Bad infections

[PharmDstudent]

What's the grossest infection you've come across?

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[Epic]

Infection of the brain... liberalism.

 

[PharmDstudent]

Infection of the brain... liberalism.

I hope you're not calling me a liberal. I'm a libertarian.

 

[WVUPharm2007]

WTF? You used to be a big proponent of liberalism...

Unless you mean the newfangled definition that means American leftists.

Worst thing I've ever seen wasn't an infection, it was TEN. Nastiest **** I could ever imagine.

 

[JerryPharmD]

Some guy that had scabies.
shudders

 

[PharmDstudent]

Some guy that had scabies.
shudders

That's just freaky. I'd flip-out if there were little mites crawling around under my skin. I hope I don't have nightmares now, but I probably will...

 

[sdn1977]

Worst I've seen (other than politically....) was a woman with an untreated breast CA. She'd been Stage 4 when she finally sought medical advice then when she was told the diagnosis, she refused all treatment.

It was AWFUL! It was, unfortunately, not close to the chest wall - closer to the epidermis.

This was during the 70's when the hospital census was high - there was no way to put her in a room down the hall & away from others. You could smell her from 30 feet away.....

Just awful & a death I decided I'd NEVER want to have!!!!


Oh - then there was the homeless guy who was brought in with multiple open wounds. ETOH intoxication, mutiple drugs on tox screen, obtunded - oh & had maggots in the wound.

Went right to surgery - I can't remember what we had at the time to treat the guy - probably gentamicin - it was "new" then.

 

[njac]

anytime an order says "apply to pannus" I throw up a little bit in my mouth.

 

[KARM12]

Oh - then there was the homeless guy who was brought in with multiple open wounds. ETOH intoxication, mutiple drugs on tox screen, obtunded - oh & had maggots in the wound.

Went right to surgery - I can't remember what we had at the time to treat the guy - probably gentamicin - it was "new" then.

I have also been "fortunate" enough to experience a maggot infestation...this one was of a mummified great toe.

 

[Moxxie]

I haven't had a chance to see a lot yet, but when I was working at a vet clinic we had the nastiest nastiest little dog. It was a chihuahua/terrier mix (maybe 10 lbs or so) that had gotten out of the house and had been attacked by another dog. The bigger dog nearly ripped one of the smaller ones legs off and punctured the abdominal wall. After a few days the little guy managed to drag himself home and was rushed to us.

Irrigating the wounds was nasty - he got a clostridial infection, which exhibited as rank, bright green pus from all sites. Even after a week of antibiotics, you could smell this dog from across the clinic. The vet ended up having to take out most of the quadriceps and the gastroc from one leg. And yet the little guy survived and walked again.

 

[tussionex]

anytime an order says "apply to pannus" I throw up a little bit in my mouth.

agreed.

i didn't see him or smell him, but heard plenty about a patient who came to our ER with duct tape wrapped around his legs. they allegedly looked like a pizza that had been left out for a MONTH, according to the ER techs, with mystery fluid running onto the floor as they cut the tape off.

we gave the ER ammonia inhalants to pop and get rid of the smell.

 

[njac]

agreed.

i didn't see him or smell him, but heard plenty about a patient who came to our ER with duct tape wrapped around his legs. they allegedly looked like a pizza that had been left out for a MONTH, according to the ER techs, with mystery fluid running onto the floor as they cut the tape off.

we gave the ER ammonia inhalants to pop and get rid of the smell.

grody!! what the heck was going on there?

we use peppermint oil for stinks. I think I prefer that to ammonia.

 

[PharmaSynergy]

I have also been "fortunate" enough to experience a maggot infestation...this one was of a mummified great toe.

Yikes! Yep, one thing's for sure, I'd never survive as a Fear Factor contestant thanks to the "creepy-crawly" part of the challenge.

