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Sample records for retropharyngeal abscess secondary

  1. 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 ...

  2. 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.

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

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    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.

  4. Retropharyngeal Calcific Tendonitis Mimics a Retropharyngeal Abscess

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    Natasha Pollak

    2013-01-01

    Full Text Available Retropharyngeal calcific tendonitis (RCT is an uncommon, self-limiting condition that is often omitted in the differential diagnosis of a retropharyngeal fluid collection. This condition mimics a retropharyngeal abscess and should be considered when evaluating a fluid collection in the retropharyngeal space. Although calcific tendonitis at other sites has been well described in the medical literature, it appears that this entity has been underreported in the otolaryngology literature where only a few case reports have been identified. Presumably, the actual incidence is higher than the reported incidence, due to lack of familiarity with this disorder. As an otolaryngologist’s scope of practice includes the managements of retropharyngeal lesions, it is important for the otolaryngologist to recognize the presentation of acute RCT and be familiar with appropriate treatment strategies. Retropharyngeal calcific tendonitis presents with neck pain, limitation of neck range of motion and includes inflammation, calcifications, and a sterile effusion within the longus colli muscle. Treatment is medical with nonsteroidal anti-inflammatory medications. RCT does not require surgical treatment, and an accurate diagnosis can prevent unnecessary attempts at operative drainage. In this study, we discuss two cases of RCT, summarize the salient features in diagnosis, including key radiologic features, discuss treatment options, and review the literature.

  5. Cervical Epidural and Retropharyngeal Abscess Induced by a Chicken Bone

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    Wei-Ting Hsu

    2011-09-01

    Full Text Available Retropharyngeal abscess is occasionally seen in children, but is less common in adults where it usually occurs secondary to iatrogenic oropharynx trauma or a perforated foreign body in the oropharynx. Spinal epidural abscess in combination with a retropharyngeal abscess, which may cause rapid and irreversible neurological deterioration, is not often found, as indicated by the very few reports in the literature. Here we report a 52-year-old male with a clinical history of seizure and mental retardation since childhood who presented at our emergency room with severe sore throat of 1 day’s duration. A chicken bone was removed successfully. However, he complained of progressive dysphagia, sore throat and posterior neck pain during the following 5 days. Flexible fiber-laryngoscopy showed bulging of the retropharyngeal wall and a small ulcer at the right posterior pharyngeal wall. A neck computed tomography (CT scan showed a retropharyngeal abscess at the oropharynx and hypopharynx level. His symptoms showed partial improvement after the administration of intravenous antibiotics. However, 2 weeks later he developed high fever, posterior neck pain and flaccid tetra-paresia. Emergent neck CT scan revealed a mild retropharyngeal abscess and epidural abscess formation between the second and third cervical vertebrae. The patient’s family refused drainage of the pre-vertebral and epidural pus. After receiving 2 months of antibiotics, the patient regained the mobility of his limbs

  6. Retropharyngeal abscess with secondary osteomyelitis and epidural abscess: proposed pathophysiological mechanism of an underrecognized complication of unstable craniocervical injuries: case report.

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    Goulart, Carlos R; Mattei, Tobias A; Fiore, Mariano E; Thoman, William J; Mendel, Ehud

    2016-01-01

    Because of the proximity of the oropharynx (a naturally contaminated region) to the spinal structures of the craniocervical junction, it is possible that small mucosal lacerations in the oropharynx caused by unstable traumatic craniocervical injuries may become contaminated and lead to secondary infection and osteomyelitis. In this report, the authors describe the case of a previously healthy and immunocompetent patient who developed a large retropharyngeal abscess with spinal osteomyelitis after a high-energy craniocervical injury. This unusual report of osteomyelitis with a delayed presentation after a high-energy traumatic injury of the craniocervical junction highlights the possibility of direct injury to a specific area in the oropharyngeal mucosa adjacent to the osteoligamentous structures of the craniocervical junction, an overall underrecognized complication of unstable craniocervical injuries.

  7. 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.

  8. Multifocal Extensive Spinal Tuberculosis with Retropharyngeal Abscess

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    Farzana Shumy

    2011-09-01

    Full Text Available An unusual case of a young boy presenting with spinal tuberculosis involving cervical & thoracic vertebrae, along with retropharyngeal abscess is reported. The patient presented with progressive quadriparesis, fever, night sweat and cervical lymphadenopathy. The lab studies confirmed tuberculosis and patient received anti-tubercular chemotherapy. After development of quadriparesis, spinal surgery was done. The post operative course was uneventful and the patient is on gradual neurological recovery. DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8646 BSMMU J 2011; 4(2:128-130

  9. Retropharyngeal cold abscess without Pott's spine | Singh | South ...

    African Journals Online (AJOL)

    Retropharyngeal cold abscess without Pott's spine. ... pyogenic osteomyelitis, tube‚rculosis of the spine, or external injuries caused by endoscopes ... in an adult woman without tuberculosis of the cervical spine who was managed surgically by ...

  10. A case of retropharyngeal abscess with spondylitis causing tetraplegia

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    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.

  11. Late evolution retropharyngeal abscess after ingestion of foreign body

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    Imamura, Rui

    2009-09-01

    Full Text Available Introduction: The complications relating to the ingestion of foreign bodies, such as retropharyngeal abscess, are of low prevalence, but potentially severe. Objective: To present one case of late evolution retropharyngeal abscess after ingestion of foreign body. Case Report: Female patient presenting with dysphagia, pain upon cervical motion and sensation of foreign body in the pharynx, about one month after removal of foreign body from the level of the cricopharyngeal muscle. In spite of not having fever or leukocytosis, due to the slight difficulty for cervical move and loss of the laryngeal crepitation, simple radiography and computed tomography were carried out in the neck, which showed signs of retropharyngeal abscess. Surgical draining of the abscess and antibiotic therapy led to good evolution of the case and symptoms reversion. Conclusion: The retropharyngeal abscess may occur during several weeks after ingestion of a foreign body. The absence of fever and leukocytosis does not exclude the diagnosis even in immunocompetent patients. A high degree of suspicion leads to the performance of diagnostic exams and suitable procedures.

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

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    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.

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

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    Christine M. Clark

    2016-01-01

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

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

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

    2016-01-01

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

  15. Fish bone foreign body presenting with an acute fulminating retropharyngeal abscess in a resource-challenged center: a case report

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    Oyewole Ezekiel O

    2011-04-01

    Full Text Available Abstract Introduction A retropharyngeal abscess is a potentially life-threatening infection in the deep space of the neck, which can compromise the airway. Its management requires highly specialized care, including surgery and intensive care, to reduce mortality. This is the first case of a gas-forming abscess reported from this region, but not the first such report in the literature. Case presentation We present a case of a 16-month-old Yoruba baby girl with a gas-forming retropharyngeal abscess secondary to fish bone foreign body with laryngeal spasm that was managed in the recovery room. We highlight specific problems encountered in the management of this case in a resource-challenged center such as ours. Conclusion We describe an unusual presentation of a gas-forming organism causing a retropharyngeal abscess in a child. The patient's condition was treated despite the challenges of inadequate resources for its management. We recommend early recognition through adequate evaluation of any oropharyngeal injuries or infection and early referral to the specialist with prompt surgical intervention.

  16. A CROSS-SECTIONAL STUDY OF RETROPHARYNGEAL ABSCESS

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    Mitta

    2016-06-01

    Full Text Available For many ENT-clinicians, it is very difficult to diagnose the stage of infection and options available for treating retropharyngeal space abscesses (RPSAs with very limited literature available to focus on the treatment options in limited resource setup. The main cutting edge of the study aims to correlate post-surgical complications of RPSAs and also to know the age related incidence. MATERIALS AND METHODS A prospective and retrospective study was undertaken in the Department of ENT, Narayana Medical College & General Hospital, Nellore, Andhra Pradesh during the period of 2011-15. The incumbent laboratory parameters like throat swab culture was done for all the suspected patients along with Complete blood counts (CBC & X-ray neck. RESULTS A total sixty suspected paediatric patients were prospectively and retrospectively studied for the period of four years, out of which males 35 and females were 25 respectively. The mean age of the patient was 8.96±1.25 years (IQR 4-14 years median age was 10 years. Radiological examination and Computed tomography (CT scan was done for greater accuracy. Blocked airway is most common postsurgical intervention and it was found to be statistically significant (p<0.00 with respect to lower age group of the population. CONCLUSION The present study concludes that proper positioning and avoidance of unnecessary manipulation is essential for preventing the postoperative complications of RPSAs. The spread of infection to the spine can lead to replicate the osteomyelitis and vertebral erosion, which in turn results in subluxation and subsequent spinal cord injury, rupture of the abscess with inhalation of contents can lead to aspiration pneumonia (or rarely asphyxiation and spread of infection to mediastinum can lead to mediastinitis. More research could be intervened to prevent the infections at poor resource setup.

  17. 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 ...

  18. RETROPHARYNGEAL ABSCESS FROM FISHBONE IN ADULT IMMUNOCOMPETENT HOST PRESENTING AS ACUTE THYROIDITIS

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    Andrea Attard

    2015-04-01

    Full Text Available Retropharyngeal abscesses (RPA are rare in adults. We report a case of a healthy adult with RPA presenting with clinical symptoms of acute thyroiditis. A 37-yr-old female presented with a painful mass in the anterior region of the neck, sore throat, mild fever and dysphagy for liquids and solids. Neck emergency US disclosed normal thyroid ventrally displaced by a huge retropharyngeal hypoechoic mass. Direct laryngoscopy revealed erythema of the posterior pharyngeal wall with bulges (8 cm preventing the correct visualization of the glottic plane. CT confirmed the presence of retropharyngeal abscess and laryngoscopic drainage was performed. The patient was discharged on 11th post-operative day, in good condition. The high mortality rate of retropharyngeal abscess is related to its association with invasion of contiguous structures and mediastinum: once mediastinitis occurs, mortality reaches 50%, even with antibiotic therapy. CT is fundamental for the diagnosis, but in many cases, as our, ultrasonography of the neck may play a pivotal role as quickly as possible. Surgical treatment (intraoral incision and drainage is the better definitive and resolutive treatment. The clinical diagnosis of retropharyngeal abscess in adult can be difficult because of the lacking and non specificity of clinical presentation. It is recommended to collect accurate clinical history, careful examination of the head and neck and use of early ultrasound examination of the neck, which in real time can give precise indications to guide the diagnosis and therapy. The management of a retropharyngeal abscess depends on the patient’s clinical condition, moving from conservative treatment with steroids and antibiotics to reanimation and aggressive surgical drainage.

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

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    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. Atypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.

    LENUS (Irish Health Repository)

    Uzomefuna, Vincent

    2012-02-01

    Retropharyngeal abscesses (RPA) are uncommon but potentially lethal deep neck space infections, over 95% of which occur in children under six years of age. Without a high index of suspicion, early recognition and prompt intervention, catastrophic consequences can ensue, and mortality can be as high as 60% if jugular vein thrombosis or mediastinitis occurs. While older children may have specific complaints referable to the pharynx, infants and young children may present with vague symptoms. To date, a lot of emphasis continues to be placed on the importance of lateral soft tissue neck X-ray in the diagnosis and management of patients with suspected retropharyngeal abscesses; and lateral neck X-ray has been cited as the most useful radiological view of the laryngopharynx. While we recognise the role of lateral neck X-rays in retropharyngeal and other upper airway pathologies, we present three case series in which lateral neck X-rays were normal and diagnosis was made only after CT scanning. These three cases were unusual as the abscesses were located high in the naso-pharynx making them impossible to detect on the lateral soft tissue neck X-rays and this underscores the need for high index of suspicion and prompt CT or MRI scanning, in any child with symptoms or signs suggestive of a possible retropharyngeal abscess.

  1. Subdural empyema, retropharyngeal and parapharyngeal space abscess: Unusual complications of chronic otitis media

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    Erdevički Ljiljana

    2012-01-01

    Full Text Available Introduction. Otitic complications arise from expansion of the middle ear infection. Subdural empyema is a rare otitic complication, and both retropharyngeal and parapharyngeal abscesses have been described in just a few cases. Case report. A 30-year-old male was, admitted as an emergency case because of breathing difficulties, secretion from the ear, and fever. Clinical examination had shown a purulent, fetid secretion from the ear, swelling on the roof of epipharynx, left tonsil pushed medialy, immobile epiglottis, reduced breathing space. Computed tomography revealed thick hypodense content filling cavity, mastoid entering the posterior cranial fossa, descending down throw the parapharyngeal space to the mesopharynx. On the roof and posterior wall of the epipharynx hypodense collection was also present. Tracheotomy was conducted, and incision of the parapharyngeal and retropharyngeal abscess and radical tympanomastoidectomy were performed. The patient’s state deteriorated on the tenth postoperative day with hemiparesis and consciousness disorder. Magnetic resonance imaging was done. It showed subdural empyema of the left frontoparietal region and next to the falx, so craniotomy and abscess drainage were conducted. Conclusion. Parapharyngeal, retropharyngeal abscess and subdural empyema are rare otitic complications. Adequate antibiotic therapy and radical surgical treatment make possible an outcome with survival.

  2. Dual presentation of tuberculosis: Otitis media with retropharyngeal abscess - The first case report

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    Priyanka Gairola

    2016-01-01

    Full Text Available Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rarer. We have not come across any such case in the English literature of the dual presentation of tuberculosis to the best of our knowledge so far. Early diagnosis and prompt management are the key to reduce the disease burden and also to avoid life-threatening complications.

  3. Airway compromise during central venous cannulation in an undiagnosed tubercular retropharyngeal abscess: A case report

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    Sujay Samanta

    2015-01-01

    Full Text Available Central venous cannulation is often associated with complications during insertion even by expert′s hand and with the aid of ultrasound. We encountered a patient for central line insertion through the right internal jugular vein having a retropharyngeal abscess of tubercular origin. We accidentally punctured the abscess cavity leading to increased respiratory distress and subsequent need of intubation to the patient. This kind of complication during central line insertion has never been reported before. We intend to report such a case to alert everyone about the grave complications it can lead to and the methods to minimize them in the times ahead.

  4. Zygomatic haematoma in an 11-month-old helps diagnose retropharyngeal abscess, with concurrent tonsillitis and subsequent infant tonsillectomy.

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    Collis, David H; Sanu, Ameeth

    2016-09-20

    An 11-month-old boy presented with a 2-day history of non-specific symptoms and a zygomatic haematoma. With aetiology uncertain after admission clerking and blood tests, a CT head scan was arranged for suspected traumatic injury and revealed a retropharyngeal abscess (RPA) with significant airway narrowing in the transverse plane. The patient received urgent intraoral abscess drainage and bilateral tonsillectomy in theatre. This case highlights the need for a high index of suspicion regarding RPAs. These abscesses have potentially fatal sequelae and are difficult to diagnose in the infant paediatric population.

  5. Retropharyngeal Calcific Tendinitis Mimicking a Retropharyngeal Phlegmon

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    Nathalie Gabra

    2013-01-01

    Full Text Available Background. Acute retropharyngeal tendinitis is a little known but not an uncommon condition. It was first described by Hartley in 1964 as an inflammation of the longus colli muscle secondary to calcium crystals deposition on its insertion. The calcifications are mostly located on the oblique portion of the muscle at the level of C1-C2. Methods. We will describe this disease through 4 cases that presented in our institution. Results. The most common symptoms are severe neck pain, odynophagia, and a painful restriction of neck movement. It is associated with mild fever and inflammatory lab findings such as a slight elevation of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. CT scan is recommended as the first-line imaging modality to establish a diagnosis. Treatments consist of NSAIDs and analgesics to accelerate the healing process. If symptoms are severe, a course of corticosteroids is required. Conclusion. Since the clinical and laboratory findings of this condition and those of a retropharyngeal abscess overlap, it is important to establish the right diagnosis in order to prevent more invasive procedures. A good knowledge of this clinical entity by otolaryngologists would prevent delays in hospital discharge and unnecessary anxiety.

  6. [Eight cases of calcific retropharyngeal tendinitis/retropharyngeal calcific tendinitis].

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    Ohtsuka, Yuichiro; Chazono, Hideaki; Suzuki, Homare; Ohkuma, Yusuke; Sakurai, Toshioki; Hanazawa, Toyoyuki; Okamoto, Yoshitaka

    2013-11-01

    Calcific retropharyngeal tendinitis/retropharyngeal calcific tendinitis is an inflammation of the longus colli muscle caused by calcium hydroxyapatite crystal depositon in the longus colli muscle tendon. The three major symptoms are neck pain, limitations of neck movement, and swallowing pain. We treated 8 cases of calcific retropharyngeal tendinitis/ retropharyngeal calcific tendinitis. Each patient complained of neck pain, limitations of neck movement, and swallowing pain. The only local finding was the smooth swelling of the posterior pharyngeal wall. CT imaging showed calcification of the tendon of the longus colli muscle and a low density area in the retropharyngeal space without ring enhancement, suggesting a retropharyngeal abscess. MR imaging showed the smooth swelling of the retropharyngeal space and an increased signal intensity on T2-weighted MR imaging. Calcific retropharyngeal tendinitis heals spontaneously, and treatment is not usually required. However, the clinical outcomes are similar and can be confused with retropharyngeal abscess and pyogenic spondylitis, so antibiotics are administrated in many cases. In our report, 7 patients were hospitalized and were treated with the intravenous administration of antibiotics, while 1 patient who refused hospitalization was treated with an oral antibiotic. Steroids were administrated in 2 cases. The 7 patients who were hospitalized were cured within 6 to 10 days.

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

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

    1996-06-01

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

  8. Retropharyngeal hematoma secondary to whiplash injury in childhood: a case report.

    Science.gov (United States)

    Nurata, Hakan; Yilmaz, Muhammet Bahadır; Borcek, Alp Ozgun; Oner, Ali Yusuf; Baykaner, M Kemali

    2012-01-01

    Whiplash Associated Disorders (WAD) has been reported as an adult phenomenon. Whiplash injury has classically been described as a cervical soft tissue hyperextension- flexion injury after a trauma such as a rear end impact car crash, contact sport injuries, blows to the head from a falling object or a punch and shaken baby syndrome and is mostly seen in adults . It is important as it may cause severe disability due to spinal cord injury, decrease work productivity and even retropharyngeal hematoma resulting airway obstruction and mortality due to bleeding amongst deep cervical fascias. We describe a case of retropharyngeal hematoma after whiplash injury in a childhood.

  9. 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.

  10. Nnursing Care for One Child after Surgical Drainage of Retropharyngeal Abscess and Tracheotomy%1例巨大咽后壁脓肿切开引流合并气管切开患儿的护理

    Institute of Scientific and Technical Information of China (English)

    黄雀兰; 钟茜; 孟凡玲

    2014-01-01

    Objective:Summarizing experience of nursing care for child after surgical drainage of retropharyngeal abscess and tracheotomy. Method:Nursing care was focused on apostasis basic nurse,airway maintain,abscess drainage and nutrition support.Result:Condition of the child was controlled.Abscess drainage catheter was pulled out ofter 22 days,airway catheter was pulled out ofter 22 days and the child was discharged ofter 25 days. Conclusion:Nursing care is a very important aspect for retropharyngeal abscess treatment.%目的:总结1例巨大咽后壁脓肿切开引流合并气管切开患儿的护理经验。方法:密切监测病情变化,做好基础护理、气管切开和脓肿切开引流护理及营养支持。结果:患儿病情得到有效控制,住院20 d后拔除脓肿引流管,22 d后拔除气切导管,25 d后治愈出院。结论:采取有效的护理措施对咽后壁肿瘤的治疗是十分重要的。

  11. Tonsillar Cellulitis and Abscess

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    ... 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, ...

  12. Unusual liver abscess secondary to ingested foreign body: laparoscopic management

    Science.gov (United States)

    PANEBIANCO, A.; LOZITO, R.C.; PRESTERA, A.; IALONGO, P.; VOLPI, A.; CARBOTTA, G.; PALASCIANO, N.

    2015-01-01

    Liver abscess is a cause of febrile abdominal pain and usually the origin of a liver abscess is ascending cholangitis, hemathological diffusion, via the portal vein or the hepatic artery, or superinfection of necrotic tissue. Solitary pyogenic abscess with no obvious systemic cause may be secondary to a local event such as the migration of an ingested foreign body. We report the case of a solitary liver abscess caused by an ingested foreign body, a fish bone, migrated through the gastric wall into the left lobe. PMID:26017106

  13. Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery

    Directory of Open Access Journals (Sweden)

    Cristina G. Calogero

    2015-01-01

    Full Text Available Inferior thyroid artery (ITA rupture is rare and may progress to life-threatening conditions. We present a patient who visited the emergency department after an episode of syncope and dizziness in which he had a mechanical fall that resulted in abrasions and a hematoma to his left forehead. The patient presented with dysphagia and anterior neck swelling that progressed rapidly into airway compromise requiring endotracheal intubation. Emergent computed tomography revealed a large retropharyngeal hematoma, with active arterial extravasation that was thought to be arising from the thyrocervical trunk on the left. The hematoma measured approximately 6.7 cm transversely and 3.2 cm anteroposteriorly and extended from the level of the lower nasopharynx, down the neck into the retropharyngeal and danger space and into the mediastinum posterior to the esophagus, overall approximately 25 cm. The larynx was deviated anteriorly and there was esophageal compression. An emergent arteriogram and catheterization confirmed bleeding from branches of the ITA, and successful embolization was performed. It is important to recognize the ITA rupture as a potential etiology of an acute airway compromise. In emergent situations, while securing an airway is a priority, rapidly initiating diagnostic testing to confirm the diagnosis and arranging for arterial embolization can be life-saving.

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

    Science.gov (United States)

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

    2013-09-01

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

  15. [Acute cholangitis secondary to ascariasis and complicated by liver abscesses].

    Science.gov (United States)

    Rakotonaivo, A; Ranoharison, H D; Razarimahefa, S H; Rakotozafindrabe, R; Rabenjanahary, T H; Ramanampamonjy, R M

    2015-01-01

    Acute cholangitis secondary to ascariasis is rare and occurs mainly in areas of high endemicity. The clinical presentation is non-specific, sometimes complicated by liver abscess. Abdominal ultrasound plays an important role in diagnosis and therapeutic surveillance. We report the case of a 35-year-old Malagasy woman with an acute cholangitis secondary to ascariasis and complicated by liver abscesses and its course to full recovery under medical treatment.

  16. Acute retropharyngeal calcific tendinitis: a case report with unusual location of calcification

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Young; Jin, Wook; Yang, Dal Mo [East-West Neo-Medical Center, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea); Lee, Sang Hun [East-West Neo Medical Center, College of Medicine, Kyung Hee University, Department of Orthopedic Surgery, Seoul (Korea); Park, Ji Seon; Ryu, Kyung Nam [Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea)

    2010-08-15

    Retropharyngeal calcific tendinitis is an inflammatory process caused by calcium hydroxyapatite crystal deposition in the longus colli tendon of the prevertebral space, and it may mimic a retropharyngeal infection or abscess. The diagnosis of retropharyngeal calcific tendinitis will be made radiologically by the detection of calcifications anterior to C1-C3 and prevertebral soft tissue swelling. We present a case of acute retropharyngeal calcific tendinitis with an unusual location of calcification anterior to the C5-C6 disc. (orig.)

  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. A case of Bacteroides pyogenes bacteremia secondary to liver abscess.

    Science.gov (United States)

    Park, Jong Eun; Park, So-Young; Song, Dong Joon; Huh, Hee Jae; Ki, Chang-Seok; Peck, Kyong Ran; Lee, Nam Yong

    2016-12-01

    Bacteroides pyogenes, a non-spore-forming, anaerobic, gram-negative rod, is a component of the oral flora of animals and has, on occasion, been reported to cause human infection through dog or cat bites. We report the first case of B. pyogenes bacteremia secondary to liver abscess with no history of an animal bite. The microorganism was identified by 16S rRNA sequencing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Cerebellar peduncle abscess secondary to disseminated strangles in a six-week-old miniature foal

    Directory of Open Access Journals (Sweden)

    Brianne Henderson

    2011-11-01

    Full Text Available During a strangles outbreak within a herd of minature horses, a six week old foal developed acute onset clinical signs of sepsis and neurological deficits. The foal was euthanized and submitted for post-mortem at the Animal Health Laboratories, Guelph Ontario. Gross post-mortem examination noted severe bronchopneumonia, hypopyon of the right eye and a singular cerebellar peduncle abscess. Culture of the lungs and cerebellum produced a pure growth of Streptococcus equi ssp. equi. Streptococcus equi ssp. equi, the causative agent of equine strangles, produces an acute pyrexia, purulent lymphadenopathy of submandibular and retropharyngeal lymph nodes. Commonly, lymph node abscesses rupture and resolve without complication. Rarely, complications may include: dissemination of the bacteria with diffuse abscess formation, immune mediated disease (purpura haemorrhagica, rarely abscess formation within the central nervous system (CNS can occur. These can be managed medically with appropriate antibiotics and drugs to reduce intra-cranial pressure, however surgical drainage and debulking of the abscess has been attempted successfully in a few cases.

  20. Pyogenic liver abscess secondary to disseminated Streptococcus Anginosus from Sigmoid Diverticulitis

    Directory of Open Access Journals (Sweden)

    Shishir Murarka

    2011-01-01

    Full Text Available Pyogenic liver abscess secondary to dissemination from Sigmoid diverticulitis is rare. Streptococcus anginosus has been linked to abscesses but has been rarely reported from a Sigmoid diverticulitis source. We report a case of liver abscess in which the source was confounding but eventually was traced to Sigmoid diverticulitis on laparotomy.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Retropharyngeal calcific tendonitis: report of two cases.

    Science.gov (United States)

    Razon, Rhea Victoria B; Nasir, Asad; Wu, George S; Soliman, Manal; Trilling, Jeffrey

    2009-01-01

    Retropharyngeal calcific tendonitis is an inflammatory process of the superior oblique tendons of the longus colli muscle, a neck flexor in the upper cervical spine, caused by deposition of calcium hydroxyapatite crystals; the definitive diagnostic test is computed tomography (CT). Presented in this article are two cases seen at our institution. Patients typically present with acute onset of neck pain/spasm, odynophagia, dysphagia, and/or low grade fevers. Leukocytosis and elevated erythrocyte sedimentation rate may be noted. It is important to understand this entity because its signs and symptoms are mimickers of those of the more serious condition of retropharyngeal space abscess. Calcific tendonitis is managed conservatively whereas retropharyngeal abscess requires incision and drainage. Some may argue that this entity is a zebra because its reported incidence in the literature is low. However, most of these studies were done in an era when CT was not yet in vogue. With today's widespread use of CT and its superb ability to visualize the calcification, the true incidence of this condition is probably higher and, thus, it is important for the family practitioner to be aware of this entity. The astute clinician may save the patient from unnecessary diagnostic workup, undue anxiety, and delays in hospital discharge.

  3. 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 ...

  4. Retropharyngeal Tendinitis: Radiographic and Magnetic Resonance Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Gelineck, J.; Salomonsen, M.; Hviid, C. [Aarhus Univ. Hospital (Denmark). Dept. of Radiology

    2006-10-15

    Purpose: To describe the magnetic resonance imaging (MRI) findings in retropharyngeal tendinitis. Material and methods: Within 1 year, four patients presenting with symptoms of retropharyngeal tendinitis were examined by radiography and MRI. Results: On MRI and radiographs, all patients had characteristic soft-tissue swellings and calcifications related to the tendon of the longus colli muscle situated inferior to the anterior arc of C1. MRI showed well-defined edema, with high signal in the retropharyngeal tissue anterior to C1-C5 on short T1 inversion recovery (STIR) sequences, low signal on T1-weighted sequences, and low signal in the calcification on both sequences. In addition, three patients had high signal intensity changes on STIR sequences in the atlantoaxial joint situated posterior to the anterior arc of C1. Conclusion: MRI is a sensitive and accurate method in the diagnosis of retropharyngeal tendinitis. A new finding in this condition is an effusion or synovitis in the anterior atlantoaxial joint. MRI is a valuable tool in differentiating retropharyngeal tendinitis from other diagnoses such as retropharyngeal abscess, pyogenic spondylitis, and spondyloarthropathy.

