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Sample records for brain abscess caused

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

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    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.

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

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    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.

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

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

    2016-06-01

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

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

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    Khaja M

    2017-01-01

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

  5. Liver and brain abscess caused by Aggregatibacter paraphrophilus in association with a large patent foramen ovale: a case report

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    Carmichael Andrew

    2010-02-01

    Full Text Available Abstract Introduction Aggregatibacter paraphrophilus (former name Haemophilus paraphrophilus is a normal commensal of the oral flora. It is a rare cause of hepatobiliary or intracerebral abscesses. Case presentation We report a case of a 53-year-old Caucasian man with a liver abscess and subsequent brain abscesses caused by Aggregatibacter paraphrophilus. The probable source of the infection was the oral flora of our patient following ingestion of a dental filling. The presence of a large patent foramen ovale was a predisposing factor for multifocal abscesses. Conclusion In this case report, we describe an unusual case of a patient with both liver and brain abscesses caused by an oral commensal Aggregatibacter paraphrophilus that can occasionally show significant pathogenic potential.

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

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

    2014-01-01

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

  7. Brain Abscess after Esophageal Dilatation

    DEFF Research Database (Denmark)

    Gaïni, S; Grand, M; Michelsen, J

    2007-01-01

    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...

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

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

    2006-11-01

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

  9. Brain abscess: Current management

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    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.

  10. Brain abscess: Current management

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

    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 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

  11. 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.

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

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    Jacopo Monticelli

    2014-12-01

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

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

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    Rupam Borgohain

    2015-01-01

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

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

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    Vázquez Toledo María Eugenia

    2014-07-01

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

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

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    Albrecht Philipp

    2012-11-01

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

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

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    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.

  17. Prostatic Abscess Caused by Streptococcus mutans

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    Chau Nguyen

    1990-01-01

    Full Text Available The first reported case of prostatic abscess caused by Streptococcus mutans isolated in pure culture is described. Urethral dilation for obstruction was unsuccessful, so suprapubic cystostomy was performed. Perineal aspiration under ultrasonic guidance resulted in 10 mL of pus containing pure Strep mutans. Diagnosis of prostatic abscess is difficult since the clinical manifestations are nonspecific.

  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. Morganella morganii , subspecies morganii, biogroup A: An unusual causative pathogen of brain abscess

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    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.

  20. Morganella morganii, subspecies morganii, biogroup A: An unusual causative pathogen of brain abscess.

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    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.

  1. 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.

  2. The role of Streptococcus intermedius in brain abscess.

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    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. Favorable outcome in cerebral abscesses caused by Citrobacter koseri in a newborn infant

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    Sarah Algubaisi; Christoph Bührer; Ulrich-Wilhelm Thomale; Birgit Spors

    2014-01-01

    The treatment of brain abscesses in newborn infants is controversial. We report on a 6-week-old infant with multiple brain abscesses caused by Citrobacter koseri that resolved after treatment with combined surgical drainage and intravenous therapy with meropenem and fosfomycin.

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

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    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.

  5. Brain abscess by Kocuria rosea: Case report and literature review

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    Juan Esteban Muñoz Montoya

    2017-03-01

    Full Text Available Brain abscess is one of the most serious complications of head and neck infections (Tunkel, 2010 [1]. Defined as a focal intracranial infection that is initiated as an area of cerebritis and evolves into a collection of pus surrounded by a vascularized capsule (Tunkel and Scheld, 2011 [2]. The infectious agents depend on the pathogenesis of the infection and the presence of various predisposing conditions, however, in general: Streptococcus sp. is the most frequent microorganism (Tunkel and Scheld, 2011 [2]: Greenberg, 2010 [3]. In this article we report a case of brain abscess caused by Kocuria rosea, an entity that has not been reported previously in literature.

  6. Acute abdomen caused by brucellar hepatic abscess.

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    Ibis, Cem; Sezer, Atakan; Batman, Ali K; Baydar, Serkan; Eker, Alper; Unlu, Ercument; Kuloglu, Figen; Cakir, Bilge; Coskun, Irfan

    2007-10-01

    Brucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.

  7. ENTEROCOCCAL BRAIN ABSCESS OF OTOGENIC ORIGIN: A CA SE REPORT

    OpenAIRE

    2012-01-01

    ABSTRACT: Various aerobic and anaerobic bacteria have been r eported as causative agents of brain abscess but only a few cases of enterococcal brain abscesses have been reported. We report a case of enterococcal brain abscess of otoge nic origin in a 35 year old male who was known case of chronic suppurative otitis media (CSOM) and cholesteotoma of the right ear. The abscess material culture yielded an isolate which w as identified as Enterococcus faecium ...

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

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

    2009-09-01

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

  9. Citrobacter freundii brain abscess in a preterm infant: a case report and literature review.

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    Plakkal, Nishad; Soraisham, Amuchou Singh; Amin, Harish

    2013-04-01

    Intracranial abscesses are serious conditions but uncommon in preterm neonates. Citrobacter species are an uncommon cause of bacterial meningitis in neonates, but are associated with brain abscesses in a majority of cases. We report a preterm infant who developed Citrobacter freundii meningitis with brain abscess, who was successfully treated with antibiotics and surgical drainage. The infant had normal neurological outcome at follow-up. We report this case to highlight the importance of serial neuroimaging in the diagnosis of cerebral abscess in infants with Citrobacter meningitis.

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

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

    2016-03-01

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

  11. A delayed frontorbital abscess caused by a penetrating nonmissile foreign body a bamboo stick

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    Liu Wen-ke

    2009-01-01

    Full Text Available We report an interesting case of delayed frontal abscess caused by a penetrating nonmissile foreign body, a bamboo stick in a 1.5-year-old male child. A parietal craniotomy was performed, and the brain abscess was resected along with the foreign body without any damage to the surrounding brain tissue. He also received the appropriate antibiotics. The child made a good recovery.

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

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    V R Borade

    2011-01-01

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

  13. Adult brain abscess associated with patent foramen ovale: a case report

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    Stathopoulos Georgios T

    2007-08-01

    Full Text Available Abstract Brain abscess results from local or metastatic septic spread to the brain. The primary infectious site is often undetected, more commonly so when it is distant. Unlike pediatric congenital heart disease, minor intracardiac right-to-left shunting due to patent foramen ovale has not been appreciated as a cause of brain abscess in adults. Here we present a case of brain abscess associated with a patent foramen ovale in a 53-year old man with dental-gingival sepsis treated in the intensive care unit. Based on this case and the relevant literature we suggest a link between a silent patent foramen ovale, paradoxic pathogen dissemination to the brain, and development of brain abscess.

  14. ENTEROCOCCAL BRAIN ABSCESS OF OTOGENIC ORIGIN: A CA SE REPORT

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    Vidyasagar

    2012-09-01

    Full Text Available ABSTRACT: Various aerobic and anaerobic bacteria have been r eported as causative agents of brain abscess but only a few cases of enterococcal brain abscesses have been reported. We report a case of enterococcal brain abscess of otoge nic origin in a 35 year old male who was known case of chronic suppurative otitis media (CSOM and cholesteotoma of the right ear. The abscess material culture yielded an isolate which w as identified as Enterococcus faecium by standard biochemical reaction. The isolate was sens itive to penicillin, ampicillin, gentamicin, vancomycin, ofloxacin, lincomycin, and cloxacillin.

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

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

    2012-01-01

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

  16. 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.

  17. Abscess

    Science.gov (United States)

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

  18. Hyperbaric oxygen therapy in spontaneous brain abscess patients

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Aboal

    2006-06-01

    aspiration and the beginning of an antimicrobial therapy are essential to the patient’s good evolution. This paper presents a patient with a primary polycythaemia and a recurrent brain abscess by Nocardia asteroides, probably of dental origin.

  20. 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.

  1. Case of a cerebral abscess caused by Porphyromonas gingivalis in a subject with periodontitis

    Science.gov (United States)

    Grisar, Koenraad; Maes, Honorine; Politis, Constantinus

    2017-01-01

    We report the case of a 65-year-old man presenting with generalised seizures after developing a right frontal brain abscess. Stereotactic aspiration and subsequent matrix assisted laser desorption/ionisation time-of-flight analyzer (MALDI-TOF) spectrometry revealed Porphyromonas gingivalis as the only causative anaerobe microorganism. Secondary incision and drainage was required due to neurological deterioration with increased dimensions of the abscess, intracranial pressure and formation of a subdural occipitoparietal empyema. Oral imaging was positive for apical periodontitis of multiple elements; therefore, the remaining dentition was removed. Targeted antibiotic treatment included intravenous ceftriaxone and ornidazole. The patient was discharged to our revalidation unit 59 days after admission to make a full recovery. To the best of our knowledge, this is the sixth reported case of P. gingivalis causing an intracranial abscess and the third case of a true intracerebral parenchymal abscess caused by this bacterium. PMID:28228396

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Brain Abscesses Associated with Asymptomatic Pulmonary Arteriovenous Fistulas

    Science.gov (United States)

    Nam, Taek-Kyun; Park, Yong-sook; Kwon, Jeong-taik

    2017-01-01

    Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source. PMID:28061502

  5. A case of retropharyngeal abscess with spondylitis causing tetraplegia

    Directory of Open Access Journals (Sweden)

    Takeshi Kusunoki

    2012-04-01

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

  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....... Only in 1984 a case of acute epiglottitis due to H. parainfluenzae has been described in the literature. Still, in this case we think that H. parainfluenzae was the most likely pathogen causing the abscess....

  7. Brain abscesses in neonates: Neurosonographic diagnosis and long-term follow-up

    Directory of Open Access Journals (Sweden)

    Obradović Slobodan

    2005-01-01

    Full Text Available 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 a ventriculoperitoneal shunt in two cases, because of the development of hydrocephalus. Follow-up on the operated infants revealed that one infant died at the age of 9 months; one, who had a bilateral abscess, demonstrated significant neurodevelopmental retardation in the third month of his life (so far it has not been brought under control; while the third one, whom we monitored until the age of 2, displayed regular psychomotor development (preserved intellect, motor skills, sight, and hearing.

  8. Chronic and Recurrent Subareolar Abscess of the Breast from Underlying Causes

    Energy Technology Data Exchange (ETDEWEB)

    An, Jin Kyung; Kang, Jae Hee; Kim, Eun Kyung; Hong, Young Ok [Eulji University, Eulji Hospital, Daejeon (Korea, Republic of)

    2012-03-15

    A subareolar abscess is the most common non-puerperal abscess of the breast. The main cause of a subareolar abscess is squamous metaplasia, which obstructs the lactiferous ducts and leads to the stasis of secretions and rupture of the ducts. However, there are other causes of subareolar abscess formation

  9. A fatal case of Nocardia otitidiscaviarum pulmonary infection and brain abscess: taxonomic characterization by molecular techniques

    Directory of Open Access Journals (Sweden)

    Aranaz Carlos

    2009-04-01

    Full Text Available Abstract We report on a rare case of pulmonary Nocardiosis and brain abscess caused by Nocardia otitidiscaviarum in an elderly woman with chronic obstructive pulmonary disease. Taxonomic identification involved phenotypic testing, restriction fragment length polymorphism (RFLP, and complete 16S rRNA gene sequencing.

  10. 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.

  11. Epidural abscess caused by Streptococcus milleri in a pregnant woman

    Directory of Open Access Journals (Sweden)

    Bearman Gonzalo

    2005-11-01

    Full Text Available Abstract Background Bacteria in the Streptococcus milleri group (S. anginosus, S. constellatus, and S. intermedius are associated with bacteremia and abscess formation. While most reports of Streptococcus milleri group (SMG infection occur in patients with underlying medical conditions, SMG infections during pregnancy have been documented. However, SMG infections in pregnant women are associated with either neonatal or maternal puerperal sepsis. Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia. We report a case of spinal-epidural abscess caused by SMG in a young, pregnant woman without an antecedent history of spinal epidural anesthesia and without any underlying risk factors for invasive streptococcal disease. Case presentation A 25 year old pregnant woman developed neurological symptoms consistent with spinal cord compression at 20 weeks gestation. She underwent emergency laminectomy for decompression and was treated with ceftriaxone 2 gm IV daily for 28 days. She was ambulatory at the time of discharge from the inpatient rehabilitation unit with residual lower extremity weakness. Conclusion To our knowledge, this is the first reported case of a Streptococcus milleri epidural abscess in a healthy, pregnant woman with no history of epidural anesthesia or invasive procedures. This report adds to the body of literature on SMG invasive infections. Treatment of SMG spinal-epidural abscess with neurologic manifestations should include prompt and aggressive surgical decompression coupled with targeted anti-infective therapy.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Science.gov (United States)

    Chauhan, V; Thakur, S; Rana, B

    2015-01-01

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

  14. Surgical Treatment of a Chronic Brain Abscess and Growing Skull Fracture in a Dog

    Directory of Open Access Journals (Sweden)

    Amy W. Hodshon

    2015-01-01

    Full Text Available A 2-year-old female spayed Miniature Dachshund was presented for seizures and right prosencephalic signs. A multiloculated, ring-enhancing mass in the right cerebrum associated with dilation of the right lateral ventricle and brain herniation was seen on magnetic resonance imaging. An irregular calvarial defect with smoothly scalloped edges was seen overlying the mass on computed tomography. The mass was removed via craniectomy and was diagnosed as a chronic brain abscess caused by Peptostreptococcus anaerobius. The patient was maintained on antibiotics for 12 weeks. Follow-up MRI performed 14 weeks after surgery confirmed complete removal of the abscess as well as a contrast-enhancing collection of extra-axial material consistent with a chronic subdural hematoma. The neurologic abnormalities, including seizures, have improved in the 44 months since surgery. Brain abscesses in dogs can have an insidious clinical course prior to causing serious neurologic deterioration. Ventricular entrapment by an intracranial mass can contribute to acute neurologic decline. If surgically accessible, outcome following removal of a brain abscess can be excellent; aerobic and anaerobic bacterial culture should be performed in these cases. Subdural hematoma can occur following removal of a large intracranial mass. Growing skull fractures can occur in dogs but may not require specific surgical considerations.

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

    Science.gov (United States)

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

    2013-04-22

    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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-02-01

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

  18. Perianal abscess caused by Actinomyces: report of a case.

    Science.gov (United States)

    Magdeburg, R; Grobholz, R; Dornschneider, G; Post, S; Bussen, D

    2008-12-01

    Most anal abscesses are caused by anal fistula and invasion of the surrounding tissues by a mixed colonic flora. The treatment comprises excision of the abscess and. if appropriate, fistulectomy. Primary anorectal actinomycosis and perianal actinomycosis are very rare and are caused by Actinomyces, which is a ubiquitous microaerophilic bacterium. Here we report a case of perianal actinomycosis. The patient had a short history of painless perineal induration without fever or leucocytosis with normal routine blood tests. After excision sulphur granules drained from the cavity and the pathological investigations were indicative of perianal actinomycosis. Appropriate surgery and antibiotic treatment healed the perianal infection. After elimination of other diagnoses, e.g. Crohn's disease, tuberculosis and malignant growths, this rare case of perianal actinomycosis should be kept in mind in the differential diagnosis of a painless perianal mass.

  19. Liver abscess caused by Ascaris lumbricoides: case report

    OpenAIRE

    Pinilla,Análida Elizabeth; Myriam Consuelo LÓPEZ; Ricaurte, Orlando; 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.

  20. Brain abscess with an unexpected finding: Actinomyces meyeri CNS infection

    DEFF Research Database (Denmark)

    Eiset, Andreas Halgreen; Thomsen, Marianne Kragh; Wejse, Christian

    oedema. By MRI an abscess was suspected and the patient was transferred to the department of neurosurgery, where drainage was performed. Microscopy revealed gram-positive cocci and gram-negative rods and iv. treatment with ceftriaxone 4g x 1 and metronidazole 1g x 1 was commenced. Pus cultures showed...... Prevotella spp. and A. meyeri and the initial treatment was changed to penicillin G 5 MIU x 4 and metronidazole 500 mg x 3 for four weeks followed by oral amoxicillin 500 mg x 3 for three months. The abscess regressed on this treatment and there were no CNS related symptoms at three months follow......-up. The source of infection was most likely periodontitis with spread to the lungs from aspiration or oropharyngeal secretion into the respiratory tract, alternatively from haematogenous spread. Conclusions: We report of the successful treatment of a cerebral abscess caused by A. meyeri with narrow spectrum...

  1. Abscess

    Science.gov (United States)

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

  2. Thoracic spinal epidural abscess caused by Salmonella typhi.

    Science.gov (United States)

    Abdullah, Saad Hamdan; Ata, Osama Abu; El-Adwan, Nael

    2008-03-01

    A 56-year-old man presented with a rare spinal epidural abscess manifesting as attacks of back pain associated with fever, weight loss, generalized weakness and fatigability, and constipation. He had multiple skin pustules in the last 4 months treated with oral amoxicillin. He had suffered diabetes mellitus for the last 5 years and was insulin dependent. Physical examination found slight paraparesis with sensory loss around the nipple and sphincteric urgency, and diabetic retinopathy. Magnetic resonance imaging showed edematous T2, T3, and T4 vertebral bodies, and narrow enhanced T3-4 disk space with a soft tissue enhanced mass mostly anterior to the spinal cord and indenting the cord. T3-4 costotransversectomy was performed to remove the extradural mass and evacuate the intradiscal material. Histological examination of the bone found osteomyelitis, and culture of the soft tissue showed Salmonella typhi sensitive to ceftriaxone and ciprofloxacin. Intravenous ceftriaxone administration was started, and the patient was discharged after 6 days in good condition. The outcome of spinal epidural abscess is devastating unless recognized and treated early. The present case of spinal epidural abscess in the thoracic spine caused by Salmonella typhi infection illustrates the importance of cultures to assess the drug sensitivity of the specific strain detected and adjusting the treatment accordingly.

  3. 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.

  4. 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.)

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

    Directory of Open Access Journals (Sweden)

    Norair Adjamian

    2015-01-01

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

  6. Cladophialophora bantiana brain abscess masquerading cerebral tuberculoma in an immunocompetent host

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2014-03-01

    Full Text Available Phaeohyphomycosis is a term that collectively describes fungal infections caused by moulds and yeasts that have brown-pigmented cell walls (due to the presence of melanin. We report a case of 45 year female who had multiple coalescing lesions in the right basal ganglionic and thalamic region. Based on the imaging and investigation findings a diagnosis of cerebral tuberculoma was suspected. Histopathology of the excised specimen showed brown colored fungal hyphae surrounded by neutrophilic infiltrate. A diagnosis of phaeohyphomycosis caused by Cladophialophora bantiana was made and accordingly antifungal treatment was started. Brain abscess caused by Cladophialophora bantiana in an immunocompetent host is relatively uncommon and usually associated with overall high mortality. The best outcomes have been reported in patients who receive both surgical excision of the abscess followed by systemic antifungal therapy. In view of its rarity of these lesions preoperative diagnosis is difficult particularly in an immunocompetent host and absence of other risk factors.

  7. Thigh Abscess Caused by Yersinia enterocolitica in an Immunocompetent Host

    Directory of Open Access Journals (Sweden)

    Purva Gumaste

    2012-01-01

    Full Text Available Yersinia enterocolitica is primarily a gastrointestinal tract pathogen known to cause gastroenteritis, although it may produce extra-intestinal infections like sepsis and its sequelae. However, primary cutaneous infections are extremely rare. We present a case of Y. enterocolitica thigh abscess in an immunocompetent adult. The portal of entry is unclear in this case. He did many outdoor activities that involved skin injuries and exposure to soil and contaminated water. Hence, direct inoculation as a result of exposure to contaminated water is postulated in the absence of evidence for a gastrointestinal route of infection.

  8. 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.

  9. 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.

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

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    V Chauhan

    2015-01-01

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

  11. Periprosthetic breast abscess caused by Streptococcus pyogenes after scarlet fever.

    Science.gov (United States)

    Persichetti, Paolo; Langella, Marika; Marangi, Giovanni Francesco; Vulcano, Ettore; Gherardi, Giovanni; Dicuonzo, Giordano

    2008-01-01

    We present a case of a 32-year-old white women, affected by breast cancer and treated with mastectomy, who underwent immediate breast reconstruction with a tissue expander. She presented a periprosthetic infection from Streptococcus pyogenes (group A streptococcus, GAS) after scarlet fever. S. pyogenes may be responsible for suppurative complications of the respiratory system and a variety of metastatic foci of infection such as suppurative arthritic, endocarditis, meningitis, or brain abscess. Even though, in the literature, several cases and types of infection associated with breast implantation have been described, to our knowledge this is the first case report of periprosthetic infection after scarlet fever. Signs, symptoms, diagnosis, and treatment of GAS infection that occurred 2 months after the surgery are discussed.

  12. 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.

  13. Pseudomonas Sepsis and Multiple Brain Abscesses in a Newborn Infant Following Neurosurgical Procedure for Meningocele

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    Bilgili Gökmen

    2015-10-01

    Full Text Available Introduction: Postneurosurgical brain abscess carries a high risk of neurologic morbidity and mortality. Case Presentation: A newborn infant had Pseudomonas sepsis and multiple brain abscesses after meningocele repair, and was successfully treated medically. Conclusion: Prompt recognition of this life-threatening condition is crucial.

  14. A case of a brain stem abscess with a favorable outcome

    NARCIS (Netherlands)

    Bulthuis, Vincent J; Gubler, Felix S; Teernstra, Onno P M; Temel, Yasin

    2015-01-01

    BACKGROUND: A brain stem abscess is a rare and severe medical condition. Here, we present a rare case of a brain stem abscess in a young pregnant woman, requiring acute stereotactic intervention. CASE DESCRIPTION: A 36-year-old woman presented with a headache, nausea, and vomiting, and computed tomo

  15. [Fungal mycotic aneurysms and multiple cerebral abscesses caused by Scedosporium apiospermum. Apropos of a case with review of the literature].

    Science.gov (United States)

    Baudrillard, J C; Rousseaux, P; Lerais, J M; Toubas, O; Scherpereel, B; Gari, M; Comte, P

    1985-04-01

    The authors report a case of intracranial fungal aneurysm and brain abscesses. The compromised host was a young drowned woman. Scedosporium Apiospermum was isolated in fungal culture from abscess. Radiological and clinical pictures are typical of the hyphal form.

  16. Cholecystocolonic Fistulas from Diverticulosis: A Potentially Missable Cause of Liver Abscesses

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    Ben Warner

    2016-01-01

    Full Text Available Cholecystocolonic fistulas (CCF due to colonic diverticulosis are a rare cause of liver abscesses. It is even rarer to simultaneously have choledocholithiasis, another cause for liver abscesses. In this case report, we found both pathologies and emphasise the need to study cholangiograms carefully so as not to miss alternative diagnoses.

  17. Cholecystocolonic Fistulas from Diverticulosis: A Potentially Missable Cause of Liver Abscesses

    Science.gov (United States)

    Wong, Terry; Berry, Philip

    2016-01-01

    Cholecystocolonic fistulas (CCF) due to colonic diverticulosis are a rare cause of liver abscesses. It is even rarer to simultaneously have choledocholithiasis, another cause for liver abscesses. In this case report, we found both pathologies and emphasise the need to study cholangiograms carefully so as not to miss alternative diagnoses. PMID:27994893

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

    Science.gov (United States)

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

    2009-04-01

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

  19. 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.

  20. Disseminated tuberculosis causing isolated splenic vein thrombosis and multiple splenic abscesses.

    Science.gov (United States)

    Jain, Deepak; Verma, Kamal; Jain, Promil

    2014-09-01

    Tuberculosis is a common infectious cause of splenic enlargement in developing countries, but tubercular splenic abscesses are a rare presentation, found predominantly in immunocompromised populations. We report a case of tubercular splenic abscesses with isolated splenic vein thrombosis in an immunocompetent person.

  1. Thoracic spinal epidural abscess caused by fishbone perforation

    Science.gov (United States)

    Chen, Jian-Min; Wang, Zhi-Yong; Ni, Guo-Xin

    2016-01-01

    Abstract Rationale: Ingestion of a fishbone is a common cause of esophageal injury, but spinal epidural abscess (SEA) is a rare condition due to the esophageal penetration by a swallowed fishbone. Prompt diagnosis can be seldom made owing to incomplete patient history taking and difficulties in imaging evidence identification. Patient concerns: We describe the case of a 62-year-old woman who was stuck in her throat by a fishbone, and complained of back pain, paresis of the lower limbs and fever, successively. To our knowledge, this is the first case report that we know of thoracic SEA caused by fishbone perforation. Diagnoses: About 20 days after the onset of severe back pain, she was diagnosed with SEA based on the clinical presentation and imaging findings. Interventions: Antibiotic therapy and rehabilitation therapy were carried out afterwards. However, due to exacerbation of her condition, surgical intervention had to be taken eventually. Outcomes: It is quite unfortunate for this patient to have a poor prognosis due to a delayed diagnosis and an improper management. Lessons: A number of lessons can be learnt from this case. PMID:27930507

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

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    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.

  3. Brain abscess associated with Aggregatibacter actinomycetemcomitans : case report and review of literature

    NARCIS (Netherlands)

    Rahamat-Langendoen, Janette C.; van Vonderen, Marit G. A.; Engstrom, Lex J.; Manson, Willem L.; van Winkelhoff, Arie Jan; Mooi-Kokenberg, Esther A. N. M.

    2011-01-01

    Introduction: Aggregatibacter actinomycetemcomitans is considered a major pathogen in localized and generalized aggressive periodontitis. A. actinomycetemcomitans has been found in various extra oral infections and most frequently in endocarditis. We report a patient with multiple brain abscesses du

  4. Brain Abscess in the Computed Tomography Era: A 10-year Experience from Auckland, New Zealand

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    DJ Holland

    1993-01-01

    Full Text Available Notes were reviewed for 68 patients with brain abscess diagnosed at Auckland Hospital, Auckland, New Zealand between 1978 and 1988. Mean age was 30 years (range one week to 74 years. There were 48 men and 40% were Maori or Pacific Island Polynesians. Seventy-two per cent of patients had headache, 54% had fever and 72% had lateralizing neurological signs. Thirty-one per cent of abscesses were associated with contiguous infection (otic, sinus, dental. Forty-four per cent were in the frontal lobe. Two abscesses were sterile; 197 bacterial isolates were cultured from the remainder. Fifty-four per cent contained obligate anaerobes, which were the only isolates in 22%. Streptococcus anginosus was the single most common isolate present in 22% of the abscesses. Amoxycillin plus metronidazole provided cover for approximately 95% of the total isolates on the basis of sensitivity testing. Treatment was with surgery and antibiotics in all but three patients, who were cured with antibiotics alone. Sixty per cent had a definitive regimen of penicillin (or ampicillin/amoxycillin and/or metronidazole, always intravenous initially but subsequently often orally. Median duration of antibiotic treatment was 57 days (range 28 to 206. Seventy-five per cent had initial aspiration, 9% open drainage and 7% were excised initially. Seventy-one per cent had a good functional outcome. Mortality was 8.8%. Factors associated with a poor outcome were trauma as a cause, and delays after admission of more than seven days to diagnosis and/or operation.

  5. BRAIN ABSCESS DUE TO Staphylococcus aureus OF CRYPTOGENIC SOURCE IN AN HIV-1 INFECTED PATIENT IN USE OF ANTIRETROVIRAL THERAPY

    Science.gov (United States)

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

    2016-01-01

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

  6. Submucosal Abscess of the Esophagus Caused by Piriform Sinus Fistula Treated with Transoral Video Laryngoscopic Surgery.

    Science.gov (United States)

    Koyama, Satoshi; Fujiwara, Kazunori; Morisaki, Tsuyoshi; Fukuhara, Takahiro; Kawamoto, Katsuyuki; Kitano, Hiroya; Takeuchi, Hiromi

    2016-01-01

    Piriform sinus fistula (PSF) is a rare branchial anomaly that causes repetitive acute suppurative thyroiditis or deep neck abscess. The definitive treatment of PSF is open neck surgery. However, such surgery has a cosmetic problem and a high risk of recurrence. Furthermore, identifying the fistula is difficult due to previous repetitive infections. We report a case of esophageal submucosal abscess caused by PSF treated with endoscopic mucosal incision. The patient underwent transoral video laryngoscopic surgery (TOVS), and endoscopy as well as fluoroscopy revealed complete closure of PSF without any complication. TOVS is a novel surgical technique for the definitive treatment of PSF with esophageal submucosal abscess.

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

    Science.gov (United States)

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

    2002-02-01

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

  8. Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

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    Joji Inamasu

    2015-07-01

    Full Text Available Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative is more appropriate in patients with primary intraventricular brain abscesses.

  9. Multiple Pyogenic Liver Abscesses Caused by Microperforation of an Idiopathic Cecal Ulcer.

    Science.gov (United States)

    Yeom, Dong Han; Sohn, Ki Chang; Chu, Min Su; Jo, Dong Ho; Cho, Eun Young; Kim, Haak Cheoul

    2016-01-25

    Idiopathic cecal ulcer is a rare disease entity of unknown cause diagnosed by ruling out other known causes of cecal ulceration. The most common complication of an idiopathic cecal ulcer is bleeding; perforation, peritonitis, abscess, and stricture formation have been noted. The authors treated a 53-year-old woman who presented with fever and intermittent right upper quadrant abdominal pain. Multiple pyogenic liver abscess and a solitary cecal ulcer were diagnosed by radiologic, endoscopic, and pathologic examination, followed by laparoscopic cecectomy. After extensive study, we concluded that this patient's liver abscesses were a complication of the idiopathic cecal ulcer. Herein, we report a case of multiple pyogenic liver abscess caused by microperforation of idiopathic cecal ulcer.

  10. 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.

  11. Haemophilus influenzae as a cause of Brodie's abscess in an infant.

    Science.gov (United States)

    Kurlandsky, L E; Quinn, P H; Sills, E M

    1979-01-01

    Brodie's abscess is a form of subacute osteomyelitis which is defined by a particular constellation of clinical, radiological and pathological features. Its occurrence in infants is extremely rare. This case documents just such an occurrence. To our knowledge, the pathogen Haemophilus influenzae has not been previously recognized as a cause of Brodie's abscess in particular or subacute osteomyelitis in general. The clinical presentation and diagnostic pitfalls which may be encountered in this age group are discussed.

  12. Septic-embolic and septic-metabolic brain abscess; Septisch-embolischer und septisch-metastatischer Hirnabszess

    Energy Technology Data Exchange (ETDEWEB)

    Weber, W.; Henkes, H.; Kuehne, D. [Alfried-Krupp-Krankenhaus Essen (Germany). Klinik fuer Radiologie und Neuroradiologie; Felber, S. [Universitaetsklinik Innsbruck (Austria). Klinische Abt. der Radiologie I; Jaenisch, W. [Freie Univ. Berlin (Germany). Inst. fuer Neuropathologie; Woitalla, D. [Bochum Univ. (Germany). St. Josef-Hospital

    2000-11-01

    The hematogeneous spread of bacteria, fungi and protozoa may also reach the brain vessels, which happens mostly through septic emboli. >From such an embolus a metastatic focal encephalitis and later a septic-embolic brain abscess may arise. The most frequently underlying infections that may cause septic emboli are bacterial endocarditis as well as bacterial infections of artificial heart valve prostheses. Congenital heart malformations with a right-to-left shunt also play here a certain role. Basically, however, all septic conditions and bacteriemias may cause septic-embolic brain abscesses. They occur frequently as multiple lesions. MRI is superior to CT in depicting the different stages of evolution from focal encephalitis, through the hardly encapsulated early abscess, to the formation of a membrane and later a dense fibrous capsule. The medical treatment of a brain abscess requires properly performed CT or MRI follow-up examinations in order to realize early enough a possible growing of such a lesion. (orig.) [German] Die haemoatogene Ausbreitung von Bakterien, Pilzen oder Protozoen bis in die Hirngefaesse erfolgt meist durch eine septische Embolie. Es entstehen eine metastatische Herdenzephalitis und im weiteren Verlauf daraus ein septisch-embolischer Hirnabszess. Die haeufigste Grunderkrankung die zu septischen Embolien fuehrt, ist die bakterielle Endokarditis sowie die bakterielle Infektion von Herzklappenprothesen. Eine besondere Bedeutung kommt hier den angeborenen kardialen Fehlbildungen mit Rechts-Links-Shunt zu. Grundsaetzlich koennen jedoch alle Bakteriaemien zu septisch-embolischen Hirnabszessen fuehren. Septisch-embolische Hirnabszesse treten aufgrund ihres Entstehungsmechanismus haeufig multipel auf. Die CT und besser noch die MRT erlauben die Darstellung aller Entwicklungsstadien von der Herdenzephalitis ueber den kaum abgegrenzten Abszess, die Membranbildung bis zur Entstehung einer dicken, die eitergefuellte Hoehle allseits umgebenden

  13. Bacillus cereus bacteremia and multiple brain abscesses during acute lymphoblastic leukemia induction therapy.

    Science.gov (United States)

    Hansford, Jordan R; Phillips, Marianne; Cole, Catherine; Francis, Joshua; Blyth, Christopher C; Gottardo, Nicholas G

    2014-04-01

    Bacillus cereus can cause serious infections in immunosuppressed patients. This population may be susceptible to B. cereus pneumonia, bacteremia, cellulitis, and rarely cerebral abscess. Here we report an 8-year-old boy undergoing induction therapy for acute lymphoblastic leukemia who developed multifocal B. cereus cerebral abscesses, highlighting the propensity for B. cereus to develop cerebral abscesses. A review of the literature over the past 25 years identified another 11 cases (3 children and 8 adults) of B. cereus cerebral abscess in patients undergoing cancer therapy. B. cereus cerebral abscesses were associated with a high mortality rate (42%) and significant morbidity. Notably, B. cereus bacteremia with concomitant cerebral abscess was associated with induction chemotherapy for acute leukemia in both children and adults (10 of 12 case reports). Our case report and review of the literature highlights the propensity for B. cereus to develop cerebral abscess(es). Therefore, early consideration for neuroimaging should be given for any neutropenic cancer patient identified with B. cereus bacteremia, in particular those with acute leukemia during induction therapy.

  14. Nocardia abscessus-related intracranial aneurysm of the internal carotid artery with associated brain abscess: A case report and review of the literature.

    Science.gov (United States)

    Farran, Yvette; Antony, Suresh

    2016-01-01

    Nocardia infections primarily begin in the lungs and spread hematogenously to other sites in the body. Thus, a Nocardia brain abscess is not a completely uncommon occurrence. However, a Nocardia brain abscess complicated by a middle cerebral artery and infectious intracranial aneurysm is a very rare clinical entity. We present a case of an infectious intracranial aneurysm with an associated Nocardia brain abscess that required surgical intervention and resection. The patient was an immunocompetent 60-year-old male who presented with a chief complaint of headache and was found to have an infected intracranial aneurysm and cerebral abscess. He underwent drainage of the abscess with subsequent resection of the infected aneurysm. Cultures from both the blood vessel and brain tissue grew Nocardia abscessus. He was successfully treated with 6 weeks of ceftriaxone and high-dose trimethoprim-sulfamethoxazole. Infectious intracranial aneurysms of the brain caused by Nocardia are rare occurrences, and only a single previous case has been described in the literature. The outcomes of this condition can be catastrophic if it is not treated with a combination of surgery and intravenous antibiotics. The guidelines for the management of this infection are not well defined at this time.

  15. 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.

  16. [Drainage of the Frontal Sinus to Cure Epidural and Brain Abscesses Developed after Surgery via Anterior Interhemispheric Approach].

    Science.gov (United States)

    Bando, Kazuhiko; Ebisutani, Daizo

    2015-08-01

    We report a woman whose anterior communicating artery (AcomA) aneurysm was clipped via an anterior interhemispheric approach when she was 49 years old. At the age of 51, she presented with a subcutaneous abscess and osteomyelitis, so the cranioplastic bone was removed. Six months later, she underwent cranioplasty using hydroxyapatite. Her subcutaneous abscess recurred and the epidural abscess and hydroxyapatite were removed 11 years later after the first operation. The patient underwent observation therapy for the next 4 years, as the dura was ossified. She presented with frontal swelling 15 years after aneurysmal clipping, and neither abscess puncture nor the administration of antibacterial drugs was curative. The patient also complained of chill, thirst, and tremor, and developed disorientation 25 days later. Computed tomography (CT) and magnetic resonance imaging (MRI) showed extension of the epidural and subcutaneous abscesses to a frontal brain abscess. After consulting an otolaryngologist, we performed frontal drainage into the nasal cavity. After making a bicoronal skin incision, the subcutaneous, epidural, and intracapsular brain abscesses were removed while taking care not to damage the capsules. A silicone T-tube was placed in the bifrontal epidural cavity (previous frontal sinus), and its tip was inserted into the nasal cavity through the nasofrontal duct for abscess drainage. After 3 months, the tube was removed. A CT scan acquired 10 years later showed no brain abscess, perifocal edema, or epidural and subcutaneous abscesses.

  17. Amebic liver abscess

    Science.gov (United States)

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

  18. Epidural abscess

    Science.gov (United States)

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

  19. Brain Abscess and Keratoacanthoma Suggestive of Hyper IgE Syndrome

    Directory of Open Access Journals (Sweden)

    Soheyla Alyasin

    2015-01-01

    Full Text Available Hyper immunoglobulin-E (IgE syndrome is an autosomal immune deficiency disease. It is characterized by an increase in IgE and eosinophil count with both T-cell and B-cell malfunction. Here, we report an 8-year-old boy whose disease started with an unusual skin manifestation. When 6 months old he developed generalized red, nontender nodules and pathologic report of the skin lesion was unremarkable (inflammatory. Then he developed a painless, cold abscess. At the age of 4 years, he developed a seronegative polyarticular arthritis. Another skin biopsy was taken which was in favor of Keratoacanthoma. Laboratory workup for immune deficiency showed high eosinophil count and high level of immunoglobulin-E, due to some diagnostic criteria (NIH sores: 41 in 9-year-olds, he was suggestive of hyper IgE syndrome. At the age of 8, the patient developed an abscess in the left inguinal region. While in hospital, the patient developed generalized tonic colonic convulsion and fever. Brain computed tomography scan revealed an abscess in the right frontal lobe. Subsequently magnetic resonance imaging (MRI of the brain indicated expansion of the existing abscess to contralateral frontal lobe (left side. After evacuating the abscesses and administrating intravenous antibiotic, the patient’s condition improved dramatically and fever stopped.

