Sample records for abscessed tooth patient

  1. The management of an endodontically abscessed tooth: patient health state utility, decision-tree and economic analysis

    Shepperd Sasha


    Full Text Available Abstract Background A frequent encounter in clinical practice is the middle-aged adult patient complaining of a toothache caused by the spread of a carious infection into the tooth's endodontic complex. Decisions about the range of treatment options (conventional crown with a post and core technique (CC, a single tooth implant (STI, a conventional dental bridge (CDB, and a partial removable denture (RPD have to balance the prognosis, utility and cost. Little is know about the utility patients attach to the different treatment options for an endontically abscessed mandibular molar and maxillary incisor. We measured patients' dental-health-state utilities and ranking preferences of the treatment options for these dental problems. Methods Forty school teachers ranked their preferences for conventional crown with a post and core technique, a single tooth implant, a conventional dental bridge, and a partial removable denture using a standard gamble and willingness to pay. Data previously reported on treatment prognosis and direct "out-of-pocket" costs were used in a decision-tree and economic analysis Results The Standard Gamble utilities for the restoration of a mandibular 1st molar with either the conventional crown (CC, single-tooth-implant (STI, conventional dental bridge (CDB or removable-partial-denture (RPD were 74.47 [± 6.91], 78.60 [± 5.19], 76.22 [± 5.78], 64.80 [± 8.1] respectively (p The standard gamble utilities for the restoration of a maxillary central incisor with a CC, STI, CDB and RPD were 88.50 [± 6.12], 90.68 [± 3.41], 89.78 [± 3.81] and 91.10 [± 3.57] respectively (p > 0.05. Their respective willingness-to-pay ($CDN were: 1,782.05 [± 361.42], 1,871.79 [± 349.44], 1,605.13 [± 348.10] and 1,351.28 [± 368.62]. A statistical difference was found between the utility of treating a maxillary central incisor and mandibular 1st-molar (p The expected-utility-value for a 5-year prosthetic survival was highest for the CDB and the

  2. Carotid sheath abscess caused by a tooth decay infection on the opposite side.

    Tuncturk, F Ruya; Uzun, Lokman; Kalcioglu, M Tayyar; Egilmez, Oguz Kadir; Timurlenk, Emine; Erguven, Muferet


    Deep neck infections are mortal diseases that need emergency treatment. It can occur at any age but usually in pediatric ages. In this report, a left cervical carotid space abscess of a pediatric patient was discussed. It was interesting that the only origin of the left carotid sheath abscess was right inferior first molar tooth decay. Right neck spaces were all clean. Patient had no immunosupression and also there were no congenital masses such as branchial cleft cysts, foreign bodies, or masses suspicious for malignancies in cervical ultrasound and MRI. We discussed this rare condition under the light of the literature.

  3. A Case of Buccal Abscess from an Impacted Wisdom Tooth in an Elderly Person with Malnutrition

    Yuki Kojima


    Full Text Available We report a case of buccal abscess caused by an impacted wisdom tooth in an extremely elderly person with malnutrition. The patient was a 94-year-old man, who complained that he had found it hard to open his mouth and that his cheek had been swollen for the previous 2 weeks. He had a shallow oral wound caused by an improperly fitting denture; however, the wound became infected. We performed incisional drainage of the abscess under local anesthesia. The swelling disappeared and he was able to open his mouth 55 mm. The elderly have a high risk of healing failure of injuries and it has been reported that infection in a host in a compromised state is severely intractable. This elderly patient was in a compromised state because of malnutrition. Cases such as this one will increase as the elderly population increases. Dentists need to consider the quality of life of patients with a longer life expectancy and should offer patients several treatment options before their general condition deteriorates.

  4. Abscess

    An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area ... parasites and swallowed objects can all lead to abscesses. Skin abscesses are easy to detect. They are ...

  5. A rare presentation of tuberculous prostatic abscess in young patient

    Santosh Kumar


    Conclusion: Tuberculous prostatic abscess although very uncommon in immunocompetent patient, we should have high index of suspicion in patients of PUO. Once diagnosed it should be treated with complete drainage of abscess and ATT with close follow up.

  6. Splenic abscess in a patient with fecal peritonitis

    Spiros G Delis; Petros N Maniatis; Charikleia Triantopoulou; John Papailiou; Christos Dervenis


    Splenic abscess is a rare entity normally associated with underlying diseases. We report a case of splenic abscess with large gas formation in a non-diabetic and non-immunosuppressed patient after surgery for colon perforation. The most frequent cause of splenic abscess is septic embolism arising from bacterial endocarditis. Splenic abscess has a high rate of mortality when it is diagnosed late. Computed tomography resolved any diagnostic doubt, and subsequent surgery confirmed the diagnosis.

  7. Tooth abscess

    ... 2016 Updated by: Michael Kapner, DDS, general and aesthetic dentistry, Norwalk Medical Center, Norwalk, CT. Review provided ... for EHRs For Developers U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD 20894 U.S. Department ...

  8. Emphysematous liver abscess in diabetic patient: two cases report

    Rhim, Hyun Chul; Koo, Ja Hong; Kim, Sung Tae; Kim, Yong Soo; Koh, Byung Hee; Cho, On Koo [College of Medicine, Hanyang University, Seoul (Korea, Republic of)


    There has not been any report on massive air-containing liver abscess in diabetic patients, although emphysematous cholecystitis or pyelonephritis is a well-known complication in them. Authors report two cases of emphysematous liver abscess in diabetic patient, which showed typical findings of massive air-containing hepatic abscess on ultrasonography and computed tomography, but very poor prognosis in spite of immediate and successful percutaneous drainage procedure.

  9. Porphyromonas gingivalis causing brain abscess in patient with recurrent periodontitis.

    Rae Yoo, Jeong; Taek Heo, Sang; Kim, Miyeon; Lee, Chang Sub; Kim, Young Ree


    We report an extremely rare case of Porphyromonas gingivalis causing brain abscess in a patient with recurrent periodontitis. The patient presented with right-sided homonymous hemianopsia and right hemiparesis. Emergent surgical drainage was performed and antibiotics were administered. P. gingivalis was identified from the anaerobic culture of the abscess. The clinical course of the patient improved with full recovery of the neurologic deficit.

  10. Gordonia terrae kidney graft abscess in a renal transplant patient.

    Nicodemo, A C; Odongo, F C A; Doi, A M; Sampaio, J L M


    We present the first report, to our knowledge, of a renal abscess cause by an infection from Gordonia terrae in a kidney transplant patient. The patient simultaneously had pulmonary tuberculosis and a perirenal allograft abscess caused by G. terrae. After treatment with imipenem, in addition to anti-tuberculous drugs, the patient was cured.

  11. Abscess

    ... For Kids For Parents MORE ON THIS TOPIC Cellulitis Wound Healing and Care Peritonsillar Abscess Immune System Appendicitis Paronychia Staph Infections MRSA Contact Us Print Resources Send to a ...

  12. Hyperbaric oxygen therapy in spontaneous brain abscess patients

    Bartek, Jiri; Jakola, Asgeir S; Skyrman, Simon


    BACKGROUND: There is a need to improve outcome in patients with brain abscesses and hyperbaric oxygen therapy (HBOT) is a promising treatment modality. The objective of this study was to evaluate HBOT in the treatment of intracranial abscesses. METHOD: This population-based, comparative cohort...

  13. Brucellar spondylodiscitis: comparison of patients with and without abscesses.

    Kaptan, Figen; Gulduren, Hakki Mustafa; Sarsilmaz, Aysegul; Sucu, Hasan Kamil; Ural, Serap; Vardar, Ilknur; Coskun, Nejat Ali


    Brucellosis is an important cause of spondylodiscitis in endemic areas. Brucellar spondylodiscitis is a serious complication because of its association with abscess formation. Prospective studies comparing patients with and without abscesses are lacking. The objective of this study was to determine the frequency and demographic, clinical, laboratory, and radiological features of brucellar spondylodiscitis and to compare patients with and without abscesses regarding treatment and outcome. Out of 135 consecutive patients with brucellosis, 31 patients with spondylodiscitis were recruited for the study. Patients were grouped according to magnetic resonance imaging findings. The frequency of spondylodiscitis was 23.0 %. Sites of involvement were lumbar (58.1 %), lumbosacral (22.6 %), cervical (9.7 %), thoracolumbar (6.5 %), and thoracic (3.2 %). Abscesses occurred in 19 (61.3 %) patients and were associated with low hemoglobin levels. Medical treatment included a combination of streptomycin (for the first 3 weeks), doxycycline, and rifampin. The total duration of treatment was 12-39 (mean 17.0 ± 8.5 SD) weeks. By 12 weeks of treatment, evidence of clinical improvement (67 vs. 28 %) and radiological regression (92 vs. 50 %) was significantly greater in patients without abscesses. The duration of treatment was longer if an abscess was present. Two female patients with abscesses required surgical intervention. Both patients presented with high fever, neurologic deficit, and high Brucella standard tube agglutination test titers. Each patient should be evaluated individually, based on clinical findings, laboratory data, and radiological results, when undergoing treatment for brucellar spondylodiscitis. If abscesses are found, a longer course of treatment and even surgical intervention may be needed.

  14. Retrospective evaluation of the clinical management of patients with periodontal abscesses attending a teaching hospital

    Modupeoluwa Omotunde Soroye


    Full Text Available Aim: This study aimed to examine the clinical management of patients who attended a Nigerian teaching hospital with periodontal abscesses. Setting and Design: This is a retrospective study among patients who attended the Periodontics Clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between January 2008 and December 2015. Patients and Methods: Information about the diagnosis was obtained from the departmental log book, and case notes were retrieved from record department. Data collection elicited information on age, sex, tribe, frequency of tooth brushing, dental attendance, medical history, clinical features, involved tooth/teeth, and treatment received. Statistical Analysis Used: Epi info version 3.5.1 was used for statistical analysis. Results: Patients aged between 15 and 87 years, with a mean age of 35.53 ± 19.30 years. Majority of patients were males, had minor ethnic extractions, had some form of education, first dental clinic attendees, indulged in once-daily toothbrushing, fully dentate, and had fair/poor oral hygiene. A total of 8.8% and 31.6% of the participants smoked cigarettes and consumed alcohol, respectively. A fifth of the participants had systemic diseases such as hypertension, diabetes mellitus, and peptic ulcer disease. Majority of the participants (91.2% had severe pain. About two-fifths had periodontal abscess around the incisors and the molars. The upper right quadrant was mostly involved (31.6%. Two-fifth of the patients had extraction done. Conclusion: Data from this study revealed periodontal abscess as a severely painful condition in naÏve dental patients, successfully treated mainly through extraction of the implicated tooth/teeth. This implies that oral health awareness and regular dental attendance may prevent its occurrence.

  15. Escherichia coli Eyelid Abscess in a Patient with Alcoholic Cirrhosis

    Matthew Stratton


    Full Text Available Escherichia coli (E. coli is a rare cause of ocular infections and has not yet been reported as a cause of an ocular abscess. We describe the case of a 47-year-old woman with a history of alcoholic cirrhosis who presented with painful left lower eyelid swelling that did not improve with oral antibiotics. The abscess was drained and cultures were positive for E. coli. Patients with cirrhosis are at increased risk for developing E. coli bacterial infections, but to our knowledge this is the first case of an E. coli eyelid abscess reported in the literature.

  16. Isolated Aspergillosis Myocardial Abscesses in a Liver-Transplant Patient

    Kim-Diêp Dang-Tran


    Full Text Available Cardiac abscess is an uncommon and fatal complication after transplantation. We report a case of an initially isolated aspergillosis myocardial abscess diagnosed by cardiac magnetic resonance imaging (CMRI. At that time, there was no other biological evidence or other extracardiac manifestations. A three-month course of dual antifungal therapy followed by a single antifungal therapy was empirically given. Six month after admission, Aspergillus fumigatus was isolated for the first time and the patient deceased from a disseminated aspergillosis.

  17. Clostridium glycolicum isolated from a patient with otogenic brain abscesses.

    Leer, C.C. van; Wensing, A.M.; Leeuwen, J.P. van; Zandbergen, E.G.; Swanink, C.M.A.


    We describe a case of brain abscesses with gas formation following otitis media, for which the patient treated himself by placing clay in his ear. Several microorganisms, including Clostridium glycolicum, were cultured from material obtained from the patient. This is the first report of an infection

  18. Upper Cervical Epidural Abscess in a Patient With Parkinson Disease

    Al-Hourani, Khalid; Frost, Chelsea


    To our knowledge, there are no reports in the literature of patients with Parkinson disease (PD) developing upper cervical spine infections. Our objective is to present a case of upper cervical epidural abscess in a patient with PD and to review upper cervical spine infection. We present the patient’s presentation, physical examination, imaging findings, and management as well a review of the literature. A 66-year-old male with PD presented to the emergency department (ED) following referral by a neurologist for a presumed C2 fracture. The preceding history was 1 week of severe neck pain requiring a magnetic resonance imaging (MRI), which was initially interpreted as a C2 fracture. On admission from the ED, further review of the MRI appeared to show anterior prevertebral abscess and an epidural abscess. The patient’s neurological examination was at baseline. In the span of 2 days, the patient developed significant motor weakness. A repeat MRI demonstrated expansion of the epidural collection and spinal cord compression. Surgical management consisting of C1 and C2 laminectomy, irrigation, and debridement from anterior and posterior approaches was performed. Postoperatively, the patient did not recover any motor strength and elected to withdraw care and died. Spinal epidural abscess requires a high index of suspicion and needs prompt recognition to prevent neurological impairment. Upper cervical spine infections are rare but can lead to lethal consequences. PMID:26623170

  19. Dysgonic fermenter 3-associated abscess in a diabetic patient

    Bangsborg, Jette Marie; Frederiksen, W; Bruun, B


    We report a case in which a strain of the U.S.A. Centers for Disease Control (CDC) dysgonic fermenter (DF) 3, together with Citrobacter freundii, was isolated from an abscess in a diabetic patient. DF 3 may be easily overlooked due to its fastidious nature, a characteristic shared with two former...

  20. Renal Abscess in a Patient Presenting with Persistent Hiccups

    Mark Flanagan


    Full Text Available Hiccups are common, typically limited, and rarely present with adverse complications. In the context of persistent or intractable episodes, however, hiccups may signal a more serious underlying cause. Here, we present an unexpected and pathologic case of hiccups in a patient who was ultimately diagnosed with renal abscesses.

  1. Capnocytophaga Lung Abscess in a Patient with Metastatic Neuroendocrine Tumor

    Thirumala, Raghu; Rappo, Urania; Babady, N. Esther; Kamboj, Mini; Chawla, Mohit


    Capnocytophaga species are known commensals of the oral cavity of humans and animals (mainly dogs and cats) and are a rare cause of respiratory tract infections. We report a case of cavitary lung abscess caused by a Capnocytophaga species in a patient with a metastatic neuroendocrine tumor.

  2. Sternoclavicular joint septic arthritis following paraspinal muscle abscess and septic lumbar spondylodiscitis with epidural abscess in a patient with diabetes: a case report

    Shioya Nobuki


    Full Text Available Abstract Background Septic arthritis of the sternoclavicular joint (SCJ is extremely rare, and usually appears to result from hematogenous spread. Predisposing factors include immunocompromising diseases such as diabetes. Case presentation A 61-year-old man with poorly controlled diabetes mellitus presented to our emergency department with low back pain, high fever, and a painful mass over his left SCJ. He had received two epidural blocks over the past 2 weeks for severe back and leg pain secondary to lumbar disc herniation. He did not complain of weakness or sensory changes of his lower limbs, and his bladder and bowel function were normal. He had no history of shoulder injection, subclavian vein catheterization, intravenous drug abuse, or focal infection including tooth decay. CT showed an abscess of the left SCJ, with extension into the mediastinum and sternocleidomastoid muscle, and left paraspinal muscle swelling at the level of L2. MRI showed spondylodiscitis of L3-L4 with a contiguous extradural abscess. Staphylococcus aureus was isolated from cultures of aspirated pus from his SCJ, and from his urine and blood. The SCJ abscess was incised and drained, and appropriate intravenous antibiotic therapy was administered. Two weeks after admission, the purulent discharge from the left SCJ had completely stopped, and the wound showed improvement. He was transferred to another ward for treatment of the ongoing back pain. Conclusion Diabetic patients with S. aureus bacteremia may be at risk of severe musculoskeletal infections via hematogenous spread.

  3. Sciatic Hernia Mimicking Perianal Abscess in a Cirrhotic Patient

    Wellington Andraus


    Full Text Available Abdominal hernias are very frequent in cirrhotic patients with ascites. The hernias usually present as umbilical, inguinal, incisional, or femoral. However, these patients can also develop uncommon hernias such as pelvic hernias because of pelvic floor weakness and high abdominal pressure due to ascites. We present the first case of a cirrhotic patient with ascites that developed a giant sciatic hernia mimicking a perianal abscess.

  4. Phellinus tropicalis Abscesses in a Patient with Chronic Granulomatous Disease

    Ramesh, Manish; Resnick, Elena; Hui, Yiqun; Maglione, Paul J.; Mehta, Harshna; Kattan, Jacob; Bouvier, Nicole M.; LaBombardi, Vincent; Victor, Tanya R.; Chaturvedi, Sudha


    Chronic Granulomatous Disease (CGD), caused by genetic defects in components of the phagocyte NADPH oxidase pathway, leads to recurrent life-threatening bacterial and invasive fungal infections. While a number of unique pathogens have been associated with this disease, the causative organisms may be difficult to identify. Here, we present a 24 year old male with known X-linked CGD who concurrently developed a cervical abscess and an abscess in the subcutaneous tissues of the right hip, both of which were surgically drained. Cultures failed to identify any organisms. He was treated empirically with ertapenem but the hip abscess recurred at the original site and in contiguous dependent areas in the posterior thigh and knee. A filamentous organism was observed microscopically, initially considered a contaminant, but on culture yielded a mold growth, identified as Phellinus tropicalis (synonym: Inonotus tropicalis) based on phenotypic and molecular methods. This is the third case report of human infection with P. tropicalis, all in subjects with CGD. The patient was treated with voriconazole with resolution of his symptoms. PMID:24310980

  5. Spinal epidural abscess in a patient with piriformis pyomyositis

    Gerald S Oh


    Conclusion: A 19-year-old male presented with a holospinal epidural abscess (C2 to sacrum originating from piriformis pyomyositis. The multilevel cord abscess was emergently decompressed, leading to a marked restoration of neurological function.

  6. Disseminated nocardiosis with psoas abscess in a patient with AIDS: first reported case.

    Corti, Marcelo; Solari, Rubén; De Carolis, Luis; Cangelos, Diana; Bianchi, Mario; Negroni, Ricardo


    Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last years. We present a case of a patient with advanced human immunodeficiency virus infection who developed a disseminated infection due to Nocardia asteroides sensu stricto type VI with psoas abscess. To our knowledge no other cases of Nocardia psoas abscess in the setting of HIV infection have been reported in the literature.

  7. Ingestion and Pharyngeal Trauma Causing Secondary Retropharyngeal Abscess in Five Adult Patients

    Sudhir B. Sharma


    Full Text Available Retropharyngeal abscess most commonly occurs in children. When present in adults the clinical features may not be typical, and associated immunosuppression or local trauma can be part of the presentation. We present a case series of five adult patients who developed foreign body ingestion trauma associated retropharyngeal abscess. The unusual pearls of each case, along with their outcomes, are discussed. Pertinent information for the emergency medicine physician regarding retropharyngeal abscess is presented as well.

  8. Ultrasound guided percutaneous treatment for splenic abscesses: The significance in treatment of critically ill patients

    Enver Zerem; Jacob Bergsland


    AIM: To analyze the results of ultrasound guided percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess.METHODS: Thirty-six patients (14 females and 22 males, with an average age of 54.1 ± 14.1 years) with splenic abscess were treated with ultrasound guided PNA and/or PCD. Patients with splenic abscess < 50 mm in diameter were initially treated by PNA and those with abscess ≥ 50 mm and bilocular abscesses were initially treated by an 8-French catheter drainage. The clinical characteristics, underlying diseases, organism spectra,therapeutic methods, and morality rates were analyzed.RESULTS: Twenty-seven patients had unilocular and 9 bilocular abscess. PNA was performed in 19 patients (52.8%), and 8 of them (42.1%) required PCD because of recurrence of abscess. In 17 patients (47.2%), PCD was performed initially. PCD was performed twice in six patients and three times in two. PNA was definitive treatment for 10 and PCD for 21 patients. One patient with PCD was referred for splenectomy, with successful outcome. In all 4 deceased patients, malignancy was the underlying condition. Twenty-one patients (58.3%)underwent 33 surgical interventions on abdomen before treatment. Cultures were positive in 30 patients (83.3%).Gram-negative bacillus predominated (46.7%). There were no complications related to the procedure.CONCLUSION: Percutaneous treatmnet of splenic abscess is an effective alternative to surgery, allowing preservation of the spleen. This treatment is especially indicative for the patients in critical condition postoperatively. We recommend PNA as primary treatment for splenic abscesses < 50 mm, and PCD for those ≥ 50 mm in diameter and for bilocular abscesses.

  9. Patient Discomfort Following Single-Tooth Implant Placement

    Spin-Neto, Rubens; Pontes, Ana Emília Farias; Wenzel, Ann


    Aims: Evaluate postoperative discomfort (pain, bleeding and swelling) in single-tooth implant patients submitted to immediate or conventional tooth restoration together with assessment of treatment time. Methods: Twenty-four patients who received single-tooth maxillary dental implants were randomly...... assigned to an IR (Immediate Restoration) or CR (Conventional Restoration) group. In IR, an implant was inserted and a provisional tooth crown was delivered within the same session, while in CR it was delivered three months after implantation. Pain (first three days), bleeding (first day) and swelling...

  10. [Brodie's abscess].

    Lindsetmo, R O; Due, J; Singh, K; Stalsberg, H


    Brodie's abscess is a localized subacute or chronic osteomyelitis independent of any known previous acute infection. The entity is often mistaken for a bone tumour. The diagnosis requires biopsy. The treatment is curettage, drainage and antibiotics for a minimum of six weeks. We describe the characteristics of Brodie's abscess and describe a patient with an illustrating history, but with an unusual localization of the abscess (osilium).

  11. Role of percutaneous abscess drainage in the management of young patients with Crohn disease

    Pugmire, Brian S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Gee, Michael S. [Massachusetts General Hospital for Children, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Kaplan, Jess L.; Winter, Harland S. [Massachusetts General Hospital for Children, Department of Pediatrics, Boston, MA (United States); Hahn, Peter F.; Gervais, Debra A. [Massachusetts General Hospital, Division of Abdominal Imaging, Boston, MA (United States); Doody, Daniel P. [Massachusetts General Hospital for Children, Department of Surgery, Boston, MA (United States)


    Intra-abdominal abscess is a common complication of Crohn disease in children. Prior studies, primarily in adults, have shown that percutaneous abscess drainage is a safe and effective treatment for this condition; however, the data regarding this procedure and indications in pediatric patients is limited. Our aim was to determine the success rate of percutaneous abscess drainage for abscesses related to Crohn disease in pediatric patients with a focus on treatment endpoints that are relevant in the era of biological medical therapy. We retrospectively reviewed 25 cases of patients ages ≤20 years with Crohn disease who underwent percutaneous abscess drainage. Technical success was defined as catheter placement within the abscess with reduction in abscess size on post-treatment imaging. Clinical success was defined as (1) no surgery within 1 year of drainage or (2) surgical resection following drainage with no residual abscess at surgery or on preoperative imaging. Multiple clinical parameters were analyzed for association with treatment success or failure. All cases were classified as technical successes. Nineteen cases were classified as clinical successes (76%), including 7 patients (28%) who required no surgery within 1 year of percutaneous drainage and 12 patients (48%) who had elective bowel resection within 1 year. There was a statistically significant association between resumption of immunosuppressive therapy within 8 weeks of drainage and both clinical success (P < 0.01) and avoidance of surgery after 1 year (P < 0.01). Percutaneous abscess drainage is an effective treatment for Crohn disease-related abscesses in pediatric patients. Early resumption of immunosuppressive therapy is statistically associated with both clinical success and avoidance of bowel resection, suggesting a role for percutaneous drainage in facilitating prompt initiation of medical therapy and preventing surgical bowel resection. (orig.)

  12. Prevotella brain abscess in a healthy young patient with a patent foramen ovale.

    Han, Seong Rok; Choi, Chan Young; Kwak, Jae-Jin


    Brain abscesses are frequently caused by poly-microbial conditions. Comparatively, brain abscesses caused by Prevotella species are very rare. Right-to-left cardiac shunting due to a patent foramen ovale may predispose patients to infection. We report an isolated Prevotella brain abscess that occurred in a healthy, young, male patient with a patent foramen ovale. The patient did not have a clinically obvious odontogenic source of infection, and no other distant extracranial infectious sources were observed. The patient was successfully treated with stereotactic aspiration and antibiotics.

  13. Cerebral abscesses among Danish patients with hereditary haemorrhagic telangiectasia

    Kjeldsen, A D; Tørring, P M; Nissen, H;


    Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs), which due to paradoxical embolization may cause cerebral abscess.......Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs), which due to paradoxical embolization may cause cerebral abscess....

  14. Meningitis and subdural empyema as complication of pterygomandibular space abscess upon tooth extraction.

    Cariati, Paolo; Cabello-Serrano, Almudena; Monsalve-Iglesias, Fernando; Roman-Ramos, Maria; Garcia-Medina, Blas


    Complication of dental infections might be various and heterogeneous. The most common complications are represented by maxilar celulitis, canine space celulitis, infratemporal space celulitis, temporal celulitis and bacteremia. Among rarest complications we found: sepsis, bacterial endocarditis, mediastinitis, intracranial complications, osteomyelitis, etc. Although dental infections are often considered trivial entities, sometimes they can reach an impressive gravity. In this regard, the present study describes a case of dental infection complicated by meningitis, subdural empiema and cerebral vasculitis. Furthermore, we observed other neurological complications, like thalamic ischemic infarction, during the disease evolution. Noteworthy, these entities were not presented when the patient was admitted to hospital. Therefore, the main aim of this report is to highlight the serious consequences that an infection of dental origin could cause. Key words:Meningitis, subdural empyema, odontogenic infections.

  15. Meningitis and subdural empyema as complication of pterygomandibular space abscess upon tooth extraction

    Cabello-Serrano, Almudena; Monsalve-Iglesias, Fernando; Roman-Ramos, Maria; Garcia-Medina, Blas


    Complication of dental infections might be various and heterogeneous. The most common complications are represented by maxilar celulitis, canine space celulitis, infratemporal space celulitis, temporal celulitis and bacteremia. Among rarest complications we found: sepsis, bacterial endocarditis, mediastinitis, intracranial complications, osteomyelitis, etc. Although dental infections are often considered trivial entities, sometimes they can reach an impressive gravity. In this regard, the present study describes a case of dental infection complicated by meningitis, subdural empiema and cerebral vasculitis. Furthermore, we observed other neurological complications, like thalamic ischemic infarction, during the disease evolution. Noteworthy, these entities were not presented when the patient was admitted to hospital. Therefore, the main aim of this report is to highlight the serious consequences that an infection of dental origin could cause. Key words:Meningitis, subdural empyema, odontogenic infections. PMID:27703619

  16. Large Retropharyngeal Abscesses in an Immunocompetent Adult Patient with Disseminated Tuberculosis

    Amaya-Tapia, Gerardo; Rodríguez-Toledo, Arturo; Aguilar-Benavides, Sergio; Aguirre-Avalos, Guadalupe


    Patient: Male, 46 Final Diagnosis: Generalized tuberculous lymphadenitis with retropharyngeal abscesses and disseminated tuberculosis Symptoms: Lymphadenopathy • dysphagia • weight loss Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Unusual clinical course Background: The retropharyngeal abscess is a rare presentation of head and neck tuberculosis. The pathogenesis of the abscess formation in the retropharyngeal space in the adult is controversial. Case Report: We report a case of large retropharyngeal abscesses in a 46-year-old man with disseminated tuberculosis. The patient had severe progressive dysphagia, weight loss, and a slowly enlarging bilateral cervical mass during a period of three months. His posterior pharynx wall was bulging and red, and both tonsils were enlarged and congested. The neck had an abscess of 5 cm in diameter that was firm, tender, and warm along the left sternocleidomastoid muscle. Palpable bilateral lymphadenitis was detected in the submandibular, cervical, axillary, and inguinal regions. A computed tomographic (CT) scan of the neck revealed large bilobulated retropharyngeal abscesses. A liver ultrasound showed multiple hypoechoic lesions. A Ziehl-Neelsen smear for acid-fast bacilli was positive from different abscess samples, and mycobacterial cultures subsequently yielded Mycobacterium tuberculosis. Antituberculous therapy was begun and the retropharyngeal abscesses were aspirated by external incision with complete drainage and relief of symptoms. Conclusions: Large retropharyngeal abscess is a rare entity in which Mycobacterium tuberculosis etiology should be considered, especially in endemic countries, and the diagnosis may be difficult because symptoms and signs are influenced by abscess size and time of onset, or if the etiology is not suspected. PMID:27680292

  17. Rapidly expanding lung abscess caused by Legionella pneumophila in immunocompromised patients: a report of two cases.

    Miyara, Takayuki; Tokashiki, Kaori; Shimoji, Tsutomu; Tamaki, Kazunori; Koide, Michio; Saito, Atsushi


    We describe two cases of lung abscess caused by Legionella pneumophila in immunocompromised patients. The first case had been treated initially with 60 mg prednisolone for ulcerative colitis, and L. pneumophila serogroup 1 was isolated from sputum samples after cavitation of the lung lesion. The second case was diagnosed as plasma cell lymphoma at post-mortem examination. L. pneumophila serogroup 5 was isolated from the contents of lung abscess, together with Enterococcus faecium and Prevotella intermedia in the post-mortem examination. Lung abscess caused by Legionella is unusual. Here, we discuss the difficulty of diagnosis of legionellosis in patients with unusual chest radiographic findings.

  18. Prospective observational study of the frequency and features of intra-abdominal abscesses in patients with melioidosis in northeast Thailand.

    Maude, Rapeephan R; Vatcharapreechasakul, Teerapon; Ariyaprasert, Pitchayanant; Maude, Richard J; Hongsuwan, Maliwan; Yuentrakul, Prayoon; Limmathurotsakul, Direk; Koh, Gavin C K W; Chaowagul, Wipada; Day, Nicholas P J; Peacock, Sharon J


    Retrospective case series from Thailand have reported the presence of intra-abdominal abscesses in around half of patients with melioidosis, a much higher rate than our clinical experience would suggest. We performed a prospective, observational study of 230 adult patients with culture-confirmed melioidosis in which all patients underwent abdominal ultrasound. One or more abscesses were detected in the liver and/or spleen in 77 (33%) cases. These were often multiple (70%, 31/44 in hepatic abscesses and 88%, 50/57 in splenic abscesses) and clinically silent (27% of cases with abscesses presenting with abdominal pain). The mortality rate at 4 weeks post-discharge was lower in patients who were abscess-positive vs abscess-negative (10%, 8/77 vs 20%, 31/153).

  19. Thymic abscess with bacteremia and manubriosternal pyarthrosis in a geriatric patient.

    Rubinstien, E; Slavin, J


    We describe a geriatric patient with acute substernal chest pain thought to be due to coronary heart disease, who was subsequently found to have Staphylococcus aureus bacteremia associated with infection of the thymus and manubriosternal joint. To our knowledge, this is the first report of (1) a thymic abscess in a geriatric patient, (2) a thymic abscess associated with bacteremia, (3) extra-articular extension of manubriosternal pyarthrosis, and (4) manubriosternal pyarthrosis in the geriatric age group.

  20. Tuboovarian Abscess due to Colonic Diverticulitis in a Virgin Patient with Morbid Obesity: A Case Report

    Zafer Selçuk Tuncer


    Full Text Available Since tuboovarian abscess is almost always a complication of pelvic inflammatory disease, it is rarely observed in virgins. A 30-year-old virgin patient presented with pelvic pain, fever, and vaginal spotting for the previous three weeks. Her abdominopelvic computed tomography scan revealed bilateral multiseptated cystic masses with prominent air-fluid levels suggesting tuboovarian abscesses. The sigmoid colon was lying between two tuboovarian masses, and its borders could not be distinguished from the ovaries. The patient was presumed to have bilateral tuboovarian abscesses which developed as a complication of the sigmoid diverticulitis. She was administered intravenous antibiotic therapy followed by percutaneous drainage under ultrasonographic guidance. She was discharged on the twenty second day with prominent clinical and radiological improvement. Diverticulitis may be a reason for development of tuboovarian abscess in a virgin patient. Early recognition of the condition with percutaneous drainage in addition to antibiotic therapy helps to have an uncomplicated recovery.

  1. [Brain abscess due to Fusobacterium necrophorum in a patient with convulsion and no signs of meningitis].

    Shimohata, Mitsuteru; Naruse, Satoshi; Kawasaki, Satoshi; Watanabe, Yumiko; Koyama, Miyako; Ito, Yasushi; Tanaka, Hajime


    Here, we report brain abscess due to Fusobacterium necrophorum (F. necrophorum) in a 78-year-old healthy man. He developed convulsion and did not have any signs of meningitis. Although the brain magnetic resonance imaging findings of the left occipital lobe were typical of a brain abscess, his cerebrospinal fluid examination revealed only slight pleocytosis and mild increase in protein levels. Thus, it was difficult to rule out the possibility of metastatic brain tumor; the patient's condition was provisionally diagnosed as symptomatic epilepsy secondary to brain abscess. His convulsion disappeared soon after administration of antiepileptic, antibacterial, and steroid agents. A craniotomy was performed to evacuate the abscess, and F. necrophorum was identified by culturing the abscess contents. After the operation, he was treated with appropriate antibacterial agents, which resulted in resolution of the brain abscess. Although Fusobacterium species are gram-negative anaerobic bacilli commensal of the human oropharynx, we need to recognize that Fusobacterium species can be a primary pathogen causing brain abscesses and may leave residual neurological sequelae without early appropriate treatment.

  2. Endoscopic ultrasound-guided drainage of pelvic abscess: A case series of 8 patients

    Muhammed; Hadithi; Marco; J; Bruno


    AIM: To show the safety and effectiveness of endo-scopic ultrasound(EUS)-guided drainage of pelvic ab-scess that were inaccessible for percutaneous drainage. METHODS: Eight consecutive patients with pelvic abscess that were not amenable to drainage under computed tomography(CT) guidance were referred for EUS-guided drainage. The underlying cause of the abscesses included diverticulitis in 4, postsurgical surgi-cal complications in 2, iatrogenic after enema in 1, and Crohn’s disease in 1 patient. Abscesses were all drained under EUS guidance via a transrectal or transsigmoidal approach. RESULTS: EUS-guided placement of one or two 7 Fr pigtail stents was technically successful and uneventful in all 8 patients(100%). The abscess was perisigmoidal in 2 and was multilocular in 4 patients. All procedures were performed under conscious sedation and without fluoroscopic monitoring. Fluid samples were success-fully retrieved for microbiological studies in all cases and antibiotic policy was adjusted according to cultureresults in 5 patients. Follow-up CT showed complete re-covery and disappearance of abscess. The stents were retrieved by sigmoidoscopy in only two patients and had spontaneously migrated to outside in six patients. All drainage procedures resulted in a favourable clinical outcome. All patients became afebrile within 24 h after drainage and the mean duration of the postprocedure hospital stay was 8 d(range 4-14). Within a median follow up period of 38 mo(range 12-52) no recurrence was reported. CONCLUSION: We conclude that EUS-guided drain-age of pelvic abscesses without fluoroscopic monitoring is a minimally invasive, safe and effective approach that should be considered in selected patients.

  3. Fungal splenic abscesses in the immunosuppressed patient. Correlation of imaging modalities

    Vasquez, T.E.; Evans, D.G.; Schiffman, H.; Ashburn, W.L.


    A patient with fungal splenic abscesses is presented in whom multiple noninvasive diagnostic imaging modalities were available for correlation. Of the five imaging modalities, three (Gallium-67, ultrasound and computed tomography) were diagnostically useful, while two (liver-spleen scan and In-111 white blood cell scan) were not as useful. This case also stresses the use of repeated studies correlating with clinical impressions to obtain an accurate diagnosis in a potentially life-threatening condition such as splenic abscess.

  4. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature

    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.


    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  5. Expressive aphasia caused by Streptococcus intermedius brain abscess in an immunocompetent patient

    Khaja M


    Full Text Available Misbahuddin Khaja,1 Darryl Adler,2 George Lominadze2 1Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, 2Division of Critical Care Medicine, New York Presbyterian‑Lawrence Hospital Center, Affiliated with Columbia University College of Physician and Surgeons, Bronx, New York, NY, USA Background: Brain abscess is an uncommon but life-threatening infection. It involves a focal, intracerebral infection that begins in a localized area of cerebritis and develops into a collection of pus, surrounded by a well-vascularized capsule. Brain abscess still poses a significant problem in developing countries but rarely in developed countries. Predisposing factors vary in different parts of the world. With the introduction of antibiotics and imaging studies, the mortality rate has decreased between 5% and 15%. If left untreated it may lead to serious neurologic sequelae. The temporal lobe abscess can be caused by conditions like sinusitis, otitis media, dental infections, and mastoiditis if left untreated or partially treated. Additionally, in neurosurgical procedures like craniotomy, the external ventricular drain can get infected, leading to abscess formation. Case presentation: We present the case study of an elderly female patient who presented with expressive aphasia caused by brain abscess, secondary to Streptococcus intermedius infection. The 72-year-old female with a medical history of hypertension came to hospital for evaluation with word-finding difficulty, an expressive aphasia that began a few days prior to presentation. Computed tomography of the head showed a left temporal lobe mass-like lesion, with surrounding vasogenic edema. The patient was empirically started on courses of antibiotics. The next day, she was subjected to magnetic resonance imaging of the brain, which showed a left temporal lobe septated rim-enhancing mass lesion, with bright restricted

  6. Aesthetic rehabilitation in a patient with tooth wear

    Haroon Rashid


    Full Text Available This case report sheds light upon the procedural treatment of aesthetic oral rehabilitation in patients with tooth wear so that not only a specialist but also a general dental practitioner can easily tackle cases of this caliber. In this case report, the treatment of a 58-year-old man with aesthetics concerns, tooth wear, and sensitivity in anterior teeth is discussed. The need for a stabilizing splint, crown lengthening, and the provisioning of partial dentures in the upper and lower arches were all part of the treatment protocol in this case. The prevalence of tooth wear and the aesthetic demands of patients have increased in our society nowadays. When both of these problems are encountered together in the dental practice, strict treatment planning is needed to achieve success.

  7. Ileocecal masses in patients with amebic liver abscess: Etiology and management

    Sri Prakash Misra; Vatsala Misra; Manisha Dwivedi


    AIM: To assess the causes of ileocecal mass in patients with amebic liver abscess.METHODS: Patients with amebic liver abscess and ileocecal mass were carefully examined and investigated by contrast-enhanced CT scan followed by colonoscopy and histological examination of biopsy materials from lesions during colonoscopy.RESULTS: Ileocecal masses were found in seventeen patients with amebic liver abscess. The cause of the mass was ameboma in 14 patients, cecal tuberculosis in 2 patients and adenocarcinoma of the cecum in 1 patient. Colonic ulcers were noted in five of the six (83%) patients with active diarrhea at presentation. The ileocecal mass in all these patients was ameboma. Ulcers were seen in only one of the 11 (9%) patients without diarrhea. The difference was statistically significant from the group with diarrhea (P< 0.005).CONCLUSION: Ileocecal mass is not an uncommon finding in patients with amebic liver abscess. Although,the ileocecal mass is due to ameboma formation in most cases, it should not be assumed that this is the case in all patients. Colonoscopy and histological examination of the target biopsies are mandatory to avoid missing a more sinister lesion.

  8. Risk of Liver Abscess Formation in Patients with Prior Biliary Intervention Following Yttrium-90 Radioembolization

    Cholapranee, Aurada; Houten, Diana van; Deitrick, Ginna; Dagli, Mandeep; Sudheendra, Deepak; Mondschein, Jeffrey I.; Soulen, Michael C., E-mail: [University of Pennsylvania, Division of Interventional Radiology (United States)


    PurposePatients without a competent sphincter of Oddi due to prior surgical or endoscopic therapy are at high risk for liver abscess following chemoembolization despite aggressive antimicrobial prophylaxis. We examined a cohort of such patients undergoing Y-90 resin radioembolization and compared them to a cohort of chemoembolized patients.MethodsReview of our quality-assurance database identified 24 radioembolizations performed in 16 patients with prior biliary intervention. An aggressive prophylactic regimen of oral levofloxacin and metronidazole 2 days pre-procedure continuing for 14 days after, oral neomycin/erythromycin bowel prep the day before, and IV levofloxacin/metronidazole the day of treatment was prescribed. Patients underwent resin microsphere radioembolization dosed according to the BSA method. Patients had clinical, imaging, and laboratory assessment 1 month after each treatment, and then every 3 months. The chemoembolization cohort consisted of 13 patients with prior biliary intervention who had undergone 24 chemoembolization procedures.ResultsNo radioembolization patient developed an abscess. In the cohort of chemoembolized patients who received the same prophylaxis, liver abscess occurred following 3 of 24 (12.5 %) procedures in 3 of 13 (23 %) patients, one fatal.ConclusionsThis preliminary experience suggests that the risk of liver abscess among patients with prior biliary intervention may be lower following radioembolization than chemoembolization, which could potentially expand treatment options in this high-risk population.

  9. Peritonsillar abscess

    Sørensen, J A; Godballe, C; Andersen, N H;


    The occurrence of disease in the remaining tonsil after unilateral tonsillectomy à chaud in the treatment of peritonsillar abscess, was studied in 536 patients. No patient had a history of previous severe tonsillitis at the time of the unilateral tonsillectomy, 6.1 per cent of the patients were...... of patients younger than 30 years old who suffer from peritonsillar abscess irrespective of previous tonsillar disease. Patients older than 30 should be treated with unilateral ablation, unless there is a clear indication for bilateral tonsillectomy....

  10. Candidal liver abscesses and cholecystitis in a 37-year-old patient without underlying malignancy

    Chung-Hsu Lai; Hsin-Pai Chen; Te-Li Chen; Chang-Phone Fung; Cheng-Yi Liu; Shou-Dong Lee


    We report a case of candidal liver abscesses and concomitant candidal cholecystitis in a diabetic patient, in whom differences were noted relative to those found in patients with hematologic malignancies. In our case, the proposed entry route of infection is ascending retrograde from the biliary tract. Bile and aspirated pus culture repeatedly tested positive, and blood negative, for Candida albicans and Candida glabrata. Cholecystitis was cured by percutaneous gallbladder drainage and amphotericin B therapy. The liver abscesses were successfully treated by a cumulative dosage of 750 mg amphotericin B. We conclude that in cases involving less immunocompromised patients and those without candidemia, a lower dosage of amphotericin B may be adequate in treating candidal liver abscesses.

  11. Treatment of patients with acute colonic diverticulitis complicated by abscess formation

    Gregersen, Rasmus; Mortensen, Laura Quitzau; Burcharth, Jakob


    . Two authors screened the records independently, initially on title and abstract and subsequently on full-text basis. Articles describing patients treated acutely for Hinchey Ib and II were included. Results were presented by treatment, classified as non-operative (percutaneous abscess drainage (PAD......PURPOSE: This study aimed to systematically review the literature and present the evidence on outcomes after treatment for acute diverticulitis with abscess formation. Secondly, the paper aimed to compare different treatment options. METHODS: PubMed, EMBASE and the Cochrane Library were searched...... were the only available evidence. Treatment generally failed for 20% of patients, regardless of non-operative treatment choice. Abscesses with diameters less than 3 cm were sufficiently treated with antibiotics alone, possibly as outpatient treatment. Of patients treated non-operatively, 25...

  12. Professional and patient-based evaluation of oral rehabilitation in patients with tooth agenesis

    Dueled, Erik; Gotfredsen, Klaus; Trab Damsgaard, Mogens


    variables were acceptable in 92% of the implant reconstructions and for 83% of the tooth-supported fixed dental prostheses (FDPs). The total OHIP score was inferior in rehabilitated patients with tooth agenesis to that of the control group without tooth agenesis. The total OHIP score after rehabilitation......: The study included 129 patients with tooth agenesis rehabilitated with implant- or tooth-supported reconstructions, and a control group of 58 patients. Professional assessments included biological, technical and aesthetic variables. An aesthetic index score included mucosal discoloration, crown morphology......% of the patients in whom orthodontic treatment had been performed. Twelve percent of patients had implants with 5-7 mm peri-implant bone defects. Mucosal discoloration was recorded in 57% of the patients. Twelve percent of the patients had metal visible on the buccal side. The median scores for all five aesthetic...

  13. Lesion mimicking perianal abscess in an immunocompromised patient: Report of a case

    Aranzazu Calero-Lillo


    CONCLUSION: Intramuscular administration of drugs should be avoided in patients with thrombocytopenia. Gluteal region is connected to perianal area through the sciatic notch. Usually perianal abscess in immunocompromised patients arise from proctologic origin, but other causes may be taken into account.


    Manoj Kumar


    Full Text Available BACKGROUND: Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm containing necrotic debris or fluid caused by microbial infection. This pus - filled cavity is often caused by aspiration, which may occur during altered consciousness. OBJECTIVE: To study the clinical and etiological profile of lung abscess in patients admitted at a tertiary care centre. MATERIAL AND METHODS : A prospective study was condu cted on 142 cases with age more than 15 years, who were the suspected cases of lung abscess and the cases with evidence of lung abscess on the X - ray, CT scan presented to the OPD/ IPD clinic, Department of Pulmonary Medicine, Rohilkhand Medical College and Hospital (RMCH, Bareilly from January 2013 to December 2014 were included in the study. RESULTS: out of 142 patients enrolled in the study, 47(33.09% belonged to age group of ›60 years followed by 42(29.57% belong to 41 - 60 years of age. 116(81.6% wer e male and 26(18.3% were female. The most frequent symptom was cough (92.95%, followed by expectoration (91.54%, fever (87.32% and hemoptysis (41.5%. CONCLUSION: In our study conducted, data collection shows that lung abscess was more seen in the elderly and male patients 116( 81.6% as compared to female patients 26(18.3%. Majority of the patients had a risk factor of smoking, dental diseases, altered sensorium, comatosed patients, alcohol, diabetes, on steroid therapy and immunocompromised immune status. The following were the major symptoms in our patients : - Cough (92.95%, expectoration (91.54% , Fever(87.32%, Foul smell (66.90% , Chest pain (58.45% , Hemoptysis (41.5%, Impaired consciousness (29.57%. In our study locus of lesion was more pro minently on right side i.e. 101 patients ( 71.12% as compared to 36 ( 25.35%,while lung abscess was seen bilateral in 5 patients ( 3.5%. Primary lung abscess is a common presentation amongst the patients with the periodontal diseases, seizure

  15. Intramedullary abscess resulting from disseminated cryptococcosis despite immune restoration in a patient with AIDS.

    Rambeloarisoa, J; Batisse, D; Thiebaut, J-B; Mikol, J; Mrejen, S; Karmochkine, M; Kazatchkine, M D; Weiss, L; Piketty, C


    We report on a case of cryptococcal intramedullary abscess, which occurred three years after a disseminated cryptococcosis and two years after a lymph node cryptococcal recurrence in a HIV-infected patient who exhibited a long-standing immune restoration. At the time of diagnosis, CD4(+) lymphocyte-count was 640x10(6)/l and HIV viral load was undetectable. Spinal involvement is rare during cryptococcosis of the central nervous system. As far as we are aware, there is only one case of proven intramedullary cryptococcal abscess reported in the literature and this case is then the second one. The significant and sustained increase in CD4 count following effective antiretroviral therapy was probably associated with only a partial immune restitution that did not allow to avoid the occurrence of the cryptococcal medullar abscess. Finally, this case raises the question of when to stop secondary prophylaxis of cryptococcal disease after increase in CD4 cell count under antiretroviral therapy.

  16. Bilateral otogenic cerebellar abscesses.

    Nadkarni T


    Full Text Available An unusual presentation of bilateral otogenic cerebellar abscesses observed in two of our patients is reported. Both gave a history of otorrhoea, fever, headache, vomiting and had bilateral cerebellar signs and conductive hearing loss. The abscesses were detected on computerised tomography. X-rays revealed bilateral mastoiditis. The therapy followed was excision of abscesses, mastoidectomy and antibiotic therapy.

  17. Symmetrical Brodie's abscess.

    Chambler, A F; Chapman-Sheath, P J; Pearse, M F; Hollingdale, J


    Chronic recurrent multifocal osteomyelitis is often confused with symmetrical Brodie's abscess as it has a similar pathogenesis. We report an otherwise healthy 17-year-old boy presenting with a true symmetrical Brodie's abscess. We conclude that a symmetrical Brodie's abscess presenting in an otherwise healthy patient is a separate clinical condition with a different management protocol.

  18. Xylohypha bantiana Multiple Brain Abscesses in a Patient with Systemic Lupus Erythematosus

    Khalid F AlHabib


    Full Text Available Xylohypha bantiana is a rare cause of cerebral fungal infection (phaeohyphomycosis. We report on a 72-year-old man who, while taking several immunosuppressive medications for systemic lupus erythematosus, presented with multiple bilateral cerebral abscesses caused by X bantiana. The lesions were not surgically amenable and the patient died two months after discontinuing antifungal therapy.

  19. Prediction of Deep Neck Abscesses by Contrast-Enhanced Computerized Tomography in 76 Clinically Suspect Consecutive Patients

    Freling, Nicole; Roele, Elise; Schaefer-Prokop, Cornelia; Fokkens, Wytske


    Objectives/Hypothesis: Contrast-enhanced computerized tomography (CECT) has become the imaging method of choice in patients with clinical suspicion of a deep neck abscess. The purpose of this retrospective study was to assess the predictive value of the diagnosis of deep neck abscess using CECT. Stu

  20. Clinical and pathological features of pyogenic liver abscess in patients with diabetes mellitus

    An-lai JI


    Full Text Available Objective To summarize the clinical and pathological features of pyogenic liver abscess (PLA in patients with diabetes mellitus (DM. Methods A retrospective study was performed to analyze the clinical and pathological data of 42 DM patients with PLA in 306 Hospital of PLA from January 2001 to December 2010. Results All the DM patients with PLA were cured without relapse and mortality, and the hospital stay was 19-57 days. Thirty-three patients received minimally invasive surgical treatment, including 10 percutaneous needle aspiration (PNA, 23 percutaneous catheter drainage (PCD, and 3 patients undergoing surgical excision, with full and uneventful recovery. Among the 10 patients undergoing PNA, 6 patients were cured after one aspiration procedure, 3 patients after two, and 1 patient after three aspirations. The drainage tubes were removed from patients who received PCD after a mean of 8.6 days. 3-4 days after surgery, the temperature of patients returned to normal, and no complications occurred. The pathological examination revealed numerous fibrous septa in the abscess cavity, inflammatory cells infiltration in the liver tissues surrounding the abscess, and the presence of Mallory bodies in the cytoplasm. The examination also showed that the number of glycogen granule in the hepatocyte was decreased, and the expression of cytokeratin 8 increased (P<0.05. Conclusion  More attention should be paid to DM with the complication of PLA because of its particular clinical and pathological characteristics.

  1. Delayed Presentation of a Cervical Spinal Epidural Abscess of Dental Origin after a Fall in an Elderly Patient.

    Bodman, Alexa; Riordan, Margaret; Chin, Lawrence S


    Spinal epidural abscesses are an uncommon cause of spinal cord injury but, depending on the size and presence of neurological deficits, urgent neurosurgical intervention may be required. We present a unique case of a patient presenting with a spinal epidural collection several days after a fall. While a spinal epidural hematoma was suspected based on the patient's history and MRI findings, a spinal epidural abscess was found during surgery. The patient underwent laminectomy and instrumented fusion with successful treatment of her infection.

  2. Isolation of Salmonella enterica serotype Worthington from a splenic abscess in a patient with chronic myeloid leukemia

    Ghadage D.P.


    Full Text Available Splenic abscesses are caused by Staphylococcus aureus, Streptococcus and bacteria belonging to the family Enterobacteriaceae. We report a case of splenic abscess caused by an unusual serotype of Salmonella. A 55 year old man was admitted with complaints of fever and abdominal pain. On the basis of clinical findings and laboratory reports, a diagnosis of chronic myeloid leukemia was made. Ultrasonography of the abdomen revealed a single large cystic lesion in the spleen. Percutaneous drainage of the abscess was carried out. Salmonella enterica serotype Worthington was isolated from a pus sample taken from the abscess. The isolate was resistant to ampicillin, gentamicin, cefotaxime, chloramphenicol and tetracycline, and sensitive to amikacin and norfloxacin. Serotype Worthington is an emerging pathogen. This is the first report of isolation of this serotype from a splenic abscess. In seriously ill patients, such infections should be treated with a combination of antibiotics to circumvent problems with multidrug resistance.

  3. Lower extremities and iliopsoas pyomyositis with concurrent septic arthritis and spinal epidural abscess in a diabetic patient.

    Vallianou, N; Gounari, P; Skourtis, A; Kougias, M; Sioula, E


    Pyomyositis is a rarely encountered infection among diabetics, which usually affects lower extremities. Herein, we present a case of lower extremities and iliopsoas pyomyositis with concurrent septic arthritis and spinal epidural abscess in a patient with poorly controlled diabetes mellitus.

  4. Situs inversus totalis with azoospermia in a patient presenting with liver abscess

    P. Mohan Rao


    Full Text Available Situs inversus with dextrocardia is a rare congenital anomaly. Azoospermia and situs inversus may be encountered in ciliary dyskinesia syndromes. We report the case of a 30-year-old male who manifested situs inversus totalis, dextrocardia and azoospermia with maturation arrest at primary spermatogenesis who presented with liver abscess. The patient responded well to treatment with i.v. metronidazole and oral chloroquine.

  5. Patients with culture negative pyogenic liver abscess have the same outcomes compared to those withKlebsiella pneumoniae pyogenic liver abscess

    Vishal G Shelat; Qiao Wang; Clement LK Chia; Zhongkai Wang; Jee Keem Low; Winston WL Woon


    BACKGROUND: Etiologic organism is not frequently isolated despite multiple blood and lfuid cultures during management of pyogenic liver abscess (PLA). Such culture negative pyogen-ic liver abscess (CNPLA) is routinely managed by antibiotics targeted toKlebsiella pneumoniae. In this study, we evaluated the outcomes of such clinical practice. METHODS: All the patients with CNPLA andKlebsiella pneu-moniaePLA (KPPLA) admitted from January 2003 to Decem-ber 2011 were included in the study. A retrospective review of medical records was performed and demographic, clinical and outcome data were collected. RESULTS: A total of 528 patients were treated as CNPLA or KPPLA over the study period. CNPLA presented more com-monly with abdominal pain (P=0.024). KPPLA was more com-mon in older age (P=0.029) and was associated with thrombo-cytopenia (P=0.001), elevated creatinine (P=0.002), bilirubin (P=0.001), alanine aminotransferase (P=0.006) and C-reactive protein level (P=0.036). CNPLA patients tend to have anemia (P=0.015) and smaller abscess (P=0.008). There was no differ-ence in hospital stay (15.7 vs 16.8 days) or mortality (14.0% vs 11.0%). No patients required surgical drainage after initiation of medical therapy. CONCLUSION: Despite demographic and clinical differences between CNPLA and KPPLA, overall outcomes are not different.

  6. Finding of biliary fascioliasis by endoscopic ultrasonography in a patient with eosinophilic liver abscess.

    Behzad, Catherine; Lahmi, Farhad; Iranshahi, Majid; Mohammad Alizadeh, Amir Houshang


    Fascioliasis is an endemic zoonotic disease in Iran. It occurs mainly in sheep-rearing areas of temperate climates, but sporadic cases have been reported from many other parts of the world. The usual definitive host is the sheep. Humans are accidental hosts in the life cycle of Fasciola. Typical symptoms may be associated with fascioliasis, but in some cases diagnosis and treatment may be preceded by a long period of abdominal pain and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 6 months, with imaging suggesting liver abscess and normal biliary ducts. The patient had no eosinophilia with negative stool examinations, so she was initially treated with antibiotics for liver abscess. Her clinical condition as well as follow-up imagings showed appropriate response after antibiotic therapy. Finally, endoscopic ultrasonography revealed Fasciola hepatica, which was then extracted with endoscopic retrograde cholangiopancreatography.

  7. Skin Abscess due to Serratia marcescens in an Immunocompetent Patient after Receiving a Tattoo

    J. Diranzo García


    Full Text Available The incidence of skin infections caused by Serratia marcescens is extremely low and such infections are typically observed in immunocompromised patients. The clinical manifestations of these infections include cellulitis, abscesses, fluctuant nodules, or granulomatous lesions. Infections caused by S. marcescens are very difficult to treat due to their resistance to many antibiotics, which often leads to specific and prolonged treatment. Infections after receiving a tattoo are very rare and are caused by unhygienic conditions or the inexperience of the tattooist. In this paper we present the case of a 32-year-old male with no comorbidity, who presented an abscess caused by S. marcescens in a area that was tattooed one month earlier. The case was resolved with surgery and antimicrobial therapy that was based on the antibiogram. To our knowledge, this is the first reported case of a S. marcescens skin infection following a tattoo, in the absence of immunosuppression.

  8. Morganella morganii causing solitary liver abscess complicated by pyopericardium and left pleural effusion in a nondiabetic patient.

    Tsai, Wen-Cheng; Chang, Liang-Kai


    Morganella morganii is a rare cause of solitary liver abscess in Taiwan. The complication of pyopericardium and pleural effusion in nondiabetic patient with solitary liver abscess are also rare. We present a case of a 48-year-old nondiabetic woman who experienced with epigastric discomfort 1 month prior to admission. Chills and fever developed 2 weeks before admission. Physical examination on admission revealed engorgement of the jugular vein over the right neck, precordial friction rubs, and tenderness over the right upper quadrant of abdomen. Chest film showed mild cardiomegaly and left pleural effusion. Computed tomography of the abdomen showed liver abscess, left hepatic lobe, pyopericardium, and left pleural effusion. M. morganii was isolated from 2 sets of blood cultures, one set of hepatic pus culture, and one set of pericardial pus culture. After pigtail drainage of liver abscess, pyopericardium for 12 days, and ceftriaxone intravenous administration for 19 days, the patient was discharged in stable condition.

