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Sample records for amoebic liver abscess

  1. Imported amoebic liver abscess in France.

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    Hugues Cordel

    Full Text Available BACKGROUND: Worldwide, amoebic liver abscess (ALA can be found in individuals in non-endemic areas, especially in foreign-born travelers. METHODS: We performed a retrospective analysis of ALA in patients admitted to French hospitals between 2002 and 2006. We compared imported ALA cases in European and foreign-born patients and assessed the factors associated with abscess size using a logistic regression model. RESULTS: We investigated 90 ALA cases. Patient median age was 41. The male:female ratio was 3.5:1. We were able to determine the origin for 75 patients: 38 were European-born and 37 foreign-born. With respect to clinical characteristics, no significant difference was observed between European and foreign-born patients except a longer lag time between the return to France after traveling abroad and the onset of symptoms for foreign-born. Factors associated with an abscess size of more than 69 mm were being male (OR = 11.25, p<0.01, aged more than 41 years old (OR = 3.63, p = 0.02 and being an immigrant (OR = 11.56, p = 0.03. Percutaneous aspiration was not based on initial abscess size but was carried out significantly more often on patients who were admitted to surgical units (OR = 10, p<0.01. The median time to abscess disappearance for 24 ALA was 7.5 months. CONCLUSIONS/SIGNIFICANCE: In this study on imported ALA was one of the largest worldwide in terms of the number of cases included males, older patients and foreign-born patients presented with larger abscesses, suggesting that hormonal and immunological factors may be involved in ALA physiopathology. The long lag time before developing ALA after returning to a non-endemic area must be highlighted to clinicians so that they will consider Entamoeba histolytica as a possible pathogen of liver abscesses more often.

  2. Residual amoebic liver abscess in a prospective renal transplant recipient

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    Ashish V Choudhrie

    2012-01-01

    Full Text Available Amoebic liver abscess (ALA is by far the most common extraintestinal manifestation of invasive amoebiasis. The vast majority of these resolve with treatment; however, a small percentage of the treated ALAs are known to persist asymptomatically. Herein, we present a prospective renal allograft recipient with a residual liver abscess who had a successful renal transplant after treatment. In our opinion, persistence of a radiological finding of residual abscess in the absence of clinical disease does not appear to be a contraindication to renal transplantation.

  3. Amoebic liver abscess production by Entamoeba dispar.

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    Dolabella, Silvio S; Serrano-Luna, Jesús; Navarro-García, Fernando; Cerritos, René; Ximénez, Cecilia; Galván-Moroyoqui, José Manuel; Silva, Edward F; Tsutsumi, Víctor; Shibayama, Mineko

    2012-01-01

    Although Entamoeba dispar displays a similar morphology to Entamoeba histolytica, cellular and molecular studies have revealed significant differences between these two amoebae, including the former being characterized as non-pathogenic and the later as pathogenic. However, recent in vivo and in vitro experiments have shown that E. dispar strains of different origin are capable of causing liver damage and destroying cell culture lines in the presence of common intestinal bacteria. These results suggested that E. dispar may present pathogenic behavior according to the specific E. dispar strain, culture and environmental conditions. To investigate this possibility, we carried out in vivo and in vitro studies using a xenic strain E. dispar (ICB-ADO) isolated from a symptomatic non-dysenteric Brazilian patient. This strain was able to induce liver necrosis in a hamster model that was more severe than that produced by E. histolytica. The ICB-ADO isolate also caused significantly more destruction of cultured MDCK cells and increased loss of transepithelial resistance than did the E. histolytica. Xenic E. dispar exhibited high proteolytic activity, which was partially inhibited by the addition of cysteine-protease inhibitors. Based on our biochemical and molecular characterization of E. dispar (ICB-ADO) xenic culture and its ability to produce liver abscesses, we conclude that this specific strain can indeed produce tissue damage, distinct from the frequently used non- pathogenic E. dispar SAW 760 strain.

  4. Amoebic liver abscess: ultrasonographic characteristics and results of different therapeutic approaches.

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    Widjaya, P; Bilić, A; Babić, Z; Ljubicić, N; Bakula, B; Pilas, V

    1991-01-01

    This prospective study was carried out on 33 patients with clinically, serologically and ultrasonographically confirmed amoebic liver abscess. All patients were randomly treated with metronidazole and chlorochin or a combination of medicamentous therapy and percutaneous drainage. Ultrasonographic characteristics of amoebic liver abscesses were rotound or oval shape, usually hypoechogenic content with specific dorsal sonic enhancement, and in the majority of cases, location near liver capsule. Shorter duration of amoebic liver abscess resolution time in the group of patients treated with the combined therapy was observed particularly in the first four weeks of the treatment. The authors concluded that percutaneous drainage in combination with medicamentous therapy represents a successful therapeutic approach in the treatment of amoebic liver abscesses. PMID:2035339

  5. Amoebic liver abscess in the medical emergency of a North Indian hospital

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    Lal Anupam

    2010-01-01

    Full Text Available Abstract Background Amoebic Liver abscess although fairly common in developing countries, yet, there is limited data on the clinical presentation to the emergency department. A retrospective analysis of 86 indoor cases of Amoebic Liver Abscess presenting to the emergency department over a 5-year period was carried out. Findings The mean age of patients was 40.5 ± 2.1 years (male-female ratio = 7:1. Fever, pain abdomen and diarrhea were seen in 94%, 90% and 10.5% respectively. Duration of symptoms less than 2 weeks was seen in 48% cases. Hepatomegaly was present in 16% cases only, a right sided pleural effusion in 14% cases and ascites in 5.7%. On ultrasound, a right lobe abscess was seen in 65%, a left lobe abscess in 13% and multiple abscesses in both the lobes in 22% cases. Seventy one cases underwent per-cutaneous pigtail catheter drainage for a mean period of 13.4 ± 0.8 days. The mortality rate was 5.8%. On multivariate regression and correlation analysis, a higher number of inserted pigtail catheters correlated to mortality. Conclusions Amoebic liver abscess presents commonly to the emergency department and should be suspected in persons with prolonged fever and pain abdomen. Conservative management for uncomplicated amoebic liver abscess and insertion of single per-cutaneous pigtail catheter drainage for complicated amoebic liver abscess are efficacious as treatment modalities.

  6. Huge amoebic liver abscess presented with massive right empyema: a case report.

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    Mostafa El-Shamy

    2014-03-01

    Full Text Available Amoebic liver abscess is a complication of amoebiasis that needs early diagnosis and proper treatment before further complications occur. We report a-35 year old female presented by fever and dyspnea due to huge liver abscess complicated by massive right side empyema. The patient was effectively treated by percutaneous drainage for both the right lobe abscess and empyema together with pharmacologic agents.

  7. First report of Entamoeba histolytica infection from Timor-Leste--acute amoebic colitis and concurrent late development of amoebic liver abscess in returned travellers to Australia.

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    Nourse, Clare B; Robson, Jennifer M; Whitby, Michael R; Francis, Josh R

    2016-02-01

    This communication reports invasive amoebic colitis and late onset amoebic liver abscess in three members of a group of 12 Australian travellers to Timor-Leste (TL). This is the first report of Entamoeba histolytica infection from TL. Clinicians in Australia need to consider amoebiasis in the differential diagnosis in travellers returning with colitis, abdominal pain and fever. Presentation with amoebic liver abscess months after exposure is rare but should be suspected in symptomatic individuals with a relevant history of travel. PMID:26858275

  8. Entamoeba histolytica acetyl–CoA synthetase: biomarker of acute amoebic liver abscess

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    Lim Boon Huat

    2014-06-01

    Conclusions: This finding suggested the significant role of EhACS as a biomarker for moribund hamsters with acute amoebic liver abscess (ALA infection. It is deemed pertinent that future studies explore the potential roles of EhACS in better understanding the pathogenesis of ALA; and in the development of vaccine and diagnostic tests to control ALA in human populations.

  9. Precision-cut hamster liver slices as an ex vivo model to study amoebic liver abscess.

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    Carranza-Rosales, Pilar; Santiago-Mauricio, María Guadalupe; Guzmán-Delgado, Nancy Elena; Vargas-Villarreal, Javier; Lozano-Garza, Gerardo; Ventura-Juárez, Javier; Balderas-Rentería, Isaías; Morán-Martínez, Javier; Gandolfi, A Jay

    2010-10-01

    Entamoeba histolytica is the etiological agent of amoebiasis, the second cause of global morbidity and mortality due to parasitic diseases in humans. In approximately 1% of the cases, amoebas penetrate the intestinal mucosa and spread to other organs, producing extra-intestinal lesions, among which amoebic liver abscess (ALA) is the most common. To study ALA, in vivo and in vitro models are used. However, animal models may pose ethical issues, and are time-consuming and costly; and cell cultures represent isolated cellular lineages. The present study reports the infection of precision-cut hamster liver slices with Entamoeba histolytica trophozoites. The infection time-course, including tissue damage, parallels findings previously reported in the animal model. At the same time amoebic virulence factors were detected in the infected slices. This new model to study ALA is simple and reproducible, and employs less than 1/3 of the hamsters required for in vivo analyses.

  10. Diagnostic tests for amoebic liver abscess: comparison of enzyme - linked immunosorbent assay (Elisa and counterimmunoelectrophoresis (CIE

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    Marcos I. Restrepo

    1996-02-01

    Full Text Available The liver abscess is the most frequent extraintestinal complication of intestinal amoebiasis: its diagnosis is suggested by the clinical picture but it must be confirmed by paraclinic tests. Themost stringent diagnosis requires identification of E. histolytica. But this is possible only in a few cases. Serological tests greatly improve the diagnosis of this severe complication of amoebiasis. We compared the Enzyme Linfed Immunosorbent Assay and the Counterimmunoeletrophoresis techniques. Both techniques were used to detect amoebic antibodies in 50 control patients, 30 patients with liver abscess and 30 patients with intestinal amoebiasis. All the sera from control patients gave negative results iin both techniques. When analysing the sera from patients with intestinal amoebiasis, 10% of them were positive by ELISA but non by CIE. The sera of patients with liver abscess, we found that 90% were positive by the ELISA method and 66.6% by the CIE technique. In patients with amoebic liver abscess, the results showed that the ELISA was more sensitive than the CIE, as it presented a higher sensitivity (100% than that of the CIE technique (66%.

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

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

    2013-08-01

    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.

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

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

    2013-08-01

    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. PMID:23680184

  13. Entamoeba histolytica acetyl-CoA synthetase:biomarker of acute amoebic liver abscess

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    Lim Boon Huat; Pim Chau Dam; Alfonso Olivos Garcia; Tan Zi Ning; Wong Weng Kin; Rahmah Noordin; Siti Shafiqah Anaqi Azham; Lee Zhi Jie; Guee Cher Ching; Foo Phiaw Chong

    2014-01-01

    Objective: To characterize the Entamoeba histolytica (E. histolytica) antigen(s) recognized by moribound amoebic liver abscess hamsters.Methods:in 1D- and 2D-Western blot analyses. The antigenic protein was then sent for tandem mass spectrometry analysis. The corresponding gene was cloned and expressed in Escherichia coli BL21-AI to produce the recombinant E. histolytica ADP-forming acetyl-CoA synthetase (EhACS) protein. A customised ELISA was developed to evaluate the sensitivity and specificity of the recombinant protein.Results:Crude soluble antigen of E. histolytica was probed with sera of moribund hamsters detected by sera of hamsters in the control group. Tandem mass spectrometry analysis revealed the protein to be the 77 kDa E. histolytica ADP-forming acetyl-CoA synthetase (EhACS). The customised ELISA results revealed 100% sensitivity and 100% specificity when tested against infected (n=31) and control group hamsters (n=5) serum samples, respectively.Conclusions:This finding suggested the significant role of EhACS as a biomarker for moribund A ~75 kDa protein band with a pI value of 5.91-6.5 was found to be antigenic; and not hamsters with acute amoebic liver abscess (ALA) infection. It is deemed pertinent that future studies explore the potential roles of EhACS in better understanding the pathogenesis of ALA; and in the development of vaccine and diagnostic tests to control ALA in human populations.

  14. Detection of excretory Entamoeba histolytica DNA in the urine, and detection of E. histolytica DNA and lectin antigen in the liver abscess pus for the diagnosis of amoebic liver abscess

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    Khairnar Krishna; Parija Subhash C

    2007-01-01

    Abstract Background Amoebic liver abscess (ALA) and pyogenic liver abscesses (PLA) appear identical by ultrasound and other imaging techniques. Collection of blood or liver abscess pus for diagnosis of liver abscesses is an invasive procedure, and the procedure requires technical expertise and disposable syringes. Collection of urine is a noninvasive procedure. Therefore, there has been much interest shown towards the use of urine as an alternative clinical specimen for the diagnosis of some ...

  15. Experimental amoebic liver abscess in hamsters caused by trophozoites of a Brazilian strain of Entamoeba dispar.

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    Guzmán-Silva, Maria Angélica; Santos, Helena Lúcia Carneiro; Peralta, Regina Saramago; Peralta, José Mauro; de Macedo, Heloisa Werneck

    2013-05-01

    It has been claimed that amoebic molecules such as amoebapore, galactose/N-acetyl galactosamine inhibitable lectin, and cysteine proteases are responsible for host tissue destruction and are present in both pathogenic Entamoeba histolytica and non-pathogenic Entamoeba dispar. Some reports have provided evidence that after infection with E. dispar, pathological changes may occur in some humans. The aim of this study was to evaluate E. dispar pathogenicity by comparing it to the pathogenicity of E. histolytica through liver abscesses induced in hamsters. Syrian golden hamsters were challenged by intrahepatic inoculation with the 03C E. dispar strain or with two strains of E. histolytica (HM1:IMSS and EGG) to compare their virulence grades. As control groups, we used bacterial flora and Pavlova's modified medium. Lesions were verified at 1, 3 and 6 days after inoculation. Multiplex Polymerase Chain Reaction was performed to characterize each strain using EdP1/EdP2 and EhP1/EhP2 primers. The EGG and HM1:IMSS E. histolytica strains and 03C E. dispar were able to cause liver lesions. The EGG strain caused extensive hepatic abscesses, and trophozoites were found in the lesions throughout the three periods of study. The HM1:IMSS strain caused smaller abscesses when compared to EGG lesions; however, trophozoites were observed at 1 and 3 days after inoculation. The 03C E. dispar strain caused intermediate abscesses when compared to the others; trophozoites were observed in all periods analyzed. The EGG strain caused progressive evolution of the injury, which differed from the HM1:IMSS and 03C strains. These results strongly suggest that the 03C E. dispar strain is pathogenic in the experimental hamster model. Additional studies are necessary to identify potential factors that regulate the manifestation of virulence of this strain and others.

  16. Detection of Entamoeba histolytica DNA in the saliva of amoebic liver abscess patients who received prior treatment with metronidazole.

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    Khairnar, Krishna; Parija, Subhash Chandra

    2008-12-01

    Saliva is an easily-accessible and a non-invasive clinical specimen alternate to blood and liver pus. An attempt was made to detect Entamoeba histolytica DNA released in the saliva of amoebic liver abscess (ALA) patients by applying 16S-like rRNA gene-based nested multiplex polymerase chain reaction (NM-PCR). The NM-PCR detected E. histolytica DNA in the saliva of eight (28.6%) of 28 ALA patients. The NM-PCR result was negative for E. histolytica DNA in the saliva of all the eight ALA patients who were tested prior to treatment with metronidazole but was positive in the saliva of eight (40%) of 20 ALA patient who were tested after therapy with metronidazole. The NM-PCR detected E. histolytica DNA in liver abscess pus of all 28 (100%) patients with ALA. The TechLab E. histolytica II enzyme-linked immunosorbent assay was positive for E. histolytica Gal/GalNAc lectin antigen in the liver abscess pus of 13 (46.4%) of the 28 ALA patients. The indirect haemagglutination (IHA) test was positive for anti-amoebic antibodies in the serum of 22 (78.6%) of the 28 ALA patients and 2 (5.7%) of 35 healthy controls. The present study, for the first time, demonstrates the release of E. histolytica DNA in the saliva of ALA patients by applying NM-PCR. PMID:19069620

  17. Detection of Entamoeba histolytica DNA in the Saliva of Amoebic Liver Abscess Patients Who Received Prior Treatment with Metronidazole

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    Khairnar, Krishna; Parija, Subhash Chandra

    2008-01-01

    Saliva is an easily-accessible and a non-invasive clinical specimen alternate to blood and liver pus. An attempt was made to detect Entamoeba histolytica DNA released in the saliva of amoebic liver abscess (ALA) patients by applying 16S-like rRNA gene-based nested multiplex polymerase chain reaction (NM-PCR). The NM-PCR detected E. histolytica DNA in the saliva of eight (28.6%) of 28 ALA patients. The NM-PCR result was negative for E. histolytica DNA in the saliva of all the eight ALA patient...

  18. Entamoeba histolytica calreticulin: an endoplasmic reticulum protein expressed by trophozoites into experimentally induced amoebic liver abscesses.

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    González, Enrique; de Leon, Maria del Carmen García; Meza, Isaura; Ocadiz-Delgado, Rodolfo; Gariglio, Patricio; Silva-Olivares, Angelica; Galindo-Gómez, Silvia; Shibayama, Mineko; Morán, Patricia; Valadez, Alicia; Limón, Angelica; Rojas, Liliana; Hernández, Eric G; Cerritos, René; Ximenez, Cecilia

    2011-02-01

    Entamoeba histolytica calreticulin (EhCRT) is remarkably immunogenic in humans (90-100% of invasive amoebiasis patients). Nevertheless, the study of calreticulin in this protozoan is still in its early stages. The exact location, biological functions, and its role in pathogenesis are yet to be fully understood. The aim of the present work is to determine the location of EhCRT in virulent trophozoites in vivo and the expression of the Ehcrt gene during the development of experimentally induced amoebic liver abscesses (ALA) in hamsters. Antibodies against recombinant EhCRT were used for the immunolocalization of EhCRT in trophozoites through confocal microscopy; immunohistochemical assays were also performed on tissue sections of ALAs at different times after intrahepatic inoculation. The expression of the Ehcrt gene during the development of ALA was estimated through both in situ RT-PCR and real-time RT-PCR. Confocal assays of virulent trophozoites showed a distribution of EhCRT in the cytoplasmic vesicles of different sizes. Apparently, EhCRT is not exported into the hepatic tissue. Real-time RT-PCR demonstrated an over-expression of the Ehcrt gene at 30 min after trophozoite inoculation, reaching a peak at 1-2 h; thereafter, the expression fell sharply to its original levels. These results demonstrate for the first time in an in vivo model of ALA, the expression of Ehcrt gene in E. histolytica trophozoites and add evidence that support CRT as a resident protein of the ER in E. histolytica species. The in vivo experiments suggest that CRT may play an important role during the early stages of the host-parasite relationship, when the parasite is adapting to a new environment, although the protein seems to be constitutively synthesized. Moreover, trophozoites apparently do not export EhCRT into the hepatic tissue in ALA.

  19. Entamoeba histolytica: inflammatory process during amoebic liver abscess formation involves cyclooxygenase-2 expression in macrophages and trophozoites.

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    Gutiérrez-Alarcón, A; Moguel-Torres, M; Mata-Leyva, O; Cuellar-Nevárez, G; Siqueiros-Cendón, T; Erosa, G; Ramos-Martínez, E; Talamás-Rohana, P; Sánchez-Ramírez, B

    2006-11-01

    It has been demonstrated that expression of cyclooxygenase-2 (COX-2) isoform is induced by Entamoeba histolytica in macrophages and polymorphonuclear cells during amoebic liver abscess (ALA) formation in hamsters. Trophozoites present in the lesion were also positive for COX-2 signal. However, no cross reactivity of the anti-COX-2 antibody with protein extract of cultivated trophozoites was found. To clarify if trophozoites are involved in PGE(2) production during ALA development, COX-2 expression was detected by in situ hybridization and RT-PCR in liver tissue from intrahepatically infected hamsters. COX-2 mRNA was in polymorphonuclear cells since 4h postinfection, and subsequently, local macrophages expressed COX-2 mRNA in a similar way. Additionally, a positive signal for COX-2 mRNA expression was detected in E. histolytica trophozoites, suggesting that, in vivo, parasite COX expression may be an important mechanism to promote inflammation.

  20. A RARE CASE REPORT OF SITUS INVERSUS TOTALIS WITH RUPTURED AMOEBIC LIVER ABSCESS IN A PATIENT SUFFERING FROM SERUM HEPATITIS

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    Suraj Kumar

    2015-05-01

    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.

  1. The Trend in Distribution of Q223R Mutation of Leptin Receptor Gene in Amoebic Liver Abscess Patients from North India: A Prospective Study

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    Anil Kumar Verma

    2014-01-01

    Full Text Available Host genetic susceptibility is an important risk factor in infectious diseases. We explored the distribution of Q223R mutation in leptin receptor gene of amoebic liver abscess (ALA patients of North India. A total of 55 ALA samples along with 102 controls were subjected to PCR-RFLP analysis. The frequency of allele “G” (coding for arginine was in general high in Indian population irrespective of the disease. Our results of Fisher exact test shows that heterozygous mutant (QQ versus QR, P=0.049 and homozygous mutant (QQ versus RR, P=0.004 were significantly associated with amoebic liver abscess when compared with homozygous wild (QQ.

  2. In vivo programmed cell death of Entamoeba histolytica trophozoites in a hamster model of amoebic liver abscess.

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    Villalba-Magdaleno, José D'Artagnan; Pérez-Ishiwara, Guillermo; Serrano-Luna, Jesús; Tsutsumi, Víctor; Shibayama, Mineko

    2011-05-01

    Entamoeba histolytica trophozoites can induce host cell apoptosis, which correlates with the virulence of the parasite. This phenomenon has been seen during the resolution of an inflammatory response and the survival of the parasites. Other studies have shown that E. histolytica trophozoites undergo programmed cell death (PCD) in vitro, but how this process occurs within the mammalian host cell remains unclear. Here, we studied the PCD of E. histolytica trophozoites as part of an in vivo event related to the inflammatory reaction and the host-parasite interaction. Morphological study of amoebic liver abscesses showed only a few E. histolytica trophozoites with peroxidase-positive nuclei identified by terminal deoxynucleotidyltransferase enzyme-mediated dUTP nick end labelling (TUNEL). To better understand PCD following the interaction between amoebae and inflammatory cells, we designed a novel in vivo model using a dialysis bag containing E. histolytica trophozoites, which was surgically placed inside the peritoneal cavity of a hamster and left to interact with the host's exudate components. Amoebae collected from bags were then examined by TUNEL assay, fluorescence-activated cell sorting (FACS) and transmission electron microscopy. Nuclear condensation and DNA fragmentation of E. histolytica trophozoites were observed after exposure to peritoneal exudates, which were mainly composed of neutrophils and macrophages. Our results suggest that production of nitric oxide by inflammatory cells could be involved in PCD of trophozoites. In this modified in vivo system, PCD appears to play a prominent role in the host-parasite interaction and parasite cell death.

  3. Detection of excretory Entamoeba histolytica DNA in the urine, and detection of E. histolytica DNA and lectin antigen in the liver abscess pus for the diagnosis of amoebic liver abscess

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    Khairnar Krishna

    2007-05-01

    Full Text Available Abstract Background Amoebic liver abscess (ALA and pyogenic liver abscesses (PLA appear identical by ultrasound and other imaging techniques. Collection of blood or liver abscess pus for diagnosis of liver abscesses is an invasive procedure, and the procedure requires technical expertise and disposable syringes. Collection of urine is a noninvasive procedure. Therefore, there has been much interest shown towards the use of urine as an alternative clinical specimen for the diagnosis of some parasitic infections. Here, we report for the first time the detection of E. histolytica DNA excreted in the urine for diagnosis of the cases of ALA. Results E. histolytica DNA was detected in liver abscess pus specimen of 80.4% of ALA patients by a nested multiplex polymerase chain reaction (PCR targeting 16S-like r RNA gene. The nested PCR detected E. histolytica DNA in all 37 (100% liver abscess pus specimens collected prior to metronidazole treatment, but were detected in only 53 of 75 (70.6% pus specimens collected after therapy with metronidazole. Similarly, the PCR detected E. histolytica DNA in 21 of 53 (39.6% urine specimens of ALA patients. The test detected E. histolytica DNA in only 4 of 23 (17.4% urine specimens collected prior to metronidazole treatment, but were detected in 17 of 30 (56.7% urine specimens collected after treatment with metronidazole. The enzyme-linked immunosorbent assay (ELISA for the detection of lectin E. histolytica antigen in the liver abscess pus showed a sensitivity of 50% and the indirect haemagglutination (IHA test for detection of amoebic antibodies in the serum showed a sensitivity of 76.8% for the diagnosis of the ALA. Conclusion The present study for the first time shows that the kidney barrier in ALA patients is permeable to E. histolytica DNA molecule resulting in excretion of E. histolytica DNA in urine which can be detected by PCR. The study also shows that the PCR for detection of E. histolytica DNA in urine of

  4. Mucosal Delivery of ACNPV Baculovirus Driving Expression of the Gal-Lectin LC3 Fragment Confers Protection against Amoebic Liver Abscess in Hamster

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    DM Meneses-Ruiz, JP Laclette, H Aguilar-Díaz, J Hernández-Ruiz, A Luz-Madrigal, A Sampieri, L Vaca, JC Carrero

    2011-01-01

    Full Text Available Mucosal vaccination against amoebiasis using the Gal-lectin of E. histolytica has been proposed as one of the leading strategies for controlling this human disease. However, most mucosal adjuvants used are toxic and the identification of safe delivery systems is necessary. Here, we evaluate the potential of a recombinant Autographa californica baculovirus driving the expression of the LC3 fragment of the Gal-lectin to confer protection against amoebic liver abscess (ALA in hamsters following oral or nasal immunization. Hamsters immunized by oral route showed complete absence (57.9% or partial development (21% of ALA, resulting in some protection in 78.9% of animals when compared with the wild type baculovirus and sham control groups. In contrast, nasal immunization conferred only 21% of protection efficacy. Levels of ALA protection showed lineal correlation with the development of an anti-amoebic cellular immune response evaluated in spleens, but not with the induction of seric IgG anti-amoeba antibodies. These results suggest that baculovirus driving the expression of E. histolytica vaccine candidate antigens is useful for inducing protective cellular and humoral immune responses following oral immunization, and therefore it could be used as a system for mucosal delivery of an anti-amoebic vaccine.

  5. Mucosal delivery of ACNPV baculovirus driving expression of the Gal-lectin LC3 fragment confers protection against amoebic liver abscess in hamster.

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    Meneses-Ruiz, D M; Laclette, J P; Aguilar-Díaz, H; Hernández-Ruiz, J; Luz-Madrigal, A; Sampieri, A; Vaca, L; Carrero, J C

    2011-01-01

    Mucosal vaccination against amoebiasis using the Gal-lectin of E. histolytica has been proposed as one of the leading strategies for controlling this human disease. However, most mucosal adjuvants used are toxic and the identification of safe delivery systems is necessary. Here, we evaluate the potential of a recombinant Autographa californica baculovirus driving the expression of the LC3 fragment of the Gal-lectin to confer protection against amoebic liver abscess (ALA) in hamsters following oral or nasal immunization. Hamsters immunized by oral route showed complete absence (57.9%) or partial development (21%) of ALA, resulting in some protection in 78.9% of animals when compared with the wild type baculovirus and sham control groups. In contrast, nasal immunization conferred only 21% of protection efficacy. Levels of ALA protection showed lineal correlation with the development of an anti-amoebic cellular immune response evaluated in spleens, but not with the induction of seric IgG anti-amoeba antibodies. These results suggest that baculovirus driving the expression of E. histolytica vaccine candidate antigens is useful for inducing protective cellular and humoral immune responses following oral immunization, and therefore it could be used as a system for mucosal delivery of an anti-amoebic vaccine.

  6. Mucosal Delivery of ACNPV Baculovirus Driving Expression of the Gal-Lectin LC3 Fragment Confers Protection against Amoebic Liver Abscess in Hamster

    Science.gov (United States)

    Meneses-Ruiz, DM; Laclette, JP; Aguilar-Díaz, H; Hernández-Ruiz, J; Luz-Madrigal, A; Sampieri, A; Vaca, L; Carrero, JC

    2011-01-01

    Mucosal vaccination against amoebiasis using the Gal-lectin of E. histolytica has been proposed as one of the leading strategies for controlling this human disease. However, most mucosal adjuvants used are toxic and the identification of safe delivery systems is necessary. Here, we evaluate the potential of a recombinant Autographa californica baculovirus driving the expression of the LC3 fragment of the Gal-lectin to confer protection against amoebic liver abscess (ALA) in hamsters following oral or nasal immunization. Hamsters immunized by oral route showed complete absence (57.9%) or partial development (21%) of ALA, resulting in some protection in 78.9% of animals when compared with the wild type baculovirus and sham control groups. In contrast, nasal immunization conferred only 21% of protection efficacy. Levels of ALA protection showed lineal correlation with the development of an anti-amoebic cellular immune response evaluated in spleens, but not with the induction of seric IgG anti-amoeba antibodies. These results suggest that baculovirus driving the expression of E. histolytica vaccine candidate antigens is useful for inducing protective cellular and humoral immune responses following oral immunization, and therefore it could be used as a system for mucosal delivery of an anti-amoebic vaccine. PMID:22110386

  7. Immunization with a tetramer derivative of an anti-inflammatory pentapeptide produced by Entamoeba histolytica protects gerbils (Meriones unguiculatus) against experimental amoebic abscess of the liver.

    Science.gov (United States)

    Giménez-Scherer, Juan Antonio; Cárdenas, Guadalupe; López-Osuna, Martha; Velázquez, Juan Raymundo; Rico, Guadalupe; Isibasi, Armando; Maldonado, María del Carmen; Morales, María Esther; Fernández-Diez, Jorge; Kretschmer, Roberto R

    2004-01-01

    Axenically grown Entamoeba histolytica produces a pentapeptide (Met-Gln-Cys-Asn-Ser) with several anti-inflammatory properties, including the inhibition of human monocyte locomotion (Monocyte Locomotion Inhibitory Factor (MLIF)). A construct displays the same effects as the native material. It remains to be seen if MLIF is used, or even produced in vivo by the tissue-invading parasite. If MLIF were to be relevant in invasive amoebiasis, immunizing against it could diminish this parasite advantage and prevent lesions. KLH-linked MLIF mixed with Freund's adjuvant was too aggressive an immunizing material to answer this question. However, immunization with a tetramer of MLIF (but not a scrambled version of MLIF) around a lysine core (MLIF-MAPS), that displays increased antigenicity, yet lacks excessive innate immunity activation, completely protects gerbils against amoebic abscess of the liver caused by the intraportal injection of virulent E. histolytica. Liver abscesses caused by Listeria monocytogenes were not prevented. Invasive E. histolytica may produce the parent protein of MLIF in vivo, and if appropriately cleaved, it may play a role in invasive amoebiasis. MLIF may join new vaccination strategies against amoebiasis.

  8. Pyogenic liver abscess

    Science.gov (United States)

    Liver abscess; Bacterial liver abscess ... There are many potential 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 ...

  9. Participación del óxido nítrico durante el desarrollo del absceso hepático amebiano Nitric oxide participation during amoebic liver abscess development

    Directory of Open Access Journals (Sweden)

    Joel Ramírez-Emiliano

    2007-04-01

    Full Text Available El óxido nítrico participa en funciones fisiológicas y fisiopatológicas, así como en el mecanismo de defensa del sistema inmunológico de mamíferos contra parásitos, virus y bacterias. La Entamoeba histolytica es un parásito protozoario causante de la amebiasis, la cual se caracteriza por el daño intestinal y la formación del absceso hepático amebiano (AHA. El desarrollo del absceso hepático amebiano en el hámster es similar al que desarrolla el humano, mientras que el ratón es resistente a la formación de este absceso, debido a un incremento en la producción de óxido nítrico. A diferencia del ratón, el desarrollo del absceso hepático amebiano en el hámster es debido a un exceso en la producción de óxido nítrico o posiblemente a una mayor susceptibilidad del hámster al daño producido por el óxido nítrico. Por lo tanto, sería importante realizar más estudios para determinar si en el humano, un exceso en la producción de óxido nítrico favorece la formación del absceso hepático amebiano.Nitric oxide participates in both physiological and pathophysiological functions, and it plays an important role in the mammalian immune system in killing or inhibiting the growth of many pathogens, including parasites, viruses and bacteria. Entamoeba histolytica is a protozoan parasite that causes amoebiasis, which is characterized by intestinal damage and amoebic liver abscess development. The development of amoebic liver abscess in hamsters is similar to that in humans, whereas mice are resistant to amoebic liver abscess development due to an increase in nitric oxide production. Unlike in mice, amoebic liver abscess development in hamsters is due to an excess in nitric oxide production or possibly to a greater susceptibility of the hamster to damage caused by nitric oxide. Therefore, it could be important to elucidate if, in humans, an excess in nitric oxide production favors amoebic liver abscess development.

  10. Overexpression of Differentially Expressed Genes Identified in Non-pathogenic and Pathogenic Entamoeba histolytica Clones Allow Identification of New Pathogenicity Factors Involved in Amoebic Liver Abscess Formation.

    Science.gov (United States)

    Meyer, Martin; Fehling, Helena; Matthiesen, Jenny; Lorenzen, Stephan; Schuldt, Kathrin; Bernin, Hannah; Zaruba, Mareen; Lender, Corinna; Ernst, Thomas; Ittrich, Harald; Roeder, Thomas; Tannich, Egbert; Lotter, Hannelore; Bruchhaus, Iris

    2016-08-01

    We here compared pathogenic (p) and non-pathogenic (np) isolates of Entamoeba histolytica to identify molecules involved in the ability of this parasite to induce amoebic liver abscess (ALA)-like lesions in two rodent models for the disease. We performed a comprehensive analysis of 12 clones (A1-A12) derived from a non-pathogenic isolate HM-1:IMSS-A and 12 clones (B1-B12) derived from a pathogenic isolate HM-1:IMSS-B. "Non-pathogenicity" included the induction of small and quickly resolved lesions while "pathogenicity" comprised larger abscess development that overstayed day 7 post infection. All A-clones were designated as non-pathogenic, whereas 4 out of 12 B-clones lost their ability to induce ALAs in gerbils. No correlation between ALA formation and cysteine peptidase (CP) activity, haemolytic activity, erythrophagocytosis, motility or cytopathic activity was found. To identify the molecular framework underlying different pathogenic phenotypes, three clones were selected for in-depth transcriptome analyses. Comparison of a non-pathogenic clone A1np with pathogenic clone B2p revealed 76 differentially expressed genes, whereas comparison of a non-pathogenic clone B8np with B2p revealed only 19 differentially expressed genes. Only six genes were found to be similarly regulated in the two non-pathogenic clones A1np and B8np in comparison with the pathogenic clone B2p. Based on these analyses, we chose 20 candidate genes and evaluated their roles in ALA formation using the respective gene-overexpressing transfectants. We conclude that different mechanisms lead to loss of pathogenicity. In total, we identified eight proteins, comprising a metallopeptidase, C2 domain proteins, alcohol dehydrogenases and hypothetical proteins, that affect the pathogenicity of E. histolytica. PMID:27575775

  11. Overexpression of Differentially Expressed Genes Identified in Non-pathogenic and Pathogenic Entamoeba histolytica Clones Allow Identification of New Pathogenicity Factors Involved in Amoebic Liver Abscess Formation

    Science.gov (United States)

    Lorenzen, Stephan; Schuldt, Kathrin; Bernin, Hannah; Zaruba, Mareen; Lender, Corinna; Ittrich, Harald; Roeder, Thomas; Tannich, Egbert; Lotter, Hannelore; Bruchhaus, Iris

    2016-01-01

    We here compared pathogenic (p) and non-pathogenic (np) isolates of Entamoeba histolytica to identify molecules involved in the ability of this parasite to induce amoebic liver abscess (ALA)-like lesions in two rodent models for the disease. We performed a comprehensive analysis of 12 clones (A1–A12) derived from a non-pathogenic isolate HM-1:IMSS-A and 12 clones (B1–B12) derived from a pathogenic isolate HM-1:IMSS-B. “Non-pathogenicity” included the induction of small and quickly resolved lesions while “pathogenicity” comprised larger abscess development that overstayed day 7 post infection. All A-clones were designated as non-pathogenic, whereas 4 out of 12 B-clones lost their ability to induce ALAs in gerbils. No correlation between ALA formation and cysteine peptidase (CP) activity, haemolytic activity, erythrophagocytosis, motility or cytopathic activity was found. To identify the molecular framework underlying different pathogenic phenotypes, three clones were selected for in-depth transcriptome analyses. Comparison of a non-pathogenic clone A1np with pathogenic clone B2p revealed 76 differentially expressed genes, whereas comparison of a non-pathogenic clone B8np with B2p revealed only 19 differentially expressed genes. Only six genes were found to be similarly regulated in the two non-pathogenic clones A1np and B8np in comparison with the pathogenic clone B2p. Based on these analyses, we chose 20 candidate genes and evaluated their roles in ALA formation using the respective gene-overexpressing transfectants. We conclude that different mechanisms lead to loss of pathogenicity. In total, we identified eight proteins, comprising a metallopeptidase, C2 domain proteins, alcohol dehydrogenases and hypothetical proteins, that affect the pathogenicity of E. histolytica. PMID:27575775

  12. Amoebicidal Activity of Essential Oil of Dysphania ambrosioides (L. Mosyakin & Clemants in an Amoebic Liver Abscess Hamster Model

    Directory of Open Access Journals (Sweden)

    Manuel Enrique Ávila-Blanco

    2014-01-01

    Full Text Available Amebiasis is a parasitic disease that extends worldwide and is a public health problem in developing countries. Metronidazole is the drug recommended in the treatment of amebiasis, but its contralateral effects and lack of continuity of treatment induce low efficiency, coupled with the appearance of resistant amoebic strains. Therefore, the search of new compounds with amoebicidal activity is urgent and important. In this study, we evaluated the in vitro and in vivo antiamoebic activity of the essential oil Dysphania ambrosioides (L. Mosyakin & Clemants. It exhibited an IC50 = 0.7 mg/mL against trophozoites. The oral administration of essential oil (8 mg/kg and 80 mg/kg to hamster infected with Entamoeba histolytica reverted the infection. Ascaridole was identified as the main component of essential oil of D. ambrosioides. The identification of amoebicidal activity of Ascaridole gives support to the traditional use. Further studies with Ascaridole will be carried out to understand the mechanism involved.

  13. Amebic liver abscess

    Science.gov (United States)

    ... liver in response to an intestinal parasite called Entamoeba histolytica . ... Amebic liver abscess is caused by Entamoeba histolytica. This ... dysentery. After an infection has occurred, the parasite may ...

  14. Protection against Amoebic Liver Abscess in Hamster by Intramuscular Immunization with an Autographa californica Baculovirus Driving the Expression of the Gal-Lectin LC3 Fragment

    Science.gov (United States)

    Meneses-Ruiz, Dulce María; Aguilar-Diaz, Hugo; Bobes, Raúl José; Sampieri, Alicia; Laclette, Juan Pedro; Carrero, Julio César

    2015-01-01

    In a previous study, we demonstrated that oral immunization using Autographa californica baculovirus driving the expression of the Gal-lectin LC3 fragment (AcNPV-LC3) of Entamoeba histolytica conferred protection against ALA development in hamsters. In this study, we determined the ability of AcNPV-LC3 to protect against ALA by the intramuscular route as well as the liver immune response associated with protection. Results showed that 55% of hamsters IM immunized with AcNPV-LC3 showed sterile protection against ALA, whereas other 20% showed reduction in the size and extent of abscesses, resulting in some protection in 75% of animals compared to the sham control group. Levels of protection showed a linear correlation with the development and intensity of specific antiamoeba cellular and humoral responses, evaluated in serum and spleen of hamsters, respectively. Evaluation of the Th1/Th2 cytokine patterns expressed in the liver of hamsters showed that sterile protection was associated with the production of high levels of IFNγ and IL-4. These results suggest that the baculovirus system is equally efficient by the intramuscular as well as the oral routes for ALA protection and that the Gal-lectin LC3 fragment is a highly protective antigen against hepatic amoebiasis through the local induction of IFNγ and IL-4. PMID:26090442

  15. Protection against Amoebic Liver Abscess in Hamster by Intramuscular Immunization with an Autographa californica Baculovirus Driving the Expression of the Gal-Lectin LC3 Fragment

    Directory of Open Access Journals (Sweden)

    Dulce María Meneses-Ruiz

    2015-01-01

    Full Text Available In a previous study, we demonstrated that oral immunization using Autographa californica baculovirus driving the expression of the Gal-lectin LC3 fragment (AcNPV-LC3 of Entamoeba histolytica conferred protection against ALA development in hamsters. In this study, we determined the ability of AcNPV-LC3 to protect against ALA by the intramuscular route as well as the liver immune response associated with protection. Results showed that 55% of hamsters IM immunized with AcNPV-LC3 showed sterile protection against ALA, whereas other 20% showed reduction in the size and extent of abscesses, resulting in some protection in 75% of animals compared to the sham control group. Levels of protection showed a linear correlation with the development and intensity of specific antiamoeba cellular and humoral responses, evaluated in serum and spleen of hamsters, respectively. Evaluation of the Th1/Th2 cytokine patterns expressed in the liver of hamsters showed that sterile protection was associated with the production of high levels of IFNγ and IL-4. These results suggest that the baculovirus system is equally efficient by the intramuscular as well as the oral routes for ALA protection and that the Gal-lectin LC3 fragment is a highly protective antigen against hepatic amoebiasis through the local induction of IFNγ and IL-4.

  16. Protection against Amoebic Liver Abscess in Hamster by Intramuscular Immunization with an Autographa californica Baculovirus Driving the Expression of the Gal-Lectin LC3 Fragment.

    Science.gov (United States)

    Meneses-Ruiz, Dulce María; Aguilar-Diaz, Hugo; Bobes, Raúl José; Sampieri, Alicia; Vaca, Luis; Laclette, Juan Pedro; Carrero, Julio César

    2015-01-01

    In a previous study, we demonstrated that oral immunization using Autographa californica baculovirus driving the expression of the Gal-lectin LC3 fragment (AcNPV-LC3) of Entamoeba histolytica conferred protection against ALA development in hamsters. In this study, we determined the ability of AcNPV-LC3 to protect against ALA by the intramuscular route as well as the liver immune response associated with protection. Results showed that 55% of hamsters IM immunized with AcNPV-LC3 showed sterile protection against ALA, whereas other 20% showed reduction in the size and extent of abscesses, resulting in some protection in 75% of animals compared to the sham control group. Levels of protection showed a linear correlation with the development and intensity of specific antiamoeba cellular and humoral responses, evaluated in serum and spleen of hamsters, respectively. Evaluation of the Th1/Th2 cytokine patterns expressed in the liver of hamsters showed that sterile protection was associated with the production of high levels of IFNγ and IL-4. These results suggest that the baculovirus system is equally efficient by the intramuscular as well as the oral routes for ALA protection and that the Gal-lectin LC3 fragment is a highly protective antigen against hepatic amoebiasis through the local induction of IFNγ and IL-4.

  17. 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

    Directory of Open Access Journals (Sweden)

    A. Cosme

    2010-02-01

    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

  18. Therapy of Liver Abscesses

    Science.gov (United States)

    Lübbert, Christoph; Wiegand, Johannes; Karlas, Thomas

    2014-01-01

    Summary Background Liver abscess (LA) is an uncommon but potentially life-threatening disease with significant morbidity and mortality. Methods This review comprehensively describes epidemiology, pathogenesis, diagnosis, and treatment of LA, with a strong focus on antimicrobial treatment choices and the impact of multidrug-resistant pathogens. Results In industrialized areas, pyogenic liver abscess (PLA) accounts for over 80% of the cases, whereas Entamoeba histolyticais responsible for up to 10% of the cases, with a higher incidence in tropical areas. Highly virulent strains of Klebsiella pneumoniaehave emerged as a predominant cause of PLA in Asian countries and tend to spread to the USA, Australia, and European countries, therefore requiring special alertness. Most common symptoms of LA are fever, chills, and right upper quadrant abdominal pain, although a broad spectrum of non-specific symptoms may also occur. Conclusion Imaging studies (ultrasound, computed tomography scan) and microbiological findings play a crucial role in the diagnosis of LA. The treatment of choice for PLA is a multimodal approach combining broad-spectrum antibiotics and aspiration or drainage of larger abscess cavities. Amebic LA can be cured by metronidazole therapy without drainage. PMID:26287275

  19. Morphological Findings in Trophozoites during Amoebic Abscess Development in Misoprostol-Treated BALB/c Mice

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    Andrés Aceves-Cano

    2015-01-01

    Full Text Available During amoebic liver abscess (ALA formation in susceptible animals, immune response is regulated by prostaglandin E2 (PGE2 dependent mechanisms. The aim of this study was to analyze the effect of misoprostol (MPL, a PGE1 analogue, on ALA formation in BALB/c mice. Male mice from BALB/c strain were intrahepatically infected with 7.5×105 trophozoites of E. histolytica strain HM1:IMSS and treated with 10−4 M of MPL daily until sacrifice at 2, 4, and 7 days postinfection (p.i.. ALA formation was evaluated at 2, 4, and 7 days postinfection; trophozoite morphology was analyzed using immunohistochemistry and image analysis. Results showed an increase in frequency of ALA formation in infected and MPL-treated mice only at 2 days p.i. (P=0.03. A significant diminution in the size of trophozoites was detected in abscesses from mice independently of MPL treatment (from 5.8±1.1 µm at 2 days p.i. to 2.7±1.9 µm at 7 days p.i. compared with trophozoites dimensions observed in susceptible hamsters (9.6±2.7 µm (P<0.01. These results suggest that MPL treatment may modify the adequate control of inflammatory process to allow the persistence of trophozoites in the liver; however, natural resistance mechanisms cannot be discarded.

  20. Balantidium Coli liver abscess: first case report from India.

    Science.gov (United States)

    Kapur, P; Das, A K; Kapur, P R; Dudeja, M

    2016-03-01

    Protozoal infections are common in the tropics. Amoebic colitis is the commonest of these infections and can lead to liver abscess as a complication. Balantidium coli is a rare free moving protozoal parasite which is known to infest human large intestine causing a type of colitis very similar to that caused by Entamoeba histolytica. However this pathogen is not known to cause liver invasion in humans. We report here a case of liver abscess caused by B. coli, which is probably the first such case reported in Indian literature. PMID:27065613

  1. Amebic pericardial effusion: a rare complication of amebic liver abscess.

    Science.gov (United States)

    Agrawal, B V; Somani, P N; Khanna, M N; Srivastava, P K; Jha, B N; Verma, S P

    1975-06-01

    Two rare cases of amebic pericardial effusion as a complication of amoebic liver abscess in the left lobe are described. The pericardial amebiasis should be suspected in a patient presenting with signs and symptoms of pericardial effusion with an evidence of hepatic abscess (in the left lobe) or in a patient with pericardial effusion of uncertain etiology. Aspiration of "anchovy sauce" pus from both the pericardial cavity and the liver should be regarded as confirming the diagnosis of amebic pericarditis secondary to amebic liver abcess because demonstration of Entamoeba hystolytica is seldom possible. Removal of pericardial pus and metronidazole intake were markedly effective in treating our patients. PMID:123716

  2. Detection of Entamoeba histolytica in experimentally induced amoebic liver abscess:comparison of three staining methods

    Institute of Scientific and Technical Information of China (English)

    Tan Zi Ning; Wong Weng Kin; Shaymoli Mustafa; Arefuddin Ahmed; Rahmah Noordin; Tan Gim Cheong; Olivos-Garcia Alfonso; Lim Boon Huat

    2012-01-01

    Objective: To compare the efficacy of three different tissue stains, namely haematoxylin and eosin (H&E), periodic-acid Schiff (PAS) and immunohistochemical (IHC) stains for detection of Entamoeba histolytica (E. histolytica) trophozoites in abscessed liver tissues of hamster.Methods:Amoebic liver abscess was experimentally induced in a hamster by injecting 1 × 106 of axenically cultured virulent E. histolytica trophozoites (HM1-IMSS strain) into the portal vein. After a week post-inoculation, the hamster was sacrificed and the liver tissue sections were stained with H&E, PAS and IHC stains to detect the amoebic trophozoite. Results: The three stains revealed tissue necrosis and amoebic trophozoites, but with varying clarity. H&E and PAS stained the trophozoites pink and magenta, respectively, however it was difficult to differentiate the stained trophozoites from the macrophages because of their similarity in size and morphology. On the other hand, IHC stain revealed distinct brown appearance of the trophozoites in the infected liver tissues. Conclusions: It can be concluded that out of the three stains, IHC is the best for identification of E. histolytica trophozoites in tissue sections.

  3. Amoebic Liver Abscess. A Case Report

    OpenAIRE

    Valente, M.; Acúrcio, L; Estrada, H; Mihon, C; Neves, D.; Margarido, E; Teixeira, H.

    2013-01-01

    A amebíase é uma das doenças parasitárias mais comuns no mundo. As principais formas invasivas da doença são a colite amebiana e o abcesso hepático. Apresenta-se o caso clínico de um homem de 42 anos admitido com um quadro agudo de febre elevada e dor abdominal no hipocôndrio direito com dois dias de evolução. A tomografia axial computorizada do abdómen revelou a presença de 3 lesões abcedadas a nível do lobo direito do fígado. Tratando-se de um doente residente em área endémica de ameb...

  4. Multidrug resistant citrobacter: an unusual cause of liver abscess.

    Science.gov (United States)

    Kumar, Prabhat; Ghosh, Soumik; Rath, Deepak; Gadpayle, A K

    2013-01-01

    Liver abscesses are infectious, space occupying lesions in the liver, the two most common abscesses being pyogenic and amoebic. A pyogenic liver abscess (PLA) is a rare condition with a reported incidence of 20 per 100 000 hospital admissions in the western population. The right lobe of the liver is the most common site in both types of liver abscess. Clinical presentation is elusive with complaints of fever, right upper quadrant pain in the abdomen and hepatomegaly with or without jaundice. The aetiology of PLA has changed in the past few decades and may be of biliary, portal, arterial or traumatic origin, but many cases are still cryptogenic. The most common organisms causing PLA are Gram-negative aerobes, especially Escherichia coli and Klebsiella pneumoniae. Studies have shown a high degree of antimicrobial susceptibility of isolated organism resulting in an overall lower mortality in PLA. Here, we present a case of PLA caused by multidrug-resistant Citrobacter freundii, which is an unusual organism to be isolated.

  5. Multicystic Hepatocarcinoma Mimicking Liver Abscess

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    Evangelos Falidas

    2013-01-01

    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.

