Open AccessA penetrating injury with a cocktail stick resulting in a spreading infection with Streptococcus milleri
Author(s) -
Ross Elledge,
Doraisami Mohan
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.02.2009.1592
Subject(s) - medicine , debridement (dental) , cellulitis , intravenous antibiotics , surgery , emergency department , antibiotics , penetrating trauma , accident and emergency , surgical debridement , skin grafting , intensive care medicine , medical emergency , blunt , psychiatry , microbiology and biotechnology , biology
This case deals with a penetrating injury with a cocktail stick sustained to the right foot in a 72-year-old woman. Despite being discharged from the Accident and Emergency Department on empirical oral antibiotic therapy, she went on to develop a severe cellulitis, necessitating admission for intravenous antibiotics, multiple debridement procedures under general anaesthesia and eventual split thickness skin grafting to repair areas of necrosis. This case raises a number of important issues, including the potential hazards of apparently so trivial an injury with a common household item, the absence of any benefit of plain radiography in these injuries and the need for exploration and debridement early in the management, in the face of a refractory response to empirical antibiotics.