  9. Genotyping Klebsiella pneumoniae isolated from hepatic abscesses in three patients from Bogota, Colombia

    Dora I. Ríos


    Full Text Available Pyogenic liver abscess caused by Klebsiella pneumoniae represents an ever increasing entity which has mainly been described as occurring in Asia, even though, on a smaller scale, cases are being more frequently described from the USA and Europe, 13% overall mortality being reached worldwide. Affected patients are severely sick, suffering from fever, sweating, having increased acute phase reactants and risk factors such as Diabetes Mellitus, alcoholism and the inherent characteristics of the bacteria causing the disease. Objective: in this work we used a Multilocus Sequencing Typing (MLST, a nucleotide sequence-based method in order to characterize the genetic relationships among bacterial isolates. Materials and methods: the report is focused on three cases involving patients suffering from pyogenic liver abscess caused by Klebsiella pneumoniae in two hospitals in Bogota, Colombia, where phenotyping and hypermucoviscosity studies were carried out, as well as the genotyping of cultured Klebsiella isolates. Reults: it was found that the isolated microorganism in cases I and II corresponded to the same K. pneumoniae strain, having 100% sequence identity for the 5 genes being studied while the strain in Case III was genotypically different. Conclusion: it is important to carry out multidisciplinary studies allowing all pyogenic liver abscess cases reported in Colombia to be complied to ascertain the frequency of microorganisms causing this pathology in our country, as well as a genotyping study of different K. pneumoniae strains to compare them and confirm clonal and pathogenicity relationships through housekeeping gene analysis.

  10. Staphylococcus lugdunensis gluteal abscess in a patient with end stage renal disease on hemodialysis

    Mansoor Mehmood


    Full Text Available A 57-year-old end stage renal disease patient on hemodialysis (HD presented with sepsis secondary to right buttock abscess and overlying cellulitis. She was started on broad-spectrum antibiotic therapy and underwent incision and drainage with marked improvement. Her cultures grew methicillin-resistant Staphylococcus lugdunensis. This bacterium is more virulent than other coagulase negative staphylococci and has been implicated in causing a variety of serious infections but it has been underreported as a cause of skin infections in HD patients and possible other patient populations.

  11. Effect of rehabilitation on a patient suffering from a tuberculous brain abscess with Gerstmann's syndrome: case report.

    Kuo, Chih-Lan; Lo, Sui-Foon; Liu, Chun-Lin; Chou, Chia-Hui; Chou, Li-Wei


    There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann's syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann's syndrome, and right-sided apraxia.

  12. Entamoeba histolytica antigenic protein detected in pus aspirates from patients with amoebic liver abscess.

    Othman, Nurulhasanah; Mohamed, Zeehaida; Yahya, Maya Mazuwin; Leow, Voon Meng; Lim, Boon Huat; Noordin, Rahmah


    Entamoeba histolytica is a causative agent of amoebic liver abscess (ALA) and is endemic in many underdeveloped countries. We investigated antigenic E. histolytica proteins in liver abscess aspirates using proteomics approach. Pus samples were first tested by real-time PCR to confirm the presence of E. histolytica DNA and the corresponding serum samples tested for E. histolytica-specific IgG by a commercial ELISA. Proteins were extracted from three and one pool(s) of pus samples from ALA and PLA (pyogenic liver abscess) patients respectively, followed by analysis using isoelectric focussing, SDS-PAGE and Western blot. Unpurified pooled serum samples from infected hamsters and pooled human amoebic-specific IgG were used as primary antibodies. The antigenic protein band was excised from the gel, digested and analysed by MALDI-TOF/TOF and LC-MS/MS. The results using both primary antibodies showed an antigenic protein band of ∼14kDa. Based on the mass spectrum analysis, putative tyrosine kinase is the most probable identification of the antigenic band.

  13. Bacillus cereus brain abscesses occurring in a severely neutropenic patient: successful treatment with antimicrobial agents, granulocyte colony-stimulating factor and surgical drainage.

    Sakai, C; Iuchi, T; Ishii, A; Kumagai, K; Takagi, T


    Multiple brain and liver abscesses developed immediately after Bacillus cereus bacteremia in a neutropenic patient with acute lymphoblastic leukemia. After even 8 weeks of antimicrobial chemotherapy together with administration of granulocyte colony-stimulating factor, every infectious process disappeared but the patient's headache has still persisted. Because the wall of one brain abscess became thin and was in danger of rupturing into the ventricle, surgical drainage was performed, resulting in disappearance of headache and resolution of brain abscess. The present case indicates that a combined medical and surgical approach is mandatory to treat patients with brain abscesses.

  14. Morphological and Functional Parameters in Patients with Tooth Wear before and after Treatment

    Sierpinska, Teresa; Kuc, Joanna; Golebiewska, Maria


    Advanced tooth wear often results in lost vertical dimension and impacts facial aesthetics. Complex restorative treatment can replace the lost tooth structure and improve functional occlusal and facial skeleton parameters. Purpose: The aim of the study is to assess changes in the morphological and functional occlusal parameters of the facial skeleton after prosthetic rehabilitation that increased lost occlusal vertical dimension. Material and Methodology: 50 patients with advanced tooth wear ...

  15. Isolation on Chocolate Agar Culture of Legionella pneumophila Isolates from Subcutaneous Abscesses in an Immunocompromised Patient

    Cavalie, Laurent; Daviller, Benjamin; Dubois, Damien; Mantion, Benoît; Delobel, Pierre; Debard, Alexa; Prere, Marie-Françoise; Marchou, Bruno; Martin-Blondel, Guillaume


    Cutaneous infections due to Legionella species have rarely been reported (L. J. Padrnos, J. E. Blair, S. Kusne, D. J. DiCaudo, and J. R. Mikhael, Transpl Infect Dis 16:307–314, 2014; P. W. Lowry, R. J. Blankenship, W. Gridley, N. J. Troup, and L. S. Tompkins, N Engl J Med 324:109–113, 1991; M. K. Waldor, B. Wilson, and M. Swartz, Clin Infect Dis 16:51–53, 1993). Here we report the identification of Legionella pneumophila isolates, from subcutaneous abscesses in an immunocompromised patient, that grew in an unusual medium for Legionella bacteria. PMID:26292305

  16. Cerebral Abscess and Extraaxial Empyema in a Patient with Kartagener Syndrome

    Idil Gunes Tatar


    Full Text Available The triad of situs inversus totalis, bronchiectasis and sinusitis is known as Kartagener syndrome which is among the diseases with ciliopathies. Herein we present a case of cerebral abscess and extraaxial empyema detected in a 21-year-old male patient with Kartagener syndrome and a 10-year history of substance abuse. Preoperative CT, MRI findings and postoperative complications are presented with clinical and radiological review of primary ciliary dyskinesia. The consideration of primary ciliary dyskinesia in the differential diagnosis of frequent occurence of cough, rhinitis and otitis media in children is crucial since early diagnosis is known to affect the short term and long term morbidity.

  17. Rare and Serious Complications of Sinusitis in Pediatric Patients: Epidural Abscess.

    Sade, Recep; Polat, Gökhan


    Intracranial abscess has serious mortality. Therefore, early diagnosis and treatment is important. Intracranial abscess is rarely seen as a complication of sinusitis. Specially in children it has been reported rarely. Fever and headache can indicate complications in children.

  18. Effect of rehabilitation on a patient suffering from a tuberculous brain abscess with Gerstmann's syndrome: case report

    Kuo CL


    Full Text Available Chih-Lan Kuo1, Sui-Foon Lo1,2, Chun-Lin Liu3, Chia-Hui Chou4, Li-Wei Chou1,2,5¹Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; ²School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan; 4Department of Infectious disease, China Medical University Hospital, Taichung, Taiwan; 5Department of Physical Therapy, China Medical University, Taichung, TaiwanAbstract: There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann's syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann's syndrome, and right-sided apraxia.Keywords: tuberculous brain abscess, Gerstmann's syndrome, rehabilitation

  19. Multiple pyogenic liver abscess

    Mabrouk Bahloul; Anis Chaari; Nadia Bouaziz-Khlaf; Hatem Kallel; Leila Herguefi; Hedi Chelly; Chokri Ben Hamida; Mounir Bouaziz


    Multiple pyogenic liver abscesses have been rarely described. We report a fatal case of multiple pyogenic liver abscesses affecting a 38-year-old woman requiring surgical drainage. Evolution was marked by occurrence of a septic shock with multi-organ system failure. The patient died 48 h after surgery. Causes, therapeutics and outcome of the disease are discussed.

  20. Nocardia farcinica abscess of the cerebellum in an immunocompetent patient: A case report and review of the literature

    Pascual-Gallego, María; Alonso-Lera, Pedro; Arribi, Ana; Barcia, Juan A.; Marco, Javier


    Nocardial brain abscesses are uncommon and rarely occur in patients without predisposing factors. They may be mistaken for gliomas or necrotic metastases, and surgical intervention may be required to make the diagnosis. We report the first case of Nocardia farcinica cerebellar abscess in a patient without immunosuppression. He presented to us with headache and instability beginning a week before. Brain magnetic resonance imaging (MRI) revealed a cystic lesion located at the right cerebellar hemisphere, hypointense in T1 and hyperintense in T2, with a fine wall that enhanced after injection of gadolinium. Image tests also showed a cavitated lesion at the upper lobule of the right lung. The patient underwent craniotomy and drainage of the cerebellar abscess. Initial post-operative treatment with linezolid produced a limited response. He was re-operated and vancomycin, imipenem and ciprofloxacin were added with an excellent outcome of the cerebellar and lung lesions. PMID:27695569

  1. [Brain abscess caused by Haemophilus influenzae type E in a pediatric patient suffering from Apert syndrome].

    Isasmendi, Adela M; Pinheiro, José L; Escudé, Natalia García; Efrón, Adriana M; Moscoloni, María A; Hernández, Claudia M


    We report a case of a brain abscess caused by Haemophilus influenzae type e in a 12 year-old patient suffering from Apert syndrome. Apert syndrome is characterized by the premature closure of cranial sutures. In 2010 the patient suffered head trauma in the frontal area with cranial fracture and a cerebrospinal fluid fistula. In February 2013 he was admitted to hospital with fever, vomiting and generalized tonic-clonic seizure with deteriorating mental status/progressive sensory impairment. The computerized axial tomographic scan showed a right frontal lesion, perilesional edema, mild ventricular dilatation and pansinusitis. A brain abscess was diagnosed and drained. The clinical sample was then cultured. A gram negative coccobacillus was isolated and identified as Haemophilus influenzae serotype e. Empirical treatment was started with meropenem (120 mg/kg/day) and vancomycin (60 mg/kg/day), which was later switched to ceftriaxone (100 mg/kg/day) and metronidazole (500 mg/8 h) after culture results arrived. The patient was discharged in good clinical condition.

  2. Quality-of-life in Charcot-Marie-Tooth disease: the patient's perspective.

    Johnson, Nicholas E; Heatwole, Chad R; Dilek, Nuran; Sowden, Janet; Kirk, Callyn A; Shereff, Denise; Shy, Michael E; Herrmann, David N


    This study determines the impact of symptoms associated with Charcot-Marie-Tooth disease on quality-of-life. Charcot-Marie-Tooth patients in the Inherited Neuropathies Consortium Rare Diseases Clinical Research Network Contact Registry were surveyed. The survey inquired about 214 symptoms and 20 themes previously identified as important to Charcot-Marie-Tooth patients through patient interviews. Symptom population impact was calculated as the prevalence multiplied by the relative importance of each symptom identified. Prevalence and symptom impact were analyzed by age, symptom duration, gender, Charcot-Marie-Tooth type, and employment status. 407 participants returned the survey, identifying foot and ankle weakness (99.7%) and impaired balance (98.6%) as the most prevalent themes. Foot and ankle weakness and limitations with mobility were the themes with the highest impact. Both symptom prevalence and impact gradually increased with age and symptom duration. Several themes were more prevalent in women with Charcot-Marie-Tooth, including activity limitations, pain, fatigue, hip-thigh weakness, and gastrointestinal issues. All of the themes, except emotional or body image issues, were more prevalent among unemployed individuals. There were minimal differences in symptom prevalence between Charcot-Marie-Tooth types. There are multiple symptoms that impact Charcot-Marie-Tooth quality-of-life in adults. These symptoms have different levels of importance, are readily recognized by patients, and represent critical areas of Charcot-Marie-Tooth health.

  3. Salmonella enterica serovar Ohio septic arthritis and bone abscess in an immunocompetent patient: a case report

    Kato Hideaki


    Full Text Available Abstract Introduction Non-typhi Salmonella species cause severe extra-intestinal focal infection after occult bacteremia. Although the number of cases of non-typhi salmonellosis is increasing worldwide among patients with immunocompromising conditions such as human immunodeficiency virus infection, infection is uncommon in immunocompetent subjects. We report a case of septic arthritis and bone abscess due to a rare non-typhi Salmonella organism that developed after a prolonged asymptomatic period. Case presentation A 44-year-old Japanese immunocompetent man presented with acute-onset left knee pain and swelling. He had no history of food poisoning, and his most recent travel to an endemic area was 19 years ago. Salmonella enterica serovar Ohio was identified from samples of bone abscess and joint tissue. Arthrotomy and necrotic tissue debridement followed by intravenous ceftriaxone was successful. Conclusions Non-typhi Salmonella species only rarely cause extra-intestinal focal infections in immunocompetent patients. Our case suggests that non-typhi Salmonella species can cause severe focal infections many years after the occult bacteremia associated with food poisoning.

  4. Breast imaging after dark: patient outcomes following evaluation for breast abscess in the emergency department after hours.

    Bosma, Melissa S; Morden, Kasey L; Klein, Katherine A; Neal, Colleen H; Knoepp, Ursula S; Patterson, Stephanie K


    In our study, we sought to report the management, clinical outcomes, and follow-up rates of patients who presented for evaluation of breast abscess in the Emergency Department (ED) after hours. A retrospective search of ultrasound reports at our institution identified all patients from January 1, 2009 to June 30, 2013 who were scanned in the ED after hours to evaluate for breast abscess. Patient demographics, clinical information, imaging findings, follow-up rates, and outcomes were reviewed. One hundred eighty-five patients were included in the study. Forty-four percent (86/185) of the patients were diagnosed with abscess based on ultrasound findings in the ED. Twenty-seven percent (23/86) were recently post-operative, and 12 % (10/86) were postpartum/breastfeeding. Mastitis was the diagnosis in the remaining 54 % (99/185). Only 1/86 cases were associated with breast cancer. Seventy-seven percent (66/86) of patients were treated with an invasive procedure; 39 % (26/66) had surgical evacuation, 30 % (20/66) image-guided drainage, 23 % (15/66) bedside or clinic incision and drainage, and 8 % (5/66) palpation-guided fine needle aspiration (FNA). Seventy-seven percent (143/185) of patients had clinical and/or imaging follow-up. Forty-four percent (63/143) had long-term follow-up (≥ 3 months). Almost 50 % of the patients who presented to the ED for evaluation of abscess were diagnosed with abscess while the remaining patients were diagnosed with mastitis. Appropriate clinical and/or imaging follow-up occurred in 77 %. Long-term follow-up (≥ 3 months) occurred more frequently in patients older than 30 years of age. Appropriate follow-up does not occur in approximately one fourth of cases, suggesting that additional clinician and patient education is warranted.

  5. Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extension depicted by CT and MR in 30 patients

    Schuknecht, B. [Medizinisch Radiologisches Institut, Section Neuroradiology, Zurich (Switzerland); MRI, Zurich (Switzerland); Stergiou, G.; Graetz, K. [University Hospital of Zurich Switzerland, Department of Cranio-Maxillofacial Surgery, Zurich (Switzerland)


    Propagation of odontogenic masticator space abscesses is insufficiently understood. The purpose was to analyse pathways of spread in 30 patients with odontogenic masticator space abscess. The imaging findings in 30 patients (CT in 30, MR in 16 patients) were retrospectively analysed. CT and MR imaging depicted a masticator space abscess within: medial pterygoid muscle in 13 patients (43.3%), lateral masseter and/or pterygoid muscle in 14 (46.7%) and superficial temporal muscle in 3 patients (10%). In the lateral masticator space intra-spatial abscess extension occurred in 7 of 14 patients (50%). The sub-masseteric space provided a pathway in seven (70%). Extra-spatial extension involved the submandibular space only in 3 of 14 patients (21.4%). Medial masticator space abscesses exhibited extra-spatial spread only. Extension affected the parapharyngeal space and/or soft palate in 7 of 13 lesions (53.8%). MR imaging in comparison to CT increased the number of abscess locations from 18 to 23 (27.8%) and regions affected by a cellular infiltrate from 12 to 16 (33.3%). The sub-masseteric space served as a previously underestimated pathway for intra-spatial propagation of lateral masticator abscesses. Medial masticator space abscesses tend to display early extra-spatial parapharyngeal space and/or soft palate extension. (orig.)

  6. Proton MR spectroscopy in patients with pyogenic brain abscess: MR spectroscopic imaging versus single-voxel spectroscopy

    Hsu, Shuo-Hsiu, E-mail: [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); Chou, Ming-Chung, E-mail: [Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC (China); Ko, Cheng-Wen, E-mail: [Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC (China); Hsu, Shu-Shong, E-mail: [Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); Lin, Huey-Shyan, E-mail: [Program of Health-Business Administration, School of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC (China); Fu, Jui-Hsun, E-mail: [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); Wang, Po-Chin, E-mail: [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC (China); Pan, Huay-Ben, E-mail: [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC (China); Lai, Ping-Hong, E-mail: [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC (China)


    Purpose: Single-voxel spectroscopy (SVS) has been the gold standard technique to diagnose the pyogenic abssess. Two-dimensional magnetic resonance spectroscopic imaging (MRSI) is able to provide spatial distribution of metabolic concentration, and is potentially more suitable for differential diagnosis between abscess and necrotic tumors. Therefore, the purpose of this study was to evaluate the equivalence of MRSI and SVS in the detection of the metabolites in pyogenic brain abscesses. Materials and methods: Forty-two patients with pyogenic abscesses were studied by using both SVS and MRSI methods. Two neuroradiologists reviewed the MRS data independently. A κ value was calculated to express inter-reader agreement of the abscesses metabolites, and a correlation coefficient was calculated to show the similarity of two spectra. After consensus judgment of two readers, the binary value of metabolites of pyogenic abscesses (presence or absence) was compared between SVS and MRSI. Results: The consistency of spectral interpretation of the two readers was very good (κ ranged from 0.95 to 1), and the similarity of two spectra was also very high (cc = 0.9 ± 0.05). After consensus judgment of two readers, the sensitivities of MRSI ranged from 91% (acetate) to 100% (amino acids, succinate, lactate, lipid), and the specificities of MRSI were 100% for detecting all metabolites with SVS as reference. Conclusion: SVS and MRSI provide similar metabolites in the cavity of pyogenic brain abscess. With additional metabolic information of cavity wall and contralateral normal-appearing brain tissue, MRSI would be a more suitable technique to differentiate abscesses from necrotic tumors.

  7. Retropharyngeal abscess

    ... page: // Retropharyngeal abscess To use the sharing features on this page, please enable JavaScript. Retropharyngeal abscess is a collection of pus in the tissues ...

  8. Pancreatic abscess

    ... page: // Pancreatic abscess To use the sharing features on this page, please enable JavaScript. A pancreatic abscess is an area filled with pus within the ...

  9. Spinal epidural abscess in hemodialysis patients: a case series and review.

    Wong, San S; Daka, Smitha; Pastewski, Andrew; Kyaw, Win; Chapnick, Edward; Sepkowitz, Douglas


    Spinal epidural abscess (SEA) is a rare but potentially devastating condition. We noticed an increase in the number of cases of SEA, with the majority in hemodialysis (HD) patients. This prompted a retrospective chart review of all cases of SEA admitted from 2000 to 2005 and a literature search of similar cases. We identified 19 SEA cases treated at Long Island College Hospital during this 6-year period, of which six were on HD: four were dialyzed via catheter, one via arteriovenous fistula, and in one the method of dialysis was not documented. Four patients had bacteremia with Staphylococcus aureus. Four patients presented with paresis or paralysis; only one improved. The mortality rate was 33% (2/6). We found 30 other cases of SEA in patients on HD from the literature. These 36 HD cases were compared with 85 SEA cases that were not on HD (13 from our study and 72 described in two large case series). The mortality rate was noted to be much higher in HD patients (23% [6/26] versus 7% [6/85]). Neurologic deficit at presentation was noted in 47% (17/36) of HD patients versus 69% (59/85) of non-HD patients, but neurologic improvement was higher in non-HD patients (71% [42/59] versus 29% [5/17]). This is the largest literature review of SEA in patients on HD. When compared with non-HD patients, HD patients had a higher mortality rate and were less likely to improve neurologically.

  10. Management of premature primary tooth loss in the child patient.

    Law, Clarice S


    Premature loss of primary teeth can result in a loss of arch length and have a negative effect on occlusion and alignment, often increasing the need for orthodontic treatment. Use of space maintainers can reduce the severity of problems such as crowding, ectopic eruption, tooth impaction and poor molar relationship. This article presents a review of the consequences of premature tooth loss and discusses the appliances commonly used for space maintenance.

  11. Brodie's abscess revisited.

    Kornaat, P R; Camerlinck, M; Vanhoenacker, F M; De Praeter, G; Kroon, H M


    Radiology plays an important role in the diagnosis of a Brodie's abscess, as can be difficult for a clinician to identify the disease using clinical information alone. A Brodie's abscess is clinically difficult to diagnose because patients typically have mild local symptoms, few or no constitutional symptoms, and near normal laboratory values. Furthermore, a Brodie's abscess may mimic various benign and malignant conditions, resulting in delayed diagnosis and treatment. The most frequently made incorrect diagnosis is that of a primary bone tumor. The present pictorial review summarizes imaging clues to the diagnosis of a Brodie's abscess, such as the serpentine sign on conventional radiographs and the penumbra sign seen on Magnetic Resonance (MR) images. A Brodie's abscess is difficult to diagnose, however, once diagnosed, it is a curable disease with a 100% cure rate.

  12. First Case of Lung Abscess due to Salmonella enterica Serovar Abony in an Immunocompetent Adult Patient

    Vassiliki Pitiriga


    Full Text Available In healthy individuals, nontyphoidal Salmonella species predominantly cause a self-limited form of gastroenteritis, while they infrequently invade or cause fatal disease. Extraintestinal manifestations of nontyphoidal Salmonella infections are not common and mainly occur among individuals with specific risk factors; among them, focal lung infection is a rare complication caused by nontyphoidal Salmonella strains typically occurring in immunocompromised patients with prior lung disease. We describe the first case of a localized lung abscess formation in an immunocompetent healthy female adult due to Salmonella enterica serovar Abony. The patient underwent lobectomy and was discharged after full clinical recovery. This case report highlights nontyphoidal Salmonellae infections as a potential causative agent of pleuropulmonary infections even in immunocompetent healthy adults.

  13. Disseminated Cunninghamella bertholletiae infection with spinal epidural abscess in a kidney transplant patient: case report and literature review.

    Navanukroh, O; Jitmuang, A; Chayakulkeeree, M; Ngamskulrungroj, P


    Cunninghamella bertholletiae is a rare cause of invasive mucormycosis. We report the case of a 42-year-old Thai woman who suffered from disseminated C. bertholletiae infection. The patient developed dry cough, sharp shooting pain in the left buttock referred to the left leg, and fever 1 month after undergoing deceased-donor kidney transplantation. Radiographic studies exhibited multiple pulmonary cavities, osteomyelitis of the sacral spine, epidural abscess along the lumbrosacral spine, and paravertebral soft tissue involvement. Surgical debridement of the epidural abscess concurrent with prolonged intravenous administration of amphotericin B resulted in a good outcome.

  14. Pericardial effusion in a diabetic patient with prostatic abscess; Derrame pericardico associado a abscesso prostatico em paciente diabetico

    Omais, Ali Kassen; Oliveira, Julio Cesar; Tenuta, Marcos de Thadeu; Marchese, Miriam; Ricca, Rene A. Mattos; Tenuta, Maria Carolina Antunes de Oliveira, E-mail: [Hospital Geral Universitario (HGU/UNIC), Cuiaba, MT (Brazil); Chauchar, Fause; Cardoso Junior, Valdiro Jose; Carvalho, Valdinei Vieira de [Centro de Cardiologia, Cuiaba, MT (Brazil)


    Purulent pericarditis is a rare and potentially fatal disease. Its diagnosis and treatment is difficult. An aggressive antibiotic treatment and pericardial drainage are essentials for the treatment of purulent pericarditis. We report an unusual case of a diabetic patient with purulent pericarditis and prostatic abscess with good evolution after appropriate treatment. (author)

  15. An unusual case of a cheek abscess in a patient with oral submucous fibrosis

    Sushma Pandey Dhakal


    Full Text Available Abscess formation in the soft tissues of the face is not an uncommonly encountered phenomenon in dental practice. However, the presence of oral mucosal pathologies can alter the manifestation of abscess formation. We report the illustration of a 51-year-old man, a known case of oral submucous fibrosis, who presented to us with a buccal abscess. After drainage of the abscess 2 days later, a piece of meat-bone was retrieved and found to be the causative factor. The paper discusses briefly the effects of such foreign body impaction and the clinician′s role in the management.

  16. Septic thrombophlebitis of the superior mesenteric vein and multiple liver abscesses in a patient with Crohn's disease at onset

    Grueso Jose


    Full Text Available Abstract Background Portal-mesenteric vein thrombosis, pylephlebitis and liver abscesses are rare complications of inflammatory bowel disease (IBD. The purpose of this case report is to relate an unusual presentation of CD in order to show how conservative treatment could be an appropriate option as a bridge to the surgery, in patients with septic thrombophlebitis and multiple liver abscesses with CD. Case presentation We report a case of a 25-year-old man with Crohn's disease (CD who developed a superior mesenteric venous thrombosis, multiple liver abscesses and pylephlebitis, diagnosed through abdominal ultrasound and an abdominal computed tomography (CT scan. The patient was successfully treated with conservative treatment consisting of intravenous antibiotics, subcutaneous anticoagulation and percutaneous catheter drainage of liver abscesses. Conclusion We reported an unnusual case of pylephlebitis in CD. Until now this association has not been reported in adult patients at onset. We hypothesise that the infection developed as a result of mucosal disease and predisposed by corticoid therapy. Adequated management was discussed.

  17. Dual Site Sampling Improved Detection Rates for MRSA Colonization in Patients with Cutaneous Abscesses

    May, L.; McCann, C.; Brooks, G.; Rothman, R.; Miller, L.; Jordan, J.


    Extranasal sites are common reservoirs of Staphylococcus aureus colonization, and may be relevant for methicillin-resistant S. aureus (MRSA) screening and infection control strategies. The objective here was to determine whether inguinal specimens could also be screened using Xpert SA Nasal Complete assay for MRSA. Results were compared to broth enrichment culture. Among 162 consented adults seeking care in the Emergency Department for cutaneous abscesses, inguinal specimens were found positive for MRSA more often than nares specimens; 24% and 26% by PCR or culture, respectively compared to 19% each by PCR or culture. Overall, 6% of adults colonized with MRSA would have been missed by nares screening alone. Compared to culture, Xpert SA Nasal Complete assay demonstrated sensitivity and specificity of 89% and 97%, respectively for detecting nares and/or inguinal MRSA colonization. In conclusion, inguinal specimens were a more common reservoir for MRSA than nares specimens in this population of patients. PMID:24958641

  18. Fever with intradialytic pelvic pain: a case of iliopsoas abscess complicated with Methicillin-sensitive Staphylococcus Aureus bacteraemia in an end stage renal failure patient.

    Alif Adlan, M T; Wan Mohd Rasis, W A K; Mohd Ramadhan, M D


    Staphylococcus Aureus is a Gram-positive cocci bacteria which had been found to be the causative organism in over 88% of patients with primary iliopsoas abscess. We report the case of a 53-year-old diabetic woman with end-stage renal failure diagnosed with left iliopsoas abscess with a catheter-related infection. Computed tomogram (CT) of abdomen and pelvis revealed hypodense lesions of left psoas, iliacus and quadratus lumborum suggestive of psoas abscesses. In addition, osteomyelitis changes at left sacroiliac and hip joint were seen. At surgery, she was found to have abscess at the posterior psoas muscle where she underwent open surgery drainage and percutaneous drain was inserted. A high index of suspicion of iliopsoas abscess should be maintained among haemodialysis patients presenting with intradialytic pelvic and hip pain and treated with optimal antibiotics therapy with appropriate surgical intervention.


    de OLIVEIRA, Anna Paula Romero; PAPPALARDO, Mara Cristina; DANTAS, Daniel; LINS, Diogo; VIDAL, José Ernesto


    The spectrum of neurological complications associated with human immunodeficiency virus type 1 (HIV-1) infection is broad. The most frequent etiologies include primary diseases (caused by HIV itself) or secondary diseases (opportunistic infections or neoplasms). Despite these conditions, HIV-infected patients are susceptible to other infections observed in patients without HIV infection. Here we report a rare case of a brain abscess caused by Staphylococcus aureus in an HIV-infected patient. After drainage of the abscess and treatment with oxacilin, the patient had a favorable outcome. This case reinforces the importance of a timely neurosurgical procedure that supported adequate management of an unusual cause of expansive brain lesions in HIV-1 infected patients. PMID:27074328

  20. Autogenous tooth transplants for the pediatric dental patient: report of three cases.

    Kennedy, David


    There are select instances where autogenous tooth transplantation should be considered as part of the overall management of the developing occlusion in the child patient. These circumstances occur when there are missing mandibular premolars in Class II malocclusions with good faces, unevenly distributed agenesis, missing or lost incisors, and ectopic teeth. The purposes of this paper were to educate pediatric dentists about the autogenous tooth transplantation technique, its success, its potential advantages and disadvantages and to report on three cases treated with autogenesis tooth transplantation.

  1. Case presentation of an intranasal ectopic tooth in a pediatric patient.

    Yu, Chao; Gu, Deying; An, Junnan; Tang, Yuedi


    An ectopic tooth in the nasal cavity is a rare phenomenon, especially on the inferior turbinate. In most of the reported cases, no etiological explanation of the intranasal teeth has been suggested or found. In children, intranasal ectopic teeth are usually associated with cleft lip and alveolus. Here, we report a rare case of a pediatric patient with unilateral nasal obstruction due to an intranasal ectopic tooth originating from the inferior turbinate without any facial and dental deformities. This case is unique due to the unusual location of the ectopic tooth and its presentation in a child without facial and dental deformities.

  2. Smile design for the adolescent patient--interdisciplinary management of anterior tooth size discrepancies.

    Waldman, Alexander B


    Adolescent patients often seek orthodontic treatment to correct spacing of the maxillary anterior teeth. If the spacing is caused by a tooth size discrepancy that affects one or more anterior teeth, an interdisciplinary treatment plan involving orthodontic, restorative, and periodontal treatment is recommended to achieve a harmonious esthetic result. This article describes a clinical approach for treatment of these complex cases, focusing on the importance of tooth form, gingival esthetics, and treatment sequencing.

  3. Pyogenic liver abscess caused by Klebsiella pneumoniae: analysis of the clinical characteristics and outcomes of 84 patients

    CHAN Khee-siang; YU Wen-liang; TSAI Chi-lun; CHENG Kuo-chen; HOU Ching-cheng; LEE Meng-chih; TAN Che-kim


    Background The increased incidence of pyogenic liver abscess caused by Klebsiella pneumoniae (K. pneumoniae) was reported in the recent literature. This study was conducted retrospectively to investigate the clinical characteristics and outcomes of these patients. Methods Microbiological and medical databases of a medical center were searched from January 2000 to June 2003. Eighty-four patients with liver abscess caused by K. pneumoniae were analyzed. Results In the 84 patients, 52 men and 32 women aged (58.2±13.3) years on average, 64.4% had concomitant diabetes mellitus and 23.8% had biliary disease. The most common clinical symptoms were fever (98.8%), chills (69.0%) and abdominal pain (58.3%). 85.7% of the 84 patients received catheter drainage for the abscess. The length of hospital stay was (17.4±8.7) days. The mortality rate was 7.1%. Older age and presence of biliary disease were associated with mortality.Conclusions The Iow mortality of our patients was probably related to the high proportion of patients who received catheter drainage. Older age and presence of biliary disease were associated with the mortality.

  4. Patient satisfaction with single-tooth implant therapy in the esthetic zone

    den Hartog, Laurens; Meijer, Henny J. A.; Santing, Hendrik J.; Vissink, Arjan; Raghoebar, Gerry M.


    This prospective study assessed patient satisfaction before and after single-tooth implant therapy in the esthetic zone. Before implant therapy, patients wore an acrylic resin tissue-supported removable partial denture (RPD). A total of 153 patients were included. Self-administered questionnaires re

  5. Clinical and Epidemiological behavior of Acute Dentoalveolar Abscess in Patients of the Health Area VII in Cienfuegos

    Ana Belkys Hernández Millán


    Full Text Available Background: acute dentoalveolar abscess is a dental emergency and one of the major condition affecting the population; however, there are few studies on the subject. Objective: to describe the clinical and epidemiological characteristics of acute dentoalveolar abscess in patients of the health area VII in Cienfuegos. Methods: a descriptive study was conducted from January to December 2013 in the Health Area VII, Cienfuegos. The universe consisted of 672 patients and the sample included 374 individuals selected by simple random sampling. Primary data recording and data collection was obtained from medical records prior informed consent of the patients. The main variables were age, sex, pulp irritating agents. Results: females were more affected with 55, 35% and the 19-34 year age group with 33.69%. The main pulp irritator was microbial, 59.36%. Among the iatrogenic factors, the remains of decayed tissues were significant with 32.35%. Conclusions: there is a high number of patients with acute dentoalveolar abscess, thus, as a dental emergency, the dentist should know the characteristics and factors that develop the disease to promote a comprehensive job in terms of health promotion, prevention, treatment and rehabilitation of affected patients.

  6. [Cord blood transplantation after successful treatment of brain abscess caused by Bacillus cereus in a patient with acute myeloid leukemia].

    Kuwabara, Hideyuki; Kawano, Tomoko; Tanaka, Masatugu; Kobayashi, Shoichi; Okabe, Gaichi; Maruta, Atsuo; Nagao, Takeshi; Ishigatsubo, Yoshiaki; Mori, Hiraku


    Central nervous system infection caused by Bacillus cereus is a rare condition, which often progresses rapidly and is fatal in immunocompromised patients. A 54-year-old woman with acute myelogenous leukemia fell into a coma with high fever during severe neutropenia while undergoing chemotherapy. A blood culture demonstrated the presence of B. cereus and magnetic resonance imaging showed multiple abnormal lesions in her brain. The patient was treated with meropenem and vancomycin, and recovered from the coma in a week. Antibiotic therapy was administered for seven weeks, and then she underwent cord blood transplantation for refractory acute myelogenous leukemia with successful engraftment without exacerbation of the brain abscess. This case demonstrates that brain abscess caused by B. cereus can be treated without surgical treatment.

  7. Brodie's Abscess in a Patient Presenting with Sickle Cell Vasoocclusive Crisis.

    Ogbonna, Onyekachi Henry; Paul, Yonette; Nabhani, Hasan; Medina, Adriana


    First described by Sir Nicholas Brodie in 1832, Brodie's abscess is a localized subacute or chronic infection of the bone, typically seen in the metaphases of long bones in children and adolescents. The diagnosis can prove to be enigmatic due to absence of clinical signs and symptoms of systemic disease. We report a very interesting case of Brodie's abscess masquerading as sickle cell vasoocclusive crisis in a 20-year-old female with sickle cell disease and review the literature.

  8. Immediate fixed partial denture after tooth extraction in patients with systemic diseases: A clinical report

    Kang, Hyun Sun; Lee, Su Young


    For patients with systemic diseases who face difficulties visiting dental clinics, wearing fixed partial denture in the anterior region on the same day of tooth extraction can reduce the total period of treatment and the number of visits, as well as post-treatment psychological effect on the patient.

  9. Immediate fixed partial denture after tooth extraction in patients with systemic diseases: A clinical report.

    Kang, Hyun Sun; Lee, Su Young


    For patients with systemic diseases who face difficulties visiting dental clinics, wearing fixed partial denture in the anterior region on the same day of tooth extraction can reduce the total period of treatment and the number of visits, as well as post-treatment psychological effect on the patient.

  10. Immediate fixed partial denture after tooth extraction in patients with systemic diseases: A clinical report


    For patients with systemic diseases who face difficulties visiting dental clinics, wearing fixed partial denture in the anterior region on the same day of tooth extraction can reduce the total period of treatment and the number of visits, as well as post-treatment psychological effect on the patient. PMID:28018570

  11. Usefulness of Serum Procalcitonin Levels in Predicting Tubo-Ovarian Abscess in Patients with Acute Pelvic Inflammatory Disease.

    Erenel, Hakan; Yilmaz, Nevin; Oncul, Mahmut; Acikgoz, Abdullah Serdar; Karatas, Suat; Ayhan, Isil; Aslan, Berna; Tuten, Abdullah


    We aimed to investigate the clinical importance of serum procalcitonin (PCT) levels in the diagnosis of tubo-ovarian abscess (TOA). Patients diagnosed with pelvic inflammatory disease (PID; n = 36) and patients diagnosed with TOA (n = 42) were included in the study. Sociodemographic characteristics, laboratory and clinical parameters were compared between the 2 groups. Mean PCT level was higher in the TOA group (p = 0.004). Mean length of stay in hospital was longer in patients with TOA (p TOA. Serum PCT is a promising inexpensive marker for the diagnosis of TOA in PID patients.

  12. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst


    We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection ...

  13. [Acute periproctal abscesses].

    Slauf, P; Antoš, F; Marx, J


    Periproctal inflammations related to the anus are characterized by the rapid spread of the infection to the surrounding tissue, which is determined by the anatomical characteristics and infectious agents. Inflammation, which starts as a phlegmon, quickly forms boundaries and an abscess develops in most cases. Up to 80-90% of anorectal abscesses develop according to the crypto-glandular theory on the basis of infection of the anal glands, spilling into the Morgagni crypts in the anal canal. Up to two-thirds of such abscesses are associated with the emergence of anorectal fistulas. Anorectal abscesses can be divided into marginal and subcutaneous perianal abscesses, submucosal, intersphincteric, ischiorectal and supralevator abscesses. Their diagnosis is based on thorough physical examination, sometimes also with the help of imaging methods such as computed tomography, magnetic resonance imaging and endoanal ultrasound. What is decisive for the successful treatment of anorectal abscessess is their early and adequate surgical drainage. Adjuvant antibiotic therapy is necessary only when the overall signs of sepsis are present and for patients with a comorbidity such as diabetes, valvular heart disease, or immunodeficiency.

  14. Comparison of Tooth Size Discrepancy in Cl II Malocclusion Patients with Normal Occlusions

    Moradi M.


    Full Text Available Statement of Problem: There must be a proper mesiodistal tooth size ratio (Bolton analysis between maxillary and mandibular teeth for good occlusal interdigitation. Therefore the Bolton analysis should be considered during diagnosis, treatment planning and predication of ultimate results.Purpose: The purpose of this study was to appraise tooth size ratios in Cl II malocclusion group and compare them with normal individuals. Materials and Method: This study was carried out on 60 pre-treatment orthodontic casts of class II malocclusion patients and 60 diagnostic casts of normal occlusion individuals which were selected through cluster sampling in accordance with the selective criteria. Each group consisted of 30 men and 30 women. The greatest mesiodistal diameters of all the teeth on each cast were measured by a digital calliper with 0.01mm accuracy except the second and third molars. Then tooth size ratios were analyzed as Bolton described. The statistical analysis were performed by chi-square and t-tests using SPSS. Results: The prevalence of anterior and overall tooth size discrepancy was rela-tively high (28.3%, 20%, showing no significant difference between men and women (p> 0.05. The mean of anterior and overall tooth- size ratios in Cl II malocclusion group were 79.18 and 92.39 respectively, which were statistically different from the Bolton study (ideal occlusion ratios (p 0.05.Conclusion: Considering the high frequency of tooth size discrepancy among CLII patients and the significant difference in Bolton ratios between this malocclusion and ideal occlusions; it seems that tooth size discrepancy can be considered as a possible etiologic factor and Bolton analysis should be performed as a pre-treatment diagnostic tool for this type of malocclusion.

  15. Tumor abscess formation caused by Morganella morganii complicated with bacteremia in a patient with gastrointestinal stromal tumor.

    Chen, Hsuan-Wei; Lin, Te-Yu


    We report the case of a 22-year-old man who presented with a 3-day history of watery diarrhea, abdominal pain, and fever. An image of the abdomen showed a heterogeneously echogenic mass lesion in the pelvis. The results of the blood cultures performed on admission showed the presence of Morganella morganii. Computed tomography-guided tube drainage was performed, and a culture of the drained abscess fluid yielded M. morganii growth. Exploratory laparotomy with segmental resection of the jejunum and excision of the tumor was performed. Pathological examination showed a gastrointestinal stromal tumor (GIST). A GIST abscess caused by M. morganii was diagnosed on the basis of radiological, microbiological, and histopathological findings. The possibility of an infected GIST should be considered during the differential diagnosis of patients with suspected abdominal neoplasm and bacteremia.

  16. Distribution of common pathogens in patients with pyogenic liver abscess in China: a meta-analysis.

    Luo, M; Yang, X-X; Tan, B; Zhou, X-P; Xia, H-M; Xue, J; Xu, X; Qing, Y; Li, C-R; Qiu, J-F; Li, Y-L


    Pyogenic liver abscess (PLA) is a potentially life-threatening disease in many parts of the world, especially in Asia. The aim of this study was to quantify the proportion of common pathogens in patients with PLA in China, using a meta-analysis method based on systematic review of published studies. Several electronic databases were searched to identify the studies reporting the pathogens of PLA. We performed a meta-analysis to calculate the pooled proportion of pathogens and subgroup analysis among the included studies using R 3.1.1 software. In total, 183 studies were included in our final analysis, Klebsiella spp (54 %), Escherichia spp (29 %), Enterobacter spp (9 %), Proteus spp (6 %) and Pseudomonas spp (5 %) comprised the major gram-negative bacteria. Gram-positive bacteria mainly included Staphylococcus spp (13 %), Streptococcus spp (8 %) and Enterococcus spp (7 %). The distribution of pathogens in PLA patients were different in different economic regions in China. The proportion of Klebsiella spp had an upward tendency in recent years compared to other pathogens. In addition, the proportion of common pathogens in PLA patients with diabetes mellitus (DM) were carried out indicating that the dominant pathogens were Klebsiella spp (66 %), Escherichia spp (21 %) and Enterobacter spp (11 %). This meta-analysis showed that the main pathogens of PLA were Klebsiella spp, Escherichia spp, Staphylococcus spp, and Enterobacter spp in China. To ensure a precise estimate of the epidemiology of the pathogens, further large-scale or even a population-based study is needed.

  17. Urinary Tract Infection Caused by Citrobacter koseri in a Patient With Spina Bifida, an Ileal Conduit and Renal Caluli Progressing to Peri-nephric Abscess and Empyema.

    Stewart, Zachary E; Shaker, Mohammed; Baxter, J David


    Urological problems are common in spina bifida and are often treated with urinary diversions. Spina bifida and ileal conduits put patients at increased risk for ascending urinary tract infections. Here we present a novel case of a Citrobacter koseri urinary tract infection complicated by a perinephric abscess with pleural extension. To our knowledge, no case of an ascending C. koseri UTI progressing to peri-nephric abscess and empyema by direct extension exists in the literature.

  18. Anorectal abscess

    Complications of anorectal abscess may include: Anal fistula (abnormal connection between the anus and another structure) Infection that spreads to the blood ( sepsis ) Continuing pain Problem keeps coming back (recurrence) ...

  19. Epidural abscess

    ... or scalp Bone infections of the spine (vertebral osteomyelitis) People who inject drugs are also at increased ... may include: Brain abscess Brain damage Bone infection (osteomyelitis) Chronic back pain Meningitis Nerve damage Return of ...

  20. Klebsiella Pneumoniae Multi-organ Abscesses not Accompanied by Liver Abscesses: A Case Report

    Kim, Sung Taek; Park, Chul Hi; Hwang, Ho Kyung; Lee, Mi Ran; Lee, Dong Hoon; Kim, Min Ji [Dept. of Radiology, Seoul Medical Center, Seoul (Korea, Republic of)


    A Klebsiella pneumoniae infection has a tendency to spread to multiple organs. It is most commonly seen in patients with liver abscesses, but infection in more than three organs without liver abscesses is unusual. We report one case of a K. pneumoniae infection that presented acute pyelonephritis with left perirenal, anterior pararenal, left psoas, and prostate abscesses without liver abscesses in a diabetic patient. With effective antibiotics and ultrasound-guided percutaneous drainage, the patient recovered without significant sequelae.

  1. Splenic abscesses.

    Al-Hajjar, Nadim; Graur, Florin; Hassan, Aboul B; Molnár, Geza


    Splenic abscesses are rare entities (autopsy incidence between 0.14-0.7%). The most frequent etiology is the septic emboli seeding from bacterial endocarditis (about 20% of cases) or other septic foci (typhoid fever, malaria, urinary tract infections, osteomielitis, otitis). The treatment of splenic abscesses was until recently splenectomy with antibiotherapy. The actual trends are more conservative (mini invasive or non-invasive) because the immunologic role of the spleen has been better understood over the last year

  2. Absceso intramedular en paciente con enfermedad de Rendu-Osler-Weber Spinal abscess in a patient with hereditary hemorrhagic telangiectasia

    Lorena V Maldonado


    Full Text Available La enfermedad de Rendu-Osler-Weber es una enfermedad autosómica dominante que se manifiesta por telangiectasias en piel y mucosas y malformaciones arteriovenosas en diversos órganos. El compromiso neurológico puede ocurrir por la presencia de malformaciones arterio-venosas cerebrales, hemorragia intracraneal, y más habitualmente por accidentes cerebrovasculares isquémicos y abscesos cerebrales secundarios a embolia paradojal, en pacientes con malformaciones arteriovenosas pulmonares. El absceso intramedular es una entidad rara, inusual como complicación de la enfermedad de Rendu-Osler-Weber. Presentamos el caso de una mujer de 56 años de edad, con antecedentes familiares de enfermedad de Rendu-Osler- Weber, que ingresó a Terapia Intensiva con cuadriplejia aguda e hipoxemia, en quien se diagnosticó fístulas arteriovenosas pulmonares y un absceso intramedular cervical.Rendu-Osler-Weber syndrome is an autosomal dominant disorder characterized by multiple skin and mucosal telangiectasis and multiorgan arteriovenous malformations. Neurological manifestations may occur because of cerebral arteriovenous malformations, intracranial hemorrhage, and most commonly by ischemic stroke and brain abscess secondary to paradoxical embolization in patients with pulmonary arteriovenous malformations. Intramedullary abscess is a rare, unusual condition, in Rendu-Osler-Weber syndrome. We report the case of a 56 years old woman, with a familial history of Rendu-Osler-Weber syndrome, admitted to intensive care with acute quadriplegia and hypoxemia. Our diagnosis was pulmonary arteriovenous malformations and intramedullary abscess.

  3. On the use of prothrombin complex concentrate in patients with coagulopathy requiring tooth extraction.

    Morimoto, Yoshinari; Niwa, Hitoshi; Nakatani, Takeshi


    In patients on high-level anticoagulant therapy (prothrombin time-international normalized ratio [PT-INR] ≥ 4.5), surgical procedures can be carried out with bridging therapy using heparin. However, surgical treatment options are severely limited in patients on high-level anticoagulant therapy and who have heparin-induced thrombocytopenia (HIT), as heparin use is contraindicated. We performed tooth extraction using prothrombin complex concentrate (PCC) in 2 HIT patients on high-level anticoagulation therapy (PT-INR ≥ 4.5). Five hundred units of PCC were administered intravenously, and after 15 minutes, it was confirmed that PT-INR was less than 2.0. Tooth extraction was then performed and sufficient local hemostasis was achieved. At 3 hours after tooth extraction, PT-INR was 2.0 or higher and later increased to 4.0 or higher, but postoperative bleeding was mostly absent. When performing tooth extraction in HIT patients on high-level anticoagulant therapy, favorable hemostatic management was achieved through sufficient local hemostasis and transient warfarin reversal using PCC.

  4. Community-Acquired Serratia Marcescens Spinal Epidural Abscess in a Patient Without Risk Factors: Case Report and Review

    Michael D Parkins


    Full Text Available Serratia marcescens has rarely been reported as an agent of invasive disease in patients presenting from the community. Furthermore, S marcescens is frequently opportunistic, affecting individuals with serious medical comorbidities including immune suppression and diabetes. A case of a community-acquired S marcescens spontaneous lumbar epidural abscess presenting as cauda equina syndrome is reported in a previously well 36-year-old man with no identifiable risk factors. To the authors’ knowledge, this is the first report of invasive S marcescens causing disease in a patient with no medical comorbidities.

  5. Case Report: Emergency awake craniotomy for cerebral abscess in a patient with unrepaired cyanotic congenital heart disease

    Fassl, Jens; Tobler, Daniel; Zumofen, Daniel; Steiner, Luzius A.; Goettel, Nicolai


    We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease. PMID:27928498

  6. Community-acquired Serratia marcescens spinal epidural abscess in a patient without risk factors: Case report and review.

    Parkins, Michael D; Gregson, Daniel B


    Serratia marcescens has rarely been reported as an agent of invasive disease in patients presenting from the community. Furthermore, S marcescens is frequently opportunistic, affecting individuals with serious medical comorbidities including immune suppression and diabetes. A case of a community-acquired S marcescens spontaneous lumbar epidural abscess presenting as cauda equina syndrome is reported in a previously well 36-year-old man with no identifiable risk factors. To the authors' knowledge, this is the first report of invasive S marcescens causing disease in a patient with no medical comorbidities.

  7. Peritonsillar Abscess (For Teens)

    ... Surgery? A Week of Healthy Breakfasts Shyness Peritonsillar Abscess KidsHealth > For Teens > Peritonsillar Abscess A A A ... en español Abscesos periamigdalinos What Is a Peritonsillar Abscess? A peritonsillar abscess is an area of pus- ...

  8. Percutaneous Abscess Drainage

    ... Physician Resources Professions Site Index A-Z Percutaneous Abscess Drainage An abscess is an infected fluid collection ... are the benefits vs. risks? What is Percutaneous Abscess Drainage? An abscess is an infected fluid collection ...

  9. Endophthalmitis after tooth extraction in a patient with previous perforating eye injury.

    Ogurel, Tevfik; Onaran, Zafer; Ogurel, Reyhan; Örnek, Kemal


    The aim of this stuty is to describe a case of endophthalmitis after tooth extraction in a patient with previous perforating eye injury. 50 years old male patient attempted to our clinic with complaints of sudden severe pain, reduced vision, light sensitivity and redness in the right eye. The patient stated that severe pain in his eye began approximately 12 hours following tooth extraction. The patient's ocular examination revealed a visual acuity of hand motion in the right eye. Anterior segment examination of the right eye showed intense conjunctival hyperemia, chemosis, a fine keraticprespitat and corneal edema. Dental procedures of the patients who had recently underwent ocular surgery or trauma should be done in a more controlled manner under anti -infective therapy or should be postponed in elective procedures.

  10. First clinical description of Eggerthia catenaformis bacteremia in a patient with dental abscess

    Kordjian, Hayarpi H; Schultz, Joyce D J H; Rosenvinge, Flemming Schønning


    We present a case of Eggerthia catenaformis bacteremia originating from a dental abscess and imitating necrotizing fasciitis in a previously healthy adult. The isolates were easily identified by MALDI-TOF MS. The clinical course, surgical and antibiotic treatment as well as the successful outcome...

  11. Laparoscopic appendectomy in a pediatric patient with type 1 Charcot-Marie-Tooth disease.

    Heller, Joshua A; Marn, Richard Y


    A pediatric patient with type 1 Charcot-Marie-Tooth disease-a disorder associated with a demyelinating polyneuropathy-presented for laparoscopic appendectomy in the setting of acute appendicitis. Induction and maintenance of anesthesia were successfully managed without the use of any depolarizing or nondepolarizing neuromuscular blocking agents. The patient was successfully extubated at the completion of the procedure without any respiratory or neuromuscular sequelae, with excellent pain control and no postoperative nausea or vomiting.

  12. Surgical Treatment of Scoliosis in Patients with Charcot-Marie-Tooth Disease

    Farzad Omidi Kashani; Ibrahim Ghayem Hasankhani; Mahdi Banaii


    Objective: Apparently, scoliosis occurs in approximately one-third of patients with Charcot-Marie-Tooth disease. Little is known about the response of these curves to treatment. The purpose of this study was to evaluate the results of spinal surgery in these peculiar patients. Methods: We retrospectively evaluated the results of spinal surgery in eight patients who had scoliosis due to clinically and electrophysiologically proven Charcot-Marie-Tooth disease. Radiographs were reviewed. The location and direction of the curve pattern, the age at the time of surgery, type of surgery, number of levels fused, instrumentations used, intra or postoperative complications, and results and need for reoperation were recorded. Results: Eight patients associated with Charcot-Marie-Tooth disease who underwent scoliotic surgery were identified. The average age and curve at the time of surgery were 21.1 years and 56.4° respectively. 62.5% of the curves had left thoracic component and more than one third was associated with thoracic hyperkyphosis. Long posterior spinal fusion was performed most often, with an average of 11.5 spinal segments fused. Instrumentation was used in all posterior fusions. At an average of 39 months (range, 24 to 72 months) postoperatively, the fusion appeared to be solid in all patients. Conclusion: Scoliosis in patients with Charcot-Marie-Tooth disease differs from that in patients with idiopathic scoliosis in regarding to the etiology and the prevalence of thoracic hyperkyphosis, but the surgical management appears to be similar. Spondylodesis does not appear to be associated with a high rate of complications.

  13. Brain abscess caused by Haemophilus para phrophilus following a dental treatment in a girl. Report of a case

    Vázquez Toledo María Eugenia


    Full Text Available We report the case of a six year old girl who developed three brain abscesses following a dental intervention (extraction of a tooth two weeks before. The etiologic agent was identified as Haemophilus paraprophilus, a gramnegative microorganism bacillus native mi- crobiota of the oropharynx nasopharynx and the gastrointestinal tract. 1 The patient was given ceftriaxone due to the sensitivity of the microorganism and metronidaole -because we couldn’t discard etiology by anaerobic- during six weeks. Surgical drainage of the abscesses was performed successfully. To date the patient has minimal neurologic sequelae. The importance of this case is that is the second report in the international literature of brain abscess secondary to Haemophilus paraprophilus in a pediatric patient and without associated heart disease.

  14. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

    Koichiro Mandai


    Full Text Available Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient’s condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

  15. Late Onset Spinal Epidural Abscess After Spinal Anesthesia in a Patient With Anklosing Spondylitis: A Case Report

    Cagatay Ozdol


    Full Text Available In this study we present a 61-year-old female patient who was admitted to the hospital with dorsal and lower back pain and recent paraparesis. There was no history of trauma. She was admitted to the hospital due to suffering from ankylosing spondylitis for the past 35 years. Moreover, she had undergone a total hip replacement 2 months prior under spinal anesthesia. Magnetic resonance imaging revealed spinal cord compression due to a mass lesion involving the spinal epidural region at the T11 to T12 level. There were also some imaging findings attributable to discitis. The patient%u2019s neurological condition required an urgent surgical decompression. Spinal epidural abscess is an uncommon complication of spinal anesthesia and invovement of the thoracic region is even rarer. Surgical decompression and antibiotherapy are the treatments of choice for patients with spinal epidural abscesses. Neurological prognosis is generally not promising, particularly when treatment is not begun within the first 72 hours.

  16. A Rasch Analysis of the Charcot-Marie-Tooth Neuropathy Score (CMTNS) in a Cohort of Charcot-Marie-Tooth Type 1A Patients

    Guedj, Mickaël; Bertrand, Viviane; Foucquier, Julie; Jouve, Elisabeth; Commenges, Daniel; Proust-Lima, Cécile; Murphy, Niall P.; Blin, Olivier; Magy, Laurent; Cohen, Daniel; Attarian, Shahram


    The Charcot-Marie-Tooth Neuropathy Score (CMTNS) was developed as a main efficacy endpoint for application in clinical trials of Charcot-Marie-Tooth disease type 1A (CMT1A). However, the sensitivity of the CMTNS for measuring disease severity and progression in CMT1A patients has been questioned. Here, we applied a Rasch analysis in a French cohort of patients to evaluate the psychometrical properties of the CMTNS. Overall, our analysis supports the validity of the CMTNS for application to CMT1A patients though with some limitations such as certain items of the CMTNS being more suitable for moderate to severe forms of the disease, and some items being disordered. We suggest that additional items and/or categories be considered to better assess mild-to-moderate patients. PMID:28095456

  17. Abscesso cerebral por Nocardia sp em paciente imunossuprimido Brain abscess by Nocardia sp in immunocompromised patient

    Cristina Hueb Barata


    Full Text Available Paciente portadora de anemia hemolítica autoimune e púrpura trombocitopênica idiopática (Síndrome de Evans em uso de terapia imunossupressora (predinisona e azatioprina, desenvolveu quadro de abscesso cerebral não responsivo a 23 dias de terapia antimicrobiana. O diagnóstico de nocardiose foi possível após coleta de material de abscesso peribulbar e observação deste material por período superior há uma semana.Pacient with autoimmune haemolytic anaemia and thrombocytopenic purpura (Evans Syndrome, treated with immunosuppressive therapy (prednisone and azathioprine developed brain abscess unresponsive to antimicrobial therapy, in spite of its 23 days duration. Diagnosis could be possible after recover secretion of peribulbar abscess and maintenance of this material over seven days in incubation.

  18. Lung abscess mimicking lung cancer developed around staples in a patient with permanent tracheostoma.

    Watanabe, Yui; Aoki, Masaya; Suzuki, Soichi; Umehara, Tadashi; Harada, Aya; Wakida, Kazuhiro; Nagata, Toshiyuki; Kariatsumari, Kota; Nakamura, Yoshihiro; Sato, Masami


    A 68-year-old male with a tracheostoma due to hypopharyngeal cancer was admitted because his chest computed tomography (CT) showed a small nodule in the right middle lobe. Following a partial resection of the right middle lobe, histopathological diagnosis of the resected sample was that of organizing pneumonia. Eleven months later, chest CT showed a mass with pleural indentation and spiculation in the right middle lobe. 18-Fluorodeoxyglucose-positron emission tomography showed significant accumulation in the middle lobe tumor mass shadow. The abnormal chest shadow that had developed around surgical staples suggested inadequate resection and tumor recurrence. As the abnormal radiological shadow was enlarging, middle lobectomy was carried out. Histological examination revealed that the tumor was a lung abscess without malignant features. This is a unique case of lung abscess mimicking lung cancer which developed around staples used during partial resection of the lung.