  6. Primary tubercular liver abscess in an immunocompetent adult: a case report

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    Baveja CP

    2009-10-01

    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.

  7. Klebsiella pneumoniae Liver Abscess and Metastatic Endophthalmitis

    OpenAIRE

    Wells, Jason T.; Lewis, Catherine R.; Danner, Omar K.; Wilson, Kenneth L; Matthews, L Ray

    2015-01-01

    Introduction. Klebsiella pneumoniae is a well-known cause of liver abscess. Higher rates of liver abscess associated with Klebsiella pneumoniae are seen in Taiwan. Metastatic endophthalmitis is a common complication associated with a poor prognosis despite aggressive therapy. Case Report. We report a case of a 67-year-old Korean female with Klebsiella pneumoniae liver abscess. The patient developed metastatic endophthalmitis and ultimately succumbed to her disease despite aggressive medical a...

  8. Ruptured liver abscess in a neonate

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    Prashant Jain

    2012-01-01

    Full Text Available We report a rare case of 17-day-old neonate, diagnosed to have ruptured liver abscess secondary to Methicillin-resistant Staphylococcal aureus infection. The child presented with septicemia and abdominal distension. On exploration, there was pyoperitoneum with ruptured liver abscess.

  9. Treatment and prognosis of pyogenic liver abscess

    OpenAIRE

    Su, Yu-Jang; Lai, Yen-Chun; Lin, Yu-Chia; Yeh, Yu-Hang

    2010-01-01

    Background There are many combinations of treatments for pyogenic liver abscess (PLA). Different treatments are indicated for different clinical courses of PLA. Aims To realize the current prevalence, clinical course, trend of treatment, and prognosis of pyogenic liver abscess (PLA) in Taiwan. Methods We retrospectively reviewed the medical records of 126 patients with PLA. We divided them into four groups: M, MD, MS, and MDS, represented as parenteral antibiotic only, parenteral antibiotic w...

  10. Epidemiology, Clinical Features and Outcome of Liver Abscess: A single Reference Center Experience in Qatar

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    Mushtak Talib Abbas

    2014-07-01

    intervention was unnecessary in almost all the cases. Liver abscess, Amoebic abscess, Pyogenic abscess, Klebseilla pneumonia,

  11. Pyogenic liver abscess: An audit of 10 years’ experience

    Institute of Scientific and Technical Information of China (English)

    Tony CY Pang; Thomas Fung; Jaswinder Samra; Thomas J Hugh; Ross C Smith

    2011-01-01

    AIM: To describe our own experience with pyogenic liver abscesses over the past 10 years and investigate the risk factors associated with failure of initial percutaneous therapy. METHODS: A retrospective study of records of 63 PLA patients presenting between 1998 and 2008 to Australian tertiary referral centre, were reviewed. Amoebic and hydatid abscesses were excluded. Demographic, clinical, radiological, and microbiological characteristics, as well as surgical/radiological interventions, were recorded. RESULTS: Sixty-three patients (42 males, 21 females) aged 65 (± 14) years [mean ± (SD)] had prodromal symptoms for a median (interquartile range; IQR) of 7 (5-14) d. Only 59% of patients were febrile at presentation; however, the serum C-reactive protein was elevated in all 47 in whom it was measured. Liver function tests were non-specifically abnormal. 67% of patients had a solitary abscess, while 32% had > 3 abscesses with a median (IQR) diameter of 6.3 (4-9) cm. Causative organisms were: Streptococcus milleri 25%, Klebsiella pneumoniae 21%, and Escherichia coli 16%. A presumptive cryptogenic cause was most common (34%). Four patients died in this series: one from sepsis, two from advanced cancer, and one from acute myocardial infarction. The initial procedure was radiological aspiration ± drainage in 54 and surgery in two patients. 17% underwent surgical management during their hospitalization. Serum hypoalbuminaemia [mean (95% CI): 32 (29-35) g/L vs 28 (25-31) g/L, P = 0.045] on presentation was found to be the only factor related to failure of initial percutaneous therapy on univariate analysis. CONCLUSION: PLA is a diagnostic challenge, because the presentation of this condition is non-specific. Intravenous antibiotics and radiological drainage in the first instance allows resolution of most PLAs; However, a small proportion of patients still require surgical drainage.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2012-06-15

    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.

  13. Liver Abscess Caused by Klebsiella pneumoniae in Siblings

    OpenAIRE

    Chiu, Cheng-Hsun; Su, Lin-Hui; Wu, Tsu-Lan; Hung, Iou-Jih

    2001-01-01

    Klebsiella pneumoniae has been emerging as the leading cause of liver abscess in diabetic patients. Results of molecular typing of K. pneumoniae isolates from two siblings with liver abscess, their family members, and the environment suggest a possibility of cross infection of liver abscess by the fecal-oral route within diabetic patients.

  14. Amebic liver abscess in Iranian children

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    Khotaii Gh

    2003-05-01

    Full Text Available Although amebic liver abscess can be a cause of significant morbidity and mortality in all ages, there are few reports dealing with this entity in children. Twenty-four children with amebic liver abscess. Ages ranging between 8 weeks and 14.5 years were managed at the Tehran university hospital of children, Iran, between November 1987, and October 2001. The most frequency presentation was high-grade fever and right upper quadrant pain, associated with tender hepatomegaly, leukocytosis and an elevated erythrocyte sedimentation rate. The diagnosis was confirmed by elevated indirect hemagglutination titers and ultrasonograpy of the liver. Unlike the experience in adult patients, none of the patients had concomitant jaundice and significant derangement of liver enzymes. The abscesses were likely to be solitary (22 of 24 patients. There were 17 males and 7 females. Most patients (80% were between 8 weeks to 14.5 years of age. In five patients possible predisposing factors were tuberculosis, chickenpox, tetralogy of fallot and thalassemia major. All patients received metronidazole (50 mg/kg/day, followed by a therapeutic course of a luminal amebicide. There was no death despite a mean delay of 15 days before presentation to our hospital. In conclusion a high index of suspicion, early institution of metronidazole therapy and aspiration of abscesses with potential to rupture are believed to have contributed to the better outcome in these children when compared with results in previous reports.

  15. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

    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.

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

    International Nuclear Information System (INIS)

    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

  17. Nocardia Brain Abscess in a Liver Transplant Recipient

    OpenAIRE

    Moon, Jung Hyeon; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun

    2011-01-01

    Nocardia brain abscess is rare. We report on a unique case of N. farcinica brain abscess in a liver transplant recipient, following Aspergillus fumigatus pneumonia. A 43-year-old liver transplant recipient presented with altered mentality at 2 months after A. fumigates pneumonia. He was successfully treated with surgical removal and antibiotic therapy with trimethoprim-sulfamethoxazole and ceftriaxone.

  18. Intrahepatic cholangiocarcinoma presenting as liver abscess: report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kwon Hyoung; Cho, On Koo; Kim, Yong Soo; Rhim, Hyun Chul; Koh, Byung Hee [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-10-01

    Intrahepatic cholangiocarcinoma is the second most common primary malignant hepatic neoplasm. We describe two cases of intrahepatic cholangiocarcinoma which initially presented as liver abscess both clinically and radiologically. Mucin-hypersecretion from the tumor cells and extensive necrosis or secondary bacterial infection was responsible for the radiologic appearance of a liver abscess.=20.

  19. Klebsiella pneumoniae: An Emerging Pathogen of Pyogenic Liver Abscess

    OpenAIRE

    Basu, Somansu

    2009-01-01

    Before 1980’s, the most common cause of pyogenic liver abscess was Escherichia coli but more recently Klebsiella pneumoniae is being increasingly reported in patients from Asian countries and United States. This report focuses on two cases of pyogenic liver abscess caused by the emerging pathogen Klebsiella pneumoniae in a regional hospital diagnosed and treated successfully.

  20. APPLICATION OF POLYMERASE CHAIN REACTION FOR DIAGNOSING AMEBIC LIVER ABSCESS

    Institute of Scientific and Technical Information of China (English)

    郭增柱; 王正仪; 安亦军; 祝宏

    1996-01-01

    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.

  1. Insidious manifestation of pyogenic liver abscess caused by Streptococcus intermedius and Micrococcus luteus: a case report.

    Science.gov (United States)

    Ioannou, Antreas; Xenophontos, Eleni; Karatsi, Alexandra; Petrides, Christos; Kleridou, Maro; Zintilis, Chrysostomos

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora.

  2. Liver abscesses with pyopericardium: Laparoscopic management in a preterm neonate

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    Ravishankaran Praveen

    2010-01-01

    Full Text Available We report a 28-day-old neonate presenting with signs of fever, abdominal distension, and refusal to feed. The baby was diagnosed to have multiple liver abscesses which ruptured and a tract lead to the pericardium resulting in a pyo-pericardium. Laparoscopic drainage of the abscess cavities and the pyo-pericardium was performed. An extensive search of the literature revealed that this case is the youngest one to have undergone such simultaneous laparoscopic drainage.

  3. Klebsiella pneumoniae liver abscess in an immunocompetent child.

    Science.gov (United States)

    Kwon, Jang-Mi; Jung, Hye Lim; Shim, Jae Won; Kim, Deok Soo; Shim, Jung Yeon; Park, Moon Soo

    2013-09-01

    Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed 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 an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess 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 appropriate treatment of KLA.

  4. Klebsiella pneumoniae liver abscess in an immunocompetent child

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    Jang Mi Kwon

    2013-09-01

    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.

  5. Detection and Analysis of Klebsiella pneumoniae causing Liver Abscess

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    Yunfang Sun

    2015-07-01

    Full Text Available Background: Compared with “classical” K. pneumoniae, hypervirulent variant of Klebsiella pneumoniae have the ability to cause serious, life-threatening community-acquired infection, including liver abscess, pneumonia, meningitis and endophthalmitis and the ability to metastatically spread. An objective diagnostic test suitable for routine use in the clinical microbiology laboratory is needed. Methods: A retrospective study was conducted in 240 patients with cultures positive for K. pneumoniae hospitalized in the Chinese PLA General Hospital from May 2013 to August 2014. The clinical and molecular data of the hypervirulent K. pneumoniae (hvKP causing liver abscess were analyzed. Results: Among 240 strains of K. pneumoniae, hvKP accounted for 42.5% (102/240, hvKP causing liver abscess were 37 strains, accounting for 36.3% (37/102, patients with diabetes were 11 (11/37, 29.7%, 13 (13/37, 35.1% patients were diagnosed as fever of unknown origin at first, 7(7/37, 18.9% patients with tumor, the rest 6 (6/37, 16.2% patients with postoperative infection or other site infection. Univariate analysis revealed the following risk factors for hvKP causing liver abscess: string test (odds ratio (OR, 11.306[95% confidence interval (CI, 3.579-35.711], serotype K1 (OR, 3.109[95% CI, 1.338–7.222] and fever of unknown origin (OR, 6.921[95% CI, 2.503–19.136]. The results detected by multiplex PCR were consistent with single PCR. 102 strains of hvKP were tested the sensitivity to 14-19 drug, 37 strains caused liver abscess were not found with ESBL. Conclusions: The detection of string test combined with rmpA and aerobactin can better identify hvKP. Patients with liver abscess generally were diabetes, but some patients didn’t have other disease. There is not much difference about the chance to be attacked by hvKP among male and female. ESBL was not detected among the hvKP causing liver abscess. Multiplex PCR assay could detect hvKP quickly.

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

    Science.gov (United States)

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

    1994-01-01

    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.

  7. Analysis of the Bacterial Diversity in Liver Abscess: Differences Between Pyogenic and Amebic Abscesses.

    Science.gov (United States)

    Reyna-Fabián, Miriam E; Zermeño, Valeria; Ximénez, Cecilia; Flores, Janin; Romero, Miguel F; Diaz, Daniel; Argueta, Jesús; Moran, Patricia; Valadez, Alicia; Cerritos, René

    2016-01-01

    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.

  8. Occult Liver Abscess Following Clinically Unsuspected Ingestion of Foreign Bodies

    OpenAIRE

    Tsui, Ban CH; Mossey, J

    1997-01-01

    Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gut with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic sc...

  9. The first case report of Raoultella planticola liver abscess.

    Science.gov (United States)

    Sitaula, Sujata; Shahrrava, Anahita; Al Zoubi, Moamen; Malow, James

    2016-01-01

    Raoultella species are a group of gram-negative, non-motile bacilli commonly isolated from the environment. The group was considered a member of the genus Klebsiella until the late 1990s. Raoultella planticola is a rare cause of human infections. We report the first case of liver abscess caused by this organism. The patient was successfully treated with appropriate antimicrobials combined with operative drainage.

  10. The first case report of Raoultella planticola liver abscess

    Directory of Open Access Journals (Sweden)

    Sujata Sitaula, M.D

    2016-01-01

    Full Text Available Raoultella species are a group of gram-negative, non-motile bacilli commonly isolated from the environment. The group was considered a member of the genus Klebsiella until the late 1990s. Raoultella planticola is a rare cause of human infections. We report the first case of liver abscess caused by this organism. The patient was successfully treated with appropriate antimicrobials combined with operative drainage.

  11. Liver abscess caused by Ascaris lumbricoides: case report

    OpenAIRE

    PINILLA Análida Elizabeth; LÓPEZ Myriam Consuelo; Orlando RICAURTE; CASTILLO Blanca; Murcia, Martha Isabel; Nicholls, Rubén Santiago; Duque, Sofía; Orozco, Luis Carlos

    2001-01-01

    A case is reported of a woman who lived in a rural area with a chronic illness that consisted of weight loss and abdominal pain in the epigastrium and upper right quadrant. The initial diagnosis was a mass in the liver, which was later, demonstrated, both by direct and histological examination, to be an abscess caused by Ascaris lumbricoides. Eggs of Ascaris lumbricoides and abundant Charcot-Leyden Crystals were found.

  12. Post-traumatic hepatic artery pseudo-aneurysm combined with subphrenic liver abscess treated with embolization

    Institute of Scientific and Technical Information of China (English)

    Long Sun; Yong-Song Guan; Hua Wu; Wei-Min Pan; Xiao Li; Qing He; Yuan Liu

    2006-01-01

    A 23-year-old man with post-traumatic hepatic artery pseudo-aneurysm and subphrenic liver abscess was admitted. He underwent coil embolization of hepatic artery pseudo-aneurysm. The pseudo-aneurysm was successfully obstructed and subphrenic liver abscess was controlled. Super-selective trans-catheter coil embolization may represent an effective treatment for hepatic artery pseudo-aneurysm combined with subphrenic liver abscess in the absence of other therapeutic alternatives.

  13. A case of pyogenic liver abscess in a 10-year-old girl

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    Jung Lim Byun

    2010-05-01

    Full Text Available Pyogenic liver abscesses are rare in children. In pediatric patients, altered host defences seem to play an important role. However, pyogenic liver abscess also occurs in healthy children. We experienced a case of pyogenic liver abscess in a healthy immunocompetent 10-year-old-girl. The patient presented two distinct abscesses: one subphrenic and the other intrahepatic. The intrahepatic abscess resolved with percutaneous drainage and 3 weeks of parenteral antibiotic therapy but the subphrenic abscess which could not be drained needed prolonged parenteral antibiotic therapy in addition to oral antibiotic therapy. We performed follow-up serial CT scan of the abscess cavity to decide on the duration of antibiotic therapy. Here we present this case with a brief review of the literature.

  14. [A case of multiple liver abscesses associated with Streptococcus salivarius in a patient with chronic periodontitis].

    Science.gov (United States)

    Kamachi, Saori; Otsuka, Taiga; Tsuji, Chika; Nakashita, Shunya; Ide, Yasushi; Mizuta, Toshihiko

    2014-08-01

    Streptococcus salivarius is an oral commensal bacterium that rarely causes disease in humans. Here, we report a case of liver abscess associated with S. salivarius in a 41-year-old woman who presented with continuous abdominal discomfort, fatigue, and fever. She was diagnosed with multiple liver abscesses; she underwent percutaneous transhepatic abscess drainage. Thereafter, S. salivarius was isolated in all bacterial cultures of the drained abscesses, and it was sensitive to penicillins. She made a good recovery after treatment. In the absence of an infective source other than chronic periodontitis, the cause of liver abscesses was attributed to oral S. salivarius. S. salivarius is a normal oral commensal, and oral commensals must be considered if the infective origin of liver abscess cannot be determined. PMID:25100350

  15. Occult liver abscess following clinically unsuspected ingestion of foreign bodies.

    Science.gov (United States)

    Tsui, B C; Mossey, J

    1997-01-01

    Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gur with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further. PMID:9286481

  16. A Case of Liver Abscess with Desulfovibrio desulfuricans Bacteremia

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    Saho Koyano

    2015-01-01

    Full Text Available Desulfovibrio spp. are gram-negative, sulfate-reducing, and anaerobic bacteria found in the digestive tract of humans. Because Desulfovibrio spp. are infrequent causative agents of infectious diseases and are difficult to isolate and to identify from clinical specimens, the appropriate antibiotic therapy to infection with Desulfovibrio spp. has not been determined. We report the first case of liver abscess with bacteremia due to Desulfovibrio desulfuricans to show the clinical presentation and treatment. The patient was successfully treated with intravenous piperacillin-tazobactam and oral amoxicillin-clavulanic acid.

  17. [A case of subcapsular liver abscess secondary to perforating ulcer of gastric cancer].

    Science.gov (United States)

    Jung, Hyun Gwang; Kim, Do Hyeong; Lee, Chang Hun

    2010-08-01

    Intrahepatic abscess is an unusual complication of peptic ulcer disease. We present a case of gastric cancer in which the ulcer penetrated into the left lobe of liver with subsequent abscess and fistula formation. Esophagogastroduodenoscopy confirmed ulcers and a fistula opening in the antrum. Abdominal computed tomogram showed a subcapsular liver abscess adjacent to the gastric antrum. Subtotal gastrectomy with curettage of the fistulous tract was performed. The final diagnosis was the signet ring cell gastric carcinoma complicating subcapsular liver abscess. To our knowledge, this is the first reported case in Korea.

  18. A Rare Case of Pediatric Nosocomial Liver Abscess Developing During Dialysis Therapy

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    Mittal

    2015-08-01

    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.

  19. Liver Abscess Caused by magA+ Klebsiella pneumoniae in North America

    OpenAIRE

    Fang, Ferric C.; Sandler, Netanya; Libby, Stephen J.

    2005-01-01

    Taiwan has witnessed an emerging syndrome of liver abscess caused by Klebsiella pneumoniae carrying the magA gene required for exopolysaccharide web biosynthesis. We report a patient transferred from Alaska to Washington State with a magA+ K. pneumoniae liver abscess and describe a simple approach for recognition of these hypervirulent strains.

  20. Cavernous Transformation of the Portal Vein Might Increase the Risk of Liver Abscess

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    Xin-Bo Ai

    2010-09-01

    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.

  1. A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients

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    Wiwanitkit Viroj

    2002-07-01

    Full Text Available Abstract Background Amebic liver abscess is a tropical disease with a wide spectrum of clinical presentations. Given the often nonspecific nature of the complaints related to amebic abscess, a retrospective review of patients with confirmed disease to recognize the most common patterns of presentation is useful. Here, we study the clinical presentations of 62 Thai patients with amebic liver abscess. We also compare the clinical presentations of Anti HIV seronegative and Anti HIV seropositive patients. Methods A retrospective case review was carried out for 62 Thai patients who had been diagnosed with amebic liver abscess. Clinical information was collected, including symptoms and signs, location and number of abscesses. The Anti HIV serology laboratory investigation was also reviewed. Results According to our study, the common clinical symptoms and signs are abdominal pain (85.5 %, fever and chills (74.2 %, and abdominal tenderness (69.4 %. The location of the abscess was predominantly in the right lobe (74.2 %, and most of patients had a single abscess (77.4 %. Similar trends in clinical presentations were observed in both Anti HIV seropositive and Anti HIV seronegative subjects. Conclusions In conclusion, the clinical presentations of our amebic liver abscess patients were similar to those in previous reports. A similarity to those in the pyogenic liver abscess patients can be observed. Nevertheless, we could not detect important significant differences in the clinical presentations between Anti HIV seropositive and Anti HIV seronegative groups of patients.

  2. A Case of Primary Adenosquamous Carcinoma of the Liver Presented with Liver Abscess

    OpenAIRE

    Kwon, Oh Sang; Lee, Hong Sik; Koh, Dong Wook; Cho, Young Jig; Park, Yeon Ho; Park, Dong Kyu; Oh, Yong Leul; Seo, Jae Hong; Chun, Hoon Jai; Um, Sun Ho; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck; Ryu, Ho Sang; Hyun, Jin Hai

    2001-01-01

    Primary adenosquamous carcinoma of the liver is a very rare type of cholangiocarcinoma and is defined as a cancer containing both squamous and adenomatous components in the same lesion. Recently, we experienced a primary adenosquamous carcinoma of the liver presented as liver abscess. A 63-year-old man was presented with a 4-day history of fever and chill. The radiologic study showed a 4 cm-sized, central hypoattenuated mass with peripheral rim enhancement in the left lobe of the liver. Ultra...

  3. [A Case of Delayed-onset Multiple Metastatic Infection following Liver Abscess].

    Science.gov (United States)

    Lee, Kang Hoon; Moon, Sun Young; Kim, In Ae; Kwon, So Young; Kim, Jeong Han; Choe, Won Hyeok; Kwon, Yong Wonn

    2015-10-01

    Klebsiella pneumoniae liver abscess has a tendency to spread to distant sites early in the course of disease and to involve multiple organs synchronously. A 59-year-old male was admitted because of liver abscess accompanied by fever and abdominal pain. The patient underwent percutaneous catheter drainage and received intravenous antibiotics. Symptom relief was achieved after the treatment as well as marked reduction in the size of the abscess. Despite proper treatment of the liver abscess, however, patient developed multiple metastatic infections in a non-concurrent manner: left and right endophthalmitis, psoas abscess, and infectious spondylitis at 5, 23, 30 and 65 days after initial manifestations of liver abscess, respectively. Each infectious episode followed one another after resolution of the former one. For each episode of metastatic infections, the patient promptly underwent treatment with systemic and local antibiotics, interventional abscess drainage, and surgical treatments as needed. The patient fully recovered without sequelae after the use of intravenous antibiotics for an extended period of time. Herein, we report a case of K. pneumoniae liver abscess complicated with delayed-onset multiple metastatic infections.

  4. "PYOGENIC LIVER ABSCESS IN CHILDREN: A LONG TIME HOSPITAL EXPERIENCE"

    Directory of Open Access Journals (Sweden)

    G. Khotaii

    2004-05-01

    Full Text Available Consensus regarding management of pyogenic liver abscess (PLA among children is yet to emerge, and documentation on these subjects is scanty. Eighteen cases of PLA admitted at Children’s Medical Center in Tehran, Iran, over a 15 year period were analyzed to document the clinical profile and to evaluate the management of PLA among children. Records of all patients were reviewed for presenting signs and symptoms, any associated condition, investigative results, management, and follow–up findings. The overall rate of PLA was 48.9 per 100,000 pediatric admissions in our hospital. Moderate to severe malnutrition was present in five (27.8% and ascariasis in seven (38.9% children. Common presentations were fever (100%, abdominal pain (76.9%, and tender hepatomegaly (83.3%. Fourteen patients (77.8% had solitary liver abscess. Organism was isolated in 11 cases (63.3%, and staphylococcus aureus was the commonest isolate (66.7%.Twelve cases were managed conservatively with antibiotics alone, of these only two (16.7% required drainage later. Percutaneous aspiration was also undertaken in four additional (22.2% cases and open drainage in two (11.1%, at presentation. The overall mortality rate was 11.1%. Time taken for complete resolution ranged from 10 to 40 days. Altogether, we conclude that any child presenting with fever, abdominal pain, and tender hepatomegaly should be subjected to ultrasound scan for early detection of PLA. It seems that a combination of cloxacillin and gentamicin or a third generation cephalosporine and gentamicin, especially in infants, is a satistactory initial coverage. Therapeutic drainage is not an obligation in all cases of PLA. When required, percutaneous needle aspiration is safe and effective. Resolution and significant reduction in mortality has been made possible by early detection and appropriate antibiotic therapy.

  5. Hepatic abscess secondary to a rosemary twig migrating from the stomach into the liver

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver, where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum, then migrating to the liver, complicated by hepatic abscess and Staphylococcus aureus sepsis is reported. A 59-year-old man without a history of foreign body ingestion was admitted to our hospital because of sepsis and epigastralgia, which had progressively worsened. No foreign body was identified at preoperative imaging, but a rosemary twig was discovered during laparotomy. The liver abscess and sepsis were controlled successfully with surgery and antibiotics. This unusual condition should be kept in mind when dealing with cases of hepatic abscess, or even sepsis of unknown origin. Despite the improvement of non-surgical techniques such as percutaneous drainage and interventional endoscopy, surgery still remains important in the treatment of hepatic abscess caused by an ingested foreign body.

  6. Streptococcus intermedius Bacteremia and Liver Abscess following a Routine Dental Cleaning

    Directory of Open Access Journals (Sweden)

    Lachara V. Livingston

    2014-01-01

    Full Text Available Streptococcus intermedius is a member of the Streptococcus anginosus group of bacteria. This group is part of the normal flora of the oropharynx, genitourinary, and gastrointestinal tracts; however, they have been known to cause a variety of purulent infections including meningitis, endocarditis, and abscesses, even in immunocompetent hosts. In particular, S. intermedius has been associated with the development of liver and brain abscesses. There have been several case reports of S. intermedius liver abscesses with active periodontal infection. To our knowledge, however, there has not been a case following a routine dental procedure. In fact, the development of liver abscesses secondary to dental procedures is very rare in general, and there are only a few case reports in the literature describing this in relation to any pathogen. We present a rare case of S. intermedius bacteremia and liver abscess following a dental cleaning. This case serves to further emphasize that even routine dental procedures can place a patient at risk of the development of bacteremia and liver abscesses. For this reason, the clinician must be sure to perform a detailed history and careful examination. Timely diagnosis of pyogenic liver abscesses is vital, as they are typically fatal if left untreated.

  7. Streptococcus intermedius Bacteremia and Liver Abscess following a Routine Dental Cleaning.

    Science.gov (United States)

    Livingston, Lachara V; Perez-Colon, Elimarys

    2014-01-01

    Streptococcus intermedius is a member of the Streptococcus anginosus group of bacteria. This group is part of the normal flora of the oropharynx, genitourinary, and gastrointestinal tracts; however, they have been known to cause a variety of purulent infections including meningitis, endocarditis, and abscesses, even in immunocompetent hosts. In particular, S. intermedius has been associated with the development of liver and brain abscesses. There have been several case reports of S. intermedius liver abscesses with active periodontal infection. To our knowledge, however, there has not been a case following a routine dental procedure. In fact, the development of liver abscesses secondary to dental procedures is very rare in general, and there are only a few case reports in the literature describing this in relation to any pathogen. We present a rare case of S. intermedius bacteremia and liver abscess following a dental cleaning. This case serves to further emphasize that even routine dental procedures can place a patient at risk of the development of bacteremia and liver abscesses. For this reason, the clinician must be sure to perform a detailed history and careful examination. Timely diagnosis of pyogenic liver abscesses is vital, as they are typically fatal if left untreated.

  8. Liver Abscess Formation Following Transarterial Chemoembolization: Clinical Features, Risk Factors, Bacteria Spectrum, and Percutaneous Catheter Drainage.

    Science.gov (United States)

    Lv, Wei-Fu; Lu, Dong; He, Yu-Sheng; Xiao, Jing-Kun; Zhou, Chun-Ze; Cheng, De-Lei

    2016-04-01

    To investigate the clinical features, risk factors, and bacterial spectrum of liver abscess following transarterial chemoembolization (TACE) and evaluate the therapeutic effect of percutaneous catheter drainage (PCD) on the abscesses.A retrospective review of patient charts was performed in 3613 patients who suffered from liver malignancies (2832 patients with hepatocellular carcinoma and 781 with metastatic hepatic tumor) and had undergone 11,054 TACE procedures from January 2005 to October 2013. Liver abscesses were found in 21 patients. PCD was performed in all abscess patients. The clinical features, risk factors, and bacterial spectrum of liver abscess following TACE were investigated and the therapeutic effect of PCD was evaluated.The incidence of liver abscess was 0.58% per patient and 0.19% per procedure. Approximately 57.1% of the patients had a medical history of bilioenteric anastomosis or biliary stent implantation. On computed tomography scans, the abscesses appeared as low-attenuation lesions and high-density iodinate oil scattered in the abscesses. The ultrasound showed the well defined, heterogeneously hypoechoic lesions. Positive microbiological isolates were obtained in all pus cultures and in 47.6% of blood cultures. The most common bacterium was Escherichia coli (52.4%). Twenty patients (95.2%) were cured from abscesses by using PCD, and 1 died of sepsis.Patients with predisposing factors are prone to an increased risk of liver abscess following TACE. Bacterial culture and antibiotic sensitivity tests on pus and blood help on the antibiotics selection. PCD combined with aggressive antibiotics can be recommended as the first-line therapeutic regimen. PMID:27124055

  9. CT features of liver abscesses caused by the fasciola hepatica infection

    International Nuclear Information System (INIS)

    Objective: To study CT features of liver abscesses caused by the fasciola hepatica infection, and discuss its pathologic basis. Methods: CT images of 15 Patients were collected. All patients underwent both unenhanced and biphasic enhanced CT scanning, then its CT performances were analyzed. Results: round and nodular lesions were observed in 15 cases, branching and stripping lesions like dilated bile duct in 9 cases. The density of lesions was inhomogeneous, and the lesions were multifocal and multiform. The liver abscesses caused by the fasciola hepatica infection had no 'rim sign' or 'target' sign, Liver abscesses were less than 3.0 cm in diameter, and the dilation of the bile duct were not observed. Conclusion: Liver abscessed caused by the fasciola hepatica infection have characteristic CT features. Combined with clinical examination and laboratory test, the reliability of diagnosis will be considerably increased. (authors)

  10. An Unusual Zoonosis: Liver Abscess Secondary to Asymptomatic Colonic Foreign Body

    OpenAIRE

    Gundara, Justin S.; Richard Harrison

    2010-01-01

    A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pai...

  11. Amebic Liver abscess Complicated by Inferior Vena Cava Thrombosis: A Case Report.

    Science.gov (United States)

    Ray, S; Khanra, D; Saha, M; Talukdar, A

    2012-10-01

    Amebic liver abscess is the most common extraintestinal manifestation of infection with Entamoeba histolytica. It is a common disease, especially in endemic areas, but it is a rare cause of inferior vena cava (IVC) obstruction, with only a few cases appearing in the literature. The authors describe a case of amebic liver abscess in a patient who developed a rare vascular complication of inferior vena cava thrombosis. The case responded to conservative treatment and radiological intervention.

  12. Absceso hepático asociado a absceso pulmonar y endoftalmitis Liver abscess associated to lung abscess and endophthalmitis

    Directory of Open Access Journals (Sweden)

    Jairo Cordero-Chen

    2013-03-01

    Full Text Available El absceso hepático piógeno producido por Klebsiella pneumoniae es relativamente raro y puede complicarse con lesiones sépticas a distancia. Esto se relaciona con características propias del germen que incluyen el genotipo K1, resistencia a la fagocitosis y la presencia del gen mag-A. Tales metástasis sépticas contemplan absceso pulmonar, meningitis, endocarditis bacteriana y, muy especialmente, endoftalmitis. Esta última ocurre con mayor frecuencia en pacientes diabéticos, y puede causar ceguera. Se reporta caso de absceso hepático por K. pneumoniae asociado a absceso pulmonar y endoftalmitis, y se revisa epidemiología, fisiopatología, diagnóstico y tratamiento de la entidad.The pyogenic liver abscess due to Klebsiella pneumoniae is relatively rare and can be complicated by distant septic metastases. This can be related to specific bacterial properties including genotype K1, resistance to phagocytosis and the presence of the gene mag-A. The septic metastases include lung abscess, meningitis, infective endocarditis and specially endophtalmitis. The latter is more frequent in diabetic patients and can result in blindness. We report a case of liver abscess produced by K. pneumoniae associated to pulmonary abscess and endophtalmitis, and review the epidemiology, pathophysiology, diagnosis and treatment of this disease.

  13. Pyogenic liver abscess after choledochoduodenostomy for biliary obstruction caused by autoimmune pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Nobuyuki Toshikuni; Hirofumi Morishita; Koichi Uesaka; Shiro Yuasa; Kyohei Kai; Shizo Sato; Motoko Kitano; Masayoshi Fujisawa; Hiroaki Okushin; Kazuhiko Morii; Shinjiro Takagi; Masahiro Takatani

    2006-01-01

    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.

  14. Liver abscess caused by an unnoticed swallowed toothpick perforating the colonic wall.

    Science.gov (United States)

    Serwe, S; Weber, J; Strock, P; Lens, V

    2007-10-01

    We present an unusual case of a liver abscess caused by a swallowed toothpick in a 43-year-old man. The abscess was first punctured under percutaneous ultrasound control and intraveneous administration of antibiotics whereas the diagnosis of the foreign body stuck in the sigmoid bowel wall was only made by a follow-up computed tomography since the patient had no complains indicating a colonic pathology. Even more, the patient did not remember ever having ingested a foreign body. The wooden toothpick was then successfully removed by endoscopy. The case report stresses the need for a search of the cause of unexplained liver abscesses and highlights the importance of computed tomography as the first imaging technique as the foreign body was missed on the ultrasound examination. Finally, the non-surgical treatment as first line management of liver abscesses will be discussed.

  15. Actinomyces naeslundii and Eikenella corrodens as rare causes of liver abscesses.

    Science.gov (United States)

    Jaqua, Nathan Thomas; Smith, Adam J; Shin, Terry T; Jahanmir, Jay

    2013-01-01

    A 48-year-old man with an unremarkable medical history was admitted with vague conditions of fever, chills, myalgias and malaise. Physical examination was remarkable for only scleral icterus. Laboratory evaluation revealed elevated aminotransferases, alkaline phosphatase and bilirubin. Imaging demonstrated two masses in the right lobe of his liver, which were ultimately drained and cultures demonstrated Actinomyces and Eikenella. He continued to have fever on broad-spectrum antibiotics until catheter drainage of the abscesses was performed. He was eventually discharged in improved condition on amoxicillin-clavulanate. His aminotransferases, alkaline phosphatase and bilirubin continued to improve and he remained afebrile and asymptomatic. A repeat CT 2 months after discharge demonstrated resolution of the abscesses. Actinomyces and Eikenella are rare causes of liver abscesses and treatment requires drainage and an extended course of antibiotics. The polymicrobial character typical of liver abscesses makes antibiotic therapy challenging when cultures reveal rare organisms such as Actinomyces and Eikenella. PMID:23867879

  16. Amebic Liver Abscess in Israeli Travelers: A Retrospective Study.

    Science.gov (United States)

    Lachish, Tamar; Wieder-Finesod, Anat; Schwartz, Eli

    2016-05-01

    Amebic liver abscess (ALA) is endemic in developing countries. The epidemiology and clinical characteristics of the disease in developing countries are well described. Travelers from nonendemic countries can serve as a model for the natural history of ALA. Currently, the available literature on travelers is limited. This is a retrospective observational study on Israeli travelers diagnosed with ALA. Data regarding travel history, clinical presentation, imaging, and treatment were collected and analyzed. Among 6,867 ill returning Israeli travelers, amebiasis was diagnosed in 53 travelers (0.77%), of whom 14 were with ALA (0.2%). Twelve ALA cases (86%) had an exposure in the Indian subcontinent. The male to female ratio was 1:1, with no significant clinical differences between the sexes. The average lag period between exposure and onset of symptoms was 17.1 months. The lack of male predominance and the prolonged lag period may imply that behavioral factors are pivotal in the development of ALA. Larger case series of travelers are required. PMID:26928829

  17. Pyrosequencing reveals the complex polymicrobial nature of invasive pyogenic infections: microbial constituents of empyema, liver abscess, and intracerebral abscess.

    Science.gov (United States)

    Sibley, C D; Church, D L; Surette, M G; Dowd, S E; Parkins, M D

    2012-10-01

    The polymicrobial nature of invasive pyogenic infections may be underestimated by routine culture practices, due to the fastidious nature of many organisms and the loss of viability during transport or from prior antibacterials. Pyrosequencing was performed on brain and liver abscesses and pleural fluid and compared to routine culture data. Forty-seven invasive pyogenic infection samples from 44 patients [6 intracerebral abscess (ICA), 21 pyogenic liver abscess (PLA), and 18 pleural fluid (PF) samples] were assayed. Pyrosequencing identified an etiologic microorganism in 100 % of samples versus 45 % by culture, p <0.01. Pyrosequencing was also more likely than traditional cultures to classify infections as polymicrobial, 91 % versus 17 %, p <0.001. The median number of genera identified by pyrosequencing compared to culture was 1 [interquartile range (IQR) 1-3] versus 0 (IQR 0-1) for ICA, 7 (IQR 1-15) versus 1 (IQR 0-1) for PLA, and 15 (IQR 9-19) versus 0 (IQR 0-1) for PF. Where organisms were cultured, they typically represented the numerically dominant species identified by pyrosequencing. Complex microbial communities are involved in invasive pyogenic infection of the lung, liver, and brain. Defining the polymicrobial nature of invasive pyogenic infections is the first step towards appreciating the clinical and diagnostic implications of these complex communities.

  18. The EhADH112 recombinant polypeptide inhibits cell destruction and liver abscess formation by Entamoeba histolytica trophozoites.

    Science.gov (United States)

    Martínez-López, Carolina; Orozco, Esther; Sánchez, Tomás; García-Pérez, Rosa María; Hernández-Hernández, Fidel; Rodríguez, Mario A

    2004-04-01

    The Entamoeba histolytica EhCPADH complex, formed by a cysteine proteinase (EhCP112) and an adhesin (EhADH112), is involved in adherence, phagocytosis and cytolysis. This makes this complex an attractive candidate as a vaccine against amoebiasis. Here, we produced the recombinant polypeptide EhADH243, which includes the adherence epitope detected by a monoclonal antibody against the EhCPADH complex. EhADH243 was purified, and the effect of the polypeptide on in vitro and in vivo virulence was studied. Antibodies against EhADH243 reacted with the EhCPADH complex and with the recombinant polypeptide. EhADH243 and antibodies against this polypeptide inhibited adherence, phagocytosis and destruction of cell monolayers by live trophozoites, but had little effect on cell monolayer destruction by trophozoite extracts. EhADH243 recognized a 97 kDa protein in the MDCK membrane fraction that could be a putative receptor for E. histolytica trophozoites. Hamsters immunized with EhADH243 developed humoral response against EhCPADH, and animals were partially protected from amoebic liver abscess.

  19. The first report of treatment of liver abscess due to Candida albicans with intra-abscess and intravenous administration of liposomal amphotericin B (Amphotec)

    Institute of Scientific and Technical Information of China (English)

    LIAO Wan-qing; YAO Zhi-rong; WEN Hai; XU Hong; YANG Song-lin; LIU Xing-hua; TAN Wei-ping

    2005-01-01

    Increasing reports on application and safety of liposomal amphotericin B (Amphotec) in the treatment of deep fungal infections have been described recently. This is the first report that a case of liver abscess due to Candida albicans was completely cured with intra-abscess and intravenous administration of liposomal amphotericin B without recurrence in three-year follow-up period.

  20. Biostatistical analysis of treatment results of bacterial liver abscesses using minimally invasive techniques and open surgery

    Directory of Open Access Journals (Sweden)

    Кipshidze A.A.

    2013-12-01

    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.

  1. Liver abscess due to Klebsiella pneumoniae in a healthy 12-year-old boy

    Directory of Open Access Journals (Sweden)

    Da Hye Yoon

    2013-11-01

    Full Text Available Pyogenic liver abscess (PLA is rare in healthy children. We report a case of PLA in an immunocompetent 12-year-old boy. Percutaneous catheter drainage was performed for the abscess. In addition, parenteral antibiotics were administered for 3 weeks. Klebsiella pneumoniae was detected in the culture of blood and drained fluid. Here, we present this case and a brief review of the literature on this subject.

  2. Liver abscess due to Klebsiella pneumoniae in a healthy 12-year-old boy

    Directory of Open Access Journals (Sweden)

    Da Hye Yoon

    2013-12-01

    Full Text Available Pyogenic liver abscess (PLA is rare in healthy children. We report a case of PLA in an immunocom­ petent 12­year­old boy. Percutaneous catheter drainage was performed for the abscess. In addition, parenteral antibiotics were administered for 3 weeks. Klebsiella pneumoniae was detected in the culture of blood and drained fluid. Here, we present this case and a brief review of the literature on this subject.

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

    Directory of Open Access Journals (Sweden)

    Kim-Diêp Dang-Tran

    2014-01-01

    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.

  4. Long-term follow-up of pyogenic liver abscess by ultrasound

    International Nuclear Information System (INIS)

    Background/aims: To study the morphology of residual abscess in successfully treated pyogenic liver abscess by ultrasound. Methods: 116 consecutive patients of liver abscess diagnosed from April 2004 to March 2007 were included in this study. Patients with amebic liver abscess were excluded. Patients were treated with antibiotics for 6 weeks and when indicated drained percutaneously. Ultrasound scan was repeated after 2 weeks, 1 month, 3 months, 6 months and 12 months of treatment. Thereafter it was repeated every 6 months. Results: After exclusion, 102 patients with >150 lesions were studied. Diagnosis was made on the basis of clinical presentation, ultrasound examination and diagnostic aspiration. It was single in 83, double in 12 and more than 2 in seven patients. Size varied from 4.2 cm to 15 cm. Organisms were isolated in 29 patients (E. coli 10, Kliebsiella sp. 6, S. aureus 5, Pseudomonas aeruginosa 2, Acenetobacter 1 and multiple growth 5) in blood and eight patients (E. coli 5 and S. aureus 3 and multiple growth 2) in pus. Majority of abscess resolved sonologically after 2-18 weeks of treatment. Healing was delayed in alcoholic and diabetic patients. In eight patients there was residual abscess even after 104 weeks of follow-up. In four patients it healed with calcification. Conclusions: Majority of pyogenic liver abscess resolve to normal parenchyma within 18 weeks time. However, some lesions may take longer time to heal even after successful treatment. It should be considered in differential diagnosis of space occupying lesion of the liver in ultrasound and need no therapeutic intervention.

  5. Long-term follow-up of pyogenic liver abscess by ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Sudhamshu, K.C. [Liver Unit, National Academy of Medical Sciences, Bir Hospital, Kathmandu (Nepal)], E-mail: sudhamshu.liver@gmail.com; Sharma, Dilip [Liver Unit, National Academy of Medical Sciences, Bir Hospital, Kathmandu (Nepal)

    2010-04-15

    Background/aims: To study the morphology of residual abscess in successfully treated pyogenic liver abscess by ultrasound. Methods: 116 consecutive patients of liver abscess diagnosed from April 2004 to March 2007 were included in this study. Patients with amebic liver abscess were excluded. Patients were treated with antibiotics for 6 weeks and when indicated drained percutaneously. Ultrasound scan was repeated after 2 weeks, 1 month, 3 months, 6 months and 12 months of treatment. Thereafter it was repeated every 6 months. Results: After exclusion, 102 patients with >150 lesions were studied. Diagnosis was made on the basis of clinical presentation, ultrasound examination and diagnostic aspiration. It was single in 83, double in 12 and more than 2 in seven patients. Size varied from 4.2 cm to 15 cm. Organisms were isolated in 29 patients (E. coli 10, Kliebsiella sp. 6, S. aureus 5, Pseudomonas aeruginosa 2, Acenetobacter 1 and multiple growth 5) in blood and eight patients (E. coli 5 and S. aureus 3 and multiple growth 2) in pus. Majority of abscess resolved sonologically after 2-18 weeks of treatment. Healing was delayed in alcoholic and diabetic patients. In eight patients there was residual abscess even after 104 weeks of follow-up. In four patients it healed with calcification. Conclusions: Majority of pyogenic liver abscess resolve to normal parenchyma within 18 weeks time. However, some lesions may take longer time to heal even after successful treatment. It should be considered in differential diagnosis of space occupying lesion of the liver in ultrasound and need no therapeutic intervention.

  6. Splenectomy Correlates With Increased Risk of Pyogenic Liver Abscess: A Nationwide Cohort Study in Taiwan

    Directory of Open Access Journals (Sweden)

    Shih-Wei Lai

    2015-09-01

    Full Text Available Objectives: Little is known about the risk of pyogenic liver abscess in patients with splenectomy. We explored the relationship between splenectomy and pyogenic liver abscess in Taiwan. Methods: We conducted a nationwide cohort analysis using the hospitalization dataset of the Taiwan National Health Insurance Program. We included 17 779 subjects aged 20–84 years who underwent splenectomy in 1998 to 2010 (splenectomy group and 70 855 randomly selected subjects without splenectomy (non-splenectomy group. Both groups were matched by sex, age, other comorbidities, and hospitalization year of receiving splenectomy. The incidence of pyogenic liver abscess at the end of 2011 was measured. The multivariable Cox proportional hazard regression model was used to estimate the hazard ratios and 95% confidence intervals for pyogenic liver abscess associated with splenectomy and other comorbidities. Results: The overall incidence rate was 3.75-fold higher in the splenectomy group than that in the non-splenectomy group (2.15 vs 0.57 per 1000 person-years; 95% confidence interval, 3.57–3.94. After controlling for potential confounding factors, the adjusted hazard ratio of pyogenic liver abscess was 3.89 in subjects with splenectomy (95% confidence interval, 3.20–4.72 when compared with subjects without splenectomy. In further analysis, the hazard ratio markedly increased to 14.34 for those with splenectomy and having any of the assessed comorbidities, including alcoholism, biliary stone, chronic kidney disease, chronic liver diseases, and diabetes mellitus (95% confidence interval, 10.61–19.39. Conclusions: Patients with splenectomy are at an increased risk of developing pyogenic liver abscess, particularly when they have comorbid conditions.

  7. EPIDEMIOLOGICAL, CLINICAL FEATURES, MANAGEMENT PROFILE & OUTCOME IN PATIENTS OF LIVER ABCESS: A TERTIARY CARE CENTRE EXPERIENCE OF GWALIOR, MADHYA PRADESH

    Directory of Open Access Journals (Sweden)

    Mukesh Singh

    2015-10-01

    Full Text Available : Liver abscess is a common and major health problem in the lower socio-economic group. Evolution in diagnostics and treatment methodology has resulted in marked reduction in morbidity and mortality associated with liver abscess. Today with improved antibiotics and operative techniques, we could achieve much better response in patients with liver abscess. AIM: The aim of the study was to review the demographic data, etiological profile, predisposing factors, variation in clinical presentation in liver abscesses & to formulate management plan in liver abscess. METHODS: This retrospective study was conducted at the Department of General Surgery, Gajra Raja Medical College Gwalior and Jaya Arogya Group of Hospitals, a tertiary care centre in Gwalior by reviewing all admitted patients with suspected liver abscess from the period of May 2013 To May 2015 to analyze etiological profile (Etiological & predisposing factors, variation in clinical presentation in liver abscesses, laboratory & microbiological profile and to formulate management plan in liver abscess. RESULTS: Pyogenic & Amoebic liver abscess is most common in 5th & 4th decade of life with male to female ratio of 17:1. Alcohol consumption, Diabetes Mellitus & low socio economic status are important predisposing factors. Most common presenting complain & clinical finding is abdominal pain & RUQ tenderness respectively with intraperitoneal rupture is most common complication. On ultrasound most abscess are solitary, in right lobe of liver & having greater than 150cc of volume. E. coli is commonest among pyogenic while E. histolytica is common in amoebic liver abscess, earlier respond better with pigtail drainage while later with percutaneous aspiration with antibiotics. CONCLUSION: The commonest presentation was young male, alcoholic of low socioeconomic class having right lobe solitary amoebic liver abscess. Appropriate use of minimally invasive drainage along with intravenous antibiotics

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

    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.

  9. First case of amebic liver abscess 22 years after the first occurrence

    Directory of Open Access Journals (Sweden)

    Nespola Benoît

    2015-01-01

    Full Text Available A 72-year-old man consulted in November 2012 for abdominal pain in the right upper quadrant. The patient had a history of suspected hepatic amebiasis treated in Senegal in 1985 and has not traveled to endemic areas since 1990. Abdominal CT scan revealed a liver abscess. At first, no parasitological tests were performed and the patient was treated with broad-spectrum antibiotics. Only after failure of this therapy, serology and PCR performed after liver abscess puncture established the diagnosis of hepatic amebiasis. The patient was treated with metronidazole and tiliquinol-tilbroquinol. Amebic liver abscess is the most frequent extra-intestinal manifestation. Hepatic amebiasis 22 years after the last visit to an endemic area is exceptional and raises questions on the mechanisms of latency and recurrence of these intestinal protozoan parasites.

  10. Community-acquired Klebsiella pneumoniae liver abscess: an emerging infection in Ireland and Europe.

    LENUS (Irish Health Repository)

    Moore, R

    2013-02-05

    INTRODUCTION: Klebsiella pneumoniae has emerged as a predominant cause of community-acquired mono-microbial pyogenic liver abscess. This was first described in Taiwan and has been widely reported in Asia. This infectious entity has been described in Europe, with single case reports predominating. METHODS: We present three cases in one year from our institution in Ireland and review the European literature to date. RESULTS\\/CONCLUSION: Klebsiella pneumoniae invasive liver abscess syndrome is now emerging in Europe and notably is not restricted to individuals of Asian descent.

  11. 以肝脓肿为首发表现的横结肠癌溃疡穿孔一例%One case report with liver abscess as the first performance of transverse colon cancer ulcerative ;perforation

    Institute of Scientific and Technical Information of China (English)

    王延召; 吴凤; 张宏林; 黄文生; 雷福明; 顾晋

    2016-01-01

    临床上肝脓肿是一种常见的腹部急症,为细菌或阿米巴等寄生虫导致。结肠癌是临床常见的恶性肿瘤。但临床上,结肠癌穿孔致肝脓肿为首发表现则较为罕见,我们结合临床实践中遇到的一例以肝脓肿为首发症状的结肠癌,对此类病例进行讨论与复习,为其他医院的医生诊治提供参考。%Liver abscess is a common kind of abdominal emergency, which was caused by bacteria or amoebic parasites. Colon cancer is one of the most malignant tumors. But clinically, colon perforation caused by liver abscess as the first performance is relatively rare, we combined with a case of a liver abscess as the first symptom of colon cancer, to discuss and review such cases, for providing some experiences of diagnosis and treatment.