  20. Simultaneous detection of valine and lactate using MEGA-PRESS editing in pyogenic brain abscess.

    Science.gov (United States)

    Lange, Thomas; Ko, Cheng-Wen; Lai, Ping-Hong; Dacko, Michael; Tsai, Shang-Yueh; Buechert, Martin

    2016-12-01

    Valine and lactate have been recognized as important metabolic markers to diagnose brain abscess by means of MRS. However, in vivo unambiguous detection and quantification is hampered by macromolecular contamination. In this work, MEGA-PRESS difference editing of valine and lactate is proposed. The method is validated in vitro and applied for quantitative in vivo experiments in one healthy subject and two brain abscess patients. It is demonstrated that with this technique the overlapping lipid signal can be reduced by more than an order of magnitude and thus the robustness of valine and lactate detection in vivo can be enhanced. Quantification of the two abscess MEGA-PRESS spectra yielded valine/lactate concentration ratios of 0.10 and 0.27. These ratios agreed with the concentration ratios determined from concomitantly acquired short-TE PRESS data and were in line with literature values. The quantification accuracy of lactate (as measured with Cramér-Rao lower bounds in LCModel processing) was better for MEGA-PRESS than for short-TE PRESS in all acquired in vivo datasets. The Cramér-Rao lower bounds of valine were only better for MEGA-PRESS in one of the two abscess cases, while in the other case coediting of isoleucine confounded the quantification in the MEGA-PRESS analysis. MEGA-PRESS and short-TE PRESS should be combined for unambiguous quantification of amino acids in abscess measurements. Simultaneous valine/lactate MEGA-PRESS editing might benefit the distinction of brain abscesses from tumors, and further categorization of bacteria with reasonable sensitivity and specificity.

  1. Liver abscess caused by CTX-M-55-type extended-spectrum β-lactamase (ESBL)-producing Salmonella enteritidis.

    Science.gov (United States)

    Imoto, Akira; Ooi, Yukimasa; Edogawa, Shoko; Ogura, Takeshi; Masuda, Daisuke; Mohamed, Malak; Takii, Michiaki; Umegaki, Eiji; Kawahara, Ryuji; Ukimura, Akira; Higuchi, Kazuhide

    2014-01-01

    Liver abscesses secondary to Salmonella species are rarely described in the general population. We herein describe a case of a liver abscess caused by CTX-M-55-type extended-spectrum β-lactamase (ESBL)-producing Salmonella enteritidis, which has not been reported in the literature. A 54-year-old male was admitted due to a high fever and was clinically diagnosed with a liver abscess. Culture of the fluid from the liver abscess revealed CTX-M-55-type ESBL-producing S. enteritidis. Although the patient underwent percutaneous transhepatic abscess drainage and antibiotic therapy, he died one month later. It should be noted that liver abscesses are potentially fatal depending on the causative pathogen.

  2. Pyogenic liver abscess

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Khalid F AlHabib

    2003-01-01

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

  4. Do neutrophils play a role in establishing liver abscesses and distant metastases caused by Klebsiella pneumoniae?

    Science.gov (United States)

    Lin, Jung-Chung; Chang, Feng-Yee; Fung, Chang-Phone; Yeh, Kuo-Ming; Chen, Chiung-Tong; Tsai, Yu-Kuo; Siu, L Kristopher

    2010-11-30

    Serotype K1 Klebsiella pneumoniae is a major cause of liver abscesses and endophthalmitis. This study was designed to identify the role of neutrophils in the development of distant metastatic complications that were caused by serotype K1 K. pneumoniae. An in vitro cellular model was used to assess serum resistance and neutrophil-mediated killing. BALB/c mice were injected with neutrophils containing phagocytosed K. pneumoniae. Serotype K1 K. pneumoniae was significantly more resistant to serum killing, neutrophil-mediated phagocytosis and intra-cellular killing than non-K1 isolates (pneutrophils containing phagocytosed serotype K1 K. pneumoniae led to abscess formation in multiple sites including the subcutaneous tissue, lung, and liver, whereas no abscess formation was observed in mice injected with non-K1 isolates. The resistance of serotype K1 K. pneumoniae to complement- and neutrophil-mediated intracellular killing results in the dissemination of K. pneumoniae via the bloodstream. Escape from neutrophil intracellular killing may contribute to the dissemination and establishment of distant metastases. Thus, neutrophils play a role as a vehicle for helping K. pneumoniae and contributing to the establishment of liver abscess and distant metastatic complications.

  5. Campylobacter jejuni, an uncommon cause of splenic abscess diagnosed by 16S rRNA gene sequencing.

    Science.gov (United States)

    Seng, Piseth; Quenard, Fanny; Menard, Amélie; Heyries, Laurent; Stein, Andreas

    2014-12-01

    Splenic abscess is a rare disease that primarily occurs in patients with splenic trauma, endocarditis, sickle cell anemia, or other diseases that compromise the immune system. This report describes a culture-negative splenic abscess in an immunocompetent patient caused by Campylobacter jejuni, as determined by 16S rRNA gene sequencing.

  6. Tuberculous brain abscess and subdural empyema in an immunocompetent child: Significance of AFB staining in aspirated pus

    Directory of Open Access Journals (Sweden)

    B Vijayakumar

    2012-01-01

    Full Text Available Tuberculous brain abscess and subdural empyema are extremely rare manifestations of central nervous system tuberculosis. Here, we report a case of an 11-year-old immunocompetent child who developed temporal lobe abscess and subdural empyema following chronic otitis media. A right temporal craniotomy was performed and the abscess was excised. The Ziehl Nielsen staining of the aspirated pus from the temporal lobe abscess yielded acid fast bacilli. Prompt administration of antituberculous treatment resulted in complete recovery of the child. Even though the subdural abscess was not drained, we presume that to be of tubercular aetiology. Ours is probably the first case of brain abscess and subdural empyema due to Mycobacterium tuberculosis reported in the same child. This case is being reported because of its rarity and to stress the importance of routine staining for tubercle bacilli in all cases of brain abscess, especially in endemic areas, as it is difficult to differentiate tuberculous from pyogenic abscess clinically as well as histopathologically.

  7. Staphylococcal abscess caused by trauma with a rosebush aculeus (Plantae, Rosaceae): apropos of a case*

    OpenAIRE

    2013-01-01

    Cutaneous abscess is a localized collection of pus in the dermis and subcutaneous tissue usually caused by trauma. The authors report the case of a 30-year-old male patient, gardener, that presents an ulcerated plaque in the third right finger, caused by an aculeus plant wound. The examination of the lesion's exudate ruled out the existence of fungi and showed the presence of Staphylococcus aureus. The authors emphasize the sporotrichosis as an important differential diagnosis, especially in ...

  8. A liver abscess deprived a healthy adult of eyesight: endogenous endophthalmitis associated with a pyogenic liver abscess caused by serotype K1 Klebsiella pneumonia.

    Science.gov (United States)

    Maruno, Takahisa; Ooiwa, Yoko; Takahashi, Ken; Kodama, Yuzo; Takakura, Shunji; Ichiyama, Satoshi; Chiba, Tsutomu

    2013-01-01

    Klebsiella pneumonia usually causes urinary tract infections, pneumonia, and other infectious diseases in hospitalized and immunocompromised patients. Among the types of Klebsiella pneumonia, serotype K1 is known to be a highly virulent pathogen. We herein report the case of a healthy 63-year-old man with a pyogenic liver abscess and bilateral endogenous endophthalmitis caused by serotype K1 Klebsiella pneumonia. Although the patient received percutaneous abscess drainage and antibiotic therapy, he lost his eyesight. To improve the poor prognoses of ocular complications, providing both an earlier diagnosis and treatment is critical.

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

    Science.gov (United States)

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

    2012-01-01

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

  10. Clinical and Genomic Analysis of Liver Abscess-Causing Klebsiella pneumoniae Identifies New Liver Abscess-Associated Virulence Genes

    Directory of Open Access Journals (Sweden)

    Meiping Ye

    2016-11-01

    Full Text Available Hypervirulent variants of Klebsiella pneumoniae (hvKp that cause invasive community-acquired pyogenic liver abscess have emerged globally. Little is known about the virulence determinants associated with hvKp, except for the virulence genes rmpA/A2 and siderophores (iroBCD/iucABCD carried by the pK2044-like large virulence plasmid. Here, we collected most recent clinical isolates of hvKp from pyogenic liver abscess (PLA samples in China, and performed clinical, molecular, and genomic sequencing analyses. We found that 90.9% (40/44 of the pathogens causing PLA were K. pneumoniae. Among the 40 LA-Kp, K1 (62.5% and K2 (17.5% were the dominant serotypes, and ST23 (47.5% was the major sequence type. S1-PFGE analyses demonstrated that although 77.5% (31/40 of the LA-Kp isolates harbored a single large virulence plasmid varied in size, 5 (12.5% isolates had no plasmid and 4 (10% had two or three plasmids. Whole genome sequencing and comparative analysis of 3 LA-Kp and 3 non-LA-Kp identified 133 genes present only in LA-Kp. Further, large scale screening of the 133 genes in 45 LA-Kp and 103 non-LA-Kp genome sequences from public databases identified 30 genes that were highly associated with LA-Kp, including iroBCD, iucABCD and rmpA/A2 and 21 new genes. Then, these 21 new genes were analyzed in 40 LA-Kp and 86 non-LA-Kp clinical isolates collected in this study by PCR, showing that new genes were present 80-100% among LA-Kp isolates while 2-11% in K. pneumoniae isolates from sputum and urine. Several of the 21 genes have been proposed as virulence factors in other bacteria, such as the gene encoding SAM-dependent methyltransferase and pagO which protects bacteria from phagocytosis. Taken together, these genes are likely new virulence factors contributing to the hypervirulence phenotype of hvKp, and may deepen our understanding of virulence mechanism of hvKp.

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

    Science.gov (United States)

    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.

  12. Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus bacteraemia.

    Science.gov (United States)

    Wu, Carolyn M Yu; Noska, Amanda

    2016-03-10

    Intrauterine devices (IUDs) are rarely associated with serious infections. We report an unusual concomitant infection of group A Streptococcus (GAS) causing toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus associated with an IUD in a healthy 50-year-old patient. The IUD was subsequently removed and the patient recovered on the appropriate antibiotics. This case highlights the importance of clinicians' high index of suspicion of an IUD infection and prompt removal of the infected foreign body to obtain source control.

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

    Directory of Open Access Journals (Sweden)

    Kuo CL

    2012-05-01

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

  14. The ectopic appendicolith from perforated appendicitis as a cause of tubo-ovarian abscess

    Energy Technology Data Exchange (ETDEWEB)

    Vyas, Rajashree C.; Sides, Corey; Klein, Deborah J. [University of Rochester Medical Center, Rochester, NY (United States); Reddy, Sireesha Y. [University of Rochester, Obstetrics and Gynecology, Rochester, NY (United States); Santos, Mary C. [University of Rochester, Pediatric Surgery, Rochester, NY (United States)

    2008-09-15

    Acute appendicitis is a common surgical cause of abdominal pain in the pediatric population. History and physical examination are atypical in up to a third of patients. Known potential complications of untreated or delayed management of acute appendicitis include appendiceal perforation, periappendiceal abscess formation, peritonitis, bowel obstruction and rarely septic thrombosis of mesenteric vessels. We report an unusual complication of perforated appendicitis. A tubo-ovarian abscess developed secondary to appendicolith migration into the right fallopian tube in a patient who had undergone interval laparoscopic appendectomy for perforated appendicitis. The retained appendicolith was visualized within the obstructed and dilated fallopian tube on contrast-enhanced CT. We discuss the CT imaging features of this unusual complication of perforated appendicitis. (orig.)

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

    Science.gov (United States)

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

    2001-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Cristina Hueb Barata

    2000-12-01

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

  17. Brain abscess in a non-penetrating traumatic intracerebral hematoma: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Thomas Santhosh

    2009-01-01

    Full Text Available We report a 57-year-old man who presented one month after sustaining a traumatic right temporal intracerebral hematoma with history of headache, left hemiparesis and altered sensorium of two days duration. A diagnosis of right temporal resolving hematoma was made on computed tomography scan. However, his sensorium progressively deteriorated and he underwent craniotomy and partial excision of an abscess. He was treated with appropriate antibiotics for six weeks despite of which he did not improve and died nine months later. We conclude that there should be a high index of suspicion for brain abscess in patients with traumatic intracerebral hemorrhage if the clinical and radiological picture is different from the expected course of a resolving hematoma.

  18. Staphylococcal abscess caused by trauma with a rosebush aculeus (Plantae, Rosaceae): apropos of a case.

    Science.gov (United States)

    Bernardes Filho, Fred; Alves, Andreia Oliveira; Martins, Gustavo; Sasso, Letícia Soares; Gama, Carolina Mendonça; Cenci, Gardênia Borges

    2013-01-01

    Cutaneous abscess is a localized collection of pus in the dermis and subcutaneous tissue usually caused by trauma. The authors report the case of a 30-year-old male patient, gardener, that presents an ulcerated plaque in the third right finger, caused by an aculeus plant wound. The examination of the lesion's exudate ruled out the existence of fungi and showed the presence of Staphylococcus aureus. The authors emphasize the sporotrichosis as an important differential diagnosis, especially in endemic areas, and the indication of the exudate culture is discussed.

  19. Clinical and Genomic Analysis of Liver Abscess-Causing Klebsiella pneumoniae Identifies New Liver Abscess-Associated Virulence Genes

    Science.gov (United States)

    Ye, Meiping; Tu, Jianfei; Jiang, Jianping; Bi, Yingmin; You, Weibo; Zhang, Yanliang; Ren, Jianmin; Zhu, Taohui; Cao, Zhuo; Yu, Zuochun; Shao, Chuxiao; Shen, Zhen; Ding, Baixing; Yuan, Jinyi; Zhao, Xu; Guo, Qinglan; Xu, Xiaogang; Huang, Jinwei; Wang, Minggui

    2016-01-01

    Hypervirulent variants of Klebsiella pneumoniae (hvKp) that cause invasive community-acquired pyogenic liver abscess (PLA) have emerged globally. Little is known about the virulence determinants associated with hvKp, except for the virulence genes rmpA/A2 and siderophores (iroBCD/iucABCD) carried by the pK2044-like large virulence plasmid. Here, we collected most recent clinical isolates of hvKp from PLA samples in China, and performed clinical, molecular, and genomic sequencing analyses. We found that 90.9% (40/44) of the pathogens causing PLA were K. pneumoniae. Among the 40 LA-Kp, K1 (62.5%), and K2 (17.5%) were the dominant serotypes, and ST23 (47.5%) was the major sequence type. S1-PFGE analyses demonstrated that although 77.5% (31/40) of the LA-Kp isolates harbored a single large virulence plasmid varied in size, 5 (12.5%) isolates had no plasmid and 4 (10%) had two or three plasmids. Whole genome sequencing and comparative analysis of 3 LA-Kp and 3 non-LA-Kp identified 133 genes present only in LA-Kp. Further, large scale screening of the 133 genes in 45 LA-Kp and 103 non-LA-Kp genome sequences from public databases identified 30 genes that were highly associated with LA-Kp, including iroBCD, iucABCD and rmpA/A2 and 21 new genes. Then, these 21 new genes were analyzed in 40 LA-Kp and 86 non-LA-Kp clinical isolates collected in this study by PCR, showing that new genes were present 80–100% among LA-Kp isolates while 2–11% in K. pneumoniae isolates from sputum and urine. Several of the 21 genes have been proposed as virulence factors in other bacteria, such as the gene encoding SAM-dependent methyltransferase and pagO which protects bacteria from phagocytosis. Taken together, these genes are likely new virulence factors contributing to the hypervirulence phenotype of hvKp, and may deepen our understanding of virulence mechanism of hvKp. PMID:27965935

  20. [First Report of Intraorbital Abscess Caused by Candida allociferrii and Specific PCR for Differentiating Stephanoascus ciferrii Complex Species].

    Science.gov (United States)

    Soki, Hironobu; Abo, Kazushige; Yamazaki, Kenichiro; Kojima, Takayoshi; Oda, Toshimi; Uzawa, Yutaka; Kikuchi, Ken

    2015-01-01

    We present a rare case of intraorbital abscess caused by Candida allociferrii, which was described as a new species of Stephanoascus ciferrii complex in 2002, in a patient after enucleation of choroidal melanoma. This strain showed resistance to itraconazole, and fluconazole. After debridement and topical use of amphotericin B, his wound abscess was disappeared. To our knowledge, this is the first C. allociferrii infection case in human.

  1. Staphylococcal α-hemolysin is neurotoxic and causes lysis of brain cells in vivo and in vitro.

    Science.gov (United States)

    Dahlberg, Daniel; Mariussen, Espen; Goverud, Ingeborg Løstegaard; Tønjum, Tone; Mæhlen, Jan; Antal, Ellen-Ann; Hassel, Bjørnar

    2015-05-01

    Formation of a bacterial brain abscess entails loss of brain cells and formation of pus. The mechanisms behind the cell loss are not fully understood. Staphylococcus aureus, a common cause of brain abscesses, produces various exotoxins, including α-hemolysin, which is an important factor in brain abscess formation. α-Hemolysin may cause cytolysis by forming pores in the plasma membrane of various eukaryotic cells. However, whether α-hemolysin causes lysis of brain cells is not known. Nor is it known whether α-hemolysin in the brain causes cell death through pore formation or by acting as a chemoattractant, recruiting leukocytes and causing inflammation. Here we show that α-hemolysin injected into rat brain causes cell damage and edema formation within 30 min. Cell damage was accompanied by an increase in extracellular concentrations of zinc, GABA, glutamate, and other amino acids, indicating plasma membrane damage, but leukocytic infiltration was not seen 0.5-12h after α-hemolysin injection. This was in contrast to injection of S. aureus, which triggered extensive infiltration with neutrophils within 8h. In vitro, α-hemolysin caused concentration-dependent lysis of isolated nerve endings and cultured astrocytes. We conclude that α-hemolysin contributes to the cell death inherent in staphylococcal brain abscess formation as a pore-forming neurotoxin.

  2. 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.

  3. [Brain abscess following the use of skull traction with Gardner-Wells tongs].

    Science.gov (United States)

    Soyer, J; Iborra, J P; Fargues, P; Pries, P; Clarac, J P

    1999-09-01

    Brain abscess after insertion of skull traction is a rare and serious complication. Its development is secondary to superficial infection. Adequate preventive measures have to be taken: proper sterile dressing and daily care. Signs of local irritation are not always synonymous with skull migration. When gradual loosening of the skull occurs, especially associated with superficial infection, the pins must not be tightened. The more appropriate management is to investigate for penetration of the inner cranial cave. When in doubt, repositioning the pins may be necessary, as well as establishing an aggressive treatment against cutaneous infection.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, Shuo-Hsiu, E-mail: gerwuver@gmail.com [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); Chou, Ming-Chung, E-mail: mcchou@kmu.edu.tw [Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC (China); Ko, Cheng-Wen, E-mail: chengwen.ko@gmail.com [Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC (China); Hsu, Shu-Shong, E-mail: sshsu59@yahoo.com [Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); Lin, Huey-Shyan, E-mail: sc035@fy.edu.tw [Program of Health-Business Administration, School of Nursing, Fooyin University, Kaohsiung, Taiwan, ROC (China); Fu, Jui-Hsun, E-mail: fujuihsun@gmail.com [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); Wang, Po-Chin, E-mail: hiscore6@gmail.com [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC (China); Pan, Huay-Ben, E-mail: panhb@vghks.gov.tw [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC (China); Lai, Ping-Hong, E-mail: pinghonglai@gmail.com [Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC (China); School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC (China)

    2013-08-15

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

  5. The efficacy of trovafloxacin versus ceftriaxone in the treatment of experimental brain abscess/cerebritis in the rat.

    Science.gov (United States)

    Nathan, Barnett R; Scheld, W Michael

    2003-08-22

    Current estimates of the mortality associated with brain abscesses range from 0-24%, with neurological sequellae in 30-55% of survivors. Although the incidence of brain abscess appears to be increasing, likely due to an increase in the population of immunosuppressed patients, the condition is still sufficiently uncommon to make human clinical trials of therapy problematic. An animal model to study the efficacy of new treatment regimens, specifically, new antimicrobial agents is therefore necessary. This study uses a well-defined experimental paradigm as an inexpensive method of inducing and studying the efficacy of antibiotics in brain abscess. The rat model of brain abscess/cerebritis developed at this institution was used to determine the relative efficacy of trovafloxacin as compared to ceftriaxone in animals infected with Staphylococcus aureus. S. aureus ( approximately 10(5) CFU in 1 microliter) was injected with a Hamilton syringe, very slowly, over the course of 70 minutes after a two mm burr hole was created with a spherical carbide drill just posterior to the coronal suture and four mm lateral to the midline. Eighteen hours later treatment was begun; every 8 hours the rats were dosed with subcutaneous ceftriaxone (n = 10), trovafloxacin (n = 11) or 0.9% sterile pyogen-free saline (n = 10). After four days of treatment the brains were removed and sectioned with a scalpel. The entire injected hemisphere was homogenized and quantitative cultures performed. The mean +/- SEM log(10) colony forming units/ml S. aureus recovered from homogenized brain were as follows: controls 6.10 +/- 0.28; ceftriaxone 3.43 +/- 0.33; trovafloxacin 3.65 +/- 0.3. There was no significant difference in bacterial clearance between ceftriaxone versus trovafloxacin (p = 0.39). Trovafloxacin or other quinolones may provide a viable alternative to intravenous antibiotics in patients with brain abscess/cerebritis.

  6. Diagnosis and Clinical Value of CT on Brain Abscess%脑脓肿CT诊断的临床分析

    Institute of Scientific and Technical Information of China (English)

    高廷军; 李涛

    2015-01-01

    Objective To probe manifest actions of brain abscess on CT and clinical value of CT in brain abscess. Methods CT feature in 29 patients pathologically o r clinically proved were retro spectively analyzed. Results 25 cases of CT examination for the ifrst time to make a deifnite diagnosis, the other 4 cases after 7-15 d, review of the diagnosis of brain abscess. Conclusion CT has characteristic manifestations on brain abscess. It should be the ifrst choice for t he diagnosis.%目的: CT对脑脓肿的诊断价值和临床意义。方法分析29例经手术病理和临床证实的脑脓肿的CT表现及临床,得出CT对于临床诊断疗效。结果25例首次CT检查就做出明确诊断,另4例经7~15 d后复查,诊断为脑脓肿。结论脑脓肿CT表现有一定特征性,是诊断脑脓肿首选方法。

  7. Spinal cord abscess

    Science.gov (United States)

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

  8. 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.

  9. Neck swelling from a retropharyngeal abscess caused by penicillin-resistant Streptococcus pneumoniae: a case report

    OpenAIRE

    2014-01-01

    Background In small children, retropharyngeal abscesses usually occur after upper respiratory tract infections. Unlike in adults, these abscesses are difficult to diagnose in small children, and can rapidly develop into deep neck or mediastinal abscesses. Case presentation A 2-year-old Japanese boy recently presented to our department with a chief complaint of neck swelling. Physical examination revealed bilateral tonsillitis and swelling of the left posterior pharyngeal wall. Emergency neck ...

  10. 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.

  11. The usefulness of CT guided drainage of abscesses caused by retained appendicoliths

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, O. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Geoghegan, T. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Ridgeway, P. [Department of Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colhoun, E. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Snow, A. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail: william.torreggiani@amnch.ie

    2006-10-15

    Objectives: To determine the utility of percutaneous computed tomography (CT) guided drainage of abscesses formed secondary to retained appendicoliths. Materials and methods: A retrospective review was conducted over a 5-year period to identify patients who underwent CT guided drainage of abscesses related to retained appendicoliths. Inclusion criteria were a history of prior proven appendicitis treated by laparoscopic appendicectomy, identification of a post-operative abscess related to a visualised retained appendicolith and initial treatment by CT guided drainage. Data regarding initial technical success as well as long-term outcome was recorded in each case. Results: In total, five patients were identified who underwent CT guided abscess drainage related to retained appendicoliths. There were three males and two females (age range 12-54 years). Initial drainage under CT guidance was technically successful in all cases with successful catheter placement and resolution of the abscess cavity. In all five cases however, there was recurrence of abscess formation following catheter removal. In one case, a second attempt with CT guided drainage was performed. Again this was initially successful with abscess recurrence following catheter removal. In all five cases, formal surgical drainage with removal of retained appendicolith resulted in a successful outcome. Conclusion: CT guided percutaneous drainage of intra abdominal abscess secondary to retained appendicoliths is only successful in the short term. Formal surgical drainage and removal of the appendicolith is required for long-term success.

  12. Endoscopic Endonasal Transethmoidal Approach for the Management of a Traumatic Brain Abscess and Reconstruction of the Accompanying Anterior Skull Base Defect.

    Science.gov (United States)

    Tanriover, Necmettin; Kucukyuruk, Baris; Erdi, Fatih; Kafadar, Ali Metin; Gazioğlu, Nurperi

    2015-09-01

    Skull base endoscopy in the treatment of brain abscesses has been rarely published. Moreover, endoscopic endonasal transethmoidal approach (EETA) for the treatment of brain abscess following a head trauma has been reported only in a few case reports. We report the management of a patient of intracerebral abscess and reconstruction of the accompanying anterior skull base defect through an EETA.Thirty-year-old male with a frontal lobe abscess due to a penetrating skull base trauma was operated via EETA. After drainage of the abscess, dural and bony defects were repaired to prevent any recurrence. Postoperative radiological imaging revealed prominent decrease in abscess size. The patient did not need any further surgical intervention, and antibiotherapy was adequate.EETA is safe and effective in the management of brain abscesses. Skull base endoscopy provides direct visualization of the abscess cavity through a minimal invasive route, facilitates wide exposure of surrounding neurovascular structures within the operative field, and enables concurrent closure of the skull base defect.

  13. Propionibacterium acnes as a cause of lung abscess in a cardiac transplant recipient.

    Science.gov (United States)

    Veitch, David; Abioye, Abu; Morris-Jones, Stephen; McGregor, Alastair

    2015-12-16

    A 29-year-old man was admitted with fevers, cough, left-sided chest pain and lethargy for 1 week. He had a cardiac transplant 10 years prior and was on immunosuppressive drugs. He was found to have a pulmonary lesion and went on to develop a lung abscess. Propionibacterium acnes was identified on matrix-assisted laser desorption ionisation mass spectrometry-time of flight and 16s rRNA gene sequencing after drainage. He was curatively treated with co-trimoxazole and co-amoxiclav. He divulged a longstanding history of seborrhoeic dermatitis with frequent flares leading to large volumes of squames collecting on his bed sheets. We hypothesise this was a possible route of entry: inhalation of the Propionibacterium. This case highlights how a common commensal bacterium, P. acnes, was able to cause pathology in an immunosuppressed patient. This is the only case of a patient with transplantation developing a P. acnes pulmonary infection and the only case of P. acnes causing these clinical features to be reported in the literature.

  14. 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.

  15. Brain abscesses after Serratia marcescens infection on a neonatal intensive care unit: differences on serial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Messerschmidt, A.; Olischar, M.; Pollak, A.; Birnbacher, R. [Division of Neonatology and Intensive Care, Department of Paediatrics, University of Vienna, Wahringer Guertel 18-20, 1090, Vienna (Austria); Prayer, D. [Division of Radiology, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna (Austria)

    2004-02-01

    Serratia are known to be a possible cause of severe cerebral infections in neonates. We describe imaging of three premature infants infected with Serratia marcescens. Born in the 31{sup st}, 25{sup th} and 28{sup th} weeks of gestation, they presented with signs of septicaemia on postnatal days 9, 24 and 32. Initial sonography showed cysts in the first child, two areas with anechoic centre and echogenic rim in the second, and several echogenic areas in the third. Lesions were seen on CT, of low density in two cases and minimally increased density in the third. MRI in the first patient showed cysts with incomplete contrast enhancement of the lesions, while patient 2 showed five ring-enhancing fluid-containing lesions with thick walls. In the third patient two abscesses with contrast enhancement and several high-signal spots were seen. We discuss the pathophysiology of the lesions and the impact of the various imaging methods. (orig.)

  16. T2*-weighted MR angiography substantially increases the detection of hemorrhage in the wall of brain abscess: implications in clinical interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Rakesh Kumar [Sanjay Gandhi Post Graduate Institute of Medical Sciences, MR Section, Department of Radiodiagnosis, Lucknow, Uttar Pradesh (India); Tomar, Vaishali; Awasthi, Rishi; Yadav, Abhishek [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, Uttar Pradesh (India); Husain, Nuzhat [Chhatrapati Sahuji Maharaj Medical University, Department of Pathology, Lucknow, Uttar Pradesh (India); Bharadwaj, Vikas; Ojha, Bal K. [Chhatrapati Sahuji Maharaj Medical University, Department of Neurosurgery, Lucknow, Uttar Pradesh (India); Behari, Sanjay [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Department of Neurosurgery, Lucknow, Uttar Pradesh (India); Prasad, Kashi N. [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Department of Microbiology, Lucknow, Uttar Pradesh (India); Singh Rathore, Ram Kishore [Indian Institute of Technology, Department of Mathematics and Statistics, Kanpur, Uttar Pradesh (India)

    2012-06-15

    The purpose of the present study was to identify the true prevalence of hemorrhage in the abscess using T2*-weighted angiography (SWAN) imaging and to study its influence on diffusion tensor imaging (DTI) metrics. Fifteen patients of brain abscess underwent conventional, SWAN, and DT imaging on a 3-T MRI followed by its confirmation with histology. DTI metrics were quantified by region-of-interest analysis on hemorrhagic and non-hemorrhagic regions of the abscess wall. Prussian blue staining was performed on excised abscess walls to confirm hemorrhage on histology. Eleven of 15 patients showed evidence of hemorrhage on both Prussian blue staining as well as SWAN imaging. Fractional anisotropy (FA) and linear anisotropy (CL) values were significantly higher, while spherical anisotropy was significantly lower in hemorrhagic compared to non-hemorrhagic regions of the abscess wall. Hemorrhage in the abscess wall is a common feature and may not always indicate neoplasm. The presence of intracellular iron in addition to concentrically laid collagen fibers may have synergistic effect on FA and CL values in the abscess wall. Inclusion of SWAN to MRI protocol will define the true prevalence of hemorrhage in brain abscess. (orig.)

  17. Surgical management of cervical spinal epidural abscess caused by Brucella melitensis : report of two cases and review of the literature.

    Science.gov (United States)

    Ekici, Mehmet Ali; Ozbek, Zühtü; Gökoğlu, Abdülkerim; Menkü, Ahmet

    2012-06-01

    Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

  18. Sepsis complicated by brain abscess following ESWL of a caliceal kidney stone: a case report

    Science.gov (United States)

    Capitanini, Alessandro; Rosso, Luca; Giannecchini, Laura; Meniconi, Ophelia; Cupisti, Adamasco

    2016-01-01

    ABSTRACT A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL) of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU). Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT). Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred. The patient was then discharged but three day later the patient returned to the hospital to seek treatment for left facial hemiparesis and hypotonia of his left arm. The brain computed tomography showed a wide abscess (55×75mm) in the frontal right parietal region. A neurosurgical intervention was then performed and the culture of the drained material resulted positive for Escherichia coli. The guidelines of European and American Associations of Urology do not suggest a prophylactic antibiotic therapy for pre-ESWL (except in the presence of risk factors). The serious complication that occurred in the described low risk patient raises the question of whether routine culture and/or antibiotic prophylaxis, is appropriate. PMID:27583356

  19. Sepsis complicated by brain abscess following ESWL of a caliceal kidney stone: a case report

    Directory of Open Access Journals (Sweden)

    Alessandro Capitanini

    Full Text Available ABSTRACT A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU. Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT. Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred. The patient was then discharged but three day later the patient returned to the hospital to seek treatment for left facial hemiparesis and hypotonia of his left arm. The brain computed tomography showed a wide abscess (55×75mm in the frontal right parietal region. A neurosurgical intervention was then performed and the culture of the drained material resulted positive for Escherichia coli. The guidelines of European and American Associations of Urology do not suggest a prophylactic antibiotic therapy for pre-ESWL (except in the presence of risk factors. The serious complication that occurred in the described low risk patient raises the question of whether routine culture and/or antibiotic prophylaxis, is appropriate.

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

    Science.gov (United States)

    Chen, Hsuan-Wei; Lin, Te-Yu

    2012-04-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Septic arthritis in a lumbar facet joint: a rare cause of an epidural abscess

    Energy Technology Data Exchange (ETDEWEB)

    Heenan, S.D. [Dept. of Neuroradiology, Atkinson Morley`s Hospital, London (United Kingdom); Britton, J. [Dept. of Neuroradiology, Atkinson Morley`s Hospital, London (United Kingdom)

    1995-08-01

    A 10-year-old boy presented with a 7-day history of back pain and pyrexia. MRI showed an epidural abscess arising from septic arthritis in a lumbar facet joint. To our knowledge, there are only two previously reported cases of septic arthritis of a facet joint leading to an epidural abscess. This case illustrates how infection in a synovial joint may extend into the extradural space and might be the route of infection in more cases than has previously been recognised. (orig.)

  3. Brodie's abscess of the posterior ilium: a rare cause for low back pain in children.

    Science.gov (United States)

    Balaji, Gopisankar; Thimmaiah, Sreenivas; Menon, Jagdish

    2014-05-09

    Brodie's abscess of the pelvis is very rare in healthy children. It can be missed because of its varied presentation. We present an 11-year-old boy who presented with low back pain. Investigations revealed a well-defined lesion in the posterior ilium. He underwent open biopsy and debridement. At the end of the final follow-up, he was asymptomatic and there was no recurrence. We present this case for the rare site of Brodie's abscess and for its unusual presentation as low back pain.

  4. 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.

  5. Morganella morganii causing abscess over the anterior chest wall- a case report.

    Science.gov (United States)

    D, Vijaya; Jv, Sathish; Mk, Yashaswini; S, Sulaiman

    2014-09-01

    A 17-year-old female college student presented with recurrent abscess over the anterior chest wall since one and half year. Morganella morganii was isolated from the aspirated pus. Patient was started on oral ciprofloxacin and the lesion resolved in two weeks.

  6. Cerebral candida abscess in an infant

    Directory of Open Access Journals (Sweden)

    Baradkar V

    2009-01-01

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

  7. 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.

  8. Streptococcus oralis cerebral abscess following monkey bite in a 2-month-old infant.

    Science.gov (United States)

    Thiagarajan, Srinivasan; Krishnamurthy, Sriram; Raghavan, Renitha; Mahadevan, Subramanian; Madhugiri, Venkatesh S; Sistla, Sujatha

    2016-05-01

    Although cerebral abscesses caused by animal bites have been reported, they are extremely rare in infants and have not been described following monkey bite. A 55-day-old male infant presented with a multi-loculated Streptococcus oralis cerebral abscess following a monkey bite on the scalp. There was a clinical response to antibiotic therapy and repeated surgical aspiration followed by a ventriculoperitoneal shunt. This is the first report of a patient with a brain abscess following a monkey bite.

  9. Bacteria Associated with Subcutaneous Abscesses of Cattle Caused by Hypoderma spp Larvae in North of Iran

    Directory of Open Access Journals (Sweden)

    Hossein Tajik

    2010-09-01

    Full Text Available This study was performed from February to April 2006; several visits were made to abattoirs in the north of Iran for Hypoderma spp infestation. Necropsy inspection of slaughtered and skinned animals were carried out by examination of the inner skin surface and subcutaneous tissues. Warbles were isolated by squeezing nodules from subcutaneous tissues. In the case of abscess presence, aseptic sample were taken from abscesses. The parasitological and bacteriological examinations were performed on the samples. The results indicated that 104 out of 958 of slaughtered animals were infested to Hypoderma spp in which 48 (46.15 %, 34 (32.69 % and 22 (21.15 % were infested to Hypoderma bovis, Hypoderma lineatum and both species, respectively. Following bacterial analysis, the following bacteria were isolated: Escherichia coli, Streptococcus pyogenes, Staphylococcus aureus, Staphylococcus epidermidis and Klebsiella pneumonia.

  10. Covert lung abscess as a cause of atrial arrhythmia: case report

    Institute of Scientific and Technical Information of China (English)

    LI Mei; LIAO De-ning; ZHANG Jia-you; YIN Ren-fu; WU Zong-gui

    2005-01-01

    @@ Atrial arrhythmia is common in clinic. Recently, it was revealed that ectopic impulses originating in sleeve muscles around the orifices of pulmonary veins (PVs) were deemed to be one of the most important reasons that trigger or drive atrial arrhythmia, which was called myocardial sleeve related arrhythmia. Electrical isolation by radiofrequency ablation is becoming highlight and proved to be an effective method for the arrhythmia. We report a 55-year-old man with paroxysmal atrial tachy-arrhythmias admitted for PV electrical isolation. An abscess was discovered in right inferior lung before the operation. The arrhythmia was disappeared after resection of the abscess. It implies that for such sufferer and recidivist after ablation, the factors outside the pulmonary veins should be excluded or treated as far as possible, especially before radiofrequency ablation therapy.

  11. [Abscessing salpingo-oophoritis caused by Actinomyces in a woman using an IUD].

    Science.gov (United States)

    Milia, S; D'Ovidio, N; Firinu, C

    1983-04-01

    Recent studies have demonstrated that there is a connection between actinomycetic genital swelling and longterm use of the Lippes Loop. After a literature review, a case of actinomycetic abscessing salpingo-ovaritis in a woman who had worn the same Lippes Loop for 12 years is reported. It is concluded that Actinomyces must be always considered a potential etiological agent in all cases where genital swelling is found in patients fitted with such loops. (author's modified)

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

    OpenAIRE

    Pinilla,Análida Elizabeth; Myriam Consuelo LÓPEZ; Ricaurte, Orlando; 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...

  13. [Abscess at the implant site following apical parodontitis. Hardware-related complications of deep brain stimulation].

    Science.gov (United States)

    Sixel-Döring, F; Trenkwalder, C; Kappus, C; Hellwig, D

    2006-08-01

    Deep brain stimulation of the subthalamic nucleus is an important treatment option for advanced stages of idiopathic Parkinson's disease, leading to significant improvement of motor symptoms in suited patients. Hardware-related complications such as technical malfunction, skin erosion, and infections however cause patient discomfort and additional expense. The patient presented here suffered a putrid infection of the impulse generator site following only local dental treatment of apical parodontitis. Therefore, prophylactic systemic antibiotic treatment is recommended for patients with implanted deep brain stimulation devices in case of operations, dental procedures, or infectious disease.

  14. Spinal epidural abscess caused by Bacteroides fragilis group after dilation and curettage for incomplete abortion

    Directory of Open Access Journals (Sweden)

    Masaki Ohyagi

    2012-01-01

    Full Text Available Spinal epidural abscess (SEA is a rare infection complicated in patients who have some risk factors such as injection-drug use, diabetes mellitus, and several illnesses. However, no case of SEA associated with abortion has been reported. Here we report a case of SEA in a 30-year-old woman after dilation and curettage for incomplete abortion. The diagnosis of SEA was done by MRI and pus was drained after the cervical discectomy. Bacteroides fragilis group was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotics.