  19. Tooth agenesis in patients referred to an Irish tertiary care clinic for the developmental dental disorders.

    Hashem, Atef A


    PURPOSE: This study was carried out to determine the prevalence, severity and pattern of hypodontia in Irish patients referred to a tertiary care clinic for developmental dental disorders. MATERIALS AND METHODS: Details of 168 patients with hypodontia referred during the period 2002-2006 were entered in a database designed as a national record. Tooth charting was completed using clinical and radiographic examinations. The age of patients ranged from 7-50 years, with a median age of 20 years (Mean: 21.79; SD: 8.005). RESULTS: Hypodontia referrals constituted 65.5% of the total referrals. Females were more commonly affected than males with a ratio of 1.3:1. The number of referrals reflected the population density in this area; the majority were referrals from the public dental service. Mandibular second premolars were the most commonly missing teeth, followed by maxillary second premolars and maxillary lateral incisors; maxillary central incisors were the least affected. Symmetry of tooth agenesis between the right and left sides was an evident feature. Slightly more teeth were missing on the left side (n = 725) than on the right side (n = 706) and in the maxillary arch (n = 768) as compared to the mandibular arch (n = 663). Some 54% of patients had severe hypodontia with more than six teeth missing; 32% had moderate hypodontia, with four to six teeth missing. The most common pattern of tooth agenesis was four missing teeth. CONCLUSION: Hypodontia was a common presentation in a population referred to this tertiary care clinic. The pattern and distribution of tooth agenesis in Irish patients appears to follow the patterns reported in the literature.

  20. Orbital abscess: Management and outcome

    N Suneetha


    Full Text Available Purpose: To discuss the diagnosis, management and outcome of various types of orbital abscess. Methods: The medical records of 13 patients diagnosed and treated for orbital abscess were reviewed. The sources of infection included: paranasal sinusitis (n = 5, odontogenic origin of infection (n = 4, one each, temporal fossa abscess, palatal abscess, furuncle on the nose, and secondary to retrobulbar injection of steroid. Computed tomographic scans revealed the presence of an abscess in all 13 cases. Associated findings on CT scan included: sinus disease (n = 8, cavernous sinus thrombosis (n = 2 and subdural empyema (n = 2. All patients were treated with intensive, multiple, intravenous antibiotics and early surgical drainage. Results: Purulent material collected surgically from the orbit cultured Staphylococcus aureus (n = 3, two each Pseudomonas aeruginosa, Proteus mirabilis, Acinetobacter species and one each β-haemolytic Streptococci, Citrobacter frundi and Enterobacter. Final visual acuity was good in 6 patients (6/12 - 6/6 and no light perception in 6 others. Visual acuity could not be recorded in the infant. The other complications were intracranial abscess (n = 4, cavernous sinus thrombosis (n = 2 and restricted ocular motility (n = 1. Conclusions: A high index of suspicion is necessary, along with early institution of appropriate diagnostic imaging, and aggressive medical and surgical treatment for a favourable outcome in cases of orbital abscess.

  1. Late-onset fistula presenting as buttock abscess in two patients with ileo-anal J-pouches for ulcerative colitis.

    Banerjee, S; Farquharson, M; Cecil, T D; Gold, D; Moran, B J


    Two cases are described of patients who presented with a buttock abscess 3 and 5 years after restorative proctocolectomy for ulcerative colitis. In both the abscess was secondary to a fistula, which was shown on further investigation to be a track traversing the greater sciatic notch. Both patients had had an ileo-anal J-pouch after a proctectomy which had included a mesorectal excision. The possibility that these unusual fistulae might be more common following removal of the mesorectum rather than a close rectal dissection is explored.

  2. Central Nervous System Demyelination in a Charcot-Marie-Tooth Type 1A Patient

    Christos Koros; Maria-Eleftheria Evangelopoulos; Costas Kilidireas; Elisabeth Andreadou


    Introduction. Central nervous system involvement, either clinical or subclinical, has been reported mainly in X-linked Charcot-Marie-Tooth (CMT-X) patients. Case Presentation. We present the case of a 31-year-old man with a genetically confirmed history of CMT1A who developed CNS involvement mimicking multiple sclerosis (MS). Clinical, imaging, and laboratory findings suggested an autoimmune CNS demyelination. Discussion. Although the simultaneous existence of CMT1A and MS could be coincident...

  3. Splenic abscess: a rare presentation

    Mohit Bhatia


    Full Text Available Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies. When untreated, splenic abscess is associated with nearly 100% mortality; in treated patients, the mortality rate is 16.6% during the first 90 days. It mostly occurs in patients with neoplasia, immunodeficiency, trauma, diabetes or splenic infarct. The incidence of splenic abscess is thought to be growing because of the increase in the number of immunocompromised patients who are particularly at risk for this disease and also because of the widespread use of diagnostic modalities. However, the optimal treatment for this remains unclear. We present a case of a 42-year-old man diagnosed with multiloculated splenic abscess and was subjected to splenectomy.

  4. An Analysis of the Symptomatic Domains Most Relevant to Charcot Marie Tooth Neuropathy (CMT) Patients


    Charcot Marie Tooth Disease (CMT); Hereditary Sensory and Motor Neuropathy; Nerve Compression Syndromes; Tooth Diseases; Congenital Abnormalities; Genetic Diseases, Inborn; Heredodegenerative Disorders, Nervous System

  5. Dynamic CT features of hepatic abscesses

    ZOU Li-guang; CHEN Ken; LI Yan-yu; YI Xi-zhi


    Objective: To investigate the features of hepatic abscess by dynamic contrast-enhanced CT. Methods: CT films of 62 cases of hepatic abscesses were reviewed retrospectively. All the patients underwent both plain and enhanced CT scanning, and 23 of them received dynamic CT examination. Results: The dynamic phase (60~90 s), the enhancement patterns of the abscesses varied from the ring enhancement of the abscess diminished in which the hypodense ring enhanced and became isodense, or the abscess enhanced diffusely and became smaller, the colliquative necrosis area more obvious. Conclusion: Contrast enhanced CT should be used routinely in the evaluation of hepatic abscesses. The dynamic and delayed scan is necessary to diagnose atypical hepatic abscesses.

  6. A case of odontogenic brain abscess arising from covert dental sepsis

    Clifton, TC; Kalamchi, S


    Odontogenic infections can spread to any organ of the body and in some cases cause life threatening infections. We report a case of multiple odontogenic brain abscesses resulting from undetected tooth decay. Whereas most odontogenic brain abscesses occur following dental treatment, this report documents brain abscesses prior to dental treatment, signifying the dangers of covert dental infections. This case report updates the literature on the topic of odontogenic brain abscesses.

  7. Endoscopic management of brain abscesses

    Yadav Yad


    Full Text Available Background: Treatment of brain abscess is still a subject of controversy. Simple therapeutic approaches like twist drill/burr hole aspiration with or without insertion of a drain are also quite effective. There are reports of encouraging results following endoscopic treatment. We are reporting our results of endoscopic approach on 24 patients. Materials and Methods: This is a prospective study on 24 patients of brain abscesses treated between January 2004 and January 2007. All the cases except those with small abscesses (less than 1.0 cm in diameter and multiloculated abscesses were included. Gabb 6-degree rigid endoscope was used. Repeat CT scan was done in all cases within 7 and 30 days after surgery. Ten patients (42% had small residual abscess on 7 th post-operative day′s CT scan, while 30 th post-operative day′s CT scan did not show any significant lesion in all the cases. Results: There were 23 patients of chronic otitis media and one of congenital cyanotic heart disease. Glasgow coma score (GCS was 3 in one patient, 13 in two cases, 14-15 in 21 cases. There were 14 cerebellar, 8 temporal and 1 frontal and thalamic abscess each. All the patients recovered completely except one who died (GCS 3. There was no procedure-related complication. Hospital stay ranged from 7 to 12 days with an average of 8.2 days. Follow-up ranged between 6 and 42 months. Conclusion: Endoscopic aspiration of brain abscess appears to be a safe and effective alternative method of treatment. There is direct visualization of abscess cavity, completeness of aspiration can be assessed, and perioperative bleeding can be controlled.

  8. A Case of Pyomyositis and Primary Thigh Abscess in a Systemic Lupus Erythematous Patient MimickingThigh Hematoma

    Rahele Mehrain


    Full Text Available Routes of extension of infection into the thigh can"nbe either direct, through the subcutaneous tissue, or"nthrough naturally occurring defects in the abdominal"nwall. These include: (1 Along the psoas muscle deep"nto the inguinal ligament; (2 Through the femoral"ncanal; (3 By way of the obturator foramen; and (4"nThrough the sacrosciatic notch. Pyomyositis is a"nprimary deep bacterial infection of the skeletal muscle"nwithout contiguous spread from adjacent structures,"nusually accompanied by abscess formation within"nthe skeletal muscle, but may also present as a diffuse"ninflammatory or a rapidly progressing myonecrotic"nprocess. Pyomyositis in patients with SLE has rarely"nbeen reported. Because of its rarity and often vague"nclinical presentation, it is unlikely to be considered"nduring the initial differential diagnosis. Moreover,"nthe diagnosis may be delayed as the affected muscle is"ndeeply situated and local signs are not apparent. This"ndelay in diagnosis may result in increased morbidity"nand sometimes a significant mortality rate. Here,"nwe describe a 57-year-old woman, known case of"nSLE with pyomyositis and primary left thigh abscess"nthat mimicked DVT in physical examination and"nhematoma in MRI. The purpose of this report was to"ndraw attention to this rare occurrence and to highlight"nthe etiology, presentation and the imaging features.

  9. Brain abscesses caused by Nocardia paucivorans in a multiple myeloma patient treated with lenalidomide and dexamethasone: a case report and review of literature.

    Jacopo Monticelli


    Full Text Available We report the first case of multiple brain abscesses caused by Nocardia paucivorans in a patient suffering from multiple myeloma on treatment with lenalidomide and dexamethasone. Nocardia  paucivorans is a recently described species of the genus Nocardia, which is supposed to have a heightened neurotropism in cases of disseminated infection. Although nocardiosis itself is an uncommon infectious complication in multiple myeloma so far, nocardial brain abscess should be added to the spectrum of adverse effects due to this novel chemotherapy regimen.

  10. Precision of SPECT/CT allows the diagnosis of a hidden Brodie's abscess of the talus in a patient with sickle cell disease

    Al jafar, Hassan [Dept. of Hematology, Amiri Hospital, Kuwait (Kuwait); Al Shemmeri, Eman [Dept. of Nuclear Medicine, Farwaniya Hospital, Al-Farwania (Kuwait); Al Shemmeri, Jehan; Al Enizi, Saud [Faculty of Medicine, Nuclear Medicine Dept, Kuwait University, Kuwait (Kuwait); Aytglu, Leena [Molecular Imaging Center, Jaber Al-Ahmad Center, Kuwait (Kuwait); Afzai, Uzma [Dept. of Nuclear Medicine, Farwaniya Hospital, Al-Farwania (Kuwait)


    Brodie's abscess is a rare subacute osteomyelitis that can be found in sickle cell disease along with other bone complications. A 21-year-old female with sickle cell disease was presenting frequently to the medical casualty department for painful vasoocclusive crises and for persistent ankle pain and swelling. Hybrid imaging with single-photon emission computed tomography-computed tomography (SPECT-CT) incidentally revealed Brodie's abscess in the talus bone of the ankle, causing persisting long-standing pain. SPECT-CT is a modern technology used to scan bone to detect both anatomical and functional abnormalities with high specificity. Brodie's abscess is a rare bone inflammation that could be a hidden cause of pain and infection in sickle cell disease. Although rare, this lesion requires more attention in patients with sickle cell disease because their immunocompromised status renders them prone to this infection.

  11. Precision of SPECT/CT Allows the Diagnosis of a Hidden Brodie's Abscess of the Talus in a Patient with Sickle Cell Disease.

    Al-Jafar, Hassan; Al-Shemmeri, Eman; Al-Shemmeri, Jehan; Aytglu, Leena; Afzal, Uzma; Al-Enizi, Saud


    Brodie's abscess is a rare subacute osteomyelitis that can be found in sickle cell disease along with other bone complications. A 21-year-old female with sickle cell disease was presenting frequently to the medical casualty department for painful vasoocclusive crises and for persistent ankle pain and swelling. Hybrid imaging with single-photon emission computed tomography-computed tomography (SPECT-CT) incidentally revealed Brodie's abscess in the talus bone of the ankle, causing persisting long-standing pain. SPECT-CT is a modern technology used to scan bone to detect both anatomical and functional abnormalities with high specificity. Brodie's abscess is a rare bone inflammation that could be a hidden cause of pain and infection in sickle cell disease. Although rare, this lesion requires more attention in patients with sickle cell disease because their immunocompromised status renders them prone to this infection.

  12. Pyogenic liver abscess

    Liver abscess; Bacterial liver abscess ... There are many possible causes of liver abscesses, including: Abdominal infection, such as appendicitis , diverticulitis , or a perforated bowel Infection in the blood Infection of the bile draining tubes ...

  13. Factors determining tooth extraction anxiety and fear in adult dental patients: a systematic review.

    Astramskaitė, I; Poškevičius, L; Juodžbalys, G


    The aim of this study was to review previous studies and to identify reliable factors determining anxiety in adult patients undergoing tooth extraction procedures. An electronic literature search was conducted of the MEDLINE, ScienceDirect, SpringerLink, and Wiley Online Library databases covering the period January 2005 to May 2015. Sequential screening was performed at the title/abstract and full-text level. The review included all human prospective and retrospective follow-up studies and clinical trials, cohort studies, case-control studies, and case series that demonstrated at least one factor determining tooth extraction anxiety and/or fear and used specific scales for measurement. The search identified 16 articles meeting the inclusion criteria. Factors related to tooth extraction in patients were assessed: propensity to anxiety (P<0.05), pain experience or expectations (P<0.05), level of disturbance during the procedure (P<0.001), difficulty of the procedure (P=0.034), marital status (P=0.003), social class (P=0.012), and type of local anaesthesia (P=0.008). Using a video as the method of providing information (P<0.05) and having had a previous negative dental experience (P<0.05) led to an increase in patient anxiety level. Due to disagreements between studies, further investigations into the other factors are required to clarify the results. However, the absence of a single and appropriate scale that includes both the patient's evaluation and that of the doctor, hinders the rating of patient anxiety.

  14. Amebic liver abscess

    Hepatic amebiasis; Extraintestinal amebiasis; Abscess - amebic liver ... Amebic liver abscess is caused by Entamoeba histolytica. This parasite causes amebiasis , an intestinal infection that is also called ...

  15. Otogenic brain abscess: A rising trend of cerebellar abscess an institutional study

    Rupam Borgohain


    Full Text Available Chronic inflammation of the middle ear is the most frequent cause of otogenic complications. Meningitis is the most frequent intracranial complications, followed by otogenic brain abscess in neglected otitis media. Although temporal lobe abscesses are more common than cerebellar abscesses, the converse was found to be true in our series of 17 cases. 16 cases of cerebellar abscess and 1 case of temporal lobe abscess were reported as a complication of chronic otitis media (COM. In our group of patients, otogenic brain abscesses were more frequent in male patients of age group 5–20 years with mean age of 14 years. Diagnostic procedure included history, clinical, otorhinolaryngological examination, audiological, microbiological, neurological, ophthalmological, and radiological examinations. The treatment included primary neurosurgical approach (abscess drainage followed by radical otosurgical treatment.

  16. Spinal epidural abscess penetrating into retroperitoneal space in patient with diabetes mellitus type 2: early diagnosis and treatment requirement.

    Grabysa, Radosław; Moczulska, Beata


    Spinal epidural abscess (SEA) is a rare condition with very serious prognosis. Predisposing factors for SEA include bacterial infections, immunocompromised states such as diabetes mellitus, intravenous drug abuse, alcoholism, AIDS, as well as spinal surgery and modern techniques of epidural anesthesia. The most common causative agent for SEA is Staphylococcus aureus. The typical clinical signs of SEA are back pain, fever and neurologic dysficit. Magnetic resonance (MR) of the spine and vertebral column is the best imaging diagnostic method in suspected cases. Emergency surgical decompression combined with intravenous antibiotics is the therapeutic method of choice. Conservative treatment may be appropriate in selected patients. Unless the typical presentation of SEA correct diagnosis of this illness is often overlooked and not considered initially. It delays suitable management and leads to poor outcome. We report a classic case of SEA in a woman with a history of diabetes mellitus.


    Suraj Kumar


    Full Text Available SITUS INVERSUS VISCERUM : The literal meaning of: Inverted position of internal organs is a rare autosomal recessive disorder with incidence of 0.001% to 0.01% with male: female ratio of 3:2 . (1 It can be either total or partial. Total situsinversus is characterized by mirror image dextrocardia where the heart and stomach is present on right side of midline and liver and gall bladder on left side. Generally this rare genetic anomaly is discovered/diagnosed incidentally during thoracic and abdominal imaging. Here we are presenting yo u a case of situsinversustotalis with ruptured amoebic liver abscess in a patient of serum hepatitis which is a rare clinical entity.

  18. Soft-laser use in the preoperative preparation and postoperative treatment of the patients with chronic lung abscesses

    Ledin, A. O.; Dobkin, V. G.; Sadov, A. Y.; Galichev, K. V.; Rzeutsky, V. S.


    We counted expedient to include different methods of the soft-laser use in the preoperative medicinal program and in the postoperative period. During the preoperative preparation the basic group patients together with standard treatment received the combined soft-laser therapy, which included intravenous laser blood irradiation (ILBI) by He-Ve laser and external transcutaneous irradiation of the abscess projection by semi-conductorial arrenite-gallium laser. During postoperative treatment with ILBI remarkable changes were observed in the functional activity of the T- and B- cell. The soft-laser use allowed to achieve improvement of quality and shortening of terms of the preoperative preparation of 1,4 times, to level the immunosuppressive influence of surgery to reduce amount of the postoperative complications in 1,8 times and duration of the postoperative period in 1,5 times.

  19. Brain abscess: Current management

    Hernando Alvis-Miranda


    Full Text Available Brain abscess (BA is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA.

  20. Brain abscess: Current management

    Alvis Miranda, Hernando; Castellar-Leones, Sandra Milena; Elzain, Mohammed Awad; Moscote-Salazar, Luis Rafael


    Brain abscess (BA) is defined as a focal infection within the brain parenchyma, which starts as a localized area of cerebritis, which is subsequently converted into a collection of pus within a well-vascularized capsule. BA must be differentiated from parameningeal infections, including epidural abscess and subdural empyema. The BA is a challenge for the neurosurgeon because it is needed good clinical, pharmacological, and surgical skills for providing good clinical outcomes and prognosis to BA patients. Considered an infrequent brain infection, BA could be a devastator entity that easily left the patient into dead. The aim of this work is to review the current concepts regarding epidemiology, pathophysiology, etiology, clinical presentation, diagnosis, and management of BA. PMID:24174804

  1. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    C. Tran


    Full Text Available We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection of vesical fistula.

  2. Dental implant as an option for tooth replacement: The awareness of patients at a tertiary hospital in a developing country

    Olaide Shakeerah Gbadebo


    Full Text Available Aim: A survey was set out to evaluate the knowledge of patients about tooth replacement as a whole, and assess their awareness of implant-retained prosthesis as an option of tooth replacement. Materials and Methods: Information on sociodemographic characteristics, knowledge about implant-retained tooth as an option for missing tooth replacement, cost implication, source of information and knowledge about other options of tooth replacement were obtained from patients attending the dental clinics of the University College Hospital, Ibadan, using structured self-administered questionnaires. Data were analyzed using SPSS version 20. Result: A total of 220 patients aged 18-84 years with a mean age of 37.6 (±16.5 years participated in the study, with a male to female ratio of 1:1.1. The majority (92.5% knew that missing teeth can be replaced, while a significantly lower proportion (28.9% knew about dental implants as an option (P < 0.01. Dentists were the major source of information on dental implants (68%. Only 21 (36.8% of those who had heard about dental implant had knowledge about the cost (P < 0.000. Conclusion: A low level of awareness about dental implant as tooth replacement option exist in this environment, although most of the study participants were aware that missing teeth can be replaced.

  3. A unique case of phaeohyphomycosis subretinal abscess in a patient with arthropathy and lung pathology

    Bryan J Matthews


    Full Text Available A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.

  4. Postural instability in Charcot-Marie-Tooth type 1A patients is strongly associated with reduced somatosensation.

    Linden, M.H. van der; Linden, S.C. van der; Hendricks, H.T.; Engelen, B.G.M. van; Geurts, A.C.H.


    In order to determine the influence of somatosensory impairments, due to the loss of large myelinated fibres, on the postural stability of Charcot-Marie-Tooth 1A (CMT) patients, a cross-sectional balance assessment was done. Nine CMT patients were compared with eight patients with a distal type of S

  5. Tuberculous retropharyngeal abscess without cervical spine TB

    ChandrakantPatil; RashmiKharatPatil; PrasadDeshmukh; SameerSinghal; BlendaDSouza


    Tuberculous retropharyngeal abscess is a rare presentation. It is present in adults usually due to involvement of cervical spine by tuberculosis. Retropharyngeal space usually gets involved in children due to pyogenic organisms or secondary to trauma. Here is a case of tuberculous retropharyngeal abscess in an adult female, with pulmonary tuberculosis. The patient was not having tuberculous involvement of cervical spine and was managed surgically by aspirating the retropharyngeal abscess transorally and AKT Category I.

  6. Splenic abscess due to Salmonella enteritidis

    Hatice Çabadak


    Full Text Available Splenic abscess is a very rare complication of non-typhoidal Salmonella infections. We report a case of splenic abscess caused by Salmonella enteritidis. The patient is a 63-year-old woman with diabetes mellitus and underwent splenectomy. This case suggests that the patients with comorbities are at increased risk for invasive infections in non-typhoidal Salmonella infections.

  7. Bilateral Blindness in a Patient With Temporal Arteritis After Wisdom Tooth Extraction.

    Tartaglia, Gianluca Martino; Maiorana, Carlo; Sforza, Chiarella


    A 78-year-old woman reported pain in her right hemiface (middle and upper portions) together with nuchal headache, some days after upper right wisdom tooth extraction. She was treated with nonsteroidal anti-inflammatory drugs by her dentist. Three weeks later, a localized headache over her right superficial temporal artery was reported, and progressive bilateral blindness appeared. A biopsy showed a late stage of temporal arteritis. All the symptoms disappeared following corticosteroid treatment, except blindness. The possible complications linking oral bacteria and extraoral infections and diseases should always be attentively considered during the clinical management of fragile patients.

  8. Presence and consequence of tooth periapical radiolucency in patients with cirrhosis

    Grønkjær, Lea Ladegaard; Holmstrup, Palle; Schou, Søren;


    BACKGROUND: Periapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related com......, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05). CONCLUSION: Periapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings....

  9. Sharp tooth induced sublingual hematoma in a patient with elevated international normalized ratio

    John Baliah


    Full Text Available Sublingual hematoma secondary to anticoagulation is a rare fatal condition. Hemorrhagic complications of warfarin are well-known. This particular case is unique because the patient was on warfarin for the past 2 years but did not develop the sublingual hematoma. However, a trauma by an attrited sharp cusp triggered the episode of the sublingual hematoma in this patient. Being a medical emergency, patient was promptly hospitalized in cardiac care unit and managed by medical team. The patient was transfused with 2 units of fresh frozen plasma and warfarin was temporarily stopped for 4 days. Alternate day regimen of warfarin was started after 4 days, and international normalized ratio dropped to 3. In dental management, enameloplasty of the mandibular first molar tooth was done to prevent trauma and ulcer development in the floor of the mouth. The hematoma resolved, and no new hematoma formation was observed for a period of 6 months.




    Full Text Available Complications of sinusitis are rare nowadays because of higher and broad spectrum antibiotics. Preseptal abscess may rarely present as a complication of sinusitis. Our patient presented with a preseptal abscess with underlying ethmoidal sinusitis. The patient was treated with antibiotics; Incision and drainage of the preseptal abscess were done and infection in the ethmoidal sinuses was eradicated by endoscopic sinus surgery

  11. Assessment of general pre and postoperative anxiety in patients undergoing tooth extraction: a prospective study.

    López-Jornet, Pia; Camacho-Alonso, Fabio; Sanchez-Siles, Mariano


    Our aim was to analyse the amount of anxiety and fear felt before, immediately after, and one week after, dental extraction. We studied 70 patients (35 men and 35 women (mean (SD) age 43 (±10) years), who were listed for dental extraction under local anaesthesia in a private clinic that specialised in oral surgery. Patients were evaluated on 3 consecutive occasions: immediately preoperatively, immediately postoperatively, and 7 days later. Each patient's anxiety was measured using Spielberger's State-Trait Anxiety Inventory (Spanish version), the Modified Corah Dental Anxiety Scale (MDAS) and the Dental Fear Survey. There were significant differences in the STAI-Trait scale between before and 7 days after extraction (p=0.04), and in the MDAS between before and immediately after extraction (p=0.02), and between immediately after and 7 days after extraction (p=tooth extraction may be influenced by operative techniques (type of anaesthesia, duration of operation, or position of tooth extracted), but anxiety at 7 days after extraction is not.

  12. 糖尿病并发咽旁脓肿12例综合治疗%Comprehensive treatment of 12 diabetes patients complicated with parapharyngeal abscess

    陈伟龙; 陈锦贤; 麦锦生; 林楚标


    目的:探讨糖尿病并发咽旁脓肿的临床特点及治疗要点。方法对12例糖尿病并发咽旁脓肿的治疗情况进行分析。结果12例患者均治愈出院,无并发纵隔脓肿、颅内感染及大出血等严重并发症。结论糖尿病并发咽旁脓肿发展快而迅速,必须明确诊断,及时施行脓肿切开排脓,积极控制感染的同时严格控制血糖波动,加强支持疗法。%Objective To investigate the clinical features and treatment points of diabetes patients compli-cated with parapharyngeal abscess .Methods The clinical data of 12 diabetes mellitus patients complicated with parapharyngeal abscess were analyzed .Results 12 patients were all cured and discharged without concurrent medias-tinal abscess ,intracranial infection and serious complications such as bleeding .Conclusion The development of dia-betes mellitus complicated with parapharyngeal abscess is rapid ,we must confirm the diagnosis ,timely implementation of abscess incision and drainage ,effective drainage of pus ,keep the airway open ,actively control the infection at the same time strictly control the fluctuations in blood sugar ,strengthen supportive therapy ,thus to improve treatment and reduce the incidence of complications .

  13. An emboligenic pulmonary abscess leading to ischemic stroke and secondary brain abscess

    Albrecht Philipp


    Full Text Available Abstract Background Ischemic stroke by septic embolism occurs primarily in the context of infective endocarditis or in patients with a right-to-left shunt and formation of a secondary cerebral abscess is a rare event. Erosion of pulmonary veins by a pulmonary abscess can lead to transcardiac septic embolism but to our knowledge no case of septic embolic ischemic stroke from a pulmonary abscess with secondary transformation into a brain abscess has been reported to date. Case presentation We report the case of a patient with a pulmonary abscess causing a septic embolic cerebral infarction which then transformed into a cerebral abscess. After antibiotic therapy and drainage of the abscess the patient could be rehabilitated and presented an impressive improvement of symptoms. Conclusion Septic embolism should be considered as cause of ischemic stroke in patients with pulmonary abscess and can be followed by formation of a secondary cerebral abscess. Early antibiotic treatment and repeated cranial CT-scans for detection of a secondary abscess should be performed.

  14. The association of haemoglobin A{sub 1C} levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus

    Wang, Hong-Hau [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Tri-Service General Hospital Songshan Branch. National Defense Medical Center, Department of Radiology, Taipei (China); Tsai, Shih-Hung [Tri-Service General Hospital, National Defense Medical Center, Department of Emergency Medicine, Taipei (China); Yu, Chih-Yung; Hsu, Hsian-He; Liu, Chang-Hsien; Huang, Guo-Shu; Chang, Wei-Chou [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Lin, Jung-Chung [Tri-Service General Hospital, National Defense Medical Center, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Taipei (China); Cheng, Wei-Tung; Chen, Ching-Yang [Tri-Service General Hospital Songshan Branch. National Defense Medical Center, Department of Radiology, Taipei (China); Tung, Ho-Jui [Asia University, Department of Healthcare Administration, Taichung (China)


    To compare the characteristics of Klebsiella pneumoniae liver abscesses (KPLA) in diabetic patients with different levels of glycaemic control. The institutional review board approved this retrospective study. A total of 221 patients with KPLA were included. Clinical features of KPLA were compared. We divided the 120 diabetic patients with KPLA into three subgroups based on haemoglobin A{sub 1C} (HbA{sub 1C}) concentration (good, HbA{sub 1C} ≤ 7.0 %; suboptimal, 7.0 % < HbA{sub 1C} ≤ 9.0 %; poor, HbA{sub 1C} > 9.0 %). In this study, we used a semiautomated quantitative method to assess the gas and total abscess volumes in KPLA. Statistical analysis was performed with the chi-squared test and one-way analysis of variance. The mortality rate did not significantly differ between the nondiabetic and diabetic groups. However, patients with poor glycaemic control had significantly more complications and therefore a longer hospital stay (P < 0.05). In our study, CT and quantitative analyses found that patients in the group with poor glycaemic control had a significantly higher incidence of gas formation and hepatic venous thrombophlebitis and a higher gas-to-abscess volume ratio than patients with suboptimal and good glycaemic control (P < 0.05). Diabetic patients with a high HbA{sub 1C} concentration (>9.0 %) have an association with hepatic venous thrombophlebitis, gas formation and metastatic infection complications associated with KPLA. (orig.)

  15. Endoscopic Drainage of an Odontogenic Pterygoid Muscle Abscess

    Rickul Varshney


    Full Text Available The infratemporal fossa (ITF is a potential space bounded by bony structures that can be occupied by both benign and malignant tumors. It is also a potential area of abscess development, most commonly of dental origin. As with any abscess, the treatment of an ITF abscess is surgical drainage. We present a case of an ITF abscess involving the pterygoid muscles following dental extraction in a poorly controlled diabetic patient. The ITF was accessed with an endoscopic transseptal approach through the maxillary sinus to drain the abscess. This case of successful management supports the feasibility of the endoscopic approach in dealing with abscesses of the ITF.

  16. Pyogenic versus amoebic liver abscesses: A comparative clinical study in a series of 58 patients Absceso hepático piógeno versus amebiano: Estudio clínico comparativo de una serie de 58 casos

    A. Cosme; E. Ojeda; Zamarreño, I.; Bujanda, L.; G. Garmendia; M. J. Echeverría; Benavente, J.


    Objective: to compare the clinical and epidemiological characteristics of patients with pyogenic liver abscess (PLA) and with amebic liver abscess (AHA) in order to determine the potential factors that may help improve diagnosis and treatment for this disease. Material and method: a retrospective study of clinical histories of 45 patients with PLA and 13 with ALA, diagnosed between 1985 and 2005 in Donostia Hospital in San Sebastián. Results: among the 45 patients with PLA (30 men and 15 wome...

  17. Anesthetic Management of a Patient With Charcot-Marie-Tooth Disease.

    Ohshita, Naohiro; Oka, Saeko; Tsuji, Kaname; Yoshida, Hiroaki; Morita, Shosuke; Momota, Yoshihiro; Tsutsumi, Yasuo M


    Charcot-Marie-Tooth disease (CMTD) is a hereditary peripheral neuropathy and is characterized by progressive muscle atrophy and motor-sensory disorders in all 4 limbs. Most reports have indicated that major challenges with general anesthetic administration in CMTD patients are the appropriate use of nondepolarizing muscle relaxants and preparation for malignant hyperthermia in neuromuscular disease. Moderate sedation may be associated with the same complications as those of general anesthesia, as well as dysfunction of the autonomic nervous system, reduced perioperative respiratory function, difficulty in positioning, and sensitivity to intravenous anesthetic agents. We decided to use intravenous sedation in a CMTD patient and administered midazolam initially and propofol continuously, with total doses of 1.5 mg and 300 mg, respectively. Anesthesia was completed in 3 hours and 30 minutes without adverse events. We suggest that dental anesthetic treatment with propofol and midazolam may be effective for patients with CMTD.

  18. Cerebral Abscess Potentially of Odontogenic Origin

    Marouene Ben Hadj Hassine


    Full Text Available Odontogenic origins are rarely implicated in the formation of brain abscesses. The relative paucity of this kind of infection and the difficulty in matching the causative microorganisms of a brain abscess to an odontogenic source can explain the late management of patients. We herein describe a case of a 46-year-old man with a cerebellar abscess that was probably due to an odontogenic infection. The diagnosis supported by imaging and microscopic identification, mini craniectomy for abscess drainage followed by eradication of all potential dental infectious foci, and an antibiotic regimen based on cephalosporins, metronidazole, and vancomycine contributed to a successful outcome.

  19. Basidiobolus: An unusual cause of lung abscess

    Chetambath Ravindran


    Full Text Available Non-resolving pneumonia leading to lung abscess is always a challenge to the treating physician especially in a diabetic patient. Atypical radiological features of lung abscess should raise the suspicion of unusual organisms. This is a case report of a 42 year old diabetic male presented with features suggestive of lung abscess and multiple target organ damage. Subsequent work up revealed that the etiological agent is a rare fungus - Basidiobolus. To the best of our knowledge this is the first case of Basidiobolus lung abscess reported from India.

  20. Tooth demineralization and associated factors in patients on fixed orthodontic treatment

    Salmerón-Valdés, Elías Nahúm; Lara-Carrillo, Edith; Medina-Solís, Carlo Eduardo; Robles-Bermeo, Norma Leticia; Scougall-Vilchis, Rogelio José; Casanova-Rosado, Juan Fernando; Pontigo-Loyola, América Patricia; Fernández Barrera, Miguel Ángel


    Dental demineralization was determined in patients at three time points during fixed orthodontic treatment. A multiple cross-sectional study included 108 patients divided into three different groups: (1) beginning of orthodontic treatment; (2) one year into treatment; and (3) two years into treatment. Demineralization was estimated using a DIAGNOdent pen. We obtained data from multiple tooth-by-tooth demineralization readings combined with salivary pH and patients’ oral hygienic and dietary behaviors. A t-test for independent samples and Spearman´s correlation were performed. No demineralizations differences were found between the initial stage and one year into treatment. Between one and two years small differences were observed, but demineralization increased between the initial stage and second treatment year, predominating in upper right central incisors (p = 0.056), upper left lateral incisors (p = 0.040), both upper canines (p = 0.055 and p = 0.040, respectively) and first left premolars (p = 0.034 and p = 0.053, respectively). We did not find associations between oral hygiene and dietary behaviours or salivary pH. In conclusion, demineralization occurred in first year of treatment and increased during second year, predominating in the upper arch and the left side mainly in upper right central incisors, upper left lateral incisors, both upper canines, and first left premolars. PMID:27805027

  1. CT of pituitary abscess

    Fong, T.C.; Johns, R.D.; Long, M.; Myles, S.T.


    Pituitary abscess is a rare condition, with only 50 cases reported in the literature. Of those, 29 cases were well documented for analysis. Preoperative diagnosis of pituitary abscess is difficult. The computed tomographic (CT) appearance of pituitary abscess was first described in 1983; the abscess was depicted by axial images with coronal reconstruction. The authors recently encountered a case of pituitary abscess documented by direct coronal CT of the sella turcica.

  2. Recurrent periodontal abscess associated with "teeth as a tool"

    G Subraya Bhat


    Full Text Available We report an unusual case of recurrent periodontal abscess in a 31-year-old male electrician due to his habit of using his teeth as a tool for stripping electrical wires. The patient was not aware of the consequences of this habit. Clinically, there was presence of moderate depth of periodontal pocket around the tooth and, radiographically, there was a vertical defect mesial to the involved teeth. The patient was educated about the consequences of his habit and surgical treatment was undertaken. A papilla preservation flap with regenerative periodontal surgical procedure was done, orthodontic and restorative treatment was planned at the follow-up. This case highlights the importance of eliciting a proper and complete personal history, including occupational details. In our patient these details helped us correlate the destruction of the periodontium to the unusual etiology.

  3. Pulp-dentine complex changes and root resorption during intrusive orthodontic tooth movement in patients prescribed nabumetone.

    Villa, Paula A; Oberti, Giovanni; Moncada, Cesar A; Vasseur, Olga; Jaramillo, Alejandro; Tobón, Diego; Agudelo, Jaime A


    Pulpitis, external root resorption, and pain may be experienced during orthodontic movement. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been suggested to control these changes. The purpose of this study was to observe pulp-dentinal reactions, root resorption, tooth pain, and tooth movement after the application of a 4-ounce intrusive orthodontic force to human maxillary first premolars in patients given the NSAID nabumetone. Thirty-four maxillary first premolars were evaluated. A placebo was prescribed to 17 patients after an intrusive force was activated and reactivated for an 8-week period on the right side. The same procedure was repeated on the left side after patients were given nabumetone. Pulp-dentinal reactions and external root resorption were evaluated by histology. Pain and movement were also evaluated. Nabumetone was found to be useful in reducing pulpitis, external root resorption, and pain caused by intrusive orthodontic movement, without altering tooth movement in response to the application of orthodontic force.

  4. Clinical and genetic spectra in a series of Chinese patients with Charcot-Marie-Tooth disease.

    Wang, Rui; He, Jin; Li, Jin-Jing; Ni, Wang; Wu, Zhi-Ying; Chen, Wan-Jin; Wang, Yi


    The aim of this study was to determine the clinical features and frequencies of genetic subtypes in a series of patients with Charcot-Marie-Tooth (CMT) disease from Eastern China. Patients were divided into three subtypes, CMT1, CMT2 and hereditary neuropathy with liability to pressure palsy (HNPP), according to their electrophysiological manifestations. Multiplex ligation-dependent probe analysis (MLPA) was performed to detect duplications/deletions in the PMP22 gene. The coding regions and splice sites of the GJB1, MPZ, MFN2 and GDAP-1 genes were determined by direct sequencing. Among the 148 patients in the study, 37.2% of the cases had mutations in genes assessed. The mutation detection rate was higher in patients with family histories than in spontaneous cases. PMP22 duplication (13.5%) was predominant in this group of patients, followed by PMP22 deletion (11.5%), and point mutations in GJB1 (8.8%), MPZ (2.0%) and MFN2 (0.7%). Three novel mutations (c.151T>C and c.310 A>G in GJB1 and c.1516 C>G in MFN2) were detected. A small deletion in PMP22 exon 4 was detected in a patient with severe CMT1. Genetic tests have great value in CMT patients with family histories. The frequency of PMP22 duplications was lower in Asian patients than in others. We suggest that genetic testing strategies in CMT patients should be primarily based on electromyography data.

  5. Hepatic abscess associated with Salmonella serotype B in a chronic alcoholic patient

    Sidhartha S Tulachan; Charles E Wilkins; Anthony F Cutrona


    BACKGROUND: Hepatic  abscess  secondary  to  Salmonella  is extremely rare in the United States and other Western countries. METHODS: A  43-year-old  Caucasian  man,  with  a  history of  chronic  alcohol  abuse,  was  admitted  to  the  hospital  for intermittent  abdominal  pain,  fever  and  diarrhea.  Clinical, radiological  and  laboratory  results  were  analyzed.  Medical literature in PubMed pertaining to similar cases was reviewed. RESULTS: Stool culture was positive for Salmonella serotype B and a CT scan of the abdomen with contrast was consistent with a solitary hepatic abscess. Appropriate intravenous antibiotics followed by oral maintenance therapy for six weeks resulted in a complete clinical recovery and radiographic resolution. CONCLUSIONS: The  cause  of  Salmonella  hepatic  abscess  in our patient was most likely associated with decreased mucosal resistance  to  the  bacteria,  seeding  of  infection  via  transient portal  bacteremia  and  loss  of  host  immunity.  Our  case highlights the fact that appropriate antibiotic alone is sufficient in the management of a solitary hepatic abscess less than 3-5 cm.

  6. Study on the effect of hyperbaric oxygen therapy on the wound healing and the related serum indexes of rectal abscess patients after surgery

    Bo Mo; Qing He; Juan Ma; Bing Xu


    Objective:To observe and research the influence degree of hyperbaric oxygen therapy on wound healing and related serum indexes of rectal abscess patients after surgery. Methods:A total of 48 rectal abscess patients treated with operation in my hospital from April 2014 to August 2015 were taken as research objects, and the 48 patients were randomly divided into two groups:control group (postoperative routine treatments, 24 cases) and observation group (postoperative routine treatments and hyperbaric oxygen therapy, 24 cases), and then compared the time constitutes of wound healing, the edema degrees and the related serum indexes of patients in two test groups before the operation and at 1 d, 3 d and 10 d after operation. Results:The time constitute of wound healing of observation group is better than that of control group, and the edema degree and the related serum index of observation group are lower than those of control group, and the test result of two groups have significant differences. Conclusions:The hyperbaric oxygenation therapy can effectively promote the postoperative wound healing of patients with rectal abscess, and it also has active clinical significance for the control of edema and related serum indexes.

  7. Tooth extraction

    ... this page: // Tooth extraction To use the sharing features on this page, please enable JavaScript. A tooth extraction is a procedure to remove a tooth from ...

  8. A Case Report of Tooth Wear Associated with a Patient's Inappropriate Efforts to Reduce Oral Malodor Caused by Endodontic Lesion

    Masahiro Yoneda


    Full Text Available Here, we report a case of severe tooth wear associated with a patient's inappropriate efforts to reduce oral malodor. A 72-year-old male patient visited our breath clinic complaining of strong breath odor. Former dentists had performed periodontal treatments including scaling and root planing, but his oral malodor did not decrease. His own subsequent breath odor-reducing efforts included daily use of lemons and vinegar to reduce or mask the odor, eating and chewing hard foods to clean his teeth, and extensive tooth brushing with a hard-bristled toothbrush. Oral malodor was detected in our breath clinic by several tests, including an organoleptic test, portable sulphide monitor, and gas chromatography. Although patient's oral hygiene and periodontal condition were not poor on presentation, his teeth showed heavy wear and hypersensitiving with an unfitted restoration on tooth 16. Radiographic examination of the tooth did not reveal endodontic lesion, but when the metal crown was removed, severe pus discharge and strong malodor were observed. When this was treated, his breath odor was improved. After dental treatment and oral hygiene instruction, no further tooth wear was observed; he was not concerned about breath odor thereafter.

  9. A Case Report of Tooth Wear Associated with a Patient's Inappropriate Efforts to Reduce Oral Malodor Caused by Endodontic Lesion

    Yoneda, Masahiro; Uchida, Hatsumi; Suzuki, Nao; Mine, Mariko; Iwamoto, Tomoyuki; Masuo, Yosuke; Naito, Toru; Hatano, Yuko; Hirofuji, Takao


    Here, we report a case of severe tooth wear associated with a patient's inappropriate efforts to reduce oral malodor. A 72-year-old male patient visited our breath clinic complaining of strong breath odor. Former dentists had performed periodontal treatments including scaling and root planing, but his oral malodor did not decrease. His own subsequent breath odor-reducing efforts included daily use of lemons and vinegar to reduce or mask the odor, eating and chewing hard foods to clean his teeth, and extensive tooth brushing with a hard-bristled toothbrush. Oral malodor was detected in our breath clinic by several tests, including an organoleptic test, portable sulphide monitor, and gas chromatography. Although patient's oral hygiene and periodontal condition were not poor on presentation, his teeth showed heavy wear and hypersensitiving with an unfitted restoration on tooth 16. Radiographic examination of the tooth did not reveal endodontic lesion, but when the metal crown was removed, severe pus discharge and strong malodor were observed. When this was treated, his breath odor was improved. After dental treatment and oral hygiene instruction, no further tooth wear was observed; he was not concerned about breath odor thereafter. PMID:20339568

  10. Characterization of novel MSX1 mutations identified in Japanese patients with nonsyndromic tooth agenesis.

    Seishi Yamaguchi

    Full Text Available Since MSX1 and PAX9 are linked to the pathogenesis of nonsyndromic tooth agenesis, we performed detailed mutational analysis of these two genes sampled from Japanese patients. We identified two novel MSX1 variants with an amino acid substitution within the homeodomain; Thr174Ile (T174I from a sporadic hypodontia case and Leu205Arg (L205R from a familial oligodontia case. Both the Thr174 and Leu205 residues in the MSX1 homeodomain are highly conserved among different species. To define possible roles of mutations at these amino acids in the pathogenesis of nonsyndromic tooth agenesis, we performed several functional analyses. It has been demonstrated that MSX1 plays a pivotal role in hard tissue development as a suppressor for mesenchymal cell differentiation. To evaluate the suppression activity of the variants in mesenchymal cells, we used the myoD-promoter, which is one of convenient reporter assay system for MSX1. Although the gene products of these MSX1 variants are stable and capable of normal nuclear localization, they do not suppress myoD-promoter activity in differentiated C2C12 cells. To clarify the molecular mechanisms underlying our results, we performed further analyses including electrophoretic mobility shift assays, and co-immunoprecipitation assays to survey the molecular interactions between the mutant MSX1 proteins and the oligonucleotide DNA with MSX1 consensus binding motif or EZH2 methyltransferase. Since EZH2 is reported to interact with MSX1 and regulate MSX1 mediated gene suppression, we hypothesized that the T174I and L205R substitutions would impair this interaction. We conclude from the results of our experiments that the DNA binding ability of MSX1 is abolished by these two amino acid substitutions. This illustrates a causative role of the T174I and L205R MSX1 homeodomain mutations in tooth agenesis, and suggests that they may influence cell proliferation and differentiation resulting in lesser tooth germ formation in

  11. Role of stretch therapy in comprehensive physical habilitation of patients with Charcot–Marie–Tooth hereditary neuropathy

    N. A. Shnayder


    Full Text Available Charcot–Marie–Tooth hereditary neuropathy (Charcot–Marie–Tooth disease, CMT is the most common form of hereditary neuropathies, accompanied by sensory disorders, progressive muscle weakness with the formation of disabling contractures of the limbs. Currently, the main treatment program is effective CMT habilitation, which can prevent the development of limb deformities and thereby improve the life quality of the patient. Stretch therapy is one of the most effective methods of prevention and treatment of contractures in patients with CMT. This article provides a brief review of the literature regarding the use of stretching as physical therapy program of CMT habilitation.

  12. Sensitivity of computed tomography in detection of perirectal abscess.

    Caliste, Xzabia; Nazir, Shazia; Goode, Terral; Street, James H; Hockstein, Michael; McArthur, Karina; Trankiem, Christine T; Sava, Jack A


    Most patients with anorectal abscess are diagnosed clinically based on pain, erythema, warmth, and fluctuance. Some patients, however, present with subtle or atypical signs. CT is easily accessible and is commonly used for diagnosis and delineation of anorectal abscess. The purpose of this study is to determine the sensitivity of CT scan in detecting perirectal abscesses and to see if immune status impacts the accuracy of CT. A retrospective study was conducted to identify patients from 2000 to 2009 with International Classification of Diseases, 9th Revision code 566 (anal or rectal abscess). Patients included had a CT scan less than 48 hours before drainage. Patients with CT-positive abscess were compared with patients with CT-negative abscess. Patients were categorized as either immunocompetent or immunosuppressed based on documentation of diabetes mellitus, cancer, human immunodeficiency virus, or end-stage renal disease. One hundred thirteen patients were included in this study. Seventy-four (65.5%) were male and the average age was 47 years. Eighty-seven of 113 (77%) patients were positive on CT for anorectal abscess. Sixty of 113 (53%) patients included in this study were immunocompromised. CT missed 26 of 113 (23%) patients with confirmed perirectal abscess. Eighteen (69%) of these patients were immunocompromised compared with CT-positive patients (42 [48%], P = 0.05). The overall sensitivity of CT in identifying abscess was 77 per cent. CT lacks sensitivity in detecting perirectal abscess, particularly in the immunocompromised patient.

  13. A case of laparoscopic cystogastrostomy for pancreatic abscess

    FAN Hua; ZHANG Dong; ZHAO Xin; PAN Fei; JIN Zhong-kui


    To the Editor:Open surgery is considered the gold standard for pancreatic abscess.1 With the development of laparoscopic ultrasound and laparoscopic skills,laparoscopic internal drainage for pancreatic abscess becomes feasible.We report a successful application of the laparoscopic cystogastrostomy for pancreatic abscess in a patient.

  14. Holocord spinal epidural abscess in a pregnant patient presenting as premature labour: a rare presentation of an unusual diagnosis.

    Burton, Kirsteen R; Wang, Xi; Dhanoa, Deljit


    Spinal epidural abscess (SEA) is a rare clinical entity. It is less common when the entire epidural space is involved, known as a holocord or panspinal SEA, and it is even less common in a pregnant patient. We report a case of methicillin-resistant Staphylococcus aureus holocord SEA in a 30-year-old female at approximately 22 weeks' gestational age who presented with lumbar pain and pelvic pressure and the urge to bear down. Magnetic resonance imaging of the spine demonstrated extensive SEA and meningitis from the foramen magnum to the lumbar spine that was treated both medically and surgically. The incidence of, clinical presentation of, and risk factors for developing SEA are discussed. If untreated, expanding SEAs produce sensory symptoms and signs, motor dysfunction, and, eventually, paralysis and death. The medical and surgical management of SEA is also discussed. SEA can have an insidious and atypical presentation despite extensive involvement of the epidural space. Therefore, the diagnosis of SEA should always be considered in patients who present to the emergency department with back pain.

  15. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography


    Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT) is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were reco...

  16. A Discussion about the Clinical effects of 146 Patients with Perianal Abscess%肛周脓肿146例临床治疗探讨

    李新刚; 罗瑞升; 刘菊芳


    Objective This thesis is to discuss the clinical effects of the surgical treatment on perianal abscess.The method is to trace and analyze the clinical effects of the surgical therapy on 146 cases of perianal abscess in our hospital.Methods Among the 146 patients,we applied incision and drainage of perianal abscess during the first operation to 103 patients and incision-thread-drawing procedure to another 27 patients;we adopted incision and drainage of simple abscess on the other 16 patients who were later operated a second time after archosyrinx appeared.Results 126 patients out of the 130 cases where only one operation was performed completely recovered,with a success rate of 96.9%.The rest 4 patients were cured but with a second treatment,as with the 16 cases where incision and drainage of simple abscess was performed.We did a follow-up among these 146 patients.During the three to six months of the Flup,neither copracrasia nor Stenosis of anal canal occurred in these cured146 cases.Conclusion It is satisfactory and effective to apply primary radical surgery procedure in the treatment of perianal abscess,which can also shorten the course of treatment and reduce the possibility of a second operation.Meanwhile,as a traditional treatment,incision and drainage of simple abscess is still necessary for those whose inner-ora cannot be found during operation or whose abscess is in high position or is too large and too deep,and for the elderly with general toxic symptoms.%目的:探讨手术治疗肛周脓肿的临床疗效。方法回顾分析我院146例肛周脓肿患者采用手术治疗的临床效果。临床资料:146例患者中,采用一期切开根治引流术103例,一期切开引流挂线术27例,单纯脓肿切开引流术16例,待形成肛瘘后行二期手术。分析患者手术治疗的效果。结果行一期手术的130例患者中一次手术治愈126例,治愈率为96.9%,未治愈的4例连同单纯脓肿切开引流的16例患

  17. Validation of diagnostic codes for Charcot–Marie–Tooth disease in the Danish National Patient Registry

    Vaeth, Signe; Jensen, Uffe Birk; Christensen, Rikke; Andersen, Henning


    Purpose To validate the diagnostic codes for Charcot–Marie–Tooth disease (CMT) in the Danish National Patient Registry (DNPR) using positive predictive value (PPV) as a measure of validity. Patients and methods We used the DNPR to identify all patients diagnosed with at least one primary CMT diagnosis at a specialized department in the Central Denmark Region during the period 1977–2012. From this population, we randomly selected 123 patients for the validation study. Medical files were reviewed and used as reference standard. We estimated the PPV of the CMT diagnoses and stratified the analysis according to age at diagnosis, gender, and calendar time. Results In the DNPR, 275 patients were identified. We were able to retrieve 96 medical files from the random sample of 123 patients, and 85 CMT diagnoses were confirmed. The average age at diagnosis was 42.5 years, and 34% were female. The PPV was 88.5% (95% confidence interval: 80.4–94.1). Conclusion The CMT diagnoses in the DNPR have high validity. The DNPR can be used as a data source for epidemiologic research on CMT. PMID:27920579

  18. Spinal epidural abscess in brucellosis.

    Boyaci, Ahmet; Boyaci, Nurefsan; Tutoglu, Ahmet; Dokumaci, Dilek Sen


    Involvement of the skeletal system is a common complication of brucellosis. However, muscle involvement or paraspinal abscess formation are rare complications. Paraspinal abscess usually develops secondary to spondylitis. A case is reported here of a 33-year-old woman with symptoms of night sweats, fever and low back pain. Rose-Bengal test for brucellosis was positive and Brucella standard tube agglutination test was positive at a titre of 1/160. The diagnosis was made on MRI. The patient was treated with doxycycline and rifampin daily for 16 weeks. On day 14 of treatment, decline was observed in the patient's symptoms. In the presence of inflammatory lower back pain and fever, brucellosis should be considered particularly in the endemic areas. Furthermore, tuberculosis should be remembered in the differential diagnosis when a spinal epidural abscess is determined.

  19. Nerve abscess in primary neuritic leprosy.

    Rai, Dheeraj; Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Goel, Madhu Mati; Malhotra, Kiran Preet; Kumar, Vijay; Singh, Arun Kumar; Jain, Amita; Kohli, Neera; Singh, Shailesh Kumar


    Nerve abscess is an infrequently reported complication of leprosy. We describe a patient with a pure neuritic type of leprosy with multiple nerve abscesses, who presented with tingling and numbness in the medial aspect of his right forearm and hand. Subsequently he developed pain, redness and swelling over the medial side of his right elbow and the flexor aspect of his right wrist. High-resolution ultrasound showed diffuse thickening of the right ulnar nerve with hypoechoic texture housing a cystic lesion with internal debris suggesting an abscess, at the cubital tunnel. Histopathological examination of the pus and tissue obtained from the abscess revealed presence of granulomas with lepra bacilli. The patient responded to surgery and multidrug therapy. In conclusion, the nerve abscess as the first manifestation of leprosy is uncommon and a high index of suspicion is required to make a correct diagnosis.

  20. Quality of life in patients with Charcot-Marie-Tooth disease type 1A

    Juliana B. Taniguchi


    Full Text Available We assessed the functional impairment in Charcot-Marie-Tooth resulting from 17p11.2-p12 duplication (CMT1A patients using the Short-Form Health Survey (SF-36, which is a quality of life questionnaire. Twenty-five patients of both genders aged ≥10 years with a positive molecular diagnosis of CMT1A were selected. Age- and gender-matched Control Group (without family history of neuropathy, and the sociodemographic and professional conditions similar to the patients' group were selected to compare the SF-36 results between them. The results showed that the majority quality of life impairments in CMT1A patients occurred in the social and emotional domains. Functional capacity also tended to be significantly affected; other indicators of physical impairment were preserved. In conclusion, social and emotional aspects are mostly neglected in the assistance provided to CMT1A Brazilian patients, and they should be better understood in order to offer global health assistance with adequate quality of life as a result.

  1. The detection of sleep apnea in the awake patient. The 'saw-tooth' sign.

    Sanders, M H; Martin, R J; Pennock, B E; Rogers, R M


    We studied 21 subjects, 13 of whom had the sleep apnea hypersomnolence syndrome associated with upper airway obstruction during sleep (SAHS-UAO) to determine if "saw-toothing" on the flow-volume loop was significantly associated with the phenomenon of airway occlusion during sleep. A "saw-tooth" pattern was present on the flow-volume loop in 11 of 13 subjects with SAHS-UAO. The presence of saw-toothing correlated with fluttering of tissue that was visualized in the upper airway via the fiberoptic bronchoscope. The specificity of the saw-tooth pattern for SAHS-UAO was 100%. Generalized obesity may indirectly influence the presence of saw-toothing due to deposition of what appeared to be adipose tissue in the pharyngeal walls. Although the number of subjects in this study is small, saw-toothing on the flow-volume loop appears to be an important aid in the diagnosis of SAHS-UAO.

  2. Bacteremia with an iliopsoas abscess and osteomyelitis of the femoral head caused by Enterococcus avium in a patient with end-stage kidney disease.

    Okada, Akira; Hangai, Mika; Oda, Toshimi


    A 70-year-old man on hemodialysis for end-stage kidney disease due to polycystic kidney disease presented with hip pain on extension and a high C-reactive protein level. Further examinations revealed an iliopsoas abscess and femoral head osteomyelitis caused by Enterococcus avium (E. avium) detected in blood and pus cultures. Complete resolution of the infection with ampicillin-resistant E. avium required six months of vancomycin therapy and two surgical drainage procedures. There have been no previous case reports in which both blood and abscess cultures confirmed E. avium infection. Careful attention should be paid to the detection of non-specific symptoms in patients on hemodialysis, with blood cultures being essential in such cases.

  3. Abscess - abdomen or pelvis

    ... infected fluid and pus located inside the belly (abdominal cavity). This type of abscess can be located near ... abdominal abscesses: Abdominal x-ray Ultrasound of the abdomen and pelvis CT scan of the abdomen and ...

  4. Spinal cord abscess

    ... drugs The infection often begins in the bone ( osteomyelitis ). The bone infection may cause an epidural abscess ... Boils Cerebral spinal fluid (CSF) collection Epidural abscess Osteomyelitis Pulmonary tuberculosis Sepsis Spinal cord trauma Swelling Review ...

  5. Tonsillar Cellulitis and Abscess

    ... Vocal Cord Contact Ulcers Vocal Cord Paralysis Tonsillar cellulitis is a bacterial infection of the tissues around the tonsils. A tonsillar ... Laryngoceles Retropharyngeal Abscess Salivary Gland Disorders Submandibular ... and Tonsillar Abscess Tonsillopharyngitis Vocal Cord Polyps, Nodules, ...

  6. Feasibility of rapid polymerase chain reaction for detection of methicillin-resistant Staphylococcus aureus colonization among emergency department patients with abscesses

    Pulia MS


    Full Text Available Michael S Pulia,1 Mary Calderone,2 Brad Hansen,2 Christine E Stake,3 Mark Cichon,3 Zhanhai Li,4 Nasia Safdar51Division of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; 2Loyola University Stritch School of Medicine, Maywood, IL, USA; 3Department of Emergency Medicine, Loyola University Medical Center, Maywood, IL, USA; 4University of Wisconsin Department of Biostatistics and Medical Informatics, Madison, WI, USA; 5William S Middleton Veterans Affairs Medical Center and the Department of Medicine, Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, WI, USAPurpose: In the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA, clinicians face a difficult challenge when selecting antibiotics to treat abscesses. The lack of rapid diagnostics capable of identifying the causative organism often results in suboptimal antibiotic stewardship practices. Although not fully elucidated, the association between MRSA colonization and subsequent infection represents an opportunity to enhance antibiotic selectivity. Our primary objective was to examine the feasibility of utilizing a rapid polymerase chain reaction (PCR system (Cepheid’s GeneXpert® to detect MRSA colonization prior to patient discharge in the emergency department (ED.Methods: This feasibility study was conducted at a tertiary care, urban, academic ED. Patients presenting with a chief complaint related to a potential abscess during daytime hours over an 18-week period were screened for eligibility. Subjects were enrolled into either the PCR swab protocol group (two-thirds or traditional care group (one-third. PCR swabs were obtained from known MRSA carriage sites (nasal, pharyngeal and the superficial aspect of the wound.Results: The two groups were similar in terms of demographics, abscess location, and MRSA history. The PCR results were available prior to patient

  7. [Prostatic abscesses. A review].