  12. Multiple Pyogenic Liver Abscesses Caused by Eggerthella lenta Treated with Ertapenem: A Case Report

    Directory of Open Access Journals (Sweden)

    Richard M. Elias

    2012-01-01

    Full Text Available Anaerobic gram-positive bacilli can occasionally be implicated in infections but are difficult to identify in culture by conventional biochemical methods. We report a case of liver abscesses caused by Eggerthella lenta, identified via 16S rRNA sequencing in a previously healthy patient, successfully treated with percutaneous drainage and ertapenem.

  13. Peroxynitrite and Peroxiredoxin in the Pathogenesis of Experimental Amebic Liver Abscess

    Directory of Open Access Journals (Sweden)

    Judith Pacheco-Yepez

    2014-01-01

    Full Text Available The molecular mechanisms by which Entamoeba histolytica causes amebic liver abscess (ALA are still not fully understood. Amebic mechanisms of adherence and cytotoxic activity are pivotal for amebic survival but apparently do not directly cause liver abscess. Abundant evidence indicates that chronic inflammation (resulting from an inadequate immune response is probably the main cause of ALA. Reports referring to inflammatory mechanisms of liver damage mention a repertoire of toxic molecules by the immune response (especially nitric oxide and reactive oxygen intermediates and cytotoxic substances released by neutrophils and macrophages after being lysed by amoebas (e.g., defensins, complement, and proteases. Nevertheless, recent evidence downplays these mechanisms in abscess formation and emphasizes the importance of peroxynitrite (ONOO−. It seems that the defense mechanism of amoebas against ONOO−, namely, the amebic thioredoxin system (including peroxiredoxin, is superior to that of mammals. The aim of the present text is to define the importance of ONOO− as the main agent of liver abscess formation during amebic invasion, and to explain the superior capacity of amoebas to defend themselves against this toxic agent through the peroxiredoxin and thioredoxin system.

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

    Institute of Scientific and Technical Information of China (English)

    Sri Prakash Misra; Vatsala Misra; Manisha Dwivedi

    2006-01-01

    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.

  15. K2 Serotype Klebsiella pneumoniae Causing a Liver Abscess Associated with Infective Endocarditis▿

    OpenAIRE

    Rivero, Andres; Gomez, Eric; Alland, David; David B. Huang; Chiang, Tom

    2009-01-01

    Klebsiella pneumoniae primary liver abscess (KPLA) is an emerging disease that is associated with distant septic complications. We report the first case of KPLA associated with infective endocarditis. The K. pneumoniae strain was a hypermucoid K2 serotype carrying the rmpA virulence-associated gene.

  16. Fusobacterium nucleatum: Atypical organism of pyogenic liver abscess might be related to sigmoid diverticulitis

    Directory of Open Access Journals (Sweden)

    Karn Wijarnpreecha

    2016-01-01

    Full Text Available Context: Pyogenic liver abscesses (PLAs are the most common form of liver abscesses in the United States. Most cases are caused by enteric bacteria and anaerobes. We report a case of PLA caused by a rare pathogen, Fusobacterium nucleatum, from an unusual primary site of infection. Case Report: A 60-year-old male presented with subacute fever. Initial work-up revealed leukocytosis and elevated alkaline phosphatase (ALP. Dental examination and Panorex x-ray were normal. Imaging of the liver with abdominal computed tomography demonstrated a 5.5 cm abscess in the right lobe of the liver. Culture of the aspirate grew Fusobacterium nucleatum. He improved with abscess drainage and antibiotic therapy with moxifloxacin and metronidazole. Colonoscopy performed a few weeks later, demonstrated sigmoid ulceration most likely from the previous diverticulitis. Conclusion: PLAs can be a complication of sigmoid diverticulitis and as a result of occult dental disease as well. The clinical presentation of Fusobacterium infection is diverse and can be fatal if diagnosis is delayed. Therefore, early diagnosis and treatment are the keys to preventing serious complications.

  17. Recurrent Upper Quadrant Pain: A Fish Bone Secondary to Gastric Perforation and Liver Abscess

    Directory of Open Access Journals (Sweden)

    Hui Liang

    2011-12-01

    Full Text Available A 60-year-old male patient was admitted to our hospital for recurrent upper quadrant pain for 1 month. He had a past history of coronary artery disease. After admission, he repeatedly suffered from high-grade fever, chills and upper quadrant pain. Computed tomography (CT showed a round hypodense mass in the left lobe of the liver, approximately 2.7 × 2.2 cm in size, and a fish bone was confirmed by surgery in the left lobe of liver. The patient was cured completely after surgical removal of the fish bone and liver abscess. CT scan 1 month after discharge showed that the liver abscess had disappeared completely.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

    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.

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

    International Nuclear Information System (INIS)

    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

  20. Primary Hepatic Lymphoma Is Difficult to Discriminate from a Liver Abscess

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takeuchi

    2014-01-01

    Full Text Available An 82-year-old woman presented with a high-grade fever of 40°C and was admitted to our institution for intensive examination and treatment. Noncontrast abdominal computed tomography (CT revealed low-density masses at segments 5 and 8, suggestive of a liver abscess. On further examination, a contrast-enhanced abdominal CT showed a 30×30 mm mass with an enhanced margin at segment 8 in the arterial phase; the contrast agents were washed out in the venous phase. In addition, a 63×52 mm mass with a density lower than that of liver parenchyma was observed at segment 8 in the portal phase. On the basis of these findings, either a liver abscess or hepatocellular carcinoma was suspected. To confirm the diagnosis, a fine needle biopsy was scheduled. Histopathological analysis of the biopsied specimens confirmed the diagnosis of diffuse large B-cell lymphoma. Chemotherapy was not indicated owing to the patient’s age and poor performance status; thus, best supportive care was planned. On day 22 after admission, the patient died of pneumonia. We experienced a case of PHL that was difficult to discriminate from a liver abscess. Imaging alone is insufficient to diagnose PHL; therefore, fine needle biopsy is recommended for a definitive diagnosis.

  1. [Case report: tenesmus in a cow with a liver abscess and nephritis].

    Science.gov (United States)

    Braun, U; Jehle, W; Thio, T; Pospischil, A

    2004-01-01

    A two-year-old Swiss Braunvieh cow was referred to our clinic because of tenesmus and weight loss. Clinical examination revealed a moderately abnormal general behaviour and condition, thin body condition and a rectal temperature of 40.1 degrees C. Tenesmus was evident, and rumen and intestinal motility were markedly reduced. All tests for a reticular foreign body were positive. On rectal examination, a round, smooth, firm, non-painful mass with a diameter of approximately 15 cm was palpated far cranially on the right side. Abnormal haematological and biochemical findings included marked anaemia, neutrophilic leucocytosis, markedly elevated concentration of fibrinogen and mildly elevated gamma-glutamyl-transferase activity. The clotting time of the glutaraldehyde test was one minute. Ultrasonographic examination revealed abscesses involving the liver and extending caudally into the right flank region. The liver parenchyma had diffuse changes. Because of a grave prognosis, the cow was euthanized. Postmortem findings substantiated ultrasonographic results; there were abscesses, caused by Fasciola hepatica infestation, originating in the liver and extending into the right flank. As well, there was severe, bilateral, multifocal, suppurative nephritis due to thromboembolism. Based on all the findings, a diagnosis of liver abscess caused by fascioliasis and bilateral suppurative nephritis was made.

  2. Purulent Pericarditis after Liver Abscess: A Case Report

    Directory of Open Access Journals (Sweden)

    María Fidalgo García

    2014-01-01

    Full Text Available We present the case of a 49-year-old woman, with previous clinical antecedents of recent hepatic metastasis, who was admitted to the ICU due to respiratory failure and hemodynamic instability. She was found to have purulent pericarditis complicated by pericardial tamponade and pleural effusion, as well as surgical site infection, which was the origin of the disease. Cultures of the surgical wound and the pericardial effusion were positive for Enterococcus faecalis and Escherichia coli. A pericardial tap was performed and the intra-abdominal abscess was surgically drained. Pleural effusion was also evacuated. She received antibiotic treatment and recovered successfully. The only after-effect was a well-tolerated effusive-constrictive pericarditis.

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

    Science.gov (United States)

    Tsai, Wen-Cheng; Chang, Liang-Kai

    2002-09-01

    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.

  4. Endogenous endophthalmitis and liver abscess syndrome secondary due to Klebsiella pneumoniae:report of three cases from Qatar

    Institute of Scientific and Technical Information of China (English)

    Ahmed; AR; Mohamad; Al; Ani; Abdel-Naser; Elzouki; Ali; Rahil; Fouad; Al-Ani

    2015-01-01

    Endogenous endophthalmitis is a rare but devastating disease that may frequently result in visual loss despite appropriate and early antibiotic treatment Recent reports have suggested an increased incidence of endogenous endophthalmitis in East Asia,particularly in Taiwan,where the major source of infection has been liver abscess secondary to Klebsiella pneumoniae.Here we report three cases who presented in Qatar with severe endogenous endophthalmitis associated with Klebsiella pneumonia septicemia secondary to pyogenic liver abscess in a diabetes mellitus underlying.

  5. Churg-Strauss syndrome complicated by colon erosion,acalculous cholecystitis and liver abscesses

    Institute of Scientific and Technical Information of China (English)

    Msahiro Suzuki; Kazuo Nabeshima; Mitsukazu Miyazaki; Hitoshi Yoshimura; Shinsei Tagawa; Katsuya Shiraki

    2005-01-01

    We report on a case of Churg-Strauss syndrome (CSS)with colon erosion, cholecystitis and liver abscesses. A 21-year-old woman with a history of bronchial asthma for 3 years was admitted with a complaint of abdominal pain. Laboratory findings included remarkable leukocytosis and eosinophilia, and a colonoscopy revealed erosion from the rectum to the ileocecal region. In addition, a colonic biopsy specimen showed necrotizing vasculitis and marked eosinophilic infiltration. On the basis of the clinical features and histopathological findings, she was diagnosed with CSS and subsequently treated with oral prednisolone,after which the eosinophilia and abdominal pain disappeared. However, on the 15th d in hospital she developed cholecystitis and liver abscesses. She was therefore treated with antibiotics and as a result went into clinical remission.

  6. Localization of Entamoeba histolytica amebopore in amebic liver abscesses in hamsters.

    Science.gov (United States)

    González, A; Monterrubio, D; Nequiz, M; López, R; Olivos, A; García de Léon, C; Tello, E; Salaiza, N; Ramos, E; Gudiño, M; Montfort, I; Pérez-Tamayo, R

    2008-12-01

    Amebopore was purified from axenically grown trophozoites of the Entamoeba histolytica strain HM1:IMSS. The purification procedure involved Mono Q anion-exchange chromatography and electroelution. Sequence analysis of the final product revealed that amebopore A was completely pure. Polyclonal antibodies against the purified amebopore were obtained from rabbits, and Western blot studies demonstrated their specificity. Sections of experimental, acute (1, 2, 3, and 4 days), amebic liver abscesses produced in hamsters were stained with the anti-amebopore antibody; in all the analyzed stages, amebopore appeared as a constitutively expressed cytoplasmic molecule in trophozoites. No extracellular or hepatocyte-membrane amebopore was found. This study is the first to trace amebopore in an in vivo model of amebic liver abscesses.

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

    Directory of Open Access Journals (Sweden)

    P. Mohan Rao

    2014-04-01

    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.

  8. Pyogenic liver abscess: Differences in etiology and treatment in Southeast Asia and Central Europe

    Institute of Scientific and Technical Information of China (English)

    Herwig; Cerwenka

    2010-01-01

    Knowledge of etiology and timely treatment of underlying causes,when possible,play an important role in the successful therapy of patients with pyogenic liver abscess (PLA).Recent publications from Central Europe and Southeast Asia hint at considerable differences in etiology.In this article,we aim to elaborate these differences and their therapeutic implications.Apart from some special types of PLA that are comparable in Southeast Asia and Central Europe (such as posttraumatic or postprocedural PLA),there ...

  9. Hepatic scintiangiography using gamma camera system: diagnosis of hepatomas and liver abscess

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Choon Yul; Bahk, Yong Whee; Yoon, Sei Chul [Catholic Medical College, Seoul (Korea, Republic of)

    1980-12-15

    The purpose of this investigation is to distinguish hepatomas from the liver abscess by scintiangiography using Anger camera system. Ninety-five patients were imaged by Gamma camera system in St. Mary's Hospital, Catholic Medical College between May 1979 and January 1980 and their medical records were reviewed in detail. Of a total of 95 patients 38 patients were proved by histology. The patients were placed supine under Gamma camera detector head to view the anterior projection of the liver and spleen. Following an intravenous bolus injection of 10 mCi Tc-99m-phytate in volume of 3 {approx} 4ml, rapid sequential imaging 1 second duration was obtained for 16 and 30 seconds, and recorded 16 to 30 images in one film. The 4 {approx} 5 scintigraphic images obtained from the time of the first appearance of radioactivity in the abdominal aorta until its disappearance from the abdominal aorta were classified as the arterial phase of the study. In normal arterial phase, there is little or no radioactivity in the hepatic bed, compared to the lungs, heart and right kidney. When a radioactivity (early arterial staining) is depicted in the hepatic bed in the arterial phase of the scintiangiography, neoplastic condition is highly suggested. Hepatoma (47 cases) and metastasis (4 cases) show that extremely high concentration of radioactivity (early arterial staining) was noted in arterial phase in 44 cases and equivocal in 7 cases. A total of early arterial staining is concerted into the cold area in the static liver imaging. This early arterial staining is thought to be due definitely to neovascularization and feeding arteries of tumors. Liver abscess (4 cases) shows that appearance of radioactivity in the hepatic scintiangiogram as a whole was normal, except for reactive rim of hyperemia in arterial and early venous phases, but the area identified on the static liver imaging as a cold area. The hepatic scintiangiography plus static liver imaging using gamma camera system

  10. Three-phase dynamic CT findings of liver abscess: related factors with multiple layering enhancement pattern

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Ju Bae; Kim, Yong Soo; Rhim, Hyun Chul; Koh, Byung Hee; Cho, On Koo; Kim, Bong Soo; Park, Dong Woo; Park, Choong Ki [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-01-01

    To determine the number of multiple alternating layers of liver abscess, and changes in this number, as revealed by spiral CT, and to ascertain which factors are related to changes occurring during the three phase of this modality. Using three-phase sprial CT imagingewe studied 26 cases of liver abscess (pyogenic: amebi = 23:3). The number of layers comprising the abscess, as seen on postcontrast CT scans, was determined during the arterial (30sec), portal (70sec),and delayed (220sec) phase, and all cases were assigned to one of to groups according to changes in the number of layers observed during the three phases. With regard to underlying disease, the two groups were compared in terms of the presence of abscess and of diabetes mellitus, CT interval (time from oneset of symptoms to CT scanning), microbial agent (pyogenic vs. amebic), and the largest diameter of abscess as revealed by CT. Except in one case, three or four alternating layers (in 13(50%) and 7(27%) cases, respectively) were seen only during the arterial and portal phase. During each of the three phase and especially the delayed phase, where it was present in 25 of cases (96%)-two alternating layers (2:2:2) was the most common pattern, with a 3:3:3 pattern occurring in one case. All 12 cases (46%) in the unchanging-layer group showed one of three two patterns. All changing-layer group cases (14;54%) demonstrated three or four layers during the arterial and portal phase but only two during the delayed phase. The CT interval was the only significantly different factor between the two groups. During the first week, the number of cases in the unchanging-layer group was much higher than in the changing layergroup (86%, 14%), but during the second week this situation reversed (25%, 75%). Our study reveals that on three-phase dynamic CT images, a characteristic enhancement feature of liver abscess is three or four layers during the arterial and portal phases, with reduction to two layers during the delayed

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

    Directory of Open Access Journals (Sweden)

    An-lai JI

    2012-09-01

    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.

  12. Investigating amoebic pathogenesis using Entamoeba histolytica DNA microarrays

    Indian Academy of Sciences (India)

    Upinder Singh; Preetam Shah

    2002-11-01

    Entamoeba histolytica, a protozoan parasite, causes diarrhea and liver abscesses resulting in 50 million cases of infection worldwide annually. Elucidation of parasite virulence determinants has recently been investigated using genetic approaches. We have undertaken a genomics approach to identify novel virulence determinants in the parasite. A DNA microarray of E. histolytica is being developed based on sequenced genomic clones from the genome sequencing efforts of The Institute of Genomic Research (TIGR) and the Sanger Center. Hybridization of the slides with samples labelled differentially using fluorescent dyes allows the characterization of transcriptional profiles of genes under the biological conditions tested. Additionally, a genome-wide comparison of E. histolytica and E. dispar can be undertaken. The development of an E. histolytica microarray will be outlined and its uses in identifying novel virulence determinants and characterizing amoebic biology will be discussed.

  13. Review: amebic liver abscess in children - the role of diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Merten, D.F.; Kirks, D.R.

    1984-12-01

    Amebiasis, infection with the protozoan Entamoeba histolytica, affects at least 10% of the world's population, with an incidence exceeding 30% in tropical and subtropical regions. Amebic liver abscess (ALA) is the most common extraintestinal form of invasive amebiasis and is a serious life-threatening disease in children. Recent experience indicates the prognosis of ALA in childhood to be improved with early identification of abscesses and prompt institution of treatment. The authors incorporate experience with a case of ALA in infancy with a review of current literature (1974-1983) to delineate clinical and radiologic features of ALA in childhood and further define the role of hepatic imaging in the diagnosis and treatment.

  14. Modulation of endogenous Cysteine Protease Inhibitor (ICP) 1 expression in Entamoeba histolytica affects amoebic adhesion to Extracellular Matrix proteins.

    Science.gov (United States)

    Lee, Young Ah; Saito-Nakano, Yumiko; Kim, Kyeong Ah; Min, Arim; Nozaki, Tomoyoshi; Shin, Myeong Heon

    2015-02-01

    Entamoeba histolytica is an enteric tissue-invading protozoan parasite that causes amoebic colitis and occasionally liver abscess in humans. During tissue invasion, amoebic adhesion to host components is an important event for host cell death leading to successful invasion and infection. Among amoebic virulence factors, Gal/GalNAc lectin is known to be major adhesion factor to host cells. In this study, we investigated the role of amoebic secreted CP (Cysteine Proteases) in amoebic adhesion to extracellular matrix (ECM) protein using CP inhibitor and E. histolytica strains in which the endogenous inhibitor of cysteine protease (ICP) 1 gene was overexpressed (ICP1(+)) or repressed by antisense small RNA-mediated gene silencing (ICP1(-)). We found that pretreatment of wild-type amoebae with CP inhibitor E64, or thiol-group modifiers such as diamide and N-Ethylmaleimide resulted in a significant decrease in adhesion to laminin and collagen ECM proteins. Furthermore, ICP1(+) strain, with a reduction of secreted CP activity, exhibited reduced ability by 40% to adhere to laminin. In contrast, ICP1(-) strain, with a 1.9-fold increase of secreted CP activity, showed a two-fold increase in amoebic adherence to laminin compared to the control strain. In addition, total amount of secreted CP5 was decreased in ICP1(+) amoeba. Conversely, total amount of secreted CP1 and mature-form CP5 were increased in ICP1(-) amoeba. We also found that ICP1 was secreted into extracellular milieu. These results suggest that secreted CP activity by E. histolytica may be an important factor affecting adhesion to host proteins, and regulation of CP secretion by ICP plays a major role in pathogenesis. This study provides insight into the CP-mediated tissue pathogenesis in amoeba-invaded lesions during human amoebiasis.

  15. Detection of early gastric cancer facilitated by surveillance for a pyogenic liver abscess caused by Streptococcus intermedius.

    Science.gov (United States)

    Shigefuku, Ryuta; Matsunaga, Kotaro; Tamura, Tomohiro; Ozawa, Shun-Ichiro; Matsuo, Yasumasa; Takahashi, Hideaki; Matsumoto, Nobuyuki; Okuse, Chiaki; Suzuki, Michihiro; Itoh, Fumio

    2016-01-01

    We report a case of early gastric cancer that was detected during surveillance of a pyogenic liver abscess caused by Streptococcus intermedius, an oral microbiota. Treatment with proton pump inhibitors can result in the alteration of gastric bacterial flora by altering intragastric acidity. This can place immunocompromised patients, such as those with diabetes mellitus and the elderly, at an increased risk for disease of the upper gastrointestinal tract to be a route of bacterial transmission. In this case, the patient developed a pyogenic liver abscess.

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

    Directory of Open Access Journals (Sweden)

    Grueso Jose

    2007-06-01

    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. First Case of Liver Abscess in Scandinavia Due to the International Hypervirulent Klebsiella Pneumoniae Clone ST23

    DEFF Research Database (Denmark)

    Gundestrup, Svend; Struve, Carsten; Stahlhut, Steen G;

    2014-01-01

    This is the first case report from Scandinavia of a pyogenic liver abscess caused by a Klebsiella pneumoniae isolate belonging to the international hyper virulent clone ST23. The patient, an 85-year old Caucasian, had no history of foreign travel or any classical predisposing factors for infection...

  18. Septic pulmonary embolism caused by a Klebsiella pneumoniae liver abscess: clinical characteristics, imaging findings, and clinical courses

    Directory of Open Access Journals (Sweden)

    Deng-Wei Chou

    2015-06-01

    Full Text Available OBJECTIVES: Septic pulmonary embolism caused by a Klebsiella (K. pneumoniae liver abscess is rare but can cause considerable morbidity and mortality. However, clinical information regarding this condition is limited. This study was conducted to elucidate the full disease spectrum to improve its diagnosis and treatment. METHOD: We reviewed the clinical characteristics, imaging findings, and clinical courses of 14 patients diagnosed with septic pulmonary embolism caused by a K. pneumoniae liver abscess over a period of 9 years. RESULTS: The two most prevalent symptoms were fever and shortness of breath. Computed tomography findings included a feeding vessel sign (79%, nodules with or without cavities (79%, pleural effusions (71%, peripheral wedge-shaped opacities (64%, patchy ground-glass opacities (50%, air bronchograms within a nodule (36%, consolidations (21%, halo signs (14%, and lung abscesses (14%. Nine (64% of the patients developed severe complications and required intensive care. According to follow-up chest radiography, the infiltrates and consolidations were resolved within two weeks, and the nodular opacities were resolved within one month. Two (14% patients died of septic shock; one patient had metastatic meningitis, and the other had metastatic pericarditis. CONCLUSION: The clinical presentations ranged from insidious illness with fever and respiratory symptoms to respiratory failure and septic shock. A broad spectrum of imaging findings, ranging from nodules to multiple consolidations, was detected. Septic pulmonary embolism caused by a K. pneumoniae liver abscess combined with the metastatic infection of other vital organs confers a poor prognosis.

  19. Gastrointestinal stromal tumor as entry port for S. intermedius causing bacteremia and multiple liver abscesses. Case report and review of literature.

    Science.gov (United States)

    Benou, C; Walter, B M; Schlitter, M A; Wilhelm, D; Neu, B; Schmid, R M

    2016-03-01

    We report a case of a previously healthy 52-year-old man who presented with fever and liver lesions suspicious for metastatic disease, which proved subsequently to be abscesses. Further workup revealed a gastrointestinal stromal tumor (GIST) in the gastric corpus as entry port to Streptococcus intermedius-associated bacteremia and liver abscesses. After antibiotic treatment and surgical resection of the tumor, the patient recovered well. This unusual case indicates that gastrointestinal stromal tumors can remain undetected until they cause a life threatening infection. A review of recent literature pertaining to GIST and liver abscesses follows.

  20. Protection of gerbils from amebic liver abscess by immunization with a recombinant protein derived from the 170-kilodalton surface adhesin of Entamoeba histolytica.

    OpenAIRE

    Zhang, T.; Stanley, S L

    1994-01-01

    The protozoan parasite Entamoeba histolytica causes extensive morbidity and mortality worldwide through intestinal infection and amebic liver abscess. Here we show that vaccination of gerbils, a standard model for amebic liver abscess, with recombinant proteins derived from the 170-kDa galactose-binding adhesin of E. histolytica and the serine-rich E. histolytica protein or a combination of the two recombinant antigens provides excellent protection against subsequent hepatic challenge with vi...

  1. Protection of gerbils from amebic liver abscess by immunization with the galactose-specific adherence lectin of Entamoeba histolytica.

    OpenAIRE

    Petri, W A; Ravdin, J I

    1991-01-01

    No protective antigens from Entamoeba histolytica have been previously defined. We tested the ability of the galactose-specific adherence lectin of E. histolytica to elicit a protective immune response in conjunction with Freund's incomplete and complete adjuvants. The gerbil (Meriones unguiculatus) model of an experimental amebic liver abscess was used. Gerbils were immunized intraperitoneally or subcutaneously with 10 micrograms of the affinity-purified lectin in complete Freund's adjuvant ...

  2. Immunization with the Entamoeba histolytica surface metalloprotease EhMSP-1 protects hamsters from amebic liver abscess.

    Science.gov (United States)

    Roncolato, Eduardo C; Teixeira, José E; Barbosa, José E; Zambelli Ramalho, Leandra N; Huston, Christopher D

    2015-02-01

    Diarrhea and amebic liver abscesses due to invasive Entamoeba histolytica infections are an important cause of morbidity and mortality in the developing world. Entamoeba histolytica adherence and cell migration, two phenotypes linked to virulence, are both aberrant in trophozoites deficient in the metallosurface protease EhMSP-1, which is a homologue of the Leishmania vaccine candidate leishmanolysin (GP63). We examined the potential of EhMSP-1 for use as a vaccine antigen to protect against amebic liver abscesses. First, existing serum samples from South Africans naturally infected with E. histolytica were examined by enzyme-linked immunosorbent assay (ELISA) for the presence of EhMSP-1-specific IgG. Nine of 12 (75%) people with anti-E. histolytica IgG also had EhMSP-1-specific IgG antibodies. We next used a hamster model of amebic liver abscess to determine the effect of immunization with a mixture of four recombinant EhMSP-1 protein fragments. EhMSP-1 immunization stimulated a robust IgG antibody response. Furthermore, EhMSP-1 immunization of hamsters reduced development of severe amebic liver abscesses following intrahepatic injection of E. histolytica by a combined rate of 68% in two independent animal experiments. Purified IgG from immunized compared to control animals bound to the surface of E. histolytica trophozoites and accelerated amebic lysis via activation of the classical complement cascade. We concluded that EhMSP-1 is a promising antigen that warrants further study to determine its full potential as a target for therapy and/or prevention of invasive amebiasis.

  3. A review of the proposed role of neutrophils in rodent amebic liver abscess models

    Directory of Open Access Journals (Sweden)

    Campos-Rodríguez Rafael

    2016-01-01

    Full Text Available Host invasion by Entamoeba histolytica, the pathogenic agent of amebiasis, can lead to the development of amebic liver abscess (ALA. Due to the difficulty of exploring host and amebic factors involved in the pathogenesis of ALA in humans, most studies have been conducted with animal models (e.g., mice, gerbils, and hamsters. Histopathological findings reveal that the chronic phase of ALA in humans corresponds to lytic or liquefactive necrosis, whereas in rodent models there is granulomatous inflammation. However, the use of animal models has provided important information on molecules and mechanisms of the host/parasite interaction. Hence, the present review discusses the possible role of neutrophils in the effector immune response in ALA in rodents. Properly activated neutrophils are probably successful in eliminating amebas through oxidative and non-oxidative mechanisms, including neutrophil degranulation, the generation of free radicals (O2−, H2O2, HOCl and peroxynitrite, the activation of NADPH-oxidase and myeloperoxidase (MPO enzymes, and the formation of neutrophil extracellular traps (NETs. On the other hand, if amebas are not eliminated in the early stages of infection, they trigger a prolonged and exaggerated inflammatory response that apparently causes ALAs. Genetic differences in animals and humans are likely to be key to a successful host immune response.

  4. A review of the proposed role of neutrophils in rodent amebic liver abscess models.

    Science.gov (United States)

    Campos-Rodríguez, Rafael; Gutiérrez-Meza, Manuel; Jarillo-Luna, Rosa Adriana; Drago-Serrano, María Elisa; Abarca-Rojano, Edgar; Ventura-Juárez, Javier; Cárdenas-Jaramillo, Luz María; Pacheco-Yepez, Judith

    2016-01-01

    Host invasion by Entamoeba histolytica, the pathogenic agent of amebiasis, can lead to the development of amebic liver abscess (ALA). Due to the difficulty of exploring host and amebic factors involved in the pathogenesis of ALA in humans, most studies have been conducted with animal models (e.g., mice, gerbils, and hamsters). Histopathological findings reveal that the chronic phase of ALA in humans corresponds to lytic or liquefactive necrosis, whereas in rodent models there is granulomatous inflammation. However, the use of animal models has provided important information on molecules and mechanisms of the host/parasite interaction. Hence, the present review discusses the possible role of neutrophils in the effector immune response in ALA in rodents. Properly activated neutrophils are probably successful in eliminating amebas through oxidative and non-oxidative mechanisms, including neutrophil degranulation, the generation of free radicals (O2(-), H2O2, HOCl) and peroxynitrite, the activation of NADPH-oxidase and myeloperoxidase (MPO) enzymes, and the formation of neutrophil extracellular traps (NETs). On the other hand, if amebas are not eliminated in the early stages of infection, they trigger a prolonged and exaggerated inflammatory response that apparently causes ALAs. Genetic differences in animals and humans are likely to be key to a successful host immune response. PMID:26880421

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

    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.

  6. Liver abscess caused by Ascaris lumbricoides: case report Absceso hepático por Ascaris lumbricoides: reporte de un caso

    OpenAIRE

    PINILLA Análida Elizabeth; LÓPEZ Myriam Consuelo; Orlando RICAURTE; CASTILLO Blanca; Murcia, Martha Isabel; Nicholls, Rubén Santiago; Duque, Sofía; Orozco, Luis Carlos

    2001-01-01

    A case is reported of a woman who lived in a rural area with a chronic illness that consisted of weight loss and abdominal pain in the epigastrium and upper right quadrant. The initial diagnosis was a mass in the liver, which was later, demonstrated, both by direct and histological examination, to be an abscess caused by Ascaris lumbricoides. Eggs of Ascaris lumbricoides and abundant Charcot-Leyden Crystals were found.Se presenta el caso de una mujer que vivía en zona rural con una enfermedad...

  7. Is hepatic neoplasm-related pyogenic liver abscess a distinct clinical entity?

    Institute of Scientific and Technical Information of China (English)

    Siu-Tong Law; Ki Kong Li

    2012-01-01

    AIM:To compare the clinical characteristics of pyogenic liver abscess (PLA) in patients with and without hepatic neoplasm (HN).METHODS:Authors performed a retrospective analysis involving patients with PLA.The demographic,clinical features,laboratory and imaging findings,management and outcome of patients with and without HN were studied.RESULTS:From January 2000 to December 2009 inclusive,318 patients (35 with HN) had PLA,and mean age and comorbidity were comparable between the two groups.More patients with HN experienced right upper quadrant pain (68.6% vs 52.7%,P < 0.04),developed jaundice (14.3% vs 5.7%,P < 0.03) and hepatomegaly (17.1% vs 3.9%,P < 0.01),and had higher serum total bilirubin level (43.3 μmol/L vs 30.0 μmol/L,P =0.05).Most patients in both groups had PLAs in the right hepatic lobe,and biliary tract disorder was the most common underlying cause (71.4% and 61.8%).However,more PLAs in the HN group were associated with thicker abscess wall (37.1% vs 19.4%,P < 0.01),septal lobulation (77.1% vs 58%,P < 0.02),gaseous cavitation (17% vs 7.8%,P =0.03),portal thrombophlebitis (11.4% vs 1.8%,P < 0.01) and aerobilia (25.9% vs 5.5%,P < 0.01).Mixed bacterial growth (40% vs 15.2%,P < 0.01) and Gram-negative bacilli (22.8% vs 60.4%,P < 0.01) were dominant isolates in PLAs with and without HN,respectively.Although incidence of the complications was comparable between the two groups,patients with HN had a higher mortality rate than those without (71.4% vs 8.8%,P < 0.01).Multivariate logistic regression analysis revealed underlying active malignancy [odds ratio (OR):40.45,95% CI:14.76-111.65],hypoalbuminemia (OR:1.22,95% CI:1.14-1.38),disseminated intravascular coagulation (OR:3.32,95%CI:1.19-9.69) and acute coronary syndrome (OR:4.48,95% CI:1.08-17.8) were independent risk factors associated with mortality.However,several HN cases,presented concurrently with PLAs,were found to have

  8. A comparative study of image-guided percutaneous procedures for the treatment of liver abscesses; Estudos comparativos dos procedimentos percutaneos orientados por metodos de imagem no tratamento das colecoes hepaticas

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Giselle Guedes Netto de; Meirelles, Gustavo de Souza Portes; Oliveira, Jose Marcelo Amatuzzi de; Ajzen, Sergio; D' Ippolito, Giuseppe; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP), SP (Brazil). Dept. de Diagnostico por Imagem

    2001-04-01

    The objective was to determine and compare the efficacy of percutaneous needle aspiration and percutaneous catheter drainage, both guided by imaging methods, for the treatment of liver abscesses. From 52 patients referred to our service for percutaneous treatment of abdominal abscesses, 17 presented liver abscesses, 13 of which were considered non complex and four were considered complex (multiloculated, multiple or associated to fistulas). Percutaneous needle aspiration was performed in 7/17 patients and 10/17 patients were submitted to percutaneous catheter drainage. The method used was considered successful when there was complete abscess resolution with both clinical and laboratorial improvement. The procedures were successful in 82.4% of all cases. In the group submitted to percutaneous needle aspiration the rate of success was 57.1% and in the group submitted to percutaneous catheter drainage the rate of success was 100%. Successful treatment was achieved in 75% of the patients submitted to percutaneous needle aspiration for abscesses smaller than 100 ml, but in only 33.3% of the patients with abscesses between 100 and 250 ml. There was complete resolution of the abscesses with percutaneous needle aspiration in 75% of the simple abscesses and in 25% of the complex abscesses. Percutaneous catheter drainage is more effective than percutaneous needle aspiration for the treatment of liver abscesses. Needle aspiration may probably be used as a valid alternative for smaller and non complex abscesses. (author)

  9. A Case of Neck Abscess Caused by Salmonella Serotype D in a Patient with Liver Cirrhosis

    OpenAIRE

    Kwon, Mee-Hye; Kang, Mi-Il; Chun, Ji-Young; Lim, Hyun-Woo; Yeum, Yoon-Sik; Kang, Young-Woo; Kim, Young-Jin; Kim, Young Keun

    2009-01-01

    Non-typhoidal salmonellosis, which is increasing nowadays in Korea as well as in the developed countries, is manifested as enteritis in most cases, but it also encompasses bacteremia, intraabdominal infections, and bone, joint and soft tissue infections. These rare diseases are known to result from primary gastrointestinal infection and subsequent bacteremia with or without symptoms. We experienced a case of neck abscess caused by Salmonella serotype D, which is a rare but important different...

  10. Epidural abscess

    Science.gov (United States)

    ... intracranial epidural abscess if it is inside the skull area. It is called a spinal epidural abscess if it is found in the ... of infection is found. An abscess inside the skull is called an ... is called a spinal epidural abscess. It may be seen in people ...

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

    Directory of Open Access Journals (Sweden)

    Shuichi Hagiwara

    2009-04-01

    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.

  12. Evaluation of the C-Terminal Fragment of Entamoeba histolytica Gal/GalNAc Lectin Intermediate Subunit as a Vaccine Candidate against Amebic Liver Abscess.

    Directory of Open Access Journals (Sweden)

    Xiangyang Min

    2016-01-01

    Full Text Available Entamoeba histolytica is an intestinal protozoan parasite that causes amoebiasis, including amebic dysentery and liver abscesses. E. histolytica invades host tissues by adhering onto cells and phagocytosing them depending on the adaptation and expression of pathogenic factors, including Gal/GalNAc lectin. We have previously reported that E. histolytica possesses multiple CXXC sequence motifs, with the intermediate subunit of Gal/GalNAc lectin (i.e., Igl as a key factor affecting the amoeba's pathogenicity. The present work showed the effect of immunization with recombinant Igl on amebic liver abscess formation and the corresponding immunological properties.A prokaryotic expression system was used to prepare the full-length Igl and the N-terminal, middle, and C-terminal fragments (C-Igl of Igl. Vaccine efficacy was assessed by challenging hamsters with an intrahepatic injection of E. histolytica trophozoites. Hamsters intramuscularly immunized with full-length Igl and C-Igl were found to be 92% and 96% immune to liver abscess formation, respectively. Immune-response evaluation revealed that C-Igl can generate significant humoral immune responses, with high levels of antibodies in sera from immunized hamsters inhibiting 80% of trophozoites adherence to mammalian cells and inducing 80% more complement-mediated lysis of trophozoites compared with the control. C-Igl was further assessed for its cellular response by cytokine-gene qPCR analysis. The productions of IL-4 (8.4-fold and IL-10 (2-fold in the spleen cells of immunized hamsters were enhanced after in vitro stimulation. IL-4 expression was also supported by increased programmed cell death 1 ligand 1 gene.Immunobiochemical characterization strongly suggests the potential of recombinant Igl, especially the C-terminal fragment, as a vaccine candidate against amoebiasis. Moreover, protection through Th2-cell participation enabled effective humoral immunity against amebic liver abscesses.

  13. Hematogenous Pasteurella multocida brain abscess

    International Nuclear Information System (INIS)

    A case of hematogenously acquired brain abscess caused by Pasteurella multocida is described. CT scans of the head revealed the lesions in a 67 year old man with mild alcoholic liver disease and severe chronic obstructive pulmonary disease. Ultrasound examinations of the abdomen and chest and an echocardiogram failed to reveal a source for the abscess. On autopsy examination three encapsulated brain abscesses were found. 34 references, 2 figures, 1 table

  14. Gastrectomy is Associated with an Increased Risk of Pyogenic Liver Abscess: A 13-Year Nationwide Cohort Study

    Science.gov (United States)

    Tsai, Ming-Shian; Lin, Cheng-Li; Jeng, Long-Bin

    2016-01-01

    Whether patients who have undergone gastrectomy are at a high risk of developing pyogenic liver abscess (PLA) remains debatable. From the inpatient claims records of Taiwan’s National Health Insurance Research Database, we identified 33 834 patients with a history of 2000–2010 and135 336 controls without a history of gastrectomy. The 2cohorts were matched by age, sex, and admission year and followed-up until the end of 2011 for estimating the risk of PLA. Overall, the incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10 000 person-y). The adjusted hazard ratio (aHR) for the gastrectomy cohort obtained using the multivariate Cox proportional hazards regression model was 3.08 (95% confidence interval [CI] = 2.60–3.64). An elevated post gastrectomy PLA risk was observed in both men and women. Age-specific data revealed that the aHR for the gastrectomy cohort, compared with the control cohort, was the highest in patients younger than 50 years (aHR = 5.16, 95% CI = 2.96–9.01). An addition analysis showed that the gastrectomy cohort exhibited an elevated PLA risk regardless of whether the patients underwent total or partial gastrectomy. Patients with a history of gastrectomy exhibit a high risk of PLA. PMID:27671754

  15. Actinomyces naeslundii and Eikenella corrodens as rare causes of liver abscesses

    OpenAIRE

    Jaqua, Nathan Thomas; Smith, Adam J.; Shin, Terry T; Jahanmir, Jay

    2013-01-01

    A 48-year-old man with an unremarkable medical history was admitted with vague conditions of fever, chills, myalgias and malaise. Physical examination was remarkable for only scleral icterus. Laboratory evaluation revealed elevated aminotransferases, alkaline phosphatase and bilirubin. Imaging demonstrated two masses in the right lobe of his liver, which were ultimately drained and cultures demonstrated Actinomyces and Eikenella. He continued to have fever on broad-spectrum antibiotics until ...

  16. Clinical features of 118 patients with pyogenic liver abscesses%118例细菌性肝脓肿临床特点分析

    Institute of Scientific and Technical Information of China (English)

    葛瑛; 刘正印; 李太生

    2011-01-01

    目的 探讨近年来细菌性肝脓肿的临床特点、病原学、诊断和治疗的变化.方法 回顾性分析1986年1月-2010年6月北京协和医院118例细菌性肝脓肿住院患者的临床资料.结果 118例平均年龄53.3岁,其中发热(97.5%)、寒战(91.5%)、右上腹痛(44.1%)是最常见的临床表现.糖尿病(41.5%)、胆系疾病(24.6%)是主要易患因素.绝大多数患者外周血白细胞增高(104例),红细胞沉降率增快(62例).肝右叶(93例)单发脓肿(88例)最多见.21例脓液培养和55例血培养阳性,肺炎克雷伯菌是最主要病原菌,占56.4%.80例经B超或CT引导下穿刺引流并联合抗生素治疗.死亡3例,总有效率为96.6%.结论 细菌性肝脓肿患者的平均患病年龄有增大趋势,以肝右叶单发脓肿最常见,且临床表现多样,病原学以肺炎克雷伯菌最常见,糖尿病和胆系疾病是主要的易患因素.%Objective To investigate the clinical features, pathology, diagnosis and treatment of patients with pyogenic liver abscesses. Methods Clinical data of 118 patients with pyogenic liver abscesses, admitted to Peking Union Medical College Hospital from Jan. 1986 to Jun. 2010, were analyzed retrospectively. Results The mean age of 118 patients was 53.5 years. They were mainly manifested with fever (97.5%), chills (91.5%) and right upper quadrant pain (44.1%). Patients with diabetes (41.5%) and biliary diseases (24.6%) were the most likely to develop pyogenic liver abscesses. An elevated white blood cell count was seen in 104 patients and an elevated erythrocyte sedimentation rate in 62 patients. The abscesses in the right lobe were found in 93 patients, and the abscesses of 88 patients were solitary. Twenty-one purulent secretion cultures and 55 blood cultures were bacteriologically positive.Klebsiella pneumonia was identified in 56.4% of the patients. Eighty patients received ultrasound B or CT-guided porcutaneous drainage combined with antibiotic therapy

  17. Tooth abscess

    Science.gov (United States)

    ... your teeth, mouth, and gums. You may have pain when the dentist taps the tooth. Biting or closing the mouth tightly also increases ... abscess; Dental abscess; Tooth infection; Abscess - tooth Images Tooth anatomy References Amsterdam JT. Oral Medicine. In: Marx JA, Hockberger RS, Walls RM, et ...

  18. Amebic liver abscess with bacterial superinfection in a patient with no epidemiologic risk factors Absceso hepático amebiano sobreinfectado sin antecedentes epidemiológicos

    Directory of Open Access Journals (Sweden)

    P. Sánchez-Pobre

    2004-11-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2014-05-15

    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.)

  20. [Brodie's abscess].

    Science.gov (United States)

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

    1993-08-10

    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).

  1. Prevalent HLA Class II Alleles in Mexico City Appear to Confer Resistance to the Development of Amebic Liver Abscess.

    Directory of Open Access Journals (Sweden)

    Eric G Hernández

    Full Text Available Amebiasis is an endemic disease and a public health problem throughout Mexico, although the incidence rates of amebic liver abscess (ALA vary among the geographic regions of the country. Notably, incidence rates are high in the northwestern states (especially Sonora with a rate of 12.57/100,000 inhabitants compared with the central region (Mexico City with a rate of 0.69/100,000 inhabitants. These data may be related to host genetic factors that are partially responsible for resistance or susceptibility. Therefore, we studied the association of the HLA-DRB1 and HLA-DQB1 alleles with resistance or susceptibility to ALA in two Mexican populations, one each from Mexico City and Sonora. Ninety ALA patients were clinically diagnosed by serology and sonography. Genomic DNA was extracted from peripheral blood mononuclear cells. To establish the genetic identity of both populations, 15 short tandem repeats (STRs were analyzed with multiplexed PCR, and the allelic frequencies of HLA were studied by PCR-SSO using LUMINEX technology. The allele frequencies obtained were compared to an ethnically matched healthy control group (146 individuals. We observed that both affected populations differed genetically from the control group. We also found interesting trends in the population from Mexico City. HLA-DQB1*02 allele frequencies were higher in ALA patients compared to the control group (0.127 vs 0.047; p= 0.01; pc= NS; OR= 2.9, 95% CI= 1.09-8.3. The less frequent alleles in ALA patients were HLA-DRB1*08 (0.118 vs 0.238 in controls; p= 0.01; pc= NS; OR= 0.42, 95% CI= 0.19-0.87 and HLA-DQB1*04 (0.109 vs 0.214; p= 0.02; pc= NS; OR= 0.40, 95% CI= 0.20-0.94. The haplotype HLA-DRB1*08/-DQB1*04 also demonstrated a protective trend against the development of this disease (0.081 vs. 0.178; p=0.02; pc=NS; OR= 0.40, 95% CI= 0.16-0.93. These trends suggest that the prevalent alleles in the population of Mexico City may be associated with protection against the

  2. Prevalent HLA Class II Alleles in Mexico City Appear to Confer Resistance to the Development of Amebic Liver Abscess

    Science.gov (United States)

    Hernández, Eric G.; Granados, Julio; Partida-Rodríguez, Oswaldo; Valenzuela, Olivia; Rascón, Edgar; Magaña, Ulises; Escamilla-Tilch, Mónica; López-Reyes, Alberto; Nieves-Ramírez, Miriam; González, Enrique; Morán, Patricia; Rojas, Liliana; Valadez, Alicia; Luna, Alexandra; Estrada, Francisco J.; Maldonado, Carmen; Ximénez, Cecilia

    2015-01-01

    Amebiasis is an endemic disease and a public health problem throughout Mexico, although the incidence rates of amebic liver abscess (ALA) vary among the geographic regions of the country. Notably, incidence rates are high in the northwestern states (especially Sonora with a rate of 12.57/100,000 inhabitants) compared with the central region (Mexico City with a rate of 0.69/100,000 inhabitants). These data may be related to host genetic factors that are partially responsible for resistance or susceptibility. Therefore, we studied the association of the HLA-DRB1 and HLA-DQB1 alleles with resistance or susceptibility to ALA in two Mexican populations, one each from Mexico City and Sonora. Ninety ALA patients were clinically diagnosed by serology and sonography. Genomic DNA was extracted from peripheral blood mononuclear cells. To establish the genetic identity of both populations, 15 short tandem repeats (STRs) were analyzed with multiplexed PCR, and the allelic frequencies of HLA were studied by PCR-SSO using LUMINEX technology. The allele frequencies obtained were compared to an ethnically matched healthy control group (146 individuals). We observed that both affected populations differed genetically from the control group. We also found interesting trends in the population from Mexico City. HLA-DQB1*02 allele frequencies were higher in ALA patients compared to the control group (0.127 vs 0.047; p= 0.01; pc= NS; OR= 2.9, 95% CI= 1.09-8.3). The less frequent alleles in ALA patients were HLA-DRB1*08 (0.118 vs 0.238 in controls; p= 0.01; pc= NS; OR= 0.42, 95% CI= 0.19-0.87) and HLA-DQB1*04 (0.109 vs 0.214; p= 0.02; pc= NS; OR= 0.40, 95% CI= 0.20-0.94). The haplotype HLA-DRB1*08/-DQB1*04 also demonstrated a protective trend against the development of this disease (0.081 vs. 0.178; p=0.02; pc=NS; OR= 0.40, 95% CI= 0.16-0.93). These trends suggest that the prevalent alleles in the population of Mexico City may be associated with protection against the development of ALA

  3. Bacterial Alkaloids Prevent Amoebal Predation.

    Science.gov (United States)

    Klapper, Martin; Götze, Sebastian; Barnett, Robert; Willing, Karsten; Stallforth, Pierre

    2016-07-25

    Bacterial defense mechanisms have evolved to protect bacteria against predation by nematodes, predatory bacteria, or amoebae. We identified novel bacterial alkaloids (pyreudiones A-D) that protect the producer, Pseudomonas fluorescens HKI0770, against amoebal predation. Isolation, structure elucidation, total synthesis, and a proposed biosynthetic pathway for these structures are presented. The generation of P. fluorescens gene-deletion mutants unable to produce pyreudiones rendered the bacterium edible to a variety of soil-dwelling amoebae. PMID:27294402

  4. 细菌性肝脓肿合并糖尿病患者非手术治疗的护理%Nursing care of non operation treatment of bacterial liver abscess in patients with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    王瑞梅

    2015-01-01

    Bacterial liver abscess and diabetes are common clinical diseases.They have a serious impact on the patients health and life.In this paper,the author briefly introduces nursing care of non operation treatment of bacterial liver abscess in patients with diabetes mellitus.%细菌性肝脓肿和糖尿病是临床常见疾病,对患者的健康和生活产生严重的影响。本文简要介绍细菌性肝脓肿合并糖尿病患者非手术治疗的护理。

  5. 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

    Institute of Scientific and Technical Information of China (English)

    赵小芹; 许岚

    2011-01-01

    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.

  6. 摩根摩根菌致肝脓肿一例并文献复习%A case of liver abscess caused by morganella morganii and the literature review

    Institute of Scientific and Technical Information of China (English)

    艾学军; 邓凤英; 唐云志; 崔青云; 何卫平

    2015-01-01

    ObjectiveTo improve the clinical understanding of liver abscess caused by morganella morganii.Methods Clinical data of a 60-year-old woman with pyogenic liver abscess were retrospectively analyzed, and reviewed the literature.Results The patient was admitted to hospital with complaints of fever, chills, fatigue, nausea, vomiting, loss of appetite, liver abscess was confirmed by magnetic resonance imaging and M. morganii was determined by abscess material bacterial culture, the patient recovered after cefoperazone/sulbactum and ornidazole combined therapy.Conclusion Liver abscess caused by morganella morganii was the first report in our country. It is important to treat liver abscess with accurately bacterial identification and drug susceptibility.%目的:提高对摩根摩根菌导致肝脓肿的临床认识。方法对1例60岁女性摩根摩根菌导致的肝脓肿患者的临床资料进行回顾性分析,并复习相关文献。结果本例患者因发热、寒战、乏力、恶心、呕吐、食欲下降就诊,经影像学检查及穿刺后细菌学检查证实为摩根摩根菌导致的肝脓肿,经头孢哌酮舒巴坦钠联合奥硝唑治疗后病情恢复。结论本文为国内首次报道摩根摩根菌导致肝脓肿,积极进行细菌学检查及药敏试验,对肝脓肿患者治疗尤为重要。

  7. Anorectal abscess

    Science.gov (United States)

    ... from the rectum Fatigue, fever , night sweats, and chills Redness, painful and hardened tissue in the area ... other symptoms of anorectal abscess You have fever, chills, or other new symptoms after being treated for ...