  15. Spinal epidural abscess caused by bacteroides fragilis group after dilation and curettage for incomplete abortion.

    Science.gov (United States)

    Ohyagi, Masaki; Ohkubo, Takuya; Taniyama, Takashi; Tomizawa, Shoji; Okawa, Atsushi; Yokota, Takanori; Mizusawa, Hidehiro

    2012-04-01

    Spinal epidural abscess (SEA) is a rare infection complicated in patients who have some risk factors such as injection-drug use, diabetes mellitus, and several illnesses. However, no case of SEA associated with abortion has been reported. Here we report a case of SEA in a 30-year-old woman after dilation and curettage for incomplete abortion. The diagnosis of SEA was done by MRI and pus was drained after the cervical discectomy. Bacteroides fragilis group was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotics.

  16. Have the organisms that cause breast abscess changed with time?--Implications for appropriate antibiotic usage in primary and secondary care.

    Science.gov (United States)

    Dabbas, Natalie; Chand, Manish; Pallett, Ann; Royle, Gavin T; Sainsbury, Richard

    2010-01-01

    Many patients with breast abscess are managed in primary care. Knowledge of current trends in the bacteriology is valuable in informing antibiotic choices. This study reviews bacterial cultures of a large series of breast abscesses to determine whether there has been a change in the causative organisms during the era of increasing methicillin-resistant Staphylococcus aureus (MRSA). Analysis was undertaken of all breast abscesses treated in a single unit over 2003 - 2006, including abscess type, bacterial culture, antibiotic sensitivity and resistance patterns. One hundred and ninety cultures were obtained (32.8% lactational abscess, 67.2% nonlactational). 83% yielded organisms. Staphylococcus aureus was the commonest organism isolated (51.3%). Of these, 8.6% were MRSA. Other common organisms included mixed anaerobes (13.7%), and anaerobic cocci (6.3%). Lactational abscesses were significantly more likely to be caused by S. aureus (p flucloxacillin with or without metronidazole (or amoxicillin-clavulanate as a single preparation) as initial empirical therapy.

  17. Multiple pyogenic liver abscess

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Science.gov (United States)

    Bang, Jin Hyuk; Cho, Keun-Tae

    2015-09-01

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

  19. The importance of subcutaneous abscess infection by Pasteurella spp. and Staphylococcus aureus as a cause of meat condemnation in slaughtered commercial rabbits

    Directory of Open Access Journals (Sweden)

    A. Ferreira

    2014-12-01

    Full Text Available Subcutaneous abscesses are lesions frequently reported in commercial rabbits. Both at farm and slaughterhouse level, these lesions are responsible for economic losses and a potential decrease in meat quality. The present study was devised to identify the main causes of meat condemnation in slaughtered commercial rabbits and assess the importance of abscess lesions in this domain. For these purposes, 281423 rabbits were evaluated during meat inspection at the slaughterhouse. The results achieved showed that subcutaneous abscesses were the major cause of condemnation, being responsible for the rejection of 1355 (0.48% rabbit carcasses. The main affected area was the hind limbs (31.37%, followed by the cervical area (23.10%. Microbiological analyses of 27 abscess samples indicated Pasteurella spp. as the bacteria mostly isolated (59.3%, followed by Staphylococcus aureus (25.9%. These results enable us to advise the industry on the significance of abscesses as an important cause of economic losses, due to meat condemnation during post mortem inspection, and highlight the importance of implementing monitoring plans as a way to control this pathological problem.

  20. Abscess of the iliopsoas muscle associated external fistula of the rectum caused by radiation proctitis. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Shigeru; Imazu, Hiroki; Matubara, Toshiki; Sakurai, Yoichi; Ochiai, Masahiro; Funabiki, Takahiko [Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine

    1999-12-01

    This paper deals with a case of abscess of the iliopsoas muscle, an intractable external fistula of the rectum caused by radiation proctitis in a 68-year-old man. There were previous histories of undergoing an A-C bypass operation for coronary stricture 10 years before; and undergoing aportial resection of the bladder with radiation therapy for urinary bladder cancer, followed by colostomy for hemorrhage and stricture of the rectum for radiation proctitis 2 years before admission. In April, 1997 when he had been treated at outpatient clinic, exhumation of pusfrom the sacurred that was diagnosed external fistula of the rectum on a fistulography and he was continuously treated on an ambulant basis. On November 17, 1997, the patient had a temperature 38.7deg C, the white blood cell count increased to 35 x 10{sup 4} /ml, inflammation reaction increased, and unconsciousness appeared. An emergency CT revealed retention of fluid in the retroperitoneum covering from the fistulation through the iliopsoas muscle to pelvis. An abscess of the iliopsoas muscle was diagnosed. It was determined that any operations under general anesthesia were impossible due to poor general condition, and an emergency incision drainage was performed under local anesthesia. Thereafter, the patient developed MRSA septicemia which demanded redrainage and strict general management, but he was successfully freed from the management. Although the intractable fistula in persistently present, he was discharged after a resection of sequestrum and is followed on an ambulant basis. (author)

  1. Abdominal pregnancy with placenta inserted in the spleen left in situ causing subphrenic abscess

    Directory of Open Access Journals (Sweden)

    Čolović Radoje B.

    2002-01-01

    Full Text Available Abdominal pregnancy appears once in 3000 pregnancies. It usually terminates with abortion and urgent surgery. Thanks to ultrasonography and computed tomography the diagnosis is possible before surgery. Most frequently the diagnosis has been established during emergency laparotomy. Gynaecologists are not in agreement wheather removal of placenta is mandatory or not, as it may include removal of parts or entire organs or may be followed with serious bleeding difficult to control. We present a 21-year old woman in whom during an urgent laparotomy performed for abdominal pregnancy placenta inserted in the spleen was left in situ. Postoperatively the patient developed subphrenic abscess which could not be solved without reoperation during which both the placenta and the spleen were removed. Ten years after surgery she is symptom-free.

  2. Cystic metastasis versus brain abscess: Role of MR imaging in accurate diagnosis and implications on treatment

    Directory of Open Access Journals (Sweden)

    Shetty Prakash

    2010-01-01

    Full Text Available Intracranial cystic metastases are difficult to differentiate from non neoplastic lesions like a cystic abscess on routine magnetic resonance imaging (MRI sequences in patients with a known primary cancer. Diffusion weighted MRI sequences can help in differentiating between the two. This carries significant implications on the intent and nature of treatment. We present a case of a forty five-year- old patient of squamous cell carcinoma of larynx who developed an intracranial cystic ring enhancing lesion following chemotherapy. Though routine MRI was equivocal, MR diffusion was highly suggestive of an abscess and this led to surgical excision which confirmed the diagnosis. We discuss this case and review the literature regarding the role of newer MRI sequences and the ramifications on patient treatment.

  3. Molecular epidemiology and virulence factors of pyogenic liver abscess causing Klebsiella pneumoniae in China.

    Science.gov (United States)

    Luo, Y; Wang, Y; Ye, L; Yang, J

    2014-11-01

    The molecular epidemiology and prevalence of virulence factors of isolates from patients with Klebsiella pneumoniae liver abscess (KLA) in mainland China are unknown. Klebsiella pneumoniae isolates were obtained from drainage samples aseptically collected from patients with pyogenic liver abscess (PLA). The genetic similarity of KLA isolates was analyzed by pulsed-field gel electrophoresis. The hypermucoviscosity (HV) phenotype was identified by a positive string test. The K1 and K2 genotypes, the pLVPK-derived genetic loci, aerobactin gene, kfu and alls were detected by PCR amplification. The sequence types (STs) were identified by multilocus sequence typing. Among the 51 non-repetitive KLA isolates, 49 PFGE types have been identified. In total, 19 (37.2%) and 14 (27.4%) of the 51 KLA isolates belonged to clonal complex (CC) 23 and CC65, respectively, while the other 18 isolates (35.3%) were defined as other STs. CC23 consisted of only K1 strains, while CC65 included only K2 strains. All non-K1/K2 strains were classified as STs other than CC23 and CC65. Approximately 70.6% (36/51) of KLA isolates exhibited an HV phenotype. Both K1 and K2 isolates presented significantly higher prevalence of the pLVPK-derived loci than non-K1/K2 isolates. The K1 isolates had a significantly higher prevalence of the kfu and allS genes than K2 and non-K1/K2 isolates, while the K2 isolates exhibited higher repA prevalence than K1 and non-K1/K2 isolates. The majority of KLA isolates belonged to CC23K1 and CC65K2, while other STs with non-K1/K2 capsular types have also been identified. The virulent factors exhibited diverse distribution among the different clones of KLA isolates.

  4. Cerebral candiasis: CT studies in a case of brain abscess and granuloma due to candida albicans

    Energy Technology Data Exchange (ETDEWEB)

    Thron, A.; Wiethoelter, H.

    1982-08-01

    The CT features of a young female patient suffering from systemic candidiasis with intracerebral manifestation are reported. The definite diagnosis was made by spinal fluid cultures. The diffuse granulomatous lesions as well as an abscess formation remitted after specific therapy with 5-fluorocytosine and amphotericin B for now more than 1 year. In contrast to reports of other cases with mycosis of the central nervous system this case of candidiasis shows lesions of primarily increased attenuation coefficients.

  5. Bmi-1 absence causes premature brain degeneration.

    Directory of Open Access Journals (Sweden)

    Guangliang Cao

    Full Text Available Bmi-1, a polycomb transcriptional repressor, is implicated in cell cycle regulation and cell senescence. Its absence results in generalized astrogliosis and epilepsy during the postnatal development, but the underlying mechanisms are poorly understood. Here, we demonstrate the occurrence of oxidative stress in the brain of four-week-old Bmi-1 null mice. The mice showed various hallmarks of neurodegeneration including synaptic loss, axonal demyelination, reactive gliosis and brain mitochondrial damage. Moreover, astroglial glutamate transporters and glutamine synthetase decreased in the Bmi-1 null hippocampus, which might contribute to the sporadic epileptic-like seizures in these mice. These results indicate that Bmi-1 is required for maintaining endogenous antioxidant defenses in the brain, and its absence subsequently causes premature brain degeneration.

  6. Retropharyngeal abscess

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000984.htm Retropharyngeal abscess To use the sharing features on this page, please enable JavaScript. Retropharyngeal abscess is a collection of pus in the tissues ...

  7. Pancreatic abscess

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000270.htm Pancreatic abscess To use the sharing features on this page, please enable JavaScript. A pancreatic abscess is an area filled with pus within the ...

  8. Abscessos cerebrais múltiplos após apendicectomia: relato de caso Multiple brain abscesses following appendicectomy: case report

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    Michele Schops

    1996-06-01

    Full Text Available Paciente masculino de 39 anos, com quadro de abdomen agudo de evolução de 72 horas, foi submetido a apendicectomia. Desenvolveu 14 dias após, quadro de cefaléia, vômitos, afasia, torpor, hemiplegia à direita e rigidez de nuca. A tomografia computadorizada craniana mostrou múltiplos abscessos cerebrais supra tentoriais bilateralmente. Após punção aspirativa do maior deles foi instituída antibióticoterapia resultando em cura do paciente.A 39 years old male patient with a 72 hours evolution of acute abdominal syndrome was submitted to appendicectomy. Fourteen days later he developed headache, vomiting, aphasia, torpor, nuchal stiffness and right hemiplegia. A CT-scan showed multiple brain abscesses on both hemispheres. After aspirative puncture of the largest one, antibiotic treatment was established with total recovery of the patient.

  9. Fulminant citrobacter meningitis with multiple periventricular abscesses in a three-month-old infant

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    P. Anoop

    2003-12-01

    Full Text Available Citrobacter, a Gram-negative enteric bacillus, is a rare cause of septicemia and meningitis, seldom reported beyond the neonatal period. It is characterized by a fulminant clinical course and a high incidence of complications, including brain abscesses. We studied a three-month-old infant with Citrobacter meningitis, who developed acute communicating hydrocephalus and multiple periventricular brain abscesses while on treatment. The patient died, despite intensive antibiotic treatment directed towards the causative organism, C. diversus.

  10. Treatment of intra-abdominal abscesses caused by Candida albicans with antifungal agents and recombinant murine granulocyte colony-stimulating factor.

    NARCIS (Netherlands)

    Vonk, A.G.; Netea, M.G.; Krieken, J.H.J.M. van; Verweij, P.E.; Meer, J.W.M. van der; Kullberg, B.J.

    2003-01-01

    The aim of the present study was to assess the influence of immunomodulation of host defense with recombinant murine granulocyte colony-stimulating factor (rmG-CSF) on intra-abdominal abscesses caused by Candida albicans. Mice received prophylaxis or therapy with 1 microg of rmG-CSF/day in the prese

  11. Primary cellulitis and cutaneous abscess caused by Yersinia enterocolitica in an immunocompetent host: A case report and literature review.

    Science.gov (United States)

    Kato, Hirofumi; Sasaki, Shugo; Sekiya, Noritaka

    2016-06-01

    Primary extraintestinal complications caused by Yersinia enterocolitica are extremely rare, especially in the form of skin and soft-tissue manifestations, and little is known about their clinical characteristics and treatments. We presented our case and reviewed past cases of primary skin and soft-tissue infections caused by Y enterocolitica. We report a case of primary cellulitis and cutaneous abscess caused by Y enterocolitica in an immunocompetent 70-year-old woman with keratodermia tylodes palmaris progressiva. She presented to an outpatient clinic with redness, swelling, and pain of the left ring finger and left upper arm without fever or gastrointestinal symptoms 3 days before admission. One day later, ulceration of the skin with exposed bone of the proximal interphalangeal joint of the left ring finger developed, and cefditoren pivoxil was described. However, she was admitted to our hospital due to deterioration of symptoms involving the left finger and upper arm. Cefazolin was initiated on admission, then changed to sulbactam/ampicillin and vancomycin with debridement of the left ring finger and drainage of the left upper arm abscess. Wound culture grew Y enterocolitica serotype O:8 and methicillin-sensitive Staphylococcus aureus. Blood cultures were negative and osteomyelitis was ruled out. Vancomycin was switched to ciprofloxacin, then skin and soft-tissue manifestations showed clear improvement within a few days. The patient received 14 days of ciprofloxacin and oral amoxicillin/clavulanate and has since shown no recurrence. We reviewed 12 cases of primary skin and soft-tissue infections caused by Y enterocolitica from the literature. In several past cases, portal entry involved failure of the skin barrier on distal body parts. Thereafter, infection might have spread to the regional lymph nodes from the ruptured skin. Y enterocolitica is typically resistant to aminopenicillins and narrow-spectrum cephalosporins. In most cases, these inefficient

  12. Anorectal abscess during pregnancy.

    Science.gov (United States)

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

    2014-02-01

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

  13. [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).

  14. Differentiation of brain abscesses from glioblastomas and metastatic brain tumors: comparisons of diagnostic performance of dynamic susceptibility contrast-enhanced perfusion MR imaging before and after mathematic contrast leakage correction.

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    Cheng Hong Toh

    Full Text Available PURPOSE: To compare the diagnostic performance of dynamic susceptibility contrast-enhanced perfusion MRI before and after mathematic contrast leakage correction in differentiating pyogenic brain abscesses from glioblastomas and/or metastatic brain tumors. MATERIALS AND METHODS: Cerebral blood volume (CBV, leakage-corrected CBV and leakage coefficient K2 were measured in enhancing rims, perifocal edema and contralateral normal appearing white matter (NAWM of 17 abscesses, 19 glioblastomas and 20 metastases, respectively. The CBV and corrected CBV were normalized by dividing the values in the enhancing rims or edema to those of contralateral NAWM. For each study group, a paired t test was used to compare the K2 of the enhancing rims or edema with those of NAWM, as well as between CBV and corrected CBV of the enhancing rims or edema. ANOVA was used to compare CBV, corrected CBV and K2 among three lesion types. The diagnostic performance of CBV and corrected CBV was assessed with receiver operating characteristic (ROC curve analysis. RESULTS: The CBV and correction CBV of enhancing rim were 1.45±1.17 and 1.97±1.01 for abscesses, 3.85±2.19 and 4.39±2.33 for glioblastomas, and 2.39±0.90 and 2.97±0.78 for metastases, respectively. The CBV and corrected CBV in the enhancing rim of abscesses were significantly lower than those of glioblastomas and metastases (P = 0.001 and P = 0.007, respectively. In differentiating abscesses from glioblastomas and metastases, the AUC values of corrected CBV (0.822 were slightly higher than those of CBV (0.792. CONCLUSIONS: Mathematic leakage correction slightly increases the diagnostic performance of CBV in differentiating pyogenic abscesses from necrotic glioblastomas and cystic metastases. Clinically, DSC perfusion MRI may not need mathematic leakage correction in differentiating abscesses from glioblastomas and/or metastases.

  15. Bacillus Calmette-Guérin-related cold thigh abscess as an unusual cause of thigh swelling in infants following BCG vaccine administration: a case series

    Directory of Open Access Journals (Sweden)

    Al Shaalan Mohammad

    2011-09-01

    Full Text Available Abstract Introduction Thigh swelling in an infant can be a symptom of a simple benign condition or a life-threatening condition. We observed a cluster of thigh swelling episodes in infants in which the cause was Bacillus Calmette-Guérin-related cold thigh abscess. We report this unusual case series to raise awareness about this diagnosis. Case presentations We performed a retrospective review of five infants (four boys and one girl who presented with Bacillus Calmette-Guérin-related left thigh abscess. The swelling was noticed by the parents at a mean period of three months prior to presentation. The ages at presentation were five, five, eight and nine months for the boys, and six months for the girl. All of the patients were healthy Saudi infants, and received the Bacillus Calmette-Guérin vaccine at birth. Clinically, all of the patients were well and did not demonstrate signs of systemic infection. All patients underwent needle aspiration, with subsequent incision and drainage in four of the five cases. The cultures obtained from the abscess fluids were the key to establishing the diagnosis. Only three patients (60% received antituberculosis drugs. Wound healing lasted for a mean period of approximately seven months. Two-year follow-up was unremarkable for all of our patients. Conclusions Technical errors continue to be significant in the development of vaccine-related complications. Bacillus Calmette-Guérin-related cold thigh abscess is an extremely rare entity.

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

    Directory of Open Access Journals (Sweden)

    Análida Elizabeth PINILLA

    2001-12-01

    Full Text Available 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 crónica consistente en pérdida de peso y dolor epigástrico y del cuadrante superior derecho del abdomen. El diagnóstico inicial fue de masa hepática izquierda a estudio, demostrándose luego por frotis directo y por histopatología que se trataba de un absceso hepático por Ascaris lumbricoides. Huevos de Ascaris lumbricoides y abundantes cristales de Charcot-Leyden fueron encontrados.

  17. Necrotizing cellulitis with multiple abscesses on the leg caused by Serratia marcescens.

    Science.gov (United States)

    Hau, Estelle; Bouaziz, Jean-David; Lafaurie, Matthieu; Saussine, Anne; Masson, Vincent; Rausky, Jonathan; Bagot, Martine; Guibal, Fabien

    2016-03-01

    Serratia marcescens is an unusual cause of severe skin infection initially described in immunocompromised patients. We report a case of necrotizing cellulitis of the leg caused by S marcescens in a 68-year-old woman with diabetes mellitus and a history of chronic lymphoedema of the leg. We reviewed the literature and found 49 cases of severe skin infections from S marcescens that included 20 cases of necrotizing fasciitis (NF) as well as 29 cases of severe skin infections without NF (non-NF cases). Patients were immunocompromised in 59% to 70% of cases. The mortality rate was high in NF cases (60%) versus non-NF cases (3%). Surgery was required in 95% of NF cases and in 24% of non-NF cases. The other clinical manifestations of S marcescens skin infection reported in the literature included disseminated papular eruptions in patients infected with human immunodeficiency virus with folliculitis on the trunk. Serratia marcescens is naturally resistant to amoxicillin alone and amoxicillin associated with clavulanic acid. Broad-spectrum antibiotics are indicated to treat S marcescens skin infections, and surgery should be promptly considered in cases of severe skin infections if appropriate antibiotic therapy does not lead to rapid improvement.

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

    Science.gov (United States)

    Okada, Akira; Hangai, Mika; Oda, Toshimi

    2015-01-01

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

  19. Primary psoas muscle abscess in pregnancy.

    Science.gov (United States)

    Swanson, Amy; Lau, Kenneth K; Korman, Tony M; Kornman, Tony; Wallace, Euan M; Polyakov, Alex

    2008-12-01

    Primary iliacus-psoas muscle abscess formation is very uncommon during pregnancy. We present a case of a primary iliacus-psoas muscle abscess in pregnancy causing back pain with delayed diagnosis and treatment. Understanding the clinical presentation of iliacus-psoas muscle abscess helps with considering it in the differential diagnosis of back pain during pregnancy.

  20. Anorectal abscess

    Science.gov (United States)

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

  1. 耳源性脑脓肿CT表现和鉴别诊断%CT manifestations and differential diagnosis of otogenic brain abscesses

    Institute of Scientific and Technical Information of China (English)

    彭强; 贺际宏; 李波

    2011-01-01

    目的 提高对耳源性脑脓肿CT表现的认识和诊断水平.方法 对21例脑脓肿患者行多层螺旋CT平扫与增强扫描后对其CT表现进行回顾性分析.结果 病灶位于颞叶16例,小脑半球4例,顶叶1例;CT平扫表现为不规则片状低密度影,边界模糊,占位效应不明显16例;平扫表现为类圆形囊状低密度影5例,其中2例内有液气平面,注射造影剂后,斑片状、脑回样强化、环状强化17例;无明显强化4例.结论 多层螺旋CT在耳源性脑脓肿的诊断中具有重要诊断价值.%Objective To improve the otogenic brain abscesses CT manifestations of understanding and diagnostic level. Methods Twenty - one cases of brain abscesses patients were done MDCT flat after Saul and enhancement of the CT scan showed were retrospectively analyzed. Results The temporal lobe chondroblastoma in 16 cases, cerebellum involving 4 cases, the parietal lobe 1; CT flat for irregular sheets Saul performance, low density shadow fuzzy boundaries placeholder effect is not obvious, 16 cases; Flat performance for the class round Saul cystic low density shadow 2 cases in 5 cases, including in hydraulic pneumatic plane, contrast -enhanced sonogram obtained after, patchy, brain return sample aggrandizement, cricoid strengthening 17 cases; No obvious strengthening 4 cases. Conclusions In multislice CT otogenic diagnosis of brain abscess has important diagnostic value.

  2. Splenic abscesses.

    Science.gov (United States)

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

    2002-03-01

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

  3. Brain abscesses resulting from Bacillus cereus and an Aspergillus-like mold.

    Science.gov (United States)

    Psiachou-Leonard, Elene; Sidi, Vasiliki; Tsivitanidou, Maria; Gompakis, Nicolas; Koliouskas, Dimitrios; Roilides, Emmanuel

    2002-10-01

    An 11-year-old boy with alveolar rhabdomyosarcoma of the thigh experienced three instances of catheter-related bacteremia resulting from After two episodes of seizures, two low-density lesions in the right parietal lobe and the left corpus callosum with enhanced pericavitary opacity were detected. The catheter was removed. A brain biopsy sample grew and revealed dichotomously branched septate hyphae compatible with The patient was treated with ceftriaxone and liposomal amphotericin B for 12 and 52 weeks, respectively, until biopsy-confirmed resolution of the infections.

  4. Study of CT, MRI and pathology in experimental brain abscess%实验性脑脓肿的CT、MRI和病理特征分析

    Institute of Scientific and Technical Information of China (English)

    赵春生; 杨树源

    2001-01-01

    目的研究实验性脑脓肿不同时期的CT、MRI及病理特征。方法建立狗脑脓肿模型,应用动态CT、MRI检查,结合多项病理学观测进行分析。结果脑炎期MRI T1成像中心坏死区为低信号边缘不清,T2成像上为高信号,且与高信号水肿区融为一体,其范围比CT低密度区广泛。包膜期T1成像上包膜为等或略高信号,T2成像上为一光滑的、薄的、不连续的低信号“带”,其机理可能是脓肿壁上巨噬细胞产生的自由基不均匀分布所致。结论脑脓肿MRI特征与其临床分期及病理学变化的相关性较好,能更加准确、迅速区别脓肿的脑炎期和包膜形成期。%Objective To study the correlation of CT,MRI and pathology in experimental brain abscess.Methods An experimental model of brain in dogs was developed to study the feature of CT and MRI of various stage of brain abscess and pathological bases.Results The MRI appearance of cerebritis stage showed central necrosis producing mild hypointensity signal relative to brain tissue on T1-weighted,while central necrosis and surrounding edematous brain tissue showing high intensity signals on T1-weighted.The high-intensity signals region was more extensive than the contrast-enhanced lesion seen on CT.The MRI features of well encapsulated abscess showed peripheral edema producing mild hypointensity signals on T1-weighted and marked hyperintensity signals on T2-weighted,central necrosis with abscess fluid hypointense signals relative to brain tissue and hyperintense signals relative to CSF on T1-weighted and hyperintense signal relative to brain tissue on T2-weighted as well.Visualizaion of the abscess capsule was iso-to mildly hyperintense signal relatiove to brain tissue on T1-weighted.The rims of hypointensity signals on T2-weighted were thin smooth.The hypointense rims on T2-weighted of MRI is likely due to the presence of heterogeneously

  5. Nocardia brain abscesses in a male patient with SLE: successful outcome despite delay in diagnosis.

    Science.gov (United States)

    Justiniano, Maria; Glorioso, Sarah; Dold, Sylvia; Espinoza, Luis R

    2007-06-01

    We report a 37-year-old African-American man with systemic lupus erythematosus (SLE) diagnosed in May 2001 when he presented with biopsy-proven nephritis. He had been treated intermittently from May 2001 to November 2004 with intravenously (i.v.) administered cyclophosphamide and high doses of prednisone due to unrelenting proteinuria. In November 2004, he was admitted to the hospital because of deterioration of renal function and massive proteinuria (21 g dl(-1) 24 h(-1)) and treated with pulses of methylprednisolone and two courses of i.v. administered cyclophosphamide. His hospital course was complicated by cellulitis and bacteremia with Pseudomonas spp. and Streptococcus bovis. He was discharged on prednisone 60 mg daily, ciprofloxacin, augmentin, and hemodialysis. He was readmitted a week later with new onset of seizure activity, slurred speech, and left-sided hemiparesis. Magnetic resonance imaging of the brain revealed multiple ringlike enhancing foci in the frontal and occipital lobes. Brain biopsy was performed, and Gram stain and initial cultures were negative. Empiric tobramycin, cefepime, and metronidazole were administered. Diagnosis was delayed for several months, but culture eventually grew Nocardia asteroides. Trimethoprim-sulfomethoxazole and linezolid therapy was begun. This was followed by slow, but steady, clinical improvement. Risk factors, diagnostic clues, and treatment are reviewed.

  6. Peritonsillar Abscess (For Teens)

    Science.gov (United States)

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

  7. Percutaneous Abscess Drainage

    Science.gov (United States)

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

  8. Cerebral Abscess Potentially of Odontogenic Origin

    Directory of Open Access Journals (Sweden)

    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.

  9. Necrotizing Pneumonia Caused by Panton-Valentine Leucocidin-Producing Staphylococcus aureus Originating from a Bartholin's Abscess

    Directory of Open Access Journals (Sweden)

    N. Jung

    2008-01-01

    Full Text Available Background. Panton-Valentine leukocidin (PVL-producing Staphylococcus aureus is emerging as a serious problem worldwide. There has been an increase in the incidence of necrotizing lung infections in otherwise healthy young people with a very high mortality associated with these strains. Sporadic severe infectious complications after incision of Bartholin's abcesses have been described but involvement of S. aureus is rare. Case report. We present a 23-year-old apparently healthy female patient without any typical predisposing findings who developed severe sepsis with necrotizing pneumonia and multiple abscesses following incision of a Bartholin's abscess. Methicillin-sensitive S. aureus harbouring Panton-Valentine leucocidin genes were cultured from the abscess fluid, multiple blood cultures and a postoperative wound swab. Aggressive antibiotic therapy with flucloxacillin, rifampicin and clindamycin, drainage and intensive supportive care lead finally to recovery. Conclusions. S. aureus, in particular PVL-positive strains, should be considered when a young, immunocompetent person develops a fulminant necrotizing pneumonia. Minor infections—such as Bartholin's abscess—can precede this life-threating syndrome. Bactericidal antistaphylococcal antibiotics are recommended for treatment, and surgical procedures may become necessary.

  10. Sinking Brain: Unusual Cause of Orthostatic Headache

    Directory of Open Access Journals (Sweden)

    Raina R

    2015-04-01

    Full Text Available We report a case presenting with an orthostatic headache. Brain magnetic resonance imaging (MRI revealed typical pachymeningeal enhancement. CT myelography revealed leakage at the thoracic level. Patient was successfully treated by lumbar epidural blood patch (EBP.

  11. 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...... of patients younger than 30 years old who suffer from peritonsillar abscess irrespective of previous tonsillar disease. Patients older than 30 should be treated with unilateral ablation, unless there is a clear indication for bilateral tonsillectomy....

  12. Jejunal diverticulitis: an unusual cause of an intra-abdominal abscess - coronal Computed Tomography reconstruction can aid the diagnosis

    Directory of Open Access Journals (Sweden)

    Jim Virjee

    2008-11-01

    Full Text Available Jejunal diverticulitis is a rare condition that can present with an acute abdomen and be referred for imaging.  We present the case of an elderly patient who at CT was diagnosed with an intra-abdominal abscess involving both jejunum and transverse colon. However, the underlying eitiology was not initially clear until small bowel barium follow-through.Pertinent points regarding CT findings in jejunal diverticulitis are discussed, and practical recommendations in small bowel diverticulum recognition and diagnosis are made. 

  13. Movement disorders caused by brain tumours.

    Directory of Open Access Journals (Sweden)

    Bhatoe H

    1999-01-01

    Full Text Available Movement disorders are uncommon presenting features of brain tumours. Early recognition of such lesions is important to arrest further deficit. We treated seven patients with movement disorders secondary to brain tumours over a period of seven years. Only two of these were intrinsic thalamic tumours (astrocytomas while the rest were extrinsic tumours. The intrinsic tumours were accompanied by hemichorea. Among the extrinsic tumours, there was one pituitary macroadenoma with hemiballismus and four meningiomas with parkinsonism. Symptoms were unilateral in all patients except one with anterior third falcine meningioma who had bilateral rest tremors. There was relief in movement disorders observed after surgery. Imaging by computed tomography or magnetic resonance imaging is mandatory in the evaluation of movement disorders, especially if the presentation is atypical, unilateral and/or accompanied by long tract signs.

  14. An atypical cause of rapidly progressing breast lump with abscess formation: Pure squamous cell carcinoma of the breast.

    Science.gov (United States)

    Cilekar, Murat; Erkasap, Serdar; Oner, Ulku; Akici, Murat; Ciftci, Evrim; Dizen, Hayrettin; Turel, Serkan; Kavak, Ozgu I; Yilmaz, Sezgin

    2015-01-01

    Squamous cell carcinoma (SCC) is a rare type of breast malignancy and little is known about long-term outcome. In the present report, the clinical features, histopathologic findings and postoperative course of a patient with squamous cell carcinoma are described. We have treated a 47-years-old woman who admitted for right breast mass without any discharge, bleeding and pain. The tumor was, 3 × 2 × 1.5 cm in size with central abscess formation. The result of surgical biopsy revealed large cell keratinizing type of SCC. The metastatic work-up studies ruled out any other probable sources of primary tumor. The patient was performed modified radical mastectomy and axillary dissection and received two cycles of chemotherapy. Squamous cell carcinoma of the breast (SCCB) is a rare entity and should be considered in patients with rapidly progressing breast mass. It should also be considered in breast lesions with abscess formation. The initial therapeutic approach should be surgical excision after histopathological diagnosis.

  15. Misdiagnosis Cause Analysis of Tuberculous Neck Lymphadenitis Abscess%颈淋巴结结核性脓肿误诊原因分析

    Institute of Scientific and Technical Information of China (English)

    渠晨晖; 郭艳

    2011-01-01

    Objective To analyze the causes of misdiagnosis of tuberculous neck lymphadenitis abscess and to improve the level of clinical diagnosis. Methods 2 cases of tuberculous neck lymphadenitis abscess were analyzed retrospectively, both of whom were treated in our department during January 2006 and January 2011. Results 2 cases (16.67% ) were misdiagnosed, characterized by neck or lower jaw mass, exemple one was accompanied with low fever and exemple two was accompanied with pain. They were misdiagnosed as inflammatory mass in the right neck mass complicated by infection and branchial cyst. They were treated by enlarged resection and were identified by histopathology examination: tuberculous lymphadenitis abscess. Conclusion Early diagnosis of tuberculous neck lymphadenitis abscess is difficult. We should im-prove our diagnosis and therapy level in tuberculosis, make the best use of methods of clinical examination in order to confirm diagnosis and choose proper treatment earlier.%目的 探讨颈淋巴结结核性脓肿的临床特点和误诊原因,提高临床诊断水平.方法 回顾性分析2006年1月~2011年1月我科收治的2例颈淋巴结结核性脓肿误诊病例的临床资料.结果 误诊的2例颈淋巴结结核性脓肿占我院同期收治的颈淋巴结结核性脓肿的16.67%,均表现为颈部或颌下肿物,例1伴低热、肿物溢脓,例2伴疼痛.2例分别误诊为右颈部炎性肿物和鳃裂囊肿,均行颈部肿物扩大切除术,术后病理检查诊断为颈淋巴结结核性脓肿.结论 颈淋巴结结核性脓肿早期诊断较为困难,故应全面提高对结核病的诊断和治疗能力,充分利用多种临床检查手段明确诊断,尽早确定个性化治疗方案.

  16. Irreversible brain damage caused by methamphetamine

    Directory of Open Access Journals (Sweden)

    Sebastian Moeller

    2016-03-01

    Full Text Available Methamphetamine is an addictive scene substance usage of which is increasing rapidly. While methamphetamine often causes neuropsychiatric symptoms like anxiety, psychosis and hallucinations, reports of structural ongoing cerebral alterations are rare. We here report a case of this kind of damage caused through methamphetamine use.

  17. 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.

  18. 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.

  19. Central nervous system infection caused by vancomycin-intermediate Staphylococcus aureus (SCCmec type IV, ST8).

    Science.gov (United States)

    Kino, Hiroyoshi; Suzuki, Hiromichi; Yamaguchi, Tetsuo; Notake, Shigeyuki; Oishi, Tsuyoshi; Ito, Yoshiro; Nakamura, Kazuhiro; Miyazaki, Haruko; Matsumoto, Tetsuya; Uemura, Kazuya; Matsumura, Akira

    2014-10-01

    A 77-year-old Japanese man with a history of surgical treatment of chronic subdural hemorrhage was hospitalized for drainage of a subdural abscess and brain abscess in the right occipital area. Pus obtained from both the subdural abscess and brain abscess grew vancomycin-intermediate Staphylococcus aureus (VISA) (minimum inhibitory concentration = 4 μg/mL), which was confirmed by population analysis. The SCCmec type and sequence type were subsequently identified as IV and ST8, respectively. The VISA strains were both sensitive to levofloxacin, clindamycin, minocycline, and linezolid. The patient was successfully treated with linezolid and discharged on day 51 after admission. We herein describe the first reported case of a brain abscess and subdural abscess caused by VISA in Japan.

  20. Bacteriemia y absceso hepático causado por Yersinia enterocolitica Bacteremia and hepatic abscess caused by Yersinia enterocolitica

    Directory of Open Access Journals (Sweden)

    A. Navascués

    2004-08-01

    Full Text Available Yersinia enterocolitica es un cocobacilo gram negativo de amplia distribución mundial cuyo reservorio natural se encuentra en una gran variedad de animales. La transmisión a los humanos se realiza principalmente a través de la vía fecal-oral aunque también se han descrito casos de transmisión a través de transfusiones sanguíneas. Su aislamiento se realiza habitualmente dentro de un cuadro gastrointestinal y rara vez produce trastornos extraintestinales como bacteriemia, abscesos, manifestaciones cutáneas, etc. Éstos se han asociado a diferentes enfermedades de base como alteraciones del metabolismo del hierro, diabetes mellitus, alcoholismo, malnutrición, tumores, terapia inmunosupresora y cirrosis. Presentamos el caso de un paciente diabético que desarrolló bacteriemia asociada a abscesso hepático por Yersinia enterocolitica.Yersinia enterocolitica is a Gram-negative coccobacillus that is distributed world-wide and whose natural reservoire is found in a great variety of animals. Transmission to humans mainly occurs through the faecal-oral path although cases have been described of transmission through blood transfusions. It is isolated within a gastro-intestinal clinical picture and it rarely produces extra-intestinal disorders such as bacteraemia, abscesses, cutaneous signs, etc. The latter have been associated with different underlying diseases such as alterations of the iron metabolism, diabetes mellitus, alcoholism, malnutrition, tumours, immunosuppressant therapy and cirrhosis. We present the case of a diabetic patient who developed bacteraemia associated with hepatic abscess due to Yersinia enterocolitica.

  1. Pathogenesis of Staphylococcus aureus abscesses.

    Science.gov (United States)

    Kobayashi, Scott D; Malachowa, Natalia; DeLeo, Frank R

    2015-06-01

    Staphylococcus aureus causes many types of human infections and syndromes-most notably skin and soft tissue infections. Abscesses are a frequent manifestation of S. aureus skin and soft tissue infections and are formed, in part, to contain the nidus of infection. Polymorphonuclear leukocytes (neutrophils) are the primary cellular host defense against S. aureus infections and a major component of S. aureus abscesses. These host cells contain and produce many antimicrobial agents that are effective at killing bacteria, but can also cause non-specific damage to host tissues and contribute to the formation of abscesses. By comparison, S. aureus produces several molecules that also contribute to the formation of abscesses. Such molecules include those that recruit neutrophils, cause host cell lysis, and are involved in the formation of the fibrin capsule surrounding the abscess. Herein, we review our current knowledge of the mechanisms and processes underlying the formation of S. aureus abscesses, including the involvement of polymorphonuclear leukocytes, and provide a brief overview of therapeutic approaches.

  2. Perianal abscesses due to ingested foreign bodies

    Directory of Open Access Journals (Sweden)

    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.