    Rabii, R; Rais, H; Joual, A; el Mrini, M; Benjelloun, S


    We review the literature to the diagnosis and therapeutic aspect of prostatic abscess. The prostatic abscess having become an uncommon disease. The diagnosis of prostatic abscess has been nearly made by transrectal ultrasound and computed tomography scan. The best diagnostic method is considered to be the transrectal ultrasound. The choice therapy was intravenous antibiotic, and drainage by ultrasound guided transperineal percutaneous puncture.

  8. GDAP1 mutations in Italian axonal Charcot-Marie-Tooth patients: Phenotypic features and clinical course.

    Pezzini, I; Geroldi, A; Capponi, S; Gulli, R; Schenone, A; Grandis, M; Doria-Lamba, L; La Piana, C; Cremonte, M; Pisciotta, C; Nolano, M; Manganelli, F; Santoro, L; Mandich, P; Bellone, E


    Mutations in the ganglioside-induced differentiation associated-protein 1 (GDAP1) gene have been associated with both autosomal recessive (AR) and dominant (AD) Charcot-Marie-Tooth (CMT) axonal neuropathy. The relative frequency of heterozygous, dominant mutations in Italian CMT is unknown. We investigated the frequency of dominant mutations in GDAP1 in a cohort of 109 axonal Italian patients by sequencing genomic DNA and search for copy number variations. We also explored correlations with clinical features. All cases had already been tested for variants in common axonal AD genes. Eight patients (7.3%) harbored five already reported heterozygous mutations in GDAP1 (p.Arg120Gly, p.Arg120Trp, p.His123Arg, p.Gln218Glu, p.Arg226Ser). Mutations had different penetrances in the families; the onset of symptoms is in the first decade and progression is slower than usually seen in GDAP1-related AR-CMT. We show that the relative frequency of mutations in GDAP was slightly higher than those observed in MFN2 and MPZ (7.3% vs 6.3% and 5.0%). The relatively milder clinical features and the quite indolent course observed are relevant for prognostic assessment. On the basis of our experience and the data reported here, we suggest GDAP1 as the first gene that should be analysed in Italian patients affected by CMT2.

  9. Characterization of gait parameters in patients with Charcot-Marie-Tooth disease.

    Kuruvilla A


    Full Text Available The gait of five patients with Charcot-Marie-Tooth(CMT disease was analyzed using light-emitting diodes and a force plate. The flexion-extension motions of the hips, knees, and ankles, as well as their moments (vector sums of forces acting at the joints in the flexion-extension and abduction-adduction planes, were quantified. The gait of the CMT patients showed abnormalities consistent with both distal weakness (ankle dorsi- and plantar-flexors and weakness of the hip abductor muscles. The latter weakness appeared to produce asymmetric hip moments and truncal instability in the mediolateral plane during ambulation. However, the extent to which the gait was abnormal appeared not to be exclusively related to the severity of the sensorimotor conduction deficits in the peripheral nerves. In the four patients for whom nerve conduction velocity studies were available, decrease in the lower-extremity distal conduction velocities and evoked motor amplitude potentials did not correlate with the severity and extent of the gait abnormalities.

  10. Increased incidence of osteonecrosis of the jaw after tooth extraction in patients treated with bisphosphonates: a cohort study.

    Yamazaki, T; Yamori, M; Ishizaki, T; Asai, K; Goto, K; Takahashi, K; Nakayama, T; Bessho, K


    This study estimated the cumulative incidence and risk ratio for osteonecrosis of the jaw (ONJ) after tooth extraction in patients with and without administration of bisphosphonates (BP) and identified potential risk factors for bisphosphonate-induced osteonecrosis of the jaw (BIONJ). A cohort study was conducted in all patients undergoing tooth extraction at a university hospital in Japan from April 2006 to June 2009. Of 3216 patients, 126 had BP administration, of whom 5 (3.9%, 95% confidence interval (CI): 1.2-9.2) developed ONJ, versus 1 (0.032%, 95% CI: 0.00081-0.18) among 3090 patients without BP administration. BP administration was associated with the development of ONJ after tooth extraction, with an unadjusted risk ratio of 122.6 (95% CI: 14.4-1041.8). When stratified by age and route of BP administration, the risk ratio for ONJ patients aged 65 years or older with intravenous BP administration compared to those without was 200.2 (95% CI: 23.8-1679.4, P<0.001). Patients receiving BP showed a significant association between the incidence of BIONJ and alveolar bone loss score. The risk of ONJ is higher in patients with than without BP administration, particularly intravenous administration. Severe periodontitis might be a risk factor for BIONJ.

  11. Disseminated nocardiosis with psoas abscess in a patient with AIDS: first reported case Nocardiose disseminada com abscesso do psoas em paciente com AIDS: primeiro caso relatado

    Marcelo Corti


    Full Text Available Psoas muscle abscess is an uncommon infection that have been diagnosed increasingly in the last years. We present a case of a patient with advanced human immunodeficiency virus infection who developed a disseminated infection due to Nocardia asteroides sensu stricto type VI with psoas abscess. To our knowledge no other cases of Nocardia psoas abscess in the setting of HIV infection have been reported in the literature.O abscesso do músculo psoas é uma infecção pouco comum que tem sido diagnosticada de maneira crescente nos últimos anos. Apresentamos um caso de paciente com infecção avançada pelo vírus da imunodeficiência humana (HIV que desenvolveu uma infecção disseminada por Nocardia asteroides senso estrito tipo VI, com abscesso no psoas. Em nosso conhecimento, não foram relatados na literatura outros casos de abscesso do psoas por Nocardia, no contexto da infecção por HIV.


    Jathin Sam


    Full Text Available Intratonsillar abscess is a rare complication of acute tonsillitis. It is a rarely diagnosed infection occurring in both children and adults. Herein, we present a case of intratonsillar abscess in a 25-year-old female patient, who was managed by needle aspiration which is a minimally invasive procedure and it is low cost, safe and effective along with antibiotic therapy. The aspiration of the pus from the tonsil confirms the diagnosis of intratonsillar abscess. So intratonsillar abscesses are uncommon, but should be considered in the differential diagnosis of peritonsillar abscess and tonsillitis.

  13. Case Report: Emergency awake craniotomy for cerebral abscess in a patient with unrepaired cyanotic congenital heart disease [version 1; referees: 2 approved

    Corinne D’Antico


    Full Text Available We report the case of a 39-year-old male with complex cyanotic congenital heart disease undergoing emergency craniotomy for a cerebral abscess. Maintenance of intraoperative hemodynamic stability and adequate tissue oxygenation during anesthesia may be challenging in patients with cyanotic congenital heart disease. In this case, we decided to perform the surgery as an awake craniotomy after interdisciplinary consensus. We discuss general aspects of anesthetic management during awake craniotomy and specific concerns in the perioperative care of patients with congenital heart disease.

  14. Transmastoid approach to otogenic brain abscess: 14 years experience

    V R Borade


    Full Text Available Objectives: Objectives of this study were to review our experience in on otogenic brain abscess and its management by transmastoid drainage and compare the results. Materials and Methods: All patients with brain abscess secondary to CSOM presenting to our department from January 1997 to December 2010 were included in this study. All patients subjected to clinical, neurological, opthalmological examination and CT scan was done as an imaging modality. All patients managed by radical mastoidectomy or modified radical mastoidectomy and transmastoid drainage of brain abscess as neurosurgical facility not available. Results: Seventy-two patients in whom brain abscess secondary to chronic suppurative otitis media was diagnosed and has been treated since 1997 are presented. 85% of patients were below 20 years of age. More than 50% patients presented with more than one complication of chronic suppurative otitis media. 85% of patients were having extensive cholesteatoma and 15% patients were having extensive granulations in middle ear and mastoid air cells. 83% patients were having cerebellar abscess while 17% patients were having temporal lobe abscess. 80% of the pus culture was sterile while in 20% patients various microorganisms such as Proteus spp., Escherichia coli, Pseudomonas aeruginosa, Staphylococcus spp., and Streptococcus spp were cultured. Overall mortality in this series was 4.4%. Conclusion: In diagnosis of otogenic brain abscess CT scan with constrast is of immense help. Transmastoid drainage of brain abscess is a safe and effective method that can be performed by otologists in cases of otogenic brain abscess.

  15. Deep neck abscesses: the Singapore experience.

    Lee, Yan Qing; Kanagalingam, Jeevendra


    This study aims to review our experience with deep neck abscesses, identify key trends, and improve the management of this condition. This is a retrospective chart review of patients diagnosed with deep neck abscesses in the Department of ENT (Otorhinolaryngology) at Tan Tock Seng Hospital, Singapore between 2004 and 2009. Patient demographics, etiology, bacteriology, systemic disease, radiology, treatment, complications, duration of hospitalization, and outcomes were reviewed. 131 patients were included (64.9% male, 35.1% female) with a median age of 51.0 years. 54 (41.2%) patients had diabetes mellitus. The parapharyngeal space (23.7%) was the most commonly involved space. Odontogenic and upper airway infections were the leading causes of deep neck abscesses (28.0% each). Klebsiella pneumoniae (27.1%) was the most commonly cultured organism in this study and among the diabetic patients (50.0%). 108 (82.4%) patients underwent surgical drainage. 42 patients suffered complications. All 19 patients, who had upper airway obstruction, had either a tracheostomy or intubation. Patients with multi-space abscesses, diabetes mellitus, and complications had prolonged hospitalizations. Old age and diabetes are risk factors for developing deep neck abscesses and their sequelae. The empiric choice of antibiotics should recognize that a dental source is likely, and that Klebsiella is most common in diabetics. Surgical drainage and adequate antibiotic coverage remains the cornerstone of treatment of deep neck abscesses. Therapeutic needle aspiration may successfully replace surgical drainage, if the abscesses are small and no complications are imminent. Airway obstruction should be anticipated in multi-space and floor of mouth abscesses.

  16. Presence and consequence of tooth periapical radiolucency in patients with cirrhosis

    Grønkjær, Lea Ladegaard; Holmstrup, Palle; Schou, Søren; Schwartz, Kristoffer; Kongstad, Johanne; Jepsen, Peter; Vilstrup, Hendrik


    Background Periapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related complications. Methods A total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width. Predictors of periapical radiolucency and the association with systemic inflammation markers and cirrhosis-related complications were explored by univariable and multivariable logistic regression analyses. Results Periapical radiolucency was present in one or more teeth in 46% of the patients. Strong predictors were gross caries (odds ratio [OR] 3.12, 95% confidence interval [CI] 1.43–6.79) and severe periodontitis (OR 3.98, 95% CI 1.04–15.20). Also old age (OR 1.10, 95% CI 1.01–1.19) and smoking (OR 3.24, 95% CI 1.02–17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors. The patients with periapical radiolucency had higher C-reactive protein (15.8 mg/L vs 8.1 mg/L, P=0.02) and lower albumin contents (25 g/L vs 28 g/L, P=0.04) than those without. Furthermore, the patients with periapical radiolucency had a higher prevalence of cirrhosis-related complications such as ascites, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05). Conclusion Periapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings. PMID:27695370

  17. Pyogenic brain abscess, a 15 year survey

    Helweg-Larsen Jannik


    Full Text Available Abstract Background Brain abscess is a potentially fatal disease. This study assesses clinical aspects of brain abscess in a large hospital cohort. Methods Retrospective review of adult patients with pyogenic brain abscess at Rigshospitalet University Hospital, Denmark between 1994 and 2009. Prognostic factors associated with Glasgow Outcome Score (GOS (death, severe disability or vegetative state were assessed by logistic regression. Results 102 patients were included. On admission, only 20% of patients had a triad of fever, headache and nausea, 39% had no fever, 26% had normal CRP and 49% had no leucocytosis. Median delay from symptom onset to antibiotic treatment was 7 days (range 0–97 days. Source of infection was contiguous in 36%, haematogenous in 28%, surgical or traumatic in 9% and unknown in 27% of cases. Abscess location did not accurately predict the portal of entry. 67% were treated by burr hole aspiration, 20% by craniotomy and 13% by antibiotics alone. Median duration of antibiotic treatment was 62 days. No cases of recurrent abscess were observed. At discharge 23% had GOS ≤3. The 1-, 3- and 12-month mortality was 11%, 17% and 19%. Adverse outcome was associated with a low GCS at admission, presence of comorbidities and intraventricular rupture of abscess. Conclusions The clinical signs of brain abscess are unspecific, many patients presented without clear signs of infection and diagnosis and treatment were often delayed. Decreased GCS, presence of comorbidities and intraventricular rupture of brain abscess were associated with poor outcome. Brain abscess remains associated with considerable morbidity and mortality.

  18. Ascariasis as a cause of hepatic abscess: A report of 3 cases.

    Chauhan, V; Thakur, S; Rana, B


    We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

  19. Tooth anatomy

    ... page: // Tooth anatomy To use the sharing features on this page, ... upper jawbone is called the maxilla. Images Tooth anatomy References Lingen MW. Head and neck. In: Kumar ...

  20. 封闭负压引流技术在乳房脓肿切开引流术中的临床意义%Clinical value of vacuum sealing drainage for the treatment of the patients with mammary abscess



    目的:探讨封闭负压引流技术(vacuum sealing drainage ,VSD)在乳房脓肿切开引流术中的临床意义。方法2010年6月至2012年5月对住院治疗的20例乳房脓肿病人使用传统手术方法脓肿切开引流、凡士林纱布填塞治疗作为对照组。2012年6月至2013年11月对住院治疗的18例乳房脓肿病人结合VSD技术治疗乳房脓肿作为VSD组。两种治疗方法在脓肿的愈合时间、手术瘢痕长度、患者的满意度、医生工作量等方面进行比较。结果 VSD技术组较对照组术后脓肿的愈合时间短,手术瘢痕短,患者满意度高,医生工作量明显减少。结论结合VSD技术治疗乳房脓肿是一种安全、有效和非常实用的方法。%Objective To explore the clinical signiifcance of vacuum sealing drainage(VSD) in incision and drainage for the treatment of the patients with mammary abscess.Methods Twenty patients with breast abscess underwent traditional operation method ie.abscess incision and abscess drainage and Vaseline gauze packing as control group from June 2010 to May 2012. 18 patients with breast abscess underwent VSD for the treatment of the patients with breast abscess as the group of VSD from June 2012 to November 2013.Comparison and analysis were made between the 2 groups for the healing time, scar length ,the satisfaction of patients and the doctor workload.Result The healing time is shorter, operation scar length is shorter, the satisfaction of patients is higher and the surgeon need not frequently change dress for the patients in the patients with breast abscess as the group of VSD compared with the control group.Conclusion The vacuum sealing drainage for the treatment of the patients with mammary abscess is a safe and effective kind for treating mammary abscess.

  1. Bacteroides fragilis in biopsies of patients with major abscesses and diabetic foot infections: direct molecular versus culture-based detection

    Stappers, Mark H. T.; Hagen, Ferry; Reimnitz, Peter; Mouton, Johan W.; Meis, Jacques F.; Gyssens, Inge C


    Direct determination by pathogen-specific real-time PCR assay for Bacteroides fragilis was compared to culture in major abscess and diabetic foot infection biopsy samples. Real-time PCR resulted in an increased detection rate of 12% for B. fragilis and could improve the detection of B. fragilis in clinical samples. (C) 2016 Elsevier Inc. All rights reserved.

  2. A Clinical Analysis of Tooth Size Discrepancy (Bolton Index) among Orthodontic Patients in Wuhan of Central China

    Philipos Tadesse; Handong ZHANG; Xiaosi LONG; Lili CHEN


    The purpose of this study was to determine the total Bolton index (TBI) and anterior Bolton index (ABI), evaluate the clinical significance of tooth size discrepancies and the influence of gender variation of mesiodistal tooth width on Bolton Index and estimate which tooth has the greatest influence on Bolton Index. A total of 110 pairs of pretreatment dental study casts (41 male and 69female) were selected from patients treated in Department of Orthodontics of Union Hospital in Wuhan, China. A sliding dental Vernier caliper was used for the measurement of the mesiodistal tooth width. Descriptive statistical mean values, standard deviation, standard error of the mean values, coefficient of variance and the t-test were used for the statistical analysis of the data. The study found that TBI, ABI and the total sum of teeth width had no significant difference between male and female.Male group indicated that Bolton Index (BI) was mostly influenced by the width of lower right second premolar, whereas female group showed that BI was mostly influenced by the width of both the right and left maxillary lateral incisor.

  3. Immediate natural tooth pontic: A viable yet temporary prosthetic solution: A patient reported outcome

    Sudhir Bhandari


    Conclusion: The concept of immediate pontic placement is surely a viable treatment option and promises an excellent transient esthetic solution for a lost tooth as well as enables good preparation of the extraction site for future prosthetic replacement.

  4. Telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement

    Mladenović Dragan


    Full Text Available Introduction. In the management of edentulous spaces, there is a permanent need of a dentist-prosthetician in charge to consult other specialists. Modern telemedicine, based on powerful computer and telecomunication systems, offers an adequate answer to these challenges, being able to transfer and obtain clinical data and consultation information over large distances. Using smartphone or a computer, the teleconsultant acces the system, downloads and review the data and photographs and gave suggestions. The system then enables direct, real time contact with the consultant, chat, or directs them to contact each other by phone. Case report. We presented telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement in 3 cases with different teleconsultation requirements: the first case for prosthetic rehabilitation of his upper teeth, the second one for prosthetic management of his partial edentulousness and “a growth on his gums” in the vestibular region of the frontal teeth and the third one for prosthetic management of total edentulousness of her upper jaw. We used the system of telemedicine in dentistry, established at the Faculty of Medicine in Kosovska Mitrovica. The operation was based on the computer application system XPA3 Online, computer networking and mobile smartphone network. All consultations were succefull with no need for further procedures in regional center. Conclusion. The use of a mobile smartphone has brought about the mobility and availability of teleconsultant specialists in an extent never seen before. Prostheticians are thus able to offer better service to their patients and improve the quality of management of partially or totally edentulous patients, especially in rural areas.

  5. Myelin protein zero gene mutated in Charcot-Marie-Tooth type 1B patients

    Su, Ying; Li, Lanying; Lepercq, J.; Lebo, R.V. (Univ. of California, San Francisco, CA (United States)); Brooks, D.G.; Ravetch, J.V. (Sloan-Kettering Institute, New York, NY (United States)); Trofatter, J.A. (Massachusetts General Hospital, Boston, MA (United States))


    The autosomal dominant of Charcot-Marie-Tooth disease (CMT), whose gene is type 1B (CMT1B), has slow nerve conduction with demyelinated Schwann cells. In this study the abundant peripheral myelin protein zero (MPZ) gene, MPZ, was mapped 130 kb centromeric to the Fc receptor immunoglobulin gene cluster in band 1q22, and a major MPZ point mutation was found to cosegregate with CMT1B in one large CMT1B family. The MPZ point mutation in 18 of 18 related CMT1B pedigree 1 patients converts a positively charged lysine in codon 96 to a negatively charged glutamate. The same MPZ locus cosegregates with the CMT1B disease gene in a second CMT1B family [total multipoint logarithm of odds (lod) = 11.4 at [theta] = 0.00] with a splice junction mutation. Both mutations occur in MPZ protein regions otherwise conserved identically in human, rat, and cow since these species diverged 100 million years ago. MPZ protein, expressed exclusively in myelinated peripheral nerve Schwann cells, constitutes >50% of myelin protein. These mutations are anticipated to disrupt homophilic MPZ binding and result in CMT1B peripheral nerve demyelination.

  6. 糖尿病合并细菌性肝脓肿的临床特点%Clinical characteristics of diabetic patients suffering from bacterial liver abscess

    赵小芹; 许岚


    糖尿病患者并发细菌性肝脓肿以往较少见,近年来随着诊疗技术的进步和临床认识的提高,其发病率似有增多趋势,但此类患者在发病机制、临床表现、实验室检查、致病微生物以及治疗等方面均有自身的特点,其临床表现较不典型,容易导致漏诊和误诊,治疗较非糖尿病者困难,已引起临床医生的广泛重视.%Diabetic patients suffering from bacterial liver abscess was rare in the past.Now with the development of diagnostic technique and clinical recognition,the incidence of bacterial liver abscess seems to be increasing in diabetic patients.However,the pathogenesis,clinical manifestation,laboratory examination,pathogenic bacterium and treatment are different in diabetic ones.The clinical manifestation of diabetic patients was not typical and it was easy to misdiagnose the disease.Compared with nondiabetic patients,the treatment was more difficult in diabetic ones,which made the clinicians to pay more attention to it.

  7. Effect of reinforced flowable resin restoration on periodontal tissue in patients with severe periodontitis and anterior tooth loss

    Zhao-Ran Fu


    Objective:To study the effect of traditional flowable resin and reinforced flowable resin restoration on periodontal tissue in patients with severe periodontitis and anterior tooth loss. Methods: A total of 76 patients with severe periodontitis and anterior tooth loss who received treatment in our hospital from May 2012 to October 2015 were selected and randomly divided into reinforced group and traditional group who received reinforced flowable resin restoration and traditional flowable resin restoration respectively. Inflammation indexes, oxidative stress indexes, bone metabolism indexes and apoptotic indexes in gingival crevicular fluid were compared between two groups.Results:2 weeks after treatment, NLRP3, IL-1β, IL-18, RANKL, MDA, O2-, H2O2, Fas, FasL, Bax, Smac, Apaf-1 and Caspase-3 levels as well as caspase-1 vitality in gingival crevicular fluid of reinforced group were significantly lower than those of traditional group while SOD, GSH-Px, OPG, ALP, Runx2, OCN and Col-1 levels were significantly higher than those of traditional group.Conclusion: Reinforced flowable resin restoration can alleviate inflammation and oxidative stress in periodontal tissue, and inhibit alveolar bone resorption and cell apoptosis in patients with severe periodontitis and anterior tooth loss.

  8. Brodie's abscess of the cuboid bone: a case report.

    Bagatur, A Erdem; Zorer, Gazi


    The case of a patient with Brodie's abscess of the cuboid bone and who presented with a painful and swollen right foot is described. The patient was treated successfully by surgical evacuation of the abscess and with antibiotics. To the authors' knowledge, Brodie's abscess of the cuboid bone has not been reported previously. The clinical presentation and diagnostic difficulties which may be encountered are discussed.

  9. Septic arthritis of the knee associated with calf abscess.

    Izumi, Masashi; Ikeuchi, Masahiko; Tani, Toshikazu


    Septic arthritis associated with extra-articular abscess is rare. We report on 2 non-rheumatic patients with septic arthritis of the knee associated with calf abscess. Magnetic resonance imaging showed a distinct leakage pathway from the knee joint in each patient. One was a ruptured popliteal cyst (posteromedial). Another was a pathologic popliteus hiatus (posterolateral). These patients underwent open drainage of the calf abscess via a small incision, followed by arthroscopic debridement of the knee. Careful palpation of the lower leg, followed by magnetic resonance imaging and needle aspiration, is important to exclude a possible extra-articular abscess regardless of the presence of a popliteal cyst.

  10. INMUNOGLOBULINA G EN PACIENTE CON ABSCESO HEPÁTICO AMEBIANO Inmunoglobulin-IgG antibodies- in one patients with amebic liver abscess

    Análida Elizabeth Pinilla Roa


    Full Text Available La infección por Entamoeba histo­lytica puede causar disentería y absceso hepático amebiano, enfermedades de alta morbi-mortalidad. Los estudios seroepidemio­lógicos han demostrado que la mayoría (81-100% de los pacientes con absceso hepático amebiano y hasta la mitad en la colitis amebiana desarrollan inmuno­globulina G (IgG específica para E. histolytica, que persiste por varios años. Por tal motivo, hay controversia acerca de la utilidad de la prueba de ELISA IgG para el diagnóstico de absceso hepático amebiano en países tropicales, donde se ha reportado una alta prevalencia de la enfermedad. Se presenta el seguimiento, durante 32 meses, mediante IgG de un paciente de 69 años, proveniente del Chocó en Colombia, con diagnóstico de absceso hepático amebiano, comprobado mediante ecografía, ELISA para IgG, e inmunodifusión y por la respuesta al tratamiento con metronidazol. Las pruebas inmunodiagnósticas han permanecido positivas durante el seguimiento.Entamoeba histolytica causes dysentery and amebic liver abscess diseases, with high morbid and mortality. Seroepidemiological surveys have shown that 81-100% of patients with amebic liver abscess and 50% of patients with amebic colitis developed specific anti-E. histolytica IgG antibodies which may persist for several years. For this reason the usefulness of the ELISA test for IgG antibodies in amebic liver abscess diagnosis has been questioned in tropical countries where prevalence of the disease is high. This paper presents the follow-up during 32 months of the IgG antibodies in a 69 year old patient from Chocó (Colombia, with one amebic liver abscess confirmed by liver ultrasound, ELISA IgG and inmunodifution, who response to treatment with metronidazole. The immunodiagnostic tests have been consistently positive during follow-up.

  11. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Hsueh-Chou Lai; Cho-Yu Chan; Cheng-Yuan Peng; Chih-Bin Chen; Wen-Hsin Huang


    Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases: (1) an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; (2) DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

  12. Scalp abscess--a cautionary tale.

    Nugent, Nora F


    Transcranial extension of frontal sinus infection is a rare, but not eradicated entity. We present a 21-year-old male, in whom a persistent scalp abscess heralded the discovery of skull vault osteomyelitis and extradural abscesses secondary to frontal sinusitis. Patients with prolonged or unusual symptoms with a history of sinusitis or trauma warrant further investigation as they may have developed serious intracranial complications. Urgent management, both surgical and antimicrobial, is indicated in such scenarios.

  13. Analysis of split tooth as an unstudied reason for tooth extraction

    Osaghae, Ifueko Patience; Azodo, Clement Chinedu


    Background Split tooth is an unstudied reason for tooth extraction. The purpose of this study was to determine and analyze split tooth as a reason for extraction in a dental clinic in Benin City. Methods The prospective study was carried out on 669 patients having tooth extraction between May, 2005 and December, 2012. Over the period of the study, diagnosis and tooth extraction were done by three dentists of more five years practice experience. The indications for tooth extraction were noted ...

  14. Current trends in the diagnosis and treatment of tuboovarian abscess

    Landers, D.V.; Sweet, R.L.


    Tuboovarian abscess is a well-recognized complication of acute salpingitis and has been reported in as many as one third of hospital admissions for acute salpingitis. The incidence of tuboovarian abscess is expected to increase as a result of the current epidemic of sexually transmitted diseases and their sequelae. Patients with tuboovarian abscess most commonly present with lower abdominal pain and an adnexal mass(es). Fever and leukocytosis may be absent. Ultrasound, computed tomographic scans, laparoscopy, or laparotomy may be necessary to confirm the diagnosis. Tuboovarian abscess may be unilateral or bilateral regardless of intrauterine contraceptive device usage. Tuboovarian abscess is polymicrobial with a preponderance of anaerobic organisms. An initial conservative antimicrobial approach to the management of the unruptured tuboovarian abscess is appropriate if the antimicrobial agents used can penetrate abscesses, remain active within the abscess environment, and are active against the major pathogens in tuboovarian abscess, including the resistant gram-negative anaerobes such as Bacteroides fragilis and Bacteroides bivius. However, if the patient does not begin to show a response within a reasonable amount of time, about 48 to 72 hours, surgical intervention should be undertaken. Suspicion of rupture should remain an indication for immediate operation. Once operation is undertaken, a conservative approach with unilateral adnexectomy for one-side tuboovarian abscess is appropriate if future fertility or hormone production is desired.

  15. Pyogenic liver abscess in beta-thalassemia major--report of two cases.

    Hwang, C F; Lee, C Y; Lee, P I; Chen, J M; Lli, K H; Lin, D T; Chang, M H


    Pyogenic liver abscess, which may lead to devastating consequences, is an uncommon medical problem in pediatrics and has generally been reported in compromised hosts. This article describes two patients with beta-thalassemia major and hemochromatosis complicated by Klebsiella pneumoniae liver abscess. One of the patients had severe complications, including subphrenic abscess, pleural effusion and meningitis. To present knowledge, the occurrence of K. pneumoniae liver abscess in patients with beta-thalassemia major has never before been reported in the literature.

  16. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: An extremely fulminant form of a common disease

    Chi-Hsun Hsieh; Yu-Chun Wang; Horng-Ren Yang; Ping-Kuei Chung; Long-Bin Jeng; Ray-Jade Chen


    As a disease commonly encountered in daily practice,acute appendicitis is usually diagnosed and managed easily with a low mortality and morbidity rate.However, acute appendicitis may occasionally become extraordinarily complicated and life threatening. A56-year-old man, healthy prior to this admission, was brought to the hospital due to spiking high fever, poor appetite, dysuria, progressive right flank and painful swelling of the thigh for 3 d. Significant inflammatory change of soft tissue was noted, involving the entire right trunk from the subcostal margin to the knee joint. Painful disability of the right lower extremity and apparent signs of peritonitis at the right lower abdomen were disclosed. Laboratory results revealed leukocytosis and an elevated C-reactive protein level. Abdominal CT revealed several communicated gas-containing abscesses at the right retroperitoneal region with mass effect, pushing the duodenum and the pancreatic head upward, compressing and encasing inferior vena cava,destroying psoas muscle and dissecting downward into the right thigh. Laparotomy and right thigh exploration were performed immediately and about 500 mL of frank pus was drained. A ruptured retrocecal appendix was the cause of the abscess. The patient fully recovered at the end of the third post-operation week. This case reminds us that acute appendicitis should be treated carefully on an emergency basis to avoid serious complications.CT scan is the diagnostic tool of choice, with rapid evaluation followed by adequate drainage as the key to the survival of the patient.

  17. Hepatocellular Carcinoma Mimicking Liver Abscesses in a Cirrhotic Patient with Severe Septic Shock as a Result of Salmonella O9 HG Infection

    Shuichi Hagiwara


    Full Text Available We describe a case of severe Salmonella O9 HG sepsis with a mass in the liver, which was diagnosed as hepatocellular carcinoma (HCC by autopsy of the liver. The patient was a 67-year-old man with chronic high blood pressure. In addition, he was an alcoholic and had been drinking every day for many years. He had had a dinner of ‘sukiyaki’ with a raw egg two days before admission. The next morning, he had developed vomiting, diarrhea, and abdominal pain. Salmonella O9 HG was found in the blood and stool cultures. In the computed tomography (CT finding of the liver, there was a 2 cm early-enhanced mass with a multilocular structure, with ringed enhancement and daughter nodes. Since we thought that the mass was a liver abscess, we performed needle aspiration from the liver mass and were able to withdraw blood. Despite adequate antibiotic treatment, the patient died as a result of complications on the 55th day after admission. After the patient’s death, we conducted an autopsy. There were two HCC masses, a moderately-differentiated and a well-differentiated mass, as a result of alcoholic cirrhosis of the liver. As the HCC had multilocular cyst-like structures, which were fiber- and necrosis-rich, CT images of the liver masses resembled abscesses.

  18. Multicystic Hepatocarcinoma Mimicking Liver Abscess

    Evangelos Falidas


    Full Text Available The diagnosis of hepatocellular carcinoma (HCC became easier in relation to the improved radiological examinations; however, the neoplasm may occur under atypical presentations mimicking other benign or malignant processes. Multicystic HCC mimicking a liver abscess associated with septic-type fever and leukocytosis is rare, has a poor prognosis, and poses diagnostic and therapeutic dilemmas. We present the case of an 80-year-old patient, who presented with fever, leukocytosis, and large cystic masses involving right and left lobes of the liver initially considered abscesses and finally diagnosed as HCC after open drainage and liver biopsy. Although the patient died on the tenth postoperative day due to pulmonary oedema, the authors emphasize the high index of suspicion needed in the diagnosis of this unusual presentation of HCC.

  19. Retropharyngeal abscess after radiation therapy and cis-platinum, 5-fluorouracil treatment for nasopharyngeal carcinoma with collagen disease. Report of two patients and a review of the literature

    Hareyama, Masato; Nagakura, Hisayasu; Tamakawa, Mitsuharu [Sapporo Medical Univ. (Japan)] [and others


    Collagen disease are frequently associated with malignant tumors. Recently, radiotherapy combined with chemotherapy has been recommended for improving the efficacy of treatment for nasopharyngeal carcinoma. Two patients with nasopharyngeal carcinoma complicated by collagen diseases (dermatomyositis in one, and Sjoegren`s syndrome with mixed connective tissue disease in the other) were given radiotherapy combined with chemotherapy consisting of cis-platinum and 5-fluorouracil. Following this combination therapy, both patients developed retropharyngeal abscess and ulceration of the mucosal membrane on the posterior wall of the oropharynx; there was no tumor cell involvement. Because these injuries were more severe than would have been expected from radiotherapy alone, It is recommended that special attention be paid to combination therapy in patients with nasopharyngeal carcinoma complicated by collagen disease. (author)

  20. Successful medical treatment of spinal epidural abscess.

    Xiao, Bo-Ren; Wang, Chih-Wei; Lin, Jung-Chung; Chang, Feng-Yee


    Spinal epidural abscess is a rare but potentially fatal disease. A 67-year-old female suffered fever and painful swelling of the right knee and lower leg for one week. Both synovial fluid and blood cultures yielded methicillin-sensitive Staphylococcus aureus. Low back pain developed and fever was sustained despite the administration of intravenous oxacillin. Magnetic resonance imaging (MRI) of the thoracolumbar spine revealed spinal epidural abscess from T12 to S1. Because of severe hypoalbuminemia and general anasarca and followed by exploratory laparotomy for massive duodenal bleeding, she did not receive surgical intervention for the spinal epidural abscess. After intravenous administration of oxacillin 2 g 4-hourly for 12 weeks, she recovered and follow-up MRI confirmed the efficacy of the medical treatment. She remained well at 1-year follow-up. In a patient with minimal neurological deficit or surgical contraindication, spinal epidural abscess can be successfully treated with a medical regimen.

  1. Pyogenic Liver Abscess. A Case Report

    Miguel Ángel Serra Valdés


    Full Text Available Liver abscesses account for 13% of all abdominal abscesses and 48% of those occurring in the viscera. The bacterial or pyogenic liver abscesses are the most frequent. A case of a 34-year-old woman of mixed race with history of gallstones (2011, extrahepatic obstructive jaundice caused by cholelithiasis (May 2012, cholangitis after endoscopic retrograde cholangiopancreatography (ERCP and cholecystectomy (August 2012 due to gallstones is presented. In September 2012, she began suffering from high fever with chills every day, usually in the evenings. In addition, she presented night sweats, loss of appetite, weight loss, nausea and pain in the right upper quadrant of the abdomen which was sharp, permanent and annoying sometimes. The signs and symptoms, history, ultrasound scan and multislice computed tomography confirmed the diagnosis of pyogenic liver abscess. The risk factors leading to the infection were well-identified. The patient progressed satisfactorily with the medical treatment provided.

  2. Anal abscess and fistula.

    Sneider, Erica B; Maykel, Justin A


    Benign anorectal diseases, such as anal abscesses and fistula, are commonly seen by primary care physicians, gastroenterologists, emergency physicians, general surgeons, and colorectal surgeons. It is important to have a thorough understanding of the complexity of these 2 disease processes so as to provide appropriate and timely treatment. We review the pathophysiology, presentation, diagnosis, and treatment options for both anal abscesses and fistulas.

  3. Whole-tooth regeneration: it takes a village of scientists, clinicians, and patients.

    Snead, Malcolm L


    A team of senior scientists was formed in 2006 to create a blueprint for the regeneration of whole human teeth along with all of the supporting structure of the dentition. The team included experts from diverse fields, each with a reputation for stellar accomplishment. Participants attacked the scientific issues of tooth regeneration but, more importantly, each agreed to work collaboratively with experts from other disciplines to form a learning organization. A commitment to learn from one another produced a unique interdisciplinary and multidisciplinary team. Inspired by the Kennedy space program to send a man to the moon, with its myriad of problems and solutions that no one discipline could solve, this tooth regeneration team devised an ambitious plan that sought to use stem cell biology, engineering, and computational biology to replicate the developmental program for odontogenesis. In this manner, team members envisioned a solution that consisted of known or knowable fundamentals. They proposed a laboratory-grown tooth rudiment that would be capable of executing the complete program for odontogenesis when transplanted to a suitable host, recreating all of the dental tissues, periodontal ligament, cementum, and alveolar bone associated with the canonical tooth. This plan was designed to bring regenerative medicine fully into the dental surgery suite, although a lack of funding has so far prevented the plan from being carried out.


    Pehlivanov, B; Matev, M


    We report a case of a 34 years old primigravida with Charcot-Marie-Tooth disease (CMTD). The course of pregnancy was uneventful with no deterioration of symptoms due to the disease. Performed amniocentesis showed healthy fetus. Planned cesarean section with spinal anesthesia was performed because of the restricted pelvis. The possible issues of combination pregnancy and CMTD are discussed.

  5. Treatment of bacterial brain abscess by repeated aspiration. Follow up by serial computed tomography

    Yamamoto, Masaaki; Fukushima, Takeo; Hirakawa, Katsuyuki; Kimura, Hideo; Tomonaga, Masamichi [Fukuoka Univ. (Japan). School of Medicine


    Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (author)

  6. Predictive factors for early aspiration in liver abscess

    Rustam Khan; Saeed Hamid; Shahab Abid; Wasim Jafri; Zaigham Abbas; Mohammed Islam; Hasnain Shah; Shaalan Beg


    AIM: To determine the predictive factors for early aspiration in liver abscess.METHODS: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess.RESULTS: A total of 966 patients, 738 (76%) male, mean age 43 ± 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age ≥ 55 years, size of abscess ≥ 5 cm, involvement of both lobes of the liver and duration of symptoms ≥ 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group.CONCLUSION: Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.

  7. An unusual presentation of autonomic dysreflexia in a patient with cold abscess of cervical spine for anterolateral decompression

    Sarangi, Susmita; Taneja, Dipali; Saxena, Bhavna


    A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C4, C6, C7, T2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation. Autonomic dysreflexia was suspected with stimulus arising from distended rectum as all other causes of hypertension were ruled out. PMID:28003699

  8. An unusual presentation of autonomic dysreflexia in a patient with cold abscess of cervical spine for anterolateral decompression

    Susmita Sarangi


    Full Text Available A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C 4 , C 6 , C 7 , T 2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation. Autonomic dysreflexia was suspected with stimulus arising from distended rectum as all other causes of hypertension were ruled out.

  9. On a Boat: A Case in Australia of Endophthalmitis and Pyogenic Liver, Prostatic, and Lung Abscesses in a Previously Well Patient due to Klebsiella pneumoniae

    Alecia Vandevelde


    Full Text Available This is a case report about a patient who arrived in our emergency department in Western Australia to the care of the urologists having just gotten off a ship with a bacterial infection that would result in a 44-day stay in hospital and have quite devastating lasting effects for the young male. His story was in fact reflective of an emerging global phenomenon. Once thought to generally be a bacterium of threat only to the elderly and alcoholics, causing pneumonia and urinary tract infections, this case report describes the potentially devastating consequences of what is now becoming recognized as a hypervirulent form of Klebsiella pneumoniae with the potential to spread throughout the system rapidly seeding abscesses and causing significant morbidity in nonimmunocompromised patients. Initially noticed in Asia increasingly case reports are emerging in Western countries suggesting a global spread.

  10. Evaluation of holmium laser for transurethral deroofing of severe and multiloculated prostatic abscesses

    Lee, Chan Ho; Ku, Ja Yoon; Park, Young Joo; Lee, Jeong Zoo; Shin, Dong Gil


    Purpose Our objective was to evaluate the use of a holmium laser for transurethral deroofing of a prostatic abscess in patients with severe and multiloculated prostatic abscesses. Materials and Methods From January 2011 to April 2014, eight patients who were diagnosed with prostatic abscesses and who underwent transurethral holmium laser deroofing at Pusan National University Hospital were retrospectively reviewed. Results Multiloculated or multifocal abscess cavities were found on the preope...

  11. Incidence of bisphosphonate-related osteonecrosis of the jaw in high-risk patients undergoing surgical tooth extraction.

    Bodem, Jens Philipp; Kargus, Steffen; Eckstein, Stefanie; Saure, Daniel; Engel, Michael; Hoffmann, Jürgen; Freudlsperger, Christian


    As the most suitable approach for preventing bisphosphonate-related osteonecrosis of the jaw (BRONJ) in patients undergoing surgical tooth extraction is still under discussion, the present study evaluates the incidence of BRONJ after surgical tooth extraction using a standardized surgical protocol in combination with an adjuvant perioperative treatment setting in patients who are at high-risk for developing BRONJ. High-risk patients were defined as patients who received intravenous bisphosphonate (BP) due to a malignant disease. All teeth were removed using a standardized surgical protocol. The perioperative adjuvant treatment included intravenous antibiotic prophylaxis starting at least 24 h before surgery, a gastric feeding tube and mouth rinses with chlorhexidine (0.12%) three times a day. In the follow-up period patients were examined every 4 weeks for the development of BRONJ. Minimum follow-up was 12 weeks. In 61 patients a total number of 184 teeth were removed from 102 separate extraction sites. In eight patients (13.1%) BRONJ developed during the follow-up. A higher risk for developing BRONJ was found in patients where an additional osteotomy was necessary (21.4% vs. 8.0%; p = 0.0577), especially for an osteotomy of the mandible (33.3% vs. 7.3%; p = 0.0268). Parameters including duration of intravenous antibiotic prophylaxis, the use of a gastric feeding tube and the duration of intravenous BP therapy showed no statistical impact on the development of BRONJ. Furthermore, patients currently undergoing intravenous BP therapy showed no higher risk for BRONJ compared with patients who have paused or completed their intravenous BP therapy (p = 0.4232). This study presents a protocol for surgical tooth extraction in high-risk BP patients in combination with a perioperative adjuvant treatment setting, which reduced the risk for postoperative BRONJ to a minimum. However, the risk for BRONJ increases significantly if an additional osteotomy is necessary

  12. [The role of echography in osteolytic tubercular abscesses].

    Gandolfo, N; Serrato, O; Sandrone, C; Serafini, G


    Tubercular abscesses are relatively common complications of tubercular spondylodiscitis. Fifty-one patients with suspected abscesses were selected from a group of 97 patients with tubercular spondylodiscitis and submitted to US. In 10 cases CT was performed before US and detected 7 abscesses, all of them confirmed by US. In the extant 41 cases, CT followed US; in 13 cases only US poorly visualized ilio-psoas muscles. As for the group of 23 patients who underwent both CT and US, if the former method is assumed as the reference gold standard, overall US sensitivity is 97% (1 false negative) and its specificity is 100%. In all cases where US findings were accurate and specific enough, CT was not performed; the patients were followed every seventh month and no abscesses found. US showed abscesses in the iliac fossa in 20 cases, along the psoas fascia in 6 and in the thighs in 3 cases. Two cases of gluteal localization were observed, together with 1 Grynfelt's triangle abscess, 1 Petit's triangle and 1 Scarpa's triangle abscesses; finally, 1 abscess was found in the knee. The most common appearance of tubercular abscesses is a hypoechoic and inhomogeneous pattern; sometimes caseum makes the abscess solid and hyperechoic. Calcifications were unusual in our series. All patients were submitted to percutaneous drainage under US guidance. The results proved US to allow the early and unquestionable diagnosis of tubercular abscesses and to confirm clinical suspicion. Moreover, US is also useful to guide percutaneous drainage and to follow the patients after drainage. As for CT, it remains the method of choice to depict vertebral involvement, but, in our series, it exhibited no significant advantages over US in the study of abscessual lumbar collections.

  13. Infrahyoid spread of deep neck abscess: anatomical consideration.

    Ojiri, H; Tada, S; Ujita, M; Ariizumi, M; Ishii, C; Mizunuma, K; Fukuda, K


    The aim of this study was to determine the pathway of infrahyoid extension of the oropharyngeal abscess considering the anatomy of the fascial spaces by cross-sectional imaging. CT scans and MR images were retrospectively reviewed in ten patients with known infrahyoid extension of oropharyngeal abscesses (eight with acute tonsillitis, two with acute phlegmonous oropharyngitis). In seven of eight patients tonsillar abscesses descended along the deep cervical fascia converging on the hyoid bone and further accumulated in the anterior cervical space through which extension to the mediastinum took place in four patients. In seven patients the abscesses involved the retropharyngeal space at the infrahyoid neck. In two of these seven patients the abscesses directly extended down into the upper mediastinum through the retropharyngeal space. In one patients of the seven mediastinal spread of an abscess occurred through the posterior cervical space, not through the retropharyngeal space. Cross-sectional imaging is valuable in the evaluation of deep neck abscesses and the pathway of spread. The anterior cervical space in the infrahyoid neck is important for mediastinal extension of pharyngeal abscesses.

  14. Clinical study of tooth extraction in patients with cardiovascular diseases%心血管病患者拔牙的临床分析及治疗

    尚君兰; 孙明磊


    Objective To investigate the clinical experience and methods of enhancing the safety of tooth extraction for patients with cardiovascular disease. Methods Two hundred and fifty-six patients with cardiovascular disease needing tooth extraction were selected. Results All the patients completed tooth extraction successfully. The fear and heart rate increasing took place in 26 cases. Blood pressure elevated temporarily in 6 cases during the tooth extraction. No patient had severed complication.Conclusions Patients with cardiovascular diseases have risk in tooth extraction. While the safety of tooth extraction for these patients could be enhanced by strict case screening, effective psychotherapy pre-operation, keeping emotion stability, good anaesthesia during the operation, perfect technique of tooth extraction and careful observation post-operation.%目的 探讨提高心血管疾病患者拔牙安全性的措施.方法 回顾性分析256例心血管疾病患者拔牙的临床资料.结果 本组256例心血管病患者拔牙均顺利完成,仅26例术中出现恐惧、心率加快,6例出现暂时血压升高,对症处理后缓解,无严重并发症发生.结论 心血管疾病患者拔牙术前充分心理辅导,术中麻醉确切、手术操作快速准确和术后观察可有效防止并发症的发生.

  15. Radiological diagnosis of Brodie's abscess.

    Kowalewski, Michał; Swiatkowski, Jan; Michałowska, Ilona; Swiecicka, Dorota


    Background. Brodie's abscess is a kind of rare subacute or chronic osteitis. It is probably caused by mistreated or non-treated osteitis, or by bacteria of low virulence. Material and methods. In the Orthopedic and Traumatology Clinic of our medical school 5 patients were diagnosed with Brodie's obsecess between 1999 and 2002. all the patients had conventional x-rays, while one also had CT and MRI. Results and conclusions. The typical x-ray image shows an osteolytic lesion with sclerotic margin in the diametophysis. Each of the 5 patients had surgery. In 4 cases the histopatological results confirmed the radiological diagnosis. In one case fibrous dysplasia was found.

  16. Right adrenal abscess -- an unusual complication of acute apendicitis.

    Dimofte, Gabriel; Dubei, Liviu; Lozneanu, Lili-Gabriela; Ursulescu, Corina; Grigora Scedil, Mihai


    Acute appendicitis represents one of the most frequent abdominal emergencies encountered in everyday surgical practice. Local infectious complications are not unusual and retroperitoneal abscesses after acute retrocaecal appendicitis have been previously described. The authors present the case of a 22-years-young female patient, admitted for a right iliac fossa abscess, secondary to gangrenous appendicitis. A right adrenal mass 35/40 mm was revealed during preoperative ultrasound evaluation, which evolved in an adrenal abscess that spontaneously drained 10 days after appendectomy and retrocecal drainage. Adrenal abscesses are exceptionally rare, with only a few cases being reported in the literature, but none of these after acute appendicitis.

  17. Head and neck cancers masquerading as deep neck abscesses.

    Soon, Sue Rene; Kanagalingam, Jeevendra; Johari, Shirish; Yuen, Heng Wai


    Deep neck space abscesses are common otolaryngological emergencies, and prompt incision and drainage is the treatment of choice. Head and neck cancers often present with cervical metastases that may become secondarily infected. Clinical presentation is similar to a deep neck abscess. Surgical drainage of such collections has implications on subsequent treatment. In this case series, we describe six cases with this unusual presentation that were subsequently found to have a head and neck malignancy, and where three patients had their abscesses treated surgically. We aim to raise awareness of this unusual presentation of a head and neck carcinoma, and to avoid a potential pitfall in the management of deep neck abscess.

  18. Misunderstanding of foot drop in a patient with charcot-marie-tooth disease and lumbar disk herniation.

    Han, Youngmin; Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung


    We report the case of 57-year-old woman diagnosed with Charcot-Marie-Tooth (CMT) disease and lumbar disk herniation (LDH). She had left leg weakness and foot numbness, foot deformity (muscle atrophy, high arch, and clawed toes). The lumbar spine MRI showed LDH at L4-5. Additionally, electrophysiology results were consistent with chronic peripheral motor-sensory polyneuropathy (axonopathy). In genetic testing, 17p11.2-p12 duplication/deletions characteristic of CMT disease were observed. We confirmed the patient's diagnosis as CMT disease and used conservative treatment.

  19. Tooth in oropharynx

    D Nagarajappa


    Full Text Available The incidence of ectopic teeth has increased. In many cases, the etiology of ectopic teeth cannot be identified. Ectopic tooth in deciduous dentition period is very rare and information is limited about its causes and characteristics. The conditions commonly associated with an increased prevalence of ectopic teeth include cleft lip and palate, cleidocranial dysplasia, and Gardner syndrome. The diagnosis is made by the clinical and radiological examinations. The indication for extraction in ectopic teeth cases is in general determined by the presence of symptomatology, or by the need for preventing future complications. We present a case of an ectopic maxillary tooth in a 4 year-old boy. In addition, this report also addresses a young patient with a tooth in the oropharynx with the objective of non traumatic etiology, and such a clinical presentation is extremely rare. The authors believe the case presented here is the first documented case of an ectopic supernumerary tooth seen in the oropharynx.

  20. Tooth in oropharynx.

    Nagarajappa, D; Manjunatha, Bs


    The incidence of ectopic teeth has increased. In many cases, the etiology of ectopic teeth cannot be identified. Ectopic tooth in deciduous dentition period is very rare and information is limited about its causes and characteristics. The conditions commonly associated with an increased prevalence of ectopic teeth include cleft lip and palate, cleidocranial dysplasia, and Gardner syndrome. The diagnosis is made by the clinical and radiological examinations. The indication for extraction in ectopic teeth cases is in general determined by the presence of symptomatology, or by the need for preventing future complications. We present a case of an ectopic maxillary tooth in a 4 year-old boy. In addition, this report also addresses a young patient with a tooth in the oropharynx with the objective of non traumatic etiology, and such a clinical presentation is extremely rare. The authors believe the case presented here is the first documented case of an ectopic supernumerary tooth seen in the oropharynx.

  1. Amebic liver abscesses masquerading as pyemic abscesses.

    Nattakom, S; Serrato, P; Bright, T; Anaya, A; Stubbers, S; Verghese, A


    We describe a 50-year-old man who presented with multiple liver abscesses that suggested biliary sepsis or portal pyemia. A wet preparation of a sample of aspirate showed the presence of amebic trophozoites, and subsequent serological testing for amebae was strongly reactive.

  2. 3-D analysis of tooth formation and eruption in patients with craniofacial anomalies

    Kreiborg, Sven; Larsen, Per; Bro-Nielsen, Morten


    A number of craniofacial anomalies or syndromes involve severe disturbances of tooth formation and eruption (e.g. Apert syndrome, Crouzon syndrome, tricho-dento-osseous syndrome, cleidocranial dysplasia, and cleft lip and palate). So far, studies of these dental problems have been limited to two......-dimensional analysis from orthopantomograms, intra-oral X-rays or cephalometric radiographs. A method for visualization of the developing tooth crowns in three dimensions based on CT-scans of the jaws has been developed (Bro-Nielsen et al., 1996). The purpose of the present study was to apply this new visualization...... method to the analysis of the complex dental problems found in some of the syndromes listed above....

  3. Equine corneal stromal abscesses

    Henriksen, M. D. L.; Andersen, P. H.; Plummer, C. E.


    The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal....... Medical and surgical treatments are now directed towards elimination of fungal and bacterial infections, reduction and replacement of diseased corneal stroma, and suppression of iridocyclitis. If the abscess and anterior uveitis do not respond satisfactorily to medical therapy, full thickness or split...

  4. PTH1R Mutants Found in Patients with Primary Failure of Tooth Eruption Disrupt G-Protein Signaling

    Kollert, Sina; Rukoyatkina, Natalia; Sturm, Julia; Gambaryan, Stepan; Stellzig-Eisenhauer, Angelika; Meyer-Marcotty, Philipp; Eigenthaler, Martin; Wischmeyer, Erhard


    Aim Primary failure of tooth eruption (PFE) is causally linked to heterozygous mutations of the parathyroid hormone receptor (PTH1R) gene. The mutants described so far lead to exchange of amino acids or truncation of the protein that may result in structural changes of the expressed PTH1R. However, functional effects of these mutations have not been investigated yet. Materials and Methods In HEK293 cells, PTH1R wild type was co-transfected with selected PTH1R mutants identified in patients with PFE. The effects on activation of PTH-regulated intracellular signaling pathways were analyzed by ELISA and Western immunoblotting. Differential effects of wild type and mutated PTH1R on TRESK ion channel regulation were analyzed by electrophysiological recordings in Xenopus laevis oocytes. Results In HEK293 cells, activation of PTH1R wild type increases cAMP and in response activates cAMP-stimulated protein kinase as detected by phosphorylation of the vasodilator stimulated phosphoprotein (VASP). In contrast, the PTH1R mutants are functionally inactive and mutant PTH1R/Gly452Glu has a dominant negative effect on the signaling of PTH1R wild type. Confocal imaging revealed that wild type PTH1R is expressed on the cell surface, whereas PTH1R/Gly452Glu mutant is mostly retained inside the cell. Furthermore, in contrast to wild type PTH1R which substantially augmented K+ currents of TRESK channels, coupling of mutated PTH1R to TRESK channels was completely abolished. Conclusions PTH1R mutations affect intracellular PTH-regulated signaling in vitro. In patients with primary failure of tooth eruption defective signaling of PTH1R mutations is suggested to occur in dento-alveolar cells and thus may lead to impaired tooth movement. PMID:27898723

  5. Absceso recidivante por Nocardia asteroides en una paciente portadora de poliglobulia primaria Recurrent brain abscess caused by Nocardia asteroides in a patient with primary polycythaemia

    Carlos Aboal


    Full Text Available La nocardiosis del sistema nervioso central (SNC es una enfermedad poco común, cuya frecuencia ha aumentado con el crecimiento de los tratamientos inmunosupresores. El hombre se infecta por inhalación, inoculación traumática cutánea directa y tras una infección periodontal ingiriendo alimentos contaminados. La localización pulmonar es la más frecuente, siendo la fuente inicial de diseminación hemática, con predominio en piel, tejido celular subcutáneo y SNC. Es conocida la predilección de Nocardia por el SNC. Estos abscesos, asociados a altos índices de mortalidad, especialmente en pacientes inmunocomprometidos, siguen constituyendo un desafío diagnóstico y terapéutico, permaneciendo no aclarado su manejo terapéutico óptimo. A pesar de la controversia en cuanto al manejo quirúrgico de estas lesiones, el diagnóstico precoz, por aspiración esterotáxica, y la iniciación de una terapia antimicrobiana son esenciales para la buena evolución del paciente. Se presenta una paciente portadora de una poliglobulia primaria, con absceso cerebral recidivante por Nocardia asteroides de posible origen dentario.Nocardiosis of the central nervous system (CNS is an uncommon disease, but its frequency has increased due to the high number of immunosuppressive treatments. People become infected by inhalation, direct traumatic cutaneous inoculation and eating contaminated food after a periodontal abscess. Lung localization is the most frequent one, being the origin of haematic dissemination, with a high incidence in skin, subcutaneous tissue and the CNS. The preference of Nocardia for the CNS is well-known. These abscesses are a diagnostic and therapeutic challenge, since they are associated to high mortality rates, specially in immunocompromised patients; the best therapeutic management remains unclear. In spite of the existing controversy with regard to the surgical management of these lesions, an early diagnosis through stereotactic

  6. Extensive spinal epidural abscess as a complication of Crohn's disease.

    Smith, Chez; Kavar, Bhadrakant


    A spinal epidural abscess is a neurosurgical emergency. Successful treatment frequently requires decompression of the spinal canal in combination with intravenous antibiotics. We report a patient with Crohn's disease who developed an extensive spinal epidural abscess communicating with an intra-abdominal collection.

  7. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

    Melisa Lim Seer Yee


    Full Text Available Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were recorded. 75 patients were diagnosed as having neck abscess on CECT; out of those 71 patients were found to have pus. Overall CECT findings were found to have a high sensitivity (98.6% and positive predictive value (PPV (94.7% but lower specificity (67.2% in diagnosing neck abscess. The CECT diagnostic criterion with the highest PPV is the presence of rim irregularity (96%. The most common deep neck space involved is the submandibular compartment, which correlates with the finding that odontogenic cause was the most common identifiable cause of abscess in the study population. Thus, in a patient clinically suspected of having neck abscess, CECT findings of a hypodense mass with rim irregularity are helpful in confirming the diagnosis and guiding clinical management.

  8. Brodie's abscess--an uncommon cause of leg pain.

    Amin, Muhammad Umar; Shafique, Mobeen; Jalil, Jawad; Nafees, Muhammad; Khan, Shamraiz


    A rare case of Brodie's abscess of distal left tibia is presented in a child which was initially missed on clinical grounds alone. Differentiation from different bone neoplasms was done on radiological grounds. The patient was managed surgically with high dose intravenous antibiotics. Brodie's abscess is very rarely encountered in our reporting of X-rays.