  8. Professor WANG Changhong's Experience in Treatment of Bacterial Liver Abscess%王长洪教授治疗细菌性肝脓肿经验

    Institute of Scientific and Technical Information of China (English)

    高文艳; 王长洪

    2013-01-01

    Professor WANG Changhong thinks that the external cause of bacterial liver abscess is the accumulation of heat and toxin,clearing away heat and toxic materia is the fundamental treatment,the herb's dosage should be heavy.The internal cause is deficiency of healthy Qi,benefiting vital energy should through the treatment,the Mongolian Milkvetch Root should be used most frequently ; Qi-stagnation and blood stasis is the critical pathogenesis,activating blood circulation to dissipate blood stasis can promote abscess to dissipate.Treating by stages has the better manipuility.%王长洪教授认为细菌性肝脓肿热毒内蕴是外因,清热解毒是根本大法,用药宜重剂;正气虚损是内因,益气扶正宜贯穿治疗始终,应用黄芪最为常;气阻血瘀是关键病机,活血化瘀促消散.临证之时,分期论治更具可操作性.

  9. The association of haemoglobin A1C levels with the clinical and CT characteristics of Klebsiella pneumoniae liver abscesses in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    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 A1C (HbA1C) concentration (good, HbA1C ≤ 7.0 %; suboptimal, 7.0 % 1C ≤ 9.0 %; poor, HbA1C > 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 1C concentration (>9.0 %) have an association with hepatic venous thrombophlebitis, gas formation and metastatic infection complications associated with KPLA. (orig.)

  10. Development of perianal ulcer as a result of acute fulminant amoebic colitis

    Institute of Scientific and Technical Information of China (English)

    Takayuki Torigoe; Yoshifumi Nakayama; Koji Yamaguchi

    2012-01-01

    We report a case of acute fulminant amoebic colitis that resulted in the development of a perianal ulcer in a 29-year-old Japanese homosexual man with acquired immunodeficiency syndrome (AIDS).The patient was admitted to our hospital with a persistent perianal abscess that was refractory to antibiotic therapy administered at another hospital.On admission,we observed a giant ulcer in the perianal region.At first,cytomegalovirus colitis was suspected by blood investigations.Ganciclovir therapy was initiated; however,the patient developed necrosis of the skin around the anus during therapy.We only performed end-sigmoidostomy and necrotomy to avoid excessive surgical invasion.Histopathological examination of the surgical specimen revealed the presence of trophozoite amoebae,indicating a final diagnosis of acute fulminant amoebic colitis.The patient's postoperative course was favorable,and proctectomy of the residual rectum was performed 11 mo later.Amoebic colitis is one of the most severe complications affecting patients with AIDS.Particularly,acute fulminant amoebic colitis may result in a poor prognosis; therefore,staged surgical therapy as a less invasive procedure should be considered as one of the treatment options for these patients.

  11. Cell Based Drug Delivery: Micrococcus luteus Loaded Neutrophils as Chlorhexidine Delivery Vehicles in a Mouse Model of Liver Abscesses in Cattle.

    Science.gov (United States)

    Wendel, Sebastian O; Menon, Sailesh; Alshetaiwi, Hamad; Shrestha, Tej B; Chlebanowski, Lauren; Hsu, Wei-Wen; Bossmann, Stefan H; Narayanan, Sanjeev; Troyer, Deryl L

    2015-01-01

    The recent WHO report on antibiotic resistances shows a dramatic increase of microbial resistance against antibiotics. With only a few new antibiotics in the pipeline, a different drug delivery approach is urgently needed. We have obtained evidence demonstrating the effectiveness of a cell based drug delivery system that utilizes the innate immune system as targeting carrier for antibacterial drugs. In this study we show the efficient loading of neutrophil granulocytes with chlorhexidine and the complete killing of E. coli as well as Fusobacterium necrophorum in in-vitro studies. Fusobacterium necrophorum causes hepatic abscesses in cattle fed high grain diets. We also show in a mouse model that this delivery system targets infections of F. necrophorum in the liver and reduces the bacterial burden by an order of magnitude from approximately 2•106 to 1•105.

  12. Cell Based Drug Delivery: Micrococcus luteus Loaded Neutrophils as Chlorhexidine Delivery Vehicles in a Mouse Model of Liver Abscesses in Cattle.

    Directory of Open Access Journals (Sweden)

    Sebastian O Wendel

    Full Text Available The recent WHO report on antibiotic resistances shows a dramatic increase of microbial resistance against antibiotics. With only a few new antibiotics in the pipeline, a different drug delivery approach is urgently needed. We have obtained evidence demonstrating the effectiveness of a cell based drug delivery system that utilizes the innate immune system as targeting carrier for antibacterial drugs. In this study we show the efficient loading of neutrophil granulocytes with chlorhexidine and the complete killing of E. coli as well as Fusobacterium necrophorum in in-vitro studies. Fusobacterium necrophorum causes hepatic abscesses in cattle fed high grain diets. We also show in a mouse model that this delivery system targets infections of F. necrophorum in the liver and reduces the bacterial burden by an order of magnitude from approximately 2•106 to 1•105.

  13. Post-partum pyogenic abscess containing Ascaris lumbricoides

    OpenAIRE

    Hamid, Raashid; Wani, Sajad; Ahmad, Nawab; Akhter, Afrozah

    2013-01-01

    We report an unusual case of multiple pyogenic liver abscesses containing Ascariasis lumbricoides in a 35-year-old post-partum female who had delivered 1 month back. Open drainage of liver abscess along with liver worm was done. Patient did well post-operatively.

  14. 超声在肝脓肿诊断及治疗中的应用效果分析%Application Analysis of Ultrasound in the Diagnosis and Treatment of Liver Abscess

    Institute of Scientific and Technical Information of China (English)

    李丽娟

    2015-01-01

    Objective To analyze effects of ultrasound in the diagnosis and treatment of liver abscess. Methods From January 2012 to December 2013, 42 patients with liver abscess were treated as research object, for all patients with two-dimensional and color Doppler examination in the diagnosis of liver abscess lesions were observed the morphology, size, echo and blood flow condition. Results 42 cases with liver abscess lesions in 32 cases, ultrasound demonstrates a typical lesions as round or class round solid cystic mixed mass, fuzzy boundaries, wall thickness, the lining is not smooth, the center for low echo, visible flake liquid dark space, of a CDFI:lumps peripheral and internal can be detected with abundant blood flow signals, 6 cases of atypical liver abscess, the mass present uneven medium and low echo, fuzzy boundaries, of a CDFI: not obvious blood flow signal detection, 4 patients with diagnosis is not clear. Conclusion Ultrasound diagnosis for the liver abscess lesions has good positioning effect, is the current method of choice for clinical diagnosis for patients with liver abscess.%目的:分析探讨超声在肝脓肿的诊断和治疗中的效果。方法选择我院2012年1月~2013年12月之间收治的42例肝脓肿患者作为观察对象,对全部患者实施二维及彩色多普勒检查诊断,观察患者肝脓肿病灶的形态、大小、回声和血流状况。结果42例患者超声显示典型肝脓肿病灶有32例,病灶为圆形或者类圆形囊实性混合性肿物、边界模糊,壁厚,内壁不光滑,中心部为低回声、可见片状液性暗区, CDFI :肿物周边或内部可检出较丰富血流信号;非典型肝脓肿6例,肿物呈现不均匀中等及低回声,边界模糊,CDFI :未检出明显血流信号;诊断不明确患者4例。结论超声诊断对于肝脓肿病灶具有较好的定位作用,是当前对肝脓肿患者进行临床诊断的首选方法。

  15. Peritonsillar abscess

    DEFF Research Database (Denmark)

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

    1991-01-01

    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...... readmitted for surgery of the remaining tonsil during the follow-up period. Ninety-seven per cent of these patients were younger than 30 years of age. Previous investigations have shown increasing frequency by age of pharyngitis after bilateral tonsillectomy. We suggest bilateral tonsillectomy in all cases...

  16. 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

    Institute of Scientific and Technical Information of China (English)

    赵小芹; 蒋艳敏; 朱晓巍; 徐湘; 许岚

    2012-01-01

    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).

  17. 细菌性肝脓肿118例临床分析%Pyogenic liver abscess: a clinical analysis of 118 cases

    Institute of Scientific and Technical Information of China (English)

    龚剑; 戴维; 潘志刚

    2013-01-01

    The clinical data of 118 patients with bacterial liver abscess admitted to a tertiary hospital from January 2007 to December 2009 were analyzed retrospectively.Etiology study showed that 45.8%(54/118) cases of bacterial liver abscess were cryptogenic,40.7% (48/118) were biliary source and 13.5% (16/118) were hematogenous.The positive rate of pus culture was 57.1% (36/63),among which klebsiella pneumoniae accounted for 72.2% (26/36).The positive rate of blood culture was 31.2%(20/64) and klebsiella pneumoniae accounted for 95% (19/20).One hundred and sixteen patients (98.3%) underwent color ultrasound examination with an accuracy rate of 93.2%.84 patients (71.2%)underwent the CT scan with an accuracy rate of 95.3% and 20 patients underwent MRI with an accuracy rate of 85%.Seventy five patients (63.6%)accepted ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotic therapy; 40 patients(33.9%)were treated with antibiotics alone.On the discharge 27 patients(22.9%) achieved clinical cure,87 patients (73.7%) were classified as effective,4 patients (3.4%) had no effect and no death in this group of patients.The average length of hospital stay was 16 days.Cryptogenic was the most common cause of bacterial liver abscess,biliary source took the second place.Kleibsiella pneumoniae was the predominant organism.Detailed medical history inquiry,physical examination and assistant examination may increase the accuracy rate of diagnosis.Needle biopsy should be performed if necessary.Ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotics should be the first-line treatment.%分析2007年1月至2009年12月于某三级医院住院的118例细菌性肝脓肿患者的临床资料.结果显示,细菌性肝脓肿的病因:隐源性占45.8%(54/118),胆源性占40.7%(48/118),血源性为13.5% (16/118).脓液培养阳性率为57.1%(36/63),肺炎克雷伯菌占72.2%(26/36)

  18. 糖尿病合并细菌性肝脓肿的临床特点与诊治%Clinical Characteristics and Diagnosis and Treatment of Diabetes Complicated with Bacterial Liver Abscess

    Institute of Scientific and Technical Information of China (English)

    王瑞杰

    2015-01-01

    Objective To study the analysis of diabetic clinical characteristics and treatment of bacterial liver abscess. Methods Retrospective analysis of our hospital in November 2012 to November 2014 admit ed during the period of clinical data of 18 cases of diabetic patients with bacterial liver abscess. Results The diabetic patients with bacterial liver abscess in the elderly is given priority to, including clinical symptoms obviously for 7 cases (38.9%), while no typical symptoms patients reach 11 cases (61.1%), poor control of blood sugar is easy intercur ent disease, easy cause higher white blood cel s, liver function damage, etc., to take insulin to control blood sugar levels in al 18 cases. Conclusion Diabetic bacterial liver abscess has no typical clinical symptoms, the diagnosis of the disease is mainly by chao deng B testing, due to the timely control blood sugar levels in the early onset, according to patients condition for antibiotics, such as puncture drainage treatment, to ensure the clinical curative ef ect.%目的研究分析糖尿病合并细菌性肝脓肿的临床特点与诊治方法。方法回顾分析我院2012年11月~2014年11月收治的18例糖尿病合并细菌性肝脓肿患者临床资料。结果糖尿病合并细菌性肝脓肿患者中以老年群体为主,其中临床症状表现明显占7例(38.9%),而无典型症状患者达到11例(61.1%),血糖控制不良者易并发该病,易引发白细胞增高,肝功能损害等情况,18例患者均采取胰岛素控制血糖水平。结论糖尿病合并细菌性肝脓肿的临床症状表现不具典型,在诊断该病是主要靠B超等检测,在发病早期因及时控制血糖水平,根据患者情况进行抗生素、穿刺引流等方式治疗,确保临床疗效。

  19. 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

    Institute of Scientific and Technical Information of China (English)

    顾朝丽; 单荣芳; 刘颖; 黄金兰; 蒋雅琼

    2011-01-01

    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.

  20. Retrospective analysis of 30 cases bacterial liver abscess in Jinshan district of Shanghai%上海金山地区30例细菌性肝脓肿回顾分析

    Institute of Scientific and Technical Information of China (English)

    李欢庆; 卜淑蕊

    2012-01-01

    Objective To study the association of Liver schistosomiasis comorbid with pyogenic hepatic abscess, summarize our experience on its diagnosis and treatment within recent 5 years in Jinshan distict of Shanghai, and to explore the predispose factors and preventive management. Methods 30 patients with pyogenic liver abscess were analyzed hy clinical data,radiological characteristics, the efficacy and history of cholecystectomy clinic date were compared between pyogenic liver abscess with and without schistosomiasis. Result 01 30 patients, the presenting symptoms of 10 cases with liver schistosomiasis were atypical,including moderate fever, abdominal distension and anorexia, other 20 cases without liver schistosomiasis manifested with high fever,chills and abdominal pain of right-upper-quadrant,hepatomegaly and leukocytosis,with or without elevated liver function. The diagnostic sensitivities of ultrasonography ( US) and computed tomography( CT) were 96. 7% ,suspected rate was 3.3%. Conclusions The symptoms of liver schistosomiasis comorbid with pyogenic hepatic abscess in Jin shan distict of Shanghai are a-typical, earlier diagnosis and proper therapy are key issue, the incidence rate of liver schistosomiasis comorbid with hepatatic abscess is higher in Liver schistosomiasis comlicated with diabetes or cholecystectomy history than those withoutliver schislosomiasis.%目的 研究近5年上海金山地区细菌性肝脓肿病因与伴发疾病之间的关系,了解该地区血吸虫肝病伴发肝脓肿的临床特点及诊治经验,分析其易患因素和预防策略.方法 回顾性分析30例细菌性肝脓肿患者的临床资料、影像学特点、治疗及既往是否有胆囊切除术史等,并对其中并发血吸虫肝病与未合并血吸虫肝病患者的临床资料进行比较.结果 30例患者中,10例合并血吸虫肝病的肝脓肿患者症状不典型,仅以中等发热、腹胀及纳差为主要临床表现;而20例未合并血吸虫肝病患

  1. The monocyte locomotion inhibitory factor an anti-inflammatory peptide; therapeutics originating from amebic abscess of the liver.

    Science.gov (United States)

    Velazquez, Juan R

    2011-01-01

    Entamoeba histolytica in culture produces a pentapeptide (MQCNS). This oligopeptide inhibits the in vitro and in vivo locomotion of human monocytes, hence its denomination Monocyte Locomotion Inhibitory Factor (MLIF). The original isolated peptide and its synthetic construct display similar effects, among others, being inhibition of the respiratory burst in monocytes and neutrophils, decrease of Dinitrochlorobenzene (DNCB) skin hypersensitivity in guinea pigs and gerbils, and delay of mononuclear leukocytes in human Rebuck skin windows with inhibition of vascular cell Very late antigen (VLA)-4 and Vascular adhesion molecules (VCAM) in endothelia and monocytes. The MLIF molecular mechanism of action is unknown, but data reveal its implication in Nuclear factor-kappa B (NF-κB) and Mitogenactivated protein kinase (MAPK) pathways. This could explain MLIF multiplicity of biological effects. On the other hand, the amebic peptide has been useful in treating experimental amebiasis of the liver. The amebic peptide is effective in reducing inflammation induced by carragenin and arthritis in a Collagen-induced arthritis (CIA) model. Microarray data from experimental arthritis revealed an MLIF gene expression profile that includes genes that are involved in apoptosis, cell adhesion, extracellular matrix, and inflammation / chemotaxis. MLIF could be involved in unsuspected biological factions because there is increasing data on the peptide effect on several cell activities. This review also presents uses of MLIF as described in patents.

  2. Leptospira Exposure and Patients with Liver Diseases: A Case-Control Seroprevalence Study

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Hernández-Tinoco, Jesús; Ramos-Nevárez, Agar; Margarita Cerrillo-Soto, Sandra; Alberto Guido-Arreola, Carlos

    2016-01-01

    The seroepidemiology of Leptospira infection in patients suffering from liver disease has been poorly studied. Information about risk factors associated with infection in liver disease patients may help in the optimal planning of preventive measures. We sought to determine the association of Leptospira IgG seroprevalence and patients with liver diseases, and to determine the characteristics of the patients with Leptospira exposure. We performed a case-control study of 75 patients suffering from liver diseases and 150 age- and gender-matched control subjects. Diagnoses of liver disease included liver cirrhosis, steatosis, chronic hepatitis, acute hepatitis, and amoebic liver abscess. Sera of participants were analyzed for the presence of anti- Leptospira IgG antibodies using a commercially available enzyme immunoassay. Anti-Leptospira IgG antibodies were found in 17 (22.7%) of 75 patients and in 15 (10.0%) of 150 control subjects (OR = 2.32; 95% CI: 1.09-4.94; P=0.03). This is the first age- and gender-matched case control study about Leptospira seroprevalence in patients with liver diseases. Results indicate that Leptospira infection is associated with chronic and acute liver diseases. Results warrants for additional studies on the role of Leptospira exposure in chronic liver disease. PMID:27493589

  3. The Discussion of Differential Diagnosis Value of Ultrasound in the Atypical Liver Cyst, Liver Abscesses and Liver Cyst Type of Malignancy%超声对不典型肝囊肿、肝脓肿和肝囊肿型恶性肿瘤的鉴别诊断价值探讨

    Institute of Scientific and Technical Information of China (English)

    管正平

    2015-01-01

    Objective To evaluate the diagnostic value of ultrasonography in the identification of atypical liver cyst, liver abscesses and liver cyst type of malignancy. Methods 133 patients of requirements from March 2012 to June 2015 treated as a clinical data, they were treated with ultrasound for liver cystic cancer, liver abscess, the differential diagnosis of hepat-ic cysts.Recorded and compared lesion size, flow velocity, the integral value of the three groups. Results Blood flow velocity and integral value of the three groups compared, the difference were statistical significance(P0.05). Liver abscesses and liver cancer in pa-tients with cystic wall nodules, cyst fluid and separator echo compared,the differences were statistically significant (P0.05). Conclusion Liver cystic cancer, liver cysts and liver abscess in ultrasound image perfor-mance chart are different, but internal lesions within the partition, and the partition wall and the inner wall of blood flow walled cystic nodule for diagnosis of liver cancer has a high value.%目的:探讨超声对不典型肝囊肿、肝脓肿和肝囊肿型恶性肿瘤的鉴别诊断价值。方法该院整群选择2012年3月-2015年6月期间符合研究要求的133例患者作为病例资料,利用超声对肝囊肿型恶性肿瘤42例、肝脓肿38例、肝囊肿53例患者进行鉴别诊断,记录3组患者的病灶大小、血流速度、积分值,并对超声结果进行分析比较。结果3组患者的积分值、血流速度差异有统计学意义(P0.05)。肝脓肿和肝囊肿型恶性肿瘤患者的壁结节、囊液回声和分隔相比较,差异有统计学意义(P0.05)。结论肝囊肿型恶性肿瘤、肝囊肿和肝脓肿在超声像图上的表现各不相同,而病灶内有分隔、囊壁以及分隔内有血流和囊壁内有壁结节对于诊断肝囊肿型恶性肿瘤具有较高的价值。

  4. Granulomatous Amoebic Encephalitis: Clinical Diagnosis and Management

    OpenAIRE

    Khan, Naveed A.

    2005-01-01

    Granulomatous amoebic encephalitis (GAE) is a serious human disease with fatal consequences. With the mortality rate of more than 90%, it is not surprising that the majority of GAE infections are identified at the post-mortem stage. The most distressing aspect is that the high level of mortality is attributed to lack of awareness. Early diagnosis with aggressive treatment can lead to successful prognosis for the patient. Here, we describe a brief overview of the current understanding of the p...

  5. Case Analysis of Refractory Diabetic Ketoacidosis Combined with Pyogenic Liver Abscess%以顽固性酸中毒发病的糖尿病并肝脓肿病例分析

    Institute of Scientific and Technical Information of China (English)

    辛彩虹; 洛伟光; 辛月颖; 旷劲松

    2015-01-01

    Objective To investigate clinical characteristics of refractory diabetic ketoacidosis combined with pyogenic liver abscess patients so as to raise awareness of the disease. Methods Retrospective analysis on clinical data of one case of di-abetic ketoacidosis combined with pyogenic liver abscess was made and the literature was reviewed. Results The 51-year-old female patient had suffered from and had type 2 diabetes no system treatment for 5 years before admission. The patient com-plained of abdominal distention, abdominal pain and difficulty in breathing, and the patient had obvious high serum glucose con-centrations (31. 5 mmol/L), and carbon dioxide combining power was low (7. 3 mmol/L), and she was diagnosed as having di-abetic ketoacidosis. After the blood sugar and fluid treatment, her condition did not improve obviously. History inquiry showed that the patient's liver contusion had carried heavy things. Liver CT examination showed pyogenic liver abscess and growth of Klebsiella pneumonia in cultures. Percutaneous needle aspiration and percutaneous catheter drainage were performed. Antibiotics were reasonablely used to control blood sugar and fluid according to the drug ( drug resistance) test results, and diabetic ketoaci-dosis was corrected. CT shown that the abscess cavity closed narrow, and the patient was discharged after her symptoms were re-lieved remarkably. Conclusion When refractory diabetic ketoacidosis is hard to correct, clinicians should look carefully for the cause of the disease. The clinical presentations of secondary pyogenic liver abscess in diabetic patients are atypical, and rates of misdiagnosis and missed diagnosis are high. Therefore, early diagnosis and treatment is the key for cure.%目的 探讨糖尿病酮症酸中毒并肝脓肿的临床特点,以提高对该病的认识. 方法 对以顽固性酸中毒发病的糖尿病并肝脓肿1例的临床资料进行回顾性分析. 结果 本例为51岁女性患者,因出现心悸、气短

  6. Spinal cord abscess

    Science.gov (United States)

    ... abscess: Back injuries or trauma, including minor ones Boils on the skin, especially on the back or ... of spinal cord abscess. Prevention Thorough treatment of boils, tuberculosis, and other infections decreases the risk. Early ...

  7. Symmetrical Brodie's abscess.

    Science.gov (United States)

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

    1997-10-01

    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.

  8. 16S rRNA基因测序技术在肝脓疡细菌鉴定中的作用%Usefulness of 16S rRNA Gene Sequencing for Identification of Bacteria from Pyogenic Liver Abscess

    Institute of Scientific and Technical Information of China (English)

    宋伦圭

    2014-01-01

    目的:评价16S核糖体RNA (rRNA)基因测序在肝脓疡中细菌鉴定中的应用价值。方法2012年1月-2013年12月间共20例肝脓疡行经皮置管引流的患者,分别行脓液培养,血培养和16S rRNA基因测序。利用454 GS Junior System对脓液基因组DNA行PCR和16S rRNA基因测序。脓液培养,血液培养和16S rRNA 基因测序结果进行分别评价。结果脓液和血液培养阳性的患者分别是9例(45%)和4例(20%)。16S rRNA基因测序细菌鉴定率为90%,明显高于传统的培养方法。结论16S rRNA基因测序方法较传统的培养方法能更准确和有效对肝脓疡进行细菌鉴定。%Background/Aims To evaluate the usefulness of 16S ribosomal RNA (rRNA) gene sequencing for an accurate and better identification of bacteria from pyogenic liver abscess (PLA). Methodology 20 patients with PLA were included who underwent percutaneous catheter drainage, abscess culture, blood culture and 16S rRNA gene sequencing for isolates from January 2012 to December 2013. Genomic DNAs of abscess fluids were subjected to PCR and sequencing of 16S rRNA gene by on a 454 GS Junior System. The results were evaluated between abscess cultures, blood and 16S rRNA gene sequencing for isolates. Results Abscess and blood cultures were positive in 9 (45%) and 4 (20%) patients, respectively. The 16S rRNA gene sequencing showed with 90% identification of bacteria a significantly greater identification than conventional cultured methods. Conclusion This study showed a greater usefulness of 16S rRNA gene sequencing than conventional cultured methods for accurate and better identification of bacteria from PLA.

  9. [COMPLICATED AMOEBIC APENDICITIS.REPORT OF A CASE

    Science.gov (United States)

    Casavilca Zambrano, Sandro; Gomez Anchante, Victor; Cisneros Gallegos, Eduardo

    2000-01-01

    We report a case of acute abdomen that is operated with the presumptive diagnosis of complicated acute appendicitis. In the histologic examination we make the diagnosis of complicated amoebic appendicitis. We discuss clinical manifestations and histopathologic findings of this unusual presentation of amoebic infection.

  10. Granulomatous Amoebic Encephalitis: Clinical Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Naveed A. Khan

    2005-01-01

    Full Text Available Granulomatous amoebic encephalitis (GAE is a serious human disease with fatal consequences. With the mortality rate of more than 90%, it is not surprising that the majority of GAE infections are identified at the post-mortem stage. The most distressing aspect is that the high level of mortality is attributed to lack of awareness. Early diagnosis with aggressive treatment can lead to successful prognosis for the patient. Here, we describe a brief overview of the current understanding of the pathophysiology of GAE, available diagnostic methods, possible therapeutic interventions and the causative agents.

  11. Spontaneous cholecystocutaneous abscess.

    Science.gov (United States)

    Metsemakers, W J; Quanten, I; Vanhoenacker, F; Spiessens, T

    2010-01-01

    Spontaneous cholecystocutaneous abscesses or fistulae are rare complications of neglected biliary calculous disease which have become extremely rare during the last decades. We report a case of spontaneous cholecystocutaneous abscess in a 69-year-old male who presented with a mass in the right subcostal region.The diagnosis was made by CT scan with multiplanar reformating. Treatment consisted of incision and drainage of the abdominal wall abscess followed by cholecystectomy in a one-stage protocol.

  12. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Khalil M Al-Salem

    2014-01-01

    Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

  13. Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Noboru Hanaoka; Katsuhiko Higuchi; Satoshi Tanabe; Tohru Sasaki; Kenji Ishido; Takako Ae; Wasaburo Koizumi; Katsunori Saigenji

    2009-01-01

    A 52-year-old man had bloody stools during chemotherapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently,peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved.with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.

  14. Primary Amoebic Meningoencephalitis in an Iranian Infant

    Directory of Open Access Journals (Sweden)

    Zahra Movahedi

    2012-01-01

    Full Text Available Introduction. Naegleria fowleri, a free living amoeba, can cause devastating and deadly diseases in humans. This is the first report of primary amoebic meningoencephalitis from Iran. Case report. A five-month-old male infant presented with the history of fever and eye gaze for three days, after beginning of bacterial meningitis, a plain and contrast CT revealed communicated hydrocephalus. In the repeat of CSF analysis on microscopic examination of wet preparation of CSF, Naegleria Fowleri was seen. Then, Amphotericin B and Rifampin were started. On followup, two months later, the patient was totally asymptomatic. Conclusion. Though occurrence of PAM is rare, this unusual disease has grave prognosis, so infection with free living amoebas must be considered in differential diagnosis of pediatric patients of purulent meningitis without evidence of bacteria on Gram’s stain and imaging findings, nonspecific brain edema on CT or hydrocephalus even without history of contact.

  15. The occult abscess

    International Nuclear Information System (INIS)

    The clinical signs of an abscess may be masked by the patient's immunosuppressed state or antibiotic therapy. The authors reviewed the clinical presentations of 30 patients with 32 occult abscesses diagnosed with CT or US over 4 years. The abscesses included 12 intraperitoneal, 16 retroperitoneal, and four pleural infected fluid collections. Initial symptoms included fever of unknown origin in six patients and musculoskeletal complaints in four. Six patients were diagnosed with noninflammatory medical problems, five were under investigation for tumor, and, while an infectious process was suspected in nine patients, an associated abscess was not. The occult abscess may mimic other disease processes, and the radiological may be the first to suggest the diagnosis in patients in whom the classic signs and symptoms are absent

  16. Brodie's abscess revisited.

    Science.gov (United States)

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

    2010-01-01

    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.

  17. Amoebic ulcer of the male genitala: A rare case report

    Directory of Open Access Journals (Sweden)

    Mohanty Indrani

    2010-01-01

    Full Text Available Amoebic ulcer of the penis is a very rare clinical entity. We report a case of amoebic ulcer of the glans penis in a 47-year-old male homosexual, symptomatic with severe pain and foul-smelling hemopurulent discharge of acute onset. He had received systemic antibiotics like ciprofloxacin and azithromycin prior to presentation with no improvement. Diagnosis was confirmed by wet mount microscopic examination of the discharge. The patient responded well to a course of metronidazole.

  18. Diagnosis of bacterial hepatic abscess by CT

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

    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.

  19. Hepatic abscess induced by foreign body: Case report and literature review

    Institute of Scientific and Technical Information of China (English)

    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

    2007-01-01

    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.

  20. [Brain abscess - overview].

    Science.gov (United States)

    Sveinsson, Olafur Arni; Asgeirsson, Hilmir; Olafsson, Ingvar H

    2013-01-01

    Brain abscess is a life threatening illness, demanding rapid diagnosis and treatment. Its development requires seeding of an organism into the brain parenchyma, often in an area of damaged brain tissue or in a region with poor microcirculation. The lesion evolves from a cerebritis stage to capsule formation. Brain abscesses can be caused by contiguous or haematogenous spread of an infection, or by head trauma/ neurosurgical procedure. The most common presentation is that of headache and vomiting due to raised intracranial pressure. Seizures have been reported in up to 50% of cases. Focal neurological deficits may be present, depending on the location of the lesion. Treatment of a brain abscess involves aspiration or excision, along with parenteral antibiotic therapy. The outcome has improved dramatically in the last decades due to improvement in diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. The authors provide an overview of the pathogenesis, diagnosis and management of brain abscesses. PMID:23341403

  1. Legionella micdadei Brain Abscess

    OpenAIRE

    Charles, Marthe; Johnson, Edward; Macyk-Davey, Andrea; Henry, Monica; Nilsson, Jan-Erik; Miedzinski, Lil; Zahariadis, George

    2013-01-01

    We describe an immunocompromised patient who developed a large frontal brain abscess caused by Legionella micdadei. This is, to our knowledge, a rare case of culture-proven Legionella central nervous system infection.

  2. Estudo comparativo dos procedimentos percutâneos orientados por métodos de imagem no tratamento das coleções hepáticas A comparative study of image-guided percutaneous procedures for the treatment of liver abscesses

    Directory of Open Access Journals (Sweden)

    Giselle Guedes Netto de Mello

    2001-04-01

    Full Text Available OBJETIVO: Verificar e comparar a eficácia da punção aspirativa e da drenagem percutânea, orientadas por métodos de imagem, no tratamento das coleções hepáticas. MATERIAIS E MÉTODOS: Foram encaminhados, ao nosso setor, 52 pacientes para tratamento percutâneo de coleções abdominais. Destes, 17 apresentavam coleções hepáticas, sendo 13/17 não-complexas e 4/17, complexas (multiloculadas, múltiplas ou associadas a fístulas. Foram submetidas a punção aspirativa 7/17 coleções (41,2% e a drenagem percutânea, 10/17 (58,8%. Considerou-se como sucesso do método a resolução completa da coleção, com melhora clínica e laboratorial do paciente. RESULTADOS: O sucesso do procedimento ocorreu em 82,4% dos casos. Nas coleções submetidas exclusivamente a punção aspirativa, obteve-se sucesso em 57,1%, enquanto nas submetidas a drenagem percutânea o sucesso foi de 100%. O índice de sucesso no grupo submetido a punção aspirativa foi de 75% nas coleções menores que 100 ml, e de 33,3% naquelas entre 100 e 250 ml. Houve sucesso com a punção aspirativa em 75% das coleções não-complexas e em 25% das complexas. CONCLUSÃO: A drenagem percutânea é mais eficaz que a punção aspirativa no tratamento das coleções hepáticas. A punção aspirativa talvez possa ser empregada como alternativa válida nas coleções de menor volume e não-complexas.OBJECTIVE: To determine and compare the efficacy of percutaneous needle aspiration and percutaneous catheter drainage, both guided by imaging methods, for the treatment of liver abscesses. MATERIALS AND METHODS: From 52 patients referred to our service for percutaneous treatment of abdominal abscesses, 17 presented liver abscesses, 13 of which were considered noncomplex and four were considered complex (multiloculated, multiple or associated to fistulas. Percutaneous needle aspiration was performed in 7/17 patients and 10/17 patients were submitted to percutaneous catheter drainage. The

  3. Brain abscess: Current management

    OpenAIRE

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

    2013-01-01

    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 ...

  4. Spontaneous spinal epidural abscess.

    LENUS (Irish Health Repository)

    Ellanti, P

    2011-10-01

    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.

  5. Diagnóstico de absceso hepático amibiano mediante el inmunoensayo enzimático ligado a una enzima (ELISA Diagnosis of amebic liver abscess by means of an anzyme-linked immunoabsorbent assay

    Directory of Open Access Journals (Sweden)

    Jorge Humberto Botero Garcés

    2001-02-01

    Full Text Available El absceso hepático amibiano (aha es la complicación extraintestinal más frecuente de la amibiasis; su cuadro clínico es generalmente agudo y se lo considera una urgencia médica. Se manifiesta con síntomas generales, acompañado de dolor en hipocondrio derecho, que se puede irradiar al hombro; la hepatomegalia dolorosa es un signo sugestivo pero no diagnóstico; debe diferenciarse del absceso hepático piógeno y del hepatoma necrótico; para el enfoque diagnóstico se requieren ayudas imaginológicas y pruebas de laboratorio como las inmunológicas. En este estudio se puso a punto la prueba de ELISA para la determinación de anticuerpos antiamibianos en sueros controles de pacientes con AHA, estandarizada en el Instituto Nacional de Salud de Bogotá. Además se evaluaron 67 muestras de pacientes con sospecha clínica de AHA, procedentes del Hospital González Valencia de Bucaramanga y del Hospital Universitario San Vicente de Paúl de Medellín. El 70.2% de los sueros problema evaluados fueron positivos, con una tasa de positividad significativamente mayor en los procedentes de Bucaramanga. Amebic liver abscess (ALA is the most frequent extraintestinal complication of amibiasis; its clinical presentation is generally acute, and it is considered a medical emergency. Patients manifest general symptoms, accompanied by pain in the right hypochondrium that can irradiate to the shoulder; painful hepatomegalia is a suggestive but not diagnostic sign; it should be distinguished from pyogenic liver abscess and necrotic hepatoma; for the diagnostic approach to ALA imagenologic exams and laboratory tests are required, among the latter the immunologic ones. In this study we used the ELISA test for the determination of antiamebic antibodies in control ALA sera, as described by the National Institute of Health Bogotá, Colombia (7. Furthermore, 67 serum samples were evaluated from patients with clinic suspicion of ALA. Of these 70.2 were positive

  6. Entamoeba histolytica and E. dispar trophozoites in the liver of hamsters: in vivo binding of antibodies and complement

    Directory of Open Access Journals (Sweden)

    Gomes Maria A

    2010-03-01

    Full Text Available Abstract Background Human amoebiasis is caused by the parasitic protozoan Entamoeba histolytica that lives in the large intestine of hosts, where can produce asymptomatic colonization until severe invasive infections with blood diarrhea and spreading to other organs. The amoebic abscesses in liver are the most frequent form of amoebiasis outside intestine and still there are doubts about the pathogenic mechanisms involved in their formation. In this study we evaluated the in situ binding of antibodies, C3 and C9 complement components on trophozoites, in livers of hamsters infected with E. histolytica or E. dispar. These parameters were correlated with the extension of the hepatic lesions observed in these animals and with trophozoites survivor. Methods Hamsters were inoculated intra-hepatically with 100,000 trophozoites of E. histolytica or E. dispar strain and necropsied 12, 24, 48, 72, 144 and 192 h after inoculation. Antibodies, C3 and C9 binding to trophozoites were detected by immunohistochemistry. The estimation of the necrosis area and the number of labeled trophozoites was performed using digital morphometry analysis. Results In the liver sections of animals inoculated with the amoebas, the binding of antibodies to E. histolytica trophozoites was significantly lower than to E. dispar trophozoites. Trophozoites of E. dispar were also more frequently vacuolated and high labeled cellular debris observed in the lesions. Positive diffuse reaction to C3 complement component was more intense in livers of animals inoculated with E. histolytica after 24 and 72 h of infection. C3(+ and C9(+ trophozoites were detected in the vascular lumen, granulomas and inside and in the border of necrotic areas of both infected group animals. C3(+ and C9(+ trophozoite debris immunostaining was higher in livers of E. dispar than in livers of E. histolytica. A positive correlation between necrotic areas and number of C9(+ trophozoites was observed in animals

  7. Primary Amoebic Meningoencephalitis in an Infant due to Naegleria fowleri

    Directory of Open Access Journals (Sweden)

    Vinay Khanna

    2011-01-01

    Full Text Available Primary amoebic meningoencephalitis (PAM caused by free-living amebae Naegleria fowleri is a rare and fatal condition. A fatal case of primary amoebic meningoencephalitis was diagnosed in a 5-month-old infant who presented with the history of decrease breast feeding, fever, vomiting, and abnormal body movements. Trophozoites of Naegleria fowleri were detected in the direct microscopic examination of CSF and infant was put on amphotericin B and ceftazidime. Patient condition deteriorated, and he was discharged against medical advice and subsequently expired. We also reviewed previously reported 8 Indian cases of primary amoebic meningoencephalitis (PAM and observed that for the last 5 years, none of the patients responded to amphotericin B. Has an era of amphotericin B-resistant Naegleria fowleri been emerged? Management strategy of PAM needs to be reviewed further.

  8. Fulminant amoebic enteritis that developed in the perinatal period.

    Science.gov (United States)

    Goto, Mayako; Mizushima, Yasuaki; Matsuoka, Tetsuya

    2015-06-25

    We present a case of a 30-year-old postpartum woman who delivered by caesarean section at 34 weeks. On postoperative day 9, she was admitted to our hospital in shock. Emergency abdominal surgery was performed. Massive purulent ascites collected in the abdominal cavity and was associated with intestinal necrosis, which extended from the ascending colon to one-third of the descending colon. The necrotic lesion was excised, and an artificial anus was constructed at the ileum end. A histological finding on the 15th day indicated the possibility of amoebic enteritis, and the patient was started on metronidazole therapy. The diarrhoea improved dramatically after metronidazole treatment was started. The patient was able to walk unassisted on the 45th day and was subsequently discharged. Amoebic enteritis has been thought to be epidemic in developing countries, but today, the incidence of amoebic enteritis as a sexually transmitted disease is increasing in developed countries.

  9. Cholangitis and multiple liver abscesses after percutaneous ethanol injection (PEI for recurrent hepatocellular carcinoma (HCC Colangitis y abscesos hepáticos múltiples tras la inyección percutánea de etanol (IPE en el tratamiento del carcinoma hepatocelular recurrente

    Directory of Open Access Journals (Sweden)

    Fernando Macias-García

    2013-02-01

    Full Text Available Percutaneous ablation procedures are minimally invasive treatments for unresectable early stage hepatocellular carcinoma (HCC. These techniques are usually safe, but rare and even fatal complications have been described. We present a fatal result after percutaneous ethanol injection (PEI for the treatment of a recurrent HCC in a non-cirrhotic liver, with subsequent development of diffuse cholangitis and multiple liver abscesses. Although percutaneous drainage and intensive antibiotic treatment were employed, the patient finally died. We discuss about the etiology and the physiopathology of this rare complication in which the therapeutic options are limited and usually unsuccessful.

  10. Endoscopic transcystic stent placement for an intrahepatic abscess due to gallbladder perforation

    Institute of Scientific and Technical Information of China (English)

    Myung Soo Kang; Do Hyun Park; Ki Du Kwon; Jeong Hoon Park; Suck-Ho Lee; Hong-Soo Kim; Sang-Heum Park; Sun-Joo Kim

    2007-01-01

    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.

  11. Hepatic abscesses associated with diabetes mellitus in two dogs

    International Nuclear Information System (INIS)

    Two diabetic dogs were presented for anorexia, persistent fever, and poor control of hyperglycemia. Both had neutrophilia with left shift, hypoalbuminemia, and increased serum alkaline phosphatase (SAP) activity. Radiography indicated intrahepatic gas densities in 1 dog and a hepatic mass in the other. Abdominal sonography demonstrated multiple well-demarcated hypoechoic hepatic lesions consistent with abscesses. Both dogs were successfully treated by surgical resection of the abscessed liver lobes inconjunction with antibiotics and supportive therapy. Good control of hyperglycemia was achieved in both dogs after recovery. Intracellular and extracellular Gram-negative rod-shaped bacteria were abundant in the abscesses from both dogs. These cases suggest an association between diabetes mellitus and hepatic abscessation

  12. A new human 3D-liver model unravels the role of galectins in liver infection by the parasite Entamoeba histolytica.

    Directory of Open Access Journals (Sweden)

    Debora B Petropolis

    2014-09-01

    Full Text Available Investigations of human parasitic diseases depend on the availability of appropriate in vivo animal models and ex vivo experimental systems, and are particularly difficult for pathogens whose exclusive natural hosts are humans, such as Entamoeba histolytica, the protozoan parasite responsible for amoebiasis. This common infectious human disease affects the intestine and liver. In the liver sinusoids E. histolytica crosses the endothelium and penetrates into the parenchyma, with the concomitant initiation of inflammatory foci and subsequent abscess formation. Studying factors responsible for human liver infection is hampered by the complexity of the hepatic environment and by the restrictions inherent to the use of human samples. Therefore, we built a human 3D-liver in vitro model composed of cultured liver sinusoidal endothelial cells and hepatocytes in a 3D collagen-I matrix sandwich. We determined the presence of important hepatic markers and demonstrated that the cell layers function as a biological barrier. E. histolytica invasion was assessed using wild-type strains and amoebae with altered virulence or different adhesive properties. We showed for the first time the dependence of endothelium crossing upon amoebic Gal/GalNAc lectin. The 3D-liver model enabled the molecular analysis of human cell responses, suggesting for the first time a crucial role of human galectins in parasite adhesion to the endothelial cells, which was confirmed by siRNA knockdown of galectin-1. Levels of several pro-inflammatory cytokines, including galectin-1 and -3, were highly increased upon contact of E. histolytica with the 3D-liver model. The presence of galectin-1 and -3 in the extracellular medium stimulated pro-inflammatory cytokine release, suggesting a further role for human galectins in the onset of the hepatic inflammatory response. These new findings are relevant for a better understanding of human liver infection by E. histolytica.

  13. A new human 3D-liver model unravels the role of galectins in liver infection by the parasite Entamoeba histolytica.

    Science.gov (United States)

    Petropolis, Debora B; Faust, Daniela M; Deep Jhingan, Gagan; Guillen, Nancy

    2014-09-01

    Investigations of human parasitic diseases depend on the availability of appropriate in vivo animal models and ex vivo experimental systems, and are particularly difficult for pathogens whose exclusive natural hosts are humans, such as Entamoeba histolytica, the protozoan parasite responsible for amoebiasis. This common infectious human disease affects the intestine and liver. In the liver sinusoids E. histolytica crosses the endothelium and penetrates into the parenchyma, with the concomitant initiation of inflammatory foci and subsequent abscess formation. Studying factors responsible for human liver infection is hampered by the complexity of the hepatic environment and by the restrictions inherent to the use of human samples. Therefore, we built a human 3D-liver in vitro model composed of cultured liver sinusoidal endothelial cells and hepatocytes in a 3D collagen-I matrix sandwich. We determined the presence of important hepatic markers and demonstrated that the cell layers function as a biological barrier. E. histolytica invasion was assessed using wild-type strains and amoebae with altered virulence or different adhesive properties. We showed for the first time the dependence of endothelium crossing upon amoebic Gal/GalNAc lectin. The 3D-liver model enabled the molecular analysis of human cell responses, suggesting for the first time a crucial role of human galectins in parasite adhesion to the endothelial cells, which was confirmed by siRNA knockdown of galectin-1. Levels of several pro-inflammatory cytokines, including galectin-1 and -3, were highly increased upon contact of E. histolytica with the 3D-liver model. The presence of galectin-1 and -3 in the extracellular medium stimulated pro-inflammatory cytokine release, suggesting a further role for human galectins in the onset of the hepatic inflammatory response. These new findings are relevant for a better understanding of human liver infection by E. histolytica.

  14. Atypical Liver Abscess Misdiagnosed as a Bile Duct Carcinoma with Dynamic Enhancement CT Manifestations and Pathology%不典型肝脓肿误诊为胆管细胞癌的CT动态增强表现及病理

    Institute of Scientific and Technical Information of China (English)

    邹建华; 郑巧

    2012-01-01

    目的:探讨不典型肝脓肿的CT动态增强表现及其病理基础,提高对肝脓肿及胆管细胞癌的鉴别诊断水平。方法:回顾性分析经手术病理证实的3例不典型肝脓肿的临床资料及CT表现。结果:不典型肝脓肿的CT表现具有多样性,CT平扫病灶呈均匀或不均匀低密度区,形态呈类圆形,边缘模糊或较清楚。增强扫描动脉期病灶呈轻度强化,门静脉期及延迟扫描病灶呈小环状、蜂窝状及不均匀强化,部分形如"花瓣状"改变,类似肝内胆管细胞癌的影像学表现。结论:螺旋CT动态多期增强扫描对鉴别肝内胆管细胞癌与不典型肝脓肿有一定价值。%Objective:To investigate the atypical liver abscess of dynamic enhancement CT manifestations and pathologic foundation,improve the liver abscess and bile duct carcinoma in the differential diagnosis of level. Methods:retrospective analysis of the operation and pathology in 3 cases of atypical liver abscess clinical data and CT manifestation.Results:the CT manifestations of atypical liver abscess with diversity:unenhanced CT lesions showed homogeneous or inhomogeneous low density area,circular shape,blurred edges or more clearly. Enhanced arterial lesions enhanced slightly,portal venous phase lesions showed a small annular,honeycomb, petaloid,grid,cluster,with no obvious reinforced low density zone,the delay period lesions still strengthen the performance.The imaging manifestation and bile duct cell carcinoma is similar to.Conclusion:spiral CT dynamic multi phase enhanced scan in differential diagnosis of atypical hepatic abscess and bile duct cancer cells have a certain value.

  15. Multiple brain abscesses: A case report

    Directory of Open Access Journals (Sweden)

    Banić-Horvat Sofija

    2004-01-01

    Full Text Available Case Report 10 days before admission a 45-year old female experienced general weakness, and T 38oC. During that period she had no cardio-respiratory nor neurological complaints, and the temperature varied between 37.5oC and 38oC. Her medical history was unremarkable, without immunodeficiency. The day before admission she presented with left arm paresis and during the next day it progressed to paralysis. She had no headache. On admission the following diagnostic procedures were performed: the cranial CT scan showed two lesions (possibly meta lesions. Chest X-ray was normal. WBC=15x109/L, ESR= 90/120. On the second day following admission brain MRI showed multiple abscesses in both hemispheres, mostly in the gray/white junction. High doses of IV metronidasol, cephtriaxon and cipfloxacin were administered without obtaining specimens for micro- biological diagnosis. In next two days she developed coma, respiratory insufficiency and septic temperature. Brain surgery was not performed due to severe involvement of the brain with multiple abscesses. Repeated chest X-ray revealed bilateral pneumonia. A lethal outcome occurred on the third day, regardless of all efforts. Autopsy showed multiple brain abscesses as well as on the lungs and liver. A beta-hemolytic streptococcal infection was established. Conclusions Prevention includes treatment of the infection source. The classic triad of headache, fever and focal deficit occur in less than 50% of patients. Even in such cases brain abscess must be reconsidered. CT appearance of brain abscess is similar to that of neoplastic and other infectious and non infectious deseases - especially in the stage of early cerebritis. If the CT findings are not clear, MRI should be performed.

  16. Tubercular thyroid abscess.

    Science.gov (United States)

    Kumar, Awanish; Pahwa, Harvinder Singh; Srivastava, Rohit; Khan, Khursheed Alam

    2013-01-01

    We encountered a patient who presented with neck swelling, difficulty in swallowing, voice change along with systemic features such as evening rise of temperature, chronic cough and weight loss. Ultrasonography of the thyroid gland revealed two cystic swellings. An ultrasound guided fine needle aspiration cytology was suggestive of tubercular abscess. The patient responded well to antigravity aspiration of the swellings and antitubercular treatment.

  17. Brain abscess: Current management.

    Science.gov (United States)

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

    2013-08-01

    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

  18. Brain abscess: Current management

    Directory of Open Access Journals (Sweden)

    Hernando Alvis-Miranda

    2013-01-01

    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.

  19. Analysis of Bacterial Liver Abscess in Nursing Care of Non Operation Treatment of Patients With Diabetes Mellitus%细菌性肝脓肿合并糖尿病患者非手术治疗的护理要点分析

    Institute of Scientific and Technical Information of China (English)

    王菊敏

    2015-01-01

    目的:总结采用非手术方式治疗细菌性肝脓肿的糖尿病患者的护理对策。方法择取2014年1~12月我院收治的50例采用非手术方式治疗细菌性肝脓肿的糖尿病患者,为患者进行穿刺抽脓和控制血糖治疗,并从饮食、心理等方面行以精心护理。结果50例患者中有48例恢复情况良好,1例恢复较差,1例死亡,总有效率为96%。结论非手术治疗糖尿病及细菌性肝脓肿患者,要针对血糖进行有效控制,并及时补充营养,以加快患者恢复速度。%Objective To summarize the non-surgical treatment of bacterial liver abscess the nursing strategy of diabetic patients.MethodsTo pick in January 2014~December 2014, our hospital of 50 patients with non-surgical treatment of bacterial liver abscess, patients with diabetes in the treatment of patients with puncture pumping pus and control blood sugar, and from the perspectives of diet, psychological line with elaborate care.Results 50 cases of 48 cases of recovering well, 1 case of poor recovery, 1 case of death, the total effective rate was 96%. Conclusion Non-surgical treatment of diabetes and patients with bacterial liver abscess, to effectively control blood sugar, and timely supplement nutrition, to speed up the patients recover.

  20. Brain abscess in hepatopulmonary syndrome associated with biliary atresia.

    Science.gov (United States)

    Morita, Keiichi; Fukuzawa, Hiroaki; Maeda, Kosaku

    2015-12-01

    The first-choice therapy for biliary atresia (BA) is Kasai hepatoportoenterostomy, which has been shown to greatly improve outcome. Various long-term complications, however, such as portal hypertension and hepatopulmonary syndrome (HPS), can occur in patients with native liver. A rare case of brain abscess in an 11-year-old girl with HPS associated with BA is reported. The patient underwent hepatoportoenterostomy for BA at 53 days of age, with resolution of hyperbilirubinemia. At 10 years of age, she was diagnosed with severe HPS with right-to-left shunting, and preparations for liver transplantation proceeded. Three months after the diagnosis, she had a right parietal brain abscess. Given that the brain abscess enlarged in size, surgical drainage of the brain abscess was performed. The postoperative course was uneventful, but a slight left hemiplegia remained at discharge. The presumed mechanism of abscess formation in HPS may be right-to-left bacterial transit through intrapulmonary vascular dilatations and/or arteriovenous fistulae. PMID:26711920

  1. Intraperitoneal tuberculous abscess: computed tomography features

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

    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.