  5. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Cantasdemir, M. E-mail: cantas1@yahoo.com; Kara, B.; Cebi, D.; Selcuk, N.D.; Numan, F

    2003-10-01

    AIM: To report our experience with computed tomography (CT)-guided percutaneous catheter drainage (PCD) of iliopsoas abscesses. MATERIALS AND METHODS: Twenty-two iliopsoas abscesses in 21 patients (11 women, 10 men) aged between 18 and 66 years (mean 36 years) were treated with PCD. Abdominal CT demonstrated the iliopsoas abscesses, which were definitively determined by Gram staining and aspirate cultures. Twenty of the 22 iliopsoas abscesses were primary and two were secondary. All PCD procedures were performed under local anaesthesia using a single-step trocar technique (n=19) or Seldinger technique (n=3). RESULTS: PCD was an effective treatment in 21 out of the 22 iliopsoas abscesses. Recurrence was seen in three abscesses as minimal residual collections. Two of them resolved spontaneously with anti-tuberculous regimen. One required percutaneous needle aspiration. The procedure failed in a diabetic patient with a secondary abscess, who died due to sepsis. The length of time that catheters remained in place ranged from 21 to 75 days (mean 59.7 days). Complications included catheter dislocation in four abscesses, which required removal of dislocated catheters and indwelling new ones. CONCLUSION: CT-guided PCD is a safe and effective front-line treatment of iliopsoas abscesses. Surgery should be reserved for failure of PCD and presence of contraindications to PCD.

  6. Renocolic Fistula Secondary to a Perinephric Abscess: A Late Complication of a Forgotten Double J Stent

    Science.gov (United States)

    Kim, Jeong Hyun

    2009-01-01

    Late complications of ureteral stents are frequent, and longer indwelling times are associated with an increased frequency of complications. Although there are reports of various complications of long-term indwelling ureteral stents, a renocolic fistula secondary to a perinephric abscess resulting from an indwelling ureteral stent has not been reported. Here, we present a fatal case of a renocolic fistula secondary to a perinephric abscess caused by an encrusted forgotten double J stent in a functionally solitary kidney. PMID:19795000

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

    Science.gov (United States)

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

    2001-08-01

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

  8. Incidence of retropharyngeal calcific tendinitis (longus colli tendinitis) in the general population.

    Science.gov (United States)

    Horowitz, Gilad; Ben-Ari, Oded; Brenner, Adi; Fliss, Dan M; Wasserzug, Oshri

    2013-06-01

    To determine the incidence of retropharyngeal calcific tendinitis (longus colli tendinitis) in a general urban adult population. Observational study in a municipal medical center. Single tertiary referral center. All symptomatic patients with a differential diagnosis of retropharyngeal calcific tendinitis underwent fiber-optic assessment, laboratory studies, and imaging studies. The main outcome measure was the incidence of retropharyngeal calcific tendinitis. Thirteen patients with symptoms suggestive of retropharyngeal calcific tendinitis were evaluated in our institution between January 2008 and December 2011. Final diagnosis was made by means of a computed tomographic scan: 8 patients had retropharyngeal calcific tendinitis, 1 had retropharyngeal abscess, and the remaining 4 had other deep neck infections. The mean annual crude retropharyngeal calcific tendinitis incidence was 0.50 cases per 100,000 person-years, and the standardized incidence was 1.31 for the age-matched population. Retropharyngeal calcific tendinitis is not a rare disease and is probably underdiagnosed because symptoms are nonspecific, treating physicians are often unfamiliar with this entity, and it is a self-limiting pathology.

  9. Retropharyngeal cellulitis complicated by cervical spondylodiscitis: A case report

    Directory of Open Access Journals (Sweden)

    Gülşen İskender

    2015-12-01

    Full Text Available Secondary to pharyngeal trauma such as endotracheal intubation, endoscopy and after foreign body ingestion, or removal may develop retropharyngeal cellulitis in adults. These infections occur mainly in children between 1 to 8 years of age with 75% of cases occurring before the age of 5 years. Retropharyngeal cellulitis is a serious deep space infection which can extend from neck to the mediastinum.Herein, we represent a case of 24-year-old female patient who presented with neck pain, odynophagia, and malaise two months after accidental ingestion of a little pin. Uncomplicated removal of this pin was followed by development of retropharyngeal cellulitis and cervical pondylodiscitis. The patient was successfully treated with intravenous and oral antibiotics for 12 weeks without need to surgical intervention.We believe that early and aggressive medical treatment can eradicate nonsuppurative complicated retropharyngeal infection without the need for surgery. J Microbiol Infect Dis 2015;5(4: 180-183

  10. 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.

  11. Early secondary suture versus healing by second intention of incisional abscesses

    DEFF Research Database (Denmark)

    Hermann, G G; Bagi, P; Christoffersen, I

    1988-01-01

    A controlled trial was set up to compare the treatment of wound abscesses, occurring after laparotomy, with either early secondary suture combined with cefuroxime and metronidazole given intravenously or by healing by second intention. The secondary suture was performed two days after wound...... drainage and resulted in a significant reduction (p less than 0.01) in healing time without complications. No reinfections occurred....

  12. Abscess of the cervical spine secondary to injection site infection in a heifer.

    Science.gov (United States)

    Braun, Ueli; Gerspach, Christian; Kühn, Karolin; Bünter, Julia; Hilbe, Monika

    2017-01-31

    Abscesses in the neck region can result from infection associated with injection of drugs into the neck muscles. To our knowledge, there have been no reports of osteomyelitis of the cervical vertebra and spinal cord compression secondary to an abscess in the neck. This case report describes the findings in a 9.5-month-old heifer with an abscess of the cervical spine secondary to injection site infection. The main clinical findings were swelling on the left side of the neck, proprioceptive deficits in all limbs and generalised ataxia. The ultrasonographic examination of the swelling showed an abscess. Radiographs showed a well-defined lytic lesion in 5th cervical vertebra (C5). Postmortem examination revealed an intramuscular encapsulated abscess on the left side of the neck at the level of C5. The abscess had invaded the vertebral canal and caused marked compression of the spinal cord. Injection technique is critical for the prevention of problems such as those described in this report. Sterile hypodermic needles must be used, and the volume of drug per injection site limited to 10-15 ml in young cattle.

  13. A Unique Case of Penile Necrotizing Fasciitis Secondary to Spontaneous Corpus Cavernosal Abscess

    Directory of Open Access Journals (Sweden)

    N. J. Dempster

    2013-01-01

    Full Text Available Corpus cavernosal abscess and necrotizing fasciitis occur rarely, and precipitating factors can usually be elicited with careful history and examination. Whilst both conditions share common risk factors such as diabetes mellitus, this is the first reported case of penile necrotizing fasciitis secondary to spontaneous corpus cavernosal abscess in an otherwise healthy patient. A 32-year-old man presented with 4-day history of swollen, painful penis, with ultrasound confirming corpus cavernosal abscess. Biopsies were taken and the cavity aspirated, but, despite intravenous antibiotics, he developed penile necrotizing fasciitis necessitating open cavernostomy and debridement. The overlying skin defect healed by secondary intention, but the patient experienced persistent postoperative erectile dysfunction, so he was referred for penile prosthesis insertion.

  14. Pancreatic and Colonic Abscess Formation Secondary to HELLP Syndrome

    Directory of Open Access Journals (Sweden)

    James M. O’Brien

    2015-01-01

    Full Text Available Preeclampsia and the variant HELLP syndrome are systemic conditions associated with vascular changes resulting in vasoconstriction. Most commonly, patients present with elevated blood pressure and proteinuria, with a background of complaints such as headache, scotoma, and right upper quadrant pain. The systemic vascular changes experienced can target any organ system, oftentimes with more than one organ system being involved. We present the case of a patient admitted with HELLP syndrome who subsequently developed multisystem organ dysfunction, including placental abruption, disseminated intravascular coagulopathy, acute renal failure, colitis, abdominal ascites, pancreatitis, and the development of pancreatic and colonic abscesses.

  15. Diagnosis of anterior cervical spinal epidural abscess by US and MRI in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Gudinchet, F.; Chapuis, L. (University Hospital, Lausanne (Switzerland). Dept. of Radiology); Berger, D. (University Hospital, Lausanne (Switzerland). Dept. of Pediatric Surgery)

    1991-11-01

    A 10-day-old girl who initially presented with fever developed over five days a complete paresis of both upper arms and swallowing difficulty. After emergency drainage of a retropharyngeal abscess, cervical US demonstrated a cervical anterior epidural mass compressing the cord. MRI confirmed the diagnosis of spinal epidural abscess secondary to C4-C5 spondylodiscitis. Surgical removal of the abscess was followed by complete disappearance of the neurologic symptoms after six months of follow-up. This is the first case of spinal epidural abscess in a newborn to be diagnosed by US and MRI preoperatively. The advantages of these non-invasive imaging modalities are discussed, and compared to myelography. (orig.).

  16. Multiple hepatic abscesses due to Yersinia enterocolitica infection secondary to primary haemochromatosis

    DEFF Research Database (Denmark)

    Bergmann, T K; Vinding, K; Hey, H

    2001-01-01

    A case of hepatic abscesses due to Yersinia enterocolitica in an immunocompetent male is presented. Re-examination after 3 months showed that the patient had primary haemochromatosis. Treatment with repeated phlebotomies was instituted. Two years after the patient was first admitted to hospital. 17...... showed that prior to this case only 45 cases of hepatic abscess secondary to Yersinia enterocolitica have been registered. Of the 45 reported cases, 64% had underlying haemochromatosis and 29% had diabetes mellitus. The overall mortality was 31%. Mortality before 1987 was 60% (n = 20) and since 1987...

  17. A case of calcific retropharyngeal tendinitis: the significance of an early diagnosis.

    Science.gov (United States)

    Terao, Kyoichi; Kusunoki, Takeshi; Mori, Kazunori; Murata, Kiyotaka; Doi, Katsumi

    2013-02-01

    The clinical presentation of calcific retropharyngeal tendinitis, a rare entity, can mimic more serious disorders. We describe the case of a 35-year-old man who was referred to us for evaluation of a suspected retropharyngeal abscess. At presentation, the patient reported severe cervical pain and stiffness. He exhibited mild fever, torticollis, and a moderately elevated white blood count; no swelling of the retropharyngeal wall was observed. Based on the results of plain radiography and computed tomography (CT), we diagnosed the patient with calcific retropharyngeal tendinitis. He was treated with a 7-day course of a nonsteroidal anti-inflammatory drug and a 3-day course of a steroid, and he recovered well. We suggest that the true incidence of calcific retropharyngeal tendinitis is actually higher than what is generally believed because this diagnosis is frequently missed. Contrast-enhanced CT can aid in diagnosing calcific retropharyngeal tendinitis. CT should be performed in patients who present with nonspecific symptoms such as severe neck pain, sore throat, odynophagia, and mild fever.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ahmed AR Mohamad Al Ani

    2015-01-01

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

  20. Skin abscess

    Science.gov (United States)

    Abscess - skin; Cutaneous abscess; Subcutaneous abscess; MRSA - abscess; Staph infection - abscess ... Skin abscesses are common and affect people of all ages. They occur when an infection causes pus ...

  1. Secondary Healing versus Delayed Excision and Direct Closure after Incision and Drainage of Acute Pilonidal Abscess: A Controlled Randomized Trial

    Directory of Open Access Journals (Sweden)

    Mahmoud F. Sakr

    2012-02-01

    Conclusions: Although there is more rapid healing and fewer visits for dressing with I and D and DE/DC of an acute pilonidal abscess, this is accompanied by a significantly higher overall complication rate than with I and D and secondary healing. Recurrence of an acute abscess or development of a chronic pilonidal sinus is similar with both procedures. [Arch Clin Exp Surg 2012; 1(1.000: 8-13

  2. Calcific retropharyngeal tendinitis. [Radiological findings

    Energy Technology Data Exchange (ETDEWEB)

    Karasick, D.; Karasick, S.

    1981-12-01

    Calcific retropharyngeal tendinitis is an imflammation of the longus colli muscle tendon which is located on the anterior surface of the verterbral column extending from the atlas to the third thoracic vertebra. The acute inflammatory condition is selflimiting with symptoms consisting of a gradually increasing neck pain often associated with throat pain and difficulty swallowing. The pain is aggravated by head and neck movement. Clinically the condition can be confused with retropharyngeal absecess, meningitis, infectious spondylitis, and post-traumatic muscle spasm. The radiographic features of this condition consist of pre-vertebral soft tissue swelling from C1 to C4 and amorphous calcific density in the longus colli tendon anterior to the body of C2 and inferior to the anterior arch of C1.

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

    Science.gov (United States)

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

    1998-01-01

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

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

    Science.gov (United States)

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

    2010-08-01

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

  5. Traditional Chinese surgical treatment for anal fistulae with secondary tracks and abscess

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; Jin-Gen Lu; Yong-Qing Cao; Yi-Bo Yao; Xiu-Tian Guo; Hao-Qiang Yin

    2012-01-01

    AIM:To evaluate the efficacy and safety of traditional Chinese surgical treatment for anal fistulae with secondary tracks and abscess.METHODS:Sixty patients with intersphincteric or transsphincteric anal fistulas with secondary tracks and abscess were randomly divided into study group [suture dragging combined with pad compression (SDPC)] and control group [fistulotomy (FSLT)].In the SDPC group,the internal opening was excised and incisions at external openings were made for drainage.Silk sutures were put through every two incisions and knotted in loose state.The suture dragging process started from the first day after surgery and the pad compression process started when all sutures were removed as wound tissue became fresh and without discharge.In the FSLT group,the internal opening and all tracts were laid open and cleaned by normal saline postoperatively till all wounds healed.The time of healing,postoperative pain score (visual analogue scale),recurrence rate,patient satisfaction,incontinence evaluation and anorectal manometry before and after the treatment were examined.RESULTS:There were no significant differences between the two groups regarding age,gender and fistulae type.The time of healing was significantly shorter (24.33 d in SDPC vs 31.57 d in FSLT,P < 0.01) and the patient satisfaction score at 1 mo postoperative follow-up was significantly higher in the SDPC group (4.07 in SDPC vs 3.37 in FSLT,P < 0.05).The mean maximal postoperative pain scores were 5.83 ± 2.5 in SDPC vs 6.37 ± 2.33 in FSLT and the recurrence rates were 3.33 in SDPC vs 0 in FSLT.None of the patients in the two groups experienced liquid and solid fecal incontinence and lifestyle alteration postoperatively.The Wexner score after treatment of intersphincter fistulae were 0.17 ± 0.41 in SDPC vs 0.40 ± 0.89 in FSLT and transsphincter fistulae were 0.13 ± 0.45 in SDPC vs 0.56 ±1.35 in FSLT.The maximal squeeze pressure and resting pressure declined after treatment in both groups

  6. Penile abscess and necrotizing fasciitis secondary to neglected false penile fracture

    Directory of Open Access Journals (Sweden)

    Al-Reshaid Reshaid

    2010-01-01

    Full Text Available Penile infection and abscess formation have been described in association with priapism, cavernosography, intracavernosal injection therapy, trauma and penile prosthesis. We report a case of penile abscess and necrotizing fasciitis of penile skin in a 37-year-old male, presented 3 weeks after neglected false penile fracture.

  7. Early Pregnancy Loss Following Laparoscopic Management of Ovarian Abscess Secondary to Oocyte Retrieval

    Directory of Open Access Journals (Sweden)

    Emre Goksan Pabuccu

    2014-11-01

    Full Text Available Severe pelvic infections following ultrasound-guided transvaginal oocyte retrieval (TVOR are rare but challenging. Ovarian abscess formation is one of the consequences and management of such cases as highly debated in pregnant patients. In this case report, an early fetal loss following laparoscopic management of ovarian abscess is described and possible etiologies are discussed.

  8. 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.

  9. Rare Intensely Fluorine-18-fluorodeoxyglucose Avid Large Retropharyngeal Goiter in a Patient with Invasive Breast Carcinoma

    Directory of Open Access Journals (Sweden)

    Bina Kviatkovsky

    2016-01-01

    Full Text Available Diffuse increased fluorine-18-fluorodeoxyglucose ( 18 F-FDG avidity on positron emission tomography (PET scans has been demonstrated in patients with chronic thyroiditis, likely secondary to increased inflammatory cell glucose uptake. A complex association has been demonstrated between breast cancer and thyroid disease, although the mechanism remains elusive. Development of chronic thyroiditis and/or goiter in breast cancer patients has been suggested to convey a more favorable prognosis. Goiter extension is almost exclusively into retrosternal space, with only a handful of cases reported with superior extension into retropharyngeal space. We present a rare case of a diffusely enlarged goiter extending superior and posterior into the retropharyngeal space with an associated intense 18 F-FDG avidity standardized uptake value maximum (SUV max of 16.1 in a patient with invasive ductal breast cancer. To our knowledge, this represents the first published case of diffusely 18 F-FDG avid goiter with retropharyngeal extension.

  10. Peritonitis secondary to ruptured splenic abscess: a grave complication of typhoid fever.

    Science.gov (United States)

    George, Peter; Ahmed, Ashfaq; Maroli, Roshan; Tauro, Leo Francis

    2012-12-01

    Splenic abscesses are increasingly being identified, possibly due to widespread use of imaging modalities in clinical practice. The commonest clinical features are high grade fever and exclusively localised left upper quadrant abdominal pain. These symptoms are similar to most infectious diseases prevalent in the tropics, making imaging by ultrasonography or computer tomography a necessity in the diagnosis. There are reports from different geographic areas on splenic abscesses associated with typhoid fever. We reported ruptured splenic abscess presenting with peritonitis as a rare and grave complication of typhoid fever.

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

    Science.gov (United States)

    Gundara, Justin S.; Harrison, Richard

    2010-01-01

    A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases. PMID:21113288

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

    Directory of Open Access Journals (Sweden)

    Justin S. Gundara

    2010-01-01

    Full Text Available A liver abscess may arise following any insult to gut integrity allowing portal drainage of bacteria to hepatocytes. Foreign bodies such as bones, toothpicks and items of stationery have previously been implicated in compromising gut epithelium. Here we present the case of a 57 year old man suffering from a left liver abscess. This was defined on CT which incidentally also identified a chicken bone protruding through the wall of the distal sigmoid colon. Whilst unwell with upper abdominal pain and sepsis, the presumed source of portal sepsis within the colon remained asymptomatic throughout. Following percutaneous drainage, the liver abscess resolved but the chicken bone had not passed at two months, necessitating atraumatic removal at colonoscopy. A high rate of incidental diagnoses suggests that unidentified foreign bodies may be vastly under recognised in cases of hepatic sepsis. Thus, identification of the precise mechanism of the liver insult demands thorough consideration; foreign body should be considered in all cases.

  13. A rare cause of liver abscess secondary to hydatid cyst: pseudomonas stutzeri

    Directory of Open Access Journals (Sweden)

    Bulent Durdu

    2016-03-01

    Full Text Available Pseudomonas stutzeri is non-fermentative gram negative bacteria which rarely leads to infections. In this report, we presented for the first time a liver abscess which was caused by P. stutzeri. [Cukurova Med J 2016; 41(0.100: 17-19

  14. Retropharyngeal spindle cell/plemorphic lipoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Kyung; Hwang, Seung Bae; Chung, Gyung Ho; Hong, Ki Hwang; Jang, Kyu Yun [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2013-06-15

    Spindle cell/pleomorphic lipoma is an uncommon benign adipose tissue tumor most frequently arising from the subcutaneous tissue of the back, shoulder, head and neck, and extremities. The deep cervical spaces are the rarely affected locations. Herein we report on the imaging findings of spindle cell/pleomorphic lipoma involving the retropharyngeal space in an elderly woman.

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

    Directory of Open Access Journals (Sweden)

    Hui Liang

    2011-12-01

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

  16. Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hun; Joo, Kyung Bin; Lee, Kyu Hoon; Uhm, Wan Sik [Hanyang University Hospital, Seoul (Korea, Republic of)

    2011-08-15

    Retropharyngeal calcific tendinitis is defined as inflammation of the longus colli muscle and is caused by the deposition of calcium hydroxyapatite crystals, which usually involves the superior oblique fibers of the longus colli muscle from C1-3. Diagnosis is usually made by detecting amorphous calcification and prevertebral soft tissue swelling on radiograph, CT or MRI. In this report, we introduce a case of this disease which was misdiagnosed as a retropharyngeal tuberculous abscess, or a muscle strain of the ongus colli muscle. No calcifications were visible along the vertical fibers of the longus colli muscle. The lesion was located anterior to the C4-5 disc, in a rheumatoid arthritis patient with atlantoaxial subluxation. Calcific tendinitis of the longus colli muscle at this location in a rheumatoid arthritis patient has not been reported in the English literature.

  17. Magnetic resonance imaging in retropharyngeal tendinitis

    Energy Technology Data Exchange (ETDEWEB)

    Ekbon, K.; Annell, K.; Traeff, J.; Torhall, J. (Soeder Hospital, Stockholm (Sweden))

    1994-08-01

    Seven consecutive patients with acute retropharyngeal tendinitis underwent plain X-ray and magnetic resonance imaging (MRI) of the cervical spine. All seven had marked soft tissue swelling anterior to C1 and C2 on plain X-ray, and soft tissue calcification at this level was present in five of them. On MRI, there was markedly increased signal intensity on T[sub 2]-weighted images in the acute phase and intermediate signal intensity on T[sub 1]-weighted images, anterior to the level of CI and C2, often extending as far down as C6. These changes correlated well with the soft tissue swelling seen on conventional X-ray of the cervical spine. The maximum mid-sagittal thickness of the soft issues was significantly greater in the tendinitis patients than in 12 control subjects free of symptoms from the pharynx or the cervical spine. Treatment with non-steroidal anti-inflammatory drugs rapidly alleviated symptoms, and at follow-up MRI showed regression or complete restitution of the changes. In conclusion, MRI can visualize the edematous changes in the longus colli muscle and adds useful diagnostic information in suspected cases of acute retropharyngeal tendinitis. 9 refs., 4 figs., 3 tabs.

  18. 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 ...

  19. [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).

  20. Retropharyngeal thymus and parathyroid gland: a case report.

    Science.gov (United States)

    Schramm, Jordan C; Perry, Deborah A; Sewell, Ryan K

    2014-01-01

    Cervical ectopic thymus occurs when thymic tissue arrests during its embryologic descent through the neck to the upper mediastinum. Most often it presents as an asymptomatic neck mass. Rarely does it present with airway compromise, particularly in neonates. A neonate presented with a retropharyngeal mass causing dynamic upper airway obstruction, mimicking a venolymphatic malformation. Ultimately this proved to be aberrant ectopic thymus with an associated parathyroid gland. While there have been isolated reports of thymus or parathyroid in the retropharyngeal space, none of the prior reports found both within the same patient. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. 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 ...

  2. 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) ...

  3. 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

  4. 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- ...

  5. 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 ...

  6. Orbital abscess secondary to acute dacryocystitis: case report Abscesso orbitário secundário à dacriocistite aguda: relato de caso

    Directory of Open Access Journals (Sweden)

    Marcia Clivati Martins

    2008-08-01

    Full Text Available Acute dacryocystitis usually induces preseptal infection. In rare instances the infection that is confined to the lacrimal sac can extend to the orbital contents resulting in orbital cellulitis. We present a case of intraconal abscess secondary to acute dacryocystitis and review the literature of orbital cellulitis resulting from acute lacrimal sac infection.A dacriocistite aguda comumente evolui para infecção pré-septal. Raramente a infecção localizada no saco lacrimal pode estender-se ao conteúdo orbitário resultando em celulite orbitária. Apresentamos um caso de abscesso orbitário intraconal secundário à dacriocistite aguda e uma revisão de literatura de celulite orbitária causada por infecção aguda do saco lacrimal.

  7. Difficult Airway due to Retropharyngeal Hematoma after Stabbing to the Neck

    Directory of Open Access Journals (Sweden)

    Kouhei Iwashita

    2014-07-01

    Full Text Available Reports of retropharyngeal hematoma have been scarce in the anesthesiology literature. We report a patient whose trachea was difficult to intubate due to retropharyngeal hematoma after stabbing to the neck. A woman with a knife injury to the common carotid artery required emergency carotid arterioplasty. When tracheal intubation was attempted, marked swelling of the posterior pharyngeal wall made the vocal cords impossible to visualize. Preoperative computed tomography showed a retropharyngeal hematoma. The patient required mechanical ventilation for 2 days.

  8. 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....

  9. 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.

  10. Retropharyngeal tendinitis may be more common than we think: a report on 45 cases seen in Danish chiropractic clinics

    DEFF Research Database (Denmark)

    Hviid, Carsten; Salomonsen, Mette; Gelineck, John;

    2009-01-01

    This study presents information from 45 cases of retropharyngeal tendinitis that were collected in Danish chiropractic clinics.......This study presents information from 45 cases of retropharyngeal tendinitis that were collected in Danish chiropractic clinics....

  11. CT Analysis of Retropharyngeal Abnormality in Kawasaki Disease

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Kyung Min; Lee, Sun Wha; Yoo, Heong Hyun [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2011-11-15

    To retrospectively compare the imaging characteristics of retropharyngeal density and associated findings for Kawasaki disease with those for non-Kawasaki disease, and identify the distinguishing features which aid the CT diagnosis of Kawasaki disease with retropharyngeal low density. Among the enhanced neck CT performed in children less than 8-years old with clinical presentation of fever and cervical lymphadenopathy over a 6-year period, only cases with retropharyngeal low density (RLD) were included in this study. The 56 cases of RLD were divided into two groups; group A included cases diagnosed as Kawasaki disease (n = 34) and group B included cases diagnosed as non-Kawasaki disease (n = 22). We evaluated the CT features including the thickness of RLD and its extent into the deep neck spaces, as well as soft tissue change in the adjacent structure. We also scored the extent of RLD into the deep neck spaces and the soft tissue changes in the adjacent structure. The thickness of RLD was greater in group A than in group B (group A, 6.0 {+-} 2.1; group B, 4.6 {+-} 1.5, p = 0.01). The score of the RLD extent into the deep neck spaces was significantly greater in group A than in group B (group A, 2.3 {+-} 1.3; group B, 0.8 {+-} 1.0, p < 0.01). Also, the score of the adjacent soft tissue changes was greater in group A than in group B (group A, 2.0 {+-} 1.1; group B, 1.0 {+-} 1.0, p < 0.01). If children present with fever and cervical lymphadenopathy that display retropharyngeal low density with extension into more deep neck spaces as well as changes in more adjacent soft tissue, the possibility of Kawasaki disease should be considered.

  12. Breast Abscess: A Brief Communication

    Directory of Open Access Journals (Sweden)

    Pradipta Das

    2017-07-01

    Full Text Available Breast infections commonly affect women aged between 18 and 50 years and are categorized as lactational and non-lactational infections. The infection can affect the skin overlying the breast when it can be a primary event or, it may occur secondary to mastitis and/or, secondary to a lesion in the skin. The commoner clinical findings consist of a tender, hard breast mass with erythema of the overlying skin. Needle aspiration yields pus cultures of which yield the infecting microorganisms. In practice, treatment is usually empiric consisting of bed rest, frequent nursing, fluids, Acetaminophen for pain and fever and a course of antibiotics. The other common line of treatment for breast abscess consists of incision and drainage with primary and/or, secondary closure. This brief communication on breast abscess gives an overview of the possible etiologies, clinical signs and symptoms and the treatment lines for breast abscess.