  9. Anorectal abscess during pregnancy.

    Koyama, Shinsuke; Hirota, Masaki; Kobayashi, Masaki; Tanaka, Yusuke; Kubota, Satoshi; Nakamura, Ryo; Isobe, Masanori; Shiki, Yasuhiko


    Anorectal symptoms and complaints caused by hemorrhoids or anal fissures are common during pregnancy. It is known that one-third of pregnant women complain of anal pain in the third trimester. Anal pain may be caused by a wide spectrum of conditions, but if it begins gradually and becomes excruciating within a few days it may indicate anorectal abscess. We experienced a case of anorectal abscess during pregnancy which was diagnosed by magnetic resonance imaging and treated by incision and seton drainage at 36 weeks of gestation, followed by a normal spontaneous delivery at 38 weeks of gestation. To our knowledge, this is the first case report of anorectal abscess during pregnancy in the English-language published work. The clinical course of our case and clinical considerations of anorectal abscesses are discussed.

  10. CT findings of hepatic abscess arising from perforated acute cholecystitis

    Choi, Sang Hee; Lee, Kyoung Soo; Lee, Jin Seoung; Lee, Moon Gyu; Chung, Young Hwa; Lee, Young Sang; Lee, Sung Gyu; Auh, Yong Ho [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)


    The purpose of this study was to report the CT findings of four patients with hepatic abscess secondary to perforated acute cholecystitis. We retrospectively reviewed the CT findings of four patients with surgically proven hepatic abscess secondary to perforated acute cholecystitis. CT findings were analysed with respect to the observation of the gallbladder, pericholecystic space, hepatic lesions, and peritoneal cavity. All patients underwent cholecystectomy, with drainage of the hepatic abscess. CT findings of hepatic abscess secondary to perforated acute cholecystitis were hypodense mass formation in the pericholecystic space(n=3), irreguarity and wall defect of Gallbladder(n=4), thickened Gallbladder wall(n=4), stone with debris(n=4), and local or diffuse infiltration of the pericholecystic area(n=3), omentum, and mesentery. CT was helpful in diagnosing the hepatic abscess secondary to perforated acute cholecystitis.

  11. Spontaneous spinal epidural abscess.

    Ellanti, P


    Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.

  12. Aspergillus spinal epidural abscess

    Byrd, B.F. III (Vanderbilt Univ. School of Medicine, Nashville, TN); Weiner, M.H.; McGee, Z.A.


    A spinal epidural abscess developed in a renal transplant recipient; results of a serum radioimmunoassay for Aspergillus antigen were positive. Laminectomy disclosed an abscess of the L4-5 interspace and L-5 vertebral body that contained hyphal forms and from which Aspergillus species was cultured. Serum Aspergillus antigen radioimmunoassay may be a valuable, specific early diagnostic test when systemic aspergillosis is a consideration in an immunosuppressed host.

  13. Central corneal abscess.

    van Bijsterveld, O P


    Central corneal abscess developed in the experimental animal after inoculation of biologically active staphylococcal strains in a paracentral epithelial lesion of the cornea. These abscesses did not ulcerate, developed only with high inocula, occurred more frequently in immunized rabbits. A serpiginous type of ulceration did not develop at the site of the initial epithelial lesion nor at any other place in the cornea. Histologically, the lesions consisted of densely packed polymorphonuclear leukocytes between the corneal lamellae.

  14. Recurrent amebic liver abscesses over a 16-year period: A case report

    D. Creemers-Schild; P.J.J. van Genderen (Perry); L.G. Visser; J.J. van Hellemond (Jaap); P.J. Wismans (Pieter)


    textabstractBackground: Amebic liver abscess is a rare disease in high-income countries. Recurrence of amebic liver abscess is even rarer with only a few previous reports. Here we present a patient who developed three subsequent amebic liver abscesses over a sixteen-year period. Case presentation: A

  15. Spinal epidural abscess following glossectomy and neck dissection: A case report

    Esther Cheng; Eric Thorpe; Richard Borrowdale


    Introduction: Spinal epidural abscess is an uncommon but potentially life threatening entity that rarely occurs after otolaryngology procedures. Presentation of case: We report a case of a diabetic patient who presented with a lumbar spinal epidural abscess eight days after head and neck oncologic surgery. Magnetic resonance imaging revealed an L4 spinal epidural abscess. Cultures from the spinal epidural abscess, blood, urine, and the previous neck incision grew Klebsiella pneumoniae. The...

  16. Brodie's abscess. A long-term review.

    Stephens, M M; MacAuley, P


    In 20 patients with 21 Brodie's abscesses, a long-term review revealed that 13 occurred in the second decade of life. All had local symptoms for six weeks or more. The tibia was involved in 11 cases and seven of these were in the proximal metaphysis. The erythrocyte sedimentation rate (ESR) was elevated in only six cases. When the ESR was more than 40 mm per hour, recurrence was more likely. Staphylococcus aureus was cultured from 11 abscesses. Curettage and antibiotics for six weeks were adequate for treatment in most cases. However, lesions larger than 3 cm in diameter should be grafted, and patients with an elevated ESR require more aggressive decompression and prolonged antibiotic therapy. Lesions within the neck of the femur pose particular anatomic problems and should not be approached laterally. All cases were followed to full bone maturity. No significant leg length inequality was clinically or roentgenologically apparent. If an abscess was juxtaphyseal, deformity of the epiphysis could develop.

  17. Differentiation of pyogenic and fungal brain abscesses with susceptibility-weighted MR sequences

    Antulov, Ronald; Miletic, Damir [Clinical Hospital Centre Rijeka, Department of Radiology, Rijeka (Croatia); Dolic, Kresimir [Clinical Hospital Centre Split, Department of Radiology, Split (Croatia); Fruehwald-Pallamar, Julia; Thurnher, Majda M. [Medical University Vienna, University Hospital Vienna, Department of Radiology-Subdivision of Neuroradiology and Musculoskeletal Radiology, Vienna (Austria)


    Conventional magnetic resonance imaging (MRI) techniques are insufficient to determine the causative agent of brain abscesses. We investigated: (1) the value of susceptibility-weighted MR sequences (SWMRS) in the differentiation of fungal and pyogenic brain abscesses; and (2) the effect of different SWMRS (susceptibility-weighted imaging (SWI) versus venous blood oxygen level dependent (VenoBOLD)) for the detection of specific imaging characteristics of pyogenic brain abscesses. We studied six patients with fungal and ten patients with pyogenic brain abscesses. Imaging characteristics on conventional MRI, diffusion-weighted imaging (DWI) and SWMRS were recorded in all abscesses. All lesions were assessed for the presence of a ''dual-rim sign'' on SWMRS. Homogenously hyperintense lesions on DWI were present in 60 % of patients with pyogenic abscesses, whereas none of the patients with fungal abscesses showed such lesions. On SWMRS, 90 % of patients with pyogenic abscesses and 60 % of patients with fungal abscesses had only lesions with a low-signal-intensity rim. On SWI, the dual-rim sign was apparent in all pyogenic abscesses. None of the fungal abscesses on SWI (P = 0.005) or any of the pyogenic abscesses on VenoBOLD (P = 0.005) were positive for a dual-rim sign. In fungal abscesses, the dual-rim sign is not present but a prominent peripheral rim or central susceptibility effects on SWI will be seen. The appearance of pyogenic abscesses on SWMRS depends on the used sequence, with the dual-rim sign a specific feature of pyogenic brain abscesses on SWI. (orig.)

  18. Clinical and radiographic findings following placement of single-tooth implants in young patients--case reports.

    Brugnolo, E; Mazzocco, C; Cordioll, G; Majzoub, Z


    Single-tooth implants were inserted in the maxillary anterior segments of three young patients aged 11.5 to 13 years. The patients were monitored for a period of 2.5 to 4.5 years. All implant-supported crowns ended up in an infraocclusion position relative to the adjacent teeth because of the continued vertical growth of the maxillary alveolar process. Between base-line examination and the date of recall, the distance from a fixed reference point located on the fixture to the crestal bone on the proximal surfaces of teeth adjacent to the implant sites increased up to 3 mm. Transverse growth changes were also observed. Although the prostheses could be removed and modified to compensate for the resulting soft and hard tissue changes, complications may occur altering the health of the mucogingival unit and the esthetic appearance of implant-supported restorations, and requiring further soft tissue correction procedures.

  19. Paediatric acute retropharyngeal abscesses: An experience

    Khan A Nazir


    Full Text Available Background: To describe our experience of paediatric patients with acute retropharyngeal abscess in terms of clinical presentation, diagnosis, management and complications. Materials and Methods: A prospective study was done for a period of 4 years (Jan 2009 to Jan 2013 on paediatric patients (< 15 years with acute retropharyngeal abscess at two tertiary hospitals in Srinagar. Diagnosis was made on the basis of X-ray, CECT scan findings and confirmed on incision and drainage. Pus was aspirated from all patients and sent for culture and sensitivity. Data for clinical presentation, X-ray, CECT scan findings, causes, complications, bacteriology and management were collected. Thirty-five abscesses were drained while 5 with small abscesses on CECT were managed conservatively. Results: A total of 40 patients were diagnosed as acute retropharyngeal abscesses. Males were commonly affected, and most of the patients were less than 6 years of age. Most common symptom at presentation was fever (35 followed by neck pain (30 Dysphagia/odynophagia (22, swelling in neck (19. Most common clinical sign observed was oropharyngeal swelling and limitation of neck movements (30, cervical swelling/lymphadenopathy in 22 patients. Torticollosis and drooling were seen in 15 patients. Complications were seen in 8 patients. Most common X-ray finding was pre-vertebral thickening. Success rate with primary surgical drainage was 95% while 3 patients in conservative group failed. Conclusion: Children with RPA most commonly present with restricted neck movements, fever and cervical lymphadenopathy, and rarely with respiratory distress or stridor. Surgical intervention is necessary for most of these patients.

  20. Specific Diurnal EMG Activity Pattern Observed in Occlusal Collapse Patients: Relationship between Diurnal Bruxism and Tooth Loss Progression

    Kawakami, Shigehisa; Kumazaki, Yohei; Manda, Yosuke; Oki, Kazuhiro; Minagi, Shogo


    Aim The role of parafunctional masticatory muscle activity in tooth loss has not been fully clarified. This study aimed to reveal the characteristic activity of masseter muscles in bite collapse patients while awake and asleep. Materials and Methods Six progressive bite collapse patients (PBC group), six age- and gender-matched control subjects (MC group), and six young control subjects (YC group) were enrolled. Electromyograms (EMG) of the masseter muscles were continuously recorded with an ambulatory EMG recorder while patients were awake and asleep. Diurnal and nocturnal parafunctional EMG activity was classified as phasic, tonic, or mixed using an EMG threshold of 20% maximal voluntary clenching. Results Highly extended diurnal phasic activity was observed only in the PBC group. The three groups had significantly different mean diurnal phasic episodes per hour, with 13.29±7.18 per hour in the PBC group, 0.95±0.97 per hour in the MC group, and 0.87±0.98 per hour in the YC group (p<0.01). ROC curve analysis suggested that the number of diurnal phasic episodes might be used to predict bite collapsing tooth loss. Conclusion Extensive bite loss might be related to diurnal masticatory muscle parafunction but not to parafunction during sleep. Clinical Relevance: Scientific rationale for study Although mandibular parafunction has been implicated in stomatognathic system breakdown, a causal relationship has not been established because scientific modalities to evaluate parafunctional activity have been lacking. Principal findings This study used a newly developed EMG recording system that evaluates masseter muscle activity throughout the day. Our results challenge the stereotypical idea of nocturnal bruxism as a strong destructive force. We found that diurnal phasic masticatory muscle activity was most characteristic in patients with progressive bite collapse. Practical implications The incidence of diurnal phasic contractions could be used for the prognostic

  1. Specific diurnal EMG activity pattern observed in occlusal collapse patients: relationship between diurnal bruxism and tooth loss progression.

    Shigehisa Kawakami

    Full Text Available AIM: The role of parafunctional masticatory muscle activity in tooth loss has not been fully clarified. This study aimed to reveal the characteristic activity of masseter muscles in bite collapse patients while awake and asleep. MATERIALS AND METHODS: Six progressive bite collapse patients (PBC group, six age- and gender-matched control subjects (MC group, and six young control subjects (YC group were enrolled. Electromyograms (EMG of the masseter muscles were continuously recorded with an ambulatory EMG recorder while patients were awake and asleep. Diurnal and nocturnal parafunctional EMG activity was classified as phasic, tonic, or mixed using an EMG threshold of 20% maximal voluntary clenching. RESULTS: Highly extended diurnal phasic activity was observed only in the PBC group. The three groups had significantly different mean diurnal phasic episodes per hour, with 13.29±7.18 per hour in the PBC group, 0.95±0.97 per hour in the MC group, and 0.87±0.98 per hour in the YC group (p<0.01. ROC curve analysis suggested that the number of diurnal phasic episodes might be used to predict bite collapsing tooth loss. CONCLUSION: Extensive bite loss might be related to diurnal masticatory muscle parafunction but not to parafunction during sleep. CLINICAL RELEVANCE SCIENTIFIC RATIONALE FOR STUDY: Although mandibular parafunction has been implicated in stomatognathic system breakdown, a causal relationship has not been established because scientific modalities to evaluate parafunctional activity have been lacking. PRINCIPAL FINDINGS: This study used a newly developed EMG recording system that evaluates masseter muscle activity throughout the day. Our results challenge the stereotypical idea of nocturnal bruxism as a strong destructive force. We found that diurnal phasic masticatory muscle activity was most characteristic in patients with progressive bite collapse. PRACTICAL IMPLICATIONS: The incidence of diurnal phasic contractions could be used for

  2. Nursing of Severe Aplastic Anemia Patients with Perianal Abscess%重型再生障碍性贫血伴肛周脓肿患者的护理体会



    Objective To summarize the experience of nursing care of severe aplastic anemia patients with perianal abscess. Methods The implementation of hemostasis, anti infection and anemia cor ection and perianal special care of 1 severe aplastic anemia patients with perianal abscess. Results After the treatment and care of patients with stable vital signs, perianal painbet er, perianal abscess broken skin, smooth drainage, no redness of the skin around the. Conclusion In severe aplastic anemia patients with perianal abscess, take ef ectivesymptomatic and supportive treatment, can reduce the suf ering of patients,reduce the cost for the patient, but also improve the patient's satisfaction.%目的:探讨对重型再生障碍性贫血伴肛周脓肿患者的护理体会。方法对1例重型再生障碍性贫血伴肛周脓肿的患者实施止血、抗感染以及纠正贫血和肛周特殊护理。结果经过治疗和护理,患者生命体征平稳,肛周疼痛好转,肛周脓肿处破皮,引流通畅、周围皮肤未见发红。结论对重型再障伴肛周脓肿患者,采取有效的对症支持治疗,能充分减低患者的痛苦,降低患者的经济费用,也提高了患者的满意度。

  3. Diagnosis of bacterial hepatic abscess by CT

    Cheng-Lin Wang; Xue-Jun Guo; Shui-Bo Qiu; Yi Lei; Zhi-Dong Yuan; Han-Bin Dong; Hui-An Liu


    BACKGROUND: Bacterial hepatic abscess usually is acute and progressive, often resulting in sepsis, impairment of liver function and disseminated intravascular coagulation. The mortality rate was as high as 80%in the past. For the purpose of early diagnosis and differential diagnosis of this disease, we probed the imaging manifestations and their characteristics in bacterial hepatic abscesses by CT scan. METHODS:Twenty-four lesions from 21 patients with bacterial hepatic abscesses that were conifrmed by clinical features, puncture and culture were reviewed for CT manifestations. Fourteen patients were male and 7 were female, with an average age of 56.2 years. All lesions underwent CT plain scan and three-phase enhanced scan and 15 patients underwent delayed-phase imaging. Three senior radiologists read the iflms in accordance with a standard. RESULTS: Among 24 lesions, 18 (75%) were situated in the right liver with diameters of 1.4-9.3 cm (average 4.5 cm). Nineteen (79.2%) lesions were round or sub-round in shape, and 22 (91.7%) had smooth, uninterrupted and sharp edges. All lesions showed low attenuation of less than 20 Hu. Twenty-two enhanced lesions (91.7%) had rim-shaped enhancement in the abscess wall, and 13 (54.2%) showed single or double-ring signs. Eighteen (75%) displayed honeycomb-like, grid-like or strip-like enhancement. Eighteen (75%) were regionally enhanced in the surroundings or upper or lower layers. Only 2 (8.3%) displayed a gas-liquid surface sign. CONCLUSIONS:  The CT ifndings of bacterial hepatic abscess are usually typical, and the diagnosis of the abscess is not dififcult. To precisely diagnose atypical cases, it is necessary to combine CT with clinical observations and follow-up.

  4. Spinal and Intracranial Epidural Abscess

    J Gordon Millichap


    Full Text Available Presentation, epidemiology, diagnosis and treatment of spinal epidural abscess (SEA and intracranial epidural abscess (ICEA are reviewed by researchers at The John's Hopkins University School of Medicine, Baltimore, MD, and Universidad de Santander, Columbia.

  5. Diagnosis and treatment of prostatic abscess

    Paulo Oliveira


    Full Text Available OBJECTIVES: Present and discuss the pathogenesis, diagnostic methods and treatment of the prostatic abscess. MATERIALS AND METHODS: We have retrospectively studied the medical records of 9 patients diagnosed and treated for prostatic abscess, between March 1998 and December 2000, assessing age, context, associated diseases, and diagnostic and therapeutic methods. We have compared the data found with those described in literature, based on Medline data. RESULTS: Mean age was 52.6 years. Three patients had previous diabetes mellitus diagnosis, and one was infected by HIV virus. Transrectal ultrasound of the prostate confirmed the diagnosis of prostatic abscess in all 7 cases in which it was performed. All cases received antibiotic treatment, and 77.8% needed concomitant surgical treatment. Two cases of microabscess were treated only with antibiotics. Four patients were submitted to perineal catheter drainage, 2 were submitted to transurethral resection of the prostate (TURP, and one patient required both procedures. Mean hospitalization time was 11.2 days, and most frequent bacterial agent was S. aureus. All patients were discharged from the hospital, and there was no death in this series. CONCLUSIONS: Prostatic abscess should be treated with broad-spectrum antibiotics and surgical drainage (perineal puncture or TURP. Microabscess may heal without surgery.

  6. Rapid genetic screening of Charcot-Marie-Tooth disease type 1A and hereditary neuropathy with liability to pressure palsies patients

    Xiaobo Li; Kun Xia; Beisha Tang; Ruxu Zhang; Xiaohong Zi; Lin Li; Yajing Zhan; Shunxiang Huang; Jin Li; Xuning Li; Xigui Li; Zhengmao Hu


    We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 (PMP22) to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Tooth disease type 1 and one family with hereditary neuropathy with liability to pressure palsies. The proband and one subclinical family member from the Charcot-Marie-Tooth disease type 1 family had a PMP22 gene duplication; one patient from the hereditary neuropathy with liability to pressure palsies family had a PMP22 gene deletion. Electron microscopic analysis of ultrathin sections of the superficial peroneal nerve from the two probands demonstrated demyelination and myelin sheath hyperplasia, as well as an ‘onion-like’ structure in the Charcot-Marie-Tooth disease type 1A patient. We observed an irregular thickened myelin sheath and ‘mouse-nibbled’-like changes in the patient with hereditary neuropathy with liability to pressure palsies. In the Charcot-Marie-Tooth disease type 1A patient, nerve electrophysiological examination revealed moderate-to-severe reductions in the motor and sensory conduction velocities of the bilateral median nerve, ulnar nerve, tibial nerve, and sural nerve. Moreover, the compound muscle action potential amplitude was decreased. In the patient with hereditary neuropathy with liability to pressure palsies, the nerve conduction velocity of the bilateral tibial nerve and sural nerve was moderately reduced, and the nerve conduction velocity of the median nerve and ulnar nerve of both upper extremities was slightly reduced.

  7. Cerebral candida abscess in an infant

    Baradkar V


    Full Text Available Brain abscess is uncommon in the pediatric population. Here, we report one such case due to Candida albicans in one-year-old infant, without any predisposing factors. The child presented with progressively increasing size of head circumference. The diagnosis was confirmed by CT scan of brain and microbiological investigations on the drained pus material. The patient responded to combination of surgery (drainage and intravenous amphotericin B. Neurological development six months after hospital discharge was normal. The organism being a rare cause of cerebral abscess in pediatric population is reported here.

  8. Chest wall abscess due to Prevotella bivia

    Gwo-jong HSU; Cheng-ren CHEN; Mei-chu LAI; Shi-ping LUH


    Prevotella bivia is associated with pelvic inflammatory disease. A 77-year-old man developed a rapidly growing chest wall abscess due to P. Bivia within days. He underwent surgical resection of the infected area; his postoperative course was un-eventful. This is the first case of chest wall abscess due to P. Bivia infection. Its correct diagnosis cannot be underestimated be-cause fulminam infections can occur in aged or immunocompromised patients if treated incorrectly. Prompt, appropriate surgical management, and antibiotic therapy affect treatment outcome.

  9. Filarial abscess in the submandibular region

    Rupinder Kaur


    Full Text Available Filariasis is a parasitic infectious disease caused by filarial nematode worms. These worms mainly dwell in subcutaneous tissues and lymphatics of the human host, with a predilection for lower limbs, retroperitoneal tissues, spermatic cord, and epididymis. Oral or perioral involvement of the filarial nematode is rare. This case report describes a filarial abscess in the right submandibular region. Fine needle aspiration cytology of the abscess revealed the presence of microfilaria of Wuchereria bancrofti species. The parasite was also present in the peripheral blood smear. Filarial infection presenting in this region is unusual and can cause diagnostic dilemma. The clinician can consider filariasis as one of the differential diagnosis while treating those abscesses in the orofacial region that are unresponsive to routine management, especially, patients hailing from endemic areas.

  10. Autogenous tooth transplantation: an alternative to replace extracted tooth

    David B. Kamadjaja


    Full Text Available Background: The gold standard treatment to replace missing tooth is dental implants, however, in certain cases, such as in young patients its placement is contraindicated. Autogenous tooth transplantation, which has been widely done in Scandinavian countries for many years, may become a good alternative to overcome this problem. Purpose: This article attempted to provide information about the indication, treatment planning, surgical technique and the successful result of autogenous tooth transplantation. Case: A fifteen year old male patient presented with large caries and periapical disease of his lower left first molar, which was partially erupted and the roots was not fully formed in radiograph. Case management: Autogenous tooth transplantation procedure was performed consisting of extraction of #36, odontectomy of #38 followed by its implantation to socket #36 and fixation of the transplanted tooth to the adjacent teeth. Post operative evaluation was done on regular basis within 18 months period. There was no complaint, the tooth was clinically stable and no evidence of periodontal problem. Serial radiographs showed healing of alveolar bone and periodontal tissue, and the complete root formation was evident by 18 months post operatively. Conclusion: Autogenous tooth transplantation is a potential alternative to replace extracted tooth. Provided that the case be properly planned and operation carefully performed, successful result of this treatment can be achieved.

  11. Analysis on patients'' cognition of using antibiotics after tooth extraction%患者对拔牙术后抗生素使用的认知调查分析

    陈俊良; 何芸; 赵威


    目的 通过探讨患者对拔牙术后抗生素使用的认知情况,促进抗生素的合理使用.方法 选取2015年1~4月期间到四川医科大学附属口腔医院口腔颌面外科门诊就诊的健康成年拔牙患者,完成问卷调查.采用χ2检验,分别分析问题答案是否与年龄,性别和教育程度有关.结果 收回完整问卷调查共978份,有842例患者(86.1%)希望拔牙术后医生开具抗生素,674例患者(69.9%)会在医生未开具抗菌素的时候要求医生开,因为他们认为使用抗生素可以预防术后感染.901例患者(92.1%)因为牙龈肿胀就诊的时候,会要求医生使用抗生素,62.0%的患者(606/978)在牙痛就诊的时候会要求医生开具抗生素,64.0%的患者(626/978)曾经在感冒时要求医生开具抗生素.年龄、性别和受教育程度对这些问题答案的影响差异无统计学意义(P>0.05).结论 大部分患者对于常规拔牙术后抗生素使用的认知不足,需要加强抗生素知识的宣教和普及.%Objective To evaluate patients' cognition of using antibiotics after tooth extraction for accelerating the correct application of antibiotics. Methods From January to April in 2015, male patients treated in the Department of Oral and Maxillofacial Surgery, the Hospital of Stomatology, Sichuan Medical University for routine exodontia were requested to complete a questionnaire. The positive and negative answers to the questions were analyzed for possible cor-relations with the age, gender and level of education using Chi-square test. Results The study included a total of 978 patients. According to the questionnaire, 842 patients (86.1%) expected to receive antibiotics after tooth extraction, among which 674 would ask for antibiotics if not prescribed for reason of preventing postoperative infection. More pa-tients [901 (92.1%)] expected to be prescribed antibiotics if they had a dental abscess compared with those (62.0%) had a toothache. 64.0%patients had ever asked

  12. [Cerebellar abscesses secondary to infection of an occipital dermal sinus].

    García Galera, A; Martínez León, M I; Pérez da Rosa, S; Ros López, B


    A dermal sinus is a congenital defect arising from a closure failure of the neural tube that results in different degrees of communication between the skin and the central nervous system. A dermal sinus can occur anywhere from the root of the nose to the conus medullaris, and the occipital location is the second most common. Dermal sinuses are often found in association with dermoid or epidermoid cysts and less frequently with teratomas. Patients with an occipital dermoid cyst associated with a dermal sinus can develop meningitis and/or abscesses as the first clinical manifestation of the disease due to the dermoid cyst itself becoming abscessed or to the formation of secondary abscesses; few cases of the formation of secondary abscesses have been reported. We present a case of a dermoid cyst associated with an infected dermal sinus and posterior development of cerebellar abscesses and hydrocephalus.

  13. Orthodontic Elastic Separator-Induced Periodontal Abscess: A Case Report

    Talia Becker


    Full Text Available Aim. Orthodontic elastic bands were proposed as being the source of gingival abscesses that can rapidly lead to bone loss and teeth exfoliation. We report an adolescent, otherwise, healthy patient whose periodontal status was sound. Shortly after undergoing preparations for orthodontic treatment consisting of orthodontic separators, he presented with a periodontal abscess for which there was no apparent etiology. A non-orthoradial X-ray was inconclusive, but an appropriate one revealed a subgingival orthodontic separator as the cause of the abscess. Removal of the separator and thorough scaling led to complete resolution of the abscess, but there was already residual mild damage to the alveolar bone. Summary. Failure to use appropriate imaging to reveal the cause of gingival abscesses can result in the delay of implementing treatment and halting irreversible alveolar bone loss. An inflammatory process restricted to the gingiva and refractive to conventional therapy should raise the possibility of a foreign body etiology.

  14. Perioperative nursing care and follow-up for 118patients with liver abscess treated by CT-guided percutaneous drainage%CT引导下肝脓肿引流的围手术期护理及随访

    虞岑琳; 曹传武; 潘慧; 李茂全


    Objective To investigate the perioperative effective nursing method for patients with liver abscess treated by CT-guided percutaneous drainage Methods Giving perioperative nursing care for 118 patients diagnosed with liver abscess treated by CT-guided percutaneous drainage, as lfushing drainage tube with antibiotics, abserving the condition of drainage lfuid till the absence of vomica and uprooting the tube. Results Out of the 118 patients, 114 patients received imaging examination which conifrmed the absence of vomica and abscess, and discharged with normal body temperature. Conclution Thorough nursing care is critical to the effectiveness of patient with liver abscess treated by CT-guided percutaneous drainage.%目的:探讨在CT引导下肝脓肿穿刺引流术患者的有效护理方法。方法:对118例确诊为肝脓肿的患者做好CT引导下穿刺引流术前护理,每日用抗生素反复冲洗,观察引流液的情况,直至脓腔消失,拔除引流管。结果118例肝脓肿患者,其中114例均影像学检查,脓腔消失,脓肿明显消失,体温正常,痊愈出院。结论周密细致的护理工作对CT引导穿刺引流治疗肝脓肿患者的治疗起到关键性的作用。

  15. Clinical features of bacterial liver abscess in diabetic patients%糖尿病合并细菌性肝脓肿的临床特征分析

    赵小芹; 蒋艳敏; 朱晓巍; 徐湘; 许岚


    This retrospective analysis showed that the most frequent pathogen causing bacterial liver abscess was Klebsiella pneumoniae in 138 patients.Compared with the patients without diabetes mellitus,it was found that:( 1 ) the percentage of diabetic patients having typical abdominal pain was lower ( P < 0.05 ) ; ( 2 ) neutrophilic granulocytosis was more marked,but albumin and hemoglobin levels were lower in diabetic patients( P<0.05 ) ; ( 3 )more diabetic patients were complicated with urinary tract infection and suffered from septicemia( P<0.05 ) ; (4) the clinical course of treatment in diabetic patients was much more prolonged( P<0.05 ).%回顾性分析138例细菌性肝脓肿患者的临床资料,发现细菌性肝脓肿主要致病菌为肺炎克雷伯杆菌.与非糖尿病者相比,糖尿病患者合并细菌性肝脓肿有如下特点:(1)典型腹痛表现者所占比例低(P<0.05);(2)血中性粒细胞比值高,血清白蛋白、血红蛋白水平低(P<0.05);(3)合并尿路感染、并发败血症比例高(P<0.05);(4)症状较难控制,疗程长(P<0.05).

  16. Tuberculous splenic abscess in a neonate with thrombocytopenia

    Amodio, John; Biskup, Darius; Rivera, Rafael; Fefferman, Nancy [New York University Medical Center, Department of Radiology, NY (United States); Shah, Shetal [New York University Medical Center, Division of Neonatology, Department of Pediatrics, Avenue, NY (United States)


    We present a case of a premature neonate who presented with anemia and persistent thrombocytopenia. The patient was ultimately diagnosed with disseminated tuberculosis. Initial sonographic evaluation of the abdomen revealed a heterogeneous but predominately hypoechoic spleen; there was subsequent evolution of a splenic abscess. The patient was treated medically with anti-tubercular drugs. Follow-up post-treatment sonograms of the spleen showed diminution of the abscess and the evolution of multiple calcifications compatible with calcified granulomas. This case is an unusual presentation of tuberculosis in an infant with splenic abscess associated with thrombocytopenia and anemia. (orig.)

  17. [Endosonography control of percutaneous paracoccygeal drainage of deep pelvic abscesses after rectum resection].

    Truong, S; Willis, S; Jansen, M; Neuerburg, J; Schumpelick, V


    Pelvic abscesses are severe complications after rectal surgery. In recent years, surgical drainage has been edged out by percutaneous drainage techniques. We report our experience with the drainage of postoperative pelvic abscesses via the paracoccygeal route controlled by endosonography. In eight patients the diagnosis of a retrorectal pelvic abscess was established by endosonography and confirmed by endosonographically controlled exploratory puncture. Drainage of the abscesses was performed via the paracoccygeal access route by trocar or Seldinger technique under permanent visual control by endoluminal sonography. Irrigation of the abscess cavity was than performed daily. In all cases drainage was successful without complications. Duration of drainage was 9-14 days with a mean of 10.8 days. In one patient there was a recurrence of the abscess because of early removal of the drainage catheter. Because of its overall availability and its good results, paracoccygeal percutaneous endosonographically controlled drainage seems to be a suitable uncomplicated method for drainage of postoperative pelvic abscesses.

  18. Retroperitoneoscopic drainage of bilateral psoas abscesses under intraoperative laparoscopic ultrasound guidance.

    Kodama, Koichi; Takase, Yasukazu; Motoi, Isamu; Mizuno, Hideki; Goshima, Kenichi; Sawaguchi, Takeshi


    Despite improved diagnostic modalities for psoas abscesses, the optimum management strategy is not uniform. A 67-year-old man presented with bilateral psoas abscesses secondary to L1-L2 pyogenic discitis. On contrast-enhanced CT, the largest of these abscesses measured 13 × 14 × 33 mm on the right. The patient developed sepsis caused by Klebsiella pneumonia. There were no signs of improvement after 3 weeks of systematic antibiotic administration. We performed surgical drainage of bilateral psoas abscesses by retroperitoneoscopy. Intraoperative laparoscopic ultrasound was useful to determine abscess location in the muscles prior to drainage and confirm no residual abscesses after drainage. The patient was afebrile 3 days later, and his clinical symptoms resolved. Retroperitoneoscopic drainage may represent a feasible minimally invasive therapeutic option for psoas abscess, and intraoperative laparoscopic ultrasound has the potential to increase the safety and efficacy of this surgical procedure.

  19. Ascariasis as a cause of hepatic abscess: A report of 3 cases

    V Chauhan


    Full Text Available We receive around 60 cases of hepatic abscess in a year. The commonest diagnosis reached at the time of discharge is amoebic liver abscess. The diagnosis of amoebic liver abscess is mostly presumptive and thus the patients are usually given a mixed treatment with injection ceftriaxone and tablet metronidazole. Here we report three cases of hepatic abscess diagnosed recently, where ascariasis was the probable etiology. Ascariasis may be a much commoner cause of hepatic abscesses in this region than we think.

  20. Absence of Dystrophin Related Protein-2 disrupts Cajal bands in a patient with Charcot-Marie-Tooth disease.

    Brennan, Kathryn M; Bai, Yunhong; Pisciotta, Chiara; Wang, Suola; Feely, Shawna M E; Hoegger, Mark; Gutmann, Laurie; Moore, Steven A; Gonzalez, Michael; Sherman, Diane L; Brophy, Peter J; Züchner, Stephan; Shy, Michael E


    Using exome sequencing in an individual with Charcot-Marie-Tooth disease (CMT) we have identified a mutation in the X-linked dystrophin-related protein 2 (DRP2) gene. A 60-year-old gentleman presented to our clinic and underwent clinical, electrophysiological and skin biopsy studies. The patient had clinical features of a length dependent sensorimotor neuropathy with an age of onset of 50 years. Neurophysiology revealed prolonged latencies with intermediate conduction velocities but no conduction block or temporal dispersion. A panel of 23 disease causing genes was sequenced and ultimately was uninformative. Whole exome sequencing revealed a stop mutation in DRP2, c.805C>T (Q269*). DRP2 interacts with periaxin and dystroglycan to form the periaxin-DRP2-dystroglycan complex which plays a role in the maintenance of the well-characterized Cajal bands of myelinating Schwann cells. Skin biopsies from our patient revealed a lack of DRP2 in myelinated dermal nerves by immunofluorescence. Furthermore electron microscopy failed to identify Cajal bands in the patient's dermal myelinated axons in keeping with ultrastructural pathology seen in the Drp2 knockout mouse. Both the electrophysiologic and dermal nerve twig pathology support the interpretation that this patient's DRP2 mutation causes characteristic morphological abnormalities recapitulating the Drp2 knockout model and potentially represents a novel genetic cause of CMT.

  1. Improving molecular diagnosis of Chinese patients with Charcot-Marie-Tooth by targeted next-generation sequencing and functional analysis.

    Li, Li-Xi; Zhao, Shao-Yun; Liu, Zhi-Jun; Ni, Wang; Li, Hong-Fu; Xiao, Bao-Guo; Wu, Zhi-Ying


    Charcot-Marie-Tooth (CMT) disease is the most common hereditary peripheral neuropathy. More than 50 causative genes have been identified. The lack of genotype-phenotype correlations in many CMT patients make it difficult to decide which genes are affected. Recently, targeted next-generation sequencing (NGS) has been introduced as an alternative approach for diagnosis of genetic disorders. Here, we applied targeted NGS in combination with PMP22 duplication/deletion analysis to screen causative genes in 22 Chinese CMT families. The novel variants detected by targeted NGS were then further studied in cultured cells. Of the 22 unrelated patients, 8 had PMP22 duplication. The targeted NGS revealed 10 possible pathogenic variants in 11 patients, including 7 previously reported variants and 3 novel heterozygous variants (GJB1: p.Y157H; MFN2: p.G127S; YARS: p.V293M). Further classification of the novel variants according to American College of Medical Genetics and Genomics (ACMG) standards and guidelines and functional analysis in cultured cells indicated that p.Y157H in GJB1 was pathogenic, p.G127S in MFN2 was likely pathogenic, while p.V293M in YARS was likely benign. Our results suggest the potential for targeted NGS to make a more rapid and precise diagnosis in CMT patients. Moreover, the functional analysis is required when the novel variants are indistinct.

  2. Improving molecular diagnosis of Chinese patients with Charcot-Marie-Tooth by targeted next-generation sequencing and functional analysis

    Liu, Zhi-Jun; Ni, Wang; Li, Hong-Fu; Xiao, Bao-Guo; Wu, Zhi-Ying


    Charcot-Marie-Tooth (CMT) disease is the most common hereditary peripheral neuropathy. More than 50 causative genes have been identified. The lack of genotype-phenotype correlations in many CMT patients make it difficult to decide which genes are affected. Recently, targeted next-generation sequencing (NGS) has been introduced as an alternative approach for diagnosis of genetic disorders. Here, we applied targeted NGS in combination with PMP22 duplication/deletion analysis to screen causative genes in 22 Chinese CMT families. The novel variants detected by targeted NGS were then further studied in cultured cells. Of the 22 unrelated patients, 8 had PMP22 duplication. The targeted NGS revealed 10 possible pathogenic variants in 11 patients, including 7 previously reported variants and 3 novel heterozygous variants (GJB1: p.Y157H; MFN2: p.G127S; YARS: p.V293M). Further classification of the novel variants according to American College of Medical Genetics and Genomics (ACMG) standards and guidelines and functional analysis in cultured cells indicated that p.Y157H in GJB1 was pathogenic, p.G127S in MFN2 was likely pathogenic, while p.V293M in YARS was likely benign. Our results suggest the potential for targeted NGS to make a more rapid and precise diagnosis in CMT patients. Moreover, the functional analysis is required when the novel variants are indistinct. PMID:27027447

  3. Charcot-Marie-Tooth type 1A disease from patient to laboratory.

    Perveen, Shazia; Mannan, Shazia; Hussain, Abrar; Kanwal, Sumaira


    Charcot-Marie-Tooth (CMT) disease is a well-known neural or spinal type of muscular atrophy. It is the most familiar disease within a group of conditions called Hereditary Motor and Sensory Neuropathies (HMSN). The disease was discovered by three scientists several years ago. Several genes are involved as the causative agents for the disease. Hundreds of causative mutations have been found and research work for the identification of a novel locus and for the treatment of CMT1A is going on. This review article was planned to gather information on CMT disease and updates on its treatment.National Center for Biotechnology Information (NCBI) and PubMed were searched for data retrieval. Molgen database, which is the exclusive site for CMT mutation, was the other source of articles. Different aspects of the CMT disease were compared.Advancements in the finding of the causative gene, discovery of the novel Loci are the current issues in this regard.CMT disease is incurable, but researchers are trying to get some benefits from different natural compounds and several therapeutic agents.Various groups are working on the treatment projects of CMT1A. Major step forward in CMT research was taken in 2004 when ascorbic acid was used for transgenic mice treatment. Gene therapy for constant neurotrophin-3 (NT- 3) delivery by secretion by muscle cells for the CMT1A is also one of the possible treatments under trial.

  4. Oral Health, Temporomandibular Disorder, and Masticatory Performance in Patients with Charcot-Marie-Tooth Type 2

    Rejane L. S. Rezende


    Full Text Available Background. The aim of this study was to evaluate the oral health status of temporomandibular disorders (TMD and bruxism, as well as to measure masticatory performance of subjects with Charcot-Marie-Tooth type 2 (CMT2. Methods and Results. The average number of decayed, missing, and filled teeth (DMFT for both groups, control (CG and CMT2, was considered low (CG = 2.46; CMT2 = 1.85, P=0.227. The OHIP-14 score was considered low (CG = 2.86, CMT2 = 5.83, P=0.899. The prevalence of self-reported TMD was 33.3% and 38.9% (P=0.718 in CG and CMT2 respectively and for self-reported bruxism was 4.8% (CG and 22.2% (CMT2, without significant difference between groups (P=0.162. The most common clinical sign of TMD was masseter (CG = 38.1%; CMT2 = 66.7% and temporalis (CG = 19.0%; GCMT2 = 33.3% muscle pain. The geometric mean diameter (GMD was not significantly different between groups (CG = 4369; CMT2 = 4627, P=0.157. Conclusion. We conclude that the CMT2 disease did not negatively have influence either on oral health status in the presence and severity of TMD and bruxism or on masticatory performance.




    Full Text Available The purpose: to define the diagnostic importance of computer esthesiometry for use in diagnostics of hereditary neuropathy with primary defeat of myelin sheath of peripheral nerves of the upper extremities. Materials and methods: 47 individuals in a condition of relative health (control group from 21 to 50 years, comparable group % 40 patients from 6 to 81 years, with hereditary neuropathy Charcot%Marie%Tooth (CMT. Vibrating sensitivity was investigated by means of computer vibrometer “Vibrotester MBN” VТ%02%1 (MBN, RF in a wide strip of frequencies of vibration (8, 16, 32, 64, 125, 250, 500 Hz. Statistical data processing of research was lead by means of programs STATISTICA v. 7.0 (StatSoft, USA. Results and discussion: We compared received corridors vibrating sensitivity on the upper extremities for healthy volunteers with those at patients with CMT. Statistically significant increase of vibration sensitivity thresholds in a wide range of vibration frequencies on upper extremities and at patients with CMT versus healthy volunteers is shown. Computer esthesiometry method demonstrates high sensitivity in diagnostics of hereditary neuropathy with primary damage of myelin sheath of peripheral nerves of upper extremities on an example of CMT.

  6. A multidisciplinary approach for the management of pathologic tooth migration in a patient with moderately advanced periodontal disease.

    Kim, Young-Il; Kim, Myung-Jin; Choi, Jeom-Il; Park, Soo-Byung


    The physiologic tooth position is determined by interactions between the periodontal tissue and occlusal, tongue, and lip forces. Bone destruction resulting from chronic periodontal disease disturbs the equilibrium of these interactive balances, leading to pathologic tooth migration, often requiring multidisciplinary treatment approaches. The present case demonstrates a systematic periodontal-orthodontic-prosthetic treatment for achieving the optimal structural, functional, and esthetic outcomes.

  7. The application of single tooth anesthesia in the tooth extraction of the elderly patients with periodontal disease%STA无痛麻醉仪在老年牙周病患者牙拔除术中的应用

    杨霞; 侯锐; 尚磊; 许广杰; 薛芃


    目的:比较新型STA无痛麻醉仪和传统手推卡局式注射器在老年牙周病患者牙周韧带注射麻醉和松动患牙拔除术中对患者血压、心率、疼痛程度、面部表情、合作程度和耐受行为的影响。方法:对52例老年牙周病患者的104颗松动牙采用随机、双盲、自身对照的方法进行研究。在局部麻醉时使用新型STA无痛麻醉仪(试验组)和卡局式注射器(对照组)行牙周韧带注射,分别记录麻醉和手术时患者的血压、心率数值并进行疼痛视觉模拟量表(VAS)、 Kuttner、 Frankl和Houpt各量表的评估,收集数据进行统计分析。结果:与卡局式注射器相比,使用新型STA无痛麻醉仪局部麻醉时,老年患者的舒张压(DBP)、 VAS和Kuttner分值明显降低, Frankl和Houpt分值明显升高,差异有统计学意义(P0.05)。结论:使用新型STA无痛麻醉仪能明显减轻麻醉中老年患者的血压波动和疼痛程度、缓解面部紧张表情、提高合作程度和耐受行为。%Objective:To compare the effect of single tooth anesthesia and the traditional hand-push cartridge on the blood pressure, heart rate, pain level, facial expression, cooperation and tolerance of the elderly patients during local anesthesia and tooth extraction.Methods:Fifty-two patients had their bilateral loose teeth removed through a random, double-blind, self-controlled clinical trial in two visits. On one side single tooth anesthesia (experimental group) was used for the periodontal ligament injection. On the other side, hand-push cartridge (control group) was used the same way. Blood pressure, heart rate, Visual Analogue Scale(VAS), Kuttner facial expressions, Frankl Behavior Rating Score and Houpt Behavior Rating Scale were assessed during local anesthesia and tooth extraction. The data were collected and the statistical analyses were performed.Results:Compared with the hand-push cartridge,single tooth anesthesia could

  8. Solving tooth sensitivity.

    Miller, Michael B


    Solving tooth sensitivity requires both you and the patients to be resilient and to understand that if one approach doesn't work, you can try another one that is non-invasive or, at worst, minimally invasive. Much like the clinician who posted the original question, I strongly believe that it is our responsibility to convince patients that jumping to a radical solution could be totally unnecessary--and expensive-- and still might not solve the problem.

  9. An Unusual Case of Acute Epiglottic Abscess

    Tanthry Deepalakshmi


      Incision and drainage was performed under general anaesthesia after haematological investigations. Patient was extubated the next day, and was discharged after two days, also oral antibiotics, and analgesics were prescribed. Patient was reviewed after 2 weeks, and indirect laryngoscopy revealed a normal epiglottis.Although pharyngitis is the most common cause of sore throat in adults, acute epiglottitis must be considered in differential diagnosis when there is unrelenting throat pain, and minimal objective signs of pharyngitis. Epiglottic abscess formation is more common in adults than children. They most commonly occur as a complication of acute pharyngitis or with abscess of lingual tonsil .The abscess most frequently comes to a point on or near the lingual surface of the epiglottis. Streptococcus was isolated more frequently. Other organisms reported were Haemophilus influenzae, E.coli, Pseudomonas, Micro- coccus catarrhalis, Pneumococci. In our case, there were no preceding symptoms of acute pharyngitis. Risk factors include adult age at onset, diabetes mellitus, trauma, presence of a foreign body, and immune- compromised state. This case is unusual because of the absence of above risk factors. Incision and drainage under general anaesthesia is the treatment of choice. To the author’s knowledge, very few cases of acute epiglottic abscesses have been reported in the literature. This case is unusual because there are no preceding symptoms of pharyngitis or tonsillitis, and no association of risk factors like diabetes mellitus, trauma, foreign body or immunocompromised state.

  10. Nocardia Brain Abscess and CD4+ Lymphocytopenia in a Previously Healthy Individual

    Norair Adjamian


    Full Text Available Nocardia brain abscesses are a known occurrence in patients with immunocompromised conditions. Nocardial infection is commonly an unfortunate sequela to other complications which these patients are being followed up and treated for. The incidence of nocardial brain abscess in an otherwise healthy patient is extremely rare. We present a case of Nocardia brain abscess in a previously healthy individual, who, upon workup for vision and gait abnormalities, was shown to have multiple brain abscesses and a decreased absolute CD4+ lymphocyte count. Adding to the rarity of our case, the finding of lymphocytopenia in our patient was unrelated to any known predisposing condition or infectious state.

  11. Intraperitoneal tuberculous abscess: computed tomography features

    Peng; Dong; Jing-Jing; Chen; Xi-Zhen; Wang; Ya-Qin; Wang


    AIM: To evaluate the computed tomography(CT) features of intraperitoneal tuberculous abscess(IPTA). METHODS: Eight patients with IPTA confirmed by pathology were analyzed retrospectively. The clinical symptoms, medical images, and surgical findings were evaluated. Involvement of the intestine, peritoneum, viscera, and lymph nodes was also assessed. RESULTS: All 8 patients had a history of abdominal discomfort for 1 to 6 mo. Physical examination revealed a palpable abdominal mass in 6 patients. Three patients had no evidence of pulmonary tuberculosis(TB). All IPTAs(11 abscesses) were seen as a multiseptated, peripherally enhanced, hypodense mass with enlarged, rim-enhanced lymph nodes. The largest abscess diameter ranged from 4.5 cm to 12.2 cm. CT showed 2 types of IPTA: Lymph node fusion and encapsulation. Of the 8 patients, one had liver tuberculosis and one had splenic and ovarian tuberculosis. Two cases showed involvement of the terminal ileum and ileocecal junction. Ascites were found in 4 cases. Three patients had peritonitis and mesenteritis. Three patients showed involvement of the omentum. Three patients had histological evidence of caseating granuloma, and 5 had histological evidence of acid-fast bacilli. CONCLUSION: CT is crucial in the detection and characterization of IPTA. Certain CT findings are necessary for correct diagnosis.

  12. Coexistence of Colon Cancer and Diverticilutis Complicated with Diverticular Abscess

    Dursun Ozgur Karakas


    Full Text Available Coexistence of a diverticular abscess and colorectal cancer is an extremely rare phenomenon. The clinical presentation and the extension of a diverticular abscess could cause mis-staging of colon cancer. We are presenting an overstaged colon cancer due to a diverticular abscess penetrating into the abdominal wall. A 65-year-old male patient with a history of an enlarging mass in the left lower quadrant of the abdomen was admitted to our service. Diagnostic studies revealed a sigmoid tumor communicating with an abdominal wall mass. The patient was clinically staged as T4 N1. Exploration revealed a diverticular abscess penetrating into the abdominal wall and a sigmoid tumor. Histopathological examination reported an intermediately differentiated T3 N0 adenocarcinoma of the sigmoid colon. After an uneventful postoperative recovery, the patient was referred to chemotherapy. [Arch Clin Exp Surg 2015; 4(4.000: 231-233

  13. The experience of diagnosis and treatment of one amebic liver abscess patient after kidney transplantation%肾移植术后引起疑似阿米巴肝脓肿的诊治体会

    王旭; 陈虹; 黄云帆; 范铁艳; 赵青春


    一例肾移植术后患者出现发热、右上腹痛、果酱样便、肝脓肿,明确诊断后,给予抗阿米巴治疗、脓肿穿刺引流及脓腔冲洗,观察患者预后.治疗26d后患者体温完全降至正常,脓肿逐渐缩小.及时诊断、避免误诊,是提高移植术后阿米巴感染治疗成功率的关键.%One patient after kidney transplantation suffered from fever,upper-right abdominal pain,diarrhea,bloody stools,liver abscess.After diagnosis the antiamebic therapy,percutaneous drainage and pus cavity flushing were given and the prognosis of the patient was observed.Fever disappeared,abscess gradually cured after twenty-six days therapy.Timely diagnosis and avoiding misdiagnosis were the key of successful treatment for amebic liver abscess after transplantation.

  14. Anterior ilioinguinal incision for drainage of high-located perianal abscess.

    Peng, K-T; Hsieh, M-C; Hsu, W-H; Li, Y-Y; Yeh, C-H


    Most perianal abscesses originate from infected anal glands at the base of the anal crypts. Most abscesses below are usually drained through perianal incision and can be treated successfully. However, when perianal abscesses extend to the high intrapelvic cavity, it may be inadequate treatment through a single route incision through a perianal approach. The aim of this technical note is to show that combined anterior ilioinguinal and perianal incisions may provide optimal surgical field and multiple drainages. Here, we report a 56-year-old male patient with perianal-originating parapsoas abscesses. Residual abscess still remained after initial perianal incision and drainage after 1-month treatment. We presented combined anterior ilioinguinal and perianal incision technique methods for proper drainage in this complicated case. No recurrent or residual abscess remained after 2 weeks of operation. So, combined anterior ilioinguinal incision is feasible for high-located perianal abscess.

  15. A case of brain abscess extended from deep fascial space infection.

    Sakamoto, Haruo; Karakida, Kazunari; Otsuru, Mitsunobu; Arai, Masayuki; Shimoda, Masami


    A case of brain abscess in the temporal lobe caused by direct intracranial extension of deep neck abscess is described. The abscess also spread to the orbital cavity through infraorbital fissure. The possible etiology of this case might be dental surgery. The diagnostic imaging clearly showed the routes of intracranial and -orbital extension of parapharyngeal and masticator space abscesses. From the abscess specimens, oral streptococci, anaerobic streptococci, and anaerobic gram-negative bacilli were isolated. Antimicrobial susceptibility testing of isolates showed that some Prevotella and Fusobacterium strains had decreased susceptibility to penicillin, and these bacteria produced beta-lactamase. The bacteria from the deep neck abscess were consistent with those detected from the brain abscess. Proper diagnosis, aggressive surgical intervention, and antibiotics chemotherapy saved the patient from this life-threatening condition.

  16. A Rare Complication of Brucellosis: Testicular Abscess

    Ümit Gul


    Full Text Available Brucellosis is a zoonosis caused by Brucella species. Brucella epididymo-orchitis had been reported in up to 20% of patients with brucellosis. This case was a male patient who developed Brucella epidiymo-orchitis and testicular abscess. He had fever, arthralgia and his right epididymis and right testicle were enlarged and tender. Ultrasound evaluation showed hypertrophy of the right epididymis and testis and moreover hypoechoic area within the testis. Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided. In areas where brucella infection is endemic brucella epididymo-orchitis should be considered in the differential diagnosis. Effective and rapid treatment is important. It should be noted that these patients may develop testicular abscess.

  17. Retroperitoneal abscess: an extra-abdominal manifestation.

    Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias


    Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission.

  18. Rapidly Progressive Gas-containing Lumbar Spinal Epidural Abscess.

    Bang, Jin Hyuk; Cho, Keun-Tae


    Gas-containing (emphysematous) infections of the abdomen, pelvis, and extremities are well-known disease entities, which can potentially be life-threatening. They require aggressive medical and often surgical treatment. In the neurosurgical field, some cases of gas-containing brain abscess and subdural empyema have been reported. Sometimes they progress rapidly and even can cause fatal outcome. However, gas-containing spinal epidural abscess has been rarely reported and clinical course is unknown. We report on a case of rapidly progressive gas-containing lumbar spinal epidural abscess due to Enterococcus faecalis in a 72-year-old male patient with diabetes mellitus.

  19. Pancreatic abscess following scrub typhus associated with multiorgan failure

    Sun Young Yi; Jung Hyun Tae


    Clinical severity of scrub typhus ranges from mild to fatal. Acute pancreatitis with abscess formation is a rare complication among patients with scrub typhus. This paper reports a case of scrub typhus in a 75 years old man with acute pancreatitis with abscess formation and multiorgan failure. Abdominal computed tomography showed multiple infected pancreatic pseudocysts with peri-pancreatic infiltration. Multiorgan failure was successfully treated with doxycycline, ceftriaxone, and supportive management. The pancreatic abscess was successfully drained percutaneously and the sizes of pseudocysts decreased remarkably.

  20. Liver abscess associated with an oral flora bacterium Streptococcus anginosus

    Hava Yılmaz


    Full Text Available Viridans group Streptococcus, a bacterium of the oral flora has a low-virulence and rarely causes liver abscess. A 40-yearoldmale patient was admitted to the hospital complaining of high fever and malaise. A physical examination revealedpoor oral hygiene; there were caries on many teeth, and he had hepatomegaly. A hepatic abscess was identified inhis abdominal tomography. Streptococcus anginosus was isolated from the drainage material, and the bile ducts werenormal in his MRI cholangiography. An immunocompetent case of liver abscess caused by Streptococcus anginosusoriginated most probably from oral flora is presented here. J Microbiol Infect Dis 2012; 2(1:33-35

  1. Wandering biliary ascariasis with hepatic abscess in a postmenopausal woman.

    Nahar, N; Khan, N; Islam, S M; Chakraborty, R K; Rima, S Z; Alam, M N; Roy, A S


    Hepatobiliary ascariasis is common in developing countries where there is a low standard of public health and hygiene. We are reporting a rare case of ascariasis which induced multiple liver abscesses in a post menopausal woman who presented with fever, anorexia, nausea, vomiting and mild hepatomegaly. Ultrasonography revealed biliary ascariasis with multiple hepatic abscesses. Laparoscopic drainage of hepatic abscesses was done and microscopic examination of drainage materials showed decorticated eggs of Ascaris Lumbricoides. The post operative recovery of the patient was uneventful. Ultrasonography is a reliable modality to diagnose and follow up of such cases.

  2. Brodie's abscess of the ulna caused by Salmonella typhi.

    Ip, K C; Lam, Y L; Chang, Robert Y P


    Osteomyelitis caused by Salmonella typhi is rare in patients with no haemoglobinopathies or other diseases causing immunosuppression. Brodie's abscess is a special variety of subacute or chronic osteomyelitis. An otherwise healthy woman who presented with forearm swelling for 6 months was diagnosed with a Brodie's abscess of the ulna caused by Salmonella typhi. Magnetic resonance imaging and a computed tomography-guided needle biopsy were performed. She was later found to be a Salmonella carrier. The Brodie's abscess was treated by surgical debridement and a course of antibiotics. The clinical, radiological, and management aspects of the disease are discussed.

  3. Recurrent Episodes of Stroke-Like Symptoms in a Patient with Charcot-Marie-Tooth Neuropathy X Type 1

    Ning Wu


    Full Text Available Charcot-Marie-Tooth disease (CMT, also known as hereditary motor sensory neuropathy, is a heterogeneous group of disorders best known for causing inherited forms of peripheral neuropathy. The X-linked form, CMTX1, is caused by mutations in the gap junction protein beta 1 (GJB1 gene, expressed both by peripheral Schwann cells and central oligodendrocytes. Central manifestations are known but are rare, and there are few case reports of leukoencephalopathy with transient or persistent neurological deficits in patients with this CMT subtype. Here, we report the case of a man with multiple male and female family members affected by neuropathy who carries a pathologic mutation in GJB1. He has experienced three transient episodes with variable neurological deficits over the course of 7 years with corresponding changes on magnetic resonance imaging (MRI. This case illustrates CMT1X as a rare cause of transient neurological deficit and demonstrates the evolution of associated reversible abnormalities on MRI over time. To the best of our knowledge, this report provides the longest period of serial imaging in a single patient with this condition in the English language literature.

  4. Initial observations of cheek tooth abnormalities in sheep in Slovenia.

    Erjavec, V; Crossley, D


    Observations were made on a small flock of 50 sheep of the native Slovenian Jezersko-Solcava breed by investigators with dental training. The aim was to determine the range of naturally occurring dental diseases, so postmortem examinations were performed on animals slaughtered for meat or culled due to disease. Additional data were obtained by examination of 25 specimens submitted for investigation of unexplained death at a pathology centre. Seventeen (34 per cent) of the flock had incisor disease but only five became clinically ill; all these five had advanced cheek tooth disease (gingival recession, periodontal pocketing, diastemata, missing teeth, occlusal wear abnormalities, food impaction, tooth mobility, tooth fracture, tooth loss and/or jaw abscessation). Advanced cheek tooth disease was found in 21 (84 per cent) of the sheep submitted to the pathology laboratory, while only seven (28 per cent) had advanced incisor disease. The results show that, as in other countries, dental disease is a serious problem for sheep in Slovenia.

  5. Percutaneous drainage of abscess in psoas compartment and epidural space; Case report and review of literature. [Radiological studies

    Cwikiel, W. (Lund Univ. Hospital (Sweden). Dept. of Diagnostic Radiology)


    The history of a patient with neurological deficit symptoms secondary to a spinal epidural abscess connected with psoas abscess and several fistulas on the buttocks is described. Etiology, diagnosis, and treatment are discussed. Percutaneous drainage of the spinal epidural abscess is suggested as an alternative to surgery. (orig.).

