Combination Therapy of Infections Caused by Injection of Paint Using Medical Laser

Doubtlessly, one of the most important developments in medical science has been the discovery of antibiotics and their use in the treatment of infectious diseases caused by the various bacteria. However, every day we witness the emergence of resistant strains of bacteria which their resistance power against the antibiotics are increasing; although scientists discover new antibiotics every year to supply the consumption market, antimicrobial resistance is a much faster trend and therefore it slows the healing process of many infectious diseases.1 In the modern medical technologies, it is tried to eliminate the germs and remove pus of the lesion, as well as draining out the infection site using alternative solutions rather than the use of antibiotics.2 Laser is a new technology which in recent years, it has found many applications in various scientific fields such as military and civilian industries as well as various branches of medical science. The action mechanism of laser energy is to absorb the light energy by the molecules in the tissue which causes the certain tissue molecules becoming warm, hot and ultimately destroys them; whereas laser is a mono-wavelength beam of light, it is able just to heat up and destroy specific structures.3 Some antiinflammatory effects of laser were previously mentioned.4-6 On May 25th 2013, a 27-year old woman visited the Emergency Department of Ayatolah Mousavi Hospital with the history of schizophrenia, drug use, and hyper-lipidemia. During the examination, it was found that the patient was injected the paint into the left forearm and right thigh last week which led to the edema and erythema at the injury site. Two days after the injection, purulent discharge was observed at the injury. She was hospitalized initially at the burn unit of the hospital, and then the patient was transferred to the infectious diseases unit of Valiasr Hospital due to the severe infection of soft tissue at the injury. Body temperature=8/36, HR=86, RR=19, BP=10/6. Through the examination, erythematous lesions were observed with the necrotic center of 6-7 cm diameter having purulent discharge on the forearm to the elbow, and also the erythematous and edematous lesions containing scattered pustules in an undulation form were seen on the patient’s right thigh injury. The drugs, including clindamycin, vancomycin, ciprofloxacin and ryfampy have been prescribed for the treatment, as well as fluvoxamine, inderal, respridone, thiothixene, clonazepam, and pethidine according to the psychiatrist. Later, the arterial and venous Doppler ultrasound was performed on the injury site with 1. Plastic Surgery, Zanjan University of Medical Sciences, Zanjan, Iran; 2. Infectious disease specialists, Zanjan University of Medical Sciences, Zanjan, Iran; 3. Laser Ward, Zanjan University of Medical Sciences, Zanjan, Iran