  3. 克雷伯杆菌所致肝脏巨大气性脓肿一例报告%One Case Report: Hepatic Huge Gas Abscess Caused by Klebsiella Pneumoniae

    Institute of Scientific and Technical Information of China (English)

    李文娟; 丁军; 邓大勇; 张宝; 付卫光; 杨琳媛

    2013-01-01

    Objective: To analyse possible causes and pathogenesis of hepatic abscess caused by Klebsiella pneumoniae; to improve the accuracy of diagnosis and to provide help for clinical treatment. Methods: This paper reports one rare case of hepatic huge gas abscess, describes information of its clinical manifestations, laboratory examinations. Results: In this case, the result of bacterial culture was Klebsiella pneumoniae, the patient got better after active treatment. Conclusion: The incidence of hepatic abscess caused by Klebsiella is increasing, Klebsiella pneumoniae has been the most common microorganism causing hepatic abscess. In addition to the general performance of bacterial hepatic abscess, hepatic abscess caused by Klebsiella pneumoniae has its unique characteristics. Diabetic mellitus has been reported to be the most common underlying disease in patients with K. pneumoniae hepatic abscess, and these patients'condition often progresses rapidly, and their early symptoms and CT findings are not typical, so for the infected patients with diabetic mellitus, we should be wary of the occurrence of Klebsiella pneumoniae hepatic abscess.%目的:分析克雷伯杆菌导致肝脓肿的的可能原因和发病机理,提高诊断的准确性,并对临床治疗提供帮助.方法:本文报道了本院收治的一例肝内罕见巨大气性脓肿,详细分析了其影像学表现特点及临床表现、辅助检查等情况.结果:本病例细菌培养结果为克雷伯杆菌.患者经积极治疗后病情好转.结论:肺炎克雷伯杆菌引起的肝脓肿发病率呈上升趋势,并已经成为细菌性肝脓肿最常见的致病菌.克雷伯杆菌所致的肝脓肿除了有细菌性肝脓肿的普遍表现外,还有其独特的特点.另外,糖尿病是克雷伯杆菌肝脓肿常见的基础疾病,糖尿病患者的肝脓肿往往进展迅速,且早期症状及CT表现多不典型,因此对于感染入院的糖尿病患者应该警惕克雷伯杆菌肝脓肿的发生.

  4. Schistosomiasis: predisposing cause for the formation of hepatic abscesses? Case report Esquistossomose: causa predisponente para a formação de abscessos hepáticos?

    Directory of Open Access Journals (Sweden)

    Vasco Carvalho Pedroso de Lima

    1995-06-01

    Full Text Available An adult patient with chronic schistosomiasis from an endemic area, complained about a seven day fever, along with jaundice and lumbar backache on the right side. Image exams showed multiple pyogenic liver abscesses. All the classic etiologies were discarded through clinical, radiological and laboratorial criteria. Schistosomiasis can cause pylephlebitis as a complication, along with immunesuppression, granulomatous reaction with central lobular liver necrosis and a greater risk of infection. The authors suggest that schistosomiasis in its chronic form may be the predisposing cause of multiple pyogenic liver abscesses, especially in endemic areas.Paciente adulto, natural de região endêmica para esquistossomose e portador crônico da doença, apresentava queixa de febre há sete dias, associada à ictericia e dor lombar em região direita. Os exames radiológicos mostraram abscessos hepáticos piogênicos múltiplos, cuja causa predisponente é conhecida, segundo trabalhos da literatura, em 100% dos casos. Através de parâmetros clínicos, laboratoriais e radiológicos todas as etiologias clássicas foram afastadas. Sabe-se que a esquistossomose pode provocar, como complicação, a pileflebite, além de depressão imunológica e reação granulomatosa com necrose lobular central e maior risco de infecção. Os autores deste relato de caso sugerem ser a esquistossomose, na sua forma crônica, causa predisponente para formação de abscessos hepáticos piogênicos múltiplos, principalmente em regiões endêmicas.

  5. Genetic causes of congenital brain malformations in epilepsy patients

    DEFF Research Database (Denmark)

    Møller, Rikke Steensbjerre

    2008-01-01

    The search for genetic causes of congenital brain malformations, severe epilepsy and mental retardation plays an important role in neuropediatrics and neurology. Disclosure of the aetiology of the intellectual disabilities, seizures and the underlying brain malformation may be of psychological...... value for the family, and it is essential for proper genetic counselling. The human brain is one of the most complex structures known, and probably many of the 25.000- 30.000 genes that comprise the human genome are involved in its development, which means that thousands of genes could be candidate...... genes for developmental brain defects. The overall aim of the present study has been to identify new candidate genes or predisposing factors involved in congenital brain malformations in epilepsy patients....

  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. Cerebral phaeohyphomycosis caused by Rhinocladiella mackenziei in a woman native to Afghanistan.

    Science.gov (United States)

    Cristini, Alejandro; Garcia-Hermoso, Dea; Celard, Marie; Albrand, Gilles; Lortholary, Olivier

    2010-09-01

    Rhinocladiella mackenziei is a recognized cause of endemic cerebral phaeohyphomycosis in the Middle East area. Surgical resection of the abscesses and posaconazole treatment have improved the ominous prognosis of this disease. We describe the case of a native Afghan woman living in France who presented with brain abscesses due to R. mackenziei.

  8. Cerebral Phaeohyphomycosis Caused by Rhinocladiella mackenziei in a Woman Native to Afghanistan ▿

    OpenAIRE

    Cristini, Alejandro; Garcia-Hermoso, Dea; Celard, Marie; Albrand, Gilles; Lortholary, Olivier

    2010-01-01

    Rhinocladiella mackenziei is a recognized cause of endemic cerebral phaeohyphomycosis in the Middle East area. Surgical resection of the abscesses and posaconazole treatment have improved the ominous prognosis of this disease. We describe the case of a native Afghan woman living in France who presented with brain abscesses due to R. mackenziei.

  9. Multiple brain abscesses due to Penicillium spp infection Abscessos cerebrais múltiplos causados por infecção por Penicillium spp

    Directory of Open Access Journals (Sweden)

    Danilo Teixeira Noritomi

    2005-06-01

    Full Text Available We present a case of central nervous system (CNS infection by a member of the Penicillium genera in a HIV-negative man in Brazil. The patient was admitted complaining of loss of visual fields and speech disturbances. CT scan revealed multiple brain abscesses. Stereothacic biopsies revealed fungal infection and amphotericin B treatment begun with initial improvement. The patient died few days later as a consequence of massive gastrointestinal bleeding due to ruptured esophageal varices. The necropsy and final microbiologic analyses disclosed infection by Penicillium sp. There are thousands of fungal species of the Penicillium genera. Systemic penicilliosis is caused by the P. marneffei and was formerly a rare disease, but now is one of the most common opportunistic infection of AIDS patients in Southeast Asia. The clinical presentation usually involves the respiratory system and the skin, besides general symptoms like fever and weight loss. Penicillium spp infection caused by species other than P. marneffei normally cause only superficial or allergic disease but rare cases of invasive disease do occur. We report the fourth case of Penicillium spp CNS infection.Apresentamos um caso de infecção do sistema nervoso central (SNC por Penicillium spp em paciente do sexo masculino, HIV-negativo no Brasil. O paciente apresentou-se ao Serviço de Urgência do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo queixando-se de alteração visual e dificuldade na fala. Exames de neuroimagem mostraram lesões múltiplas, compatíveis com abscessos. A biópsia esterotáxica revelou infecção fúngica, iniciando-se o tratamento com anfotericina B com sucesso inicial. O paciente morreu poucos dias depois, vítima de uma hemorragia digestiva maciça devido a varizes de esôfago. A necropsia e a análise microbiológica final da biópsia cerebral revelaram infecção por Penicillium spp. Exixtem centenas de espécies de fungos do g

  10. CT of pituitary abscess

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-06-01

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

  11. 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.

  12. Splenic abscess due to Salmonella enteritidis

    Directory of Open Access Journals (Sweden)

    Hatice Çabadak

    2012-02-01

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

  13. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

    OpenAIRE

    2014-01-01

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

  14. Splenic abscess in a patient with fecal peritonitis

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

  16. Abscess - abdomen or pelvis

    Science.gov (United States)

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

  17. Tonsillar Cellulitis and Abscess

    Science.gov (United States)

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

  18. [Prostatic abscesses. A review].

    Science.gov (United States)

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

    1999-01-01

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

  19. Bilateral otogenic cerebellar abscesses.

    Directory of Open Access Journals (Sweden)

    Nadkarni T

    1993-01-01

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

  20. 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.

  1. Actinomycosis, a rare and unsuspected cause of anal fistulous abscess: report of three cases and review of the literature.

    Science.gov (United States)

    Coremans, G; Margaritis, V; Van Poppel, H P; Christiaens, M R; Gruwez, J; Geboes, K; Wyndaele, J; Vanbeckevoort, D; Janssens, J

    2005-03-01

    Primary perianal actinomycosis is rare. Sporadic cases, with lesions varying in extent have been reported. The infection is caused by the bacterium Actinomyces, which often is a saprophyte. Male gender and diabetes are risk factors, but the exact pathogenic mechanism remains speculative. The diagnosis is a challenge and often delayed, with a protracted history of masses and sinuses extending into the gluteal and genital region. The treatment, a combination of surgery and antibiotics, is poorly standardized. We report three cases and compare their characteristics to those of published cases, found by a computerized literature search (1968-2002). The lesions, a simple fistula-in-ano or a mass, were diagnosed in an early stage in all three patients. The infection always spread into the scrotum. There were no risk factors other than gender, except in one patient. The diagnosis was suspected by the observation of draining sulfur granules and promptly confirmed by histology in the three cases. All patients healed with antibiotics in addition to simple surgical procedures. Treatment consisted of amoxicillin for two weeks in two cases and more extended antimicrobial treatment in the third. These findings are contrasting with the classic picture of perianal actinomycosis. It is concluded that perianal actinomycosis can occur in the absence of risk factors and that early diagnosis requires a high degree of suspicion. An infection with Actinomyces should be suspected in the presence of lesions containing watery purulent material with sulfur granules. The indication for extended antibiotherapy combined with sphincter damaging surgery may need to be revised in the presence of early detection.

  2. Splenic abscess in typhoid fever -Surgical management

    Institute of Scientific and Technical Information of China (English)

    Col Prasan Kumar Hota

    2009-01-01

    Splenic abscess is an uncommon clinical presentation in surgical practice,associated with high morbidity and mortality.Mortality may be 100 % if left untreated.Splenic abscess is also rarely encountered as a complica-tion of typhoid fever.We present here a case of multiple splenic abscesses with neuropsychiatric complications due to typhoid fever,which was managed successfully with splenectomy and other supportive therapies.Anoth-er case of single splenic abscess due to enteric fever was treated successfully with CT-guided aspiration and ap-propriate antibiotics.Being a rare entity in clinical practice,splenic abscess has been poorly studied.Haemat-ogenous seeding of the spleen due to typhoid is a common cause of splenic abscess in the tropical countries.In multiple or multiloculated abscesses aspiration usually does not succeed,which happened in our case.Sple-nectomy remains the definitive choice of treatment.However,Ultra sonography (USG)or CT-guided aspira-tion may be tried in selective cases.

  3. COLLAR STUD ABSCESS AN INTERESTING CASE REPORT

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2012-04-01

    Full Text Available 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.

  4. Frontal mucocele with an accompanying orbital abscess mimicking a fronto-orbital mucocele: case report

    OpenAIRE

    Akkuzu Guzin; Aydin Erdinc; Akkuzu Babur; Bilezikci Banu

    2006-01-01

    Abstract Background Mucoceles are slowly expanding cystic lesions with respiratory epithelium containing mucus most commonly affecting the frontal and ethmoidal sinuses. They are caused by obstruction of sinus ostium. Mucoceles exert pressure on the bony boundaries and due to the proximity to the brain and orbit extension to these areas are common. Case presentation A case of a frontal mucocele with an accompanying orbital abscess mimicking a fronto-orbital mucocele is reported. A 77 year old...

  5. 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.

  6. Multiple Scedosporium apiospermum abscesses in a woman survivor of a tsunami in northeastern Japan: a case report

    Directory of Open Access Journals (Sweden)

    Nakamura Yutaka

    2011-10-01

    Full Text Available Abstract Introduction Scedosporium apiospermum is increasingly recognized as a cause of localized and disseminated mycotic infections in near-drowning victims. Case presentation We report the case of a 59-year-old Japanese woman who was a survivor of a tsunami in northeastern Japan and who had lung and brain abscesses caused by S. apiospermum. Initially, an aspergillus infection was suspected, so she was treated with micafungin. However, computed tomography scans of her chest revealed lung abscesses, and magnetic resonance images demonstrated multiple abscesses in her brain. S. apiospermum was cultured from her bronchoalveolar lavage fluid, and antimycotic therapy with voriconazole was initiated. Since she developed an increase in the frequency of premature ventricular contractions, an adverse drug reaction to the voriconazole was suspected. She was started on a treatment of a combination of low-dose voriconazole and liposomal amphotericin B. After combination therapy, further computed tomography scans of the chest and magnetic resonance images of her brain showed a demarcation of abscesses. Conclusions Voriconazole appeared to have a successful record in treating scedosporiosis after a near drowning but, owing to several adverse effects, may possibly not be recommended. Thus, a combination treatment of low-dose voriconazole and liposomal amphotericin B may be a safe and effective treatment for an S. apiospermum infection. Even though a diagnosis of scedosporiosis may be difficult, a fast and correct etiological diagnosis could improve the patient's chance of recovery in any case.

  7. 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....

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

    Science.gov (United States)

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

    2014-08-01

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

  9. Pyogenic Liver Abscess. A Case Report

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Serra Valdés

    2013-06-01

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

  10. Anal abscess and fistula.

    Science.gov (United States)

    Sneider, Erica B; Maykel, Justin A

    2013-12-01

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

  11. 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.

  12. Deep neck abscesses: the Singapore experience.

    Science.gov (United States)

    Lee, Yan Qing; Kanagalingam, Jeevendra

    2011-04-01

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

  13. 肺炎克雷伯菌致多发性肝脓肿患者的加强护理%The intensive care to patients with multiple liver abscess caused by Klebsiella pneumonia

    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.

  14. Impairment of brain endothelial glucose transporter by methamphetamine causes blood-brain barrier dysfunction

    Directory of Open Access Journals (Sweden)

    Murrin L Charles

    2011-03-01

    Full Text Available Abstract Background Methamphetamine (METH, an addictive psycho-stimulant drug with euphoric effect is known to cause neurotoxicity due to oxidative stress, dopamine accumulation and glial cell activation. Here we hypothesized that METH-induced interference of glucose uptake and transport at the endothelium can disrupt the energy requirement of the blood-brain barrier (BBB function and integrity. We undertake this study because there is no report of METH effects on glucose uptake and transport across the blood-brain barrier (BBB to date. Results In this study, we demonstrate that METH-induced disruption of glucose uptake by endothelium lead to BBB dysfunction. Our data indicate that a low concentration of METH (20 μM increased the expression of glucose transporter protein-1 (GLUT1 in primary human brain endothelial cell (hBEC, main component of BBB without affecting the glucose uptake. A high concentration of 200 μM of METH decreased both the glucose uptake and GLUT1 protein levels in hBEC culture. Transcription process appeared to regulate the changes in METH-induced GLUT1 expression. METH-induced decrease in GLUT1 protein level was associated with reduction in BBB tight junction protein occludin and zonula occludens-1. Functional assessment of the trans-endothelial electrical resistance of the cell monolayers and permeability of dye tracers in animal model validated the pharmacokinetics and molecular findings that inhibition of glucose uptake by GLUT1 inhibitor cytochalasin B (CB aggravated the METH-induced disruption of the BBB integrity. Application of acetyl-L-carnitine suppressed the effects of METH on glucose uptake and BBB function. Conclusion Our findings suggest that impairment of GLUT1 at the brain endothelium by METH may contribute to energy-associated disruption of tight junction assembly and loss of BBB integrity.

  15. Amebic liver abscesses masquerading as pyemic abscesses.

    Science.gov (United States)

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

    2001-12-15

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

  16. Equine corneal stromal abscesses

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  17. Roseomonas spinal epidural abscess complicating instrumented posterior lumbar interbody fusion.

    Science.gov (United States)

    Maraki, Sofia; Bantouna, Vasiliki; Lianoudakis, Efstratios; Stavrakakis, Ioannis; Scoulica, Efstathia

    2013-07-01

    The first case of a spinal epidural abscess caused by Roseomonas mucosa following instrumented posterior lumbar fusion is presented. Although rare, because of its highly resistant profile, Roseomonas species should be included in the differential diagnosis of epidural abscesses in both immunocompromised and immunocompetent hosts.

  18. Roseomonas Spinal Epidural Abscess Complicating Instrumented Posterior Lumbar Interbody Fusion

    OpenAIRE

    Maraki, Sofia; Bantouna, Vasiliki; Lianoudakis, Efstratios; Stavrakakis, Ioannis; Scoulica, Efstathia

    2013-01-01

    The first case of a spinal epidural abscess caused by Roseomonas mucosa following instrumented posterior lumbar fusion is presented. Although rare, because of its highly resistant profile, Roseomonas species should be included in the differential diagnosis of epidural abscesses in both immunocompromised and immunocompetent hosts.

  19. Iliacus abscess with radiculopathy mimicking herniated nucleus pulposus: Additional diagnostic value of magnetic resonance imaging.

    Science.gov (United States)

    Kim, D H; Woo, S H; Lee, W J

    2017-03-01

    An iliacus abscess is an extremely rare cause of low back pain. With an iliacus abscess, the classical signs seen with a psoas abscess are frequently absent. Therefore, a timely diagnosis at the initial visit is difficult and inadequate treatment usually results in high mortality. Here, we report the case of 19-year-old man who presented with acute low back pain with radiculopathy and was ultimately diagnosed with an iliacus muscle abscess.

  20. Polymicrobial Pituitary Abscess Predominately Involving Escherichia coli in the Setting of an Apoplectic Pituitary Prolactinoma

    Science.gov (United States)

    Beatty, Norman; Medina-Garcia, Luis; Al Mohajer, Mayar; Zangeneh, Tirdad T.

    2016-01-01

    Pituitary abscess is a rare intracranial infection that can be life-threatening if not appropriately diagnosed and treated upon presentation. The most common presenting symptoms include headache, anterior pituitary hypofunction, and visual field disturbances. Brain imaging with either computed tomography or magnetic resonance imaging usually reveals intra- or suprasellar lesion(s). Diagnosis is typically confirmed intra- or postoperatively when pathological analysis is done. Clinicians should immediately start empiric antibiotics and request a neurosurgical consult when pituitary abscess is suspected. Escherichia coli (E. coli) causing intracranial infections are not well understood and are uncommon in adults. We present an interesting case of an immunocompetent male with a history of hypogonadism presenting with worsening headache and acute right eye vision loss. He was found to have a polymicrobial pituitary abscess predominantly involving E.   coli in addition to Actinomyces odontolyticus and Prevotella melaninogenica in the setting of an apoplectic pituitary prolactinoma. The definitive etiology of this infection was not determined but an odontogenic process was suspected. A chronic third molar eruption and impaction in close proximity to the pituitary gland likely led to contiguous spread of opportunistic oral microorganisms allowing for a polymicrobial pituitary abscess formation. PMID:27006841

  1. Polymicrobial Pituitary Abscess Predominately Involving Escherichia coli in the Setting of an Apoplectic Pituitary Prolactinoma

    Directory of Open Access Journals (Sweden)

    Norman Beatty

    2016-01-01

    Full Text Available Pituitary abscess is a rare intracranial infection that can be life-threatening if not appropriately diagnosed and treated upon presentation. The most common presenting symptoms include headache, anterior pituitary hypofunction, and visual field disturbances. Brain imaging with either computed tomography or magnetic resonance imaging usually reveals intra- or suprasellar lesion(s. Diagnosis is typically confirmed intra- or postoperatively when pathological analysis is done. Clinicians should immediately start empiric antibiotics and request a neurosurgical consult when pituitary abscess is suspected. Escherichia coli (E. coli causing intracranial infections are not well understood and are uncommon in adults. We present an interesting case of an immunocompetent male with a history of hypogonadism presenting with worsening headache and acute right eye vision loss. He was found to have a polymicrobial pituitary abscess predominantly involving E.   coli in addition to Actinomyces odontolyticus and Prevotella melaninogenica in the setting of an apoplectic pituitary prolactinoma. The definitive etiology of this infection was not determined but an odontogenic process was suspected. A chronic third molar eruption and impaction in close proximity to the pituitary gland likely led to contiguous spread of opportunistic oral microorganisms allowing for a polymicrobial pituitary abscess formation.

  2. 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.

  3. Aspergillus spinal epidural abscess

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-12-17

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

  4. Central corneal abscess.

    Science.gov (United States)

    van Bijsterveld, O P

    1976-05-01

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

  5. 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.

  6. 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.

  7. [Acute periproctal abscesses].

    Science.gov (United States)

    Slauf, P; Antoš, F; Marx, J

    2014-04-01

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

  8. Enterococcal cerebellopontine angle abscess in a 12-year-old female

    Directory of Open Access Journals (Sweden)

    Sonavane Alka

    2010-01-01

    Full Text Available Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally. Various aerobic and anaerobic bacteria have been reported as causative agents of brain abscess but only a few cases of enterococcal brain abscesses have been reported. Here we report a case of brain abscess in a 12-year-old female patient, who presented with a history of fever, chills, headache, convulsions since seven days and history of altered sensorium and aphasia since the last two days . The patient had chronic suppurative otitis media of both ears following trauma and presented with ear discharge. The diagnosis of brain abscess was done by computerized tomography scan and the pus was aspirated by left suboccipital burr hole operation. Enterococcus species was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotic treatment.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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.

  11. Rapidly Progressive Spontaneous Spinal Epidural Abscess

    Directory of Open Access Journals (Sweden)

    Abdurrahman Aycan

    2016-01-01

    Full Text Available Spinal epidural abscess (SEA is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

  12. Rapidly Progressive Spontaneous Spinal Epidural Abscess.

    Science.gov (United States)

    Aycan, Abdurrahman; Aktas, Ozgür Yusuf; Guzey, Feyza Karagoz; Tufan, Azmi; Isler, Cihan; Aycan, Nur; Gulsen, İsmail; Arslan, Harun

    2016-01-01

    Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

  13. Chest wall abscess due to Prevotella bivia

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  14. Spinal and Intracranial Epidural Abscess

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-03-01

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

  15. A Rare Case of Fusobacterium Necrophorum Liver Abscesses

    Science.gov (United States)

    Hannoodi, Faris; Sabbagh, Hussam; Kulairi, Zain; Kumar, Sarwan

    2017-01-01

    Liver abscesses are an uncommon disease that can present with vague symptoms. Fusobacterium necrophorum causing liver abscesses is a rare condition and only a few cases have been reported. An 88-year-old female presented to her primary care physician with one week of fevers, night sweats, chills, fatigue and vague right upper quadrant abdominal pain. She denied nausea, vomiting, constipation, diarrhea and unintentional weight loss. A computed tomography scan of the abdomen showed two liver abscesses in the right lobe as well as extensive diverticulosis. Percutaneous drainage was performed and draining catheters were placed in the abscesses. Culture of the abscess fluid grew Fusobacterium necrophorum. She was treated with ceftriaxone and metronidazole as per sensitivities. Rare cases of F. necrophorum hepatic abscesses have been published. The source of infection described in reported cases included hematogenous spread from dental caries/peritonsillar abscess and those involving the gastrointestinal tract resulting from inflammation of the bowel wall or from inflamed diverticuli via the portal circulation. In one study, thirteen cases of liver abscess due to F. necrophorum were studied, and two of these cases had diverticular disease without inflammation.

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

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    Hava Yılmaz

    2012-03-01

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

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

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    Matthew Stratton

    2015-01-01

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

  18. Vascular changes caused by deep brain stimulation using double-dose gadolinium-enhanced brain MRI

    Institute of Scientific and Technical Information of China (English)

    Byeong Sam Choi; Yong Hwan Kim; Sang Ryong Jeon

    2014-01-01

    We retrospectively analyzed the clinical data of 32 patients with medically intractable idiopathic Parkinson’s disease who had undergone staged bilateral deep brain stimulation of the subtha-lamic nuclei from January 2007 to May 2011. The vascularture of the patients who received two deep brain stimulations was detected using double-dose gadolinium-enhanced brain MRI. The dimensions of straight sinus, superior sagittal sinus, ipsilateral internal cerebral vein in the tha-lamic branch and ipsilateral anterior caudate vein were reduced. These ifndings demonstrate that bilateral deep brain stimulation of the subthalamic nuclei affects cerebral venous blood lfow.

  19. Authenticity or autonomy? When deep brain stimulation causes a dilemma.

    Science.gov (United States)

    Kraemer, Felicitas

    2013-12-01

    While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients' feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between autonomy and authenticity. This case study is meant to point out the normatively meaningful tension patients under DBS experience between authenticity and autonomy.

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

    Science.gov (United States)

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

    2014-05-01

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

  1. Immunization with cocktail of HIV-derived peptides in montanide ISA-51 is immunogenic, but causes sterile abscesses and unacceptable reactogenicity.

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    Barney S Graham

    Full Text Available BACKGROUND: A peptide vaccine was produced containing B and T cell epitopes from the V3 and C4 Envelope domains of 4 subtype B HIV-1 isolates (MN, RF, CanO, & Ev91. The peptide mixture was formulated as an emulsion in incomplete Freund's adjuvant (IFA. METHODS: Low-risk, healthy adult subjects were enrolled in a randomized, placebo-controlled dose-escalation study, and selected using criteria specifying that 50% in each study group would be HLA-B7+. Immunizations were scheduled at 0, 1, and 6 months using a total peptide dose of 1 or 4 mg. Adaptive immune responses in16 vaccine recipients and two placebo recipients after the 2nd immunization were evaluated using neutralization assays of sera, as well as ELISpot and ICS assays of cryopreserved PBMCs to assess CD4 and CD8 T-cell responses. In addition, (51Cr release assays were performed on fresh PBMCs following 14-day stimulation with individual vaccine peptide antigens. RESULTS: 24 subjects were enrolled; 18 completed 2 injections. The study was prematurely terminated because 4 vaccinees developed prolonged pain and sterile abscess formation at the injection site-2 after dose 1, and 2 after dose 2. Two other subjects experienced severe systemic reactions consisting of headache, chills, nausea, and myalgia. Both reactions occurred after the second 4 mg dose. The immunogenicity assessments showed that 6/8 vaccinees at each dose level had detectable MN-specific neutralizing (NT activity, and 2/7 HLA-B7+ vaccinees had classical CD8 CTL activity detected. However, using both ELISpot and ICS, 8/16 vaccinees (5/7 HLA-B7+ and 0/2 controls had detectable vaccine-specific CD8 T-cell responses. Subjects with moderate or severe systemic or local reactions tended to have more frequent T cell responses and higher antibody responses than those with mild or no reactions. CONCLUSIONS: The severity of local responses related to the formulation of these four peptides in IFA is clinically unacceptable for continued

  2. Injection site abscess due to mycobacterium fortuitum: A case report

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    Devi DR

    2003-01-01

    Full Text Available Injection abscess is an iatrogenic infection occurring as an isolated case or as cluster outbreak. These infections occur due to contaminated injectables or lapse in sterilisation protocol. While pathogens such as Pseudomonas, Klebsiella, E. coli, and S. aureus are the usual causative agents, unusual organisms such as mycobacteria, particularly the rapidly growing non-tuberculous mycobacteria (NTM may cause the abscess. The chances of overlooking these organisms is high unless an acid fast bacilli (AFB smear and culture is done on all aspirated pus specimens. We report a case of a three year old child who presented with a gluteal abscess following an intramuscular infection with an unknown preparation.

  3. 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.

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

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    Burak Ulaş

    2013-12-01

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

  5. 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.

  6. Frontal mucocele with an accompanying orbital abscess mimicking a fronto-orbital mucocele: case report

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    Akkuzu Guzin

    2006-04-01

    Full Text Available Abstract Background Mucoceles are slowly expanding cystic lesions with respiratory epithelium containing mucus most commonly affecting the frontal and ethmoidal sinuses. They are caused by obstruction of sinus ostium. Mucoceles exert pressure on the bony boundaries and due to the proximity to the brain and orbit extension to these areas are common. Case presentation A case of a frontal mucocele with an accompanying orbital abscess mimicking a fronto-orbital mucocele is reported. A 77 year old female patient suffering from left sided proptosis and pain around the left eye was admitted to our department. She had a history of left frontal sinus mucocele one year ago that was offered an osteoplastic frontal sinus surgery that the patient refused. Patient had limitation of eye movements. Fundoscopic examination revealed a minimal papilledema. Coronal computerized tomography and orbital magnetic resonance imaging showed a frontal mucocele with suspicious erosion of the orbital roof and a superiorly localized extraconal mass displacing the orbit lateroinferiorly. Frontal and orbital masses had similar intensities. Thus surgery was planned for a fronto-orbital mucocele. During surgery no defect was found on the orbital roof. Frontal mucocele and orbital cystic mass was removed separately. Pathological examination showed a frontal mucocele and an orbital abscess wall. Postoperatively eye movements returned to normal and papilledema resolved. Conclusion Fronto-orbital mucoceles are commonly encountered pathologies, but frontal mucocele with an orbital abscess is a rarely seen and should be kept in mind because their treatments differ.

  7. A derangement of the brain wound healing process may cause some cases of Alzheimer's disease.

    Science.gov (United States)

    Lehrer, Steven; Rheinstein, Peter H

    2016-08-01

    A derangement of brain wound healing may cause some cases of Alzheimer's disease. Wound healing, a highly complex process, has four stages: hemostasis, inflammation, repair, and remodeling. Hemostasis and the initial phases of inflammation in brain tissue are typical of all vascularized tissue, such as skin. However, distinct differences arise in brain tissue during the later stages of inflammation, repair, and remodeling, and closely parallel the changes of Alzheimer's disease. Our hypothesis -- Alzheimer's disease is brain wound healing gone awry at least in some cases -- could be tested by measuring progression with biomarkers for the four stages of wound healing in humans or appropriate animal models. Autopsy studies might be done. Chronic traumatic encephalopathy might also result from the brain wound healing process.

  8. Management of a Low-Energy Penetrating Brain Injury Caused by a Nail

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    V. R. Ferraz

    2016-01-01

    Full Text Available Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

  9. Paediatric acute retropharyngeal abscesses: An experience

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    Khan A Nazir

    2013-01-01

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

  10. Clinical Practice Guidelines for Cerebral Abscess Treatment

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    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.

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

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    Dursun Ozgur Karakas

    2015-12-01

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

  12. Subperiosteal abscess in a child. Trueta's osteomyelitis hypothesis undermined?

    Science.gov (United States)

    Weenders, S G M; Janssen, N E; Landman, G W D; van den Berg, F P

    2015-10-01

    Subperiosteal abscess formation is almost exclusively seen secondary to underlying hematogenous infected osteomyelitis or secondary as a result of a contagious focus. We present an unusual case of a 9-year-old girl with progressive ankle pain due to an isolated subperiosteal abscess of the distal fibula without concomitant osteomyelitis. The subperiosteal abscess was most likely caused by hematogenous spread to the periosteal region of the distal fibula located above the highly vascularized metaphysis. Remarkably, there were no signs of osteomyelitis on either MRI or during surgical inspection. She was successfully treated with debridement and antibiotic therapy. We hypothesize that subperiosteal abscess formation near the metaphysis originates in the periosteal region and not from outward extension from the sinusoidal veins in the intrametaphyseal area to the cortex and subperiosteal region.

  13. Endotoxin-induced lung alveolar cell injury causes brain cell damage

    Science.gov (United States)

    Rodríguez-González, Raquel; Ramos-Nuez, Ángela; Martín-Barrasa, José Luis; López-Aguilar, Josefina; Baluja, Aurora; Álvarez, Julián; Rocco, Patricia RM; Pelosi, Paolo

    2015-01-01

    Sepsis is the most common cause of acute respiratory distress syndrome, a severe lung inflammatory disorder with an elevated morbidity and mortality. Sepsis and acute respiratory distress syndrome involve the release of inflammatory mediators to the systemic circulation, propagating the cellular and molecular response and affecting distal organs, including the brain. Since it has been reported that sepsis and acute respiratory distress syndrome contribute to brain dysfunction, we investigated the brain-lung crosstalk using a combined experimental in vitro airway epithelial and brain cell injury model. Conditioned medium collected from an in vitro lipopolysaccharide-induced airway epithelial cell injury model using human A549 alveolar cells was subsequently added at increasing concentrations (no conditioned, 2%, 5%, 10%, 15%, 25%, and 50%) to a rat mixed brain cell culture containing both astrocytes and neurons. Samples from culture media and cells from mixed brain cultures were collected before treatment, and at 6 and 24 h for analysis. Conditioned medium at 15% significantly increased apoptosis in brain cell cultures 24 h after treatment, whereas 25% and 50% significantly increased both necrosis and apoptosis. Levels of brain damage markers S100 calcium binding protein B and neuron-specific enolase, interleukin-6, macrophage inflammatory protein-2, as well as matrix metalloproteinase-9 increased significantly after treating brain cells with ≥2% conditioned medium. Our findings demonstrated that human epithelial pulmonary cells stimulated with bacterial lipopolysaccharide release inflammatory mediators that are able to induce a translational clinically relevant and harmful response in brain cells. These results support a brain-lung crosstalk during sepsis and sepsis-induced acute respiratory distress syndrome. PMID:25135986

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-03-01

    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.

  15. Two rare manifestations of Q fever: splenic and hepatic abscesses and cerebral venous thrombosis, with literature review ma non troppo.

    Science.gov (United States)

    Gomes, Manuel Mendes; Chaves, Andreia; Gouveia, Ana; Santos, Lèlita

    2014-02-05

    Q fever is a zoonosis caused by Coxiella burnetii. It often manifests as a flu-like syndrome; other common manifestations are pneumonia, hepatitis and endocarditis. Its course may be acute or chronic. The authors present two clinical cases of Q fever with rare manifestations. Case 1: A 55-year-old man admitted due to abdominal pain, diarrhoea and fever. Blood tests showed elevated transaminases, low platelets and elevated C reactive protein, with normal white cell counts; abdominal ultrasound showed splenic and hepatic abscesses. Serologies to C burnetii were positive (1:640), leading to the diagnosis of Q fever with splenic and hepatic abscesses. Case 2: A 47-year-old man admitted due to headache after sneezing, with unstable gait and vertigo. A brain tomography showed cerebral venous thrombosis. After an exhaustive investigation, antibodies to C burnetii were found and were undoubtedly positive (1:5120), leading to the diagnosis of Q fever. Both patients were treated with oral doxycycline.

  16. An 81-year-old male with iliopsoas abscess by Streptococcus sanguis.

    Science.gov (United States)

    dos Santos, Vitorino Modesto; Fachinelli, Leticia Rita; Farage, Luciano; de Souza Lima, Gylseanne; Machado de Carvalho, Maira Rocha; Nogueira de Andrade, Igor Gabriel

    2015-03-01

    Iliopsoas muscle abscess is an uncommon condition, which has been growing in incidence. We describe a primary iliopsoas abscess by Streptococcus sanguis affecting an 81-year-old man cured by antibiotic therapy and aspiration procedure. The objective is to enhance the suspicion index about the iliopsoas abscess that may be mistaken for other causes of acute abdomen. The important diagnostic role of abdominal imaging studies is also emphasised.

  17. Perianal Abscess and Proctitis by Klebsiella pneumoniae.

    Science.gov (United States)

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

    2015-01-01

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

  18. Mutant alpha-synuclein causes age-dependent neuropathology in monkey brain.

    Science.gov (United States)

    Yang, Weili; Wang, Guohao; Wang, Chuan-En; Guo, Xiangyu; Yin, Peng; Gao, Jinquan; Tu, Zhuchi; Wang, Zhengbo; Wu, Jing; Hu, Xintian; Li, Shihua; Li, Xiao-Jiang

    2015-05-27

    Parkinson's disease (PD) is an age-dependent neurodegenerative disease that often occurs in those over age 60. Although rodents and small animals have been used widely to model PD and investigate its pathology, their short life span makes it difficult to assess the aging-related pathology that is likely to occur in PD patient brains. Here, we used brain tissues from rhesus monkeys at 2-3, 7-8, and >15 years of age to examine the expression of Parkin, PINK1, and α-synuclein, which are known to cause PD via loss- or gain-of-function mechanisms. We found that α-synuclein is increased in the older monkey brains, whereas Parkin and PINK1 are decreased or remain unchanged. Because of the gain of toxicity of α-synuclein, we performed stereotaxic injection of lentiviral vectors expressing mutant α-synuclein (A53T) into the substantia nigra of monkeys and found that aging also increases the accumulation of A53T in neurites and its associated neuropathology. A53T also causes more extensive reactive astrocytes and axonal degeneration in monkey brain than in mouse brain. Using monkey brain tissues, we found that A53T interacts with neurofascin, an adhesion molecule involved in axon subcellular targeting and neurite outgrowth. Aged monkey brain tissues show an increased interaction of neurofascin with A53T. Overexpression of A53T causes neuritic toxicity in cultured neuronal cells, which can be attenuated by transfected neurofascin. These findings from nonhuman primate brains reveal age-dependent pathological and molecular changes that could contribute to the age-dependent neuropathology in PD.

  19. Intracranial abscess in Ectopia Cordis.

    Science.gov (United States)

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

    2014-08-25

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

  20. 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....

  1. Amebic abscess of urachal remnants.

    Science.gov (United States)

    Catanzaro, D; Mirk, P; Carbone, A; Macis, G; Danza, F M

    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.

  2. 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.

  3. 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.

  4. Alternative causes of hypopituitarism: traumatic brain injury, cranial irradiation, and infections.

    Science.gov (United States)

    Pekic, Sandra; Popovic, Vera

    2014-01-01

    Hypopituitarism often remains unrecognized due to subtle clinical manifestations. Anterior pituitary hormone deficiencies may present as isolated or multiple and may be transient or permanent. Traumatic brain injury (TBI) is recognized as a risk factor for hypopituitarism, most frequently presenting with isolated growth hormone deficiency (GHD). Data analysis shows that about 15% of patients with TBI have some degree of hypopituitarism which if not recognized may be mistakenly ascribed to persistent neurologic injury and cognitive impairment. Identification of predictors for hypopituitarism after TBI is important, one of them being the severity of TBI. The mechanisms involve lesions in the hypothalamic-pituitary axis and inflammatory changes in the central nervous system (CNS). With time, hypopituitarism after TBI may progress or reverse. Cranial irradiation is another important risk factor for hypopituitarism. Deficiencies in anterior pituitary hormone secretion (partial or complete) occur following radiation damage to the hypothalamic-pituitary region, the severity and frequency of which correlate with the total radiation dose delivered to the region and the length of follow-up. These radiation-induced hormone deficiencies are irreversible and progressive. Despite numerous case reports, the incidence of hypothalamic-pituitary dysfunction following infectious diseases of the CNS has been underestimated. Hypopituitarism usually relates to the severity of the disease, type of causative agent (bacterial, TBC, fungal, or viral) and primary localization of the infection. Unrecognized hypopituitarism may be misdiagnosed as postencephalitic syndrome, while the presence of a sellar mass with suprasellar extension may be misdiagnosed as pituitary macroadenoma in a patient with pituitary abscess which is potentially a life-threatening disease.