  2. Taking a bite: Amoebic trogocytosis in Entamoeba histolytica and beyond.

    Science.gov (United States)

    Ralston, Katherine S

    2015-12-01

    Entamoeba histolytica is a diarrheal pathogen with the ability to cause profound host tissue damage. This organism possesses contact-dependent cell killing activity, which is likely to be a major contributor to tissue damage. E. histolytica trophozoites were recently shown to ingest fragments of living human cells. It was demonstrated that this process, termed amoebic trogocytosis, contributes to cell killing. Recent advances in ex vivo and 3-D cell culture approaches have shed light on mechanisms for tissue destruction by E. histolytica, allowing amoebic trogocytosis to be placed in the context of additional host and pathogen mediators of tissue damage. In addition to its relevance to pathogenesis of amoebiasis, an appreciation is emerging that intercellular nibbling occurs in many organisms, from protozoa to mammals.

  3. Modern management of pyogenic hepatic abscess: a case series and review of the literature.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2012-01-31

    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.

  4. Brain Abscess after Esophageal Dilatation

    DEFF Research Database (Denmark)

    Gaïni, S; Grand, M; Michelsen, J

    2007-01-01

    Brain abscess formation is a serious disease often seen as a complication to other diseases and to procedures. A rare predisposing condition is dilatation therapy of esophageal strictures. A case of brain abscess formation after esophageal dilatations is presented. A 59-year-old woman was admitted...... 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...... illustrates the possible association between therapeutic esophageal dilatation and the risk of brain abscess formation....

  5. Isolation of amoebic-bacterial consortia capable of degrading trichloroethylene

    International Nuclear Information System (INIS)

    Groundwater from a waste disposal site contaminated with chlorinated alkenes was examined for the presence of amoebic-bacterial consortia capable of degrading the suspected carcinogen, trichloroethylene (TCE). Consortia were readily isolated from all of four test wells. They contained free-living amoebae, and heterotrophic and methylotrophic bacteria. Electron microscopic examination showed bacteria localized throughout the amoebic cytoplasm and an abundance of hyphomicrobium, but not Type I methanotrophs. The presence of Type II methanotrophs was indirectly indicated by lipid analysis of one consortium. The consortia have been passaged for over two years on mineral salts media in a methane atmosphere, which would not be expected to maintain the heterotrophs or amoebae separately. The methanotrophic bacteria apparently provided a stable nutrient source, allowing the persistence of the various genera. By use of 14C-radiotracer techniques, the degradation of TCE by the consortia was observed with 14C eventuating predominantly in CO2 and water-soluble products. In a more detailed examination of one consortia, the amoebae and heterotrohic components did not degrade TCE, while a mixed culture of heterotrophs and methanotrophs did degrade TCE, suggesting the latter component was the primary cause for the consortium's ability to degrade TCE. Amoebic-bacterial consortia may play a role in stabilizing and preserving methylotrophic bacteria in hostile environments

  6. Amoebic meningoencephalitis and disseminated infection caused by Balamuthia mandrillaris in a Western lowland gorilla (Gorilla gorilla gorilla).

    Science.gov (United States)

    Gjeltema, Jenessa L; Troan, Brigid; Muehlenbachs, Atis; Liu, Lindy; Da Silva, Alexandre J; Qvarnstrom, Yvonne; Tobias, Jeremy R; Loomis, Michael R; De Voe, Ryan S

    2016-02-01

    CASE DESCRIPTION A 22-year-old male gorilla (Gorilla gorilla gorilla) housed in a zoo was evaluated for signs of lethargy, head-holding, and cervical stiffness followed by development of neurologic abnormalities including signs of depression, lip droop, and tremors. CLINICAL FINDINGS Physical examination under general anesthesia revealed a tooth root abscess and suboptimal body condition. A CBC and serum biochemical analysis revealed mild anemia, neutrophilia and eosinopenia consistent with a stress leukogram, and signs consistent with dehydration. Subsequent CSF analysis revealed lymphocytic pleocytosis and markedly increased total protein concentration. TREATMENT AND OUTCOME Despite treatment with antimicrobials, steroids, and additional supportive care measures, the gorilla's condition progressed to an obtunded mentation with grand mal seizures over the course of 10 days. Therefore, the animal was euthanized and necropsy was performed. Multifocal areas of malacia and hemorrhage were scattered throughout the brain; on histologic examination, these areas consisted of necrosis and hemorrhage associated with mixed inflammation, vascular necrosis, and intralesional amoebic trophozoites. Tan foci were also present in the kidneys and pancreas. Immunohistochemical testing positively labeled free-living amoebae within the brain, kidneys, eyes, pancreas, heart, and pulmonary capillaries. Subsequent PCR assay of CSF and frozen kidney samples identified the organism as Balamuthia mandrillaris, confirming a diagnosis of amoebic meningoencephalitis. CLINICAL RELEVANCE Infection with B mandrillaris has been reported to account for 2.8% of captive gorilla deaths in North America over the past 19 years. Clinicians working with gorillas should have a high index of suspicion for this diagnosis when evaluating and treating animals with signs of centrally localized neurologic disease. PMID:26799111

  7. Iatrogenic psoas abscess. Case report

    DEFF Research Database (Denmark)

    Bernstein, Inge Thomsen; Hansen, B J

    1991-01-01

    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....

  8. Amebic abscess of urachal remnants

    Energy Technology Data Exchange (ETDEWEB)

    Catanzaro, Daniela; Mirk, Paoletta; Carbone, Arnaldo; Macis, Giuseppe; Danza, Francesco Maria

    2001-06-01

    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.

  9. Operative treatment of Brodie's abscess.

    Science.gov (United States)

    Dunn, E C; Singer, L

    1991-01-01

    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.

  10. Dental abscess: A microbiological review

    Directory of Open Access Journals (Sweden)

    Shweta

    2013-01-01

    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. Pancreatic Lesion: Malignancy or Abscess?

    Science.gov (United States)

    Shulik, Oleg; Cavanagh, Yana; Grossman, Matthew

    2016-01-01

    BACKGROUND Pancreatic abscesses are rare. They may be seen in patients with pancreatic inflammation or pancreatitis. Patients with pancreatic abscesses may have abdominal pain, fever, chills, and nausea/vomiting or an inability to eat. Presentation with alternate symptomatology is extremely unusual. CASE REPORT A 67-year-old Asian male presented with painless, afebrile obstructive jaundice and a CA 19-9 of 1732 IU. He was found to have a 3.1×2.4 cm low-density lesion in the head of the pancreas and the right lobe of the liver, suggesting malignancy. Surgical management was considered, however additional diagnostic workup, including an endoscopic retrograde cholangiopancreatography (ERCP), was performed to complete staging of the presumed mass. A smooth, 3-cm-long, tapering stricture was found it the common bile duct. It was stented from the common hepatic duct to the duodenum. Subsequent endoscopic ultrasound (EUS) evaluation of the pancreatic head lesion revealed a drainable fluid collection that was aspirated and found to contain pyogenic material on pathology. The patient's symptoms resolved, and he was subsequently managed conservatively. A repeat ERCP confirmed complete resolution of the previously visualized cystic lesion. Interestingly, laboratory values showed concomitant normalization of CA 19-9 to 40 IU. CONCLUSIONS EUS-guided biopsy is not widely regarded as a required step before surgery, in the management of patients with pancreatic masses. It is generally reserved for determination of resectability or staging, and only utilized when clinically indicated. However, this practice may be associated with an inherently significant risk of misdiagnosis and subsequent unnecessary surgery, as illustrated by this case. Malignancy was initially suspected in our patient and surgical resection was recommended. Endoscopic measures were only pursued to complete staging. We propose that EUS-guided biopsy may be a crucial diagnostic step in the management algorithm

  12. Splenic abscess owing to cancer at the splenic flexure

    Science.gov (United States)

    Awotar, Gavish K.; Luo, Fuwen; Zhao, Zhengdong; Guan, Guoxin; Ning, Shili; Ren, Jinshuai; Liu, Yaqing; Wang, Guangzhi; Liu, Pixu

    2016-01-01

    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

  13. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Energy Technology Data Exchange (ETDEWEB)

    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)

    1986-10-15

    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%.

  14. Orbital abscess: Management and outcome

    Directory of Open Access Journals (Sweden)

    N Suneetha

    2000-01-01

    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.

  15. Submasseteric abscess: A rare head and neck abscess

    Directory of Open Access Journals (Sweden)

    Ashutosh Rai

    2011-01-01

    Full Text Available The objective of the article is to highlight and make people aware of a rare abscess which is often missed or misdiagnosed. As only a few cases have been reported, the authors feel that reporting such a case would help in proper management of the disease. We are presenting a 6.5-year-old male child with 3 weeks history of right facial swelling in the parotid region, with low-grade fever and trismus. Submasseteric abscess is a rare abscess which is often misdiagnosed as a parotid abscess or parotitis. Only a few cases have been reported. The cause is mostly dental in origin. Intravenous antibiotics often fail to alleviate the symptoms as this is a closed space and needs prompt drainage. Therefore, awareness of this complication of dental infections is vital for proper diagnosis and timely management.

  16. Cerebral abscess in children

    International Nuclear Information System (INIS)

    A cerebral abscess (CA) is a focal, infectious process only or multiple, located in the cerebral parenchyma that produces tisular lysis and it behaves like a lesion of space occupative, being a suppurative illness, who origin is a distant infection, or for continuity that studies initially as an area of focal cerebritis and it is developed to a collection surrounded purulent. At the moment they are perfecting technical and protocols diagnoses and therapeutic and measures for allow to control the natural history of the illness, making from the confrontation to this pathology a necessarily interdisciplinary complicated art, stiller in the infantile population, due to their difficulty in the diagnosis and the relevance of the same one. The paper includes epidemiology, etiology, risk factors, localization, pathology, clinic, diagnoses, treatment and diagnostic images

  17. Two Cases of Adrenal Abscesses Following Histoacryl® (N-butyl-2-cyanocrylate) Injection

    OpenAIRE

    Lee, Bo Young; Jang, Jae Young; Jeong, Soung Won; Bok, Gene Hyun; Ham, Jeong Ho; Cho, Joo Young; Lee, Joon Seong; Shim, Chan Sup

    2011-01-01

    We report two cases of adrenal abscesses that occurred following a Histoacryl® (N-butyl-2-cyanocrylate) injection for variceal bleeding. Patients had been diagnosed with alcoholic liver cirrhosis and gastric varices bleeding and received a Histoacryl® injection for the variceal bleeding. Patients had fever and abdominal tenderness and were diagnosed with an adrenal abscess at 2 months following the Histoacryl® injection. One patient received open drainage and the other underwent percutaneous ...

  18. Splenic abscess: a rare presentation

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    Mohit Bhatia

    2015-01-01

    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.

  19. CT diagnosis of abdominal abscesses

    International Nuclear Information System (INIS)

    The noninvasive nature and amount of information obtained using computed tomography have very quickly put this method of diagnosis to the forefront of the interest of the medical public. So far the authors examined 21 cases of intraabdominal abscess. The successful detection of the abscess depends on the site of the abscess, the stage of development, the size, the choice of measuring program and the experience of the examining physician. The diagnostic possibilities of CT as compared with other radiological methods are by far the best. Ultrasound and scintigraphy are also highly successful but CT also allows the physician to localize the abscess, to determine its size, shape and distance from neighbouring organs which is very important in targeted aspiration biopsy. CT also makes it possible to estimate the stage of development, to make a choice of therapy and to evaluate the state of healing or the success of drainage. (author)

  20. Pan-Genome Analysis of Brazilian Lineage A Amoebal Mimiviruses

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    Felipe L. Assis

    2015-06-01

    Full Text Available Since the recent discovery of Samba virus, the first representative of the family Mimiviridae from Brazil, prospecting for mimiviruses has been conducted in different environmental conditions in Brazil. Recently, we isolated using Acanthamoeba sp. three new mimiviruses, all of lineage A of amoebal mimiviruses: Kroon virus from urban lake water; Amazonia virus from the Brazilian Amazon river; and Oyster virus from farmed oysters. The aims of this work were to sequence and analyze the genome of these new Brazilian mimiviruses (mimi-BR and update the analysis of the Samba virus genome. The genomes of Samba virus, Amazonia virus and Oyster virus were 97%–99% similar, whereas Kroon virus had a low similarity (90%–91% with other mimi-BR. A total of 3877 proteins encoded by mimi-BR were grouped into 974 orthologous clusters. In addition, we identified three new ORFans in the Kroon virus genome. Additional work is needed to expand our knowledge of the diversity of mimiviruses from Brazil, including if and why among amoebal mimiviruses those of lineage A predominate in the Brazilian environment.

  1. Primary Amoebic Meningoencephalitis: Neurochemotaxis and Neurotropic Preferences of Naegleria fowleri.

    Science.gov (United States)

    Baig, Abdul Mannan

    2016-08-17

    Naegleria fowleri causes one of the most devastating necrotic meningoencephalitis in humans. The infection caused by this free-living amoeba is universally fatal within a week of onset of the signs and symptoms of the disease called primary amoebic meningoencephalitis (PAM). In all the affected patients, there is always a history of entry of water into the nose. Even though the diagnostic and treatment protocols have been revised and improved, the obstinate nature of the disease can be gauged by the fact that the mortality rate has persisted around ∼95% over the past 60 years. Some of the unanswered questions regarding PAM are is there a neurochemical basis of the chemotaxis of N. fowleri to the brain? What immune evasion means occurs preceding the neurotropic invasion? What is the contribution of the acute inflammatory response in the fatal cases? Can a combination of anti-amoebic drugs with antagonism of the acute inflammation help save the patient's life? As prevention remains the most valuable safeguard against N. fowleri, a quicker diagnosis, better understanding of the pathogenesis of PAM coupled with testing of newer and safer drugs could improve the chances of survival in patients affected with PAM.

  2. [Intramural abscesses of the rectum].

    Science.gov (United States)

    Denis, J; Ganansia, R; Arnous-Dubois, N; du Puy-Montbrun, T; Lemarchand, N

    1983-05-01

    Intramural abscesses of the rectum developed in the complex longitudinal layer may be isolated or associated with a transphincteric fistula. They may be acute or subacute and are diagnosed by intrarectal palpation. The only treatment is surgical: the abscess is opened into the rectal cavity, except in case of association with suprasphincteric fistula, when it must be drained through the skin. Postoperative complications are minor ones and relapses are rare (1.75% of cases). PMID:6222301

  3. Endoscopic management of brain abscesses

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    Yadav Yad

    2008-01-01

    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.

  4. Brodie's abscess: a case report.

    Science.gov (United States)

    Alter, S A; Sprinkle, R W

    1995-01-01

    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.

  5. 肺炎克雷伯菌肝脓肿的临床及微生物特征分析%The clinical and bacterial features of Klebsiell a pnuemoniae liver abscess

    Institute of Scientific and Technical Information of China (English)

    吴华; 李东冬; 王京; 孙运芳; 叶丽艳; 沈定霞

    2015-01-01

    目的 对肺炎克雷伯菌肝脓肿的临床特征和致病菌的微生物特性进行总结,为临床的诊治提供依据.方法 采用回顾性分析方法,收集2010年1月至2014年12月就诊于北京3家教学医院,经B超或CT诊断为肝脓肿、脓肿穿刺物培养为肺炎克雷伯菌的152例患者病历,对其中137份完整的病历进行分析;对来自肝脓肿的非重复患者的152株肺炎克雷伯菌进行黏丝试验确定高黏液性状,使用PCR方法进行荚膜血清分型和毒力基因检测,K-B法进行药敏试验,采用χ2 检验对结果进行统计分析.结果 肺炎克雷伯菌肝脓肿多发生于中老年男性及糖尿病患者,92.7%(127/137)有发热,80.3%(110/137)的脓肿为单发,单发脓肿中80.9%(89/110)发生于右叶,33.6%(46/137)的脓肿内可见气体;74.5%(102/137)的白细胞计数、83.2%(114/137)的中性粒细胞百分比、78.1%(107/137)的谷丙氨酸转氨酶和51.8%(71/137)的胆红素升高.87.5%(133/152)菌株属于高黏液型;K1型是最常见的血清型,其次为K2 型;毒力基因 rmpA 和气杆菌素的检出率分别为82.9%(126/152)和88.2%(134/152);不伴其他肝胆疾病的肝脓肿的K1型比例、rmpA和气杆菌素检出率分别为65.7%、94.9%和96.0%,高于伴有其他肝胆疾病肝脓肿的28.9%、50.0%和68.4%,差异有统计学意义(x2 =14.98、38.40、17.61,均P<0.01),未分型比例为5.1%,低于伴有其他肝胆疾病脓肿的26.3%,差异有统计学意义(x2 =10.65,P<0.01).肺炎克雷伯菌对常见抗生素的耐药率较低.结论 肺炎克雷伯菌肝脓肿多由高黏液、携带毒力基因rmpA和气杆菌素的高毒力肺炎克雷伯菌引起,大多数菌株对抗生素尚敏感.%Objective To summarize the clinical and bacterial features of Klebsiella pnuemoniae liver abscess (KPLA) in order to provide the basis for the diagnosis and treatment of KPLA.Methods Retrospective study was conducted.One hundred and fifty-two medical records, from 3 teaching hospitals in

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

    Science.gov (United States)

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

    2016-01-01

    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

  7. Cervical epidural abscess caused by brucellosis.

    Science.gov (United States)

    Lampropoulos, Christos; Kamposos, Panagiotis; Papaioannou, Ioanna; Niarou, Vasiliki

    2012-01-01

    A 70-year-old Greek lady presented with fever, arthralgias of knees, cervical and lumbar pain during the last month. On clinical examination the patient was found to have tenderness of the cervical and the lumbar spine with great motion restriction. The blood tests revealed high erythrocyte sedimentation rate and C-reactive protein, abnormal liver function tests and a positive rheumatoid factor. Serological test for Brucella was positive while cervical MRI revealed epidural abscess and spondylodiscitis. Conservative treatment with streptomycin (it was substituted by rifampicin after the third week) and doxycyclin for 4 months significantly improved her symptoms. The frequency as well as the diagnosis and management of this manifestation are discussed. PMID:23188848

  8. Primary amoebic meningoencephalitis: first reported case from Rohtak, North India

    Directory of Open Access Journals (Sweden)

    Naveen Gupta

    2009-06-01

    Full Text Available A fatal case of primary amoebic encephalitis (PAM in a 20 year old boy, a proven case of acute leukemic leukemia (ALL type L2, in remission is described. No history of swimming could be elicited. The clinical presentation, the isolation of the amoeba from the cerebrospinal fluid (CSF, the poor response to amphotericin B, and the ultimately fatal outcome are all consistent with the diagnosis of PAM. On the basis of its ability to grow at temperature 42ºC and 45ºC, morphology of trophozoite, and the presence of flagellate forms in CSF, the amoeba was identified as Naegleria fowleri. Other drugs used in combination with amphotericin B are tetracycline, rifampicin, and miconazole. A possibility of PAM should always be considered in all cases of acute purulent meningoencephalitis in which no bacteria or fungus are found.

  9. Primary amoebic meningoencephalitis: first reported case from Rohtak, North India.

    Science.gov (United States)

    Gupta, Naveen; Bhaskar, Hemlata; Duggal, Shalini; Ghalaut, Pratap S; Kundra, Shailja; Arora, Des R

    2009-06-01

    A fatal case of primary amoebic encephalitis (PAM) in a 20 year old boy, a proven case of acute leukemic leukemia (ALL) type L2, in remission is described. No history of swimming could be elicited. The clinical presentation, the isolation of the amoeba from the cerebrospinal fluid (CSF), the poor response to amphotericin B, and the ultimately fatal outcome are all consistent with the diagnosis of PAM. On the basis of its ability to grow at temperature 42 degrees C and 45 degrees C, morphology of trophozoite, and the presence of flagellate forms in CSF, the amoeba was identified as Naegleria fowleri. Other drugs used in combination with amphotericin B are tetracycline, rifampicin, and miconazole. A possibility of PAM should always be considered in all cases of acute purulent meningoencephalitis in which no bacteria or fungus are found.

  10. Snapshot in surgery: brain abscess as a complication of a recurrent sigmoid diverticular abscess

    Science.gov (United States)

    Zhou, Zhaowei; Wuppalapati, Siddhartha; Scott, Nigel

    2015-01-01

    Key Clinical Message A 35-year-old man was found to have a cerebral abscess secondary to a recurrent sigmoid diverticular abscess. Both cultures grew Streptococcus anginosus. Brain abscess is a rare but potential complication of sigmoid diverticulitis. Streptococcus anginosus, which is found in human gut flora, is a common cause of brain abscess. PMID:26185659

  11. Visual Improvement for Hepatic Abscess Sonogram by Segmentation after Curvelet Denoising

    Directory of Open Access Journals (Sweden)

    Mohammed Tarek GadAllah

    2013-06-01

    Full Text Available A wise automated method for wisely improving the visualization of hepatic abscess sonogram, a modest trial is being done to denoise and reduce the ultrasound scan speckles wisely and effectively. As an effective way for improving the diagnostic decision; improved sonogram for hepatic abscess is reconstructed by ultrasound scan image segmentation after denoising in Curvelet transform domain. Better sonogram visualization is required for better human interpretation. Speckle noise filtering of medical ultrasound images is needed for enhanced diagnosis. Double thresholding segmentation was applied on, an ultrasound scan image for a Liver with amebic abscess, after it had been denoised in Curvelet transform domain. The result is enhanced wise effect on the hepatic abscess sonogram image's visualization which improves physicians' decisions. Moreover, this method effectively reduces the memory storage size for the image which consequently decreases computation processing time.

  12. Radiologic viewpoint of splenic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jae Chun; Jung, Kyung Hwa; Byun, Woo Mok; Kim, Sun Yong; Hwang, Mi Soo; Park, Bok Hwan [Yeungnam University College of Medicine, Kyungsan (Korea, Republic of)

    1988-12-15

    Splenic abscess is not a common disease, and has been infrequently diagnosed during life because of vague symptom and presence of underlying disease. However, advent of newer diagnostic imaging and interventional technology have augmented our ability to diagnose and treat the abscess. Authors experienced eight cases of splenic abscess, which were confirmed by operation or aspiration and, herein, we describe the radiological viewpoint and clinical course. Summary is follows: 1. Radiological finding was well defined, noncontrast enhancing wedge or lentiform lower density lesion, either single or multiple, focal or massive, parenchymal or subcapsular in location. Prognosis was favorable in focal parenchymal lesion after medical treatment. 2. Pancreatitis is the most common combined disease and this made the localization delay. 3. High incidence of sterile culture suggests possibility of anaerobic of fungal infection. 4. Hypoechoic lesion suggesting splenic abscess should be aspirated under the guidance of ultrasound and The aspirate should be cultured including anaerobic and fungus. C.T. scan should be done for better evaluation of the lesion. 5. According to pathology, organism and loculation pattern, various treatment modalities can be considered rather than routine splenectomy.

  13. Kawasaki Disease Mimicking Retropharyngeal Abscess

    Science.gov (United States)

    Srividhya, Vazhkudai Sridharan; Vasanthi, Thiruvengadam; Shivbalan, Somu

    2010-01-01

    Kawasaki disease is an acute, self-limiting febrile mucocutaneous vasculitis of infants and young children. Retropharyngeal lymphadenopathy is a rare presentation of Kawasaki disease. We present a case of Kawasaki disease mimicking a retropharyngeal abscess, with upper airway obstruction resulting in delayed diagnosis. PMID:20635457

  14. Radiologic viewpoint of splenic abscess

    International Nuclear Information System (INIS)

    Splenic abscess is not a common disease, and has been infrequently diagnosed during life because of vague symptom and presence of underlying disease. However, advent of newer diagnostic imaging and interventional technology have augmented our ability to diagnose and treat the abscess. Authors experienced eight cases of splenic abscess, which were confirmed by operation or aspiration and, herein, we describe the radiological viewpoint and clinical course. Summary is follows: 1. Radiological finding was well defined, noncontrast enhancing wedge or lentiform lower density lesion, either single or multiple, focal or massive, parenchymal or subcapsular in location. Prognosis was favorable in focal parenchymal lesion after medical treatment. 2. Pancreatitis is the most common combined disease and this made the localization delay. 3. High incidence of sterile culture suggests possibility of anaerobic of fungal infection. 4. Hypoechoic lesion suggesting splenic abscess should be aspirated under the guidance of ultrasound and The aspirate should be cultured including anaerobic and fungus. C.T. scan should be done for better evaluation of the lesion. 5. According to pathology, organism and loculation pattern, various treatment modalities can be considered rather than routine splenectomy.

  15. Computed tomography in pituitary abscess

    Energy Technology Data Exchange (ETDEWEB)

    Appel, W.; Scharphuis, T.; Distelmaier, P.

    1986-06-01

    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.

  16. 不同糖化血红蛋白控制水平糖尿病并发肺炎克雷伯杆菌肝脓肿患者的临床和影像学表现%Clinical and Imaging Features of Patients With Bacterial Liver Abscess Caused by Klebsiella Pneumoniae in Diabetics at Different Levels of Glycosylated Hemoglobin Control

    Institute of Scientific and Technical Information of China (English)

    刘波; 丁炎; 王爱花; 周群燕; 邬匡杰; 程海燕

    2016-01-01

    Objective To discuss the clinical and imaging features of patients with bacterial liver abscess caused by Klebsiella pneumoniae liver abscesses( KPLA)in diabetics at different levels of glycosylated hemoglobin( HbA1c )control. Methods A total of 146 patients with diabetes combined with KPLA admitted in Wuxi People′s Hospital of NanJing Medical University from January 2008 to September 2015 were selected. According to the levels of HbA1c ,they were divided into three groups,namely group A including 31 patients with good control of HbA1c level,HbA1c≤ 7. 0% ;group B including 52 patients with relatively control of HbA1c level,7. 0% 9. 0% . The basic information,underlying diseases,signs and symptoms,imaging features before abscess drainage,complications,abscess metastasis,treatment and prognosis of the patients in 3 groups were collected and compared. Results The time of hospital stay of patients in group B was longer than that in group A(P 9.0%。收集并比较3组患者基本资料、基础疾病、症状和体征、穿刺引流术前影像学表现、并发症、脓肿转移、治疗及预后情况。结果 B 组患者住院时间较 A 组延长(P <0.05);C 组患者年龄较 A 组和 B 组小、住院时间较 A 组和 B 组延长(P <0.05)。B 组患者高脂血症、慢性肾功能不全、超声检查胆管系统积气、CT 检查脓腔内积气及胸膜增厚、胸腔积液发生率较 A 组升高,C 组患者高脂血症、慢性肾功能不全、超声检查胆管系统积气、CT 检查脓腔内积气及胸膜增厚、胸腔积液、膈下脓肿发生率较 A 组和 B 组升高(P <0.01)。患者入院后均采用超声引导定位下肝脓肿穿刺引流,C 组患者 1例因全身多发感染并发多器官衰竭死亡,其余患者均恢复出院。结论糖尿病并发 KPLA 患者 HbA1c水平控制差者年龄偏小、住院时间较长,高脂血症、慢性肾功能不全发生率高,超声检查胆管系统积气、CT 检查脓

  17. Cryptococcal 3-Hydroxy Fatty Acids Protect Cells Against Amoebal Phagocytosis.

    Science.gov (United States)

    Madu, Uju L; Ogundeji, Adepemi O; Mochochoko, Bonang M; Pohl, Carolina H; Albertyn, Jacobus; Swart, Chantel W; Allwood, J William; Southam, Andrew D; Dunn, Warwick B; May, Robin C; Sebolai, Olihile M

    2015-01-01

    We previously reported on a 3-hydroxy fatty acid that is secreted via cryptococcal capsular protuberances - possibly to promote pathogenesis and survival. Thus, we investigated the role of this molecule in mediating the fate of Cryptococcus (C.) neoformans and the related species C. gattii when predated upon by amoebae. We show that this molecule protects cells against the phagocytic effects of amoebae. C. neoformans UOFS Y-1378 (which produces 3-hydroxy fatty acids) was less sensitive toward amoebae compared to C. neoformans LMPE 046 and C. gattii R265 (both do not produce 3-hydroxy fatty acids) and addition of 3-hydroxy fatty acids to C. neoformans LMPE 046 and C. gattii R265 culture media, causes these strains to become more resistant to amoebal predation. Conversely, addition of aspirin (a 3-hydroxy fatty acid inhibitor) to C. neoformans UOFS Y-1378 culture media made cells more susceptible to amoebae. Our data suggest that this molecule is secreted at a high enough concentration to effect intracellular signaling within amoeba, which in turn, promotes fungal survival.

  18. Cryptococcal 3-hydroxy fatty acids protect cells against amoebal phagocytosis

    Directory of Open Access Journals (Sweden)

    Uju Lynda Madu

    2015-12-01

    Full Text Available We previously reported on a 3-hydroxy fatty acid that is secreted via cryptococcal capsular protuberances - possibly to promote pathogenesis and survival. Thus, we investigated the role of this molecule in mediating the fate of Cryptococcus (C. neoformans and the related species C. gattii when predated upon by amoebae. We show that this molecule protects cells against the phagocytic effects of amoebae. C. neoformans UOFS Y-1378 (which produces 3-hydroxy fatty acids was less sensitive towards amoebae compared to C. neoformans LMPE 046 and C. gattii R265 (both do not produce 3-hydroxy fatty acids and addition of 3-hydroxy fatty acids to C. neoformans LMPE 046 and C. gattii R265 culture media, causes these strains to become more resistant to amoebal predation. Conversely, addition of aspirin (a 3-hydroxy fatty acid inhibitor to C. neoformans UOFS Y-1378 culture media made cells more susceptible to amoebae. Our data suggest that this molecule is secreted at a high enough concentration to effect intracellular signalling within amoeba, which in turn, promotes fungal survival.

  19. Surviving within the amoebal exocyst: the Mycobacterium avium complex paradigm

    Directory of Open Access Journals (Sweden)

    Drancourt Michel

    2010-04-01

    Full Text Available Abstract Background Most of environmental mycobacteria have been previously demonstrated to resist free-living amoeba with subsequent increased virulence and resistance to antibiotics and biocides. The Mycobacterium avium complex (MAC comprises of environmental organisms that inhabit a wide variety of ecological niches and exhibit a significant degree of genetic variability. We herein studied the intra-ameobal location of all members of the MAC as model organisms for environmental mycobacteria. Results Type strains for M. avium, Mycobacterium intracellulare, Mycobacterium chimaera, Mycobacterium colombiense, Mycobacterium arosiense, Mycobacterium marseillense, Mycobacterium timonense and Mycobacterium bouchedurhonense were co-cultivated with the free-living amoeba Acanthamoeba polyphaga strain Linc-AP1. Microscopic analyses demonstrated the engulfment and replication of mycobacteria into vacuoles of A. polyphaga trophozoites. Mycobacteria were further entrapped within amoebal cysts, and survived encystment as demonstrated by subculturing. Electron microscopy observations show that, three days after entrapment into A. polyphaga cysts, all MAC members typically resided within the exocyst. Conclusions Combined with published data, these observations indicate that mycobacteria are unique among amoeba-resistant bacteria, in residing within the exocyst.

  20. Characterization of brain inflammation during primary amoebic meningoencephalitis.

    Science.gov (United States)

    Cervantes-Sandoval, Isaac; Serrano-Luna, José de Jesús; García-Latorre, Ethel; Tsutsumi, Víctor; Shibayama, Mineko

    2008-09-01

    Naegleria fowleri is a free-living amoeba and the etiologic agent of primary amoebic meningoencephalitis (PAM). Trophozoites reach the brain by penetrating the olfactory epithelium, and invasion of the olfactory bulbs results in an intense inflammatory reaction. The contribution of the inflammatory response to brain damage in experimental PAM has not been delineated. Using both optical and electron microscopy, we analyzed the morphologic changes in the brain parenchyma due to inflammation during experimental PAM. Several N. fowleri trophozoites were observed in the olfactory bulbs 72 h post-inoculation, and the number of amoebae increased rapidly over the next 24 h. Eosinophils and neutrophils surrounding the amoebae were then noted at later times during infection. Electron microscopic examination of the increased numbers of neutrophils and the interactions with trophozoites indicated an active attempt to eliminate the amoebae. The extent of inflammation increased over time, with a predominant neutrophil response indicating important signs of damage and necrosis of the parenchyma. These data suggest a probable role of inflammation in tissue damage. To test the former hypothesis, we used CD38-/- knockout mice with deficiencies in chemotaxis to compare the rate of mortality with the parental strain, C57BL/6J. The results showed that inflammation and mortality were delayed in the knockout mice. Based on these results, we suggest that the host inflammatory response and polymorphonuclear cell lysis contribute to a great extent to the central nervous system tissue damage.

  1. Etiological factors of psoas abscesses

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    Mehmet Nuri Bodakçi

    2014-03-01

    Full Text Available Objective: Psoas abscess (PA is a rare infection disease, which is difficult to diagnose. In the present study, we aimed to evaluate etiological factors and treatment results of patients with PA. Methods: Files of 20 patients who were diagnosed as PA between December 2006 and January 2013, were retrospectively analyzed. Patient’s whose data were entirely reached and diagnosed by Ultrasonography and/or Computed Tomography as an exact PA were included to the study. Results: The mean age of the 20 patients was 48.8 (range 17-82 year, and 6 of them were female and remaining were male. Psoas abscess were on the right side in 12 patients (60%, on the left side in seven patients (35%, and bilateral in one (5%. According to data records four patients had Diabetes Mellitus (20%, two had Hypertension (10%, one had cerebrovascular disease (5%, one had tuberculosis (5%, one had hyperthyroidism (5%, one had mental retardation (5%, and one had paraplegia (5%. Six case (30% were diagnosed as a primary psoas abscess (pPA, sPA and remaining (n=14, %70 were diagnosed as secondary. Percutaneous drainage was performed to 13 patients (65% and exploration was performed to three patients (15% as a treatment modality. Remaining four patients (20% were followed by medical treatment. Conclusion: Psoas abscess is rare and have variable and non-specific clinical characteristic, which may lead to difficulty in diagnosis. In developed and developing countries, it has been reported that the most common causes of sPA are Pott's disease, and Crohn's disease, also it should be taken into account that open surgery and urinary tract stone disease can receive a significant portion of the etiological factors. J Clin Exp Invest 2014; 5 (1: 59-63

  2. Ovarian Abscess Following Therapeutic Insemination

    OpenAIRE

    Kolb, Bradford A.; Lane Mercer; Albert J. Peters; Ralph Kazer

    1994-01-01

    Background: Artificial insemination is a commonly performed procedure for the treatment of various forms of infertility. Infectious complications have only rarely been noted as a complication of intrauterine insemination (IUI). Case: In this presentation, we report the first case of an ovarian abscess following IUI with the husband's semen. Despite treatment with triple antibiotics, an oophorectomy was required. Surgical as well as pathological evaluation confirmed the diagnosis of an ovarian...

  3. Microbiological profile of orbital abscess

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    N Suneetha

    2012-01-01

    Full Text Available Background: Knowledge of the culture and sensitivity pattern is necessary, for the institution of appropriate empirical antibiotic therapy in orbital abscess. Objective: The objective of this study is to describe culture and sensitivity patterns of specimens from the orbit and surrounding structures. Materials and Methods: Retrospectively the medical records of 56 cases of orbital abscess were reviewed. Results: Cultures were positive in 38/56 (68.8% orbital specimens and the organisms included Staphylococcus aureus 18, Streptococci 7, Pseudomonas aeruginosa 3, 2 each of Enterobactersp, Escherichia coli, Proteus mirabilis, Acinetobacter sp. and 1 each of Actinomyces israelii, Diptheroids, Coagulase negative Staphylococcus, Citrobacter freundii, Methicillin-resistant S. aureus and Enterococcus faecalis. Four had polymicrobial infection. Culture of purulent nasal discharge, swabs taken from foci of infection on the face, and blood cultures were done in 26/56, and positive cultures were obtained in 16/26 (61.5% specimens. In 12 patients, there was a concurrence in the organism cultured from the orbit and from cultures from other sites. Gram-negative organisms were associated with increased ocular morbidity. Conclusion: Gram-positive cocci, especially S. aureus are the most common organisms isolated from orbital abscesses. Infections by Gram-negative organisms were associated with more complications. Empirical intravenous antibiotic therapy should have a broad spectrum of activity effective against a wide range of Staphylococcal organisms and Gram-negative bacilli.

  4. Extrahepatic lesions causing false-positive liver scans

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    Chaudhuri, T.K.

    1976-02-01

    Photoscanning of the liver is a valuable diagnostic procedure for intrahepatic lesions. Thus /sup 99m/Tc-sulfur colloid liver scan in patients with primary or secondary neoplasm of the liver, liver abscess, cyst or cirrhosis of the liver may show either focal defect or heterogeneous distribution of the colloid. We are presenting here three cases of retroperitoneal (renal or extrarenal) mass causing such changes in the liver scintiscan, although the liver itself was quite normal in each case.

  5. Multiple intracranial abscesses: Heralding asymptomatic venosus ASD

    OpenAIRE

    Praveen K. Gupta; Marzook, Rehab Ali; Sulaibeekh, Leena

    2013-01-01

    A case of multiple intracranial abscesses in an immune-competent young girl is reported. She had chicken pox. Two weeks later, she presented with multiple intracranial abscesses. No significant cardiac abnormality was detected on transthoracic echocardiogram (TTE). The condition was treated medically. However, one of the abscesses adjacent to the CSF pathways enlarged on treatment and caused obstructive hydrocephalus that required stereotactic aspiration. Gram stain showed gram positive cocci...

  6. Perianal abscesses due to ingested foreign bodies

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    Doublali Mbarek

    2010-01-01

    Full Text Available The clinical presentation of perianal abscesses due to foreign bodies (FBs impacted in the anal canal mimics common causes of acute anal pain. The diagnosis can be established by digital rectal examination and/or proctoscopy, but may miss the presence of an FB. Incision and drainage of the abscess, along with removal of the FB, results in immediate pain relief and cure. Impacted FB must not be overlooked as an unusual cause of perianal abscess. One case of perianal abscesses due to FB impacted in the anal canal is reported.

  7. Cerebral Abscess Potentially of Odontogenic Origin

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    Marouene Ben Hadj Hassine

    2015-01-01

    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.

  8. Non-interventional management of splenic abscess

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    Saket Kumar

    2014-01-01

    Full Text Available Splenic abscess is not an uncommon entity in tropics. In Indian subcontinent, where the incidence of enteric fever is high, abscess formation in spleen is frequently seen in clinical practice. In view of immunological functions, splenic preservation is preferred over splenectomy, especially in children and young adults. Medical management with antibiotics alone is considered inadequate for management of splenic abscess. Hereby, we report an unusual case of complete resolution of a florid splenic abscess with antibiotics alone without the need for any invasive intervention.

  9. Basidiobolus: An unusual cause of lung abscess

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    Chetambath Ravindran

    2010-01-01

    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.

  10. Unusual cervical spine epidural abscess.

    Science.gov (United States)

    Liou, Jr-Han; Su, Yu-Jang

    2015-10-01

    A 48-year-old man presented to the emergency department with complain of severe neck pain and anterior chest pain. Intermittent fever in the recent 2 days was also noted. There is a track maker over his left side of neck. The laboratory examination showed leukocytosis and high C-reactive protein level. Urine drug screen was positive for opiate. Empirical antibiotic administration was given. Blood culture grew gram-positive cocci in chain, and there was no vegetation found by heart echocardiogram. However, progressive weakness of four limbs was noted, and patient even cannot stand up and walk. The patient also complained of numbness sensation over bilateral hands and legs, and lower abdomen. Acute urine retention occurred. We arranged magnetic resonance imaging survey, which showed evidence of inflammatory process involving the retropharyngeal spaces and epidural spaces from the skull base to the bony level of T5. Epidural inflammatory process resulted in compression of the spinal cord and bilateral neural foramen narrowing. Neurosurgeon was consulted. Operation with laminectomy and posterior fusion with bone graft and internal fixation was done. Culture of epidural abscess and 2 sets of blood culture all yielded methicillin-sensitive Staphylococcus aureus. For epidural abscess, the most common involved spine is lumbar followed by thoracic and cervical spine. Diagnosis and treatment in the drug abusers are still challenging because they lack typical presentation, drug compliance, and adequate follow-up and because it is hard to stop drug abuser habit. Significant improvement of neurological deficit can be expected in most spinal abscess in drug abusers after treatment. PMID:26298050

  11. Patterns of Hepatosplenic Brucella Abscesses on Cross-Sectional Imaging: A Review of Clinical and Imaging Features.

    Science.gov (United States)

    Heller, Tom; Bélard, Sabine; Wallrauch, Claudia; Carretto, Edoardo; Lissandrin, Raffaella; Filice, Carlo; Brunetti, Enrico

    2015-10-01

    While diffuse involvement of liver and spleen is frequently seen in brucellosis, suppurative abscesses caused by Brucella are less common but well described. With the increased availability of cross-sectional imaging techniques, reports have become more frequent. Four patients with hepatosplenic abscesses caused by Brucella spp. are described and included in a review of 115 previously published cases. Clinical characteristics and patterns on ultrasound (US) and computed tomography imaging were analyzed. Furthermore, the proportion of patients with brucellosis affected by suppurative hepatosplenic lesions was estimated. Hepatosplenic abscesses were seen in 1.2% of patients with brucellosis and were mostly caused by Brucella melitensis. Imaging analysis revealed two main distinct patterns. Solitary abscesses involving liver more frequently than spleen, and showing characteristic central calcifications, characterize the first pattern. Multiple smaller abscesses, frequent spleen involvement, and absence of calcifications characterize the second pattern. Blood and aspirate cultures were frequently negative, however, the positivity rate increased over the past years. Indirect Coombs test was positive in 96%. Half of the patients were cured by antibiotic treatment; case fatality in this series was 1.9%. Hepatosplenic abscesses due to Brucella infections have characteristic imaging findings. Clinicians should be aware of these and the proactive use of cross-sectional imaging, particularly US, should be encouraged in endemic regions.

  12. Radiological diagnosis of Brodie's abscess.

    Science.gov (United States)

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

    2002-12-30

    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.

  13. Collar stud abscess an interesting case report

    OpenAIRE

    Balasubramanian Thiagarajan; Kameshwaran Punniyakodi

    2012-01-01

    Cervical Lymphadenopathy with collar stud abscess of tuberculous etiology is uncommon nowadays. This case is being reported for clinical interest and for the purpose of documentation.Introduction Tubercular Lymphadenopathy is a common extra pulmonary manifestation of tuberculosis.Collar stud abscess are rarely seen in OPD nowadays. Tuberculosis remains a problem throughout the world and is still a common cause of cervical lymphadenopathy.

  14. Nerve abscess in primary neuritic leprosy.

    Science.gov (United States)

    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

    2013-06-01

    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.

  15. Two Cases of Adrenal Abscesses Following Histoacryl® (N-butyl-2-cyanocrylate) Injection.

    Science.gov (United States)

    Lee, Bo Young; Jang, Jae Young; Jeong, Soung Won; Bok, Gene Hyun; Ham, Jeong Ho; Cho, Joo Young; Lee, Joon Seong; Shim, Chan Sup

    2011-06-01

    We report two cases of adrenal abscesses that occurred following a Histoacryl® (N-butyl-2-cyanocrylate) injection for variceal bleeding. Patients had been diagnosed with alcoholic liver cirrhosis and gastric varices bleeding and received a Histoacryl® injection for the variceal bleeding. Patients had fever and abdominal tenderness and were diagnosed with an adrenal abscess at 2 months following the Histoacryl® injection. One patient received open drainage and the other underwent percutaneous drainage. When a patient has previously been injected with Histoacryl® for the treatment of variceal bleeding and presents with fever, an evaluation for an unusual complication such as adrenal abscess is recommended. PMID:21814609

  16. Clinical characteristics and prognostic factors of splenic abscess: A review of 67 cases in a single medical center of Taiwan

    Institute of Scientific and Technical Information of China (English)

    Kuo-Chin Chang; Chuan-Mo Lee; Tsung-Hui Hu; Seng-Kee Chuah; Chi-Sin Changchien; Tung-Lung Tsai; Sheng-Nan Lu; Yi-Chun Chiu; Yaw-Sen Chen; Chih-Chi Wang; Jui-Wei Lin

    2006-01-01

    AIM: To analyze 67 cases of splenic abscess in a medical center of Taiwan during a period of 19 years.METHODS: From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics,underlying diseases, organism spectra, therapeutic methods, APACHE Ⅱ scores, and mortality rates were analyzed.RESULTS: There were 41 males and 26 females with the mean age of 54.1± 14.1 years. Multiple splenic abscesses (MSA) account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixtyseven patients (35.8%) had extrasplenic abscesses, with leading site of liver (34.6%). Microbiological cultures were positive in 58 patients (86.6%), with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus (GNB) infection predominated (55.2%),with leading pathogen ofKlebsiella pneumoniae (22.4%),followed by gram positive coccus (GPC) infection (31%).Splenectomy was performed in 26 patients (38.8%),percutaneous drainage or aspiration in 21 (31.3%),and antibiotic therapy alone in 20 patients (29.9%).Eventually, 12 of 67 patients expired (17.9 %). By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC(P=0.036). Patients with GNB infection (P= 0.009) andmultiple abscesses (P= 0.011) experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE Ⅱ score of 12 expired patients (16.3 ±3.2) was significantly higher than that of the 55 survivals (7.2 ± 3.8) (P< 0.001).CONCLUSION: MSA, GNB infection, and high APACHEⅡ scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.

  17. Abscess

    Science.gov (United States)

    ... protect yourself from germs. Also, don't share clothing, towels, razors, or bed linens with anyone else. When these items get dirty, wash them separately in very hot water. Wash your hands often using plain soap and water for at least 20 seconds each time. It's OK to use alcohol-based ...

  18. Pyogenic brain abscess, a 15 year survey

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    Helweg-Larsen Jannik

    2012-11-01

    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.

  19. Emphysematous prostatic abscess with rectoprostatic fistula

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    Po-Cheng Chen

    2014-12-01

    Full Text Available Emphysematous prostatic abscess is a rare but relatively serious infectious disease, and its association with rectoprostatic fistula is extremely unusual. The reported risk factors for this condition include diabetes mellitus, immunosuppression, and prostate surgery. We report a rare case of emphysematous prostatic abscess successfully treated by transurethral drainage. Nonetheless, a rectoprostatic fistula was found postoperatively. The fistula healed spontaneously without fasting or fecal diversion after suprapubic cystostomy and placement of a urethral catheter. This case highlights the importance of surgical drainage for the treatment of an emphysematous prostatic abscess and that conservative treatment can be a safe and effective approach for an associated rectoprostatic fistula.

  20. Liver resection in liver transplant recipients

    Institute of Scientific and Technical Information of China (English)

    Gabriele Marangoni; Walid Faraj; Harsheet Sethi; Mohamed Rela; Paolo Muiesan; Nigel Heaton

    2008-01-01

    BACKGROUND: Liver resection after liver transplantation is a relatively uncommon procedure. Indications for liver resection include hepatic artery thrombosis (HAT), non-anastomotic biliary stricture (ischemic biliary lesions), liver abscess, liver trauma and recurrence of hepatocellular carcinoma (HCC). Organ shortage and lower survival after re-transplantation have encouraged us to make attempts at graft salvage. METHODS: Eleven resections at a mean of 59 months after liver transplantation were made over 18 years. Indications for liver resection included HCC recurrence in 4 patients, ischemic cholangiopathy, segmental HAT, sepsis and infected hematoma in 2 each, and ischemic segmentⅣafter split liver transplantation in 1. RESULTS: There was no perioperative mortality. Morbidity included one re-laparotomy for small bowel perforation, one bile leak treated conservatively, one right subphrenic collection, one wound infection and 5 episodes of Gram-negative sepsis. One patient underwent re-transplantation 4 months after resection for chronic rejection. There were 3 deaths, two from HCC recurrence and one from post-transplant lymphoproliferative disorder. The overall mean follow-up after resection was 48 months. CONCLUSIONS: Liver resection in liver transplant recipients is safe, and has good outcome in selected patients and avoids re-transplantation in the majority of patients. Recipients with recurrent HCC in graft may beneift from resection, but cure is uncommon.

  1. Liver metastases

    Science.gov (United States)

    Metastases to the liver; Metastatic liver cancer; Liver cancer - metastatic; Colorectal cancer - liver metastases; Colon cancer - liver metastases; Esophageal cancer - liver metastases; Lung cancer - liver metastases; Melanoma - liver ...

  2. Fatal thalamic abscess secondary to dental infection.

    Science.gov (United States)

    Basyuni, Shadi; Sharma, Valmiki; Santhanam, Vijay; Ferro, Ashley

    2015-01-01

    We present the case of poor neurological recovery and subsequent death secondary to a thalamic abscess in a 53-year-old man. This patient initially presented with sudden dysarthria and left hemiparesis while driving. Neuroimaging showed a multilobular abscess involving the right thalamus with oedema extending to the basal ganglionic region and brainstem. The source of the abscess was initially unknown and it required draining multiple times while the different causes were being explored. The patient's neurological state along with intubation made for a difficult and inconclusive oral examination. It was only after neuroimaging included tooth-bearing areas that it became evident that this patient had extensive periodontal disease with multiple areas of periapical radiolucencies. The patient underwent complete dental clearance alongside repeated drainage of the abscess. Despite initial postoperative improvement, the patient never recovered from the neurological damage and died 3 weeks later. PMID:26678690

  3. Imaging of cerebritis, encephalitis, and brain abscess.

    Science.gov (United States)

    Rath, Tanya J; Hughes, Marion; Arabi, Mohammad; Shah, Gaurang V

    2012-11-01

    Imaging plays an important role in the diagnosis and treatment of brain abscess, pyogenic infection, and encephalitis. The role of CT and MRI in the diagnosis and management of pyogenic brain abscess and its complications is reviewed. The imaging appearances of several common and select uncommon infectious encephalitides are reviewed. Common causes of encephalitis in immunocompromised patients, and their imaging appearances, are also discussed. When combined with CSF, serologic studies and patient history, imaging findings can suggest the cause of encephalitis. PMID:23122258

  4. Breast abscess caused by penicillin resistant Pneumococci

    OpenAIRE

    Boppe Appalaraju; Mathews, Anila A.; Appolo C Bhaskaran; Pavai Arunachalam

    2011-01-01

    Breast abscess is mostly caused by Staphylococcus aureus. A 26-year-old immunocompetent lady was admitted with breast abscess. Incision and drainage (I/D) was done and Pneumococci were isolated from the drained pus. The patient was earlier treated with Augmentin which was later changed to linezolid after testing for antibiotic susceptibility. This strain showed a high level of resistance to penicillin. It had been noticed that there was a slow increase in the number of penicillin resistant Pn...

