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Case Reports
. 2024 Mar 26:50:40-43.
doi: 10.1016/j.jdcr.2024.03.008. eCollection 2024 Aug.

Empiric intralesional tumescent drug delivery of antimicrobials effectively treated a painful necrotizing skin infection

Paytra A Klein  1 , Gerald A Wagner  2 , Ronald J Barr  3 , Jeffrey A Klein  3 , Roy S Rogers 3rd  4
Affiliations
Case Reports

Empiric intralesional tumescent drug delivery of antimicrobials effectively treated a painful necrotizing skin infection

Paytra A Klein et al. JAAD Case Rep. .
No abstract available

Keywords: TDD; TEL; amikacin; amphotericin B; antibiotic; antimicrobial; cefazolin; drug delivery; ecthyma gangrenosum; empiric treatment; epinephrine; infection; infiltration; injection; intralesional; leukemia cutis; lidocaine; necrosis; necrotic; necrotizing; oral dermatology; polymicrobial; skin infection; targeted; tumescent antibiotic delivery; tumescent delivery; tumescent drug delivery; tumescent epinephrine; tumescent epinephrine lidocaine; tumescent infiltration; tumescent injection; tumescent lidocaine; tumescent local anesthesia; ulcer.

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Conflict of interest statement

Jeffrey A. Klein owns HK Surgical, Inc (a surgical supply and equipment company that develops infiltration pumps that can be used for Tumescent Drug Delivery). Jeffrey A. Klein and Paytra A. Klein have patents regarding Tumescent Drug Delivery.

Figures

Fig 1
Fig 1
Ulceration before-and-after: A, Before tumescent drug delivery (TDD) of antimicrobials. B, 10 days after TDD of antimicrobials – ulceration was a third of its original size.
Fig 2
Fig 2
A and B, Oral commissure ulceration punch biopsy (hematoxylin and eosin [H&E], 100×-400×): Dense diffuse dermal infiltrate consists of myeloblasts with an inflammatory background of lymphocytes and scattered neutrophils.
See this image and copyright information in PMC

References

    1. Klein J.A., Jeske D.R. Estimated maximal safe dosages of tumescent lidocaine. Anesth Analg. 2016;122(5):1350–1359. doi: 10.1213/ANE.0000000000001119. - DOI - PMC - PubMed
    1. Cho-Vega J.H., Medeiros L.J., Prieto V.G., Vega F. Leukemia cutis. Am J Clin Pathol. 2008;129(1):130–142. doi: 10.1309/WYACYWF6NGM3WBRT. - DOI - PubMed
    1. Vaiman M., Lazarovitch T., Heller L., Lotan G. Ecthyma gangrenosum and ecthyma-like lesions: review article. Eur J Clin Microbiol Infect Dis. 2015;34(4) doi: 10.1007/s10096-014-2277-6. - DOI - PubMed
    1. Son Y.M., Na S.Y., Lee H.Y., Baek J.O., Lee J.R., Roh J.Y. Ecthyma gangrenosum: a rare cutaneous manifestation caused by stenotrophomonas maltophilia in a leukemic patient. Ann Dermatol. 2009;21(4):389–392. doi: 10.5021/ad.2009.21.4.389. - DOI - PMC - PubMed
    1. Logre E., Enser M., Tanaka S., et al. Amikacin pharmacokinetic/pharmacodynamic in intensive care unit: a prospective database. Ann Intensive Care. 2020;10(1):75. doi: 10.1186/s13613-020-00685-5. - DOI - PMC - PubMed

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