Potential adjustments of feeding style in a culturally sensitive manner may be addressed at a pre-travel visit. Breastfeeding women and their infants can travel safely, but need special attention to protect the infant. A critical goal is to maintain selleck compound adequate hydration. Geographic areas where clean water and sanitation are lacking pose particular hurdles to any traveler and are especially difficult for the breastfeeding woman. Careful planning and assessment of local resources are important to preserve the health of infant and mother. The authors thank
Drs I. Dale Carroll and Robert Steffen, and Brenda Phipps, BS, IBCLC, for their thoughtful review of the manuscript and helpful comments. The authors state that they have no conflicts of interest to declare. “
“We present a 31-year-old man who, after a Conus textile sting acquired in New Caledonia, developed a cutaneous abscess on a buttock. The abscess was accompanied by pain, paraesthesia, general malaise, and fever. Complete remission was achieved by sodium
hypochlorite packs and oral amoxicillin/clavulanic acid, metronidazole, and tramadol. A 31-year-old man was admitted because of selleck chemical an abscess located in the right buttock. The patient stated that the abscess had appeared 2 weeks earlier, during a trip to New Caledonia (South-West Pacific Ocean). The patient claimed that he was snorkeling, when he observed a beautiful shell: he picked it up and put it in the back pocket of the bathing suit. Some minutes later, the patient complained of a burning sensation in the right buttock. Three hours later, a painful swelling appeared in the same area. Two days later, fever (<38°C) and general malaise appeared. Before admission to our department, the patient was unsuccessfully treated at other SB-3CT centers with topical antiseptics, clotrimazole and hydrocortisone butyrate, and oral paracetamol. Dermatological examination revealed an abscess: it was round, 3.5 cm in diameter, red in color, with two fistulas discharging pus. The lesion was surrounded by erythematous edema, hard in consistency (Figure 1). The patient complained of severe pain, local paraesthesia, and fever (37.8°C). General physical examination
revealed nothing pathological. Laboratory examinations showed leucocytosis (12.700 white blood cells/mm3, with 9.300 neutrophils/mm3), and increase in erythrocyte sedimentation rate (71 mm at the first hour) and C-reactive protein (7.9 mg/L). Bacteriological examinations of the abscess were positive for Escherichia coli, Staphylococcus aureus, and Peptostreptococcus sp. The shell was classified as a 10.3 cm long specimen of Conus textile Linnaeus 1758 (Figure 2). The patient was treated with sodium hypochlorite packs and, on the basis of antibiogram results, with oral amoxicillin/clavulanic acid [minimum inhibitory concentration (MIC): ≤0.03 µg/mL for both Escherichia coli and S aureus; 3 g/d for 10 d], oral metronidazole (MIC: ≤0.