  5. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    OpenAIRE

    Al Soub, Hussam; Al-Maslamani, Eman; Al-Maslamani, Mona

    2008-01-01

    We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably r...

  6. Intraventricular tuberculous abscess : a case report.

    Directory of Open Access Journals (Sweden)

    Vajramani G

    1999-10-01

    Full Text Available Ventricles can be involved in different ways in neurotuberculosis, however, the occurrence of intraventricular abscess has been rarely reported. We report a young woman who had intraventricular tubercular abscess. Cranial computed tomographic scan showed hypodense ring enhancing lesion in the right lateral ventricle with unilateral hydrocephalus. She underwent parasagittal craniotomy with total excision of the lesion. The pus obtained from the lesion was teeming with acid fast bacilli.

  7. Filarial abscess in the submandibular region

    OpenAIRE

    Rupinder Kaur; Kandathil Joseph Philip; Laxman, Kumar R; Kanwal Masih

    2013-01-01

    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 Wucherer...

  8. Scalp abscess--a cautionary tale.

    LENUS (Irish Health Repository)

    Nugent, Nora F

    2010-08-01

    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.

  9. Bilateral Brodie's abscess at the proximal tibia.

    Science.gov (United States)

    Buldu, Halil; Bilen, Fikri Erkal; Eralp, Levent; Kocaoglu, Mehmet

    2012-08-01

    Brodie's abscess is a form of subacute osteomyelitis, which typically involves the metaphyses of the long tubular bones, particularly in the tibia. The diagnosis is usually made incidentally, as there are no accompanying symptoms or laboratory studies. Bilateral involvement at the proximal tibia is unusual. However, orthopaedic surgeons should be aware of this entity, as it may present without symptoms. Checking the contralateral limb for concomitant Brodie's abscess is recommended.

  10. Primary amoebic meningoencephalitis caused by Naegleria fowleri: an old enemy presenting new challenges.

    Science.gov (United States)

    Siddiqui, Ruqaiyyah; Khan, Naveed Ahmed

    2014-08-01

    First discovered in 1899, Naegleria fowleri is a protist pathogen, known to infect the central nervous system and produce primary amoebic meningoencephalitis. The most distressing aspect is that the fatality rate has remained more than 95%, despite our advances in antimicrobial chemotherapy and supportive care. Although rare worldwide, most cases have been reported in the United States, Australia, and Europe (France). A large number of cases in developing countries go unnoticed. In particular, religious, recreational, and cultural practices such as ritual ablution and/or purifications, Ayurveda, and the use of neti pots for nasal irrigation can contribute to this devastating infection. With increasing water scarcity and public reliance on water storage, here we debate the need for increased awareness of primary amoebic meningoencephalitis and the associated risk factors, particularly in developing countries.

  11. Primary amoebic meningoencephalitis caused by Naegleria fowleri: an old enemy presenting new challenges.

    Directory of Open Access Journals (Sweden)

    Ruqaiyyah Siddiqui

    2014-08-01

    Full Text Available First discovered in 1899, Naegleria fowleri is a protist pathogen, known to infect the central nervous system and produce primary amoebic meningoencephalitis. The most distressing aspect is that the fatality rate has remained more than 95%, despite our advances in antimicrobial chemotherapy and supportive care. Although rare worldwide, most cases have been reported in the United States, Australia, and Europe (France. A large number of cases in developing countries go unnoticed. In particular, religious, recreational, and cultural practices such as ritual ablution and/or purifications, Ayurveda, and the use of neti pots for nasal irrigation can contribute to this devastating infection. With increasing water scarcity and public reliance on water storage, here we debate the need for increased awareness of primary amoebic meningoencephalitis and the associated risk factors, particularly in developing countries.

  12. Primary Amoebic Meningoencephalitis Caused by Naegleria fowleri: An Old Enemy Presenting New Challenges

    Science.gov (United States)

    Siddiqui, Ruqaiyyah; Khan, Naveed Ahmed

    2014-01-01

    First discovered in 1899, Naegleria fowleri is a protist pathogen, known to infect the central nervous system and produce primary amoebic meningoencephalitis. The most distressing aspect is that the fatality rate has remained more than 95%, despite our advances in antimicrobial chemotherapy and supportive care. Although rare worldwide, most cases have been reported in the United States, Australia, and Europe (France). A large number of cases in developing countries go unnoticed. In particular, religious, recreational, and cultural practices such as ritual ablution and/or purifications, Ayurveda, and the use of neti pots for nasal irrigation can contribute to this devastating infection. With increasing water scarcity and public reliance on water storage, here we debate the need for increased awareness of primary amoebic meningoencephalitis and the associated risk factors, particularly in developing countries. PMID:25121759

  13. Evidence that the intra-amoebal Legionella drancourtii acquired a sterol reductase gene from eukaryotes

    Directory of Open Access Journals (Sweden)

    Fournier Pierre-Edouard

    2009-03-01

    Full Text Available Abstract Background Free-living amoebae serve as a natural reservoir for some bacteria that have evolved into «amoeba-resistant» bacteria. Among these, some are strictly intra-amoebal, such as Candidatus "Protochlamydia amoebophila" (Candidatus "P. amoebophila", whose genomic sequence is available. We sequenced the genome of Legionella drancourtii (L. drancourtii, another recently described intra-amoebal bacterium. By comparing these two genomes with those of their closely related species, we were able to study the genetic characteristics specific to their amoebal lifestyle. Findings We identified a sterol delta-7 reductase-encoding gene common to these two bacteria and absent in their relatives. This gene encodes an enzyme which catalyses the last step of cholesterol biosynthesis in eukaryotes, and is probably functional within L. drancourtii since it is transcribed. The phylogenetic analysis of this protein suggests that it was acquired horizontally by a few bacteria from viridiplantae. This gene was also found in the Acanthamoeba polyphaga Mimivirus genome, a virus that grows in amoebae and possesses the largest viral genome known to date. Conclusion L. drancourtii acquired a sterol delta-7 reductase-encoding gene of viridiplantae origin. The most parsimonious hypothesis is that this gene was initially acquired by a Chlamydiales ancestor parasite of plants. Subsequently, its descendents transmitted this gene in amoebae to other intra-amoebal microorganisms, including L. drancourtii and Coxiella burnetii. The role of the sterol delta-7 reductase in prokaryotes is as yet unknown but we speculate that it is involved in host cholesterol parasitism.

  14. Primary amoebic meningoencephalitis caused by Naegleria fowleri: an old enemy presenting new challenges.

    OpenAIRE

    Ruqaiyyah Siddiqui; Naveed Ahmed Khan

    2014-01-01

    First discovered in 1899, Naegleria fowleri is a protist pathogen, known to infect the central nervous system and produce primary amoebic meningoencephalitis. The most distressing aspect is that the fatality rate has remained more than 95%, despite our advances in antimicrobial chemotherapy and supportive care. Although rare worldwide, most cases have been reported in the United States, Australia, and Europe (France). A large number of cases in developing countries go unnoticed. In particular...

  15. Concurrent amoebic and histoplasma colitis:A rare cause of massive lower gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Peng; Soon; Koh; April; Camilla; Roslani; Kumar; Vasudeavan; Vimal; Mohd; Shariman; Ramasamy; Umasangar; Rajkumar; Lewellyn

    2010-01-01

    Infective colitis can be a cause of massive lower gastrointestinal bleeding requiring acute surgical intervention. Causative organisms include entamoeba and histoplasma species. However, concurrent colonic infection with both these organisms is very rare, and the in vivo consequences are not known. A 58-year-old male presented initially to the physicians with pyrexia of unknown origin and bloody diarrhea. Amoebic colitis was diagnosed based on biopsies, and he was treated with metronidazole. Five days later...

  16. UNUSUAL PRESENTATION OF MASTOID ABSCESS

    Directory of Open Access Journals (Sweden)

    Poorva Chandrashekhar

    2016-03-01

    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.

  17. Unusual complication of amebic liver abscess: Hepatogastricfistula

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Amebic liver abscess is a parasitic disease which isoften encountered in tropical countries. A hepatogastricfistula secondary to an amebic liver abscess is a rarecomplication of this disease and there are only a handfulof reported cases in literature. Here we present a caseof an amebic liver abscess which was complicated withthe development of a hepatogastric fistula. The patientpresented with the Jaundice, pain and distension ofabdomen. The Jaundice and pain improved partially afterhe had an episode of brownish black colored increasein frequency of stools for 5 to 6 d. Patient also hadascites and anemia. He was a chronic alcohol drinker.Esophagogastroduodenoscopy performed in view ofthe above findings. It showed a fistulous opening withbilious secretions along the lesser curvature of thestomach. On imaging multiple liver abscesses seenincluding one in sub capsular location. The patient wasmanaged conservatively with antiamebic medicationsalong with proton pump inhibitors. The pigtail drainageof the sub capsular abscess was done. The patientimproved significantly. The repeat endoscopy performedafter about two months showed reduction in fistulasize. A review of the literature shows that hepatogastricfistulas can be managed conservatively with medicationsand drainage, endoscopically with biliary stenting or withsurgical excision.

  18. Right iliac fossa abscess as first manifestation of perforated adenocarcinoma of sigmoid: a rare case report

    Institute of Scientific and Technical Information of China (English)

    Mohammad Hossein Hajisadeghizadeh; Hamid Reza Soltani. G; Seyed Mohammad Reza Mortazavizadeh; Fatemeh Akhiri A

    2012-01-01

    Colorectal cancer usually present with known symptoms while there are less common manifestation including abscess formation which can be intra or extra peritoneal. A 60-year-old Caucasian male with a history of RLQ abdominal pain, nausea, vomiting and anorexia from 15 days ago referred to surgery ward. Ultrasound showed a hypoachoic lesion with diameters 50 mm × 70 mm in RLQ of abdomen and a round echogenic area in right lobe of liver with diameter 15 mm. The findings were revealed an abscess located in right iliac fossa then local drainage of abscess was performed. Four days later the patient was re-admitted because of severe abdominal distention and lack of bowel movement. Laparoscopy was performed before proceeding with further examinations, due to the poor general condition of the patient. The sigmoid was adherent into the abdominal wall and mild intestinal loop distention and apple-core view was observed during operation. Can-cer of sigmoid complicated by a right iliac fossa abscess was diagnosed and Hartman colestomy was undertaken. At the last follow-up examination 3 months after operation, the patient was in good health with no clinical evidence of recurrence.

  19. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

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    P. J. Corsi

    1999-01-01

    Full Text Available Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.

  20. Neuroimaging features of cerebral aspergillus abscess: Case report

    Directory of Open Access Journals (Sweden)

    Jie Bai

    2015-06-01

    Conclusion: Cerebral aspergillus abscesses possess some degree neuroimaging features on traditional CT/MR imaging. Combined with patient's clinical history, CT/MRI examination could facilitate early diagnosis of aspergillus abscesses in central nervous system.

  1. Filarial abscess in the submandibular region

    Directory of Open Access Journals (Sweden)

    Rupinder Kaur

    2013-01-01

    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.

  2. Renal abscess caused by Salmonella Typhi

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    Amarjeet Kaur

    2015-01-01

    Full Text Available Salmonella typhi is a true pathogen, which is capable of causing both intestinal and extraintestinal infections. Unusual presentations of Salmonella should always be kept in mind as this organism can cause disease in almost any organ of the body. S. typhi has been reported to cause the life-threatening infections such as meningitis, endocarditis, myocarditis, empyema, and hepatic abscess. Renal involvement by S. typhi is a relatively rare presentation. We report a case of renal abscess caused by S. typhi in an afebrile, 10-year-old child who did not have any clinical history of enteric fever. To our knowledge, this is the first reported case of isolation of S. typhi from the renal abscess, and interestingly this isolate was found to be resistant to quinolones.

  3. Bronchoscopic drainage of a malignant lung abscess.

    Science.gov (United States)

    Katsenos, Stamatis; Psathakis, Konstantinos; Chatzivasiloglou, Fotini; Antonogiannaki, Elvira-Markela; Psara, Anthoula; Tsintiris, Konstantinos

    2015-04-01

    Bronchoscopic drainage of a pyogenic lung abscess is an established therapeutic approach in selected patients in whom conventional antibiotic therapy fails. This intervention has also been undertaken in patients with abscess owing to underlying lung cancer and prior combined radiochemotherapy. However, this procedure has rarely been performed in cavitary lesions of advanced tumor origin before initiating any chemotherapy/radiotherapy scheme. Herein, we describe a case of a 68-year-old woman with lung adenocarcinoma stage IIIB, who underwent bronchoscopic drainage of necrotizing tumor lesion, thus improving her initial poor clinical condition and rendering other treatment modalities, such as radiotherapy, more effective and beneficial. Bronchoscopic drainage of a symptomatic cancerous lung abscess should be considered as an alternative and palliative treatment approach in patients with advanced inoperable non-small cell lung cancer. PMID:25887013

  4. Bilateral Psoas Abscess in the Emergency Department

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    Tomich, Eric B

    2009-11-01

    Full Text Available We present the case of a 45-year-old female who presented multiple times to the emergency department with acute low back pain and was subsequently diagnosed with bilateral psoas muscle abscess. Psoas abscess is an uncommon cause of acute low back pain that is associated with high morbidity and mortality. The onset of symptoms is frequently insidious and the clinical presentation vague. Proper diagnosis requires vigilance of the physician to recognize signs in the history and physical examination that are suggestive of a potentially serious spinal condition and initiate further workup. While most patients with acute low back pain have a benign etiology, this case report demonstrates the challenge of diagnosing a patient with bilateral psoas abscess who had few known risk factors and symptoms typical of mechanical low back pain.[West J Emerg Med. 2009;10(4:288-291.

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

    Science.gov (United States)

    Stephens, M M; MacAuley, P

    1988-09-01

    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.

  6. Empirical antimicrobial therapy of acute dentoalveolar abscess

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    Matijević Stevo

    2009-01-01

    Full Text Available Background/Aim. The most common cause of acute dental infections are oral streptococci and anaerobe bacteria. Acute dentoalveolar infections are usually treated surgically in combination with antibiotics. Empirical therapy in such infections usually requires the use of penicillin-based antibiotics. The aim of this study was to investigate the clinical efficiency of amoxicillin and cefalexin in the empirical treatment of acute odontogenic abscess and to assess the antimicrobial susceptibility of the isolated bacteria in early phases of its development. Methods. This study included 90 patients with acute odontogenic abscess who received surgical treatment (extraction of a teeth and/or abscess incision and were divided into three groups: two surgicalantibiotic groups (amoxicillin, cefalexin and the surgical group. In order to evaluate the effects of the applied therapy following clinical symptoms were monitored: inflammatory swelling, trismus, regional lymphadentytis and febrility. In all the patients before the beginning of antibiotic treatment suppuration was suched out of the abscess and antibiotic susceptibility of isolated bacteria was tested by using the disk diffusion method. Results. The infection signs and symptoms lasted on the average 4.47 days, 4.67 days, and 6.17 days in the amoxicillin, cefalexin, and surgically only treated group, respectively. A total of 111 bacterial strains were isolated from 90 patients. Mostly, the bacteria were Gram-positive facultative anaerobs (81.1%. The most common bacteria isolated were Viridans streptococci (68/111. Antibiotic susceptibility of isolated bacteria to amoxicillin was 76.6% and cefalexin 89.2%. Conclusion. Empirical, peroral use of amoxicillin or cefalexin after surgical treatment in early phase of development of dentoalveolar abscess significantly reduced the time of clinical symptoms duration in the acute odontogenic infections in comparison to surgical treatment only. Bacterial strains

  7. A case of laparoscopic cystogastrostomy for pancreatic abscess

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

    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.

  8. Mycobacterium fortuitum abdominal wall abscesses following liposuction

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    Al Soub Hussam

    2008-01-01

    Full Text Available We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. Combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.

  9. MR spectroscopy in a cervical abscess

    International Nuclear Information System (INIS)

    MR spectroscopy (MRS) has been used to analyse noninvasively tissues at a molecular level. Hydrogen and phosphorus MRS have been used for characterisation of intracranial solid and cystic masses, gynaecological tumours and lymph nodes. We report a cystic, tick-walled mass in the soft tissues of the neck. Single-voxel proton MRS revealed a prominent acetate peak at 1.92 ppm and a diagnosis of abscess was suggested. At operation a pyogenic neck abscess was confirmed, with culture of the pus. (orig.)

  10. TNFα-Mediated Liver Destruction by Kupffer Cells and Ly6Chi Monocytes during Entamoeba histolytica Infection

    OpenAIRE

    Elena Helk; Hannah Bernin; Thomas Ernst; Harald Ittrich; Thomas Jacobs; Joerg Heeren; Frank Tacke; Egbert Tannich; Hannelore Lotter

    2013-01-01

    Author Summary Amebic liver abscess (ALA), an infectious disease caused by the protozoan parasite Entamoeba histolytica is characterized by severe focal liver damages. According to its name giving activity, destruction of liver tissue by E. histolytica has been attributed to parasite-specific effector molecules. However, abscess lesions contain considerable numbers of innate immune cells, such as neutrophils and macrophages, raising the question whether these host cells might contribute to th...

  11. Orbital abscess from dacryocystitis caused by Morganella morganii.

    Science.gov (United States)

    Carruth, Bryant P; Wladis, Edward J

    2013-02-01

    A 22-year-old female with multiple developmental abnormalities stemming from cardiofaciocutaneous syndrome presented with a recurrent orbital abscess 2 years after orbitotomy with drainage of an abscess of presumed hematogenous-origin. During careful intraoperative examination the abscess was seen to directly extend from the lacrimal sac. Cultures were taken and grew Morganella morganii, a Gram negative rod uncommon in ocular and periocular infections. To the author's knowledge, this microorganism has been reported in only one previous case of orbital abscess and underscores the need for organism identification and antibiotic sensitivity analysis in cases of orbital abscess, particularly those with extension from dacryocystitis.

  12. A CASE OF INTRATONSILLAR ABSCESS MANAGED BY NEEDLE ASPIRATION

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    Jathin Sam

    2016-03-01

    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. Stenotrophomonas maltophilia and Vermamoeba vermiformis relationships: bacterial multiplication and protection in amoebal-derived structures.

    Science.gov (United States)

    Cateau, Estelle; Maisonneuve, Elodie; Peguilhan, Samuel; Quellard, Nathalie; Hechard, Yann; Rodier, Marie-Helene

    2014-12-01

    Stenotrophomonas maltophilia, a bacteria involved in healthcare-associated infections, can be found in hospital water systems. Other microorganisms, such as Free Living amoebae (FLA), are also at times recovered in the same environment. Amongst these protozoa, many authors have reported the presence of Vermamoeba vermiformis. We show here that this amoeba enhances S. maltophilia growth and harbors the bacteria in amoebal-derived structures after 28 days in harsh conditions. These results highlight the fact that particular attention should be paid to the presence of FLA in hospital water systems, because of their potential implication in survival and growth of pathogenic bacterial species.

  14. Magnetic resonance imaging of a brain abscess

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) was performed on 13 patients with brain abscesses, and the alternation of MRI findings, as correlated with the progression of brain-abscess formation, was reviewed. In the cerebritis stage, spin-echo images showed a high intensity, and inversion-recovery images, a low intensity, due to inflammation and edema. The spin-echo images were very sensitive in delineating the brain edema; however, it was difficult to distinguish the inflammation from the surrounding edema. In the capsule stage, due to the accumulation of purulent material, the central necrotic area was demonstrated as a low-intensity area, while the capsule of the abscess was revealed as an iso-intensity ring on the inversion-recovery images. The central necrotic area also decreased in intensity on spin-echo images in the later period of this stage. With contrast enhancement (Gd-DTPA), the SR image showed the capsule as a high-intensity ring. MRI was found to be a useful method for estimating the process of the formation of a brain abscess. (author)

  15. Magnetic resonance imaging of a brain abscess

    Energy Technology Data Exchange (ETDEWEB)

    Oikawa, Akihiro; Kagawa, Mizuo; Yatoh, Seiji; Izawa, Masahiro; Ujiie, Hiroshi; Sakaguchi, Jun; Onda, Hideaki; Kitamura, Kohichi

    1988-06-01

    Magnetic resonance imaging (MRI) was performed on 13 patients with brain abscesses, and the alternation of MRI findings, as correlated with the progression of brain-abscess formation, was reviewed. In the cerebritis stage, spin-echo images showed a high intensity, and inversion-recovery images, a low intensity, due to inflammation and edema. The spin-echo images were very sensitive in delineating the brain edema; however, it was difficult to distinguish the inflammation from the surrounding edema. In the capsule stage, due to the accumulation of purulent material, the central necrotic area was demonstrated as a low-intensity area, while the capsule of the abscess was revealed as an iso-intensity ring on the inversion-recovery images. The central necrotic area also decreased in intensity on spin-echo images in the later period of this stage. With contrast enhancement (Gd-DTPA), the SR image showed the capsule as a high-intensity ring. MRI was found to be a useful method for estimating the process of the formation of a brain abscess.

  16. An Unusual Case of Acute Epiglottic Abscess

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    Tanthry Deepalakshmi

    2014-01-01

      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.

  17. Multiple intracranial abscesses: Heralding asymptomatic venosus ASD.

    Science.gov (United States)

    Gupta, Praveen K; Marzook, Rehab Ali; Sulaibeekh, Leena

    2013-10-01

    A case of multiple intracranial abscesses in an immune-competent young girl is reported. She had chicken pox. Two weeks later, she presented with multiple intracranial abscesses. No significant cardiac abnormality was detected on transthoracic echocardiogram (TTE). The condition was treated medically. However, one of the abscesses adjacent to the CSF pathways enlarged on treatment and caused obstructive hydrocephalus that required stereotactic aspiration. Gram stain showed gram positive cocci in chain. Pus was sterile on culture. She was treated with broad spectrum IV antibiotics based on Gram staining report for 6 weeks followed by another 8 weeks of oral antibiotics. She made good recovery and had been leading a normal life. The abscess capsules took 30 months to resolve completely on MRI. A repeat TTE done in the follow up showed enlarged right heart chambers with a suggestion of a venosus ASD. A trans-esophageal echocardiogram (TEE) confirmed the presence of sinus venosus ASD from the SVC side with mainly left to right shunt. There was also partial anomalous drainage of the pulmonary veins. The patient underwent correction of the defect and has been doing well. PMID:24551007

  18. Imaging of liver and spleen candidiasis in patients with acute leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Seino, Yasuo; Tamakawa, Y.; Kato, T.; Kimura, Y.; Miyazaki, S.; Miura, R.; Ishida, H.

    1988-01-01

    Four patients with acute leukemia were found to have candidal abscess of liver and spleen. CT and US showed hepatosplenomegaly and microabscess. These findings might be useful in diagnosis of visceral candidiasis.

  19. Imaging of liver and spleen candidiasis in patients with acute leukemia

    International Nuclear Information System (INIS)

    Four patients with acute leukemia were found to have candidal abscess of liver and spleen. CT and US showed hepatosplenomegaly and microabscess. These findings might be useful in diagnosis of visceral candidiasis. (author)

  20. ANTI-MICROBIAL AND ANTI-AMOEBIC ACTIVITY SOME AZOMETHINES - POTENTIAL TEXTILE DYESTUFFS

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    DJORDJEVIC Dragan

    2016-05-01

    Full Text Available In this paper, new synthesized three azomethine derivatives applied in dyeing textiles checking the anti-microbial properties of active components, at the same time [1-3]. The emphasis is thrown on the verification of anti-microbial properties that are important for obtaining textile with significantly improved performance. All compounds were characterized and evaluated for their anti-microbial activity against 7 pathogenic bacteria, 1 parasitic protozoan and 1 fungus. It estimated anti-bacterial activity in vitro against the following microorganisms Staphylococcus aureus, Bacillus anthracis, Streptococcus faecalis, Enterobacter sp., Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, and Candida albicans. The anti-amoebic activity in vitro was evaluated against the HM1: IMSS strain of Entamoeba histolytica and the results were compared with the standard drug, metronidazole. The synthesized azomethines, showed very good substantivity for wool fibers, gave fine coloring, with good degree of exhaustion after dyeing. The combination of extended synthetic analogues of natural molecules leads to discovery of chemical entities which might be excellent anti-microbial and anti-amoebic compounds as depicted in our results. Being highly the effects this compound can be explored in future as an option for decreasing pathogenic potential of infecting from different sources. Azomethines containing hydrazone (dyestuff 1 and phenylhydrazone (dyestuff 2 as moiety show average yield and moderate inhibition activity while azomethines containing thiosemicarbazone (dyestuff 3 as moiety show higher yield and greater inhibition activity towards gram-negative and gram-positive bacteria as well as a fungus.

  1. Another case of canine amoebic meningoencephalitis--the challenges of reaching a rapid diagnosis.

    Science.gov (United States)

    Hodge, Priscilla J; Kelers, Kylie; Gasser, Robin B; Visvesvara, Govinda S; Martig, Sandra; Long, Sam N

    2011-04-01

    A case of granulomatous amoebic meningoencephalitis in a previously healthy, mature, apparently immunocompetent dog, with a history of exposure to stagnant water, is reported. The case presented with ataxia and a tendency to fall to the left side. A computed tomography (CT) showed a ring-enhancing lesion within the cerebellum; an examination of cerebrospinal fluid (CSF) revealed nonspecific mixed-cell pleocytosis. Despite antibiotic and anti-inflammatory therapy, clinical signs progressed rapidly to decerebellate rigidity over 4 days, and the dog was euthanased. Significant post-mortem findings were restricted to the brain, with a localised lytic lesion in the deep cerebellar white matter. Histopathological examination of the brain showed focally extensive cavitation of the white matter and communication of the lesion with the fourth ventricle. The affected area contained structures consistent with amoebae and was infiltrated by neutrophils mixed with lower numbers of macrophages, plasma cells and lymphocytes. The amoebae were identified as Balamuthia mandrillaris, based on specific immunofluorescence detection. Amoebic meningoencephalitis should be considered in dogs with evidence of focal cavitary lesions in the brain, particularly in cases with a history of swimming in stagnant water. PMID:21161275

  2. Bacterial-type oxygen detoxification and iron-sulfur cluster assembly in amoebal relict mitochondria.

    Science.gov (United States)

    Maralikova, Barbora; Ali, Vahab; Nakada-Tsukui, Kumiko; Nozaki, Tomoyoshi; van der Giezen, Mark; Henze, Katrin; Tovar, Jorge

    2010-03-01

    The assembly of vital reactive iron-sulfur (Fe-S) cofactors in eukaryotes is mediated by proteins inherited from the original mitochondrial endosymbiont. Uniquely among eukaryotes, however, Entamoeba and Mastigamoeba lack such mitochondrial-type Fe-S cluster assembly proteins and possess instead an analogous bacterial-type system acquired by lateral gene transfer. Here we demonstrate, using immunomicroscopy and biochemical methods, that beyond their predicted cytosolic distribution the bacterial-type Fe-S cluster assembly proteins NifS and NifU have been recruited to function within the relict mitochondrial organelles (mitosomes) of Entamoeba histolytica. Both Nif proteins are 10-fold more concentrated within mitosomes compared with their cytosolic distribution suggesting that active Fe-S protein maturation occurs in these organelles. Quantitative immunoelectron microscopy showed that amoebal mitosomes are minute but highly abundant cellular structures that occupy up to 2% of the total cell volume. In addition, protein colocalization studies allowed identification of the amoebal hydroperoxide detoxification enzyme rubrerythrin as a mitosomal protein. This protein contains functional Fe-S centres and exhibits peroxidase activity in vitro. Our findings demonstrate the role of analogous protein replacement in mitochondrial organelle evolution and suggest that the relict mitochondrial organelles of Entamoeba are important sites of metabolic activity that function in Fe-S protein-mediated oxygen detoxification. PMID:19888992

  3. Risk assessment of bioaccumulation in the food webs of two marine AMOEBE species: common tern and harbor seal

    NARCIS (Netherlands)

    Jongbloed RH; Mensink BJWG; Vethaak AD; Luttik R; Rijksinstituut voor Kust en Zee; ACT; RIKZ

    1995-01-01

    A model has been developed for calculating Maximum Permissible Concentrations (MPCs) in water for chemicals accumulating in food webs of sea birds and mammals. Calculations are carried out for two marine AMOEBE species: common tern (Sterna hirundo) and harbor seal (Phoca vitulina), and five chemical

  4. Risk assessment of bioaccumulation in the food webs of two marine AMOEBE species: common tern and harbor seal

    NARCIS (Netherlands)

    Jongbloed RH; Mensink BJWG; Vethaak AD; Luttik R; ACT; RIKZ

    1995-01-01

    Een model is ontwikkeld voor de berekening van Maximaal Toelaatbare Risiconiveau's (MTR's) in water voor stoffen die accumuleren in voedselketens van zeevogels en zeezoogdieren. Berekeningen zijn uitgevoerd voor twee zoutwater AMOEBE soorten: visdief (Sterna hirundo) en zeehond (Phoca vit

  5. A Rare Complication of Brucellosis: Testicular Abscess

    Directory of Open Access Journals (Sweden)

    Ümit Gul

    2016-01-01

    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.

  6. Breast abscess caused by penicillin resistant Pneumococci

    Directory of Open Access Journals (Sweden)

    Boppe Appalaraju

    2011-01-01

    Full Text Available Breast abscess is mostly caused by Staphylococcus aureus. A 26-year-old immunocompetent lady was admitted with breast abscess. Incision and drainage (I/D was done and Pneumococci were isolated from the drained pus. The patient was earlier treated with Augmentin which was later changed to linezolid after testing for antibiotic susceptibility. This strain showed a high level of resistance to penicillin. It had been noticed that there was a slow increase in the number of penicillin resistant Pneumococci isolated in our hospitals. The increase in penicillin-resistant Pneumococci correlates with the intensive use of beta-lactam antibiotics. Hence, antibiotics should be used judiciously, avoiding their use particularly in mild self-limiting upper respiratory infections. Attention therefore, should focus on monitoring resistance in Pneumococci to prevent mortality and morbidity associated with this organism, which continues to take a heavy toll on children and the elderly.

  7. Endometriosis presenting like a psoas abscess

    International Nuclear Information System (INIS)

    Endometriosis is the presence of ectopic endometrial tissue that responds to hormonal stimulation. Although endometriosis occurs most often in the pelvis, several unusual sites have been reported. We present a case of endometriosis mimicking, a psoas abscess. A 39-year-old lady presented around the right hip, of 5 years duration. Computed tomography (CT) scan showed a multi-loculated mass in the right iliopsoas muscle. On exploration, a hemorrhagic cystic mass was seen pressing on the femoral nerve. The lesion was excised and histological examination of the tissue showed features of endometriosis. The patient was treated by cyclic hormonal suppressive therapy for 3 months. Her pain and flexion deformity of the hip resolved completely. Retroperitoneal endometriosis presenting with deformity and pain in the hip may mimic a psoas abscess. If the possibility of this diagnosis is entertained, inappropriate treatment may be avoided. (author)

  8. Brain abscess caused by Nocardia asiatica

    Science.gov (United States)

    Uneda, Atsuhito; Suzuki, Kenta; Okubo, Shuichi; Hirashita, Koji; Yunoki, Masatoshi; Yoshino, Kimihiro

    2016-01-01

    Background: Nocardia infection of the central nervous system leading to brain abscess is a rare condition but has a high mortality rate. Among the species of Nocardia, only three cases of brain abscess due to Nocardia asiatica infection have been reported. Case Description: A 65-year-old man with a history of autoimmune hemolytic anemia treated with prednisolone presented to our hospital because of occipital headache. Brain magnetic resonance imaging showed bilateral occipital lesions. The patient underwent craniotomy and resection of the left occipital lobe lesion. N. asiatica was identified by 16S rRNA sequencing of the resected specimen. Treatment with trimethoprim/sulfamethoxazole led to a complete resolution of the brain lesion. Conclusion: Because of the different antimicrobial sensitivity patterns among Nocardia species, both appropriate subtyping and susceptibility testing of uncommon species such as N. asiatica are required for the successful treatment of nocardial infections.

  9. Brain Abscess After Soft Tissue Infection

    Directory of Open Access Journals (Sweden)

    Akoz A et al.

    2013-06-01

    Full Text Available The brain abscess, which is a focal intracerebral infection, is one of the serious complications of the head infections. It generally occurs in the immunocompromised patients due to the spreading from another infection focus on the body. It can be seen with the findings such as fever, headache, nausea, vomiting, diplopia, dysarthria and paralysis. Imaging methods are used in the diagnosis. In its treatment, antibiotherapy and surgical methods can be used. Sometimes, as in our case, brain abscess can appear in a case which is thought to be a simple soft tissue infection. We think that especially, at the diagnosis and treatment stage of infections in head and neck region, physicians must be more careful and diligent.

  10. Radiofrequency ablation of a misdiagnosed Brodie's abscess.

    Science.gov (United States)

    Chan, Rs; Abdullah, Bjj; Aik, S; Tok, Ch

    2011-04-01

    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.

  11. Scintigraphic findings in a Brodie's abscess.

    Science.gov (United States)

    Silva, F; Laguna, R; Acevedo, M; Ruíz, C; Orduña, E

    1995-10-01

    A 9-year-old girl had a 6-month history of left hip pain. Radiographs of the left hip showed a metaphyseal osteolytic lesion with sclerotic borders in the femoral neck. Tc-99m MDP bone imaging and a Ga-67 scan showed focal areas of increased activity in the left femoral neck. These areas of increased uptake corresponded to a lytic area on x-rays, which was due to a Brodie's abscess. The combination of Tc-99m MDP bone and Ga-67 imaging has been widely used in the confirmation of bone infection, increasing the accuracy in the diagnosis of osteomyelitis. However, nuclear scintigraphy has not been previously reported in the confirmation of a Brodie's abscess.

  12. Subdural abscess in infant and child

    International Nuclear Information System (INIS)

    Two cases of subdural abscess in infant and child treated with irrigation via burr holes were reported. The first case was a 1.4-year-old boy with right hemiparesis and mental retardation since severe head trauma at 9 months old. The patient with manifested with an acute onset of high fever followed by disturbance of consciousness and convulsive seizures 2.5 months prior to admission to our department. During admission in the other hospital, the diagnosis of septicemia caused by E. coli was made by blood cultures when CT scan demonstrated a huge lentiform low density area over the right hemisphere and contralateral crescent low density area. The low density area on the right side was well circumscribed by high density rim which was enhanced by contrast medium. Under the diagnosis of bilateral subdural abscess secondary to septicemia caused by E. coli, irrigation of the purulent cavity was carried out. The contralateral low density area was found to be chronic subdural effusion. The second case of 3-month-old infant who complained of high fever, neck stiffness, unconsciousness and right hemiconvulsions 8 days prior to admission. CT scan showed bilateral crescent low density areas indicating subdural effusion. Subdural punctures performed via the fontanelle revealed pus in the left subdural space and xanthocromic fluid in the right side. The low density area on CT scan was changed to the lentiform high density area circumscribed smooth high density rim during the course of the patient. The subdural abscess was treated with irrigation via burr holes. In this report, the etiology of the subdural abscess and route of infection in addition to follow up study of CT findings were presented with the literature. (author)

  13. Salmonella typhimurium abscess of the chest wall

    OpenAIRE

    Tonziello, Gilda; Valentinotti, Romina; Arbore, Enrico; Cassetti, Paolo; Luzzati, Roberto

    2013-01-01

    Patient: Male, 73 Final Diagnosis: Salmonella typhimurium abscess of the chest wall Symptoms: — Medication: Ciprofloxacin Clinical Procedure:— Specialty: Infectious Diseases Objective: Unusual clinical course Background: Non-typhoid Salmonella extra-intestinal infections usually develop in infants and in adult patients with pre-existing predisposing conditions. Blood stream infections and urinary tract infections are the most common clinical presentations, but other sites of infection may be ...

  14. Successful Treatment of Multifoci Nocardial Brain Abscesses

    OpenAIRE

    Xu, Qingsheng; ZHAN, Renya; Feng, Yiping; Chen, Jiajia

    2015-01-01

    Abstract Brain nocardiosis is a serious opportunistic infection with high mortality. It exists more common in the immunocompromised hosts than the immunocompetent patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) has been mostly considered as the choice of the medical treatment. Linezolid is also newly found to be effective to avoid the invasive surgery. The authors reported a case of patient with multifoci nocardial brain abscesses who failed with the combination of linezolid and TMP-SMZ alo...

  15. Empirical antimicrobial therapy of acute dentoalveolar abscess

    OpenAIRE

    Matijević Stevo; Lazić Zoran; Kuljić-Kapulica Nada; Nonković Zorka

    2009-01-01

    Background/Aim. The most common cause of acute dental infections are oral streptococci and anaerobe bacteria. Acute dentoalveolar infections are usually treated surgically in combination with antibiotics. Empirical therapy in such infections usually requires the use of penicillin-based antibiotics. The aim of this study was to investigate the clinical efficiency of amoxicillin and cefalexin in the empirical treatment of acute odontogenic abscess and to assess the antimicrobial susceptibility ...

  16. Clinical Practice Guidelines for Cerebral Abscess Treatment

    Directory of Open Access Journals (Sweden)

    Danny Barrueta Reyes

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Cerebral Abscess Treatment. It has been defined as a festering process caused by any germ and placed inside the cerebral parenchyma; this is a diagnostic and therapeutic challenge for surgeons and general doctors since the clinical and radiological manifestations are often imprecise. This document describes its etiological agents, clinical presentation, diagnosis and treatment. It includes assessment guidelines focused on the most important aspects to be accomplished.

  17. Brain Abscess After Soft Tissue Infection

    OpenAIRE

    Akoz A et al.

    2013-01-01

    The brain abscess, which is a focal intracerebral infection, is one of the serious complications of the head infections. It generally occurs in the immunocompromised patients due to the spreading from another infection focus on the body. It can be seen with the findings such as fever, headache, nausea, vomiting, diplopia, dysarthria and paralysis. Imaging methods are used in the diagnosis. In its treatment, antibiotherapy and surgical methods can be used. S...

  18. [Streptococcus intermedius: a rare cause of brain abscess in children].

    Science.gov (United States)

    Jouhadi, Z; Sadiki, H; Hafid, I; Najib, J

    2013-03-01

    Streptococcus intermedius is a member of the Streptococcus anginosus group, also known as the Streptococcus milleri group. Although this is a commensal agent of the mouth and upper airways, it has been recognized as an important pathogen in the formation of abscesses. However, it has rarely been involved in the formation of brain abscess in children. We report 4 pediatric cases of brain abscess caused by S. intermedius. Three boys and 1 girl, all aged over 2 years, were admitted for a febrile meningeal syndrome and seizures, caused by a S. intermedius brain abscess. Diagnosis was obtained by brain imaging combined with culture of cerebrospinal fluid. The outcome was favorable after antibiotic therapy and abscess puncture. S. intermedius should be considered a potential pathogen involved in the development of brain abscess in children.

  19. Systemic lupus erythematosus and splenic abscess

    International Nuclear Information System (INIS)

    Systemic lupus erythematosus is an autoimmune disease in which there is an increase risk of infections by common germ as by opportunistic germs. This fact is explained by the alterations in the humoral and cellular immunity, and phagocytic mononuclear system due to the disease and the immunosuppressive therapy use for its treatment. Multiple infectious processes have been describes in patients with SLE and within them, the splenic abscess, although in few cases. Usually its presence is associated with an underlying disease such as sepsis or peritonitis, with multiple outcomes. Due to its low frequency as well as the unusual presentation, we reported a case of a solitary splenic abscess documented by ultrasound in a teenager with SLE and immunosuppressive treatment, without any underlying infection, who presents with fever, abdominal pain, leucocytosis and elevation of acute phase reactants. He received antibiotic therapy with clindamycin and ceftriaxone and percutaneous drainage of the abscess guided by ultrasound and sent to culture in which grew non-typificable anaerobe germs, with a favorable evolution after 5 year of follow up

  20. [Brodie abscess. Primarily misinterpreted as traumatic lesion].

    Science.gov (United States)

    Nicolajsen, K; Jørgensen, P S; Tørholm, C

    1996-01-01

    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.

  1. Liver Transplant

    Science.gov (United States)

    ... Home > Your Liver > Liver Disease Information > Liver Transplant Liver Transplant Explore this section to learn more about liver ... harmful substances from your blood. What is a liver transplant? A liver transplant is the process of replacing ...

  2. Dynamic computed tomographic scans in experimental brain abscess

    International Nuclear Information System (INIS)

    Dynamic computed tomographic scans were performed in an experimental brain abscess model to establish criteria that could be utilized in abscess staging. The vascular phase of the time-density curves did not differentiate cerebritis and capsule stages. The amount of residual enhancement after the first pass of an intra-arterial contrast bolus differed between major abscess stages, the greater residual enhancement being noted in the capsule stage. (orig.)

  3. Dynamic computed tomographic scans in experimental brain abscess

    Energy Technology Data Exchange (ETDEWEB)

    Enzmann, D.R.; Britt, R.H.; Placone, R.C.

    1984-07-01

    Dynamic computed tomographic scans were performed in an experimental brain abscess model to establish criteria that could be utilized in abscess staging. The vascular phase of the time-density curves did not differentiate cerebritis and capsule stages. The amount of residual enhancement after the first pass of an intra-arterial contrast bolus differed between major abscess stages, the greater residual enhancement being noted in the capsule stage.

  4. Nocardial brain abscess in a patient with pulmonary alveolar proteinosis

    OpenAIRE

    Shirani, Kiana; Poulsen, Asger Nyborg; Hakamifard, Atousa

    2015-01-01

    Brain abscesses caused by Nocardia are rare but have a very high mortality and specific requirements of antibiotic treatment. Nocardial brain abscesses are mainly found in patients with predisposing conditions such as pulmonary alveolar proteinosis (PAP), a disease associated with chronic exposure to silica dust. We present a case of multiple nocardial brain abscesses in a man with PAP probably due to long-term occupational exposure to silica dust. Conclusively, in patients presenting brain a...

  5. Psoas abscess localization by gallium scan in aplastic anemia

    International Nuclear Information System (INIS)

    Gallium 67 scanning is an effective method of detecting inflammatory lesions, especially abscesses. A 10-year-old boy with aplastic anemia and severe leukopenia and granulocytopenia had a psoas abscess diagnosed by gallium scan. The patient died with Candida sepsis 18 days after bone marrow transplantation. At autopsy, a chronic psoas abscess with Candida was found. The gallium scan offers a clinically effective and noninvasive means of evaluating suspected infection in the granulocytopenia patient. (U.S.)

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

    Science.gov (United States)

    Bagatur, A Erdem; Zorer, Gazi

    2003-03-01

    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.

  7. Brodie's abscess of the femoral neck simulating osteoid osteoma.

    Science.gov (United States)

    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

    Subacute osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Though reported in the metaphyseal region of the femur, Brodie's abscess is rarer in the femoral neck. The authors present a case of Brodie's abscess in the femoral neck, which clinico-radiologically simulated an osteoid osteoma. Retrospectively, the presence of a cortical sinus tract should have aroused suspicion.

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

    Science.gov (United States)

    Izumi, Masashi; Ikeuchi, Masahiko; Tani, Toshikazu

    2012-08-01

    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.

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

    Science.gov (United States)

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

    2004-09-01

    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.

  10. Abscess disease, caseous lymphadenitis, and pulmonary adenomatosis in imported sheep

    DEFF Research Database (Denmark)

    Møller, Kristian; Agerholm, J.S.; Ahrens, Peter;

    2000-01-01

    The occurrence of abscess disease, caseous lymphadenitis, and pulmonary adenomatosis in sheep in Denmark is reported for the first time. Subcutaneous abscesses were observed in imported 4- to 5-month-old lambs of the Lacaune breed 10 days after arrival in Denmark. Abscesses were mostly located...... in the head, neck and shoulder regions close to the regional lymph nodes. Bacteriological examinations revealed growth of Staphylococcus aureus ssp. anaerobius in all animals with subcutaneously located abscesses containing a viscous white-yellow odourless mass. In addition, Corynebacterium pseudotuberculosis...

  11. ROLE OF BACTERIA IN THE TOOTH ABSCESS: A MINI REVIEW

    OpenAIRE

    Biswajit Batabyal; Gautam kr. Kundu

    2013-01-01

    A tooth abscess or root abscess is pus enclosed in the tissues of the jaw bone at the apex of an infected tooth's root(s). Usually the abscess originates from a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by untreated tooth decay, cracked teeth or extensive periodontal disease. A failed root canal treatment may also create a similar abscess. Recently developed molecular methods have made it possible to characterise mixed micro flora ...

  12. Focal inflammatory diseases of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Oto, Aytekin; Akhan, Okan; Oezmen, Mustafa

    1999-10-01

    Inflammatory lesions constitute an important subgroup of focal liver lesions. They may mimic primary or metastatic neoplastic lesions and their differentiation from neoplasia is clinically very important since management of the patient significantly changes. Radiologists should have an important role in both the diagnosis and therapy of these lesions by performing percutaneous aspirations and drainages. In this review we discussed the radiological findings of pyogenic abscesses, amebic abscesses, candidiasis, tuberculosis, hydatic cysts, fascioliasis, ascariasis, schistosomiasis, and sarcoidosis with a special emphasis on US, CT and MR characteristics.

  13. Focal inflammatory diseases of the liver

    International Nuclear Information System (INIS)

    Inflammatory lesions constitute an important subgroup of focal liver lesions. They may mimic primary or metastatic neoplastic lesions and their differentiation from neoplasia is clinically very important since management of the patient significantly changes. Radiologists should have an important role in both the diagnosis and therapy of these lesions by performing percutaneous aspirations and drainages. In this review we discussed the radiological findings of pyogenic abscesses, amebic abscesses, candidiasis, tuberculosis, hydatic cysts, fascioliasis, ascariasis, schistosomiasis, and sarcoidosis with a special emphasis on US, CT and MR characteristics

  14. Isolation of the etiological agent of primary amoebic meningoencephalitis from artificially heated waters

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, A.R.; Tyndall, R.L.; Coutant, C.C.; Willaert, E.

    1977-12-01

    To determine whether artificial heating of water by power plant discharges facilitates proliferation of the pathogenic free-living amoebae that cause primary amoebic meningoencephalitis, water samples (250 ml) were taken from discharges within 3,000 feet (ca. 914.4 m) of power plants and were processed for amoeba culture. Pathogenic Naegleria fowleri grew out of water samples from two of five lakes and rivers in Florida and from one of eight man-made lakes in Texas. Pathogenic N. fowleri did not grow from water samples taken from cooling towers and control lakes, the latter of which had no associated power plants. The identification of N. fowleri was confirmed by pathogenicity in mice and by indirect immunofluorescence analyses, by using a specific antiserum.

  15. Mutations in Novel Lipopolysaccharide Biogenesis Genes Confer Resistance to Amoebal Grazing in Synechococcus elongatus.

    Science.gov (United States)

    Simkovsky, Ryan; Effner, Emily E; Iglesias-Sánchez, Maria José; Golden, Susan S

    2016-05-01

    In natural and artificial aquatic environments, population structures and dynamics of photosynthetic microbes are heavily influenced by the grazing activity of protistan predators. Understanding the molecular factors that affect predation is critical for controlling toxic cyanobacterial blooms and maintaining cyanobacterial biomass production ponds for generating biofuels and other bioproducts. We previously demonstrated that impairment of the synthesis or transport of the O-antigen component of lipopolysaccharide (LPS) enables resistance to amoebal grazing in the model predator-prey system consisting of the heterolobosean amoeba HGG1 and the cyanobacteriumSynechococcus elongatusPCC 7942 (R. S. Simkovsky et al., Proc Natl Acad Sci U S A 109:16678-16683, 2012,http://dx.doi.org/10.1073/pnas.1214904109). In this study, we used this model system to identify additional gene products involved in the synthesis of O antigen, the ligation of O antigen to the lipid A-core conjugated molecule (including a novel ligase gene), the generation of GDP-fucose, and the incorporation of sugars into the lipid A core oligosaccharide ofS. elongatus Knockout of any of these genes enables resistance to HGG1, and of these, only disruption of the genes involved in synthesis or incorporation of GDP-fucose into the lipid A-core molecule impairs growth. Because these LPS synthesis genes are well conserved across the diverse range of cyanobacteria, they enable a broader understanding of the structure and synthesis of cyanobacterial LPS and represent mutational targets for generating resistance to amoebal grazers in novel biomass production strains. PMID:26921432

  16. Differentiation of pyogenic hepatic abscesses from malignant mimickers using multislice-based texture acquired from contrast-enhanced computed tomography

    Institute of Scientific and Technical Information of China (English)

    Shi-Teng Suo; Zhi-Guo Zhuang; Meng-Qiu Cao; Li-Jun Qian; Xin Wang; Run-Lin Gao; Yu Fan; Jian-Rong Xu

    2016-01-01

    BACKGROUND: Pyogenic hepatic abscess may mimic prima-ry or secondary carcinoma of the liver on contrast-enhanced computed tomography (CECT). The present study was to ex-plore the usefulness of the analysis of multislice-based texture acquired from CECT in the differentiation between pyogenic hepatic abscesses and malignant mimickers. METHODS: This retrospective study included 25 abscesses in 20 patients and 33 tumors in 26 subjects who underwent CECT. To make comparison, we also enrolled 19 patients with hepatic single simple cyst. The images from CECT were ana-lyzed using a Laplacian of Gaussian band-pass iflter (5 iflter levels with sigma weighting ranging from 1.0 to 2.5). We also quantiifed the uniformity, entropy, kurtosis and skewness of the multislice-based texture at different sigma weightings. Sta-tistical signiifcance for these parameters was tested with one-way ANOVA followed by Tukey honestly signiifcant difference (HSD) test. Diagnostic performance was evaluated using the receiver operating characteristic (ROC) curve analysis. RESULTS: There were signiifcant differences in entropy and uniformity at all sigma weightings (P CONCLUSION: Multislice-based texture analysis may be use-ful for differentiating pyogenic hepatic abscesses from malig-nant mimickers.