  5. The Effect of Mangiferin Against Brain Damage Caused by Oxidative Stress and Inflammation Induced by Doxorubicin

    Directory of Open Access Journals (Sweden)

    Soni Siswanto

    2016-04-01

    Full Text Available Doxorubicin (DOX is an anthracycline antibiotic used for anticancer therapy. However, this agent can cause various systemic side effects including cognitive impairments in chronic use. Brain damage due to DOX is caused by an increase of tumor necrosis factor-alpha (TNF-α level in the brain. Increased TNF-α can further lead to chronic inflammation which can lead to neuronal deaths or neurodegenerative diseases. Mangiferin (MAG, a compound extracted from Mangifera indica, has been found neuroprotective activities, but its effect on DOX-induced brain damage is unknown. This study aims to determine the effect of MAG on brain damage induced by DOX. Male Sprague-Dawley rats were induced by DOX intraperitoneally. MAG was given orally at the doses of 30 and 60 mg/kg bw for 7 consecutive weeks. The parameters measured were inflammatory and oxidative stress markers in brain tissue. Coadministration of MAG with DOX reduced inflammation which was marked by the reduction of TNF-α mRNA expression, decreased TNF-α level and reduction of oxidative stress marked by increase of superoxide dismutase level and decrease of malondialdehyde level. In conclusion, MAG was shown to have a neuroprotective effect on brain damage induced by DOX, partly due to inhibition of inflammation and oxidative stress.

  6. Dental abscess: A microbiological review

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    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.

  7. Serious brain injury coexisting with multiple injuries caused by traffic accidents in 69 cases

    Institute of Scientific and Technical Information of China (English)

    张浚; 张鹤飞; 等

    1999-01-01

    Objective To explore the speciality,diagnosis,cure principle of serious brain injury coexisting with nultiple injuries caused by traffic accidents.Methods To analyze the clinic data of 69 cases of serious rain injury combined by oter parts of injuries caused by traffic accidents received from January 1998 to April 1999.Results This type of injury took up 11.5 percent of brain injuries in the same term and 33.6 percent of serious brain injuries.The specialities of the injury are that most of them were pedestrians crashed by vehicles.Coesisting injuries including chest injury and limb fractures accounted for a large part.The brain injury usally presented profound disturbance of consciousness,being dangerous and complicated,and a high ISS value.After treatment 13 cases died,9 cases was heavily crippled,11 cases lightly crippled,and 36 cases recovered.The death was usually caused by brain injury.Conclusions Road traffic accidents increased substantially every year.Most of them are related with violating drive rules and regulations.It is important to decrease the road traffic accidents by strengthening propaganda on traffic safety and traffic management.The main principles for salvage should emphasize the importance of pre-hospital emergency rescue and the accurate diagnosis rate,especially the distinction between coma and shock.The priority should be put on those injuries threatening to life.

  8. Report: Central nervous system (CNS) toxicity caused by metal poisoning: Brain as a target organ.

    Science.gov (United States)

    Gilani, Syeda Rubina; Zaidi, Syed Raza Ali; Batool, Madeeha; Bhatti, Amanat Ali; Durrani, Arjumand Iqbal; Mahmood, Zaid

    2015-07-01

    People relate the neural disorders with either inheritance or psychological violence but there might be some other reasons responsible for the ailment of people that do not have such a background. The present study explains the chronic effect of heavy toxic metals on nervous system. During experimentation, rabbits used as laboratory animals, were given test metals in their diet. Concentration of metals given to them in the diet was less than their tolerable dietary intake. Behavioral changes were observed during experimentation. Periodic increase in the metal concentration was seen in the blood sample of rabbits. They were slaughtered after a period of eight months of slow poisoning. Histological examination of brain tissues was performed. The brain samples were analyzed by Atomic absorption spectroscopy and Inductively Coupled Plasma Mass Spectrometry to find the retention of heavy metals in mammalian brain. Concentration of lead, mercury and cadmium in the blood samples of occupationally exposed people and patients with neurological disorders at the time of neurosurgery was determined by using the same techniques. During circulation, toxic metals passes through the nerve capillaries to settle down in the brain. Heavy metals cross the blood brain barrier and 'may retain themselves in it. Brain tumors and biopsy samples of patients with neurological disorder were also analyzed to relate neurotoxicity and heavy metal poisoning. Results obtained shows that lead, mercury and cadmium retain themselves in the brain for longer period of time and are one of the causes of neurotoxicity.

  9. Liver irradiation causes distal bystander effects in the rat brain and affects animal behaviour.

    Science.gov (United States)

    Kovalchuk, Anna; Mychasiuk, Richelle; Muhammad, Arif; Hossain, Shakhawat; Ilnytskyy, Slava; Ghose, Abhijit; Kirkby, Charles; Ghasroddashti, Esmaeel; Kovalchuk, Olga; Kolb, Bryan

    2016-01-26

    Radiation therapy can not only produce effects on targeted organs, but can also influence shielded bystander organs, such as the brain in targeted liver irradiation. The brain is sensitive to radiation exposure, and irradiation causes significant neuro-cognitive deficits, including deficits in attention, concentration, memory, and executive and visuospatial functions. The mechanisms of their occurrence are not understood, although they may be related to the bystander effects.We analyzed the induction, mechanisms, and behavioural repercussions of bystander effects in the brain upon liver irradiation in a well-established rat model.Here, we show for the first time that bystander effects occur in the prefrontal cortex and hippocampus regions upon liver irradiation, where they manifest as altered gene expression and somewhat increased levels of γH2AX. We also report that bystander effects in the brain are associated with neuroanatomical and behavioural changes, and are more pronounced in females than in males.

  10. 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.

  11. An interesting case of cerebral abscess.

    Science.gov (United States)

    Rafiq, Muhammad Khizar

    2009-01-01

    An immigrant from Romania was referred to the neurosurgical unit with a cerebral abscess. On examination she was cyanosed and had clubbing of her fingers. A cardiovascular system examination revealed a systolic murmur heard all over the precordium. However, the diagnosis was not congenital cyanotic heart disease. The patient had a history of frequent nosebleeds and had multiple telangiectases on her body, leading to the diagnosis of hereditary haemorrhagic telangiectasia (HHT). A search was carried out for the presence of arteriovenous malformations in internal organs. Large arteriovenous malformations were found in the lungs, causing her cyanosis due to right-to-left shunting of blood and cerebral abscess due to paradoxical septic embolisation into cerebral circulation.

  12. Bacterial Abscess Formation Is Controlled by the Stringent Stress Response and Can Be Targeted Therapeutically.

    Science.gov (United States)

    Mansour, Sarah C; Pletzer, Daniel; de la Fuente-Núñez, César; Kim, Paul; Cheung, Gordon Y C; Joo, Hwang-Soo; Otto, Michael; Hancock, Robert E W

    2016-10-01

    Cutaneous abscess infections are difficult to treat with current therapies and alternatives to conventional antibiotics are needed. Understanding the regulatory mechanisms that govern abscess pathology should reveal therapeutic interventions for these recalcitrant infections. Here we demonstrated that the stringent stress response employed by bacteria to cope and adapt to environmental stressors was essential for the formation of lesions, but not bacterial growth, in a methicillin resistant Staphylococcus aureus (MRSA) cutaneous abscess mouse model. To pharmacologically confirm the role of the stringent response in abscess formation, a cationic peptide that causes rapid degradation of the stringent response mediator, guanosine tetraphosphate (ppGpp), was employed. The therapeutic application of this peptide strongly inhibited lesion formation in mice infected with Gram-positive MRSA and Gram-negative Pseudomonas aeruginosa. Overall, we provide insights into the mechanisms governing abscess formation and a paradigm for treating multidrug resistant cutaneous abscesses.

  13. Diffuse large B cell lymphoma presenting as a peri-anal abscess.

    Science.gov (United States)

    Jayasekera, Hasanga; Gorissen, Kym; Francis, Leo; Chow, Carina

    2014-06-04

    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.

  14. 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.

  15. Brain shrinkage in alcoholics is not caused by changes in hydration: a pathological study.

    OpenAIRE

    Harper, C. G.; Kril, J J; Daly, J.M.

    1988-01-01

    Measurement of the water content of the cerebral white matter in 26 control and 24 alcoholic cases supports in vivo MRI studies and previous necropsy studies which appeared to show an increase in the water content in the alcoholic group. This negates the hypothesis that reversible brain shrinkage in alcoholics is caused by changes in the state of hydration.

  16. Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses.

    Science.gov (United States)

    Brook, Itzhak

    2004-12-01

    This review describes the microbiology, diagnosis, and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses in children. Predominant anaerobic organisms isolated in peritonsillar, lateral pharyngeal, and retropharyngeal abscesses are Prevotella, Porphyromonas, Fusobacterium and Peptostreptococcus spp.; aerobic organisms are group A streptococcus ( Streptococcus pyogenes ), Staphylococcus aureus and Haemophilus influenzae . Anaerobic bacteria can be isolated from most abscesses whenever appropriate techniques for their cultivation have been used, while S. pyogenes is isolated in only about one third of cases. More than two thirds of deep neck abscesses contain beta-lactamase producing organisms. Management of tonsillar, peritonsillar, and retropharyngeal abscesses is similar. Systemic antimicrobial therapy should be given in large doses whenever the diagnosis is made. However, when pus is formed, antimicrobial therapy is effective only in conjunction with adequate surgical drainage. Untreated abscesses can rupture spontaneously into the pharynx, causing catastrophic aspiration. Other complications are extension of infection laterally to the side of the neck or dissection into the posterior mediastinum through facial planes and the prevertebral space. Death can occur from aspiration, airway obstruction, erosion into major blood vessels, or extension to the mediastinum.

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

    Science.gov (United States)

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

    2013-04-01

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

  18. 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.

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

    Science.gov (United States)

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

    2009-01-01

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

  20. Unusual Cause of Seizure: Pott Puffy Tumor.

    Science.gov (United States)

    Sade, Recep; Polat, Gokhan; Kantarci, Mecit

    2016-09-01

    Seizures is a comparatively common neurologic unwellness in children that has significant implications for development, parents, and society. The etiologic categories of seizures involve idiopathic, symptomatic, and cryptogenic. Pott puff tumor is a rare cause of seizures. The authors present a rare cause of the seizures.A 12-year-old boy presented with seizures. On physical examination there was swelling on his glabella. Laboratory testing indicated leukocytosis and increased C-reactive protein, and microbiological testing showed the presence of pathogenic streptococcus sp. Brain magnetic resonance imaging was performed. T1-weighted image with gadolinium enhancement revealed frontal bone defects and subcutaneous abscess and left frontal swelling. On the diffusion-weighted imaging, the abscess has relatively homogeneous increased signal intensity b1000. The apparent diffusion coefficient map reveals low intensity. Intracranial spread also showed contrast-enhanced image (). Magnetic resonance imaging typically reveals an intracranial abscess.Pott puffy tumor is an unusual clinical existence characterized by osteomyelitis of the frontal bone. The very common symptoms are headache, swelling fever, and nasal discharge. Frontal sinus infection may induce osteomyelitis, subperiosteal, and epidural abscess.

  1. 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.

  2. Why most traumatic brain injuries are not caused by linear acceleration but skull fractures are.

    Directory of Open Access Journals (Sweden)

    Svein eKleiven

    2013-11-01

    Full Text Available Injury statistics have found the most common accident situation to be an oblique impact. An oblique impact will give rise to both linear and rotational head kinematics. The human brain is most sensitive to rotational motion. The bulk modulus of brain tissue is roughly five to six orders of magnitude larger than the shear modulus so that for a given impact it tends to deform predominantly in shear. This gives a large sensitivity of the strain in the brain to rotational loading and a small sensitivity to linear kinematics. Therefore, rotational kinematics should be a better indicator of traumatic brain injury risk than linear acceleration. To illustrate the difference between radial and oblique impacts, perpendicular impacts through the center of gravity of the head and 45o oblique impacts were simulated. It is obvious that substantially higher strain levels in the brain are obtained for an oblique impact, compared to a corresponding perpendicular one, when impacted into the same padding using an identical impact velocity. It was also clearly illustrated that the radial impact causes substantially higher stresses in the skull with an associated higher risk of skull fractures, and traumatic brain injuries secondary to those.

  3. Prion Protein Deficiency Causes Diverse Proteome Shifts in Cell Models That Escape Detection in Brain Tissue.

    Science.gov (United States)

    Mehrabian, Mohadeseh; Brethour, Dylan; Williams, Declan; Wang, Hansen; Arnould, Hélène; Schneider, Benoit; Schmitt-Ulms, Gerold

    2016-01-01

    A popular method for studying the function of a given protein is to generate and characterize a suitable model deficient for its expression. For the prion protein (PrP), best known for its role in several invariably fatal neurodegenerative diseases, a natural choice, therefore, would be to undertake such studies with brain samples. We recently documented the surprising observation that PrP deficiency caused a loss or enhancement of NCAM1 polysialylation, dependent on the cell model used. To identify possible causes for this disparity, we set out to systematically investigate the consequence of PrP deficiency on the global proteome in brain tissue and in four distinct cell models. Here we report that PrP deficiency causes robust but surprisingly divergent changes to the global proteomes of cell models but has no discernible impact on the global brain proteome. Amongst >1,500 proteins whose levels were compared in wild-type and PrP-deficient models, members of the MARCKS protein family exhibited pronounced, yet cell model-dependent changes to their steady-state levels. Follow-up experiments revealed that PrP collaborates with members of the MARCKS protein family in its control of NCAM1 polysialylation. We conclude that the physiological function of PrP may be masked in analyses of complex brain samples but its cell-type specific influence on a lipid raft-based NCAM1-related cell biology comes to the fore in investigations of specific cell types.

  4. Draft Genome Sequence of Fusobacterium necrophorum subsp. funduliforme Bovine Liver Abscess Isolate B35.

    Science.gov (United States)

    Calcutt, Michael J; Foecking, Mark F; Nagaraja, Tiruvoor G; Stewart, George C

    2014-05-01

    Fusobacterium necrophorum is a Gram-negative anaerobic bacterium that causes foot rot and liver abscesses in cattle. F. necrophorum subsp. necrophorum and the less virulent organism F. necrophorum subsp. funduliforme are recognized. We present here a draft genome sequence of the bovine liver abscess isolate F. necrophorum subsp. funduliforme strain B35, which affords a genomic perspective of virulence and bovine adaptation.

  5. 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.

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

    OpenAIRE

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

    2012-01-01

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

  7. Novel Peritonsillar Abscess Task Simulator.

    Science.gov (United States)

    Taylor, Steven R; Chang, C W David

    2014-07-01

    The management of peritonsillar abscesses is a skill developed early in residency training. Although drainage is not technically complicated, the procedure is intimidating to the neophyte. Task simulators have become increasingly common to provide training opportunities in a controlled environment. The authors designed a peritonsillar abscess simulator using a latex moulage of the oral cavity and other common materials. Twelve medical professionals of various levels of experience were instructed to expose, anesthetize, aspirate, and drain the simulated abscess. After completion, a questionnaire was completed by each volunteer. Initial impressions were positive that the model adequately replicated the tasks requisite for abscess drainage and was suitable as an instructional device. The initial construct cost was approximately 10 dollars, with disposables costing roughly 25 cents. Further research is under way to formally assess the simulator for face, content, and construct validity.

  8. Splenic abscess: a rare presentation

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. Spreading of multiple Listeria monocytogenes abscesses via central nervous system fiber tracts: case report.

    Science.gov (United States)

    Bojanowski, Michel W; Seizeur, Romuald; Effendi, Khaled; Bourgouin, Patrick; Magro, Elsa; Letourneau-Guillon, Laurent

    2015-12-01

    Animal studies have shown that Listeria monocytogenes can probably access the brain through a peripheral intraneural route, and it has been suggested that a similar process may occur in humans. However, thus far, its spreading through the central nervous system (CNS) has not been completely elucidated. The authors present a case of multiple L. monocytogenes cerebral abscesses characterized by a pattern of distribution that suggested spread along white matter fiber tracts and reviewed the literature to identify other cases for analysis. They elected to include only those cases with 3 or more cerebral abscesses to make sure that the distribution was not random, but rather followed a pattern. In addition, they included those cases with abscesses in both the brainstem and the cerebral hemispheres, but excluded cases in which abscesses were located solely in the brainstem. Of 77 cases of L. monocytogenes CNS abscesses found in the literature, 17 involved multiple abscesses. Of those, 6 were excluded for lack of imaging and 3 because they involved only the brainstem. Of the 8 remaining cases from the literature, one was a case of bilateral abscesses that did not follow a fiber tract; another was also bilateral, but with lesions appearing to follow fiber tracts on one side; and in the remaining 6, to which the authors added their own case for a total of 7, all the abscesses were located exclusively in the same hemisphere and distributed along white matter fiber tracts. The findings suggest that after entering the CNS, L. monocytogenes travels within the axons, resulting in a characteristic pattern of distribution of multiple abscesses along the white matter fiber tracts in the brain. This report is the first description suggesting intraaxonal CNS spread of L. monocytogenes infection in humans following its entry into the brain. This distinct pattern is clearly seen on imaging and its recognition may be valuable in the diagnosis of listeriosis. This finding may allow for

  11. Silent diabetes mellitus, periodontitis and a new case of thalamic abscess.

    Science.gov (United States)

    Karageorgiou, Ioannis; Chandler, Christopher; Whyte, Martin Brunel

    2014-07-21

    Brain abscess is an unusual complication of uncontrolled diabetes. A solitary thalamic abscess is an uncommon type of brain abscess. We report a case of thalamic abscess, whereupon diabetes mellitus and periodontitis were diagnosed. The diagnosis and management of thalamic abscess, and the interplay of type 2 diabetes and periodontitis are discussed. A 56-year-old, Caucasian, man with no medical or travel history, presented with 5-day symptoms of meningeal irritation. Body mass index 30.6 kg/m(2). CT demonstrated a solitary midline lesion with neoplasia as a differential diagnosis. It was biopsied and cultures grew Streptococcus milleri. He was treated by stereotactic puncture, external drainage and targeted intrathecal and systemic antibiotic therapy. HIV negative but glycated haemoglobin (HbA1c) 10.7% (93 mmol/mol). Dental examination revealed a small molar abscess. Radiological resolution of the thalamic abscess occurred within 2 months. Diabetes improved with 7 weeks of insulin, and maintained on metformin, HbA1c 6.9% (51 mmol/mol). There was no residual neurological disability.

  12. 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.

  13. 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.

  14. Hydrocephalus and Pressure on Brain Stem Cause Death in Patients with Neurofibromatosis Type 2

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    M. Khazaei

    2014-07-01

    Full Text Available Introduction: Neurofibromatosis type 2 is an inherited autosomal dominant syndrome, charac-terized by multiple neoplasms of the central and peripheral nervous system associated with ocular abnormalities. The most common tumor associated with the disease is the vestibulo-cochlear and in later stages are meningioma and other brain tumors. Case Report: The patient was a 35 year old woman admitted to the Farshchian hospital in Hamadan due to unconciousness and respiratory distress She had sensorineural hearing loss and inability to see due to decrease visulal acuity. In addition, due to lower extremity paresis she has been unable to walk and wheelchair-dependent for many years. Brain CT scan and MRI showed multiple tumors in the posterior fossa causing obstructive hydrocephalus even-tually caused the patient's death . Conclusion: Brain tumors, especially in the posterior fossa can cause death in Neurofibroma-tosis type 2. Early surgery can be life saving. (Sci J Hamadan Univ Med Sci 2014; 21 (2:167-170

  15. A porcine model of haematogenous brain infectionwith staphylococcus aureus

    DEFF Research Database (Denmark)

    Astrup, Lærke Boye; Agerholm, Jørgen Steen; Nielsen, Ole Lerberg;

    2012-01-01

    A PORCINE MODEL OF HAEMATOGENOUS BRAIN INFECTION WITH STAPHYLOCOCCUS AUREUS Astrup Lærke1, Agerholm Jørgen1, Nielsen Ole1, Jensen Henrik1, Leifsson Páll1, Iburg Tine2. 1: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark boye@life.ku.dk 2: National Veterinary Institute......, Uppsala, Sweden Introduction Staphylococcus aureus (S.aureus) is a common cause of sepsis and brain abscesses in man and a frequent cause of porcine pyaemia. Here we present a porcine model of haematogenous S. aureus-induced brain infection. Materials and Methods Four pigs had two intravenous catheters...

  16. Presacral abscess as a rare complication of sacral nerve stimulator implantation.

    Science.gov (United States)

    Gumber, A; Ayyar, S; Varia, H; Pettit, S

    2017-03-01

    A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement. The patient was treated with broad spectrum antibiotics, and the sacral nerve stimulator and electrode were removed. Attempts were made to drain the abscess transrectally using minimally invasive techniques but these were unsuccessful and CT guided transperineal drainage was then performed. Despite this, the presacral abscess progressed, developing enlarging gas locules and extending to the pelvic brim to involve the aortic bifurcation, causing hydronephrosis and radiological signs of impending sacral osteomyelitis. MRI showed communication between the rectum and abscess resulting from transrectal drainage. In view of the progressive presacral sepsis, a laparotomy was performed with drainage of the abscess, closure of the upper rectum and formation of a defunctioning end sigmoid colostomy. Following this, the presacral infection resolved. Presacral abscess formation secondary to an infected sacral nerve stimulator electrode has not been reported previously. Our experience suggests that in a similar situation, the optimal management is to perform laparotomy with drainage of the presacral abscess together with simultaneous removal of the sacral nerve stimulator and electrode.

  17. The study of risk factors affecting the prognosis of lung abscess

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    Aghajan Zadeh M

    2000-09-01

    Full Text Available In spite the emergence of potent and broad spectrum antibiotics and recent advances in bronchoscopy and pulmonary physiotherapy, still there is a high rate of morbidity and mortality because of lung abscess. The objective of this study is the indication of risk factors, which have undesirable effects on the prognosis of lung abscess. In a retrospective study, all cases of lung abscess who was confined to bed during 1994 to 1999 in Rasht were collected and analyzed. From 52 cases, 40 (77% were male and 12 (23% were female. The mean duration of stay was 20 day (15 to 35. The secondary cause for lung abscess was as follows: 10 cases (19% COPD, 10 cases (19% preumonia, 15 cases (29% bronchiectasia 2 cases lung cancer, 2 cases lung hydatid cyst and 3 cases atelectasia. Extrapulmonary causes of lung abscess were consist of: 10 case (10% aspiration, 10 case (19% esophageal diseases tending to reflux, 5 case (9% periodontal disease. The factors, which had underiable effects on prognosis of disease were lung cancer, anemia, hypoalbuminemia, age over 60, abscess with pseudomonas, abscess cavity greater thus 8 cm, lower lobe in right lung and TB. Because of high mortality and morbidity of lung abscess, due attention for internal drainage, bronchoscopy, physiotherapy and timed surgery are seriously indicated.

  18. Prion Protein Deficiency Causes Diverse Proteome Shifts in Cell Models That Escape Detection in Brain Tissue.

    Directory of Open Access Journals (Sweden)

    Mohadeseh Mehrabian

    Full Text Available A popular method for studying the function of a given protein is to generate and characterize a suitable model deficient for its expression. For the prion protein (PrP, best known for its role in several invariably fatal neurodegenerative diseases, a natural choice, therefore, would be to undertake such studies with brain samples. We recently documented the surprising observation that PrP deficiency caused a loss or enhancement of NCAM1 polysialylation, dependent on the cell model used. To identify possible causes for this disparity, we set out to systematically investigate the consequence of PrP deficiency on the global proteome in brain tissue and in four distinct cell models. Here we report that PrP deficiency causes robust but surprisingly divergent changes to the global proteomes of cell models but has no discernible impact on the global brain proteome. Amongst >1,500 proteins whose levels were compared in wild-type and PrP-deficient models, members of the MARCKS protein family exhibited pronounced, yet cell model-dependent changes to their steady-state levels. Follow-up experiments revealed that PrP collaborates with members of the MARCKS protein family in its control of NCAM1 polysialylation. We conclude that the physiological function of PrP may be masked in analyses of complex brain samples but its cell-type specific influence on a lipid raft-based NCAM1-related cell biology comes to the fore in investigations of specific cell types.

  19. Blood-Brain Barrier Abnormalities Caused by HIV-1 gp120: Mechanistic and Therapeutic Implications

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    Jean-Pierre Louboutin

    2012-01-01

    Full Text Available The blood-brain barrier (BBB is compromised in many systemic and CNS diseases, including HIV-1 infection of the brain. We studied BBB disruption caused by HIV-1 envelope glycoprotein 120 (gp120 as a model. Exposure to gp120, whether acute [by direct intra-caudate-putamen (CP injection] or chronic [using SV(gp120, an experimental model of ongoing production of gp120] disrupted the BBB, and led to leakage of vascular contents. Gp120 was directly toxic to brain endothelial cells. Abnormalities of the BBB reflect the activity of matrix metalloproteinases (MMPs. These target laminin and attack the tight junctions between endothelial cells and BBB basal laminae. MMP-2 and MMP-9 were upregulated following gp120-injection. Gp120 reduced laminin and tight junction proteins. Reactive oxygen species (ROS activate MMPs. Injecting gp120 induced lipid peroxidation. Gene transfer of antioxidant enzymes protected against gp120-induced BBB abnormalities. NMDA upregulates the proform of MMP-9. Using the NMDA receptor (NMDAR-1 inhibitor, memantine, we observed partial protection from gp120-induced BBB injury. Thus, (1 HIV-envelope gp120 disrupts the BBB; (2 this occurs via lesions in brain microvessels, MMP activation and degradation of vascular basement membrane and vascular tight junctions; (3 NMDAR-1 activation plays a role in this BBB injury; and (4 antioxidant gene delivery as well as NMDAR-1 antagonists may protect the BBB.

  20. Central nervous system infection caused by Morganella morganii.

    Science.gov (United States)

    Abdalla, Jehad; Saad, Mustafa; Samnani, Imran; Lee, Prescott; Moorman, Jonathan

    2006-01-01

    Central nervous system (CNS) infection with Morganella morganii is very rare. We describe a 38-year-old female patient with frontal brain abscess caused by M morganii who was unsuccessfully treated. We also review all reported cases of Morganella CNS infections with an emphasis on treatment modalities and outcomes. Aggressive surgical management and appropriate antimicrobial therapy can lead to cure, but the mortality rate for these infections remains high.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. INHERITED NEURODEVELOPMENTAL BRAIN DISEASES: APPLICATIONS OF HOMOZYGOSITY MAPPING TO IDENTIFY NEW GENETIC CAUSES OF DISEASE

    Directory of Open Access Journals (Sweden)

    Joseph G. Gleeson

    2008-06-01

    Full Text Available ObjectiveThe last two decades have seen major advancements in our understanding of some of the most common neurodevelopmental disorders in the field of child neurology. However, in the majority of individual patients, it is still not possible to arrive at a molecular diagnosis, due in part to lack of knowledge ofmolecular causes of these tremendously complex conditions. Common genetic disorders of brain development include septo-optic dysplasia, schizencephaly, holoprosencephaly, lissencephaly and hindbrain malformations. For each of these disorders, a critical step in brain development is disrupted. Specific genetic diagnosis is now possible in some patients with most of these conditions. For the remaining patients, it is possible to apply gene-mapping strategies using newly developed high-density genomic arrays to clone novel genes. This is especially important in countries like Iran where large family size and marriage between relatives makes these strategies tremendously powerful.

  6. 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)

  7. Renal Abscess in a Patient Presenting with Persistent Hiccups

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    Mark Flanagan

    2013-01-01

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

  8. 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.

  9. A palatable hyperlipidic diet causes obesity and affects brain glucose metabolism in rats

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    Motoyama Caio SM

    2011-09-01

    Full Text Available Abstract Background We have previously shown that either the continuous intake of a palatable hyperlipidic diet (H or the alternation of chow (C and an H diet (CH regimen induced obesity in rats. Here, we investigated whether the time of the start and duration of these feeding regimens are relevant and whether they affect brain glucose metabolism. Methods Male Wistar rats received C, H, or CH diets during various periods of their life spans: days 30-60, days 30-90, or days 60-90. Experiments were performed the 60th or the 90th day of life. Rats were killed by decapitation. The glucose, insulin, leptin plasma concentration, and lipid content of the carcasses were determined. The brain was sliced and incubated with or without insulin for the analysis of glucose uptake, oxidation, and the conversion of [1-14C]-glucose to lipids. Results The relative carcass lipid content increased in all of the H and CH groups, and the H30-60 and H30-90 groups had the highest levels. Groups H30-60, H30-90, CH30-60, and CH30-90 exhibited a higher serum glucose level. Serum leptin increased in all H groups and in the CH60-90 and CH30-90 groups. Serum insulin was elevated in the H30-60, H60-90, CH60-90, CH30-90 groups. Basal brain glucose consumption and hypothalamic insulin receptor density were lower only in the CH30-60 group. The rate of brain lipogenesis was increased in the H30-90 and CH30-90 groups. Conclusion These findings indicate that both H and CH diet regimens increased body adiposity independent treatment and the age at which treatment was started, whereas these diets caused hyperglycemia and affected brain metabolism when started at an early age.

  10. Radiological management of multiple hepatic artery pseudoaneurysms associated with cholangitic abscesses

    Directory of Open Access Journals (Sweden)

    Ankur Goyal

    2016-01-01

    Full Text Available Hepatic artery pseudoaneurysms (HAP are uncommon, occurring mostly as a complication of trauma (accidental or iatrogenic. Liver abscess rarely causes HAP and multiple HAP associated with cholangitic abscesses have not been reported in the literature. We present a patient of acute necrotizing pancreatitis with stent block cholangitis and multiple cholangitic abscesses who developed hemorrhagic output through drainage catheter in the liver abscess. A multiphasic CT angiography demonstrated three HAP, which were treated with a combination of endovascular coil embolization and percutaneous thrombin injection. The fact that cholangitic abscesses may be associated with pseudoaneurysms should not be neglected, considering the potentially catastrophic complication and relatively easy radiological management. CT angiography permits accurate diagnosis and lays down the roadmap for endovascular procedures.

  11. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    OpenAIRE

    2014-01-01

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

  12. 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.

  13. MULTIPLE LIVER ABSCESS BY MIXED BACTERIAL ETIOLOGY: AN UNUSUAL CASE REPORT

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    Mannur

    2012-11-01

    Full Text Available ABSTRACT: Pyogenic liver abscess is a serious disease, which is potentially fatal if left untreated. In developed countries, pyogenic abscesses are the most common but worldwide, amoebae are the most common cause. We report a 60-ye ar-old diabetic woman with a 2 months history of pain abdomen, 1 month history of high fev er and anorexia who had multiple liver abscess caused by anaerobic Actinomyces species and Enterococcus faecalis and was complicated by peritonitis. Treatment included prompt percutaneous drainage coupled with long-term intravenous administration of Amikacin, M etronidazole and Piperacillin/ Tazobactum. The patient later died due to peritoniti s.

  14. Anterior mediastinal abscess diagnosed in a young sumo wrestler after closed blunt chest trauma

    Institute of Scientific and Technical Information of China (English)

    Tatsuro Sassa; Ken-ichiro Kobayashi; Masayuki Ota; Takuya Washino; Mayu Hikone; Naoya Sakamoto; Sentaro Iwabuchi

    2015-01-01

    Most mediastinal abscesses result from infections after thoracotomy, esophageal perforation or penetrating chest trauma.This disease is rarely caused by closed blunt chest trauma.All previously reported such cases after closed blunt chest trauma presented with hematoma and sternal osteomyelitis resulting from sternal fracture.Here we report a 15-year-old sumo wrestler who presented with an anterior mediastinal abscess without any mediastinal fracture.The mediastinal abscess resulted from the hematogenous spread of Staphylococcus aureus to a hematoma that might have been caused by a closed blunt chest trauma incurred during sumo wrestling exercises.

  15. Spinal epidural abscess in brucellosis.

    Science.gov (United States)

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

    2013-09-26

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

  16. α3Na+/K+-ATPase deficiency causes brain ventricle dilation and abrupt embryonic motility in zebrafish

    DEFF Research Database (Denmark)

    Doganli, Canan; Beck, Hans Christian; Ribera, Angeles B

    2013-01-01

    leads to brain ventricle dilation, a likely consequence of ion imbalances across the plasma membrane that cause accumulation of cerebrospinal fluid in the ventricle. The brain ventricle dilation is accompanied by a depolarization of spinal Rohon-Beard neurons in Atp1a3a knockdown embryos, suggesting...

  17. Dynamic changes during evacuation of a left temporal abscess in open MRI: technical case report

    Energy Technology Data Exchange (ETDEWEB)

    Bernays, R.L.; Yonekawa, Y. [Department of Neurosurgery, University Hospital, Zurich (Switzerland); Kollias, S.S. [Institute of Neuroradiology, University Hospital of Zurich (Switzerland)

    2002-05-01

    We demonstrate the usefulness of ''near real-time'' neuro-navigation by open MRI systems for guidance of stereotactic evacuation of intracranial abscesses. A 70-year-old patient was referred to our institution with an intracranial left temporal abscess. He presented with headache, senso-motor aphasia and mild right hemiparesis. The abscess (35 x 25 mm) was stereotactically evacuated under MRI guidance, and a recurrence of a daughter abscess was again evacuated on the 9th postoperative day. ''Near real-time'' imaging showed an indentation of the abscess wall of 11 mm along the trajectory. A thermosensitive MRI protocol demonstrated a higher temperature around the abscess capsule than in the brain tissue more distant to the capsule, demonstrating the inflammatory process. The patient had 6 weeks of antibiotic therapy for gram-negative bacteria and was discharged with improved clinical symptoms 5 weeks after admission. Follow-up CT 2 months postoperatively showed a complete resolution of the abscess. Open MRI-guided interventions with ''near real-time'' imaging demonstrate the anatomical changes during an ongoing procedure and can be accommodated for enhancing the overall precision of stereotactic procedures. Thermosensitive MRI protocols are capable of revealing temperature gradients around inflammatory processes. (orig.)

  18. Chronic Calcific Pancreatitis Presenting as an Isolated Left Perinephric Abscess: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ragesh Babu Thandassery

    2011-09-01

    Full Text Available Context Acute and chronic pancreatitis may present with pseudocysts in atypical locations. Activated pancreatic enzymes track along anatomic fascial planes causing digestion of the surrounding tissues and resulting in distant pseudocysts. Pseudocysts at atypical locations pose significant diagnostic as well as therapeutic challenges. Case report We report an unusual presentation of a pancreatic pseudocyst in a young male who presented with a left perinephric abscess. Percutaneous drainage was not successful in resolving the abscess and he was subsequently diagnosed as having chronic pancreatitis together with a left perinephric abscess. Needle knife sphincterotomy of the ampulla of Vater resulted in the gradual resolution of the abscess. Conclusion We report a rare presentation of chronic pancreatitis with a perinephric abscess and its non-surgical management. This case report indicates that any patient presenting with a perinephric abscess of unknown etiology not responding to conventional treatment modalities should be investigated for underlying pancreatitis.

  19. Peritonsillar abscess: clinical aspects of microbiology, risk factors, and the association with parapharyngeal abscess.

    Science.gov (United States)

    Klug, Tejs Ehlers

    2017-03-01

    PTA is a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is considered a complication of acute tonsillitis and is the most prevalent deep neck infection (approximately 2000 cases annually in Denmark) and cause of acute admission to Danish ENT departments. Teenagers and young adults are most commonly affected and males may predominate over females. However, no studies of age- and gender-stratified incidence rates have previously been published. Furthermore, smoking may be associated with increased risk of peritonsillar abscess (PTA) development, although the magnitude of the association has not been estimated. Complications are relatively rare. They include parapharyngeal abscess (PPA), upper airway obstruction, Lemierre´s syndrome, necrotizing fasciitis, mediastinitis, erosion of the internal carotid artery, brain abscess, and streptococcal toxic shock syndrome. The treatment consists of abscess drainage and antimicrobial therapy. There are three accepted methods of surgical intervension: needle aspiration, incision and drainage (ID), and acute tonsillectomy (á chaud). Internationally, there is a strong trend towards less invasive surgical approach to PTA treatment with avoidance of acute tonsillectomy, needle aspiration instead of ID, and in some cases even antibiotic treatment without surgical drainage. The preferred antibiotic regimen varies greatly between countries and centers. Group A streptococcus (GAS) is the only established pathogen in PTA. However, GAS is only recovered from approximately 20% of PTA patients. The pathogens in the remaining 80% are unknown. Culturing of PTA pus aspirates often yields a polymicrobial mixture of aerobes and anaerobes. As the tonsils of healthy individuals are already heavily and diversely colonized, the identification of significant pathogens is challenging. In addition, when studying PTA microbiology, one must consider diagnostic precision, collection, handling, and

  20. PBP-2 Negative Methicillin Resistant Staphylococcus schleiferi Bacteremia from a Prostate Abscess: An Unusual Occurrence

    Directory of Open Access Journals (Sweden)

    Chandni Merchant

    2016-01-01

    Full Text Available Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative Staphylococcus which has been described as a pathogen responsible for various nosocomial infections including bacteremia, brain abscess, and infection of intravenous pacemakers. Recently, such bacteria have been described to be found typically on skin and mucosal surfaces. It is also believed to be a part of the preaxillary human flora and more frequently found in men. It is very similar in its pathogenicity with Staphylococcus aureus group and expresses a fibronectin binding protein. Literature on this pathogen reveals that it commonly causes otitis among dogs because of its location in the auditory meatus of canines. Also, it has strong association with pyoderma in dogs. The prime concern with this organism is the antibiotic resistance and relapse even after appropriate treatment. Very rarely, if any, cases have been reported about prostatic abscess (PA with this microbe. Our patient had a history of recurrent UTIs and subsequent PA resulting in S. schleiferi bacteremia in contrast to gram negative bacteremia commonly associated with UTI. This organism was found to be resistant to methicillin, in spite of being negative for PBP2, which is a rare phenomenon and needs further studies.