  6. Oral microbiota species in acute apical endodontic abscesses

    Noelle George


    Full Text Available Background and objectives: Acute apical abscesses are serious endodontic diseases resulting from pulpal infection with opportunistic oral microorganisms. The objective of this study was to identify and compare the oral microbiota in patients (N=18 exhibiting acute apical abscesses, originating from the demographic region in Portland, Oregon. The study hypothesis is that abscesses obtained from this demographic region may contain unique microorganisms not identified in specimens from other regions. Design: Endodontic abscesses were sampled from patients at the Oregon Health & Science University (OHSU School of Dentistry. DNA from abscess specimens was subjected to polymerase chain reaction amplification using 16S rRNA gene-specific primers and Cy3-dCTP labeling. Labeled DNA was then applied to microbial microarrays (280 species generated by the Human Oral Microbial Identification Microarray Laboratory (Forsyth Institute, Cambridge, MA. Results: The most prevalent microorganisms, found across multiple abscess specimens, include Fusobacterium nucleatum, Parvimonas micra, Megasphaera species clone CS025, Prevotella multisaccharivorax, Atopobium rimae, and Porphyromonas endodontalis. The most abundant microorganisms, found in highest numbers within individual abscesses, include F. nucleatum, P. micra, Streptococcus Cluster III, Solobacterium moorei, Streptococcus constellatus, and Porphyromonas endodontalis. Strong bacterial associations were identified between Prevotella multisaccharivorax, Acidaminococcaceae species clone DM071, Megasphaera species clone CS025, Actinomyces species clone EP053, and Streptococcus cristatus (all with Spearman coefficients >0.9. Conclusions: Cultivable and uncultivable bacterial species have been identified in endodontic abscesses obtained from the Portland, Oregon demographic region, and taxa identifications correlated well with other published studies, with the exception of Treponema and Streptococcus cristae, which

  7. Liver abscesses with venous extension - rare complication of a common problem.

    Lal, Hira; Thakral, Anuj; Sharma, Manohar Lal; Kumar, Tarun


    Considering the high incidence of amoebic and pyogenic liver abscess in the developing world, occurrence of inferior vena cava thrombosis secondary to liver abscess is a rare but life threatening complication. We report 4 such complicated cases of liver abscess(s). The first case involved a large caudate lobe abscess extending across middle hepatic vein into suprahepatic inferior vena cava (IVC). Development of a left hepatic artery pseudoaneurysm following attempted percutaneous aspiration highlights the difficulties encountered in percutaneous interventional management of caudate lobe abscesses. The second case involved multiple liver abscesses with large thrombus in the right ventricular cavity & right ventricular outflow tract. The patient developed cardiorespiratory arrest limiting any aggressive management options for the complex nature of illness. The third case had a large caudate lobe abscess with direct extension into Intrahepatic IVC while the fourth showed a segment 4 abscess with thrombosis of adjacent left hepatic vein. These cases highlight the fact that diagnosis of such life threatening complications of liver abscesses as hepatic vein & IVC thrombosis requires high clinical suspicion followed by targeted imaging. Image guided interventional therapy is a useful tool for management in cases of liver abscess. But, abscesses in precarious locations like caudate lobe are associated with higher risk of complications including pseudoaneurysm formation asking for a cautious approach to interventional therapy in such circumstances.

  8. Clinical and CT findings of Klebsiella liver abscess: comparison with non-Klebsiella liver abscess

    Woo, Young Geun; Kim, Man Deuk; Yoon, Sang Wook; Kim, Hee Jin [Bundang CHA General Hospital, Seongnam (Korea, Republic of); Kim, Hyun [Daejon St. Mary' s Hospital, Taejon (Korea, Republic of); Lee, Kang Mun [St. Vincent Hospital, Suwon (Korea, Republic of); Lee, Eun Ja [Myungji Hospital, Goyang (Korea, Republic of)


    To analyse the clinical features and CT findings of pyogenic liver abscess due to Klebsiella pneumoniae, and to compare the findings with those of cases in which abscesses were caused by other pathogens. Twenty-one cases of pyogenic liver abscess were assigned to either the Klebsiella or the non-Klebsiella group, and the patients' past medical history and intra-abdominal abnormalities such as calculus or malignancy were reviewed. Laboratory data such as alkaline phosphatase (ALT), SGOT and SGPT levels were analyzed, and on the basis of the CT findings, decisions were reached as to (a) whether abscesses were single or multiple contiguous or discontiguous, uniloculated or multiloculated; and (b) the presence or absence of gas, hepatic parenchymal enhancement, peripheral rim enhancement, and extrahepatic abnormality. For statistical analysis, fisher's exact test was used. Among 21 abscesses, Klebsiella pneumoniae was the most common pathogen (n=11). The others were Pseudomonas (n=3), E.coli (n=2), Enterococcus (n=2), G. (+) cocci (n=2) and polymicrobial (n=1). Diabetes mellitus was more common among patients in the Klebsiella group, among whom a multiloculated single cavity was a frequent finding. Five patients in the non-Klebsiella group experienced biliary tract obstruction, which was not demonstrated in the Klebsiella group. Hepatic parenchymal enhancement was more common in the non-Klebsiella group. In case of pyogenic liver disease, especially where diabates mellitus is involved, Klebsiella pneumoniae is a major pathogen. Significant CT findings of Klebsiella liver abscess included a multiloculated single cavity, rare biliary tract obstruction, and little hepatic parenchymal enhancement.

  9. Subperiostal Orbital Abscess and Frontal Epidural Abscess Due to Sinusitis: A Case Report

    Burak Ulaş


    Full Text Available A seventeen-year-old girl was admitted to our clinic with complaint of rubor, swelling, and pain on the left upper eyelid. Her medical history revealed that she had received high-dose oral steroid treatment for one week for the diagnosis of acute angioedema in another clinic. On ophthalmologic examination, her left upper eyelid had edema, swelling, and hyperemia. Additionally, she had restriction in up-gaze in the left eye. Her best-corrected visual acuity was 0.7. The patient’s computerized tomography revealed ethmoidal, maxillary and frontal sinusitis, as well as subperiostal orbital abscess, and frontal epidural abscess. Intravenous antibiotic treatment has been arranged. Due to persistence of the clinical signs, surgical drainage of the abscesses has been performed. Following, she has been discharged from the hospital on oral antibiotic treatment. Postoperatively, at the first-month visit, the left eye’s up-gaze restriction was recovered, and visual acuity was improved to 1.0. If a patient presents with eyelid swelling, differential diagnosis should be performed carefully before making the decision to start steroid treatment. Sinusitis, which is seen frequently in clinical practice, should be kept in mind due to its potential to cause orbital abscess, epidural abscess, and intracranial complications. (Turk J Ophthalmol 2013; 43: 464-7

  10. 一次性输液贴用于肛周脓肿术后护理的体会%Nursing experience of disposable infusion paste using in patients taken anal abscess sugery



    Objective:To explore the nursing experience of disposable infusion paste used in patients who taken anal abscess operation.Methods:500 patients with anal abscess were selected,During relieve nature,there 400 patients taken disposable infusion paste to protected the wound,while the other 100 patients were not used.Then compared the hospitalization time between the two groups.Results:The hospitalization time of patients whom used disposable infusion paste advanced average of 3 to 5 days than those patients who had not used.Conclusion:Disposable infusion paste used in the nuring care of patients after anal abscess surgery can reduce the pain,can make the wound healing in advance,it is also cheap and utility.%目的:探讨一次性输液贴用于肛周脓肿术后的护理体会。方法:收治肛周脓肿患者500例,400例患者大便时用一次性输液贴保护伤口,100例患者未用输液贴,比较两组患者的住院时间。结果:应用一次性输液贴的患者较未用者平均提前3~5 d出院。结论:一次性输液贴应用于肛周脓肿术后护理减轻了患者疼痛,伤口提前愈合,经济、适用。

  11. Multidisciplinary treatment of tooth wear in a patient with Asperger’s Syndrome and dental anxiety

    Wetselaar, P.; Vermaire, J.H.; Lobbezoo, F.


    This case report describes a patient who is referred by his home physician to a centre for special dental care because of the presence of severe oral pain with an existing dental phobia. The patient has Asperger's Syndrome. Besides his extreme fear for dental treatment and several deep carious lesio

  12. A rare complication following maxillary third molar extraction: infratemporal fossa abscess

    Görkem Müftüoğlu


    Full Text Available

    Infratemporal fossa abscess formation is a very rare and life threatening condition and also its differential diagnosis is a very difficult process. Infratemporal fossa abscess following the non-infected, asymptomatic, erupted maxillary third molar extraction in a young and healthy patient is an unexpected and unusual complication.

    A 25 years old, male patient with a significant infratemporal fossa abscess and his treatment protocol was presented in this case report.

  13. Effectiveness of percutaneous catheter drainage for tuberculous iliopsoas abscess associated with tuberculous spondylitis

    Shin, Kue Hee; Kim, Yun Hwan [Korea Univ. College of Medicine, Seoul (Korea, Republic of)


    To evaluate the efficacy of percutaneous catheter drainage of tuberculous abscess associated with tuberculous spondylitis. In twelve patients (male: female=1:2; mean age, 37.3 years) tuberculous abscess was diagnosed, and was treated by percutaneous abscess drainage(PAD). All patients had either a psoas or iliopsoas abscess and in two, a paravertebral abscess was also present. Four had bilateral lesions, one, a unilateral lesion, and one, paravertebral abscesses and bilateral psoas. The size of abscesses ranged from 4x5x12cm to 6x9x30cm;four were septated and all were lobulated. Using an 8.5-14F catheter, 17 of 18 abscesses were percutaneously drained; Ultrasound guidance was used in 12 cases, and CT guidance in five. The volume of drainage mater ranged from 150 to 1200 cc(mean, 600cc), and the duration of catheter insertion was 6-48 (mean, 17.4) days. In no patient did significant complications arise during or after drainage, and in all cases, follow-up studies using ultrasound, CT or MRI were performed. The duration of follow-up ranged from 3 to 35 (mean, 15.4) months; during this time, no recurrence was noted. Chemotherapy alone is sufficient for treating a small tuberculous psoas or iliopsoas abscess, but for a large abscess, adjuvant drainage is necessary.

  14. Ovarian tubercular abscess mimicking ovarian carcinoma: A rare case report

    Abinash Agarwala


    Full Text Available Although genito-urinary tuberculosis is common, reports of isolated ovarian tubercular abscess are rare. Ovarian tubercular abscess may mimics that of an ovarian tumor, leading to diagnostic difficulties. We reported a case report of 35 years woman presented with chronic pain abdomen, weight loss, low-grade fever and a right ovarian mass on ultrasound, with a significantly elevated CA-125 level. On clinical and radiological evidence, diagnosis of ovarian carcinoma was made, and laparotomy was performed with resection of the ovary. Postoperative specimen sent for histological examination that revealed classic epithelioid granuloma and acid-fast bacilli were present in Ziehl-Neelsen stain. Patient was put on antitubercular regimen from our Dots center. She is improving clinical after taking antitubercular drug and is on regular follow up at our chest outpatient department. Ovarian tubercular abscess is common in young women living in endemic zones, but case report of isolated tubercular abscess is rarely reported. CA-125 can be raised in both ovarian tubercular abscess and ovarian carcinoma, and only imaging is not always conclusive. Laparotomy followed by tissue diagnosis can be helpful in this situation. As the prognosis and treatment outcome of ovarian tubercular abscess and ovarian carcinoma is different, proper diagnosis by laparotomy should be done. Early diagnosis of ovarian tubercular abscess is vital as untreated disease can lead to infertility.

  15. Tuboovarian Abscesses: Is Size Associated with Duration of Hospitalization & Complications?

    Jason DeWitt


    Full Text Available Objective. To evaluate the association between abscess size and duration of hospitalization and need for surgical intervention. Methods. We collected data from patients admitted with ICD-9 codes 614.9 (PID and 614.2 (TOA from January 1, 1999—December 31, 2005. We abstracted data regarding demographics, diagnostic testing/laboratory testing, imaging, treatment, and clinical course. Two abscess groups were created: ≤8 cm or >8 cm. Descriptive statistics were calculated, and duration of hospitalization and surgical intervention for women with large abscesses were compared to women with smaller collections. Results. Of the 373 charts reviewed, 135 had a TOA and 31% required management with drainage and/or surgery. The average abscess size for those treated successfully with conservative management was 6.3 cm versus those requiring drainage and/or surgery (7.7 cm, P=.02. Every 1 cm increase in abscess size as associated with an increase in hospitalization by 0.4 days (P=.001. Abscesses greater than 8 cm were associated with an increased risk of complications (P<.01. Conclusions. Larger tubo-ovarian abscesses are associated with an increased duration of hospitalization and more complications including an increased need for drainage or surgery. Additional research to determine the most efficacious antibiotic regimen management strategy is needed.

  16. Masticator space abscess in a 47-day-old infant

    Eunhee Kim


    Full Text Available A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about 2.0¡¿1.5 cm that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

  17. Brodie's abscess of the cuboid in a pediatric male.

    Agarwal, Sharat; Akhtar, Mohammad Nasim; Bareh, Jerryson


    Brodie's abscess of the tarsal cuboid is a rare presentation of a common disease. In the present report, we describe the case of Brodie's abscess of the tarsal cuboid after a thorn prick in the foot of a 10-year-old boy. The patient was asymptomatic in the acute phase of the injury, and on presentation, no evidence was found of an open cutaneous wound. The foot radiographs showed a cavitary osteolytic lesion in the cuboid bone. Magnetic resonance imaging revealed a classic penumbra sign and an abscess in the plantar intrinsic musculature. The patient was treated with curettage and debridement combined with broad-spectrum antibiotics, which resulted in complete resolution of the symptoms by 6 weeks postoperatively. Although microbiologic analysis of the surgical specimen failed to reveal a causative microorganism, histopathologic inspection showed chronic inflammation, consistent with Brodie's abscess.

  18. A Rare Case: Isolated Testicular and Epidural Abscess Associated with Brucellosis

    Tugce Kalayci


    Full Text Available Coincidence of isolated testicular abscess and epidural-paravertebral abscess is a rare complication of brucellosis. A 24-year-old male patient was admitted to our clinic with 2 months ongoing back pain, night sweats and left scrotal pain. Septal cystic lesion with dense content in the left testis was considered to isolated testicular abscess in scrotal Doppler examination. Multiple spinal epidural and right paraspinal abscess were detected in the spinal magnetic resonance imaging. The patient was treated with drainage of abscess and oral antibiotics. The rare combination of spinal epidural and testicular abscess should be kept in the mind if a patient presented with low back pain and scrotal pain in regions where brucellosis was endemic.

  19. 糖尿病并发深部脓肿的危险因素及临床特点分析%Analysis of risk factors and clinical features of diabetic patients with deep abscess

    高莉; 方向明; 叶文春; 漆晓玲; 侯灵静


    Objective To investigate the clinical features and risk factors of diabetic patients with deep abscess in order to guide the clinical diagnosis,treatment and prevention of the disease.Methods The clinical features,risk factors,infection site,common pathogenic bacteria and drug sensitivity of 32 diabetic patients with deep abscess were retrospectively analyzed .Results Most of the patients were the type 2 diabetes (96.88%).The first symptom was fever that accounted for 62.5%.37.5% of the patients were the first diagnosis of diabetes with age equal to or older than 60 years old.The patients came from rural area or small towns .The poor blood sugar control and hypoalbuminemia were risk factors for deep abscess in these patients .The most common sites of infection were liver ( 68.75%) and the second was kidney and perirenal tissues .The common pathogens were Klebsiella pneumoniae and Escherichia coli . Conclusion It is very important to effectively control the blood sugar ,improve the nutritional status and the knowledge of diabetes for preventing diabetic patients with deep abscess .The clinical symptoms of diabetic patients with deep abscess are often not typical .There-fore,it should be alert for deep abscess as diabetic patients with fever of unknown origin .The abdominal ultrasound and chest X-ray should be applied as a routine screening program for diabetes patients with fever .We may experimentally select the antibiotics sensitive to gram-negative bacteria before bacterial culture results .%目的:探讨糖尿病合并深部脓肿的临床特点、危险因素,指导临床诊断、治疗及预防。方法回顾性分析32例糖尿病合并深部脓肿住院病例的临床特点、危险因素、感染部位、常见病原菌及药敏结果。结果该组病例以2型糖尿病为主(96.88%),62.50%以发热为首发症状,37.50%初次诊断糖尿病,年龄≥60岁、患者来源农村及乡镇、血糖控制差、低蛋白血症是糖尿

  20. A case of retropharyngeal abscess with spondylitis causing tetraplegia

    Takeshi Kusunoki


    Full Text Available We report a case of retropharyngeal abscess with spondylitis causing tetraplegia. At a previous hospital, administration of antibiotics improved the inflammation findings. However, magnetic resonace imaging showed a remaining retropharyngeal abscess. This patient showed a disturbance of consciousness under this therapy. Therefore, he was admitted to our hospital and underwent a drainage operation. At 1 day after this operation, he recovered from the disturbance of consciousness.

  1. A cohort study of MFN2 mutations and phenotypic spectrums in Charcot-Marie-Tooth disease 2A patients.

    Choi, B-O; Nakhro, K; Park, H J; Hyun, Y S; Lee, J H; Kanwal, S; Jung, S-C; Chung, K W


    Charcot-Marie-Tooth disease 2A (CMT2A) is the most common axonal form of peripheral neuropathy caused by a defect in the mitofusin 2 (MFN2) gene, which encodes an outer mitochondrial membrane GTPase. MFN2 mutations result in a large range of phenotypes. This study analyzed the prevalence of MFN2 mutation in Korean families with their assorted phenotypes (607 CMT families and 160 CMT2 families). Direct sequencing of the MFN2 coding exons or whole-exome sequencing has been applied to identify causative mutations. A total of 21 mutations were found in 36 CMT2 families. Comparative genotype-phenotype correlations impacting severity, onset age, and specific symptoms were assessed. Most mutations were seen in the GTPase domain (∼86%). A deletion mutation found in the transmembrane helices is reported for the first time, as well as five novel mutations at other domains. MFN2 mutations made up 5.9% of total CMT families, whereas 22.9% in CMT2 families, of which 27.8% occurred de novo. Interestingly, patient phenotypes ranged from mild to severe even for the same mutation, suggesting other factors influenced phenotype and penetrance. This CMT2A cohort study will be useful for molecular diagnosis and treatment of axonal neuropathy.

  2. Endodontic therapy or single tooth implant? A systematic review.

    Torabinejad, Mahmoud; Lozada, Jaime; Puterman, Israel; White, Shane N


    Should a tooth with pulpal involvement be saved through endodontic therapy, or extracted and replaced with a single tooth implant? Within the limitations of the existing literature, this systematic review of treatment outcomes found that initial endodontic treatment had a high long-term survival rate, equivalent to replacement of a missing tooth with an implant-supported restoration. Single tooth implants should be considered as the first treatment option for patients requiring extraction and tooth replacement.

  3. Clinical analysis on patients with perianal abscess treated by using different surgical methods%不同方法治疗肛周脓肿500例对比分析



    目的:探讨肛周脓肿的最佳治疗方法.方法:对500例肛周脓肿患者采用不同手术方法进行治疗,其中一期切开术372例,一期切开挂线术54例,不全切开加对口引流术31例,单纯切开引流术43例.并观察不同手术方法的临床效果.结果:随访2个月至3年,一次性愈合426例,形成肛瘘74例,愈合时间28~180d,平均35d,无肛门失禁、肛门畸形出现.结论:根据肛周脓肿的类型,选择不同手术方法能够减轻病人痛苦,缩短伤口愈合时间,减少后遗症的发生.%Objective : To discuss an more effective approach in the treatment of perianal abscess.Methods : The retrospective analysis was preformed in 500 patients with perianal abscess.372 patients were treated by primary curative incision, 54 treated by incision and superior position thread-drawing,31 treated by incomplete incision plus contradrainage, 43 treated with simple incision and drainage.Results: The patients were followed-up for 2 months to 3 years, 426 cases were healed, 74 cases were formed anal fistula, healing time 28d~180d, an average of 35d.No patient was found to be with anal incontinence or anal abnormalities.Conclusion: Based on the type of perianal abscess, choosing a different surgical method can reduce patient pain and shorter wound healing time and reduce the incidence of complications.

  4. 一次性肛周脓肿根治术对患者肛周疼痛及生活质量的影响%Disposable Perianal Abscess Radical Surgery on Perianal Pain and Quality of Life in Patients with Perianal Abscess



    Objective To study disposable perianal abscess radical surgery on perianal pain and quality of life in patients with perianal abscess. Methods 102 patients with perianal abscess were randomly divided into two groups, the control group(n=51 cases)and the observation group(n=51 cases). The patients in the control group were operated through simple incision and drainage, while the patients in the observation group were operated through disposable perianal abscess radical surgery. Perianal pain and quality of life were observed. Results Cured 47 cases in the observation group were signiifcantly higher than the control group with 11 cases (P<0.01). The number of cases of recurrent and anal ifstula formation were signiifcantly less than the control group(P<0.01). After 6 months, quality of life score in the observation group was(8.91±1.05)points and(6.54±0.77)points in the control group. The observation group score was signiifcantly higher(P<0.05). Conclusions Disposable perianal abscess radical surgery can signiifcantly decrease perianal pain and improve quality of life.%目的:探讨一次性肛周脓肿根治术对患者肛周疼痛及生活质量的影响。方法102例肛周脓肿患者按照数字表法随机分为两组,对照组51例,采用单纯切开引流术,观察组51例,采用一次性肛周脓肿根治术。观察组术后患者的肛周疼痛及生活质量。结果观察组痊愈47例,明显高于对照组11例(P<0.01)。观察组复发、肛瘘形成例数明显少于对照组(P<0.01)。观察组术后肛周疼痛明显小于对照组(P<0.05)。观察组术后6个月生活质量评分为(8.91±1.05)分,对照组评分为(6.54±0.77)分,观察组评分明显高于对照组(P<0.05)。结论一次性肛周脓肿根治术可以更明显减轻肛周脓肿患者肛周疼痛和提高生活质量。

  5. [Liver abscesses - one of possible causes of fever of unknown origin].

    Husa, P; Freibergerová, M; Svacinka, R; Nebeský, T; Neubauer, J; Robek, O; Turanská, K; Zimová, I


    Liver abscess is a focal suppurative liver process. According to the etiology liver abscesses are divided into bacterial (pyogenic), and parasiti (amebic). Parasitic cysts (e.g. caused by Echinococcus granulosus) can be secondary bacterial infected and their clinical and laboratory manifestations are like pyogenic abscesses. In clinical manifestation of liver abscesses dominates fever of unknown origin. Authors present two characteristic cases of liver abscesses as a Case reports. The origin of multiple pyogenic abscesses of mixed etiology (Enterococcus faecium, E. coli ESBL, Candida albicans, Candida tropicalis) in 73-years old man was either in secondary infected liver hematomas after his fall and injury or in intrascapular subcutaneous abscess with spreading of microbes by blood stream into liver. Some of liver abscesses were evacuated during surgical laparotomy; the residual ones were puncted by radiologist under CT control. The patient was treated with combination of meropenem, vancomycin, metronidazol (4 weeks), and fluconazole (20 days). Antibiotic treatment with per oral doxycycline was continuing after patient's discharge from the hospital for 3 weeks. Three amebic liver abscesses were diagnosed in 27-years old man of Indian origin. The treatment was based on drainage of abscesses under CT control a long-term metronidazol treatment.

  6. A prospective study of USG guided pigtail catheter drainage in management of liver abscess

    Haresh B. Italiya


    Full Text Available Background: Treatment of the liver abscess of any etiology has evolved in the recent years. Percutaneous drainage of liver abscess has been an important advancement in the treatment of pyogenic liver abscesses. Aim: to evaluate and assess response, morbidity and complication rates of percutaneous pig tail catheter drainage in treatment of liver abscess. Methods: During a period of 27 months, 25 patients with liquefied liver abscess and #8805;5x5 cm underwent percutaneous drainage under sonographic guidance. Results: 18 had solitary abscess, while 7 had multiple abscesses. Pigtail catheters of various sizes (10 F or 12 F were introduced in these patients using the Seldinger technique. The volume of pus drained ranged from 150 to 400 ml, while the period of catheter drainage ranged from 6 to 17 days. Complications were minor and included catheter blockage in 2 patients and tract pain in 8 patients. There was no mortality associated with this procedure. This study shows a success rate of 96% (successful treatment in 24 out of 25 patients. Conclusion: Percutaneous catheter drainage of liver abscesses is successful with a low morbidity and mortality and should be the first line of management in liquefied moderate to large sized liver abscesses. [Int J Res Med Sci 2015; 3(3.000: 574-578

  7. CT-guided percutaneous drainage within intervertebral space for pyogenic spondylodiscitis with psoas abscess

    Matsumoto, Tomohiro; Morishita, Hiroyuki; Lida, Shigeharu; Asai, Shunsuke; Masui, Koji; Sato, Osamu (Department of Diagnostic Radiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto (Japan)), Email:; Yamagami, Takuji; Nishimura, Tsunehiko (Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan)); Yamazoe, Shoichi (Department of Orthopedic Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto (Japan))


    Background. Reports on CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis with a secondary psoas abscess are limited. Purpose. To evaluate CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis and a secondary psoas abscess in which the two sites appear to communicate. Material and Methods. Eight patients with pyogenic spondylodiscitis and a secondary psoas abscess showing communication with the intradiscal abscess underwent CT-guided percutaneous drainage within the intervertebral space. The clinical outcome was retrospectively assessed. Results. An 8-French pigtail catheter within the intervertebral space was successfully placed in all patients. Seven patients responded well to this treatment. The one remaining patient who had developed septic shock before the procedure died on the following day. The mean duration of drainage was 32 days (13-70 days). Only one patient with persistent back pain underwent surgery for stabilization of the spine after the improvement of inflammation. Among seven patients responding well, long-term follow-up (91-801 days, mean 292 days) was conducted in six patients excluding one patient who died of asphyxiation due to aspiration unrelated to the procedure within 30 days after the procedure. In these six patients, no recurrence of either pyogenic spondylodiscitis or the psoas abscess was noted. Conclusion. CT-guided percutaneous drainage within the intervertebral space can be effective for patients with pyogenic spondylodiscitis and a secondary psoas abscess if the psoas abscess communicates with the intradiscal abscess

  8. 2型糖尿病合并细菌性肝脓肿116例临床分析%Clinical analysis of 1 16 patients about type 2 diabetes with bacterial liver abscess



    目的:分析2型糖尿病并发细菌性肝肿的临脓床特点及治疗,为减少临床医师漏诊误诊,及更好的治疗提供依据。方法:回顾性分析116例2型糖尿病合并细菌性肝脓肿患者的基础疾病、症状体征、实验室检查、影像学检查、病原学检查、治疗情况。结果:116例2型糖尿病并发细菌性肝脓肿患者中,只有45例患者出现腹痛,116例中大部分呈现出空腹血糖、外周血中性粒细胞百分数、血沉、C-反应蛋白升高,而血红蛋白、血浆白蛋白、胆固醇明显下降,呈"四高三低"现象。64例患者在B超引导下经皮经肝穿刺引流术,41例行内科保守治疗,8例行开腹肝脓肿切开引流,3例行腹腔镜脓肿切开引流,110例好转出院。结论:2型糖尿病并发细菌性肝脓肿临床表现不典型,C反应蛋白、血沉和B超有助于减少疾病的漏诊、误诊;治疗应及时纠正高血糖,抗感染,脓肿予以穿刺引流,必要时切开引流。%Objective:Clinical characteristics and treatment of type 2 diabetes with bacterial liver abscess,for reduce missed diagnosis and misdiagnose. Methods:Review 1 16 patients about type 2 diabetes with bacterial liver abscess,in basic disease,symptoms and signs,laboratory examination,imaging exami-nation and treatment. Results:In 1 16 patients,only 45 patients appear abdominal pain,Them fasting blood-glucose,eripheral blood neutrophils percentage,e-rythrocyte sedimentation rate (ESR)and C-reactive proteinp(CRP)all elevation. But ,Hemoglobin,plasma albumin and cholesterol significantly decreased. Present four high three low,64 cases for B ultrasound guided percutaneous drainage of liver puncture. 41 cases only medication ,8 cases incision and drainage of abdominal liver abscess,3 cases laparoscopic drainage of liver abscess. 1 10 cases improvement leavehospital. Conclusion:Type 2 diabetes with bacterial liver ab-scess clinic symptom wasn

  9. Perianal Abscess and Proctitis by Klebsiella pneumoniae.

    Jeong, Woo Shin; Choi, Sung Youn; Jeong, Eun Haeng; Bang, Ki Bae; Park, Seung Sik; Lee, Dae Sung; Park, Dong Il; Jung, Yoon Suk


    Klebsiella pneumoniae (K. pneumoniae) can at times cause invasive infections, especially in patients with diabetes mellitus and a history of alcohol abuse. A 61-year-old man with diabetes mellitus and a history of alcohol abuse presented with abdominal and anal pain for two weeks. After admission, he underwent sigmoidoscopy, which revealed multiple ulcerations with yellowish exudate in the rectum and sigmoid colon. The patient was treated with ciprofloxacin and metronidazole. After one week, follow up sigmoidoscopy was performed owing to sustained fever and diarrhea. The lesions were aggravated and seemed webbed in appearance because of damage to the rectal mucosa. Abdominal computed tomography and rectal magnetic resonance imaging were performed, and showed a perianal and perirectal abscess. The patient underwent laparoscopic sigmoid colostomy and perirectal abscess incision and drainage. Extended-spectrum beta-lactamase-producing K. pneumoniae was identified in pus culture. The antibiotics were switched to ertapenem. He improved after surgery and was discharged. K. pneumoniae can cause rapid invasive infection in patients with diabetes and a history of alcohol abuse. We report the first rare case of proctitis and perianal abscess caused by invasive K. pneumoniae infection.

  10. In patients presenting to the emergency department with skin and soft tissue infections what is the diagnostic accuracy of point-of-care ultrasonography for the diagnosis of abscess compared to the current standard of care? A systematic review and meta-analysis

    Chenkin, Jordan; Cho, Dennis D; Jelic, Tomislav; Scheuermeyer, Frank X


    Objectives The primary objective of this systematic review was to determine the accuracy of point-of-care ultrasonography (POCUS) in diagnosing abscess in emergency department (ED) patients with skin and soft tissue infections (SSTI). The secondary objective was the accuracy of POCUS in the paediatric population subgroup. Setting Prospective studies set in emergency departments. Participants Emergency department patients (adult and paediatric) presenting with SSTI and suspected abscess. Primary and secondary outcome measures This systematic review was conducted according to Cochrane Handbook guidelines, and the following databases were searched: PubMed, MEDLINE, EMBASE and the Cochrane database of systematic reviews (1946–2015). We included prospective cohort and case–control studies investigating ED patients with SSTI and abscess or cellulitis, a defined POCUS protocol, a clearly defined gold standard for abscess and a contingency table describing sensitivity and specificity. Two reviewers independently ascertained all potentially relevant citations for methodologic quality according to QUADAS-2 criteria. The primary outcome measure was the sensitivity and specificity of POCUS for abscess. A preplanned subgroup (secondary) analysis examined the effects in paediatric populations, and changes in management were explored post hoc. Results Of 3028 articles, 8 were identified meeting inclusion criteria; all were rated as good to excellent according to QUADAS-2 criteria. Combined test characteristics of POCUS on the ED diagnosis of abscess for patients with SSTI were as follows: sensitivity 96.2% (95% CI 91.1% to 98.4%), specificity 82.9% (95% CI 60.4% to 93.9%), positive likelihood ratio 5.63 (95% CI 2.2 to 14.6) and negative likelihood ratio 0.05 (95% CI 0.01 to 0.11). Conclusions A total of 8 studies of good-to-excellent quality were included in this review. The use of POCUS helps differentiate abscess from cellulitis in ED patients with SSTI. Trial registration

  11. Spinal epidural abscess as a result of dissemination from gluteal abscess secondary to intramuscular analgesic injection.

    Sasani, Mehdi; Aydin, Ozlem; Aydin, Ahmet Levent; Oktenoglu, Tunc; Ozer, Ali Fahir; Ercelen, Omur


    Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflammatory drug over a 1-year period. Hematogenous or direct dissemination is the suspected cause. To prevent serious morbidity and mortality, early diagnosis is essential. Patients with localized back pain who are at risk for developing such epidural spinal abscesses should receive a magnetic resonance imaging scan with contrast enhancement without delay. The existence of predisposing factors such as intramuscular injections should be considered in the assessment of suspected spinal epidural abscess.

  12. Organization experience of diagnostic and medicosocial services for patients with Charcot—Marie—Tooth disease in Krasnoyarsk region

    E. V. Glushchenko


    Full Text Available Hereditary neuropathy Charcot-Marie-Tooth (CMT is the most common form of hereditary polyneuropathies. Goal of the study was the development of evidence-based diagnostic and treatment algorithms using patients with CMT (for example, in Krasnoyarsk Territory.Materials and methods: A total of 324 people. (probands and their relatives 1 and 2 lines of kinship. We analyzed 125 (38,5 % clinical cases of CMT, 64/125 (51,2 % clinical cases were include to statistical analysis (probands and their family trees, past the full range of clinical and laboratory findings according to the protocol this study. Age ranged from 6 to 81 years, median age — 30,5 years, including women 24 (37,5 %, median age — 33,5 years; males 40 (62,5 %, median age — 28,5 years. Methods of diagnosis: clinical, genetic, neurophysiological, molecular genetic, assessment of quality of life assessment of anxiety and depression.Results: The family history of CMT noted in 53/57 (93,0 % cases, with a predominance of autosomal dominant type of inheritance —52 (91,2 % cases. As a result of DNA testing duplication of peripheral myelin protein gene (RMR22 on chromosome 17, held 34 survey, this mutation was found in 17 (50,0 % patients. Modified method of computer esthesiometry for CMT diagnosis using domestic diagnostic equipment “Vibrotester-MBN” BT-02-1 has a high sensitivity in the early stages of the disease and can be recommended for more widespread adoption of on par with other subjects of the Russian Federation.

  13. Role of Thr399Ile and Asp299Gly polymorphisms of toll-like receptor-4 gene in acute dental abscess

    Miri-Moghaddam, Ebrahim; Baghaee, Elnaz; Bazi, Ali; Garme, Yasaman


    Background Apical Periodontitis (AP) is an inflammatory disease that affects the tissues surrounding the root end of a tooth. The disease which is caused by endodontic infections presents in different clinical ways including development of an acute abscess. Recent studies have provided information suggesting role of a multitude of factors in pathogenesis of acute apical abscess (AAA). In this case-control study, our goal was to evaluate the frequency and potential role of two common polymorphisms of toll like receptor-4 (TLR-4) gene; Thr399Ile (1196 C>T) and Asp299Gly (+896 A>G), in 50 patients with AAA as cases and 50 patients with asymptomatic apical periodontitis (AAP) as controls. Material and Methods Saliva sample containing mucosal epithelial cells was used for DNA extraction. Polymorphisms were detected by Tetra-ARMS (Amplification Refractory Mutation System) PCR method. Statistical analyses were carried out in SPSS 21 software. Results Homozygous wild type (CC) and heterozygous (CT) genotypes of Thr399Ile polymorphism were detected in 84% and 16% of AAA patients respectively. In controls, respective ratios were 94% (CC) and 6% (CT). Observed difference was not statistically significant (P>0.05) for distribution of these genotypes. The mutant homozygous (TT) genotype of this polymorphism was identified in neither of the participants. Overall, T allele frequency was obtained 8% in AAA and 3% in AAP (OR=2.6, 95% CI; 0. 6-10.6, p>0.05). For Asp299Gly polymorphism, no individual was detected with the mutant allele in case or control groups. Conclusions Our results indicated a possible role for Thr399Ile polymorphism in acute presentations of abscess in AAA. However, the impact of this polymorphism needs to be more assessed in future studies. Key words:Genetic polymorphism, periapical abscess, periapical periodontitis, toll-like receptor 4. PMID:28210435

  14. Tuberculous abscess in hepatoduodenal ligament: Evaluation with contrast-enhanced computed tomography

    Peng Dong; Bin Wang; Ye-Quan Sun


    Two patients with tuberculous abscess in the hepatoduodenal ligament were studied. Both patients underwent contrast-enhanced computed tomography (CT) scan. The abscess showed a low density with an irregular thick wall in the hepatoduodenal ligament on CT images, the margin was poorly defined. Contrastenhanced CT images showed the contrast-enhanced thick wall, homogeneous and peripheral-enhanced lymph nodes. Although features of the tuberculous abscess in the hepatoduodenal ligament could be conspicuously shown with contrast-enhanced CT, further experience is needed to evaluate the potential value of CT in detecting early tuberculous abscess in relation to other entities in the hepatoduodenal ligament.

  15. Direct molecular versus culture-based assessment of Gram-positive cocci in biopsies of patients with major abscesses and diabetic foot infections

    M.H.T. Stappers (Mark H. T.); F. Hagen (Ferry); P. Reimnitz (Peter); J.W. Mouton (Johan); J.F. Meis (Jacques F.); I.C. Gyssens (Inge)


    textabstractMajor abscesses and diabetic foot infections (DFIs) are predominant subtypes of complicated skin and skin structure infections (cSSSIs), and are mainly caused by Staphylococcus aureus and β-hemolytic streptococci. This study evaluates the potential benefit of direct pathogen-specific rea

  16. An Unusual Cause of Renal and Perirenal Abscesses: Candida albicans



    Full Text Available A 42-year-old female with history of surgery due to urolithiasis was admitted to hospital with complaints of fever, left fl ank pain and vomiting. She was found to have acute kidney injury due to urinary tract infection. Abdominal computed tomography revealed right atrophic kidney and left renal and perirenal abscesses together with urolithiasis. Urine, blood and abscess cultures yielded C. albicans. The patient was treated with fl uconazole and percutaneous drainage of the perirenal abscess, which was 60 mm in diameter. Her serum creatinine returned to the normal ranges within two weeks of hospitalization. Nearly 18 months following this presentation, she has normal serum creatinine and no abscesses in the kidneys.

  17. [Breast abscess with Salmonella typhi and review of the literature].

    Delori, M; Abgueguen, P; Chennebault, J-M; Pichard, E; Fanello, S


    We report the case of a 54-year-old woman who presented with breast abscess, which appeared through a common alimentary toxi-infection with Salmonella Typhi, infection, which implied twelve patients having attended the same restaurant. With around hundred native cases a year in France, typhoid fever is not a very frequent toxi-infection. Among the known extra-intestinal manifestations of Salmonella infections, the breast abscess remains rare and the literature revealed less than ten published cases, including some revealed the disease. In our observation, the imputability of S. Typhi was retained based on the chronology of the clinical signs, specific treatments, and the successful outcome under antibiotherapy, in spite of the negativity of the breast abscess bacteriological samples. We also analyze rare cases of breast abscess due to S. Typhi found in the literature.


    郭增柱; 王正仪; 安亦军; 祝宏


    Polymerase chain reaction (PCR) has been applied in diagnosing amebic liver infection by detecting pathogenic Entamoeba histolytica DNA in liver aspirates. Oligonucleotide primers found to he specific for the gene encoding the 30 kDa molecule of this pathogenic ameba were used in the test. Liver aspirates obtained from 23 patients with amebic liver abscess substantiated by typical clinical rnanifastation or with very high titres of anti-E histtolytica antibodies by ELISA were found to he positive by PCR. Fourteen controlsamples (3 cases of bacterial liver abscess, I of liver cancer and 10 of other abscess) were all found to be negative to this reaction. The results suggested PCR to he a specific and sensitive tool for diagnosing amebic liver abscess infections.

  19. [Intracranial epidural abscess in a newborn secondary to skin catheter].

    Fernández, L M; Domínguez, J; Callejón, A; López, S; Pérez-Avila, A; Martín, V


    Intracranial epidural abscesses are uncommon lesions, being more frequents in older children and adults. They commonly arise as a result of direct extension of a preexisting infection and rarely present with focal deficit. We present a case of a 11-days old preterm infant who developed an intracranial epidural abscess as a result of an infected scalp vein catheter. The diagnosis was made on the basis of the cranial ultrasound and CT scan images. An identified strain of Enterococcus faecium was cultured from all the samples. The patient underwent a right frontal craniotomy with drainage of the abscess and a 2-week total course of intravenous antibiotics was administrated. CT scan imaging 3 week after the procedure demonstrated no evidence of residual lesion. When present, a scalp vein catheter, in absence of others predisponing factors, must be considered as an etiologic agent for an intracranial epidural abscess in this age-group.

  20. Ultrasound-guided drainage of deep pelvic abscesses

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn


    The aim of this study was to demonstrate and evaluate the ultrasound-guided drainage of deep pelvic abscesses in which transabdominal percutaneous access could not be performed because of overlying structures. A retrospective analysis of 32 consecutive patients with 33 deep pelvic abscesses...... (median diameter 7 cm), 19 were treated with catheter drainage and 18 of these cases resulted in favorable clinical outcomes. Of the smaller abscesses (median diameter 4 cm), 14 were treated with needle drainage. In two of these cases, follow-up US showed that a repeat puncture and drainage was necessary...... and the subsequent in-dwelling catheter period, there were no serious complications related to the drainage procedures. We conclude that ultrasound-guided transrectal, transvaginal, transperineal and transgluteal drainage of deep pelvic abscesses are safe and effective treatment approaches. Based on our findings...

  1. Intra-abdominal gout mimicking pelvic abscess

    Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)


    Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)

  2. Presence and consequence of tooth periapical radiolucency in patients with cirrhosis

    Grønkjær, Lea Ladegaard; Holmstrup, Palle; Schou, Søren;


    -related complications. METHODS: A total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width. Predictors of periapical radiolucency and the association...... interval [CI] 1.43-6.79) and severe periodontitis (OR 3.98, 95% CI 1.04-15.20). Also old age (OR 1.10, 95% CI 1.01-1.19) and smoking (OR 3.24, 95% CI 1.02-17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors...

  3. Clinical characteristics and progression of liver abscess caused by toxocara

    Kyung; Ho; Ha; Jung; Eun; Song; Byung; Seok; Kim; Chang; Hyeong; Lee


    AIM: To evaluate the clinical characteristics and progression of liver abscess caused by toxocara.METHODS: We retrospectively reviewed the medical records of patients with serum Ig G antibody to Toxocara canis and liver abscess diagnosed using abdominal computed tomography between February 2010 and February 2015. Among 84 patients exhibiting serum Ig G antibody to Toxocara canis, 34 patients were diagnosed with liver asbscess and treated with albendazole. A follow-up period of 1 year was conducted. RESULTS: Mean patient age was 53(34-79) years, with 26(76.5%) patients being male. Twenty-one(61.7%) patients were moderate or heavy drinkers, 23(67.6%) patients had a history of eating raw meat or liver and 6(17.6%) patients owned pet dogs or cats. Main patient symptoms consisted of right upper quadrant pain, fever, and fatigue; 18(52.9%) patients, however, presented with no symptoms. Lung involvement was detected in 444(11.7%) patients. The eosinophil count increased in 29(85.3%) patients at initial diagnosis, and decreased in most patients after albendazole treatment. The initial serum Ig E level increased in 25(73.5%) patients, but exhibited various response levels after albendazole treatment. Liver abscess formation improved in all patients.CONCLUSION: The liver abscess was improved with albendazole treatment.

  4. Intracranial abscess in Ectopia Cordis.

    Merola, Joseph; Tipper, Geoffrey Adrian; Hussain, Zakier; Balakrishnan, Venkataraman; Gan, Peter


    We present a case of intracranial abscess in a young female with Ectopia Cordis, an exceptionally rare cardiac condition. The neurosurgical implication is the predisposition to intracranial abscess formation. A heightened awareness of this association will aid diagnosis in similar clinical scenarios.

  5. Iatrogenic psoas abscess. Case report

    Bernstein, Inge Thomsen; Hansen, B J


    A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago.......A case of iatrogenic pneumococcus psoas abscess is reported. The etiology was probably repeated local anaesthetic blockades in the lumbogluteal structures because of lumbago....

  6. Amebic abscess of urachal remnants.

    Catanzaro, D; Mirk, P; Carbone, A; Macis, G; Danza, F M


    We report a rare case of amebic abscess of the urachus, mimicking an urachal neoplasm: no previous reports of amebic infection of the urachus were found in the literature. The challenges of the differential diagnosis between urachal abscess and carcinomas based both on clinical and radiological data are discussed.

  7. Amebic abscess of urachal remnants

    Catanzaro, Daniela; Mirk, Paoletta; Carbone, Arnaldo; Macis, Giuseppe; Danza, Francesco Maria


    We report a rare case of amebic abscess of the urachus, mimicking an urachal neoplasm: no previous reports of amebic infection of the urachus were found in the literature. The challenges of the differential diagnosis between urachal abscess and carcinomas based both on clinical and radiological data are discussed.

  8. Operative treatment of Brodie's abscess.

    Dunn, E C; Singer, L


    This manuscript deals with a unique operative management of unilateral Brodie's abscess in a 16-year-old male. Brodie's abscess is a common finding in childhood osteomyelitis. A review of the radiographic appearance, clinical presentation, and surgical management is presented.

  9. Streptococcus oralis cerebral abscess following monkey bite in a 2-month-old infant.

    Thiagarajan, Srinivasan; Krishnamurthy, Sriram; Raghavan, Renitha; Mahadevan, Subramanian; Madhugiri, Venkatesh S; Sistla, Sujatha


    Although cerebral abscesses caused by animal bites have been reported, they are extremely rare in infants and have not been described following monkey bite. A 55-day-old male infant presented with a multi-loculated Streptococcus oralis cerebral abscess following a monkey bite on the scalp. There was a clinical response to antibiotic therapy and repeated surgical aspiration followed by a ventriculoperitoneal shunt. This is the first report of a patient with a brain abscess following a monkey bite.

  10. Dental abscess: A microbiological review



    Full Text Available Dental abscess is a frequently occurring infectious process known to the health practice. The fate of the infection depends on the virulence of the bacteria, host resistance factors, and regional anatomy. Serious consequences arising from the spread of a dental abscess lead to significant morbidity and mortality. Acute dental abscess is polymicrobial, comprising of strict anaerobes, such as anaerobic cocci, Prevotella, Fusobacterium species, and facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group. Numerous novel, uncultivable and fastidious organisms have been identified as potential pathogens with the use of non-culture techniques. The majority of localized dental abscesses respond to surgical treatment while the use of antimicrobials is limited to severe spreading infections. There is a need for good-quality clinical trials of sufficient size to identify the ideal treatment. The microbiology of the acute dentoalveolar abscess and its treatment in the light of improved culture and diagnostic methods are reviewed.

  11. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Lee, Jong Tae; Kwon, Tae Hee; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Ho [Cheil General Hospital, Seoul (Korea, Republic of)


    Percutaneous catheter drainage has been reported to be an effective method in the management of selected patients with abscess and fluid collection. Its high success rate and relatively low complications make the procedure an alternative to surgery in the individual cases. During past two years percutaneous catheter drainage in 25 patients with intraabdominal abscesses and fluid collection was performed at the Department of Radiology, Yonsei University College of medicine. Here the technique and author's results were summarized. 1. The total 25 patients who had percutaneous catheter drainage are 10 liver abscesses, 3 subphrenic, one subhepatic, 4 renal and perirenal, 2 pelvic, one psoas, one anterior pararenal fluid from acute pancreatitis, one pancreas pseudocyst and 2 malignant tumor necrosis. 2. The modified Seldinger technique used for all cases of abscess and fluid drainage under guidance of ultrasound scan. The used catheters were 10F. Pigtail and 14F. Malecot (Cook c/o) catheters. 3. The abscesses and fluid of 17 patients among 25 were cured by the percutaneous catheter drainage and 4 patients were clinically improved. The catheter drainage was failed in 2 patients and 3 complication were developed. 4. The success rate of this procedure was 91.3%, failure rate was 8.7% and complication rate was 12%.

  12. Analysis of the Bacterial Diversity in Liver Abscess: Differences Between Pyogenic and Amebic Abscesses.

    Reyna-Fabián, Miriam E; Zermeño, Valeria; Ximénez, Cecilia; Flores, Janin; Romero, Miguel F; Diaz, Daniel; Argueta, Jesús; Moran, Patricia; Valadez, Alicia; Cerritos, René


    Several recent studies have demonstrated that virulence in Entamoeba histolytica is triggered in the presence of both pathogenic and nonpathogenic bacteria species using in vitro and in vivo experimental animal models. In this study, we examined samples aspirated from abscess material obtained from patients who were clinically diagnosed with amebic liver abscess (ALA) or pyogenic liver abscess (PLA). To determine the diversity of bacterial species in the abscesses, we performed partial 16S rRNA gene sequencing. In addition, the E. histolytica and Entamoeba dispar species were genotyped using tRNA-linked short tandem repeats as specific molecular markers. The association between clinical data and bacterial and parasite genotypes were examined through a correspondence analysis. The results showed the presence of numerous bacterial groups. These taxonomic groups constitute common members of the gut microbiota, although all of the detected bacterial species have a close phylogenetic relationship with bacterial pathogens. Furthermore, some patients clinically diagnosed with PLA and ALA were coinfected with E. dispar or E. histolytica, which suggests that the virulence of these parasites increased in the presence of bacteria. However, no specific bacterial groups were associated with this effect. Together, our results suggest a nonspecific mechanism of virulence modulation by bacteria in Entamoeba.

  13. 肺炎克雷伯菌致多发性肝脓肿患者的加强护理%The intensive care to patients with multiple liver abscess caused by Klebsiella pneumonia

    顾朝丽; 单荣芳; 刘颖; 黄金兰; 蒋雅琼


    Objective To conclude the successful rescue and intensive care to patients with multiple liver abscess caused by Klebsiella pneumonia. Methods The rescuing coordination to two critically ill patients, the nursing of liver puncture and tube indwelling, incision and drainage were summarized. The characteristics of the infection of Klebsiella pneumonia and the prevention of cross infection, the nursing of high fever, medicine taking, basic nursing, nutrition support, psychological nursing, discharge instructions and so on were introduced as well. Results After intensive care, two patients were discharged from hospital after recovery. Conclusion Klebsiella pneumonia is multidrug resistant, which can cause multiple liver abscess. Patients with multiple liver abscess are seriously sick and it takes a long time to cure them. The key to a successful rescue includes intensive care, dealing with the life - threatened symptoms and physical signs, early using anti - biotic drugs, cutting open the pyogenic liver abscess and leading the liquid out effectively and preventing the cross infection.%目的 总结肺炎克雷伯菌致多发性肝脓肿患者的成功抢救与加强护理.方法 介绍2例危重患者的抢救配合、肝脓肿穿刺置管与手术切开冲洗引流护理、肺炎克雷伯菌感染特点与预防交叉感染、高热护理、用药护理、基础护理、营养支持、心理护理、出院指导等.结果 2例患者经加强护理,完全康复出院.结论 肺炎克雷伯菌是常见的多重耐药菌,其引起的多发性肝脓肿患者病情危重、病程长,加强监护、积极处理危及生命的症状和体征、尽早使用敏感抗菌药物、有效的脓肿切开引流、预防交义感染是抢救成功的关键.

  14. Analysis of mutations in 17p 11.2 region in patients with Charcot-Marie-Tooth type 1 disease and patients with tomaculose neuropathy

    Zamurović Nataša


    Full Text Available Charcot-Marie-Tooth type 1Α disease (CMT1A and hereditary neuropathy with liability to pressure palsies (HNPP are common inherited disorders of the peripheral nervous system associated with duplication and deletion respectively, of the 17p11.2 segment including the gene of peripheral myelin protein 22. We studied 48 subjects belonging to 29 families with clinical and electrophysiological signs of definite CMT1, 20 patients with suspected CMT phenotype, and 17 patients and healthy members of their families with HNPP. Blood sampling and DNA isolation, PCR, restriction analysis, southern blotting were performed using standard procedures. Of 48 patients with diagnosis of definite CMT1 in 25 (52% we found a 1.5 Mb tandem duplication in chromosome 17p11.2. These duplications were not found in any of 20 sporadic cases with the clinical phenotype of CMT but without reliable electrophysiological data. Only 13 (44.8%of 29 unrelated CMT1 patients from the first group had 17p11.2 duplications. Three of 4 sporadic cases (75% with definite CMT1 had 17p11.2 duplications. Of 17 patients from 6 families with HNPP deletion of 17p11.2 segment was found in 15 (88.2%, as well as in 5 (83.3% of six unrelated cases. Detection of CMT1A/HNPP recombination hotspot is a simple and reliable DNA diagnostic method, which is useful only for the patients with clinically already verified CMT1, and HNPP for further genetic counseling of patients and members of their families.

  15. Epidemiology, Clinical Features and Outcome of Liver Abscess: A single Reference Center Experience in Qatar

    Mushtak Talib Abbas


    Full Text Available Objective: To describe the etiology, clinical presentation, management and outcome of liver abscess in adult patients admitted at Hamad general hospital, Qatar. Methods: A cross sectional study was conducted to involve all adult patients who sequentially encountered episodes of liver abscess during the period from January 1, 2009, to December 31, 2010. Blood cultures were drawn from all patients in the first 24 hours after admission. In addition, all patients had stool examinations and indirect Hemagglutination test for Entameba histolytica. Aspiration of abscess was done under CT guidance and aspirated pus was sent for gram stain and culture. Results: In total, 67 patients were admitted with liver abscess; 56 patients with pyogenic liver abscess and 11 with amebic liver abscess. There were 61 (91% males and six (9% females and their mean age was 47.4 ± 18.5 years. Fever, abdominal pain and vomiting were the commonest presenting features. Of the 56 pyogenic liver abscess patients, four discharged against medical advice and seven refused all invasive procedures and were treated with antibiotics for six weeks. The remaining 44 (79% patients were treated with antibiotics and one or more invasive procedures, while one patient was treated surgically. The commonest organism isolated was Klebseilla pneumonia found in 21 patients (38%. The mean duration of hospitalization was 13.6 ± 8.1 days; the mean duration of antibiotic therapy was 34.7 ± 40.6 days, and one patient died. In contrast, all amebic liver abscess patients underwent ultrasound guided aspiration and showed good response to metronidazole treatment. Their mean duration of hospitalization was 7.7 ± 4.1 days, mean duration of therapy was 11.8 ± 2.1 days, and all patients were cured. Conclusion: Pyogenic liver abscess was more common than amebic liver abscess with Klebseilla pneumonia being the commonest organism. With good medical measures and early drainage of liver abscess, surgical

  16. An interesting case of cerebral abscess.

    Rafiq, Muhammad Khizar


    An immigrant from Romania was referred to the neurosurgical unit with a cerebral abscess. On examination she was cyanosed and had clubbing of her fingers. A cardiovascular system examination revealed a systolic murmur heard all over the precordium. However, the diagnosis was not congenital cyanotic heart disease. The patient had a history of frequent nosebleeds and had multiple telangiectases on her body, leading to the diagnosis of hereditary haemorrhagic telangiectasia (HHT). A search was carried out for the presence of arteriovenous malformations in internal organs. Large arteriovenous malformations were found in the lungs, causing her cyanosis due to right-to-left shunting of blood and cerebral abscess due to paradoxical septic embolisation into cerebral circulation.

  17. [Pelvic actinomycosis abscess and intrauterine device].

    Ko-Kivok-Yun, P; Charasson, T; Halasz, A; Fournié, A


    A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

  18. Radiofrequency ablation of a misdiagnosed Brodie's abscess.

    Chan, Rs; Abdullah, Bjj; Aik, S; Tok, Ch


    Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie's abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie's abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment.

  19. 负压吸引在低位肛周脓肿根治术后引流效果的临床观察%Negative pressure drainage in patients underwent primary radical surgical procedure for low perianal abscess

    岳中文; 张建余


    目的 探讨负压吸引装置在低位肛周脓肿根治术后的应用效果.方法 将60例低位肛周脓肿患者随机分为两组,治疗组30例,采用负压吸引装置引流;对照组30例,采用生理盐水纱条引流,就一次治愈率、愈合时间及住院天数进行对比分析.结果 肛周脓肿根治术后应用负压吸引装置提高了愈合率,加快切口愈合,缩短住院时间.结论 负压吸引装置操作简便,安全可靠,是低位肛周脓肿根治术后引流有效的方法之一.%Objective To evaluate the effect of negative pressure drainage in patients underwent primary radical surgical procedure for low perianal abscess. Methods Sixty patients with low perianal abscess were divided randomly into the treatment group (30 cases) and the control group (30 cases). After primary radical surgical procedure, the treatment group was treated by negative pressure drainage, and the control group drained by normal saline gauze. Results The treatment group had a higher cure rate, shorter wound healing time and hospital stay than those of the control group. Conclusion Negative pressure drainage is a simple, safe and effective method for low perianal abscess after primary radical surgical procedure.

  20. Complications associated with cheek tooth extraction in the horse.

    Earley, Edward T; Rawlinson, Jennifer E; Baratt, Robert M


    Common indications for cheek tooth extraction in the horse include dental fracture, periodontal disease, severe decay/ caries, mandibular fracture with alveolar/tooth involvement, and periapical abscess. Complications secondary to extraction of cheek teeth are prevalent. Typical complications may include retained root tip(s), collateral damage of neighboring teeth and alveolar bone, mandibular fracture non-union or delayed union, cemental ankylosis, dilacerated root(s), oroantral/oronasal fistula, palatal deviation of cheek teeth, bone sequestration, sinus involvement, alveolar plug failure, and palatine artery laceration. This paper presents a series of cases that had complications following cheek tooth extraction. Anticipation of problematic extractions, recognition of complications, and appropriate treatment will aid the clinician in managing the inevitable cheek tooth extraction complication.

  1. Conservative management of post-appendicectomy intra-abdominal abscesses

    Dhaou Mahdi


    Full Text Available Abstract Purpose Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage. Methods Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively. Results This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable. For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85% with clinical, biological and radiological recovery of the abscess. There was one failure (14%. The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days. In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20. Conclusion Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization.

  2. Atypical pyogenic brain abscess evaluation by diffusion-weighted imaging: diagnosis with multimodality MR imaging.

    Ozbayrak, Mustafa; Ulus, Ozden Sila; Berkman, Mehmet Zafer; Kocagoz, Sesin; Karaarslan, Ercan


    Whether a brain abscess is apparent by imaging depends on the stage of the abscess at the time of imaging, as well as the etiology of the infection. Because conventional magnetic resonance imaging (MRI) is limited in its ability to distinguish brain abscesses from necrotic tumors, advanced techniques are required. The management of these two disease entities differs and can potentially affect the clinical outcome. We report a case having atypical imaging features of a pyogenic brain abscess on advanced MRI, in particular, on diffusion-weighted and perfusion imaging, in a patient with osteosarcoma undergoing chemotherapy.

  3. Diffuse large B cell lymphoma presenting as a peri-anal abscess.

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina


    A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management.