  17. Investigation of Legionella Contamination in Bath Water Samples by Culture, Amoebic Co-Culture, and Real-Time Quantitative PCR Methods

    Directory of Open Access Journals (Sweden)

    Akiko Edagawa

    2015-10-01

    Full Text Available We investigated Legionella contamination in bath water samples, collected from 68 bathing facilities in Japan, by culture, culture with amoebic co-culture, real-time quantitative PCR (qPCR, and real-time qPCR with amoebic co-culture. Using the conventional culture method, Legionella pneumophila was detected in 11 samples (11/68, 16.2%. Contrary to our expectation, the culture method with the amoebic co-culture technique did not increase the detection rate of Legionella (4/68, 5.9%. In contrast, a combination of the amoebic co-culture technique followed by qPCR successfully increased the detection rate (57/68, 83.8% compared with real-time qPCR alone (46/68, 67.6%. Using real-time qPCR after culture with amoebic co-culture, more than 10-fold higher bacterial numbers were observed in 30 samples (30/68, 44.1% compared with the same samples without co-culture. On the other hand, higher bacterial numbers were not observed after propagation by amoebae in 32 samples (32/68, 47.1%. Legionella was not detected in the remaining six samples (6/68, 8.8%, irrespective of the method. These results suggest that application of the amoebic co-culture technique prior to real-time qPCR may be useful for the sensitive detection of Legionella from bath water samples. Furthermore, a combination of amoebic co-culture and real-time qPCR might be useful to detect viable and virulent Legionella because their ability to invade and multiply within free-living amoebae is considered to correlate with their pathogenicity for humans. This is the first report evaluating the efficacy of the amoebic co-culture technique for detecting Legionella in bath water samples.

  18. Investigation of Legionella Contamination in Bath Water Samples by Culture, Amoebic Co-Culture, and Real-Time Quantitative PCR Methods

    Science.gov (United States)

    Edagawa, Akiko; Kimura, Akio; Kawabuchi-Kurata, Takako; Adachi, Shinichi; Furuhata, Katsunori; Miyamoto, Hiroshi

    2015-01-01

    We investigated Legionella contamination in bath water samples, collected from 68 bathing facilities in Japan, by culture, culture with amoebic co-culture, real-time quantitative PCR (qPCR), and real-time qPCR with amoebic co-culture. Using the conventional culture method, Legionella pneumophila was detected in 11 samples (11/68, 16.2%). Contrary to our expectation, the culture method with the amoebic co-culture technique did not increase the detection rate of Legionella (4/68, 5.9%). In contrast, a combination of the amoebic co-culture technique followed by qPCR successfully increased the detection rate (57/68, 83.8%) compared with real-time qPCR alone (46/68, 67.6%). Using real-time qPCR after culture with amoebic co-culture, more than 10-fold higher bacterial numbers were observed in 30 samples (30/68, 44.1%) compared with the same samples without co-culture. On the other hand, higher bacterial numbers were not observed after propagation by amoebae in 32 samples (32/68, 47.1%). Legionella was not detected in the remaining six samples (6/68, 8.8%), irrespective of the method. These results suggest that application of the amoebic co-culture technique prior to real-time qPCR may be useful for the sensitive detection of Legionella from bath water samples. Furthermore, a combination of amoebic co-culture and real-time qPCR might be useful to detect viable and virulent Legionella because their ability to invade and multiply within free-living amoebae is considered to correlate with their pathogenicity for humans. This is the first report evaluating the efficacy of the amoebic co-culture technique for detecting Legionella in bath water samples. PMID:26492259

  19. Tuberculous Orbital Abscess Associated with Thyroid Tuberculosis

    Directory of Open Access Journals (Sweden)

    Kumudini Sharma

    2011-01-01

    Full Text Available Purpose: To report an unusual presentation of tuberculosis. Case Report: A six-year old boy presented with left upper lid swelling of 15 days′ duration and an asymptomatic midline neck mass from 2 months ago. Imaging studies, and microbiologic tests which demonstrated acid-fast bacilli in the fine needle aspirate of the thyroid mass, both confirmed a diagnosis of cold tuberculous thyroid abscess with presumed hematogenous spread to the orbit. The patient demonstrated marked improvement of both lesions with antitubercular drugs. Conclusion: This case illustrates a very rare association of orbital and thyroid tuberculosis.

  20. Clostridium septicum brain abscesses in a premature neonate.

    Science.gov (United States)

    Sadarangani, Sapna P; Batdorf, Rachel; Buchhalter, Lillian C; Mrelashvili, Anna; Banerjee, Ritu; Henry, Nancy K; Huskins, W Charles; Boyce, Thomas G

    2014-05-01

    Brain abscesses in neonates are typically caused by Gram-negative organisms. There are no previously described cases caused by Clostridium septicum. We present a case of a premature male infant who developed recurrent episodes of suspected necrotizing enterocolitis followed by brain abscesses, cerebritis and ventriculitis caused by C. septicum. PMID:24220230

  1. Aeromonas hydrophila septicaemia and muscle abscesses associated with immunosuppression.

    OpenAIRE

    Slevin, N J; Oppenheim, B A; Deakin, D. P.

    1988-01-01

    We report a case of septicaemia and muscle abscesses due to Aeromonas hydrophila. The patient was immunosuppressed due to Hodgkin's disease and treatment with cytotoxic chemotherapy. The abscesses resolved after prolonged antibiotic therapy. Organisms that were once considered rarely pathogenic are emerging as increasingly important in causing potentially lethal infections in immunosuppressed patients.

  2. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

    Directory of Open Access Journals (Sweden)

    Melisa Lim Seer Yee

    2014-01-01

    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.

  3. Ultrasound-guided drainage of deep pelvic abscesses

    DEFF Research Database (Denmark)

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn

    2011-01-01

    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 was p...

  4. Cerebral abscesses among Danish patients with hereditary haemorrhagic telangiectasia

    DEFF Research Database (Denmark)

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

    2013-01-01

    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....

  5. Brain Abscess after Transanal Hemorrhoidal Dearterialization: A Case Report

    Directory of Open Access Journals (Sweden)

    A.E.M. Berkel

    2013-05-01

    Full Text Available A relatively new therapy in the treatment of hemorrhoids is transanal hemorrhoidal dearterialization (THD. We report a case of brain abscess caused by Streptococcus milleri following THD. Although a brain abscess after drainage of a perianal abscess has been described in the literature, no report exists of a brain abscess following treatment of hemorrhoids. A healthy 51-year-old man with hemorrhoids underwent THD. Two weeks later he presented with a headache, bradyphrenia, flattened behavior and a left hemiplegia. No perianal complaint and/or perianal abscess was present. A contrast CT scan of the cerebrum showed a right temporoparieto-occipital abscess, with edema and compression of the surrounding tissue and lateral ventricles. MRI showed an abscess with leakage in the right lateral ventricle. Treatment with dexamethasone and intravenous antibiotics was started. Because of progression of symptoms, 3 weeks later ventriculoscopy was performed and the abscess was drained. Culture of the punctuate showed S. milleri. Because of developing hydrocephalus 3 days after ventriculoscopy, first an external ventricle drain and later a ventriculoperitoneal drain was placed. Hereafter the hemiplegia and cognitive disorders improved. This case report describes a severe complication following treatment of hemorrhoids with THD which until now, to our knowledge, has never been described in the literature.

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

    Science.gov (United States)

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

    2008-03-01

    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.

  7. Respiratory failure caused by intrathoracic amoebiasis

    Directory of Open Access Journals (Sweden)

    Toshinobu Yokoyama

    2010-03-01

    Full Text Available Toshinobu Yokoyama1, Masashi Hirokawa1, Yutaka Imamura2, Hisamichi Aizawa11Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University, Japan; 2Department of Hematology, St. Mary’s Hospital, Kurume, JapanAbstract: A 41-year-old male was admitted to the hospital with symptoms of diarrhea, fever and rapidly progressive respiratory distress. A chest radiograph and computed tomography (CT of the chest and the abdomen showed a large amount of right pleural effusion and a large liver abscess. The patient was thus diagnosed to have amoebic colitis, amoebic liver abscess and amoebic empyema complicated with an HIV infection. The patient demonstrated agranulocytosis caused by the administration of trimethoprim-sulfamethoxazole. However, the administration of granulocyte colony-stimulating factor made it possible for the patient to successfully recover from agranulocytosis, and he thereafter demonstrated a good clinical course.Keywords: amebiasis, amoebic empyema, HIV, agranulocytosis, trimethoprim-sulfamethoxazole

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

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    Talia Becker

    2012-01-01

    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.

  9. Medical image of the week: pancreatic abscess

    Directory of Open Access Journals (Sweden)

    Lurachi-Monjagatta C

    2014-02-01

    Full Text Available No abstract available. Article truncated after 150 words. A 55 year old woman, with a history of alcohol abuse and necrotizing pancreatitis, was readmitted for worsening abdominal pain and acute respiratory failure. A CT scan of the abdomen and pelvis showed an atrophic pancreas and multiple fluid collections. Along the inferior surface of the pancreas, there is a fluid collection with an evolving loculated rim, which is asymmetric, the larger component measure 2.9 cm x 4.7 cm (Figure 1, large arrow. Anterior to the body of the pancreas, there is an additional 2.2 cm x 2.4 cm with evolving loculated rim (Figure 1, short arrow, both compatible with a pseudocyst. Ultrasound of the abdomen showed a distended pancreatic duct that communicates to the smaller fluid collection (Figure 2. Coronal CT of the abdomen and pelvis showed a 12.4 cm pelvic abscess (Figure 3. CT guided drainage of the pelvic abscess was performed with positive culture of the fluid …

  10. [A case of cerebral abscess due to methicillin-resistant Staphylococcus aureus which is treated with linezolid + rifampin combination].

    Science.gov (United States)

    Sipahi, Oğuz Reşat; Cağıran, Inanç; Yurtseven, Taşkın; Işıkgöz Taşbakan, Meltem; Arda, Bilgin; Tünger, Alper; Ulusoy, Sercan

    2010-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a rare cause of cerebral abscesses, however it is a relatively more common etiologic agent in post-neurosurgical abscesses and the main antibacterial therapy option is vancomycin. In this report, a case of brain abscess due to MRSA which did not respond neither to moxifloxacin + vancomycin nor vancomycin + rifampin combination therapies, and merely treated by linezolid + rifampin combination, has been presented. Fifty-one years old female patient who was operated 40 days ago for subarachnoid bleeding and aneurysm in middle cerebral artery bifurcation, was hospitalized due to purulent leakage from the operation area. She did not have fever and her physical examination, including the neurologic system, was normal. Computerized tomography revealed an approximately 1 cm lesion compatible with subdural empyema and cerebral abscess in the right frontoparietal area in supratentorial sections. The patient was operated for wound revision and moxifloxacin was initiated. Since the operation materials revealed MRSA growth, vancomycin (4 x 500 mg, IV) was added to the treatment. The isolate was identified by conventional methods, and antibiotic susceptibility test performed by disk diffusion method showed that it was susceptible to levofloxacin, linezolid, rifampin, vancomycin and teicoplanin. Since no clinical response was obtained in two weeks, moxifloxacin was switched to rifampin (300 mg 1 x 2). On the 10th day of vancomycin + rifampin therapy, radiological findings showed development of cerebritis and therefore vancomycin was changed with linezolid (2 x 600 mg, IV). The control CT of the patient revealed regression of the brain lesion and linezolid + rifampin treatment continued for six weeks. The patient did not develop any hematological, liver or renal toxicity during the therapy and the radiological findings regressed. No relapse were detected in the one year follow-up period. This case suggested that linezolid might

  11. Varicella Infection Complicated by Group A Beta-Hemolytic Streptococcal Retropharyngeal Abscess.

    Science.gov (United States)

    Clark, Christine M; Huntley, Colin; Carr, Michele M

    2016-01-01

    An unimmunized 19-month-old child presented with a retropharyngeal abscess and coincident varicella infection. The abscess resolved with operative drainage. This is the first published report of this connection, although varicella is known to be associated with abscesses in general. Practitioners should be aware that cervical abscesses may complicate varicella infections. PMID:27651967

  12. [Familial brain abscess as a complication of hereditary hemorrhagic telangiectasia].

    Science.gov (United States)

    Szöts, M; Szapáry, L; Nagy, F; Vetö, F

    2001-10-21

    The hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) is an inherited autosomal dominant disease with angiodysplasia of the skin, mucosa, parenchymal organs, and it can affect the central nervous system. In 40% of the cases neurological complications, most frequently intracerebral abscesses occur. In this study, the case history of a patient with central nervous system manifestation of hereditary hemorrhagic telangiectasia showing familiar aggregation of brain abscess will be presented. A young male patient was admitted to Neurological Department because of his first epileptic seizure and progressive right hemispheric symptoms. His examinations showed frontal abscess, which was surgically removed. The frequent nose-bleeding of the patient and recurrent brain abscess in his brother's history provided the possibility of hereditary hemorrhagic telangiectasia. The background of brain abscess were multiple pulmonary arteriovenous malformation, which were embolized by repeated angiography. Familiar brain abscess is very rare. However, in the case of brain abscess especially with familiarity diagnosis of the Rendu-Osler-Weber disease should be considered. PMID:11760648

  13. Oral microbiota species in acute apical endodontic abscesses

    Science.gov (United States)

    George, Noelle; Flamiatos, Erin; Kawasaki, Kellie; Kim, Namgu; Carriere, Charles; Phan, Brian; Joseph, Raphael; Strauss, Shay; Kohli, Richie; Choi, Dongseok; Craig Baumgartner, J.; Sedgley, Christine; Maier, Tom; Machida, Curtis A.

    2016-01-01

    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 were not commonly

  14. Pancreatic abscess following scrub typhus associated with multiorgan failure

    Institute of Scientific and Technical Information of China (English)

    Sun Young Yi; Jung Hyun Tae

    2007-01-01

    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.

  15. Brain abscess caused by Citrobacter koseri infection in an adult.

    Science.gov (United States)

    Liu, Heng-Wei; Chang, Chih-Ju; Hsieh, Cheng-Ta

    2015-04-01

    Citrobacter koseri is a gram-negative bacillus that causes mostly meningitis and brain abscesses in neonates and infants. However, brain abscess caused by Citrobacter koseri infection in an adult is extremely rare, and only 2 cases have been described. Here, we reported a 73-year-old male presenting with a 3-week headache. A history of diabetes mellitus was noted. The images revealed a brain abscess in the left frontal lobe and pus culture confirmed the growth of Citrobacter koseri. The clinical symptoms improved completely postoperatively.

  16. Renal abscess with Morganella morganii complicating leukemoid reaction.

    Science.gov (United States)

    Osanai, Shinobu; Nakata, Hiroaki; Ishida, Kensuke; Hiramatsu, Mie; Toyoshima, Eri; Ogasa, Toshiyuki; Ohsaki, Yoshinobu; Kikuchi, Kenjiro

    2008-01-01

    We report a case of leukemoid reaction (LR) complicating renal abscess caused by Morganella morganii infection in an 80-year-old man. On administration, laboratory tests revealed white blood cell count of 76160 /microL and C reactive protein 3.09 mg/dL. Although chronic myeloid leukemia was suspected, bcr/abl fusion transcript was not observed. Contrast enhanced computer tomography imaging of the abdomen showed abscess in the right kidney. M. morganii was detected repeatedly in material of liquid from the abscess and arterial blood culture. To our knowledge, this is the first case of M. morganii infection complicating LR.

  17. [Primary psoas abscess in a young healthy male

    DEFF Research Database (Denmark)

    Nassehi, D.; Galbo, H.; Skovsgaard, F.

    2008-01-01

    A young male saw his general practitioner because of lower back pain, limpness, nightly sweating, subfebrilia, and weight loss. Further diagnostics showed that he had a primary psoas abscess. Psoas abscesses are categorized as primary and secondary. Primary psoas abscess is a rare disease in Europe...... and North America. It is primarily seen in young men, and the classical symptom-triad is: fever, back pain, and limpness. The golden standard diagnostic tool is computed tomography, and treatment involves appropriate antibiotics, which can be combined with percutaneous drainage Udgivelsesdato: 2008/11/24...

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

    Science.gov (United States)

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

    2008-04-01

    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.

  19. Characterization of Naegleria fowleri strains isolated from human cases of primary amoebic meningoencephalitis in Mexico.

    Science.gov (United States)

    Cervantes-Sandoval, Isaac; de Serrano-Luna, José Jesús; Tapia-Malagón, José Luis; Pacheco-Yépez, Judith; Silva-Olivares, Angélica; Galindo-Gómez, Silvia; Tsutsumi, Victor; Shibayama, Mineko

    2007-01-01

    The protozoon Naegleria fowleri (N. fowleri) is a free-living amoeba that produces primary amoebic meningoencephalitis (PAM), which is an acute and frequently fatal infection of the central nervous system. We characterized the strains of N. fowleri isolated from the cerebrospinal fluid (CSF) of two cases presented in northwestern Mexico. The strains were isolated and cultured in 2% bactocasitone medium. Enflagellation assays, ultrastructural analysis, protein and protease electrophoresis patterns, and PCR were performed as confirmatory tests. Virulence tests were done using in Balb/c mice. Light microscopy analysis of brain tissue showed amoebae with abundant inflammatory reaction and extensive necrotic and hemorrhagic areas. The enflagellation assay was positive and the electron microscopy showed trophozoites with morphologic features typical of the genus. Protein and protease profiles of the isolated strains were identical to the reference strain. Finally, a 1500-bp PCR product was found in all three strains. Based on all the analyses performed, we concluded that the etiologic agent of both PAM cases was N. fowleri. The need for better epidemiological information and educational programs about basic clinical and pathological aspects of free-living amoebae provided by the health authorities are emphasized.

  20. Lipid composition of multilamellar bodies secreted by Dictyostelium discoideum reveals their amoebal origin.

    Science.gov (United States)

    Paquet, Valérie E; Lessire, René; Domergue, Frédéric; Fouillen, Laetitia; Filion, Geneviève; Sedighi, Ahmadreza; Charette, Steve J

    2013-10-01

    When they are fed with bacteria, Dictyostelium discoideum amoebae produce and secrete multilamellar bodies (MLBs), which are composed of membranous material. It has been proposed that MLBs are a waste disposal system that allows D. discoideum to eliminate undigested bacterial remains. However, the real function of MLBs remains unknown. Determination of the biochemical composition of MLBs, especially lipids, represents a way to gain information about the role of these structures. To allow these analyses, a protocol involving various centrifugation procedures has been developed to purify secreted MLBs from amoeba-bacterium cocultures. The purity of the MLB preparation was confirmed by transmission electron microscopy and by immunofluorescence using H36, an antibody that binds to MLBs. The lipid and fatty acid compositions of pure MLBs were then analyzed by high-performance thin-layer chromatography (HPTLC) and gas chromatography (GC), respectively, and compared to those of amoebae as well as bacteria used as a food source. While the bacteria were devoid of phosphatidylcholine (PC) and phosphatidylinositol (PI), these two polar lipid species were major classes of lipids in MLBs and amoebae. Similarly, the fatty acid composition of MLBs and amoebae was characterized by the presence of polyunsaturated fatty acids, while cyclic fatty acids were found only in bacteria. These results strongly suggest that the lipids constituting the MLBs originate from the amoebal metabolism rather than from undigested bacterial membranes. This opens the possibility that MLBs, instead of being a waste disposal system, have unsuspected roles in D. discoideum physiology.

  1. Successful Treatment of Multifoci Nocardial Brain Abscesses

    Science.gov (United States)

    Xu, Qingsheng; Zhan, Renya; Feng, Yiping; Chen, Jiajia

    2015-01-01

    Abstract Brain nocardiosis is a serious opportunistic infection with high mortality. It exists more common in the immunocompromised hosts than the immunocompetent patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) has been mostly considered as the choice of the medical treatment. Linezolid is also newly found to be effective to avoid the invasive surgery. The authors reported a case of patient with multifoci nocardial brain abscesses who failed with the combination of linezolid and TMP-SMZ alone but recovered with the surgery intervention and sequential antibiotics for 2 years. The patient lived a high quality life without recurrence and complications during the 30 months follow-up. Through the literature review, we recommend earlier stereotactic aspiration for diagnosis, combination with surgery intervention and prolonged anti-infection therapy would improve the prognosis. PMID:25984673

  2. CT evaluation of primary epiphyseal bone abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Azouz, E.M. (Dept. of Radiology, McGill Univ., Montreal Children' s Hospital, PQ (Canada)); Greenspan, A. (Dept. of Radiology, California Univ., Davis School of Medicine, Sacramento, CA (United States)); Marton, D. (Dept. of Radiology, Montreal Univ., Hopital Ste Justine, PQ (Canada))

    1993-01-01

    We reviewed the clinical, radiographic, and computed tomographic (CT) findings in eight children with a histologically proven diagnosis of epiphyseal or apophyseal osteomyelitis. In all cases the femur was involved: in five the osteomyelitis was localized in the femoral condyle, in two it was in the greater trochanter, and in one it was in the femoral head epiphysis. In four of the six cases of epiphyseal involvement there was associated joint effusion or septic arthritis. CT examination may demonstrate a serpentine tract, a sequestrum, cortical destruction or adjacent soft tissue swelling and can differentiate osteomyelitis from other epiphyseal lucent lesions, particularly chondroblastoma and osteoid osteoma. Early diagnosis helps avoid delays in initiating antibiotic or surgical treatment caused by the unusual (epiphyseal or apophyseal) location of the bone abscess. (orig./GD)

  3. MDCT imaging of post interventional liver: a pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Tortora, Giovanni [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Scaglione, Mariano [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Lassandro, Francesco [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Guidi, Guido [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy); Grassi, Roberto [Institute of Radiology, Department ' Magrassi-Lanzara' , Second University of Naples, Naples 80138 (Italy); Romano, Luigia [Department of Diagnostic Imaging, Section of General and Emergency Radiology, A.Cardarelli Hospital, Viale Cardarelli, 9, 80131 Naples (Italy)

    2005-03-01

    In this pictorial essay, we consider the post operative MDCT findings after liver resection, transplantation, surgical managed major trauma and radiofrequency ablation of focal lesions. Common complications such as fluid collections, hemorrhage, biloma, vascular disease, hematoma, abscesses will be also considered.

  4. Computerized tomography and angiography - competing processes in liver diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Wunschik, F.; Luetgemeier, J.; Hoerst, M.

    1981-02-01

    In the diagnostics of liver diseases, computerized tomography is a valuable method. It is particularly superior to angiography in detecting cysts, parasitosis and abscesses. Angiography however is better for known solid tumours regarding differencial diagnosis. Both methods supplement each other in the tumour and bile ducts diagnostics.

  5. MDCT imaging of post interventional liver: a pictorial essay

    International Nuclear Information System (INIS)

    In this pictorial essay, we consider the post operative MDCT findings after liver resection, transplantation, surgical managed major trauma and radiofrequency ablation of focal lesions. Common complications such as fluid collections, hemorrhage, biloma, vascular disease, hematoma, abscesses will be also considered

  6. [Unusual location of a brain abscess due to Listeria monocytogenes].

    Science.gov (United States)

    Coste, J-F; Duval, V; Nguyen, Y; Guillard, T; Brasme, L; David, C; Strady, C; Lecuit, M; de Champs, C

    2012-10-01

    Here we report a case of sustentorial brain abscess due to Listeria monocytogenes. Blood culture and procalcitonine blood measurement were negative. L. monocytogenes was isolated from CSF after inoculation in Castañeda medium. PMID:21835558

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

    Directory of Open Access Journals (Sweden)

    Serhan PİŞKİNPAŞA

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Eunhee Kim

    2011-08-01

    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.

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

    Science.gov (United States)

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

    2012-01-01

    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.

  10. The experience of stereotactic aspiration in treatment of brain abscesses

    OpenAIRE

    Zinkevych, Iaroslav; Kostiuk, Kostyantyn; Glavatskyi, Oleksandr; Bolіukh, Andrii; Malysheva, Tatyana; Tkachik, Irina; Tsymbaliuk, Vitaliy

    2015-01-01

    Purpose. To estimate efficiency of stereotactic aspiration of intracerebral abscesses in deep and functionally eloquent brain areas.Methods. 12 patients with brain abscesses who underwent stereotactic aspiration were included into the study. Stereotactic interventions were performed using CRW Radionics Stereotactic System with StereoFusion, StereoPlan (Radionics) and FraimLink (Medtronic) software for target definition. Postoperative follow-up was from 1 to 36 months, in average (14±3.6) mont...

  11. Solitary supratentorial Listeria monocytogenes brain abscess in an immunocompromised patient

    Science.gov (United States)

    Onofrio, Anthony R.; Martinez, Lauren C.; Opatowsky, Michael J.; Spak, Cedric W.; Layton, Kennith F.

    2015-01-01

    We describe an 81-year-old man receiving azacitidine monotherapy for myelodysplastic syndrome who was improving from Listeria monocytogenes bacteremia after receiving antibiotic therapy during an earlier hospital admission. Shortly after discharge he developed new-onset seizure activity, with brain imaging on subsequent admissions demonstrating a posterior right frontal lobe mass. Specimen cultures after resection of the mass revealed this to be a cerebral abscess related to L. monocytogenes. Brain abscesses related to this organism are rare. PMID:26130881

  12. Management of Pleural Effusion, Empyema, and Lung Abscess

    OpenAIRE

    Yu, Hyeon

    2011-01-01

    Pleural effusion is an accumulation of fluid in the pleural space that is classified as transudate or exudate according to its composition and underlying pathophysiology. Empyema is defined by purulent fluid collection in the pleural space, which is most commonly caused by pneumonia. A lung abscess, on the other hand, is a parenchymal necrosis with confined cavitation that results from a pulmonary infection. Pleural effusion, empyema, and lung abscess are commonly encountered clinical problem...

  13. CONCOMITANT CUTANEOUS METASTATIC TUBERCULOUS ABSCESSES AND MULTIFOCAL SKELETAL TUBERCULOSIS

    OpenAIRE

    Sezgin Betul; Atilganoglu Ulviye; Yigit Ozgul; Ergun Selma; Cambaz Nevin; Demirkesen Cuyan

    2008-01-01

    Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteo...

  14. A novel vaccine targeting Fusobacterium nucleatum against abscesses and halitosis

    OpenAIRE

    Liu, Pei-Feng; Haake, Susan Kinder; Gallo, Richard L; Huang, Chun-Ming

    2009-01-01

    An abscess in a gum pocket, resulting from bacterial infection, is a common source of chronic halitosis. Although antibiotics are generally prescribed for abscesses, they require multiple treatments with risks of creating resistant bacterial strains. Here we develop a novel vaccine using ultraviolet-inactivated Fusobacterium nucleatum (F. nucleatum), a representative oral bacterium for halitosis. A gum pocket model, established by continuous inoculation of F. nucleatum, was employed to valida...

  15. Gram Staining for the Treatment of Peritonsillar Abscess

    OpenAIRE

    Yukinori Takenaka; Kazuya Takeda; Tadashi Yoshii; Michiko Hashimoto; Hidenori Inohara

    2012-01-01

    Objective. To examine whether Gram staining can influence the choice of antibiotic for the treatment of peritonsillar abscess. Methods. Between 2005 and 2009, a total of 57 cases of peritonsillar abscess were analyzed with regard to cultured bacteria and Gram staining. Results. Only aerobes were cultured in 16% of cases, and only anaerobes were cultured in 51% of cases. Mixed growth of aerobes and anaerobes was observed in 21% of cases. The cultured bacteria were mainly aerobic Streptococcus,...

  16. Reversible fatty infiltration of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Bostel, F.; Hauger, W.

    1987-11-01

    Case studies show that acute pancreatitis occurring independently or combined with a preceding abuse of alcohol may be the cause of fatty infiltration of the liver. These fat areas can evolve in a very short time and provoke in the case of focal incidence diagnostic problems of differentiation against abscesses of metastases. Due to this fact and because of the rapid reversibility of the fatty infiltration under therapy, the safest method to clarify the situation consists of short-term CT controls.

  17. Conservative management of post-appendicectomy intra-abdominal abscesses

    Directory of Open Access Journals (Sweden)

    Dhaou Mahdi

    2010-10-01

    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.

  18. Deep neck abscess. A 42-case retrospective review

    International Nuclear Information System (INIS)

    We reviewed 42 cases of deep neck abscess drained surgically or treated conservatively between February 2001 and August 2008, based on age, gender, primary focus, main symptom, abscess location, systemic disease, pathogenic bacteria, hospital treatment, hospitalization length, complications and long-term hospitalization. Of the 42, 26 were men and 16 women aged 14 to 80 (central age: 54.5 years). Abscess was caused most by tonsil inflammation (38.1%). Main symptom were sore throat (54.8%) and neck swelling (35.7%). Abscesses were found in the supra- and infrahyoid region in 30 cases and extended to the mediastinum in 2. Of the 42, 14 (33.3%) had hypertension and 11 (26.2%) diabetes mellitus (DM). Inflammation was due to aerobic bacteria (mainly Streptococcus milleri) in 23 cases (54.8%) and to anaerobic bacteria (mainly Peptostreptococcus) in 11 cases (26.2%). Flexible fiberscopic examination was important in evaluating pharyngeal and laryngeal mucosal disorders and enhanced computed tomography was useful in both diagnosis and postoperative observation. Of the 42, 38 required surgical drainage and 4 were cured using needle aspiration and antibiotics. Of the 38 undergoing surgery-tracheostomy was required in 22. Hospitalization for those with tracheostomy and DM was longer than in those without these factors. Complications included 2 cases each of, mediastinal abscess, sepsis, disseminated intravascular coagulation (DIC), acute renal failure, severe pneumonia, upper digestive tract bleeding and swallowing disorder. Early surgical drainage and intravenous antibiotic administration are thus essential for treating deep neck abscesses. (author)

  19. Brain abscess associated with ethmoidal sinus osteoma: A case report

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    Hiroaki Nagashima

    2014-12-01

    Full Text Available Osteoma of the paranasal sinus is uncommon, and the occurrence of brain abscess associated with ethmoidal osteoma is particularly rare. We report here a case of a brain abscess complicating an ethmoidal osteoma in a 68-year-old man who presented with high-grade fever and disturbance in the level of consciousness. Computed tomography scanning and magnetic resonance imaging revealed a ring-enhancing mass in the left frontal lobe with surrounding edema and a bony mass in the ethmoidal sinus. We scheduled a two-stage operation. First, emergency aspiration and drainage of the abscess via the forehead were performed to reduce the abscess volume. These were followed by a left frontal craniotomy to totally remove both the brain abscess and the bony mass. The bony mass had breached the dura mater. After removing the bony mass, we repaired the anterior skull base using a pericranial flap. Pathological findings of the bony tumor were consistent with osteoma. The postoperative course was uneventful. In the case of a huge brain abscess associated with an ethmoidal osteoma, volume reduction by drainage followed by surgical removal of both lesions may help to control infection and achieve a cure. Use of a vascularized pericranial flap is important to prevent direct communication between the paranasal sinuses and the cranial cavity.

  20. Tuberculous prostatic abscess following intravesical bacillus Calmette-Guérin immu-notherapy:a case report%卡介苗膀胱灌注治疗致结核性前列腺脓肿1例

    Institute of Scientific and Technical Information of China (English)

    叶海云; 许清泉; 黄晓波; 马凯; 王晓峰

    2015-01-01

    SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

  1. Long-term survival and virulence of Mycobacterium leprae in amoebal cysts.

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    William H Wheat

    2014-12-01

    Full Text Available Leprosy is a curable neglected disease of humans caused by Mycobacterium leprae that affects the skin and peripheral nerves and manifests clinically in various forms ranging from self-resolving, tuberculoid leprosy to lepromatous leprosy having significant pathology with ensuing disfiguration disability and social stigma. Despite the global success of multi-drug therapy (MDT, incidences of clinical leprosy have been observed in individuals with no apparent exposure to other cases, suggestive of possible non-human sources of the bacteria. In this study we show that common free-living amoebae (FLA can phagocytose M. leprae, and allow the bacillus to remain viable for up to 8 months within amoebic cysts. Viable bacilli were extracted from separate encysted cocultures comprising three common Acanthamoeba spp.: A. lenticulata, A. castellanii, and A. polyphaga and two strains of Hartmannella vermiformis. Trophozoites of these common FLA take up M. leprae by phagocytosis. M. leprae from infected trophozoites induced to encyst for long-term storage of the bacilli emerged viable by assessment of membrane integrity. The majority (80% of mice that were injected with bacilli extracted from 35 day cocultures of encysted/excysted A. castellanii and A. polyphaga showed lesion development that was similar to mice challenged with fresh M. leprae from passage mice albeit at a slower initial rate. Mice challenged with coculture-extracted bacilli showed evidence of acid-fast bacteria and positive PCR signal for M. leprae. These data support the conclusion that M. leprae can remain viable long-term in environmentally ubiquitous FLA and retain virulence as assessed in the nu/nu mouse model. Additionally, this work supports the idea that M. leprae might be sustained in the environment between hosts in FLA and such residence in FLA may provide a macrophage-like niche contributing to the higher-than-expected rate of leprosy transmission despite a significant decrease in

  2. Nuclease Activity of Legionella pneumophila Cas2 Promotes Intracellular Infection of Amoebal Host Cells

    Science.gov (United States)

    Gunderson, Felizza F.; Mallama, Celeste A.; Fairbairn, Stephanie G.

    2014-01-01

    Legionella pneumophila, the primary agent of Legionnaires' disease, flourishes in both natural and man-made environments by growing in a wide variety of aquatic amoebae. Recently, we determined that the Cas2 protein of L. pneumophila promotes intracellular infection of Acanthamoeba castellanii and Hartmannella vermiformis, the two amoebae most commonly linked to cases of disease. The Cas2 family of proteins is best known for its role in the bacterial and archeal clustered regularly interspaced short palindromic repeat (CRISPR)–CRISPR-associated protein (Cas) system that constitutes a form of adaptive immunity against phage and plasmid. However, the infection event mediated by L. pneumophila Cas2 appeared to be distinct from this function, because cas2 mutants exhibited infectivity defects in the absence of added phage or plasmid and since mutants lacking the CRISPR array or any one of the other cas genes were not impaired in infection ability. We now report that the Cas2 protein of L. pneumophila has both RNase and DNase activities, with the RNase activity being more pronounced. By characterizing a catalytically deficient version of Cas2, we determined that nuclease activity is critical for promoting infection of amoebae. Also, introduction of Cas2, but not its catalytic mutant form, into a strain of L. pneumophila that naturally lacks a CRISPR-Cas locus caused that strain to be 40- to 80-fold more infective for amoebae, unequivocally demonstrating that Cas2 facilitates the infection process independently of any other component encoded within the CRISPR-Cas locus. Finally, a cas2 mutant was impaired for infection of Willaertia magna but not Naegleria lovaniensis, suggesting that Cas2 promotes infection of most but not all amoebal hosts. PMID:25547789

  3. Reevaluation of an Acanthamoeba Molecular Diagnostic Algorithm following an Atypical Case of Amoebic Keratitis.

    Science.gov (United States)

    Lau, Rachel; Cunanan, Marlou; Jackson, Jonathan; Ali, Ibne Karim M; Chong-Kit, Ann; Gasgas, Jason; Tian, Jinfang; Ralevski, Filip; Boggild, Andrea K

    2015-10-01

    Amoebic keratitis (AK) is a potentially blinding infection, the prompt diagnosis of which is essential for limiting ocular morbidity. We undertook a quality improvement initiative with respect to the molecular detection of acanthamoebae in our laboratory because of an unusual case of discordance. Nine ATCC strains of Acanthamoeba and 40 delinked, biobanked, surplus corneal scraping specimens were analyzed for the presence of acanthamoebae with four separate real-time PCR assays. The assay used by the Free-Living and Intestinal Amebas Laboratory of the CDC was considered the reference standard, and the performance characteristics of each individual assay and pairs of assays were calculated. Outcome measures were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Of 49 included specimens, 14 (28.6%) were positive by the gold standard assay, and 35 (71.4%) were negative. The sensitivities of the individual assays ranged from 64.3% to 92.9%, compared to the gold standard, while the specificities ranged from 88.6% to 91.4%. The PPVs and NPVs ranged from 69.2% to 78.6% and from 86.1% to 96.9%, respectively. Combinations of assay pairs led to improved performance, with sensitivities ranging from 92.9% to 100% and specificities ranging from 97.1% to 100%. ATCC and clinical strains of Acanthamoeba that failed to be detected by certain individual assays included Acanthamoeba castellanii, Acanthamoeba culbertsoni, and Acanthamoeba lenticulata. For three clinical specimens, false negativity of the gold standard assay could not be excluded. Molecular diagnostic approaches, especially combinations of highly sensitive and specific assays, offer a reasonably performing, operator-independent, rapid strategy for the detection of acanthamoebae in clinical specimens and are likely to be more practical than either culture or direct microscopic detection.

  4. Pathogenesis of amoebic encephalitis: Are the amoebae being credited to an 'inside job' done by the host immune response?

    Science.gov (United States)

    Baig, Abdul Mannan

    2015-08-01

    Pathogenic free living amoeba like Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris are known to cause fatal "amoebic meningoencephalitis" by acquiring different route of entries to the brain. The host immune response to these protist pathogens differs from each another, as evidenced by the postmortem gross and microscopic findings from the brains of the affected patients. Cited with the expression of 'brain eating amoeba' when the infection is caused by N. fowleri, this expression is making its way into parasitology journals and books. The impression that it imparts is, as if the brain damage is substantially due to the enzymes and toxins produced by this amoeba. A detailed review of the literature, analysis of archived specimens and with our experimental assays, here we establish that with N. fowleri, Acanthamoeba and Balamuthia spp., the infections result in an extensive brain damage that in fact is substantially caused by the host immune response rather than the amoeba. Due to the comparatively larger sizes of these pathogens and the prior exposure of the amoebal antigen to the human body, the host immune system launches an amplified response that not only breaches the blood brain barrier (BBB), but also becomes the major cause of brain damage in Amoebic meningoencephalitis. It is our understanding that for N. fowleri the host immune response is dominated by acute inflammatory cytokines and that, in cases of Acanthamoeba and Balamuthia spp., it is the type IV hypersensitivity reaction that fundamentally not only contributes to disruption and leakiness of the blood brain barrier (BBB) but also causes the neuronal damage. The further intensification of brain damage is done by toxins and enzymes secreted by the amoeba, which causes the irreversible brain damage.

  5. Brain abscess caused by Burkholderia pseudomallei

    International Nuclear Information System (INIS)

    Full text: Melioidosis, or infection with Burkholderia pseudomallei, is an important human disease in South East Asia and Northern Australia. Neurological manifestations are well recognized amongst its protean presentations, but direct focal central nervous system infection is infrequently described with only 9 adult and 5 paediatric cases reported in the English language literature. A case of brain abscess due to Burkholderia pseudomallei occurring in a 20 year old Dutch visitor to Australia which progressed despite antibiotic treatment is described. A review of the clinical manifestations, Magnetic Resonance (MR) appearance, diagnosis and treatment of melioidosis is presented, highlighting that: (i) physicians outside endernic areas should consider melioidosis in any patient with an appropriate travel history, (ii) MR imaging is more sensitive then CT in diagnosing early brain infection, especially of the brainstem; (iii) Bacterial culture, the mainstay of diagnosis, has many shortcomings; (iv)In vitro antibiotic sensitivity testing may not translate into clinical efficacy; and (v) Steroids appear to have little role, even in severe disease

  6. Progression of Liver Disease

    Science.gov (United States)

    ... Browse Related Terms Progression of Liver Disease , Family History of Liver Disease , Liver Wellness , Liver Failure , Liver Biopsy Home > Your Liver > Liver Disease Information > The Progression ...

  7. The mitochondrial genome and a 60-kb nuclear DNA segment from Naegleria fowleri, the causative agent of primary amoebic meningoencephalitis.

    Science.gov (United States)

    Herman, Emily K; Greninger, Alexander L; Visvesvara, Govinda S; Marciano-Cabral, Francine; Dacks, Joel B; Chiu, Charles Y

    2013-01-01

    Naegleria fowleri is a unicellular eukaryote causing primary amoebic meningoencephalitis, a neuropathic disease killing 99% of those infected, usually within 7-14 days. Naegleria fowleri is found globally in regions including the US and Australia. The genome of the related nonpathogenic species Naegleria gruberi has been sequenced, but the genetic basis for N. fowleri pathogenicity is unclear. To generate such insight, we sequenced and assembled the mitochondrial genome and a 60-kb segment of nuclear genome from N. fowleri. The mitochondrial genome is highly similar to its counterpart in N. gruberi in gene complement and organization, while distinct lack of synteny is observed for the nuclear segments. Even in this short (60-kb) segment, we identified examples of potential factors for pathogenesis, including ten novel N. fowleri-specific genes. We also identified a homolog of cathepsin B; proteases proposed to be involved in the pathogenesis of diverse eukaryotic pathogens, including N. fowleri. Finally, we demonstrate a likely case of horizontal gene transfer between N. fowleri and two unrelated amoebae, one of which causes granulomatous amoebic encephalitis. This initial look into the N. fowleri nuclear genome has revealed several examples of potential pathogenesis factors, improving our understanding of a neglected pathogen of increasing global importance.

  8. Detection of Free-Living Amoebae Using Amoebal Enrichment in a Wastewater Treatment Plant of Gauteng Province, South Africa

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    P. Muchesa

    2014-01-01

    Full Text Available Free-living amoebae pose a potential health risk in water systems as they may be pathogenic and harbor potential pathogenic bacteria known as amoebae resistant bacteria. Free-living amoebae were observed in 150 (87.2% of the environmental water samples. In particular, Acanthamoeba sp. was identified in 22 (12.8% using amoebal enrichment and confirmed by molecular analysis. FLA were isolated in all 8 stages of the wastewater treatment plant using the amoebal enrichment technique. A total of 16 (9.3% samples were positive for FLA from influent, 20 (11.6% from bioreactor feed, 16 (9.3% from anaerobic zone, 16 (9.3% from anoxic zone, 32 (18.6% from aerators, 16 (9.3% from bioreactor effluent, 11 (6.4% from bioreactor final effluent, and 45 (26.2% from maturation pond. This study provides baseline information on the occurrence of amoebae in wastewater treatment plant. This has health implications on receiving water bodies as some FLA are pathogenic and are also involved in the transmission and dissemination of pathogenic bacteria.

  9. Detection of free-living amoebae using amoebal enrichment in a wastewater treatment plant of Gauteng Province, South Africa.

    Science.gov (United States)

    Muchesa, P; Mwamba, O; Barnard, T G; Bartie, C

    2014-01-01

    Free-living amoebae pose a potential health risk in water systems as they may be pathogenic and harbor potential pathogenic bacteria known as amoebae resistant bacteria. Free-living amoebae were observed in 150 (87.2%) of the environmental water samples. In particular, Acanthamoeba sp. was identified in 22 (12.8%) using amoebal enrichment and confirmed by molecular analysis. FLA were isolated in all 8 stages of the wastewater treatment plant using the amoebal enrichment technique. A total of 16 (9.3%) samples were positive for FLA from influent, 20 (11.6%) from bioreactor feed, 16 (9.3%) from anaerobic zone, 16 (9.3%) from anoxic zone, 32 (18.6%) from aerators, 16 (9.3%) from bioreactor effluent, 11 (6.4%) from bioreactor final effluent, and 45 (26.2%) from maturation pond. This study provides baseline information on the occurrence of amoebae in wastewater treatment plant. This has health implications on receiving water bodies as some FLA are pathogenic and are also involved in the transmission and dissemination of pathogenic bacteria.

  10. Growth of Entamoeba invadens in sediments with metabolically repressed bacteria leads to multicellularity and redefinition of the amoebic cell system.

    Science.gov (United States)

    Niculescu, Vladimir F

    2013-01-01

    Extracellular signaling and mechanisms of cell differentiation in Entamoeba are misunderstood. The main reason is the popular use of axenic media, which do not correspond to the natural habitats of Entamoeba. The axenic environment lacks the exogenous activators and repressors provided by natural habitats. Absent bacterial commensals understanding of the development of the amoebic cell system remains deficient. The present Aa(Sm) culture method using mixed sediments of antibiotically repressed Aerobacter aerogens and amoebae was developed to model in vitro extracellular signaling that induce multicellularity in cultures of E. invadens. Repressed oxygen consuming sediment bacteria supply E. invadens the hypoxic environment needed for differentiation and development. The amoebae themselves alter the environment by consuming the bacteria by phagocytosis thus reversing hypoxia. Exogenous activators are in this manner down regulated and suppressed. This feedback effect controls amoebic development and differentiation. Co-existing cell types and cell fractions with different life spans and cell cycle length could be identified. Aa(Sm) long term cultures contain continuous and non-continuous self renewing cell lines producing quiescent and terminally differentiated daughter cells (precysts) by asymmetric division. This culturing method helps to understand the intimate relationship between hypoxic environments and the multicellular behaviour of E. invadens and the interrelations existing between the distinct cell types.

  11. Amoebic PI3K and PKC is required for Jurkat T cell death induced by Entamoeba histolytica.

    Science.gov (United States)

    Lee, Young Ah; Kim, Kyeong Ah; Min, Arim; Shin, Myeong Heon

    2014-08-01

    The enteric protozoan parasite Entamoeba histolytica is the causative agent of human amebiasis. During infection, adherence of E. histolytica through Gal/GalNAc lectin on the surface of the amoeba can induce caspase-3-dependent or -independent host cell death. Phosphorylinositol 3-kinase (PI3K) and protein kinase C (PKC) in E. histolytica play an important function in the adhesion, killing, or phagocytosis of target cells. In this study, we examined the role of amoebic PI3K and PKC in amoeba-induced apoptotic cell death in Jurkat T cells. When Jurkat T cells were incubated with E. histolytica trophozoites, phosphatidylserine (PS) externalization and DNA fragmentation in Jurkat cells were markedly increased compared to those of cells incubated with medium alone. However, when amoebae were pretreated with a PI3K inhibitor, wortmannin before being incubated with E. histolytica, E. histolytica-induced PS externalization and DNA fragmentation in Jurkat cells were significantly reduced compared to results for amoebae pretreated with DMSO. In addition, pretreatment of amoebae with a PKC inhibitor, staurosporine strongly inhibited Jurkat T cell death. However, E. histolytica-induced cleavage of caspase-3, -6, and -7 were not inhibited by pretreatment of amoebae with wortmannin or staurosporin. In addition, we found that amoebic PI3K and PKC have an important role on amoeba adhesion to host compartment. These results suggest that amebic PI3K and PKC activation may play an important role in caspase-independent cell death in Entamoeba-induced apoptosis.

  12. Ring enhancement of brain abscess as followed by computerized tomography

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    Kawashima, K.; Satoh, S.; Hidaka, T.; Takai, N.; Kamada, K. (Yamagata Prefectural Central Hospital (Japan))

    1981-08-01

    A 39-year-old male was admitted due to brain abscess and was treated nonsurgically. On the CT examination, the intravenous injection of a contrast material (meglumine amidotrizoate) showed an early ring-form enhancement around the infected locus. Since the ring enhancement associated with brain abscess can be seen both in the late stage of cerebritis and in the formation of the abscess capsule, we tried to determine the process of the capsule formation on the CT image. As a result, the enhancement in the brain abscess by cerebritis appeared heterogeneous in density, and with an irregular, incomplete ring-shaped form, while the matured capsule exhibited a thin but homogeneous and completed ring in the enhanced CT. When the ''full-width half-maximum'' method was used, the ring enhancement in the premature capsule (from the 11th to the 51st day after clinical symptoms appeared) was irregular, incomplete, and ill-shaped. It became a complete and well-shaped ring only at the 60th day. After the appearance of the complete ring, all the clinical symptoms and CSF findings were improved. The size of the ring thereafter shrank significantly, and no enhancement effect was seen at discharge. These observations suggest strongly that the ring enhancement in a brain abscess varies during the course of the disease. The maturation of the capsule formation can be detected in CT image by means of the ''full-width half-maximum'' technique.

  13. Ring enhancement of brain abscess as followed by computerized tomography

    International Nuclear Information System (INIS)

    A 39-year-old male was admitted due to brain abscess and was treated nonsurgecally. On the CT examination, the intravenous injection of a contrast material (meglumine amidotrizoate) showed an early ring-form enhancement around the infected locus. Since the ring enhancement associated with brain abscess can be seen both in the late stage of cerebritis and in the formation of the abscess capsule, we tried to determine the process of the capsule formation on the CT image. As a result, the enhancement in the brain abscess by cerebritis appeared heterogeneous in density, and with an irregular, incomplete ring-shaped form, while the matured capsule exhibited a thin but homogeneous and completed ring in the enhanced CT. When the ''full-width half-maximum'' method was used, the ring enhancement in the premature capsule (from the 11th to the 51st day after clinical symptoms appeared) was irregular, incomplete, and ill-shaped. It became a complete and well-shaped ring only at the 60th day. After the appearance of the complete ring, all the clinical symptoms and CSF findings were improved. The size of the ring thereafter shrank significantly, and no enhancement effect was seen at discharge. These observations suggest strongly that the ring enhancement in a brain abscess varies during the course of the disease. The maturation of the capsule formation can be detected in CT image by means of the ''full-width half-maximum'' technique. (author)

  14. Giant retroperitoneal abscess following necrotizing pancreatitis treated with internal drainage

    Institute of Scientific and Technical Information of China (English)

    Ludmil Marinov Veltchev; Manol Anastasov Kalniev

    2009-01-01

    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.

  15. Efficacy of hand held, inexpensive UV light sources on Acanthamoeba, causative organism in amoebic keratitis

    Directory of Open Access Journals (Sweden)

    Ivan Cometa

    2010-01-01

    /protocols might capitalize on this synergistic action.Keywords: UV light sources, amoebic keratitis, MPS

  16. HIDA scans in the management of liver transplant

    International Nuclear Information System (INIS)

    Rejection is the most challenging diagnostic and management problem in liver transplantation today. Physicians generally alter immunosuppressive therapy based on the patient's clinical appearance and serum liver function studies. Liver biopsy can be helpful in the management of these patients but is not without morbidity and mortality in this high risk group. Here the authors report on their experience with serial HIDA scans in the management of liver transplant patients. 33 HIDA scans were performed on a total of 12 liver transplant recipients. Based on this experience, the authors have reached the following conclusions: HIDA scans can be a useful tool to aid the liver transplant surgeon in the diagnosis of early hepatic rejection, biliary obstruction, space occupying lesions (abscess, infarct, tumor) and biliary leakage. It should be used routinely in the monitoring of liver transplant recipients

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

    OpenAIRE

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

    2015-01-01

    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...

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

    OpenAIRE

    Clifton, TC; Kalamchi, S

    2011-01-01

    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.

  19. Aseptic Splenic Abscess as Precursory Extraintestinal Manifestation of Inflammatory Bowel Disease

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    Joel Brooks

    2014-01-01

    Full Text Available Splenic abscesses are most often secondary to aerobic bacterial infections due to Streptococcus, Staphylococcus, and Enterococcus species of organisms. Sterile splenic abscesses rarely occur and diagnosis and treatment of those are challenging. We report a case of a previously healthy young female presenting with aseptic splenic abscesses as the initial manifestation of Crohn’s disease along with a review of the literature on aseptic splenic abscess as an extraintestinal manifestation of Crohn’s disease.

  20. Candida albicans skin abscess Abscesso de pele por Candida albicans

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    Felipe Francisco Tuon

    2006-10-01

    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.