  13. Foreign body ingestion: rare cause of cervical abscess.

    Science.gov (United States)

    Costa, Liliana; Larangeiro, João; Pinto Moura, Carla; Santos, Margarida

    2014-01-01

    Foreign body ingestion is a frequent emergency occurrence. Serious complications, although rare, include pharyngooesophageal perforation, aorto-oesophageal fistula and deep neck infection. A retrospective review was performed of all cases of foreign body ingestion requiring hospitalization between 1989 and 2011, in a tertiary Hospital. Cases complicated by deep cervical abscess were selected and their clinical presentation, results of diagnostic exams, therapeutics and clinical evolution are presented. Among a total of 1679 cases, 319 were related to pediatric patients and 1360 to adults. Two cases were reported (0.12%): an adult, 41 years-old, with parapharyngeal abscess subsequent to fishbone ingestion, and a child, 13 months-old, with retropharyngeal abscess consequent to chicken bone ingestion. Complications appeared three and four days after foreign body removal, respectively. In both situations cervical computerized tomography scan with contrast and surgical drainage were accomplished; the child was also submitted to rigid esophagoscopy for residual foreign body removal and closure of the associated pharyngeal laceration. Deep cervical abscesses are an uncommon but possible complication of foreign body ingestion and constitute a diagnostic challenge, particularly in children. Previous oesophageal manipulation by flexible endoscopy may be considered a risk factor for such complication. Imagiological studies proved to be crucial for diagnosis and therapeutic planning. Although a rare complication, given a recent history of foreign body ingestion/removal and the presence of compatible symptoms, cervical abscesses should be taken into account, highlighting their potential morbimortality in the absence of an appropriate therapeutic approach.

  14. Ruptured liver abscess in a neonate

    Directory of Open Access Journals (Sweden)

    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.

  15. [Primary psoas abscess in a young healthy male

    DEFF Research Database (Denmark)

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

    2008-01-01

    A young male saw his general practitioner because of lower back pain, limpness, nightly sweating, subfebrilia, and weight loss. Further diagnostics showed that he had a primary psoas abscess. Psoas abscesses are categorized as primary and secondary. Primary psoas abscess is a rare disease in Europe...

  16. Edema in the retropharyngeal space associated with head and neck tumors: CT imaging characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Kurihara, Noriko; Nakamura, Mamoru; Tsuda, Masashi; Saito, Haruo [National Hospital Organization Sendai Medical Center, Department of Radiology, Sendai, Miyagi (Japan); Takahashi, Shoki; Higano, Shuichi [Tohoku University, Department of Diagnostic Radiology, Sendai, Miyagi (Japan)

    2005-08-01

    To determine computed tomographic (CT) imaging characteristics of retropharygeal edema, we reviewed CT images in 18 patients with head and neck tumors. Retropharyngeal edema spread craniocaudally between soft palate and upper half of thyroid cartilage in all patients. No edema fluid extended above soft palate and below thyroid cartilage. Horizontally, it spread symmetrically in ten and asymmetrically in eight patients. Predominance in asymmetrical retropharyngeal edema was found on the same side as that of unilateral predominance both in lymph nodes enlargement and jugular vein stenosis/occlusion. All patients had edema also in other cervical spaces. Edema of retropharyngeal and other spaces fluctuated synchronously. In 14 patients, as primary lesion and/or cervical lymph nodes regressed, retropharyngeal edema disappeared or decreased. Retropharyngeal edema had some imaging characteristics. With knowledge of that, we could avoid diagnostic confusion when evaluating head and neck CT images. (orig.)

  17. 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 ...

  18. 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 ...

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Severe upper airway obstruction due to delayed retropharyngeal hematoma formation following blunt cervical trauma

    Directory of Open Access Journals (Sweden)

    Ciceri David P

    2007-03-01

    Full Text Available Abstract Background We report a case of severe upper airway obstruction due to a retropharyngeal hematoma that presented nearly one day after a precipitating traumatic injury. Retropharyngeal hematomas are rare, but may cause life-threatening airway compromise. Case presentation A 50 year-old man developed severe dyspnea with oropharyngeal airway compression due to retropharyngeal hematoma 20 hours after presenting to the emergency department. The patient also had a fractured first cervical vertebra and was diagnosed with a left brachial plexopathy. The patient underwent emergent awake fiberoptic endotracheal intubation to provide a definitive airway. Conclusion Retropharyngeal hematoma with life-threatening airway compromise can develop hours or days after a precipitating injury. Clinicians should be alert to the potential for this delayed airway collapse, and should also be prepared to rapidly secure the airway in this patient population likely to have concomitant cervical spinal or head injuries.

  4. Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome

    OpenAIRE

    2016-01-01

    Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendiniti...

  5. 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.

  6. 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 ...

  7. 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 ...

  8. 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.

  9. [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.

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-01-01

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

  12. 新生儿继发于筛窦炎的眼眶脓肿%Orbital abscess secondary to ethmoidal sinusitis in neonates

    Institute of Scientific and Technical Information of China (English)

    C D Che Mahiran; K Wan Mariny; J Alagaratnam; W H Wan Hazabbah

    2008-01-01

    A subperiosteal abscess is a form of orbital cellulitis characterized by a collection of fluid and pus confined by the periosteal lining of the orbit. In neonates, orbital abscesses are extremely rare. We present a case of a 26-day-old baby girl with severe orbital cellulitis in the right eye. A computed tomography (CT) scan of the orbits and paranasal sinuses revealed right orbital cellulitis with medial subperiosteal and retro-orbital abscess. The growth of Staphylococcus aureus was found in eye discharges. The patient was started on intravenous ceftriaxone and intravenous metronidazole. Urgent drainage of the abscess was performed via functional endoscopic sinus surgery (FESS). She recovered well after intravenous antibiotics and surgical drainage. Surgical drainage via endoscopic technique is the preferred treatment to prevent further complications.%骨膜下脓肿是眼眶蜂窝织炎的一种,以脓和渗出液汇集在眼眶内骨膜下为特点.对于新生儿,眼眶脓肿非常罕见.我们报告1例年龄为26d的右眼患有严重眼眶蜂窝织炎的女患儿.眼眶和副鼻窦CT扫描显示右眼眶蜂窝织炎并内侧骨膜下和眼眶后部脓肿.眼分泌物培养见葡萄球菌生长,经用先锋霉素和甲硝唑静脉注射和经内窥镜鼻窦手术行急诊脓肿引流,恢复良好.通过内窥镜的鼻窦引流手术是预防更严重的并发症的首选治疗.

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

    Science.gov (United States)

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

    2004-09-01

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

  14. Ganglioneuroma of the retropharyngeal space in a patient with glottic cancer.

    Science.gov (United States)

    Dias, Raquel Baptista; Rosa, Duarte; Rito, Miguel; Borges, Alexandra

    2017-09-07

    We describe the case of a 71-year-old man with a ganglioneuroma of the retropharyngeal space. The patient presented with a submucosal bulge of the left oropharyngeal wall during follow-up examination of a treated vocal cord carcinoma. CT and MRI revealed a non-specific, well-defined retropharyngeal soft tissue lesion. Positron emission tomography-CT did not show relevant metabolic activity, excluding the hypothesis of metastatic nodal disease. Surgical biopsy of the lesion was compatible with ganglioneuroma. Ganglioneuromas are well-differentiated tumours composed of mature sympathetic ganglion cells that account for approximately 1% of spinal and paraspinal tumours. Peripherally, ganglioneuromas are predominantly found in the posterior mediastinum and retroperitoneal space. Only nine ganglioneuromas of the retropharyngeal space have been reported in the English literature since the early 1980s. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Internal Carotid Artery Ectasia: The Value of Imaging Studies Prior to Biopsy of a Retropharyngeal Mass

    Directory of Open Access Journals (Sweden)

    Kenneth Chan

    2010-11-01

    Full Text Available The presence of retropharyngeal tissue mass often raises the suspicion of malignancy, especially in elderly patients. This prompts urgent biopsy to investigate tissue histology. We discuss a case where this is contraindicated as the retropharyngeal mass was illustrated by CT scanning and confirmed with MRI to be a tortuous coursing internal carotid artery. An awareness of this unusual anatomical variation and a careful interpretation of imaging studies both at the stage of differential diagnosis and pre-operative screening are essential to avoid damage to important structures, causing unnecessary complications.

  17. Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome.

    Science.gov (United States)

    Oh, Ji Youn; Lim, Jin Hun; Kim, Yong Seok; Kwon, Young Eun; Yu, Jae Yong; Lee, Jun Hak

    2016-01-01

    Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.

  18. A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management

    Directory of Open Access Journals (Sweden)

    Birkholz Torsten

    2010-01-01

    Full Text Available A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation.

  19. A REVIEW OF PSOAS ABSCESS

    African Journals Online (AJOL)

    The triad of presentation; fever, loin pain ... The main stay of treatment is medical and or surgical drainage of abscess and .... parent. Clinically, psoas' abscess must be differentiated from renal abscess, ruptured .... Child Health 1995; 31:.

  20. Intraoperative hypotension associated with massive deep space neck abscesses in a 9-month old: A case report.

    Science.gov (United States)

    Plum, Ann; Sobin, Lindsay; Tatum, Sherard

    2016-04-01

    The neck is divided into multiple compartments by cervical fasciae. The deep space compartments, which all have a potential for becoming infected, are interconnected, providing a mechanism for the spread of infections. Thus, infections of the deep spaces can lead to devastating consequences, especially when there is extension to the mediastinum. Here we report a case of intraoperative hypotension in a 9-month-old child with extensive bilateral parapharyngeal and retropharyngeal abscesses with mediastinal extension with a focus on when hemodynamic monitoring should be considered.

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

    Directory of Open Access Journals (Sweden)

    Joel Brooks

    2014-01-01

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

  2. 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.

  3. Tubercular breast abscess

    Directory of Open Access Journals (Sweden)

    Pradeep S Jadhav

    2013-01-01

    Full Text Available Tubercular breast abscess is a rare clinical entity and affects women from mainly the Indian subcontinent. It often mimics breast carcinoma and pyogenic breast abscess clinically. Routine laboratory investigations are not helpful in the diagnosis. Fine needle aspiration cytology (FNAC or biopsy is essential for diagnosis, and tuberculous culture when positive may be very useful to start antitubercular treatment.

  4. 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.

  5. 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...

  6. Etiological factors of psoas abscesses

    Directory of Open Access Journals (Sweden)

    Mehmet Nuri Bodakçi

    2014-03-01

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

  7. Fusobacterium Liver Abscess

    Directory of Open Access Journals (Sweden)

    Ben D. Buelow

    2013-11-01

    Full Text Available Fusobacterium is well characterized as an oropharyngeal pathogen that may induce a septic thrombophlebitis by direct extension of abscess into an adjacent neck vessel (Lemierre's syndrome; its potential for visceral abscess formation, however, remains under-recognized. A 65-year-old man with a recent history of multiple rim-enhancing liver lesions presented to the emergency room with fever and abdominal pain. Based on interval increase in the size of the lesions, abscess was suspected. A liver biopsy was performed, and although no organism could be identified on routine microscopy, Warthin-Starry stain revealed Gram-negative bacilli consistent with an anaerobic Fusobacterium species as the underlying etiology of liver abscess formation. Subsequent anaerobic culture results confirmed the diagnosis. This case highlights the importance of consideration for Fusobacterium infection in the setting of liver abscess if anaerobic organisms have not yet been excluded on initial culture evaluation.

  8. 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.

  9. Radiologic assessment of retropharyngeal node involvement in oropharyngeal carcinomas stratified by HPV status.

    Science.gov (United States)

    Tang, Chad; Komakula, Sirisha; Chan, Cato; Murphy, James D; Jiang, Wen; Kong, Christina; Lee-Enriquez, Nancy; Jensen, Kristin C; Fischbein, Nancy J; Le, Quynh-Thu

    2013-11-01

    Radiation of retropharyngeal nodes (RPN) results in increased toxicities. This study assessed characteristics associated with RPN involvement in 165 oropharynx cancer patients. Factors associated with involvement were stage N2c-3 disease and stage N2b disease with either advanced T-stage, ⩾3 involved cervical LN, and ⩾1 involved contralateral LN, or lateral/posterior subsites.

  10. A Comparative Study of Deep Neck Abscess with Regards to Anatomical Location and Age Groups Using CT and Clinical Data

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Ho; Han, Jong Kyu; Kim, Young Tong; Shin, Hyeong Cheol; Kim, Hyung Hwan; Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

    2012-04-15

    To evaluate differences anatomical location and age groups on CT and clinical data in deep neck abscess. This study included 200 patients who underwent CT and were diagnosed with a deep neck abscess, from December 2005 to July 2010. Patients were divided into four groups by age (children, adolescent, adult, elderly). Next, the anatomic location, location multiplicity and clinical data regarding the deep neck abscesses were analyzed retrospectively. The deep neck abscesses observed were defined as superficial or deep and partitioned into sub-groups, with further analysis of their clinical data. The incidence of the parapharyngeal abscess was more frequent in children and elderly groups (p < 0.05). The masticator abscess was only observed among patients in the elderly group (p < 0.05). Multiple locations were observed with increased frequency in children and elderly groups (p < 0.05). Swelling in the neck was more frequently observed in children and elderly groups (p < 0.05), cervical lymphadenitis was frequently seen in children and adolescent groups (p < 0.05), and the incidence of symptoms including sore throat were significantly increased in adolescent and adult groups (p < 0.05). Location multiplicity was significantly higher in parapharyngeal, retropharyngeal, submandibular, danger, visceral and masticator spaces than other spaces (p < 0.05). With regards to anatomic location, neck swelling was more frequent in superficial group and sore throat was more frequent in deep group (p < 0.05). Deep neck abscess would show significant differences with regards to the abscess location, location multiplicity, and clinical symptoms according to age. The clinical symptoms observed are dependent on the anatomic location as defined by a superficial or deep abscess.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. [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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-03-01

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

  19. A rare case of aortic sinuses of valsalva fistula to multiple cardiac chambers secondary to periannular aortic abscess formation from underlying Brucella endocarditis

    Directory of Open Access Journals (Sweden)

    Sabzi, Feridoun

    2015-11-01

    Full Text Available The concomitant presence of abnormal connection from three aortic valsalva sinuses to cardiac chambers is a rare complication of native aortic endocarditis. This case report presents a 37-year-old Iranian female patient who had native aortic valve endocarditis complicated by periannular abscess formation and subsequent perforation to multi-cardiac chambers associated with congestive heart failure and left bundle branch block. Multiple aorto-cavitary fistulas to right atrium, main pulmonary artery, and formation of a pocket over left atrial roof were detected by transthoracic echocardiogram (TTE. She had received a full course of antibiotics therapy in a local hospital and was referred to our center for further surgery. TTE not only detected multiple aorto-cavitary fistulas but also revealed large vegetation in aortic and mitral valve leaflets and also small vegetation in the entrance of fistula to right atrium. However, the tricuspid valve was not involved in infective endocarditis. She underwent open cardiac surgery with double valve replacement with biologic valves and reconstruction of left sinus of valsalva fistula to supra left atrial pocket by pericardial patch repair. The two other fistulas to main pulmonary artery and right atrium were closed via related chambers. The post-operative course was complicated by renal failure and prolonged dependency to ventilator that was managed accordingly with peritoneal dialysis and tracheostomy. The patient was discharged on the 25 day after admission in relatively good condition. The TTE follow-up one year after discharge revealed mild paravalvular leakage in aortic valve position, but the function of mitral valve was normal and no residual fistulas were detected.

  20. Pediatric Synovial Sarcoma in the Retropharyngeal Space: A Rare and Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Sanjay Vaid

    2015-01-01

    Full Text Available Synovial sarcomas in the head and neck are extremely rare tumors, especially in the pediatric population. 3–5% of synovial sarcomas occur in the head and neck region displaying varied imaging and histopathological features resulting in frequent misdiagnosis. These tumors have a poor prognosis; hence early diagnosis and accurate classification based on imaging, histopathology, and immunohistochemistry are critical for prompt treatment. To the best of our knowledge, imaging findings of pediatric retropharyngeal lipomatous synovial sarcoma have not been reported to date in English medical literature. We report, for the first time, a rare case of retropharyngeal lipomatous synovial sarcoma in a ten-year-old child and discuss the case-specific imaging findings in our patient using magnetic resonance imaging and computed tomography.

  1. 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.

  2. Distribution of S-100 positive dendritic cells in bovine pharynx,tonsils, and retropharyngeal lymph nodes

    Institute of Scientific and Technical Information of China (English)

    Jiaxin WANG; Haixia BIAN; Wei SHI; Zhanjun LU

    2008-01-01

    Dendritic cells (DCs) are professional antigen-presenting cells. However, the distribution of bovine DCs in the pharynx, tonsil, and retropharyngeal lymph nodes has not yet been documented. To address this issue, immunohistochemistry was conducted using S-100 pro-tein as a marker for DCs. It was observed that S-100 positive Langerhans cells (LCs) were primarily found in the basal layer of the pharyngeal epithelium. Some DCs were found in the outer layer of the epithelium and their dendrites extended out towards the epithelial surface. In the tonsil, S-100 positive DCs were found either in follicular germinal centers or in the T-cell areas. It is worth noting that the S-100 positive DCs were not only distributed in the cortex, but also in the medulla of bovine retropharyngeal lymph nodes. The distribution patterns of bovine DCs in the pharynx, tonsil, and retropharyngeal lymph nodes have an important implica-tion for our understanding of the interaction between pathogens and host.

  3. 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.

  4. 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.

  5. 继发性腰椎间隙感染合并肺脓肿的救治%The Cure of Secondary Cases Interspace of Lumbar Vertebrae Infection Complicated Pulmonary Abscess

    Institute of Scientific and Technical Information of China (English)

    张淼; 顾苏俊

    2009-01-01

    OBJECTIVE Research the therapeutic effectiveness of combination Imipenem and teicoplanin to treat septicemia due to interspace of lumbar vertebrae Infection complicated pulmonary abscess and the method of diagnosis, prevention and cure of Secondary interspace of lumbar vertebrae Injection. METHODS The successful cure case-report that severe postoperative interspace of lumbar vertebrae infection complicated blood-borne pulmonary abscess used small needle knife to treat Lumbar intervertebral disc protrusion (LIDP) were reviewed.RESULTS Unstandard asepsis technique and invasive operation long time operation, too mang damage of tissue in operation, patient weak, diabetes, glucocorticoid, lacking postoperative anti infection therapy etc. Lumbocrural pain were found aggravated, high fever, blood sedimentation increased, CRP heightened. CONCLUSIONS Strict asepsis,sufficient preoperotive preparation, Standard operation, less damage, can reduce interspace of lumbar vertebrae infection rate. Strict asepsis and less damage in the operation can reduce the incidence of intervertebral disc space infection.%目的 探讨亚胺培南/西司他丁与替考拉宁联合应用治疗腰椎间隙感染后败血症合并肺脓肿的疗效以及继发件腰椎间隙感染的发病特点、诊断及防治方法.方法 通过对1例小针刀治疗腰椎间盘突出后导致重度腰椎间隙感染合并血源性肺脓肿患者的成功救治进行同顾性总结分析.结果 无菌观念不严格、介入性操作不规范、手术时间长、术中组织损伤多、患者基础条件差、糖尿病、应用糖皮质激素、术后抗炎不足等因素有关;患者术后3 d腰腿痛加剧.高热,血沉增快,C-反应蛋白增高.结论 严格无菌观念,充分术前准备,术中操作规范减少损伤可减少腰椎间隙感染的发生.

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

    Science.gov (United States)

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

    2014-12-01

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

  7. [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.

  8. Enlarged superior cervical sympathetic ganglion mimicking a metastatic lymph node in the retropharyngeal space: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Min; Kim, Jin Na; Kim, Se Hoon; Choi, Eun Chang [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    The superior cervical sympathetic ganglion, the largest and most cranial of the three cervical sympathetic ganglia, transfers sympathetic signals to specific targets on the head and neck. This ganglion is located just lateral to the retropharyngeal space along the medial margin of the carotid sheath. Located thus, an enlarged superior cervical sympathetic ganglion can mimic a metastatic lymph node in the retropharyngeal space of the suprahyoid neck in head and neck cancer patients. However, this is often disregarded by radiologists due to lack of interest in its anatomic location. We present a case of an enlarged superior cervical sympathetic ganglion mimicking a retropharyngeal metastatic lymph node in a 42-year-old man with oral tongue cancer.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-02-15

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

  10. [Orbital abscess after peribulbar anesthesia in a frontoethmoidal mucocele].

    Science.gov (United States)

    Pardo-López, D; España-Gregori, E; Alamar, A; Morera, H; Diaz-Llopis, M

    2014-06-01

    Peribulbar anesthesia is used in daily practice during cataract surgery. It is a safe technique, but not without complications. We present the case of a man who had an orbital abscess secondary to peribulbar anesthesia that led to the perforation of an unknown frontoethmoidal mucocele. Orbital abscess secondary to an iatrogenic mucocele perforation after anesthesia is a periorbital complication not described. The detection of the orbital process, intensive medical treatment and monitoring for signs of deterioration are vital in preventing serious complications. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Asha B Patil

    2012-01-01

    Full Text Available Morganella morganii is a gram negative aerobe , found often as intestinal commensal. It is commonly implicated in Urinary tract infections and pyogenic infections, but rarely causes CNS infections especially brain abscess. There are very few published reports of Morganella morganii as a causative pathogen in brain abscess. High index of suspicion of this pathogen is important in cases of brain abscess secondary to otogenic infections. This paper reports an unusual case of Morganella morganii, subspecies morganii, biogroup A Brain abscess .The paper also reviews other infections caused by Morganell morganii.

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

    Science.gov (United States)

    Patil, Asha B; Nadagir, Shobha D; Lakshminarayana, Sa; Syeda, Fasiha M

    2012-09-01

    Morganella morganii is a gram negative aerobe , found often as intestinal commensal. It is commonly implicated in Urinary tract infections and pyogenic infections, but rarely causes CNS infections especially brain abscess. There are very few published reports of Morganella morganii as a causative pathogen in brain abscess. High index of suspicion of this pathogen is important in cases of brain abscess secondary to otogenic infections. This paper reports an unusual case of Morganella morganii, subspecies morganii, biogroup A Brain abscess. The paper also reviews other infections caused by Morganell morganii.

  13. Brain abscess: Current management

    Science.gov (United States)

    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

  14. Brain abscess: Current management

    Directory of Open Access Journals (Sweden)

    Hernando Alvis-Miranda

    2013-01-01

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

  15. 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

  16. Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development

    Directory of Open Access Journals (Sweden)

    Robert S. Qiu

    2015-01-01

    Full Text Available Atlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who suffered an atlantooccipital dislocation and C5-C6 three-column injury. A unique MRI image of a defect in the ventral dura posterior to C2 was appreciated. He underwent occiput to T2 internal fixation and arthrodesis. During surgery, CSF egress was seen caudal to the right C2 nerve root. A DuraMatrix onlay patch reinforced with DuraSeal was placed to stop the CSF leak. A lumbar subarachnoid drain was also placed. The patient made a satisfactory recovery with residual mild weakness of his right upper extremity. In this report, we demonstrate that careful MRI review can reveal a ventral durotomy in a traumatic atlantooccipital dislocation and, if discovered, effective treatment including a lumbar subarachnoid drain for CSF diversion may prevent progression to a retropharyngeal pseudomeningocele. The literature on this rare presentation and associated durotomy is provided.

  17. Ultrasound-Guided Transoral Videolaryngoscopic Surgery for Retropharyngeal Lymph Node Metastasis of Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Kazunori Fujiwara

    2017-07-01

    Full Text Available Background: Endoscopic-assisted transoral surgery, including transoral robotic surgery for metastatic retropharyngeal lymph node (RPN from well-differentiated thyroid cancer, has been reported to reduce the complications resulting from transcervical and transmandibular approaches. However, the narrow working space and difficulty identifying RPN are problematic. To solve these issues, several studies have used intraoperative ultrasound in endoscopic-assisted transoral surgery. However, the type of ultrasonography suitable for this purpose remains unclear. Case Presentation: A 60-year-old female with thyroid papillary carcinoma (T4aN1bM0 initially underwent total thyroidectomy and paratracheal and selective neck dissections (D2a, with resectional management of recurrent laryngeal nerve, trachea, and esophagus. Three years later, she was diagnosed with left retropharyngeal and upper mediastinal lymph node metastases of papillary thyroid cancer. Transoral videolaryngoscopic surgery was performed with a combination of ultrasonography with a flexible laparoscopic transducer manipulated with forceps for identifying RPN intraoperatively. Due to the transducer’s small size and thin, flexible cable, the transducer interrupted the procedure in spite of the narrowness of oral cavity. RPN was resected completely without adverse events. Conclusion: We performed intraoperative ultrasound-guided endoscopic transoral surgery for metastatic RPN from papillary thyroid cancer and achieved complete resection as well as preservation of swallowing function.

  18. Evaluation of two commercial, rapid, ELISA kits testing or scrapie in retro-pharyngeal lymph nodes in sheep

    NARCIS (Netherlands)

    Kittelberger, R.; McIntuyre, L.; Watts, S.; MacDiarmid, S.; Hannah, M.J.; Jenner, J.; Bueno, R.; Swainsbury, R.; Langeveld, J.P.M.; Keulen, van L.J.M.; Zijderveld, van F.G.; Wemheuer, W.M.; Richt, J.A.; Sorenson, S.J.; Pigott, C.J.; O'Keefe, J.S.

    2014-01-01

    AIMS: To estimate the number of cases of scrapie that would occur in sheep of different prion protein (PrP) genotypes if scrapie was to become established in New Zealand, and to compare the performance of two commercially available, rapid ELISA kits using ovine retro-pharyngeal lymph nodes (RLN) fro

  19. A 92-year-old man with retropharyngeal hematoma caused by an injury of the anterior longitudinal ligament

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Shinichi lizuka; Haruna Hirakawa; Shigeo Higami; Takeshi Yamagiwa; Sadaki Inokuchi

    2010-01-01

    Traumatic retropharyngeal hematoma is a rare condition and may be lethal in some cases.In patients with this condition, the absence of a vertebral fracture or a major vascular injury is extremely rare.We present the case of a 92-year-old man who hit his forehead by slipping on the floor in his house.He had no symptoms at the time; however, he experienced throat pain and dyspnea at 6 hours after the injury.On arrival, he complained of severe dyspnea; therefore, an emergency endotracheal intubation was performed.A lateral neck roentgenogram after intubation showed dilatation of the retropharyngeal and retrotracheal space and no evidence of a cervical vertebral fracture.Cer-vical computed tomography (CT) with contrast medium re-vealed a massive hematoma extending from the retropharyngeal to the superior mediastinal space but no evidence of contrast medium extravasation or a vertebral fracture.However, sagittal magnetic resonance imaging (MRI) revealed an anterior longitudinal ligament (C levels)injury.We determined that the cause of the hematoma was an anterior longitudinal ligament injury and a minor vascu-lar injury around the injured ligament.Therefore, we recom-mend that patients with retropharyngeal hematoma undergo sagittal cervical MRI when roentgehography and CT reveal no evidence of injury.

  20. 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.

  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. 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....

  4. 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.

  5. Prosthetic Valve Endocarditis: A Complication of Spinal Epidural Abscess

    Directory of Open Access Journals (Sweden)

    Armando Bedoya

    2010-01-01

    Full Text Available Epidural injections for chronic low back pain are controversial, and their effectiveness is debated. Although epidural injections are considered a minor procedure with low morbidity, catastrophic complications may occur. We describe a case of prosthetic valve endocarditis secondary to an epidural abscess after epidural injection to alert clinicians to this unusual association.

  6. Prosthetic Valve Endocarditis: A Complication of Spinal Epidural Abscess

    OpenAIRE

    Bedoya, Armando; Gentilesco, Bethany

    2010-01-01

    Epidural injections for chronic low back pain are controversial, and their effectiveness is debated. Although epidural injections are considered a minor procedure with low morbidity, catastrophic complications may occur. We describe a case of prosthetic valve endocarditis secondary to an epidural abscess after epidural injection to alert clinicians to this unusual association.

  7. Dental abscess: A microbiological review

    Directory of Open Access Journals (Sweden)

    Shweta

    2013-01-01

    Full Text Available Dental abscess is a frequently occurring infectious process known to the health practice. The fate of the infection depends on the virulence of the bacteria, host resistance factors, and regional anatomy. Serious consequences arising from the spread of a dental abscess lead to significant morbidity and mortality. Acute dental abscess is polymicrobial, comprising of strict anaerobes, such as anaerobic cocci, Prevotella, Fusobacterium species, and facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group. Numerous novel, uncultivable and fastidious organisms have been identified as potential pathogens with the use of non-culture techniques. The majority of localized dental abscesses respond to surgical treatment while the use of antimicrobials is limited to severe spreading infections. There is a need for good-quality clinical trials of sufficient size to identify the ideal treatment. The microbiology of the acute dentoalveolar abscess and its treatment in the light of improved culture and diagnostic methods are reviewed.