  1. Presymptomatic generalized brain atrophy in frontotemporal dementia caused by CHMP2B mutation

    DEFF Research Database (Denmark)

    Rohrer, Jonathan D; Ahsan, R Laila; Isaacs, Adrian M;

    2009-01-01

    BACKGROUND/AIMS: CHMP2B mutations are a rare cause of familial frontotemporal dementia (FTD). The clinical syndrome is dominated by personality change and behavioural symptoms, but language, memory, calculation and praxis impairments are also seen early in the course of the disease. There are no ......BACKGROUND/AIMS: CHMP2B mutations are a rare cause of familial frontotemporal dementia (FTD). The clinical syndrome is dominated by personality change and behavioural symptoms, but language, memory, calculation and praxis impairments are also seen early in the course of the disease....... There are no detailed studies of brain imaging in CHMP2B mutation-associated FTD. This study aimed to investigate whether there were early or presymptomatic changes in this group of patients. METHODS: Subjects comprised 16 members of a Danish family with CHMP2B mutation-associated FTD. Nine subjects were presymptomatic...... mutation carriers with a control group of 7 mutation-negative family members. Volumetric MRI brain scans were performed on all subjects at two time points, and rates of volume change were compared between the two groups. RESULTS: We demonstrate that generalized atrophy occurs presymptomatically in CHMP2B...

  2. Empyema Caused by Clostridium bifermentans: A Case Report

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    Safa Edagiz

    2015-01-01

    Full Text Available A case of pneumonia with associated empyema caused by Clostridium bifermentans is described. C bifermentans is an anaerobic, spore-forming, Gram-positive bacillus. This organism is infrequently reported as a cause of infection in humans, and older publications tended to regard it as nonpathogenic. However, in more recent reports, C bifermentans has been documented as a cause of septic arthritis, osteomyelitis, soft tissue infection, abdominal infections, brain abscess, bacteremia and endocarditis. The present case is the third reported case of empyema caused by C bifermentans, and it serves to further define the spectrum of illness due to this uncommon organism.

  3. Successful Management of a Recurrent Supralevator Abscess: A Case Report

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    S. Sanyal

    2012-01-01

    Full Text Available Anorectal abscesses are commonly encountered in clinical surgical practice. These abscesses require surgical management. Supralevator abscesses are thought to originate either from an ischiorectal or intersphincteric abscess extension or from an intraperitoneal source. These abscesses are quite uncommon and present a difficult surgical problem. We present a case here of a 42-year-old female with a recurrent supralevator abscess requiring multiple surgical procedures for adequate drainage and care of her abscess.

  4. Good penetration of moxifloxacin into human abscesses.

    Science.gov (United States)

    Sauermann, Robert; Karch, Rudolf; Kjellsson, Maria C; Feurstein, Thomas; Püspök, Andreas; Langenberger, Herbert; Böhmdorfer, Michaela; Jäger, Walter; Zeitlinger, Markus

    2012-01-01

    Abscesses are often treated with antibiotics in addition to incision or when incision is unfeasible, but accurate information about antibiotic abscess penetration in humans is missing. This study aimed at evaluating the penetration of moxifloxacin into human abscesses. After administration of a single dose of 400 mg moxifloxacin, drug concentrations were measured in 10 differently located abscesses at incision, and in plasma over 8 h. At incision performed 0.9-4.8 h after administration, moxifloxacin concentrations in abscesses ranged from ≤0.01 to 9.2 mg/l (1.9 ± 3.4 mg/l), indicating pronounced drug accumulation in some abscesses. The degree of abscess penetration could not be explained by covariates like the ratio of surface area to volume or pH of abscesses, or by moxifloxacin plasma concentrations. Concluding, moxifloxacin was detectable in most abscesses and may be a useful antibiotic for this indication. However, antibiotic abscess penetration was highly variable and unpredictable, suggesting surgical abscess incision whenever possible.

  5. Dynamic CT features of hepatic abscesses

    Institute of Scientific and Technical Information of China (English)

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

    2002-01-01

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

  6. Computed tomography in pituitary abscess

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    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.

  7. Multiple Renal Abscesses due to ESBL Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Causing Acute Pyelonephritis and Bacteremia: A Case Report with a Good Outcome (No Drainage Required)

    Science.gov (United States)

    Qurash, Musaad; Saleh, Asem; Ali, Rasha

    2016-01-01

    Extended-spectrum beta-lactamase-producing Enterobacteriaceae urinary tract infections are challenging infections with increased mortality, morbidity, and failure of therapy. A 44-year-old Saudi male diabetic patient was seen at the ER of IMC Hospital with features of acute pyelonephritis: fever, burning urine, and left flank pain for three days. He was treated for cystitis at the Endocrine Clinic two weeks prior to his ER visit with nitrofurantoin and levofloxacin orally according to urine culture and sensitivity result. The patient was admitted, received IV meropenem, and continued to be febrile for three days. His urine and blood culture at ER grew the same ESBL-producing E. coli as in his urine culture from the Endocrine Clinic. His abdomen CT scan showed two left renal abscesses at the upper and middle poles. His temperature resolved on the fourth day of IV therapy. Intravenous meropenem was continued for 4 weeks after inserting PICC line and the patient was followed up by home healthcare. He was feeling better with occasional left flank pain and repeated abdomen CT scan showed complete resolution of both renal abscesses. PMID:28018690

  8. An autopsy case of otogenic intracranial abscess and meningitis with Bezold's abscess: evaluation of inflammatory bone destruction by postmortem cone-beam CT.

    Science.gov (United States)

    Kanawaku, Yoshimasa; Yanase, Takeshi; Hayashi, Kino; Harada, Kazuki; Kanetake, Jun; Fukunaga, Tatsushige

    2013-11-01

    The deceased was an unidentified young male found unconscious on a walkway. On autopsy, outer and inner fistulae of the left temporal bone, subcutaneous abscess in the left side of the neck and head, and an intracranial abscess were noted. A portion of the left temporal bone was removed and scanned by cone-beam computed tomography (CT) (normally used for dentistry applications) to evaluate the lesion. The cone-beam CT image revealed roughening of the bone wall and hypolucency of the mastoid air cells, consistent with an inflammatory bone lesion. According to autopsy and imaging findings, the cause of death was diagnosed as intracranial abscess with Bezold's abscess secondary to left mastoiditis as a complication of otitis media. Although determining the histopathology of bone specimens is time-consuming and costly work, we believe that use of cone-beam CT for hard tissue specimens can be useful in forensic practice.

  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

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    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. Recurrent Breast Abscesses due to Corynebacterium kroppenstedtii, a Human Pathogen Uncommon in Caucasian Women

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    Anne Le Flèche-Matéos

    2012-01-01

    Full Text Available Background. Corynebacterium kroppenstedtii (Ck was first described in 1998 from human sputum. Contrary to what is observed in ethnic groups such as Maori, Ck is rarely isolated from breast abscesses and granulomatous mastitis in Caucasian women. Case Presentation. We herein report a case of recurrent breast abscesses in a 46-year-old Caucasian woman. Conclusion. In the case of recurrent breast abscesses, even in Caucasian women, the possible involvement of Ck should be investigated. The current lack of such investigations, probably due to the difficulty to detect Ck, may cause the underestimation of such an aetiology.

  12. Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Jalaludin, M A

    1993-10-01

    Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

  13. Subphrenic Abscess as a Complication of Hemodialysis Catheter-Related Infection

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    Fernando Caravaca

    2014-01-01

    Full Text Available We describe an unusual case of subphrenic abscess complicating a central venous catheter infection caused by Pseudomonas aeruginosa in a 59-year-old woman undergoing hemodialysis. The diagnosis was made through computed tomography, and Pseudomonas aeruginosa was isolated from the purulent drainage of the subphrenic abscess, the catheter tip and exit site, and the blood culture samples. A transesophageal echocardiography showed a large tubular thrombus in superior vena cava, extending to the right atrium, but no evidence of endocarditis or other metastatic infectious foci. Catheter removal, percutaneous abscess drainage, anticoagulation, and antibiotics resulted in a favourable outcome.

  14. Exposure to 1-bromopropane causes degeneration of noradrenergic axons in the rat brain.

    Science.gov (United States)

    Mohideen, Sahabudeen Sheik; Ichihara, Gaku; Ichihara, Sahoko; Nakamura, Shoji

    2011-07-11

    1-Bromopropane (1-BP) has been used as an alternative to ozone-depleting solvents. Previous studies showed that 1-BP is neurotoxic in animals and humans. In humans, exposure to 1-BP caused various neurological and neurobehavioral symptoms or signs including depressive or irritated mood. However, the neurobiological changes underlying the depressive symptoms induced by 1-BP remain to be determined. The depressive symptoms are thought to be associated with degeneration of axons containing noradrenaline and serotonin. Based on this hypothesis, the present study examined the effects of repeated exposure to 1-BP on serotonergic and noradrenergic axons. Exposure to 1-BP induced dose-dependent decreases in the density of noradrenergic axons in the rat prefrontal cortex, but no apparent change in the density of serotonergic axons. The results suggest that depressive symptoms in workers exposed to 1-BP are due, at least in part, to the degeneration of noradrenergic axons in the brain.

  15. 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.

  16. Pneumococcal Sepsis Complicated by Splenic Abscesses and Purpura Fulminans in a 15-Month-Old Child

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    Scott Pangonis MD

    2016-02-01

    Full Text Available Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD with and without underlying immunological disorders such as asplenia. Here, we report a patient with IPD complicated by splenic abscesses and PF. Our patient initially presented with bacteremia, septic shock, and disseminated intravascular coagulation. She subsequently developed PF and splenic abscesses. She survived her illness after receiving a total of 8 weeks of antibiotic therapy. This case highlights 2 rare complications of IPD and demonstrates the need to keep pneumococcal disease in the differential diagnosis even in children whose vaccination status is up to date.

  17. 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.

  18. A Giant Retroperitoneal Abscess Mimicking Incarcerated Inguinal Hernia

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    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.

  19. The frequency of dental abscesses increases in periods of low barometric pressure.

    Science.gov (United States)

    Seemann, Rudolf; Svabik, Otto; Orlik, Alexander; Figl, Michael; Fischer, Michael B; Schicho, Kurt; Wutzl, Arno; Forster, Johannes; Jesch, Philip; Perisanidis, Christos; Undt, Gerhard; Millesi, Werner

    2015-11-01

    Bioclimatic conditions are thought to have an impact on the frequency of dental abscesses but previous studies have suffered from small patient cohorts, methodological obstacles, and restriction to a single site resulting in limited geographic and meteorological variability. The aim of the present study was to investigate the influence of environmental temperature and barometric pressure on the frequency of dental abscesses. Three maxillofacial and two dental clinics in Vienna retrospectively provided a total of 19,218 patients with dentoalveolar abscesses who were treated by intraoral incision between 1998 and 2011. Daily records from six local meteorological stations were consulted to assess daily meteorological parameters. Univariate and multivariate hurdle count regression models were fitted to estimate the effect of daily average barometric pressure and temperature on registered abscess frequencies. Temporal confounders causing variance of the observed abscess frequencies - such as weekday, business day, and month - were taken into consideration. On days of low barometric pressure a significant rise in dental abscess frequency was observed, even when adjusting for confounders. Environmental temperature, in contrast, did not show any effect. In conclusion, bioclimatic conditions affect health as low barometric pressure increases the number of patients with dental abscesses.

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

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    Ghadage D.P.

    2002-01-01

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

  1. 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.

  2. Frequency, Causes, and Findings of Brain CT Scans of Neonatal Seizure at Besat Hospital, Hamadan, Iran

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    Fateme EGHBALIAN*

    2015-01-01

    Full Text Available How to Cite This Article: Eghbalian F, Rasuli B, Monsef F. Frequency, Causes, and Findings of Brain CT Scans of Neonatal Seizure at Besat Hospital, Hamadan, Iran. Iran J Child Neurol. 2015 Winter;9(1:56-63.AbstractObjectiveNeonatal seizures are the most common neurological symptoms and often signal an underlying serious neurologic condition. This study determines the frequency of neonatal seizure, predisposing factors, and brain computed tomography (CT scan findings.Materials & MethodsIn a descriptive cross-sectional study, we evaluated all neonates with seizures who had been hospitalized in Besat hospital from 2007–2012. All data were gathered with questionnaires and used to compare with statistical tests by SPSS (ver 16. Results141 (4.08% neonates (M:F; 1:2.2 were diagnosed with neonatal seizures. From the total number of 3,452 neonatal hospitalization, 78% of neonates with seizures were less than 10 days old and 60.3% of infants were born from natural vaginal delivery. As the most common cause, hypoxic-ischemic encephalopathy in this study was associated with 31.3% (n=44 of neonatal seizures and with the highest mortality rate (n=6. Among admitted neonates with seizures, the overall mortality rate was 12.8% (18 cases. A total of 33.3% of patients (47 cases had abnormal CT scan reports and 24.8% (35 cases of patients were not evaluated with a CT scan. Hypoxic-ischemic encephalopathy (47% and local ischemic changes (25.5% were the most common findings in the CT scans of neonates with seizures.ConclusionThere was a significant correlation between neonatal seizures and delivery circumstances (p-value < 0.05. Therefore, with improvement of obstetric and delivery circumstances, early detection of predisposing factors and other rare conditions, and rapid effective treatment of these contributing factors, the rate of neonatal seizure in this period can be reduced.ReferencesScher MS. Seizure in the newborn infant: diagnosis, treatment, and outcome

  3. Abdominal wall abscess secondary to spontaneous rupture of pyogenic liver abscess

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    Maurizio Zizzo

    2016-01-01

    Conclusion: Pyogenic liver abscess is a serious and life-threatening illness. Abscess rupture might occur. Many authors consider this complication a surgical emergency, but the site of abscess rupture changes the clinical history of the disease: in case of free rupture into the peritoneum, emergency surgery is mandatory, while a rupture localized in neighboring tissues or organs can be successfully treated by a combination of systemic antibiotics and fine needle aspiration and/or percutaneous drainage of the abscess.

  4. 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.

  5. Tuberculous retropharyngeal abscess without cervical spine TB

    Institute of Scientific and Technical Information of China (English)

    ChandrakantPatil; RashmiKharatPatil; PrasadDeshmukh; SameerSinghal; BlendaDSouza

    2011-01-01

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

  6. 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)

  7. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

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    C. Tran

    2014-01-01

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

  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. Moderate traumatic brain injury causes acute dendritic and synaptic degeneration in the hippocampal dentate gyrus.

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    Xiang Gao

    Full Text Available Hippocampal injury-associated learning and memory deficits are frequent hallmarks of brain trauma and are the most enduring and devastating consequences following traumatic brain injury (TBI. Several reports, including our recent paper, showed that TBI brought on by a moderate level of controlled cortical impact (CCI induces immature newborn neuron death in the hippocampal dentate gyrus. In contrast, the majority of mature neurons are spared. Less research has been focused on these spared neurons, which may also be injured or compromised by TBI. Here we examined the dendrite morphologies, dendritic spines, and synaptic structures using a genetic approach in combination with immunohistochemistry and Golgi staining. We found that although most of the mature granular neurons were spared following TBI at a moderate level of impact, they exhibited dramatic dendritic beading and fragmentation, decreased number of dendritic branches, and a lower density of dendritic spines, particularly the mushroom-shaped mature spines. Further studies showed that the density of synapses in the molecular layer of the hippocampal dentate gyrus was significantly reduced. The electrophysiological activity of neurons was impaired as well. These results indicate that TBI not only induces cell death in immature granular neurons, it also causes significant dendritic and synaptic degeneration in pathohistology. TBI also impairs the function of the spared mature granular neurons in the hippocampal dentate gyrus. These observations point to a potential anatomic substrate to explain, in part, the development of posttraumatic memory deficits. They also indicate that dendritic damage in the hippocampal dentate gyrus may serve as a therapeutic target following TBI.

  10. Cardiobacterium hominis-induced acute dacryocystitis and lacrimal abscess

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    Guru Prasad Manderwad

    2014-01-01

    Full Text Available Cardiobacterium hominis is a member of the HACEK (Haemophilus sp., Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella kingae group commonly associated with endocarditits and is normally present in the respiratory tract. We describe the first case of acute dacryocystitis with lacrimal abscess caused by C. hominis along with a brief review of the literature. The patient responded to oral and topical ciprofloxacin after incision and drainage and awaits dacryocystorhinostomy.

  11. 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

  12. Infected aortic aneurysm presenting as prevertebral abscess in magnetic resonance imaging: A case report

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    Yu, Jung Re; Ko, Seong Joo; Heo, Sang Taek; Kim, Jin Seok; Kim, Seung Hyoung [Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2013-09-15

    The differential diagnosis of mass-like lesions around the aorta includes saccular pseudoaneurysms and abscesses. A 69-year-old female was admitted with multiple abscesses and fluid collections in several muscles and joints. Methicillin susceptible Staphylococcus aureus was isolated from her blood and pus. Even though she was treated with repeated operations and appropriate antibiotics, her conditions worsened with persistent fever and newly developed abscesses at other sites. Serial enhanced computed tomography (CT) revealed a newly developed saccular abdominal aortic aneurysm in the retroaortic space at the celiac axis level. However, the infected aortic aneurysm mimicked a prevertebral abscess on enhanced spinal magnetic resonance imaging (MRI) due to its heterogeneous signal intensity caused by intraaneurysmal turbulent blood flow. We report to alert the pitfall in the diagnosis of saccular aortic aneurysm using spinal MRI and the importance of serial enhanced CT study in highly suspicious patients.

  13. Assessment of murine brain tissue shrinkage caused by different histological fixatives using magnetic resonance and computed tomography imaging.

    Science.gov (United States)

    Wehrl, Hans F; Bezrukov, Ilja; Wiehr, Stefan; Lehnhoff, Mareike; Fuchs, Kerstin; Mannheim, Julia G; Quintanilla-Martinez, Leticia; Kohlhofer, Ursula; Kneilling, Manfred; Pichler, Bernd J; Sauter, Alexander W

    2015-05-01

    Especially for neuroscience and the development of new biomarkers, a direct correlation between in vivo imaging and histology is essential. However, this comparison is hampered by deformation and shrinkage of tissue samples caused by fixation, dehydration and paraffin embedding. We used magnetic resonance (MR) imaging and computed tomography (CT) imaging to analyze the degree of shrinkage on murine brains for various fixatives. After in vivo imaging using 7 T MRI, animals were sacrificed and the brains were dissected and immediately placed in different fixatives, respectively: zinc-based fixative, neutral buffered formalin (NBF), paraformaldehyde (PFA), Bouin-Holland fixative and paraformaldehyde-lysine-periodate (PLP). The degree of shrinkage based on mouse brain volumes, radiodensity in Hounsfield units (HU), as well as non-linear deformations were obtained. The highest degree of shrinkage was observed for PLP (68.1%, P brain shrinkage and only small deformations and is therefore recommended for in vivo ex vivo comparison studies.

  14. Deviations in the endocrine system and brain of patients with fibromyalgia: cause or consequence of pain and associated features?

    Science.gov (United States)

    Geenen, Rinie; Bijlsma, Johannes W J

    2010-04-01

    The brain and endocrine system are crucial interfaces responding to pathological and psychological processes. This review discusses whether endocrine deviations and structural and functional changes in the brain are a cause or consequence of fibromyalgia. Studies in patients with fibromyalgia virtually uniformly observed subtle alterations in hypothalamic pituitary adrenal functioning, hyporeactive autonomic nervous system responsiveness to stressors, and structural and functional changes in the brain. Our model proposes that predisposing factors, such as genetic vulnerability and trauma, have led to an alteration of the nociceptive system including several neuroendocrine changes. The resulting pain and associated symptoms, such as sleep disturbance, low fitness, fatigue, stress, and distress, are a cause of new neuroendocrine changes. The model predicts that favorable neuroendocrine changes are to be expected after successful pharmacological or non-pharmacological interventions that target pain and associated symptoms.

  15. Mechanism of blood-brain barrier impairment after mild traumatic brain injury caused by blast shock waves and its relationship with delayed nerve dysfunction

    Directory of Open Access Journals (Sweden)

    Zhao-xi XU

    2016-06-01

    Full Text Available Mild traumatic brain injury (mTBI caused by blast shock waves (BSWs is one of the most common injuries among soldiers in the war. Such mTBI can also happen in civilians if exposed to shock waves of accidental explosion disasters, bomb attacks by terrorists and so on. This injury often results in cognitive problems, memory dysfunction and emotional disorder, and these neurological deficits are closely related to the dysfunction or disruption of the blood-brain barrier (BBB. The present paper discusses mainly the relationship between dysfunction or disruption of BBB and inflammatory reaction in mild brain injury associated with explosive shock wave and effects of early intervention of oxidative stress injury, repairing the BBB and blocking inflammation on relieving delayed neurological deficits. DOI: 10.11855/j.issn.0577-7402.2016.05.15

  16. Idiopathic Spinal Epidural Abscess: A Case Report

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    Chaitali Biswas

    2011-11-01

    Full Text Available Epidural abscess is a potentially life-threatening disease which can lead to medical-surgical emergency. Idiopathic spinal epidural abscess (SEA with atypical manifestations is extremely rare. We describe such a case which led to severe neurological compromise and was not associated with any known risk factors.

  17. Idiopathic Spinal Epidural Abscess: A Case Report

    OpenAIRE

    Chaitali Biswas; Anirban Pal; Saswata Bharati; Nitesh Sinha

    2011-01-01

    Epidural abscess is a potentially life-threatening disease which can lead to medical-surgical emergency. Idiopathic spinal epidural abscess (SEA) with atypical manifestations is extremely rare. We describe such a case which led to severe neurological compromise and was not associated with any known risk factors.

  18. Liver Abscess: Increasing Occurrence in Premature Newborns

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    OKTAV BOSNALI

    2013-03-01

    Full Text Available Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management.

  19. Liver Abscess: Increasing Occurrence in Premature Newborns

    Science.gov (United States)

    Bosnalı, Oktav; Moralıoğlu, Serdar; Pektaş, Osman

    2013-01-01

    Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management. PMID:26023443

  20. Liver Abscess: Increasing Occurrence in Premature Newborns

    Directory of Open Access Journals (Sweden)

    Oktav Bosnalı

    2013-04-01

    Full Text Available Neonatal liver abscess is a very rare condition associated with high morbidity and mortality rates. There seems to be an increasing trend of this rare condition amongst the newborns admitted to neonatal intensive care units. We report a case of liver abscess in a premature newborn and briefly review the literature and discuss its management.

  1. 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.

  2. A case of leukoencephalopathy caused by radiation and chemotherapy for brain metastasis of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Shigeru; Sonoo, Hiroshi; Nomura, Tsunehisa; Ohkubo, Sumiko; Yamamoto, Yutaka; Tanaka, Katsuhiro; Kurebayashi, Junichi; Hiratsuka, Junichi [Kawasaki Medical School, Kurashiki, Okayama (Japan)

    2002-08-01

    A case of treatment-related leukoencephalopathy is presented. A patient with breast cancer metastasis to the brain, liver, bone and distant lymph nodes was treated with whole brain radiation and docetaxcel. Eleven months after radiation, magnetic resonance imaging showed diffuse leukoencephalopathy. Twenty-two months after radiation, the patient had gait disturbance, parkinsonism, dementia and urinary incontinence. From this experience, stereotactic radiosurgery such as cyber knife and gamma knife therapy, representing a new modality for delivering intense focal radiation, should be come preferred techniques for treating patients with brain metastases, to avoid the potential cognitive side effects of fractionated whole-brain radiotherapy. (author)

  3. Bartholinitis caused by Streptococcus pneumoniae : Case report and review of literature

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    Parvathi S

    2009-04-01

    Full Text Available Most of the Bartholin′s gland abscesses have been thought to be caused by colonizing micro-organisms of the perineal region. We encountered an interesting case of acute Bartholins abscess caused by Streptococcus pneumoniae in a primigravida. The abscess was incised and drained. The patient was treated with Cefuroxime. This case is presented for its rarity.

  4. 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.

  5. Chronic breast abscess due to Mycobacterium fortuitum: a case report

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    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.

  6. 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.

  7. Zika virus infection during the period of maximal brain growth causes microcephaly and corticospinal neuron apoptosis in wild type mice

    Science.gov (United States)

    Huang, Wen-Chin; Abraham, Rachy; Shim, Byoung-Shik; Choe, Hyeryun; Page, Damon T.

    2016-01-01

    Zika virus (ZIKV) infection in pregnant women has been established as a cause of microcephaly in newborns. Here we test the hypothesis that neurodevelopmental stages when the brain is undergoing rapid growth are particularly vulnerable to the effects of ZIKV infection. We injected ZIKV intracranially into wild type C57BL/6 mice at two different time points: early postnatal development, when the brain is growing at its maximal rate, and at weaning, when the brain has largely reached adult size. Both time points showed widespread immunoreactivity for ZIKV and cleaved caspase 3 (CC3, a marker of apoptosis) throughout the brain. However, in early postnatal ZIKV injected mice, some brain areas and cell types display particularly large increases in apoptosis that we did not observe in older animals. Corticospinal pyramidal neurons, a cell type implicated in human microcephaly associated with ZIKV infection, are an example of one such cell type. Proliferating cells in the ventricular zone stem cell compartment are also depleted. These findings are consistent with the hypothesis that periods of rapid brain growth are especially susceptible to neurodevelopmental effects of ZIKV infection, and establish a valuable model to investigate mechanisms underlying neurodevelopmental effects of ZIKV infection and explore candidate therapeutics. PMID:27713505

  8. Perforin expression by CD8 T cells is sufficient to cause fatal brain edema during experimental cerebral malaria.

    Science.gov (United States)

    Huggins, Matthew; Johnson, Holly L; Jin, Fang; N'Songo, Aurelie; Hanson, Lisa M; LaFrance, Stephanie J; Butler, Noah S; Harty, John T; Johnson, Aaron J

    2017-03-06

    Human cerebral malaria (HCM) is a serious complication of Plasmodium falciparum infection. The most severe outcomes for patients include coma, permanent neurological deficits, and death. Recently, a large-scale magnetic resonance imaging (MRI) study in humans identified brain swelling as the most prominent predictor of fatal HCM. Therefore, in this study we sought to define the mechanism controlling brain edema through the use of the murine experimental cerebral malaria (ECM) model. Specifically, we investigated the ability of CD8 T cells to initiate brain edema during ECM. We determined that areas of blood-brain barrier (BBB) permeability colocalized with a reduction of the cerebral endothelial cell tight junction proteins claudin-5 and occludin. Furthermore, through small animal MRI we analyzed edema and vascular leakage. Using gadolinium enhanced T1-weighted MRI we determined that vascular permeability is not homogeneous, but rather confined to specific regions of the brain. Our findings show that BBB permeability was localized within the brainstem, olfactory bulb, and lateral ventricle. Concurrently with the initiation of vascular permeability, T2-weighted MRI revealed edema and brain swelling. Importantly, ablation of the cytolytic effector molecule perforin fully protected against vascular permeability and edema. Furthermore, perforin production specifically by CD8 T cells was required to cause fatal edema during ECM. We propose that CD8 T cells initiate BBB breakdown through perforin mediated disruption of tight junctions. In turn, leakage from the vasculature into the parenchyma causes brain swelling and edema. This results in a breakdown of homeostatic maintenance that likely contributes to ECM pathology.

  9. Degeneration of noradrenergic fibres from the locus coeruleus causes tight-junction disorganisation in the rat brain.

    Science.gov (United States)

    Kalinin, Sergey; Feinstein, Douglas L; Xu, Hao-Liang; Huesa, Gema; Pelligrino, Dale A; Galea, Elena

    2006-12-01

    Although functional studies demonstrate that noradrenaline controls the permeability of the blood-brain barrier, it has never been determined whether this neurotransmitter regulates the tight junction (TJ) assembly that confers the barrier property to brain microvessels. We thus tested in rats the effect of pharmacological depletion of noradrenaline with the noradrenergic toxin DSP4 (5 mg/kg) on the expression of the TJ proteins zonula occludens-1 (ZO1) and occludin. The effectiveness of the lesion was confirmed by tyrosine hydroxylase immunoreactivity, which showed noradrenergic fibre reduction accompanied by debris and swollen fibres in DSP4-treated brains. Noradrenergic fibre degeneration caused: (i) gliosis; (ii) disappearance of TJ proteins in vascular cell-to-cell contacts (49.9 and 38.3% reductions for occludin and ZO1, respectively); (iii) a 49.2% decrease in total ZO1 protein, measured by Western blot analysis, parallel to a 39.5% decrease in ZO1 mRNA, measured by real-time PCR; and (iv) a relative increase in the beta occludin isoform (62.9%), with no change in total occludin protein or mRNA. The expression of endothelial brain antigen, a marker of a functionally competent brain endothelium, was also reduced. We conclude that damage to the ascending fibres from the locus coeruleus caused TJ disruption and gliosis, a sign of inflammation. These results imply that the locus coeruleus degeneration reported in Alzheimer's and Parkinson's diseases may contribute to these disorders by causing blood-brain barrier dysfunction. Whether the vascular damage is the result of impaired noradrenergic transmission or secondary to the inflammatory reaction remains to be determined.

  10. Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Battal, Bilal; Hamcan, Salih; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Ankara (Turkey); Oz, Oguzhan [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Castillo, Mauricio [University of North Carolina School of Medicine, Division of Neuroradiology, Department of Radiology, Chapel Hill, NC (United States)

    2016-06-15

    To determine frequency, imaging features and clinical significance of herniations of brain parenchyma into dural venous sinuses (DVS) and/or calvarium found on MRI. A total of 6160 brain MRI examinations containing at least one high-resolution T1- or T2-weighted sequence were retrospectively evaluated to determine the presence of incidental brain herniations into the DVS or calvarium. MRI sequences available for review were evaluated according to their capability to demonstrate these herniations. Patients' symptoms and clinical findings were recorded. Twenty-one (0.32 %) brain parenchyma herniations into the DVS (n = 18) or calvarium (n = 3) in 20 patients were detected. The most common locations of the herniations were the transverse sinuses (n = 13) and those involving inferior gyrus of the temporal lobe (n = 9). High-resolution T1- and T2-weighted sequences were equally useful in the detection of these brain herniations. According to clinical symptoms, brain herniations were considered to be incidental but headaches were present in nine patients. Brain herniations with surrounding cerebrospinal fluid (CSF) into the DVS and/or calvarium are incidental findings and not proven to be associated with any symptoms. Although rare, these herniations are more common than previously recognized and should not be confused with arachnoid granulations, clots or tumours. (orig.)

  11. Bilateral Psoas Muscle Abscess Associated with Emphysematous Cystitis

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    Jae-Ki Choi

    2015-01-01

    Full Text Available Psoas muscle abscess associated with emphysematous urinary tract infection is very rare. There were very few reports about urinary tract infections such as renal abscess, perinephric abscess, and emphysematous pyelonephritis complicated with psoas muscle abscess; however, psoas muscle abscess associated with emphysematous cystitis has not yet been reported. Here, we report a case of bilateral posas muscle abscess following emphysematous cystitis in an 81-year-old nondiabetic man, who was treated successfully with prolonged antibiotic therapy and supportive care. Early recognition of psoas muscle abscess can prevent aggressive interventional procedure and warrant good prognosis.

  12. Glue-sniffing as a cause of a positive radio-isotope brain scan

    Energy Technology Data Exchange (ETDEWEB)

    Lamont, C.M.; Adams, F.G.

    1982-08-01

    Convulsions are a known complication of the acute intoxicant effects of solvent abuse. A radio-isotope brain scan done 9 months following status epilepticus secondary to toluene inhalation, in a previously normal school-boy, demonstrated several wedge-shaped areas of increased uptake, in both cerebral hemispheres, consistent with infarcts. It is worth remembering that a positive brain scan in a young person, with recent onset of epilepsy, may be due to glue-sniffing.

  13. Emphysematous prostatic abscess with rectoprostatic fistula

    Directory of Open Access Journals (Sweden)

    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.

  14. Pre-existing interleukin 10 in cerebral arteries attenuates subsequent brain injury caused by ischemia/reperfusion.

    Science.gov (United States)

    Liang, Qiu-Juan; Jiang, Mei; Wang, Xin-Hong; Le, Li-Li; Xiang, Meng; Sun, Ning; Meng, Dan; Chen, Si-Feng

    2015-09-01

    Recurrent stroke is difficult to treat and life threatening. Transfer of anti-inflammatory gene is a potential gene therapy strategy for ischemic stroke. Using recombinant adeno-associated viral vector 1 (rAAV1)-mediated interleukin 10 (IL-10), we investigated whether transfer of beneficial gene into the rat cerebral vessels during interventional treatment for initial stroke could attenuate brain injury caused by recurrent stroke. Male Wistar rats were administered rAAV1-IL-10, rAAV1-YFP, or saline into the left cerebral artery. Three weeks after gene transfer, rats were subjected to occlusion of the left middle cerebral artery (MCAO) for 45 min followed by reperfusion for 24 h. IL-10 levels in serum were significantly elevated 3 weeks after rAAV1-IL-10 injection, and virus in the cerebral vessels was confirmed by in situ hybridization. Pre-existing IL-10 but not YFP decreased the neurological dysfunction scores, brain infarction volume, and the number of injured neuronal cells. AAV1-IL-10 transduction increased heme oxygenase (HO-1) mRNA and protein levels in the infarct boundary zone of the brain. Thus, transduction of the IL-10 gene in the cerebral artery prior to ischemia attenuates brain injury caused by ischemia/reperfusion in rats. This preventive approach for recurrent stroke can be achieved during interventional treatment for initial stroke.

  15. Amoebic liver abscess production by Entamoeba dispar.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2014-01-01

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

  17. 小切口、持续负压引流与传统切开引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿的比较%The comparison betweenthe outcomes of using small cuts and continuous negative pressure drainage and the traditional incision and drainage to treat mammary abscess caused by HPG breast implants

    Institute of Scientific and Technical Information of China (English)

    郑轲; 何山; 刘兵; 刘美宏; 冯佳

    2012-01-01

    Objective To discuss the outcomes of using small cuts and continuous negative pressure drainage to treat mammary abscess caused by HPG breast implants. Methods Small cuts and continuous negative pressure drainage were per-formeded in 20 cases of mammary abscess caused by HPG breast implants and the traditional incision and drainage was performed-ed in another 20 cases to evaluate the outcomes. Results Using small cuts and continuous negative pressure drainage to treat mammary abscess caused by HPG breast implants has obvious advantages over the group of using incision and drainage in healing time, the frequency of changing dressings, the degree of pain and the bigrosmall of scar. Conclusion Using small cuts and continuous negative pressure drainage can obviously shorten the healing time, reduce the the frequency of changing dressings, reduce patients pain and reduce scar formation. It is the idealest way to treat mammary abscess caused by HPG breast implants.%目的 探讨小切口、持续负压引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿的效果.方法 20例患者采用小切口、持续负压引流和20例患者采用传统切开油纱填塞引流治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿,观察治疗效果.结果 小切口、持续负压引流组在愈合时间、换药次数、疼痛程度、瘢痕大小等方面均明显优于传统切开引流组.结论 持续负压引流组可以明显缩短愈合时间,减少换药次数,减轻换药痛苦,减少瘢痕形成.是治疗聚丙烯酰胺水凝胶隆乳术后乳腺脓肿最理想方法.

  18. Contents of myelin-basic protein and S-100 in serum and brain tissue of neonatal rats with intrauterine infection-caused brain injury

    Institute of Scientific and Technical Information of China (English)

    Xiaojie Li; Hongying Li; Zhihai Lu

    2006-01-01

    BACKGROUND: The change of the content of myelin basic protein (MBP) in serum and brain tissue is the bio chemical diadynamic index of amyelination. S-100 is a specific and sensitive marker of central nervous system (CNS) injury. Whether or not the content of S-100 and MBP in blood and brain tissue can be used as the quan titative index for early diagnosing the intrauterine infection-caused brain injury still needs investigation. OBJECTIVE: To observe whether or not MBP and S-100 detection can be used as the biochemical indexes for early diagnosing the intrauterine infection-caused brain injury. DESIGN: Randomized controlled animal experiment. SETTING: Laboratory of Pediatric Neuro-rehabilitation, Medical College of Rehabilitation, Jiamusi University. MATERIALS: Sixty female and thirty male common Wistar rats, weighing from 180 to 240 g, were provided by the Experimental Animal Center of Jiamusi University. Reagent: Lipopolysaccharide(LPS, serological type 055: B5, SIGMA Company of USA); MBP enzyme linked immunosobent assay (ELISA) immunoreagent kit (Preclinicai Recombination DNA Laboratory, Chengdu Huaxi Medical Center, Sichuan Province); S-100 ELISA immunoreagent kit ( Department of Physiology, the Fourth Military Medical University of Chinese PLA) and bovine serum albumin(Haitaike Biotechnology Co.,Ltd.).METHODS: This experiment was carried out in the Laboratory of Pediatric Neuro-Rehabilitation, Experimental Animal Center, Department of Pathology and Central Laboratory of Jiamusi University from July 2005 to March 2006. ① Preparation of models and grouping: The female and male rats were placed in one cage at 2: 1 at 17:00 o'clock. Vaginal smear was checked at 8:00 on the next morning. Sperm was found and 0 day of pregnancy was recorded. Pregnant rats were bred in another cage. The pregnant 47 rats were randomly divided into 2 groups: control group (n =10) and experimental group (n =37). The experimental pregnant rats were intraperitoneally injected with LPS

  19. 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.

  20. Deregulation of c-myc and SV40Tag causing brain tumor in mice

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Deregulated expressions of both c-myc and simian virus 40 large T antigen (SV40Tag) are consistent features of lots of tumors. To investigate whether the expression of c-myc and SV40Tag in mouse might help develop a model of human tumor, we generated c-myc transgenics by inserting human c-myc gene into pTRE2 of Tet-On system. We obtained conditional expression of SV40Tag transgenics by the Tet-On system from Yangzhou University. Crossing the c-myc transgenic mouse with the SV40Tag transgenic mice to generate bitransgenics we got double-transgenic mice expressing c-myc and SV40Tag by the Tet-On system. After being treated with doxycycline continuously, single-transgenic SV40Tag mice developed brain tumor infrequently (3 of 84, 3.6%) with a long onset (185 d on average). In contrast, double-transgenic c-myc/SV40Tag mice developed brain tumor with a short onset (96 days on average) and a 41% brain tumor incidence rate (7 of 17, 41%). This tumor was assumed to be medulloblastoma. Our experiments suggest that deregulated expression of c-myc and SV40Tag in brain might generate a mouse model of human brain tumor that recapitulates some features of human medulloblastoma.

