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Management of Severe Crush Injuries in Austere Environments: A Special Operations Perspective
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Physiological and Psychological Stressors Affecting Performance, Health, and Recovery in Special Forces Operators: Challenges and Solutions. A Scoping Review
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Obstacle Course Events: Hazards and Prevention Measures
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Tactical Combat Casualty Care Maritime Scenario: Shipboard Missile Strike
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Severe Lower Body Swelling and Bacteremia Secondary to Shewanella algae Bacteremia During Basic Underwater Demolition SEAL Training
Bridwell RE, Carius BM, Oliver JJ 19(4). 19 - 21 (Case Reports)
Shewanella algae is a unique bacterium largely documented in skin and soft tissue infections (SSTIs) with a wide range of presentations from gas-producing necrotizing fasciitis to osteomyelitis. Seawater exposure to lower extremity ulcers and wounds is most often correlated with infection, which has been documented in causing complications of bacteremia, sepsis, and infective endocarditis. Further complicating treatment is poor response to most empiric regimens prior to definitive diagnosis and an uneven response to antibiotics, including documented resistance to carbapenem. This case documents the presentation of a Basic Underwater Demolition SEAL (BUD/S) training candidate who presented acutely for complaints of severe lower body swelling and abrasions during "Hell Week" and was found to have polymicrobial bacteremia with Staphylococcus aureus, Enterococcus, and S algae.
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