  4. Medical management of cerebellar abscess: a case report and review of the literature.

    Turner, Ryan C; Dodson, Sean C; Rosen, Charles L


    A large abscess of the posterior fossa often warrants surgical intervention. We report a case of a 50-year-old male presenting with a cerebellar abscess measuring 2.8 cm x 1.6 cm located in the left cerebellar hemisphere at the level of the middle cerebellar peduncle that was treated conservatively and successfully with antibiotics. Therapeutic management options are discussed in regards to this case specifically as well as a review of the literature. This case illustrates the successful medical management of a cerebellar abscess of otogenic origin in an adult, a unique result in terms of abscess size and age of the patient.

  5. Hepatic abscess induced by foreign body: Case report and literature review

    Sofia A Santos; Jo(a)o R Deus; Sara CF Alberto; Elsa Cruz; Eduardo Pires; Tomás Figueira; (E)lia Coimbra; José Estevez; Mário Oliveira; Luís Novais


    Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon.Pre-operative diagnosis is difficult as patients are often unaware of the foreign body ingestion and symptoms and imagiology are usually non-specific. The authors report a case of 62-year-old woman who was admitted with fever and abdominal pain. Further investigation revealed hepatic abscess, without resolution despite antibiotic therapy. A liver abscess resulting from perforation and intra-hepatic migration of a bone coming from the pilorum was diagnosed by surgery. The literature concerning foreign body-induced perforation of the gastrointestinal tract complicated by liver abscess is reviewed.

  6. Amebic liver abscess with bacterial superinfection in a patient with no epidemiologic risk factors Absceso hepático amebiano sobreinfectado sin antecedentes epidemiológicos

    P. Sánchez-Pobre


    Full Text Available The amebic liver abscess is uncommon in developed countries like Spain, but the incidence is increasing probably due to the migratory movements of the population. We report a case of an amebic abscess, initially unsuspected due to the absence of epidemiologic risk factors and the negative serology for amebiasis, in the early stages of the disease.El absceso hepático amebiano es infrecuente en países desarrollados, como lo es el caso de España, pero su incidencia está aumentando, posiblemente en relación con los movimientos migratorios de la población. Presentamos un caso de absceso hepático amebiano, no sospechado inicialmente, debido a la ausencia de antecedentes epidemiológicos y a la negatividad de las pruebas serológicas en las fases iniciales de enfermedad.

  7. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    Cantasdemir, M. E-mail:; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F


    AIM: To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses. MATERIALS AND METHODS: Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3). RESULTS: PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones. CONCLUSION: CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD.

  8. Usefulness of intracavitary urokinase injection under sonographic guidance in treatment for periappendiceal abscess

    Ha, Jong Soo; Cha, Sang Hoon; Kim, Beak Hyun; Jung, Hwan Hoon; Kim, Taik Kun [Ansan Hospital, Korea University School of Medicine, Ansan (Korea, Republic of); Seo, Bo Kyoung; Chung, Kyoo Byung [Anam Hospital, Korea University School of Medicine, Seoul (Korea, Republic of); Park, Cheol Min [Guro Hospital, Korea University School of Medicine, Seoul (Korea, Republic of)


    To evaluate usefulness of intracavitary urokinase injection for the treatment of small sized periappendiceal abscess which was not unsuitable for percutaneous catheter drainage. From December 1997 to December 1999, we performed intracavitary injection of urokinase as a treatment of periappendiceal abscess in six patients. Initially, aspiration of the abscess was done using a 18 G needle under sonographic guidance. We measured the maximal length of residual abscess and injected 5000 IU of urokinase per centimeter of the diameter of the residual abscess. 24 hours after the injection of urokinase, repeated aspiration of the residual abscess was done, and follow-up sonographic examination was performed. The size of initial abscesses in each patients was ranged from 1.6 X 1.2 to 5.8 X 3.4 cm (mean=3.9 X 2.4 cm), and initial volume of aspirated pus was ranged from 3 to 31 cc (mean=11.8 cc).24 hour after the injection, the volume of respirated pus was ranged from 4 to 13.5 cc (mean=10.4 cc). Follow-up sonography performed 3 to 10 days later revealed no residual abscess. The mean duration of hospitalization was 5.5 days. Intracavitary urokinase injection under the sonographic guidance can be a useful method for the treatment of small sized periappendiceal abscess which is not suitable for percutaneous catheter drainage.

  9. Cavernous Transformation of the Portal Vein Might Increase the Risk of Liver Abscess

    Xin-Bo Ai


    Full Text Available Cavernous transformation of the portal vein (CTPV is not quite common in adults, and cases with CTPV and acute liver abscess are lacking. We report a patient with CTPV inducing extrahepatic and intrahepatic obstruction, finally leading to acute liver abscess due to bile duct infection. We aim to find out the possible relationship between CTPV and acute liver abscess. A 45-year-old female patient was admitted to our hospital for recurrent upper abdominal pain and distension for one year, aggravated with fever for three years. A diagnosis of CTPV and liver abscess was made by 16-slice computed tomography. Effective antibiotics and drainage were used for this patients, and she was eventually cured. When treating patients with CTPV, extrahepatic and intrahepatic obstruction, one should be aware of the presence of acute liver abscess, and empirical antibiotics might be valuable.

  10. Patients' experience of partial tooth loss and expectations to treatment: a qualitative study in Danish and Swedish patients

    Øzhayat, Esben Boeskov; Öwall, Bengt; Åkerman, Sigvard;


    Knowledge of impairments, wishes and expectations is essential to make correct decisions regarding oral rehabilitation. The purpose of this study was to investigate discomforts, wishes and expectations in patients' with partial edentulism before entering oral rehabilitation. In Copenhagen, Denmar...

  11. CT-guided percutaneous drainage of intra-abdominal abscesses: APACHE III score stratification of 1-year results

    Betsch, Angelika; Belka, Claus [Department of Radiation Oncology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Wiskirchen, Jakub; Truebenbach, Jochen; Claussen, Claus D.; Duda, Stephan H. [Department of Diagnostic Radiology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Manncke, Klaus H. [Department of General Surgery, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)


    Our objective was to evaluate the clinical success rates of percutaneously drained intra-abdominal abscesses using a risk stratification score for severely ill patients (APACHE III; Acute Physiology, Age, Chronic Health Evaluation). In 75 patients CT-guided percutaneous abscess drainage was performed to treat intra-abdominal abscesses. The clinical success rate based on a 1-year follow-up was correlated with abscess etiology, size, and structure, as well as with the initial APACHE III score. Clinical success, i.e., the complete removal of the abscess without surgical treatment, was observed in 62 of 75 patients (83%). Abscess size (<200 cm{sup 3}) and abscesses with a simple structure correlated with higher clinical success rates. Patients presenting with APACHE III scores below 30 were treated by percutaneous abscess drainages (PAD) alone significantly more often than patients presenting with higher APACHE scores. The percutaneous drainage of intra-abdominal abscesses shows good long-term results as long as abscesses are singular, small (<200 cm{sup 3}), and located in well accessible regions in combination with low APACHE scores (<30). (orig.)

  12. A 3-year prospective study of implant-supported, single-tooth restorations of all-ceramic and metal-ceramic materials in patients with tooth agenesis

    Hosseini, Mandana; Worsaae, Nils; Schiødt, Morten


    of crowns, cement excess and technical complications. The aesthetic outcome was assessed by using the Copenhagen Index Score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire. The statistical analyses were mainly performed by using mixed model of ANOVA for quantitative data...... and PROC NLMIXED for ordinal categorical data. RESULTS: The 3-year survival rate was 100% for implants and 97% for abutments and crowns. Significantly more marginal bone loss was registered at gold-alloy compared to zirconia abutments (P = 0.040). The mPlI and mBI were not significantly different at three......-up examinations, the biological outcome variables such as survival rate of implants, marginal bone level, modified Plaque Index (mPlI), modified Sulcus Bleeding Index (mBI) and biological complications were registered. The technical outcome variables included abutment and crown survival rate, marginal adaptation...

  13. A clinical study of 156 elderly patients with hypertension receiving tooth extraction%156例老年高血压患者拔牙临床研究

    卢丽虹; 胡顺广; 魏远坚


    Objective To explore and summarize a safe and effective strategy of decreasing blood pressure for elderly patients with hypertension receiving tooth extraction. Methods Clinical data of 156 elderly patients with hypertension receiving tooth extraction were analyzed retrospectively. Patients all received medicine to control their blood pressure before tooth extraction. 76 Patients receiving nifedipine plus diazepam were allocated to an observation group, and 80 patients receiving nifedipine alone were allocated to a control group. Changes of SBP, DBP and HR before and after the treatment were compared between the two groups. Results The 156 elderly patients with hypertension successfully received tooth extraction without severe complications occurred. Decrease of SBP and DBP in the observation group was significantly greater than that in the control group, and the change of HR was smaller than that in the control group. The differences were statistically significant(P < 0.05). Conclusion Application of nifedipine combined with diazepam for elderly patients with hypertension before tooth extraction is beneficial to control peri-operative blood pressure and keep a stable heart rate, and to reduce emergencies such as severe elevation of blood pressure during peri-operative period of tooth extraction.%目的:探讨老年高血压患者拔牙安全有效的降压策略。方法回顾性分析156例拔牙治疗的老年高血压患者的临床资料,患者均在拔牙前采用药物控制性降压,将采用硝苯地平+安定者76例纳入观察组,单独应用硝苯地平者80例纳入对照组,比较两组患者治疗前后收缩压(SBP)、舒张压(DBP)及心率(HR)的变化。结果本研究156例老年高血压患者均顺利地完成了拔牙,无严重并发症发生。其中观察组SBP、DBP下降效果明显优于对照组,而心率变化小于对照组,差异均有统计学意义(P<0.05)。结论老年高血压患者拔牙前

  14. Spinal epidural abscess with gadolinium-enhanced MRI: serial follow-up studies and clinical correlations

    Sadato, N. (Dept. of Diagnostic Radiology, Maryland Univ. Medical System, Baltimore, MD (United States)); Numaguchi, Y. (Dept. of Diagnostic Radiology, Maryland Univ. Medical System, Baltimore, MD (United States)); Rigamonti, D. (Dept. of Neurological Surgery, Maryland Univ. Medical System, Baltimore, MD (United States)); Kodama, T. (Dept. of Diagnostic Radiology, Maryland Univ. Medical System, Baltimore, MD (United States)); Nussbaum, E. (Dept. of Neurological Surgery, Maryland Univ. Medical System, Baltimore, MD (United States)); Sato, S. (Dept. of Diagnostic Radiology, Maryland Univ. Medical System, Baltimore, MD (United States)); Rothman, M. (Dept. of Diagnostic Radiology, Maryland Univ. Medical System, Baltimore, MD (United States))


    We reviewed serial MRI with and without gadolinium-DTPA in eight patients with spinal epidural abscess and correlated the findings and the clinical manifestations. In four patients, diffuse abscesses spanned four vertebral bodies or more; the others had focal abscesses associated with osteomyelitis and/or diskitis. In three of the four patients with diffuse abscesses, MRI (NCMRI) showed diffuse encasement of the subarachnoid space. Contrast-enhanced MRI (CEMRI) demonstrated linear enhancement surrounding unenhanced pus. In the four patients with focal abscesses, CEMR delineated the inflammatory process more clearly than NCMR. On follow-up studies, decrease in abscess size and better visualization of the subarachnoid space correlated with clinical improvement in both diffuse and focal abscesses. Despite clinical improvement, contrast enhancement persisted in the disk or epidural space of three patients, and was thought to represent chronic granulomatous change or postsurgical scar. CEMR is very valvable for the initial diagnosis of an epidural abscess, particularly if it involves lengthy segments. During follow-up, CEMR can document responses to therapy, and provide information for determining appropriate treatment. (orig.)

  15. A Rare Case of Pediatric Nosocomial Liver Abscess Developing During Dialysis Therapy



    Full Text Available Introduction Liver abscess developing during hospital stay in pediatric patients on dialysis for acute kidney injury has been previously unreported. Impaired immunity, prolonged use of antibiotics, diabetes and malnutrition predispose to liver abscess in chronic hemodialysis patients. Case Presentation We reported a case of liver abscess developing in a 6-year-old boy admitted with sepsis and multiorgan dysfunction syndrome including acute kidney injury. He received peritoneal and subsequently hemodialysis, as he did not improve on peritoneal dialysis. He developed fever while on hemodialysis, which was due to a liver abscess developing during the course of hospital stay. The abscess was in the right lobe of the liver with a volume of 40 mL. Staphylococcus aureus is the leading cause of pyogenic liver abscesses in children and infection acquired from hospital. The patient received vancomycin and responded well with complete resolution and did not require any drainage procedure. He may have acquired bacteremia during dialysis with subsequent hepatic seeding. Conclusions Though rare, liver abscess may develop even in patients undergoing short-term dialysis therapy. Liver abscess is a medical emergency and if not treated promptly may lead to significant mortality. Invasive therapeutic procedures, like drainage is associated with further risk of complications. Therefore, a high index of suspicion should be kept when evaluating a patient who develops unexplained fever while being on hemodialysis. Early medical intervention through appropriate antibiotics can significantly reduce the morbidity and mortality. Strict infection control policies should be followed to prevent such nosocomial infections.

  16. [Brodie abscess. Primarily misinterpreted as traumatic lesion].

    Nicolajsen, K; Jørgensen, P S; Tørholm, C


    Two case histories are presented. In the first, a 49 year-old man fell on his right hip. He was able to walk, but because of pain he came to our emergency room. Radiographics gave an impression of an undislocated intertrochanteric fracture, scintigraphy confirmed the suspicion. There were no signs of infection. On starting osteosynthesis with the drilling of a hole in the lateral cortex, discharge of pus was observed and curettage of the abscess cavity was performed. In the second, a 21 year-old man hit his right knee against a table. Because of pain he was admitted to hospital. Primary signs of a lesion of the lateral meniscus were found and arthroscopy was scheduled. When readmitted we found signs of an infection and X-ray revealed a Brodie's abscess in the proximal tibia. The abscess cavity was opened and curettage was performed. Radiographics, scintigraphics, blood parameters and pathological and microbiological investigations revealed primary chronic osteomyelitis in both patients. Antibiotic therapy was instituted and six weeks after primary operation bone transplantation was performed. The further course was uncomplicated.

  17. Tooth polishing: The current status.

    Sawai, Madhuri Alankar; Bhardwaj, Ashu; Jafri, Zeba; Sultan, Nishat; Daing, Anika


    Healthy teeth and gums make a person feel confident and fit. As people go about their daily routines and with different eating and drinking habits, the tooth enamel turns yellowish or gets stained. Polishing traditionally has been associated with the prophylaxis procedure in most dental practices, which patients know and expect. However, with overzealous use of polishing procedure, there is wearing of the superficial tooth structure. This would lead to more accumulation of local deposits. Also, it takes a long time for the formation of the fluoride-rich layer of the tooth again. Hence, now-a-days, polishing is not advised as a part of routine oral prophylaxis procedure but is done selectively based on the patients' need. The article here, gives an insight on the different aspects of the polishing process along with the different methods and agents used for the same.

  18. Experience in Treatment of Elderly Patients with Tooth Extraction%老年拔牙患者的治疗体会

    熊书函; 刘道华; 赖璟研


    Objective To investigate the clinical experience in treatment of elderly patients with tooth extraction. Methods A retrospective analysis of our hospital since 2010 January to 2014 June, there were 5182 cases of outpatients and inpatients in elderly patients with extraction. Results In this group, 5182 cases in 3 cases of bleeding after tooth extraction more, after thoroughly cleaning alveolar fossa, suture wound edge after cure. 121 cases of postoperative pain symptoms are obvious, the anti-inflammatory and symptomatic treatment to cure. The remaining patients with tooth extraction wound healed, no infection and other serious complications. Conclusion Ful understanding of senile systemic disease, doctors have the ability of emergency treatment, the hospital emergency treatment facilities, improve the quality of life of the elderly.%目的探讨老年拔牙患者的临床治疗体会。方法回顾性分析选择我院自2010年1月~2014年6月,共收治门诊和住院5182例老年拔牙患者。结果本组5182例中有3例拔牙术后出血较多,经再次彻底清理牙槽窝,缝合创缘后治愈。术后疼痛症状明显者121例,经抗炎对症处理后治愈。其余患者拔牙创面一期愈合,均未发生感染和其他严重并发症。结论充分了解老年全身性疾病,医生具备应急处理的能力,院方应急处理设备齐全,提高老年人的生活质量。

  19. 微创拔牙在糖尿病患者中的应用%Minimally Invasive Tooth Extraction in Diabetic Patients

    徐其章; 王晓宇; 吴鹏飞


    目的:探讨和总结微创拔牙技术在糖尿病患者中的临床应用效果。方法:2009-06-2013-06期间,采用微创拔牙技术拔除糖尿病人患牙95颗,记录术前、术中及术后1、7、14 d复诊时,患者症状及拔牙创情况。结果:术后感染2例,感染率2.35%;术中低血糖1例(1.25%);术后疼痛5例(5.88%);术后肿胀3例(3.53%)。结论:微创拔牙技术疗效可靠、操作简便,在糖尿病患者中是目前值得推广的较好拔牙方法。%Objective: To review and summarize the clinical understanding of minimally invasive tooth extraction in diabetic patients. Method: 95 teeth from 2009-06-2013-06 with the minimally invasive tooth extraction in diabetic were reviewed. Signs, symptoms, and complaints were recorded in preoperation, during operation, and 1, 7, and 14 days after operation. Results:2 patients complicated with infection. 1 case demonstrated hypoglycemia during extraction, and 3 cases experienced restriction of mouth opening. 5 cases appeared postoperative pain. Conclusion: The minimally invasive tooth extraction in diabetic patients is a reliable treatment.

  20. Endoscopic transcystic stent placement for an intrahepatic abscess due to gallbladder perforation

    Myung Soo Kang; Do Hyun Park; Ki Du Kwon; Jeong Hoon Park; Suck-Ho Lee; Hong-Soo Kim; Sang-Heum Park; Sun-Joo Kim


    Perforation of the gallbladder with cholecystohepatic communication is a rare cause of liver abscess. Because it is a rare entity, the treatment modality has not been fully established. We report for the first time a patient with an intrahepatic abscess due to gallbladder perforation successfully treated by endoscopic stent placement into the gallbladder who had a poor response to continuous percutaneous drainage.

  1. Prolonged antibiotic treatment does not prevent intra-abdominal abscesses in perforated appendicitis.

    Wijck, K. van; Jong, J.R. de; Heurn, L.W.E. van; Zee, D.C. van der


    BACKGROUND: Children with perforated appendicitis have a relatively high risk of intra-abdominal abscesses. There is no evidence that prolonged antibiotic treatment after surgery reduces intra-abdominal abscess formation. We compared two patient groups with perforated appendicitis with different pos

  2. The "Penumbra Sign" on Magnetic Resonance Images of Brodie's Abscess: A Case Report.

    Afshar, Ahmadreza; Mohammadi, Afshin


    This report presents the "penumbra sign" of a Brodie's abscess in a 69-year-old male patient. The lesion was located in the proximal metaphysis of the left tibia. Histopathology confirmed the diagnosis of subacute osteomyelitis. The penumbra sign on magnetic resonance (MR) images is a helpful sign for the diagnosis of Brodie's abscess.

  3. Novel Peritonsillar Abscess Task Simulator.

    Taylor, Steven R; Chang, C W David


    The management of peritonsillar abscesses is a skill developed early in residency training. Although drainage is not technically complicated, the procedure is intimidating to the neophyte. Task simulators have become increasingly common to provide training opportunities in a controlled environment. The authors designed a peritonsillar abscess simulator using a latex moulage of the oral cavity and other common materials. Twelve medical professionals of various levels of experience were instructed to expose, anesthetize, aspirate, and drain the simulated abscess. After completion, a questionnaire was completed by each volunteer. Initial impressions were positive that the model adequately replicated the tasks requisite for abscess drainage and was suitable as an instructional device. The initial construct cost was approximately 10 dollars, with disposables costing roughly 25 cents. Further research is under way to formally assess the simulator for face, content, and construct validity.

  4. Enterococcal cerebellopontine angle abscess in a 12-year-old female

    Sonavane Alka


    Full Text Available Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally. Various aerobic and anaerobic bacteria have been reported as causative agents of brain abscess but only a few cases of enterococcal brain abscesses have been reported. Here we report a case of brain abscess in a 12-year-old female patient, who presented with a history of fever, chills, headache, convulsions since seven days and history of altered sensorium and aphasia since the last two days . The patient had chronic suppurative otitis media of both ears following trauma and presented with ear discharge. The diagnosis of brain abscess was done by computerized tomography scan and the pus was aspirated by left suboccipital burr hole operation. Enterococcus species was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotic treatment.

  5. Retroperitoneal abscess: an extra-abdominal manifestation

    Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias


    Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur ...

  6. The specific gallium-67 scan uptake pattern in psoas abscesses

    Kao, P.-F.; Tzen, K.-Y.; Tsai, M.-F.; Yen, T.-C. [Dept. of Nuclear Medicine, Univ. School of Medicine, Tauyuan (Taiwan, Province of China); Tsui, K.-H. [Dept. of Urology, Chang Gung Memorial Hospital, Tauyuan (Taiwan, Province of China)


    A psoas abscess is a rare clinical entity that presents diagnostic and therapeutic challenges. In this retrospective study, we reviewed gallium-67 scan findings in cases of psoas abscess to determine the specific uptake pattern and the usefulness of {sup 67}Ga scans in diagnosis and management. Fifteen psoas abscess lesions in 13 patients who had undergone a {sup 67}Ga scan during an 8-year period were found in the hospital computer. All but two of the patients had been diagnosed as having fever of unknown origin, urinary tract infection or another irrelevant disease prior to the {sup 67}Ga scan. Of the 15 psoas abscess lesions, 12 (80%) could be clearly diagnosed on the basis of the specific {sup 67} Ga uptake pattern, in which: (1) the oblique direction of the {sup 67}Ga-avid lesion correlates with the orientation of the psoas muscle from the lumbar region to the hip joint region; (2) the lesion does not cross the abdominal midline; (3) the lesion goes through the inguinal region; and (4) the lesion involves at least two-thirds of the whole length of the psoas muscle. The specific features may help in the differentiation of psoas abscess from other intra-abdominal lesions or normal bowel distribution, especially with single-photon emission tomographic images. In 7 of 13 patients (53.8%) the {sup 67}Ga scan findings contributed to the clinical management of the patients by first detecting the focus of the infection. Multiple concomitant {sup 67}Ga-avid lesions were found in ten patients. In conclusion, the specific features as well as the whole-body survey with {sup 67}Ga scan are useful and important in the diagnosis of psoas abscesses and the detection of unexpected concomitant multiple infectious foci in clinically suspicious infectious disease patients. (orig.) With 4 figs., 2 tabs., 29 refs.

  7. Brodie's abscess: a case report.

    Alter, S A; Sprinkle, R W


    The authors present a case report with a 1-year follow-up period, demonstrating the successful diagnosis and surgical treatment of a focal lesion of the distal metaphysis of the right tibia in an 11-year-old female. The author discusses the pathology of hematologic osteomyelitis and its role in the development of a subacute abscess. A review of the literature and a detailed description of the pathogenesis of Brodie's abscess is submitted as well.

  8. Clinical usefulness of c-arm cone-beam CT inpercutaneous drainage of inaccessible abscess

    So, Young Ho; Choi, Young Ho; Woo, Hyun Sik; Moon, Min Hoan; Sung, Chang Kyu [Dept. of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Hur, Bo Yun [Dept. of Radiology, National Cancer Center, Goyang (Korea, Republic of)


    The objective of this study was to evaluate the usefulness of C-arm cone-beam CT (CBCT) in drainage of inaccessible abscesses. To identify the trajectory of the needle or guide wire, CBCT was performed on 21 patients having an inaccessible abscess. CBCT was repeated until proper targeting of the abscess was achieved, before the insertion of a large bore catheter. The etiology, location of the abscess, causes of inaccessibility, radiation dose, technical and clinical success rates of drainage, and any complications confronted, were evaluated. A total of 29 CBCTs were performed for 21 abscesses. Postoperative and non-postoperative abscesses were 9 (42.9%) and 12 (57.1%) in number, respectively. Direct puncture was performed in 18 cases. In 3 cases, the surgical drain or the fistula opening was used as an access route. The causes of inaccessibility were narrow safe window due to adjacent or overlying organs (n = 9), irregularly dispersed abscess (n = 7), deep location with poor sonographic visualization (n = 4), and remote location of the abscess from surgical drain (n = 1). Technical and clinical successes were 95.5% and 100%, respectively. Cumulative air kerma and dose-area product were 21.62 ± 5.41 mGy and 9179.87 ± 2337.70 mGycm2, respectively. There were no procedure related complications. CBCT is a useful technique for identifying the needle and guide wire during drainage of inaccessible abscess.

  9. Degenerative alterations of the cementum-periodontal ligament complex and early tooth loss in a young patient with periodontal disease.

    Petruţiu, S A; Buiga, Petronela; Roman, Alexandra; Danciu, Theodora; Mihu, Carmen Mihaela; Mihu, D


    Premature exfoliation of primary or permanent teeth in children or adolescents is extremely rare and it can be a manifestation of an underlying systemic disease. This study aims to present the histological aspects associated with early tooth loss in a case of periodontal disease developed without local inflammation and with minimal periodontal pockets and attachment loss. The maxillary left second premolar was extracted together with a gingival collar attached to the root surface. The histological analysis recorded the resorption of the cementum in multiple areas of the entire root surface with the connective tissue of the desmodontium invading the lacunae defects. The connective tissue rich in cells occupied the periodontal ligamentar space and the resorptive areas. No inflammation was obvious in the periodontal ligament connective tissue. This report may warn clinicians about the possibility of the association of cemental abnormalities with early tooth loss.

  10. Pathogenesis of Staphylococcus aureus abscesses.

    Kobayashi, Scott D; Malachowa, Natalia; DeLeo, Frank R


    Staphylococcus aureus causes many types of human infections and syndromes-most notably skin and soft tissue infections. Abscesses are a frequent manifestation of S. aureus skin and soft tissue infections and are formed, in part, to contain the nidus of infection. Polymorphonuclear leukocytes (neutrophils) are the primary cellular host defense against S. aureus infections and a major component of S. aureus abscesses. These host cells contain and produce many antimicrobial agents that are effective at killing bacteria, but can also cause non-specific damage to host tissues and contribute to the formation of abscesses. By comparison, S. aureus produces several molecules that also contribute to the formation of abscesses. Such molecules include those that recruit neutrophils, cause host cell lysis, and are involved in the formation of the fibrin capsule surrounding the abscess. Herein, we review our current knowledge of the mechanisms and processes underlying the formation of S. aureus abscesses, including the involvement of polymorphonuclear leukocytes, and provide a brief overview of therapeutic approaches.

  11. Ewing′s sarcoma in mandibular similar to dental abscess

    Forouz Keshani


    This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing′s sarcoma diagnosis.

  12. Lower extremity muscles activity in standing and sitting position with use of sEMG in patients suffering from Charcot-Marie-Tooth syndrome.

    Kuciel, Natalia Maria; Konieczny, Grzegorz Krzysztof; Oleksy, Łukasz; Wrzosek, Zdzisława


    There is very limited, evidenced data about movement possibilities in patients with high level of lower limb muscles atrophy and fatigue in patients suffering from Charcot-Marie-Tooth syndrome. Patient (age 46) suffering from Charcot-Marie-Tooth disease for 30 years with multiple movement restrictions and muscles atrophy above knees took part into the study. Tests were performed for 8 muscles of the lower limb and pelvis. Muscles electrical activity was tested in sitting and standing position (for knees extended and hyperextended). In the right leg rectus femoris, vastus lateralis obliquus, gluteus medius and semitendinosus muscles activated at first and were working the longest time. The highest activity was observed in standing position with knees extended. In the left leg rectus femoris and biceps femoris muscles activated at first and biceps femoris was working the longest time. Activity level in left lower limb is much lower than in the right one. Muscles weakness is asymmetric. Left leg is much weaker and engages antagonists and synergists muscles to compensate weaker rectus femoris, vastus medialis obliquus and vastus lateralis obliquus.

  13. Isolated subacute tuberculous spinal epidural abscess of the cervical spine: a brief report of a special case.

    Alg, Varinder S; Demetriades, Andreas K; Naik, Sunil; Gunasekera, Lal


    A tuberculous spinal epidural abscess is seen rarely as a late complication of Pott's disease or in immunocompromised patients. Such abscesses in isolation are rare indeed and very uncommon in the developed and developing world. We report a patient with an isolated subacute tuberculous spinal epidural abscess without disc or vertebral involvement and no primary focus or risk factors associated with the development of spinal tuberculosis.

  14. How the anal gland orifice could be found in anal abscess operations

    Shahram Paydar


    Full Text Available Background: On an average 30-50% of patients who undergo incision and drainage (I and D of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal abscess and fitula-in-ano at the same time. Materials and Methods: In this cross-sectional descriptive study 49 from 77 patients with anal abscess whose internal orifice was not identified by pressing on the abscess, diluted hydrogen peroxide (2% and methylene blue was injected into the abscess cavity and the anal canal was inspected to find out the internal opening. Once the opening was distinguished, an incision was given from the anal verge to the internal opening. Results: The internal orifice was identified in 44 out of 49 patients (90% who underwent this new technique. Up to 18 months during follow-up, only 2.5% of patients with primary fistulotomy developed fistula on the site of a previous abscess. Conclusion: Conventional method to seek the internal orifice of anal abscesses is successful in about one-third of cases. By applying this new technique, surgeons would properly find the internal opening in >90% of patients. Needless to say, safe identification of the anal gland orifice in anal abscess disease best helps surgeons to do primary fistulotomy and in turn it would significantly decrease the rate of recurrence in anal abscess and fistula formation.




    Full Text Available A prospective and retrospective study was conducted in Hamidia hospital and Gandhi medical college Bhopal from year June 2010 to May 2014. Study included patients having intracranial abscesses. The objective was to know the incidence and prevalen ce, clinical features and management as well as outcome. Radiological and microbiological investigations were done. Procedures performed were lumbar puncture and intracranial abscess drainage by aspiration or craniotomy in few patients. There were total 33 patients in five years out of which 17 patients were operated and 16 were treated conservatively. Most common complication was residual abscess, meningitis and persistent hemiplegic.

  16. Pyogenic versus amoebic liver abscesses: A comparative clinical study in a series of 58 patients Absceso hepático piógeno versus amebiano: Estudio clínico comparativo de una serie de 58 casos

    A. Cosme


    Full Text Available Objective: to compare the clinical and epidemiological characteristics of patients with pyogenic liver abscess (PLA and with amebic liver abscess (AHA in order to determine the potential factors that may help improve diagnosis and treatment for this disease. Material and method: a retrospective study of clinical histories of 45 patients with PLA and 13 with ALA, diagnosed between 1985 and 2005 in Donostia Hospital in San Sebastián. Results: among the 45 patients with PLA (30 men and 15 women, with a mean age of 61 years and 11 months, more than a half were cholangitic (13 cases or were of unknown origin (15 cases. In 10 patients, diabetes was considered to be a predisposing condition. Increased ESR (> 30, leukocytosis (> 12,000, fever and abdominal pain were observed in 95.5%, 86.7%, 82.8% and 68.9%, respectively. Twenty-five patients had single abscesses. Abscess and blood cultures were positive in 77.1% and 50% of cases, respectively (44.4% with polymicrobial infection. E. coli and S. milleri were the most commonly found germs. A percutaneous drainage was performed on 22 patients. Mean hospital stay was 27 days, and overall mortality, including that related to concomitant conditions, was 7 of 45 cases. Of the 13 cases of ALA (7 men and 6 women, with mean age of 42,9 years, 2 were locally acquired. Increased AF and GGTP (> 2N, fever, leukocytosis and ESR (> 30 were observed in 92.3, 77, 70 and 61.5% of cases, respectively. There were single abscesses in 10 patients and all except one were located in the right lobe. The serological test for E. histolytica (IFF ≥ 1/256 was positive in 100% of cases. A percutaneous drainage was carried out on 6 patients. Mean hospital stay was 18 days and two patients died. Conclusions: In our series, the clinical parameters suggesting pyogenic origin were: age 50 or older, male gender, diabetes, moderately elevated bilirubin and transaminases. In amoebic cases the associated features were being aged 45 or

  17. Effect of treatment of perianal abscess in patients with severe aplastic anemia%重型再生障碍性贫血患者肛周脓肿治疗效果分析

    杨舟; 杨琳; 肖朝晖; 刘文华; 郝敬全; 赵复锦; 江劲波; 王跃


    OBJECTIVE To enhance the clinicians'cognition of severe aplastic anemia complicated with perianal ab-scess so as to raise the cure rate .METHODS A retrospective survey was conducted for 1 case of severe aplastic ane-mia complicated with perianal abscess ,including the clinical data ,clinical manifestations ,B-ultrasound ,results of etiological culture ,and treatment process ,with the review of literature accompanied .RESULTS The Escherichia coli strains were cultured from this patient after the admission ,the symptom was improved and the scope of peri-anal abscess was reduced after the treatment with cefoperazone-tazobactam and etimicin ,the patient was automati-cally discharged after the treatment for 7 days and was readmitted due to the perianal pain ,the previous anti-infec-tion treatment was ineffective ,the perianal bacterial culture was carried out for the second time ,the Citrobacter freundii and Enterococcus faecium were isolated ,meropenem and teicoplanin were used for anti-infection treatment based on the results of the drug susceptibility testing ,accompanied by the hip bath of TCM ,elevation of white blood cells ,and blood transfusion ,and the perianal abscess was completely cured after the treatment for two weeks .CONCLUSION The reasonable use of antibiotics accompanied by the hip bath of TCM and active supportive treatment can raise the cure rate of the perianal abscess in the patient with severe aplastic anemia .%目的 加强临床医师对重型再生障碍性贫血合并肛周脓肿的认识 ,提高治愈率.方法 回顾性分析1例重型再生障碍性贫血合并肛周脓肿患者的临床资料、临床表现、B超、病原学培养结果及治疗经过 ,并结合文献复习.结果 该例患者入院后肛周细菌培养为大肠埃希菌 ,给予头孢哌酮/他唑巴坦和依替米星抗感染 ,患者症状好转、肛周脓肿范围缩小 ,治疗7d后自动出院 ;两周后患者因肛周疼痛再次入院 ,应用

  18. MSCT and MRI Findings of Transient Hepatic Perfusion Disorders in Patients with Hepatic Abscess%肝脓肿邻近肝实质一过性灌注异常的CT和MRI表现

    沈文东; 李惠民


    目的:探讨肝脓肿伴发的一过性肝灌注异常(THPD)的影像表现及其主要机制.方法:回顾性分析CT上明确显示THPD的19例肝脓肿患者的CT和MRI资料,男9例,女10例,年龄35~82岁,平均62.8±13.8岁.全部完成16层CT与MRI的平扫和增强.结果:CT增强显示16例高灌注THPD,3例低灌注THPD,MRI增强T1WI显示14例高灌注THPD,4例低灌注THPD,1例未见灌注异常.常规T2WI显示灌注异常区高信号16例(84.2%).CT和MRI灌注表现一致15例(78.9%),不一致4例,其低或等灌注的检查均先于高灌注的检查.结论:脓肿伴发的一过性肝灌注异常的CT和MRI表现一致,较早期可以表现为低灌注,后期均为高灌注.MR T2WI可以很好显示THPD,有助于诊断.%Purpose: To evaluate the CT and MRI findings of transient hepatic perfusion disorders (THPD) in patients with hepatic abscess and explore their main mechanism. Methods: Nineteen hepatic abscess patients (9 male, 10 female, age ranging from 35 to 82, mean 62.8± 13.8 years) with THPD diagnosed on CT images were enrolled in our study. All patients were undergone non-contrasted and contrasted scanning with a 16-slice CT scanner and 1.5T MRI scanner. Results: Hyper-perfusion THPD in 16 patients and hypo-perfusion THPD in 3 patients were shown on CT scans. Hyper-perfusion THPD in 14 patients and hypo-perfusion THPD in 4 patients were shown on MRI scans. The THPD region was hyper-intensity in 16 patients(84.2%). Fifteen THPD shown on MRI were consistent with that on CT (78.9%). The other 4 THPD lesions were first shown with hypo- or iso-perfusion and lastly shown with hyper-perfusion. Conclusion: The THPD in patients with hepatic abscess have the same perfusion findings on CT and MRI. There may be hypo-perfusion during early phase and hyper-perfusion during late phase of hepatic abscess. T2-weighed imaging could reveal the THPD correctly and may be helpful for the diagnosis.

  19. Bacillus cereus bacteremia and multiple brain abscesses during acute lymphoblastic leukemia induction therapy.

    Hansford, Jordan R; Phillips, Marianne; Cole, Catherine; Francis, Joshua; Blyth, Christopher C; Gottardo, Nicholas G


    Bacillus cereus can cause serious infections in immunosuppressed patients. This population may be susceptible to B. cereus pneumonia, bacteremia, cellulitis, and rarely cerebral abscess. Here we report an 8-year-old boy undergoing induction therapy for acute lymphoblastic leukemia who developed multifocal B. cereus cerebral abscesses, highlighting the propensity for B. cereus to develop cerebral abscesses. A review of the literature over the past 25 years identified another 11 cases (3 children and 8 adults) of B. cereus cerebral abscess in patients undergoing cancer therapy. B. cereus cerebral abscesses were associated with a high mortality rate (42%) and significant morbidity. Notably, B. cereus bacteremia with concomitant cerebral abscess was associated with induction chemotherapy for acute leukemia in both children and adults (10 of 12 case reports). Our case report and review of the literature highlights the propensity for B. cereus to develop cerebral abscess(es). Therefore, early consideration for neuroimaging should be given for any neutropenic cancer patient identified with B. cereus bacteremia, in particular those with acute leukemia during induction therapy.

  20. Primary culprit for tooth loss!!

    Sailavanya Nuvvula


    Full Text Available Aim: In order to facilitate planning for dental health services and to progress strategies to continue the reduction in tooth loss, it is important to identify the factors that result in such loss. therefore the aim of the study is to investigate the major cause for tooth extraction. Objective: to examine whether the major reason for tooth extraction is dental caries or periodontal disease. Materials and Methods: The study is carried out among the dental practitioners in our district. A questionnaire containing 10 items was distributed to the dental practitioners, which included age, gender, no of teeth indicated for extraction, the reason for extraction, and the periodontal parameters that are involved with the extracted tooth and were requested to complete the form on every extraction they were to undertake. the study form was collected at the end of the study period and data was subjected to statistical analysis. Results: A total of 502 patients were enrolled during the study period, and a total of 1055 teeth were extracted for several reasons. we found that 51.14%extractions are due to dental caries in case of 20-30years age groups, which is more when compared to tooth loss due to periodontal diseases in this age group. whereas in case of >40years of age group periodontal diseases account for 54.11%, and dental caries accounts for only 29.11%. Showing more teeth were lost due to periodontal disease. Conclusion: therefore we concluded that, caries is the dominant reason for extraction in patients with 20–30 years of age while periodontal disease accounts for the majority of tooth extraction in patients older than 40 years.

  1. Renal abscess after the Fontan procedure: a case report

    Kumar Suresh


    Full Text Available Abstract Introduction The Fontan procedure is an intervention that helps to correct single ventricle physiology. There are many known long-term complications of 'Fontan physiology'. However, the occurrence of renal abscess in such patients has not yet been reported in the literature. The first generation of adults has now undergone the procedure and it is necessary to be aware of the long-term outcomes and complications associated with it. Case presentation We report the case of a 22-year-old South Indian man who had developed a staphylococcal renal abscess against a background of xanthogranulomatous pyelonephritis, nine years after Fontan surgery. He presented to our hospital with a high-grade fever of 25-days duration but with no other symptoms. Physical examination identified costovertebral angle tenderness and pedal edema. An ultrasound scan revealed a mass in his left kidney. The results of a computed tomography scan were consistent with a renal abscess. Despite treatment with the appropriate parenteral antibiotics, there was no change in the size of the abscess and a left nephrectomy was performed as a curative procedure. Conclusions The learning points here are manifold. It is important to be aware of the possibility of renal abscess in a post-procedural patient. The early diagnosis of a septic focus in the kidneymay help to prevent the rare outcome of nephrectomy.

  2. Late evolution retropharyngeal abscess after ingestion of foreign body

    Imamura, Rui


    Full Text Available Introduction: The complications relating to the ingestion of foreign bodies, such as retropharyngeal abscess, are of low prevalence, but potentially severe. Objective: To present one case of late evolution retropharyngeal abscess after ingestion of foreign body. Case Report: Female patient presenting with dysphagia, pain upon cervical motion and sensation of foreign body in the pharynx, about one month after removal of foreign body from the level of the cricopharyngeal muscle. In spite of not having fever or leukocytosis, due to the slight difficulty for cervical move and loss of the laryngeal crepitation, simple radiography and computed tomography were carried out in the neck, which showed signs of retropharyngeal abscess. Surgical draining of the abscess and antibiotic therapy led to good evolution of the case and symptoms reversion. Conclusion: The retropharyngeal abscess may occur during several weeks after ingestion of a foreign body. The absence of fever and leukocytosis does not exclude the diagnosis even in immunocompetent patients. A high degree of suspicion leads to the performance of diagnostic exams and suitable procedures.

  3. Biologically Based Restorative Management of Tooth Wear

    Martin G. D. Kelleher


    Full Text Available The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as “The Daughter Test”, this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.


    Poorva Chandrashekhar


    Full Text Available In spite of a significant decrease in cases of chronic otitis media following the advent of antibiotics, complications of otitis media still represent a challenging situation owing to their high mortality rate. Factors that can cause complications include the level of virulence of the infectious organism, poor resistance of the patient, the presence of chronic systemic diseases and resistance of the infecting organism to antibiotics. The contemporary risk for developing extracranial complications of otitis media is approximately twice that of developing intracranial complications. Inflammation and infection may result in necrosis of the mastoid tip, allowing the pus to track from the medial side of the mastoid process through the incisura digastrica (digastric groove. The pus is prevented from reaching the body surface by the neck musculature, but can track along the fascial planes of the digastric muscle, sternomastoid or trapezius muscles. Pneumatisation of the mastoid process leads to thinning of the bone and is considered an important factor in the development of a trapezius or Bezold’s abscess.

  5. Fabricating a tooth- and implant-supported maxillary obturator for a patient after maxillectomy with computer-guided surgery and CAD/CAM technology: A clinical report.

    Noh, Kwantae; Pae, Ahran; Lee, Jung-Woo; Kwon, Yong-Dae


    An obturator prosthesis with insufficient retention and support may be improved with implant placement. However, implant surgery in patients after maxillary tumor resection can be complicated because of limited visibility and anatomic complexity. Therefore, computer-guided surgery can be advantageous even for experienced surgeons. In this clinical report, the use of computer-guided surgery is described for implant placement using a bone-supported surgical template for a patient with maxillary defects. The prosthetic procedure was facilitated and simplified by using computer-aided design/computer-aided manufacture (CAD/CAM) technology. Oral function and phonetics were restored using a tooth- and implant-supported obturator prosthesis. No clinical symptoms and no radiographic signs of significant bone loss around the implants were found at a 3-year follow-up. The treatment approach presented here can be a viable option for patients with insufficient remaining zygomatic bone after a hemimaxillectomy.

  6. Facing the Danger Zone: The Use of Ultrasound to Distinguish Cellulitis from Abscess in Facial Infections

    Dywanda L. Lewis


    Full Text Available Physical exam alone is often insufficient to determine whether or not cellulitis is accompanied by an abscess. Bedside ultrasound can be a valuable tool in ruling out suspected abscess by allowing direct visualization of a fluid collection. The proximity of the infection to adjacent structures can also be determined, thus aiding clinical decision making. Patients with cellulitis near the eye and nose are of particular concern due to the adjacent facial structures and the anatomy of the venous drainage. Accurately determining the presence or absence of an associated abscess in these patients is a crucial step in treatment planning. The purpose of this report is to (1 emphasize the benefits of bedside ultrasound when used in conjunction with the physical exam to rule out abscess; (2 demonstrate the utility of bedside ultrasound in planning a treatment strategy for soft tissue infection; (3 depict an instance where ultrasound detected an abscess when computed tomography (CT scan did not.

  7. Spinal epidural abscess – a rare complication of inflammatory bowel disease

    Brown, Carl J.; Hussein Jaffer; Nasir Jaffer; Claude Burul; McLeod, Robin S.


    Spinal epidural abscess is an uncommon but highly morbid illness. While it usually afflicts older, immunocompromised patients, this condition has been reported as a result of intestinal perforation in the setting of inflammatory bowel disease. Two cases of spinal epidural abscess in patients with inflammatory bowel disease are reported: one in a patient with Crohn’s disease and one in a patient with ulcerative colitis after restorative proctocolectomy.

  8. Spinal Epidural Abscess – A Rare Complication of Inflammatory Bowel Disease

    Carl J Brown


    Full Text Available Spinal epidural abscess is an uncommon but highly morbid illness. While it usually afflicts older, immunocompromised patients, this condition has been reported as a result of intestinal perforation in the setting of inflammatory bowel disease. Two cases of spinal epidural abscess in patients with inflammatory bowel disease are reported: one in a patient with Crohn’s disease and one in a patient with ulcerative colitis after restorative proctocolectomy.

  9. Crypt abscess-associated microbiota in inflammatory bowel disease and acute self-limited colitis

    Harry; Sokol; Nadia; Vasquez; Nadia; Hoyeau-Idrissi; Philippe; Seksik; Laurent; Beaugerie; Anne; Lavergne-Slove; Philippe; Pochart; Philippe; Marteau


    AIM:To evaluate whether crypt abscesses frominflammatory bowel disease(IBD)patients containbacteria and to establish their nature.METHODS:We studied 17 ulcerative colitis patients,11 Crohn's disease patients,7 patients with acute selflimited colitis(ASLC)and normal colonic biopsies from5 subjects who underwent colonoscopy for colon cancer screening.A fluorescent in situ hybridization techniquewas applied to colonic biopsies to assess the microbiotacomposition of the crypts and crypt abscesses.RESULTS:Crypts...

  10. Prostatic abscess: Diagnosis and management in the modern antibiotic era

    Punit Tiwari


    Full Text Available This retrospective study was aimed at analyzing the clinical findings and thera-peutic strategies in 24 patients who were admitted with prostatic abscess, during the period from 1999 to 2008. The diagnosis of prostatic abscesses was made clinically by digital rectal palpation based on the presence of positive fluctuation with tenderness. All cases were confirmed by trans-rectal ultrasound (TRUS, and only positive cases were included in this study. The diagnostic work-up included analysis of midstream urine and abscess fluid culture for pathogens. Therapeutic options included endoscopic trans-urethral incision or trans-perineal aspiration under ultrasound guidance, or conservative therapy. Of the 24 patients studied, 45.83% of the cases had a pre-di-posing factor, and diabetes mellitus (37.50% was the most common. Digital rectal palpation re-vealed fluctuation in 70.83% of the cases. Trans-abdominal ultrasonography missed the condition in 29.16% of the cases. On TRUS, all the study patients showed hypo-echoic zones, while nine others showed internal septations. In most of the cases, the lesion was peripheral. A causative pathogen could be identified in 70.83% of the cases. Surgical drainage of the abscess by trans-urethral deroofing was performed in 17 cases (including one with failed aspiration, trans-perineal aspiration under TRUS guidance was performed in three cases and conservative therapy was followed in five cases. Our data confirms the importance of predisposing factors in the patho-genesis of prostatic abscess. In most of the cases, the clue to diagnosis is obtained by digital rectal palpation. TRUS gives the definite diagnosis and also helps in follow-up of patients. Trans-urethral deroofing is the ideal therapy where the abscess cavity is more than 1 cm, although in some selected cases, TRUS-guided aspiration or conservative therapy does have a role in treatment.

  11. Tooth polishing: The current status

    Madhuri Alankar Sawai


    Full Text Available Healthy teeth and gums make a person feel confident and fit. As people go about their daily routines and with different eating and drinking habits, the tooth enamel turns yellowish or gets stained. Polishing traditionally has been associated with the prophylaxis procedure in most dental practices, which patients know and expect. However, with overzealous use of polishing procedure, there is wearing of the superficial tooth structure. This would lead to more accumulation of local deposits. Also, it takes a long time for the formation of the fluoride-rich layer of the tooth again. Hence, now-a-days, polishing is not advised as a part of routine oral prophylaxis procedure but is done selectively based on the patients′ need. The article here, gives an insight on the different aspects of the polishing process along with the different methods and agents used for the same.

  12. Congenitally Missing Maxillary Lateral Incisors: Functional and Periodontal Aspects in Patients Treated with Implants or Space Closure and Tooth Re-Contouring

    Marchi, Luciana Manzotti De; Pini, Núbia Inocencya Pavesi; Hayacibara, Roberto Massayuki; Silva, Rafael Santos; Pascotto, Renata Corrêa


    To evaluate functional and periodontal aspects in patients with unilateral or bilateral congenitally missing maxillary lateral incisors, treated with either implants or space closure and tooth re-contouring. The sample consisted of 68 volunteers, divided into 3 groups: SCR - space closure and tooth re-contouring with composite resin (n = 26); SOI – implants placed in the area of agenesis (n = 20); and CG - control group (n = 22). A modified Helkimo questionnaire and the Research Diagnostic Criteria for Temporomandibular Disorders were used by a single, previously calibrated evaluator to assess signs and symptoms of temporomandibular joint disorder. The periodontal assessment involved the following aspects: plaque index, bleeding upon probing, pocket depth greater than 3 mm, gingival recession, abfraction, periodontal biotype and papilla index. The data were analyzed using Fisher's exact test and the nonparametric Mann-Whitney and Kruskal-Wallis tests (α=.05). No differences in periodontal status were found between treatments. None of the groups were associated with signs and symptoms of temporomandibular joint disorder. Both treatment alternatives for patients with congenitally missing maxillary lateral incisors were satisfactory and achieved functional and periodontal results similar to those of the control group. PMID:23346262

  13. Analysis of Inlay Restoration of Patients with Tooth Defect%对牙体缺损患者的嵌体修复分析



    目的:探讨嵌体的修复步骤。方法对36例牙体缺损患者应用嵌体修复各种原因所造成的牙体缺损。结果应用嵌体修复恢复牙体咬合及形态,金箔嵌体稳固,无松动,患者口感舒适,功能良好。经1~2年定期复查,其中3例嵌体完好牙脱落,经重新粘固后效果满意。结论通过嵌体修复恢复牙体缺损的形态、功能的修复体。%Objective Restoration steps of inlay are to be investigated. Methods Inlay restoration was applied into 36 cases of patients with tooth defect caused by various reasons. Results Inlay restoration was applied to restore the dental occlusion and its form with stable and non-loose golden inlay.It’s comfortable for the patients with excellent performance.After 1 to 2 years’ fol ow-up,there are 3 cases with intact inlay but teeth fal ing off,which have a satisfactory effect after re-cementation. Conclusion The inlay restoration was applied to restore the form and function of the tooth defeat.

  14. Tooth sensitivity and whitening.

    Swift, Edward J


    This article presents a review of the basic concepts of tooth sensitivity and how those concepts apply to cervical dentin hypersensitivity and the sensitivity frequently associated with tooth whitening. The etiology and treatment of cervical dentin hypersensitivity are described. The clinical presentation, incidence, and predisposing factors for sensitivity associated with tooth whitening also are discussed.

  15. [Drainage of the Frontal Sinus to Cure Epidural and Brain Abscesses Developed after Surgery via Anterior Interhemispheric Approach].

    Bando, Kazuhiko; Ebisutani, Daizo


    We report a woman whose anterior communicating artery (AcomA) aneurysm was clipped via an anterior interhemispheric approach when she was 49 years old. At the age of 51, she presented with a subcutaneous abscess and osteomyelitis, so the cranioplastic bone was removed. Six months later, she underwent cranioplasty using hydroxyapatite. Her subcutaneous abscess recurred and the epidural abscess and hydroxyapatite were removed 11 years later after the first operation. The patient underwent observation therapy for the next 4 years, as the dura was ossified. She presented with frontal swelling 15 years after aneurysmal clipping, and neither abscess puncture nor the administration of antibacterial drugs was curative. The patient also complained of chill, thirst, and tremor, and developed disorientation 25 days later. Computed tomography (CT) and magnetic resonance imaging (MRI) showed extension of the epidural and subcutaneous abscesses to a frontal brain abscess. After consulting an otolaryngologist, we performed frontal drainage into the nasal cavity. After making a bicoronal skin incision, the subcutaneous, epidural, and intracapsular brain abscesses were removed while taking care not to damage the capsules. A silicone T-tube was placed in the bifrontal epidural cavity (previous frontal sinus), and its tip was inserted into the nasal cavity through the nasofrontal duct for abscess drainage. After 3 months, the tube was removed. A CT scan acquired 10 years later showed no brain abscess, perifocal edema, or epidural and subcutaneous abscesses.

  16. The usefulness of CT guided drainage of abscesses caused by retained appendicoliths

    Buckley, O. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Geoghegan, T. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Ridgeway, P. [Department of Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colhoun, E. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Snow, A. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail:


    Objectives: To determine the utility of percutaneous computed tomography (CT) guided drainage of abscesses formed secondary to retained appendicoliths. Materials and methods: A retrospective review was conducted over a 5-year period to identify patients who underwent CT guided drainage of abscesses related to retained appendicoliths. Inclusion criteria were a history of prior proven appendicitis treated by laparoscopic appendicectomy, identification of a post-operative abscess related to a visualised retained appendicolith and initial treatment by CT guided drainage. Data regarding initial technical success as well as long-term outcome was recorded in each case. Results: In total, five patients were identified who underwent CT guided abscess drainage related to retained appendicoliths. There were three males and two females (age range 12-54 years). Initial drainage under CT guidance was technically successful in all cases with successful catheter placement and resolution of the abscess cavity. In all five cases however, there was recurrence of abscess formation following catheter removal. In one case, a second attempt with CT guided drainage was performed. Again this was initially successful with abscess recurrence following catheter removal. In all five cases, formal surgical drainage with removal of retained appendicolith resulted in a successful outcome. Conclusion: CT guided percutaneous drainage of intra abdominal abscess secondary to retained appendicoliths is only successful in the short term. Formal surgical drainage and removal of the appendicolith is required for long-term success.

  17. [Retrospective evaluation of 15 cases with psoas abscesses].

    Turunç, Tahsin; Turunç, Tuba; Demiroğlu, Y Ziya; Colakoğlu, Sule


    Psoas abscesses are suppurative collections within the fascia surrounding the psoas and iliacus muscles. In this retrospective study it was aimed to evaluate the demographic characteristics, clinical and laboratory findings and treatment outcomes of 15 psoas abscess cases admitted to Baskent University Hospital, Ankara, Turkey during June 2003-January 2008 period. The mean age of the patients was 55.8 years (range 18 to 70 years) with a female to male ratio of 5/10. Thirteen of the cases (86.5%) were admitted with the complaints of fever and back pain. Thirteen of the cases were diagnosed by abdominal computerized tomography while the other two by abdominal ultrasonography. One of the 15 patients was considered as primary psoas abscess, while the remaining 14 as secondary psoas abscess. The most common accompanying disease was diabetes mellitus (66.6%). Fourteen patients with secondary psoas abscess had vertebral osteomyelitis which was due to tuberculosis in five cases, to urinary tract infection in five cases, to pneumoniae in two cases, to surgical infection in one case and to brucellosis in one case. The cultivation of the abscess material from the 14 secondary psoas abscess cases revealed growth of bacteria in 11 of them (5 Mycobacterium tuberculosis, 1 Escherichia coli, 1 methicillin-sensitive Staphylococcus aureus, 1 methicilin-resistant S. aureus, 1 Acinetobacter baumannii, 1 Brucella melitensis, 1 Serratia marcescens). The biochemical parameters of the cases (mean leukocyte counts: 14.500 cell/mm3; mean erythrocyte sedimentation rates: 78 mm/hour; mean C-reactive protein levels: 108 mg/dl) were also high. Thirteen patients underwent percutaneous drainage and received appropriate antibiotic treatment and the other two patients were treated with open surgical debridement. The duration of antimicrobial treatment was one year for M. tuberculosis cases and about 4-6 weeks in the others. One of the cases died due to complicating meningitis and sepsis. It is

  18. Epidural abscess caused by Streptococcus milleri in a pregnant woman

    Bearman Gonzalo


    Full Text Available Abstract Background Bacteria in the Streptococcus milleri group (S. anginosus, S. constellatus, and S. intermedius are associated with bacteremia and abscess formation. While most reports of Streptococcus milleri group (SMG infection occur in patients with underlying medical conditions, SMG infections during pregnancy have been documented. However, SMG infections in pregnant women are associated with either neonatal or maternal puerperal sepsis. Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia. We report a case of spinal-epidural abscess caused by SMG in a young, pregnant woman without an antecedent history of spinal epidural anesthesia and without any underlying risk factors for invasive streptococcal disease. Case presentation A 25 year old pregnant woman developed neurological symptoms consistent with spinal cord compression at 20 weeks gestation. She underwent emergency laminectomy for decompression and was treated with ceftriaxone 2 gm IV daily for 28 days. She was ambulatory at the time of discharge from the inpatient rehabilitation unit with residual lower extremity weakness. Conclusion To our knowledge, this is the first reported case of a Streptococcus milleri epidural abscess in a healthy, pregnant woman with no history of epidural anesthesia or invasive procedures. This report adds to the body of literature on SMG invasive infections. Treatment of SMG spinal-epidural abscess with neurologic manifestations should include prompt and aggressive surgical decompression coupled with targeted anti-infective therapy.

  19. Healed perivalvular abscess: Incidental finding on transthoracic echocardiography

    Vishnu Datt


    Full Text Available A 36-year-old male patient presented with the complaints of palpitations and breathlessness. Preoperative transthoracic echocardiography (TTE revealed a bicuspid aortic valve; severe aortic regurgitation with dilated left ventricle (LV and mild LV systolic dysfunction (ejection fraction 50%. He was scheduled to undergo aortic valve replacement. History was not suggestive of infective endocarditis (IE. Preoperative TTE did not demonstrate any aortic perivalvular abscess. Intraoperative transesophageal echocardiography (TEE examination using the mid-esophageal (ME long-axis view, showed an abscess cavity affecting the aortic valve, which initially was assumed to be a dissection flap, but later confirmed to be an abscess cavity by color Doppler examination. The ME aortic valve short-axis view showed two abscesses; one was at the junction of the non-coronary and left coronary commissure and the other one above the right coronary cusp. Intraoperatively, these findings were confirmed by the surgeons. The case report demonstrates the superiority of TEE over TTE in diagnosing perivalvular abscesses.