  8. 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.

  9. [Retrospective evaluation of 15 cases with psoas abscesses].

    Science.gov (United States)

    Turunç, Tahsin; Turunç, Tuba; Demiroğlu, Y Ziya; Colakoğlu, Sule

    2009-01-01

    Psoas abscesses are suppurative collections within the fascia surrounding the psoas and iliacus muscles. In this retrospective study it was aimed to evaluate the demographic characteristics, clinical and laboratory findings and treatment outcomes of 15 psoas abscess cases admitted to Baskent University Hospital, Ankara, Turkey during June 2003-January 2008 period. The mean age of the patients was 55.8 years (range 18 to 70 years) with a female to male ratio of 5/10. Thirteen of the cases (86.5%) were admitted with the complaints of fever and back pain. Thirteen of the cases were diagnosed by abdominal computerized tomography while the other two by abdominal ultrasonography. One of the 15 patients was considered as primary psoas abscess, while the remaining 14 as secondary psoas abscess. The most common accompanying disease was diabetes mellitus (66.6%). Fourteen patients with secondary psoas abscess had vertebral osteomyelitis which was due to tuberculosis in five cases, to urinary tract infection in five cases, to pneumoniae in two cases, to surgical infection in one case and to brucellosis in one case. The cultivation of the abscess material from the 14 secondary psoas abscess cases revealed growth of bacteria in 11 of them (5 Mycobacterium tuberculosis, 1 Escherichia coli, 1 methicillin-sensitive Staphylococcus aureus, 1 methicilin-resistant S. aureus, 1 Acinetobacter baumannii, 1 Brucella melitensis, 1 Serratia marcescens). The biochemical parameters of the cases (mean leukocyte counts: 14.500 cell/mm3; mean erythrocyte sedimentation rates: 78 mm/hour; mean C-reactive protein levels: 108 mg/dl) were also high. Thirteen patients underwent percutaneous drainage and received appropriate antibiotic treatment and the other two patients were treated with open surgical debridement. The duration of antimicrobial treatment was one year for M. tuberculosis cases and about 4-6 weeks in the others. One of the cases died due to complicating meningitis and sepsis. It is

  10. A Broken Toothbrush in the Retropharyngeal Space in a Toddler of Sixteen Months.

    Science.gov (United States)

    Goswami, Saileswar; Goswami, Choitali

    2015-01-01

    A toddler of sixteen months fell while brushing his teeth and his mouth hit the ground. The toothbrush broke and one-third of it including the head got impacted in his throat. The attempt of his mother to remove it with her fingers further complicated the case and the toothbrush was ultimately lodged in the retropharyngeal space at the level from C1 to C5 vertebrae. It was strongly impacted due to the presence of the bristles. The broken end of the handle was just protruding into the nasopharynx and was very difficult to locate. The first attempt of its removal was unsuccessful. The toothbrush was removed safely in the second attempt without any complication.

  11. Submasseteric abscess: A rare head and neck abscess

    Directory of Open Access Journals (Sweden)

    Ashutosh Rai

    2011-01-01

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

  12. A retrospective analysis of one case of splenic abscess of typhoid fever secondary to primary myeloifbrosis and review of literatures%原发性骨髓纤维化合并脾伤寒脓肿1例并文献复习

    Institute of Scientific and Technical Information of China (English)

    郭海飞; 徐钰; 蒋蕾; 涂小芳; 吴芳芳

    2016-01-01

    目的:探讨原发性骨髓纤维化(PMF)合并脾伤寒脓肿的临床特点,以提高对该病的认识。方法:对我院收住的1例PMF合并脾伤寒脓肿的患者的临床资料进行分析和文献复习,为该病的诊断及治疗提供思路。结果:PMF患者在疾病发生、发展过程中容易继发感染,而脾脏肿大易导致病菌在脾内留滞。PMF患者在伤寒杆菌败血症的基础上容易并发脾伤寒脓肿。结论:临床医师应提高对PMF合并脾伤寒脓肿的认识,早期诊断,早期治疗,提高患者生存率,改善预后。%Objective: To analyze the clinical manifestations, diagnosis, treatment of the patient with splen-ic abscess of typhoid fever secondary to primary myeloifbrosis.Methods: The clinical data, including baseline clinical data, clinical features, past history, pathogen culture result, treatment of the patient with splenic abscess of typhoid fever secondary to primary myeloifbrosis retrieved from the Third Afifliated of Wenzhou Medical Uni-versity were collected and analyzed and the literatures on this topic were reviewed.Results: Patients with PMF were vulnerable to infectious disease for some facts in the disease progresses, and when splenomegaly pathogen seemed more easy to colonize . In the case of Salmonella bacteremia, the patient with PMF seemed to have an increased frequency of evolving into splenic abscess of typhoid fever.Conclusion: The patients with splenic ab-scess of typhoid fever are clinically rare and easy to misdiagnose, clinician should increase the understanding of this disease.

  13. 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.

  14. 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.

  15. Lingual abscess: a case report

    Directory of Open Access Journals (Sweden)

    Bekele K

    2017-08-01

    Full Text Available Kebebe Bekele,1 Desalegn Markos2 1Department of Surgery, School of Medicine, Madda Walabu University, Bale Goba, 2Department of Neonatology Nursing, St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia Background: Lingual abscesses have become extremely rare since the discovery of antibiotics, despite the relatively frequent exposure of tongue to bite trauma during mastication and seizures. It is a potentially life-threatening clinical entity. Even though there were some case reports on tongue abscess from overseas, none of them were reported from Africa, particularly from Ethiopia.Case presentation: A 36-year-old male patient with severe, continuous pain and swelling of tongue for 6 weeks was presented to Goba Referral Hospital. The swelling was 2 cm by 1 cm, located on posterior central tongue, and frank pus oozed from the center of the swelling. He had associated dysphagia, odynophagia, and speech difficulty. He had no previous personal and family history of similar illness and tonsillitis. Gram staining revealed the presence of Gram-positive cocci in clusters. Pyogenic lingual abscess was the diagnosis. Treatment included incision and drainage with the administration of systemic antibiotics, which covered both aerobic and anaerobic organisms, and anti-pain drugs. The condition did not relapse in 6 months of follow-up. Conclusion: Lingual abscess should be considered in patients presenting with tongue swelling, dysphagia, odynophagia, and speech difficulty. Since lingual abscess that occurs on the posterior part of the tongue has diagnostic difficulty, professionals in rural setup where diagnostic resources (such as ultrasound and magnetic resonance imaging are scarce should be careful not to misdiagnose it. Incision and drainage with the administration of systemic antibiotics and anti-pain drugs is an effective treatment option for lingual abscess. Keywords: lingual abscesses, tongue abscess, swelling, incision, drainage, case

  16. Endoscopic management of brain abscesses

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  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. [Amoebic liver abscess: echographic aspects].

    Science.gov (United States)

    Niang, H E; Ka, M M; Badiane, M; Ba, A; Konde, L; Lamouche, P

    1994-01-01

    Amoebic liver abscess is the most frequent location of the extra-intestine amibiasis with an epidemio-endemic repartition in our areas. We are reporting in this study the main echographic patterns that can be found. 117 documents were collected and studied between 1982 and 1988 in the main hospitals of Dakar (SENEGAL). Most of the patients were young, the range of age being between 25 and 55 years old and 83% of them, were male. The diagnosis of the amoebic liver abscess was evocated on the basis of the following clinical and biological symptoms: 54.38% of painful haetomegaly, 42.10% of pleuro-pulmonary and digestive signs, 3.50% of long lasting isolated fever, non specific biological sign of inflammation, 74.57% of positive hemaglutination test. An echographic test was performed before the anti-parasitic treatment with an echotomograph PHILIPS SDR 1500 in real time using a probe of 3 MHZ. The amoebic abscess of liver was detected by the echography in all cases. The unique abscess (83.10%) was the most frequent form. It was localized in the right liver (64%) and had an heterogeneous echostructure (55.70%). The hypo-echogeneous form (36.50%) was the earlier stage of the collecting abscess. The liquid form (07.80%) was observed in the latter stages of the disease. Some difficulties to determine the amoebic abscess may appear when primitive liver cancer or pyogensus abscess are present. In these cases it is necessary to analyse the liquid of ponction to be affirmative.

  3. 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.

  4. 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 ...

  5. 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.

  6. Metastatic retropharyngeal lymph nodes: Comparison of CT and MR imaging for diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki, E-mail: hkato@gifu-u.ac.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Kanematsu, Masayuki, E-mail: masa_gif@yahoo.co.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); High-level Imaging Diagnosis Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194 (Japan); Watanabe, Haruo, E-mail: haruwow860@yahoo.co.jp [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194 (Japan); Mizuta, Keisuke, E-mail: kmizuta@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan); Aoki, Mitsuhiro, E-mail: aoki@gifu-u.ac.jp [Department of Otolaryngology, Gifu University School of Medicine, Gifu (Japan)

    2014-07-15

    Purpose: The purpose of this study was to compare the diagnostic accuracies of CT and MR imaging for the detection of metastatic retropharyngeal lymph nodes (RLNs) in patients with nasopharyngeal and oropharyngeal squamous cell carcinoma (SCC). Materials and methods: The study included 38 patients (28 men and 10 women; mean age, 65 years; age range, 48–82 years) with nasopharyngeal (n = 15) and oropharyngeal (n = 23) SCC who underwent both contrast-enhanced CT and MR imaging before chemoradiotherapy. RLNs were classified as malignant or benign on the basis of the results of follow-up MR imaging. Two radiologists independently evaluated the images for diagnosing metastatic RLNs. Results: Among a total of 68 RLNs (minimum diameter, ≥4 mm) that were detected on gadolinium-enhanced fat-suppressed T1-weighted images, 30 (44%) were malignant and 38 (56%) were benign. The sensitivities of CT versus MRI were 60% versus 97% for observer 1 (p < 0.01) and 37% versus 90% for observer 2 (p < 0.01). The specificities of CT versus MRI were 92% versus 97% for observer 1 (p = 0.50) and 92% versus 100% for observer 2 (p = 0.25). The areas under the receiver operating characteristic curve (AUC) for CT versus MRI were 0.788 versus 0.996 for observer 1 (p < 0.01) and 0.693 versus 0.961 for observer 2 (p < 0.01). Conclusion: MR imaging was superior to CT for the detection of metastatic RLNs.

  7. Incidence of abnormal retropharyngeal lymph nodes in sinonasal malignancies among adults

    Energy Technology Data Exchange (ETDEWEB)

    Sai, Asari; Shimono, Taro; Yamamoto, Akira; Takeshita, Toru; Miki, Yukio [Osaka City University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Osaka (Japan); Ohsawa, Masahiko; Wakasa, Kenichi [Osaka City University Graduate School of Medicine, Department of Diagnostic Pathology, Osaka (Japan)

    2014-12-15

    The aim of this study is to investigate the relationship between abnormal retropharyngeal lymph nodes (RPLNs) and sinonasal malignancies among adults. Magnetic resonance and computed tomography images from 89 patients over 20 years old who were all histopathologically confirmed to have sinonasal malignancies from September 2001 to April 2014 were assessed retrospectively. Abnormal RPLNs were determined as those >5 mm in shortest axis or showing heterogeneous enhancement on axial images. Locations of sinonasal malignancies were categorized using the anterior border of the pterygopalatine fossa as a boundary: (a) anterior lesions, only present anterior to the boundary, or (b) posterior lesions, present or extending posterior to the boundary. Fisher's exact test was used for the analysis of the relationship between frequency of abnormal RPLNs and lesion location. Abnormal RPLNs were present in 13 of 89 patients (15 %), including 6 of 41 squamous cell carcinomas (15 %), 4 of 24 malignant lymphomas (17 %), 3 of 5 olfactory neuroblastomas (60 %), and 0 of 19 others (0 %). Four of the 39 patients (10 %) with anterior lesions showed abnormal RPLNs, compared to 9 of 50 patients (18 %) with posterior lesions. No significant difference in frequency of abnormal RPLNs was apparent between anterior and posterior lesions (P = 0.37). In primary sinonasal malignancies among adults, the highest incidence of abnormal RPLNs was seen with olfactory neuroblastoma. The frequency of abnormal RPLNs was unaffected by the location of sinonasal malignancies among adults. (orig.)

  8. Non-tuberculous iliopsoas abscess due to perforated diverticulitis presenting with intestinal obstruction and a groin mass

    Energy Technology Data Exchange (ETDEWEB)

    Kaul, V.; Jackson, M. [Dept. of Surgery, Worthing and Southlands Hospital, West Sussex (United Kingdom); Farrugia, M. [Dept. of Radiology, Worthing and Southlands Hospital, West Sussex (United Kingdom)

    2001-06-01

    Psoas abscess is an uncommon condition and, contrary to traditional teaching, tends to be of non-tuberculous aetiology in developed countries. Diagnosis can be delayed since presenting features are non-specific and in many instances misleading, necessitating a high degree of clinical suspicion and early resort to cross-sectional imaging using CT or MRI. We present a case of iliopsoas abscess secondary to perforated diverticulitis to illustrate the difficulty encountered in early diagnosis and to show that successful management of secondary psoas abscess necessitates surgical resection of the underlying condition in most cases. (orig.)

  9. A Giant Retroperitoneal Abscess Mimicking Incarcerated Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Naciye Sinem Gezer

    2015-06-01

    Full Text Available An 82-year-old man was admitted to the emergency room with an acute left-sided groin pain and scrotal swelling. He has suffered from a groin hernia for two years. Abdominal x-ray demonstrated air-fluid levels in the left upper quadrant suggesting an intestinal obstruction (Figure 1. Abdominal computed tomography (CT scan was obtained with an initial diagnosis of an incarcerated inguinal hernia. However, it showed multiple perirenal abscesses and a giant-sized retroperitoneal abscess extending from the retroperitoneal space into the scrotum through the inguinal canal (Figure 2 and 3. Retroperitoneal abscesses are most frequently seen in the 3rd to 6th decades of life (1. Gram-negative bacteria, most commonly E. coli, are the cause of infection which usually develops secondary to pyelonephritis, urinary stasis or immune suppression. The onset of clinical manifestations of the infection, including flank, abdomen and groin pain, chills, fever, tachycardia, weakness and anorexia are often insidious (2,3. Laboratory findings include leukocytosis, increased serum creatinine levels and pyuria. The literature emphasizes the possibility of diagnostic delay and postponed treatment of retroperitoneal abscess due to the fact that its prodrome phase may be long.

  10. Pseudocyst and a Collar Stud Abscess: New Face of Necrotizing Enterocolitis

    Directory of Open Access Journals (Sweden)

    Hemant Kumar

    2014-10-01

    Full Text Available Meconium pseudocyst formation secondary to antenatal perforation is well described. We present a preterm infant who had intra-abdominal pseudocyst formation following postnatal intestinal perforation secondary to necrotizing enterocolitis (NEC and secondarily leading to extra-abdominal collar stud abscess. This is new face of NEC and this presentation has not been reported earlier.

  11. Pseudocyst and a Collar Stud Abscess: New Face of Necrotizing Enterocolitis

    Science.gov (United States)

    Kumar, Hemant; Patel, Ramnik; Patwardhan, Nitin; More, Bharat

    2014-01-01

    Meconium pseudocyst formation secondary to antenatal perforation is well described. We present a preterm infant who had intra-abdominal pseudocyst formation following postnatal intestinal perforation secondary to necrotizing enterocolitis (NEC) and secondarily leading to extra-abdominal collar stud abscess. This is new face of NEC and this presentation has not been reported earlier. PMID:26023517

  12. Preseptal Cellulitis, Orbital Cellulitis, Orbital Abscess

    Directory of Open Access Journals (Sweden)

    Rana Altan Yaycıoğlu

    2012-12-01

    Full Text Available Patients with orbital infections present to our clinic usually with unilateral pain, hyperemia, and edema of the eyelids. The differentiation between preseptal and orbital cellulitis is utmost important in that the second requires hospitalization. Since in orbital cellulitis, the tissues posterior to the orbital septum are involved, signs such as conjunctival chemosis, limited eye movement, decreased vision, as well as afferent pupil defect secondary to optic nerve involvement may also be observed. Prompt intravenous antibiotic treatment should be started, and surgical drainage may be performed if patient shows failure to improve in 48 hours despite optimal management. Without treatment, the clinical course may progress to subperiosteal or orbital abscess, and even to cavernous sinus thrombosis. (Turk J Ophthalmol 2012; 42: Supplement 52-6

  13. Falciform ligament abscess: report of a case Abscesso de ligamento falciforme: relato de caso

    Directory of Open Access Journals (Sweden)

    Valdinaldo Aragão de Melo

    2003-01-01

    Full Text Available Falciform ligament abscess is rare. We report a case of a 65-year-old man who presented with right upper quadrant abdominal pain, postprandial fullness, and fever. Computed tomography disclosed a cylindrical mass in the anterior abdomen that aroused suspicion of a hepatic abscess. At laparoscopic surgery, an abscess of the falciform ligament was found and drained. Two months later, the patient developed recurrence of the abscess secondary to acute calculous cholecystitis. Abscess drainage and cholecystectomy were performed. The presence of right uppper quadrant abdominal pain, epigastric tenderness, fever, leukocytosis, and a mass in the anterior abdomen should arouse suspicion of falciform ligament abscess. Its treatment consists of abscess drainage.Abscesso de ligamento falciforme é raro. É relatado um caso de um homem de 65 anos que apresentou dor no quadrante superior direito do abdome, plenitude pós-prandial e febre. A tomografia computadorizada revelou uma massa cilíndrica no abdome anterior que causou suspeita de abscesso hepático. Na cirurgia laparoscópica, um abscesso de ligamento falciforme foi encontrado e drenado. Dois meses depois, o paciente desenvolveu recidiva do abscesso secundário a colecistite aguda calculosa. Drenagem do abscesso e colecistectomia foram realizados. A presença de dor no quadrante superior direito, febre, leucocitose e abaulamento no abdome ântero-superior deve causar suspeita dessa patologia. Seu tratamento consiste de drenagem do abscesso.

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

    Science.gov (United States)

    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.

  15. Computed tomography in pituitary abscess

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-06-01

    This is a report on a rare case of a recurring abscess in the pituitary gland. Diagnosis was extremely difficult to establish preoperatively. This is demonstrated via various radiological methods. Anamnesis and clinical disease pattern are important assisting factors in diagnosis.

  16. 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...

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. Superior cervical ganglion mimicking retropharyngeal adenopathy in head and neck cancer patients: MRI features with anatomic, histologic, and surgical correlation

    Energy Technology Data Exchange (ETDEWEB)

    Loke, S.C.; Karandikar, A.; Goh, J.P.N. [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore); Ravanelli, M.; Farina, D.; Maroldi, R. [Department of Radiology, University of Brescia, Brescia (Italy); Ling, E.A. [National University of Singapore, Department of Anatomy, Yong Loo Lin School of Medicine, Singapore (Singapore); Tan, T.Y. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

    2016-01-15

    To describe the unique MRI findings of superior cervical ganglia (SCG) that may help differentiate them from retropharyngeal lymph nodes (RPLNs). A retrospective review of post-treatment NPC patients from 1999 to 2012 identified three patients previously irradiated for NPC that were suspected of having recurrent nodal disease in retropharyngeal lymph nodes during surveillance MRI. Subsequent surgical exploration revealed enlarged SCG only; no retropharyngeal nodal disease was found. A cadaveric head specimen was also imaged with a 3T MRI before and after dissection. In addition, SCG were also harvested from three cadaveric specimens and subjected to histologic analysis. The SCG were found at the level of the C2 vertebral body, medial to the ICA. They were ovoid on axial images and fusiform and elongated with tapered margins in the coronal plane. T2-weighted (T2W) signal was hyperintense. No central elevated T1-weighted (T1W) signal was seen within the ganglia in non-fat-saturated sequences to suggest the presence of a fatty hilum. Enhancement after gadolinium was present. A central ''black dot'' was seen on axial T2W and post-contrast images in two of the three SCG demonstrated. Histology showed the central black line was comprised of venules and interlacing neurites within the central portion of the ganglion. The SCG can be mistaken for enlarged RPLNs in post-treatment NPC patients. However, there are features which can help differentiate them from RPLNs, preventing unnecessary therapy. These imaging findings have not been previously described. (orig.)

  1. Treatment of holocord spinal epidural abscess via alternating side unilateral approach for bilateral laminectomy.

    Science.gov (United States)

    Hwang, Roy; Yung, Brian H; Sedney, Cara; Miele, Vincent J

    2015-01-01

    To date, this is the first reported case of the surgical management of a holocord epidural abscess done through level-skipping laminectomies. It is also the first reported case of these laminectomies being performed via an alternating side unilateral approach for this condition. A 51-year-old patient presenting with progressive lower extremity weakness secondary to a spinal epidural abscess extending from C4 to S1. A minimally disruptive method of relieving the spinal cord compression via evacuation of the abscess was employed successfully. This report demonstrates the efficacy of level skipping laminectomies via a unilateral approach for holocord epidural abscesses (extending 20 vertebral levels). Performing the laminectomies via a unilateral approach as well as alternating the side of the approach minimized iatrogenic instability risk. Both strategies were designed to minimize incision size, tissue disruption, and the amount of muscular weakness/imbalance postoperatively.

  2. 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

  3. Giant Nephrothoracic Abscess: A Misleading Disease, a Surgical Challenge, and an Unexpected Complication

    Directory of Open Access Journals (Sweden)

    Peter Kronenberg

    2014-01-01

    Full Text Available A rare case of perinephric abscess with unilateral secondary pulmonary involvement that was further complicated by spillover of purulent content into the contralateral lung is reported here. Its diagnosis, treatment, and evolution are described and discussed along with certain features of nephropulmonary fistulas. The diagnosis of these abscesses is difficult, largely because of the paucity of primary symptoms and the frequent presence of misleading secondary symptoms. Deceptive cases like this one highlight the importance of its contemplation in every physician’s differential diagnosis.

  4. Nursing care of patient with odontogenic deep neck space infections and secondary mediastinal abscess%牙源性颈深间隙广泛感染并发纵隔脓肿患者的护理

    Institute of Scientific and Technical Information of China (English)

    李少云; 安卫红; 李宇轩; 张会芝

    2015-01-01

    A report of one case of severe dental deep neck space abscess complicated with extensive mediastinal ab-scess,after operation and nursing discharge. Early tracheotomy,ensure the ventilation function, paying attention to o-ral care and twice airway management; assessment and preparation to the floor of the mouth, neck and chest incision drainage of pus preoperative,monitoring signs of postoperative infection, wound and drainage management; reasonable arrangements for antibiotic input, ensure the stable blood drug level; strengthen psychological counseling for patients and family members.%报告1例重症牙源性颈深间隙广泛脓肿形成并发纵隔脓肿、两次手术排脓患者的护理经过。早期气管切开,保证通气功能,重视口腔护理及气道管理;做好口底和颈部及胸部切开排脓术前的评估及准备、术后感染征象的监测、创面及引流管的管理;合理安排抗生素输入,保证稳定的血药浓度;加强对患者及家属的心理疏导。

  5. [Cases of pyogenic iliopsoas abscesses in military men].

    Science.gov (United States)

    Solov'ev, A A; Petrushin, V V; Gaĭduk, V P; Zotov, I V; Pchelkin, V A; Siniakov, V F

    2008-01-01

    Four cases of pyogenic inflammation of the iliolumbar muscle were analyzed and 3 clinical cases of this disease in military men are described. A rare case of abscess of the iliolumbar muscle complicated by secondary appendicitis is also described. A hematogenic way of infection against the background of microtraumas and hematomas with m. Iliopsoas was the main one in the patients observed that was due to specificities of military service: permanent physical activity, pustular diseases of the lower extremities. The main clinical symptom of the disease is the symptom of the iliolumbar muscle. Ultrasonic scanning is the most informative method of diagnosis among additional methods. Operative treatment of the piogenic iliopsoas abscess is the only method of treatment, the open operative interventions by the retroperitoneal access being preferred. Antibacterial therapy in the postoperative period is based on the results of inoculation of the purulent discharge from the wound. Broad spectrum antibiotics must be used due to possible anaerobic character of the purulent inflammation.

  6. 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.

  7. [Psoas abscess and lumbar spine osteomyelitis: case report].

    Science.gov (United States)

    Silva, Ana M; Schmalbach, Lauwence A

    2016-10-01

    Psoas abscess is a common disease in children. It can have a nonspecific clinical presentation, insidious onset and sometimes fever. The most common type in children is the primary one; however, it can sometimes be of secondary origin and associated with severe infections such as osteomyelitis so a high index of suspicion is required to detect and treat it promptly. We present an unusual case of psoas abscess with infiltration of the vertebral body of L2 in a 14 year old male patient previously healthy with no history of trauma or fever on admission. X-ray and ultrasound were performed but the diagnosis was confirmed by magnetic resonance imaging of the lumbosacral spine. With positive blood cultures for methicillin-resistant Staphylococcus aureus he completed 2 weeks of intravenous antibiotic therapy and 4 weeks of oral antibiotic therapy with blood cultures negativization and resolution of symptoms.

  8. A CASE REPORT OF RETROPHARYNGEAL PASSAGE OF ENDOTRACHEAL TUBE WHILE ATTEMPTING BLIND NASAL INTUBATION - A RARE COMPLICATION

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    Harinath

    2015-06-01

    Full Text Available Nasal route of intubation is commonly used for surgical procedures involving Head and Neck, Patients with intra - oral pathology, structural abnormalities, trismus, cervical spine instability, cervical spine disease and OSA. The intubation may be aided by direct laryngoscopy, flexible fibreoptic laryngoscopy or by blind technique. The classical tec hnique of blind nasal intubation requires a spontaneously breathing patient and uses breath sounds to guide placement. Most common complication associated with this technique is epistaxis. Other rare complications include - Inferior turbinate avulsion, mid dle turbinate/nasal polyp/tumour avulsion, Bacteraemia, Retropharyngeal mucosa dissection/laceration. Here we present to you a case of fracture mandible posted for ORIF for which blind nasal intubation was planned. While attempting the intubation the endot racheal tube coursed behind the retropharyngeal mucosa for a short distance before entering the trachea. Post - operatively the patient was put on Ryle’s tube feeding for 3 days followed by orals. The track healed spontaneously and the recovery was uneventfu l.

  9. 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.

  10. Microbiological profile of orbital abscess

    Directory of Open Access Journals (Sweden)

    N Suneetha

    2012-01-01

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

  11. 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.

  12. [Abscess, fistula and occlusion of colonic diverticulosis].

    Science.gov (United States)

    Bouillot, J L

    1995-04-15

    Diverticular disease is generally benign but may be serious in case of septic complications. The most common complication of acute diverticulitis is development of an abscess which can be located around the colon or in the pelvis. The diagnosis can be clinically suspected in case of non-response to medical management of severe acute diverticulitis. Confirmation is obtained by conventional radiographic examinations and computerized tomography. This condition can be safely treated by percutaneous catheter drainage associated to antibiotics followed by an elective delayed single-stage operation without colostomy. Fistula occurs in 20% of the patients who undergo surgery for diverticular disease. Colovesical fistula is the most common type of spontaneous internal fistula. Routine evaluation may raise the suspicion of complication. Surgical management requires colonic resection and primary anastomosis. Complete obstruction secondary to diverticular disease is uncommon and generally resolves with conservative management. However, some degree of ileus is frequent secondary to inflammatory changes of diverticulitis but should imperatively be differentiated from ileus observed in case of generalized peritonitis.

  13. 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.

  14. 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.

  15. 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.

