Search this website

Jeffrey Tessier, MD

Subscribe to Jeffrey Tessier, MD feed Jeffrey Tessier, MD
NCBI: db=pubmed; Term=(tessier j[Author]) AND (John Peter Smith[Affiliation] OR JPS Health Network[Affiliation] OR JPS [Affiliation] OR University of North Texas Health Science Center [Affiliation] NOT Japan Pancreas Society[Affiliation])
Updated: 13 hours 45 min ago

Actinomyces turicensis Necrotizing Soft-Tissue Infection of the Thigh in a Diabetic Male.

Wed, 02/27/2019 - 15:16
Related Articles

Actinomyces turicensis Necrotizing Soft-Tissue Infection of the Thigh in a Diabetic Male.

Surg Infect (Larchmt). 2019 Feb 21;:

Authors: Panwar K, Duane TM, Tessier JM, Patel K, Sanders JM

Abstract
BACKGROUND: Necrotizing soft-tissue infections are a devastating infection that is rarely caused by Actinomyces spp.
CASE REPORT: A 45-year-old obese previously healthy male presented to the emergency department with diabetic ketoacidosis. The patient developed systemic signs of infections and right medial thigh pain subsequently diagnosed as a necrotizing soft-tissue infection. Successful treatment included prompt surgical intervention and initiation of broad-spectrum antimicrobial drugs.
CONCLUSION: Actinomyces turicensis may be the pathogen causing certain necrotizing soft-tissue infections. Clinicians should consider the possibility that this organism represents a true pathogen and not colonization/contamination.

PMID: 30789313 [PubMed - as supplied by publisher]

Measuring Provider Compliance with an Institution-Based Clinical Pathway for Diverticulitis Using Radiologic Criteria.

Wed, 01/30/2019 - 08:22
Related Articles

Measuring Provider Compliance with an Institution-Based Clinical Pathway for Diverticulitis Using Radiologic Criteria.

Surg Infect (Larchmt). 2018 Oct;19(7):655-660

Authors: Gonzalez G, Montemayor E, Sanders JM, Burton M, Tessier JM, Duane TM

Abstract
BACKGROUND: Diverticulitis remains a common disease encountered in the acute care setting. Management strategies have been developed to guide treatment decisions based on imaging. By using a multi-faceted clinical pathway approach, a standardized method of diagnosing and categorizing disease severity can be performed in order to guide appropriate management. This study evaluated provider compliance with an institutional clinical pathway designed to guide management of diverticulitis.
METHODS: An institutional clinical pathway was developed to manage diverticulitis, including radiologic classification, primary service line assignment, interventional strategies, and antimicrobial treatment. To assess provider compliance with the algorithm, we queried the institutional acute diverticulitis database for patients admitted from May 19, 2016 to February 8, 2017, which identified 83 patients. Provider compliance with the pathway was assessed using subgroup analysis of radiologic documentation (modified Neff [mNeff] classification), primary service assignment, and interventions (i.e., interventional radiology [IR] and antimicrobial agents).
RESULTS: The cohort represented a diverse group of mNeff classifications, predominantly Stage 0. Surgical interventions occurred in 10.8% of the cohort. Antimicrobial agents were administered to 88.0% and 78.3% of the outpatients and inpatients, respectively. Patients received a total duration of antimicrobial therapy (mean ± standard deviation [SD]) of 10.2 ± 5.1 days. Overall compliance occurred in 10% of the patients. Compliance with radiologic documentation, antimicrobial choice, and antimicrobial duration were 90.4%, 20.5%, and 69.9%, respectively.
CONCLUSIONS: Overall compliance with the clinical pathway was poor, except as it related to compliance with radiologic documentation, appropriate assignment to surgical service line, and antimicrobial duration. These results suggest areas for future improvement to augment compliance with the clinical pathway.

PMID: 30179571 [PubMed - indexed for MEDLINE]