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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
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Managing Pyogenic Soft-Tissue Infections in People Living With HIV in a Resource-Limited Setting: Field Lessons and a

Miloslav Mišánik1, Marek Smolár1, Diana Musová1

  • 1Clinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic.

The American Surgeon
|June 16, 2026
PubMed
Summary

This report outlines a practical, resource-adapted algorithm for treating severe pyogenic soft-tissue infections (SSTI) in people living with HIV (PLHIV) in low-resource settings, focusing on timely debridement and wound care.

Keywords:
HIVpyogenic soft-tissue infectionresource-limited settings

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Area of Science:

  • Global Health
  • Infectious Diseases
  • Surgical Infections

Background:

  • Severe pyogenic soft-tissue infections (SSTI) are a significant cause of illness in people living with HIV (PLHIV) in resource-limited healthcare settings.
  • Effective management strategies are crucial for improving outcomes in these vulnerable populations.

Purpose of the Study:

  • To present a practical, resource-adapted algorithm for the triage, source control, antibiotic treatment, and wound care of severe SSTI in district surgical units.
  • To standardize care and reduce the time to debridement for SSTI in resource-limited settings.

Main Methods:

  • Development of a field-tested algorithm based on five months of clinical experience in South Sudan.
  • Incorporation of bedside sepsis screening (qSOFA), empiric antibiotics (WHO EML/AWaRe), and prompt surgical debridement for suspected necrotizing infections.
  • Emphasis on low-cost wound care options and discharge practices mindful of potential loss to follow-up.

Main Results:

  • The algorithm provides a structured approach to managing severe SSTI, prioritizing early intervention and resource appropriateness.
  • Key components include rapid assessment, timely antibiotic administration, and decisive surgical management.
  • Low-cost wound care and adapted discharge strategies are integral to the protocol.

Conclusions:

  • A standardized, resource-adapted algorithm can effectively guide the management of severe pyogenic soft-tissue infections in resource-limited settings.
  • Prompt debridement and appropriate wound care are critical for improving patient outcomes, particularly for people living with HIV.
  • This approach aims to optimize surgical care delivery at the district level, addressing critical needs in underserved areas.