  16. Perianal abscesses due to ingested foreign bodies

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    Doublali Mbarek

    2010-01-01

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

  17. Cerebral Abscess Potentially of Odontogenic Origin

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    Marouene Ben Hadj Hassine

    2015-01-01

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

  18. Evidence for increasing severity of community-onset boils and abscesses in UK General Practice.

    Science.gov (United States)

    Shallcross, L J; Hayward, A C; Johnson, A M; Petersen, I

    2015-08-01

    In England, hospital admissions for severe staphylococcal boils and abscesses trebled between 1989 and 2004. We investigated this trend using routine data from primary and secondary care. We used The Health Improvement Network (THIN), a large primary-care database and national data on hospital admissions from Hospital Episode Statistics (HES). Time trends in the incidence of primary-care consultations for boils and abscesses were estimated for 1995-2010. HES data were used to calculate age-standardized hospital admission rates for boils, abscesses and cellulitis. The incidence of boil or abscess was 450 [95% confidence interval (CI) 447-452] per 100 000 person-years and increased slightly over the study period (incidence rate ratio 1·005, 95% CI 1·004-1·007). The rate of repeat consultation for a boil or abscess increased from 66 (95% CI 59-73) per 100 000 person-years in 1995 to peak at 97 (95% CI 94-101) per 100 000 person-years in 2006, remaining stable thereafter. Hospital admissions for abscesses, carbuncles, furuncles and cellulitis almost doubled, from 123 admissions per 100 000 in 1998/1999 to 236 admissions per 100 000 in 2010/2011. Rising hospitalization and recurrence rates set against a background of stable community incidence suggests increased disease severity. Patients may be experiencing more severe and recurrent staphylococcal skin disease with limited treatment options.

  19. 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.

  20. Rapid and discriminatory diagnosis of scrapie and BSE in retro-pharyngeal lymph nodes of sheep

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    van Zijderveld Fred G

    2006-06-01

    Full Text Available Abstract Background Diagnosis based on prion detection in lymph nodes of sheep and goats can improve active surveillance for scrapie and, if it were circulating, for bovine spongiform encephalopathy (BSE. With sizes that allow repetitive testing and a location that is easily accessible at slaughter, retropharyngeal lymph nodes (RLN are considered suitable organs for testing. Western blotting (WB of brain homogenates is, in principle, a technique well suited to both detect and discriminate between scrapie and BSE. In this report, WB is developed for rapid diagnosis in RLN and to study biochemical characteristics of PrPres. Results Optimal PrPres detection in RLN by WB was achieved by proper tissue processing, antibody choice and inclusion of a step for PrPresconcentration. The analyses were performed on three different sheep sources. Firstly, in a study with preclinical scrapie cases, WB of RLN from infected sheep of VRQ/VRQ genotype – VRQ represents, respectively, polymorphic PrP amino acids 136, 154, and 171 – allowed a diagnosis 14 mo earlier compared to WB of brain stem. Secondly, samples collected from sheep with confirmed scrapie in the course of passive and active surveillance programmes in the period 2002–2003 yielded positive results depending on genotype: all sheep with genotypes ARH/VRQ, VRQ/VRQ, and ARQ/VRQ scored positive for PrPres, but ARQ/ARQ and ARR/VRQ were not all positive. Thirdly, in an experimental BSE study, detection of PrPres in all 11 ARQ/ARQ sheep, including 7 preclinical cases, was possible. In all instances, WB and IHC were almost as sensitive. Moreover, BSE infection could be discriminated from scrapie infection by faster electrophoretic migration of the PrPres bands. Using dual antibody staining with selected monoclonal antibodies like 12B2 and L42, these differences in migration could be employed for an unequivocal differentiation between BSE and scrapie. With respect to glycosylation of PrPres, BSE cases

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Iliopsoas abscess: a re-emerging clinical entity not to be forgotten.

    LENUS (Irish Health Repository)

    Al-Hilli, Z

    2009-02-01

    Iliopsoas abscesses are relatively rare clinical entities. They present with subtle and non-specific symptoms and as a result the diagnosis is often delayed, leading to significant morbidity and mortality. With an increasing number of immunocompromised patients in the population the prevalence of this condition is set to rise. Therefore, early diagnosis and appropriate management remain a challenge for clinicians. We present three patients with iliopsoas abscesses, two of which were primary and one of which was secondary to Crohn\\'s disease. The average age of patients was 59 years and both patients with primary psoas abscesses were male. All presented with non-specific symptoms. Psoas sign was present in only one patient. CT confirmed the diagnosis in all cases. Treatment consisted of appropriate antibiotic cover and associated percutaneous drainage. The psoas abscess that was secondary to underlying Crohn\\'s disease was subsequently treated with surgical excision of the affected segment of bowel and lavage of the abscess cavity. A high index of suspicion is required to ensure the accurate and early diagnosis of this rare clinical entity. Abdominal CT scanning remains the gold standard for diagnosis. Management is with appropriate antibiotics and adequate drainage. This can be achieved by either percutaneous or surgical drainage. Such treatment can reduce the overall morbidity and mortality of this condition.

  3. 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.

  4. Splenic abscess due to Salmonella enteritidis

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    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.

  5. Microbiology and Treatment of Acute Apical Abscesses

    Science.gov (United States)

    Rôças, Isabela N.

    2013-01-01

    SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium, Parvimonas, Prevotella, Porphyromonas, Dialister, Streptococcus, and Treponema. Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease. PMID:23554416

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  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. Radiological diagnosis of Brodie's abscess.

    Science.gov (United States)

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

    2002-12-30

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

  13. 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.

  14. 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.

  15. 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

  16. Liver Abscesses after Peritoneal Venous Shunt

    Directory of Open Access Journals (Sweden)

    Hideto Kawaratani

    2013-05-01

    Full Text Available A 70-year-old man was referred to our hospital for high-grade fever with chills. He has visited our hospital for alcoholic liver cirrhosis and diabetes mellitus for over 20 years. Nine months earlier, he had received a peritoneal venous shunt (Denver shunt® because of refractory ascites. Laboratory examinations revealed elevated C-reactive protein and liver dysfunction. Ultrasonography and abdominal enhanced computed tomography showed multiple small abscesses in the right lobe of the liver. Blood culture test did not detect the pathogenic bacteria of liver abscesses. The patient was treated with antibiotics for more than 2 months and cured from the infection, but 3 months later, he developed high-grade fever again. He had a recurrence of multiple small liver abscesses involving both lobes of the liver. He was treated with antibiotics, and the abscesses disappeared within a month. After the antibiotic treatment, he had selective intestinal decontamination with kanamycin. He has had no recurrence of liver abscess for over a year. To our knowledge, this is the first report of liver abscess in a cirrhotic patient with Denver shunt. Clinicians should bear liver abscess in mind when treating patients with high-grade fever and liver dysfunction following Denver shunt implantation.

  17. 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.

  18. Pyogenic brain abscess, a 15 year survey

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    Helweg-Larsen Jannik

    2012-11-01

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

  19. Emphysematous prostatic abscess with rectoprostatic fistula

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    Po-Cheng Chen

    2014-12-01

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

  20. Late-onset chest wall abscess due to a biodegradable rib pin infection after lung transplantation.

    Science.gov (United States)

    Goda, Yasufumi; Chen-Yoshikawa, Toyofumi F; Kusunose, Masaaki; Hamaji, Masatsugu; Motoyama, Hideki; Hijiya, Kyoko; Aoyama, Akihiro; Date, Hiroshi

    2017-03-17

    A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space. Reoperative thoracotomy revealed abscesses mainly located around the fifth rib, where the pin was inserted. Both cultures of the abscess and the fifth rib were positive for methicillin-sensitive S. aureus, which suggested that the rib pin was the cause of the secondary infection. This case suggests the rib pins, even if they are biodegradable, could have a risk of infections side effect especially for the immunosuppressed patients.

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

    Science.gov (United States)

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

    2002-04-01

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

  2. Chronic Osteomyelitis of Clavicle in a Neonate: Report of Morbid Complication of Adjoining MRSA Abscess

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    Shishir Murugharaj Suranigi

    2016-01-01

    Full Text Available Osteomyelitis of clavicle is rare in neonates. Acute osteomyelitis of clavicle accounts for less than 3% of all osteomyelitis cases. It may occur due to contiguous spread, due to hematogenous spread, or secondary to subclavian catheterization. Chronic osteomyelitis may occur as a complication of residual adjoining abscess due to methicillin resistant staphylococcus aureus (MRSA sepsis. We report a newborn female with right shoulder abscess that developed chronic clavicular osteomyelitis in follow-up period after drainage. She required multiple drainage procedures and was later successfully managed with bone curettage and debridement. We report this case to highlight that a MRSA abscess may recur due to residual infection from a chronic osteomyelitis sinus. It may be misdiagnosed as hypergranulation tissue of nonhealing wound leading to inappropriate delay in treatment. High index of suspicion, aggressive initial management, and regular follow-up are imperative to prevent this morbid complication.

  3. Lung Abscess Remains a Life-Threatening Condition in Pediatrics – A Case Report

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    Chirteș Ioana Raluca

    2017-07-01

    Full Text Available Pulmonary abscess or lung abscess is a lung infection which destroys the lung parenchyma leading to cavitations and central necrosis in localised areas formed by thick-walled purulent material. It can be primary or secondary. Lung abscesses can occur at any age, but it seems that paediatric pulmonary abscess morbidity is lower than in adults. We present the case of a one year and 5-month-old male child admitted to our clinic for fever, loss of appetite and an overall altered general status. Laboratory tests revealed elevated inflammatory biomarkers, leukocytosis with neutrophilia, anaemia, thrombocytosis, low serum iron concentration and increased lactate dehydrogenase level. Despite wide-spectrum antibiotic therapy, the patient’s progress remained poor after seven days of treatment and a CT scan established the diagnosis of a large lung abscess. Despite changing the antibiotic therapy, surgical intervention was eventually needed. There was a slow but steady improvment and eventually, the patient was discharged after approximately five weeks.

  4. Pituitary aspergillosis abscess in an immunocompetent black ...

    African Journals Online (AJOL)

    Pituitary aspergillosis abscess in an immunocompetent black woman. ... female patient showed up with amenorrhea-galactorrhea syndrome with infertility for several years. The CT Findings and hormonal studies strongly suggested pituitary ...

  5. Trichomonas species in a subhepatic abscess.

    Science.gov (United States)

    Jakobsen, E B; Friis-Møller, A; Friis, J

    1987-06-01

    A rare case of Trichomonas tenax/Trichomonas hominis and mixed oral bacterial flora in pus from a subhepatic abscess in a patient with a perforated penetrating ventricular ulcer is reported and the possible pathogenicity of the flagellate is discussed.

  6. [Latex agglutination test in amebic liver abscess].

    Science.gov (United States)

    Gómez Maganda y Silva, T; García Carrizosa, R; Torres Valadez, F; Ortiz Ramírez, E; Villaseñor de la Parra, C; Flores González, A; Gómez García, E

    1978-01-01

    Amebic hepatic abscesses are one of the most frequent and serious complications of intestinal amibiasis. Although many methods exists with which the diagnosis can be made, frequently problems do arise. Serologic reactions play an important role in the diagnosis of amebic hepatic abscess. Among the most useful of the serological tests, is that which evaluates agglutination with latex particles. Latex agglutination was positive in 98.5% of 200 cases of proved amebic hepatic abscess. The pros and cons of the utility of this test compared with other serological tests are discussed. It is concluded that or the especialist as well as the general practicioner latex agglutination can be extremely useful in the diagnosis of amebic hepatic abscess.

  7. 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.

  8. Antibiotics Improve Treatment of Skin Abscesses

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_166919.html Antibiotics Improve Treatment of Skin Abscesses Drainage alone resulted ... children and adults, medical experts say. Giving an antibiotic when draining the infection significantly improves recovery, a ...

  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. 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.

  11. 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.

  12. 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...

  13. 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.

  14. Intraventricular tuberculous abscess : a case report.

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    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.

  15. COLLAR STUD ABSCESS AN INTERESTING CASE REPORT

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    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.

  16. 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.

  17. Mammary tuberculosis: percutaneous treatment of a mammary tuberculous abscess

    Energy Technology Data Exchange (ETDEWEB)

    Romero, C.; Carreira, C.; Cereceda, C.; Pinto, J. [Servicio de Radiologia, Hospital Virgen de la Salud, Toledo (Spain); Lopez, R.; Bolanos, F. [Servicio de Cirugia, Hospital Virgen de la Salud, Toledo (Spain)

    2000-03-01

    It is currently very rare to find mammary involvement in cases of tuberculosis, in either primary or secondary form. Diagnosis is classically clinical and microbiological, and the basic techniques used in imaging diagnosis are mammography and ultrasound. Computed tomography may define the involvement of the thoracic wall in those cases which present as mammary masses adhering to deep levels, and is also able to evaluate accompanying pulmonary disease, if it is present. Traditionally, treatment has consisted of quadrantectomy and specific antibiotic therapy. We present a case of tuberculous mammary abscess secondary to pulmonary disease, which was treated by percutaneous drainage controlled by CT and specific antibiotic therapy. We revise the diagnosis, differential diagnosis and treatment of mammary tuberculosis. (orig.)

  18. Endoscopic Drainage of an Odontogenic Pterygoid Muscle Abscess

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    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.

  19. UNUSUAL PRESENTATION OF MASTOID ABSCESS

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    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.

  20. German S3 guidelines: anal abscess and fistula (second revised version).

    Science.gov (United States)

    Ommer, Andreas; Herold, Alexander; Berg, Eugen; Fürst, Alois; Post, Stefan; Ruppert, Reinhard; Schiedeck, Thomas; Schwandner, Oliver; Strittmatter, Bernhard

    2017-03-01

    The incidence of anal abscess and fistula is relatively high, and the condition is most common in young men. This is a revised version of the German S3 guidelines first published in 2011. It is based on a systematic review of pertinent literature. Cryptoglandular abscesses and fistulas usually originate in the proctodeal glands of the intersphincteric space. Classification depends on their relation to the anal sphincter. Patient history and clinical examination are diagnostically sufficient in order to establish the indication for surgery. Further examinations (endosonography, MRI) should be considered in complex abscesses or fistulas. The goal of surgery for an abscess is thorough drainage of the focus of infection while preserving the sphincter muscles. The risk of abscess recurrence or secondary fistula formation is low overall. However, they may result from insufficient drainage. Primary fistulotomy should only be performed in case of superficial fistulas. Moreover, it should be done by experienced surgeons. In case of unclear findings or high fistulas, repair should take place in a second procedure. Anal fistulas can be treated only by surgical intervention with one of the following operations: laying open, seton drainage, plastic surgical reconstruction with suturing of the sphincter (flap, sphincter repair, LIFT), and occlusion with biomaterials. Only superficial fistulas should be laid open. The risk of postoperative incontinence is directly related to the thickness of the sphincter muscle that is divided. All high anal fistulas should be treated with a sphincter-saving procedure. The various plastic surgical reconstructive procedures all yield roughly the same results. Occlusion with biomaterial results in lower cure rate. In this revision of the German S3 guidelines, instructions for diagnosis and treatment of anal abscess and fistula are described based on a review of current literature.

  1. 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.

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

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    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.

  3. 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.

  4. Spinal epidural abscess in a patient with piriformis pyomyositis

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    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.

  5. 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...

  6. 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.

  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. Pituitary abscess during pregnancy: Management dilemmas

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    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.

  9. 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.

  10. RECURRENT SUBCLITORAL ABSCESS TREATED BY MARSUPIALIZATION

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    HORMOZ DABIRASHRAFI

    1986-05-01

    Full Text Available This is a report of a very rare case of recurrent subclitoral abscess. Its etiology and the best treatment of the disease is here in discussed. We, the same as Sur, believe that marsupialization is the most promising treatment. Recurrent periclitoral abscess has been described previously5. s ome of the authors believe that it is part of the pilonidal disease. The first pilonidal cyst in 7 the clitoral region was introduced by Palmer (1957."nAnother case of pilonidal sinus of clitoris was repor-2 ted by Betson . All of the researchers are not in this opinion that the disease is necessarily a pilonidal sinus 1 3,and, sometimes, there is not any hair in the epithelium lining of the cyst. One case of recurrent subclitoral abscess treated by marsupialization is presented here.

  11. 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.

  12. 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.

  13. Foot abscess in sheep: Evaluation of risk factors and management options.

    Science.gov (United States)

    Barwell, Robert; Eppleston, Jeff; Watt, Bruce; Dhand, Navneet K

    2015-12-01

    Foot abscess of sheep is a painful, suppurative and necrotic infection of the phalanges and interphalangeal joints. Sheep affected by foot abscess may be acutely lame and pregnant ewes may die with secondary pregnancy toxemia when they fail to maintain their required level of nutrition. We conducted a cross-sectional observational study to identify and quantify possible risk factors for foot abscess. A questionnaire was designed and used to conduct telephone interviews with 115 sheep farmers in the Central Tablelands of NSW in November 2012. They were asked to provide information on their farm, the animals, and management-related information for the lambing period of a selected cohort of ewes. Multivariable logistic regression analyses were conducted using two outcome variables: (a) the presence of foot abscess, and (b) low (5%) levels of foot abscess. High levels of clover in the paddocks grazed by sheep was associated with increased odds of foot abscess in both the models (binary model odds ratio [OR]: 3.18; 95% confidence interval [CI]: 1.22, 8.77 and ordinal model OR: 2.92; 95% CI: 1.35, 6.54). High risk was also associated with the farmer's observation that it had been a wet season (ordinal model OR: 7.89, 95% CI: 2.72, 24.43) and moving sheep during lambing (binary model OR: 14.15, 95% CI: 2.30, 296.61). Similarly, farms with shale/slate type soils had lower odds of the disease compared to farms with basalt-derived soils. Farmers who used foot-baths (binary model OR: 4.05, 95% CI: 1.15, 19.34) and antibiotics (ordinal model OR: 3.16, 95% CI: 1.38, 7.66) had higher odds of foot abscess, as might be expected as they adopted these measures to deal with an increased prevalence of foot abscess. The findings from this study can be used to provide extension advice to farmers and for designing further confirmatory studies.

  14. Peritonsillar Abscess: Complication of Acute Tonsillitis or Weber's Glands Infection?

    Science.gov (United States)

    Klug, Tejs Ehlers; Rusan, Maria; Fuursted, Kurt; Ovesen, Therese

    2016-08-01

    To review the literature concerning the 2 primary hypotheses put forth to explain the pathogenesis of peritonsillar abscess: "the acute tonsillitis hypothesis" (peritonsillar abscess is a complication of acute tonsillitis) and "the Weber gland hypothesis" (peritonsillar abscess is an infection of Weber's glands). PubMed, EMBASE. Data supporting or negating one hypothesis or the other were elicited from the literature. Several findings support the acute tonsillitis hypothesis. First, the 2 main pathogens in peritonsillar abscess have been recovered from pus aspirates and bilateral tonsillar tissues with high concordance rates, suggesting that both tonsils are infected in patients with peritonsillar abscess. Second, studies report signs of acute tonsillitis in the days prior to and at the time of peritonsillar abscess. Third, antibiotic treatment reduces the risk of abscess development in patients with acute tonsillitis. However, some findings suggest involvement of the Weber's glands in peritonsillar abscess pathogenesis. First, high amylase levels have been found in peritonsillar pus. Second, the majority of peritonsillar abscesses are located at the superior tonsillar pole in proximity of the Weber's glands. We propose a unified hypothesis whereby bacteria initially infect the tonsillar mucosa and spread via the salivary duct system to the peritonsillar space, where an abscess is formed. Our findings support the rationale for antibiotic treatment of patients with severe acute tonsillitis to reduce the risk of abscess development. Improved understanding of peritonsillar abscess pathogenesis is important for the development of efficient prevention strategies. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  15. 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.

  16. ETHMOIDAL SINUSITIS WITH PRESEPTAL ABSCESS: A CASE REPORT

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    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

  17. 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...

  18. Empirical antimicrobial therapy of acute dentoalveolar abscess

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    Matijević Stevo

    2009-01-01

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

  19. 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.

  20. Cervical abscess and mediastinal adenopathy: an unusual presentation of childhood histoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    McGraw, Elizabeth P. [Division of Pediatric Radiology, Department of Radiology, Box 3808, McGovern-Davison Children' s Health Center, Duke University Medical Center, Durham, NC 27710 (United States); Kane, Jason M.; Kleiman, Martin B. [James Whitcomb Riley Children' s Hospital, Indiana University Medical Center, Department of Pediatrics, Section of Pediatric Infectious Disease, 702 Barnhill Drive, Indianapolis, IN 46202 (United States); Scherer, L.R. [James Whitcomb Riley Children' s Hospital, Indiana University Medical Center, Department of Surgery, Section of Pediatric Surgery, 702 Barnhill Drive, Indianapolis, IN 46202 (United States)

    2002-12-01

    Histoplasmosis is the most common endemic respiratory mycosis in the United States. We report the clinical and imaging findings in a case of a child with the rare presentation of a neck abscess and mediastinal lymphadenopathy secondary to acute, non-disseminated histoplasmosis. Imaging findings often mimic other granulomatous infections such as tuberculosis or neoplastic processes such as lymphoma. Histoplasmosis should be considered in the differential diagnosis of a child who presents with enlarged mediastinal and cervical lymphadenopathy. (orig.)

  1. [Actinomycosis sub-masseter abscess, simulating a parotiditis. Review of case and revision of literature].

    Science.gov (United States)

    Padilla Parrado, M; Aranzana Gómez, A; Jiménez Antolín, J A; García Manríquez, A; Céspedes Más, M; Menéndez Loras, L M

    2003-01-01

    We present one case of a pluripathologic female patient who has developed an submaseterin abscess secondary to an actinomyces mandibular osteomielitis. The initial presentation seems an acute supurative parothiditis. We describe its presentation, evolution, special tests done for its diagnostic, as also the discussion of the type and duration of the treatment. And we include also a differential diagnosis between the two diseases, with a similar form. We do also a bibliographic revision of the few similar cases published.

  2. A Late-onset Psoas Abscess Formation Associated with Previous Appendectomy: A Case Report

    OpenAIRE

    Sam Moslemi; Maryam Tahamtan; Seyed Vahid Hosseini

    2014-01-01

    Psoas abscesses could originate from an adjacent source of infection in the abdominopelvic cavity known as a secondary complication of acute appendicitis. However, it is considered as a very rare event when occurring late after the presentation of appendicitis. Whether it is the source or complication of acute appendicitis following appendectomy remains unclear. A 25-year-old man was admitted to our center with fever and abdominal pain. His past medical history was unremarkable except for hav...

  3. 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.

  4. Acute abdomen caused by brucellar hepatic abscess.

    Science.gov (United States)

    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.

  5. 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.

  6. Extensive spinal epidural abscess complicated with hydrocephalus

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    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.

  7. 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.

  8. Amebic liver abscess and polycystic liver disease

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    Karan V. S. Rana

    2013-01-01

    Full Text Available Polycystic liver disease is a rare disorder which remains asymptomatic. Infection of cyst is a major complication and is usually pyogenic. We report a rare case of amebic liver abscess in a patient with polycystic liver disease. In our search we found one such case report. Clinical features and radiological findings are usually sufficient, but atypical history and the presence of multiple hepatic abscesses in CT scan delayed diagnosis in our case. Histopathology of the cyst wall and enzyme immunoassay asserted the diagnosis.

  9. Mycobacterium fortuitum abdominal wall abscesses following liposuction

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    Al Soub Hussam

    2008-01-01

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

  10. Cerebral candida abscess in an infant

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    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.

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Amebic liver abscess in Iranian children

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    Khotaii Gh

    2003-05-01

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

  17. 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.

  18. Hepatic metastasis complicated by abscess formation.

    Science.gov (United States)

    Yi, Liao; Lihua, Qiu; Xianming, Diao; Qiyong, Gong

    2015-01-01

    Hepatic abscesses and hepatic metastasis are common diseases. However, hepatic abscesses seldom occur in patients with hepatic metastases. We describe a case of a 67-year-old female patient with abdominal pain in the right upper quadrant. Magnetic resonance imaging revealed several lesions, with the largest lesion displaying features of both hepatic pyogenic abscess and liver metastasis. These features included iso- or hypointense signaling on T1WI and T2WI, hyperintense signaling on diffusion weighted imaging of the thick wall, and mixed hyperintense signal in the center on DWI, as well as dramatic and irregular peripheral enhancement was detected on LAVA dynamic contrast scanning. Aspiration and culture of the largest lesions revealed Klebsiella pneumoniae and a pathologic diagnosis of adenocarcinoma. At this point, the patient admitted a history of colon adenocarcinoma 9 years ago treated with hemicolectomy. Therefore, this patient was considered to have a hepatic pyogenic abscesses complicated by hepatic metastasis. The patient began treatment for the responsible pathogens and underwent chemoembolization of the liver lesions. In special cases, we could attempt to pursue a more detailed search for coexistence of microorganism infection and tumor.

  19. 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.

  20. 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

  1. Community-Acquired Methicillin-Resistant Staphylococcus aureus Prostatic Abscess Presenting as Acute Urinary Retention: A Case Report and Review of the Literature.

    Science.gov (United States)

    Naboush, Ali; Abou Yassine, Ali; Yasmin, Mohamad; Mobarakai, Neville

    2013-01-01

    Background. Community-associated MRSA (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. Prostatic abscess is an uncommon disease. To date, there are only 6 published reports of a prostatic abscess secondary to CA-MRSA. Case Description. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. Physical examination was remarkable for an enlarged nontender prostate. A urine analysis showed pyuria while urine cultures grew CA-MRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. Our treatment regimen included IV vancomycin followed by oral trimethoprim/sulfamethoxazole and rifampin. Eradication of CA-MRSA was confirmed by follow-up cultures 2 months following discharge. Conclusion. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Early treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity.

  2. Community-Acquired Methicillin-Resistant Staphylococcus aureus Prostatic Abscess Presenting as Acute Urinary Retention: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ali Naboush

    2013-01-01

    Full Text Available Background. Community-associated MRSA (CA-MRSA strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. Prostatic abscess is an uncommon disease. To date, there are only 6 published reports of a prostatic abscess secondary to CA-MRSA. Case Description. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. Physical examination was remarkable for an enlarged nontender prostate. A urine analysis showed pyuria while urine cultures grew CA-MRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. Our treatment regimen included IV vancomycin followed by oral trimethoprim/sulfamethoxazole and rifampin. Eradication of CA-MRSA was confirmed by follow-up cultures 2 months following discharge. Conclusion. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Early treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity.

  3. Hepatic abscess in a pre-existed simple hepatic cyst as a late complication of sigmoid colon ruptured diverticula: a case report

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    Chatzipetrou Maria

    2008-03-01

    Full Text Available Abstract Introduction Hepatic abscesses have been reported as a rare complication of diverticulitis of the bowel. This complication is recognized more commonly at the time of the diagnosis of diverticulitis, or ruptured diverticula, but also can be diagnosed prior to surgery, or postoperatively. Case presentation This report describes a man who developed an hepatic abscess within a simple hepatic cyst, two months after operation for ruptured diverticula of the sigmoid colon. The abscess was drained surgically and the patient made a complete recovery. Conclusion The development of an hepatic abscess in a pre-existing hepatic cyst, secondary to diverticulitis, is a rare complication. A high degree of clinical suspicion is required for immediate diagnosis and treatment.

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

    Science.gov (United States)

    Klug, Tejs Ehlers

    2017-03-01

    transportation of appropriate specimens, choice of methodology for detection and quantification of microorganisms, current or recent antibiotic treatment of patients, potential shift in significant pathogens during the course of infection, and factors associated with increased risk of PTA development.  The trend towards de-escalated surgical intervention and increasing reliance on antibiotic treatment, require studies defining the significant pathogens in PTA in order to determine optimal antibiotic regimens. Complications secondary to PTA may be avoided or better controlled with improved knowledge concerning the significant pathogens in PTA. Furthermore, identification of pathogens other than GAS, may lead the way for earlier bacterial diagnosis and timely intervention before abscess formation in sore throat patients. The identification and quantification of risk factors for PTA development constitutes another approach to reduce the incidence of PTA. As clinicians, we noticed that FN was recovered from PTA patients with increasing frequency and that patients infected with Fusobacterium necrophorum (FN) seemed to be more severely affected than patients infected with other bacteria. Furthermore, we occationally observed concomitant PPA in addition to a PTA, which made us hypothesize that PPA and PTA is often closely related and may share significant pathogens. Hence, our aims were: 1. To explore the microbiology of PTA with a special attention to Fusobacterium necrophorum (FN). 2. To elucidate whether smoking, age, gender, and seasons are risk factors for the development of PTA. 3. To characterize patients with PPA, explore the relationship between PPA and PTA, identify the pathogens associated with PPA, and review our management of PPA. In a retrospective study on all 847 PTA patients admitted to the ENT department at Aarhus University Hospital (AUH) from 2001 to 2006, we found that FN was the most prevalent (23%) bacterial strain in pus specimens. FN-positive patients

  5. 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.

