HomeHealth Sciences Journalvol. 10 no. 1 (2021)

Necrotizing fasciitis in a patient with Chiari malformation Type II - a family case analysis

Ramon Jason M. Javier | Marie Rosanna C. Villarin | Remigio Jay-ar Z. Butacan | Leopoldo P. Sison Jr.

 

Abstract:

The biopsychosocial approach to healthcare is fundamental to Family and Community Medicine specialists. Using the patient-centered, family-focused, community-oriented (PFC) matrix, the interplay of a myriad of biomedical and psychosocial factors is assessed in order to provide a thorough medical management that is custom-made to meet the needs and inherent values of a patient and his/her family. Family assessment tools are also utilized to better understand the family dynamics of a patient that may impact on the prescribed management plan. In addition, social determinants of health are evaluated to ascertain which ones may facilitate or hamper proper utilization of community resources. This family case analysis documented the medical ordeal of a young professional who had been diagnosed with two rare medical conditions: necrotizing fasciitis and Chiari malformation Type II. Employing the PFC matrix, the Family and Community Medicine specialist was able to provide inter-disciplinary care for the patient and his family in a holistic manner by recognizing patient needs, creating an enabling family support environment, and helping the family unit navigate various community resources.



References:

1. Rakel RE, Rakel DP. Textbook of Family Medicine, 9th Edition. Philadelphia: Elsevier, 2016.

2. Genetic and Rare Diseases Information Center – National Institutes of Health, US Department of Health and Human Services [Internet]. Available from: https://rarediseases.info.nih.gov

3. US Centers for Disease Prevention and Control. Necrotizing fasciitis [Internet]. Available from: https://www.nichd.nih.gov

4. Sarnat HB. Disorders of segmentation of the neural tube: Chiari malformations [Internet]. Hand b Clin Neurol 2008; 87: 89-103. doi: 10.1016/S0072-9752(07)87006-0. Available from: https://www.ncbi.nlm.nih.gov/pubmed?term=18809020. (Accessed 21 Nov 2018)

5. Hydrocephalus Association. What is hydrocephalus?An overview | Hydrocephalus Association. [Internet]. Available from: https://www.hydroassoc.org/what-is-hydrocephalus-an-overview. (Accessed 21 Nov 2018)

6. Mayo Clinic. Syringomyelia - symptoms and causes [Internet]. Available from: https://www.mayoclinic.org/diseases-conditions/syringomyelia/symptoms-causes/syc-20354771. (Accessed 21 Nov 2018)

7. American Association of Neurological Surgeons (AANS). Tethered spinal cord syndrome – causes, diagnosis and treatments [Internet]. Available from: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Tethered-Spinal-Cord-Syndrome. (Accessed 21 Nov 2018)

8. Medtronic. Scoliosis (curvature of the spine) - causes,symptoms, and diagnosis [Internet]. Available from: http://www.medtronic.com/us-en/patients/conditions/scoliosis.html. (Accessed 21 Nov 2018)

9. Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The Laboratory Risk Indicator for Necrotizing (LRINEC) Fasciitis Score: A tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004 Jul; 32(7): 1535-41. doi: 10.1097/01.ccm.0000129486.35458.7d Necrotizing fasciitis in a patient with Chiari malformation Type II

10. Chaudhry AA, Baker KS, Gould ES, Gupta R. Necrotizing fasciitis and its mimics: What radiologists need to know [Internet]. Am J Roentgenol 2015 Jan; 204(1): 128-39.doi: 10.2214/AJR.14.12676

11. UpToDate, Inc. Necrotizing soft tissue infections [Internet]. Available from: https://www.uptodate.com/contents/necrotizing-soft-tissue-infections. (Accessed 21 Nov 2018)

12. Stevens DL, Tanner MH, Winship J. Severe Group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever Toxin A [Internet]. N Engl J Med 1989 Jul 6; 321(1): 1-7. doi: 10.1056/NEJM198907063210101

13. Volpe JJ. Injuries of the extracranial, cranial, intracranial, spinal cord, and peripheral nervous system structures (Abstract). Volpe’s Neurology of the Newborn, Elsevier, 1093-1123.e5. (Accessed 11 Dec 2018)

14. Midwest Brachial Plexus Network. Long term complications of brachial plexus injuries [Internet]. Available fromhttp://birthinjury.org/introduction-brachial-plexus/long-term-complications. (Accessed 11 Dec 2018)

15. Mayo Clinic. Metabolic syndrome [Internet]. Available from: https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916.(Accessed 11 Dec 2018)

16. DSM-5 Major depressive disorder [Internet]. Available from: https://medicalaidmentalhealth.fmhi.usf.edu

17. Landagan MCZ, Manalo MFC. Care for the Family Caregivers. Textbook of Family Medicine: Volume 1 – Principles, Concepts, Practice, and Context. Manila: C&E Publishing, pp. 430-4, 2014.

18. Leopando ZE. The Philippines’ National Health Insurance Program and Universal Health Care. Textbook of Family Medicine: Volume 1 – Principles, Concepts, Practice, and Context. Manila: C&E Publishing, pp. 148-53, 2014.

19. Claudio AB. Family with Terminally Ill Members. Textbook of Family Medicine: Volume 2 – Enhancing the Performance of a Five-Star Physician. Manila: C&E Publishing, pp. 578-90, 2015.

20. National Council on Disability Affairs. Republic Act No. 10754 – An Act Expanding the Benefits and Privileges of Persons with Disability (PWD) [Internet]. Available from:

http://www.ncda.gov.ph/disability-laws/republic-acts/republic-act-no-10754-an-act-expanding-the-benefits-and-privileges-of-persons-with-disability-pwd. (Accessed 12Dec 2018)

21. L e o p a n d o Z E , N i c o d e mu s L A , L i m p o c o AG O, Concha MEA. The patient-centered, family-focused, and community-oriented (PFC) matrix: A toolkit for biopsychosocial approach in primary care. The Fil Fam Phys 2019; 57(1): 26-32. Available from: https://www.researchgate.net/publication/334046038_The_Patient-centered_Family-focused_and_Community-oriented_PFC_Matrix_A_Toolkit_for_Biopsychosocial_Approach_in_Primary_Care