  1. Concomitant cutaneous metastatic tuberculous abscesses and multifocal skeletal tuberculosis

    Directory of Open Access Journals (Sweden)

    Sezgin Betul

    2008-01-01

    Full Text Available Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteomyelitis is also a rare form of extrapulmonary tuberculosis in pediatric age group. Skeletal tuberculosis pathogenesis is related to reactivation of hematogenous foci or spread from adjacent paravertebral lymph nodes. Weight-bearing joints are affected most commonly. Bilateral hand and foot bone involvement is rarely reported. We present a five-year-old girl with two very rare presentations of the disease such as osteomyelitis and metastatic skin abscess.

  2. The role of Streptococcus intermedius in brain abscess.

    Science.gov (United States)

    Mishra, A K; Fournier, P-E

    2013-04-01

    Brain abscess represents a significant medical problem, despite recent advances made in detection and therapy. Streptococcus intermedius, a commensal organism, has the potential to cause significant morbidity. S. intermedius expresses one or more members of a family of structurally and antigenically related surface proteins termed antigen I/II, which plays a potential role in its pathogenesis. It is involved in binding to human fibronectin and laminin and in inducing IL-8 release from monocytes, which promotes neutrophil chemotaxis and activation. There are few published data on the role of this organism in brain abscess. This review focuses on the clinical evidence, pathogenic role, mechanism of predisposition, and currently employed strategies to fight against S. intermedius associated to brain abscess.

  3. Neurological melioidosis in Norway presenting with a cerebral abscess

    Directory of Open Access Journals (Sweden)

    Liv Hesstvedt

    2015-01-01

    Full Text Available Neurological melioidosis is a rare condition, as less than 30 cases have been reported in the last 50 years. We present a case of neurological melioidosis, presenting with a cerebral abscess in a returning traveler from an endemic area. While traveling in Cambodia on holiday, the patient was admitted to local hospital for pneumonia. Her condition improved after antimicrobial treatment, and she returned to Norway when discharged. The patient had several contacts with the health care system after returning to Norway, due to recurrent fever and deterioration. Short-term antimicrobial treatment was given with temporary improvement in her condition. Eventually she developed stroke-like symptoms, and a cerebral abscess was found. Cultures from the abscess were positive for Burkholderia pseudomallei and the treatment was adjusted accordingly.

  4. A case of subretinal tubercular abscess presenting as disc edema

    Directory of Open Access Journals (Sweden)

    Sachin Bermu Shetty

    2015-01-01

    Full Text Available We report a case of ocular tuberculosis (TB which initially presented with disc edema and was mistaken for optic neuritis. With no definite pathology being identified, the patient was treated on the lines of optic neuritis with intravenous (IV steroid with beneficial effect. Ocular TB was suspected when he presented later with a subretinal abscess. Based on positive Mantoux, QuantiFERON TB gold results and radiographic findings, a diagnosis of subretinal abscess of presumed tubercular etiology was made. The patient was successfully treated with anti-tubercular therapy. To the best of our knowledge, this is the first case report of ocular TB presenting as disc edema followed by subretinal abscess.

  5. Aspergillus sellar abscess: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hao Li

    2008-01-01

    Full Text Available Aspergillus sellar abscess is a very rare form of fungal infections of the central nervous system (CNS. In this report, we describe the successful treatment of a patient with aspergillus sellar abscess. A 65-year-old woman presented with headache, nasal discharge and decreased visual acuity. The diagnosis of sellar mass was made on the basis of magnetic resonance imaging (MRI examination. The computed tomography (CT scan revealed sellar enlargement and sellar floor bony destruction. After hospitalization the patient underwent transsphenoidal surgery. Histopathological examination of the sellar mass revealed aspergillosis. Postoperatively, amphotericine-B and itraconazole therapy was started. During a six-month follow-up, the patient′s headache and inertia disappeared, visual acuity improved. Aspergillus sellar abscess must be considered in the differential diagnosis of a sellar mass. The correct diagnosis of pituitary aspergillosis can only be achieved by histopathological examination. Surgical intervention and antifungal therapy should be considered the optimal treatment.

  6. Isolated abscess in superior rectus muscle in a child

    Directory of Open Access Journals (Sweden)

    Sushank Ashok Bhalerao

    2015-01-01

    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.

  7. RECURRENT SALMONELLA TYPHI CHEST WALL ABSCESSES IN A DIABETIC LADY

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    Jayasri Helen

    2014-09-01

    Full Text Available : Salmonella enterica serovar typhi causing typhoid fever is common in many parts of the world particularly in developing countries. Extra intestinal manifestations are uncommon and occur in immunocompromised individuals such as patients with diabetes, HIV infection, chronic steroid use, chemotherapy and malignancy. We report a case of Salmonella typhi causing recurrent chest wall abscesses in a lady with uncontrolled diabetes. She was admitted with high grade fever, left sided chest wall abscess and a previous history of two similar chest wall abscesses. After hospitalization prompt incision and drainage was done and aerobic culture of pus grew moderate growth of Salmonella typhi resistant to ciprofloxacin and sensitive to cephalosporins. Based on culture report our patient was treated with oral azithromycin for ten days and parenteral ceftriaxone for six weeks. There was rapid and full recovery and six months follow up revealed no recurrence.

  8. A left-sided periappendiceal abscess in an adult with intestinal malrotation

    Institute of Scientific and Technical Information of China (English)

    Min Ro Lee; Jong Hun Kim; Yong Hwang; Young Kon Kim

    2006-01-01

    Left-sided periappendiceal abscesses occur in association with two types of congenital anomaly: intestinal malrotation and situs inversus. It is difficult to obtain an accurate preoperative diagnosis of these abscesses due to the abnormal position of the appendix. We present an unusual case of a left-sided periappendiceal abscess in an adult with intestinal malrotation, the diagnosis of which was a challenge.

  9. Double-sided psoas abscess in a young infant: Sonographic and radiographic findings

    International Nuclear Information System (INIS)

    Psoas abscess is rare in children and is exceptional in the neonatal period. A sonographically and radiographically well-documented case of double-sided primary psoas abscess in a few-week-old infant is presented. To our knowledge this is the first description of a case of double-sided psoas abscess in a neonate. (orig.)

  10. Brodie's abscess in the first decade of life. Report of eleven cases.

    Science.gov (United States)

    Kozlowski, K

    1980-09-01

    Eleven cases of Brodie's abscess in the first decade of life are presented. Brodie's abscess in the first decade of life usually shows the "Variant type" of X-ray appearances. The X-ray diagnosis is easy if the clinical data is known to the radiologist. The preponderance of Brodie's abscesses in the lower extremities is probably due to trauma.

  11. Gallbladder Fossa Abscess Masquerading as Cholecystitis After Cholecystectomy.

    Science.gov (United States)

    Rodrigue, Paul; Fakhri, Asif; Baumgartner, Andrew

    2015-12-01

    We present a case of a 59-y-old woman who had undergone cholecystectomy and was subsequently found to have an abscess within the gallbladder fossa. A hepatobiliary scan using (99m)Tc-diisopropyliminodiacetic acid demonstrated the characteristic rim sign, a photopenic defect surrounded by a rim of mildly increased activity immediately adjacent to the gallbladder fossa. The rim sign was thought to be the result of reactive inflammation in the hepatic tissue adjacent to a postoperative abscess within the gallbladder fossa. PMID:26111711

  12. Kocuria varians infection associated with brain abscess: A case report

    Directory of Open Access Journals (Sweden)

    Tsai Tai-Hsin

    2010-04-01

    Full Text Available Abstract Background Kocuria, established by Stackebrandt et al., previously was classified into Micrococcus. Only two species, K. rosea and K. kristinae are reported to be associated as pathogenic and found with catheter-related bacteremia and acute cholecystitis. Case presentation We herein report the first case of brain abscess caused by Kocuria varians, a gram-positive microorganism, in a 52-year-old man. Hematogenous spread is the probable pathogenesis. Conclusions This report presents a case of Kocuria varians brain abscess successfully treated with surgical excision combined with antimicrobial therapy. In addition, Vitek 2 system has been used to identify and differentiate between coagulase-negative staphylococcus.

  13. Infective Endocarditis and Aortic Valve Abscess in an Infant.

    Science.gov (United States)

    Williamson, Kristy A; Gmuca, Sabrina; Rosman, Eliyahu C; Thomas, Philomena

    2015-09-01

    Infective endocarditis is relatively uncommon in the pediatric population, but when it does occur, results in substantial morbidity and mortality. Children at risk for endocarditis are typically those with an underlying congenital heart condition. Furthermore, an endocardial abscess is a very rare yet serious complication of infective endocarditis. We describe a case of a 23-month-old previously healthy male infant with no known congenital heart disease who returned to the emergency department after a recent hospitalization for pneumococcal bacteremia, presenting acutely ill but without fever. He was found to be in congestive heart failure due to endocarditis and an aortic root abscess.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2014-11-15

    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.)

  15. Liver Panel

    Science.gov (United States)

    ... liver damage. Alpha-feto protein (AFP) – associated with regeneration or proliferation of liver cell Autoimmune antibodies (e. ... the body – such as in the skeletal muscles, pancreas, or heart. It may also indicate early liver ...

  16. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  17. Liver Diseases

    Science.gov (United States)

    ... remove poisons. There are many kinds of liver diseases. Viruses cause some of them, like hepatitis A, ... the skin, can be one sign of liver disease. Cancer can affect the liver. You could also ...

  18. Multiple large brain abscesses in a newborn that may have resulted from intrauterine infection.

    Science.gov (United States)

    Celik, Istemi Han; Demirel, Gamze; Erdeve, Omer; Uraş, Nurdan; Dilmen, Uğur

    2011-01-01

    Brain abscess is a focal, intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Here, we report a case with multiple, large brain abscesses diagnosed coincidentally on postnatal day 11. This case is noteworthy because the organized abscesses were present as early as day 11 with no significant neurological signs or symptoms. Brain abscess in newborns is a very rare disease that may not exhibit the expected neurological signs and symptoms. Depending on the radiological organization, an abscess in a neonate in the first weeks may be the result of an intrauterine infection. PMID:22272460

  19. Pericardial effusion in a diabetic patient with prostatic abscess

    International Nuclear Information System (INIS)

    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)

  20. Psoas muscle abscess simulating acute appendicits: A case report

    Directory of Open Access Journals (Sweden)

    Eugenio L.C. Miller

    2016-01-01

    Conclusion: The psoas muscle abscess is uncommon and poorly characterized in its etiology, clinical associations, and its therapeutic approach. On the other hand, acute appendicitis is the most common abdominal emergency, with a 7% death rate, and surgery is its main treatment.

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

    DEFF Research Database (Denmark)

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

    1990-01-01

    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...

  2. Ewing′s sarcoma in mandibular similar to dental abscess

    Directory of Open Access Journals (Sweden)

    Forouz Keshani

    2014-01-01

    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.

  3. Abscesses of the spleen: Report of three cases

    Institute of Scientific and Technical Information of China (English)

    Constantin Fotiadis; Giagkos Lavranos; Pavlos Patapis; Gabriel Karatzas

    2008-01-01

    Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected.Moreover, immunosuppression is a major risk factor.Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting.Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography.Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three,splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited,and a study for additional risk factors may be necessary.

  4. A Giant Retroperitoneal Abscess Mimicking Incarcerated Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Naciye Sinem Gezer

    2015-06-01

    Full Text Available An 82-year-old man was admitted to the emergency room with an acute left-sided groin pain and scrotal swelling. He has suffered from a groin hernia for two years. Abdominal x-ray demonstrated air-fluid levels in the left upper quadrant suggesting an intestinal obstruction (Figure 1. Abdominal computed tomography (CT scan was obtained with an initial diagnosis of an incarcerated inguinal hernia. However, it showed multiple perirenal abscesses and a giant-sized retroperitoneal abscess extending from the retroperitoneal space into the scrotum through the inguinal canal (Figure 2 and 3. Retroperitoneal abscesses are most frequently seen in the 3rd to 6th decades of life (1. Gram-negative bacteria, most commonly E. coli, are the cause of infection which usually develops secondary to pyelonephritis, urinary stasis or immune suppression. The onset of clinical manifestations of the infection, including flank, abdomen and groin pain, chills, fever, tachycardia, weakness and anorexia are often insidious (2,3. Laboratory findings include leukocytosis, increased serum creatinine levels and pyuria. The literature emphasizes the possibility of diagnostic delay and postponed treatment of retroperitoneal abscess due to the fact that its prodrome phase may be long.

  5. Diabetes with multiple abscesses disseminated in time and place

    Institute of Scientific and Technical Information of China (English)

    Stalin Viswanathan; Bhavith Remalayam; Vivekanandan Muthu; Shyam Kumar

    2012-01-01

    We report the course of a 29 year old diabetic and alcoholic with multiple visceral and muculoskeletal abscesses that occurred sequentially over a span of 4 months that was caused by repeated interruptions in his treatment due to poor compliance and premature discharges from hospital.

  6. Epiglottitis with an abscess caused by Haemophilus parainfluenzae

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Johansen, Helle Krogh; Homøe, Preben

    2014-01-01

    A healthy 23-year-old man was admitted under the diagnosis of acute epiglottitis. Flexible fiber laryngoscopic examination showed a swollen epiglottis with an abscess. Microbiologic swab showed Haemophilus parainfluenzae, non-haemolytic Streptococcus and non-haemolytic Streptococcus salivarius...

  7. Breast abscesses after breast conserving therapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Kazuhisa [National Kyoto Hospital (Japan)

    2001-09-01

    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)

  8. Isolated tuberculous splenic abscess in an immunocompetent individual

    Institute of Scientific and Technical Information of China (English)

    Parveen Rana Kundu; SK Mathur; Sunita Singh; Amrita Duhan; Garima Aggarwal; Rajeev Sen

    2011-01-01

    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.

  9. Case series: Diffusion weighted MRI appearance in prostatic abscess

    International Nuclear Information System (INIS)

    Diffusion: weighted MRI (DWI) is a novel technique that analyzes the diffusion of water molecules in vivo. DWI has been used extensively in the central nervous system. Its use in body imaging is on the rise. In the prostate, it has been used in the evaluation of prostatic carcinoma. We present DWI findings in two patients of prostatic abscess

  10. Splenectomy and risk of renal and perinephric abscesses

    Science.gov (United States)

    Lai, Shih-Wei; Lin, Hsien-Feng; Lin, Cheng-Li; Liao, Kuan-Fu

    2016-01-01

    Abstract Little epidemiological research is available on the relationship between splenectomy and renal and perinephric abscesses. The purpose of the study was to examine this issue in Taiwan. We conducted a population-based retrospective cohort study using the hospitalization dataset of the Taiwan National Health Insurance Program. A total of 16,426 participants aged 20 and older who were newly diagnosed with splenectomy from 1998 to 2010 were assigned to the splenectomy group, whereas 65,653 sex-matched, age-matched, and comorbidity-matched, randomly selected participants without splenectomy were assigned to the nonsplenectomy group. The incidence of renal and perinephric abscesses at the end of 2011 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for risk of renal and perinephric abscesses associated with splenectomy and other comorbidities including cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis. The overall incidence rate of renal and perinephric abscesses was 2.14-fold greater in the splenectomy group than that in the nonsplenectomy group (2.24 per 10,000 person-years vs 1.05 per 10,000 person-years, 95% CI 2.02, 2.28). After controlling for sex, age, cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis, the multivariable regression analysis demonstrated that the adjusted HR of renal and perinephric abscesses was 2.24 for the splenectomy group (95 % CI 1.30, 3.88), when compared with the nonsplenectomy group. In further analysis, the adjusted HR markedly increased to 7.69 for those comorbid with splenectomy and diabetes mellitus (95% CI 3.31, 17.9). Splenectomy is associated with renal and perinephric abscesses, particularly comorbid with diabetes mellitus. In view of its potential morbidity and mortality, clinicians should consider the possibility of renal and perinephric

  11. Intranasal Coadministration of the Cry1Ac Protoxin with Amoebal Lysates Increases Protection against Naegleria fowleri Meningoencephalitis

    Science.gov (United States)

    Rojas-Hernández, Saúl; Rodríguez-Monroy, Marco A.; López-Revilla, Rubén; Reséndiz-Albor, Aldo A.; Moreno-Fierros, Leticia

    2004-01-01

    Cry1Ac protoxin has potent mucosal and systemic adjuvant effects on antibody responses to proteins or polysaccharides. In this work, we examined whether Cry1Ac increased protective immunity against fatal Naegleria fowleri infection in mice, which resembles human primary amoebic meningoencephalitis. Higher immunoglobulin G (IgG) than IgA anti-N. fowleri responses were elicited in the serum and tracheopulmonary fluids of mice immunized by the intranasal or intraperitoneal route with N. fowleri lysates either alone or with Cry1Ac or cholera toxin. Superior protection against a lethal challenge with 5 × 104 live N. fowleri trophozoites was achieved for immunization by the intranasal route. Intranasal immunization of N. fowleri lysates coadministered with Cry1Ac increased survival to 100%; interestingly, immunization with Cry1Ac alone conferred similar protection to that achieved with amoebal lysates alone (60%). When mice intranasally immunized with Cry1Ac plus lysates were challenged with amoebae, both IgG and IgA mucosal responses were rapidly increased, but only the increased IgG response persisted until day 60 in surviving mice. The brief rise in the level of specific mucosal IgA does not exclude the role that this isotype may play in the early defense against this parasite, since higher IgA responses were detected in nasal fluids of mice intranasally immunized with lysates plus either Cry1Ac or cholera toxin, which, indeed, were the treatments that provided the major protection levels. In contrast, serum antibody responses do not seem to be related to the protection level achieved. Both acquired and innate immune systems seem to play a role in host defense against N. fowleri infection, but further studies are required to elucidate the mechanisms involved in protective effects conferred by Cry1Ac, which may be a valuable tool to improve mucosal vaccines. PMID:15271892

  12. Acute diverticulitis--an unusual cause of liver abcesses in a young man: a case report.

    Science.gov (United States)

    Al Hajjar, N; Crişan, D; Grigorescu, M; Boruah, P

    2012-01-01

    Liver abscess is a rare complication of sigmoid diverticulitis and must be considered within the differential diagnosis. We report a case of a male patient, age 42, admitted to our hospital with chief complaints of a dull pain in upper right abdominal quadrant, fever, weakness, diarrhoea and weight loss of approximately 3 weeks duration. Physical examination on initial work-up revealed tenderness on palpation in upper right abdomen, and left iliac fosa and a 39 degrees C fever. Biochemistry showed marked inflammatory syndrome, leukocitosis, increased level of platelets, altered liver function. Ultrasound examination revealed inhomogeneous liver nodules and the thickening of the sigmoid wall. Further CT scan examination and MRI confirmed the lesions as beeing abscesses and also revealed trombosis of right portal vein. The sigmoid wall lesions proved to be an acute diverticulitis with perisigmoiditis, stenosis and abscess. Patient underwent a surgical treatment of sigmoid resection, but the punction of the abscesses revealed no pus at aspiration, making the surgical excision of the lesions unnecessary. After the surgery, during the antibiotic treatment, the patient developed pseudomembranous colitis treated with specific antibiotics. The evolution under this treatment was positive and the aspect of the liver lesions was improuved.

  13. Liver regeneration.

    Science.gov (United States)

    Mao, Shennen A; Glorioso, Jaime M; Nyberg, Scott L

    2014-04-01

    The liver is unique in its ability to regenerate in response to injury. A number of evolutionary safeguards have allowed the liver to continue to perform its complex functions despite significant injury. Increased understanding of the regenerative process has significant benefit in the treatment of liver failure. Furthermore, understanding of liver regeneration may shed light on the development of cancer within the cirrhotic liver. This review provides an overview of the models of study currently used in liver regeneration, the molecular basis of liver regeneration, and the role of liver progenitor cells in regeneration of the liver. Specific focus is placed on clinical applications of current knowledge in liver regeneration, including small-for-size liver transplant. Furthermore, cutting-edge topics in liver regeneration, including in vivo animal models for xenogeneic human hepatocyte expansion and the use of decellularized liver matrices as a 3-dimensional scaffold for liver repopulation, are proposed. Unfortunately, despite 50 years of intense study, many gaps remain in the scientific understanding of liver regeneration.

  14. Chronic breast abscess due to Mycobacterium fortuitum: a case report

    Directory of Open Access Journals (Sweden)

    MacNeill Fiona A

    2011-05-01

    Full Text Available Abstract Introduction Mycobacterium fortuitum is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune deficiency. There have been few published reports of Mycobacterium fortuitum associated with breast infections mainly associated with breast implant and reconstructive surgery. Case presentation We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast clinic with a two-week history of left breast swelling and tenderness. Following triple assessment and subsequent incision and drainage of a breast abscess, the patient was diagnosed with Mycobacterium fortuitum and treated with antibiotic therapy and surgical debridement. Conclusion This is a rare case of a spontaneous breast abscess secondary to Mycobacterium fortuitum infection. Recommended treatment is long-term antibacterial therapy and surgical debridement for extensive infection or when implants are involved.

  15. [Spinal epidural abscess as a complication of a finger infection].

    Science.gov (United States)

    Ridderikhof, M L; van den Brink, W A; van Dalsen, A D; Kieft, H

    2008-06-21

    An 81-year-old man was treated with intravenous antibiotics for a soft tissue infection in a finger. Despite adequate antibiotic treatment, he developed signs of spinal cord injury caused by a cervical spinal epidural abscess. An emergency laminectomy was performed. The neurological impairment appeared to be irreversible, and the patient died. Spinal epidural abscess is a rare and serious complication ofa bacteraemia. It is often caused by an infection of the skin or soft tissue with Staphylococcus aureus. Given the risk of rapidly progressive and irreversible neurological damage, this complication must be treated as soon as possible. The treatment of choice is surgery. Conservative management with intravenous antibiotics is an option only under strict conditions. PMID:18624007

  16. Tubo-ovarian abscess with Morganella morganii bacteremia.

    Science.gov (United States)

    Chou, Yen Yi; Chiu, Sheng Kang; Lai, Hung Cheng; Chang, Feng Yee

    2009-08-01

    Tubo-ovarian abscess caused by Morganella morganii is unusual. A 54-year-old menopausal woman visited the emergency room with lower abdominal pain, vomiting, and fever for 4 days. Pelvic examination revealed lifting tenderness over the right adnexum without motion tenderness of the uterus. Pelvic sonogram revealed a cystic lesion with heterogeneous content in the right ovary. Salpingo-oophoritis was suspected. Clindamycin and gentamicin were administered intravenously after obtaining blood cultures. Laparoscopy was done because of sustained fever, and an ovarian abscess was found. Laparoscopic salpingo-oophorectomy was performed. The patient was discharged 5 days later and oral clindamycin was prescribed. However, she was readmitted due to intermittent fever. The result of blood culture obtained before surgery disclosed M. morganii, which was resistant to clindamycin and cefazolin. Her symptoms resolved after administration of intravenous flomoxef. This report highlights the fact that antimicrobial resistance of M. morganii may complicate the management and outcome of this infection.

  17. Lumbar spine osteomyelitis and epidural abscess formation secondary to acupuncture.

    Science.gov (United States)

    Godhania, Vinesh

    2016-01-01

    A 39-year-old male with no previous medical history presented with abdominal and low back pain. Based on clinical and radiological findings he was diagnosed with L1/L2 osteomyelitis and epidural abscess. Further history taking revealed recent use of acupuncture for treatment of mechanical back pain. The patient was treated conservatively with an extended course of antibiotics, monitored with repeat MRI scans and had a full recovery with no neurological deficit. This is the first reported case of epidural abscess formation and osteomyelitis after acupuncture in the UK. As acupuncture becomes more commonly used in western countries, it is important to be aware of this rare but serious complication. PMID:26976275

  18. Tuberculous iliopsoas abscess in a HIV positive female patient

    International Nuclear Information System (INIS)

    Patients with HIV can often present a diagnostic challenge and may have atypical presentations of more common diseases. This case demonstrates a HIV (+) patient with an advanced immunosuppression with tuberculosis complaining about 2 months before admission to the hospital of backache, anorexia and weight loss. On investigation she was found to have unilateral tuberculous psoas abscesses, diagnosed microbiologically and with a CT scan. Complex treatment (surgical, tuberculostatics, antiretroviral) was performed with a good effect. A review of the literature shows that this is a rare presentation of an already unusual problem, with subtle signs requiring a high index of clinical suspicion. However, with HIV-positive patients more likely to present with extrapulmonary tuberculosis, there is need for increased awareness of this diagnosis. (authors) Key words: HIV. TUBERCULOUS PSOAS ABSCESS

  19. Tuberculous iliopsoas abscess in a HIV-positive female patient

    International Nuclear Information System (INIS)

    Patients with HIV can often present a diagnostic challenge and may have atypical presentations of more common diseases. This case demonstrates a HIV (+) patient with an advanced immunosuppression with tuberculosis complaining about 2 months before admission to the hospital of backache, anorexia and weight loss. On investigation she was found to have unilateral tuberculous psoas abscesses, diagnosed microbiologically and with a CT scan. Complex treatment (surgical, tuberculostatics, antiretroviral) was performed with a good effect. A review of the literature shows that this is a rare presentation of an already unusual problem, with subtle signs requiring a high index of clinical suspicion. However, with HIV-positive patients more likely to present with extrapulmonary tuberculosis, there is need for increased awareness of this diagnosis. (authors) Keywords: HIV.TUBERCULOUSPSOAS ABSCESS

  20. Radiofrequency ablation of a misdiagnosed Brodie’s abscess

    Science.gov (United States)

    Chan, RS; Abdullah, BJJ; Aik, S; Tok, CH

    2011-01-01

    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. PMID:22291860

  1. Pituitary abscess: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Apostolos K A Karagiannis

    2016-06-01

    Full Text Available Pituitary abscess is a rare life-threating entity that is usually misdiagnosed as a pituitary tumor with a definite diagnosis only made postoperatively. Over the last several decades, advances in healthcare have led to a significant decrease in morbidity and mortality due to pituitary abscess. We report a case of a 34-year-old woman who was admitted to our department for investigation of a pituitary mass and with symptoms of pituitary dysfunction, headaches and impaired vision. During her admission, she developed meningitis-like symptoms and was treated with antibiotics. She eventually underwent transsphenoidal surgery for excision of the pituitary mass. A significant amount of pus was evident intraoperatively; however, no pathogen was isolated. Six months later, the patient was well and had full recovery of the anterior pituitary function. Her menses returned, and she was only on treatment with desmopressin for diabetes insipidus that developed postoperatively.

  2. An unusual case of non-traumatic pneumococcal mediastinal abscess.

    Science.gov (United States)

    Lotan, C; Boneh, A; Tamir, I; Goitein, K J

    1985-01-01

    A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient again developed respiratory failure and on chest X-ray pneumomediastinum was seen and later evidence of a mediastinal abscess. Conservative treatment, with antibiotics, effected complete cure.

  3. A pituitary abscess masquerading as recurrent hypernatremia and aseptic meningitis

    OpenAIRE

    Gonzales, Michael; Marik, Paul Ellis; Khardori, Romesh K.; O'Brian, John T

    2012-01-01

    Pituitary abscess is a rare condition. In the setting of multiple surgical interventions, the risk of its development increases. A 49-year-old man presented with episodes of altered mental status. He had two surgeries for a recurrent suprasellar arachnoid cyst. The second surgery was complicated by a persistent cerebrospinal fluid (CSF) leak that required two repairs following which he developed panhypopituitarism and central diabetes insipidus. Twelve months after his last surgery he was dia...

  4. Lumbar spine osteomyelitis and epidural abscess formation secondary to acupuncture

    OpenAIRE

    Godhania, Vinesh

    2016-01-01

    A 39-year-old male with no previous medical history presented with abdominal and low back pain. Based on clinical and radiological findings he was diagnosed with L1/L2 osteomyelitis and epidural abscess. Further history taking revealed recent use of acupuncture for treatment of mechanical back pain. The patient was treated conservatively with an extended course of antibiotics, monitored with repeat MRI scans and had a full recovery with no neurological deficit. This is the first reported case...

  5. Psoas Abscess Secondary to Urinary Tract Fungal Infection

    OpenAIRE

    Reem Aldamanhori; Alaa Barakat; Maha Al-Madi; Baher Kamal

    2015-01-01

    Psoas abscess is a rare condition where infection spreads from a nearby or distant septic focus to the psoas sheath. The causative bacterial organisms at distal sites reach the psoas via lymphatic or hematogenous spread, whereas infection from nearby sites that include the urinary system reaches the psoas directly. There are few reports that account for bacterial infection after endourological procedures as the cause of direct spread of infection to the psoas muscle.2 We report a case of psoa...

  6. Soft Tissue Abscess due to Eikenella corrodens after Human Bite

    OpenAIRE

    Bilal Sula; Recep Tekin

    2016-01-01

    Eikenella corrodens is found in oral, gastrointestinal and genitourinary normal flora. Eikenella species have been shown to cause serious human infections such as head-neck infection, pulmonary infection, arthritis, endocarditis, intraabdominal infection, pancreatic abscesses and infection after human bite wounds. Although injuries caused by human bites are less than those caused by animal bites, such injuries have higher risk for infection and complication development. The most common cli...

  7. Migratory and misleading abscess of oro-facial region

    Science.gov (United States)

    ArunKumar, Kubsad Veerabhadrappa; Deepa, Dhruvakumar

    2015-01-01

    Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus. However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally. This may quite often cause diagnostic dilemmas necessitating thorough medical and dental history, careful clinical examination and sometimes special investigations to confirm the etiology and or origin of infection. Here, we present three such cases and their management. PMID:26392702

  8. Fungal abdominal wall abscess in a renal transplant recipient

    International Nuclear Information System (INIS)

    The incidence of fungal infection is significantly higher in patients with end-stage renal disease and renal transplant recipients than in normal individuals. Candida Albicans is an uncommon cause of abdominal wall abscess. We describe a 37 year-old renal transplant recipient with such an infection. He presented with a typical clinical manifestations and an insidious course, but was successfully treated with antifungal therapy. (author)

  9. Management of Otogenic Brain Abscess Using the Transmastoid Approach

    OpenAIRE

    Choi, June; Choi, Jong Il; Kim, Sang-Dae

    2014-01-01

    Despite significant advances in the treatment of all forms of chronic otitis media (COM), complications still can and do occur, with intracranial complications representing the most life-threatening cases, often requiring immediate therapeutic intervention. Herein, we present a rare case of rapidly progressing facial paralysis with concomitant severe headache and ipsilateral hearing loss secondary to an otogenic brain abscess, treated with the transmastoid approach, drainage, and facial nerve...

  10. Solitary supratentorial Listeria monocytogenes brain abscess in an immunocompromised patient

    OpenAIRE

    West, James A.; Onofrio, Anthony R.; Martinez, Lauren C.; Opatowsky, Michael J.; Spak, Cedric W.; Layton, Kennith F.

    2015-01-01

    We describe an 81-year-old man receiving azacitidine monotherapy for myelodysplastic syndrome who was improving from Listeria monocytogenes bacteremia after receiving antibiotic therapy during an earlier hospital admission. Shortly after discharge he developed new-onset seizure activity, with brain imaging on subsequent admissions demonstrating a posterior right frontal lobe mass. Specimen cultures after resection of the mass revealed this to be a cerebral abscess related to L. monocytogenes....

  11. Brodie's abscess in a tibia dating from the Neolithic period.

    Science.gov (United States)

    Lagier, R; Baud, C A; Kramar, C

    1983-01-01

    Radiological and macroscopic characteristics typical of Brodie's abscess were observed in inferior metaphysis of a tibia estimated to be 5,000 years old. The use of rigorous anatomico-radiological criteria in studies of bone paleopathology can provide the doctor with accurate data regarding diseases of the past in bone specimens rarely at their disposal. This approach is also necessary to obtain valid data for paleontologists, prehistorians and archeologists.

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

    Directory of Open Access Journals (Sweden)

    Tugce Kalayci

    2014-08-01

    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.

  13. Propionibacterium Acnes Brain Abscess in an Immunocompetent Man in the Absence of Prior Neurosurgery.

    Science.gov (United States)

    Odunukan, Olufunso W; Masannat, Fares; Baka, J Jeff

    2016-02-01

    Propionibacterium acnes is a rare, but established, cause of intracranial abscesses. We describe a case of P. acnes brain abscess in an immunocompetent man without prior neurosurgery. A 49-year old man with mild psoriasis presented with a two-week history of gait changes, generalized weakness and a two-day history of headaches, aphasia and confusion. Imaging revealed a left thalamic mass and surgical biopsy suggested a pyogenic abscess. Cultures of biopsy samples of the abscess grew P. acnes alone. MRI and serial neurological exam showed marked clinical improvement with intravenous antibiotics. The significant reduction in the abscess was sustained on MRI obtained at six weeks after completion of antibiotic therapy. In conclusion, P. acnes must be considered as a differential diagnosis in individuals presenting with features suggestive of a brain abscess even in the absence of immunosuppression or previous neurosurgery. PMID:26999913

  14. Successful neuroendoscopic treatment of intraventricular brain abscess rupture

    Directory of Open Access Journals (Sweden)

    Takafumi Nishizaki

    2011-07-01

    Full Text Available Intraventricular rupture of a brain abscess is still associated with a high mortality rate. Here, we report such a case in a patient with normal immunity that was treated successfully using neuroendoscopic approach. A 69-yearold man who had presented with headache and fever developed confusion and restlessness. Magnetic resonance imaging revealed a mass with ring enhancement extending to the right ventricle. Emergency aspiration of cerebrospinal fluid (CSF from the spinal canal revealed severe purulent meningitis. Bacterial culture of the CSF and blood was negative. Because of prolonged consciousness disturbance, the patient underwent evacuation of the intraventrcular abscess using a neuroendoscope. The pus was centrifuged and collected for bacterial culture, and this revealed Streptococcus intermedius/milleri. After implantation of a ventricular catheter, gentamicin sulfate was administered twice a day for 9 days. Cefotaxime sodium was also administered intravenously for 14 days, followed by oral administration of cefcapene pivoxil hydrochloride for 10 days. The patient made a complete recovery, and was discharged 31 days after admission. After 20 months of follow-up, he is doing well and has returned to his work. In cases of intraventricular rupture of a brain abscess, a neuroendoscopic approach is useful for evacuation of intraventricular debris or septum, and identification of the causative bacterium for selection of antibiotics, possibly reducing the period of hospitalization.

  15. Bacterial brain abscesses: prognostic value of an imaging severity index

    International Nuclear Information System (INIS)

    Aim: To assess the correlation between imaging findings [computed tomography (CT) or magnetic resonance imaging (MRI)] and neurological status before and after the treatment of bacterial brain abscesses. Materials and methods: CT and MRI images of 96 patients with brain abscesses were retrospectively evaluated in terms of the number, location and size of lesions, and the presence and extent of perilesional oedema and midline shift. An imaging severity index (ISI) based on these different radiological parameters was calculated. Initial Glasgow Coma Scale (GCS) scores and ISI were assessed and the prognostic value of these two indices was calculated. The Pearson correlation test, Mann-Whitney test, Chi-square test, receiver-operating characteristic (ROC) analysis, together with comparison of ROC analyses and Fisher's exact test were used. Results: There was a negative correlation between ISI and the initial GCS values: ISI increased as the GCS score decreased, indicating an inverse relationship (r = -0.51, p < 0.0001). There was a significant difference between the ISI and GCS scores of patients with an adverse event compared with patients with good recovery. Outcome was significantly worse in patients with initial ISI over the calculated cut-off values of 8 points or GCS scores under the cut-off value of 13 points. Conclusion: ISI is a useful prognostic indicator for bacterial brain abscess patients and correlates strongly with the patient outcome for all parameters studied. ISI score had a better prognostic value than GCS

  16. Brain abscesses in neonates: Neurosonographic diagnosis and long-term follow-up

    OpenAIRE

    Obradović Slobodan; Stojković-Anđelković Anđelka; Vuletić Biljana; Radovanović Marija

    2005-01-01

    Brain abscesses were neurosongraphically diagnosed in 3 out of 44 neonates who had confirmed purulent meningitis. In two cases, the cause was Proteus mirabillis, whereas in one the cause could not be isolated. The ultrasound finding indicated abscess cavities localized in the frontal (in one case bilaterally) and temporal regions of the CNS. Neurosurgical interventions were carried out on all of the neonates who had abscesses (including the evacuation of purulent cavity contents, and later on...

  17. Multiple bilateral costo-chondral abscesses due toMycobacterium tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Peter G; Basti SR; Joy AS

    2010-01-01

    Multiple abscesses of the costo-chondral junctions are very uncommon in practice. In this report we present the case of a55 year old man who presented to us with chest pain and fever of few months duration. On imaging with ultrasound andCECT we were able to demonstrate multiple abscesses of costo-chondral junctions bilaterally. We confirmed tuberculosis by FNAC and BACTEC cultures from abscesses.

  18. Psoas abscess with septic arthritis of the hip: a case report.

    Science.gov (United States)

    Belet, Nurşen; Akyurt, Büşra; Karlı, Arzu; Gülman, Birol; Selçuk, Mustafa Bekir; Şensoy, Gülnar

    2014-01-01

    Psoas abscess associated with septic arthritis of the hip is unusual in infants. A 12-month-old infant presented with the complaints of fever, left hip pain and limp. Magnetic resonance imaging revealed left psoas abscess accompanied by septic arthritis of the hip. In this report, we present a case of psoas abscess with hip septic arthritis in an infant, and we describe the clinical and radiological findings and treatment of this case.

  19. Mycobacterium Avium Arthritis with Extra-articular Abscess in a Patient with Mixed Connective Tissue Disease

    OpenAIRE

    Lee, Choong Won; Sung, Han Dong; Choi, Byong Moon; Kim, Chun Wook; Jun, Su Jin; Min, Sang Jo

    2003-01-01

    A case of Mycobacterium avium arthritis in a 39-year-old female patient with mixed connective tissue disease (MCTD) was reported. An extra-articular abscess had formed outside the knee joint and extended down the calf. A culture was taken of the abscess and synovial fluid disclosed Mycobacteriun avium. This was resistant to most anti-tuberculosis agents. A combination of anti-tuberculosis drugs followed a total resection of the abscess. We concluded that M avium septic arthritis could insidio...

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

    Directory of Open Access Journals (Sweden)

    Sudhir B. Sharma

    2012-01-01

    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.

  1. Salmonella typhi Splenic Abscess Following Blunt Abdominal Injury: A Case Report.

    Science.gov (United States)

    Sharavanan, Priyadarshini; Shanmugam, Dhivyalakshmi; Palraj, Kennedy Kumar; Antony, Tessa; Thayanidhi, Premamalini

    2016-07-01

    Splenic abscess as a complication of enteric fever due to Salmonella typhi is a rare entity. Here, we are presenting a case of splenic abscess caused by Salmonella typhi with a blunt injury to the abdomen as the predisposing factor. The patient underwent total splenectomy due to failure of conservative management. Splenic abscess is a potential life threatening disease if left untreated. In spite of its rarity, Salmonella typhi has to be considered as a possible pathogen causing the disease. PMID:27630844

  2. Clinical usefulness of c-arm cone-beam CT inpercutaneous drainage of inaccessible abscess

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2015-08-15

    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.

  3. Atypical pyogenic brain abscess evaluation by diffusion-weighted imaging: diagnosis with multimodality MR imaging.

    Science.gov (United States)

    Ozbayrak, Mustafa; Ulus, Ozden Sila; Berkman, Mehmet Zafer; Kocagoz, Sesin; Karaarslan, Ercan

    2015-10-01

    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.

  4. Morganella morganii , subspecies morganii, biogroup A: An unusual causative pathogen of brain abscess

    Directory of Open Access Journals (Sweden)

    Asha B Patil

    2012-01-01

    Full Text Available Morganella morganii is a gram negative aerobe , found often as intestinal commensal. It is commonly implicated in Urinary tract infections and pyogenic infections, but rarely causes CNS infections especially brain abscess. There are very few published reports of Morganella morganii as a causative pathogen in brain abscess. High index of suspicion of this pathogen is important in cases of brain abscess secondary to otogenic infections. This paper reports an unusual case of Morganella morganii, subspecies morganii, biogroup A Brain abscess .The paper also reviews other infections caused by Morganell morganii.

  5. Morganella morganii, subspecies morganii, biogroup A: An unusual causative pathogen of brain abscess.

    Science.gov (United States)

    Patil, Asha B; Nadagir, Shobha D; Lakshminarayana, Sa; Syeda, Fasiha M

    2012-09-01

    Morganella morganii is a gram negative aerobe , found often as intestinal commensal. It is commonly implicated in Urinary tract infections and pyogenic infections, but rarely causes CNS infections especially brain abscess. There are very few published reports of Morganella morganii as a causative pathogen in brain abscess. High index of suspicion of this pathogen is important in cases of brain abscess secondary to otogenic infections. This paper reports an unusual case of Morganella morganii, subspecies morganii, biogroup A Brain abscess. The paper also reviews other infections caused by Morganell morganii.

  6. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Cantasdemir, M. E-mail: cantas1@yahoo.com; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F

    2003-10-01

    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.

  7. Differential diagnosis between pulmonary tuberculosis and lung abscess by contrast enhanced CT

    International Nuclear Information System (INIS)

    The contrast enhanced CT findings in 14 patients with active tuberculosis and 26 patients with lung abscess were retrospectively analyzed. Reflecting the difference of pathogenesis between tuberculosis and abscess, the findings are widely different. The findings suggesting pulmonary tuberculosis rather than lung abscess were as follows; multiple and irregular necrotic areas, positive CT angiogram sign, no marginal enhancement surrounding necrosis. Contrast enhanced CT may help to distinguish pulmonary tuberculosis from lung abscess, especially in cases of caseous pneumonia showing broad consolidations or mass-like shadows. (author)

  8. Diffuse large B cell lymphoma presenting as a peri-anal abscess.

    Science.gov (United States)

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina

    2014-01-01

    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. PMID:24898408

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

    Institute of Scientific and Technical Information of China (English)

    Peng Dong; Bin Wang; Ye-Quan Sun

    2008-01-01

    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.

  10. Liver transplant

    Science.gov (United States)

    ... transplant - series References Keefe EB. Hepatic failure and liver transplantation. In: Goldman L, Schafer AI, eds. Goldman's Cecil ... Elsevier; 2011:chap 157. Martin P, Rosen HR. Liver transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. ...

  11. Brain abscess in children,experience of Mashad University

    Institute of Scientific and Technical Information of China (English)

    Faraji rad Mohammad; Faraji rad Elnaz

    2009-01-01

    Objective:Brain abscesses continue to pose a pmblem in neurosurgery,and it is a serious life-threatening complication for several diseases.The objective of this research was to look at the clinical profile of children suffering from brain abscess,predisposing conditions,microbiology and outcome of these patients.Methods:Ninety children aged less than 15 years were reviewed.The clinical presentation,predisposing factors,diagnosis,management and outcome were noted.There were 56 (62.2%)males and 34(37.7%)females.The mean age of presentation Was 5.7±4.2 years.Results:The mean duration of illness at the time of presentation Was 10.6±12.4 days.Typically patients presented with fever,vomiting,headache,neurological deficit,and seizures.The predisposing conditions found were cyanotic congenital heart disease in 18(20%)of children,meningitis in 6(6.7%),Otitis or mastoiditis in 32(35.5%),Head trauma in 6(6.7%),previous intracranial surgery in 8(8.8%)and no underlying cause Was found in 22(24.4%)children.The most common microbe in children with cyanotic congenital heart disease Was of the Streptococcus group(54%).Computerized tomography confirmed the diagnosis and the most common Iocation of the abscess was the parietal lobe of the cerebral hemisphere.That abscesses were larger than 2 cm in diameter where aspirated surgically,Excision Was performed for eight children.Six children expired,two due to intracranial bleeding and the others due to severe cerebral edema and tentorial hemiation.Complications were observed in 11 children out of which six had squeal and five had hemiparesis.Conclusion:Attention to hygiene of mouth and teeth in infant and child patients with cyanotic heart disease is very important in prevention of infectious brain diseases.We must also pay attention to ear-node-throat diseases of children.That is very important the patients be examined again after treatment because of finding and treatment of unknown otitis and chronic sinusitis.

  12. Spinal epidural abscess: a rare complication of olecranon bursitis

    OpenAIRE

    Evans, Rhys D.R.; Moe Thaya; Ne Siang Chew; Charles E.R. Gibbons

    2009-01-01

    Spinal epidural abscess is a rare but potentially fatal condition if left untreated. We report the case of a 67-year old man who presented to the Accident and Emergency department complaining of acute onset of inter-scapular back pain, left leg weakness and loss of sensation in the left foot. On examination he was found to be pyrexial with long tract signs in the left lower leg. In addition he had a left sided olecranon bursitis of three weeks duration. Blood tests revealed raised inflammator...

  13. Melioidosis:a rare cause of anterior chest wall abscess

    Institute of Scientific and Technical Information of China (English)

    Rashidi Ahmad; Azhar Amir Hamzah; Ahmad Kasfi Abdul Rahman; Phee Kheng Cheah

    2010-01-01

    Melioidosis is an unusual tropical infectious disease caused by the gram-negative bacterium Burkholderia pseudomallei, which was formerly known asPseudomonas pseudomallei. Melioidosis is characterized by abscess formation and it may manifest in any part of the human body, however, musculoskeletel melioidosis is uncommon and chest wall melioidosis is very rare. To determine the exact organism based solely on clinical presentation poses a great challenge to the physician. Yet, delay administration of antibiotic may be harmful. We describe a diabetic patient who had anterior chest wall melioidosis that mimicsStaphylococcus aureus infection. A description of his presentation and management, along with a review of literature is presented.

  14. Spinal intramedullary tuberculoma and abscess : a rare cause of paraparesis.

    Directory of Open Access Journals (Sweden)

    Devi B

    2002-10-01

    Full Text Available Five cases of spinal intramedullary tuberculomas (IMT and one case of spinal intramedullary tuberculous abscess (ITA are presented. Gd enhanced MRI revealed ring enhancing lesion with central hypodensity, suggesting granulomatous pathology. Surgical excision of the intramedullary lesions was carried out in four cases, while two patients received presumptive anti-tuberculous chemotherapy only. Repeat MRI after completion of anti-tuberculous therapy showed total resolution of the lesion. In other cases following surgical excision, the patients improved significantly. The management of these rare lesions is discussed and the literature reviewed.

  15. Pancreatic and Colonic Abscess Formation Secondary to HELLP Syndrome

    Directory of Open Access Journals (Sweden)

    James M. O’Brien

    2015-01-01

    Full Text Available Preeclampsia and the variant HELLP syndrome are systemic conditions associated with vascular changes resulting in vasoconstriction. Most commonly, patients present with elevated blood pressure and proteinuria, with a background of complaints such as headache, scotoma, and right upper quadrant pain. The systemic vascular changes experienced can target any organ system, oftentimes with more than one organ system being involved. We present the case of a patient admitted with HELLP syndrome who subsequently developed multisystem organ dysfunction, including placental abruption, disseminated intravascular coagulopathy, acute renal failure, colitis, abdominal ascites, pancreatitis, and the development of pancreatic and colonic abscesses.

  16. Pancreatic and Colonic Abscess Formation Secondary to HELLP Syndrome.

    Science.gov (United States)

    O'Brien, James M; Pursell, Nicole; Fumia, Fred

    2015-01-01

    Preeclampsia and the variant HELLP syndrome are systemic conditions associated with vascular changes resulting in vasoconstriction. Most commonly, patients present with elevated blood pressure and proteinuria, with a background of complaints such as headache, scotoma, and right upper quadrant pain. The systemic vascular changes experienced can target any organ system, oftentimes with more than one organ system being involved. We present the case of a patient admitted with HELLP syndrome who subsequently developed multisystem organ dysfunction, including placental abruption, disseminated intravascular coagulopathy, acute renal failure, colitis, abdominal ascites, pancreatitis, and the development of pancreatic and colonic abscesses. PMID:26064725

  17. Retroperitoneal Abscess: A Rare Localization of Tubercular Infection

    Directory of Open Access Journals (Sweden)

    Sami Karoui

    2010-01-01

    Full Text Available Incidence of tuberculosis infection has considerably increased during the past 20 years due to the HIV pandemic and continues to be one of the most prevalent and deadly infections worldwide. Extrapulmonary tuberculosis lacks specific clinical manifestation and can mimic many diseases. It can invade neighbouring tissue and form a big cyst with manifesting clinical symptoms. We describe a rare case of 31-year-old immunocompetent man affected by a retroperitoneal abscess secondary to tubercular infection. Exploratory laparotomy and histopathological examinations of tissue were required for achieving diagnosis of tuberculosis. No pulmonary or spinal involvement was identified. The patient was successfully treated with standard four-drug antitubercular therapy.

  18. Nocardia farcinica bacteraemia presenting as a prostate abscess

    Directory of Open Access Journals (Sweden)

    Hana Scorey

    2016-01-01

    Full Text Available Nocardia is characterised as a Gram positive filamentous rod and is found worldwide in soil, decaying vegetable matter and aquatic environments. Localised pulmonary infection is the most common clinical presentation. However, Nocardia can present in a wide variety of clinical manifestations, especially in the immunocompromised individual. We present the first case of a prostate abscess caused by Nocardia farcinica in a man with a history of severe psoriasis and psoriatic arthritis. He had been on long term immunosuppression for this with prednisolone and etanercept. His Nocardia was likely contracted through direct skin inoculation while gardening with haematological dissemination to the prostate. He responded well to long term sulfamethoxazole and trimethoprim.

  19. Nocardia farcinica bacteraemia presenting as a prostate abscess.

    Science.gov (United States)

    Scorey, Hana; Daniel, Santhosh

    2016-01-01

    Nocardia is characterised as a Gram positive filamentous rod and is found worldwide in soil, decaying vegetable matter and aquatic environments. Localised pulmonary infection is the most common clinical presentation. However, Nocardia can present in a wide variety of clinical manifestations, especially in the immunocompromised individual. We present the first case of a prostate abscess caused by Nocardia farcinica in a man with a history of severe psoriasis and psoriatic arthritis. He had been on long term immunosuppression for this with prednisolone and etanercept. His Nocardia was likely contracted through direct skin inoculation while gardening with haematological dissemination to the prostate. He responded well to long term sulfamethoxazole and trimethoprim. PMID:27419070

  20. A Case of Non-Traumatic Pneumocephalus Associated with Otogenic Proteus Mirabilis Cerebellar Abscess

    OpenAIRE

    CİHANGİROĞLU, Mustafa; ÇELİK, İlhami; AKDEMİR, İsmail; Artaş, Hakan; AKBULUT, Ayhan

    2008-01-01

    In this case, it was presented a rare cerebellar abscess case due to Proteus mirabilis has an intraparenchymal gas formation at the early stage of cerebritis where gas formation disappeared at the late cerebritis phase of the abscess formation.©2008, Fırat Üniversitesi, Tıp Fakültesi