  6. [Surgical treatment of patients with acute abscessed and phlegmonous lactation mastitis].

    Science.gov (United States)

    Oskretkov, V I; Kokin, E F

    2001-01-01

    Under analysis were results of surgical treatment of 256 patients with abscessed and phlegmonous acute lactation mastitis. Radical primary surgical treatment of the purulent cavities allowed prevention of further progression of the inflammation in the mammary gland. The use of the low frequency ultrasound for treatment of the wound allowed to quicker arrest the acute inflammatory process in the tissues of the mammary gland surrounding the purulent cavity. In cases with diffuse purulent acute lactation mastitis it is necessary to take into attention the tension of the suture threads when fulfilling the secondary surgical treatment of the wound and putting in the running secondary early suture.

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

    Directory of Open Access Journals (Sweden)

    Shioya Nobuki

    2012-06-01

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

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

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    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.

  9. 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.

  10. 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.)

  11. A Late-onset Psoas Abscess Formation Associated with Previous Appendectomy: A Case Report

    Directory of Open Access Journals (Sweden)

    Sam Moslemi

    2014-01-01

    Full Text Available Psoas abscesses could originate from an adjacent source of infection in the abdominopelvic cavity known as a secondary complication of acute appendicitis. However, it is considered as a very rare event when occurring late after the presentation of appendicitis. Whether it is the source or complication of acute appendicitis following appendectomy remains unclear. A 25-year-old man was admitted to our center with fever and abdominal pain. His past medical history was unremarkable except for having an acute appendicitis and complicated appendectomy 4 years before presenting illness. On admission, the patient was febrile with right lower quadrant abdominal tenderness and moderate leukocytosis. The Abdominopelvic CT- scan revealed a large right psoas muscle than the opposite site, that contained a hypodense mass measuring 6 cm in diameter with extension into right iliacus and internal oblique muscles..The patient underwent subsequent percutaneous abscess drainage under image guide and concurrent broad-spectrum antibiotic therapy.

  12. A Late-onset Psoas Abscess Formation Associated with Previous Appendectomy: A Case Report.

    Science.gov (United States)

    Moslemi, Sam; Tahamtan, Maryam; Hosseini, Seyed Vahid

    2014-01-01

    Psoas abscesses could originate from an adjacent source of infection in the abdominopelvic cavity known as a secondary complication of acute appendicitis. However, it is considered as a very rare event when occurring late after the presentation of appendicitis. Whether it is the source or complication of acute appendicitis following appendectomy remains unclear. A 25-year-old man was admitted to our center with fever and abdominal pain. His past medical history was unremarkable except for having an acute appendicitis and complicated appendectomy 4 years before presenting illness. On admission, the patient was febrile with right lower quadrant abdominal tenderness and moderate leukocytosis. The Abdominopelvic CT- scan revealed a large right psoas muscle than the opposite site, that contained a hypodense mass measuring 6 cm in diameter with extension into right iliacus and internal oblique muscles..The patient underwent subsequent percutaneous abscess drainage under image guide and concurrent broad-spectrum antibiotic therapy.

  13. Streptococcus constellatus Tubo-ovarian Abscess in a Non-Sexually Active Adolescent Female.

    Science.gov (United States)

    Mills, David; Sharon, Bazak; Schneider, Kari

    2016-06-02

    Tubo-ovarian abscess (TOA) in non-sexually active female adolescents is a rare presentation to the pediatric emergency department. In the following case, bilateral TOA secondary to Streptococcus constellatus was diagnosed in a 13-year-old virginal female. The patient was seen 4 months before presentation for interventional radiology-guided drainage and antibiotic treatment for an intra-abdominal abscess due to suspected appendiceal rupture. Exploratory laparotomy on the most recent presentation demonstrated an appendix with inflammation and serositis on pathology report, a concern for chronic appendicitis with microperforation and subsequent bacterial translocation of the bilateral ovaries. This case report identifies a rare cause, pathogen, and the patient's demographics presenting with bilateral TOA. Most importantly, this case demonstrates the need for emergency medicine physicians to have a high index of suspicion for TOA in patients with a significant medical history of intra-abdominal pathology to promptly diagnose and treat high-morbidity pathology.

  14. [Cervical abscess by Streptococcus anginosus-milleri after foreign body ingestion and suspicion of esophageal perforation].

    Science.gov (United States)

    Pino Rivero, V; Trinidad Ramos, G; González Palomino, A; Pantoja Hernández, C G; Mogollón Cano-Cortés, T; Carrasco Claver, F; Guerra Camacho, M; Blasco Huelva, A

    2006-01-01

    We report a case of cervical abscess after the ingestion of foreign body (chicken bone) secondary to probable esophageal perforation that it was sent to us with suspicion of mediastinal complication. The girl, 17 years-old, nothing else to arrive our hospitalary center required entrance in ICU due to her severe clinical process: High fever, intense neck-thoracic pain, laterocervical diffuse and progressive left inflammation and bad general state. The CT showed the presence of a well defined abscess and abundant aerial component that dissected the cervical muscles that made necessary to perform drainage verifying intraoperatively no mediastinal involvement. The culture of the purulent collection revealed Streptococcus anginosus/milleri resistant to clindamicine but sensible to penicilina and derivatives. We exposed a serie of considerations at respect of such microorganism and its clinical signification.

  15. Prognostic value and staging classification of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy.

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    Ling-Long Tang

    Full Text Available BACKGROUND: The development of intensity-modulated radiotherapy (IMRT has revolutionized the management of nasopharyngeal carcinoma (NPC. The purpose of this study was to evaluate the prognostic value and classification of TNM stage system for retropharyngeal lymph node (RLN metastasis in NPC in the IMRT era. MATERIAL AND METHODS: We retrospectively reviewed data from 749 patients with biopsy-proven, non-metastatic NPC. All patients received IMRT as the primary treatment. Chemotherapy was administered to 86.2% (424/492 of the patients with stage III or IV disease. RESULTS: The incidence of RLN metastasis was 64.2% (481/749. Significant differences were observed in the 5-year disease-free survival (DFS; 70.6% vs. 85.4%, P<0.001 and distant metastasis-free survival (DMFS; 79.2% vs. 90.1%, P<0.001 rates of patients with and without RLN metastasis. In multivariate analysis, RLN metastasis was an independent prognostic factor for disease failure and distant failure (P = 0.005 and P = 0.026, respectively, but not for locoregional recurrence. Necrotic RLN metastases have a negative effect on disease failure, distant failure and locoregional recurrence in NPC with RLN metastasis (P = 0.003, P = 0.018 and P = 0.005, respectively. Survival curves demonstrated a significant difference in DFS between patients with N0 disease and N1 disease with only RLN metastasis (P = 0.020, and marginally statistically significant differences in DMFS and DFS between N1 disease with only RLN metastasis and other N1 disease (P = 0.058 and P = 0.091, respectively. In N1 disease, no significant differences in DFS were observed between unilateral and bilateral RLN metastasis (P = 0.994. CONCLUSIONS: In the IMRT era, RLN metastasis remains an independent prognostic factor for DFS and DMFS in NPC. It is still reasonable for RLN metastasis to be classified in the N1 disease, regardless of laterality. However, there is a need to investigate the feasibility of classifying RLN

  16. 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

  17. A Rare Complication of Brucellosis: Testicular Abscess

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    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.

  18. 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.

  19. 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.

  20. [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.

  1. Treatment of anal fistula and abscess.

    Science.gov (United States)

    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. Copyright © 2014. Published by Elsevier Masson SAS.

  2. 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.

  3. 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.

  4. Intramedullary tubercular abscess with syrinx formation

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    Mohd Khalid

    2012-01-01

    Full Text Available Intramedullary spinal cord tubercular abscess with involvement of whole cord is a rare entity that too with syrinx formation following disseminated meningitis. Accurate diagnosis requires a high index of suspicion with clinical history and imaging features for a favorable outcome. Here-in we present a similar case with tubercular etiology which was also associated with syrinx formation and has not been reported previously in the literature up to the author′s knowledge.

  5. 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.)

  6. Clinical Practice Guidelines for Cerebral Abscess Treatment

    Directory of Open Access Journals (Sweden)

    Danny Barrueta Reyes

    2009-03-01

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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. A cerebral abscess at first internist glance.

    Science.gov (United States)

    Ribeiro, Rita; Patrício, Catarina; Valejo Coelho, Margarida Moura; Brotas, Vítor

    2015-11-27

    A 73-year-old man was transferred to the neurosurgery ward, with a presumptive diagnosis of cerebral abscess. The case was also discussed with the internists as internal medicine consultants. The neurosurgeons pointed out a right temporal lobe abscedated lesion on CT, but we noticed that the hypodense attenuation that usually surrounds the abscess wall (vasogenic oedema) extended to a broader, well-delimitated area, suggesting medium cerebral artery territory. The patient had left-sided hemiplegia with a confusional state and low-grade fever. Considering possible haematogenous dissemination, an echocardiography was performed, confirming mitral endocarditis. Blood cultures and aspirated pus isolated Escherichia coli. Investigating the patient's medical history, we learned he had been submitted to bladder catheterisation 7 weeks before for acute urinary retention due to benign prostatic hyperplasia, and empirically medicated for urinary tract infection. E. coli had also been isolated in a urine specimen at the time. The clinical history of the patient cancelled the pathogenesis of cerebral abscess. 2015 BMJ Publishing Group Ltd.

  12. 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.

  13. Intraperitoneal tuberculous abscess: computed tomography features

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    1996-01-01

    Two case histories are presented. In the first, a 49 year-old man fell on his right hip. He was able to walk, but because of pain he came to our emergency room. Radiographics gave an impression of an undislocated intertrochanteric fracture, scintigraphy confirmed the suspicion. There were no signs of infection. On starting osteosynthesis with the drilling of a hole in the lateral cortex, discharge of pus was observed and curettage of the abscess cavity was performed. In the second, a 21 year-old man hit his right knee against a table. Because of pain he was admitted to hospital. Primary signs of a lesion of the lateral meniscus were found and arthroscopy was scheduled. When readmitted we found signs of an infection and X-ray revealed a Brodie's abscess in the proximal tibia. The abscess cavity was opened and curettage was performed. Radiographics, scintigraphics, blood parameters and pathological and microbiological investigations revealed primary chronic osteomyelitis in both patients. Antibiotic therapy was instituted and six weeks after primary operation bone transplantation was performed. The further course was uncomplicated.

  15. Ultrasound-guided surgical drainage of face and neck abscesses.

    Science.gov (United States)

    Yusa, H; Yoshida, H; Ueno, E; Onizawa, K; Yanagawa, T

    2002-06-01

    An ultrasound-guided surgical drainage technique in which grey-scale and colour Doppler ultrasonography were combined is described. The technique was performed for eight deep subcutaneous abscesses subsequent to odontogenic infection, and provided easy detection and accurate, reliable penetration of abscesses that were difficult to locate by physical examination. Colour Doppler ultrasonography is particularly useful for differentiating blood vessels from the static space of abscesses.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-07-15

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

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

    Science.gov (United States)

    Bagatur, A Erdem; Zorer, Gazi

    2003-03-01

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

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

    Science.gov (United States)

    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

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

  19. 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.

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

    Science.gov (United States)

    Izumi, Masashi; Ikeuchi, Masahiko; Tani, Toshikazu

    2012-08-01

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

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

    Science.gov (United States)

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

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Cerebral abscess associated with odontogenic bacteremias, hypoxemia, and iron loading in immunocompetent patients with right-to-left shunting through pulmonary arteriovenous malformations.

    Science.gov (United States)

    Boother, E J; Brownlow, S; Tighe, H C; Bamford, K B; Jackson, J E; Shovlin, C L

    2017-04-19

    Cerebral abscess is a recognised complication of pulmonary arteriovenous malformations (PAVMs) that allow systemic venous blood to bypass the pulmonary capillary bed through anatomic right-to-left shunts. Broader implications and mechanisms remain poorly explored. Between June 2005 and December 2016, at a single institution, 445 consecutive adult patients with CT-scan confirmed PAVMs (including 403 (90.5%) with hereditary haemorrhagic telangiectasia) were recruited to a prospective series. Multivariate logistic regression, and detailed peri-abscess histories were evaluated to identify potential associations with cerebral abscess. Rates were compared to an earlier non-overlapping series. Thirty-seven (8.3%) of the 445 patients experienced a cerebral abscesses at median age 50 (range 19-76) years. The rate adjusted for ascertainment bias was 27/435 (6.2%). 29/37 (78.4%) abscess patients had no PAVM diagnosis prior to their abscess, a rate unchanged from earlier UK series. 21/37 (56.7%) suffered residual neurological deficits, most commonly memory/cognition impairment; hemiparesis, and visual defects. Isolation of periodontal microbes, and precipitating dental and other interventional events emphasised potential sources of endovascular inoculations. In multivariate logistic regression, cerebral abscess was associated with low oxygen saturation (indicating greater right-to-left shunting); higher transferrin iron saturation index; intravenous iron use for anemia (adjusted odds ratio 5.4 [95% confidence intervals 1.4, 21.1]); male gender; and venous thromboemboli. There were no relationships with anatomic attributes of PAVMs, or red cell indices often increased due to secondary polycythemia. Greater appreciation of the risk of cerebral abscess in undiagnosed PAVMs is required. Lower SaO2 and intravenous iron may be modifiable risk factors.

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

    Science.gov (United States)

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

    1993-05-01

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

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

    Science.gov (United States)

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

    2016-01-01

    Several recent studies have demonstrated that virulence in Entamoeba histolytica is triggered in the presence of both pathogenic and nonpathogenic bacteria species using in vitro and in vivo experimental animal models. In this study, we examined samples aspirated from abscess material obtained from patients who were clinically diagnosed with amebic liver abscess (ALA) or pyogenic liver abscess (PLA). To determine the diversity of bacterial species in the abscesses, we performed partial 16S rRNA gene sequencing. In addition, the E. histolytica and Entamoeba dispar species were genotyped using tRNA-linked short tandem repeats as specific molecular markers. The association between clinical data and bacterial and parasite genotypes were examined through a correspondence analysis. The results showed the presence of numerous bacterial groups. These taxonomic groups constitute common members of the gut microbiota, although all of the detected bacterial species have a close phylogenetic relationship with bacterial pathogens. Furthermore, some patients clinically diagnosed with PLA and ALA were coinfected with E. dispar or E. histolytica, which suggests that the virulence of these parasites increased in the presence of bacteria. However, no specific bacterial groups were associated with this effect. Together, our results suggest a nonspecific mechanism of virulence modulation by bacteria in Entamoeba.

  6. [Paratonsillar abscess in the patients presenting with the non-anginous form of chronic tonsillitis].

    Science.gov (United States)

    Arzamazov, C G; Ivanets, I V

    2013-01-01

    The present study was undertaken for the purpose of the comparative analysis of the degree of severity and inflammation-induced changes in palatine tonsils of the patients presenting with non-anginous forms of chronic tonsillitis both on the side of development of paratonsillitis and on the opposite side showing no visually visible signs of the acute inflammatory process. The secondary objective of the study was to compare pain syndrome during abscess-tonsillectomy and tonsillectomy proper, respectively. We analysed the causes behind the reduction of the total number of tonsillectomies for the treatment of chronic tonsillitis available from the accessible literature for the past 10 years. Moreover the analysis of medical records of the patients with chronic tonsillitis and delayed paratonsillar abscess was performed based on the results of the treatment of the patients admitted to the Otorhinolaryngological Department of the City Clinical Hospital No 1 during the period from 2002 and 2011. The severity of clinical manifestations of the inflammatory process was estimated based on the study of palatine tonsil biopsies removed during surgery using the radioautographic technique. The severity of pain syndrome during abscess-tonsillectomy and tonsillectomy proper was evaluated based on the McGill pain questionnaire. The results of the study confirmed apparent tonsillar inflammation in the patients presenting with chronic tonsillitis including its non-anginous forms.

  7. Pyogenic Liver Abscess Associated with Septic Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    Por-Wen Yang

    2008-09-01

    Conclusion: There is diagnostic value in performing a chest CT scan in diabetic patients who have liver abscess plus abnormal CXR findings with multiple ill-defined peripheral round densities, in order to detect SPE, which has a relatively poor outcome in patients with liver abscess.

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

    Science.gov (United States)

    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.

  9. 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.

  10. Infection of a brain abscess of Mycoplasma hominis.

    OpenAIRE

    Payan, D G; Seigal, N; Madoff, S

    1981-01-01

    Persistent fever in a young man after evacuation of a subdural hematoma caused by a depressed skull fracture made it necessary to carry out a computerized tomographic exam of the head that demonstrated a left frontal lobe brain abscess. Mycoplasma hominis was recovered from this abscess as the sole infecting organism. Serial computerized tomographic scans showed resolution after aspiration and antibiotic therapy.

  11. 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.

  12. 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.

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

    Science.gov (United States)

    Smith, Chez; Kavar, Bhadrakant

    2010-01-01

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

  14. Minimally invasive treatment of multilevel spinal epidural abscess.

    Science.gov (United States)

    Safavi-Abbasi, Sam; Maurer, Adrian J; Rabb, Craig H

    2013-01-01

    The use of minimally invasive tubular retractor microsurgery for treatment of multilevel spinal epidural abscess is described. This technique was used in 3 cases, and excellent results were achieved. The authors conclude that multilevel spinal epidural abscesses can be safely and effectively managed using microsurgery via a minimally invasive tubular retractor system.

  15. 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...

  16. Hepatogastric fistula: A rare complication of liver abscess

    Directory of Open Access Journals (Sweden)

    Shrihari Anikhindi

    2015-01-01

    Full Text Available Rupture of amebic liver abscess into stomach is a rare complication. We report a case of a young male presenting with haematemesis due to a rupture of left lobe amebic liver abscess into stomach. We discuss the diagnosis and management of this rare clinical entity.

  17. Retroperitoneal abscesses in two western lowland gorillas (Gorilla gorilla gorilla).

    Science.gov (United States)

    Hahn, Alicia; D'Agostino, Jennifer; Cole, Gretchen A; Raines, Jan

    2014-03-01

    This report describes two cases of retroperitoneal abscesses in female western lowland gorillas (Gorilla gorilla gorilla). Clinical symptoms included perivulvar discharge, lameness, hindlimb paresis, and general malaise. Retroperitoneal abscesses should be considered as part of a complete differential list in female gorillas with similar clinical signs.

  18. Predictive factors for early aspiration in liver abscess

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  19. 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.

  20. 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....

  1. 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.

  2. 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.

  3. Retroperitoneal abscess: an extra-abdominal manifestation

    OpenAIRE

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

    2015-01-01

    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 ...

  4. 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.

  5. Pyogenic Liver Abscess Caused by Burkhoderia pseudomallei in Taiwan

    Directory of Open Access Journals (Sweden)

    Yu-Lin Lee

    2006-01-01

    Full Text Available Pyogenic liver abscess in Taiwan is a well-known disease entity, commonly associated with a single pathogen, Klebsiella pneumoniae. Melioidosis is an endemic disease in Taiwan that can manifest as multiple abscesses in sites including the liver. We report three cases of liver abscesses caused by Burkholderia pseudomallei. The first patient was a 54-year-old diabetic woman, who presented with liver abscess and a left subphrenic abscess resulting from a ruptured splenic abscess, co-infected with K. pneumoniae and B. pseudomallei. The second patient, a 58-year-old diabetic man, developed bacteremic pneumonia over the left lower lung due to B. pseudomallei with acute respiratory distress syndrome, and relapsed 5 months later with bacteremic abscesses of the liver, spleen, prostate and osteomyelitis, due to lack of compliance with prescribed antibiotic therapy. The third patient was a 61-year-old diabetic man with a history of travel to Thailand, who presented with jaundice and fever of unknown origin. Liver and splenic abscesses due to B. pseudomallei were diagnosed. A high clinical alertness to patients' travel history, underlying diseases, and the presence of concomitant splenic abscess is essential to early detection of the great mimicker, melioidosis. The treatment of choice is intravenous ceftazidime for at least 14 days or more. An adequate duration of maintenance oral therapy, with amoxicillin-clavulanate or trimethoprim-sulfamethoxazole for 12-20 weeks, is necessary to prevent relapse. Liver abscess in Taiwan is most commonly due to K. pneumoniae, but clinicians should keep in mind that this may be a presenting feature of melioidosis.

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

    Directory of Open Access Journals (Sweden)

    Mansoor Mehmood

    2015-01-01

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

  7. [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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

  9. Evaluation and management of spinal epidural abscess.

    Science.gov (United States)

    DeFroda, Steven F; DePasse, J Mason; Eltorai, Adam E M; Daniels, Alan H; Palumbo, Mark A

    2016-02-01

    Spinal epidural abscess (SEA) is an uncommon and potentially catastrophic condition. SEA often presents a diagnostic challenge, as the "classic triad" of fever, spinal pain, and neurological deficit is evident in only a minority of patients. When diagnosis is delayed, irreversible neurological damage may ensue. To minimize morbidity, an appropriate level of suspicion and an understanding of the diagnostic evaluation are essential. Infection should be suspected in patients presenting with axial pain, fever, or elevated inflammatory markers. Although patients with no known risk factors can develop SEA, clinical concern should be heightened in the presence of diabetes, intravenous drug use, chronic renal failure, immunosuppressant therapy, or a recent invasive spine procedure. When the clinical profile is consistent with the diagnosis of SEA, gadolinium-enhanced magnetic resonance imaging of the spinal column should be obtained on an emergent basis to delineate the location and neural compressive effect of the abscess. Rapid diagnosis allows for efficient treatment, which optimizes the potential for a positive outcome.

  10. Endoanal ultrasound in perianal fistulae and abscesses.

    Science.gov (United States)

    Visscher, Arjan Paul; Felt-Bersma, Richelle J F

    2015-06-01

    Endoanal ultrasound is a technique that provides imaging of the anal sphincters and its surrounding structures as well as the pelvic floor. However, endoanal magnetic resonance imaging (MRI) is preferred by most physicians, although costs are higher and demand easily outgrows availability. Endoanal ultrasound is an accurate imaging modality delineating anatomy of both cryptoglandular as well as Crohn perianal fistula and abscess. Endoanal ultrasound is comparable with examination under anesthesia and equally sensitive as endoanal MRI in fistula detection. When fistula tracts or abscesses are located above the puborectal muscle, an additional endoanal MRI should be performed. Preoperative imaging is advocated in recurrent cryptoglandular fistula because a more complex pattern can be expected. Endoanal ultrasound can help avoid missing tracts during surgery, lowering the chance for the fistula to persist or recur. It can easily be performed in an outpatient setting and endosonographic skills are quickly incremented. Costs are low and endoanal ultrasound has the potential to improve outcome of patients with both cryptoglandular and fistulizing Crohn disease; therefore, it values more attention.

  11. [Amebic liver abscess in Tarapoto-Peru].

    Science.gov (United States)

    Samaniego, L; Calderón, J; Rodríguez, J; Zegarra, W; Alegre, P; Ramírez, H

    1992-01-01

    In order to know the incidence and epidemiologic features of the Amebic Hepatic Abscess we realized this study in the medicine service. 86.67% were males, the average age was 41.38 +/- 18.60 years old being more frequent between 30 and 69 years old (74.48%). The more affected were farmers (60%), students (10%) and Housekeepers (6.67%). The average time of the disease was 12.12 +/- 6.35 dias. The most frequent symptoms were abdominal pain in the upper right quadrant (96.66%), Hepatomegaly (83.33%), Fever (82.22%), Diarrhea (37.77%), Nausea (36.66%), Jaundice (33.33%). The initial diagnosis was AHA (45.55%), acute cholecystitis (14.44%), generalized infectious syndrome (7.77%), acute hepatitis (6.66%). The most frequent studies was: echography (98.85%). AHA alone was in the right lobe (84.05%), left lobe (14.49%). The bigger abscess was of 12 cm in diameter. The treatment was metronidazole + antibioticos (37.78%), metronidazole + antibiotico+percutaneous drainage (24.45%), Metronidazole + surgical drainage (3.33%). The complications were right pleural effusion (8.89%), peritonitis (5.56%) and pioneumothorax (1.11%). The hospitalization time was 14 +/- 8.02 days. There was one death (1.11%). The AHA was ones of each 76 deliveries in our medicine service.

  12. Thigh abscess as an extension of psoas abscess: the first manifestation of perforated appendiceal adenocarcinoma: case report.

    Science.gov (United States)

    Petrovic, Igor; Pecin, Ivan; Prutki, Maja; Augustin, Goran; Nedic, Ana; Gojevic, Ante; Potocki, Kristina; Reiner, Zeljko

    2015-08-01

    A 65-year-old woman presented with a painful, swollen, red right thigh and the mild pain in the right abdomen without nausea, vomiting or diarrhoea that lasted for 1 week. Laboratory findings revealed elevated inflammatory markers. Computed tomography of the right thigh, abdomen and pelvis showed an abscess formation in the adductor muscles draining from the abscess that completely occupied the right retroperitoneum up to the diaphragm, dissecting downward through the inguinal canal. Appendix was enlarged with an appendicolith. Emergent exploratory laparotomy revealed a perforated appendix with psoas abscess. Pathohistological diagnosis revealed adenocarcinoma of the appendix. Thigh abscess is an uncommon condition with insidious clinical presentation. Therefore, early recognition and setting of the correct diagnosis enables adequate treatment avoiding additional complications and in some cases potential life-threatening conditions. When upper leg abscess is suspected or proven abdominal examination is mandatory.

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

    Science.gov (United States)

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

    2004-03-01

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

  14. 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

  15. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review.

    Science.gov (United States)

    Bremer, Andrew A; Darouiche, Rabih O

    2004-01-01

    Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.

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

    Directory of Open Access Journals (Sweden)

    Abinash Agarwala

    2015-01-01

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

  17. [Giant liver abscess due to nearly asymptomatic choledocholithiasis].

    Science.gov (United States)

    Colović, Radoje; Grubor, Nikica; Colović, Natasa

    2002-01-01

    Solitary pyogenic liver abscess is usually caused by a metastatic infection through the portal blood flow or through the hepatic arterial blood flow from extra-abdominal pyogenic foci. Besides, it may be the result of local inflammatory diseases, such as cholecystitis, hydatid cyst, haematomas particularly with retained foreign bodies, etc. Suppurative cholangitis usually causes multiple pyogenic liver abscesses. Solitary pyogenic abscess is rarely caused by cholangitis, but practically always by suppurative cholangitis. Giant pyogenic liver abscess due to asymptomatic or mild cholangitis is a rarity. We present on a 63 year old man who developed a giant solitary pyogenic liver abscess in whom no other possible cause could be found or anticipated except practically almost asymptomatic choledocholithiasis accompanied with mild elevation of bilirubin content, alkaline phosphatase and gamma-GT. The patient was successfully treated operatively. Over 1800 ml. of pus was aspirated from the abscess cavity. Operative cholangiography performed in spite of the absence of gall bladder stones undilated and noninflamed common bile duct stone showed a small nonobstructing distal common bile duct stone. The duct was not dilated, the bile was clear and there were no signs of cholangitis in the inside of the common bile duct. Cholecystectomy and abscess cavity drainage led to uneventful recovery. The patient has been symptom-free for more than 3.5 years.

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

    Directory of Open Access Journals (Sweden)

    Jason DeWitt

    2010-01-01

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

  19. Oral microbiota species in acute apical endodontic abscesses

    Directory of Open Access Journals (Sweden)

    Noelle George

    2016-03-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Tuberculous splenic abscess in a neonate with thrombocytopenia

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-09-01

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

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2014-10-01

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

  6. Pancreatic abscess following scrub typhus associated with multiorgan failure

    Institute of Scientific and Technical Information of China (English)

    Sun Young Yi; Jung Hyun Tae

    2007-01-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  8. Excessive Surgical Adhesive Mimicking Aortic Root Abscess: A Case Report.