  1. Comparison of cerebral blood flow pattern by transcranial Doppler in patients with diffuse and focal causes of brain death

    Directory of Open Access Journals (Sweden)

    Alireza Vakilian

    2012-01-01

    Full Text Available Background: This study aims to assess the cerebral vessels flow in brain death patients with different causes, including focal and diffuse lesions and comparison of flows according to the underlying causes. Materials and Methods: Two groups of 15 brain-dead patients one with focal and the other with diffuse brain lesions were compared according to their cerebral blood flow pattern 48 h passed brain death certification. Results: Bilateral absence of flow in middle cerebral artery (MCA was found in 54.5% of brain-dead patients with diffuse lesion and 50.33% of those with focal lesions. Systolic spike pattern in MCA flow was found in 46.2% of patients with focal lesion and 16.65% of patients with diffuse lesion. Diastole-systole separation pattern in MCA was seen in 16.65% of patients with the diffuse lesions. This pattern in MCA was not seen in patients with the focal lesion group. In carotid arteries, we did not find the absence of flow in any cases. Thirty percent of all patients in both groups had a normal flow pattern (36.6% of patients with focal lesions and 23.3% of patients with diffuse lesion. Patients with focal lesion had 33.3% systolic spike pattern flow and had 23.35% diastole-systole separation flow pattern. In intra-cranial vessels, systolic spike pattern was more common among patients with focal lesions than patients with diffuse lesion, however, this difference was not statistically significant (46.2% of patients with focal lesion and 16.65% of patients with diffuse lesion (P value = 0.244-0.09. Diastole-systole separation flow was more common in patients with diffuse lesions than those with the focal lesions although this could not reach the significant level as the previous pattern (20% of patients with diffuse lesion versus no case in patients with focal lesion (P value = 0.181. Conclusion: Absence of flow was the most common brain flow pattern in the focal and diffuse group lesions. There was no difference in flow pattern

  2. Wide spectrum of developmental brain disorders from megalencephaly to focal cortical dysplasia and pigmentary mosaicism caused by mutations of MTOR

    Science.gov (United States)

    Solovieff, Nadia; Goold, Carleton; Jansen, Laura A.; Menon, Suchithra; Timms, Andrew E.; Conti, Valerio; Biag, Jonathan D.; Adams, Carissa; Boyle, Evan August; Collins, Sarah; Ishak, Gisele; Poliachik, Sandra; Girisha, Katta M.; Yeung, Kit San; Chung, Brian Hon Yin; Rahikkala, Elisa; Gunter, Sonya A.; McDaniel, Sharon S.; Macmurdo, Colleen Forsyth; Bernstein, Jonathan A.; Martin, Beth; Leary, Rebecca; Mahan, Scott; Liu, Shanming; Weaver, Molly; Doerschner, Michael; Jhangiani, Shalini; Muzny, Donna M.; Boerwinkle, Eric; Gibbs, Richard A.; Lupski, James R.; Shendure, Jay; Saneto, Russell P.; Novotny, Edward J.; Wilson, Christopher J.; Sellers, William R.; Morrissey, Michael; Hevner, Robert F.; Ojemann, Jeffrey G.; Guerrini, Renzo; Murphy, Leon O.; Winckler, Wendy; Dobyns, William B.

    2016-01-01

    Importance Focal cortical dysplasia (FCD), hemimegalencephaly (HMEG) and megalencephaly constitute a spectrum of malformations of cortical development with shared neuropathologic features. Collectively, these disorders are associated with significant childhood morbidity and mortality. FCD, in particular, represents the most frequent cause of intractable focal epilepsy in children. Objective To identify the underlying molecular etiology of FCD, HMEG, and diffuse megalencephaly. Design, Setting and Participants We performed whole exome sequencing (WES) on eight children with FCD or HMEG using standard depth (~50-60X) sequencing in peripheral samples (blood, saliva or skin) from the affected child and their parents, and deep (~150-180X) sequencing in affected brain tissue. We used both targeted sequencing and WES to screen a cohort of 93 children with molecularly unexplained diffuse or focal brain overgrowth (42 with FCD-HMEG, and 51 with diffuse megalencephaly). Histopathological and functional assays of PI3K-AKT-MTOR pathway activity in resected brain tissue and cultured neurons were performed to validate mutations. Main Outcomes and Measures Whole exome sequencing and targeted sequencing identified variants associated with this spectrum of developmental brain disorders. Results We identified low-level mosaic mutations of MTOR in brain tissue in four children with FCD type 2a with alternative allele fractions ranging from 0.012–0.086. We also identified intermediate level mosaic mutation of MTOR (p.Thr1977Ile) in three unrelated children with diffuse megalencephaly and pigmentary mosaicism in skin that resembles hypomelanosis of Ito. Finally, we identified a constitutional de novo mutation of MTOR (p.Glu1799Lys) in three unrelated children with diffuse megalencephaly and intellectual disability. Molecular and functional analysis in two children with FCD type 2a from whom multiple affected brain tissue samples were available revealed a gradient of alternate allele

  3. Successful medical treatment of spinal epidural abscess.

    Science.gov (United States)

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

    2008-04-01

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

  4. 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.

  5. Renal hemorrhagic actinomycotic abscess in pregnancy.

    Science.gov (United States)

    Smid, Marcela C; Bhardwaj, Neha R; Di Giovanni, Laura M; Eggener, Scott; Torre, Micaela Della

    2014-02-18

    Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.

  6. Renal hemorrhagic actinomycotic abscess in pregnancy

    Directory of Open Access Journals (Sweden)

    Marcela C. Smid

    2014-02-01

    Full Text Available Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.

  7. Renal Hemorrhagic Actinomycotic Abscess in Pregnancy

    OpenAIRE

    2014-01-01

    Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare in...

  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. Causes and Correlates of Brain Atrophy: A population-based MRI study

    NARCIS (Netherlands)

    T. den Heijer (Tom)

    2004-01-01

    markdownabstract__Abstract__ In 1906, Alois Alzheimer described for the first time a form of dementia that later became known as Alzheimer’s disease. At necropsy, he had observed that the brain of a 51-year-old woman with progressive cognitive decline was filled with –at that time still anonymous–

  11. Psoas abscess associated with infected total hip arthroplasty: a case report.

    Science.gov (United States)

    Plaza, R; Soriano, A; Tomas, X; Gallart, X; Garcia, S

    2006-01-01

    Psoas abscess (PA) is an uncommon disease and its diagnosis is difficult. It can be primary or secondary. Primary abscesses are of unknown origin and are presumably caused by haematogenous or lymphatic spread from a distant infectious focus. Secondary PA is caused by spreading from a contiguous infected structure, such as vertebrae (espondilodiscitis) or mesenteric abscesses (Crohns disease). PA infrequently has been associated with an infection of total hip arthroplasty (ITHA). The correct diagnosis in these cases is difficult due to the clinical similarities between PA and ITHA. Since connection between PA and ITHA is established through the acetabulum, we consider that computed tomography (CT) is the most accurate radiological test because of its efficacy in evaluating the bone structure, and the optimum therapeutic strategy is two-stage replacement surgery. We report one case of PA associated with ITHA and a review of the previous literature.

  12. A case of pituitary abscess presenting without a source of infection or prior pituitary pathology

    Directory of Open Access Journals (Sweden)

    Derick Adams

    2016-08-01

    Full Text Available Pituitary abscess is a relatively uncommon cause of pituitary hormone deficiencies and/or a suprasellar mass. Risk factors for pituitary abscess include prior surgery, irradiation and/or pathology of the suprasellar region as well as underlying infections. We present the case of a 22-year-old female presenting with a spontaneous pituitary abscess in the absence of risk factors described previously. Her initial presentation included headache, bitemporal hemianopia, polyuria, polydipsia and amenorrhoea. Magnetic resonance imaging (MRI of her pituitary showed a suprasellar mass. As the patient did not have any risk factors for pituitary abscess or symptoms of infection, the diagnosis was not suspected preoperatively. She underwent transsphenoidal resection and purulent material was seen intraoperatively. Culture of the surgical specimen showed two species of alpha hemolytic Streptococcus, Staphylococcus capitis and Prevotella melaninogenica. Urine and blood cultures, dental radiographs and transthoracic echocardiogram failed to show any source of infection that could have caused the pituitary abscess. The patient was treated with 6 weeks of oral metronidazole and intravenous vancomycin. After 6 weeks of transsphenoidal resection and just after completion of antibiotic therapy, her headache and bitemporal hemianopsia resolved. However, nocturia and polydipsia from central diabetes insipidus and amenorrhoea from hypogonadotrophic hypogonadism persisted.

  13. Predicting abscesses in adults with community-onset monomicrobial Enterobacteriaceae bacteremia: microorganisms matters.

    Science.gov (United States)

    Lee, Chung-Hsun; Lee, Ching-Chi; Hsieh, Chih-Chia; Hong, Ming-Yuan; Chi, Chih-Hsien

    2016-01-01

    Enterobacteriaceae is a leading pathogen of community-onset bacteremia. This study aims to establish a predictive scoring algorithm to identify adults with community-onset Enterobacteriaceae bacteremia who are at risk for abscesses. Of the total 1262 adults, 152 (12.0%) with abscess occurrence were noted. The 6 risk factors significantly associated with abscess occurrence-liver cirrhosis, diabetes mellitus, thrombocytopenia and high C-reactive protein (>100 mg/L) at bacteremic onset, delayed defervescence, and bacteremia-causing Klebsiella pneumoniae-were each assigned +1 point to form the scoring algorithm. In contrast, the elderly, fatal comorbidity (McCabe classification), and bacteremia-causing Escherichia coli were each assigned -1 point, owing to their negative associations with abscess occurrence. Using the proposed scoring algorithm, a cut-off value of +1 yielded a high sensitivity (85.5%) and an acceptable specificity (60.4%). Although the proposed predictive model needs further validation, this simple scoring algorithm may be useful for the early identification of abscesses by clinicians.

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

    Science.gov (United States)

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

    2016-05-23

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

  15. Genetic Deletion of Rheb1 in the Brain Reduces Food Intake and Causes Hypoglycemia with Altered Peripheral Metabolism

    Directory of Open Access Journals (Sweden)

    Wanchun Yang

    2014-01-01

    Full Text Available Excessive food/energy intake is linked to obesity and metabolic disorders, such as diabetes. The hypothalamus in the brain plays a critical role in the control of food intake and peripheral metabolism. The signaling pathways in hypothalamic neurons that regulate food intake and peripheral metabolism need to be better understood for developing pharmacological interventions to manage eating behavior and obesity. Mammalian target of rapamycin (mTOR, a serine/threonine kinase, is a master regulator of cellular metabolism in different cell types. Pharmacological manipulations of mTOR complex 1 (mTORC1 activity in hypothalamic neurons alter food intake and body weight. Our previous study identified Rheb1 (Ras homolog enriched in brain 1 as an essential activator of mTORC1 activity in the brain. Here we examine whether central Rheb1 regulates food intake and peripheral metabolism through mTORC1 signaling. We find that genetic deletion of Rheb1 in the brain causes a reduction in mTORC1 activity and impairs normal food intake. As a result, Rheb1 knockout mice exhibit hypoglycemia and increased lipid mobilization in adipose tissue and ketogenesis in the liver. Our work highlights the importance of central Rheb1 signaling in euglycemia and energy homeostasis in animals.

  16. Classifying late-onset dementia with MRI: Is arteriosclerotic brain degeneration the most common cause of Alzheimer′s syndrome?

    Directory of Open Access Journals (Sweden)

    Marie Cécile Henry-Feugeas

    2008-03-01

    Full Text Available Marie Cécile Henry-Feugeas1, Fannie Onen2, Elisabeth Schouman Claeys11Department of Radiology, 2Department of Geriatrics, Bichat-Claude Bernard University Hospital, AP-HP, Paris, FranceAbstract: Our aim was to use early magnetic resonance imaging (MRI to investigate the causes of cognitive decline in elderly people with mild cognitive impairment (MCI. Baseline structural and flow quantification MR sequences, and clinical and neuropsychological follow-up for at least two years, were performed on 62 elderly subjects with MCI. Of these subjects, 17 progressed to dementia, and 15 of these progressed to dementia of the Alzheimer type (DAT. Conversion to clinically diagnosed DAT was related to six distinct MR profiles, including one profile suggesting severe AD (20% of these converters and five profiles suggesting severe cerebrovascular dysfunction. Two profiles suggested arteriosclerotic brain degeneration, one profile suggested severe venous windkessel dysfunction, and two suggested marked cerebral hypoperfusion associated with very low craniospinal compliance or marked brain atrophy. As compared with vascular MR type converters, AD MR type converters showed high executive and mobility predementia performances. Severe whole anteromesial temporal atrophy and predominantly left brain atrophy on visual MR analysis was only observed in AD MR type converters. In conclusion, these observations enhance the pathogenic complexity of the Alzheimer syndrome, and suggest that the role of arteriosclerotic brain degeneration in late life dementia is underestimated.Keywords: Alzheimer’s disease, mild cognitive impairment, dementia, MRI, phase contrast, atherosclerosis

  17. The complexity of biomechanics causing primary blast-induced traumatic brain injury: a review of potential mechanisms.

    Directory of Open Access Journals (Sweden)

    Amy eCourtney

    2015-10-01

    Full Text Available Primary blast induced traumatic brain injury (bTBI is a prevalent battlefield injury in recent conflicts, yet biomechanical mechanisms of bTBI remain unclear. Elucidating specific biomechanical mechanisms is essential to developing animal models for testing candidate therapies and for improving protective equipment. Three hypothetical mechanisms of primary bTBI have received the most attention. Because translational and rotational head accelerations are primary contributors to TBI from non-penetrating blunt force head trauma, the acceleration hypothesis suggests that blast-induced head accelerations may cause bTBI. The hypothesis of direct cranial transmission suggests that a pressure transient traverses the skull into the brain and directly injures brain tissue. The thoracic hypothesis of bTBI suggests that some combination of a pressure transient reaching the brain via the thorax and a vagally mediated reflex result in bTBI. These three mechanisms may not be mutually exclusive, and quantifying exposure thresholds (for blasts of a given duration is essential for determining which mechanisms may be contributing for a level of blast exposure. Progress has been hindered by experimental designs which do not effectively expose animal models to a single mechanism and by over-reliance on poorly validated computational models. The path forward should be predictive validation of computational models by quantitative confirmation with blast experiments in animal models, human cadavers, and biofidelic human surrogates over a range of relevant blast magnitudes and durations coupled with experimental designs which isolate a single injury mechanism.

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

    Institute of Scientific and Technical Information of China (English)

    Muhammed; Hadithi; Marco; J; Bruno

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Endoscopic Drainage of an Odontogenic Pterygoid Muscle Abscess

    Directory of Open Access Journals (Sweden)

    Rickul Varshney

    2013-01-01

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

  1. Brain studies may alter long-held concepts about likely causes of some voice disorders

    Energy Technology Data Exchange (ETDEWEB)

    1989-02-17

    Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem.

  2. Systemic PaO2 oscillations cause mild brain injury in a pig model

    OpenAIRE

    Klein, Klaus U.; Johannes, Amelie; Brückner, Melanie; Thomas, Rainer; Matthews, Stephan; Frauenknecht, Katrin; Leukel, Petra; Mazur, Johanna; Poplawski, Alicia; Muellenbach, Ralf; Sommer, Clemens J.; Thal, Serge C.; Engelhard, Kristin

    2016-01-01

    OBJECTIVE: Systemic PaO2 oscillations occur during cyclic recruitment and derecruitment of atelectasis in acute respiratory failure and might harm brain tissue integrity. DESIGN: Controlled animal study. SETTING: University research laboratory. SUBJECTS: Adult anesthetized pigs. INTERVENTIONS: Pigs were randomized to a control group (anesthesia and extracorporeal circulation for 20 hr with constant PaO2, n = 10) or an oscillation group (anesthesia and extracorporeal circulation for 20 hr with...

  3. 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.

  4. Clinical presentation and diagnostic difficulties in amoebic liver abscess

    Directory of Open Access Journals (Sweden)

    Kaushal D Suthar

    2014-07-01

    Full Text Available Background Amoebic liver abscess (ALA is a common and major health problem in India. ALA has a highly variable presentation, causing diagnostic difficulties. Early and correct diagnosis of Amoebic liver abscess is essential, because delayed diagnosis and treatment leads to complications which has significantly higher morbidity and mortality than uncomplicated disease. Objective To find out different clinical presentation and its differential diagnosis in order to establish early diagnosis of ALA. Patients and Methods This retrospective, observational study was carried out in the Department of Surgery during February 2010 to May 2013. Inclusion criteria were defined. The data of patients were enrolled according to variables in performa predesigned for this study and analyzed. Results 187 cases of ALA were enrolled with male to female ratio of 2.8:1. Right hypochondrial pain occurred in 69.52%, left hypochondrial pain occurred in 6.41%, pain radiating to tip of right shoulder in 8.02%, fever in 86.64%, co-incident diarrhea in 36.37% and concurrent pulmonary symptoms in 12.84%. The most common signs were tender hepatomegaly in 73.74% and jaundice in 17.65%. 3.20% patients had past history of aspiration of ALA. 23.52% patients had ruptured abscess. 11.12% were due to delayed diagnosis and 1.60% was ruptured despite treatment. Mortality rate was 3.20% amongst patients with ruptured ALA. Diabetes, hypertension, AIDS and alcoholism were commonly associated co morbidities. Right lobe (82.36% is commonly involved than left lobe and single abscess (83.42% was more common than multiple abscess. Diagnosis was missed in 30.48% patients particularly those with atypical presentations. Ultrasonography, Computerized tomography (CT scan with diagnostic aspiration were useful in diagnosing ALA. Conclusion The typical features of ALA, which include pain, fever and tender hepatomegaly, are nonspecific. ALA may be missed because of variable clinical features and

  5. 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.

  6. Cluster of postinjection abscesses related to corticosteroid injections and use of benzalkonium chloride.

    Science.gov (United States)

    Olson, R K; Voorhees, R E; Eitzen, H E; Rolka, H; Sewell, C M

    1999-01-01

    Benzalkonium chloride (BC) is an unreliable disinfectant. A matched case-control study and environmental investigation were conducted to determine the cause of and risk factors for a cluster of postinjection abscesses at a private medical clinic where BC was used as a disinfectant. Twenty-eight case-patients who had an abscess at the injection site were matched with 126 control patients who had received an intramuscular injection at the clinic on the same day. Risk factors for abscess development in a multivariable logistic model were corticosteroid injection and being female. All case-patients had received a corticosteroid injection from a multidose vial. Cultures of abscesses from 20 of 23 case-patients grew Pseudomonas aeruginosa. Cultures of BC prepared at the clinic also grew P aeruginosa, suggesting that BC was the source of infection. Injection site cleaning with BC did not appear to be the route of infection since use of BC at the time of injection was not associated with abscess development. A more likely route of infection was injection of contaminated corticosteroid from multidose vials that could have been inoculated with pseudomonads via needle puncture after vial septa were wiped with contaminated BC. Benzalkonium chloride should not be used to clean injection vial septa or injection sites. PMID:10214100

  7. Wandering Fish Bone: a Case of Pelvic Abscess due to Rectum Perforation Resulting from an Accidental Fish Bone Ingestion

    Directory of Open Access Journals (Sweden)

    Sirous Abbasi

    2010-09-01

    Full Text Available Fish bone is the most common foreign body that is ingested accidentally and can be caused gastrointestinal complications such as perforation, abstraction, and abscess. We describe a 75-year-old man who suffered from constipation, diarrhea, and fever and chills for 3 months. He had mild tenderness in hypogasteric region and also mild tenderness and swelling on anterior rectal wall and prostate upon clinical examination. The abdominal and pelvic sonography and CT scan findings suggested existence of abscess in the space of between bladder and rectum. The patient underwent laparotomy to drainage the pelvic abscess. The surgeon found a 6-cm fish bone which was embedded in the abscess. The presented case indicated the importance of accidental fish bone ingestion and its possible complications. In addition, the patients with abdominal pain, GI bleeding, and fever of unknown origin living in the seaside regions, the wandering fish bone as a differential diagnosis should be kept in mind.

  8. Adolescence spinal epidural abscess with neurological symptoms: case report, a lesson to be re-learnt.

    Science.gov (United States)

    Sales, Jafar Ganjpour; Tabrizi, Ali; Elmi, Asghar; Soleimanpour, Jafar; Gavidel, Ehsan

    2013-02-01

    Epidural abscess of the spinal column is a rare condition that can be fatal if left untreated. It promptly progresses and can cause neurologic paralysis, urinary retention or cauda equina syndrome. Compromised immune system that occurs in patients with diabetes mellitus, AIDS, chronic renal failure, alcoholism, or cancer is a predisposing factor. It mostly occurs in adults. Here we would like to report a case of spontaneous pyogenic lumbar epidural abscess with neurological deficit diagnosed in a 15 year old boy. We treated this case successfully with surgical microscopic decompression and drainage.

  9. Bacillus cereus Cerebral Abscess During Induction Chemotherapy for Childhood Acute Leukemia.

    Science.gov (United States)

    Dabscheck, Gabriel; Silverman, Lewis; Ullrich, Nicole J

    2015-10-01

    A 5-year-old boy with standard-risk B-cell acute lymphoblastic anemia developed fever during induction chemotherapy. The patient had no neurological symptoms. Blood cultures grew Bacillus cereus and neuroimaging studies demonstrated a cerebral abscess. Imaging changes resolved after completion of antibiotics. Bacillus cereus bacteremia is increasingly implicated as the cause of life-threatening infections, including cerebral abscesses, in compromised patients. Positive blood cultures for this organism should prompt neuroimaging and consideration of cerebrospinal fluid sampling, as well as catheter removal. Given the worse outcome with central nervous system involvement, there is a need for increased awareness and early diagnosis, particularly in immunocompromised individuals.

  10. Diffuse large B cell lymphoma presenting as a peri-anal abscess

    OpenAIRE

    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 ...

  11. 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.

  12. The acute orbit: Differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography

    Energy Technology Data Exchange (ETDEWEB)

    Handler, L.C.; Davey, I.C. (Groote Schuur Hospital, Cape Town (South Africa). Dept. of Neuroradiology Cape Town Univ. (South Africa)); Hill, J.C.; Lauryssen, C. (Groote Schuur Hospital, Cape Town (South Africa). Dept. of Ophthalmology Cape Town Univ. (South Africa))

    1991-02-01

    A series of 65 patients suffering from acute inflammatory disease of the orbit was studied by CT. Ethmoiditis was the cause in the vast majority; trauma and dental extraction played a lesser role in causation. Orbital cellulitis was diagnosed in 17 and subperiosteal abscess in the remaining 48. It was not possible to differentiate 33 pus-containing abscesses from the six with inflammatory masses (phlegmons). The satisfactory response to aggressive medical treatment in those patients with inflammatory masses that were not drained justifies a more conservative approach; surgical drainage being reserved for those with a deterioration in proptosis, ocular movements or vision. Six abscesses arose de novo, of which some were in the orbital fat rather than the subperiosteal space. (orig.).

  13. Osteoid osteoma mimicking Brodie's abscess in a 13-year-old girl.

    Science.gov (United States)

    Schlur, Charles; Bachy, Manon; Wajfisz, Anthony; Ducou le Pointe, Hubert; Josset, Patrice; Vialle, Raphaël

    2013-04-01

    Osteoid osteoma is a solitary, benign lesion of bone causing significant nocturnal pain. Magnetic resonance imaging (MRI), computed tomography (CT), and bone scan are commonly used in this diagnosis. A case of osteoid osteoma of the distal femur mimicking chronic osteomyelitis with Brodie's abscess is reported and discussed. Initial radiographs and MRI showed a lesion of the distal femur consistent with subacute osteomyelitis with a Brodie's abscess. Because primary malignant tumor could not be eliminated, surgical biopsy was carried out. Histological examination showed a typical nidus consistent with the diagnosis of osteoid osteoma. Subacute osteomyelitis (Brodie's abscess) may be difficult to distinguish from other malignant or benign bone lesions as osteoid osteoma. CT usually is recommended as the best imaging procedure to identify the nidus and confirm the diagnosis. MRI also can be used for this purpose. Surgical biopsy remains mandatory for unclear lesions before deciding on appropriate treatment.

  14. Spinal epidural abscess in a patient with piriformis pyomyositis

    Directory of Open Access Journals (Sweden)

    Gerald S Oh

    2016-01-01

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

  15. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2015-01-01

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

  17. Myelopathy due to spinal epidural abscess without cord compression: a diagnostic pitfall.

    NARCIS (Netherlands)

    Warrenburg, B.P.C. van de; Wesseling, P.; Leyten, Q.H.; Boerman, R.H.

    2004-01-01

    Spinal epidural abscess (SEA) is a neurological emergency that requires urgent diagnosis and treatment. We report 2 patients with SEA, in whom, on neuropathological examination, the neurological signs were found to be caused by spinal cord ischemia due to thrombosis of leptomeningeal vessels and com

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

    Directory of Open Access Journals (Sweden)

    Aranzazu Calero-Lillo

    2014-01-01

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

  19. Retropharyngeal abscess with carotid involvement presenting as fever of undetermined origin in a dog.

    Science.gov (United States)

    Borkowski, Emma A

    2014-12-01

    A young dog was presented with lethargy and pyrexia of 2 days duration, not responding to empirical treatment. Thorough diagnostic investigation failed to determine the cause. A retropharyngeal abscess became apparent when it eroded into the carotid artery 2 days later. This case highlights the challenging nature of fever of undetermined origin (FUO) and the value of close monitoring for diagnosis and prompt intervention.

  20. Fusarium falciforme vertebral abscess and osteomyelitis: case report and molecular classification

    Science.gov (United States)

    Fusarium is a ubiquitous filamentous mold that rarely causes disease in immunocompetent humans but can be fatal in immunocompromised hosts. We report an unusual case of vertebral abscess and osteomyelitis in a patient with an autoimmune disorder who was on long term glucocorticoids. Multilocus DNA s...

  1. Acute meningitis caused by Cladosporium sphaerospermum.

    Science.gov (United States)

    Chen, Chi-Yu; Lu, Po-Liang; Lee, Kun-Mu; Chang, Tsung Chain; Lai, Chung-Chih; Chang, Ko; Lin, Wei-Ru; Lin, Chun-Yu; Chen, Yen-Hsu

    2013-12-01

    Phaeohyphomycosis of the central nervous system is rare but typically associated with high mortality. Treatment has not been standardized, but the combination of antifungal chemotherapy with surgical debridement is recommended. We report a 73-year-old, retired, male timber merchant with acute meningitis caused by Cladosporium sphaerospermum. The patient, who had well-controlled type 2 diabetes mellitus, presented with fever and weakness of the lower limbs. No brain abscess was apparent by cranial computed tomography. C. sphaerospermum was isolated from the cerebral spinal fluid and identified based on both morphology and DNA sequencing. He was treated with combination antifungal chemotherapy with amphotericin B and voriconazole for 28 days, followed by voriconazole monotherapy for 46 days. To date, the patient has recovered without significant sequelae. This patient represents the first reported case of cerebral phaeohyphomycosis caused by C. sphaerospermum. Moreover, the therapy was successful for totally less than 3 months of treatment duration.

  2. An 8-week brain MRI follow-up analysis of rat eosinophilic meningitis caused by Angiostrongylus cantonensis infection.

    Science.gov (United States)

    Shyu, L Y; Tsai, H H; Lin, D P; Chang, H H; Tyan, Y S; Weng, J C

    2014-09-01

    Early differential diagnosis and timely follow-up are advantageous in the management of Angiostrongylus cantonensis infection. This study aimed to characterize angiostrongyliasis in the rat brain for an 8-week period using magnetic resonance imaging (MRI) with contrast-enhanced T1-weighted images (T1WI), T2-weighted imaging (T2WI), fluid attenuation inversion recovery (FLAIR) and R2 mapping sequences. The data were analysed with Mathematica and Matlab software programs for weekly changes in each brain following the infection of 20, 50, 100 and 300 third-stage larvae (L3), respectively. The results showed that the average subarachnoid space detected by T2WI technique was peaked up to 10% increase of original size on day 35 after 100 or 300 larvae infection, while those infected with 20 or 50 larvae showed less than 4% increase during the entire course of observation. This increase was relevant to the mortality of the infected rats, because those with 100 or 300 larvae infections showed a sharp decrease in survival rate before day 40. After day 40, the average subarachnoid space was decreased, but the average ventricle size was persistently increased, with the highest increase observed in the group infected with 300 larvae on day 56. Furthermore, the R2 mapping mean and R2 mapping size were significantly different between the brains with severe infection (100 and 300 larvae groups together) and those with mild infection (20 and 50 larvae groups together) on day 49, but not on day 35. Our results showed that diagnosis for different quantity of larvae infection using MRI is possible and follow-up characterization is informative in revealing the effects of angiostrongyliasis on different brain areas. In conclusion, our results support the use of MRI as a non-invasive diagnostic technique for eosinophilic meningitis caused by A. cantonensis infection.

  3. ETHMOIDAL SINUSITIS WITH PRESEPTAL ABSCESS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vikramjit

    2014-08-01

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

  4. 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.

  5. 9 CFR 311.14 - Abrasions, bruises, abscesses, pus, etc.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Abrasions, bruises, abscesses, pus... PARTS § 311.14 Abrasions, bruises, abscesses, pus, etc. All slight, well-limited abrasions on the tongue... a carcass which is badly bruised or which is affected by an abscess, or a suppurating sore shall...

  6. Pituitary abscess during pregnancy: Management dilemmas

    Directory of Open Access Journals (Sweden)

    Krishna Chaitanya Joshi

    2013-01-01

    Full Text Available Pituitary abscess is a rare disorder and only one case of pituitary abscess in pregnancy has been reported in the literature. Since, its presenting manifestations are non-specific; the diagnosis is usually made per-operatively. A 35-year-old pregnant lady, with a sellar mass was managed successfully with trans-sphenoidal drainage of the abscess and antibiotic therapy. We discuss the unique set of problems faced in diagnosis and management. Choice of antibiotics, management of intra-operative cerebrospinal fluid leak and absence of any growth on cultures made the overall management challenging. Although, it can present with a dramatic course suggestive of central nervous system infection or a pituitary mass, but more often it mimics an indolent lesion, which can pose as a diagnostic and therapeutic challenge.

  7. 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.

  8. 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.

  9. Extensive spinal epidural abscess complicated with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Balan Corneliu

    2015-12-01

    Full Text Available Spinal epidural abscess is a rare but severe infection requiring prompt recognition in order to have a favorable outcome and appropriate treatment, mainly surgical. We present one of the largest extensions of such abscess in literature, involving the whole spine. No surgical treatment was tempted due to the involvement of 19 levels but antibiotics. The evolution of the lesion was complicated with hydrocephalus, by mechanism of cervical block of CSF flow, and needed first external derivation and later ventriculo-peritoneal drainage.

  10. [The anal fistula disease and abscess].

    Science.gov (United States)

    Strittmatter, Bernhard

    2004-01-01

    There are two forms of anal fistulas arising from its pathogenesis: the acute stage is the abscess, whereas the chronic stage is the fistula in ano. The classification of the fistula in ano is named after Parks. Pathogenesis and classification are explained. For complete cure, every abscess needs precise examination to be able to show the course and shape of the fistula. The surgical procedure depends on the fistula tract. Most fistulas can be operated by means of a fistulotomy or fistulectomy. Recovery depends on locating the total fistula tract.

  11. Mycobacterium fortuitum abdominal wall abscesses following liposuction

    Directory of Open Access Journals (Sweden)

    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.

  12. CT detection and aspiration of abdominal abscesses.

    Science.gov (United States)

    Haaga, J R; Alfidi, R J; Havrilla, T R; Cooperman, A M; Seidelmann, F E; Reich, N E; Weinstein, A J; Meaney, T F

    1977-03-01

    Computed tomography (CT) is effective in detecting intraabdominal abscesses. Loculations of fluid and extraluminal gas are clearly localized in relation to other organs. Of 22 abscess in this series, CT successfully detected 20; comparative information with gallium, techneticum, and ultrasound scans is presented. In addition to localizing these collections, CT can be used to guide needle aspiration and drainage procedures. Three sizes of needles were used to aspirate specimens and/or provide drainage. This was accomplished successfully in 12 of 14 CT-guided procedures.

  13. Rectus sheath abscess after laparoscopic appendicectomy

    Directory of Open Access Journals (Sweden)

    Golash Vishwanath

    2007-01-01

    Full Text Available Port site wound infection, abdominal wall hematoma and intraabdominal abscess formation has been reported after laparoscopic appendicectomy. We describe here a rectus sheath abscess which occurred three weeks after the laparoscopic appendicectomy. It was most likely the result of secondary infection of the rectus sheath hematoma due to bleeding into the rectus sheath from damage to the inferior epigastric arteries or a direct tear of the rectus muscle. As far as we are aware this complication has not been reported after laparoscopic appendicectomy.

  14. An electric field induced in the retina and brain at threshold magnetic flux density causing magnetophosphenes

    Energy Technology Data Exchange (ETDEWEB)

    Hirata, Akimasa; Takano, Yukinori; Fujiwara, Osamu [Nagoya Institute of Technology, Department of Computer Science and Engineering (Japan); Dovan, Thanh [SP AusNet, Division of Network Strategy and Development (Australia); Kavet, Robert, E-mail: ahirata@nitech.ac.jp [Electric Power Research Institute, Palo Alto, CA (United States)

    2011-07-07

    For magnetic field exposures at extremely low frequencies, the electrostimulatory response with the lowest threshold is the magnetophosphene, a response that corresponds to an adult exposed to a 20 Hz magnetic field of nominally 8.14 mT. In the IEEE standard C95.6 (2002), the corresponding in situ field in the retinal locus of an adult-sized ellipsoidal was calculated to be 53 mV m{sup -1}. However, the associated dose in the retina and brain at a high level of resolution in anatomically correct human models is incompletely characterized. Furthermore, the dose maxima in tissue computed with voxel human models are prone to staircasing errors, particularly for the low-frequency dosimetry. In the analyses presented in this paper, analytical and quasi-static finite-difference time-domain (FDTD) solutions were first compared for a three-layer sphere exposed to a uniform 50 Hz magnetic field. Staircasing errors in the FDTD results were observed at the tissue interface, and were greatest at the skin-air boundary. The 99th percentile value was within 3% of the analytic maximum, depending on model resolution, and thus may be considered a close approximation of the analytic maximum. For the adult anatomical model, TARO, exposed to a uniform magnetic field, the differences in the 99th percentile value of in situ electric fields for 2 mm and 1 mm voxel models were at most several per cent. For various human models exposed at the magnetophosphene threshold at three orthogonal field orientations, the in situ electric field in the brain was between 10% and 70% greater than the analytical IEEE threshold of 53 mV m{sup -1}, and in the retina was lower by roughly 50% for two horizontal orientations (anterior-posterior and lateral), and greater by about 15% for a vertically oriented field. Considering a reduction factor or safety factors of several folds applied to electrostimulatory thresholds, the 99th percentile dose to a tissue calculated with voxel human models may be used as an

  15. An electric field induced in the retina and brain at threshold magnetic flux density causing magnetophosphenes

    Science.gov (United States)

    Hirata, Akimasa; Takano, Yukinori; Fujiwara, Osamu; Dovan, Thanh; Kavet, Robert

    2011-07-01

    For magnetic field exposures at extremely low frequencies, the electrostimulatory response with the lowest threshold is the magnetophosphene, a response that corresponds to an adult exposed to a 20 Hz magnetic field of nominally 8.14 mT. In the IEEE standard C95.6 (2002), the corresponding in situ field in the retinal locus of an adult-sized ellipsoidal was calculated to be 53 mV m-1. However, the associated dose in the retina and brain at a high level of resolution in anatomically correct human models is incompletely characterized. Furthermore, the dose maxima in tissue computed with voxel human models are prone to staircasing errors, particularly for the low-frequency dosimetry. In the analyses presented in this paper, analytical and quasi-static finite-difference time-domain (FDTD) solutions were first compared for a three-layer sphere exposed to a uniform 50 Hz magnetic field. Staircasing errors in the FDTD results were observed at the tissue interface, and were greatest at the skin-air boundary. The 99th percentile value was within 3% of the analytic maximum, depending on model resolution, and thus may be considered a close approximation of the analytic maximum. For the adult anatomical model, TARO, exposed to a uniform magnetic field, the differences in the 99th percentile value of in situ electric fields for 2 mm and 1 mm voxel models were at most several per cent. For various human models exposed at the magnetophosphene threshold at three orthogonal field orientations, the in situ electric field in the brain was between 10% and 70% greater than the analytical IEEE threshold of 53 mV m-1, and in the retina was lower by roughly 50% for two horizontal orientations (anterior-posterior and lateral), and greater by about 15% for a vertically oriented field. Considering a reduction factor or safety factors of several folds applied to electrostimulatory thresholds, the 99th percentile dose to a tissue calculated with voxel human models may be used as an estimate of

  16. An electric field induced in the retina and brain at threshold magnetic flux density causing magnetophosphenes.

    Science.gov (United States)

    Hirata, Akimasa; Takano, Yukinori; Fujiwara, Osamu; Dovan, Thanh; Kavet, Robert

    2011-07-01

    For magnetic field exposures at extremely low frequencies, the electrostimulatory response with the lowest threshold is the magnetophosphene, a response that corresponds to an adult exposed to a 20 Hz magnetic field of nominally 8.14 mT. In the IEEE standard C95.6 (2002), the corresponding in situ field in the retinal locus of an adult-sized ellipsoidal was calculated to be 53 mV m(-1). However, the associated dose in the retina and brain at a high level of resolution in anatomically correct human models is incompletely characterized. Furthermore, the dose maxima in tissue computed with voxel human models are prone to staircasing errors, particularly for the low-frequency dosimetry. In the analyses presented in this paper, analytical and quasi-static finite-difference time-domain (FDTD) solutions were first compared for a three-layer sphere exposed to a uniform 50 Hz magnetic field. Staircasing errors in the FDTD results were observed at the tissue interface, and were greatest at the skin-air boundary. The 99th percentile value was within 3% of the analytic maximum, depending on model resolution, and thus may be considered a close approximation of the analytic maximum. For the adult anatomical model, TARO, exposed to a uniform magnetic field, the differences in the 99th percentile value of in situ electric fields for 2 mm and 1 mm voxel models were at most several per cent. For various human models exposed at the magnetophosphene threshold at three orthogonal field orientations, the in situ electric field in the brain was between 10% and 70% greater than the analytical IEEE threshold of 53 mV m(-1), and in the retina was lower by roughly 50% for two horizontal orientations (anterior-posterior and lateral), and greater by about 15% for a vertically oriented field. Considering a reduction factor or safety factors of several folds applied to electrostimulatory thresholds, the 99th percentile dose to a tissue calculated with voxel human models may be used as an

  17. 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.

  18. Chronic cocaine administration causes extensive white matter damage in brain: diffusion tensor imaging and immunohistochemistry studies.

