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Case cluster of necrotizing fasciitis and cellulitis associated with vein sclerotherapy.

Chan HT, Low J, Wilson L, Harris OC, Cheng AC, Athan E - Emerging Infect. Dis. (2008)

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Varicose vein sclerotherapy is a commonly performed cosmetic surgical procedure in which a sclerosing agent is injected into small varicose veins of the leg by using small gauge needles... It is regarded as a minor, safe procedure, usually performed in an office clinic... During the outbreak period, 44 patients had vein sclerotherapy with 3% polidocanol at the cosmetic surgeon’s clinic... Group A Streptococcus spp. was isolated from a throat swab taken on day 16 from the cosmetic surgeon... Decolonization of the surgeon was performed by using rifampin 600 mg daily and amoxicillin 500 mg every 6 hours for 10 days, during which time the surgeon suspended surgical procedures... The Australian Aethoxysklerol study reported no cellulitis in 16,804 legs injected with the sclerosing agent, and superficial thrombophlebitis occurred at a rate of 0.08% at 2-year review... Likewise, a multicenter registry with 22 European phlebology clinics reported no cellulitis or necrotizing fasciitis in 12,173 sessions... Similarly, surgical site infections with Group A Streptococcus spp. are uncommon... A multicenter survey of 72 centers worldwide reported all β-hemolytic Streptococcus spp. (including group A and group G) accounted for <5% of infections, while surveillance in the 1990s by Centers for Disease Control and Prevention reported <1% of all surgical wound infections was caused by group A Streptococcus spp.... A Canadian study reported invasive group A Streptococcus infections following surgery in 1.1 cases per 100,000 admissions... Outbreaks have been infrequently described, and sources of colonization range from throat to anus and vagina.

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Days of procedures for infected and noninfected patients and their first manifestations of infection. □, uninfected; ■, infected; △, patients A and B seen with infection; Ο, patient C seen with infection; and ↑, patient D seen with infection.
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Figure 1: Days of procedures for infected and noninfected patients and their first manifestations of infection. □, uninfected; ■, infected; △, patients A and B seen with infection; Ο, patient C seen with infection; and ↑, patient D seen with infection.

Mentions: During the outbreak period, 44 patients had vein sclerotherapy with 3% polidocanol at the cosmetic surgeon’s clinic. In addition to the 3 patients identified on admission to hospital, a fourth patient (patient B) sought treatment from her general practitioner for medical care for a postprocedure infection. All patients had procedures on day 1 or day 7 (Figure); patients A and B were seen consecutively on day 1, and 2 patients were treated between patients C and D on day 7.


Case cluster of necrotizing fasciitis and cellulitis associated with vein sclerotherapy.

Chan HT, Low J, Wilson L, Harris OC, Cheng AC, Athan E - Emerging Infect. Dis. (2008)

Days of procedures for infected and noninfected patients and their first manifestations of infection. □, uninfected; ■, infected; △, patients A and B seen with infection; Ο, patient C seen with infection; and ↑, patient D seen with infection.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600178&req=5

Figure 1: Days of procedures for infected and noninfected patients and their first manifestations of infection. □, uninfected; ■, infected; △, patients A and B seen with infection; Ο, patient C seen with infection; and ↑, patient D seen with infection.
Mentions: During the outbreak period, 44 patients had vein sclerotherapy with 3% polidocanol at the cosmetic surgeon’s clinic. In addition to the 3 patients identified on admission to hospital, a fourth patient (patient B) sought treatment from her general practitioner for medical care for a postprocedure infection. All patients had procedures on day 1 or day 7 (Figure); patients A and B were seen consecutively on day 1, and 2 patients were treated between patients C and D on day 7.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Varicose vein sclerotherapy is a commonly performed cosmetic surgical procedure in which a sclerosing agent is injected into small varicose veins of the leg by using small gauge needles... It is regarded as a minor, safe procedure, usually performed in an office clinic... During the outbreak period, 44 patients had vein sclerotherapy with 3% polidocanol at the cosmetic surgeon’s clinic... Group A Streptococcus spp. was isolated from a throat swab taken on day 16 from the cosmetic surgeon... Decolonization of the surgeon was performed by using rifampin 600 mg daily and amoxicillin 500 mg every 6 hours for 10 days, during which time the surgeon suspended surgical procedures... The Australian Aethoxysklerol study reported no cellulitis in 16,804 legs injected with the sclerosing agent, and superficial thrombophlebitis occurred at a rate of 0.08% at 2-year review... Likewise, a multicenter registry with 22 European phlebology clinics reported no cellulitis or necrotizing fasciitis in 12,173 sessions... Similarly, surgical site infections with Group A Streptococcus spp. are uncommon... A multicenter survey of 72 centers worldwide reported all β-hemolytic Streptococcus spp. (including group A and group G) accounted for <5% of infections, while surveillance in the 1990s by Centers for Disease Control and Prevention reported <1% of all surgical wound infections was caused by group A Streptococcus spp.... A Canadian study reported invasive group A Streptococcus infections following surgery in 1.1 cases per 100,000 admissions... Outbreaks have been infrequently described, and sources of colonization range from throat to anus and vagina.

Show MeSH
Related in: MedlinePlus