    Science.gov (United States)

    Silverton, Natalie A; Bull, David A; Morrissey, Candice K

    2017-07-15

    Aortic root abscess is a complication of aortic valve endocarditis that is associated with a high morbidity and mortality. The diagnosis usually is made with transesophageal echocardiography, which is highly sensitive and specific for the disease. We present a case of suspected aortic root abscess 1 week after mechanical aortic valve replacement for native valve endocarditis. The diagnosis was made by the use of transesophageal echocardiography but surgical inspection revealed that the paravalvular fluid collection was excessive surgical adhesive. We discuss the clinical significance and differential diagnosis of aortic root abscess in the setting of infective endocarditis.

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

    Directory of Open Access Journals (Sweden)

    Ashish V Choudhrie

    2012-01-01

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

  10. 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.

  11. 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.

  12. 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.

  13. Spinal epidural abscess treated with antibiotics alone.

    Science.gov (United States)

    Pathak, Ashish; Singh, Poonam; Gehlot, Prateek; Dhaneria, Mamta

    2013-04-30

    Spinal epidural abscess (SEA) is a rare clinical condition among children. Most patients do not present with classical signs. A 13-year-old boy without any predisposing factors presented with paraparesis, bladder and bowel involvement. MRI spine demonstrated an SEA at the C7 and D1 levels on both sides of the midline with cord oedema at the C2-3 to C6 level with minimal marrow oedema in the C6 vertebral body. We treated the patient with antibiotics (ceftriaxone and vancomycin) alone. The patient showed excellent response with only minimal residual gait disturbance at the end of 6 weeks of antibiotic therapy. This is the first paediatric report of complete recovery of a patient at clinical stage 4 following antibiotic treatment alone from India. However, caution should be exercised to closely monitor the patient's recovery as any progression in the neurological state warrants surgery.

  14. Splenic abscesses in a returning traveler.

    Science.gov (United States)

    Guo, Richard F; Wong, Frances L; Perez, Mario L

    2015-02-24

    Burkholderia, an aerobic gram-negative rod, is the causative organism behind melioidosis and is a common soil and water organism found predominantly in South-East Asia. We report the case of a 68 year-old man returning from an extended trip to the Philippines, with splenic hypodense lesions on abdominal computer tomography scan, later confirmed to be culture-positive for Burkholderia pseudomallei. The patient was treated with a course of intravenous ceftazidime followed by eradication therapy with oral doxycycline and trimethoprim-sulfamethoxazole. He recovered with complete resolution of symptoms at follow up. In a returning traveler from an endemic area, melioidosis should be considered as part of the differential for any febrile illness with abscesses.

  15. 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)

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

    Directory of Open Access Journals (Sweden)

    Eunhee Kim

    2011-08-01

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

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

    Science.gov (United States)

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

    2007-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    郭增柱; 王正仪; 安亦军; 祝宏

    1996-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  20. Ultrasound-guided drainage of deep pelvic abscesses

    DEFF Research Database (Denmark)

    Lorentzen, Torben; Nolsøe, Christian; Skjoldbye, Bjørn

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Serhan PİŞKİNPAŞA

    2014-01-01

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

  2. Anterior sacral meningocoele presenting as a peri-anal abscess.

    Science.gov (United States)

    Buxton, N; Bassi, S; Firth, J

    2002-06-01

    Anterior sacral meningoceole is a rare occurrence and presentation as a perianal abscess has not been previously reported. The case is presented and the condition discussed. The potential risks of failing to establish the diagnosis, prior to surgery, are outlined.

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

    Science.gov (United States)

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

    2012-01-01

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

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

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    Kim-Diêp Dang-Tran

    2014-01-01

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

  5. Cervical abscess and pharyngeal fistula in a horse.

    Science.gov (United States)

    Scott, E A

    1975-04-15

    A weanling Quarter Horse filly developed ventral swelling of the lower cervical area after difficult passage of a stomach tube for deworming. Intermittent bilateral nasal discharge developed. Radiography revealed fluid and gas density dorsal to the trachea and esophagus. Surgical incision with drainage and debridement of the abscess and fistulous tract, facilitated by use of drains, led to complete recovery. Contrast medium injected after surgery demonstrated a communication between the abscess and the pharyngeal region.

  6. Diabetes mellitus and spinal epidural abscess: clinical or surgical treatment?

    Science.gov (United States)

    Felício, João S; Martins, Carlliane Lins P; Liberman, Bernardo

    2011-12-01

    Spinal epidural abscess (SEA) is an uncommon condition and its most important predisposing factor is diabetes mellitus. Although the treatment of choice is prompt surgical abscess evacuation, followed by antibiotic therapy, successful conservative treatment of SEA has been reported in some cases. We describe a SEA case in a 23-year old white woman with diabetes for 14 years, who was successfully treated only with antibiotics, and achieved full recovery at the fourth month of follow-up.

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

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    Ravishankaran Praveen

    2010-01-01

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

  8. 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.

  9. 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....

  10. 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

  11. Cold abscess of the anterior abdominal wall: An unusual primary presentation

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    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available Tuberculosis is considered as ubiquitous disease as it involves any organ, but primary involvement of abdominal muscles is very rare. In most cases, the muscle involvement is secondary and is caused by either hematogenous route or direct inoculation from a tuberculous abdominal lymph node or extension from underlying tubercular synovitis and osteomyelitis. Autopsy studies have shown abdominal wall involvement in less than 1% of patients who died of tuberculosis. Antitubercular therapy is main form of management. Surgical intervention is always secondary in the form of either sonography or computerized tomography-guided aspiration or open drainage which is usually reserved for patients in whom medical treatment has failed. A case is hereby reported about primary tubercular anterior abdominal wall abscess without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an apparently healthy individual with any past history of contact or previous antituberculosis therapy.

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

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    Dhaou Mahdi

    2010-10-01

    Full Text Available Abstract Purpose Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage. Methods Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively. Results This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable. For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85% with clinical, biological and radiological recovery of the abscess. There was one failure (14%. The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days. In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20. Conclusion Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization.

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

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    Hiroaki Nagashima

    2014-12-01

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

  14. Comparison of retropharyngeal lymph node and obex region of the brainstem in detection of chronic wasting disease in white-tailed deer (Odocoileus virginianus).

    Science.gov (United States)

    Keane, Delwyn P; Barr, Daniel J; Keller, Jason E; Hall, S Mark; Langenberg, Julie A; Bochsler, Philip N

    2008-01-01

    Chronic wasting disease (CWD) in Wisconsin was first identified in February 2002. By April 2005, medial retropharyngeal lymph node (RLN) tissues had been examined from over 75,000 white-tailed deer for the presence of CWD by either immunohistochemical (IHC) staining for the prion protein associated with CWD (PrP(res)) or by using enzyme-linked immunosorbent assays with confirmation of positives by IHC staining and had been detected in 469 animals. Obex tissue was also available from 438 of the CWD-positive animals and was CWD positive by IHC staining in 355 (81%). To verify whether false-negative results were possible examining only RLN, both obex and RLN samples were examined for CWD by IHC staining from 4,430 of the white-tailed deer harvested from an area in Wisconsin where the overall deer CWD prevalence was approximately 6.2%. Two hundred and fourteen of the 269 positive deer (79.6%) had deposits of PrP(res) in both obex and lymphoid tissues, 55 (20.4%) had deposits only in lymphoid tissue, and there were no deer that had deposits only in obex.

  15. Long-Term Tumor Control despite Late Pseudoprogression on 18F-FDG-PET following Extremely Hypofractionated Stereotactic Radiotherapy for Retropharyngeal Lymph Node Metastasis from Esthesioneuroblastoma

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    Kazuhiro Ohtakara

    2014-08-01

    Full Text Available 18F-FDG-PET is a valuable adjunct to conventional imaging for evaluating treatment response following stereotactic body radiotherapy (SBRT for head and neck malignancies (HNM. The effect of treatment-related inflammation is generally deemed negligible after 12 weeks following conventionally fractionated radiotherapy. Herein, we describe an unusual case showing pseudoprogression on 18F-FDG-PET 2 years after SBRT for retropharyngeal lymph node metastasis (RPLNm from esthesioneuroblastoma. A 36-year-old man presented with right RPLNm 32 months after the diagnosis of esthesioneuroblastoma associated with ectopic adrenocorticotropic hormone production. The RPLNm was treated with SBRT in 2 fractions over 8 days using dynamic conformal arcs with concomitant chemotherapy with cisplatin and etoposide. Although follow-up MRI showed sustained lesion regression, the early/delayed maximum standardized uptake (SUVmax values on dual-time-point 18F-FDG-PET obtained 1 and 2 years after SBRT were 7.7/8.3 and 8.5/10.1, respectively, suggesting local progression. Despite no subsequent focal or systemic treatment, the SUVmax values gradually decreased thereafter over a period of 4 years (3.3/3.4 at 76 months. MRI obtained 7 years after SBRT revealed sustained tumor regression. No obvious relevant toxicities have occurred. Thus, caution should be exercised in the interpretation of the SUVmax change following ablative irradiation for HNM.

  16. Clivus osteomyelitis secondary to Enterococcus faecium infection in a 6-year-old girl.

    Science.gov (United States)

    Rusconi, R; Bergamaschi, S; Cazzavillan, A; Carnelli, V

    2005-09-01

    A 6-year-old girl was diagnosed to suffer from clivus osteomyelitis secondary to Enterococcus faecium infection. On the basis of the magnetic resonance image, the abscess was drained via the posterior wall of the pharyngeal tract immediately. Subsequent antibiotic therapy allowed rapid improvement and long-term healing of the osteomyelitic process without any side effect. Osteomyelitis or abscess of the clivus is very rare in adult patients and extremely rare in children. Some etiopathogenetic hypotheses are discussed in this case.

  17. 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.

  18. 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)

  19. Bacteriology and Antibiotic Susceptibility Pattern of Peitonsillar Abscess

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    A Acharya

    2010-06-01

    Full Text Available INTRODUCTION: Peritonsillar abscess is a common complication of acute tonsillitis. Its management consists of aspiration or surgical drainage followed by appropriate antibiotics. Appropriate antibiotic treatment depends on the common organisms associated with infection and their antibioticsensitivity pattern in local scenario. METHODS: Pus samples aspirated from diagnosed cases of peritonsillar abscess and submitted for culture and sensitivity in last two years were included in this study. Identification of different microorganisms was made on the basis of the microscopic findings, observation of their colony morphology and standard biochemical reactions. Susceptibility pattern to commonly used antibiotics were determined by Clinical Laboratory Standards Institute (CLSI guidelines. RESULTS: Altogether 24 pus samples were included in the study. Positive culture was obtained from 18 samples. Among them one organism was isolated from 13 samples whereas from five samples multiple organisms were isolated. From six samples no organisms could be cultured. Altogether Streptococcus pyogenes was isolated from 12 samples and Staphylococcus aureus from five samples. Other isolated organisms included Haemophlilus influenzae, Pseudomonas aeruginosa, Escherichia coli and Enterococcus species. Penicillin was effective for Streptococcus pyogenes whereas Staphylococcus aureus was resistant to it. Cloxacillin was found to be effective for Staphylococcus aureus. Ciprofloxacin and Ceftazidime were found to be effective for both organisms. CONCLUSIONS: Streptococcus pyogenes and Staphylococcus aureus were more commonly associated with peritonsillar abscess. Streptococcus pyogenes were sensitive to penicillin but all Staphylococcus aureus were resistant to it. This fact should be considered in clinical practice for management of peritonsillar abscess. KEYWORDS: Bacteriology, Peritonsillar abscess, Susceptibility pattern.

  20. Healed perivalvular abscess: Incidental finding on transthoracic echocardiography

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    Vishnu Datt

    2014-01-01

    Full Text Available A 36-year-old male patient presented with the complaints of palpitations and breathlessness. Preoperative transthoracic echocardiography (TTE revealed a bicuspid aortic valve; severe aortic regurgitation with dilated left ventricle (LV and mild LV systolic dysfunction (ejection fraction 50%. He was scheduled to undergo aortic valve replacement. History was not suggestive of infective endocarditis (IE. Preoperative TTE did not demonstrate any aortic perivalvular abscess. Intraoperative transesophageal echocardiography (TEE examination using the mid-esophageal (ME long-axis view, showed an abscess cavity affecting the aortic valve, which initially was assumed to be a dissection flap, but later confirmed to be an abscess cavity by color Doppler examination. The ME aortic valve short-axis view showed two abscesses; one was at the junction of the non-coronary and left coronary commissure and the other one above the right coronary cusp. Intraoperatively, these findings were confirmed by the surgeons. The case report demonstrates the superiority of TEE over TTE in diagnosing perivalvular abscesses.

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

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    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.

  2. Renal abscess after the Fontan procedure: a case report

    Directory of Open Access Journals (Sweden)

    Kumar Suresh

    2011-02-01

    Full Text Available Abstract Introduction The Fontan procedure is an intervention that helps to correct single ventricle physiology. There are many known long-term complications of 'Fontan physiology'. However, the occurrence of renal abscess in such patients has not yet been reported in the literature. The first generation of adults has now undergone the procedure and it is necessary to be aware of the long-term outcomes and complications associated with it. Case presentation We report the case of a 22-year-old South Indian man who had developed a staphylococcal renal abscess against a background of xanthogranulomatous pyelonephritis, nine years after Fontan surgery. He presented to our hospital with a high-grade fever of 25-days duration but with no other symptoms. Physical examination identified costovertebral angle tenderness and pedal edema. An ultrasound scan revealed a mass in his left kidney. The results of a computed tomography scan were consistent with a renal abscess. Despite treatment with the appropriate parenteral antibiotics, there was no change in the size of the abscess and a left nephrectomy was performed as a curative procedure. Conclusions The learning points here are manifold. It is important to be aware of the possibility of renal abscess in a post-procedural patient. The early diagnosis of a septic focus in the kidneymay help to prevent the rare outcome of nephrectomy.

  3. Percutaneous catheter drainage of intraabdominal abscesses and fluid

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tae; Kwon, Tae Hee; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Young Ho [Cheil General Hospital, Seoul (Korea, Republic of)

    1986-10-15

    Percutaneous catheter drainage has been reported to be an effective method in the management of selected patients with abscess and fluid collection. Its high success rate and relatively low complications make the procedure an alternative to surgery in the individual cases. During past two years percutaneous catheter drainage in 25 patients with intraabdominal abscesses and fluid collection was performed at the Department of Radiology, Yonsei University College of medicine. Here the technique and author's results were summarized. 1. The total 25 patients who had percutaneous catheter drainage are 10 liver abscesses, 3 subphrenic, one subhepatic, 4 renal and perirenal, 2 pelvic, one psoas, one anterior pararenal fluid from acute pancreatitis, one pancreas pseudocyst and 2 malignant tumor necrosis. 2. The modified Seldinger technique used for all cases of abscess and fluid drainage under guidance of ultrasound scan. The used catheters were 10F. Pigtail and 14F. Malecot (Cook c/o) catheters. 3. The abscesses and fluid of 17 patients among 25 were cured by the percutaneous catheter drainage and 4 patients were clinically improved. The catheter drainage was failed in 2 patients and 3 complication were developed. 4. The success rate of this procedure was 91.3%, failure rate was 8.7% and complication rate was 12%.

  4. 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.

  5. Falciform ligament abscess from left sided portal pyaemia following malignant obstructive cholangitis

    Directory of Open Access Journals (Sweden)

    Warren Leigh R

    2012-12-01

    left portal venous thrombosis, which was likely to be a delayed discovery and was managed conservatively. We present this patient’s operative images and radiographic findings, which may explain the pathophysiology behind this rare complication. We hypothesize that cholangitis, with secondary portal pyaemia and tracking via the paraumbilical veins, can cause infectious seeding of the falciform ligament, with consequent abscess formation.

  6. Pericardial abscess occurring after tuberculous pericarditis: image morphology on computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gulati, G.S.; Sharma, S. E-mail: meetisv@vsnl.commeetisv@yahoo.com

    2004-06-01

    AIM: To study the image morphology on computed tomography (CT) and magnetic resonance imaging (MRI) of pericardial abscess, an uncommon complication of tuberculous pericarditis. MATERIAL AND METHODS: In a 9-year period, 120 patients with clinical and imaging features of constrictive pericarditis were retrospectively reviewed. Of them, 13 patients (age range, 1-51 years; seven females, six males), who had a pericardial mass on echocardiography, and were subjected to CT (11 patients) and MRI (7 patients), were included as subjects of the present study. Five patients underwent both the investigations. The intra-lesional morphology, location, extent, mass effect on adjacent cardiac chambers, secondary effects on the atria and venae cavae, and pericardial thickness were studied. Histopathological confirmation of tubercular infection was available in nine patients. In the remaining four patients, the diagnosis was based on typical extra-cardiac manifestations of tuberculosis. RESULTS: A total of 15 abscesses were detected. CT showed a lesion with a hypodense core and an enhancing rim in all patients. On spin-echo T1-weighted MRI, 57% of the paients had a lesion with a hyperintense core, suggesting an exudative process. Seventy-one percent of patients showed a lesion with a hyperintense core on T2-weighted MRI, while one lesion was hypointense. Post-gadolinium MRI was performed in two patients and showed an enhancing rim in both, with enhancing septa in one. The predominant site of involvement was in the right atrioventricular (AV) groove (77%). Localized tamponade, suggested by the presence of mass effect on an adjacent cardiac chamber, was noted in nine (69%) cases, with proximal atrial dilatation in 78% of them. Four other patients (31%) had atrial dilatation without a localized mass effect. CONCLUSION: Pericardial abscess is an uncommon complication of constrictive pericarditis. Tuberculosis was responsible for abscess formation in all cases in this study. The

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

    Science.gov (United States)

    Sade, Recep; Polat, Gökhan

    2017-03-01

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

  8. Low-Grade Astrocytoma Associated with Abscess Formation: Case Report and Literature Review

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    Tai-Hsin Tsai

    2008-05-01

    Full Text Available A rare case of low-grade astrocytoma associated with abscess formation occurred in a 52-year-old man presenting with Broca's aphasia. He underwent craniotomy and tumor removal under the impression of brain tumor with necrotic cystic change. Abscess accumulation within the intra-axial tumor was found intraoperatively. Literature related to brain abscess with brain tumor is reviewed, with an emphasis on abscesses with astrocytoma. We discuss the common brain tumors that are associated with abscess, pathogens that coexist with brain tumor, and the pathogeneses of coexisting brain abscess and tumor. It is very important to know how to differentiate between and diagnose a brain abscess and tumor, or brain abscess with tumor, preoperatively from clinical presentation and through the use of computed tomography, conventional magnetic resonance imaging, diffusion-weighted imaging or magnetic resonance spectroscopy.

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

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    Lorena V Maldonado

    2007-12-01

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

  10. Clinical features of Klebsiella pneumoniae liver abscess

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    CHEN Fan

    2016-04-01

    Full Text Available ObjectiveTo analyze the clinical data of Klebsiella pneumoniae liver abscess (KPLA, and to provide a reference for early diagnosis and proper treatment. MethodsThe etiological features of 156 patients with bacterial liver abscess (BLA and positive culture results who were hospitalized in The First Hospital Affiliated to Nanjing Medical University from March 2009 to July 2015 were analyzed retrospectively. According to the culture results, BLA patients were divided into KPLA group (81 patients and non-KPLA (NKPLA group (61 patients, and other positive strains including Escherichia coli were found in the other 14 patients with positive culture results for Klebsiella pneumoniae. The clinical, laboratory, and imaging data of KPLA and NKPLA were compared. The t-test was applied for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was applied for continuous data with skewed distribution between groups; the chi-square test or Fisher′s exact test was applied for comparison of categorical data between groups. ResultsThe most common pathogenic bacteria for BLA were Klebsiella pneumonia. In comparison with the NKPLA group, the KPLA group had a significantly higher proportion of male patients (χ2=4.50, P=0.03, a significantly higher proportion of patients with diabetes (χ2=27.28,P<0.001, and a significantly lower proportion of patients who complained of abdominal pain (χ2=5.24, P=0.02. In the aspects of underlying diseases, the prevalence of biliary tract diseases, previous abdominal surgery, and a history of intraperitoneal tumors showed significant differences between the NKPLA group and the KPLA group (χ2=18.38, 20.87, and 21.68, all P<0.001. As for laboratory examination, the NKPLA group had a significantly greater reduction in hemoglobin compared with the KPLA group (t=4.903, P<0.001. In terms of imaging examination, most BLA patients showed a single lesion in the right lobe of the liver, but

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

    Esther Cheng; Eric Thorpe; Richard Borrowdale

    2016-01-01

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

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

    OpenAIRE

    Clifton, TC; Kalamchi, S

    2011-01-01

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

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

    Science.gov (United States)

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

    1994-01-01

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

  15. 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.

  16. 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.

  17. Shewanella putrefaciens, a rare cause of splenic abscess.

    Science.gov (United States)

    Basir, Norwani; Yong, Alice Moi Ling; Chong, Vui Heng

    2012-04-01

    Splenic abscess is uncommon and is still associated with significant morbidity and mortality. Gram-negative bacilli are the most commonly isolated organisms, followed by Gram-positive cocci. However, the predominant organisms found depend on the geographic location. Shewanella putrefaciens is a Gram-negative non-fermentative oxidative bacillus found in the environment. Infection usually manifests with a number of clinical syndromes, most commonly as skin or soft tissue infections, typically in patients whose immune system is compromised. Intra-abdominal abscess is extremely rare. We report a case of a 22-year-old female who presented with S. putrefaciens splenic abscesses as the first manifestation of diabetes mellitus, which was successfully managed with a course of antibiotic therapy. Copyright © 2011. Published by Elsevier B.V.

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

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    Felipe Francisco Tuon

    2006-10-01

    Full Text Available Subcutaneous candidal abscess is a very rare infection even in immunocompromised patients. Some cases are reported when breakdown in the skin occurs, as bacterial cellulites or abscess, iatrogenic procedures, trauma and parenteral substance abuse. We describe a case of Candida albicans subcutaneous abscess without fungemia, which can be associated with central venous catheter.Abscesso subcutâneo por Candida é infecção muito rara mesmo em pacientes imunocomprometidos. Alguns casos são relatados quando ocorre dano na pele, como celulite bacteriana ou abscesso, procedimentos iatrogênicos, trauma e abuso de substância parenteral. Relatamos caso de abscesso subcutâneo por Candida albicans sem fungemia, que pode estar associado com cateter venoso central.

  19. Isolated abscess in superior rectus muscle in a child

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    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.

  20. Neurological melioidosis in Norway presenting with a cerebral abscess

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    Liv Hesstvedt

    2015-01-01

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

  1. 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...

  2. Klebsiella pneumoniae liver abscess in an immunocompetent child

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    Jang Mi Kwon

    2013-09-01

    Full Text Available Klebsiella pneumoniae has emerged as a leading pathogen for pyogenic liver abscess (PLA in Korea. K. pneumoniae liver abscess (KLA is a potentially life-threatening disease and the diagnosis is challenging. In developed countries, PLA in children is rare and frequently associated with disorders of granulocyte function and previous abdominal infection. We experienced a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter placed in intrahepatic abscess was left for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin were administered for 4 weeks, followed by oral antibiotics (cefixime for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications and the appropriate treatment of KLA.

  3. Solitary liver abscess in a healthy child presenting with fever of unknown origin.

    Science.gov (United States)

    Sakran, W; Kawar, B; Chervinsky, L; Siplovich, L

    2005-06-01

    Pyogenic liver abscess is rarely encountered in normal children. We report a case of solitary pyogenic liver abscess in a healthy child aged 8 months. He presented with fever of unknown origin and mild hepatomegaly. Full recovery was achieved by surgical intervention and prolonged antibiotic treatment. Management and recommended treatment in children with liver abscess are presented.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  6. A new interventional technique for percutaneous treatment of drainage-resistant liver abscess

    NARCIS (Netherlands)

    De Jong, K. P.; Prins, T. R.; Hofker, H. S.

    2010-01-01

    The objective of this case report is to describe a device that can be used as a minimally invasive alternative for the treatment of drainage-resistant liver abscess. The device uses pulse lavage to fragment and evacuate the semi-solid contents of a liver abscess. The treatment of liver abscesses con

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

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

    Science.gov (United States)

    Kozlowski, K

    1980-09-01

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

  9. The specific gallium-67 scan uptake pattern in psoas abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Kao, P.-F.; Tzen, K.-Y.; Tsai, M.-F.; Yen, T.-C. [Dept. of Nuclear Medicine, Univ. School of Medicine, Tauyuan (Taiwan, Province of China); Tsui, K.-H. [Dept. of Urology, Chang Gung Memorial Hospital, Tauyuan (Taiwan, Province of China)

    1998-10-01

    A psoas abscess is a rare clinical entity that presents diagnostic and therapeutic challenges. In this retrospective study, we reviewed gallium-67 scan findings in cases of psoas abscess to determine the specific uptake pattern and the usefulness of {sup 67}Ga scans in diagnosis and management. Fifteen psoas abscess lesions in 13 patients who had undergone a {sup 67}Ga scan during an 8-year period were found in the hospital computer. All but two of the patients had been diagnosed as having fever of unknown origin, urinary tract infection or another irrelevant disease prior to the {sup 67}Ga scan. Of the 15 psoas abscess lesions, 12 (80%) could be clearly diagnosed on the basis of the specific {sup 67} Ga uptake pattern, in which: (1) the oblique direction of the {sup 67}Ga-avid lesion correlates with the orientation of the psoas muscle from the lumbar region to the hip joint region; (2) the lesion does not cross the abdominal midline; (3) the lesion goes through the inguinal region; and (4) the lesion involves at least two-thirds of the whole length of the psoas muscle. The specific features may help in the differentiation of psoas abscess from other intra-abdominal lesions or normal bowel distribution, especially with single-photon emission tomographic images. In 7 of 13 patients (53.8%) the {sup 67}Ga scan findings contributed to the clinical management of the patients by first detecting the focus of the infection. Multiple concomitant {sup 67}Ga-avid lesions were found in ten patients. In conclusion, the specific features as well as the whole-body survey with {sup 67}Ga scan are useful and important in the diagnosis of psoas abscesses and the detection of unexpected concomitant multiple infectious foci in clinically suspicious infectious disease patients. (orig.) With 4 figs., 2 tabs., 29 refs.

  10. Herpes zoster correlates with pyogenic liver abscesses in Taiwan.

    Science.gov (United States)

    Mei-Ling, Shen; Kuan-Fu, Liao; Sung-Mao, Tsai; Cheng-Li, Lin Ms; Shih-Wei, Lai

    2016-12-01

    The purpose of the paper was to explore the relationship between herpes zoster and pyogenic liver abscesses in Taiwan. This was a nationwide cohort study. Using the database of the Taiwan National Health Insurance Program, there were 33049 subjects aged 20-84 years who were newly diagnosed with herpes zoster from 1998 to 2010 that were selected for our study, and they were our herpes zoster group. 131707 randomly selected subjects without herpes zoster were our non-herpes zoster group. Both groups were matched by sex, age, other comorbidities, and the index year of their herpes zoster diagnosis. The incidence of pyogenic liver abscesses at the end of 2011 was then estimated. The multivariable Cox proportional hazard regression model was used to estimate the hazard ratio and 95% confidence interval for pyogenic liver abscesses associated with herpes zoster and other comorbidities. The overall incidence rate was 1.38-fold higher in the herpes zoster group than in the non-herpes zoster group (4.47 vs. 3.25 per 10000 person-years, 95% confidence interval 1.32, 1.44). After controlling for potential confounding factors, the adjusted hazard ratio of pyogenic liver abscesses was 1.34 in the herpes zoster group (95% confidence interval 1.05, 1.72) when compared with the non-herpes zoster group. Sex (in this case male), age, presence of biliary stones, chronic kidney diseases, chronic liver diseases, cancers, and diabetes mellitus were also significantly associated with pyogenic liver abscesses. Patients with herpes zoster are associated with an increased hazard of developing pyogenic liver abscesses.