    Science.gov (United States)

    Narayana, Ponnada A; Herrera, Juan J; Bockhorst, Kurt H; Esparza-Coss, Emilio; Xia, Ying; Steinberg, Joel L; Moeller, F Gerard

    2014-03-30

    The effect of chronic cocaine exposure on multiple white matter structures in rodent brain was examined using diffusion tensor imaging (DTI), locomotor behavior, and end point histology. The animals received either cocaine at a dose of 100mg/kg (N=19), or saline (N=17) for 28 days through an implanted osmotic minipump. The animals underwent serial DTI scans, locomotor assessment, and end point histology for determining the expressions of myelin basic protein (MBP), neurofilament-heavy protein (NF-H), proteolipid protein (PLP), Nogo-A, aquaporin-4 (AQP-4), and growth associated protein-43 (GAP-43). Differences in the DTI measures were observed in the splenium (scc) and genu (gcc) of the corpus callosum (cc), fimbria (fi), and the internal capsule (ic). A significant increase in the activity in the fine motor movements and a significant decrease in the number of rearing events were observed in the cocaine-treated animals. Reduced MBP and Nogo-A and increased GAP-43 expressions were most consistently observed in these structures. A decrease in the NF-H expression was observed in fi and ic. The reduced expression of Nogo-A and the increased expression of GAP-43 may suggest destabilization of axonal connectivity and increased neurite growth with aberrant connections. Increased GAP-43 suggests drug-induced plasticity or a possible repair mechanism response. The findings indicated that multiple white matter tracts are affected following chronic cocaine exposure.

  19. Enhanced zinc consumption causes memory deficits and increased brain levels of zinc

    Science.gov (United States)

    Flinn, J.M.; Hunter, D.; Linkous, D.H.; Lanzirotti, A.; Smith, L.N.; Brightwell, J.; Jones, B.F.

    2005-01-01

    Zinc deficiency has been shown to impair cognitive functioning, but little work has been done on the effects of elevated zinc. This research examined the effect on memory of raising Sprague-Dawley rats on enhanced levels of zinc (10 ppm ZnCO3; 0.153 mM) in the drinking water for periods of 3 or 9 months, both pre- and postnatally. Controls were raised on lab water. Memory was tested in a series of Morris Water Maze (MWM) experiments, and zinc-treated rats were found to have impairments in both reference and working memory. They were significantly slower to find a stationary platform and showed greater thigmotaxicity, a measure of anxiety. On a working memory task, where the platform was moved each day, zinc-treated animals had longer latencies over both trials and days, swam further from the platform, and showed greater thigmotaxicity. On trials using an Atlantis platform, which remained in one place but was lowered on probe trials, the zinc-treated animals had significantly fewer platform crossings, spent less time in the target quadrant, and did not swim as close to the platform position. They had significantly greater latency on nonprobe trials. Microprobe synchrotron X-ray fluorescence (??SXRF) confirmed that brain zinc levels were increased by adding ZnCO 3 to the drinking water. These data show that long-term dietary administration of zinc can lead to impairments in cognitive function. ?? 2004 Elsevier Inc. All rights reserved.

  20. Transrectal Drainage of Deep Pelvic Abscesses Using a Combined Transrectal Sonographic and Fluoroscopic Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kyung Soon; Lee, Eun Jung; Ko, Ji Ho; Joh, Young Duk [Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of); Jung, Gyoo Sik [Ulsan Hospital, Ulsan (Korea, Republic of)

    2005-09-15

    To evaluate the feasibility and clinical efficacy of transrectal drainage of a deep pelvic abscess using combined transrectal sonographic and fluoroscopic guidance. From March 1995 and August 2004, 17 patients (9 men; 8 women; mean age, 39 years) suffering from pelvic pain, fever and leukocytosis were enrolled in this retrospective study. Ultrasound (US) or computed tomography (CT), which was obtained prior to the procedure, showed pelvic fluid collections that were deemed unapproachable by the percutaneous trans abdominal routes. Transrectal drainage of the pelvic abscess was performed under combined transrectal sonographic and fluoroscopic guidance. The causes of the deep pelvic abscess were postoperative complications (n=7), complications associated with radiation (n=3) and chemotherapy (n=1) as well as unknown causes (n=6). A 7.5-MHz end-firing transrectal US probe with a needle biopsy guide attachment was advanced into the rectum. Once the abscess was identified, a needle was advanced via the biopsy guide and the abscess was punctured. Under US guidance, either a 0.018'or 0.035' guide wire was passed through the needle in the abscess. Under fluoroscopic guidance, the tract was dilated to the appropriate diameter with sequential fascial dilators, and a catheter was placed over the guide wire within the abscess. Clinical success of drainage was determined by a combination closure of the cavity on the follow up images and diminished leukocytosis. The technical and clinical success rate, complications, and patient's discomfort were analyzed. Drainage was technically successful in all patients and there were no serious complications. Surgery was eventually performed in two cases due to fistular formation with the rectum and leakage of the anastomosis site. The procedure was well tolerated in all but one patient who complained of discomfort while the catheter was inserted . The catheter did not interfere with defecation and there was no incidence of

  1. Zika Virus Infection as a Cause of Congenital Brain Abnormalities and Guillain–Barré Syndrome: Systematic Review

    Science.gov (United States)

    Reveiz, Ludovic; Oladapo, Olufemi T.; Martínez-Vega, Ruth; Haefliger, Anina

    2017-01-01

    Background The World Health Organization (WHO) stated in March 2016 that there was scientific consensus that the mosquito-borne Zika virus was a cause of the neurological disorder Guillain–Barré syndrome (GBS) and of microcephaly and other congenital brain abnormalities based on rapid evidence assessments. Decisions about causality require systematic assessment to guide public health actions. The objectives of this study were to update and reassess the evidence for causality through a rapid and systematic review about links between Zika virus infection and (a) congenital brain abnormalities, including microcephaly, in the foetuses and offspring of pregnant women and (b) GBS in any population, and to describe the process and outcomes of an expert assessment of the evidence about causality. Methods and Findings The study had three linked components. First, in February 2016, we developed a causality framework that defined questions about the relationship between Zika virus infection and each of the two clinical outcomes in ten dimensions: temporality, biological plausibility, strength of association, alternative explanations, cessation, dose–response relationship, animal experiments, analogy, specificity, and consistency. Second, we did a systematic review (protocol number CRD42016036693). We searched multiple online sources up to May 30, 2016 to find studies that directly addressed either outcome and any causality dimension, used methods to expedite study selection, data extraction, and quality assessment, and summarised evidence descriptively. Third, WHO convened a multidisciplinary panel of experts who assessed the review findings and reached consensus statements to update the WHO position on causality. We found 1,091 unique items up to May 30, 2016. For congenital brain abnormalities, including microcephaly, we included 72 items; for eight of ten causality dimensions (all except dose–response relationship and specificity), we found that more than half the

  2. Inflammatory responses are not sufficient to cause delayed neuronal death in ATP-induced acute brain injury.

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    Hey-Kyeong Jeong

    Full Text Available BACKGROUND: Brain inflammation is accompanied by brain injury. However, it is controversial whether inflammatory responses are harmful or beneficial to neurons. Because many studies have been performed using cultured microglia and neurons, it has not been possible to assess the influence of multiple cell types and diverse factors that dynamically and continuously change in vivo. Furthermore, behavior of microglia and other inflammatory cells could have been overlooked since most studies have focused on neuronal death. Therefore, it is essential to analyze the precise roles of microglia and brain inflammation in the injured brain, and determine their contribution to neuronal damage in vivo from the onset of injury. METHODS AND FINDINGS: Acute neuronal damage was induced by stereotaxic injection of ATP into the substantia nigra pars compacta (SNpc and the cortex of the rat brain. Inflammatory responses and their effects on neuronal damage were investigated by immunohistochemistry, electron microscopy, quantitative RT-PCR, and stereological counting, etc. ATP acutely caused death of microglia as well as neurons in a similar area within 3 h. We defined as the core region the area where both TH(+ and Iba-1(+ cells acutely died, and as the penumbra the area surrounding the core where Iba-1(+ cells showed activated morphology. In the penumbra region, morphologically activated microglia arranged around the injury sites. Monocytes filled the damaged core after neurons and microglia died. Interestingly, neither activated microglia nor monocytes expressed iNOS, a major neurotoxic inflammatory mediator. Monocytes rather expressed CD68, a marker of phagocytic activity. Importantly, the total number of dopaminergic neurons in the SNpc at 3 h (∼80% of that in the contralateral side did not decrease further at 7 d. Similarly, in the cortex, ATP-induced neuron-damage area detected at 3 h did not increase for up to 7 d. CONCLUSIONS: Different cellular

  3. Abdominal Wall Abscess due to Acute Perforated Sigmoid Diverticulitis: A Case Report with MDCT and US Findings

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    Rafailidis Vasileios

    2013-01-01

    Full Text Available Perforation of the inflamed diverticula is a common diverticulitis complication. It usually leads to the formation of a local abscess. In some rare cases, the inflammatory process may spread towards extra-abdominal sites like the anterior or posterior abdominal wall or the thigh and form an abscess in these sites. We present the case of a 73-year-old man with a history of pain at the lower left quadrant of the abdomen for 20 days and a visible mass in this site. Ultrasonography and computed tomography revealed this mass to be an abscess of the abdominal wall which had been formed by the spread of ruptured sigmoid diverticulitis by continuity of tissue through the lower left abdominal wall. Local drainage of the abscess was performed and the patient was discharged after alleviation of symptoms and an uneventful course. We also discuss causes of abdominal wall abscesses along with the possible pathways by which an intra-abdominal abscess could spread outside the abdominal cavity.

  4. Serratia marcescens spinal epidural abscess formation following acupuncture.

    Science.gov (United States)

    Yang, Chih-Wei; Hsu, Shun-Neng; Liu, Jhih-Syuan; Hueng, Dueng-Yuan

    2014-01-01

    The formation of spinal epidural abscess following acupuncture is very rare. We herein report the case of a 54-year-old woman who presented with progressive low back pain and fever with a root sign. She underwent surgical decompression, with an immediate improvement of the low back pain. A culture of the epidural abscess grew Serratia marcescens. One year postoperatively, magnetic resonance imaging revealed the almost complete eradication of the abscess. This case is the first case of Serratia marcescens-associated spinal epidural abscess formation secondary to acupuncture. The characteristics of spinal epidural abscess that develop after acupuncture and how to prevent such complications are also discussed.

  5. 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.

  6. Brain Malformations

    Science.gov (United States)

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  7. Peripheral nerve injury and TRPV1-expressing primary afferent C-fibers cause opening of the blood-brain barrier

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    Salter Michael W

    2010-11-01

    Full Text Available Abstract Background The blood-brain barrier (BBB plays the crucial role of limiting exposure of the central nervous system (CNS to damaging molecules and cells. Dysfunction of the BBB is critical in a broad range of CNS disorders including neurodegeneration, inflammatory or traumatic injury to the CNS, and stroke. In peripheral tissues, the vascular-tissue permeability is normally greater than BBB permeability, but vascular leakage can be induced by efferent discharge activity in primary sensory neurons leading to plasma extravasation into the extravascular space. Whether discharge activity of sensory afferents entering the CNS may open the BBB or blood-spinal cord barrier (BSCB remains an open question. Results Here we show that peripheral nerve injury (PNI produced by either sciatic nerve constriction or transecting two of its main branches causes an increase in BSCB permeability, as assessed by using Evans Blue dye or horseradish peroxidase. The increase in BSCB permeability was not observed 6 hours after the PNI but was apparent 24 hours after the injury. The increase in BSCB permeability was transient, peaking about 24-48 hrs after PNI with BSCB integrity returning to normal levels by 7 days. The increase in BSCB permeability was prevented by administering the local anaesthetic lidocaine at the site of the nerve injury. BSCB permeability was also increased 24 hours after electrical stimulation of the sciatic nerve at intensity sufficient to activate C-fibers, but not when A-fibers only were activated. Likewise, BSCB permeability increased following application of capsaicin to the nerve. The increase in permeability caused by C-fiber stimulation or by PNI was not anatomically limited to the site of central termination of primary afferents from the sciatic nerve in the lumbar cord, but rather extended throughout the spinal cord and into the brain. Conclusions We have discovered that injury to a peripheral nerve and electrical stimulation of C

  8. Antibodies to the α1-adrenergic receptor cause vascular impairments in rat brain as demonstrated by magnetic resonance angiography.

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    Peter Karczewski

    Full Text Available BACKGROUND: Circulating agonistic autoantibodies acting at G protein-coupled receptors have been associated with numerous sever pathologies in humans. Antibodies directed predominantly against the α(1-adrenergig receptor were detected in patients suffering from widespread diseases such as hypertension and type 2 diabetes. Their deleterious action has been demonstrated for peripheral organs. We postulate that antibodies to the α(1-adrenergig receptor are relevant pathomolecules in diseases of the central nervous system associated with vascular impairments. METHODOLOGY/PRINCIPAL FINDINGS: Using a rat model we studied the long-term action of antibodies against the α(1-adrenergig receptor either induced by immunization with a receptor peptide or applied by intravenous injection. The vasculature in the rat brains was investigated by time-of-flight magnetic resonance angiography using a 9.4 Tesla small animal MR imaging system. Visual examination of maximum-intensity-projections (MIPs of brain angiographs revealed the development of vascular defects in antibody- exposed animals between three and eight months of treatment. Relative vascular areas were derived from representative MIP image sections by grayscale analysis and used to form an index of vascular circulation. Animals exposed to the action of α(1-adrenergig receptor antibodies showed significantly reduced vascular areas (p<0.05. Calculated index values indicated attenuated blood flow in both antibody-treated cohorts compared to their respective controls reaching with (relative units ± standard error, n = 10 0.839 ± 0.026 versus 0.919 ± 0.026 statistical significance (p<0.05 for peptide-immunized rats. CONCLUSION/SIGNIFICANCE: We present evidence that antibodies to the α(1-adrenergig receptor cause cerebrovascular impairments in the rat. Our findings suggest the pathological significance of these antibodies in pathologies of the human central nervous system linked to impairments of

  9. Diagnosis and treatment of prostatic abscess

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    Paulo Oliveira

    2003-02-01

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

  10. Periappendicular Abscess Presenting within an Inguinal Hernia

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    Norman Loberant

    2015-01-01

    Full Text Available The presence of the appendix within an inguinal hernia is a rare finding. We present the case of an elderly woman who developed appendicitis within an inguinal hernia, complicated by a supervening periappendicular abscess. She was successfully treated with a combination of antibiotics and percutaneous drainage.

  11. Periappendicular Abscess Presenting within an Inguinal Hernia

    Science.gov (United States)

    Loberant, Norman; Bickel, Amitai

    2015-01-01

    The presence of the appendix within an inguinal hernia is a rare finding. We present the case of an elderly woman who developed appendicitis within an inguinal hernia, complicated by a supervening periappendicular abscess. She was successfully treated with a combination of antibiotics and percutaneous drainage. PMID:26605128

  12. Isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus infection

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    Sujit Gharai

    2012-01-01

    Full Text Available We report a case of isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus (HIV infection. A 30-year-old man presented to our outpatient department with sudden loss of visibility in his left visual field. He had no other systemic symptoms. Perimetry showed left-sided incongruous homonymous hemianopsia denser above the horizontal meridian. Magnetic resonance imaging revealed irregular well-marginated lobulated lesions right temporo-occipital cerebral hemisphere and left high fronto-parietal cerebral hemisphere suggestive of brain tubercular abscess. Serological tests for HIV were reactive, and the patient was started only on anti-tubercular drugs with the presumptive diagnosis of cerebral tubercular abscess. Therapeutic response confirmed the diagnosis. Atypical ophthalmic manifestations may be the initial presenting feature in patients with HIV infection. This highlights the need for increased index of suspicion for HIV infection in young patients with atypical ophthalmic manifestations.

  13. 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.

  14. Vascular Endothelial Growth Factor Increases during Blood-Brain Barrier-Enhanced Permeability Caused by Phoneutria nigriventer Spider Venom

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    Monique C. P. Mendonça

    2014-01-01

    Full Text Available Phoneutria nigriventer spider accidental envenomation provokes neurotoxic manifestations, which when critical, results in epileptic-like episodes. In rats, P. nigriventer venom (PNV causes blood-brain barrier breakdown (BBBb. The PNV-induced excitotoxicity results from disturbances on Na+, K+ and Ca2+ channels and glutamate handling. The vascular endothelial growth factor (VEGF, beyond its angiogenic effect, also, interferes on synaptic physiology by affecting the same ion channels and protects neurons from excitotoxicity. However, it is unknown whether VEGF expression is altered following PNV envenomation. We found that adult and neonates rats injected with PNV showed immediate neurotoxic manifestations which paralleled with endothelial occludin, β-catenin, and laminin downregulation indicative of BBBb. In neonate rats, VEGF, VEGF mRNA, and Flt-1 receptors, glutamate decarboxylase, and calbindin-D28k increased in Purkinje neurons, while, in adult rats, the BBBb paralleled with VEGF mRNA, Flk-1, and calbindin-D28k increases and Flt-1 decreases. Statistically, the variable age had a role in such differences, which might be due to age-related unequal maturation of blood-brain barrier (BBB and thus differential cross-signaling among components of the glial neurovascular unit. The concurrent increases in the VEGF/Flt-1/Flk-1 system in the cerebellar neuron cells and the BBBb following PNV exposure might imply a cytokine modulation of neuronal excitability consequent to homeostatic perturbations induced by ion channels-acting PNV neuropeptides. Whether such modulation represents neuroprotection needs further investigation.

  15. Serum-borne bioactivity caused by pulmonary multiwalled carbon nanotubes induces neuroinflammation via blood–brain barrier impairment

    Science.gov (United States)

    Aragon, Mario J.; Topper, Lauren; Tyler, Christina R.; Sanchez, Bethany; Zychowski, Katherine; Young, Tamara; Herbert, Guy; Hall, Pamela; Erdely, Aaron; Eye, Tracy; Bishop, Lindsey; Saunders, Samantha A.; Muldoon, Pretal P.; Ottens, Andrew K.; Campen, Matthew J.

    2017-01-01

    Pulmonary exposure to multiwalled carbon nanotubes (MWCNTs) causes indirect systemic inflammation through unknown pathways. MWCNTs translocate only minimally from the lungs into the systemic circulation, suggesting that extrapulmonary toxicity may be caused indirectly by lung-derived factors entering the circulation. To assess a role for MWCNT-induced circulating factors in driving neuroinflammatory outcomes, mice were acutely exposed to MWCNTs (10 or 40 µg/mouse) via oropharyngeal aspiration. At 4 h after MWCNT exposure, broad disruption of the blood-brain barrier (BBB) was observed across the capillary bed with the small molecule fluorescein, concomitant with reactive astrocytosis. However, pronounced BBB permeation was noted, with frank albumin leakage around larger vessels (>10 µm), overlain by a dose-dependent astroglial scar-like formation and recruitment of phagocytic microglia. As affirmed by elevated inflammatory marker transcription, MWCNT-induced BBB disruption and neuroinflammation were abrogated by pretreatment with the rho kinase inhibitor fasudil. Serum from MWCNT-exposed mice induced expression of adhesion molecules in primary murine cerebrovascular endothelial cells and, in a wound-healing in vitro assay, impaired cell motility and cytokinesis. Serum thrombospondin-1 level was significantly increased after MWCNT exposure, and mice lacking the endogenous receptor CD36 were protected from the neuroinflammatory and BBB permeability effects of MWCNTs. In conclusion, acute pulmonary exposure to MWCNTs causes neuroinflammatory responses that are dependent on the disruption of BBB integrity. PMID:28223486

  16. Serum-borne bioactivity caused by pulmonary multiwalled carbon nanotubes induces neuroinflammation via blood-brain barrier impairment.

    Science.gov (United States)

    Aragon, Mario J; Topper, Lauren; Tyler, Christina R; Sanchez, Bethany; Zychowski, Katherine; Young, Tamara; Herbert, Guy; Hall, Pamela; Erdely, Aaron; Eye, Tracy; Bishop, Lindsey; Saunders, Samantha A; Muldoon, Pretal P; Ottens, Andrew K; Campen, Matthew J

    2017-03-07

    Pulmonary exposure to multiwalled carbon nanotubes (MWCNTs) causes indirect systemic inflammation through unknown pathways. MWCNTs translocate only minimally from the lungs into the systemic circulation, suggesting that extrapulmonary toxicity may be caused indirectly by lung-derived factors entering the circulation. To assess a role for MWCNT-induced circulating factors in driving neuroinflammatory outcomes, mice were acutely exposed to MWCNTs (10 or 40 µg/mouse) via oropharyngeal aspiration. At 4 h after MWCNT exposure, broad disruption of the blood-brain barrier (BBB) was observed across the capillary bed with the small molecule fluorescein, concomitant with reactive astrocytosis. However, pronounced BBB permeation was noted, with frank albumin leakage around larger vessels (>10 µm), overlain by a dose-dependent astroglial scar-like formation and recruitment of phagocytic microglia. As affirmed by elevated inflammatory marker transcription, MWCNT-induced BBB disruption and neuroinflammation were abrogated by pretreatment with the rho kinase inhibitor fasudil. Serum from MWCNT-exposed mice induced expression of adhesion molecules in primary murine cerebrovascular endothelial cells and, in a wound-healing in vitro assay, impaired cell motility and cytokinesis. Serum thrombospondin-1 level was significantly increased after MWCNT exposure, and mice lacking the endogenous receptor CD36 were protected from the neuroinflammatory and BBB permeability effects of MWCNTs. In conclusion, acute pulmonary exposure to MWCNTs causes neuroinflammatory responses that are dependent on the disruption of BBB integrity.

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

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    J. Diranzo García

    2015-01-01

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

  18. Gas-Forming Pyogenic Liver Abscess with Septic Shock

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    Muhammad S. Khan

    2015-01-01

    Full Text Available The pyogenic liver abscess caused by Clostridium perfringens (C. perfringens is a rare but rapidly fatal infection. The main virulence factor of this pathogen is its α-toxin (lecithinase, which decomposes the phospholipid in cell membranes leading to cell lysis. Once the bacteria are in blood stream, massive intravascular hemolysis occurs. This can present as anemia on admission with evidence of hemolysis as indicated by low serum haptoglobin, high serum lactate dehydrogenase (LDH, elevated indirect bilirubin, and spherocytosis. The clinical course of C. perfringens septicemia is marked by rapidly deteriorating course with a mortality rate ranging from 70 to 100%. The very rapid clinical course makes it difficult to diagnose on time, and most cases are diagnosed at autopsy. Therefore it is important to consider C. perfringens infection in any severely ill patient with fever and evidence of hemolysis. We present a case of seventy-seven-year-old male with septic shock secondary to pyogenic liver abscess with a brief review of existing literature on C. perfringens.

  19. Retroperitoneal Necrotizing Fasciitis Masquerading as Perianal Abscess - Rare and Perilous.

    Science.gov (United States)

    Amaranathan, Anandhi; Sahoo, Ashok Kumar; Barathi, Deepak; Shankar, Gomathi; Sistla, Sarath Chandra

    2017-01-17

    Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings. The rapid deterioration of the patient also gives a clue towards the diagnosis. We report a 35-year-old male with perianal abscess who had been progressed to retroperitoneal necrotizing fasciitis. The patient was managed successfully with aggressive debridement and drainage after laparotomy. Appropriate antibiotics were used to combat the sepsis. The patient recovered well at follow up, three months after discharge. Another patient, a 45-year-old male with a retroperitoneal abscess, progressed to retroperitoneal necrotizing fasciitis, and extra peritoneal drainage and debridement was done. Antibiotics depending upon the culture and sensitivity were used to control sepsis. But the patient succumbed to death 45 days after surgery due to uncontrolled sepsis. Necrotizing fasciitis of any anatomical site needs aggressive surgical care with early intervention. But retroperitoneal necrotizing fasciitis needs an extra effort for diagnosis. After diagnosis, it needs timely surgical intervention and appropriate antibiotic therapy for the recovery of the patients.

  20. Malformation of certain brain blood vessels caused by TCDD activation of Ahr2/Arnt1 signaling in developing zebrafish

    Energy Technology Data Exchange (ETDEWEB)

    Teraoka, Hiroki, E-mail: hteraoka@rakuno.ac.jp [School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu 069-8501 (Japan); Ogawa, Akira [School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu 069-8501 (Japan); Kubota, Akira [School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu 069-8501 (Japan); Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA (United States); Stegeman, John J. [Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA (United States); Peterson, Richard E. [School of Pharmacy, University of Wisconsin, Madison, WI (United States); Hiraga, Takeo [School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu 069-8501 (Japan)

    2010-08-15

    2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) causes various signs of toxicity in early life stages of vertebrates through activation of the aryl hydrocarbon receptor (AHR). The AHR also plays important roles in normal development in mice, and AHR{sup -/-} mice show abnormal development of vascular structures in various blood vessels. Our previous studies revealed that Ahr type 2 (Ahr2) activation by TCDD and {beta}-naphthoflavone (BNF) caused a significant decrease in blood flow in the dorsal midbrain of zebrafish embryos. Here we report effects of TCDD exposure on the morphology of some blood vessels in the head of developing zebrafish. TCDD caused concentration-dependent anatomical rearrangements in the shape of the prosencephalic artery in zebrafish larvae. In contrast, no major vascular defects were recognized in the trunk and tail regions following exposure to TCDD at least at the concentrations used. Essentially, the same observations were also confirmed in BNF-exposed larvae. Knock-down of either Ahr2 or Ahr nuclear translocator type 1 (Arnt1) by morpholino oligonucleotides (MOs) protected larvae against abnormal shape of the prosencephalic artery caused by TCDD and BNF. On the other hand, knock-down of Ahr2 or Arnt1 in vehicle-exposed zebrafish larvae had no clear effect on morphology of the prosencephalic artery or trunk vessels. Ascorbic acid, an antioxidant, protected against the TCDD-induced decrease in blood flow through the prosencephalic artery, but not the abnormal morphological changes in the shape of this artery. These results indicate that activation of Ahr2/Arnt1 pathway by TCDD and BNF affects the shape of certain blood vessels in the brain of developing zebrafish.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-04-15

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

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

    Science.gov (United States)

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

    2011-02-01

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

  3. Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report

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    Vinay Pandit

    2009-10-01

    Full Text Available Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC from mesenteric lesion were positive for acid fast bacilli (AFB and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR. He responded well to treatment with anti tubercular drugs.

  4. Foreign body ingestion: rare cause of cervical abscess.

    Science.gov (United States)

    Costa, Liliana; Larangeiro, João; Pinto Moura, Carla; Santos, Margarida

    2014-01-01

    IntroduçÉo: A ingestÉo de corpo estranho é um motivo frequente de recurso à urgência hospitalar. As complicações graves, embora raras, incluem perfuraçÉo faringo-esofágica, fistula aorto-esofágica e infecçÉo cervical profunda.Material e Métodos: Foram analisados, retrospectivamente, os casos de ingestÉo de corpo estranho com internamento num hospital terciário, entre 1989 e 2011. Seleccionaram-se os casos complicados por abcesso cervical profundo, descrevendo-se a semiótica, resultados de meios complementares de diagnóstico, terapêutica efectuada e evoluçÉo clínica.Resultados: Dos 1679 casos, 319 referentes a crianças e 1360 a adultos, reportam-se dois casos (0,12%): uma criança, 13 meses, com abcesso retrofaríngeo após ingestÉo de osso de frango e um adulto, 41 anos, com abcesso parafaríngeo após ingestÉo de espinha de peixe. As complicações manifestaram-se quatro e três dias após remoçÉo do corpo estranho, respectivamente. Em ambos foram efectuadas Tomografias Computorizadas cervicais com contraste e drenagem cirúrgica dos abcessos; a criança foi ainda submetida a esofagoscopia rígida para remoçÉo de corpo estranho residual e encerramento da perfuraçÉo esofágica associada.DiscussÉo: Os abcessos cervicais sÉo uma complicaçÉo possível da ingestÉo de corpo estranho e constituem um desafio diagnóstico, principalmente em idade pediátrica. A manipulaçÉo esofágica prévia por fibroscopia poderá ser considerada um factor de risco. A imagiologia (Tomografia Computorizada cervical com contraste ou Resson'ncia Magnética Cervical) foi essencial para o diagnóstico e o planeamento cirúrgico.ConclusÉo: Embora raros, perante a história recente de ingestÉo/remoçÉo de corpo estranho esofágico e a presença de sintomas compatíveis, os abcessos cervicais devem ser tidos em consideraçÉo, dado o potencial de morbilidade e mortalidade na ausência de uma abordagem terapêutica adequada.

  5. A Preterm Birth Caused By Postoperative Peritonitis and Peritoneal Abscess

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    Sukru Yildiz

    2013-08-01

    Full Text Available Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. The following case illustrates our experience and to analyze clinical characteristic and the pregnancy outcome of appendicitis during the third trimester of pregnancy. [Cukurova Med J 2013; 38(4.000: 751-753

  6. Lung abscess due to Streptococcus pneumoniae simulating pulmonary tuberculosis: presentation of two cases

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    Alessandro Perazzo

    2014-03-01

    Full Text Available In the past, anaerobes were the most common cause of community-acquired lung abscess; Streptococcus species were the second most common cause. In recent years, this has changed. Klebsiella pneumoniae is now most common cause of community- acquired lung abscess, although Streptococcus species remain pathogen of major importance. We present two cases of pulmonary cavitation due to Streptococcus pneumoniae which resembled pulmonary tuberculosis with regards to their history and radiological findings. These are examples of a common diagnosis presenting in an uncommon way. Our cases had some peculiarities: they had a clinical picture strongly suggestive of pulmonary tuberculosis or lung cancer rather than necrotizing infectious pneumonia in patients with no comorbidities or underlying diseases (including oral or dental pathologies. Radiological findings did not help the clinicians: pulmonary tuberculosis was the first diagnostic hypothesis in both cases. An underlying lung cancer was excluded in the first case only after invasive pulmonary procedures.

  7. Brain radiation - discharge

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    Radiation - brain - discharge; Cancer-brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  8. Prenatal methylmercury exposure hampers glutathione antioxidant system ontogenesis and causes long-lasting oxidative stress in the mouse brain.

    Science.gov (United States)

    Stringari, James; Nunes, Adriana K C; Franco, Jeferson L; Bohrer, Denise; Garcia, Solange C; Dafre, Alcir L; Milatovic, Dejan; Souza, Diogo O; Rocha, João B T; Aschner, Michael; Farina, Marcelo

    2008-02-15

    During the perinatal period, the central nervous system (CNS) is extremely sensitive to metals, including methylmercury (MeHg). Although the mechanism(s) associated with MeHg-induced developmental neurotoxicity remains obscure, several studies point to the glutathione (GSH) antioxidant system as an important molecular target for this toxicant. To extend our recent findings of MeHg-induced GSH dyshomeostasis, the present study was designed to assess the developmental profile of the GSH antioxidant system in the mouse brain during the early postnatal period after in utero exposure to MeHg. Pregnant mice were exposed to different doses of MeHg (1, 3 and 10 mg/l, diluted in drinking water, ad libitum) during the gestational period. After delivery, pups were killed at different time points - postnatal days (PND) 1, 11 and 21 - and the whole brain was used for determining biochemical parameters related to the antioxidant GSH system, as well as mercury content and the levels of F(2)-isoprostane. In control animals, cerebral GSH levels significantly increased over time during the early postnatal period; gestational exposure to MeHg caused a dose-dependent inhibition of this developmental event. Cerebral glutathione peroxidase (GPx) and glutathione reductase (GR) activities significantly increased over time during the early postnatal period in control animals; gestational MeHg exposure induced a dose-dependent inhibitory effect on both developmental phenomena. These adverse effects of prenatal MeHg exposure were corroborated by marked increases in cerebral F(2)-isoprostanes levels at all time points. Significant negative correlations were found between F(2)-isoprostanes and GSH, as well as between F(2)-isoprostanes and GPx activity, suggesting that MeHg-induced disruption of the GSH system maturation is related to MeHg-induced increased lipid peroxidation in the pup brain. In utero MeHg exposure also caused a dose-dependent increase in the cerebral levels of mercury at

  9. Bacterial Etiology and Risk Factors Associated with Cellulitis and Purulent Skin Abscesses in Military Trainees

    Science.gov (United States)

    Johnson, Ryan C.; Ellis, Michael W.; Schlett, Carey D.; Millar, Eugene V.; LaBreck, Patrick T.; Mor, Deepika; Elassal, Emad M.; Lanier, Jeffrey B.; Redden, Cassie L.; Cui, Tianyuan; Teneza-Mora, Nimfa; Bishop, Danett K.; Hall, Eric R.; Bishop-Lilly, Kimberly A.

    2016-01-01

    Military trainees are at high risk for skin and soft-tissue infections (SSTIs). Although Staphylococcus aureus is associated with purulent SSTI, it is unclear to what degree this pathogen causes nonpurulent cellulitis. To inform effective prevention strategies and to provide novel insights into SSTI pathogenesis, we aimed to determine the etiology of SSTI in this population. We conducted a prospective observational study in US Army Infantry trainees with SSTI (cutaneous abscesses and cellulitis) from July 2012 through December 2014. We used standard microbiology, serology, and high-throughput sequencing to determine the etiology of SSTI. Furthermore, we compared purported risk factors as well as anatomic site colonization for S. aureus. Among 201 SSTI cases evaluated for SSTI risk factors, cellulitis was associated with lower extremity blisters (P = 0.01) and abscess was associated with methicillin-resistant S. aureus (MRSA) colonization (Pmicrobiome analysis, only 1 leading edge aspirate was culturable (Coagulase-negative Staphylococcus). Microbiome evaluation of aspirate specimens demonstrated that Rhodanobacter terrae was the most abundant species (66.8% average abundance), while abscesses were dominated by S. aureus (92.9% average abundance). Although abscesses and cellulitis share the spectrum of clinical SSTI, the bacterial etiologies as determined by current technology appear distinct. Furthermore, the presence of atypical bacteria within cellulitis aspirates may indicate novel mechanisms of cellulitis pathogenesis. Clinical Trials Registration: NCT01105767. PMID:27780238

  10. Thoracic osteomyelitis and epidural abscess formation due to cat scratch disease: case report.

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    Dornbos, David; Morin, Jocelyn; Watson, Joshua R; Pindrik, Jonathan

    2016-12-01

    Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease. A 5-year-old girl, who initially presented with vague constitutional symptoms, was diagnosed with cat scratch disease following biopsy of an inguinal lymph node. Despite appropriate antibiotics, she presented several weeks later with recurrent symptoms and back pain. Magnetic resonance imaging revealed 2 foci of osteomyelitis at T-8 and T-11 with an associated anterior epidural abscess from T-9 to T-12. Percutaneous image-guided vertebral biopsy revealed B. henselae by polymerase chain reaction analysis, and she was treated conservatively with doxycycline and rifampin with favorable clinical outcome.

  11. CLINICAL AND ETIOLOGICAL PROFILE OF PATIENTS WITH LUNG ABSCESS AT A TERTIARY CARE CENTRE

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    Manoj Kumar

    2015-10-01

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

  12. Retroperitoneal abscess: an extra-abdominal manifestation.

    Science.gov (United States)

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

    2015-01-09

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

  13. Treatment of anal fistula and abscess.

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    Pigot, F

    2015-04-01

    The glands of Hermann and Desfosses, located in the thickness of the anal canal, drain into the canal at the dentate line. Infection of these anal glands is responsible for the formation of abscesses and/or fistulas. When this presents as an abscess, emergency drainage of the infected cavity is required. At the stage of fistula, treatment has two sometimes conflicting objectives: effective drainage and preservation of continence. These two opposing constraints explain the existence of two therapeutic concepts. On one hand the laying-open of the fistulous tract (fistulotomy) in one or several operative sessions remains the treatment of choice because of its high cure rates. On the other hand surgical closure with tract ligation or obturation with biological components preserves sphincter function but suffers from a higher failure rate.

  14. [Pelvic actinomycosis abscess and intrauterine device].

    Science.gov (United States)

    Ko-Kivok-Yun, P; Charasson, T; Halasz, A; Fournié, A

    1997-03-01

    A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

  15. 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.

  16. 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.

  17. Citrobocter kasori spinal epidural abscess: a rare occurrence.

    Science.gov (United States)

    Kumar, Ashok; Jain, Pramod; Singh, Pritish; Divthane, Rupam; Badole, C M

    2013-01-01

    Pyogenic spinal epidural abscess Is an uncommon Infectious occurrence. Clinical prospects of pyogenic spinal epidural abscess are graver if not promptly diagnosed and treated appropriately. A case of spinal epidural abscess has been presented with sinus tract formation at L4-L5 level, of pyogenic aetiology that progressed to paraplegia over the course of the disease. MRI pointed towards an epidural abscess extending from T12 vertebral level to S1 vertebral level. Surgical decompression in the form of laminectomy and evacuation of pus was done and antibiotics were given according to culture and sensitivity. Histopathological analysis revealed the acute suppurative nature of the abscess. Citrobacter kasori was isolated on pus culture. Pyogenic epidural abscess with causative organism being Citrobacter kasori has least been documented.

  18. Evidence-based Homoeopathy: A case of corneal abscess

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    Sandeep Sudhakar Sathye

    2016-01-01

    Full Text Available Corneal abscess is a circumscribed collection of pus within the layers of cornea. It is usually endogenous in origin and commonly found near the limbal blood vessels close to corneal margin. Treatment in modern medicine is use of local and systemic antibiotics. Homoeopathy has mentioned medicines for corneal abscess. A case reported was a female of 68 years of age suffering from symptoms of redness, dull pain, and foreign body sensation in the right eye and was diagnosed as corneal abscess. The homoeopathic medicine Hepar sulphuris 200C was prescribed on the basis of pathology. Abscess was reduced considerably within 5 days and it was absorbed completely in 21 days. No recurrence of abscess was observed thereafter. Ocular photographs during follow-up visits have provided documentary evidence about the effectiveness of homoeopathic Hepar sulphuris 200C in corneal abscess.

  19. Sonographic findings of coccygeal abscess in the neonates

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jun Gi; Kim, Ji Hye; Chun Seok; Lee, Young Seok; Kim, Hyung Sik; Kim, Sang Hi [Chungang Gil Hospital, Incheon (Korea, Republic of)

    1998-03-01

    The purpose of this study was to report the sonographic findings of neonatal coccygeal abscess, previously not described. Eighteen neonates (5-18 days old) presented with swelling in the coccygeal area and by either open drainage (n=13) or follow-up after antibiotic therapy (n=5), this was diagnosed as coccygeal abscess. We retrospectively reviewed the size, shape, location, echo pattern and marginal characteristics of the abscesses, as seen on sonography, as well as their intradural content and relationship with the spine. Additional MR images (n=5) were separately reviewed. Coccygeal abscesses were confined to the subcutaneous fat layer and were either isoor hypoechoic compared with surrounding fat. In neonates, abscess formation in the coccygeal area is possible and coccygeal abscess should therefore be included in the differentiation of coccygeal masses. (author). 7 refs., 3 figs.

  20. Intra-abdominal gout mimicking pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-01

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