrier on the mucous membranes of the nasal and oral cavity and, thus, blocks the way viruses from the respiratory tract and their penetration into cells.

* Clinically tested

Absolutely safe. Can be reused. Suitable for pregnant women, breastfeeding women and children up to 1 year old.

  • AGOVIRAX has a local effect. The cells of the mucous membrane do not absorb iota-carrageenan. Except for extremely rare cases of hypersensitivity, it has no other side effects.
  • AGOVIRAX can be used for a long time. There is no occurrence of dependence or risk of overdose.
  • AGOVIRAX does not contain analgesics, preservatives, animal substances or substances that cause greenhouse effect. It contains neither lactose nor gluten and can be used by diabetics or vegans.

* Clinically tested

Clinical results

  • Agovirax reduces the number of viruses on the mucous membranes by more than 90%. [1]
  • Agovirax shortens the duration of illness by an average of 2.1 days.[2]
  • Agovirax significantly reduces relapse rates. [2]
  • Agovirax significantly reduces the symptoms of the common cold. [1]

* Clinically tested

Active virus protection up to 3 hours a day in just two seconds

Use every time before you plan to be in a virus-prone environment.