  11. Prostatic abscess: Diagnosis and management in the modern antibiotic era

    Directory of Open Access Journals (Sweden)

    Punit Tiwari

    2011-01-01

    Full Text Available This retrospective study was aimed at analyzing the clinical findings and thera-peutic strategies in 24 patients who were admitted with prostatic abscess, during the period from 1999 to 2008. The diagnosis of prostatic abscesses was made clinically by digital rectal palpation based on the presence of positive fluctuation with tenderness. All cases were confirmed by trans-rectal ultrasound (TRUS, and only positive cases were included in this study. The diagnostic work-up included analysis of midstream urine and abscess fluid culture for pathogens. Therapeutic options included endoscopic trans-urethral incision or trans-perineal aspiration under ultrasound guidance, or conservative therapy. Of the 24 patients studied, 45.83% of the cases had a pre-di-posing factor, and diabetes mellitus (37.50% was the most common. Digital rectal palpation re-vealed fluctuation in 70.83% of the cases. Trans-abdominal ultrasonography missed the condition in 29.16% of the cases. On TRUS, all the study patients showed hypo-echoic zones, while nine others showed internal septations. In most of the cases, the lesion was peripheral. A causative pathogen could be identified in 70.83% of the cases. Surgical drainage of the abscess by trans-urethral deroofing was performed in 17 cases (including one with failed aspiration, trans-perineal aspiration under TRUS guidance was performed in three cases and conservative therapy was followed in five cases. Our data confirms the importance of predisposing factors in the patho-genesis of prostatic abscess. In most of the cases, the clue to diagnosis is obtained by digital rectal palpation. TRUS gives the definite diagnosis and also helps in follow-up of patients. Trans-urethral deroofing is the ideal therapy where the abscess cavity is more than 1 cm, although in some selected cases, TRUS-guided aspiration or conservative therapy does have a role in treatment.

  12. 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.

  13. 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.

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

    Science.gov (United States)

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

    2015-09-01

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

  15. Abscess or tumour? Lumbar spinal abscess mimicking a filum terminale tumour.

    Science.gov (United States)

    Sajjad, Jahangir; Kaliaperumal, Chandrasekaran; O'Sullivan, Michael

    2012-05-30

    A 62-year-old woman presented with a 4-month history of central lower backache and a 2-week history of progressive bilateral leg weakness. She also complained of numbness on her left thigh and gluteal region, associated with urinary hesitancy and constipation. On examination, she had bilateral partial foot drop, absent knee and ankle reflexes and a negative Babinski's reflex and associated hyperaesthesia in L3 distribution bilaterally with decreased anal tone. Laboratory results revealed normal inflammatory markers. MRI scan demonstrated a large uniformly enhancing lesion in the filum terminale suggestive of a lumbar spinal tumour. An emergency spinal laminectomy from L3 to S2 was performed. Per operatively, the duramater was thickened and hyperaemic. The histopathology report suggested inflammation with no evidence of malignancy. Tissue specimen of cultured Staphylococcus aureus was sensitive to flucloxacillin. A final diagnosis of lumbar spinal abscess was made and subsequent antibiotic treatment led to good clinical recovery.

  16. 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.)

  17. Healthy sheep that differ in scrapie associated PRNP genotypes exhibit significant differences of expression pattern associated with immune response and cell-to-cell signalling in retropharyngeal lymph nodes.

    Science.gov (United States)

    Komolka, Katrin; Ponsuksili, Siriluck; Schwerin, Manfred

    2013-04-15

    The present study was conducted to test the hypothesis whether prion protein gene (PRNP) associated scrapie susceptibility is connected with physiological changes in tissue involved in pathogen uptake, migration and propagation. Jejunum, ileal Peyer's patches, retropharyngeal lymph nodes, brain stem and liver of healthy and non scrapie-infected sheep with PRNP genotypes representing the scrapie risk class R1 (scrapie-resistant) and R5 (scrapie-susceptible), respectively, were comparatively analysed by microarray technology and quantitative reverse transcriptase polymerase chain reaction (RT qPCR). Significantly higher expression levels of genes involved in immune response and cell communication pathways in retropharyngeal lymph nodes of R1 sheep in comparison with R5 animals strongly suggest PRNP associated physiological processes with impact as an early barrier in pathogen defence. Equal expression patterns in brain stem suggest no physiological differences in brain of healthy R1 and R5 animals. In addition, similar expression pattern in liver indicates that there are no transcriptional differences in genes of the hepatic energy metabolism between animals of scrapie classes R1 and R5.

  18. Abscess Formation of the Round Ligament of the Liver: Report of a Case

    Directory of Open Access Journals (Sweden)

    Ikeda,Eiji

    2008-12-01

    Full Text Available Abscess formation of the round ligament of the liver is very rare. We report a case of a 70-year-old female with abscess of the round ligament after an endoscopic papillotomy for choledocholithiasis. On the 21st day following papillotomy, abscess formation of the round ligament was found by ultrasonographic examination. Surgical treatment was performed because conservative therapy was not effective. The purulent fluid and necrotic tissue at the round ligament were completely removed. Cultures obtained from the abscess grew Staphylococcus epidermidis, but the mechanism of abscess formation in this case remains unclear.

  19. Methicillin-Resistant Staphylococcus aureus Prostatic Abscess in a Liver Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Tanima Jana

    2014-01-01

    Full Text Available Prostatic abscesses are usually related to gram-negative bacilli. However, methicillin-resistant Staphylococcus aureus (MRSA has emerged as a substantial cause of prostatic abscesses in recent years. Herein, we report the case of a 31-year-old man with a history of orthotopic liver transplantation 10 years ago who presented with acute onset dysuria and abdominal pain and was diagnosed with a MRSA prostatic abscess. To our knowledge, this is the first case describing a prostatic abscess in a liver transplant recipient and the first reporting MRSA as the causative organism of a prostatic abscess in a solid organ transplant recipient.

  20. Therapeutical efficacy of CT-guided relief puncture in amebic liver abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Mansfeld, L.; Boitz, F.; Poehls, C.; Cimanowski, N.

    1987-09-01

    Amebic liver abscesses are the most frequent clinical manifestations of the extra-intestinal amebiasis and have to be considered as a serious complication in the course of disease. The abscesses have by their risk of rupturing and bacterial superinfection quoad vitam an unfavourable prognosis. CT-guided relief punctures can, as it is demonstrated by two cases of critical amebic abscesses, effectively improve the therapy with systemic amebicides, prevent imminent rupture and contribute to the healing of the abscesses. Thus a surgical treatment of the abscess was not necessary.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Psoas muscle abscess simulating acute appendicits: A case report

    Directory of Open Access Journals (Sweden)

    Eugenio L.C. Miller

    2016-01-01

    Conclusion: The psoas muscle abscess is uncommon and poorly characterized in its etiology, clinical associations, and its therapeutic approach. On the other hand, acute appendicitis is the most common abdominal emergency, with a 7% death rate, and surgery is its main treatment.

  3. 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.

  4. Medicolegal cases for spinal epidural hematoma and spinal epidural abscess.

    Science.gov (United States)

    French, Keisha L; Daniels, Eldra W; Ahn, Uri M; Ahn, Nicholas U

    2013-01-01

    Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases.

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

    Science.gov (United States)

    Al-Hourani, Khalid; Frost, Chelsea

    2015-01-01

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

  6. Spinal epidural abscess: correlation between MRI findings and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Tung, G.A.; Yim, J.W.K.; Rogg, J.M. [Dept. of Diagnostic Imaging, Brown University School of Medicine, Providence, RI (United States); Mermel, L.A.; Philip, L. [Dept. of Internal Medicine, Division of Infectious Diseases, Brown University School of Medicine and Rhode Island Hospital, Providence (United States)

    1999-12-01

    Our purpose was to determine if specific MRI findings in spinal epidural abscess (SEA), at the time of diagnosis, are associated with the clinical outcome. The clinical records and MRI studies of 18 patients with SEA were reviewed and follow-up was obtained from the outpatient medical record, telephone interview, or both. The association between findings on contrast-enhanced MRI and clinical outcome (weakness, neck or back pain, and incomplete functional recovery) was evaluated. With univariate analysis, narrowing of 50 % or more of the central spinal canal (P = 0.03), peripheral contrast-enhancement (P = 0.05), and abnormal spinal cord signal intensity (P = 0.05) were associated with weakness at follow-up. Persistent neck or back pain was associated with spinal canal narrowing (P = 0.02), peripheral contrast-enhancement (P = 0.02), and an abscess longer than 3 cm (P = 0.04) on MRI. Incomplete clinical recovery was associated with both abscess length (P = 0.01) and the severity of canal narrowing (P = 0.01). Abscess length, enhancement pattern, and severity of canal narrowing can be incorporated in a grading system that can be used to predict outcome. (orig.)

  7. Isolated tuberculous splenic abscess in an immunocompetent individual

    Institute of Scientific and Technical Information of China (English)

    Parveen Rana Kundu; SK Mathur; Sunita Singh; Amrita Duhan; Garima Aggarwal; Rajeev Sen

    2011-01-01

    Tuberculosis (TB) of the spleen is an extremely rare clinical entity particularly among immunocompetent persons. We report a case of isolated tuberculous abscess of spleen in a 13-years- old boy. No primary focus of infection was detected in lungs or any other organ. The patient was treated by splenectomy after a therapeutic failure with standard antituberculous medication.

  8. Left ventricle to left atrium shunt via a paravalvular abscess.

    Science.gov (United States)

    Gasparovic, H; Smalcelj, A; Brida, M

    2009-10-01

    Intracardiac fistulas are rare complications of infective endocarditis that contribute to the complexity of surgical management, and impose an additional hemodynamic burden on the already challenged heart. We report on a case of successful surgical management of a paravalvular communication between the left ventricle and the left atrium via an abscess cavity. Georg Thieme Verlag KG Stuttgart. New York.

  9. Ewing′s sarcoma in mandibular similar to dental abscess

    Directory of Open Access Journals (Sweden)

    Forouz Keshani

    2014-01-01

    This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing′s sarcoma diagnosis.

  10. 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)

  11. 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.

  12. Brain Abscess Caused by Tsukamurella tyrosinosolvens in an Immunocompetent Patient▿

    Science.gov (United States)

    Sheng, Wang-Huei; Huang, Yu-Tsung; Chang, Shan-Chwen; Hsueh, Po-Ren

    2009-01-01

    We describe a previously healthy patient with chronic otitis media complicated with cerebellar abscess caused by Tsukamurella tyrosinosolvens. The organism was identified based on conventional biochemical identification methods, PCR-restriction fragment length polymorphism analysis of the hsp65 gene, and 16S rRNA gene sequencing. The patient was treated successfully with debridements and prolonged antibiotic therapy. PMID:19297591

  13. Brain abscess caused by Tsukamurella tyrosinosolvens in an immunocompetent patient.

    Science.gov (United States)

    Sheng, Wang-Huei; Huang, Yu-Tsung; Chang, Shan-Chwen; Hsueh, Po-Ren

    2009-05-01

    We describe a previously healthy patient with chronic otitis media complicated with cerebellar abscess caused by Tsukamurella tyrosinosolvens. The organism was identified based on conventional biochemical identification methods, PCR-restriction fragment length polymorphism analysis of the hsp65 gene, and 16S rRNA gene sequencing. The patient was treated successfully with debridements and prolonged antibiotic therapy.

  14. 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.

  15. Brain abscess due to Aggregatibacter aphrophilus and Bacteroides uniformis.

    Science.gov (United States)

    Bogdan, Maja; Zujić Atalić, Vlasta; Hećimović, Ivan; Vuković, Dubravka

    2015-01-01

    The aim of this report was to describe the occurrence of a bacterial brain abscess in a healthy individual, without any predisposing condition. A thirteen-year old boy was admitted to the Department of Neurosurgery after the onset of vomiting, headache and dizziness. A neurological deficit was detected during the physical examination so urgent magnetic resonance imaging of the brain was performed, revealing an intrahemispheric, right positioned solitary expansive mass with ring enhancement. Purulent material was obtained during osteoplastic craniotomy with total extirpation of the brain abscess. Aggregatibacter aphrophilus and Bacteroides uniformis were isolated. The patient's general condition improved and the neurological deficit subsided as a result of the prompt recognition and treatment of this life threatening condition. To achieve a favourable clinical outcome, prompt recognition and surgical treatment of a brain abscess are of primary importance,followed by administration of appropriate antimicrobial therapy. To our best knowledge, this is the first report of this combination of microorganisms as the cause of a brain abscess. Copyright © 2015 by Academy of Sciences and Arts of Bosnia and Herzegovina.

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

    DEFF Research Database (Denmark)

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

    1990-01-01

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

  17. 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.

  18. Pelvic Primary Staphylococcal Infection Presenting as a Thigh Abscess

    Directory of Open Access Journals (Sweden)

    T. O. Abbas

    2013-01-01

    Full Text Available Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and present as a thigh abscess. We present a case of a primary pelvic staphylococcal infection presenting as a thigh abscess. The patient was a 60-year-old man who presented with left posterior thigh pain and fever. Physical examination revealed a diffusely swollen left thigh with overlying erythematous, shiny, and tense skin. X-rays revealed no significant soft tissue lesions, ultrasound was suggestive of an inflammatory process, and MRI showed inflammatory changes along the left hemipelvis and thigh involving the iliacus muscle group, left gluteal region, and obturator internus muscle. The abscess was drained passively via two incisions in the posterior left thigh, releasing large amounts of purulent discharge. Subsequent bacterial culture revealed profuse growth of Staphylococcus aureus. The patient recovered uneventfully except for a moderate fever on the third postoperative day.

  19. Pelvic primary staphylococcal infection presenting as a thigh abscess.

    Science.gov (United States)

    Abbas, T O

    2013-01-01

    Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and present as a thigh abscess. We present a case of a primary pelvic staphylococcal infection presenting as a thigh abscess. The patient was a 60-year-old man who presented with left posterior thigh pain and fever. Physical examination revealed a diffusely swollen left thigh with overlying erythematous, shiny, and tense skin. X-rays revealed no significant soft tissue lesions, ultrasound was suggestive of an inflammatory process, and MRI showed inflammatory changes along the left hemipelvis and thigh involving the iliacus muscle group, left gluteal region, and obturator internus muscle. The abscess was drained passively via two incisions in the posterior left thigh, releasing large amounts of purulent discharge. Subsequent bacterial culture revealed profuse growth of Staphylococcus aureus. The patient recovered uneventfully except for a moderate fever on the third postoperative day.

  20. Renal Abscess in a Patient Presenting with Persistent Hiccups

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

  2. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    1997-06-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

  6. CLINICAL PRESENTATION AND MANAGEMENT OF AMOEBIC LIVER ABSCESS

    Directory of Open Access Journals (Sweden)

    Naveen

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES ALA has gained importance during recent years as a result of increasing world travel, economic globalization and the growing number of chronically immunosuppressed people. AIDS and the increasing use of organ transplants have led to a new population at risk. In our study we aimed to analyse the clinical presentation and management of Amoebic liver abscess at Sree Rajarajeshwari Medical College and Hospital, Bangalore. METHODS A hospital based prospective observational study was conducted between Dec. 2013 to June 2015 in Sree Rajarajeshwari Medical College and Hospital, Bangalore. All patients admitted with suspicion of liver abscess were confirmed with ultrasonography. After establishing sonological diagnosis according to criteria, the treatment was started from the day of admission which consisted of Antibiotics, USG guided Aspiration, Pigtail catheterization and Open surgical Drainage. RESULTS Forty five cases of Amoebic liver abscess were studied; 28 patients (62% were between 21 and 40 years of age. Male-to-Female ratio was 14:1. All the patients were from rural background. History of alcoholism was present in 10 patients (22.2%. Plain X-ray abdomen showed signs of peritonitis in 2 patients. Right lobe of liver was involved in 40 cases and left lobe in 3 cases. Both lobes were involved in 2 cases. Twenty six cases were treated conservatively, 11 cases by aspiration, 6 patients by pigtail catheterization. Two patients underwent open surgical drainage for perforated liver abscess. Complications noted in our series were rupture into peritoneal cavity in 2 cases; mortality was seen in 1 case. CONCLUSION Amoebic liver abscess is still one of the commonest parasitic infections of the liver in developing countries. Prompt diagnosis, aggressive medical treatment along with minimal intervention can keep the morbidity and mortality associated with this condition to a bare minimum. The scope of surgery in this condition is

  7. Dentoalveolar abscess among children attending a dental clinic in Nigeria.

    Science.gov (United States)

    Azodo, C C; Chukwumah, N M; Ezeja, E B

    2012-09-01

    To determine the incidence and causes of dentoalveolar abscess among children attending an outpatient dental clinic in Nigeria. This is a retrospective study of paediatric dental patients treated in University of Benin Teaching Hospital, Benin City from October 2010 to September 2011. The incidence of dentoalveolar abscess was 6.4% (53/824). However only 42 cases had their case notes retrieved for final research analysis. It occurred mostly in the lower right quadrant of the mouth. The affected children were majorly males and first or second child of monogamous family. A total 17 (40.5%) of the affected children were in the 6-11 years age group. This was the first dentist consultation among 35 (83.3%) of the children. The presenting complaint was toothache among two-thirds of the children. History of asthma, tonsillitis, peptic ulcer disease and previous surgery were medical history elicited from 6 (14.3) of the patients. The most implicated tooth was deciduous first molar. The causes of abscess include untreated dental caries 35 (83.3%), trauma 5 (11.9%), failed restoration 1 (2.4%) and periodontal diseases 1 (2.4%). Periapical radioluscency was predominant radiological finding among affected children. Tooth extraction was commonest treatment done. The incidence of dentoalveolar abscess among children was significant. The high frequency of untreated dental caries as the cause of dentoalveolar abscess indicates the need for school and community-based preventive strategies like encouraging infant oral health and preventive dentistry programs and early treatment intervention and dental health education.

  8. Teaching Incision and Drainage: Perceived Educational Value of Abscess Models.

    Science.gov (United States)

    Adams, Cynthia M; Nigrovic, Lise E; Hayes, Gavin; Weinstock, Peter H; Nagler, Joshua

    2017-07-17

    Incision and drainage (I&D) of skin abscesses is an important procedural skill for pediatric emergency medicine providers. Practical skills training using simulation provides an opportunity to learn and gain confidence with this invasive procedure. Our objective was to assess the perceived educational value of 2 versions of an abscess model as part of an educational workshop for teaching I&D. A combined didactic and practical skills workshop was developed for use at 2 national conferences. The didactic content was created through an iterative process. To facilitate hands-on training, 2 versions of an abscess model were created: 1 constructed from a negative mold and the other using a 3-dimensional printer. Participants were surveyed regarding prior experience with I&D, procedural confidence, and perceptions of the educational utility of the models. Seventy physicians and 75 nurse practitioners participated in the study. Procedural confidence improved after training using each version of the model, with the greatest improvements noted among novice learners. Ninety-four percent of physicians, and 99% of nurse practitioners rated the respective models as either "educational" or "very educational," and 97% and 100%, respectively, would recommend the abscess models to others. A combined didactic and practical skills educational workshop using novel abscess models was effective at improving learners' confidence. Our novel models provide an effective strategy for teaching procedural skills such as I&D and demonstrate a novel use of 3-dimensional printers in medical education. Further study is needed to determine if these educational gains translate into improvement in clinical performance or patient outcomes.

  9. Preseptal Cellulitis, Orbital Cellulitis, Orbital Abscess

    OpenAIRE

    Rana Altan Yaycıoğlu

    2012-01-01

    Patients with orbital infections present to our clinic usually with unilateral pain, hyperemia, and edema of the eyelids. The differentiation between preseptal and orbital cellulitis is utmost important in that the second requires hospitalization. Since in orbital cellulitis, the tissues posterior to the orbital septum are involved, signs such as conjunctival chemosis, limited eye movement, decreased vision, as well as afferent pupil defect secondary to optic nerve involvement may al...

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

    Directory of Open Access Journals (Sweden)

    Jairo Cordero-Chen

    2013-03-01

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

  11. Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study.

    Science.gov (United States)

    Zimmerer, Stephan M E; Conen, Anna; Müller, Andreas A; Sailer, Martin; Taub, Ethan; Flückiger, Ursula; Schwenzer-Zimmerer, Katja C

    2011-12-01

    Spinal epidural abscess (SEA) is a rare, but serious, condition with multiple causes. We prospectively studied the aetiology, predisposing factors, and clinical outcomes of SEA in all patients with SEA treated in our hospital's neurosurgical service from 2004 to 2008. For each patient, we recorded the medical history, comorbidities, focus of infection, pathogen(s), and outcome. The 36 patients (19 women and 17 men) ranged in age from 34 to 80 years old (mean 57; median 56). The SEA was primary (i.e., due to haematogenous spread) in 16 patients (44%); it was secondary to elective spinal procedures, either injections or surgery, in 20 patients (56%). The duration of follow-up was 12-60 months (mean 36; median 37.5). The most common pathogen, Staphylococcus aureus, was found in 18 patients (50%). Patients with primary SEA had different underlying diseases and a wider range of pathogens than those with secondary SEA. Only five patients (14%) had no major comorbidity; 16 of the 20 patients with secondary SEA (44% of the overall group) had undergone spinal surgery before developing the SEA; the treatment of the SEA involved multiple surgical operations in all 16 of these patients, and spinal instrumentation in 5 (14%); 22 patients (61% of the overall group) recovered fully.

  12. Word catheter and marsupialisation in women with a cyst or abscess of the Bartholin gland (WoMan-trial): a randomised clinical trial.

    Science.gov (United States)

    Kroese, J A; van der Velde, M; Morssink, L P; Zafarmand, M H; Geomini, P; van Kesteren, Pjm; Radder, C M; van der Voet, L F; Roovers, Jpwr; Graziosi, Gcm; van Baal, W M; van Bavel, J; Catshoek, R; Klinkert, E R; Huirne, Jaf; Clark, T J; Mol, Bwj; Reesink-Peters, N

    2017-01-01

    To compare recurrence of a cyst or abscess of the Bartholin gland after surgical treatment using a Word catheter or marsupialisation. Multicentre, open-label, randomised controlled trial. Eighteen hospitals in the Netherlands and one hospital in England. Women with a symptomatic cyst or abscess of the Bartholin gland. Women were randomised to treatment with Word catheter or marsupialisation. The primary outcome was recurrence of the cyst or abscess within 1 year of treatment. The secondary outcomes included pain during and after treatment (measured on a 10-point scale), use of analgesics, and time from diagnosis to treatment. Analysis was by intention-to-treat. To assess whether marsupialisation would reduce the recurrence rate by 5% (from 20 to 15%) we needed to include 160 women (alpha error 0.05, beta error 0.2). One hundred and sixty-one women were randomly allocated to treatment by Word catheter (n = 82) or marsupialisation (n = 79) between August 2010 and May 2014. Baseline characteristics were comparable. Recurrence occurred in 10 women (12%) allocated to Word catheter versus eight women (10%) allocated to marsupialisation: relative risk (RR) 1.1, 95% confidence interval (CI) 0.64-1.91; P = 0.70. Pain scores after treatment were also comparable. In the first 24 hours after treatment, 33% used analgesics in the Word catheter group versus 74% in the marsupialisation group (P Word catheter versus 4 hours for marsupialisation (P = 0.001). In women with an abscess or cyst of the Bartholin gland, treatment with Word catheter and marsupialisation results in comparable recurrence rates. Comparable recurrence rates for treatment of Bartholinic abscess/cyst with Word catheter and marsupialisation. © 2016 Royal College of Obstetricians and Gynaecologists.

  13. Is it an acute Mastoiditis with Torticollis?

    Directory of Open Access Journals (Sweden)

    Antonio Greco

    2014-03-01

    Full Text Available Retropharyngeal abscess is uncommonly after acute pharyngitis,. We reported a case of a deep neck abscess with torticollis in a youngwoman, misdiagnosed. Retropharyngeal abscess with mediastinal extension is a rare life-threatening complication with a mortalityrate as high as 40%.When a patient shows a torticollis with fever we must suspect a deep neck infection could be present and it is necessary to perform aTC or MRI of the neck. A retropharyngeal abscess rarely occurs but must be suspected otherwise the abscess can advance toward themediastine and cause a mediastinitis that could be very dangerous for patient’s healthy.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  16. CT diagnosis of subphrenic abscess after splenectomy for trauma; Ruolo della tomografia computerizzata nella valutazione degli ascessi subfrenici dopo splenectomia post-traumatica

    Energy Technology Data Exchange (ETDEWEB)

    Salzano, A. [Ospedale Loreto-Mare, Neaples (IT). Serv. di Radiologia] [and others

    1999-09-01

    The paper studies subphrenic inflammatory abscesses and splenic fluid collections after splenectomy for trauma. These complications may appear early or late postoperatively; they are easily demonstrated with computerized tomography, which permits accurate spatial assessment of the lesions and appropriate treatment with percutaneous drainage. It has been also investigates the diagnostic accuracy of the CT in subphrenic inflammatory conditions after emergency splenectomy for traumatic spleen rupture and found that CT is a precious tool for rapid and easy diagnosis and follow-up of subphrenic abscesses treated with percutaneous drainage. [Italian] Scopo del lavoro e' di valutare il ruolo della tomografia computerizzata nelle flogrosi subfreniche secondarie a splenectomia d'urgenza per rottura traumatica della milza, documentando come tale metodica risulti accurata nel diagnosticare e monitorare in modo semplice e rapido l'evoluzione e il controllo degli ascessi subfrenici trattati con drenaggio percutaneo.

  17. Pituitary abscess: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Apostolos K A Karagiannis

    2016-06-01

    Full Text Available Pituitary abscess is a rare life-threating entity that is usually misdiagnosed as a pituitary tumor with a definite diagnosis only made postoperatively. Over the last several decades, advances in healthcare have led to a significant decrease in morbidity and mortality due to pituitary abscess. We report a case of a 34-year-old woman who was admitted to our department for investigation of a pituitary mass and with symptoms of pituitary dysfunction, headaches and impaired vision. During her admission, she developed meningitis-like symptoms and was treated with antibiotics. She eventually underwent transsphenoidal surgery for excision of the pituitary mass. A significant amount of pus was evident intraoperatively; however, no pathogen was isolated. Six months later, the patient was well and had full recovery of the anterior pituitary function. Her menses returned, and she was only on treatment with desmopressin for diabetes insipidus that developed postoperatively.

  18. Spinal epidural abscess: a rare complication of olecranon bursitis.

    Science.gov (United States)

    Evans, Rhys D R; Thaya, Moe; Chew, Ne Siang; Gibbons, Charles E R

    2009-06-30

    Spinal epidural abscess is a rare but potentially fatal condition if left untreated. We report the case of a 67-year old man who presented to the Accident and Emergency department complaining of acute onset of inter-scapular back pain, left leg weakness and loss of sensation in the left foot. On examination he was found to be pyrexial with long tract signs in the left lower leg. In addition he had a left sided olecranon bursitis of three weeks duration. Blood tests revealed raised inflammatory markers and a staphylococcal bacteremia. Magnetic resonance imaging (MRI) confirmed the diagnosis of spinal epidural abscess and he subsequently underwent a three level laminectomy with good resolution of his back pain and neurological symptoms. He has made a complete recovery with a prolonged course of intravenous antibiotics.

  19. Spinal epidural abscess: a rare complication of olecranon bursitis

    Directory of Open Access Journals (Sweden)

    Rhys D.R. Evans

    2009-03-01

    Full Text Available Spinal epidural abscess is a rare but potentially fatal condition if left untreated. We report the case of a 67-year old man who presented to the Accident and Emergency department complaining of acute onset of inter-scapular back pain, left leg weakness and loss of sensation in the left foot. On examination he was found to be pyrexial with long tract signs in the left lower leg. In addition he had a left sided olecranon bursitis of three weeks duration. Blood tests revealed raised inflammatory markers and a staphylococcal bacteremia. Magnetic resonance imaging (MRI confirmed the diagnosis of spinal epidural abscess and he subsequently underwent a three level laminectomy with good resolution of his back pain and neurological symptoms. He has made a complete recovery with a prolonged course of intravenous antibiotics.

  20. Holocord spinal epidural abscess: Case report and literature review.

    Science.gov (United States)

    Xiang, H; Ma, X; Shen, N; Yue, B; Zhang, G; Chen, B

    2016-10-01

    Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.