Necrotizing Infections of the Soft Tissues Usual Etiologic Predisposing Clinical Type Agent Causes Manifestations Meleney Staphylococcus Surgery Slowly expanding synergistic aureus, ulceration gangrene microaerophilic confned to streptococci superfcial fascia Clostridial Clostridium Local trauma or Gas in pores and skin, cellulitis perfringens surgery fascial sparing, little systemic A toxicity Nonclostridial Mixed aerobes Diabetes Gas in tissues anaerobic and anaerobes mellitus cellulitis Gas Clostridial Trauma, crush Myonecrosis, fuel gangrene species injuries, in tissues, (Clostridium epinephrine systemic toxicity, perfringens, injections; shock Clostridium spontaneous histolyticum, or instances associated Clostridium to cancer, septicum) neutropenia, cancer chemotherapy Necrotizing Mixed Surgery, Destruction of fat fasciitis anaerobes, diabetes and fascia; pores and skin B kind 1 gram-negative mellitus, may be spared; cardio bacilli, peripheral involvement of Figure 77-2. Akathisia: prevalence and associated dysphoria in an in-affected person population with continual schizophrenia. Participants on this research additionally described several obstacles to prenatal care that are common among low-earnings women regardless of substance use, including lack of transportation and health insurance, financial obstacles, homelessness, and bureaucratic obstacles to insurance coverage and appointment scheduling antibiotic resistance history
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