Interestingly, I just recently heard about a type of biotherapy in which live, disinfected maggots are intentionally introduced into skin and soft tissue wounds to selectively clean out the necrotic tissue and promote wound healing. Supposedly, maggot therapy accelerates debridement of necrotic wounds and reduces the bacterial load, leading to earlier healing, reduced wound odor and less pain.

Has anyone actually seen the use of MDT (maggot debridement therapy) in clinical practice?

-PSyn

 

[PharmDstudent]

Yikes! Yep, one thing's for sure, I'd never survive as a Fear Factor contestant thanks to the "creepy-crawly" part of the challenge.

Interestingly, I just recently heard about a type of biotherapy in which live, disinfected maggots are intentionally introduced into skin and soft tissue wounds to selectively clean out the necrotic tissue and promote wound healing. Supposedly, maggot therapy accelerates debridement of necrotic wounds and reduces the bacterial load, leading to earlier healing, reduced wound odor and less pain.

Has anyone actually seen the use of MDT (maggot debridement therapy) in clinical practice?

-PSyn

I've never heard of MDT, but it reminds me of medicinal leeches.
http://www.leeches.biz/leech-therapy.htm

 

[Epic]

MDT is sold out of sacramento, CA I think.

I have dispensed it.

 

[Epic]

Maggots r used 2 debrid dead tissues since they stay away from clean tissues

 

[Farmercyst]

A supervisor at my old job had it done to him. He had a radial fracture due to an ATV wreck. Took him 3-4 weeks to get out of the hospital. Then another 8 weeks recuperation before he came back to work.

 

[njac]

I always get to dispense the leeches when I'm there. then of course I chase someone around with one in the forceps because they were too wussy to get them out.

 

[PharmaSynergy]

I have dispensed it.

. Administered in conjunction with antibiotics, or as monotherapy I wonder.

Maggots r used 2 debrid dead tissues since they stay away from clean tissues

So they actually prefer stale 'food' over fresh. Eh, finicky eaters.

Amazing how such a seemingly insignificant little creature can actually save a limb. Kudos to those Medical Maggots!

Thanks for the input, Epic.

-PSyn

 

[Epic]

. Administered in conjunction with antibiotics, or as monotherapy I wonder.



So they actually prefer stale 'food' over fresh. Eh, finicky eaters.

Amazing how such a seemingly insignificant little creature can actually save a limb. Kudos to those Medical Maggots!

Thanks for the input, Epic.

-PSyn

Maggots are a part of the "wound care" arena and not a mono therapy. Wound care involves antibiotics, hyperbaric therapy, Dakins solution, surgical debridement, debriding ointments like accuzyme, panafil, (voodoo medicine) and more. Not too many pharmacists are involved with it other than occassional dispensing of the meds but it's been a huge battle for some of us who's been kicking out HealthPointe reps out of our hospitals... maker of Accuzyme and Panafil.

 

[psychoandy]

Decubital ulcers with myiasis...surprisingly in a pt without DM. And it wasn't debridement therapy...surgery refused to get involved, with good reason, because there were literally hundreds crawling around. Probably 3 or 4 on my top 10 list of grossest things i've seen irl.

 

[no-see-um]

Decubital ulcers with myiasis...surprisingly in a pt without DM. And it wasn't debridement therapy...surgery refused to get involved, with good reason, because there were literally hundreds crawling around. Probably 3 or 4 on my top 10 list of grossest things i've seen irl.

I've dispensed maggots before.... In my original job (not pharm).

 

[tussionex]

grody!! what the heck was going on there?

we use peppermint oil for stinks. I think I prefer that to ammonia.

the peppermint oil didnt work!

we have dispensed leeches as well. my husband was the leech man. he used to keep them in a little tank on his desk. he devised a syringe-based system to change the water so they wouldnt attack him. [you want those guys to be hungry]

 

[tussionex]

i also saw a guy who was a quad with a stage 4 so deep you could actually see his spine. nice man, very sad case.

*shudders*