  20. Splenic abscess owing to cancer at the splenic flexure

    Awotar, Gavish K.; Luo, Fuwen; Zhao, Zhengdong; Guan, Guoxin; Ning, Shili; Ren, Jinshuai; Liu, Yaqing; Wang, Guangzhi; Liu, Pixu


    Abstract Background: The cancer of the splenic flexure of the colon is a rare medical entity with severe morbidity because of its insidious onset. Methods: We present the case of a 59-year-old male patient with dull left upper quadrant pain, leukocytosis, and anemia. A splenic abscess described as an air-fluid level with splenocolic fistula was found on CT scan imaging. Surgery was done for splenic pus drainage. He was again admitted 2 months later for intestinal obstruction. Results: An exploratory laparotomy showed multiple hard, gray liver nodules as well as a hard mass in the small bowel. Owing to extensive adhesions and a late stage of cancer involvement, the splenic flexure tumor was not resected. A loop transverse colostomy was done and a ColoplastTM Colostomy bag placed. We also reviewed the literature-linking colon cancer and splenic abscess with specific attention to the carcinoma of the splenic flexure. As the latter invades through the spleen matter, there is the creation of a splenocolic fistula, which allows the migration of normal gut flora into the spleen. This leads to the formation of the splenic abscess. Conclusion: This is the 13th case report pertaining to invading colonic cancer causing a splenic abscess. Although the treatment for splenic abscesses is shifting from splenectomy to image-guided percutaneous pus drainage, the few reported cases make the proper management of such complication still unclear. PMID:27661050

  1. Giant retroperitoneal abscess following necrotizing pancreatitis treated with internal drainage

    Ludmil Marinov Veltchev; Manol Anastasov Kalniev


    BACKGROUND: Retroperitoneal abscess is a dangerous complication of the inflammatory process in organs. The pancreas reacts by enzymatic autodigestion and inflammation to external and internal factors: alcohol abuse, trauma, biliary stones, and viral infections. Chronic pancreatitis and formation of pseudocysts are late complications. The diffuse spread of pancreatic inflammation may form a retroperitoneal phlegmon. A better outcome is the limitation of the process by capsule formation-retroperitoneal abscess. METHODS: A 62-year-old man, with a history of alcohol abuse, was admitted for intermittent abdominal pain, fever, and significant weight loss. Previous medical consultations (laboratory tests, US, CT) confirmed chronic pancreatitis with pseudocyst formation. A new CT depicted a giant retroperitoneal abscess. RESULTS: After preoperative preparation with antibiotics, laparotomy and internal drainage-longitudinal cystoje-junostomy with Roux-en-Y loop were performed. At the 8th postoperative day the patient was in good condition. CONCLUSIONS: Giant retroperitoneal abscess is a dangerous pathology with significant mortality and morbidity. Diagnosis strongly necessitates operative intervention in order to evacuate and drain the space. These conditions include one internal drainage (in the GI tract) with the stomach, duodenum, or jejunum, which does not cause early and late GI discomfort and will gradually liquidate the cavity. We propose internal drainage with Roux-en-Y jejunal loop as the only method for accomplishing these conditions in cases of giant retroperitoneal abscesses.

  2. Spinal epidural abscess treated with antibiotics alone.

    Pathak, Ashish; Singh, Poonam; Gehlot, Prateek; Dhaneria, Mamta


    Spinal epidural abscess (SEA) is a rare clinical condition among children. Most patients do not present with classical signs. A 13-year-old boy without any predisposing factors presented with paraparesis, bladder and bowel involvement. MRI spine demonstrated an SEA at the C7 and D1 levels on both sides of the midline with cord oedema at the C2-3 to C6 level with minimal marrow oedema in the C6 vertebral body. We treated the patient with antibiotics (ceftriaxone and vancomycin) alone. The patient showed excellent response with only minimal residual gait disturbance at the end of 6 weeks of antibiotic therapy. This is the first paediatric report of complete recovery of a patient at clinical stage 4 following antibiotic treatment alone from India. However, caution should be exercised to closely monitor the patient's recovery as any progression in the neurological state warrants surgery.

  3. Breast abscesses after breast conserving therapy for breast cancer

    Fujiwara, Kazuhisa [National Kyoto Hospital (Japan)


    Breast abscess after breast conserving therapy is a rare complication and the study of this cause has not been reported. A retrospective review of 190 patients undergoing breast conserving therapy in our institution revealed 4 patients with breast abscess (mean age, 50.6 years; range, 47-57 years and median follow up 4 months; 1-11 months). Risk factors which were common to all patients were: fine needle aspiration (FNA), surgical treatment; wide excision, adjuvant therapy; oral administration of tamoxifen (TAM), radiation therapy (RT) to ipsilateral whole breast; total dose of 50 Gy and skin desquamation by RT; level I or II. Other important risk factors in 3 patients were repeated aspirations of seroma post operatively and 2 patients received chemotherapy; CAF. Cultures from one abscess grew staphylococcus aureus, one grew staphylococcus epidermidis, and two were sterile. Breast abscess may be caused by a variety of factors and it is often difficult to specify the cause. This suggests that careful observation will be necessary to determine the cause. (author)

  4. Charcot-Marie-Tooth and Related Diseases

    ... of France, and Howard Henry Tooth of the United Kingdom. Although most people have never heard of CMT, ... CMT provided by patients and families. (See php.) MDA ...

  5. Behçet's disease complicated by multiple aseptic abscesses of the liver and spleen.

    Maeshima, Keisuke; Ishii, Koji; Inoue, Megumi; Himeno, Katsuro; Seike, Masataka


    Aseptic abscesses are an emergent entity and have been described in inflammatory bowel disease, especially in Crohn's disease, and in other diseases. However, aseptic abscesses associated with Behçet's disease are extremely rare. We report a Japanese male diagnosed with an incomplete type of Behçet's disease who developed multiple aseptic abscesses of the spleen and liver. In 2002, the spleen abscesses were accompanied by paroxysmal oral aphthous ulcers and erythema nodosum. As the patient's response to antibiotic treatment was inadequate, a splenectomy was performed. Severe inflammatory cell infiltration, largely of polymorphonuclear neutrophils, was observed without evidence of bacterial or fungal growth. Although the patient had no history of ocular symptoms or genital ulcers, a diagnosis of incomplete Behçet's disease was made according to the Japanese diagnostic criteria because of the presence of paroxysmal arthritis and epididymitis since 2002. In 2005, multiple liver abscesses developed with right hypochondrial pain and seemed to be attributed to Behçet's disease because the abscesses yielded negative results during a microbiologic investigation and failed to go into remission under antibiotic therapy. Oral prednisone (15 mg/d) was started in May 2006, and the abscesses dramatically disappeared 4 wk after treatment. Although the patient had a relapse of the liver abscesses in association with the tapering of prednisone, the augmentation of prednisone dosage yielded a response. The abscesses of the liver and spleen were strongly suggested to be attributed to Behçet's disease. Clinician should be aware of the existence of aseptic abscesses as uncommon manifestations of Behçet's disease.

  6. Autogenous Transplantation for Replacing a Hopeless Tooth

    Zakershahrak, Mehrsa; Moshari, Amirabbas; Vatanpour, Mehdi; Khalilak, Zohreh; Jalali Ara, Afsoon


    Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption. PMID:28179939

  7. Isolated abscess in superior rectus muscle in a child

    Sushank Ashok Bhalerao


    Full Text Available Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra-ocular muscles (EOMs remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2-year male child who was referred with complaints of swelling in left eye (LE and inability to open LE since last 1-month. Orbital computed tomography (CT scan showed a well-defined, hypo-dense, peripheral rim-enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.

  8. Klebsiella pneumoniae liver abscess in an immunocompetent child

    Jang Mi Kwon


    Full Text Available Klebsiella pneumoniae has emerged as a leading pathogen for pyogenic liver abscess (PLA in Korea. K. pneumoniae liver abscess (KLA is a potentially life-threatening disease and the diagnosis is challenging. In developed countries, PLA in children is rare and frequently associated with disorders of granulocyte function and previous abdominal infection. We experienced a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter placed in intrahepatic abscess was left for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin were administered for 4 weeks, followed by oral antibiotics (cefixime for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications and the appropriate treatment of KLA.

  9. Brain abscess with an unexpected finding: Actinomyces meyeri CNS infection

    Eiset, Andreas Halgreen; Thomsen, Marianne Kragh; Wejse, Christian

    oedema. By MRI an abscess was suspected and the patient was transferred to the department of neurosurgery, where drainage was performed. Microscopy revealed gram-positive cocci and gram-negative rods and iv. treatment with ceftriaxone 4g x 1 and metronidazole 1g x 1 was commenced. Pus cultures showed...... Prevotella spp. and A. meyeri and the initial treatment was changed to penicillin G 5 MIU x 4 and metronidazole 500 mg x 3 for four weeks followed by oral amoxicillin 500 mg x 3 for three months. The abscess regressed on this treatment and there were no CNS related symptoms at three months follow......-up. The source of infection was most likely periodontitis with spread to the lungs from aspiration or oropharyngeal secretion into the respiratory tract, alternatively from haematogenous spread. Conclusions: We report of the successful treatment of a cerebral abscess caused by A. meyeri with narrow spectrum...

  10. Candida albicans skin abscess Abscesso de pele por Candida albicans

    Felipe Francisco Tuon


    Full Text Available Subcutaneous candidal abscess is a very rare infection even in immunocompromised patients. Some cases are reported when breakdown in the skin occurs, as bacterial cellulites or abscess, iatrogenic procedures, trauma and parenteral substance abuse. We describe a case of Candida albicans subcutaneous abscess without fungemia, which can be associated with central venous catheter.Abscesso subcutâneo por Candida é infecção muito rara mesmo em pacientes imunocomprometidos. Alguns casos são relatados quando ocorre dano na pele, como celulite bacteriana ou abscesso, procedimentos iatrogênicos, trauma e abuso de substância parenteral. Relatamos caso de abscesso subcutâneo por Candida albicans sem fungemia, que pode estar associado com cateter venoso central.




    Full Text Available BACKGROUND AND OBJECTIVES ALA has gained importance during recent years as a result of increasing world travel, economic globalization and the growing number of chronically immunosuppressed people. AIDS and the increasing use of organ transplants have led to a new population at risk. In our study we aimed to analyse the clinical presentation and management of Amoebic liver abscess at Sree Rajarajeshwari Medical College and Hospital, Bangalore. METHODS A hospital based prospective observational study was conducted between Dec. 2013 to June 2015 in Sree Rajarajeshwari Medical College and Hospital, Bangalore. All patients admitted with suspicion of liver abscess were confirmed with ultrasonography. After establishing sonological diagnosis according to criteria, the treatment was started from the day of admission which consisted of Antibiotics, USG guided Aspiration, Pigtail catheterization and Open surgical Drainage. RESULTS Forty five cases of Amoebic liver abscess were studied; 28 patients (62% were between 21 and 40 years of age. Male-to-Female ratio was 14:1. All the patients were from rural background. History of alcoholism was present in 10 patients (22.2%. Plain X-ray abdomen showed signs of peritonitis in 2 patients. Right lobe of liver was involved in 40 cases and left lobe in 3 cases. Both lobes were involved in 2 cases. Twenty six cases were treated conservatively, 11 cases by aspiration, 6 patients by pigtail catheterization. Two patients underwent open surgical drainage for perforated liver abscess. Complications noted in our series were rupture into peritoneal cavity in 2 cases; mortality was seen in 1 case. CONCLUSION Amoebic liver abscess is still one of the commonest parasitic infections of the liver in developing countries. Prompt diagnosis, aggressive medical treatment along with minimal intervention can keep the morbidity and mortality associated with this condition to a bare minimum. The scope of surgery in this condition is

  12. Evaluation and management of spinal epidural abscess.

    DeFroda, Steven F; DePasse, J Mason; Eltorai, Adam E M; Daniels, Alan H; Palumbo, Mark A


    Spinal epidural abscess (SEA) is an uncommon and potentially catastrophic condition. SEA often presents a diagnostic challenge, as the "classic triad" of fever, spinal pain, and neurological deficit is evident in only a minority of patients. When diagnosis is delayed, irreversible neurological damage may ensue. To minimize morbidity, an appropriate level of suspicion and an understanding of the diagnostic evaluation are essential. Infection should be suspected in patients presenting with axial pain, fever, or elevated inflammatory markers. Although patients with no known risk factors can develop SEA, clinical concern should be heightened in the presence of diabetes, intravenous drug use, chronic renal failure, immunosuppressant therapy, or a recent invasive spine procedure. When the clinical profile is consistent with the diagnosis of SEA, gadolinium-enhanced magnetic resonance imaging of the spinal column should be obtained on an emergent basis to delineate the location and neural compressive effect of the abscess. Rapid diagnosis allows for efficient treatment, which optimizes the potential for a positive outcome.

  13. Primary psoas muscle abscess in pregnancy.

    Swanson, Amy; Lau, Kenneth K; Korman, Tony M; Kornman, Tony; Wallace, Euan M; Polyakov, Alex


    Primary iliacus-psoas muscle abscess formation is very uncommon during pregnancy. We present a case of a primary iliacus-psoas muscle abscess in pregnancy causing back pain with delayed diagnosis and treatment. Understanding the clinical presentation of iliacus-psoas muscle abscess helps with considering it in the differential diagnosis of back pain during pregnancy.

  14. Left Colon Diverticulitis Presenting as Perforated Lumbar Abscess: A Case Report and Review of the Current Literature

    Daniel Paramythiotis


    Full Text Available Diverticular perforation is a common complication of diverticulitis and can lead to the creation of abscesses. The presence of such abscesses on the abdominal wall is rare and can lead to misdiagnosis. We present the case of a patient with abdominal pain and the formation of a large left lumbar abscess due to perforation of a diverticulum of the left colon and our surgical treatment of choice with favorable results.

  15. The usefulness of transrectal endosonography in differentiating an anal abscess from a rectal carcinoma: a case report:

    Kolodziejczak, Malgorzata; Sudoł-Szopińska, Iwona


    Background. The high anal abscess might have not a typical, chronic clinical course, and its diagnosis may be difficult. Case report. The authors describe a case of a patient with the initial diagnosis of rectal cancer. Because of non-specific clinical symptoms suggesting a high anal abscess with atypical , chronic course of the disease, additional investigations were suggested. The final diagnosis was high, submucous-intersphincetric abscess. Conclusions. In the described case the most impor...

  16. Campylobacter jejuni, an uncommon cause of splenic abscess diagnosed by 16S rRNA gene sequencing.

    Seng, Piseth; Quenard, Fanny; Menard, Amélie; Heyries, Laurent; Stein, Andreas


    Splenic abscess is a rare disease that primarily occurs in patients with splenic trauma, endocarditis, sickle cell anemia, or other diseases that compromise the immune system. This report describes a culture-negative splenic abscess in an immunocompetent patient caused by Campylobacter jejuni, as determined by 16S rRNA gene sequencing.

  17. Extensive deep neck space abscess due to B-Haemolytic group G Streptococci-A case report

    Malini A


    Full Text Available Beta haemolytic phenotype of group G streptococci was isolated from the pus obtained from a patient with extensive deep neck space abscess. Patient was immunocompetent and made complete recovery after surgical drainage and administration of amoxycillin with clavulanic acid, amikacin and metronidazole. To our knowledge, this is the first report of deep neck space abscess due to group G streptococci.

  18. Radiological management of multiple hepatic artery pseudoaneurysms associated with cholangitic abscesses

    Ankur Goyal


    Full Text Available Hepatic artery pseudoaneurysms (HAP are uncommon, occurring mostly as a complication of trauma (accidental or iatrogenic. Liver abscess rarely causes HAP and multiple HAP associated with cholangitic abscesses have not been reported in the literature. We present a patient of acute necrotizing pancreatitis with stent block cholangitis and multiple cholangitic abscesses who developed hemorrhagic output through drainage catheter in the liver abscess. A multiphasic CT angiography demonstrated three HAP, which were treated with a combination of endovascular coil embolization and percutaneous thrombin injection. The fact that cholangitic abscesses may be associated with pseudoaneurysms should not be neglected, considering the potentially catastrophic complication and relatively easy radiological management. CT angiography permits accurate diagnosis and lays down the roadmap for endovascular procedures.

  19. Primary tubercular liver abscess in an immunocompetent adult: a case report

    Baveja CP


    Full Text Available Abstract Introduction Isolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis. A greater awareness of this rare clinical entity may help in commencing specific evidence-based therapy quickly and preventing undue morbidity and mortality. Case presentation A 30-year-old man, of Asian origin, developed a hepatic tubercular abscess which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram of the abdomen showed an abscess in the right lobe of his liver which was initially diagnosed as an amoebic liver abscess. Subsequently, the pus from the lesion yielded Mycobacterium tuberculosis using the BACTEC TB 460 instrument and Mycobacterium tuberculosis deoxyribonucleic acid by polymerase chain reaction. The patient was started on systemic antitubercular therapy to which he responded favorably. Conclusion This report emphasizes the fact that, although a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions.

  20. Brodie's abscess following percutaneous fixation of distal radius fracture in a child.

    Rajakulendran, Karthig; Picardo, Natasha E; El-Daly, Ibraheim; Hussein, Rami


    We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.

  1. 75例细菌性肝脓肿临床和病原学特点分析%Clinical and pathogenic characteristics in 75 patients with pyogenic liver abscess

    张成龙; 庞君丽; 曲芬; 毛远丽; 郭晶晶; 贾天野; 崔恩博; 陈素明; 李勇武; 张鞠玲; 王欢; 鲍春梅


    目的:回顾性分析细菌性肝脓肿的临床和病原学特点、易发因素及治疗效果,为肝脓肿的临床诊治提供依据。方法选择2010年1月-2013年12月北京地区2所传染病医院确诊的细菌性肝脓肿患者75例,系统性分析其临床资料和病原学特点,探讨肝脓肿发生的危险因素和治疗效果。结果75例肝脓肿患者中,男55例,女20例,年龄(51.9±16.0)岁。主要临床表现为发热(52.00%)和腹痛(30.67%)。有肝病基础疾病的72例(96.00%),包括肝炎肝硬化45例(62.50%),肝癌23例(31.94%),酒精性肝病3例(4.17%),脂肪肝1例(1.39%)。其中42例(56.00%)伴随其他疾病,包括腹膜炎24例(57.14%), AIDS 13例(30.95%),糖尿病11例(26.19%),高血压10例(23.81%)。脓液和血培养阳性率分别为46.51%(20/43)和24.39%(10/41),肺炎克雷伯菌是主要致病菌(53.33%)。45例经B超或CT引导下穿刺引流并联合抗生素治疗,有效率为88.89%。结论细菌性肝脓肿好发于老年肝病患者,男性居多,临床表现非特异性,病原菌以肺炎克雷伯菌最为常见,经B超或CT引导下穿刺引流并联合抗生素治疗可以取得良好效果。%Objective To analyze the clinical and pathogenic characteristics, susceptible factors and treatment efficacy of the patients with pyogenic liver abscess retrospectively, so as to provide evidence for the diagnosis and treatment of pyogenic liver ab-scess. Methods A total of 75 patients with pyogenic liver abscess treated in two infectious diseases hospitals in Beijing from Jan. 2010 to Dec. 2013 were enrolled in the study. The clinical data and pathogenic characteristics were analyzed, and risk factors and treatment efficacy of pyogenic liver abscess were investigated. Results Of 75 patients with pyogenic liver abscess, 55 were males and 20 were females, and the average age was 51.9 ±16.0 years old. The major

  2. Isolated tuberculous splenic abscess in an immunocompetent individual

    Parveen Rana Kundu; SK Mathur; Sunita Singh; Amrita Duhan; Garima Aggarwal; Rajeev Sen


    Tuberculosis (TB) of the spleen is an extremely rare clinical entity particularly among immunocompetent persons. We report a case of isolated tuberculous abscess of spleen in a 13-years- old boy. No primary focus of infection was detected in lungs or any other organ. The patient was treated by splenectomy after a therapeutic failure with standard antituberculous medication.

  3. Presacral abscess as a rare complication of sacral nerve stimulator implantation.

    Gumber, A; Ayyar, S; Varia, H; Pettit, S


    A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement. The patient was treated with broad spectrum antibiotics, and the sacral nerve stimulator and electrode were removed. Attempts were made to drain the abscess transrectally using minimally invasive techniques but these were unsuccessful and CT guided transperineal drainage was then performed. Despite this, the presacral abscess progressed, developing enlarging gas locules and extending to the pelvic brim to involve the aortic bifurcation, causing hydronephrosis and radiological signs of impending sacral osteomyelitis. MRI showed communication between the rectum and abscess resulting from transrectal drainage. In view of the progressive presacral sepsis, a laparotomy was performed with drainage of the abscess, closure of the upper rectum and formation of a defunctioning end sigmoid colostomy. Following this, the presacral infection resolved. Presacral abscess formation secondary to an infected sacral nerve stimulator electrode has not been reported previously. Our experience suggests that in a similar situation, the optimal management is to perform laparotomy with drainage of the presacral abscess together with simultaneous removal of the sacral nerve stimulator and electrode.

  4. CT differentiation of abscess and non-infected fluid in the postoperative neck

    Yoon, Soo Jeong; Yoon, Dae Young [Dept. of Radiology, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)], e-mail:; Kim, Sam Soo [Dept. of Radiology, Kangwon National Univ. Coll. of Medicine, Kangwon-do (Korea, Republic of); Rho, Young-Soo; Chung, Eun-Jae [Dept. of Otorhinolaryngology, Ilsong Memorial Inst. of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of); Eom, Joong Sik; Lee, Jin Seo [Dept. of Internal Medicine, Div. of infectious disease, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)


    Background: Differentiation of postoperative neck abscess from non-infected fluid is important because the treatment is different. Purpose: To determine specific CT findings that might help to differentiate abscesses from non-infected fluid collections in the postoperative neck. Material and Methods: We retrospectively reviewed CT scans of 50 patients (43 men and 7 women; mean age, 62.5 {+-} 8.9 years) who had postoperative fluid collections in the neck (26 abscesses and 24 non-infected fluid collections). Diagnosis of an abscess was determined by a positive bacteria culture from the fluid collection. Diagnoses were correlated with the following CT findings: anatomic spaces involved, the maximum transverse diameter, margin, attenuation, rim enhancement, gas bubbles, and manifestations of soft tissue adjacent to a fluid collection. Results: Rim enhancement pattern and soft tissue manifestations showed significant differences between abscess and non-infected fluid. The reliable CT findings for abscess were: (i) rim enhancement > 50% of the circumference, 54% sensitive, 71% specific, and 62% accurate; and (ii) severe soft tissue manifestations, 39% sensitive, 92% specific, and 64% accurate. There were no significant differences in the anatomic spaces involved, the maximum transverse diameter, margin, attenuation, and gas bubbles between abscess and non-infected fluid. Conclusion: CT findings that may help differentiate postoperative neck abscess from non-infected fluid were rim enhancement > 50% of the circumference and severe soft tissue manifestations.

  5. Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur.

    Jalaludin, M A


    Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

  6. Modern management of pyogenic hepatic abscess: a case series and review of the literature.

    Heneghan, Helen M


    BACKGROUND: Pyogenic hepatic abscesses are relatively rare, though untreated are uniformly fatal. A recent paradigm shift in the management of liver abscesses, facilitated by advances in diagnostic and interventional radiology, has decreased mortality rates. The aim of this study was to review our experience in managing pyogenic liver abscess, review the literature in this field, and propose guidelines to aid in the current management of this complex disease. METHODS: Demographic and clinical details of all patients admitted to a single institution with liver abscess over a 5 year period were reviewed. Clinical presentation, aetiology, diagnostic work-up, treatment, morbidity and mortality data were collated. RESULTS: Over a 5 year period 11 patients presented to a single institution with pyogenic hepatic abscess (55% males, mean age 60.3 years). Common clinical features at presentation were non-specific constitutional symptoms and signs. Aetiology was predominantly gallstones (45%) or diverticular disease (27%). In addition to empiric antimicrobial therapy, all patients underwent radiologically guided percutaneous drainage of the liver abscess at diagnosis and only 2 patients required surgical intervention, including one 16-year old female who underwent hemi-hepatectomy for a complex and rare Actinomycotic abscess. There were no mortalities after minimum follow-up of one year. CONCLUSIONS: Pyogenic liver abscesses are uncommon, and mortality has decreased over the last two decades. Antimicrobial therapy and radiological intervention form the mainstay of modern treatment. Surgical intervention should be considered for patients with large, complex, septated or multiple abscesses, underlying disease or in whom percutaneous drainage has failed.

  7. Chronic Calcific Pancreatitis Presenting as an Isolated Left Perinephric Abscess: A Case Report and Review of the Literature

    Ragesh Babu Thandassery


    Full Text Available Context Acute and chronic pancreatitis may present with pseudocysts in atypical locations. Activated pancreatic enzymes track along anatomic fascial planes causing digestion of the surrounding tissues and resulting in distant pseudocysts. Pseudocysts at atypical locations pose significant diagnostic as well as therapeutic challenges. Case report We report an unusual presentation of a pancreatic pseudocyst in a young male who presented with a left perinephric abscess. Percutaneous drainage was not successful in resolving the abscess and he was subsequently diagnosed as having chronic pancreatitis together with a left perinephric abscess. Needle knife sphincterotomy of the ampulla of Vater resulted in the gradual resolution of the abscess. Conclusion We report a rare presentation of chronic pancreatitis with a perinephric abscess and its non-surgical management. This case report indicates that any patient presenting with a perinephric abscess of unknown etiology not responding to conventional treatment modalities should be investigated for underlying pancreatitis.

  8. Liver abscess caused by CTX-M-55-type extended-spectrum β-lactamase (ESBL)-producing Salmonella enteritidis.

    Imoto, Akira; Ooi, Yukimasa; Edogawa, Shoko; Ogura, Takeshi; Masuda, Daisuke; Mohamed, Malak; Takii, Michiaki; Umegaki, Eiji; Kawahara, Ryuji; Ukimura, Akira; Higuchi, Kazuhide


    Liver abscesses secondary to Salmonella species are rarely described in the general population. We herein describe a case of a liver abscess caused by CTX-M-55-type extended-spectrum β-lactamase (ESBL)-producing Salmonella enteritidis, which has not been reported in the literature. A 54-year-old male was admitted due to a high fever and was clinically diagnosed with a liver abscess. Culture of the fluid from the liver abscess revealed CTX-M-55-type ESBL-producing S. enteritidis. Although the patient underwent percutaneous transhepatic abscess drainage and antibiotic therapy, he died one month later. It should be noted that liver abscesses are potentially fatal depending on the causative pathogen.

  9. The frequency of dental abscesses increases in periods of low barometric pressure.

    Seemann, Rudolf; Svabik, Otto; Orlik, Alexander; Figl, Michael; Fischer, Michael B; Schicho, Kurt; Wutzl, Arno; Forster, Johannes; Jesch, Philip; Perisanidis, Christos; Undt, Gerhard; Millesi, Werner


    Bioclimatic conditions are thought to have an impact on the frequency of dental abscesses but previous studies have suffered from small patient cohorts, methodological obstacles, and restriction to a single site resulting in limited geographic and meteorological variability. The aim of the present study was to investigate the influence of environmental temperature and barometric pressure on the frequency of dental abscesses. Three maxillofacial and two dental clinics in Vienna retrospectively provided a total of 19,218 patients with dentoalveolar abscesses who were treated by intraoral incision between 1998 and 2011. Daily records from six local meteorological stations were consulted to assess daily meteorological parameters. Univariate and multivariate hurdle count regression models were fitted to estimate the effect of daily average barometric pressure and temperature on registered abscess frequencies. Temporal confounders causing variance of the observed abscess frequencies - such as weekday, business day, and month - were taken into consideration. On days of low barometric pressure a significant rise in dental abscess frequency was observed, even when adjusting for confounders. Environmental temperature, in contrast, did not show any effect. In conclusion, bioclimatic conditions affect health as low barometric pressure increases the number of patients with dental abscesses.

  10. Successful Management of a Recurrent Supralevator Abscess: A Case Report

    S. Sanyal


    Full Text Available Anorectal abscesses are commonly encountered in clinical surgical practice. These abscesses require surgical management. Supralevator abscesses are thought to originate either from an ischiorectal or intersphincteric abscess extension or from an intraperitoneal source. These abscesses are quite uncommon and present a difficult surgical problem. We present a case here of a 42-year-old female with a recurrent supralevator abscess requiring multiple surgical procedures for adequate drainage and care of her abscess.

  11. Biostatistical analysis of treatment results of bacterial liver abscesses using minimally invasive techniques and open surgery

    Кipshidze A.A.


    Full Text Available Today bacterial abscesses remain one of the most difficult complications in surgical hepatology, both traditional and minimally invasive methods of their treatment are used. Bio-statistical analysis is used due to the fact that strong evidences are required for the effectiveness of one or another method of surgical intervention. The estimation of statistical significance of differences between the control and the main group of patients with liver abscesses is given in this paper. Depending on the treatment method patients were divided into two groups: 1 - minimally invasive surgery (89 cases; 2 – laporatomy surgery (74 patients. Data compa¬ri¬son was performed by means of Stjudent's criterion. The effectiveness of method of abscesses drainage using inter¬ventional sonography, outer nazobiliar drainage with reorganization of ductal liver system and abscess cavity with the help of modern antiseptics was considered. The percentage of cured patients was also estimated.

  12. Brain abscess associated with Aggregatibacter actinomycetemcomitans : case report and review of literature

    Rahamat-Langendoen, Janette C.; van Vonderen, Marit G. A.; Engstrom, Lex J.; Manson, Willem L.; van Winkelhoff, Arie Jan; Mooi-Kokenberg, Esther A. N. M.


    Introduction: Aggregatibacter actinomycetemcomitans is considered a major pathogen in localized and generalized aggressive periodontitis. A. actinomycetemcomitans has been found in various extra oral infections and most frequently in endocarditis. We report a patient with multiple brain abscesses du

  13. B超引导下经皮穿刺留置引流管治疗肝脓肿患者的护理%Clinical nursing care for liver abscess patients treated by indwelling drainage tube after puncture under ultrasonic guidance

    毛晓群; 许莹


    目的 探讨在B超引导下经皮穿刺留置引流管治疗肝脓肿患者的临床护理.方法 对我院2004年1月至2010年12月收治的64例脓腔直径≥5 cm的肝脓肿患者的治疗转归及护理资料进行回顾性分析.结果 64例肝脓肿患者经过B超引导下经皮穿刺留置引流管后,治愈率为100%,未发生并发症.结论 B超引导下经皮穿刺留置引流管治疗肝脓肿切实可行,而细致的护理也是提高其治愈率的一项重要措施.%Objective To discuss the clinical nursing care for liver abscess patients treated by indwelling drainage tube after puncture under ultrasonic guidance.Methods 64 liver abscess patients with diameter of the abscess longer than 5cm were treated by indwelling drainage tube after puncture under ultrasonic guidance,clinical nursing care was performed before and after the operation.Results The recovery rate of liver abscess treated by puncture was 100%,no complication occurred.Conclusions It is feasible for the liver abscess patients to perform puncture under ultrasonic guidance,and meticulous nursing is a pivotal measure to improve cure rate.

  14. Good penetration of moxifloxacin into human abscesses.

    Sauermann, Robert; Karch, Rudolf; Kjellsson, Maria C; Feurstein, Thomas; Püspök, Andreas; Langenberger, Herbert; Böhmdorfer, Michaela; Jäger, Walter; Zeitlinger, Markus


    Abscesses are often treated with antibiotics in addition to incision or when incision is unfeasible, but accurate information about antibiotic abscess penetration in humans is missing. This study aimed at evaluating the penetration of moxifloxacin into human abscesses. After administration of a single dose of 400 mg moxifloxacin, drug concentrations were measured in 10 differently located abscesses at incision, and in plasma over 8 h. At incision performed 0.9-4.8 h after administration, moxifloxacin concentrations in abscesses ranged from ≤0.01 to 9.2 mg/l (1.9 ± 3.4 mg/l), indicating pronounced drug accumulation in some abscesses. The degree of abscess penetration could not be explained by covariates like the ratio of surface area to volume or pH of abscesses, or by moxifloxacin plasma concentrations. Concluding, moxifloxacin was detectable in most abscesses and may be a useful antibiotic for this indication. However, antibiotic abscess penetration was highly variable and unpredictable, suggesting surgical abscess incision whenever possible.

  15. Spinal and bulbar muscular atrophy and Charcot-Marie-Tooth type 1A: Co-existence of two rare neuromuscular genetic diseases in the same patient.

    Sagnelli, Anna; Scaioli, Vidmer; Piscosquito, Giuseppe; Salsano, Ettore; Dalla Bella, Eleonora; Gellera, Cinzia; Pareyson, Davide


    Spinal and bulbar muscular atrophy is an X-linked neuromuscular disease caused by a trinucleotide CAG repeat expansion in the androgen receptor gene; it is clinically characterized by adult-onset, slowly progressive weakness and atrophy mainly affecting proximal limb and bulbar muscles. Charcot-Marie-Tooth disease type 1A is an autosomal dominant polyneuropathy due to peripheral myelin protein 22 gene duplication and characterized by slowly progressive distal limb muscle weakness, atrophy and sensory loss with foot deformities. Here we report the co-occurrence of both neuromuscular genetic diseases in the same male patient. Difficulties in climbing stairs and jaw weakness were presenting symptoms consistent with SBMA. However, predominant distal weakness and bilateral pes cavus were rather suggestive of a hereditary polyneuropathy. The combination of two diseases, even if extremely rare, should be considered in the presence of atypical symptoms; in the case of genetic diseases this event may have important implications on family members' counseling.

  16. Acute spinal epidural abscess in the whole spine: case report of a 2-year-old boy

    Shen, W.C. [Dept. of Radiology, Taichung Veterans General Hospital (Taiwan, Province of China); Lee, S.K. [Dept. of Radiology, Taichung Veterans General Hospital (Taiwan, Province of China); Ho, Y.J. [Dept. of Radiology, Taichung Veterans General Hospital (Taiwan, Province of China); Lee, K.R. [Inst. of Life Science, National Tsing-Hua Univ., Hsin-Chu (Taiwan, Province of China)


    We report on an acute epidural abscess in a 2-year-old boy, extending from the C1 level to the L5 level. The causative agent was Staphylococcus aureus as proved by pus and blood culture. The infectious source was in the scrotum. The diffuse epidural abscess was readily detected by MRI, which showed hypo-intensity in T1 WI and hyperintensity in gradient echo T2-weighted images. The abscess capsule was enhanced by Gadolinium-DTPA. The patient recovered completely after adequate treatment with antibiotics and follow up MRI showed complete disappearance of the epidural abscess. (orig.)

  17. The Value and Reason in CT Diagnosis of Transient Hepatic Perfusion Disorders in Patients with Hepatic Abscess%肝脓肿不同时相一过性灌注的 CT 表现及原因探讨



    目的:探讨肝脓肿CT 三期增强检查中伴发的异常灌注(THPD)征象的表现及产生机制。方法:回顾性分析27例经临床证实、CT 增强显示 T HPD征象的图像资料,对不同时相出现 T HPD病例的CT 表现、原因及其发生机制进行分析。结果:CT 增强显示动脉期17例高灌注 T HPD ,2例同时有高灌注和低灌注 T HPD两种表现,1例单纯低灌注 T HPD ;门脉期表现为高灌注 T HPD 者3例,单纯低灌注 T HPD 者4例。结论:动脉期T HPD有助于肝脓肿诊断,T HPD表现多样,与其产生机制多种、病程长短有关。%Objective:ToevaluatethetriphasicMSCTfeaturesoftransienthepaticperfusiondisorders (THPD)inpatientswithhepaticabscessand explore its main mechanism .Methods :Analyze the pre-contrast and dynamic contrast scan T HPD feature of 27 hepatic abscess patients (12 male ,15 female ,age ranging from 40 to 83 ,mean 60 .7 ± 11 .9 years) who were scaned by a 128 -slice MSCT scanner and confirmed by clinical .Results :Hyper-perfusion THPD in 17 patients ,hyper -and hypo -perfusion THPD in 2 patients ,and hypo -perfusion THPD in 1 patient were shown on arterial phase scans .Others were only shown on portal venous phase scans ,including hyper -perfusion THPD in 3 patients ,and hypo -perfusion THPD in 4 patients .Conclusion:The THPD accompanied with hepatic abscess shows various features ,which may be caused by different pathogenic mechanisms and courses of disease .

  18. Brain Abscess after Esophageal Dilatation

    Gaïni, S; Grand, M; Michelsen, J


    with malaise, progressive lethargy, fever, aphasia and hemiparesis. Six days before she had been treated with esophageal dilatation for a stricture caused by accidental ingestion of caustic soda. The brain abscess was treated with surgery and antibiotics. She recovered completely. This clinical case...

  19. Computed tomography in pituitary abscess

    Appel, W.; Scharphuis, T.; Distelmaier, P.


    This is a report on a rare case of a recurring abscess in the pituitary gland. Diagnosis was extremely difficult to establish preoperatively. This is demonstrated via various radiological methods. Anamnesis and clinical disease pattern are important assisting factors in diagnosis.

  20. Diagnostic algorithms in Charcot-Marie-Tooth neuropathies: experiences from a German genetic laboratory on the basis of 1206 index patients.

    Rudnik-Schöneborn, S; Tölle, D; Senderek, J; Eggermann, K; Elbracht, M; Kornak, U; von der Hagen, M; Kirschner, J; Leube, B; Müller-Felber, W; Schara, U; von Au, K; Wieczorek, D; Bußmann, C; Zerres, K


    We present clinical features and genetic results of 1206 index patients and 124 affected relatives who were referred for genetic testing of Charcot-Marie-Tooth (CMT) neuropathy at the laboratory in Aachen between 2001 and 2012. Genetic detection rates were 56% in demyelinating CMT (71% of autosomal dominant (AD) CMT1/CMTX), and 17% in axonal CMT (24% of AD CMT2/CMTX). Three genetic defects (PMP22 duplication/deletion, GJB1/Cx32 or MPZ/P0 mutation) were responsible for 89.3% of demyelinating CMT index patients in whom a genetic diagnosis was achieved, and the diagnostic yield of the three main genetic defects in axonal CMT (GJB1/Cx32, MFN2, MPZ/P0 mutations) was 84.2%. De novo mutations were detected in 1.3% of PMP22 duplication, 25% of MPZ/P0, and none in GJB1/Cx32. Motor nerve conduction velocity was uniformly 40 m/s in MFN2, and more variable in GJB1/Cx32, MPZ/P0 mutations. Patients with CMT2A showed a broad clinical severity regardless of the type or position of the MFN2 mutation. Out of 75 patients, 8 patients (11%) with PMP22 deletions were categorized as CMT1 or CMT2. Diagnostic algorithms are still useful for cost-efficient mutation detection and for the interpretation of large-scale genetic data made available by next generation sequencing strategies.

  1. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone : a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction

    den Hartog, Laurens; Huddleston Slater, James J. R.; Vissink, Arjan; Meijer, Henny J. A.; Raghoebar, Gerry M.


    den Hartog L, Huddleston Slater JJR, Vissink A, Meijer HJA, Raghoebar GM. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. J Clin Periodontol 2008; 35: 10

  2. Clinical signif icance of C-reactive protein values in antibiotic treatment for pyogenic liver abscess


    AIM:To investigate the clinical signifi cance of C-reactive protein (CRP) values in determining the endpoint of antibiotic treatment for liver abscess after drainage. METHODS: The endpoints of antibiotic treatment in 46 patients with pyogenic liver abscess after complete percutaneous drainage were assessed by performing a retrospective study. After complete percutaneous drainage, normal CRP values were considered as the endpoint in 18 patients (experimental group), and normal body temperature for at least 2...

  3. 保留括约肌虚挂线法治疗高位肛周脓肿%Clinical Efficacy of Sphincter-retaining and Loose-seton Therapy in Treating Patients with High Perianal Abscess

    伍静; 刘洪; 杨春梅; 何洪波


    Objective To investigate the clinical efficacy of sphincter-retaining and loose-seton therapy in treating high perianal abscess. Methods Using randomized controlled trial, 52 patients with high perianal abscess were randomly assigned to treatment group (n=26) treated with sphincter-retaining and loose-seton therapy and the control group (n=26) treated with perianal abscess radical surgery. The incidence of anal fistula 6 months after the treatment, healing time of incision, V AS scores of night pain 1 to 15 day s after treatment, and sequelae of anal function 6 months later were observed and compared. Results Six months after treatment, the incidences of anal fistula of the treatment group and the control group were respectively 4.0% and 3.8% (P > 0.05). The healing time of incision and night pain score of the surgery day and the 14 days after operation in the treatment group were shorter or slighter compared with those in the control group (P < 0.05). After six-month follow-up, the anal function of treatment group was normal, and the control group had a 12.0% incidence of complications, the difference of which was of statistical significance (P < 0.05). Conclusion The sphincter-retaining and loose-seton therapy on high perianal abscess is better than radical surgery in terms of postoperative pain, healing time of incision and protection of anal function.%目的 探讨保留括约肌虚挂线法治疗高位肛周脓肿的临床疗效.方法 2009年10月-2010年10月采用随机对照试验,对52例高位肛周脓肿患者施行手术治疗,其中保留括约肌虚挂线法(治疗组)26例,切开挂线引流法(对照组)26例.对两组患者术后6个月肛瘘发生率、切口愈合时间、术后1~15d每晚疼痛视觉模拟评分(VAS)和术后6个月痊愈患者肛门功能后遗症发生率进行比较.结果 术后6个月,治疗组和对照组肛瘘发生率分别为4.0%和3.8%,差异无统计学意义(P>0.05).术后7~15d治疗组VAS评分均低于

  4. Pelvic Primary Staphylococcal Infection Presenting as a Thigh Abscess

    T. O. Abbas


    Full Text Available Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and present as a thigh abscess. We present a case of a primary pelvic staphylococcal infection presenting as a thigh abscess. The patient was a 60-year-old man who presented with left posterior thigh pain and fever. Physical examination revealed a diffusely swollen left thigh with overlying erythematous, shiny, and tense skin. X-rays revealed no significant soft tissue lesions, ultrasound was suggestive of an inflammatory process, and MRI showed inflammatory changes along the left hemipelvis and thigh involving the iliacus muscle group, left gluteal region, and obturator internus muscle. The abscess was drained passively via two incisions in the posterior left thigh, releasing large amounts of purulent discharge. Subsequent bacterial culture revealed profuse growth of Staphylococcus aureus. The patient recovered uneventfully except for a moderate fever on the third postoperative day.

  5. Pelvic primary staphylococcal infection presenting as a thigh abscess.

    Abbas, T O


    Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and present as a thigh abscess. We present a case of a primary pelvic staphylococcal infection presenting as a thigh abscess. The patient was a 60-year-old man who presented with left posterior thigh pain and fever. Physical examination revealed a diffusely swollen left thigh with overlying erythematous, shiny, and tense skin. X-rays revealed no significant soft tissue lesions, ultrasound was suggestive of an inflammatory process, and MRI showed inflammatory changes along the left hemipelvis and thigh involving the iliacus muscle group, left gluteal region, and obturator internus muscle. The abscess was drained passively via two incisions in the posterior left thigh, releasing large amounts of purulent discharge. Subsequent bacterial culture revealed profuse growth of Staphylococcus aureus. The patient recovered uneventfully except for a moderate fever on the third postoperative day.

  6. Dynamic changes during evacuation of a left temporal abscess in open MRI: technical case report

    Bernays, R.L.; Yonekawa, Y. [Department of Neurosurgery, University Hospital, Zurich (Switzerland); Kollias, S.S. [Institute of Neuroradiology, University Hospital of Zurich (Switzerland)


    We demonstrate the usefulness of ''near real-time'' neuro-navigation by open MRI systems for guidance of stereotactic evacuation of intracranial abscesses. A 70-year-old patient was referred to our institution with an intracranial left temporal abscess. He presented with headache, senso-motor aphasia and mild right hemiparesis. The abscess (35 x 25 mm) was stereotactically evacuated under MRI guidance, and a recurrence of a daughter abscess was again evacuated on the 9th postoperative day. ''Near real-time'' imaging showed an indentation of the abscess wall of 11 mm along the trajectory. A thermosensitive MRI protocol demonstrated a higher temperature around the abscess capsule than in the brain tissue more distant to the capsule, demonstrating the inflammatory process. The patient had 6 weeks of antibiotic therapy for gram-negative bacteria and was discharged with improved clinical symptoms 5 weeks after admission. Follow-up CT 2 months postoperatively showed a complete resolution of the abscess. Open MRI-guided interventions with ''near real-time'' imaging demonstrate the anatomical changes during an ongoing procedure and can be accommodated for enhancing the overall precision of stereotactic procedures. Thermosensitive MRI protocols are capable of revealing temperature gradients around inflammatory processes. (orig.)

  7. Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

    Joji Inamasu


    Full Text Available Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative is more appropriate in patients with primary intraventricular brain abscesses.

  8. MRI findings, patterns of disease distribution, and muscle fat fraction calculation in five patients with Charcot-Marie-Tooth type 2 F disease

    Gaeta, Michele; Mileto, Achille; Minutoli, Fabio; Settineri, Nicola; Donato, Rocco; Ascenti, Giorgio; Blandino, Alfredo [Policlinico ' ' G. Martino' ' , Dipartimento di Scienze Radiologiche, Messina (Italy); Mazzeo, Anna; Di Leo, Rita [Policlinico ' ' G. Martino' ' , Dipartimento di Neuroscienze, Scienze Psichiatriche ed Anestesiologiche, Messina (Italy)


    To describe the magnetic resonance imaging (MRI) pattern of muscle involvement and disease progression in five patients with late-onset Charcot-Marie-Tooth (CMT) disease type 2 F, due to a previously unknown mutation. Five patients (three males, two females) underwent MRI of the lower limbs to define the pattern of muscle involvement and evaluate the muscle fat fraction (MFF) of residual thigh muscle with gradient-echo (GRE) dual-echo dual-flip angle technique. Evaluation of fatty infiltration both by visual inspection and MFF calculation was performed. A proximal-to-distal gradient of muscle involvement was depicted in male patients with extensive muscle wasting of lower legs, less severe impairment of distal thigh muscles, and sparing of proximal thigh muscles. A peculiar phenotype finding was that no or only slight muscle abnormalities could be found in the two female patients. We described the pattern of muscle involvement and disease progression in a family with CMT disease type 2 F. GRE dual-echo dual-flip angle MRI technique is a valuable technique to obtain a rapid quantification of MFF. (orig.)

  9. Pneumococcal Sepsis Complicated by Splenic Abscesses and Purpura Fulminans in a 15-Month-Old Child

    Scott Pangonis MD


    Full Text Available Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD with and without underlying immunological disorders such as asplenia. Here, we report a patient with IPD complicated by splenic abscesses and PF. Our patient initially presented with bacteremia, septic shock, and disseminated intravascular coagulation. She subsequently developed PF and splenic abscesses. She survived her illness after receiving a total of 8 weeks of antibiotic therapy. This case highlights 2 rare complications of IPD and demonstrates the need to keep pneumococcal disease in the differential diagnosis even in children whose vaccination status is up to date.

  10. Pyogenic liver abscess after choledochoduodenostomy for biliary obstruction caused by autoimmune pancreatitis

    Nobuyuki Toshikuni; Hirofumi Morishita; Koichi Uesaka; Shiro Yuasa; Kyohei Kai; Shizo Sato; Motoko Kitano; Masayoshi Fujisawa; Hiroaki Okushin; Kazuhiko Morii; Shinjiro Takagi; Masahiro Takatani


    A 68-year-old man underwent cholecystectomy and choledochoduodenostomy for biliary obstruction and nephrectomy for a renal tumor. Based on clinical and histopathologic findings, autoimmune pancreatitis (AIP) was diagnosed. The renal tumor was diagnosed as a renal cell cancer. Steroid therapy was started and thereafter pancreatic inflammation improved. Five years after surgery, the patient was readmitted because of pyrexia in a preshock state. A Klebsiella pneumoniae liver abscess complicated by sepsis was diagnosed. The patient recovered with percutaneous abscess drainage and administration of intravenous antibiotics. Liver abscess recurred 1 mo later but was successfully treated with antibiotics. There has been little information on long-term outcomes of patients with AIP treated with surgery. To our knowledge, this is the second case of liver abscess after surgical treatment of AIP.

  11. Complicated Community-Acquired Staphylococcus Endocarditis and Multiple Lung Abscesses: Case Report and Review of Literature

    Musa A. Garbati


    Full Text Available Background. Isolated tricuspid valve endocarditis in the absence of risk factors in the community setting is very rare and can be easily missed in patients with hitherto normal valves. Case Presentation. We present a case of a 49 year old gentleman who presented with generalized body aches, fever, and jaundice and was initial diagnosed as hepatitis. He subsequently developed recurrent episodes of panic attacks and shortness of breath and later multiple skin abscesses. Further investigations excluded pulmonary embolism but revealed multiple abscesses in the body including the lungs. Blood cultures and culture from abscesses grew S. aureus. An initial transthoracic echocardiogram was normal. A transesophageal echocardiogram subsequently confirmed endocarditis on a normal natural tricuspid valve and multiple lung abscesses. He was successfully treated with appropriate antibiotics. Conclusion. We discuss the pathogenesis of this patient's presentation highlight the need for assessment and proper evaluation of patients with unexplained bacteremia.

  12. Endoanal ultrasound in perianal fistulae and abscesses.

    Visscher, Arjan Paul; Felt-Bersma, Richelle J F


    Endoanal ultrasound is a technique that provides imaging of the anal sphincters and its surrounding structures as well as the pelvic floor. However, endoanal magnetic resonance imaging (MRI) is preferred by most physicians, although costs are higher and demand easily outgrows availability. Endoanal ultrasound is an accurate imaging modality delineating anatomy of both cryptoglandular as well as Crohn perianal fistula and abscess. Endoanal ultrasound is comparable with examination under anesthesia and equally sensitive as endoanal MRI in fistula detection. When fistula tracts or abscesses are located above the puborectal muscle, an additional endoanal MRI should be performed. Preoperative imaging is advocated in recurrent cryptoglandular fistula because a more complex pattern can be expected. Endoanal ultrasound can help avoid missing tracts during surgery, lowering the chance for the fistula to persist or recur. It can easily be performed in an outpatient setting and endosonographic skills are quickly incremented. Costs are low and endoanal ultrasound has the potential to improve outcome of patients with both cryptoglandular and fistulizing Crohn disease; therefore, it values more attention.

  13. Microbial flora of odontogenic abscesses in pet guinea pigs.

    Minarikova, A; Hauptman, K; Knotek, Z; Jekl, V


    Abscesses of odontogenic origin in guinea pigs pose a serious health problem and need to be treated with a combination of surgical and medical therapy. The aim of this prospective study was to describe the microbial flora of odontogenic abscesses associated with osteomyelitis in 24 pet guinea pigs, to perform antibiotic sensitivity testing, and to make recommendations for practitioners on the antibiotics of first choice. Inclusion criteria for the study included the animal being diagnosed with an odontogenic abscess which underwent surgery and was not pre-treated with an antibiotic. Inclusion criteria matched for 24 guinea pigs. Samples (pus, capsule and affected tooth/bone) for bacteriological examination were collected under sterile conditions during the surgical procedure. The most commonly isolated bacteria from abscesses of odontogenic origin were Bacteroides fragilis in 12.8 per cent (6/47) of cases, Pasteurella multocida in 10.6 per cent (5/47) and Peptostreptococcus anaerobius in 8.5 per cent (4/47). Aerobic bacterial species only were isolated in 29.2 per cent (7/24) of cases, anaerobic bacteria only were isolated in 33.3 per cent (8/24), and mixed infection with anaerobic and aerobic bacterial species was seen in 37.5 per cent (9/24). Aerobes (n=20) were sensitive to enrofloxacin and marbofloxacin in 100 per cent of samples, benzylpenicillin potassium (penicillin G, PNCG) in 90 per cent, cephalotin in 85 per cent, amoxicillin-clavulanate in 75 per cent, doxycycline in 70 per cent, gentamicin in 65 per cent and trimethoprim-sulfamethoxazole in 55 per cent. Anaerobes (n=27) were sensitive to amoxicillin-clavulanate in 100 per cent of cases, clindamycin in 96.3 per cent, metronidazole in 92.6 per cent, PNCG in 92.6 per cent and cephalotin in 74.1 per cent. As guinea pigs are strictly herbivorous animals, based on the results of this study the recommended antibiotic treatment for odontogenic abscesses is a combination of fluoroquinolones and metronidazole.

  14. Optical spectroscopy and tooth decay

    Misra, P.; De, T.; Singh, R.


    Optical spectroscopy in the ultraviolet, visible and mid-infrared spectral regions has been used to discriminate between healthy and diseased teeth of patients in the age range 15-75 years. Spectral scans of absorbance versus wavenumber and fluorescence intensity versus wavelength have been recorded and investigated for caries and periodontal disease. Such optical diagnostics can prove very useful in the early detection and treatment of tooth decay.

  15. 150例儿童患者拔牙焦虑症的调查%The prevalence of dental anxiety in 150 children patients before tooth extraction

    侯锐; 薛振恂; 夏结来


    Objective To determine the prevalence of dental anxiety in children patients before tooth extraction.Methods A modified Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Venham's clinical ratings of anxiety and cooperative behavior were used in 150 children patients ranging in age from 5 to 12 years olds before tooth extraction. The former scale was answered by parents on behalf of their children, and the latter ratings was assessed by the author. Results CFSS-DS scores and clinical ratings of behavior of the children were significantly higher in the children whose oral hygiene condition, dental experience, tooth extraction experience, spirit status on that day and whose mother's educational background were bad or low. A step regression analysis showed that oral hygiene condition had most significant interrelationship with both of the two scales(P<0.01). The correlation of the two scales was high (r=0.67).Conclusion Children’s oral hygiene condition, dental experience, tooth extraction experience, spirit status on that day and their mother’s educational background are closely related to the dental anxiety level. Oral hygiene condition is the most important predictor of anxiety level before extraction and clinical ratings of behavior during extraction.%目的调查儿童患者拔牙术前的焦虑状况。方法采用改良的儿童畏惧调查表-牙科分量表(CFSS-DS)和Venham临床焦虑及合作行为级别评定量表对150例患儿拔牙术前焦虑状况进行调查及统计分析。结果口腔卫生状况较差者,既往看牙或拔牙经历痛苦者,拔牙当天精神状态较差者或母亲文化程度较低者的患儿CFSS-DS的评分值和Venham评定级别明显较高,且有统计学意义。逐步回归分析表明:口腔卫生状况与两量表评定的相关关系均最显著(P<0.01)。两量表的相关性显著(r=0.67)。结论儿童拔牙术前的焦虑状况与其口腔卫生状况、看牙经




    Full Text Available ABSTRACT: Pyogenic liver abscess is a serious disease, which is potentially fatal if left untreated. In developed countries, pyogenic abscesses are the most common but worldwide, amoebae are the most common cause. We report a 60-ye ar-old diabetic woman with a 2 months history of pain abdomen, 1 month history of high fev er and anorexia who had multiple liver abscess caused by anaerobic Actinomyces species and Enterococcus faecalis and was complicated by peritonitis. Treatment included prompt percutaneous drainage coupled with long-term intravenous administration of Amikacin, M etronidazole and Piperacillin/ Tazobactum. The patient later died due to peritoniti s.

  17. Submucosal Abscess of the Esophagus Caused by Piriform Sinus Fistula Treated with Transoral Video Laryngoscopic Surgery.

    Koyama, Satoshi; Fujiwara, Kazunori; Morisaki, Tsuyoshi; Fukuhara, Takahiro; Kawamoto, Katsuyuki; Kitano, Hiroya; Takeuchi, Hiromi


    Piriform sinus fistula (PSF) is a rare branchial anomaly that causes repetitive acute suppurative thyroiditis or deep neck abscess. The definitive treatment of PSF is open neck surgery. However, such surgery has a cosmetic problem and a high risk of recurrence. Furthermore, identifying the fistula is difficult due to previous repetitive infections. We report a case of esophageal submucosal abscess caused by PSF treated with endoscopic mucosal incision. The patient underwent transoral video laryngoscopic surgery (TOVS), and endoscopy as well as fluoroscopy revealed complete closure of PSF without any complication. TOVS is a novel surgical technique for the definitive treatment of PSF with esophageal submucosal abscess.

  18. Preseptal Cellulitis, Orbital Cellulitis, Orbital Abscess

    Rana Altan Yaycıoğlu


    Full Text Available Patients with orbital infections present to our clinic usually with unilateral pain, hyperemia, and edema of the eyelids. The differentiation between preseptal and orbital cellulitis is utmost important in that the second requires hospitalization. Since in orbital cellulitis, the tissues posterior to the orbital septum are involved, signs such as conjunctival chemosis, limited eye movement, decreased vision, as well as afferent pupil defect secondary to optic nerve involvement may also be observed. Prompt intravenous antibiotic treatment should be started, and surgical drainage may be performed if patient shows failure to improve in 48 hours despite optimal management. Without treatment, the clinical course may progress to subperiosteal or orbital abscess, and even to cavernous sinus thrombosis. (Turk J Ophthalmol 2012; 42: Supplement 52-6

  19. Laparoscopy may have a role in the drainage of liver abscess: Early experience at Owerri, Nigeria

    Christopher N Ekwunife


    Full Text Available Background: Image-guided percutaneous drainage with antimicrobial agents is the standard modality of treatment of liver abscess. Open surgical drainage, and lately laparoscopic drainage becomes useful in selected patients. Nigeria is awakening late to the laparoscopic surgery revolution. Public health institutions have started making enormous investments in minimal access surgery, which can augment deficient diagnostic capacities. Objective: To describe the outcomes of the patients who underwent laparoscopic liver abscess drainage at the Federal Medical Centre, Owerri. Materials and Methods: A retrospective analysis of the laparoscopic liver abscess drainage procedures done between the period September 2007 and December 2012 was done. Results: A total of eight patients in the study period were worked up for abscess surgical drainage based on ultrasound (seven cases and computed tomography (one case supported localized collection in the liver. Intraoperatively, one patient was noticed to have nodules on the liver that was later confirmed as hepatocellular carcinoma. Operating time ranged from 37 to 126 min. There was no conversion to open surgery. On the follow-up, one patient had residual abscess of 45 mm diameter size, after 6 weeks, and in whose aspirate acid-fast bacilli were identified. Conclusion: Laparoscopic drainage should be considered in the management of liver abscess.

  20. To Tell the Tooth

    ... To Tell the Tooth Print and Take a Quiz + Watch Videos Dudley and Friends Sesame Street + For Preteens Healthy Habits Nutrition Be a Dentist + For Educators Career Resources Presentations and Resources Smile Smarts Dental Health Curriculum MouthHealthy Kids > Games and Quizzes > To Tell the Tooth To Tell ...